Age‐stratified longitudinal study of Alzheimer's and vascular dementia patients

Jørgensen, Isabella Friis; Aguayo-Orozco, Alejandro; Lademann, Mette; Brunak, Søren

doi:10.1002/alz.12091

Cited by 37 publications

(36 citation statements)

References 50 publications

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“…Multimorbidity was defined as the presence of 2+ chronic conditions in all but six studies. Of these six, one study 107 defined multimorbidity as the co-occurrence of 3+ conditions and four 111 , 116 , 118 , 119 did not specify a definition (Supplementary Table S6). However, all authors referenced consideration of 2+ conditions in their prose and/or tables.…”

Section: Resultsmentioning

confidence: 99%

The incidence of multimorbidity and patterns in accumulation of chronic conditions: A systematic review

Kudesia

Salimarouny

Stanley

et al. 2021

Journal of Multimorbidity and Comorbidity

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Multimorbidity, the presence of 1+ chronic condition in an individual, remains one of the greatest challenges to health on a global scale. Although the prevalence of multimorbidity has been well-established, its incidence is not fully understood. This systematic review determined the incidence of multimorbidity across the lifespan; the order in which chronic conditions accumulate to result in multimorbidity; and cataloged methods used to determine and report accumulation of chronic conditions resulting in multimorbidity. Studies were identified by searching MEDLINE, Embase, CINAHL, and Cochrane electronic databases. Two independent reviewers evaluated studies for inclusion and performed quality assessments. Of 36 included studies, there was high heterogeneity in study design and operational definitions of multimorbidity. Studies reporting incidence (n = 32) reported a median incidence rate of 30.7 per 1,000 person-years (IQR 39.5 per 1,000 person-years) and a median cumulative incidence of 2.8% (IQR 28.7%). Incidence was notably higher for persons with older age and 1+ chronic conditions at baseline. Studies reporting patterns in accumulation of chronic conditions (n = 5) reported hypertensive and heart diseases, and diabetes, as among the common starting conditions resulting in later multimorbidity. Methods used to discern patterns were highly heterogenous, ranging from the use of latent growth trajectories to divisive cluster analyses, and presentation using alluvial plots to cluster trajectories. Studies reporting the incidence of multimorbidity and patterns in accumulation of chronic conditions vary greatly in study designs and definitions used. To allow for more accurate estimations and comparison, studies must be transparent and consistent in operational definitions of multimorbidity applied.

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Section: Resultsmentioning

confidence: 99%

The incidence of multimorbidity and patterns in accumulation of chronic conditions: A systematic review

Kudesia

Salimarouny

Stanley

et al. 2021

Journal of Multimorbidity and Comorbidity

View full text Add to dashboard Cite

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“…National patient registers covering hospital only have previously been used in epidemiologic studies about dementia. 23 We adjusted for patient characteristics, comorbidity, operation year, and socioeconomic factors in our statistical models. It would have been interesting also to include genetic factors, such as apolipoprotein E (APOE) ε4, which is a significant risk factor for both dementia and coronary artery disease, [24][25] but genetic information is not included in national registries and databases.…”

Section: Discussionmentioning

confidence: 99%

The risk of dementia after coronary artery bypass grafting in relation to age and sex

Giang

Jeppsson

Karlsson

et al. 2021

Alzheimer's & Dementia

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Introduction:We examined the long-term risk of dementia after coronary artery bypass grafting (CABG) in relation to age and sex.Methods: All CABG patients in Sweden 1992Sweden -2015, and matched controls (n = 222,396) were included in a population-based study. Adjusted hazard ratios (aHR) for all-cause dementia, vascular dementia, and Alzheimer's disease were calculated.Results: There was no difference in the risk for all-cause dementia between CABG patients and control subjects (aHR 0.98 [95% confidence interval 0.95 to 1.02]). CABG patients <65 years and 65 to 74 years had higher risk and 1.08 [1.02-1.13], respectively), and patients ≥75 years had lower risk (aHR 0.76 [0.71-0.81]). The highest risk was observed in women <65 years (aHR 1.64 [1.31-2.05]).Discussion: Overall, the long-term risk for all-cause dementia does not differ between CABG patients and the general population. Younger patients have a higher risk, while older patients have a lower risk, compared to controls.

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“…Additionally, a study has reported that pneumonia-caused death was higher in Alzheimer’s disease compared to vascular dementia [ 48 ], suggesting a potential difference in patients’ respiratory and immune functions among distinct subtypes of dementia. The development of vascular dementia is closely associated with atherosclerosis and cardiovascular diseases (e.g., hypertension and cerebrovascular disease) [ 49 , 50 ], and these vascular risk factors have been largely controlled in our statistical analyses. Our findings highlight that the subtype of dementia should be taken into consideration in risk stratification for dementia patients undergoing surgery.…”

Section: Discussionmentioning

confidence: 99%

Preexisting Dementia Is Associated with Increased Risks of Mortality and Morbidity Following Major Surgery: A Nationwide Propensity Score Matching Study

Kuo

et al. 2020

IJERPH

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Patients with dementia are predisposed to multiple physiological abnormalities. It is uncertain if dementia associates with higher rates of perioperative mortality and morbidity. We used reimbursement claims data of Taiwan’s National Health Insurance and conducted propensity score matching analyses to evaluate the risk of mortality and major complications in patients with or without dementia undergoing major surgery between 2004 and 2013. We applied multivariable logistic regressions to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for the outcome of interest. After matching to demographic and clinical covariates, 7863 matched pairs were selected for analysis. Dementia was significantly associated with greater risks of 30-day in-hospital mortality (aOR: 1.71, 95% CI: 1.09–2.70), pneumonia (aOR: 1.48, 95% CI: 1.16–1.88), urinary tract infection (aOR: 1.59, 95% CI: 1.30–1.96), and sepsis (OR: 1.77, 95% CI: 1.34–2.34) compared to non-dementia controls. The mortality risk in dementia patients was attenuated but persisted over time, 180 days (aOR: 1.49, 95% CI: 1.23–1.81) and 365 days (aOR: 1.52, 95% CI: 1.30–1.78) after surgery. Additionally, patients with dementia were more likely to receive blood transfusion (aOR: 1.32, 95% CI: 1.11–1.58) and to need intensive care (aOR: 1.40, 95% CI: 1.12–1.76) compared to non-dementia controls. Senile dementia and Alzheimer’s disease were independently associated with higher rates of perioperative mortality and complications, but vascular dementia was not affected. We found that preexisting dementia was associated with mortality and morbidity after major surgery.

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Age‐stratified longitudinal study of Alzheimer's and vascular dementia patients

Cited by 37 publications

References 50 publications

The incidence of multimorbidity and patterns in accumulation of chronic conditions: A systematic review

The incidence of multimorbidity and patterns in accumulation of chronic conditions: A systematic review

The risk of dementia after coronary artery bypass grafting in relation to age and sex

Preexisting Dementia Is Associated with Increased Risks of Mortality and Morbidity Following Major Surgery: A Nationwide Propensity Score Matching Study

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