Effect of Comorbidities on Ten-Year Survival in Patients with Dementia

Abstract

Background: There is a verified association between comorbidity and survival in patients with dementia. Objective: To describe the ten-year survival probability of patients with dementia and to identify the impact of comorbidity. Methods: The prognostic retrospective cohort study was conducted using data from adults with dementia who had visited the outpatient departments at Maharaj Nakorn Chiang Mai hospital between 2006 and 2012. Dementia was verified in accordance with standard practice guidelines. Secondary data detailing about patient age, gender, date of dementia diagnosis and death, types of dementia, and comorbidities at the time of dementia diagnosis was obtained from electronic medical records. The association between comorbidity, patients’ underlying disease at dementia diagnosis, and overall survival were analyzed using a multivariable Cox proportional hazard model adjusted for age, gender, types of dementia, and other comorbidities. Results: Of the 702 patients, 56.9% were female. Alzheimer’s disease (39.6%) was the most prevalent type of dementia. Median overall survival was 6.0 years (95% CI 5.5– 6.7). The comorbidities associated with a high risk of mortality included liver disease (aHR 2.70, 95% CI 1.46– 5.00), atrial fibrillation (aHR 2.15, 95% CI 1.29– 3.58), myocardial infarction (aHR 1.55, 95% CI 1.07– 2.26), and type 2 diabetes mellitus (aHR 1.40, 95% CI 1.13– 1.74). Conclusion: Overall survival rate of patients with dementia in Thailand was comparable to previous studies. Several comorbidities were associated with a ten-year survival. The prognosis of patients with dementia may be improved by appropriate care of comorbidities.

The Role of Helicobacter pylori and Metabolic Syndrome-Related Mast Cell Activation Pathologies and Their Potential Impact on Pregnancy and Neonatal Outcomes

“…Regarding H. pylori/Mets-related AF involvement in cerebral disorders, AF has been implicated in the progression from mild cognitive impairment (MCI) to dementia [89]. There is evidence connecting AF with an increased risk and mortality rate across all categories of dementias, such as vascular dementia and AD [90][91][92][93]. Catheter ablation in AF patients, beyond H. pylori eradication, appears to decrease the risk of dementia and AD [94]; AD is reduced in patients who have undergone AF catheter ablation [95].…”

Survival analysis of older adults with dementia: predicting factors after unplanned hospitalization in Maharaj Nakorn Chiang Mai Hospital

“…In addition, advanced age, hospitalization for myocardial infarction, high serum sodium levels, lower Barthel index, and the incidence of complications during hospitalization have been identified as predictors for higher mortality in people with dementia [ 11 ]. Studies in Thailand have identified mortality risk factors in people with dementia [ 12 , 13 ]. However, specific factors associated with mortality after surviving unplanned hospitalization have not been reported in the available studies.…”