Seven-Year Survival Rate After Age 85 Years: Relation to Alzheimer Disease and Vascular Dementia

Aevarsson, Olafur; Svanborg, Alvar; Skoog, Ingmar

doi:10.1001/archneur.55.9.1226

Cited by 106 publications

(78 citation statements)

References 42 publications

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“…Patients with dementia have a higher mortality rate, independently of the effects of age and comorbidities [76, 77]. The mortality rate is also increased in patients with PSD [42,78,79,80,81], the relative risk of death ranging from 2.4 to 6.3.…”

Section: Influence Of Psd On Stroke Patients’ Prognosismentioning

confidence: 99%

Poststroke Dementia

Hénon¹,

Pasquier²,

Leys³

2006

Cerebrovasc Dis

102

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The association between stroke and dementia is frequent. The prevalence of poststroke dementia (PSD) ranges from 6 to 32%, depending on the population studied, the criteria used for the diagnosis of dementia, and the time interval between the stroke and the neuropsychological assessment. The risk of PSD is high immediately after stroke and remains higher than in controls in stroke patients nondemented 3 months after stroke. Not all cases of PSD are vascular in origin, with about one third of demented patients diagnosed as having Alzheimer’s disease plus stroke. The pathophysiology of PSD is probably multifactorial, with an influence of vascular lesions, associated Alzheimer’s lesions and white matter changes. The risk of dementia is higher in older patients and in patients with preexisting cognitive decline – no dementia, severe stroke, a history of stroke, white matter changes and cerebral atrophy. The influence of stroke location, vascular risk factors and silent infarcts remains to be determined. PSD adversely influences the outcome in stroke patients.

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Section: Influence Of Psd On Stroke Patients’ Prognosismentioning

confidence: 99%

Poststroke Dementia

Hénon¹,

Pasquier²,

Leys³

2006

Cerebrovasc Dis

102

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“…Previous studies of populationbased cohort type have evaluated survival in relation to dementia, most reporting that the risk of death is higher in the presence of dementia than in its absence (1)(2)(3)(4)(5)(6). A recent Danish population-based cohort study (14 years of follow-up) involving 3065 non-demented (73.7±6.8 years) and 234 demented (83.3±7.0 years) subjects at baseline, showed that the hazard ratio (HR) of death increased from 1.82 for very mildly demented to 9.52 for severely demented subjects (7).…”

Section: Introductionmentioning

confidence: 99%

Mild cognitive impairment, degenerative and vascular dementia as predictors of intra-hospital, short- and long-term mortality in the oldest old

Zekry

Herrmann

et al. 2011

Aging Clin Exp Res

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ABSTRACT. Background and aims: The relative weight of various etiologies of dementia and mild cognitive impairment (MCI) as predictors of intra-hospital, short-and long-term mortality in very old INTRODUCTIONDementia is a serious health problem with a significant economic impact. Previous studies of populationbased cohort type have evaluated survival in relation to dementia, most reporting that the risk of death is higher in the presence of dementia than in its absence (1-6). A recent Danish population-based cohort study (14 years of follow-up) involving 3065 non-demented (73.7±6.8 years) and 234 demented (83.3±7.0 years) subjects at baseline, showed that the hazard ratio (HR) of death increased from 1.82 for very mildly demented to 9.52 for severely demented subjects (7). However, most studies have analyzed mortality in patients with cognitive impairment as a global diagnosis (7) or only in patients with Alzheimer's disease (AD) (3,5). Only a few rare studies have considered mortality in other types of dementia, such as mixed dementia (AD plus vascular), which is very frequent in the very old, or in mild cognitive impairment (MCI) (8, 9). In addition, the non-demented subjects in these studies are often significantly younger (2, 3) and have significantly fewer comorbid conditions than the group of demented patients. Also, there are only a few studies examining short-term (1-year) mortality and rare ones examining long-term (5-year) mortality in acutely ill very old patients after discharge from hospital, and information on the same population remains scarce.

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“…Many studies, mostly of the population-based cohort type, have evaluated survival in relation to dementia, with most reporting that the risk of death is higher in the presence of dementia than in its absence [5,6,7,8,9,10]. A recent Danish population-based cohort study (14 years of follow-up) involving 3,065 nondemented (73.7 ± 6.8 years) and 234 demented subjects (83.3 ± 7.0 years) at baseline showed that the hazard ratio (HR) of death increased from 1.82 for the very mildly demented to 9.52 for severely demented subjects [11].…”

Section: Introductionmentioning

confidence: 99%

High Levels of Comorbidity and Disability Cancel Out the Dementia Effect in Predictions of Long-Term Mortality after Discharge in the Very Old

Zekry

Herrmann

et al. 2011

Dement Geriatr Cogn Disord

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Background/Aims: The relative weight of various etiologies of dementia as predictors of long-term mortality after other risk factors have been taken into account remains unclear. We investigated the 5-year mortality risk associated with dementia in elderly people after discharge from acute care, taking into account comorbid conditions and functionality. Methods: A prospective cohort study of 444 patients (mean age: 85 years; 74% female) discharged from the acute geriatric unit of Geneva University Hospitals. On admission, each subject underwent a standardized diagnostic evaluation: demographic variables, cognitive, comorbid medical conditions and functional assessment. Patients were followed yearly by the same team. Predictors of survival at 5 years were evaluated by Cox proportional hazards models. Results: The univariate model showed that being older and male, and having vascular and severe dementia, comorbidity and functional disability, were predictive of shorter survival. However, in the full multivariate model adjusted for age and sex, the effect of dementia type or severity completely disappeared when all the variables were added. In multivariate analysis, the best predictor was higher comorbidity score, followed by functional status (R² = 23%). Conclusions: The identification of comorbidity and functional impairment effects as predictive factors for long-term mortality independent of cognitive status may increase the accuracy of long-term discharge planning.

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Seven-Year Survival Rate After Age 85 Years: Relation to Alzheimer Disease and Vascular Dementia

Abstract: In extreme old age, Alzheimer disease and vascular dementia influence the mortality rate considerably. However, mild Alzheimer disease does not influence longevity, at least not during the first 7 years. These findings have important public health implications.

Cited by 106 publications

References 42 publications

Poststroke Dementia

Poststroke Dementia

Mild cognitive impairment, degenerative and vascular dementia as predictors of intra-hospital, short- and long-term mortality in the oldest old

High Levels of Comorbidity and Disability Cancel Out the Dementia Effect in Predictions of Long-Term Mortality after Discharge in the Very Old

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