Survival in Presenile Alzheimer's and Multi-lnfarct Dementias

McGonigal, Gerard; McQuade, C; Thomas, Brenda; Whalley, Lawrence J.

doi:10.1159/000110921

Cited by 23 publications

(16 citation statements)

References 6 publications

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“…If a survival analysis is used to measure duration of illness [ 15], a prevalence of 50.29 for broad Alzheimer's in the age band of 60-64 years can be calculated from the age-banded incidence rates [10], The authors have pointed out that the data for multi-infarct dementia and 'other dementias' recorded in their study should not be regarded as an accurate national estimate [12,15]. Given this proviso, the data of McGonigal et al suggest a preva lence rate of 116.35 per 100,000 per annum for 'all dementias' in the age band of 60-64 years (see Appendix for details).…”

Section: Conflicting Observations In Presenile Dementiamentioning

confidence: 99%

“…The approximate prevalence of all dementias in the age bracket of 60-64 years was calculated from study data of McGonigal et al [10,15] and broad Alzheimer's incidence rates. An arbitrary mean illness time of 5 years in the case of multi-infarct dementia and 10 years for broad Alzheimer's disease and other dementias was assumed.…”

Section: Appendixmentioning

confidence: 99%

“…The 60-to 64-year prevalence rate for all dementias was calcu lated (a) taking the age-banded incidence rates for broad Alzhei mer's, multi-infarct dementia and other dementias on a cumulative basis and (b) adjusting for survival using survival curves [15] for Broad Alzheimer's disease and multi-infarct dementia. Survival of other dementias was estimated using the broad Alzheimer's disease survival curve.…”

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confidence: 99%

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Age-Specific Hospital Incidence Rates in Dementia

Ryan¹

1994

Dement Geriatr Cogn Disord

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A random sample (n = 101,104) was taken from total general hospital admissions to Scottish hospitals (1:25 fraction) during the period 1968–1977. Record linkage was used to connect general hospital and psychiatric hospital morbidity records (SMR 1 and SMR 4). Patients with a subsequent admission with dementia (principal diagnosis ICD 9 290) were identified from the general hospital sample on follow-up. Age-specific first-admission rates for dementia were calculated for the hospital population considered. First-admission rates ranged from 41.9 (per 100,000 person-years-at-risk, PYR) for male patients aged 60–64 years to 514.2 in the age band 80 years and over. The equivalent figures for female patients were 40.8 (per 100,000 PYR) and 723.1. Epidemiological research has shown an approximate doubling of prevalence rates every 5 years after the age of 60 years, and the age-banded hospital admission rates in the present study are consistent with this underlying pattern. Expected first-admission rates in dementia were calculated from admission rates in dementia and community prevalence reported in previous studies. Expected rates were contrasted with the rates observed in the present study. An estimated 6-7% of prevalent dementia cases and between 11 and 14% of ‘expected dementia admissions’ achieved a recorded main diagnosis of dementia, and proportions were stable across age bands in the case of both measures. The wide discrepancy between expected and observed admission rates suggests relative underreporting of dementia as a principal diagnosis in hospital statistics.

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Section: Conflicting Observations In Presenile Dementiamentioning

confidence: 99%

Section: Appendixmentioning

confidence: 99%

mentioning

confidence: 99%

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Age-Specific Hospital Incidence Rates in Dementia

Ryan¹

1994

Dement Geriatr Cogn Disord

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“…Two trained raters examined the hospital rec ords and included all early onset dementia patients in whom documented features of dementia were present before age 65. Patients were classified as 'probable' early onset AD, VaD or other dementia by standard criteria [4][5][6]. All VaD cases had Hachinski scores greater than 6 [7] and a history of at least one cerebro vascular accident.…”

Section: The Samplesmentioning

confidence: 99%

Survival in Early Onset Dementia: Effects of Urbanization and Socio-Economic Deprivation

Thomas

McGonigal²,

McQuade³

et al. 1997

Neuroepidemiology

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We estimated survival of patients with early onset Alzheimer’s disease (AD) or vascular dementia (VaD) presenting to psychiatric hospitals in Scotland (1974–1988) and related this to age, gender and socio-economic variables. Hospital records of 1794 early onset dementia patients were reviewed. We identified 451 patients with early onset AD and 384 with VaD. Survival to death was calculated from symptom onset and presentation. Small geographical areas (postcode sectors) were classified by urban/rural category and deprivation score. Five-year survival from presentation of early onset AD was 32% for men and 43% for women compared to 22% for men and 36% for women with VaD. We conclude that increased age at presentation was associated with shorter survival in early onset AD and VaD. Socio-economic deprivation was associated with longer survival in VaD. The effects of urban/rural score were accounted for by the major effects of socio-economic deprivation.

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“…Many studies have reported that survival is reduced among patients with dementia, particularly in a setting of cerebrovascular disease. [1][2][3][4][5][6] It has also been reported that clinically stroke-free subjects with severe cognitive impairment are at an elevated risk of first stroke 7 and that stroke patients with dementia are at an elevated risk of long-term stroke recurrence compared with nondemented stroke patients. 8 The results of these studies suggest that the ability to accurately diagnose dementia could permit the identification of patients at risk of adverse events and the initiation of targeted interventions in those patients.…”

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confidence: 99%

Dementia as a Predictor of Adverse Outcomes Following Stroke

Desmond

Moroney

Bagiella

et al. 1998

Stroke

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Background and Purpose-Although it is understood that dementia is a risk factor for adverse outcomes, little is known about the predictive validity of the numerous methods that have been proposed for its diagnosis. Thus, we performed the present study to assess the utility of a variety of diagnostic methods in the prediction of adverse outcomes following stroke. Methods-We administered neuropsychological, neurological, and functional examinations to 244 patients (age, 71.7Ϯ8.5 years) 3 months after ischemic stroke. We diagnosed dementia using each of the following methods: (1) neuropsychological testing, requiring deficits in increasing numbers of cognitive domains, both with and without memory impairment, as well as functional impairment; (2) Mini-Mental State Examination (MMSE) score of Ͻ24; and (3) neurologists' clinical judgment. We then used survival analyses to investigate the ability of diagnoses based on those methods to predict death and recurrent stroke during long-term follow-up. Results-Log-rank tests and Cox proportional hazards analyses, with recurrent stroke entered as a time dependent covariate, determined that all of the paradigms were significant predictors of mortality, but the performance of paradigms based on neuropsychological testing was superior to the use of the MMSE and clinical judgment, particularly when memory impairment was required. Log-rank tests determined that paradigms based on neuropsychological testing were the only significant predictors of recurrent stroke and performed best when memory impairment was required. Conclusions-Our results suggest that dementia diagnosis based on neuropsychological assessment and an operationalized paradigm requiring deficits in memory and other cognitive domains is superior to other conventional methods in its ability to identify patients at elevated risk of adverse outcomes following stroke. (Stroke. 1998;29:69-74.)

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Survival in Presenile Alzheimer's and Multi-lnfarct Dementias

Cited by 23 publications

References 6 publications

Age-Specific Hospital Incidence Rates in Dementia

Age-Specific Hospital Incidence Rates in Dementia

Survival in Early Onset Dementia: Effects of Urbanization and Socio-Economic Deprivation

Dementia as a Predictor of Adverse Outcomes Following Stroke

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