Causes of Death According to Death Certificates in Individuals with Dementia: A Cohort from the Swedish Dementia Registry

被引：70

作者：

Garcia-Ptacek, Sara ^{[1
,2
]}

Kareholt, Ingemar ^{[3
,4
,5
]}

Cermakova, Pavla ^{[6
,7
,8
]}

Rizzuto, Debora ^{[3
,4
]}

Religa, Dorota ^{[2
,6
,9
]}

Eriksdotter, Maria ^{[1
,2
]}

机构：

[1] Karolinska Inst, Ctr Alzheimer Res, Dept Neurobiol Care Sci & Soc, Div Clin Geriatr, Stockholm, Sweden

[2] Karolinska Univ Hosp, Dept Geriatr Med, Stockholm, Sweden

[3] Karolinska Inst, Dept Neurobiol Care Sci & Soc, Aging Res Ctr, Stockholm, Sweden

[4] Stockholm Univ, Stockholm, Sweden

[5] Jonkoping Univ, Sch Hlth & Welf, Inst Gerontol, Jonkoping, Sweden

[6] Karolinska Inst, Dept Neurobiol Care Sci & Soc, Ctr Alzheimer Res, Div Neurogeriatr, Stockholm, Sweden

[7] Int Clin Res Ctr, Brno, Czech Republic

[8] St Annes Univ Hosp, Brno, Czech Republic

[9] Polish Acad Sci, Mossakowski Med Res Ctr, Warsaw, Poland

来源：

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY | 2016年 / 64卷 / 11期

基金：

瑞典研究理事会;

关键词：

causes of death; dementia; death certificate; Alzheimer's; Lewy body dementia; respiratory death; survival analyses; MORTALITY; SURVIVAL; DISEASE; COMORBIDITY; RISK; AGE;

D O I：

10.1111/jgs.14421

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

ObjectivesThe causes of death in dementia are not established, particularly in rarer dementias. The aim of this study is to calculate risk of death from specific causes for a broader spectrum of dementia diagnoses. DesignCohort study. SettingSwedish Dementia Registry (SveDem), 2007-2012. ParticipantsIndividuals with incident dementia registered in SveDem (N = 28,609); median follow-up 741 days. Observed deaths were 5,368 (19%). MeasurementsInformation on number of deaths and causes of mortality was obtained from death certificates. Odds ratios for the presence of dementia on death certificates were calculated. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox hazards regression for cause-specific mortality, using Alzheimer's dementia (AD) as reference. Hazard ratios for death for each specific cause of death were compared with hazard ratios of death from all causes (P-values from t-tests). ResultsThe most frequent underlying cause of death in this cohort was cardiovascular (37%), followed by dementia (30%). Dementia and cardiovascular causes appeared as main or contributory causes on 63% of certificates, followed by respiratory (26%). Dementia was mentioned less in vascular dementia (VaD; 57%). Compared to AD, cardiovascular mortality was higher in individuals with VaD than in those with AD (HR = 1.82, 95% CI = 1.64-2.02). Respiratory death was higher in individuals with Lewy body dementia (LBD, including Parkinson's disease dementia and dementia with Lewy bodies, HR = 2.16, 95% CI = 1.71-2.71), and the risk of respiratory death was higher than expected from the risk for all-cause mortality. Participants with frontotemporal dementia were more likely to die from external causes of death than those with AD (HR = 2.86, 95% CI = 1.53-5.32). ConclusionDementia is underreported on death certificates as main and contributory causes. Individuals with LBD had a higher risk of respiratory death than those with AD.

引用

页码：E137 / E142

页数：6

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