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

Article type: Research Article

Authors: Buawangpong, Nida^{a; b} | Pinyopornpanish, Kanokporn^{a; b; *} | Phinyo, Phichayut^{a; c; d} | Jiraporncharoen, Wichuda^{a; b} | Angkurawaranon, Chaisiri^{a; b} | Soontornpun, Atiwat^e

Affiliations: [a] Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand | [b] Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand | [c] Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand | [d] Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand | [e] Department of Internal Medicine, Division of Neurology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

Correspondence: [*] Correspondence to: Asst. Prof. Kanokporn Pinyopornpanish, MD, Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand. Tel.: +6653935462; E-mail: [email protected].

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.

Keywords: Alzheimer’s disease, comorbidity, dementia, survival time

DOI: 10.3233/JAD-221259

Journal: Journal of Alzheimer's Disease, vol. 94, no. 1, pp. 163-175, 2023