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Mortality of Alzheimer’s Disease Patients: A 10-Year Follow-up Pilot Study in Shanghai

Published online by Cambridge University Press:  06 December 2019

Yue-Qi Zhang
Affiliation:
Department of Neurology, Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China
Chun-Fang Wang
Affiliation:
Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
Gang Xu
Affiliation:
School of Public Health, Shanghai Jiao Tong University, Shanghai, China
Qian-Hua Zhao
Affiliation:
Department of Neurology, Huashan Hospital affiliated with Fudan University, Shanghai, China
Xin-Yi Xie
Affiliation:
Department of Neurology, Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China
Hai-Lun Cui
Affiliation:
Department of Neurology, Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China
Ying Wang
Affiliation:
Department of Neurology, Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China
Ru-Jing Ren
Affiliation:
Department of Neurology, Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China
Qi-Hao Guo
Affiliation:
Department of Gerontology, Shanghai Jiao Tong University affiliated with the Sixth People’s Hospital, Shanghai, China
Gang Wang
Affiliation:
Department of Neurology, Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China
Corresponding

Abstract:

Background:

Identifying risk factors and mortality of individuals with Alzheimer’s disease (AD) could have important implications for the clinical management of AD.

Objective:

This pilot study aimed to examine the overall mortality of AD patients over a 10-year surveillance period in Shanghai, China. This study is an extension of our previous investigation on mortality of neurodegenerative diseases.

Methods:

One hundred and thirty-two AD patients recruited from the memory clinics of two hospitals in Shanghai in 2007 were followed up until December 31, 2017 or death, representing a follow-up period of up to 10 years. Overall standardized mortality ratios (SMRs) were calculated, and predictors for survival at recruitment were estimated.

Results:

Sixty-seven patients had died by December 31, 2017, and the SMR at 10 years of follow-up was 1.225 (95% confidence interval 0.944–1.563). Employing Cox’s proportional hazard modeling, lower Mini-Mental State Examination score, and comorbid diabetes predicted poor survival in this cohort.

Conclusion:

This pilot study suggests a similar survival trend of patients with AD compared to the general population in Shanghai urban region. Poor cognitive status and comorbid diabetes had a negative impact on the survival of AD patients.

Résumé :

RÉSUMÉ :

Taux de mortalité de patients atteints de la maladie d’Alzheimer : une étude pilote de suivi menée à Shanghai au cours d’une période de dix ans. Contexte : On le sait, le fait d’identifier les facteurs de risque et de mortalité chez des patients atteints de la maladie d’Alzheimer (MA) pourrait avoir des implications importantes en ce qui concerne leur prise en charge. Objectif : Basée sur une période de suivi de dix ans, cette étude pilote entend se pencher sur le taux global de mortalité de patients atteints de la MA qui vivent en Chine dans la ville de Shanghai. Elle constitue aussi le prolongement d’une étude précédente ayant porté sur les taux de mortalité associés à certaines maladies neurodégénératives. Méthodes : Au total, 132 patients atteints de la MA et recrutés en 2007 au sein de deux cliniques de la mémoire d’hôpitaux de Shanghai ont fait l’objet d’un suivi jusqu’au 31 décembre 2017 ou jusqu’au moment de leur décès. Nous avons tout d’abord calculé leurs taux de mortalité normalisés (TMN) ; nous avons ensuite essayé de déterminer les variables explicatives de leur survie au moment de leur recrutement. Résultats : En tout, 67 patients sont décédés avant le 31 décembre 2017. Leur TMN au terme de notre suivi a été de 1,225 (IC 95 % 0,944 −1,563). En faisant appel à la régression de Cox, il s’est avéré que des résultats plus bas au test de Folstein (ou mini-mental state examination) et la présence du diabète ont permis de prédire un faible taux de survie au sein de cette cohorte. Conclusion : En matière de taux de survie, cette étude pilote suggère donc une tendance similaire chez ces patients atteints de la MA si on les compare à la population générale de la région métropolitaine de Shanghai. À ce sujet, un état cognitif détérioré de même que la présence du diabète ont entraîné un impact négatif sur leur taux de survie.

Type
Original Article
Copyright
Copyright © 2019 The Canadian Journal of Neurological Sciences Inc.

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Footnotes

Yue-Qi Zhang, Chun-Fang Wang, and Gang Xu contributed equally to this study.

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