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

  • Yue-Qi Zhang (a1), Chun-Fang Wang (a2), Gang Xu (a3), Qian-Hua Zhao (a4), Xin-Yi Xie (a1), Hai-Lun Cui (a1), Ying Wang (a1), Ru-Jing Ren (a1), Qi-Hao Guo (a5) and Gang Wang (a1)...

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 :

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.

Copyright

Corresponding author

Correspondence to: Gang Wang and Rujing Ren, Department of Neurology, Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai200025, China; Qi-Hao Guo, Department of Gerontology, Shanghai Jiao Tong University affiliated with the Sixth People’s Hospital, Shanghai200233, China. Emails: wg11424@rjh.com.cn; doctorren2001@126.com; qhguo@sjtu.edu.cn

Footnotes

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

Footnotes

References

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1.Li, G, Shen, YC, Chen, CH, et al.A three-year follow-up study of age-related dementia in an urban area of Beijing. Acta Psychiatr Scand. 1991;83:99.
2.Jia, J, Wang, F, Wei, C, et al.The prevalence of dementia in urban and rural areas of China. Alzheimers Dement. 2014;10:19.
3.Wang, G, Cheng, Q, Zhang, S, et al.Economic impact of dementia in developing countries: an evaluation of Alzheimer-type dementia in Shanghai, China. J Alzheimers Dis. 2008;15(1):109–15.
4.McKhann, G, Drachman, D, Folstein, M, et al.Clinicaldiagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology. 1984;34(7):939–44.
5.Cereda, E, Pedrolli, C, Zagami, A, et al.Body mass index and mortality in institutionalized elderly. J Am Med Dir Assoc. 2011;12:174–8.
6.Garciaptacek, S, Farahmand, B, Religa, D, et al.Mortality risk after dementia diagnosis by dementia type and underlying factors: a cohort of 15,209 patients based on the Swedish Dementia Registry. J Alzheimers Dis. 2014;41:467.
7.Zhou, M, Wang, H, Zeng, X, et al.Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019;394(10204):1145–58.
8.Helzner, EP, Scarmeas, N, Cosentino, S, et al.Survival in Alzheimer disease: a multiethnic, population-based study of incident cases. Neurology. 2008;71:1489.
9.Zilkens, RR, Davis, WA, Spilsbury, K, et al.Earlier age of dementia onset and shorter survival times in dementia patients with diabetes. Am J Epidemiol. 2013;177:1246–54.
10.Go, SM, Lee, KS, Seo, SW, et al.Survival of Alzheimer’s disease patients in Korea. Dement Geriatr Cogn Disord. 2013;35(3–4):219–28.
11.Imfeld, P, Bodmer, M, Jick, SS, et al.Metformin, other antidiabetic drugs, and risk of Alzheimer’s disease: a population-based case-control study. J Am Geriatr Soc. 2012;60:916–21.
12.Helzner, EP, Luchsinger, JA, Scarmeas, N, et al.Contribution of vascular risk factors to the progression in Alzheimer disease. Arch Neurol. 2009;66:343–8.
13.Jongen, C, Grond, J van dar, Kappelle, LJ, et al.Automated measurement of brain and white matter lesion volume in type 2 diabetes mellitus. Diabetologia. 2007;50:1509–16.
14.van Harten, B, de Leeuw, FE, Weinstein, HC, et al.Brain imaging in patients with diabetes: a systematic review. Diabetes Care. 2006;29:2539.
15.Regan, C, Katona, C, Walker, Z, et al.Relationship of vascular risk to the progression of Alzheimer disease. Neurology. 2006;67:1357–62.
16.Mielke, MM, Rosenberg, PB, Tschanz, J, et al.Vascular factors predict rate of progression in Alzheimer disease. Neurology. 2007;69:1850.
17.Knowles, TP, Vendruscolo, M, Dobson, CM. The amyloid state and its association with protein misfolding diseases. Nat Rev Mol Cell Biol. 2014;15:384–96.
18.An, Y, Varma, VR, Varma, S, et al.Evidence for brain glucose dysregulation in Alzheimer’s disease. Alzheimers Dement. 2018;14(3):318–29.
19.Han, W, Li, C. Linking type 2 diabetes and Alzheimer’s disease. Proc Natl Acad Sci U S A. 2010;107:6557–8.
20.Zhao, Q, Zhou, B, Ding, D, et al.Prevalence, mortality, and predictive factors on survival of dementia in Shanghai, China. Alzheimer Dis Assoc Disord. 2010;24:151–8.
21.Carcaillon, L, Pérès, K, Péré, JJ, et al.Fast cognitive decline at the time of dementia diagnosis: a major prognostic factor for survival in the community. Dement Geriatr Cogn Disord. 2007;23:439–45.
22.Ganguli, M, Dodge, HH, Shen, C, et al.Alzheimer disease and mortality: a 15-year epidemiological study. Arch Neurol. 2005;62:779–84.

Keywords

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

  • Yue-Qi Zhang (a1), Chun-Fang Wang (a2), Gang Xu (a3), Qian-Hua Zhao (a4), Xin-Yi Xie (a1), Hai-Lun Cui (a1), Ying Wang (a1), Ru-Jing Ren (a1), Qi-Hao Guo (a5) and Gang Wang (a1)...

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