Mortality rates and proximal causes of death in patients with Lewy body dementia versus Alzheimer's disease: A longitudinal study using secondary care mental health records.


Type
Article
Change log
Authors
Kershenbaum, Anne D  ORCID logo  https://orcid.org/0000-0001-9811-5866
Fitzgerald, James M 
Abstract

BACKGROUND: Previous studies have shown reduced survival in Lewy body dementia (LBD) compared to Alzheimer's disease (AD), but the reasons for this are not known. We identified cause of death categories accounting for the reduced survival in LBD. METHODS: We linked cohorts of patients with dementia with Lewy bodies (DLB), Parkinson's disease dementia (PDD) and AD, with proximal cause of death data. We examined mortality by dementia group and hazard ratios for each death category by dementia group in males and females separately. In a specific focus on the dementia group with the highest mortality rate versus reference, we examined cumulative incidence to identify the main causes of death accounting for the excess deaths. RESULTS: Hazard ratios for death were higher in PDD and DLB compared to AD, for both males and females. PDD males had the highest hazard ratio for death across the dementia comparison groups (HR 2.7, 95% CI 2.2-3.3). Compared with AD, hazard ratios for "nervous system" causes of death were significantly elevated in all LBD groups. Additional significant cause-of-death categories included aspiration pneumonia, genitourinary causes, other respiratory causes, circulatory and a "symptoms and signs" category in PDD males; other respiratory causes in DLB males; mental disorders in PDD females; and aspiration pneumonia, genitourinary and other respiratory causes in DLB females. CONCLUSION: Further research and cohort development is required to investigate differences by age group, to extend cohort follow-up to the whole population and to investigate the risk-balance of interventions which may differ by dementia group.

Description
Keywords
Lewy body dementia, cause of death, dementia groups, mortality rates, secondary care mental health records, Male, Female, Humans, Alzheimer Disease, Lewy Body Disease, Dementia, Cause of Death, Parkinson Disease, Longitudinal Studies, Mental Health, Secondary Care, Pneumonia, Aspiration
Journal Title
Int J Geriatr Psychiatry
Conference Name
Journal ISSN
0885-6230
1099-1166
Volume Title
Publisher
John Wiley and Sons
Sponsorship
Medical Research Council (MC_PC_17213)
National Institute for Health and Care Research (IS-BRC-1215-20014)
Medical Research Council (MR/W014386/1)
UK Alzheimer’s Society, National Institute for Health and Care Research (NIHR) Cambridge Biomedical Research Centre (BRC-1215-20014) and the Cambridge Centre for Parkinson’s Plus disorders.