TY - JOUR
T1 - Dementia increases mortality beyond effects of comorbid conditions
T2 - A national registry-based cohort study
AU - Taudorf, Laerke
AU - Nørgaard, Ane
AU - Brodaty, Henry
AU - Laursen, Thomas Munk
AU - Waldemar, Gunhild
N1 - © 2021 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
PY - 2021/7
Y1 - 2021/7
N2 - BACKGROUND AND PURPOSE: Mortality is known to be markedly increased in people with dementia. However, the association between multiple chronic conditions and mortality in dementia is not well clarified. The aim of this study was to investigate the impact of somatic and psychiatric diseases on mortality in dementia compared with the general elderly population.METHODS: Using a cohort study design, nationwide registry data from 2006 to 2015 on dementia and psychiatric and somatic comorbidities defined by the Charlson Comorbidity Index (CCI) were linked. Impact of chronic conditions was assessed according to mortality rate ratios (MRRs) in all Danish residents aged ≥65 years with and without dementia.RESULTS: Our population comprised 1,518,917 people, of whom 114,109 people were registered with dementia. The MRRs was 2.70 (95% confidence interval 2.68, 2.72) in people with dementia after adjusting for sex, age, calendar year, and comorbidities. MRRs increased with higher CCI score, and when comparing people with a similar comorbidity load, MRRs were significantly higher for people with dementia.CONCLUSIONS: The comorbidity load was associated with increased mortality in both people with and without dementia. Mortality in dementia remained increased, even after adjusting for psychiatric and chronic somatic comorbidities. Our findings suggest that dementia disorders alone contribute to excess mortality, which may be further increased by comorbidities.
AB - BACKGROUND AND PURPOSE: Mortality is known to be markedly increased in people with dementia. However, the association between multiple chronic conditions and mortality in dementia is not well clarified. The aim of this study was to investigate the impact of somatic and psychiatric diseases on mortality in dementia compared with the general elderly population.METHODS: Using a cohort study design, nationwide registry data from 2006 to 2015 on dementia and psychiatric and somatic comorbidities defined by the Charlson Comorbidity Index (CCI) were linked. Impact of chronic conditions was assessed according to mortality rate ratios (MRRs) in all Danish residents aged ≥65 years with and without dementia.RESULTS: Our population comprised 1,518,917 people, of whom 114,109 people were registered with dementia. The MRRs was 2.70 (95% confidence interval 2.68, 2.72) in people with dementia after adjusting for sex, age, calendar year, and comorbidities. MRRs increased with higher CCI score, and when comparing people with a similar comorbidity load, MRRs were significantly higher for people with dementia.CONCLUSIONS: The comorbidity load was associated with increased mortality in both people with and without dementia. Mortality in dementia remained increased, even after adjusting for psychiatric and chronic somatic comorbidities. Our findings suggest that dementia disorders alone contribute to excess mortality, which may be further increased by comorbidities.
KW - Aged
KW - Cohort Studies
KW - Comorbidity
KW - Dementia/epidemiology
KW - Denmark/epidemiology
KW - Humans
KW - Registries
UR - http://www.scopus.com/inward/record.url?scp=85105732460&partnerID=8YFLogxK
U2 - 10.1111/ene.14875
DO - 10.1111/ene.14875
M3 - Journal article
C2 - 33894084
SN - 1351-5101
VL - 28
SP - 2174
EP - 2184
JO - European Journal of Neurology
JF - European Journal of Neurology
IS - 7
ER -