Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-22T18:46:32.717Z Has data issue: false hasContentIssue false
  • English
  • Français

A five-year community-based longitudinal survival study of dementia in Beijing, China: a 10/66 Dementia Research Group population-based study

Published online by Cambridge University Press:  04 June 2010

Ying Wang ,
Yueqin Huang ,
Zhaorui Liu ,
Chuanjun Zhuo ,
Shuran Li  and
Martin Prince
Ying Wang
Affiliation:
Institute of Mental Health, Peking University, Beijing, China
Yueqin Huang*
Affiliation:
Institute of Mental Health, Peking University, Beijing, China
Zhaorui Liu
Affiliation:
Institute of Mental Health, Peking University, Beijing, China
Chuanjun Zhuo
Affiliation:
Institute of Mental Health, Peking University, Beijing, China
Shuran Li
Affiliation:
Institute of Mental Health, Peking University, Beijing, China
Martin Prince
Affiliation:
Section of Epidemiology, Health Services and Population Research, King's College London, U.K.
*
Correspondence should be addressed to: Professor Yueqin Huang, Institute of Mental Health, Peking University, No. 51 Hua Yuan Bei Road, Haidian District, Beijing 100191, China. Phone: +86 10 82802836; Fax: +86 10 82802836. Email: [email protected].
Get access

Abstract

Background: Despite the magnitude of dementia, little research on survival duration and prognosis of dementia has been reported in developing countries. This study was conducted to investigate survival times, identify related prognostic factors and construct a prognostic index (PI) for community-based dementia patients in Beijing, China.

Methods: This study is part of the 10/66 Dementia Research Group study in China. One hundred and thirty-seven dementia patients identified by 10/66 dementia criteria among 2162 participants and 137 referent subjects matched by age and sex were followed up for five years.

Results: Ninety-one (66.4%) dementia patients and 51 (37.2%) referent subjects died during the 5-year follow-up (p < 0.01). The median survival time of dementia patients was 4.2 years (95% CI: 3.8–4.6). Severity of dementia (severe/mild, HR: 8.765, 95% CI: 4.436–17.163), substantial disability (HR: 5.503, 95% CI: 3.017–8.135), co-morbidity (HR: 4.149, 95% CI: 2.254–7.736) and age (HR: 1.079, 95% CI: 1.048–1.110) were independent predictors of survival for patients with dementia. Using the PI calculated for each dementia patient, all dementia patients were classified into three groups: low, medium and high risk groups. The median survival times of each group were 5.2 years, 4.4 years and 1.5 years (p < 0.01), respectively.

Conclusions: Survival times of community-based dementia patients were significantly shorter than those of referent subjects. Severity of dementia, substantial disability, co-morbidity and age were independent predictors of survival. The PI derived from the four predictors can stratify the mortality risk and predict life expectancy for community-dwelled dementia patients, although further validation is needed.

Keywords

dementiasurvival timeprognostic factorprognostic index
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Issue 5 , August 2010 , pp. 761 - 768
Copyright
Copyright © International Psychogeriatric Association 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alonso, A. et al. (2009). Cardiovascular risk factors and dementia mortality: 40 years of follow-up in the Seven Countries Study. Journal of the Neurological Sciences, 280, 79–83.CrossRefGoogle ScholarPubMed
Barer, D. and Mitchell, J. (1998). Predicting the outcome of acute stroke: do multivariate models help? Oxford Journal of Medicine, 70, 27–39.Google Scholar
Brookmeyer, R., Corrada, M. M., Curriero, F. C. and Kawas, C. (2002). Survival following a diagnosis of Alzheimer disease. Archives of Neurology, 59, 1764–1767.CrossRefGoogle ScholarPubMed
Engel, G. L. (1997). The need for a new medical model: a challenge for biomedicine. Science, 196, 129–136.CrossRefGoogle Scholar
Ferri, C. P. et al. (2005). Global prevalence of dementia: a Delphi consensus study. Lancet, 366, 2112–2117.CrossRefGoogle ScholarPubMed
Fitzpatrick, A. L., Kuller, L. H., Lopez, O. L., Kawas, C. H. and Jagust, W. (2005). Survival following dementia onset: Alzheimer's disease and vascular dementia. Journal of the Neurological Sciences, 229, 43–49.CrossRefGoogle ScholarPubMed
Ganguli, M., Dodge, H. H., Shen, C., Pandav, R. S. and DeKosky, S. T. (2005). Alzheimer disease and mortality. Archives of Neurology, 62, 779–784.CrossRefGoogle ScholarPubMed
Guhne, U., Matschinger, H., Angermeyer, M. C. and Riedel-Heller, S. G. (2006). Incident dementia cases and mortality. Dementia and Geriatric Cognitive Disorders, 22, 185–193.CrossRefGoogle ScholarPubMed
Hayden, K. M. et al. (2005). Apolipoprotein E genotype and mortality: findings from the cache county study. Journal of the American Geriatrics Society, 53, 935–942.CrossRefGoogle ScholarPubMed
Helmer, C., Joly, P., Letenneur, L., Commenges, D. and Dartigues, J. F. (2001). Mortality with dementia: results from a French prospective community-based cohort. American Journal of Epidemiology, 154, 642–648.CrossRefGoogle ScholarPubMed
Ikeda, M., Maeda, S., Ashihara, H., Nagahama, H., Tanaka, M. and Sasaki, Y. (2010). Transcatheter arterial infusion chemotherapy with cisplatin–lipiodol suspension in patients with hepatocellular carcinoma. Journal of Gastroenterology, 45, 60–67.CrossRefGoogle ScholarPubMed
Juva, K. et al. (2000). APOE ɛ4 does not predict mortality, cognitive decline, or dementia in the oldest old. Neurology, 54, 412–415.CrossRefGoogle ScholarPubMed
Knopman, D. S., Rocca, W. A., Cha, R. H., Edland, S. D. and Kokmen, E. (2003). Survival study of vascular dementia in Rochester, Minnesota. Archives of Neurology, 60, 85–90.CrossRefGoogle ScholarPubMed
Li, G., Shen, Y. C., Chen, C. H., Zhao, Y. W., Li, S. R. and Lu, M. (1991). A three-year follow-up study of age-related dementia in an urban area of Beijing. Acta Psychiatica Scandinavica, 83, 99–104.CrossRefGoogle Scholar
Little, D. M. et al. (2009). Mortality, dementia, and apolipoprotein E genotype in elderly white women in the United States. Journal of the American Geriatrics Society, 57, 231–236.CrossRefGoogle ScholarPubMed
Liu, Z. et al. (2009). Chronic disease prevalence and care among the elderly in urban and rural Beijing, China: a 10/66 Dementia Research Group cross-sectional survey. BMC Public Health, 21, 394.CrossRefGoogle Scholar
Lladó, L. et al. (2000). A prognostic index of the survival of patients with unresectable hepatocellular carcinoma after transcatheter arterial chemoembolization. Cancer, 88, 50–57.3.0.CO;2-I>CrossRefGoogle ScholarPubMed
Morris, J. C. (1993). The clinical dementia rating (CDR): current version and scoring rules. Neurology, 43, 2412–2414.CrossRefGoogle ScholarPubMed
Newcomer, R., Covinsky, K. E., Clay, T. and Yaffe, K. (2003). Predicting 12-month mortality for persons with dementia. Journal of Gerontology: Social Science, 58, 187–198.CrossRefGoogle ScholarPubMed
Nitrini, R. et al. (2005). Mortality from dementia in a community-dwelling Brazilian population. International Journal of Geriatric Psychiatry, 20, 247–253.CrossRefGoogle Scholar
Noale, M. et al. (2003). Dementia and disability: impact on mortality. The Italian Longitudinal Study of Aging. Dementia and Geriatric Cognitive Disorders, 16, 7–14.CrossRefGoogle Scholar
Park, I. et al. (2009). Prognostic factors and predictive model in patients with advanced biliary tract adenocarcinoma receiving first-line palliative chemotherapy. Cancer, 15, 4148–4155.CrossRefGoogle Scholar
Perkins, A. J. et al. (2002). Risk of mortality for dementia in a developing country: the Yoruba in Nigeria. International Journal of Geriatric Psychiatry, 17, 566–573.CrossRefGoogle Scholar
Pilotto, A. et al. (2009). The multidimensional prognostic index (MPI), based on a comprehensive geriatric assessment, predicts short- and long-term mortality in hospitalized older patients with dementia. Journal of Alzheimer's Disease, 18, 191–199.CrossRefGoogle Scholar
Prince, M. (2001). Dementia in developing countries. International Psychogeriatrics, 13, 389–393.CrossRefGoogle ScholarPubMed
Prince, M., Acosta, D., Chiu, H., Scazufca, M. and Varghese, M. (2003). Dementia diagnosis in developing countries: a cross–cultural validation study. Lancet, 361, 909–917.CrossRefGoogle ScholarPubMed
Prince, M. et al. (2007). The protocols for the 10/66 Dementia Research Group population-based research programme. BMC Public Health, 7, 165–182.CrossRefGoogle Scholar
Prince, M. et al. (2008). The 10/66 Dementia Research Group's fully operationalised DSM-IV dementia computerized diagnostic algorithm, compared with the 10/66 dementia algorithm and a clinician diagnosis: a population validation study. BMC Public Health, 8, 219–230.CrossRefGoogle Scholar
Qiu, C., Backman, L., Winblad, B., Agüero-Torres, H. and Fratiglioni, L. (2001). The influence of education on clinically diagnosed dementia incidence and mortality data from the Kungsholmen Project. Archives of Neurology, 58, 2034–2039.CrossRefGoogle ScholarPubMed
Regla, J. L., Pousa, S. L., Franch, J. V., Olmo, G. J. and Roman, G. C. (2008). Mortality after a diagnosis of dementia in a population aged 75 and over in Spain. Neuroepidemiology, 31, 80–88.CrossRefGoogle Scholar
Rehm, D. J. et al. (2000). On the development and psychometric testing of the WHO screening instrument to assess disablement in the general population. International Journal of Methods in Psychiatric Research, 8, 110–122.CrossRefGoogle Scholar
Rodriguez, J. L. et al. (2008). Prevalence of dementia in Latin America, India, and China: a population-based cross-sectional survey. Lancet, 372, 464–474.CrossRefGoogle Scholar
Tilvis, R. S., Strandberg, T. E. and Juva, K. (1998). Apolipoprotein E phenotypes, dementia and mortality in a prospective population sample. Journal of the American Geriatrics Society, 46, 712–715.CrossRefGoogle Scholar
Tsai, P. H. et al. (2007). Survival of ethnic Chinese with Alzheimer's disease: a 5-year longitudinal study in Taiwan. Journal of Geriatric Psychiatry and Neurology, 20, 172–177.CrossRefGoogle ScholarPubMed
Ueki, A., Shinjo, H., Shimode, H., Nakajima, T. and Morita, Y. (2001). Factors associated with mortality in patients with early-onset alzheimer's disease: a five-year longitudinal study. International Journal of Geriatric Psychiatry, 16, 810–815.CrossRefGoogle ScholarPubMed
Wenger, G. C., Dykstra, P. A. and Melkas, T. (2007). Social embeddedness and late-life parenthood: community activity, close ties, and support networks. Journal of Family Issues, 28, 1419–1456.CrossRefGoogle Scholar
Wolfson, C. et al. (2001). A reevaluation of the duration of survival after the onset of dementia. New England Journal of Medicine, 344, 1111–1116.CrossRefGoogle ScholarPubMed
Xie, J., Brayne, C. and Matthews, F. E. (2008). Survival times in people with dementia: analysis from population based cohort study with 14 year follow-up. BMJ, 336, 258–262.CrossRefGoogle ScholarPubMed