Hostname: page-component-745bb68f8f-b6zl4 Total loading time: 0 Render date: 2025-01-08T12:36:47.320Z Has data issue: false hasContentIssue false
  • English
  • Français

Factors affecting survival in Alzheimer's disease

Published online by Cambridge University Press:  09 July 2009

Alistair Burns ,
Glyn Lewis ,
Robin Jacoby  and
Raymond Levy
Alistair Burns*
Affiliation:
Section of Old Age Psychiatry; Section of Epidemiology and General Practice, Institute of Psychiatry, London
Glyn Lewis
Affiliation:
Section of Old Age Psychiatry; Section of Epidemiology and General Practice, Institute of Psychiatry, London
Robin Jacoby
Affiliation:
Section of Old Age Psychiatry; Section of Epidemiology and General Practice, Institute of Psychiatry, London
Raymond Levy
Affiliation:
Section of Old Age Psychiatry; Section of Epidemiology and General Practice, Institute of Psychiatry, London
*
1Address for correspondence: Dr Alistair Burns, Section of Old Age Psychiatry, Institute of Psychiatry, De Crespigny Park, London SE5 8AF.
Get access Rights & Permissions [Opens in a new window]

Synopsis

Factors affecting survival of 178 patients diagnosed using NINCDS/ADRDA criteria for Alzheimer's disease were studied. All patients were drawn from the Camberwell Health Authority Area and so were a representative sample of subjects from a clinical old age psychiatry service. The mortality rate of the sample was 3·5 times that expected after adjustment for age. Younger subjects had a higher standardized mortality ratio than older subjects. The cumulative three-year mortality of the sample was 47%. Factors shown to be associated with a reduced survival included: increasing age, longer duration of illness, male sex, presence of physical illness, poor cognitive function, observed depression and absence of misidentification syndromes. Apraxia was a stronger predictor of early death than aphasia or dysmnesia.

Type
Original Articles
Information
Psychological Medicine , Volume 21 , Issue 2 , May 1991 , pp. 363 - 370
Copyright
Copyright © Cambridge University Press 1991

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

American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, Third Edition (Revised). APA: Washington, DC.Google Scholar
Barclay, L., Zemcov, A., Blass, J. & McDowell, F. (1985). Factors associated with duration of survival in Alzheimer's disease. Biological Psychiatry 20, 86–93.CrossRefGoogle ScholarPubMed
Berg, L., Danziger, W., Storandt, M., Coben, L., Gado, M., Hughes, C., Knesevich, J. & Botwinick, J. (1984). Predictive features in mild senile dementia of the Alzheimer type. Neurology 34, 563–569.CrossRefGoogle ScholarPubMed
Breslow, N. & Day, N. (1987). Statistical Methods of Cancer Research, vol. 2: The Design and Analysis of Cohort Studies. IARC: Lyon.Google Scholar
Burns, A., Cuthbert, P., Levy, R., Jacoby, R. & Lantos, P. (1990 a). Accuracy of clinical diagnosis in Alzheimer's disease. British Medical Journal 301, 1026.CrossRefGoogle Scholar
Burns, A., Jacoby, R. & Levy, R. (1990 b). Psychiatric symptoms and behavioural abnormalities in Alzheimer's Disease. International Psychogeriatrics 2, 25–36.CrossRefGoogle Scholar
Burns, A., Jacoby, R., Philpot, M. & Levy, R. (1991). Computed tomography in Alzheimer's disease. British Journal of Psychiatry (in the press).Google Scholar
Camargo, O. & Preston, G. (1945). What happen to patients who are hospitalised for the first time when over 65 years of age. American Journal of Psychiatry 102, 168–173.CrossRefGoogle Scholar
Christie, A. (1982). Changing patterns in mental illness in the elderly. British Journal of Psychiatry 140, 154–159.CrossRefGoogle ScholarPubMed
Christie, A. & Wood, E. (1988). Age, clinical features and prognosis in SDAT. International Journal of Geriatric Psychiatry 3, 63–68.CrossRefGoogle Scholar
Colgan, J. (1985). Regional density and survival in senile dementia. British Journal of Psychiatry 147, 63–66.CrossRefGoogle ScholarPubMed
Copeland, J., Kelleher, M., Kellett, J., Gourlay, A., Gurland, B., Fleiss, J. & Sharpe, L. (1976). The Geriatric Mental State Schedule. 1. Development and reliability. Psychological Medicine 6, 439–449.CrossRefGoogle Scholar
Cox, D. & Oakes, D. (1984). The Analysis of Survival Data. Chapman and Hall. London.Google Scholar
Drevets, W. & Rubin, E. (1989). Psychotic symptoms in the longitudinal course of senile dementia of the Alzheimer type. Biological Psychiatry 25, 39–48.CrossRefGoogle ScholarPubMed
Duckworth, G., Kedward, H. & Bailey, W. (1979). Prognosis of mental illness in old age. Canadian Journal of Psychiatry 24, 674–682.CrossRefGoogle ScholarPubMed
Faber-Langendoen, K., Morris, J., Knesevich, J., Labarge, E., Miller, J. & Berg, L. (1988). Aphasia in senile dementia of the Alzheimer type. Annals of Neurology 23, 365–370.CrossRefGoogle ScholarPubMed
Folstein, M., Folstein, S. & McHugh, P. (1975). Mini-Mental State Examination. Journal of Psychiatric Research 12, 189–198.CrossRefGoogle Scholar
Goldfarb, A. (1969). Predicting mortality in the institutionalized aged. Archives of General Psychiatry 21, 172–176.CrossRefGoogle ScholarPubMed
Gruenberg, E. (1978). Epidemiology in senile dementia. In Advances in Neurology, vol. 19 (ed. Schoenberg, B.), pp. 437–457. Raven Press; New York.Google Scholar
Hare, M. (1978). Clinical checklist for diagnosis of dementia. British Medical Journal ii, 266–267.CrossRefGoogle Scholar
Heyman, A., Wilkinson, W., Hurwitz, B., Helms, M., Haynes, C., Utley, C. & Gwyther, L. (1987). Early onset Alzheimer's disease: clinical predictors of institutionalisation and death. Neurology 37, 980–984.CrossRefGoogle ScholarPubMed
Kaszniak, A., Fox, J., Gandell, D., Garron, D., Huckman, M. & Ramsey, R. (1978). Predictors of mortality in presenile dementia. Annals of Neurology 3, 246–252.CrossRefGoogle Scholar
Kay, D. (1962). Outcome and cause of death in mental disorders of old age: a longer term follow-up of functional and organic psychoses. Acta Psychiatrica Scandinavica 38, 249–276.CrossRefGoogle Scholar
Kay, D. & Bergmann, K. (1966). Physical disability and mental health in old age. Journal of Psychosomatic Research 10, 3–12.CrossRefGoogle ScholarPubMed
Knesevich, J., Toro, F., Morris, J. & Labarge, E. (1985). Aphasia, family history and the longitudinal course of senile dementia of the Alzheimer type. Psychiatry Research 14, 255–263.CrossRefGoogle ScholarPubMed
McDonald, C. (1969). Clinical heterogeneity in senile dementia. British Journal of Psychiatry 115, 267–271.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzmas, R., Price, D. & Stadlar, E. (1984). Clinical diagnosis of Alzheimer's disease: report on the NINCDS/ADRDA work group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology 34, 939–944.CrossRefGoogle ScholarPubMed
Martin, E., Wilson, R., Penn, R., Fox, J., Clasen, R. & Savoy, S. (1987). Cortical biopsy results in Alzheimer's disease: correlation of cognitive deficits. Neurology 37, 1201–1204.CrossRefGoogle ScholarPubMed
Naguib, M. & Levy, R. (1982 a). Prediction of outcome in senile dementia – a computed tomography study. British Journal of Psychiatry 140, 263–267.CrossRefGoogle ScholarPubMed
Naguib, M. & Levy, R. (1982 b). CT scanning in senile dementia. A follow-up of survivors. British Journal of Psychiatry 141, 618–620.CrossRefGoogle ScholarPubMed
Office of Population Censuses and Surveys (1989). Mortality Statistics: Area 1987. England and Wales. HMSO: London.Google Scholar
Post, F. (1951). The outcome of mental breakdown in old age. British Medical Journal i, 436–440.CrossRefGoogle Scholar
Roth, M. (1955). The natural history of mental disorders in old age. Journal of Medical Science 101, 281–301.Google Scholar
Roth, M., Tym, E., Mountjoy, C., Huppert, F., Hendrie, H., Verma, S. & Goddard, R. (1986). CAMDEX. British Journal of Psychiatry 149, 698–709.CrossRefGoogle ScholarPubMed
Seltzer, B. & Sherwin, I. (1983). The comparison of clinical features in early and late onset primary degenerative dementia. Archives of Neurology 40, 143–146.CrossRefGoogle ScholarPubMed
Shah, K., Banks, G. & Merskey, H. (1969). Survival in arteriosclerotic and senile dementia. British Journal of Psychiatry 115, 1283–1286.CrossRefGoogle Scholar
Stern, Y., Mayeux, R., Sano, M., Hauser, W. & Bush, T. (1987). Predictors of disease course in patients with probable Alzheimer's disease. Neurology 37, 1649–1653.CrossRefGoogle ScholarPubMed
Tierney, M., Fischer, R., Lewis, A., Zorzitto, M., Snow, G., Reid, D. & Nieuwstaten, P. (1988). The NINCDS/ADRDA workgroup criteria for the clinical diagnosis of probable Alzheimer's disease. Neurology 38, 359–364.CrossRefGoogle Scholar
Wing, J., Bransby, E., Hailey, A. & Fryers, T. (1972). The statistical context: comparison with national and local statistics. In Evaluating a Community Psychiatric Service (ed. Wing, J. and Hailey, A.), pp. 77–99. Oxford University Press: London.Google Scholar
World Health Organization (1989). International Classification of Diseases – 10th Revision (ICD-10). WHO: Geneva.Google Scholar
Wragg, R. & Jeste, D. (1989). Overview of depression and psychosis in Alzheimer's disease. American Journal of Psychiatry 146, 577–587.Google ScholarPubMed
Zubenko, G. & Moossy, J. (1988). Major depression in primary dementia – clinical and neuropathologic correlates. Archives of Neurology 45, 1182–1186.CrossRefGoogle ScholarPubMed
Zweig, R., Ross, C., Hedren, J., Steele, C., Cardillo, J., Whitehouse, P., Folstein, M. & Price, D. (1988). The neuropathology of aminergic nuclei in Alzheimer's disease. Annals of Neurology 24, 233–242.CrossRefGoogle ScholarPubMed