Early-onset dementia is associated with higher mortality.
OBJECTIVE
Our objective was to compare the mortality risks of patients with early- and late-onset dementia with non-demented controls of the same age range and to analyse the mortality risks in subtypes of dementia.


METHODS
We included 1,203 subjects from our memory clinic. Patients with dementia were subdivided into 2 groups, with early- (<65 years) or late-onset dementia (>or=65 years), and compared with non-demented controls of the same age range. We used Cox proportional hazard models to estimate mortality risks.


RESULTS
When compared to non-demented controls of the same age range, the patients with early-onset dementia had a strongly elevated mortality risk [hazard ratio (95% confidence interval) = 43.3 (3.1-600.4)], while those with late-onset dementia had a moderately increased mortality risk compared to older controls [hazard ratio (95% confidence interval) = 3.4 (1.8-6.2)]. An additional analysis showed that, adjusted for age, Alzheimer's disease seemed to have the most benign course, with a fourfold increased mortality risk. Dementia with Lewy bodies and vascular dementia (frequently seen at older age) and frontotemporal lobar degeneration and 'other dementias' (often found at younger age) had a six- to eightfold increased mortality risk.


CONCLUSIONS
Dementia is a risk factor for death. Especially in young patients the impact of dementia on mortality is high.
Koedam
Esther L G E
EL
Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands. elge.koedam@vumc.nl
Pijnenburg
Yolande A L
YA
Deeg
Dorly J H
DJ
Baak
Merel M E
MM
van der Vlies
Annelies E
AE
Scheltens
Philip
P
van der Flier
Wiesje M
WM
D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D000544:Alzheimer Disease / Q000401:mortality*; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D015331:Cohort Studies; D015140:Dementia, Vascular / Q000401:mortality*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D020961:Lewy Body Disease / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D012307:Risk Factors