A five-year community-based longitudinal survival study of dementia in Beijing, China: a 10/66 Dementia Research Group population-based study.
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.
Institute of Mental Health, Peking University, Beijing, China.
Ying
Y
Wang
Yueqin
Y
Huang
Zhaorui
Z
Liu
Chuanjun
C
Zhuo
Shuran
S
Li
Martin
M
Prince
D000203:Activities of Daily Living / Q000523:psychology; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D016001:Confidence Intervals; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D006304:Health Status; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D012944:Social Support; D012959:Socioeconomic Factors; D016019:Survival Analysis