title: Dementia-associated mortality at thirteen years in the NEDICES Cohort Study.
abstract: To evaluate the mortality, thirteen years after the baseline wave (1994), of participants suffering dementia in the Neurological Disorders in Central Spain (NEDICES) Cohort Study, we conducted a population-based cohort study in the elderly (65 years and more) with 5,278 screened participants at baseline. Mortality has been evaluated by means of the National Death Registry of Spain at 1-5-2007, 13 years after enrolment. Cox's proportional hazards regression models were used to evaluate the hazard of death according to dementia severity and type, adjusting for potential covariates (gender, age, level of education, and co-morbidity). Survival was estimated using Kaplan-Meier method. Of the 5,278 participants screened at baseline, 306 had dementia. Mortality at 13 years was: 275 deaths (89.9%) in dementia subjects; and 2,426 (49.0%) in subjects without dementia. Mortality was higher and statistically significant in dementia subjects. The degree of dementia (DSM-III-R) correlated with the risk of mortality, from mild (HR = 2.23; CI: 1.77-2.82) to moderate (HR =3.10; CI: 2.47-3.89) and severe dementia (HR = 4.98; CI: 3.85-6.44). Survival was similar in Alzheimer's disease and vascular dementia. Factors associated with higher mortality in Cox proportional hazard models were older age, male gender, and comorbidity. Using Population Attributable risk (PAR%), dementia was related to 11.3% of all deaths. Dementia intensity increases the mortality risk at ten years in the NEDICES Study as in other cohort studies. Age, gender, and co-morbidity are associated with higher mortality in dementia patients. Almost one third of deaths in persons over 85 years-old could be attributable to dementia.
authors.affiliation: Department of Neurology, University Hospital 12 de Octubre, Madrid, Spain. avgalende@yahoo.es
authors.forename: Alberto
authors.initials: A
authors.lastname: Villarejo
authors.forename: Julián
authors.initials: J
authors.lastname: Benito-León
authors.forename: Rocío
authors.initials: R
authors.lastname: Trincado
authors.forename: Ignacio J
authors.initials: IJ
authors.lastname: Posada
authors.forename: Verónica
authors.initials: V
authors.lastname: Puertas-Martín
authors.forename: Raquel
authors.initials: R
authors.lastname: Boix
authors.forename: M Rm A José
authors.initials: MR
authors.lastname: Medrano
authors.forename: Félix
authors.initials: F
authors.lastname: Bermejo-Pareja
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000401:mortality; D015331:Cohort Studies; D003704:Dementia / Q000401:mortality*; D015140:Dementia, Vascular / Q000401:mortality; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D016016:Proportional Hazards Models; D012042:Registries; D018570:Risk Assessment; D012737:Sex Factors; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis