title: Mortality risk after dementia diagnosis by dementia type and underlying factors: a cohort of 15,209 patients based on the Swedish Dementia Registry.
abstract: BACKGROUND
  Knowledge on survival in dementia is crucial for patients and public health planning. Most studies comparing mortality risk included few different dementia diagnoses.
  
  
  OBJECTIVE
  To compare mortality risk in the most frequent dementia disorders in a large cohort of patients with an incident diagnosis, adjusting for potential confounding factors.
  
  
  METHODS
  15,209 patients with dementia from the national quality database, Swedish Dementia Registry (SveDem), diagnosed in memory clinics from 2008 to 2011, were included in this study. The impact of age, gender, dementia diagnosis, baseline Mini-Mental State Examination (MMSE), institutionalization, coresidency, and medication on survival after diagnosis were examined using adjusted hazard ratios (HR) with 95% confidence intervals (CI).
  
  
  RESULTS
  During a mean follow-up of 2.5 years, 4,287 deaths occurred, with 114 (95% CI 111-117) deaths/1,000 person-years. Adjusted HR of death for men was 1.56 (95% CI 1.46-1.66) compared to women. Low MMSE, institutionalization, and higher number of medications were associated with higher HR of death. All dementia diagnoses demonstrated higher HR compared to Alzheimer's disease, with vascular dementia presenting the highest crude HR. After adjusting, frontotemporal dementia had the highest risk with a HR of 1.91 (95% CI 1.52-2.39), followed by Lewy body dementia (HR 1.64; 95% CI 1.39-1.95), vascular dementia (HR 1.55; 95% CI 1.42-1.69), Parkinson's disease dementia (HR 1.47; 95% CI 1.17-1.84), and mixed Alzheimer's disease and vascular dementia (HR 1.32; 95% CI 1.22-1.44).
  
  
  CONCLUSIONS
  Worse cognition, male gender, higher number of medications, institutionalization, and age were associated with increased death risk after dementia diagnosis. Adjusted risk was lowest in Alzheimer's disease patients and highest in frontotemporal dementia subjects.
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Department of Medicine, Universidad Complutense, Madrid, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Garcia-Ptacek
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Bahman
authors.initials: B
authors.lastname: Farahmand
authors.affiliation: Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden Institute of Gerontology, School of Health Sciences, Jönköping University, Jönköping, Sweden.
authors.forename: Ingemar
authors.initials: I
authors.lastname: Kåreholt
authors.affiliation: Department of Geriatric Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden Division of KI-ADRC, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Dorota
authors.initials: D
authors.lastname: Religa
authors.affiliation: Department of Medicine, Universidad Complutense, Madrid, Spain Neurology department, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Maria Luz
authors.initials: ML
authors.lastname: Cuadrado
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Department of Geriatric Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Eriksdotter
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012042:Registries; D012306:Risk; D012737:Sex Factors; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
keywords: Alzheimer's disease; Parkinson's disease; cohort studies; dementia; frontotemporal dementia; mortality; vascular dementia