Hospitalizations and Mortality of Individuals with Dementia: Evidence from Czech National Registers.


Journal

Journal of Alzheimer's disease : JAD
ISSN: 1875-8908
Titre abrégé: J Alzheimers Dis
Pays: Netherlands
ID NLM: 9814863

Informations de publication

Date de publication:
2020
Historique:
pubmed: 12 5 2020
medline: 11 5 2021
entrez: 12 5 2020
Statut: ppublish

Résumé

Facing an increasing prevalence of dementia, the Czech Republic is developing a new nationwide strategy for the management and prevention of dementia. Lack of evidence about characteristics of individuals with dementia in the country is a major obstacle. The study aimed to 1) characterize individuals with dementia, 2) compare their mortality with the general population, and 3) analyze differences in survival between different dementia disorders. The study capitalizes on two nationwide registers in the Czech Republic, from which information about individuals who were hospitalized with dementia or died from it between 1994 and 2014 was retrieved. Standardized intensity of hospitalizations was calculated for each year, mortality was studied using standardized mortality ratio, life-tables, Kaplan-Mayer curves, and Cox proportional hazard models. Standardized intensity of hospitalizations for dementia increased more than 3 times from 1994 to 2014. Standardized mortality ratio was 3.03 (95% confidence interval 2.97-3.08). One-year survival rate was 45% and five-year survival rate 16%. Vascular dementia was the most common type of dementia disorders and was associated with higher hazard of death than Alzheimer's disease, even after adjusting for sociodemographic and clinical covariates (hazard ratio 1.04; 95% confidence interval 1.02-1.05). The study provides estimates on demographic characteristics and mortality of the Czech hospitalized dementia population, which have not been so far available and which are unique also in the context of the entire region of Central and Eastern Europe.

Sections du résumé

BACKGROUND
Facing an increasing prevalence of dementia, the Czech Republic is developing a new nationwide strategy for the management and prevention of dementia. Lack of evidence about characteristics of individuals with dementia in the country is a major obstacle.
OBJECTIVE
The study aimed to 1) characterize individuals with dementia, 2) compare their mortality with the general population, and 3) analyze differences in survival between different dementia disorders.
METHODS
The study capitalizes on two nationwide registers in the Czech Republic, from which information about individuals who were hospitalized with dementia or died from it between 1994 and 2014 was retrieved. Standardized intensity of hospitalizations was calculated for each year, mortality was studied using standardized mortality ratio, life-tables, Kaplan-Mayer curves, and Cox proportional hazard models.
RESULTS
Standardized intensity of hospitalizations for dementia increased more than 3 times from 1994 to 2014. Standardized mortality ratio was 3.03 (95% confidence interval 2.97-3.08). One-year survival rate was 45% and five-year survival rate 16%. Vascular dementia was the most common type of dementia disorders and was associated with higher hazard of death than Alzheimer's disease, even after adjusting for sociodemographic and clinical covariates (hazard ratio 1.04; 95% confidence interval 1.02-1.05).
CONCLUSION
The study provides estimates on demographic characteristics and mortality of the Czech hospitalized dementia population, which have not been so far available and which are unique also in the context of the entire region of Central and Eastern Europe.

Identifiants

pubmed: 32390620
pii: JAD191117
doi: 10.3233/JAD-191117
pmc: PMC7369115
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1017-1027

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Auteurs

Hana Marie Broulikova (HM)

Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Faculty of Informatics and Statistics, University of Economics, Prague, Czech Republic.
National Institute of Mental Health, Klecany, Czech Republic.

Marketa Arltova (M)

Faculty of Informatics and Statistics, University of Economics, Prague, Czech Republic.

Marie Kuklova (M)

National Institute of Mental Health, Klecany, Czech Republic.

Tomas Formanek (T)

National Institute of Mental Health, Klecany, Czech Republic.

Pavla Cermakova (P)

National Institute of Mental Health, Klecany, Czech Republic.
Third Faculty of Medicine, Charles University Prague, Prague, Czech Republic.
Second Faculty of Medicine, Charles University Prague, Prague, Czech Republic.

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