Can dementia become the most prevalent disease at the time of death in Germany? Projections up to the year 2060 for the five most important diseases at the time of death

Abstract

Data on the burden of disease in the last years of life are an important basis for health policy decisions and the allocation of health care resources. Since dementia is one of the most expensive diseases, we ask the question whether dementia will ever be the most common disease at the time of death in older people? While international cause-of-death statistics report the underlying cause of death, dementia patients generally die from complications or sequelae. Instead of using causes of death, we identified the five most prevalent disease categories at age 70 and older at the time of death using German health claims data from 2004 to 2007 and 2014–2017, and combined their prevalence rates with the estimated number of deaths at age 70 and older up to the year 2060. We developed two scenarios, first, to represent the impact of population aging and increasing life expectancy. Second, to additionally examine the impact of morbidity trends among those who died. We found that dementia was already the most prevalent disease at the time of death among German women aged 70 years and older in 2014–2017, while it was still in fifth place among German men. Population aging and increasing life expectancy will result in dementia ranking first among women and second among men if the morbidity profile at the time of death remains constant. Extrapolating the observed time trends into the projections, cancer will be the most prevalent disease at the time of death for both sexes. Dementia will be second for women, and third for men after IHD. In addition to projections of causes of death, we also need projections of diseases at the time of death to better prepare for the needs of people in their final stages of life.

Brain‐derived extracellular vesicles: Potential diagnostic biomarkers for central nervous system diseases

“…AD is most frequently ranked as the seventh leading cause of death in countries with an aging population, and it cannot be delayed, prevented or reversed. 24 It is a severe ND characterized by the progressive loss of neurons and synapses in the brain. One of the leading causes of AD is the accumulation of amyloid β (Aβ) in the brain that forms plaques.…”

Leading causes of death in older people and old age according to medical certificates of death in Moscow

“…В первую очередь, необходима формализация критериев указания таких первоначальной причины смерти, как «киста мозга» и «энцефалопатия неуточнённая», на долю которых приходится почти 75% смертей данной группы, в то время как доля смертей, при которых в МСС указано «деменция», составляет всего 3%, а доля «болезни Альцгеймера» -0,4%. Несмотря на клинические рекомендации по диагностике и лечению болезни Альцгеймера и других видов деменции, не существует общемировых критериев установления в качестве первоначальной причины смерти тех или иных форм деменции или когнитивных нарушений [7,8]. Так, по данным исследования, выполненного в Германии, деменция -самое распространённое заболевание на момент смерти немецких женщин в возрасте 70 лет и старше, в то время как среди мужчин занимает пятое место.…”

“…Так, по данным исследования, выполненного в Германии, деменция -самое распространённое заболевание на момент смерти немецких женщин в возрасте 70 лет и старше, в то время как среди мужчин занимает пятое место. В то же время в статистике причин смерти основной причиной у лиц с деменцией обычно указываются осложнения или последствия заболевания [8]. Можно предположить, что определённая доля умерших страдала той или иной формой деменции, которая не была диагностирована ни при жизни, ни после смерти.…”

Synthesis of Veliparib Prodrugs and Determination of Drug-Release-Dependent PARP-1 Inhibition

“…Neuronal cell death manifests itself in cognitive dysfunction, motor impairment, and behavioral alteration, giving rise to neuro­degenerative diseases and dementia. , Alzheimer’s disease (AD), Parkinson’s disease (PD), Huntington’s disease (HD), amyotrophic lateral sclerosis (ALS), and traumatic brain injury (TBI) already affect millions of people worldwide, and dementia threatens to become the most common human disease at the time of death. , …”

“…1,2 Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), amyotrophic lateral sclerosis (ALS), and traumatic brain injury (TBI) already affect millions of people worldwide, and dementia threatens to become the most common human disease at the time of death. 3,4 Mitochondrial dysfunction is a shared hallmark of aging and neurodegeneration caused by persistent oxidative stress and increased mitochondrial Ca 2+ uptake, leading to the impairment of the electron transport chain and a decrease in ATP production. 5,6 Considerable efforts have been made to identify the key molecular determinants for these pathogenic events, and several candidates have been identified.…”