Socioeconomic Disparities and Mortality After a Diagnosis of Dementia: Results From a Nationwide Registry Linkage Study

Abstract

Low socioeconomic status (SES) has been linked to a higher incidence of dementia. Less is known about the association between SES and mortality in persons with dementia. We studied this association in a prospective cohort of 15,558 patients in the Netherlands between 2000 and 2010. SES was measured using disposable household income and divided in tertiles. Overall, there was a negative relationship between SES and mortality in both sexes and both settings of care. For men who visited a day clinic, the 5-year mortality rate was 74% among those in the lowest tertile of SES and 57% among those in the highest; for women, the rates were 60% and 50%, respectively. The differences in median survival times between persons in the lower and upper tertiles of SES were 260 days for men and 300 days for women. For men who were admitted to the hospital, the 5-year mortality rate was 89% among those in the lowest tertile of SES and 86% among those in the highest; for women, the rates were 83% and 77%, respectively. The differences in median survival times between persons in the lower and upper tertiles of SES were 80 days for men and 130 days for women. Among patients who visited a day clinic, for patients in the lowest tertile of SES versus those in the highest, the adjusted hazard ratio was 1.41 (95% confidence interval: 1.26, 1.57); for those admitted to the hospital, it was 1.14 (95% confidence interval: 1.07, 1.20). In summary, lower SES was associated with a higher mortality risk in both men and women with dementia. The results of the present study should raise awareness in clinicians and caregivers about the unfavorable prognosis in the most deprived patients.

Factors Associated with Mortality Including Nursing Home Transitions: A Retrospective Analysis of 25,418 People Prescribed Anti-Dementia Drugs in Northern Ireland

“…Previous work in NI has indicated that people with lower NIMDM scores have higher levels of mental illness and poorer mental health [40]. Moreover, recent research which looked at nationwide data of PwD between 2000 and 2010 has shown that both males and females with dementia who lived in more deprived areas had higher levels of mortality in comparison to PwD who lived in less deprived areas [41]. Our findings align with those of past research, as we found that people in the less deprived areas (NIMDM scores 7-10) had significantly lower levels of mortality in comparison to people living in more deprived areas.…”

Pre-ESRD Dementia and Post-ESRD Mortality in a Large Cohort of Incident Dialysis Patients

“…[8] In a large prospective cohort of roughly fifteen thousand patients, low socio-economic status was found to be contributing to the increased risk of mortality in patients with dementia. [29] Finally, the caregivers’ perspective is not to be neglected. The medical diagnosis of dementia continues to be marred by social stigma.…”

The associations between social, built and geophysical environment and age-specific dementia mortality among older adults in a high-density Asian city

“…For example, recent studies have found that green space as a built environmental factor reduces dementia and its associated diseases (de Keijzer et al, 2016;White et al, 2018;Wu et al, 2015). Some studies have also documented the adverse impacts of socioeconomic and racial problems on these diseases (Cadar et al, 2018;Chiao et al, 2014;Cook, 2019;Van De Vorst et al, 2016;Yaffe et al, 2013), and other studies have found that long-term air pollution (e.g. tra c-related air pollution) can negatively in uence cognitive function (Chen et al, 2017a;Chen et al, 2017b;Lee et al, 2019;Hamid et al, 2010;Oudin et al, 2015;Power et al, 2010;Shin et al, 2018;Zhang et al, 2018).…”