Survival of Patients with Dementia

Dijk, P. T. van; Dippel, Diederik W.J.; Habbema, J. Dik F.

doi:10.1111/j.1532-5415.1991.tb03602.x

Cited by 108 publications

(64 citation statements)

References 60 publications

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“…In fact, higher mortality rates are reported among cognitively impaired [27][28][29] or demented subjects. [30][31][32][33] The described target population is relatively stable. Less than 1% had moved away or could not be traced.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of non-responders and the impact of non-response on prevalence estimates of dementia

Boersma

Eefsting²,

Brink³

et al. 1997

International Journal of Epidemiology

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During the last decade much attention has been paid to methodological differences as an important source of variability in the results of prevalence studies of dementia.1-3 Application of internationally accepted criteria for dementia and standardized diagnostic procedures have indeed been effective in diminishing the variation in prevalence rates of studies conducted recently. Based on meta-analysis of such studies the prevalence of dementia among the Dutch population age 65 and over can be estimated to range from 5.1% to 6.7%. [4][5][6] However, the issue of non-response, a potentially important source of variation, has attracted relatively little attention. Most studies show that non-responders do not differ from responders in terms of sociodemographic characteristics. However, a similar distribution of demographic variables in responders and nonresponders does not preclude the possibility of an unequal distribution of cognitive status, 2,7-9 which is not unlikely to affect response. 10,11 Under-or overrepresentation of cognitively impaired subjects among responders may have important implications for prevalence estimates. This is especially true in studies with low response rates, but it can also be a serious problem in studies with high response rates and large differences in cognitive status between responders and non-responders. Moreover, non-responders do not necessarily constitute a homogeneous group.12 With regard to cognitive functioning, it is unlikely that refusers, those not responding due to health problems or those moving out of the study region, are comparable. Next to response rates it can thus be hypothesized that the impact of non-response on prevalence estimates of dementia depends on the type of non-response. Background. Differential distributions of sociodemographic characteristics and cognitive impairment in responders and non-responders may result in a biased prevalence estimate of dementia based on responders only. Methods. Responders (n = 2191) to a cross-sectional, two-stage community study were compared with regard to sociodemographic characteristics and cognition with three subgroups of non-responders: (A) subjects who refused to participate (n = 369), (B) subjects who were too ill or who had died prior to the screening (n = 72) and (C) subjects who had moved out of the study region or were not traceable (n = 23). Prevalence estimates specific for age and housing situation in responders and physicians' ratings of cognitive impairment were used to estimate the prevalence of dementia among non-responders.Results. Group A differed from responders in age and housing situation, group B in age, housing and cognition, and group C only in age. Separate prevalence estimates of dementia based on age, housing and cognition yielded figures for group A between 4.9% and 7.2%, for group B between 13.1% and 19.1%, and for group C between 2.6% and 4.2%. Joined with the prevalence rate among responders (6.5%) the best possible point estimate of the prevalence of dementia in the target population lies...

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Section: Discussionmentioning

confidence: 99%

Characteristics of non-responders and the impact of non-response on prevalence estimates of dementia

Boersma

Eefsting²,

Brink³

et al. 1997

International Journal of Epidemiology

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“…In AD, several factors have been related to shorter survival. These include functional disability [7,33,34], male gender [11,34,35] and increasing age [11,34,36]. Aguero-Torres et al [12] found in a longitudinal populationbased study that shorter survival was related to male gender, advanced age, low education level and functional disability at baseline.…”

Section: Discussionmentioning

confidence: 99%

“…Current knowledge on the prognosis of dementia and AD is limited. Most studies have focused on relatively young-old adults (65+ years) and on hospital or nursing home populations [7][8][9][10][11]. Although numerous population-based prognostic studies on prevalent Alzheimer patients have been done [12][13][14][15][16], studies on incident Alzheimer patients from population-based cohorts are very limited [17,18].…”

mentioning

confidence: 99%

Prognosis of Alzheimer’s Disease: The Rotterdam Study

Ruitenberg¹,

Kalmijn²,

Ridder³

et al. 2001

Neuroepidemiology

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The aim of this study was to construct a prognostic model to predict the progression of Alzheimer’s disease (AD). Prevalent and incident cases with AD came from the Rotterdam Study, a population-based prospective cohort study of persons aged 55 years and older, including those living in institutions. Rate of cognitive decline, as measured by the Mini Mental State Examination (MMSE score), was predicted by a random effects model. Risk of institutionalization and death were estimated with polytomous logistic regression analysis. At baseline, 306 subjects were diagnosed with prevalent AD and had complete data on living conditions and cognitive function. After a mean follow-up of 2.1 years, 95 subjects with incident AD had been diagnosed. Prevalent patients showed a slower decline in cognitive function than incident patients (p = 0.004). For prevalent and incident AD patients, high age and low cognitive performance were the strongest predictors for institutionalization and death. These prognostic risk functions can provide information on the decline of Alzheimer patients and might be used to better evaluate the effect of treatments for AD.

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“…Since mortality rates are higher among subjects with dementia than without [57], indicence rates are likely to be underrated in studies in which new dementia cases remained undiagnosed because they were lost to death before the second assessment. The underestimation can be very pronounced in the case of VaD since life expectancy is relatively low [58]. Studies based on survivors miss all dead dementia cases, while studies investigating decedents miss a lot less.…”

Section: Incidence Studies Based On Survivors Only or Including Decedmentioning

confidence: 99%

The Incidence of Vascular Dementia in Canada: A Comparison with Europe and East Asia

Dubois

Hébert²

2001

Neuroepidemiology

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Vascular dementia (VaD) is the second commonest subtype of dementia after Alzheimer’s disease (AD). However, its incidence has been studied much less extensively than that of AD. This article reviews the incidence data for VaD reported in the international literature. Results from 10 incidence studies are compared to those of the Canadian Study of Health and Aging using age-standardized incidence ratios (SIR). SIRs vary from 0.42 to 2.68, indicating that geographical variation is still present after taking into account the countries’ differential age distributions. It is still unclear if these differences are due to genetic and/or environmental factors since a large part reflects methodological differences between studies.

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Survival of Patients with Dementia

Cited by 108 publications

References 60 publications

Characteristics of non-responders and the impact of non-response on prevalence estimates of dementia

Characteristics of non-responders and the impact of non-response on prevalence estimates of dementia

Prognosis of Alzheimer’s Disease: The Rotterdam Study

The Incidence of Vascular Dementia in Canada: A Comparison with Europe and East Asia

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