Survival Analysis of Patients with Alzheimer’s Disease: A Study Based on Data from the Korean National Health Insurance Services’ Senior Cohort Database
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: Korea’s rapidly aging population has experienced a sharp rise in the prevalence of dementia. Patients with Alzheimer’s disease (AD), which is estimated to be about three-quarters of all patients with dementia, tend to have higher mortality rates compared with patients without Alzheimer’s disease. In this study, a survival analysis of patients with AD was conducted in order to provide knowledge to those who provide medical care to these patients. Methods: Data on individuals over 65 years old in 2004 were extracted from the Korean National Health Insurance Services’ Senior Cohort database (2002–2013). The subjects were 209,254 patients, including 2,695 who were first diagnosed with AD (the AD group) and 206,559 that had not been diagnosed with the disease (non-AD group). To investigate the independent effect of AD on survival, the Cox proportional-hazards model, hazard ratios (confidence interval of 95%), and the Kaplan-Meier method were used. Results: Mean survival time in the AD group was 5.3±3.3 years, which was about 2.5 years shorter than that in the non-AD group (7.8±2.4 years). The mortality rate in the AD group (66.3%) was higher than that in the non-AD group (26.3%). The adjusted hazard ratio in the AD group was 2.5 and, therefore, it was found that the AD group had a 2.5-fold higher risk of death than the non-AD group. Conclusion: Overall, AD has a large, independent impact on survival. Survival time was shorter, and the mortality rate and risk were generally higher in the AD group, compared with the non-AD group.
Abstract
Background: Korea’s rapidly aging population has experienced a sharp rise in the prevalence of dementia. Patients with Alzheimer’s disease (AD), which is estimated to be about three-quarters of all patients with dementia, tend to have higher mortality rates compared with patients without Alzheimer’s disease. In this study, a survival analysis of patients with AD was conducted in order to provide knowledge to those who provide medical care to these patients. Methods: Data on individuals over 65 years old in 2004 were extracted from the Korean National Health Insurance Services’ Senior Cohort database (2002–2013). The subjects were 209,254 patients, including 2,695 who were first diagnosed with AD (the AD group) and 206,559 that had not been diagnosed with the disease (non-AD group). To investigate the independent effect of AD on survival, the Cox proportional-hazards model, hazard ratios (confidence interval of 95%), and the Kaplan-Meier method were used. Results: Mean survival time in the AD group was 5.3±3.3 years, which was about 2.5 years shorter than that in the non-AD group (7.8±2.4 years). The mortality rate in the AD group (66.3%) was higher than that in the non-AD group (26.3%). The adjusted hazard ratio in the AD group was 2.5 and, therefore, it was found that the AD group had a 2.5-fold higher risk of death than the non-AD group. Conclusion: Overall, AD has a large, independent impact on survival. Survival time was shorter, and the mortality rate and risk were generally higher in the AD group, compared with the non-AD group.
참고문헌 (27)
- World Health Organization, "Towards a dementia plan : a WHO guide", World Health Organization, ~ (2018)
- Kisler K, "Cerebral blood flow regulation and neurovascular dysfunction in Alzheimer disease", Nat Rev Neurosci, 18, pp.419~434 (2017)
- Folch J, "Review of the advances in treatment for Alzheimer disease : strategies for combating β-amyloid protein", Neurologia, 33, pp.47~58 (2018)
- Tramutola A, "Oxidative stress, protein modification and Alzheimer disease", Brain Res Bull, 133, pp.88~96 (2017)
- Kim SH, "Prevalence of dementia among the South Korean population", J Korean Diabetes, 13, pp.124~128 (2012)
- Wu YT, "Prevalence of dementia in East Asia : a synthetic review of time trends", Int J Geriatr Psychiatry, 30, pp.793~801 (2015)
- Korean dementia observatory 2017, "National Institute of Dementia", National Institute of Dementia, ~ (2018)
- 이동우, "대한민국 국가치매관리종합계획: 1차에서 3차까지", 대한의사협회지, 61(5), pp.298~303 (2018), 대한의사협회[DOI]
- Ferri CP, "Global prevalence of dementia : a Delphi consensus study", Lancet, 366, pp.2112~2117 (2005)
- Bae JB, "Is dementia more fatal than previously estimated? : a population-based prospec-tive cohort study", Aging Dis, 10, pp.1~11 (2019)
- Aevarsson O, "Seven-year survival rate after age 85years : relation to Alzheimer disease and vascular dementia", Arch Neurol, 55, pp.1226~1232 (1998)
- Ganguli M, "Alzheimer disease and mortality : a 15-year epidemiological study", Arch Neurol, 62, pp.779~784 (2005)
- Scarmeas N, "Mediterranean diet and Alzheimer disease mortality", Neurology, 69, pp.1084~1093 (2007)
- Wilson RS, "Biracial population study of mortality in mild cognitive impairment and Alzheimer disease", Arch Neurol, 66, pp.767~772 (2009)
- Go SM, "Survival of Alzheimer’s disease patients in Korea", Dement Geriatr Cogn Disord, 35, pp.219~228 (2013)
- Fitzpatrick AL, "Survival following dementia onset : Alzheimer’s disease and vascular dementia", J Neurol Sci, 229-230, pp.43~49 (2005)
- GBD 2013 Mortality and Causes of Death Collaborators, "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013", Lancet, 385, pp.117~171 (2015)
- Waring SC, "Survival among patients with dementia from a large multi-ethnic population", Alzheimer Dis Assoc Disord, 19, pp.178~183 (2005)
- Nunes BP, "Multimorbidity and mortality in older adults : a systematic review and meta-analysis", Arch Gerontol Geriatr, 67, pp.130~138 (2016)
- Barnett K, "Epidemiology of multimorbidity and implications for health care, research, and medical education : a cross-sectional study", Lancet, 380, pp.37~43 (2012)
- Vassilaki M, "Multimorbidity and risk of mild cognitive impairment", J Am Geriatr Soc, 63, pp.1783~1790 (2015)
- Garcia-Ptacek S, "Causes of death according to death certificates in individuals with dementia : a cohort from the Swedish dementia registry", J Am Geriatr Soc, 64, pp.e137~e142 (2016)
- McCormick WC, "Symptom patterns and comorbidity in the early stages of Alzheimer’s disease", J Am Geriatr Soc, 42, pp.517~521 (1994)
- Faxen-Irving G, "Nutritional and cognitive relationships and long-term mortality in patients with various dementia disorders", Age Ageing, 34, pp.136~141 (2005)
- Jang H, "Body mass index and mortality rate in Korean patients with Alzheimer’s disease", J Alzheimers Dis, 46, pp.399~406 (2015)
- Nutrition and dementia:a review of available research, "Prince M", Alzheimer’s Disease International (ADI), ~ (2014)
- Kim H, "Prognostic effect of body mass index to mortality in Korean older persons", Geriatr Gerontol Int, 18, pp.538~546 (2018)