Contribution of Alzheimer disease to mortality in the United States
Contribution of Alzheimer disease to mortality in the United States
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DOI：
10.1212/wnl.0000000000000240
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发表时间：
2014-03-25
期刊：
影响因子：
9.9
通讯作者：
Bennett, David A.
中科院分区：
文献类型：
--
作者：
James, Bryan D.;Leurgans, Sue E.;Bennett, David A.
目的：评估美国阿尔茨海默病(AD)痴呆所造成的死亡负担。方法：数据来自2项年龄在65岁及以上的非痴呆者(平均78.1岁)，这些数据来自两项关于老年的队列研究，这些研究对痴呆症的年度诊断评估相同。因为这两项研究都需要器官捐赠，所以死亡的确定已经完成，死亡日期也是准确的。根据比例风险模型对AD痴呆事件后的死亡风险比(HR)按10岁年龄层进行估计。人群归因风险百分比用于估计AD痴呆诊断后的超额死亡率。结果：在平均8年的时间里，559名(21.8%)无痴呆基线的参与者患上了阿尔茨海默病，1090名(42.4%)死亡。从AD痴呆诊断到死亡的中位时间为3.8年。75~84岁AD痴呆死亡率HR为4.30(可信区间=3.33，5.58)，85岁及以上AD痴呆死亡率HR为2.77(可信区间=2.37，3.23)(65~74岁AD痴呆死亡人数太少可用于估计HR)。75-84岁人群归因风险百分比为37.0%，85岁及以上人群归因风险百分比为35.8%。据估计，2010年75岁及以上的美国人死于阿尔茨海默病的人数为503,400人。结论：美国每年死于阿尔茨海默病的人数多于每年死于阿尔茨海默病的人数(
Objective:To assess the burden of mortality attributable to Alzheimer disease (AD) dementia in the United States.Methods:Data came from 2,566 persons aged 65 years and older (mean 78.1 years) without dementia at baseline from 2 cohort studies of aging with identical annual diagnostic assessments of dementia. Because both studies require organ donation, ascertainment of mortality was complete and dates of death accurate. Mortality hazard ratios (HRs) after incident AD dementia were estimated per 10-year age strata from proportional hazards models. Population attributable risk percentage was derived to estimate excess mortality after a diagnosis of AD dementia. The number of excess deaths attributable to AD dementia in the United States was then estimated.Results:Over an average of 8 years, 559 participants (21.8%) without dementia at baseline developed AD dementia and 1,090 (42.4%) died. Median time from AD dementia diagnosis to death was 3.8 years. The mortality HR for AD dementia was 4.30 (confidence interval = 3.33, 5.58) for ages 75-84 years and 2.77 (confidence interval = 2.37, 3.23) for ages 85 years and older (too few deaths after AD dementia in ages 65-74 were available to estimate HR). Population attributable risk percentage was 37.0% for ages 75-84 and 35.8% for ages 85 and older. An estimated 503,400 deaths in Americans aged 75 years and older were attributable to AD dementia in 2010.Conclusions:A larger number of deaths are attributable to AD dementia in the United States each year than the number (