Mortality in dementia with Lewy bodies compared with Alzheimer's dementia: a retrospective naturalistic cohort study.
Mortality in dementia with Lewy bodies compared with Alzheimer's dementia: a retrospective naturalistic cohort study.
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DOI：
10.1136/bmjopen-2017-017504
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发表时间：
2017-11-03
期刊：
影响因子：
2.9
通讯作者：
O'Brien JT
中科院分区：
文献类型：
--
作者：
Price A;Farooq R;Yuan JM;Menon VB;Cardinal RN;O'Brien JT
利用常规临床资料研究路易体痴呆（DLB）与阿尔茨海默氏痴呆（AD）的生存率。DLB是仅次于AD的第二种最常见的痴呆亚型，约占二级护理中痴呆诊断的7%，尽管研究表明它被低估了高达50%。大多数以前的DLB研究都是基于选定的研究队列，因此对常规医疗环境中疾病的结果知之甚少。剑桥郡和彼得伯勒NHS基金会信托基金，一个在英格兰提供二级精神卫生保健的精神卫生信托基金。从8年（2005-2012年）电子临床病例记录的匿名数据库中确定了251例DLB和222例AD，死亡率数据更新至2015年5月。DLB的原始（未校正）中位生存期为3.72年（95% CI 3.33至4.14），AD为6.95年（95% CI 5.78至8.12）。控制诊断时的年龄、合并症和抗精神病药物处方，该模型预测DLB的中位生存期为3.3年（95% CI 2.88 - 3.83）男性和4.0岁（95% CI 3.55至5.00），而男性AD的中位生存期为6.7年（95% CI 5.27至8.51），女性为7.0年（95% CI 5.92至8.73）。与AD相比，DLB患者首次出现认知功能障碍的生存期明显缩短，与年龄、性别、身体合并症或抗精神病药物处方无关。这一发现是迄今为止最大的DLB病例临床队列之一，增加了DLB与AD相比生存率更差的现有证据。迫切需要进一步的研究来了解解释这一发现的可能机制。
To use routine clinical data to investigate survival in dementia with Lewy bodies (DLB) compared with Alzheimer’s dementia (AD). DLB is the second most common dementia subtype after AD, accounting for around 7% of dementia diagnoses in secondary care, though studies suggest that it is underdiagnosed by up to 50%. Most previous studies of DLB have been based on select research cohorts, so little is known about the outcome of the disease in routine healthcare settings. Cambridgeshire & Peterborough NHS Foundation Trust, a mental health trust providing secondary mental health care in England. 251 DLB and 222 AD identified from an anonymised database derived from electronic clinical case records across an 8-year period (2005–2012), with mortality data updated to May 2015. Raw (uncorrected) median survival was 3.72 years for DLB (95% CI 3.33 to 4.14) and 6.95 years for AD (95% CI 5.78 to 8.12). Controlling for age at diagnosis, comorbidity and antipsychotic prescribing the model predicted median survival for DLB was 3.3 years (95% CI 2.88 to 3.83) for males and 4.0 years (95% CI 3.55 to 5.00) for females, while median survival for AD was 6.7 years (95% CI 5.27 to 8.51) for males and 7.0 years (95% CI 5.92 to 8.73) for females. Survival from first presentation with cognitive impairment was markedly shorter in DLB compared with AD, independent of age, sex, physical comorbidity or antipsychotic prescribing. This finding, in one of the largest clinical cohorts of DLB cases assembled to date, adds to existing evidence for poorer survival for DLB versus AD. There is an urgent need for further research to understand possible mechanisms accounting for this finding.
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影响因子：
48
作者：
Irwin, David;Grossman, Murray;Weintraub, Daniel;Hurtig, Howard I.;Duda, John E.;Xie, Sharon X.;Lee, Edward B.;Van Deerlin, Vivianna M.;Lopez, Oscar L.;Kofler, Julia K.;Nelson, Peter T.;Jicha, Gregory A.;Woltjer, Randy;Quinn, Joseph F.;Kaye, Jeffery;Leverenz, James B.;Tsuang, Debby;Longfellow, Katelan;Yearout, Dora;Kukull, Walter;Keene, C. Dirk;Montine, Thomas J.;Zabetian, Cyrus P.;Trojanowski, John Q.
通讯作者：
Trojanowski, John Q.
DOI：
10.1016/j.jalz.2011.03.005
发表时间：
2011-05
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
McKhann GM;Knopman DS;Chertkow H;Hyman BT;Jack CR Jr;Kawas CH;Klunk WE;Koroshetz WJ;Manly JJ;Mayeux R;Mohs RC;Morris JC;Rossor MN;Scheltens P;Carrillo MC;Thies B;Weintraub S;Phelps CH
通讯作者：
Phelps CH
影响因子：
3.5
作者：
Fernandes AC;Cloete D;Broadbent MT;Hayes RD;Chang CK;Jackson RG;Roberts A;Tsang J;Soncul M;Liebscher J;Stewart R;Callard F
通讯作者：
Callard F
影响因子：
6
作者：
Nelson PT;Jicha GA;Kryscio RJ;Abner EL;Schmitt FA;Cooper G;Xu LO;Smith CD;Markesbery WR
通讯作者：
Markesbery WR
影响因子：
4.2
作者：
Chang, Chin-Kuo;Harrison, Simon;Stewart, Robert
通讯作者：
Stewart, Robert