Survival Rate in Patients Affected by Dementia Followed by Memory Clinics (UVA) in Italy
Survival Rate in Patients Affected by Dementia Followed by Memory Clinics (UVA) in Italy
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DOI：
10.3233/jad-130002
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发表时间：
2013-01-01
影响因子：
4
通讯作者：
Dijk, Babette
中科院分区：
文献类型：
--
作者：
Ientile, Luisa;De Pasquale, Riccardo;Dijk, Babette
与非痴呆症患者相比，痴呆症患者的预期寿命缩短，在特定年龄死亡的风险高出2-4倍。痴呆症是西方世界卫生保健和社会的主要成本，特别是在意大利，预计将成为一种高资源需求的慢性疾病。本研究的目的是估计平均存活率的一组社区居住的老年人受痴呆症在意大利，并评估与生存长度的预测变量。这项回顾性研究收集了2008年至2012年期间死亡的患者（n = 290）的数据。这些数据是从热那亚（意大利）的三个门诊痴呆症诊所的2,000多名患者中提取的。收集患者临床记录中列出的人口统计学数据和其他临床参数。痴呆诊断后的平均存活率为3.3 +/- 0.1年，低于年龄匹配的健康人群。这些患者的生存率与年龄呈显著相关性（n = 290; r = -0.16：p < 0.006），认知状态（n = 285; r = 0.16：p < 0.007），有教育背景（n = 204; r = 0.23：p < 0.001），合并症（n = 138; r = -0.41：p < 0.0001），有抑郁情绪（n = 74; r = 0.44：p < 0.0001），和功能状态（ADL：n = 242，r = 0.29：p < 0.0001; IADL：n = 243; r = 0.25：p < 0.0001）。多元回归分析显示，年龄，性别和功能状态的主要决定因素告知患者的生存。该研究提供了关于早期痴呆诊断在预测较长生存期方面的关键价值的有趣和可靠的数据，并提出了全面的老年评估，其中包括该研究提供的大部分预测变量，作为估计痴呆患者预期寿命的重要工具。
People affected by dementia experienced decreased life expectancy with a 2-4 times higher risk of death at a given age compared to non-demented people. Dementia represents a major cost to health care and society in the Western world and, particularly in Italy, is projected to become a high-resource demanding chronic disease. The present study aimed to estimate the average survival rate of a group of community dwelling elderly affected by dementia in Italy, and to assess the predictive variables associated with survival length. This retrospective study collected the data of patients (n = 290) who died from 2008 to 2012. The data were extracted from a cohort of over 2,000 patients from three outpatient Dementia Clinics of Genoa (Italy). Demographic data and other clinical parameters listed in the patients' clinical records were collected. The mean survival rate after dementia diagnosis was 3.3 +/- 0.1 years, lower compared to the age-matched healthy population. The survival rate of these patients showed a significant correlation with age (n = 290; r = -0.16: p < 0.006), with the cognitive status (n = 285; r = 0.16: p < 0.007), with education (n = 204; r = 0.23: p < 0.001), with comorbidity (n = 138; r = -0.41: p < 0.0001), with depressive mood (n = 74; r = 0.44: p < 0.0001), and with the functional status (ADL: n = 242, r = 0.29: p < 0.0001; IADL: n = 243; r = 0.25: p < 0.0001). Multivariate regression analysis revealed age, gender, and functional status as the main determinants informing patient survival. The study provides interesting and reliable data on the pivotal value of early dementia diagnosis in predicting longer survival and addresses comprehensive geriatric assessment, which encompasses most of the predictive variables provided by the study, as a remarkable tool in estimating life expectancy of patients with dementia.