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Sex differences in predictors of mortality in patients with Alzheimer’s disease – A 20-year follow-up.

Wattmo, Carina LU ; Wallin, Åsa LU and Londos, Elisabet LU (2019) 14th International Conference on Alzheimer's and Parkinson's Diseases (AD/PD 2019)
Abstract
Objectives: To identify sex-specific factors that may predict life expectancy after a diagnosis of Alzheimer’s disease (AD). Methods: The Swedish Alzheimer Treatment Study (SATS) is a prospective, observational, multicentre study in clinical practice that includes 1,021 participants (367 males and 654 females) diagnosed with mild-to-moderate AD at the start of cholinesterase inhibitor treatment (time of diagnosis). Cognitive abilities and activities of daily living (ADL) were evaluated at baseline and semi-annually over 3 years, and the date of death was recorded. Cox proportional hazards regression was used to determine characteristics that affected survival: apolipoprotein E genotype, solitary living, duration of AD, age at baseline,... (More)
Objectives: To identify sex-specific factors that may predict life expectancy after a diagnosis of Alzheimer’s disease (AD). Methods: The Swedish Alzheimer Treatment Study (SATS) is a prospective, observational, multicentre study in clinical practice that includes 1,021 participants (367 males and 654 females) diagnosed with mild-to-moderate AD at the start of cholinesterase inhibitor treatment (time of diagnosis). Cognitive abilities and activities of daily living (ADL) were evaluated at baseline and semi-annually over 3 years, and the date of death was recorded. Cox proportional hazards regression was used to determine characteristics that affected survival: apolipoprotein E genotype, solitary living, duration of AD, age at baseline, years of education, specific concomitant medications, cognition, instrumental ADL (IADL) and basic ADL at baseline, and rates of decline. Results: After 20 years of follow-up, 346 (94%) of the male and 620 (95%) of the female AD patients had died (p=0.722). In Cox regression models, risk factors for shorter lifespan in all participants were: use of antihypertensive/cardiac therapy, older age, lower cognitive and basic ADL abilities at baseline and faster basal ADL deterioration/year. In males, more rapid IADL progression independently predicted shorter survival, whereas in females, the rate of cognitive decline and use of antidiabetics were found to decrease life expectancy. Conclusions: Predictors of mortality differed between sexes. A decline of ≥4 IADL points/year was a risk factor for worse prognosis among males, whereas a decline of ≥4 Mini-Mental State Examination points/year predicted earlier death among females. In females, antidiabetic therapy shortened mean survival by 17 months. (Less)
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author
organization
publishing date
type
Contribution to conference
publication status
published
subject
keywords
Alzheimer's disease, Sex-specific effects, Cognition, Activities of daily living, Survival time
conference name
14th International Conference on Alzheimer's and Parkinson's Diseases (AD/PD 2019)
conference location
Lisbon, Portugal
conference dates
2019-03-27 - 2019-03-31
language
English
LU publication?
yes
id
1292f5ec-5689-45af-a1cf-6160c98213f3
alternative location
https://cmoffice.kenes.com/cmsearchableprogrammeV15/conferencemanager/programme/personid/anonymous/adpd19/normal/b833d15f547f3cf698a5e922754684fa334885ed#!abstractdetails/0000202080
date added to LUP
2019-04-16 20:16:47
date last changed
2019-04-18 11:12:23
@misc{1292f5ec-5689-45af-a1cf-6160c98213f3,
  abstract     = {Objectives: To identify sex-specific factors that may predict life expectancy after a diagnosis of Alzheimer’s disease (AD). Methods: The Swedish Alzheimer Treatment Study (SATS) is a prospective, observational, multicentre study in clinical practice that includes 1,021 participants (367 males and 654 females) diagnosed with mild-to-moderate AD at the start of cholinesterase inhibitor treatment (time of diagnosis). Cognitive abilities and activities of daily living (ADL) were evaluated at baseline and semi-annually over 3 years, and the date of death was recorded. Cox proportional hazards regression was used to determine characteristics that affected survival: apolipoprotein E genotype, solitary living, duration of AD, age at baseline, years of education, specific concomitant medications, cognition, instrumental ADL (IADL) and basic ADL at baseline, and rates of decline. Results: After 20 years of follow-up, 346 (94%) of the male and 620 (95%) of the female AD patients had died (p=0.722). In Cox regression models, risk factors for shorter lifespan in all participants were: use of antihypertensive/cardiac therapy, older age, lower cognitive and basic ADL abilities at baseline and faster basal ADL deterioration/year. In males, more rapid IADL progression independently predicted shorter survival, whereas in females, the rate of cognitive decline and use of antidiabetics were found to decrease life expectancy. Conclusions: Predictors of mortality differed between sexes. A decline of ≥4 IADL points/year was a risk factor for worse prognosis among males, whereas a decline of ≥4 Mini-Mental State Examination points/year predicted earlier death among females. In females, antidiabetic therapy shortened mean survival by 17 months.},
  author       = {Wattmo, Carina and Wallin, Åsa and Londos, Elisabet},
  keyword      = {Alzheimer's disease,Sex-specific effects,Cognition,Activities of daily living,Survival time},
  language     = {eng},
  location     = {Lisbon, Portugal},
  title        = {Sex differences in predictors of mortality in patients with Alzheimer’s disease – A 20-year follow-up.},
  year         = {2019},
}