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Relative survival in patients with dementia with Lewy bodies and Parkinson’s disease dementia

Larsson, Victoria LU ; Torisson, Gustav LU and Londos, Elisabet LU (2018) In PLoS ONE 13(8).
Abstract
Introduction

The understanding of survival in dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) is limited, as well as the impact of these diagnoses in an ageing co-morbid population.
Methods

A retrospective study of 177 patients who received a DLB or PDD diagnosis between 1997–2014 at the Memory Clinic in Malmö, Sweden. Relative survival was evaluated by adjusting all-cause survival for expected survival, estimated from population life-tables, matched by sex, age and calendar year. Predictors of relative survival were investigated using multivariate regression modelling.
Results

At follow-up, 143 (81%) patients were deceased with a median survival of 4.1 years (IQR 2.6–6.0). After... (More)
Introduction

The understanding of survival in dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) is limited, as well as the impact of these diagnoses in an ageing co-morbid population.
Methods

A retrospective study of 177 patients who received a DLB or PDD diagnosis between 1997–2014 at the Memory Clinic in Malmö, Sweden. Relative survival was evaluated by adjusting all-cause survival for expected survival, estimated from population life-tables, matched by sex, age and calendar year. Predictors of relative survival were investigated using multivariate regression modelling.
Results

At follow-up, 143 (81%) patients were deceased with a median survival of 4.1 years (IQR 2.6–6.0). After 10-years follow-up, the standardized mortality ratio was 3.44 (95% CI 2.92–4.04). Relative survival was worse with younger age at diagnosis (excess hazard ratio [eHR] 0.91, 95% CI 0.88–0.94 per year of age), female sex (eHR 1.45, 95% CI 1.01–2.09) and lower mini-mental state examination (eHR 0.93, 95% CI 0.90–0.96). Subgroup analysis (n = 141) showed higher mortality in DLB patients who were positive for APOE ɛ4 (eHR 2.00, 95% CI 1.35–2.97).
Conclusion

The mortality is over three-times higher in patients diagnosed with dementia with Lewy bodies and Parkinson’s disease dementia during a ten-year follow-up, compared to persons in the general population. Excess mortality is found primarily in younger patients, females and carriers of APOE ε4. Further research is needed regarding survival and possible interventions, including disease-modifying treatments, to improve care for this patient group.
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
PLoS ONE
volume
13
issue
8
publisher
Public Library of Science
external identifiers
  • scopus:85051633188
ISSN
1932-6203
DOI
10.1371/journal.pone.0202044
language
English
LU publication?
yes
id
2fffffe9-f31b-4b9e-b0e2-c64f1ac937c3
date added to LUP
2018-08-20 23:36:21
date last changed
2018-11-20 03:00:20
@article{2fffffe9-f31b-4b9e-b0e2-c64f1ac937c3,
  abstract     = {Introduction<br/><br/>The understanding of survival in dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) is limited, as well as the impact of these diagnoses in an ageing co-morbid population.<br/>Methods<br/><br/>A retrospective study of 177 patients who received a DLB or PDD diagnosis between 1997–2014 at the Memory Clinic in Malmö, Sweden. Relative survival was evaluated by adjusting all-cause survival for expected survival, estimated from population life-tables, matched by sex, age and calendar year. Predictors of relative survival were investigated using multivariate regression modelling.<br/>Results<br/><br/>At follow-up, 143 (81%) patients were deceased with a median survival of 4.1 years (IQR 2.6–6.0). After 10-years follow-up, the standardized mortality ratio was 3.44 (95% CI 2.92–4.04). Relative survival was worse with younger age at diagnosis (excess hazard ratio [eHR] 0.91, 95% CI 0.88–0.94 per year of age), female sex (eHR 1.45, 95% CI 1.01–2.09) and lower mini-mental state examination (eHR 0.93, 95% CI 0.90–0.96). Subgroup analysis (n = 141) showed higher mortality in DLB patients who were positive for APOE ɛ4 (eHR 2.00, 95% CI 1.35–2.97).<br/>Conclusion<br/><br/>The mortality is over three-times higher in patients diagnosed with dementia with Lewy bodies and Parkinson’s disease dementia during a ten-year follow-up, compared to persons in the general population. Excess mortality is found primarily in younger patients, females and carriers of APOE ε4. Further research is needed regarding survival and possible interventions, including disease-modifying treatments, to improve care for this patient group.<br/>},
  articleno    = {e0202044},
  author       = {Larsson, Victoria and Torisson, Gustav and Londos, Elisabet},
  issn         = {1932-6203},
  language     = {eng},
  month        = {08},
  number       = {8},
  publisher    = {Public Library of Science},
  series       = {PLoS ONE},
  title        = {Relative survival in patients with dementia with Lewy bodies and Parkinson’s disease dementia},
  url          = {http://dx.doi.org/10.1371/journal.pone.0202044},
  volume       = {13},
  year         = {2018},
}