Mortality Rates and Mortality Risk Factors in Older Adults with Dementia from Low- and Middle-Income Countries: The 10/66 Dementia Research Group Population-Based Cohort Study
| Autor: | Déborah Oliveira, Ronaldo D. Piovezan, Daisy Acosta, Martin Prince, Nicole Arias, Cleusa P. Ferri |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Male population-based studies Care provision 03 medical and health sciences 0302 clinical medicine Sex Factors Risk Factors medicine Dementia Humans Effects of sleep deprivation on cognitive performance low- and middle-income countries Prospective Studies Cognitive decline Mortality Prospective cohort study Developing Countries Aged Aged 80 and over business.industry General Neuroscience Mortality rate Age Factors General Medicine medicine.disease Psychiatry and Mental health Clinical Psychology Malnutrition 030104 developmental biology Low and middle income countries mortality risk Female Geriatrics and Gerontology business 030217 neurology & neurosurgery Demography Research Article |
| Zdroj: | Journal of Alzheimer's Disease |
| ISSN: | 1875-8908 1387-2877 |
| Popis: | Background Dementia is the main cause of disability in older people living in low- and middle-income countries (LMIC). Monitoring mortality rates and mortality risk factors in people with dementia (PwD) may contribute to improving care provision. Objective We aimed to estimate mortality rates and mortality predictors in PwD from eight LMICs. Methods This 3-5-year prospective cohort study involved a sample of 1,488 older people with dementia from eight LMIC. Total, age- and gender-specific mortality rates per 1,000 person-years at risk, as well as the total, age- and gender-adjusted mortality rates were estimated for each country's sub-sample. Cox's regressions were used to establish the predictors of mortality. Results At follow-up, vital status of 1,304 individuals (87.6%) was established, of which 593 (45.5%) were deceased. Mortality rate was higher in China (65.9%) and lower in Mexico (26.9%). Mortality risk was higher in males (HR = 1.57; 95% CI: 1.32,1.87) and increased with age (HR = 1.04; 95% CI: 1.03,1.06). Neuropsychiatric symptoms (HR = 1.03; 95% CI: 1.01,1.05), cognitive decline (HR 1.04; 95% CI: 1.03,1.05), undernutrition (HR = 1.55; 95% CI: 1.19, 2.02), physical impairments (HR = 1.15; 95% CI: 1.03,1.29), and disease severity (HR = 1.43; 95% CI: 1.22,1.63) predicted higher mortality risk. Conclusion Several factors predicted higher mortality risk in PwD in LMICs. Males, those with higher age, higher severity of neuropsychiatric symptoms, higher number of physical impairments, higher disease severity, lower cognitive performance, and undernutrition had higher mortality risk. Addressing these indicators of long-term adverse outcomes may potentially contribute to improved advanced care planning, reducing the burden of disease in low-resourced settings. |
| Databáze: | OpenAIRE |
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