Hospitalizations and Mortality of Individuals with Dementia: Evidence from Czech National Registers
Language English Country United States Media print
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
32390620
PubMed Central
PMC7369115
DOI
10.3233/jad-191117
PII: JAD191117
Knihovny.cz E-resources
- Keywords
- Alzheimer’s disease, Czech Republic, dementia, hospitalization, mortality, population characteristics, registries,
- MeSH
- Dementia epidemiology mortality MeSH
- Hospitalization statistics & numerical data MeSH
- Kaplan-Meier Estimate MeSH
- Humans MeSH
- Mortality MeSH
- Proportional Hazards Models MeSH
- Registries MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic epidemiology MeSH
BACKGROUND: Facing an increasing prevalence of dementia, the Czech Republic is developing a new nationwide strategy for the management and prevention of dementia. Lack of evidence about characteristics of individuals with dementia in the country is a major obstacle. OBJECTIVE: The study aimed to 1) characterize individuals with dementia, 2) compare their mortality with the general population, and 3) analyze differences in survival between different dementia disorders. METHODS: The study capitalizes on two nationwide registers in the Czech Republic, from which information about individuals who were hospitalized with dementia or died from it between 1994 and 2014 was retrieved. Standardized intensity of hospitalizations was calculated for each year, mortality was studied using standardized mortality ratio, life-tables, Kaplan-Mayer curves, and Cox proportional hazard models. RESULTS: Standardized intensity of hospitalizations for dementia increased more than 3 times from 1994 to 2014. Standardized mortality ratio was 3.03 (95% confidence interval 2.97-3.08). One-year survival rate was 45% and five-year survival rate 16%. Vascular dementia was the most common type of dementia disorders and was associated with higher hazard of death than Alzheimer's disease, even after adjusting for sociodemographic and clinical covariates (hazard ratio 1.04; 95% confidence interval 1.02-1.05). CONCLUSION: The study provides estimates on demographic characteristics and mortality of the Czech hospitalized dementia population, which have not been so far available and which are unique also in the context of the entire region of Central and Eastern Europe.
2nd Faculty of Medicine Charles University Prague Prague Czech Republic
3rd Faculty of Medicine Charles University Prague Prague Czech Republic
Faculty of Informatics and Statistics University of Economics Prague Czech Republic
Faculty of Science Vrije Universiteit Amsterdam Amsterdam Netherlands
See more in PubMed
Arltová M, Langhamrová J, Langhamrová J (2013) Development of life expectancy in the Czech Republic in years 1920–2010 with an outlook to 2050, Prague Economic Papers 22, 125–143.
Czech Statistical Office (2018) Czech Demographic Handbook 2017, Czech Statistical Office, Prague.
Winblad B, Amouyel P, Andrieu S, Ballard C, Brayne C, Brodaty H, Cedazo-Minguez A, Dubois B, Edvardsson D, Feldman H (2016) Defeating Alzheimer’s disease and other dementias: A priority for European science and society, Lancet Neurol 15, 455–532. PubMed
Prince M, Comas-Herrera A, Knapp M, Guerchet Ml, Karagiannidou M (2016) World Alzheimer Report 2016. Improving healthcare for people living with dementia: Coverage, quality and costs now and in the future. Alzheimer’s Disease International, London.
Broulikova HM, Sladek V, Arltova M, Cerny J (2018) The potential impact of Alzheimer’s disease early treatment on societal costs of care in Czechia: A simulation approach, J Ment Health Policy Econ 21, 147–161. PubMed
Czech Statistical Office (2018) Average wages - 4th quarter of 2017, Czech Statistical Office, Prague.
World Health Organization (2012) Dementia: A public health priority, World Health Organization.
Seiler S, Schmidt H, Lechner A, Benke T, Sanin G, Ransmayr G, Lehner R, Dal-Bianco P, Santer P, Linortner P (2012) Driving cessation and dementia: Results of the prospective registry on dementia in Austria (PRODEM), PLoS One 7, e52710. PubMed PMC
Choi SH, Kim S, Han S-H, Na DL, Kim D-K, Cheong H-K, Lee J-H, Kim SY, Hong CH, Moon SY (2012) Neurologic signs in relation to cognitive function in subcortical ischemic vascular dementia: A CREDOS (Clinical Research Center for Dementia of South Korea) study, Neurol Sci 33, 839–846. PubMed
Johannsen P, Jørgensen K, Kørner A, Elmo EG, Lauesen LB, Utzon J (2011) Development of a dementia assessment quality database, Aging Mental Health 15, 40–46. PubMed
Persson K, Brækhus A, Selbæk G, Kirkevold Ø, Engedal K (2015) Burden of care and patient’s neuropsychiatric symptoms influence carer’s evaluation of cognitive impairment, Dement Geriatr Cogn Disord 40, 256–267. PubMed
Garre-Olmo J, Flaqué M, Gich J, Pulido TO, Turbau J, Vallmajo N, Viñas M, López-Pousa S (2009) A clinical registry of dementia based on the principle of epidemiological surveillance, BMC Neurol 9, 5. PubMed PMC
Religa D, Fereshtehnejad S-M, Cermakova P, Edlund A-K, Garcia-Ptacek S, Granqvist N, Hallbäck A, Kåwe K, Farahmand B, Kilander L (2015) SveDem, the Swedish Dementia Registry–A tool for improving the quality of diagnostics, treatment and care of dementia patients in clinical practice, PloS One 10, e0116538. PubMed PMC
Anthony S, Pradier C, Chevrier R, Festraëts J, Tifratene K, Robert P (2014) The French National Alzheimer database: A fast growing database for researchers and clinicians, Dement Geriatr Cogn Disord 38, 271–280. PubMed
Krysinska K, Sachdev PS, Breitner J, Kivipelto M, Kukull W, Brodaty H (2017) Dementia registries around the globe and their applications: A systematic review, Alzheimers Dement 13, 1031–1047. PubMed PMC
Wu Y-T, Fratiglioni L, Matthews FE, Lobo A, Breteler MMB, Skoog I, Brayne C (2016) Dementia in western Europe: Epidemiological evidence and implications for policy making, Lancet Neurol 15, 116–124. PubMed
World Health Organization (2007) International classification of diseases and related health problems, 10th revision.
Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation, J Chronic Dis 40, 373–383. PubMed
Bannay A, Chaignot C, Blotière P-O, Basson M, Weill A, Ricordeau P, Alla F (2016) The best use of the Charlson comorbidity index with electronic health care database to predict mortality, Med Care 54, 188–194. PubMed
Cermakova P, Nelson M, Secnik J, Garcia-Ptacek S, Johnell K, Fastbom J, Kilander L, Winblad B, Eriksdotter M, Religa D (2017) Living alone with Alzheimer’s disease: Data from SveDem, the Swedish Dementia Registry, J Alzheimers Dis 58, 1265–1272. PubMed PMC
Sundararajan V, Henderson T, Perry C, Muggivan A, Quan H, Ghali WA (2004) New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality, J Clin Epidemiol 57, 1288–1294. PubMed
Czech Statistical Office (2018) Life tables for the CR since 1920, Czech Statistical Office, Prague.
Subic A, Cermakova P, Religa D, Han S, von Euler M, Kareholt I, Johnell K, Fastbom J, Bognandi L, Winblad B, Kramberger MG, Eriksdotter M, Garcia-Ptacek S (2018) Treatment of atrial fibrillation in patients with dementia: A cohort study from the Swedish Dementia Registry, J Alzheimers Dis 61, 1119–1128. PubMed PMC
Garcia-Ptacek S, Kåreholt I, Cermakova P, Rizzuto D, Religa D, Eriksdotter M (2016) Causes of death according to death certificates in individuals with dementia: A cohort from the Swedish Dementia Registry, J Am Geriatr Soc 64, e137–e142. PubMed
Cermakova P, Szummer K, Johnell K, Fastbom J, Winblad B, Eriksdotter M, Religa D (2017) Management of acute myocardial infarction in patients with dementia: Data from SveDem, the Swedish Dementia Registry, J Am Med Dir Assoc 18, 19–23. PubMed
Enache D, Fereshtehnejad SM, Kareholt I, Cermakova P, Garcia-Ptacek S, Johnell K, Religa D, Jelic V, Winblad B, Ballard C, Aarsland D, Fastbom J, Eriksdotter M (2016) Antidepressants and mortality risk in a dementia cohort: Data from SveDem, the Swedish Dementia Registry, Acta Psychiatr Scand 134, 430–440. PubMed
Subic A, Zupanic E, von Euler M, Norrving B, Cermakova P, Religa D, Winblad B, Kramberger MG, Eriksdotter M, Garcia-Ptacek S (2018) Stroke as a cause of death in death certificates of patients with dementia: A cohort study from the Swedish Dementia Registry, Curr Alzheimer Res 15, 1322–1330. PubMed PMC
Wu Y-T, Beiser AS, Breteler MM, Fratiglioni L, Helmer C, Hendrie HC, Honda H, Ikram MA, Langa KM, Lobo A (2017) The changing prevalence and incidence of dementia over time—current evidence, Nat Rev Neurol 13, 327. PubMed
Schrijvers EM, Verhaaren BF, Koudstaal PJ, Hofman A, Ikram MA, Breteler MM (2012) Is dementia incidence declining? Trends in dementia incidence since 1990 in the Rotterdam Study, Neurology 78, 1456–1463. PubMed
Seblova D, Brayne C, Machu V, Kuklova M, Kopecek M, Cermakova P (2019) Changes in cognitive impairment in the Czech Republic, J Alzheimers Dis 72, 693–701. PubMed
Qiu C, von Strauss E, Bäckman L, Winblad B, Fratiglioni L (2013) Twenty-year changes in dementia occurrence suggest decreasing incidence in central Stockholm, Sweden, Neurology 80, 1888–1894. PubMed
Waldemar G, Phung KT, Burns A, Georges J, Hansen FR, Iliffe S, Marking C, Rikkert MO, Selmes J, Stoppe G (2007) Access to diagnostic evaluation and treatment for dementia in Europe, Int J Geriatr Psychiatry 22, 47–54. PubMed
Mátl O, Mátlová M, Holmerová I (2016) Zpráva o stavu demence 2016, Česká alzheimerovská spoleçnost, Praha.
Van De Vorst IE, Vaartjes I, Geerlings MI, Bots ML, Koek HL (2015) Prognosis of patients with dementia: Results from a prospective nationwide registry linkage study in the Netherlands, BMJ Open 5, e008897. PubMed PMC
Luzny J, Holmerova I, Petr W, Ondrejka I (2014) Dementia still diagnosed too late—Data from the Czech Republic, Iran J Public Health 43, 1436. PubMed PMC
Garcia-Ptacek S, Farahmand B, Kåreholt I, Religa D, Cuadrado M, Eriksdotter M (2014) Mortality risk after dementia diagnosis by dementia type and underlying factors: A cohort of 15,209 patients based on the Swedish Dementia Registry, J Alzheimers Dis 41, 466–477. PubMed
Cermakova P, Fereshtehnejad SM, Johnell K, Winblad B, Eriksdotter M, Religa D (2014) Cardiovascular medication burden in dementia disorders: A nationwide study of 19,743 dementia patients in the Swedish Dementia Registry, Alzheimers Res Ther 6, 34. PubMed PMC
Cermakova P, Johnell K, Fastbom J, Garcia-Ptacek S, Lund LH, Winblad B, Eriksdotter M, Religa D (2015) Cardiovascular diseases in ∼30,000 patients in the Swedish Dementia Registry, J Alzheimers Dis 48, 949–958. PubMed
Bobak M, Marmot M (1996) East-West mortality divide and its potential explanations: Proposed research agenda, BMJ 312, 421–425. PubMed PMC
Peasey A, Bobak M, Kubinova R, Malyutina S, Pajak A, Tamosiunas A, Pikhart H, Nicholson A, Marmot M (2006) Determinants of cardiovascular disease and other non-communicable diseases in Central and Eastern Europe: Rationale and design of the HAPIEE study, BMC Public Health 6, 255. PubMed PMC
Rizzuto D, Feldman AL, Karlsson IK, Dahl Aslan AK, Gatz M, Pedersen NL (2018) Detection of dementia cases in two Swedish health registers: A validation study, J Alzheimers Dis 61, 1301–1310. PubMed PMC
Dahl A, Berg S, Nilsson SE (2007) Identification of dementia in epidemiological research: A study on the usefulness of various data sources, Aging Clin Exp Res 19, 381–389. PubMed
Jin Y-P, Gatz M, Johansson B, Pedersen NL (2004) Sensitivity and specificity of dementia coding in two Swedish disease registries, Neurology 63, 739–741. PubMed
Solomon A, Ngandu T, Soininen H, Hallikainen MM, Kivipelto M, Laatikainen T (2014) Validity of dementia and Alzheimer’s disease diagnoses in Finnish national registers, Alzheimers Dement 10, 303–309. PubMed
Perera G, Stewart R, Higginson IJ, Sleeman KE (2016) Reporting of clinically diagnosed dementia on death certificates: Retrospective cohort study, Age Ageing 45, 668–673. PubMed PMC
Cermakova P, Lund LH, Fereshtehnejad SM, Johnell K, Winblad B, Dahlstrom U, Eriksdotter M, Religa D (2015) Heart failure and dementia: Survival in relation to types of heart failure and different dementia disorders, Eur J Heart Fail 17, 612–619. PubMed PMC
Winkler P, Formanek T, Mlada K, Cermakova P (2018) The CZEch Mental health Study (CZEMS): Study rationale, design, and methods, Int J Methods Psychiatr Res 27, e1728. PubMed PMC
Cermakova P, Formanek T, Kagstrom A, Winkler P (2018) Socioeconomic position in childhood and cognitive aging in Europe, Neurology 91, e1602–e1610. PubMed PMC
Formanek T, Kagstrom A, Winkler P, Cermakova P (2019) Differences in cognitive performance and cognitive decline across European regions: A population-based prospective cohort study, Eur Psychiatry 58, 80–86. PubMed
Horackova K, Kopecek M, Machu V, Kagstrom A, Aarsland D, Motlova LB, Cermakova P (2019) Prevalence of late-life depression and gap in mental health service use across European regions, Eur Psychiatry 57, 19–25. PubMed