Survival of Patients at a Neurology Clinic: No Improvement Over 12 Years.

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Alzheimer Disease & Associated Disorders Pub Date : 2025-01-01 Epub Date: 2025-01-30 DOI:10.1097/WAD.0000000000000658

Kyle Steenland, Youran Tan, Shirley M Mullins, Taylor E Kidd, Qiyun Gong, James J Lah

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引用次数: 0

Abstract

Introduction: We previously followed Emory patients with neurodegenerative disease from 1993 to 2006. Here, we follow survivor and new patients for 2007 to 2018.

Methods: We studied mortality from 10 different diagnostic groups among 4322 research volunteers, and compared mortality rates to controls with normal cognition, using Cox regression. We assessed mortality through the National Death Index, controlling for sex, education, race, comorbidities, and age. Supplemental analyses considered APOE and cognitive test scores.

Results: Fifty-nine percent of patients died during follow-up. Mortality rate ratios, compared with controls (n=641) in descending order were 12.54, 6.61, 4.77, 4.92, 3.36, 2.25, 2.21 1.71, 1.39, and 1.17 for diagnostic groups ALS, (n=571), FTD (n=197), LBD (n=134), PD (n=584), AD (n=1118), MCI/dementia (n=82), dementia not specified (n=165), PD symptoms (n=256), vascular dementia (n=234), and MCI (n=340), respectively. Women, non-whites, those with higher education, with no comorbidities, and lower ages had lower mortality rates for most diagnostic groups. Mortality rates were higher in the presence of APOE4 variants for several diagnostic groups. Lower MMSEs predicted worse survival for most diseases. Overall, 41% of patients survived during 12 years of follow-up, compared with an expected 75% in the US population.

Conclusion: Survival times for different diagnostic groups have changed little over several decades.

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神经内科门诊患者的生存率：12年无改善。

我们之前从1993年到2006年对埃默里大学的神经退行性疾病患者进行了随访。在这里，我们跟踪2007年至2018年的幸存者和新患者。方法：对4322名研究志愿者中10个不同诊断组的死亡率进行研究，并使用Cox回归将死亡率与认知正常的对照组进行比较。我们通过国家死亡指数评估死亡率，控制性别、教育、种族、合并症和年龄。补充分析考虑了APOE和认知测试分数。结果：59%的患者在随访期间死亡。与对照组（n=641）相比，诊断组（n=641）的死亡率由高到低依次为12.54、6.61、4.77、4.92、3.36、2.25、2.21、1.71、1.39和1.17，分别为ALS （n=571）、FTD （n=197）、LBD （n=134）、PD （n=584）、AD （n=1118）、MCI/痴呆（n=82）、未明确痴呆（n=165）、PD症状（n=256）、血管性痴呆（n=234）和MCI （n=340）。在大多数诊断组中，女性、非白人、受过高等教育、无合并症和年龄较低的人的死亡率较低。在几个诊断组中，APOE4变异的死亡率更高。较低的mmse预示着大多数疾病的较差生存率。总体而言，在12年的随访中，41%的患者存活，而美国人口的预期存活率为75%。结论：几十年来，不同诊断组的生存时间变化不大。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer Disease & Associated Disorders 医学-病理学

CiteScore

3.10

自引率

4.80%

发文量

期刊介绍： Alzheimer Disease & Associated Disorders is a peer-reviewed, multidisciplinary journal directed to an audience of clinicians and researchers, with primary emphasis on Alzheimer disease and associated disorders. The journal publishes original articles emphasizing research in humans including epidemiologic studies, clinical trials and experimental studies, studies of diagnosis and biomarkers, as well as research on the health of persons with dementia and their caregivers. The scientific portion of the journal is augmented by reviews of the current literature, concepts, conjectures, and hypotheses in dementia, brief reports, and letters to the editor.