Predictors of mortality in dementia: A systematic review and meta-analysis

Introduction

Identifying predictors of dementia and differences in mortality rates between dementia subtypes could contribute to the development of preventive strategies.

Aims

To identify risk factors for mortality in patients with dementia and to determine the incidence of mortality.

Methodology

We conducted a systematic review and meta-analysis, following the PRISMA 2020 statement. The search was performed on the PubMed/Medline, Embase, and BIREME/LILACS databases.

Results

Our meta-analysis included 15 observational studies, reporting data from 177 663 patients with dementia. The following predictors of mortality were identified: male sex (OR: 1.40 [95% CI, 1.22–1.62]), white ethnicity (OR: 1.50 [95% CI, 1.30–1.73]), Alzheimer disease (OR: 1.26 [95% CI, 1.03–1.53]), diabetes mellitus (OR: 1.29 [95% CI, 1.21–1.39]), stroke (OR: 1.25 [95% CI, 1.10–1.41]), pneumonia (OR: 3.00 [95% CI, 2.26–4.00]), Charlson Comorbidity Index (standardised mean difference (SMD): 0.21 [95% CI, 0.18–0.23]), supplemental oxygen therapy (OR: 9.97 [95% CI, 9.49–10.46]), and number of medications (SMD: 0.24 [95% CI, 0.21–0.26]). In patients with Alzheimer disease, the mortality rate was 35% (95% CI, 23%–46%), with a mean follow-up time of 34 months. The incidence of mortality in patients with other types of dementia was 48% (95% CI, 38%–56%), with a mean follow-up time of 70 months.

Conclusions

The incidence of mortality was higher in patients with dementia other than Alzheimer disease. The type of dementia and the risk factors described should be taken into account when developing prevention strategies.