Causes of death in a nationwide cohort of community-dwellers with Alzheimer’s disease

Abstract Background Alzheimer’s disease (AD) is related to higher mortality but it is not entirely evident which causes of death explain this. The objective of this study was to assess the causes of death in a nationwide cohort of clinically verified AD cases and compare the causes to a matched comp...

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Main Authors: Anna-Maija Tolppanen, Heidi Taipale, Marjaana Koponen, Jari Tiihonen, Sirpa Hartikainen
Format: Article
Language:English
Published: BMC 2020-11-01
Series:BMC Geriatrics
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12877-020-01744-z
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author Anna-Maija Tolppanen
Heidi Taipale
Marjaana Koponen
Jari Tiihonen
Sirpa Hartikainen
author_facet Anna-Maija Tolppanen
Heidi Taipale
Marjaana Koponen
Jari Tiihonen
Sirpa Hartikainen
author_sort Anna-Maija Tolppanen
collection DOAJ
description Abstract Background Alzheimer’s disease (AD) is related to higher mortality but it is not entirely evident which causes of death explain this. The objective of this study was to assess the causes of death in a nationwide cohort of clinically verified AD cases and compare the causes to a matched comparison cohort without AD. Methods Cohort of all community-dwellers with clinically verified AD residing in Finland on 31 December 2005 (n = 27,948) and a matched comparison cohort without AD (n = 27,948). Mortality (2006–2012, n = 30,641, 54.8%) and causes of death were obtained from register. Cause of death was ascertained with clinical examination (87.3% of deaths), forensic (8.0%) or medical autopsy (4.7%). Results In AD cohort, the most common causes were diseases of the nervous system (49.9%), circulatory system (31.7%) and neoplasms (7.7%), while diseases of circulatory system (53.5%), neoplasms (19.1%) and mental and behavioral disorders (7.3%) contributed for majority of deaths in the comparison cohort. There were no sex-wise differences. People with AD were over 20 times more likely to die due to diseases of the nervous system (OR, 95% CI 22.06, 19.87–24.25) than the comparison cohort, while other causes, e.g., diseases of the circulatory system (0.40, 0.38–0.42), neoplasms (0.35, 0.33–0.38), mental and behavioral disorders (0.27, 0.24–0.30) and external causes of morbidity and mortality (0.72, 0.62–0.81) were less common in the AD cohort. Conclusions Although half of the people with AD died due to diseases of the nervous system, cancers and especially cardio/cerebrovascular diseases were still important contributors to the overall mortality among them. This should be acknowledged when planning their terminal care.
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spelling doaj.art-aed2136e977d411b89c1061e6c1143b72022-12-21T17:59:36ZengBMCBMC Geriatrics1471-23182020-11-012011910.1186/s12877-020-01744-zCauses of death in a nationwide cohort of community-dwellers with Alzheimer’s diseaseAnna-Maija Tolppanen0Heidi Taipale1Marjaana Koponen2Jari Tiihonen3Sirpa Hartikainen4School of Pharmacy, University of Eastern FinlandSchool of Pharmacy, University of Eastern FinlandSchool of Pharmacy, University of Eastern FinlandDepartment of Clinical Neuroscience, Karolinska InstitutetSchool of Pharmacy, University of Eastern FinlandAbstract Background Alzheimer’s disease (AD) is related to higher mortality but it is not entirely evident which causes of death explain this. The objective of this study was to assess the causes of death in a nationwide cohort of clinically verified AD cases and compare the causes to a matched comparison cohort without AD. Methods Cohort of all community-dwellers with clinically verified AD residing in Finland on 31 December 2005 (n = 27,948) and a matched comparison cohort without AD (n = 27,948). Mortality (2006–2012, n = 30,641, 54.8%) and causes of death were obtained from register. Cause of death was ascertained with clinical examination (87.3% of deaths), forensic (8.0%) or medical autopsy (4.7%). Results In AD cohort, the most common causes were diseases of the nervous system (49.9%), circulatory system (31.7%) and neoplasms (7.7%), while diseases of circulatory system (53.5%), neoplasms (19.1%) and mental and behavioral disorders (7.3%) contributed for majority of deaths in the comparison cohort. There were no sex-wise differences. People with AD were over 20 times more likely to die due to diseases of the nervous system (OR, 95% CI 22.06, 19.87–24.25) than the comparison cohort, while other causes, e.g., diseases of the circulatory system (0.40, 0.38–0.42), neoplasms (0.35, 0.33–0.38), mental and behavioral disorders (0.27, 0.24–0.30) and external causes of morbidity and mortality (0.72, 0.62–0.81) were less common in the AD cohort. Conclusions Although half of the people with AD died due to diseases of the nervous system, cancers and especially cardio/cerebrovascular diseases were still important contributors to the overall mortality among them. This should be acknowledged when planning their terminal care.http://link.springer.com/article/10.1186/s12877-020-01744-zAlzheimer’s diseaseCauses of deathCohortMortality
spellingShingle Anna-Maija Tolppanen
Heidi Taipale
Marjaana Koponen
Jari Tiihonen
Sirpa Hartikainen
Causes of death in a nationwide cohort of community-dwellers with Alzheimer’s disease
BMC Geriatrics
Alzheimer’s disease
Causes of death
Cohort
Mortality
title Causes of death in a nationwide cohort of community-dwellers with Alzheimer’s disease
title_full Causes of death in a nationwide cohort of community-dwellers with Alzheimer’s disease
title_fullStr Causes of death in a nationwide cohort of community-dwellers with Alzheimer’s disease
title_full_unstemmed Causes of death in a nationwide cohort of community-dwellers with Alzheimer’s disease
title_short Causes of death in a nationwide cohort of community-dwellers with Alzheimer’s disease
title_sort causes of death in a nationwide cohort of community dwellers with alzheimer s disease
topic Alzheimer’s disease
Causes of death
Cohort
Mortality
url http://link.springer.com/article/10.1186/s12877-020-01744-z
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