Survival, effect measures, and impact numbers after dementia diagnosis: a matched cohort study
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Background: Knowledge on survival after diagnosis is important for all stakeholders. We
aimed to estimate the survival and life expectancy after a dementia diagnosis, and to quantify
the impact of dementia subtypes on mortality.
Methods: Retrospective matched cohort study using a linkage between a dementia-specific
registry and two primary care electronic medical records databases. Between 1 January 2007
and 31 December 2015 there were 5,156 subjects aged 60 years and over registered by the
Registry of Dementia of Girona and matched to 15,468 age-sex and comorbidity individuals
without dementia attended by general practitioners in the province of Girona (Catalonia,
Spain).
Results: The median survival was 5.2 years (95% CI 5.0 to 5.4), the median life expectancy
was 74.7 years (95% CI 71.9 to 76.5), and there were differences by gender. The mortality
rate was 127.1 per 1,000 person-years (95% CI 121.6 to 132.7), and the hazard ratio for
mortality in persons with dementia ranged between 1.63 (95% CI 1.52 to 1.76) for
Alzheimer’s disease and 2.52 (95% CI 1.90 to 3.35) for Parkinson-plus syndromes. There
was one death per year attributable to dementia for every 18.6 persons with dementia, and for
every 2.4 persons with dementia who die, one death was attributable to dementia.
Conclusion: The prognosis after dementia diagnosis is conditioned by demographic and
clinical features. Although survival is larger for women, they also experience a higher
number of years of life lost. Parkinson-plus syndromes and dementia due to multiple
etiologies are among the most malignant subtypes regarding mortality