Demographics and clinical risk factor(s) variations in mortality of Alzheimer's disease in Taiwan: A 15‐year national population‐based study

Abstract

AbstractBackgroundIdentifying variation in the demographics and clinical risk factor(s) of the mortality for Alzheimer's disease (AD) has public health applications for projecting the future burden of disease. However, very few nationwide studies have been conducted on this topic in Asia countries. This study describes age‐, sex‐ and comorbidities‐ specific mortality in Taiwan as well as assesses the disparity of demographics and clinical factor(s) on the mortality of AD.MethodThis is a population‐based cohort study. The data of onset AD aged ≧40 years were acquired from the Taiwan National Health Insurance Research Database entries between 2000 and 2002.We used proportional hazards models to assess the effect of demographic and clinical factor(s) on 15 years of mortality after AD onset, Kaplan–Meier method for median survival times. We also further investigated survival time in incident AD by age‐, sex‐ and comorbidities‐stratified analyses.ResultThe median survival time during 15 years after first‐diagnosis of AD was 7.69 (95%CI :7.46‐7.90) years for overall, 6.37(95%CI :6.06‐6.65) years for men and 8.81(95%CI :8.49‐9.12) years for women. Predictors of mortality based on proportional hazards models included older age, males, and some specific clinical factors, including hypertension, diabetes mellitus, heart disease, and chronic obstruction pulmonary disease (COPD). Regardless of any gender, the survival time was shortest in subjects aged ≧80 years, especially in those with heart disease, diabetes mellitus, and COPD.ConclusionThe significant demographics and clinical risk factor(s) variations in AD mortality. Public health interventions should consider these differences in health care resources.