Mortality in acromegaly diagnosed in the elderly in Spain is higher in women compared to the general Spanish population.

Abstract

There is no data on mortality of acromegaly diagnosed in the elderly. To compare clinical characteristics, GH-related comorbidities, therapeutic approaches and mortality of patients diagnosed before or after 2010 and to assess overall mortality compared with the general Spanish population. Spanish tertiary care centers. Retrospective evaluation of 118 patients diagnosed with acromegaly at or above the age of 65. Kaplan-Meier curves were constructed to trace survival, and Cox proportional hazard models were used to assess the risk factors associated with mortality. We also compared mortality with that of the Spanish population by using age- and gender-adjusted standardized mortality ratios (SMR). No differences were found in first-line treatment or biochemical control, between both periods except for faster biochemical control after 2010. Twenty-nine (24.6%) patients died, without differences between groups, median of follow-up 8.6 years [103, (72.3) months]. Overall SMR was 1.02 (95% CI: 0.57-1.54), [0.60 (95% CI: 0.35-1.06) for men] and [1.80 (95% CI: 1.07-2.94) for women]. The most common cause of death was cardiovascular disease (CVD). The mortality in patients with acromegaly diagnosed in the elderly was no different between both periods and there was no overall SMR difference from the general Spanish population. However, the SMR was higher in women. As CVD is the leading cause of mortality, it seems advisable to initiate an intense CVD protective treatment as soon as acromegaly is diagnosed, particularly in women, in addition to tight acromegaly control in order to prevent excess mortality.