Prevalence Of Comorbidities In Patients Research Articles

Prevalence of Comorbidities in Rheumatoid Arthritis and Evaluation of Their Monitoring in Clinical Practice: The Spanish Cohort of the COMORA Study

ObjectivesTo describe the prevalence of comorbidities in patients with RA in Spain and discuss their management and implications using data from the Spanish cohort of the multinational study on COMOrbidities in Rheumatoid Arthritis (COMORA). MethodsThis is a national sub-analysis of the COMORA study. We studied the demographics and disease characteristics of 200 adults patients diagnosed with RA (1987 ACR), and routine practices for screening and preventing the following selected comorbidities: cardiovascular, infections, cancer, gastrointestinal, pulmonary, osteoporosis and depression. ResultsPatients had a mean age of 58 years and a mean RA duration of 10 years. Mean DAS28 score was 3.3 and approximately 25% of patients were in remission (DAS28 <2.6). Forty-four (22%) patients had ≥1 comorbidity, the most frequent being depression (27%) and obesity (26%). A history of myocardial infarction or stroke was observed in 5% and 1% of patients, respectively, and any solid tumor in 6%. Having a Framingham Risk Score >20% (51%), hypercholesterolemia (46%) or hypertension (41%) and smoking (25%) were the most common CV risk factors. For prostate, colon and skin cancers, only 9%, 10% and 18% of patients, respectively, were optimally monitored. Infections were also inadequately managed, with 7% and 17% of patients vaccinated against influenza and pneumococcal, respectively, as was osteoporosis, with 47% of patients supplemented with vitamin D and 56% with a bone densitometry performed. ConclusionsIn Spain, the prevalence of comorbidities and CV risk factors in RA patients with established and advanced disease is relatively high, and their management in clinical daily practice remains suboptimal.

Evaluation of the prevalence of comorbidities in patients reporting for dentoalveolar surgeries.

Medical comorbidities have varied effects on the management of a patient for dentoalveolar surgeries. Prior diagnosis and prudence in such conditions is of utmost importance for avoidance of complications and overall welfare of the patient. There is a dilemma on the extent of investigations required to evidently ascertain the medical status and fitness of a patient for a dental procedure. The objective of this study was to evaluate the prevalence of medical comorbidities in patients reporting for dentoalveolar surgeries, which would help provide data to establish an evidence-based protocol for perioperative workup of all dental surgeries. A total of 2872 patients were included in this study age ranging from 13 years to 84 years. Detailed case history of the patient and baseline blood investigations were recorded. Physician's consultation was acquired to identify any medical comorbidity the patient may be suffering from. It was observed that 17.8% of the patients were detected with medical co-morbidities. Hypertension and Diabetes being the most prevalent (Hypertension: 9.1% and Diabetes: 6.2%). This study has shown that 8.8% of all patients in our study were either newly diagnosed with comorbidities or were inappropriately treated for a prediagnosed comorbidity. We conclude that only relying on the medical history provided by the patient is not sufficient to rule out any medical comorbidities and there is a chance of missing out on any undiagnosed medical condition that the patient may be suffering from.

Prevalence of Comorbidities in Patients With Cirrhosis Admitted to U.S. Safety Net Hospitals and Their Impact on Clinical Phenotype of Admission

Prevalence of Comorbidities in Patients With Cirrhosis Admitted to U.S. Safety Net Hospitals and Their Impact on Clinical Phenotype of Admission

Dravet Syndrome and Psychiatric Comorbidity

AbstractThis is a review of the prevalence of psychiatric comorbidity in patients with Dravet syndrome (DS) and the predictors of psychiatric comorbidity. Symptoms of attention-deficit hyperactivity disorder are most frequently reported in children with DS. Autistic features and “other behavior problems” are also found in a considerable proportion of children. No consistent relationship has been found with intellectual disability level, age of onset of seizures, delay in diagnosis, and seizure frequency. A major limitation of the literature is that formal psychiatric assessment has rarely been applied.

Changes in co-morbidity pattern in patients starting renal replacement therapy in Europe-data from the ERA-EDTA Registry.

Patients starting renal replacement therapy (RRT) for end-stage renal disease often present with one or more co-morbidities. This study explored the prevalence of co-morbidities in patients who started RRT in Europe during the period from 2005 to 2014. Using data from patients aged 20 years or older from all 11 national or regional registries providing co-morbidity data to the European Renal Association - European Dialysis and Transplant Association Registry, we examined the prevalence of the following co-morbidities: diabetes mellitus (DM) (primary renal disease and/or co-morbidity), ischaemic heart disease (IHD), congestive heart failure (CHF), peripheral vascular disease (PVD), cerebrovascular disease (CVD) and malignancy. Overall, 70% of 7578 patients who initiated RRT in 2014 presented with at least one co-morbidity: 39.0% presented with DM, 25.0% with IHD, 22.3% with CHF, 17.7% with PVD, 16.4% with malignancy and 15.5% with CVD. These percentages differed substantially between countries. Co-morbidities were more common in men than in women, in older patients than in younger patients, and in patients on haemodialysis at Day 91 when compared with patients on peritoneal dialysis. Between 2005 and 2014 the prevalence of DM and malignancy increased over time, whereas the prevalence of IHD and PVD declined. More than two-thirds of patients initiating RRT in Europe have at least one co-morbidity. With the rising age at the start of RRT over the last decade, there have been changes in the co-morbidity pattern: the prevalence of cardiovascular co-morbidities decreased, while the prevalence of DM and malignancy increased.

Prevalence of comorbidities in COPD patients by disease severity in a German population.

Comorbidities in COPD have a complex relationship with disease severity, requiring a comprehensive therapy approach.

Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring in clinical practice: the spanish cohort of the COMORA study.

To describe the prevalence of comorbidities in patients with RA in Spain and discuss their management and implications using data from the Spanish cohort of the multinational study on COMOrbidities in Rheumatoid Arthritis (COMORA). This is a national sub-analysis of the COMORA study. We studied the demographics and disease characteristics of 200 adults patients diagnosed with RA (1987 ACR), and routine practices for screening and preventing the following selected comorbidities: cardiovascular, infections, cancer, gastrointestinal, pulmonary, osteoporosis and depression. Patients had a mean age of 58 years and a mean RA duration of 10 years. Mean DAS28 score was 3.3 and approximately 25% of patients were in remission (DAS28 <2.6). Forty-four (22%) patients had ≥1 comorbidity, the most frequent being depression (27%) and obesity (26%). A history of myocardial infarction or stroke was observed in 5% and 1% of patients, respectively, and any solid tumor in 6%. Having a Framingham Risk Score >20% (51%), hypercholesterolemia (46%) or hypertension (41%) and smoking (25%) were the most common CV risk factors. For prostate, colon and skin cancers, only 9%, 10% and 18% of patients, respectively, were optimally monitored. Infections were also inadequately managed, with 7% and 17% of patients vaccinated against influenza and pneumococcal, respectively, as was osteoporosis, with 47% of patients supplemented with vitamin D and 56% with a bone densitometry performed. In Spain, the prevalence of comorbidities and CV risk factors in RA patients with established and advanced disease is relatively high, and their management in clinical daily practice remains suboptimal.

Confluence of Epidemics of Hepatitis C, Diabetes, Obesity, and Chronic Kidney Disease in the United States Population

Obesity, kidney disease, and diabetes are common conditions that can affect outcomes of patients with chronic hepatitis C. The authors aimed to quantify the burden of these comorbid conditions among adults with chronic hepatitis C in the United States and to estimate the risk of death among people with chronic hepatitis C and comorbidities. The authors conducted cross-sectional and prospective analyses of 13,726 participants in the third National Health and Nutrition Examination Survey (NHANES III) and 23,691 participants of NHANES 1999-2012. Serum samples were analyzed for the presence of antibodies to hepatitis C virus (anti-HCV); in samples found to be positive for anti-HCV, the authors quantified HCV RNA (viral load). Individuals with anti-HCV and detectable HCV RNA were considered to have chronic hepatitis C. Comorbidities were defined using self-reported, physical examination, and laboratory data, as available. The authors used logistic models and predictive margins to estimate the adjusted prevalence of comorbidities in patients with chronic hepatitis C. The authors used Poisson regression models to estimate adjusted mortality rates based on chronic hepatitis C status, with or without comorbidities. Cox proportional hazards regression models to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause, cardiovascular, and cancer mortality according to chronic hepatitis C status, with and without comorbidities. Among persons with chronic hepatitis C, the demographic-adjusted prevalence estimate of diabetes was 17.9% (95% CI, 11.2%-27.5%) and of obesity was 20.9% (95% CI, 12.4%-29.5%). Overall, 69.6% of persons with chronic hepatitis C had at least 1 major cardiometabolic comorbidity (95% CI, 62.1%-76.2%). Only 38% of adults with chronic hepatitis C reported a diagnosis of liver disease. Chronic hepatitis C was associated with a substantially increased risk of death (HR, 2.45), especially in the presence of diabetes (HR, 3.24) or chronic kidney disease (HR, 4.39). In an analysis of NHANES data, the authors found that individuals with chronic hepatitis C have a high burden of major cardiometabolic comorbidities. Diabetes and chronic kidney disease, in particular, are associated with substantial excess mortality in persons with chronic hepatitis C.

Comorbidities of rheumatoid arthritis: Results from the Korean National Health and Nutrition Examination Survey.

This study aimed to evaluate the prevalence of comorbidities in patients with rheumatoid arthritis (RA) compared with the non-RA population. The 2010–2012 Korea National Health and Nutrition Examination Survey (KNHANES), which assesses the general health status of populations in South Korea using interviews and basic health assessment, was analyzed retrospectively. Weighted prevalence and odds ratio (OR) of comorbidities were analyzed in patients with RA compared with the non-RA population. The overall weighted (n = 37,453,158) prevalence of RA was 1.5%. Patients with RA were older and more female predominant than subjects without RA. The prevalence of living in an urban area, college graduation, alcohol consumption and smoking was lower in patients with RA than non-RA. Patients with RA had more comorbidities including hypertension, dyslipidemia, myocardial infarction (MI) or angina, stoke, osteoarthritis, lung cancer, colon cancer, pulmonary tuberculosis, asthma, diabetes, depression, thyroid disease and chronic kidney disease. After adjusting socioeconomic and lifestyle characteristics, RA was associated with an increased prevalence of MI or angina (OR 1.86, 95% CI 1.17–2.96, p = 0.009), pulmonary TB (OR 1.95, 95% CI 1.24–3.09, p = 0.004), asthma (OR 1.97, 95% CI 1.05–3.71, p = 0.036), thyroid disease (OR 1.71, 95% CI 1.05–2.77), depression (OR 2.38, 95% CI 1.47–3.85, p < 0.001) and hepatitis B (OR 2.34, 95% CI 1.15–4.80, p = 0.020) compared with the non-RA population. Prevalence of solid cancer was not significantly associated with RA after adjustment.

COMORBIDITY IN CORONARY HEART DISEASE PATIENTS UNDERGOING BYPASS GRAFTING: AN EXPERIENCE OF TWO SURGERY CENTERS

Aim. To evaluate the prevalence of comorbidities in patients undergoing coronary bypass grafting (CBG) in two surgery clinics of Russia. Material and methods . Into retrospective study, done based upon the charts data of A. N. Bakulev Scientific Center for Cardiovascular Surgery (A. N. Bakulev SCCVS) and Research Institute for Complex Issues of Cardiovascular Diseases, 1702 patients included (1358 males, 344 females) from Bakulev SCCVS and 1159 (895 males, 264 females) patients from RICICD, who had underwent CBG, including multiple surgeries, during 2014-2015. Comparative analysis was performed of the prevalence of comorbidity and combination pathology. Results. The main background pathology in general group of patients was arterial hypertension (AH) — 2322 (81,2%) cases. In more than a half of cases, in anamnesis there was myocardial infarction (MI) — 1719 (60,1%), of those in 250 (8,7%) patients — with left ventricle aneurysm. Lower extremities atherosclerosis was found in 13,8% cases. Stroke anamnesis had 5,6% patients. Prior carotid endarterectomy (CEE) was found in 30 (1,0%) cases, percutaneous intervention — 190 (6,6%) patients. The most common comorbidity in general group was type 2 diabetes — 505 (17,6%) cases. Chronic obstructive pulmonary disease (COPD) was found in 352 (12,3%) patients, erosions and ulceration of gastro-intestinal tract (GIT) — in 10,6% cases. Patients of RICICD were older (62,5±7,8 vs 60,8±8,5 y.o., p=0,003), had AH more commonly (83,1 vs 79,8%, p=0,02), as stroke anamnesis (7,2 vs 4,5%, p=0,002), prior MI (66,8 vs 55,5%, p<0,05), prior PCI (12,9 vs 2,4%, p<0,05), COPD (13,8 vs 11,3%, p=0,044), GIT ulceration (15,2 vs 7,5%, p<0,05) in comparison to Bakulev SCCVS. Bakulev SCCVS patients had 1,5 times more prevalently the atherosclerotic lesion of lower extremities (15,9 vs 10,6%, p<0,05), prior CEE was done 3,7 times more prevalently than in RICICD (1,5 vs 0,4%, p=0,007), more commonly the combination intervention was done: CBG with valvular correction (11,3 vs 6,7%, p<0,05). Conclusion. The prevalence of comorbidity is determined by the age of patient, as regional specifics of morbidity in population hospitalizing to one or another surgical center.

Prevalence of co-morbidities among adult patients presented for open heart surgery and the implication on convalescence period

Background: Improvements in perioperative medical care, anesthetic management, surgical and myocardial protection techniques made cardiac surgery feasible in the high risk surgical patients. The aim of the study was to determine the prevalence of comorbidities in adult patients undergoing open heart surgery and to evaluate their implications on recovery profile.Methods: This randomized retrospective observational study of 100 adult patients presented for heart surgery for different pathologies took place at Queen Alia heart Institute in the period of time between February 2013 and June 2014. Patients' data was collected in forms, tabulated and retrospectively analyzed. Patients' demographics, co-morbidities and type of surgery were recorded. Risk stratification models (ASA-American Society of Anesthesiology and EUROSCORE 2- European system for cardiac operative risk evaluation) were used. Time of extubation, ICU discharge and hospital discharge was recorded with each patient.Results: Age of patients ranged from 18 to 77 years (mean±SD: 58±12). 83% of patients were male and 17% were female. 80 patients were presented for CABG and 20 patients for heart valve(s) surgery. BMI (body mass index, mean±SD) was 28.9±4.6 kg/m². The prevalence of smoking was 56% (6 times higher among males (64%), in comparison to females (12%). Hypertension was prevalent in 72% of patients; diabetes was present in 53%, respiratory disease in 30%, previous myocardial infarction in 23%, 37% of patients had left ventricular impairment, renal impairment in 6%, renal failure in 2% and previous stroke in 2%. EUROSCORE values ranged between 0.5 to 5.3 % (mean 1.4%). ASA grades ranged from 2 to 4 (85% of patients were grade 3). 5% of surgeries were emergent. Average operative time was 248±47 minutes (mean±SD). 30% of patients needed inotropic support and 6% needed intra-aortic balloon. Mean time in the intensive care was 43.2±28.8 hours (mean±SD).Conclusions: There is a high prevalence of co-morbidities in patients presented for cardiac surgery. Most common associated diseases were hypertension, obesity, smoking, previous myocardial infarction and diabetes; which are all well known risk factors of ischemic heart disease. Preoperative risk scoring is of paramount importance.

Prevalence of comorbidity and associated risk factors in adults with atopic dermatitis.

Atopic dermatitis (AD) is a common chronic skin disorder, which may persist into adulthood; however, the prevalence of comorbidities in patients with AD is not well characterized. AD is considered a systemic disorder like psoriasis, which has raised a need for data on the comorbidity profile of patients with AD, to assess the potential risks, benefits, and complications in management of patients with AD. We described the occurrence of medical and psychiatric comorbidities and associated risk factors in adults with AD compared with psoriasis and the general population. All Danish individuals aged ≥18 years with a hospital (inpatient or ambulatory) diagnosis of AD or psoriasis during the study period (January 1, 1995-December 31, 2012) were linked in administrative registers. Overall, prevalence of smoking and alcohol abuse was higher among patients with AD than the general population, but lower than psoriasis patients. Similarly, patients with AD had more risk factors and higher prevalence of comorbidity than the general population, but lower prevalence and reduced risk compared to psoriasis patients, except for use of anxiolytics, which was higher in severe AD. Prevalence of diabetes was lower in AD than psoriasis patients as well as general population controls. Despite an increased risk of various medical and psychiatric comorbidities compared to general population controls, adult patients with AD had markedly lower prevalence of cardiovascular disease than psoriasis patients. However, prevalence of psychiatric comorbidity and tobacco smoking was alarmingly high in severe patients with AD, which might be target for intervention in patient management.

PIN25 - Health Resources Use In Patients With Human Immunodeficiency Virus (Hiv) Infection. Real world evidence from italian administrative databases

The study was designed to evaluate the prevalence of comorbidities in patients infected with HIV and to concomitantly estimate the associated healthcare costs. An observational retrospective cohort analysis, using administrative and laboratory tests databases from 7 Local Health Units (LHUs) in Italy, was designed. Data from 1 LHU are currently available. Patients diagnosed with HIV (through hospitalisations, specific treatments or blood test results) between January 1st 2013 and December 31st 2015 were included. The date of the first HIV-related healthcare service/prescription was used as the index date. Clinical characteristics of patients enrolled in the study were investigated in the year before the index-date. All patients were followed for 1 year after the index-date. A preliminary analysis included a total of 298 HIV+ patients. Mean age was 53.5 years, 67% were male and 6% had AIDS. Twenty-five percent of patients had one comorbidity, 12% had two and 5% had three or more comorbidities. Twenty-seven percent of patients were prescribed with antihypertensive drugs, 17% with statins, 8% with anti-diabetics and 2% with osteoporosis drugs. Three percent were hospitalised for cardiovascular disease (Heart Failure, Myocardial Infarction, Cerebrovascular event). On average, the healthcare cost of a patient without comorbidities was 7’800€, the cost of a patient with one comorbidity was 9’100€ and the cost of a patient with two comorbidities and with three or more was 9’700€ and 10’000€, respectively. A significant proportion of HIV+ patients were reported to have at least one comorbidity. This study has demonstrated that healthcare costs increase according to the number of comorbidities: patients with 3 or more comorbidities costed 30% more than patients without comorbidities. As a result, it is important that the management of each HIV+ patient is made through a multidisciplinary approach, taking comorbidities into account in addition to suppressing viral load.

Prevalence of comorbidities according to predominant phenotype and severity of chronic obstructive pulmonary disease.

BackgroundIn addition to lung involvement, several other diseases and syndromes coexist in patients with chronic obstructive pulmonary disease (COPD). Our purpose was to investigate the prevalence of idiopathic arterial hypertension (IAH), ischemic heart disease, heart failure, peripheral vascular disease (PVD), diabetes, osteoporosis, and anxious depressive syndrome in a clinical setting of COPD outpatients whose phenotypes (predominant airway disease and predominant emphysema) and severity (mild and severe diseases) were determined by clinical and functional parameters.MethodsA total of 412 outpatients with COPD were assigned either a predominant airway disease or a predominant emphysema phenotype of mild or severe degree according to predictive models based on pulmonary functions (forced expiratory volume in 1 second/vital capacity; total lung capacity %; functional residual capacity %; and diffusing capacity of lung for carbon monoxide %) and sputum characteristics. Comorbidities were assessed by objective medical records.ResultsEighty-four percent of patients suffered from at least one comorbidity and 75% from at least one cardiovascular comorbidity, with IAH and PVD being the most prevalent ones (62% and 28%, respectively). IAH prevailed significantly in predominant airway disease, osteoporosis prevailed significantly in predominant emphysema, and ischemic heart disease and PVD prevailed in mild COPD. All cardiovascular comorbidities prevailed significantly in predominant airway phenotype of COPD and mild COPD severity.ConclusionSpecific comorbidities prevail in different phenotypes of COPD; this fact may be relevant to identify patients at risk for specific, phenotype-related comorbidities. The highest prevalence of comorbidities in patients with mild disease indicates that these patients should be investigated for coexisting diseases or syndromes even in the less severe, pauci-symptomatic stages of COPD. The simple method employed to phenotype and score COPD allows these results to be translated easily into daily clinical practice.

Comorbidity in clinical trial patients with advanced or metastatic non-small cell lung cancer (NSCLC).

e20606 Background: Co-morbid conditions can have an impact on the natural course of lung cancer, as well as on treatment efficacy and safety outcomes. It is important to understand the difference in co-morbidity between clinical trial patients and the general population in order to remain vigilant for an altered safety and efficacy in the post-approval setting. We did a retrospective review of the prevalence of co-morbidity in patients with advanced or metastatic NSCLC enrolled in clinical trials conducted by PSI-CRO over a decade. Methods: A retrospective review of the prevalence of co-morbidities in NSCLC patients enrolled in clinical trials conducted by PSI-CRO from 2005 to 2015 was done. A total of 8 clinical studies involving 1,355 patients were identified. Results: The median age was 60 years with 30% of patients being 65 or older. More than two-thirds (72%) were men. About one-fifth (19%) had ECOG PS of 0 with remaining four-fifths (81%) having PS of 1. Only a small subset (9%) did not have any co-morbid conditions while more than three-quarters (77%) presented with at least 2 comorbidities. The most common comorbidities were hypertension (41%), coronary artery disease (24%), and chronic obstructive pulmonary disease (COPD) (13%). Only 1.4% of patients had malignancies in the past, which could be explained by their routine exclusion from clinical trials. Also the prevalence of diabetes mellitus (2.7%) and neurologic diseases (4%) is noted to be small. Conclusions: The prevalence of hypertension and cardiovascular co-morbidity in patients with advanced or metastatic NSCLC enrolled in clinical trial is in line with that in general population. In contrast, the prevalence of COPD, diabetes, neurologic diseases, and previous malignancies was significantly lower. The differences in prevalence in some of the co-morbidities might be explained by the restrictive inclusion criteria as well as a resulting lower PS leading to ineligibility for clinical trials. Our findings suggest that with certain co-morbidities, difference exists between the general population and those enrolled in clinical trials. This may have a potential impact on post-approval drug efficacy and safety outcomes.

Prevalence of autoimmune comorbidities in patients with metastatic melanoma in the US.

9529Background: Immunotherapies have advanced the treatment of metastatic melanoma (MM); however they are associated with frequent immune-related toxicities. As a result, patients with pre-existing...

Abstract 208: Effects of Gender and BMI on Comorbidities in Patients With Non Hemorrhagic Stroke

Background: There is conflicting evidence concerning the obesity paradox in stroke patients. We sought to examine the relationship between gender, BMI, and prevalence of comorbidities in patients with non-hemorrhagic stroke. Materials and Methods: Retrospective chart review was performed in 996 consecutive patients treated for non-hemorrhagic stroke at a single academic medical center. Patients were divided according to gender and specific BMI groups according to the National Institute of Health. This study was approved by the institutional IRB. Results: Patients with BMI from 0-18.5 and 18.5-24.9 were more likely to be female (63.2% and 58.4% p&lt;.05). Whereas patients with BMI over 25-30 and 30-35 were more likely to be male (60.82% and 59.2% p&lt;.05). Morbidly obese patients (BMI&gt;35) were equally likely to be men or women. In men higher BMI correlated with presentation at younger age. Diabetes was most prevalent in patients with BMI over 35 (40% males, 44% females, p&lt;.05). In females, HTN was associated with BMI 30-34.5 and 35+ (80.5% and 73.3%, P&lt;.05). Males showed a similar though non-significant trend. The prevalence of end stage renal disease, systemic atherosclerosis, and PVD was not significantly correlated with BMI in either gender. Conclusion: Gender and BMI significantly affect associated comorbidities in patients with non-hemorrhagic stroke, possibly suggestive of unique gender specific disease mechanisms. Additional studies investigating the effect of gender and BMI on diagnostic evaluation and treatment of patients with non-hemorrhagic stroke are warranted.

Prevalence of Comorbidity in Patients With Young-Onset Alzheimer Disease Compared With Late-Onset: A Comparative Cohort Study

ObjectivesWith the lack of a cure for Alzheimer disease (AD), the identification of comorbidity is important to reduce the possibility of excess disability. Although comorbidity in patients with late-onset AD (LO-AD) is common, for people with young-onset AD (YO-AD), it is unclear how often comorbidity occurs. Furthermore, it is uncertain whether comorbidity in patients with YO-AD differs from that in patients with LO-AD. The aim of this study was to explore the prevalence, types of morbidity, and morbidity profiles in patients with YO-AD compared with those of patients with LO-AD. DesignExplorative cohort study from 2 separate Dutch cohorts (Needs in Young-onset Dementia [NeedYD] and the Clinical Course of Cognition and Comorbidity–Dementia Study [4C-Dementia study]). SettingParticipants were recruited in 2007 and 2008 from (1) the memory clinics of 3 Dutch Alzheimer centers, (2) the memory clinics of general hospitals, (3) mental health services in the southern part of the Netherlands, and (4) young-onset dementia specialized day care facilities. A comparison group of community-dwelling, elderly patients with AD was selected from the 4C-Dementia study. Patients in this study were recruited in 2010 and 2011 from the aforementioned Alzheimer centers. MeasurementsThe prevalence rates of comorbidity were compared between 177 patients with YO-AD and 155 patients with LO-AD. Comorbidity was classified using the International Classification of Diseases, 10th Revision (ICD-10). The total amount of comorbidity was established by counting the number of existing diseases (ICD categories or chapters) and comorbidity was also dichotomized as present or absent. Furthermore, a hierarchical cluster analysis was performed to study clusters of comorbidity. ResultsCompared with LO-AD, patients with YO-AD showed less (P < .001) overall comorbidity (58.2% vs 86.5%) and had lower prevalence rates of diabetes, obesity, and circulatory diseases; however, the prevalence rates of diseases of the nervous system in YO-AD (6.2%) were higher compared with those of patients with LO-AD (4.5%). The cluster analysis revealed a distinctive group of patients with YO-AD with either no comorbidity or with a disease of the nervous system. Endocrine, nutritional, and metabolic diseases and diseases of the circulatory system were present in 34% of the patients with YO-AD. ConclusionComorbidity is less common in YO-AD than in LO-AD. However, general practitioners should be aware that approximately one-third of the patients with YO-AD suffer from or have endocrine, nutritional, and metabolic diseases and/or diseases of the circulatory system. Treatment should therefore not only focus on dementia but also on comorbidity. This attention may slow the functional decline in AD. These exploratory analyses suggested a higher prevalence of nervous system diseases in YO-AD compared with LO-AD. However, the finding did not reach statistical significance and in combination with the exploratory nature of the analyses justifies further investigation. If verified, this finding may help to decrease the time to diagnosis of AD and, subsequently, support in young patients with a neurological disease. Further investigation is needed to gain more insight into the association between comorbidity and AD in younger people.

Pattern and Prevalence of Psychiatric Comorbidity in Patients with Essential Hypertension in Port Harcourt, Nigeria

Essential hypertension, a non communicable disease, is assuming an epidemic dimension, of the nature of a communicable condition. It, predominantly affects the physical, social and psychological well-being of the middle to elderly age group, with the former incidentally contributing over 50% of Nigeria workforce, hence interfering with the nation’s economic well- being . Although few of such studies have been done in this environment, hypertensionhas been variously cited to be commonly associated with psychiatric comorbidity. The aim of this study, therefore, was to determine the pattern and prevalence of psychiatric co-morbidity among subjects with essential hypertension attending the out patient clinic of the University of Port Harcourt Teacing Hospital (UPTH). In this cross-sectional study, following ethical approval from the appropriate committee of the hospital and informed consent from the participants, 360 subjects making up the study group were recruited based on the study’s inclusion exclusion criteria, after a Pilot Study (In addition, the hypertensives were screened for HIV infection and also investigated for other chronic medical illnesses). Subjects were further administered with the study’s instruments including the socio-demorgraphic questionnaire, GHQ-12 and WHOCIDI. The data were analyzed using the SPSS version 20. Confidence interval was set at 95% while P- value of less than 0.05 was considered statistically significant. The study found a 64.4% (n=232) rate of psychiatric comorbidity among the hypertensive patients with depressive illness the highest with 73(29.4%). This was followed by GAD with 16.1%, sexual dysfunction 9.0%, mixed anxiety and depression 7.8%, substance abuse 2.3%, dysthymia 0.3%, while panic without agoraphobia and personality disorders 0.9% each. Severity of hypertension correlated positively with psychiatric comorbidity. The study found that psychiatric co-morbidity among the hypertensive patient is common in UPTH. It therefore becomes imperative that the intervention measures for chronic disorders of these natures should include a well planned, elaborate and articulated neuropsychiatric evaluation for an effective and holistic management of these patients.

P-39ORGANIC COMORBIDITY IN PATIENTS WITH ALCOHOL ABUSE OR DEPENDENCE TREATED IN AN OUTPATIENT CLINIC

Objectives of the study. To examine the prevalence of somatic comorbidity in patients with Alcohol Abuse or Dependence and analyze other sociodemographic and clinical variables associated to comorbidity. Methods. Retrospective descriptive study of psychiatric outpatients diagnosed of Alcohol Abuse or Dependence, treated in a Mental Health Unit …