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Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis
Published on: September 26, 2018
Cardiovascular Diseases in ~30,000 Patients in the Swedish Dementia Registry
Pavla Cermakova1,2, Kristina Johnell3, Johan Fastbom3
1Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division for Neurogeriatrics, Huddinge, Sweden.
Insights
Cardiovascular diseases impact dementia patients differently, affecting mortality risk across various dementia types. Understanding these links is crucial for tailored patient care and treatment strategies.
Area of Science:
- Neurology
- Cardiology
- Geriatrics
Background:
- Cardiovascular diseases (CVDs) are a major cause of mortality.
- Dementia patients frequently experience co-occurring cardiovascular conditions.
- Investigating the interplay between CVDs and dementia is critical for understanding prognosis.
Purpose of the Study:
- To examine the associations between various cardiovascular diseases and distinct dementia disorders.
- To assess the impact of these cardiovascular diseases on mortality risk in dementia patients.
- To identify differences in CVD burden and prognostic significance across dementia subtypes.
Main Methods:
- Analysis of 29,630 patients from the Swedish Dementia Registry.
- Inclusion of diagnoses: Alzheimer's disease (AD), mixed dementia, vascular dementia, dementia with Lewy bodies (DLB), Parkinson's disease dementia (PDD), frontotemporal dementia (FTD), and unspecified dementia.
- Utilized Swedish National Patient Register for CVD data and applied multinomial logistic regression and Cox proportional hazard models.
Main Results:
- Mixed and vascular dementia showed a higher burden of all cardiovascular diseases compared to AD.
- Cerebrovascular diseases were more prevalent in DLB than AD; diabetes mellitus was less common in PDD and DLB than AD.
- Ischemic heart disease and atrial fibrillation predicted mortality in FTD; heart failure and diabetes mellitus in PDD; ischemic heart disease in DLB.
Conclusions:
- Significant variations exist in the occurrence of cardiovascular diseases across different dementia types.
- The prognostic impact of cardiovascular diseases on mortality differs notably among dementia disorders.
- Findings underscore the need for individualized care approaches based on dementia type and co-existing cardiovascular conditions.
Background:
Cardiovascular diseases are leading causes of death and patients with dementia are often affected by them.
Objective:
Investigate associations of cardiovascular diseases with different dementia disorders and determine their impact on mortality.
Methods:
This study included 29,630 patients from the Swedish Dementia Registry (mean age 79 years, 59% women) diagnosed with Alzheimer's disease (AD), mixed dementia, vascular dementia, dementia with Lewy bodies (DLB), Parkinson's disease dementia (PDD), frontotemporal dementia (FTD), or unspecified dementia. Records of cardiovascular diseases come from the Swedish National Patient Register. Multinomial logistic regression and cox proportional hazard models were applied.
Results:
Compared to AD, we found a higher burden of all cardiovascular diseases in mixed and vascular dementia. Cerebrovascular diseases were more associated with DLB than with AD. Diabetes mellitus was less associated with PDD and DLB than with AD. Ischemic heart disease was less associated with PDD and FTD than AD. All cardiovascular diseases predicted death in patients with AD, mixed, and vascular dementia. Only ischemic heart disease significantly predicted death in DLB patients (HR = 1.72; 95% CI = 1.16-2.55). In PDD patients, heart failure and diabetes mellitus were associated with a higher risk of death (HR = 3.06; 95% CI = 1.74-5.41 and HR = 3.44; 95% CI = 1.31-9.03). In FTD patients, ischemic heart disease and atrial fibrillation or flutter significantly predicted death (HR = 2.11; 95% CI = 1.08-4.14 and HR = 3.15; 95% CI = 1.60-6.22, respectively).
Conclusion:
Our study highlights differences in the occurrence and prognostic significance of cardiovascular diseases in several dementia disorders. This has implications for the care and treatment of the different dementia disorders.
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