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Medical Comorbidity in Alzheimer's Disease: A Nested Case-Control Study
Jen-Hung Wang1,2, Ya-Ju Wu3, Boon Lead Tee4
1Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
Journal of Alzheimer'S Disease : JAD
|April 18, 2018
Summary
Multimorbidity is common in Alzheimer's disease (AD). Key associated conditions include diabetes mellitus, osteoporosis, depression, and cerebrovascular disease, highlighting the need for integrated care.
Area of Science:
- Gerontology
- Neurology
- Public Health
Background:
- Limited understanding of the prevalence and patterns of medical comorbidities in Alzheimer's disease (AD).
- Need to characterize the disease burden associated with AD beyond cognitive decline.
Purpose of the Study:
- To delineate the comorbidity profile of Alzheimer's disease (AD) using a large-scale, population-based nested case-control study.
- To identify specific comorbidities and multimorbidity patterns associated with incident AD.
Main Methods:
- Utilized a nested case-control design within Taiwan's National Health Insurance program (2 million individuals, 2001-2011).
- Identified incident AD cases using ICD codes and drug reimbursement data.
- Employed conditional logistic regression and exploratory factor analysis to assess 14 pre-specified comorbidities and identify disease clusters.
Main Results:
- Identified 2,618 AD cases (mean age 76.1, 59% female).
- Most frequent comorbidities in AD: hypertension (55.1%), osteoarthritis (38.2%), depression (32.3%), diabetes mellitus (DM) (25.7%), and cerebrovascular disease (CVD) (22.7%).
- DM, osteoporosis, depression, and CVD were significantly associated with AD; AD patients had 3-fold greater comorbidity burden.
Conclusions:
- Multimorbidity is highly prevalent in Alzheimer's disease (AD).
- Diabetes mellitus, osteoporosis, depression, and cerebrovascular disease are significantly associated with incident AD.
- Integrated comorbidity management is crucial for optimizing patient care in AD.