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Comorbidity among inpatients with dementia: a preliminary cross-sectional study in West China
Xiaoqiang Xiao1,2,3, Shunju Xiang4,5, Qingya Xu1,2,3
1Department of Neuropsychology, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, Sichuan, China.
Insights
Hospitalized patients with dementia have more comorbidities than those without dementia. Conditions like cerebral vascular disease, epilepsy, and depression significantly increase dementia risk, particularly in vascular dementia cases.
Area of Science:
- Gerontology
- Neurology
- Internal Medicine
Background:
- Dementia is a growing global health concern, often accompanied by multiple coexisting medical conditions (comorbidities).
- Understanding these comorbidities is crucial for comprehensive patient care and management strategies.
- Hospitalized dementia patients represent a significant population with complex health needs.
Purpose of the Study:
- To investigate the prevalence and types of comorbidities in hospitalized patients diagnosed with dementia.
- To compare comorbidity profiles between dementia patients and non-dementia controls.
- To identify specific comorbidities associated with an increased risk of dementia, including Alzheimer's disease and vascular dementia.
Main Methods:
- Retrospective analysis of discharge records from 3355 hospitalized patients.
- Comorbidities identified using the Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI) based on ICD-10 codes.
- Logistic regression models used to determine associations between comorbidities and dementia, comparing dementia patients with matched controls and differentiating between Alzheimer's and vascular dementia.
Main Results:
- Dementia patients (n=3355) exhibited a higher average number of comorbidities (3.8) compared to controls (2.9).
- Prevalent comorbidities in dementia patients included cerebral vascular disease (73.0%), hypertension (62.8%), and peripheral vascular disease (53.7%).
- Significant risk factors for dementia were epilepsy (OR 4.8), cerebral vascular disease (OR 4.1), and depression (OR 4.0). Vascular dementia showed a higher burden of cardiovascular and cerebrovascular comorbidities than Alzheimer's disease.
Conclusions:
- Hospitalized patients with dementia have a significantly greater comorbidity burden than non-dementia patients.
- Cardio-cerebral vascular diseases, epilepsy, diabetes, and depression are key comorbidities associated with increased dementia risk.
- Vascular dementia patients present with more severe cardiovascular and cerebrovascular comorbidities compared to Alzheimer's disease patients.
Objective:
To investigate comorbidities among hospitalized patients with dementia.
Method:
Data were extracted from the discharge records in our hospital. Comorbidities based on ICD-10 were selected from the Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI). The distributions of these comorbidities were described in dementia inpatients and age- and sex-matched nondementia controls, as well as in inpatients with Alzheimer's disease and vascular dementia. A logistic regression model was applied to identify dementia-specific morbid conditions.
Results:
A total of 3355 patients with dementia were included, with a majority of 1503 (44.8%) having Alzheimer's disease, 395 (11.8%) with vascular dementia, and 441 (13.1%) with mixed dementia. The mean number of comorbidities was 3.8 in dementia patients (vs. 2.9 in controls). The most prevalent comorbidities in inpatients with dementia compared with those without dementia were cerebral vascular disease (73.0% vs. 35.9%), hypertension (62.8% vs. 56.2%), and peripheral vascular disease (53.7% vs. 31.2%). Comorbidities associated with dementia included epilepsy (OR 4.8, 95% CI 3.5-6.8), cerebral vascular disease (OR 4.1, 95% CI 3.7-4.5), depression (OR 4.0, 95% CI 3.2-5.0), uncomplicated diabetes (OR 1.5, 95% CI 1.4-1.7), peripheral vascular disease (OR 1.8, 95% CI 1.6-2.0), rheumatoid arthritis collagen vascular disease (OR 1.7, 95% CI 1.3-2.3), and anemia (OR 1.2, 95% CI 1.04-1.3). Some comorbidities suggested a protective effect against dementia. They were hypertension (OR 0.8, 95% CI 0.7-0.9), COPD (OR 0.6, 95% CI 0.5-0.6), and solid tumor without metastasis (OR 0.4, 95% CI 0.3-0.4). Vascular dementia has more cardiovascular and cerebrovascular comorbidities than Alzheimer's disease.
Conclusion:
Patients with dementia coexisted with more comorbidities than those without dementia. Comorbidities (esp. cardio-cerebral vascular risks) in patients with vascular dementia were more than those in patients with AD. Specifically, vascular and circulatory diseases, epilepsy, diabetes and depression increased the risk of dementia.
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