Epidemiol Health.
2023;45(1):e2023082. 10.4178/epih.e2023082.
Overall and cause-specific mortality in patients with dementia: a population-based cohort study in Taiwan
- Affiliations
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- 1Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan
- 2Department of Psychiatry, Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
- 3Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan
- 4Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
- 5Division of Epidemiology, Department of Epidemiology, Biostatistics and Demography, Health Promotion and Behavioral Science Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
- 6Department of Public Health, China Medical University College of Public Health, Taichung, Taiwan
- 7Department of Healthcare Administration, Asia University College of Medical and Health Science, Taichung, Taiwan
- KMID: 2548032
- DOI: http://doi.org/10.4178/epih.e2023082
Abstract
OBJECTIVES
Information regarding the underlying causes of death (UCODs) and standardized mortality ratio (SMR) of dementia is instrumental in formulating medical strategies to prolong life in persons with dementia (PWD). We examined the leading UCODs among PWD and estimated the overall and cause-specific SMRs in relation to dementia in Taiwan.
METHODS
Data were retrieved from 2 national datasets: the Taiwan Death Registry and the medical claim datasets of the National Health Insurance program. The observed person-years for each study participant were counted from the date of cohort enrollment to either the date of death or the final day of 2016. Sex-specific and age-specific SMRs were then calculated.
RESULTS
The leading UCOD was circulatory disease, accounting for 26.0% of total deaths (n=3,505), followed by respiratory disease at 21.3% (n=2,875). PWD were at significantly increased risk of all-cause mortality (SMR, 2.01), with SMR decreasing with advancing age. A cause-specific analysis revealed that the highest SMRs were associated with nervous system diseases (SMR, 7.58) and mental, behavioral, and neurodevelopmental disorders (SMR, 4.80). Age appeared to modify SMR, suggesting that younger age at cohort enrollment was linked to higher SMRs for nearly all causes of mortality.
CONCLUSIONS
Circulatory and respiratory diseases were the leading UCODs among PWD. The particularly elevated mortality due to nervous system diseases and mental disorders suggests that allocating more resources to neurological and psychiatric services is warranted. The elevated SMRs of various UCODs among younger PWD underscore the need for clinicians to pay particular attention to the medical care provided to these patients.
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