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Ma KZ, Hu CJ. Trends in incidence, mortality, dynamic needs and rapid evolution of healthcare in dementia. Arch Gerontol Geriatr 2024; 121:105389. [PMID: 38448314 DOI: 10.1016/j.archger.2024.105389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Affiliation(s)
- Ke-Zong Ma
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli County, Taiwan.
| | - Chaur-Jong Hu
- Department of Neurology and Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Kiderman D, Ben-Shabat N, Tsur AM, Anis S, Watad A, Cohen AD, Paz Z, Amital H. Vitamin D Insufficiency is Associated with Higher Incidence of Dementia, a Large Community-Based Retrospective Cohort Study. J Geriatr Psychiatry Neurol 2023; 36:511-518. [PMID: 36888907 DOI: 10.1177/08919887231163292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
INTRODUCTION Active metabolite of vitamin D has neuro-immunomodulatory and neuroprotective properties. However, there is still a debate about the potential association between low serum levels of hydroxy-vitamin D and increased risk for dementia. OBJECTIVES To determine an association between hypovitaminosis D and dementia for different 25-hydroxyvitamin-D (25(OH)D) serum level cutoffs. METHODS Patients were identified utilizing the database of Clalit Health Services (CHS), the largest healthcare provider in Israel. For each subject, all available values of 25(OH)D during the study period, which lasted from 2002 to 2019, were obtained. Rates of dementia were compared across different cutoffs of 25(OH)D levels. RESULTS Cohort included 4278 patients, of whom 2454 (57%) were women. The mean age at the beginning of follow-up was 53 (±17). During the 17-year study period, a total of 133 patients (3%) were diagnosed with dementia. In a fully adjusted multivariate analysis, the risk for dementia was almost 2-fold higher in patients with an average of vitamin D insufficiency (<75 nmol/l) measurements (OR = 1.8, 95% C.I. = 1.0-3.2) compared to reference values (≥75 nmol/l). Patients with vitamin D deficiency (<50 nmol/l) demonstrated higher rates of dementia (OR = 2.6, 95% C.I. = 1.4-4.8). In our cohort, patients were diagnosed with dementia at a younger age in the deficiency (77 vs. 81 P-value = 0.05) and the insufficiency groups (77 vs. 81 P-value = 0.05) compared to the reference values (≥75 nmol/l). CONCLUSION Insufficient levels of vitamin D are associated with dementia. Dementia is diagnosed at a younger age in patients with insufficient and deficient vitamin D levels.
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Affiliation(s)
- David Kiderman
- Hadassah Faculty of Medicine, The Hebrew University, Jerusalem, Israel
- Kaplan Medical Center, Rehovot, Israel
| | - Niv Ben-Shabat
- Department of Medicine B, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Avishai M Tsur
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
| | - Saar Anis
- Department of Neurology, Sheba Medical Center, Ramat Gan, Israel
| | - Abdulla Watad
- Department of Medicine B, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK
| | - Arnon D Cohen
- Clalit Health Services, Tel-Aviv, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ziv Paz
- Rheumatology Unit, Galilee Medical Center, Naharyia, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel
| | - Howard Amital
- Department of Medicine B, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Lim SJ, Son S, Chung Y, Kim SY, Choi H, Choi J. Relationship between vestibular loss and the risk of dementia using the 2002-2019 national insurance service survey in South Korea. Sci Rep 2023; 13:16746. [PMID: 37798321 PMCID: PMC10556082 DOI: 10.1038/s41598-023-42598-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 09/12/2023] [Indexed: 10/07/2023] Open
Abstract
This retrospective cross-sectional study assessed older adults aged between 40 and 80 years, registered in the Korean National Health Insurance Service database from 2002 to 2019 to investigate the association between vestibular loss and the risk of dementia. The population was divided into three groups (general, vestibular loss, and hearing loss). The hazard ratios (HRs) of dementia in the vestibular and hearing loss groups were calculated using national population data. In total, 2,347,610 individuals were identified (general: 2,145,609, vestibular loss: 60,525, hearing loss: 141,476). Mean ages were 53.29 years, 58.26 years, and 58.52 years, respectively. Dementia occurred in 127,081 (IR = 4.91 per 1000 person-years), 7705 (IR = 10.79 per 1000 person-years), and 16,116 (IR = 9.63 per 1000 person-years) patients. The vestibular and hearing loss groups had hazard ratios for dementia of 1.084 (95% CI, 1.059-1.110) and 1.074 (95% CI, 1.056-1.092), respectively, compared with the general group. The results of the current study suggest that vestibular loss increases the risk of developing dementia. Therefore, similar to hearing loss, vestibular loss should be considered a risk factor for dementia, and treatments such as adequate vestibular rehabilitation may reduce this risk.
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Affiliation(s)
- Sung Jin Lim
- Department of Otorhinolaryngology-Head and Neck Surgery, Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea
| | - Serhim Son
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Younghan Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea
| | - Sang Yeop Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea
| | - Hangseok Choi
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea.
- Medical Science Research Center, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
| | - June Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea.
- Department of Medical Informatics, Korea University College of Medicine, Seoul, Republic of Korea.
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Kuo CL, Lee PC, Ku LJE, Sun Y, Lu TH, Isfandiari MA, Li CY. Overall and cause-specific mortality in patients with dementia: a population-based cohort study in Taiwan. Epidemiol Health 2023; 45:e2023082. [PMID: 37654162 PMCID: PMC10728617 DOI: 10.4178/epih.e2023082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/11/2023] [Indexed: 09/02/2023] Open
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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Affiliation(s)
- Chia-Lun Kuo
- Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan
- Department of Psychiatry, Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
| | - Pei-Chen Lee
- Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan
| | - Li-Jung Elizabeth Ku
- Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan
| | - Yu Sun
- Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan
- Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Tsung-Hsueh Lu
- Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan
| | - Muhammad Atoillah Isfandiari
- Division of Epidemiology, Department of Epidemiology, Biostatistics and Demography, Health Promotion and Behavioral Science Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Chung-Yi Li
- Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan
- Division of Epidemiology, Department of Epidemiology, Biostatistics and Demography, Health Promotion and Behavioral Science Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
- Department of Public Health, China Medical University College of Public Health, Taichung, Taiwan
- Department of Healthcare Administration, Asia University College of Medical and Health Science, Taichung, Taiwan
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Zhang L, Wang J, Dove A, Yang W, Qi X, Xu W. Injurious falls before, during and after dementia diagnosis: a population-based study. Age Ageing 2022; 51:6964938. [PMID: 36580561 PMCID: PMC9799250 DOI: 10.1093/ageing/afac299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND the timing of incident injurious falls at different stages of dementia diagnosis is unclear. OBJECTIVES to identify when the occurrence of injurious falls begins to increase among individuals who are going to develop dementia, to explore the time point at which people living with dementia are at highest risk of injurious falls and to ascertain differences in fall-related factors pre- and post-dementia diagnosis. DESIGN this study included 2,707 participants with incident dementia and 2,707 1:1 matched (i.e. same birth year and sex) controls without dementia. METHODS dementia diagnosis and date of onset were identified from the National Patient Registry (NPR) and the Swedish Cause of Death Register following international criteria. Information on injurious falls and history of chronic disease was obtained from the NPR. Data were analysed using conditional Poisson regression and generalized estimating equation models. RESULTS compared with controls, the incidence of injurious falls among participants with dementia started to increase beginning 4 years pre-diagnosis (incidence rate ratio [IRR] 1.70, 95% confidence interval [CI] 1.30-2.22), reaching a peak (IRR 3.73, 95% CI 3.16-4.41) in the year of dementia diagnosis. Heavy drinking, physically active and cardiometabolic diseases (CMDs) were associated with incident falls among those with dementia. CONCLUSION people with dementia have a higher incidence of injurious falls beginning 4 years leading up to diagnosis and peaking during the year of diagnosis. Older age, female, heavy drinking, physically active and CMDs may predict injurious falls among people with dementia.
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Affiliation(s)
| | | | - Abigail Dove
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Wenzhe Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Xiuying Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Weili Xu
- Address correspondence to: Weili Xu, Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Tianjin 300070, Heping, China; Aging Research Center, Department of Neurobiology, Karolinska Institutet, Tomtebodavägen 18A Floor 10, SE-171 65 Solna, Stockholm, Sweden.
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Dementia epidemiology in Hungary based on data from neurological and psychiatric specialty services. Sci Rep 2021; 11:10333. [PMID: 33990624 PMCID: PMC8121883 DOI: 10.1038/s41598-021-89179-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/19/2021] [Indexed: 11/11/2022] Open
Abstract
Hungary has a single-payer health insurance system covering 10 million inhabitants. All medical reports of the in- and outpatient specialist services were collected in the NEUROHUN database. We used ICD-10 codes of Alzheimer’s disease (AD), vascular dementia (VaD), miscellaneous dementia group and mild cognitive impairment (MCI) for the inclusion of the patients. Incidence, prevalence and survival of different dementias and MCI were calculated and analyzed depending on the diagnoses given by neurological or psychiatric services or both. Between 2011 and 2016, the mean crude incidence of all dementias was 242/100,000/year, whereas the age standardized incidence was 287/100,000/year. Crude and age standardized mean prevalence rates were 570/100,000 and 649/100,000, respectively. There were significantly more VaD diagnoses than AD, the VaD:AD ratio was 2.54:1, being the highest in patients with psychiatric diagnoses only (4.85:1) and the lowest in patients with only neurological diagnoses (1.32:1). The median survival after the first diagnosis was 3.01 years regarding all dementia cases. Compared to international estimates, the prevalence of dementia and MCI is considerably lower in Hungary and the VaD:AD ratio is reversed.
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Chang YS, Rah YC, Lee MK, Park S, Kim B, Han K, Choi J. Association between the severity of hearing loss and the risk of dementia within the 2010-2017 national insurance service survey in South Korea. Sci Rep 2020; 10:20679. [PMID: 33244106 PMCID: PMC7693323 DOI: 10.1038/s41598-020-77752-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 11/13/2020] [Indexed: 11/15/2022] Open
Abstract
Hearing loss and dementia are highly prevalent neurologic conditions in older adults that can considerably impact the quality of life and create social and familial burdens. To investigate the impact of hearing loss on the risk of developing dementia in a nationwide long-term follow-up study using data obtained from the South Korean National Health Information Database. Retrospective medical data for patients of all ages were extracted from the database between January 2010 and December 2017. According to the national disability registry, the degree of severe-profound hearing loss is classified into six grades. We categorized hearing loss into three groups based on the disability registry severity: (1) severe hearing disability (HD), defined as 1st to 3rd grade disabling hearing loss; (2) non-severe HD, 4th and 5th grade disabling hearing loss; and (3) ipsilateral HD, 6th grade disabling hearing loss. After adjusting for potential confounding variables, the hazard ratio (HR) for all dementia types was 1.336 (95% CI 1.306–1.367) in the severe HD group, 1.312 (95% CI 1.286–1.338) in the non-severe HD group, and 1.257 (95% CI 1.217–1.299) in the ipsilateral HD group. On assessing by the age group, the risk of all dementia types in patients younger than 65 years was as follows: HR 1.933 (95% CI 1.779–2.101), 1.880 (95% CI 1.732–2.041), and 1.601 (95% CI 1.435–1.787) in the severe, non-severe, and ipsilateral HD groups, respectively. This study demonstrates that the impact of hearing loss on dementia incidence is severity-dependent, and the risk increases in patients younger than 65 years of age.
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Affiliation(s)
- Young-Soo Chang
- Department of Otorhinolaryngology - Head and Neck Surgery, Korea University College of Medicine, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea
| | - Yoon Chan Rah
- Department of Otorhinolaryngology - Head and Neck Surgery, Korea University College of Medicine, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea
| | - Min Kyu Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Korea University College of Medicine, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea
| | - Seongbin Park
- Department of Otorhinolaryngology - Head and Neck Surgery, Korea University College of Medicine, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea
| | - Bongseong Kim
- Department of Statistics and Actuarial Science, Soongsil University, 369 Sangdo-Ro, Dongjak-Gu, Seoul, 06978, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, 369 Sangdo-Ro, Dongjak-Gu, Seoul, 06978, Republic of Korea.
| | - June Choi
- Department of Otorhinolaryngology - Head and Neck Surgery, Korea University College of Medicine, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea.
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