BACKGROUND: The influence of dementia on mortality has not yet been reported for a Latin American country. OBJECTIVES: To evaluate the influence of dementia on mortality of a community-dwelling elderly population in Brazil, and to verify the extent to which the diagnosis of dementia is reported on death certificates. METHODS: A cohort of 1,656 individuals, aged 65 and over, was screened for dementia at their domiciles, in 1997. The same population was re-evaluated in 2000, and information on deaths was obtained from relatives and from the municipal obituary service. Kaplan-Meier curves were used for the survival analysis, and the mortality risk ratio (MMR) was calculated using Cox proportional hazards models. RESULTS: We obtained data from 1,393 subjects, corresponding to 84.1% of the target population. The number of deaths was 58 (51.3%) among the patients with dementia and 163 (12.7%) among those without dementia in 1997 (p <0.0001). Dementia and Alzheimer's disease (AD) decreased survival, with hazards ratios of 5.16 [95% Confidence Interval (CI): 3.74-7.12] for dementia and 4.76 (95% CI: 3.16-7.18) for AD. The Cox proportional hazards model identified dementia (MMR=3.92, 95% CI: 2.80-5.48) as the most significant predictor of death, followed by age, history of stroke, complaints of visual impairment and heart failure and by severe arterial hypertension in the baseline evaluation. Dementia and/or AD were mentioned in only 12.5% of the death certificates of individuals with dementia. CONCLUSIONS: Dementia causes a significant decrease in survival, and the diagnosis of dementia is rarely reported on death certificates in Brazil.
BACKGROUND: The influence of dementia on mortality has not yet been reported for a Latin American country. OBJECTIVES: To evaluate the influence of dementia on mortality of a community-dwelling elderly population in Brazil, and to verify the extent to which the diagnosis of dementia is reported on death certificates. METHODS: A cohort of 1,656 individuals, aged 65 and over, was screened for dementia at their domiciles, in 1997. The same population was re-evaluated in 2000, and information on deaths was obtained from relatives and from the municipal obituary service. Kaplan-Meier curves were used for the survival analysis, and the mortality risk ratio (MMR) was calculated using Cox proportional hazards models. RESULTS: We obtained data from 1,393 subjects, corresponding to 84.1% of the target population. The number of deaths was 58 (51.3%) among the patients with dementia and 163 (12.7%) among those without dementia in 1997 (p <0.0001). Dementia and Alzheimer's disease (AD) decreased survival, with hazards ratios of 5.16 [95% Confidence Interval (CI): 3.74-7.12] for dementia and 4.76 (95% CI: 3.16-7.18) for AD. The Cox proportional hazards model identified dementia (MMR=3.92, 95% CI: 2.80-5.48) as the most significant predictor of death, followed by age, history of stroke, complaints of visual impairment and heart failure and by severe arterial hypertension in the baseline evaluation. Dementia and/or AD were mentioned in only 12.5% of the death certificates of individuals with dementia. CONCLUSIONS:Dementia causes a significant decrease in survival, and the diagnosis of dementia is rarely reported on death certificates in Brazil.
Authors: Ricardo Nitrini; Cássio M C Bottino; Cecilia Albala; Nilton Santos Custodio Capuñay; Carlos Ketzoian; Juan J Llibre Rodriguez; Gladys E Maestre; Ana Teresa A Ramos-Cerqueira; Paulo Caramelli Journal: Int Psychogeriatr Date: 2009-06-09 Impact factor: 3.878
Authors: Raj N Kalaria; Gladys E Maestre; Raul Arizaga; Robert P Friedland; Doug Galasko; Kathleen Hall; José A Luchsinger; Adesola Ogunniyi; Elaine K Perry; Felix Potocnik; Martin Prince; Robert Stewart; Anders Wimo; Zhen-Xin Zhang; Piero Antuono Journal: Lancet Neurol Date: 2008-07-28 Impact factor: 44.182
Authors: Martin Prince; Daisy Acosta; Cleusa P Ferri; Mariella Guerra; Yueqin Huang; Juan J Llibre Rodriguez; Aquiles Salas; Ana Luisa Sosa; Joseph D Williams; Michael E Dewey; Isaac Acosta; Amuthavalli T Jotheeswaran; Zhaorui Liu Journal: Lancet Date: 2012-05-23 Impact factor: 79.321
Authors: Cleusa P Ferri; Daisy Acosta; Mariella Guerra; Yueqin Huang; Juan J Llibre-Rodriguez; Aquiles Salas; Ana Luisa Sosa; Joseph D Williams; Ciro Gaona; Zhaorui Liu; Lisseth Noriega-Fernandez; A T Jotheeswaran; Martin J Prince Journal: PLoS Med Date: 2012-02-28 Impact factor: 11.069
Authors: Juan J Llibre Rodriguez; Cleusa P Ferri; Daisy Acosta; Mariella Guerra; Yueqin Huang; K S Jacob; E S Krishnamoorthy; Aquiles Salas; Ana Luisa Sosa; Isaac Acosta; Michael E Dewey; Ciro Gaona; A T Jotheeswaran; Shuran Li; Diana Rodriguez; Guillermina Rodriguez; P Senthil Kumar; Adolfo Valhuerdi; Martin Prince Journal: Lancet Date: 2008-07-25 Impact factor: 79.321