Christoph Mueller1, Pinar Soysal2, Arvid Rongve3, Ahmet Turan Isik4, Trevor Thompson5, Stefania Maggi6, Lee Smith7, Cristina Basso8, Robert Stewart9, Clive Ballard10, John T O'Brien11, Dag Aarsland12, Brendon Stubbs9, Nicola Veronese13. 1. King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; South London and Maudsley NHS Foundation Trust, London, UK. Electronic address: christoph.mueller@kcl.ac.uk. 2. King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey. 3. University of Bergen, Department of Clinical Medicine, Bergen, Norway; Department of Research and Innovation, Haugesund Hospital, Helse Fonna HF, Haugesund, Norway. 4. Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey. 5. Faculty of Education and Health, University of Greenwich, London, UK. 6. National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy. 7. The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK. 8. Azienda Zero, Veneto Region, Venice, Italy. 9. King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; South London and Maudsley NHS Foundation Trust, London, UK. 10. King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; University of Exeter Medical School, Exeter, UK. 11. Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK. 12. King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway. 13. National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy; Azienda Zero, Veneto Region, Venice, Italy.
Abstract
OBJECTIVE: To synthesize the evidence across longitudinal studies comparing survival in dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). METHODS: We conducted a systematic review and meta-analysis of studies comparing survival in clinically diagnosed DLB to AD. Longitudinal cohort studies were identified through a systematic search of major electronic databases from inception to May 2018. A random effects meta-analysis was performed to calculate survival time and relative risk of death. RESULTS: Overall, 11 studies were identified including 22,952 patients with dementia: 2029 with DLB (mean diagnosis age 76.3; 47% female) compared with 20,923 with AD (mean diagnosis age 77.2; 65.1% female). Average survival time in DLB from diagnosis was 4.11 years (SD ± 4.10) and in AD 5.66 (SD ± 5.32) years, equating to a 1.60 (95% CI: -2.44 to -0.77) years shorter survival in DLB (p < 0.01). Relative risk of death was increased by 1.35 (95%CI: 1.17-1.55) in DLB compared to AD (p < 0.01). Differences in survival were not explained by follow-up time, age at diagnosis, gender, or cognitive score. CONCLUSIONS: There is consistent evidence for higher and earlier mortality in DLB compared to AD. This is important for all stakeholders and underlines the importance of expanding research into DLB.
OBJECTIVE: To synthesize the evidence across longitudinal studies comparing survival in dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). METHODS: We conducted a systematic review and meta-analysis of studies comparing survival in clinically diagnosed DLB to AD. Longitudinal cohort studies were identified through a systematic search of major electronic databases from inception to May 2018. A random effects meta-analysis was performed to calculate survival time and relative risk of death. RESULTS: Overall, 11 studies were identified including 22,952 patients with dementia: 2029 with DLB (mean diagnosis age 76.3; 47% female) compared with 20,923 with AD (mean diagnosis age 77.2; 65.1% female). Average survival time in DLB from diagnosis was 4.11 years (SD ± 4.10) and in AD 5.66 (SD ± 5.32) years, equating to a 1.60 (95% CI: -2.44 to -0.77) years shorter survival in DLB (p < 0.01). Relative risk of death was increased by 1.35 (95%CI: 1.17-1.55) in DLB compared to AD (p < 0.01). Differences in survival were not explained by follow-up time, age at diagnosis, gender, or cognitive score. CONCLUSIONS: There is consistent evidence for higher and earlier mortality in DLB compared to AD. This is important for all stakeholders and underlines the importance of expanding research into DLB.
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