The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62922

Annette L. Fitzpatrick, PhD, Department of Epidemiology, University of Washington, Building 29, Suite 310, 6200 NE 74th Street, Seattle, WA 98115, 206-685-7123, fitzpal@u.washington.edu, Lewis H Kuller, MD, DrPH, Graduate School of Public Health, Dept. of Epidemiology, University of Pittsburgh, A526 Crabtree Hall, 130 DeSoto Street, Pittsburgh, PA 15261, Claudia H Kawas, MD, Neurology, University of California, Irvine, 1121 Gillespie NRF, Irvine, CA 92697-4540, Corinne Dulberg, PhD, Department of Biostatistics, University of Washington, Building 29, Suite 310, 6200 NE 74th Street, Seattle, WA 98115, Constantine Lyketsos, MD, MHS, The Johns Hopkins Hospital, Johns Hopkins University, Osler 320, 600 N. Wolf Street, Baltimore, MD 21287, William Jagust, MD, Department of Neurology, University of California, Davis, ACC/UCDMC, Davis, CA 95616, and Beverly N. Jones, MD, Psychiatry and Behavioral Medicine, Wake Forest University, Medical Center Boulevard, Winston-Salem, NC 27157.

Data on mortality following the onset of dementia is needed to better understand the progression and burden of this disease. In the Cardiovascular Health Cognition Study, 3,602 participants were evaluated for the presence of dementia from 1992 until 1999 over an average of 5.5 years. A total of 227 participants (6.3%) were classified with prevalent dementia at entry into the cohort, 480 (13.3%) with incident dementia during follow-up, and 577 (16.0%) with mild cognitive impairment (MCI). From baseline until June 2000, 935 (26%) of the participants died. Using logistic regression to assess the risk of mortality associated with dementia compared to those with normal cognition, the age-gender-race adjusted odds ratios were 5.0 (95% CI:3.7-6.9) for prevalent dementia , 2.1 (95% CI:1.7-2.7) for incident dementia, and 1.8 (95% CI:1.5-2.3) for MCI. Overall, 24% of the participants with cognition problems who died were classified with a cause of death of dementia or Alzheimer’s disease (42% with prevalent dementia, 30% with incident dementia, and 2% with MCI). Individuals with a cognitive disorder were more likely to die from a cerebrovascular accident (12.4%) than were those with normal cognition (7.5%) whereas non-demented persons were more likely to die from cardiovascular disease (30.8%) compared to those with dementia/MCI (26.7%, p=.03). Almost twice as many persons of normal cognition (65%) died from cancer compared to those with dementia or MCI (33.3%). These data may be useful in planning for consequences of dementia in the community.

Learning Objectives:

At the conclusion of the session, the participant in this session will be able to:
• Describe the methodology used for ascertainment of dementia and for cause of death in the Cardiovascular Health Cognition Study;
• Evaluate risk factors for dementia and mortality in this cohort;
• Assess the risk of mortality following dementia adjusted for various covariates;
• Compare different causes of death for those with dementia and mild cognitive impairment versus those with normal cognition;
• Discuss competing risks as they impact cause of death in those with and without dementia.

Keywords: Dementia, Mortality

Related Web page: chs-nhlbi.org

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am an investigator on the NIH-sponsored grant and contracts that support this research