Multimorbidity Pattern and Risk for Mortality Among Patients With Dementia: A Nationwide Cohort Study Using Latent Class Analysis

• 발행기관: 대한신경정신의학회
• 저자명: Che-Sheng Chu 외 8명
• 간행물 정보: 『Psychiatry Investigation』제20권 제9호, 861~869쪽, 전체 9쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2023.09.30

영문 초록

Objective Individuals with dementia are at a substantially elevated risk for mortality; however, few studies have examined multimor-bidity patterns and determined the inter-relationship between these comorbidities in predicting mortality risk. Methods This is a prospective cohort study. Data from 6,556 patients who were diagnosed with dementia between 1997 and 2012 us-ing the Taiwan National Health Insurance Research Database were analyzed. Latent class analysis was performed using 16 common chronic conditions to identify mortality risk among potentially different latent classes. Logistic regression was performed to determine the adjusted association of the determined latent classes with the 5-year mortality rate. Results With adjustment for age, a three-class model was identified, with 42.7% of participants classified as “low comorbidity class (clus-ter 1)”, 44.2% as “cardiometabolic multimorbidity class (cluster 2)”, and 13.1% as “FRINGED class (cluster 3, characterized by FRacture, Infection, NasoGastric feeding, and bleEDing over upper gastrointestinal tract).” The incidence of 5-year mortality was 17.6% in cluster 1, 26.7% in cluster 2, and 59.6% in cluster 3. Compared with cluster 1, the odds ratio for mortality was 9.828 (95% confidence interval [CI]=6.708–14.401; p<0.001) in cluster 2 and 1.582 (95% CI=1.281–1.953; p<0.001) in cluster 3. Conclusion Among patients with dementia, the risk for 5-year mortality was highest in the subpopulation characterized by fracture, urinary and pulmonary infection, upper gastrointestinal bleeding, and nasogastric intubation, rather than cancer or cardiometabolic co-morbidities. These findings may improve decision-making and advance care planning for patients with dementia.

목차

INTRODUCTION

METHODS

RESULTS

DISCUSSION

키워드

Dementia Latent class analysis Mortality Multimorbidity