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Деменции позднего возраста: смертность и сроки дожития

https://doi.org/10.30629/2618-6667-2019-17-2-54-67

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Аннотация

Цель: обобщить данные исследований о показателях смертности и сроков дожития больных деменцией позднего возраста и представить изменения в представлениях продолжительности и конце жизни больных деменцией в соответствии с результатами современных исследований.

Материал и метод: для составления обзора литературы по ключевым словам «поздний возраст», «деменция», «смертность» и «дожитие» отобраны и проанализированы статьи в базах MEDLINE/PubMed с 1990 по 2019 г., а также релевантные ссылки в списках литературы анализированных статей.

Результаты и обсуждение: по результатам анализа научных публикаций представлены различия показателей смертности и сроков дожития при деменциях позднего возраста в сравнении с их значениями в отсутствие деменции. Показаны отличия показателей смертности и сроков дожития в зависимости от нейродегенеративного и сосудистого генеза деменции. Отмечена тенденция к увеличению продолжительности заболевания при деменциях позднего возраста, прежде всего, нейродегенеративного генеза, в сравнении с прежними представлениями. Среди факторов влияния на значения показателей смертности и дожития наиболее значимыми признаются гендерные и возрастные характеристики больных деменцией, наличие множественной соматической патологии. Современные возможности диагностики деменции на более ранних этапах заболевания рассмотрены в плане изменения представлений об увеличении продолжительности заболевания. Неоднозначно оценивается эффект терапевтического вмешательства, так же как условий жизни больных деменцией и организации ухода за ними.

Заключение: представление об ожидаемой продолжительности жизни больных деменцией необходимо для индивидуальной врачебной работы с пациентами и членами их семей, а также для государственного планирования объема медицинской и социальной помощи населению старшего возраста.

Об авторе

Н. М. Михайлова
ФГБНУ «Научный центр психического здоровья»
Россия
Михайлова Наталия Михайловна, доктор медицинских наук


Список литературы

1. Kontis V, Bennett JE, Mathers CD et al. Future life expectancy in 35 industrialised countries: pro-jections with a Bayesian model ensemble. Lancet. 2017;389:1323–1335 http://dx. DOI.org/10.1016/ S0140-6736(16)3238.

2. Helmer C, Joly P, Letenneur L et al. Mortality with Dementia: Results from a French Prospective Communi-ty-based Cohort. Am. J. Epidemiol. 2001;154(7):642-648.

3. Frahm-Falkenberg S, Ibsen R, Kjellberg J, Jennum P. Health, social and economic consequences of demen-tias: a comparative national cohort study. Eur. J. Neurol. 2016;23(9):1400–1407. http:// DOI: 10.1111/ene.13043.

4. Skoog I, Nilsson L, Palmertz B et al. A Population-Based Study of Dementia in 85-Year-Olds. N.-E. J. Med. 1993;328:153–158. ht tp://DOI:10.1056/nejm199301213280301.

5. Bonaiuto S, Mele M, Galluzzo L, Giannandrea E. Survival and dementia: A 7-year follow-up of an Italian elderly population Archives of Gerontology and Geriatrics 1995;20(1):105–113.

6. Rait G, Walters K, Bottomley C et al. Survival of people with clinical diagnosis of dementia in primary care: cohort study. BMJ. 2010;341:3584. http:// DOI:10.1136/bmj.c3584.

7. Villarejo A, Benito-León J, Trincado R et al. Dementia-associated mortality at thirteen years in the NED-ICES Cohort Study. J. Alzheimers Dis. 2011;26(3):543–551. http://DOI:10.3233/JAD-2011-110443.

8. Gillum RF, Yorrick R, Obisesan ThO. Population Surveillance of Dementia Mortality Int. J. Environ. Res. Public Health. 2011;8:1244–1257. http:// DOI: 10.3390/ijerph8041244.

9. Sampson EL, Burns A, Richards M. Improving end-of-life care for people with dementia BJP. 2011;199:357–359.

10. Prince M, Acosta D, Ferr i CP et al. Dementia incidence and mortality in middle-income countries, and as-sociations with indicators of cognitive reserve: a 10/66 Dementia Research Group population-based cohort study. Lancet. 2012;380(9836):50–58. http:// DOI:10.1016/S0140–6736(12)60399–711.

11. 2013 Alzheimer's disease facts and figures. Alzheimer's & Dementia. 2013;9(2):208–245 http:// DOI:10.1016/j.jalz.2013.02.003.

12. Ilbach BJ, Hubner-Liebermann B. Severity of dementia and living conditions of patients with primary admission to a psychiatric hospital: the Regens-burg experience. Eurp. Arch. Psychiat. Clin. Neurol.1998;248(suppl. 1):8.

13. Brookmeyer RI, Corrada MM, Curriero FC, Kawas C. Survival Following a Diagnosis of Alz heimer’s Dis-ease. Arch. Neurol. 2002;59:1764–1767.

14. Knopman DS, Rocca WA, Cha RH et al. Survival study of vascular dementia in Rochester, Minnesota. Arch. Neurol. 2003;60:85–90.

15. Mitchell SL, Kiely DK, Hamel MB. Dying With Advanced Dementia in the Nursing Home. Arch. Intern. Med. 2004;164(9):321–326.

16. Mitchell SL, Teno JM, Kiely DK et al. The Clinical Course of Advanced Dementia. New England J. Medicine 2009;361(16):1529–1538.

17. Fitzpatrick AL, Kullerb LH, Lopez OL et al. Sur-vival following dementia onset: Alzheimer's dis-ease and vascular dementia. J. Neurological Sci-ences. 2005;229:43–49 http://DOI:10.1016/j.jns.2004.11.02.

18. Xie J, Brayne C, Matthews FE et al. Survival times in people with dementia: analysis from population based cohort study with 14 year follow–up. BMJ.2008;336(7638):258–262. http:// DOI: 10.1136/b.

19. Witlox J, Eurelings LSM, de Jonghe JFM et al. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. JAMA. 2010;304(4):443–451. http:// DOI: 10.1001/jama.2010.1013.

20. Houttekier D, Cohen J, Bilsen J et al. Place of Death of Older Persons with Dementia. A Study in Five European Countries. J. Am. Geriatr. Soc.2010;58:751–756. ht tp://DOI:10.1111/j.1532-5415.2010.02771.x.

21. Steenland K, Macneil J, Seals R, Levey A. Factor Affecting Survival of Patients with Neurodegene-reative Diseases. Neuroepidemioligy. 2010;35:28–35. http:// DOI:10.1159/000306055.

22. Villarejo A, Benito-León J, Trincado R et al. Dementia-associated mortality at thirteen years in the NED-ICES Cohort Study. J. Alzheimers Dis. 2011;26(3):543–551. http:// DOI: 10.3233/JAD-2011-110443.

23. Zekry D, Herrmann FR, Graf CE et al. Mild cognitive impairment, degenerative and vascular dementia – hospital, short- and long-term mortality in the oldest old. Aging. Clin. Exp. Res. 2011;23(1):60–66.

24. Connors MH, Ames D, Boundy K et al. Predictors of Mortality in Dementia: The PRIME Study. Journal of Alzheimer's Disease. 2016;52(3):967–974. http:// DOI:10.3233/jad-150946.

25. Ku Li-Jung E, Li Chung-Yi, Sun Yu. Can Persistence With Cholinesterase Inhibitor Treatment Lower Mor-tality and Health-Care Costs Among Patients With Alzheimer’s Disease? A Population-Based Study in Taiwan. American Journal of Alzheimer's Disease & Other Dementiasr. 2018;33(2):86–92. http:// DOI:10.1177/1533317517734639.

26. de Miguel-Yanes JM, Jiménez-García R, Hernán-dez-Barrera V et al. Hospital Admissions in People With Alzheimer’s Disease or Senile Dementia Accord-ing to Type 2 Diabetes Status: An Observational 10-Year Study. American Journal of Alzheimer's Disease & Other Dementiasr. 2018;33(1):12–19. https://DOI.org/10.1177/1533317517726389.

27. Schiltz NK, Warner DF, Sun J et al. The Influence of Multimorbidity on Leading Causes of Death in Older Adults With Cognitive Impairment. Journal of Aging and Health. 2018;1:898264317751946. https:// DOI.org/10.1177/0898264317751946.

28. Buckley RF, Waller M, Masters CL, Dobson A. To What Extent Does Age at Death Account for Sex Differences in Alzheimer's Disease Mortality Rates? Am. J. Epide-miol. 2019;Mar 2. pii: kwz048. https:// DOI:10.1093/aje/kwz048.

29. Максимова НЕ. Клинико-катамнестическое обследование диспансерной «когорты» психически больных позднего возраста. Журнал неврологии и психиатрии им. С.С. Корсакова. 2001;101(4):53–54.

30. Ватолина МА, Самородская ИВ, Бойцов СА. Смертность и потерянные годы жизни в результате болезни Альцгеймера в России. Психиатрия.2014;61(1):47–51.

31. Heyman A, Fillenbaum GG, Welsh-Bohmer KA et al. Cerebral infarcts in patients with autopsy-proven Alzheimer’s disease. Neurology. 1998;51(1):159–162.

32. Molsa PK, Marttilla J, Rinne UK. Long-Term Survival and Predictors of Mortality In Alzheimer’s Disease and Multiinfarct Dementia. Acta Neurol. Scand. 1995;91(3):159–164.

33. Kay DWK, Forster DP, Newens AJ. Long-term survival, place of death, and death certification in clinically diagnosed pre-senile dementia in northern England: Follow-up after 8–12 years. BJP. 2000;177:156–162.

34. Мищенко ТС, Дмитриева ЕВ. Сосудистая деменция: диагностика, лечение и профилактика. Международный неврологический журнал. 2006;2(6).

35. Modrego PJ, Lobo A. Determinants of Progression and Mortality in Alzheimer’s disease: A Systematic Re-vie. Neuropsychiatry (London). 2018;8(5):1465–1475. https:// DOI: 0.4172/Neuropsychiatry.1000479.

36. Sampson EL, Leurent B, Blanchard MR et al. Survival of people with dementia after unplanned acute hospital admission: a prospective cohort study. Int. J. Geriatr. Psychiatry. 2013;28:1015–1022. https:// DOI:DOI:10.1002/gps.3919.

37. van de Vorst IE, Koek HL, de Vries R et al. Effect of vascular risk factors and diseases on mortality in individuals with dementia: Systematic Review and Meta-Analysis. J. Am. Geriatr. Soc. 2016;64(1):37–46. DOI: 10.1111/jgs.13835.

38. Fu C, Chute DJ, Farag ES et al. Comorbidi-ty in Dementia An Autopsy Study. Arch. Pathol. Lab. Med. 2004;128:32–38. https://DOI:DOI: 10.1043/1543-2165(2004)128<32:cid>2.0.co;2.

39. Staekenborg SS, Pijnenburg YA, Lemstra AW et al. Dementia and Rapid Mortality: Who is at Risk? J. Alzheimers Dis. 2016;53(1):135–142. DOI: 10.3233/JAD-151063.

40. Attems J, Konig C, Huber M et al. Cause of death in demented and non-demented elderly patients: an autopsy study of 308 cases. J. Alzheimer’s Disease.2005;8(1):57–62.

41. Avelino-Silva TJ, Campora F, Curiati JAE, Jacob-Fil-ho W. Association between delirium superimposed on dementia and mortality in hospitalized old-er adults: A prospective cohort study. PLoS Med.2017;14(3):e1002264. https://DOI.org/10.1371/jour-nal.pmed.1002264.

42. Savva G.M., Wharton S.B., Ince P.G. et al. Age, neuropathology and dementia. New England Journal of Medicine. 2009;360(22):2302–2309. https://DOI: 10.1056/NEJMoa0806142.

43. Ferrah N, Elias IJ, Kipsaina Ch, Bugeja L. Death Following Recent Admission Into Nursing Home From Community Living: A Systematic Review Into the Transition Process. Journal of Aging and Health. 2017;30(4):584–604. https://DOI.org/10.1177/0898264316686575.

44. Schafer MH, Upenieks L, MacNei AI. Disorderly Households, Self-Presentation, and Mortality: Ev-idence From a National Study of Older Adults. Re-search on Aging. 2018;40(8):762–790. https://DOI: 10.1177/0164027517741347.

45. Furumiya J, Hashimoto Y. A Descriptive Study of Elderly Patients With Dementia Who Died Wandering Outdoors in Kochi Prefecture, Japan. Am. J. Alzhei-mers Dis. Other Demen. 2015;30(3):307–312. https:// DOI:10.1177/1533317514545826.

46. Kales HC, Kim HM, Zivin K et al. Risk of Mortality Among Individual Antipsychotics in Patients With Dementia. Am. J. Psychiatry. 2012;169:71–79. https://DOI:10.1176/appi.ajp.2011.11030347.

47. Enache D, Fereshtehnejad SM, Kåreholt I et al. Antidepressants and mortality risk in a dementia cohort: data from SveDem, the Swedish Dementia Registry. Acta Psychiatr. Scand. 2016;134(5):430–440. https://DOI:10.1111/acps.12630.

48. Musicco M, Palmer K, Russo A et al. Association between prescription of conventional or atypical antipsychotic drugs and mortality in older persons with Alzheimer's disease. Dement. Geriatr. Cogn. Disord. 2011;31:218–224. DOI:10.1159/000326213.

49. Walker Z, Allen RL, Shergill S et al. Three years survival in patients with a clinical diagnosis of de-mentia with Lewy Bodies. Int. J. Geriatr. Psyciatry.2000;15:267–273. PMID:10713586.

50. Zanetti O, Solerte SB, Cantoni F. Life expectancy in Alzheimer's disease (AD). Arch. Gerontol. Geriatr. 2009;49(Suppl 1):237–243. https://DOI:10.1016/j.archger.2009.09.035.

51. Todd S, Barr S, Roberts M, Passmore PA. Survival in dementia and predictors of mortality: a review. Int. J. Geriatr. Psychiatry. 2013;28(11):1109–1124. https://DOI:10.1002/gps.3946.

52. Budson AE, Solomon PR. Memory Loss, Alzheimer’s Disease, and Dementia Elsevier Edinbourg, London, New York, Oxford, Philadelphia, St. Louis, Sydney, Toronto; 2016:258.

53. Orrell M, Butler R, Bebbington P. Social factors and the outcome of dementia. Int. J. Geriatr. Psychiatry. 2000;15:853–862. PMID:10861917.

54. Barclay LL, Zemcov A, Blass JP, Sansone J. Survival in Alzheimer’s disease and vascular dementia. Neurolo-gy.1985;35(6):834–840. PMID: 4000483.

55. Hazama S, Tagami S. The survival rate of patients with dementia and its predictors — difference in gender and type of dementia. Europ. Arch. Psychiat. Clin. Neurol. 1998.

56. Larson EB, Shadlen MF, Wang L et al. Survival after Initial Diagnosis of Alzheimer’s Disease. Ann. Intern. Med. 2004;140:573–574.

57. Waring SC, Doody RS, Pavlik VN et al. Survi val among patients with dementia from a large multi-eth-nic population. Alzheimer Dis. Assoc. Disord.2005;19(4):178–183. PMID:16327343.

58. Melkas S, Oksala NKJ, Jokinen H et al. Poststroke dementia predicting survival in longterm follow-up: Influence of prestrike cognitive decline and previous stroke. J. Neurology Neurosurgery Psychiatry. 2009;80(8):865–870. https://DOI:10.1136/jnnp.2008.166603.

59. Doody RS, Pavlik V, Massman P et al. Predicting progression of Alzheimer’s disease. Alzheimers Res. Ther. 2010;2(3):14. https://DOI:10.1186/alz-rt38.3.

60. Rountree SD, Chan W, Pavlik VN et al. Factors that influence survival in Alzheimer’s patients. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Associa-tion. 2011;7(4, Suppl.):S513.

61. Rountree SD, Chan W, Pavlik VN et al. Factors that influence survival in Alzheimer’s patients. Alzheimers Res. Ther. 2012;4(3):16–19. https://DOI:10.1186/alz-rt119.

62. Valenzuela MI, Brayne C, Sachdev P et al. Cognitive Lifestyle and Long-Term Risk of Dementia and Surviv-al After Diagnosis in a Multicenter Population-based Cohort. Am. J. Epidemiol. 2011;173(9):1004–1012. https://DOI:10.1093/aje/kwq476.

63. Rizzuto D, Bellocco R, Kivipelto M et al. Dementia after age 75: survival in different severity stages and years of life lost. Curr. Alzheimer Res. 2012;9(7):795–800. PMID: 22299618.

64. Roehr S, Luck T, Bickel H et al. Mortality in inci-dent dementia — results from the German Study on Aging, Cognition, and Dementia in Primary Care Patients. Collaborators (40). Acta Psychiatr. Scand. 2015;132(4):257–269. https://DOI:10.1111/acps.12454.

65. Mayeda ER, Glymour MM, Quesenberry CP et al. Survival after dementia diagnosis in five racial/ethnic groups. Alzheimer’s Dement. 2017;13(7):761–769. https:// DOI:10.1016/j.jalz.2016.12.008.

66. Livingston G, Sommerlad A, Orgeta V et al. Demen-tia prevention, intervention, and care. The Lan-cet. 2017;390(10113):2673–2734. http://dx.DOI.org/10.1016/S0140-6736(17)31363-6.

67. Lee K-C, Hsu W-H, Chou P-H et al. Estimating the survival of elderly patients diagnosed with de-mentia in Taiwan: A longitudinal study. PLoS ONE.2018;13(7):e0178997. https://DOI.org/10.1371/jour-nal.pone.0178997.

68. Doody RS, Dunn JK, Huang E et al. A method for estimating duration of illness in Alzheimer’s disease. Dement. Geriatr. Cogn. Disord. 2004;17(1–2):1–4. https://DOI:10.1159/000074078.

69. Bruandet A, Richard F, Bombois S et al. Alzheimer disease with cerebrovascular disease and vascular dementia: clinical features and course compared with Alzheimer disease. J. Neurol. Neurosurg. Psychiatry. 2009;80(2):133–139. https://DOI:10.1136/jnnp.2007.137851.

70. Bhargava D, Weiner MF. Vascular Disease and Risk Factors, Rate of Progression, and Survival in AD. J. Geriatr. Psychiatry Neurol. 2006;19(2):78–82. https:// DOI:10.1177/0891988706286505.

71. Bullock R. Drug Treatment for Early Alzheimer’s dis-ease. Adv. Psychiatr. Treat. 1998;4:126–134. https:// DOI:10.1192/apt. 4.3.126.

72. Salib E, Thompson J. Use of anti-dementia drugs and delayed care home placement: an observational study. The Psychiatrist. 2011;35:384–388. https:// DOI:10.1192/pb.bp.110.033431.

73. Howard R, McShane R, Lindesay J et al. Nursing home placement in the Donepezil and Memantine in Mod-erate to Severe Alzheimer's Disease (DOMINO–AD) trial: secondary and post-hoc analyses. The Lancet Neurology. 2015;14(12):1171–1181. http://dx. DOI.org/10.1016/S1474-4422(15)00258-6.

74. O’Loughlin Ch, Darley J. Has the referral of older adults with dementia changed since the availability of acetylcholinesterase inhibitors and the NICE guidelines? Psychiatric Bulletin. 2006;30,131–134. http:// DOI:10.1192/pb.30.9.354-a.

75. Rountree SD, Atrib A, Lopez OL, Doody RS. Effectiveness of antidementia drugs in delaying Alzheimer’s disease progression. Alzheimer’s & Dementia. 2013;9(3):338–345. DOI:10.1016/j.jalz.2012.01.002.

76. Lazzeroni LC, Halbauer JD, Ashford JW et al. Memantine is Associated with Longer Survival than Donepezil in a Veterans Affairs Prescription Data-base, 1997 to 2008. JAD. 2013;36(4):791–798. http:// DOI:10.3233/JAD-130662.

77. Brodaty H, Seeher K, Gibson L. Dementia time to death: a systematic literature review on survival time and years of life lost in people with dementia. Int. Psychogeriatr. 2012;24(7):1034–1045. http:// DOI:10.1017/S1041610211002924.

78. Pavlik VN, Doody RS, Rountree SD, Darby E. Vitamin E Use Is Associated with Improved Survival in an Alz-heimer’s Disease Cohort. Dement Geriatr. Cogn. Disord.2009;28:536–540. http:// DOI:10.1159/000255105.

79. Ligthart SA, Moll van Charante EP, Van Gool WA, Richard E. Treatment of cardiovascular risk factors to prevent cognitive decline and dementia: a systematic review. Vascular Health and Risk Management.2010;6:775–785. PMCID:PMC2941788;

80. Richard F, Pasquier F Can the Treatment of Vascular Risk Factors Slow Cognitive Decline in Alzheimer’s Disease Patients? Journal of Alzheimer’s Disease.2012;32(3):765–772. http:// DOI:10.3233/JAD-2012-121012.

81. Green C, Shearer J, Ritchie CW, Zajicek JP. Model-based economic evaluation in Alzheimer's disease: a review of the methods available to model Alzheimer's dis-ease progression. Value Health. 2011;14(5):621–630. http:// DOI:10.1016/j.jval.2010.12.008.

82. Ku LE, Li CY, Sun Y. Can Persistence With Cholin-esterase Inhibitor Treatment Lower Mortality and Health-Care Costs Among Patients With Alzheimer’s Disease? A Population-Based Study in Taiwan. Am. J. Alzheimers Dis. Other Demen. 2018;33(2):86–92. http:// DOI:10.1177/1533317517734639;

83. Wattmo CI, Londos E, Minthon L. Longitudinal Asso-ciations between Survival in Alzheimer's Disease and Cholinesterase Inhibitor Use, Progression, and Community-Based Services. Dement Geriatr. Cogn. Disord. 2015;40(5–6):297–310. DOI: 10.1159/000437050.


Для цитирования:


Михайлова Н.М. Деменции позднего возраста: смертность и сроки дожития. Психиатрия. 2019;17(2):54-67. https://doi.org/10.30629/2618-6667-2019-17-2-54-67

For citation:


Mikhaylova N.M. Dementia of Old Age: Mortality and Survival. Psychiatry. 2019;17(2):54-67. (In Russ.) https://doi.org/10.30629/2618-6667-2019-17-2-54-67

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