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O1.10: Poor prognosis in patients with dementia: results from a nationwide registry linkage study
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Oral presentations / European Geriatric Medicine 5S1 (2014) S45–S81
Conclusion: Our results showed a relationship between 25(OH)D and cognitive impairment in patients with AD, suggesting that 25(OH)D could be involved in the onset of dementia. Obviously, a relationship between low 25(OH)D status and cognitive impairment does not mean that 25(OH)D inadequacy causes cognitive deterioration. Additional investigation of this clinical observation, particularly with intervention studies, is clearly required for the possible development of new effective therapeutic strategies.
patients gained on average 1.7 kg in body weight, irrespective of the severity of their MTA at baseline (Figure 1). Conclusion: We found no evidence that MTA contributes to weight loss in AD patients. Moreover, contrary to what was expected, AD patients did not lose but gained weight during follow up.
O1.09 The relation of weight change trajectory with medial temporal lobe atrophy in patients with mild Alzheimer’s disease: results from a cohort study
I.E. van de Vorst, C.H. Vaartjes, M.L. Bots, H.L. Koek UMC Utrecht, The Netherlands
E. Droogsma1 , Z.B. van Asselt1 , H. Bieze1 , N. Veeger1 , P.P. de Deyn2 1 Medical Center Leeuwarden, The Netherlands; 2 University Medical Center Groningen, Groningen, The Netherlands Introduction: Weight loss is common in patients with Alzheimer’s disease (AD) and associated with negative health outcomes. Various mechanisms for weight loss in AD patients have been proposed, though, none has been proven. This study aimed to elucidate a mechanism of weight loss in AD patients by examining the hypothesis that weight loss is a consequence of medial temporal lobe atrophy (MTA). Methods: Patients from the Frisian Alzheimer’s Disease Cohort Study (a retrospective, longitudinal study of 576 communitydwelling AD patients) were included when a brain MRI was performed on which MTA could be assessed. To examine our hypothesis, we investigated whether the trajectory of body weight change depends on the severity of MTA at the time of diagnosis (i.e. baseline), using the Generalized Linear Mixed Model.
O1.10 Poor prognosis in patients with dementia: results from a nationwide registry linkage study
Introduction: Dementia is a severe disease with often a poor prognosis. However age and sex specific mortality risks are currently lacking. We calculated mortality risks of dementia and the two most common subtypes (Alzheimer’s Disease [AD] and Vascular Dementia [VaD]) in a large nationwide cohort. Methods: A cohort of patients with dementia (n = 61,055, mean age 80.6±8.6 years and 60.8% females) was identified through linkage of national registries. 1-year and 5-year age and gender specific mortality risks were quantified for dementia, AD and VaD. 1-year mortality risk was compared to the mortality risk of the general population. Cox regression models were used to assess sex differences. We adjusted for age and comorbidity. Mortality risks were presented as absolute risks and Hazard Ratio’s (HR) with 95% Confidence Intervals (CI). Results: 1-year mortality risk was 30.2% in women with dementia compared to 7.8% in the general population. For men this was 37.4% and 7.8% respectively. 5-year mortality was 57.8% for women versus 63.9% for men. The risk increased with age. Adjusted mortality risk was significantly higher in men than in women (1-year HR 1.50; 95% CI 1.46–1.55, 5-year HR 1.37; 95% CI 1.37–1.43). Similar findings were found for AD and VaD. Conclusion: Mortality risks among patients with dementia are higher compared to the general population. Mortality risks increase with age and are significantly higher in men than in women.
Genetics O1.11 Prothrombotic mutations and family history as risk factors for venous thrombosis in the elderly Figure 1. Trajectory of weight: left MTA; no or mild versus moderate, severe or very severe.
Figure 2. Trajectory of weight: right MTA; no or mild versus moderate, severe or very severe.
Results: 214 Patients (median age 79 years, median MMSE 23, mean weight 73.9 kg) were included. Patients with moderate, severe or very severe MTA at baseline weighed 3.2 to 6.8 kg more than patients with no or mild MTA (Figures 1 and 2). During 3.5 years,
A. Karasu1 , M.J. Engbers1 , M. Cushman2 , F.R. Rosendaal1 , A. van Hylckama Vlieg1 1 Leiden University Medical Center, The Netherlands; 2 Departments of Medicine and Pathology, Burlington, USA Introduction: Diseases with genetic risk factors often manifest themselves at a younger age. We aimed to assess the association between a positive family history of VT and common genetic risk factors, i.e. the factor V Leiden (FVL) and prothrombin20210A mutation (PT), and the risk of a first VT at an older age (>70 years). Methods: 401 consecutive cases with a first-time thrombosis and 431 controls were included in the AT-AGE case-control study. All subjects were ≥70 years. Information on risk factors for VT, including family history, was obtained from questionnaires. Unprovoked VT was defined as thrombosis not related to surgery, fracture, plaster cast, minor injuries or immobility within three months prior to VT. FVL and PT were determined in 394 patients and 426 controls. VT risk was assessed by calculating odds ratios (OR) with 95% confidence intervals (95% CI) after adjustment for age, sex, and study centre. Results: The risk of VT was 2.1-fold increased in FVL carriers (95% CI: 1.2–3.9, Table 1). This risk was 1.4-fold increased in PT mutation carriers (95% CI: 0.5–3.8). A positive family history was associated with a 2.1-fold increased risk of VT (95% CI: 1.5–3.1).
Oral presentations / European Geriatric Medicine 5S1 (2014) S45–S81
Conclusion: Our results showed a relationship between 25(OH)D and cognitive impairment in patients with AD, suggesting that 25(OH)D could be involved in the onset of dementia. Obviously, a relationship between low 25(OH)D status and cognitive impairment does not mean that 25(OH)D inadequacy causes cognitive deterioration. Additional investigation of this clinical observation, particularly with intervention studies, is clearly required for the possible development of new effective therapeutic strategies.
patients gained on average 1.7 kg in body weight, irrespective of the severity of their MTA at baseline (Figure 1). Conclusion: We found no evidence that MTA contributes to weight loss in AD patients. Moreover, contrary to what was expected, AD patients did not lose but gained weight during follow up.
O1.09 The relation of weight change trajectory with medial temporal lobe atrophy in patients with mild Alzheimer’s disease: results from a cohort study
I.E. van de Vorst, C.H. Vaartjes, M.L. Bots, H.L. Koek UMC Utrecht, The Netherlands
E. Droogsma1 , Z.B. van Asselt1 , H. Bieze1 , N. Veeger1 , P.P. de Deyn2 1 Medical Center Leeuwarden, The Netherlands; 2 University Medical Center Groningen, Groningen, The Netherlands Introduction: Weight loss is common in patients with Alzheimer’s disease (AD) and associated with negative health outcomes. Various mechanisms for weight loss in AD patients have been proposed, though, none has been proven. This study aimed to elucidate a mechanism of weight loss in AD patients by examining the hypothesis that weight loss is a consequence of medial temporal lobe atrophy (MTA). Methods: Patients from the Frisian Alzheimer’s Disease Cohort Study (a retrospective, longitudinal study of 576 communitydwelling AD patients) were included when a brain MRI was performed on which MTA could be assessed. To examine our hypothesis, we investigated whether the trajectory of body weight change depends on the severity of MTA at the time of diagnosis (i.e. baseline), using the Generalized Linear Mixed Model.
O1.10 Poor prognosis in patients with dementia: results from a nationwide registry linkage study
Introduction: Dementia is a severe disease with often a poor prognosis. However age and sex specific mortality risks are currently lacking. We calculated mortality risks of dementia and the two most common subtypes (Alzheimer’s Disease [AD] and Vascular Dementia [VaD]) in a large nationwide cohort. Methods: A cohort of patients with dementia (n = 61,055, mean age 80.6±8.6 years and 60.8% females) was identified through linkage of national registries. 1-year and 5-year age and gender specific mortality risks were quantified for dementia, AD and VaD. 1-year mortality risk was compared to the mortality risk of the general population. Cox regression models were used to assess sex differences. We adjusted for age and comorbidity. Mortality risks were presented as absolute risks and Hazard Ratio’s (HR) with 95% Confidence Intervals (CI). Results: 1-year mortality risk was 30.2% in women with dementia compared to 7.8% in the general population. For men this was 37.4% and 7.8% respectively. 5-year mortality was 57.8% for women versus 63.9% for men. The risk increased with age. Adjusted mortality risk was significantly higher in men than in women (1-year HR 1.50; 95% CI 1.46–1.55, 5-year HR 1.37; 95% CI 1.37–1.43). Similar findings were found for AD and VaD. Conclusion: Mortality risks among patients with dementia are higher compared to the general population. Mortality risks increase with age and are significantly higher in men than in women.
Genetics O1.11 Prothrombotic mutations and family history as risk factors for venous thrombosis in the elderly Figure 1. Trajectory of weight: left MTA; no or mild versus moderate, severe or very severe.
Figure 2. Trajectory of weight: right MTA; no or mild versus moderate, severe or very severe.
Results: 214 Patients (median age 79 years, median MMSE 23, mean weight 73.9 kg) were included. Patients with moderate, severe or very severe MTA at baseline weighed 3.2 to 6.8 kg more than patients with no or mild MTA (Figures 1 and 2). During 3.5 years,
A. Karasu1 , M.J. Engbers1 , M. Cushman2 , F.R. Rosendaal1 , A. van Hylckama Vlieg1 1 Leiden University Medical Center, The Netherlands; 2 Departments of Medicine and Pathology, Burlington, USA Introduction: Diseases with genetic risk factors often manifest themselves at a younger age. We aimed to assess the association between a positive family history of VT and common genetic risk factors, i.e. the factor V Leiden (FVL) and prothrombin20210A mutation (PT), and the risk of a first VT at an older age (>70 years). Methods: 401 consecutive cases with a first-time thrombosis and 431 controls were included in the AT-AGE case-control study. All subjects were ≥70 years. Information on risk factors for VT, including family history, was obtained from questionnaires. Unprovoked VT was defined as thrombosis not related to surgery, fracture, plaster cast, minor injuries or immobility within three months prior to VT. FVL and PT were determined in 394 patients and 426 controls. VT risk was assessed by calculating odds ratios (OR) with 95% confidence intervals (95% CI) after adjustment for age, sex, and study centre. Results: The risk of VT was 2.1-fold increased in FVL carriers (95% CI: 1.2–3.9, Table 1). This risk was 1.4-fold increased in PT mutation carriers (95% CI: 0.5–3.8). A positive family history was associated with a 2.1-fold increased risk of VT (95% CI: 1.5–3.1).