Quantitative comorbidity risk assessment of dementia in Taiwan: A population-based cohort study

Medicine (Baltimore). 2018 Apr;97(15):e0298. doi: 10.1097/MD.0000000000010298.

Abstract

Dementia is one of the most burdensome illnesses in elderly populations worldwide. However, the literature about multiple risk factors for dementia is scant.To develop a simple, rapid, and appropriate predictive tool for the clinical quantitative assessment of multiple risk factors for dementia.A population-based cohort study.Based on the Taiwan National Health Insurance Research Database, participants first diagnosed with dementia from 2000 to 2009 and aged ≥65 years in 2000 were included.A logistic regression model with Bayesian supervised learning inference was implemented to evaluate the quantitative effects of 1- to 6-comorbidity risk factors for dementia in the elderly Taiwanese population: depression, vascular disease, severe head injury, hearing loss, diabetes mellitus (DM), and senile cataract, identified from a nationwide longitudinal population-based database.This study enrolled 4749 (9.5%) patients first diagnosed as having dementia. Aged, female, urban residence, and low income were found as independent sociodemographic risk factors for dementia. Among all odds ratios (ORs) of 2-comorbidity risk factors for dementia, comorbid depression and vascular disease had the highest adjusted OR of 6.726. The 5-comorbidity risk factors, namely depression, vascular disease, severe head injury, hearing loss, and DM, exhibited the highest OR of 8.767. Overall, the quantitative effects of 2 to 6 comorbidities and age difference on dementia gradually increased; hence, their ORs were less than additive. These results indicate that depression is a key comorbidity risk factor for dementia.The present findings suggest that physicians should pay more attention to the role of depression in dementia development. Depression is a key cormorbidity risk factor for dementia. It is the urgency of evaluating the nature of the link between depression and dementia; and further testing what extent controlling depression could effectively lead to the prevention of dementia.

MeSH terms

  • Age Factors
  • Aged
  • Cataract / epidemiology*
  • Cohort Studies
  • Comorbidity
  • Craniocerebral Trauma / epidemiology*
  • Dementia* / diagnosis
  • Dementia* / epidemiology
  • Dementia* / prevention & control
  • Demography
  • Depression / epidemiology*
  • Diabetes Mellitus / epidemiology*
  • Female
  • Humans
  • Male
  • Risk Assessment / methods
  • Risk Factors
  • Sex Factors
  • Socioeconomic Factors
  • Taiwan / epidemiology
  • Vascular Diseases / epidemiology*