Survival Analysis of Patients with Alzheimer's Disease: A Study Based on Data from the Korean National Health Insurance Services' Senior Cohort Database

Korean J Fam Med. 2020 Jul;41(4):214-221. doi: 10.4082/kjfm.18.0114. Epub 2020 Apr 23.

Abstract

Background: Korea's rapidly aging population has experienced a sharp rise in the prevalence of dementia. Patients with Alzheimer's disease (AD), which is estimated to be about three-quarters of all patients with dementia, tend to have higher mortality rates compared with patients without Alzheimer's disease. In this study, a survival analysis of patients with AD was conducted in order to provide knowledge to those who provide medical care to these patients.

Methods: Data on individuals over 65 years old in 2004 were extracted from the Korean National Health Insurance Services' Senior Cohort database (2002-2013). The subjects were 209,254 patients, including 2,695 who were first diagnosed with AD (the AD group) and 206,559 that had not been diagnosed with the disease (non-AD group). To investigate the independent effect of AD on survival, the Cox proportional-hazards model, hazard ratios (confidence interval of 95%), and the Kaplan-Meier method were used.

Results: Mean survival time in the AD group was 5.3±3.3 years, which was about 2.5 years shorter than that in the non-AD group (7.8±2.4 years). The mortality rate in the AD group (66.3%) was higher than that in the non-AD group (26.3%). The adjusted hazard ratio in the AD group was 2.5 and, therefore, it was found that the AD group had a 2.5-fold higher risk of death than the non-AD group.

Conclusion: Overall, AD has a large, independent impact on survival. Survival time was shorter, and the mortality rate and risk were generally higher in the AD group, compared with the non-AD group.

Keywords: Alzheimer Disease; Database; Mortality; Survival Analysis.