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Weight loss in Alzheimer's disease, vascular dementia and dementia with Lewy bodies: Impact on mortality and hospitalization by dementia subtype

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Pinar Soysal, Semen Gokce Tan, Marianna Rogowska, Sana Jawad, Lee Smith, Nicola Veronese, Dimitrios Tsiptsios, Konstantinos Tsamakis, Robert Stewart, Christoph Mueller

Original languageEnglish
JournalInternational Journal of Geriatric Psychiatry
Early online date22 Nov 2021
DOIs
Accepted/In press17 Nov 2021
E-pub ahead of print22 Nov 2021

Bibliographical note

Funding Information: Robert Stewart has received recent research funding from Roche, Janssen, GSK and Takeda. Pinar Soysal, Semen Gokce Tan, Marianna Rogowska, Sana Jawad, Lee Smith, Nicola Veronese, Dimitrios Tsiptsios, Konstantinos Tsamakis, and Christoph Mueller declare no conflict of interest. Funding Information: Christoph Mueller and Robert Stewart receive salary support from the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. Robert Stewart is additionally funded by a NIHR Senior Investigator Award, and by the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. Publisher Copyright: © 2021 John Wiley & Sons Ltd.

King's Authors

Abstract

Objectives: Loss of weight is associated with cognitive decline as well as several adverse outcomes in dementia. The aim of this study was to assess whether weight loss is associated with mortality and hospitalization in dementia subtypes.
Methods: A cohort of 11,607 patients with dementia in Alzheimer’s disease (AD), vascular dementia (VD), or dementia with Lewy bodies (DLB) was assembled from a large dementia care health records database in Southeast London. A natural language processing algorithm was developed to established whether loss of weight was recorded around the time of dementia diagnosis. Cox proportional hazard models were applied to examine the associations of reported weight loss with mortality and emergency hospitalization.
Results: Weight loss around the time of dementia was recorded in 25.5% of the whole sample and was most common in patients with DLB. A weight loss-related increased risk for mortality was detected after adjustment for confounders (Hazard ratio (HR):1.07; 95% confidence interval (CI):1.02- 1.15) and in patients with AD (HR: 1.11;95% CI:1.04-1.20), but not in DLB and VD. Weight loss was
associated with a significantly increased emergency hospitalization risk (HR: 1.14; 95% CI: 1.08-1.20) and in all three subtypes.
Conclusions: While there were associations with increased hospitalization risk for all three subtype diagnoses, weight loss was only associated with increased mortality in AD. Weight loss should be considered as an accompanying symptom in dementia and interventions should be considered to ameliorate risk of adverse outcomes.

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