O1‐11‐05: Mortality in Dementia: Data From Svedem, Swedish Dementia Registry

A number of factors might influence mortality after a dementia diagnosis and identifying them is important to patient care. Since different factors might have different effects on men and women, stratifying analyses by sex provides valuable information. Patients diagnosed with dementia in specialist memory clinics were identified from the Swedish Dementia Registry-SveDem. 15209 patients with complete information on age, sex, MMSE, dementia diagnosis, place of residence, coresident and medication were identified. Among them, 11398 had complete data on BMI. Hazard ratios (HR) and 95% confidence intervals (CI) for mortality were calculated according to the abovementioned factors, stratifying by sex. For both sexes, Alzheimer's dementia (AD) was the dementia type associated with lowest mortality. For both sexes, mixed dementia presented a HR that was intermediate between AD and vascular dementia, with a HR for mixed dementia of 1.32 (95%CI 1.18-1.47) for women and 1.35 95% (CI 1.18-1.53) for men and a HR for VaD of 1.58 (95% CI 1.40-1.79) for women and 1.55 (1.36-1.77) for men. Frontotemporal dementia (FTD) presented the highest HR for women (HR 2.16 95% CI 1.59-2.94). The risk associated with Lewy body dementia (LBD) was non-proportional and increased over time: by day 1000 of the observation period, this was the dementia type associated with highest mortality among men, with a HR of 2.06 (95% CI 1.19-2.35). Increasing age and number of medication, and decreasing MMSE were associated with a similar increase in risk in women and men. Institutionalization was associated with 36% increased mortality risk in women and 50% increased risk in men. For women, the lowest mortality risk occurred in the overweight BMI category with a HR of 0.78 (95% CI 0.69-0.89) and in the obese category in men (HR 0.62 95% CI 0.51-0.77). For women, each point increase in BMI was associated with a decrease in mortality risk by 17% up till BMI 18.5, 8% when BMI was between 18.5-22, and 6% when BMI was 22-24.9. Each point increase in BMI decreased mortality risk in men by 18% for BMI 18.5-22 and 6% when BMI was 25-30. After dementia diagnosis, higher age and number of medication, lower MMSE, institutionalization, non-AD diagnosis and lower BMI are associated with increased mortality risk. The BMI range associated with the lowest mortality risk after a dementia diagnosis is lower in women than in men.