Abstract 16113: The Impact of Dementia on Heart Failure Mortality: A National Study of 5.2 Million People
Background: Due to ageing of the general population, the incidence of heart failure (HF) and dementia are both rising. We assessed the hypothesis that a co-morbidity of dementia has an impact upon survival in following a first hospitalization for HF.
Methods and Results: The whole Scottish population (5.2 million) receives free care from the National Health Service (NHS) and each person has a unique NHS electronic record. We screened all hospitalizations in Scotland for an incident diagnosis of HF between June 2004 and October 2010 and linked these to death registrations over the same period. Patients with dementia were identified by discharge diagnoses containing codes for alzheimer’s disease, dementia and cognitive impairment. A total of 149,685 individuals (52% female) had a first hospital discharge for HF and of these, 2,822 (1.9%) had a co-morbid diagnosis of dementia. Significantly more females than males had a diagnosis of dementia (1,929 versus 893, p<0.0001) with the mean age of the dementia cohort being significantly older than those without (83.5 years versus 74.6 years, p<0.0001). Of all co-morbidities examined, diabetes mellitus, respiratory disease, cerebrovascular disease, atrial fibrillation, hypertension, renal failure and coronary artery disease were all significantly associated with a diagnosis of dementia (p<0.0001) whereas cancer, peripheral vascular disease and acute myocardial infarction were not. Following adjustment for age, sex, comorbidities and year of admission, HF patients with a diagnosis of dementia had significantly higher mortality rates (%) at 30 days (29.4 vs 17.4, p<0.0001) , 1 year (62.9 vs 41.8, p<0.0001), 5 years (92.5 vs 72.8, p<0.0001) and 10 years (98.4 vs 86.7, p<0.0001) compared to those without. The overall median survival from first hospitalization for heart failure was significantly higher in those without dementia compared to those with dementia (1.69 years vs 0.41 years, p<0.0001).
Conclusion: A significant proportion of patients with HF (typically older and female) have a co-morbid diagnosis of dementia. Dementia is independently associated with increased mortality in HF.
Author Disclosures: J.A. Cannon: None. C.M. Wong: None. P.S. Jhund: None. J.R. Dalzell: None. T.J. Quinn: None. N.M. Broomfield: None. M.R. Walters: None. J.J. McMurray: None.
- © 2014 by American Heart Association, Inc.