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尸检确诊痴呆障碍的死因。

Cause of death in autopsy-confirmed dementia disorders.

机构信息

Division of Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden.

出版信息

Eur J Neurol. 2020 Dec;27(12):2415-2421. doi: 10.1111/ene.14450. Epub 2020 Aug 31.

Abstract

BACKGROUND AND PURPOSE

Dementia disorders predispose for lethal complications and decrease life expectancy. A more profound knowledge regarding end-stage conditions in dementia could therefore ameliorate treatment and care of these patients.

METHODS

Autopsy reports on 207 deceased individuals with clinically diagnosed neurocognitive disorder/dementia and on 200 neurocognitively healthy individuals of the same age range were studied. Autopsy results, especially cause of death, were compared between the dementia and the control groups.

RESULTS

The two most frequent causes of death in the dementia population were pneumonia (34.3%) and acute myocardial infarction (30.4%). This result differed from that of the control group, in which acute myocardial infarction (42.5%) accounted for most events of deaths, followed by circulatory failure (12.5%). The leading cause of death varied amongst dementia subtypes. Further, in Alzheimer's disease pneumonia was more frequent in severe/advanced cases whilst acute myocardial infarction was more common in milder cases.

CONCLUSIONS

Cause of death differed between the demented and the general population of the same age and between subtypes of dementia. Alzheimer's disease severity was reflected in different final conditions. The findings have relevance for the final stage care and treatment in dementia disorders.

摘要

背景与目的

痴呆症会导致致命的并发症,并降低预期寿命。因此,更深入地了解痴呆症的终末期情况可以改善这些患者的治疗和护理。

方法

研究了 207 名临床诊断为神经认知障碍/痴呆症的已故个体和 200 名年龄相同的神经认知健康个体的尸检报告。比较了痴呆症组和对照组的尸检结果,特别是死因。

结果

痴呆症人群中最常见的两种死因是肺炎(34.3%)和急性心肌梗死(30.4%)。这一结果与对照组不同,对照组中急性心肌梗死(42.5%)是大多数死亡事件的主要原因,其次是循环衰竭(12.5%)。不同类型的痴呆症导致的死亡原因也有所不同。此外,在阿尔茨海默病中,肺炎在严重/晚期病例中更为常见,而急性心肌梗死在轻度病例中更为常见。

结论

痴呆症患者和同龄一般人群之间以及不同类型的痴呆症之间的死因存在差异。阿尔茨海默病的严重程度反映在不同的终末状况中。这些发现与痴呆症患者的终末期治疗和护理有关。

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