Roderburg Christoph, Loosen Sven H, Jördens Markus S, Konrad Marcel, Luedde Tom, Kostev Karel, Luedde Mark
Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Moorenstraße 5, Düsseldorf 40225, Germany.
Health and Social, FOM University of Applied Sciences for Economics and Management Frankfurt, Franklinstr. 52, 60486 Frankfurt a.M., Germany.
Eur Heart J Open. 2021 Jul 24;1(1):oeab003. doi: 10.1093/ehjopen/oeab003. eCollection 2021 Aug.
The prognosis and quality of life of patients with heart failure (HF) is determined by comorbidities, with dementia/cognitive decline believed to have a significant impact in this regard. This study compares the incidence of dementia in patients with HF with that in patients with common cancers in a large collective of outpatients.
This retrospective cohort study assessed the incidence of dementia/cognitive decline [International Classification of Diseases, 10th revision (ICD-10): I50] in a cohort of patients ≥65 years diagnosed with HF (ICD-10: I50), breast cancer (ICD-10: C50), prostate cancer (ICD-10: C61), or digestive organ cancer (ICD-10: C15-C26) in 1274 German general practices between January 2000 and December 2018. Multivariable Cox regression models were used to study the association between HF and dementia compared to each of three cancer cohorts. We included 72 259 patients with HF, 10 310 patients with breast cancer, 12 477 patients with prostate cancer, and 12 136 patients with digestive organ cancer. A total of 27.8% of patients with HF were diagnosed with dementia during the 10-year observation period compared to 16.2% of patients with breast cancer, 18.6% of patients with digestive organ cancer, and 16.1% of patients with prostate cancer. Patients with HF were significantly more likely to develop dementia within 10 years after diagnosis than patients with breast cancer [hazard ratio (HR): 1.36 (95% confidence interval 1.28-1.45, < 0.001], prostate cancer [HR 1.38 (1.130-1.47), < 0.001], or gastrointestinal tumours [HR 1.31 (1.24-1.39), < 0.001].
Our study demonstrates the significance of dementia in patients with HF, in whom the condition is much more prevalent than in patients with cancer.
心力衰竭（HF）患者的预后和生活质量由合并症决定，其中痴呆/认知功能下降被认为在这方面有重大影响。本研究比较了大量门诊患者中HF患者与常见癌症患者的痴呆发病率。
这项回顾性队列研究评估了2000年1月至2018年12月期间，1274家德国普通诊所中≥65岁的被诊断为HF（国际疾病分类第10版（ICD-10）：I50）、乳腺癌（ICD-10：C50）、前列腺癌（ICD-10：C61）或消化器官癌（ICD-10：C15-C26）的患者队列中痴呆/认知功能下降（ICD-10：I50）的发病率。使用多变量Cox回归模型研究HF与痴呆之间的关联，并与三个癌症队列中的每一个进行比较。我们纳入了72259例HF患者、10310例乳腺癌患者、12477例前列腺癌患者和12136例消化器官癌患者。在10年观察期内，共有27.8%的HF患者被诊断为痴呆，相比之下，乳腺癌患者为16.2%，消化器官癌患者为18.6%，前列腺癌患者为16.1%。HF患者在诊断后10年内发生痴呆的可能性显著高于乳腺癌患者[风险比（HR）：1.36（95%置信区间1.28-1.45，<0.001）]、前列腺癌患者[HR 1.38（1.130-1.47），<0.001]或胃肠道肿瘤患者[HR 1.31（1.24-1.39），<0.001]。
我们的研究证明了痴呆在HF患者中的重要性，HF患者中痴呆的患病率远高于癌症患者。
