Luo Hao, Koponen Marjaana, Roethlein Christoph, Becker Cornelia, Bell J Simon, Beyene Kebede, Chai Yi, Chan Amy H Y, Chui Celine S L, Haenisch Britta, Hartikainen Sirpa, Hsu Amy T, Ilomaki Jenni, Kim Ju Hwan, Knapp Martin, Kunkel Elizabeth, Lai Edward Chia-Cheng, Lau Kui Kai, Lau Wallis C Y, Lee Hyesung, Liao Tzu-Chi, Lum Terry Y S, Man Kenneth K C, Shin Ju-Young, Tolppanen Anna-Maija, Wong Gloria H Y, Wong Ian C K
School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada.
The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China.
Commun Med (Lond). 2025 May 28;5(1):203. doi: 10.1038/s43856-025-00923-6.
BACKGROUND: Information on the survival of people living with dementia over time and across systems can help policymakers understand the real-world impact of dementia on health and social care systems. This multinational cohort study examines the trends in relative mortality risk following a dementia diagnosis.
A common protocol was applied to population-based data from the UK, Germany, Finland, Canada (Ontario), New Zealand, South Korea, Taiwan and Hong Kong. Individuals aged 60+ with an incident dementia diagnosis recorded between 2000 and 2018 were followed until death or the end of the study period. Cox proportional hazards regression was used to assess the association of mortality in dementia patients with the year of dementia diagnosis.
Data from 1,272,495 individuals, with the mean age at diagnosis ranging from 76.8 years (South Korea) to 82.9 years (Germany), show that the overall median length of survival following recorded diagnosis ranges from 2.4 years (New Zealand) to 7.9 years (South Korea). Hazard ratios (HRs) estimated from Cox proportional hazard models decline consistently over the study period in the UK, Canada, South Korea, Taiwan and Hong Kong, which accounted for 84% of all participants. For example, the HR decreases from 0.97 (95% CI: 0.92-1.02) in 2001 to 0.72 (0.65-0.79) in 2016 in comparison to year 2000 in the UK.
This study shows a steady trend of decreasing risk of mortality in five out of eight databases, which signals the potential positive effect of dementia plans and associated policies and provides reference for future policy evaluation.
背景：有关痴呆症患者随时间推移及不同系统的生存信息，有助于政策制定者了解痴呆症对健康和社会护理系统的实际影响。这项跨国队列研究考察了痴呆症诊断后相对死亡风险的趋势。
对来自英国、德国、芬兰、加拿大（安大略省）、新西兰、韩国、台湾和香港的基于人群的数据应用了通用方案。对2000年至2018年间记录有新发痴呆症诊断的60岁及以上个体进行随访，直至死亡或研究期结束。使用Cox比例风险回归来评估痴呆症患者死亡率与痴呆症诊断年份之间的关联。
来自1,272,495名个体的数据显示，诊断时的平均年龄从76.8岁（韩国）到82.9岁（德国）不等，记录诊断后的总体中位生存时长从2.4年（新西兰）到7.9年（韩国）不等。在占所有参与者84%的英国、加拿大、韩国、台湾和香港，Cox比例风险模型估计的风险比（HRs）在研究期间持续下降。例如，在英国，与2000年相比，HR从2001年的0.97（95%CI：0.92 - 1.02）降至2016年的0.72（0.65 - 0.79）。
本研究表明，八个数据库中有五个的死亡风险呈稳步下降趋势，这表明痴呆症计划及相关政策可能产生积极影响，并为未来政策评估提供参考。
