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Predictors of mortality in Māori, Pacific Island, and European patients diagnosed with dementia at a New Zealand Memory Service
Author(s) -
Cullum Sarah,
Varghese Chris,
Coomarasamy Christin,
Whittington Rosie,
Hadfield Laura,
Rajay Aakash,
Yeom Brian,
Liu Bonnie,
Christie Madeline,
Appleton Kerry,
Yates Susan,
Cheung Gary
Publication year - 2020
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.5266
Subject(s) - pacific islanders , dementia , medicine , epidemiology , gerontology , comorbidity , ethnic group , demography , disease , psychiatry , population , environmental health , sociology , anthropology
Background As the economic impact of dementia on health and social care increases, governments require disease‐specific epidemiological data that will help inform spending and policy decisions. The aim of this study is to examine predictors of mortality in dementia in consecutive referrals to a New Zealand (NZ) memory service that includes Māori, Pacific Islander, and NZ European patients. Methods Date of birth, sex, ethnicity, living situation, cognitive function, dementia subtype, dementia severity, physical comorbidity, and medication data were collected from electronic health records. The resulting data set was linked to administrative data on mortality and last hospital contact dates to allow time‐dependent survival analyses. Results The risk of death in people with dementia was increased by age (adjusted HR per year 1.08, 95%CI:1.05‐1.12) and lower cognitive score at baseline (adjusted HR for severe impairment:2.54, 95% CI:1.25‐5.16), and was reduced by cholinesterase inhibitors (adjusted HR:0.54, 95% CI:0.34‐0.88). Compared to NZ Europeans (HR:1.19, 95% CI:0.63‐2.25), antipsychotics increased the risk of death three‐fold in Māori (adjusted HR:3.62, 95% CI:0.79‐16.7) and Pacific Islanders (adjusted HR:2.54, 95%CI:1.10‐5.85). Conclusions Further research is required to elucidate the mechanisms underlying the survival rates in Māori and Pacific Islanders living with dementia in NZ,and their increased risk of death if antipsychotics are used.