A multinational cohort study of trends in survival following dementia diagnosis

Hao Luo, Marjaana Koponen, Christoph Roethlein, Cornelia Becker, J. Simon Bell, Kebede Beyene, Yi Chai, Amy H. Y. Chan, Celine S. L. Chui, Britta Haenisch, Sirpa Hartikainen, Amy T. Hsu, Jenni Ilomaki, Ju Hwan Kim, Martin Knapp, Elizabeth Kunkel, Edward Chia-Cheng Lai, Kui Kai Lau, Wallis C. Y. Lau, Hyesung LeeTzu-Chi Liao, Terry Y. S. Lum, Kenneth K. C. Man, Ju-Young Shin, Anna-Maija Tolppanen, Gloria H. Y. Wong, Ian C. K. Wong*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Methods:
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.

Results:
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.

Conclusions:
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.
Original languageEnglish
Article number203
Number of pages10
JournalCommunications Medicine
Volume5
Issue number1
Early online date28 May 2025
DOIs
Publication statusPublished - 28 May 2025

Bibliographical note

Copyright © The Author(s) 2025. This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit https://creativecommons.org/licenses/by-nc-nd/4.0/

Data Access Statement

The code used for data analysis is available on GitHub (https://github.com/yvonne840429/NeuroGEN-Dementia-Survival).

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