Incidence and outcomes of dementia after a diagnosis of heart failure: a population-based study
Notice bibliographique
Résumé
Abstract Background Although dementia and heart failure (HF) may co-exist, the interrelationships of these two conditions have not been fully explored in the population. This study aimed to assess the incidence and risk factors of dementia in HF patients and evaluate mortality after dementia diagnosis. Methods We conducted a population-based retrospective cohort study among eligible individuals aged 40 to 80 years who were newly diagnosed with HF in Canada, between April 1, 2002, and March 31, 2023. Patients with HF were stratified as inpatients or outpatients based on the location of the first recorded diagnosis of HF, and were compared with age-, sex-, and vascular risk factor-matched controls. Patients were followed from the index date of HF diagnosis until the end of study period or until an outcome occurred. Outcomes included incident dementia (using a validated administrative data algorithm) and all-cause mortality. Cause-specific proportional hazard models were used to examine associations between HF and dementia, and between dementia and subsequent outcomes, adjusting for age, sex, comorbidities, and neighborhood socioeconomic status. Results During 10-year follow-up of the inpatient cohort 14,977 patients were diagnosed with incident dementia among 156,420 HF patients. In the outpatient cohort, 24,504 patients developed incident dementia among 255,444 HF patients. The cumulative incidence of dementia was higher in HF patients than in matched controls among those diagnosed initially as inpatients or outpatients (Figure). Among inpatients diagnosed with HF before the age of 60, females had a dementia incidence rate that was 4.1 times higher than their matched controls, while males had a rate 3 times higher (Table). The incidence rate ratio decreased with increasing age, falling to 2.14 in females and 1.97 in males among those diagnosed with HF between 61 and 70 years, and 1.45 in females and 1.41 in males among those over the age of 70, indicating a diminishing rate of dementia with increasing age. Similar trends were observed in the outpatient setting. Key predictors of incident dementia included increasing age, female sex, diabetes, cerebrovascular disease, and low socioeconomic status. Using time-varying covariates, incident dementia was associated with higher mortality in both inpatient (HR: 2.44, 95% CI: 2.39, 2.49) and outpatient HF cohorts (HR: 2.67, 95% CI: 2.63, 2.72). Conclusion Patients with HF have an increased risk of dementia, with higher absolute rates of dementia in older age groups, but higher relative increase in younger patients compared to matched controls without HF. Dementia also confers higher mortality risk, emphasizing the need for integrated dementia prevention and care strategies in HF.Figure.Cumulative incidence of dementia Table.Incidence of dementia 10yr f/u
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».