Comorbidities of Alzheimer‘s disease – results of a multicentric observational COSMOS study in the Slovak Republic

Česká verzia

Authors: M. Minár ¹; J. Dragašek ²; I. Mátéffy ³; P. Valkovič ^1,4
Authors place of work: II. neurologická klinika LF UK a UN Bratislava, Slovensko ¹; I. psychiatrická klinika LF UPJŠ Košice, Slovensko ²; Psychiatrická klinika SZU UN Bratislava, Slovensko ³; Ústav normálnej a patologickej fyziológie, Slovenská akadémia vied, Bratislava, Slovensko ⁴
Published in the journal: Cesk Slov Neurol N 2020; 83(1): 95-99
Category: Původní práce
doi: https://doi.org/10.14735/amcsnn202095

Alzheimerova demencia (AD) patrí medzi najviac invalidizujúce ochorenia prevažne staršej populácie. Dáta nasvedčujú, že pridružené komorbidity komplikujú diagnostiku aj liečbu a urýchľujú progresiu AD. Epidemiologické dáta zo strednej Európy chýbajú, preto cieľom projektu COSMOS bolo odhaliť prevalenciu psychiatrických a somatických komorbidít pacientov s AD v slovenskej populácii. V tejto multicentrickej prierezovej observačnej štúdii boli údaje o pacientoch s AD z celého Slovenska získané z 89 pracovísk pomocou on-line dotazníka, ktorý obsahoval demografické a klinické údaje, informácie o všetkých komorbiditách a ich vplyve na adherenciu a účinnosť terapie.

Summary

Aim: Alzheimer‘s disease (AD) is one of the most disabling conditions predominantly affecting an elderly population. Data suggest that comorbidities complicate both diagnosis and treatment and accelerate AD progression. Epidemiological data from the Central Europe are missing, therefore, the aim of the COSMOS project was to reveal the prevalence of psychiatric and somatic comorbidities among AD patients in the Slovak population.

Methods: In this multicenter, cross--sectional, observational study, data of AD patients from all Slovak regions (89 sites) were obtained using an online questionnaire. It contained demographic and clinical data, information about all comorbidities, and their impact on adherence and tratment efficacy.

Results: Out of all 494 patients, 94.53% had at least one somatic comorbidity, 80.16% had at least one psychiatric comorbidity. The number of both somatic (r_s = 0.120; P = 0.008) and psychiatric (r_s = 0.267; P < 0.001) comorbidities correlated with the severity of AD. The number of psychiatric comorbidities (b = –0.021; P = 0.025) and the severity of AD (b = –0.071; P < 0.001) predicted a worse therapy effect. Adherent patients were more likely to have effective therapy of dementia (OR 5.270; 95% CI 3.061–9.073; P < 0.001).

Conclusion: Comorbidities in AD have been shown to accelerate progression of underlying disease and complicate diagnosis and therapy. However, they represent the most modifiable factors of cognitive deterioration. Their active screening, early diagnosis and adequate therapy can improve patient’s adherence and, thus, make AD management more effective.

Keywords:

Alzheimer‘s disease – comorbidities – psychiatric – somatic – therapy – adherence

Zdroje

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