P1530Patients with dementia in acute heart failure were exposed to serious higher risk of mortality, hospitalization for heart failure and social flail in community-based registry; KICKOFF Registry

Abstract

Dementia is a common and serious complication in patients with heart failure (HF). However, an association of dementia with social backgrounds, mortality and other event, have not been well documented in HF. Method(s): We have enrolled 746 patients with acute heart failure (AHF) at 13 hospitals in Kitakawachi located at the eastern end of the city of Osaka, Japan, from April 2015 to January 2017. The KICKOFF Registry is a prospective multicenter community-based cohort of HF patients. We compared the social backgrounds and mortality between patients with dementia (dementia; n=215) and without (non-dementia; n=531). Dementia was diagnosed if it had been previously diagnosed by the criteria of Ministry of Health, Labour and Welfare of Japan. Result(s): The patients with dementia were older, low BMI, more female, and longer mean length of hospitalization than non-dementia (84.7+/-7.6 vs. 74.1+/-11.6 years of age; p<0.01, 66.5% vs. 41.2%; p<0.01, 29.5+/-23.2 vs. 23.0+/-17.8 days; p<0.01, respectively). The dementia group had less dyslipidemia, but more chronic kidney disease, and old cerebral infraction than the non-dementia group (25.1% vs. 39.7%; p<0.01, 60.9% vs. 49.9%; p<0.01, 16.7% vs. 9%; p<0.01, respectively). In social backgrounds, 20.9% of the patients with dementia lived alone, 15.4% lived with a partner, and of these, 46.2% had the support of other family members. The dementia group had less control for both their diet and drug therapies than the non-dementia group (17.7% vs. 36.9%; p<0.01, 36.7% vs. 85.9%; p<0.01). In Kaplan-Meier analysis, the hospitalization of HF and the mortality were higher in patients with dementia than those without during six-month follow-up (p<0.01). After the adjustment in multiple logistics regression models, dementia was independently associated with higher risk of the hospitalization for HF (adjusted hazard ratio, 1.52; 95% confidence interval, 1.01-2.29; p=0.05) and the mortality (adjusted hazard ratio, 2.66; 95% confidence interval, 1.46-4.87; p<0.01). Conclusion(s): Our study provides unique information detailed the social backgrounds of HF patients with dementia. The patients with dementia had a serious risk of social frailty. Dementia was independently higher risk of mortality and the hospitalization in AHF.