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Replies to post #172458 on Anavex Life Sciences Corp (AVXL)
Living with dementia poses many challenges for people with dementia and for those who care for them. This may be coupled with other health problems as the accumulation of changes associated with ageing can lead to the accrual of illnesses and disabilities [1]. With the increased prevalence of individual health conditions associated with ageing [2], there is growing interest in the co-occurrence of medical conditions and the implications for the individual. Multimorbidity and comorbidity are used interchangeably to describe the presence of co-occurring diseases but definitions vary across studies. Multimorbidity is the co-occurrence of two or more diseases or active health conditions that may or may not be linked by a causal relationship or with no consistent dominant index disorder. Comorbidity is the term given to the presence of conditions existing concurrently with a condition considered as the primary or index disease [1] and this study will focus on the presence of conditions in addition to dementia as the index condition. Comorbidities significantly associated with dementia include physical health conditions such as congestive cerebrovascular disease, and cardiac arrhythmia [3], hypertension and diabetes [4], and depression [5].
People with dementia are more likely to have five or more health conditions and more prescription usage than those without dementia [6], and comorbidity ranging from two to eight conditions has been reported [7]. Examination of the medical records in England showed that 92% of people with dementia had a formal diagnosis of at least one other disease, and 53% were considered to have comorbidity with three or more conditions [2]. Similarly, 61% of people with Alzheimer’s disease across various care settings had three or more conditions [8]. Comorbidity rates were the same for people with dementia compared with those without dementia in a primary care [7], but for care home residents, rates were higher in people with dementia compared with older care residents without dementia [9]. There is growing interest not only in the number of comorbid conditions but also in the combinations or array of conditions referred to as ‘morbidotypes’ [10].
Comorbidity can influence a range of health outcomes such as mortality [11] and disability [12]. Multimorbidity is negatively associated with health-related quality of life (HRQoL) [9, 13], and certain disease combinations, such as diabetes and coronary disorders, impact more on HRQoL than others [14]. Higher comorbidity in people with dementia is negatively associated with ratings of disease-specific QoL [15]. Generally there is a negative association between comorbidity and QoL but the results are not conclusive, with variable findings related to QoL and HRQoL [16], and few studies examining both perceptions of health-related QoL and well-being.
People with dementia are living with comorbidity, and greater recognition of the extent and impact of this burden of disease is essential for the identification of interventions to help maintain independence and improve QOL [17]. Comorbidity poses significant challenges for care provision, and greater coordination of care planning across conditions is needed [4, 18]. The aim of this study is to investigate the comorbidity profile of people with dementia and to examine the associations between severity of comorbidity, HRQoL and QoL using a large community-based cohort of people with dementia.
