Background
Methods
Study population
Diagnosis of Alzheimer’s disease
Causes of death
Category | ICD-10 code | No AD, n = 10,171 | AD, n = 20,470 | OR (95%CI |
---|---|---|---|---|
Diseases of the circulatory system | I* | 5441 (53.5) | 6484 (31.7) | 0.40 (0.38, 0.42) |
Diseases of the nervous system | G* | 440 (4.3) | 10,218 (50.0) | 22.06 (19.87, 24.25) |
Neoplasms | C*, D00-D48 | 1942 (19.1) | 1573 (7.7) | 0.35 (0.33, 0.38) |
Mental and behavioral disorders | F* | 741 (7.3) | 425 (2.1) | 0.27 (0.24, 0.30) |
Diseases of the respiratory system | J* | 512 (5.0) | 380 (1.9) | 0.36 (0.31, 0.40) |
External causes of morbidity and mortality | V*, W*, X*, Y* | 356 (3.5) | 518 (2.5) | 0.72 (0.62, 0.81) |
Diseases of the digestive system | K* | 308 (3.0) | 423 (2.1) | 0.68 (0.58, 0.78) |
Certain infectious and parasitic diseases | A*, B* | 89 (0.9) | 96 (0.5) | 0.53 (0.40, 0.71) |
Diseases of the genitourinary system | N* | 132 (1.3) | 156 (0.8) | 0.58 (0.46, 0.74) |
Endocrine, nutritional and metabolic diseases | E* | 115 (1.1) | 116 (0.6) | 0.50 (0.38, 0.65) |
Diseases of the musculoskeletal system and connective tissue | M* | 49 (0.5) | 21 (0.1) | 0.21 (0.13, 0.35) |
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism | D50-D89 | 10 (0.1) | 11 (0.1) | 0.55 (0.23, 1.29) |
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified | R* | 10 (0.1) | 17 (0.1) | 0.84 (0.39, 1.85) |
Congenital malformations, deformations and chromosomal abnormalities | Q* | 8 (0.1) | 13 (0.1) | 0.81 (0.33, 1.95) |
Diseases of the skin and subcutaneous tissue | L* | 9 (0.1) | 4 (< 0.1) | 0.22 (0.07, 0.72) |
Diseases of the eye, adnexa, ear and mastoid process | H* | 2 < (0.1) | 0 (0.0) | N.A |
Category | ICD-10 code | < 65 years n = 409 | ≥65 years n = 20,061 | OR (95%CI |
---|---|---|---|---|
Diseases of the circulatory system | I* | 48 (11.7) | 6436 (32.1) | 3.55 (2.47–4.62) |
Diseases of the nervous system | G* | 293 (71.6) | 9925 (49.5) | 0.38 (0.30–0.47) |
Neoplasms | C*, D00-D48 | 18 (4.4) | 1555 (7.8) | 1.82 (0.96–2.69) |
Mental and behavioral disorders | F* | 12 (2.9) | 413 (2.1) | 0.69 (0.29–1.10) |
Diseases of the respiratory system | J* | 5 (1.2) | 375 (1.9) | 1.54 (0.17–2.90) |
External causes of morbidity and mortality | V*, W*, X*, Y* | 10 (2.4) | 508 (2.5) | 1.03 (0.38–1.69) |
Diseases of the digestive system | K* | 6 (1.5) | 417 (2.1) | 1.42 (0.27–2.58) |
Certain infectious and parasitic diseases | A*, B* | 0 (0) | 96 (0.5) | N. A |
Diseases of the genitourinary system | N* | 1 (0.2) | 155 (0.8) | 3.17 (0.01–9.41) |
Endocrine, nutritional and metabolic diseases | E* | 4 (1.0) | 112 (0.6) | 0.57 (0.00–1.14) |
Diseases of the musculoskeletal system and connective tissue | M* | 1 (0.2) | 20 (0.1) | 0.41 (0.00–1.22) |
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism | D50-D89 | 0 (0) | 11 (0.1) | N. A |
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified | R* | 1 (0.2) | 16 (0.1) | 0.33 (0.01–0.98) |
Congenital malformations, deformations and chromosomal abnormalities | Q* | 9 (2.2) | 4 (< 0.1) | 0.01 (0.00–0.02) |
Diseases of the skin and subcutaneous tissue | L* | 0 (0) | 4 (< 0.01) | N. A |
Statistical analyses
Results
Sample characteristics
Causes of death
Category | Men N = 10,934 | Women N = 19,707 | P for sex difference | ||
---|---|---|---|---|---|
No AD n = 3654 | AD n = 7280 | No AD n = 6517 | AD n = 13,190 | ||
Diseases of the circulatory system | 1842 (50.4) | 2202 (30.2) | 3599 (55.2) | 4282 (32.5) | 0.078 |
Diseases of the nervous system | 123 (3.4) | 3541 (48.6) | 317 (4.9) | 6677 (50.6) | 0.006 |
Neoplasms | 830 (22.7) | 667 (9.2) | 1112 (17.1) | 906 (6.9) | 0.56 |
Mental and behavioral disorders | 191 (5.2) | 152 (2.1) | 550 (8.4) | 273 (2.1) | < 0.001 |
Diseases of the respiratory system | 280 (7.7) | 228 (3.1) | 232 (3.6) | 152 (1.2) | 0.13 |
External causes of morbidity and mortality | 141 (3.9) | 197 (2.7) | 215 (3.3) | 321 (2.4) | 0.71 |
Diseases of the digestive system | 101 (2.8) | 136 (1.9) | 207 (3.2) | 287 (2.2) | 0.94 |
Certain infectious and parasitic diseases | 30 (0.8) | 37 (0.5) | 59 (0.9) | 59 (0.4) | 0.46 |
Diseases of the genitourinary system | 46 (1.3) | 45 (0.6) | 86 (1.3) | 111 (0.8) | 0.31 |
Endocrine, nutritional and metabolic diseases | 41 (1.1) | 44 (0.6) | 74 (1.1) | 72 (0.5) | 0.67 |
Diseases of the musculoskeletal system and connective tissue | 12 (0.3) | 4 (0.1) | 37 (0.6) | 17 (0.1) | 0.64 |
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism | 3 (0.1) | 5 (0.1) | 7 (0.1) | 6 (< 0.1) | 0.46 |
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified | 6 (0.2) | 7 (0.1) | 4 (0.1) | 10 (0.1) | 0.36 |
Congenital malformations, deformations and chromosomal abnormalities | 1 (< 0.1) | 5 (0.1) | 7 (0.1) | 8 (0.1) | 0.22 |
Diseases of the skin and subcutaneous tissue | 4 (0.1) | 2 (< 0.1) | 5 (0.1) | 2 (< 0.1) | 0.84 |
Diseases of the eye, adnexa, ear and mastoid process | 1 (< 0.1) | 0 (0.0) | 1 (< 0.1) | 0 (0.0) | N.A |
Causes of death in autopsied participants
Category | All autopsies (N = 3889) | Medical autopsies (N = 1445) | Forensic autopsies (N = 2444) | ||||||
---|---|---|---|---|---|---|---|---|---|
No AD(n = 1804) | AD (n = 2085) | OR (95%CI | No AD (n = 594) | AD (n = 851) | OR (95%CI | No AD (n = 1210) | AD (n = 1234) | OR (95%CI | |
Diseases of the circulatory system | 1131 (62.7) | 1099 (52.7) | 0.66 (0.58, 0.75) | 361 (60.8) | 447 (52.5) | 0.71 (0.58, 0.88) | 770 (63.6) | 652 (52.8) | 0.64 (0.54, 0.75) |
External causes of morbidity and mortality | 257 (14.2) | 331 (15.9) | 1.14 (0.95, 1.36) | 0 (0.0) | 5 (0.6) | N.A | 257 (21.2) | 326 (26.4) | 1.33 (1.10, 1.61) |
Neoplasms | 171 (9.5) | 150 (7.2) | 0.74 (0.59, 0.93) | 109 (18.4) | 102 (12.0) | 0.61 (0.45, 0.81) | 62 (5.1) | 48 (3.9) | 0.75 (0.51, 1.10) |
Diseases of the digestive system | 122 (6.8) | 148 (7.1) | 1.05 (0.82, 1.35) | 61 (10.3) | 95 (11.2) | 1.10 (0.78, 1.54) | 61 (5.0) | 53 (4.3) | 0.85 (0.58, 1.23) |
Diseases of the nervous system | 7 (0.4) | 259 (12.4) | 36.41 (17.14, 77.36) | 4 (0.7) | 152 (17.9) | 32.07 (11.81, 87.08) | 3 (0.2) | 107 (8.7) | 38.20 (12.09, 120.66) |
Diseases of the respiratory system | 60 (3.3) | 51 (2.4) | 0.73 (0.50, 1.06) | 23 (3.9) | 21 (2.5) | 0.63 (0.34, 1.15) | 37 (3.1) | 30 (2.4) | 0.79 (0.49, 1.29) |
Endocrine, nutritional and metabolic diseases | 12 (0.7) | 10 (0.5) | 0.72 (0.31, 1.67) | 7 (1.2) | 5 (0.6) | 0.50 (0.16, 1.56) | 5 (0.4) | 5 (0.4) | 0.98 (0.28, 3.40) |
Diseases of the genitourinary system | 11 (0.6) | 11 (0.5) | 0.86 (0.37, 2.00) | 8 (1.3) | 9 (1.1) | 0.78 (0.30, 2.04) | 3 (0.2) | 2 (0.2) | 0.65 (0.11, 3.92) |
Certain infectious and parasitic diseases | 12 (0.7) | 8 (0.4) | 0.58 (0.24, 1.41) | 10 (1.7) | 6 (0.7) | 0.41 (0.15, 1.15) | 2 (0.2) | 2 (0.2) | 0.98 (0.14, 6.97) |
Mental and behavioral disorders | 9 (0.5) | 11 (0.5) | 1.06 (0.44, 2.56) | 7 (1.2) | 9 (1.1) | 0.90 (0.33, 2.42) | 2 (0.2) | 2 (0.2) | 0.98 (0.14, 6.97) |
Musculoskeletal system/ connective tissue diseases | 7 (0.4) | 1 (< 0.1) | 0.12 (0.02, 1.00) | 3 (0.5) | 0 (0.0) | NA | 4 (0.3) | 1 (0.1) | 0.24 (0.03, 2.19) |
Symptoms, signs, abnormal clinical/laboratory findings | 3 (0.2) | 4 (0.2) | 1.15 (0.26, 5.16) | 0 (0.0) | 0 (0.0) | NA | 3 (0.2) | 4 (0.3) | 1.31 (0.30, 5.86) |
Congenital malformations, deformations and chromosomal abnormalities | 2 (0.1) | 1 (< 0.1) | 0.43 (0.04, 4.77) | 1 (0.2) | 0 (0.0) | NA | 1 (0.1) | 1 (0.1) | 0.98 (0.06, 15.69) |
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism | 0 (0.0) | 1 (< 0.1) | NA | 0 (0.0) | 0 (0.0) | NA | 0 (0.0) | 1 (0.1) | N.A |
Alzheimer’s disease as a cause of death
Category | ICD-10 code | No AD, n = 9129 | AD, n = 10,063 | OR (95%CI) |
---|---|---|---|---|
Diseases of the circulatory system | I* | 5438 (59.6) | 6481 (64.4) | 1.23 (1.16, 1.30) |
Diseases of the nervous system | G* | 124 (1.4) | 234 (2.3) | 1.73 (1.39, 2.16) |
Neoplasms | C*, D00-D48 | 1942 (21.3) | 1573 (15.6) | 0.69 (0.64, 0.74) |
Mental and behavioral disorders | F* | 18 (0.2) | 5 (< 0.1) | 0.25 (0.09, 0.68) |
Diseases of the respiratory system | J* | 512 (5.6) | 380 (3.8) | 0.66 (0.58, 0.74) |
External causes of morbidity and mortality | V*, W*, X*, Y* | 356 (3.9) | 518 (5.1) | 1.34 (1.17, 1.54) |
Diseases of the digestive system | K* | 308 (3.4) | 423 (4.2) | 1.26 (1.08, 1.46) |
Certain infectious and parasitic diseases | A*, B* | 89 (1.0) | 96 (1.0) | 0.98 (0.73, 1.31) |
Diseases of the genitourinary system | N* | 132 (1.4) | 156 (1.6) | 1.07 (0.85, 1.36) |
Endocrine, nutritional and metabolic diseases | E* | 115 (1.3) | 116 (1.2) | 0.91 (0.71, 1.19) |
Diseases of the musculoskeletal system and connective tissue | M* | 49 (0.5) | 21 (0.2) | 0.39 (0.23, 0.64) |
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism | D50-D89 | 10 (0.1) | 11 (0.1) | 1.00 (0.42, 2.35) |
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified | R* | 10 (0.1) | 17 (0.2) | 1.54 (0.71, 3.37) |
Congenital malformations, deformations and chromosomal abnormalities | Q* | 8 (0.1) | 13 (0.1) | 1.48 (0.61, 3.56) |
Diseases of the skin and subcutaneous tissue | L* | 9 (0.1) | 4 (< 0.1) | 0.40 (0.12, 1.31) |
Diseases of the eye, adnexa, ear and mastoid process | H* | < 2 (0.1) | 0 (0.0) | N.A |