P3‐445: factors predicting mortality at the memory clinic at siriraj hospital: 815 thai cohort

Previous studies revealed that the presence of CMBs was associated with an increased risk for cardiovascular events and cardiovascular mortality. Our study is a longitudinal cohort study within the memory clinic–based cohort at Siriraj hospital, Thailand during 2002 to June 2015. We aimed to investigate vascular neuroimaging evidences, subjects’ comorbidity, and subject characteristics in relationship to the mortality of our cohort. There were 1,284 persons in the memory clinic during 2002 to June 2015. 307 were dead (mortality prevalence 23.9%, 95% CI 21.6 – 26.3). Only 815 had appropriate brain MRI at Siriraj hospital to investigate. Some had CT scan of the brain. 168(20.6%) had MCI. Diagnoses of our cohort were AD(433,53.1%), VaD(73,9%), mixed AD & VaD(42,5.2%), FTD(29,3.6%), PDD(16,2%), DLB(21,2.6%), reversible dementia(17,2.1%), and NPH(16.2%). 74 persons(9.08%, 95%CI 7.2-11.3) were expired. The mean (SD) age of those who were alive and dead was 71.31(9.65), and 73.22(8.71) (p=0.103). TMSE scores of those who were alive and dead was 21.33(5.92) and 19.26(6.13)(p=0.02). There was no difference in daily function, FAQ scores, PCA scores, CMBs amount, number of neuropsychiatric symptoms at baseline between those who dead and alive. Being female (p=0.02, LR=5.38, having CAD(p=0.01,LR=6.51) and hyperlipidemia(p=0.035,LR=4.74) at baseline increased a risk of death later. ARWMC scores of those who were alive and dead was 7.36(5.57) and 10.40(6.02) p<0.001, OR=2.56(<9 vs >=9). Fazekas scores of those who were alive and dead was 1.57(0.93) and 2.01(0.90)(p<0.001,OR=2.39(<2 vs >=2)). The mean (SD,SE) number of lacuna infarction of those who were alive and dead was 1.15(2.33,0.09) and 2.29(3.03,0.36) (p=0.002,OR=3.21(0 vs >=1),OR=2.47(<2 vs >=2). Mean Rt & Lt MTA scores of those who were alive and dead was 1.25(0.95) and 1.63(0.91)(p=0.002,OR=2.58(0-1vs >=2). Those with 1 or more CMBs had increased mortality risk (p<0.001, OR=2.26). GCA scores of those who were alive and dead was 1.10(0.70) and 1.43(0.62)(p<0.001, OR=4.05(0 vs >=1). Having high WML burden, high MTA scores, more lacuna infarction, having one or more CMBs were risk for mortality at Siriraj MC. Lower TMSE at the entry of MC, but not age, being female, having CAD and hyperlipidemia at baseline was risk for mortality.