Morbidity and mortality of middle-aged and elderly narcoleptics

TY - JOUR

T1 - Morbidity and mortality of middle-aged and elderly narcoleptics

AU - Jennum, Poul

AU - Thorstensen, Eva Wiberg

AU - Pickering, Line

AU - Ibsen, Rikke

AU - Kjellberg, Jakob

N1 - Copyright © 2017 Elsevier B.V. All rights reserved.

PY - 2017/8

Y1 - 2017/8

N2 - OBJECTIVES: The objective of the study was to evaluate the morbidities and mortality in a national group of middle-aged and elderly narcolepsy patients before and after the first diagnosis of the condition.METHODS: From the Danish National Patient Registry (NPR), 1174 patients (45.1% males) aged 20-59 years and 339 patients (44.8% males) aged 60+ who received a diagnosis of narcolepsy between 1998 and 2014 were compared, respectively, with 4716 and 1353 control citizens matched for age, gender and geography, who were randomly chosen from the Danish Civil Registration System Statistics. In the NPR, all morbidities are grouped into major WHO classes.RESULTS: Middle-aged and elderly patients had more health contacts before and after their narcolepsy diagnosis with respect to several disease domains: infections, neoplasm, endocrine/metabolic diseases/diabetes, mental/psychiatric, neurological (including epilepsy), eye, cardiovascular (hypertension, ischemic heart disease), respiratory (upper-airway infections, sleep apnea), gastrointestinal, musculoskeletal (including discopathies) and skin diseases. Narcolepsy patients had lower reproductive rates. Furthermore, patients showed significantly more health contacts due to the evaluation and control contacts for disease and symptoms. Patients suffered from significantly more multiple diseases than did controls. The 17-year hazard ratio mortality rates were 1.35 (95% CI, 0.94-1.95, p = 0.106) among 20-59 year-olds, and 1.38 (1.12-1.69, p = 0.002) among those aged 60+ years.CONCLUSION: There are higher rates of morbidity in several disease domains before and after a diagnosis of narcolepsy. Elderly narcolepsy patients have higher mortality rates.

AB - OBJECTIVES: The objective of the study was to evaluate the morbidities and mortality in a national group of middle-aged and elderly narcolepsy patients before and after the first diagnosis of the condition.METHODS: From the Danish National Patient Registry (NPR), 1174 patients (45.1% males) aged 20-59 years and 339 patients (44.8% males) aged 60+ who received a diagnosis of narcolepsy between 1998 and 2014 were compared, respectively, with 4716 and 1353 control citizens matched for age, gender and geography, who were randomly chosen from the Danish Civil Registration System Statistics. In the NPR, all morbidities are grouped into major WHO classes.RESULTS: Middle-aged and elderly patients had more health contacts before and after their narcolepsy diagnosis with respect to several disease domains: infections, neoplasm, endocrine/metabolic diseases/diabetes, mental/psychiatric, neurological (including epilepsy), eye, cardiovascular (hypertension, ischemic heart disease), respiratory (upper-airway infections, sleep apnea), gastrointestinal, musculoskeletal (including discopathies) and skin diseases. Narcolepsy patients had lower reproductive rates. Furthermore, patients showed significantly more health contacts due to the evaluation and control contacts for disease and symptoms. Patients suffered from significantly more multiple diseases than did controls. The 17-year hazard ratio mortality rates were 1.35 (95% CI, 0.94-1.95, p = 0.106) among 20-59 year-olds, and 1.38 (1.12-1.69, p = 0.002) among those aged 60+ years.CONCLUSION: There are higher rates of morbidity in several disease domains before and after a diagnosis of narcolepsy. Elderly narcolepsy patients have higher mortality rates.

KW - Adult

KW - Age Factors

KW - Denmark/epidemiology

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Morbidity

KW - Narcolepsy/mortality

KW - Proportional Hazards Models

KW - Prospective Studies

KW - Young Adult

U2 - 10.1016/j.sleep.2017.03.029

DO - 10.1016/j.sleep.2017.03.029

M3 - Journal article

C2 - 28735916

SN - 1389-9457

VL - 36

SP - 23

EP - 28

JO - Sleep Medicine

JF - Sleep Medicine

ER -