Autore: Antonia Mincuzzi, Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
antonia.mincuzzi@asl.taranto.it
Paolo LODESERTO, Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy; Jennifer ZOLLINO, Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy; Giuseppe CORIGLIONE, Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy; Paola TRANCHINA, Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy; Rodolfo SARDONE, Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy; Lucia BISCEGLIA, Strategic Regional Agency for Health and Social Care of Apulia, Bari, Italy; Francesco ADDABBO, Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy; Sante MINERBA, Healthcare Management, Local Health Authority of Taranto, Taranto, Italy; Vito Gregorio COLACICCO, General Management, Local Health Authority of Taranto, Taranto, Italy; Orazio Valerio GIANNICO, Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy;
Categoria Primaria: Ambiente e salute
Categoria Secondaria: Farmacoepidemiologia
Introduction: In Taranto, Southern Italy, adverse impacts on environment and human health due to industrial installations have been studied. In literature, associations have been reported between different factors and dementia mortality in women and men. The aim of this study was to investigate the relationships between gender, residence in areas with high environmental pressures, age, disease duration, pandemic years, anti-dementia drugs, and death rate.
Methods: Data from the regional prescription registry were used, including all women and men with an anti-dementia medication prescription between 2015 and 2021 and with follow-up to 2021. Bayesian mixed effects logistic and Cox regression models with time varying exposures were fitted with the approach of integrated nested Laplace approximation, adjusting for patients and therapy characteristics.
Results: A total of 7,961 person-years were observed. Variables associated with lower prevalence of acetylcholinesterase inhibitors (AChEIs) prescription were male gender (OR 0.63, 95% CrI 0.42-0.96), age 70-79 (OR 0.17, 95% CrI 0.06-0.47) and ≥80 years (OR 0.08, 95% CrI 0.03-0.23), disease duration of 2-3 years (OR 0.43, 95%CrI 0.32-0.56) and 4-6 years (OR 0.21, 95% CrI 0.13-0.33), and pandemic years 2020 (OR 0.50, 95% CrI 0.37-0.67) and 2021 (OR 0.47, 95% CrI 0.33-0.65). Variables associated with higher death rate were male gender (HR 2.14, 95% CrI 1.75-2.62), residence in the contaminated site of national interest (SIN) (HR 1.25, 95% CrI 1.02-1.53), age ≥80 years (HR 6.06, 95% CrI 1.94-18.95), disease duration of 1 year (HR 1.50, 95% CrI 1.12-2.01), 2-3 years (HR 1.90, 95% CrI 1.45-2.48), 4-6 years (HR 2.21, 95% CrI 1.60.3.07), and pandemic years 2020 (HR 1.38, 95% CrI 1.06-1.80) and 2021 (HR 1.56, 95% CrI 1.21-2.02). Variables associated with lower death rate were prescription of AChEIs alone (HR 0.69, 95% CrI 0.56-0.86) and in combination with memantine (HR 0.54, 95% CrI 0.37-0.81).
Discussion: Male gender, age, disease duration, and pandemic years appeared to be associated with lower AChEIs prescriptions. Male gender, residence in the SIN of Taranto, age, disease duration, and pandemic years appeared to be associated with an increased death rate, while AChEIs prescription seemed to be associated with improved survival rate.