Pujades-Rodriguez, M orcid.org/0000-0002-1375-1028, Assi, V, Gonzalez-Izquierdo, A et al. (5 more authors) (2018) The diagnosis, burden and prognosis of dementia: a record-linkage cohort study in England. PLoS ONE, 13 (6). e0199026. ISSN 1932-6203
Abstract
Objectives: Electronic health records (EHR) might be a useful resource to study the risk factors and clinical care of people with dementia. We sought to determine the diagnostic validity of dementia captured in linked EHR.
Methods and findings: A cohort of adults in linked primary care, hospital, disease registry and mortality records in England, [CALIBER (CArdiovascular disease research using LInked Bespoke studies and Electronic health Records)]. The proportion of individuals with dementia, Alzheimer’s disease, vascular and rare dementia in each data source was determined. A comparison was made of symptoms and care between people with dementia and age-, sex- and general practice-matched controls, using conditional logistic regression. The lifetime risk and prevalence of dementia and mortality rates in people with and without dementia were estimated with random-effects Poisson models. There were 47,386 people with dementia: 12,633 with Alzheimer’s disease, 9540 with vascular and 1539 with rare dementia. Seventy-four percent of cases had corroborating evidence of dementia. People with dementia were more likely to live in a deprived area (conditional OR 1.26;95%CI:1.20–1.31 most vs least deprived), have documented memory impairment (cOR = 11.97;95%CI:11.24–12.75), falls (cOR = 2.36;95%CI:2.31–2.41), depression (cOR = 2.03; 95%CI:1.98–2.09) or anxiety (cOR = 1.27; 95%CI:1.23–1.32). The lifetime risk of dementia at age 65 was 9.2% (95%CI:9.0%-9.4%), in men and 14.9% (95%CI:14.7%-15.1%) in women. The population prevalence of recorded dementia increased from 0.3% in 2000 to 0.7% in 2010. A higher mortality rate was observed in people with than without dementia (IRR = 1.56;95%CI:1.54–1.58).
Conclusions: Most people with a record of dementia in linked UK EHR had some corroborating evidence for diagnosis. The estimated 10-year risk of dementia was higher than published population-based estimations. EHR are therefore a promising source of data for dementia research.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | (c) 2018 Pujades-Rodriguez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited; https://creativecommons.org/licenses/by/4.0/ |
Keywords: | cohort; dementia; electronic health records; mortality; prevalence; prognosis; risk assessment |
Dates: |
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Institution: | The University of Leeds |
Depositing User: | Symplectic Publications |
Date Deposited: | 20 Jun 2018 13:04 |
Last Modified: | 15 Aug 2018 15:31 |
Status: | Published |
Publisher: | Public Library of Science (PLoS) |
Identification Number: | 10.1371/journal.pone.0199026 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:132329 |
Commentary/Response Threads
- Pujades-Rodriguez, M, Assi, V, Gonzalez-Izquierdo, A, Wilkinson, T, Schnier, C, Sudlow, C, Hemingway, H and Whiteley, WN The diagnosis, burden and prognosis of dementia: a record-linkage cohort study in England. (deposited 20 Jun 2018 13:04) [Currently Displayed]
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