The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England.
<h4>Objectives</h4>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.<h4>Methods and findings</h4>A cohort of adults...
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Public Library of Science (PLoS)
2018-01-01
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| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0199026&type=printable |
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| author | Mar Pujades-Rodriguez Valentina Assi Arturo Gonzalez-Izquierdo Tim Wilkinson Christian Schnier Cathie Sudlow Harry Hemingway William N Whiteley |
| author_facet | Mar Pujades-Rodriguez Valentina Assi Arturo Gonzalez-Izquierdo Tim Wilkinson Christian Schnier Cathie Sudlow Harry Hemingway William N Whiteley |
| author_sort | Mar Pujades-Rodriguez |
| collection | DOAJ |
| description | <h4>Objectives</h4>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.<h4>Methods and findings</h4>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).<h4>Conclusions</h4>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. |
| format | Article |
| id | doaj-art-2df681c63d154c13a3d6a09862fc6d90 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-2df681c63d154c13a3d6a09862fc6d902025-08-20T02:03:52ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01136e019902610.1371/journal.pone.0199026The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England.Mar Pujades-RodriguezValentina AssiArturo Gonzalez-IzquierdoTim WilkinsonChristian SchnierCathie SudlowHarry HemingwayWilliam N Whiteley<h4>Objectives</h4>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.<h4>Methods and findings</h4>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).<h4>Conclusions</h4>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.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0199026&type=printable |
| spellingShingle | Mar Pujades-Rodriguez Valentina Assi Arturo Gonzalez-Izquierdo Tim Wilkinson Christian Schnier Cathie Sudlow Harry Hemingway William N Whiteley The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England. PLoS ONE |
| title | The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England. |
| title_full | The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England. |
| title_fullStr | The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England. |
| title_full_unstemmed | The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England. |
| title_short | The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England. |
| title_sort | diagnosis burden and prognosis of dementia a record linkage cohort study in england |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0199026&type=printable |
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