Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort.

<h4>Background</h4>Modeling trajectories of decline can help describe the variability in progression of cognitive impairment in dementia. Better characterisation of these trajectories has significant implications for understanding disease progression, trial design and care planning.<h...

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Main Authors: Elizabeth Baker, Ehtesham Iqbal, Caroline Johnston, Matthew Broadbent, Hitesh Shetty, Robert Stewart, Robert Howard, Stephen Newhouse, Mizanur Khondoker, Richard J B Dobson
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0178562&type=printable
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author Elizabeth Baker
Ehtesham Iqbal
Caroline Johnston
Matthew Broadbent
Hitesh Shetty
Robert Stewart
Robert Howard
Stephen Newhouse
Mizanur Khondoker
Richard J B Dobson
author_facet Elizabeth Baker
Ehtesham Iqbal
Caroline Johnston
Matthew Broadbent
Hitesh Shetty
Robert Stewart
Robert Howard
Stephen Newhouse
Mizanur Khondoker
Richard J B Dobson
author_sort Elizabeth Baker
collection DOAJ
description <h4>Background</h4>Modeling trajectories of decline can help describe the variability in progression of cognitive impairment in dementia. Better characterisation of these trajectories has significant implications for understanding disease progression, trial design and care planning.<h4>Methods</h4>Patients with at least three Mini-mental State Examination (MMSE) scores recorded in the South London and Maudsley NHS Foundation Trust Electronic Health Records, UK were selected (N = 3441) to form a retrospective cohort. Trajectories of cognitive decline were identified through latent class growth analysis of longitudinal MMSE scores. Demographics, Health of Nation Outcome Scales and medications were compared across trajectories identified.<h4>Results</h4>Four of the six trajectories showed increased rate of decline with lower baseline MMSE. Two trajectories had similar initial MMSE scores but different rates of decline. In the faster declining trajectory of the two, a higher incidence of both behavioral problems and sertraline prescription were present.<h4>Conclusions</h4>We find suggestive evidence for association of behavioral problems and sertraline prescription with rate of decline. Further work is needed to determine whether trajectories replicate in other datasets.
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spelling doaj-art-c4393ac3d3934f79b682dc1af5ae7bf22025-08-20T02:03:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01126e017856210.1371/journal.pone.0178562Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort.Elizabeth BakerEhtesham IqbalCaroline JohnstonMatthew BroadbentHitesh ShettyRobert StewartRobert HowardStephen NewhouseMizanur KhondokerRichard J B Dobson<h4>Background</h4>Modeling trajectories of decline can help describe the variability in progression of cognitive impairment in dementia. Better characterisation of these trajectories has significant implications for understanding disease progression, trial design and care planning.<h4>Methods</h4>Patients with at least three Mini-mental State Examination (MMSE) scores recorded in the South London and Maudsley NHS Foundation Trust Electronic Health Records, UK were selected (N = 3441) to form a retrospective cohort. Trajectories of cognitive decline were identified through latent class growth analysis of longitudinal MMSE scores. Demographics, Health of Nation Outcome Scales and medications were compared across trajectories identified.<h4>Results</h4>Four of the six trajectories showed increased rate of decline with lower baseline MMSE. Two trajectories had similar initial MMSE scores but different rates of decline. In the faster declining trajectory of the two, a higher incidence of both behavioral problems and sertraline prescription were present.<h4>Conclusions</h4>We find suggestive evidence for association of behavioral problems and sertraline prescription with rate of decline. Further work is needed to determine whether trajectories replicate in other datasets.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0178562&type=printable
spellingShingle Elizabeth Baker
Ehtesham Iqbal
Caroline Johnston
Matthew Broadbent
Hitesh Shetty
Robert Stewart
Robert Howard
Stephen Newhouse
Mizanur Khondoker
Richard J B Dobson
Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort.
PLoS ONE
title Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort.
title_full Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort.
title_fullStr Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort.
title_full_unstemmed Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort.
title_short Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort.
title_sort trajectories of dementia related cognitive decline in a large mental health records derived patient cohort
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0178562&type=printable
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