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PLoS One. 2018 Jun 26;13(6):e0199026. doi: 10.1371/journal.pone.0199026. eCollection 2018.

The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England.

Author information

1
Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom.
2
Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom.
3
Institute of Health Informatics, University College London, London, United Kingdom.
4
Health Data Research UK London, London, United Kingdom.
5
Health Data Research UK Scotland, Edinburgh, United Kingdom.
6
Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.

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.

PMID:
29944675
PMCID:
PMC6019102
DOI:
10.1371/journal.pone.0199026
[Indexed for MEDLINE]
Free PMC Article

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