The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England.
The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England.
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DOI：
10.1371/journal.pone.0199026
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Whiteley WN
中科院分区：
文献类型：
--
作者：
Pujades-Rodriguez M;Assi V;Gonzalez-Izquierdo A;Wilkinson T;Schnier C;Sudlow C;Hemingway H;Whiteley WN
电子健康记录（EHR）可能是一个有用的资源，研究痴呆症患者的危险因素和临床护理。我们试图确定关联EHR中捕获的痴呆症的诊断有效性。在英国，一组成年人在链接的初级保健，医院，疾病登记和死亡率记录，[CALIBER（使用链接的定制研究和电子健康记录的心血管疾病研究）]。确定了每个数据源中痴呆症、阿尔茨海默病、血管性和罕见痴呆症患者的比例。采用条件Logistic回归分析，对痴呆症患者与年龄、性别和一般实践相匹配的对照组之间的症状和护理进行了比较。采用随机效应泊松模型估计了痴呆症的终生风险和患病率以及痴呆症患者和非痴呆症患者的死亡率。有47,386人患有痴呆症：12,633人患有阿尔茨海默病，9540人患有血管性痴呆症，1539人患有罕见痴呆症。74%的病例有痴呆症的确凿证据。痴呆症患者更可能生活在贫困地区（条件OR 1.26;95%CI：1.20-1.31大多数与最少贫困），有记录的记忆障碍（cOR = 11.97;95%CI：11.24-12.75），福尔斯（cOR = 2.36;95%CI：2.31-2.41），抑郁（cOR = 2.03; 95%CI：1.98-2.09）或焦虑（cOR = 1.27; 95%CI：1.23-1.32）。在65岁时，男性和女性患痴呆症的终生风险分别为9.2%（95%CI：9.0%-9.4%）和14.9%（95%CI：14.7%-15.1%）。有记录的痴呆症的人口患病率从2000年的0.3%上升到2010年的0.7%。痴呆患者的死亡率高于非痴呆患者（IRR = 1.56;95%CI：1.54-1.58）。大多数在英国EHR中有痴呆症记录的人都有一些确凿的诊断证据。估计的10年痴呆症风险高于已发表的基于人口的估计。因此，EHR是痴呆症研究的一个有前途的数据来源。
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. 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). 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.
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影响因子：
9.9
作者：
Seshadri, S;Wolf, PA;D'Agostino, RB
通讯作者：
D'Agostino, RB
DOI：
10.1056/nejmoa1504327
发表时间：
2016-02-11
期刊：
The New England journal of medicine
影响因子：
--
作者：
Satizabal CL;Beiser AS;Chouraki V;Chêne G;Dufouil C;Seshadri S
通讯作者：
Seshadri S
影响因子：
4.5
作者：
Matthews FE;Chatfield M;Freeman C;McCracken C;Brayne C;MRC CFAS
通讯作者：
MRC CFAS
影响因子：
7.7
作者：
Denaxas SC;George J;Herrett E;Shah AD;Kalra D;Hingorani AD;Kivimaki M;Timmis AD;Smeeth L;Hemingway H
通讯作者：
Hemingway H
影响因子：
6.9
作者：
Eefsting, JA;Boersma, F;VanTilburg, W
通讯作者：
VanTilburg, W