Identifying dementia using medical data linkage in a longitudinal cohort study: Lothian Birth Cohort 1936.
Identifying dementia using medical data linkage in a longitudinal cohort study: Lothian Birth Cohort 1936.
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DOI：
10.1186/s12888-023-04797-7
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发表时间：
2023-05-01
期刊：
影响因子：
4.4
通讯作者：
中科院分区：
文献类型：
--
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Lothian Birth Cohort 1936 (LBC1936) 是一项针对衰老的纵向研究，具有良好的评估特征，但到目前为止，它一直依赖于自我报告或痴呆症的替代指标，例如认知测试。我们的目标有两个：a）描述在队列研究中识别痴呆症的框架。 b) 报告 LBC1936 中 865 名个体的全因痴呆和痴呆亚型的年龄特定发病率和患病率。审查了所有参与者的电子健康记录（EHR），并提取了相关信息，为有任何认知功能障碍记录的每个人形成案例摘要。 EHR 数据来源包括医院和诊所信件、全科医生和医院转诊、处方药物、影像和实验室结果。死亡证明数据是单独获得的。当担心参与者的认知时，进行临床医生评估。诊断审查委员会一致同意对可能痴呆、可能痴呆或无痴呆的诊断，该委员会由临床痴呆专家组成的多学科团队组成，他们审查了病例简介和临床医生评估函。对于那些可能患有痴呆症的人，在可能的情况下还确定了亚型。我们将新确定的痴呆症诊断与现有自我报告的痴呆症诊断之间的一致性进行了比较。在已确定的痴呆症诊断中，自我报告的痴呆症诊断仅占 17.8%。 EHR 审查发现 163/865 (18.8%) 人患有认知功能障碍。在共识诊断审查委员会中，118/163 人被诊断患有可能的全因痴呆症，患病率为 13.6%。年龄特异性痴呆患病率随着年龄的增长从 0.8%（65-74.9 岁）增加到 9.93%（85-89.9 岁）。几乎所有年龄段的女性患病率均较高。最常见的亚型是阿尔茨海默病引起的痴呆（49.2%），其次是阿尔茨海默病和脑血管疾病混合型（17.0%）、原因不明或未明确原因的痴呆（16.1%）和血管疾病引起的痴呆（8.5%）。我们为其他想要确定痴呆症诊断的队列团队提供了一个强大的系统框架和指南。新确定的痴呆症诊断为 LBC1936 的进一步分析提供了重要数据，以便探索痴呆症的生命全程预测因子。在线版本包含可在 10.1186/s12888-023-04797-7 获取的补充材料。
The Lothian Birth Cohort 1936 (LBC1936) is a longitudinal study of ageing with well-characterised assessments, but until now, it has relied on self-report or proxies for dementia such as cognitive tests. Our aims were twofold: a) to describe a framework for identifying dementia in a cohort study. b) to report the age-specific incidence and prevalence of all-cause dementia and dementia subtypes in 865 individuals in the LBC1936. Electronic Health Records (EHR) of all participants were reviewed, and relevant information was extracted to form case vignettes for everyone with any record of cognitive dysfunction. The EHR data sources include hospital and clinic letters, general practitioner and hospital referrals, prescribed medications, imaging and laboratory results. Death certificate data were obtained separately. Clinician assessments were performed when there was concern about a participant's cognition. A diagnosis of probable dementia, possible dementia, or no dementia was agreed upon by a consensus diagnostic review board, comprised of a multidisciplinary team of clinical dementia experts who reviewed case vignettes and clinician assessment letters. For those with probable dementia, a subtype was also determined, where possible. We compared the agreement between our newly ascertained dementia diagnoses with the existing self-reported dementia diagnoses. Self-reported dementia diagnoses were positive in only 17.8% of ascertained dementia diagnoses. The EHR review identified 163/865 (18.8%) individuals as having cognitive dysfunction. At the consensus diagnostic review board, 118/163 were diagnosed with probable all-cause dementia, a prevalence of 13.6%. Age-specific dementia prevalence increased with age from 0.8% (65–74.9 years) to 9.93% (85–89.9 years). Prevalence rates for women were higher in nearly all age groups. The most common subtype was dementia due to Alzheimer disease (49.2%), followed by mixed Alzheimer and cerebrovascular disease (17.0%), dementia of unknown or unspecified cause (16.1%), and dementia due to vascular disease (8.5%). We present a robust systematic framework and guide for other cohort teams wanting to ascertain dementia diagnoses. The newly ascertained dementia diagnosis provides vital data for further analyses of LBC1936 to allow exploration of lifecourse predictors of dementia. The online version contains supplementary material available at 10.1186/s12888-023-04797-7.
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影响因子：
168.9
作者：
Matthews, Fiona E.;Arthur, Antony;Barnes, Linda E.;Bond, John;Jagger, Carol;Robinson, Louise;Brayne, Carol
通讯作者：
Brayne, Carol
影响因子：
4.1
作者：
Deary IJ;Gow AJ;Taylor MD;Corley J;Brett C;Wilson V;Campbell H;Whalley LJ;Visscher PM;Porteous DJ;Starr JM
通讯作者：
Starr JM
影响因子：
4.4
作者：
Sibbett, Ruth A.;Russ, Tom C.;Starr, John M.
通讯作者：
Starr, John M.
影响因子：
2.4
作者：
Hsieh, Sharpley;Schubert, Samantha;Hodges, John R.
通讯作者：
Hodges, John R.
影响因子：
7.7
作者：
Taylor AM;Pattie A;Deary IJ
通讯作者：
Deary IJ