A commentary on studies presenting projections of the future prevalence of dementia

Norton, Sam; Matthews, Fiona E.; Brayne, Carol

doi:10.1186/1471-2458-13-1

Cited by 988 publications

(1,124 citation statements)

References 24 publications

(34 reference statements)

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“…Inconsistent evidence makes it difficult to justify the claim that LB women have fewer reproductive behaviours than heterosexual women. Previous systematic reviews on the health of LB women have considered smoking cessation,24 mental health,25 substance abuse,26 weight,4 breast cancer27 and cervical screening 7. One narrative review concluded there was little to no published literature on incidence and prevalence of endometrial and cervical cancer in LB women, and that further research was necessary to fill the knowledge gap 28…”

Section: Introductionmentioning

confidence: 99%

Lesbian and bisexual women's gynaecological conditions: a systematic review and exploratory meta‐analysis

Robinson

Galloway

Bewley

et al. 2016

BJOG

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BackgroundLittle is known about the gynaecological health of lesbian and bisexual (LB) women.ObjectivesTo examine differences in incidence and/or prevalence of gynaecological conditions in LB compared with heterosexual women.Search strategyThe systematic review protocol was prospectively registered (PROSPERO‐CRD42015027091) and searches conducted in seven databases.Selection criteriaComparative studies published 2000–2015, reporting any benign (non‐infectious) and/or malignant gynaecological conditions with no language or setting restrictions.Data collection and analysisInclusions, data extraction and quality assessment were conducted in duplicate. Meta‐analyses of condition prevalence rates were conducted where ≥3 studies reported results.Main resultsFrom 567 records, 47 full papers were examined and 11 studies of mixed designs included. No studies directly addressing the question were found. Two chronic pelvic pain studies reported higher rates in bisexual compared with heterosexual women (38.5 versus 28.2% and 18.6 versus 6.4%). Meta‐analyses showed no statistically significant differences in polycystic ovarian syndrome, endometriosis and fibroids. There was a higher rate of cervical cancer in bisexual than heterosexual women [odds ratio (OR) = 1.94; 95% CI 1.46–2.59] but no difference overall (OR = 0.76; 95% CI 0.15–3.92). There was a lower rate of uterine cancer in lesbian than heterosexual women (OR = 0.28; 95% CI 0.11–0.73) and overall (OR = 0.36; 95% CI 0.13–0.97), but no difference in bisexual women (OR = 0.43; 95% CI 0.06–3.07).ConclusionsMore bisexual women may experience chronic pelvic pain and cervical cancer than heterosexual women. There is no information on potential confounders. Better evidence is required, preferably monitoring sexual orientation in research using the existing validated measure and fully reporting results.Tweetable abstractLesbians have less uterine cancer than heterosexual women; bisexuals have more pelvic pain and cervical cancer.

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Section: Introductionmentioning

confidence: 99%

Lesbian and bisexual women's gynaecological conditions: a systematic review and exploratory meta‐analysis

Robinson

Galloway

Bewley

et al. 2016

BJOG

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“…Third, current dementia projection methods are typically based on the assumption that certain factors will remain stable over time, such as age-specific dementia prevalence (ADI, 2015), mortality, and dementia risk factors (except demographics) (Rocca et al, 2011). Such projections do not adequately account for "changing patterns in risk factors" (Norton et al, 2013), i.e. trends in population-level factors, Time trends in dementia incidence and prevalence 1645 that can be accounted for in studies based on administrative health data.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous temporal trends in dementia incidence and prevalence, 2005–2013: a population-based retrospective cohort study in Saskatchewan, Canada

Kosteniuk

Morgan

O’Connell

et al. 2016

Int. Psychogeriatr.

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Background:Original studies published over the last decade regarding time trends in dementia report mixed results. The aims of the present study were to use linked administrative health data for the province of Saskatchewan for the period 2005/2006 to 2012/2013 to: (1) examine simultaneous temporal trends in annual age-and sex-specific dementia incidence and prevalence among individuals aged 45 and older, and (2) stratify the changes in incidence over time by database of identification.

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“…[3][4][5] It is associated with significant disability for patients, considerable caregiver burden and increased use of health and social services. [6][7][8][9][10] The United Kingdom estimates forecast an increase from approximately 750,000 individuals currently affected to more than 1.7 million by 2051 as the population ages.…”

Section: Introductionmentioning

confidence: 99%

Place of death and end-of-life transitions experienced by very old people with differing cognitive status: Retrospective analysis of a prospective population-based cohort aged 85 and over

et al. 2013

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Background: Despite fast-growing 'older old' populations, 'place of care' trajectories for very old people approaching death with or without dementia are poorly described and understood. Aim: To explore end-of-life transitions of 'older old' people across the cognitive spectrum. Design: Population-based prospective cohort (United Kingdom) followed to death. Setting/participants: Mortality records linked to 283 Cambridge City over-75s Cohort participants' cognitive assessments <1 year before dying aged ≥85 years. Results: Overall, 69% were community dwelling in the year before death; of those with severe cognitive impairment 39% were community dwelling. Only 6% subsequently changed their usual address. However, for 55% their usual address on death registration was not their place of death. Dying away from the 'usual address' was associated with cognition, overall fewer moving with increasing cognitive impairment -cognition intact 66%, mildly/moderately impaired 55% and severely impaired 42%, trend p = 0.003. This finding reflects transitions being far more common from the community than from institutions: 73% from the community and 28% from institutions did not die where last interviewed (p < 0.001). However, severely cognitively impaired people living in the community were the most likely group of all to move: 80% (68%−93%). Hospitals were the most common place of death except for the most cognitively impaired, who mostly died in care homes. Conclusion: Most very old community-dwelling individuals, especially the severely cognitively impaired, died away from home. Findings also suggest that long-term care may play a role in avoidance of end-of-life hospital admissions. These results provide important information for planning end-of-life services for older people across the cognitive spectrum, with implications for policies aimed at supporting home deaths. KeywordsCognitive impairment, dementia, aged, 80 and over, aged, frail elderly, patient transfer, residential characteristics, homes for the aged, nursing homes, delivery of health care, terminal care 221What is already known about the topic?• More people will be dying in very old age and dying with dementia or cognitive impairment.• Half the very old move in the last year of life and die away from their usual residence, but it is poorly understood how cognitive impairment affects these transitions. What this article adds?• Prospective population-based research with very old people, including cognitive assessments, reveals patterns in individual trajectories through care settings that routine data cannot explore.• Although 39% of ≥85-year-olds with severe cognitive impairment live in the community in their last year of life, only 8% die there, compared with 20% home deaths among cognitively unimpaired ≥85-year-olds.• The proportions of very old people dying in hospitals or in care homes decrease and increase, respectively, with worsening cognitive impairment. Implications for practice, theory or policy• Community end-of-life care provision needs to in...

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A commentary on studies presenting projections of the future prevalence of dementia

Cited by 988 publications

References 24 publications

Lesbian and bisexual women's gynaecological conditions: a systematic review and exploratory meta‐analysis

Lesbian and bisexual women's gynaecological conditions: a systematic review and exploratory meta‐analysis

Simultaneous temporal trends in dementia incidence and prevalence, 2005–2013: a population-based retrospective cohort study in Saskatchewan, Canada

Place of death and end-of-life transitions experienced by very old people with differing cognitive status: Retrospective analysis of a prospective population-based cohort aged 85 and over

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