How good are medical and death records for identifying dementia?

Schliep, Karen C.; Ju, Shinyoung; Foster, Norman L.; Smith, Ken R.; Varner, Michael W.; Østbye, Truls; Tschanz, JoAnn T.

doi:10.1002/alz.12526

Cited by 5 publications

(10 citation statements)

References 36 publications

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“…Further research that takes into account confounding of the exposure–mediator relationship and of the mediator–outcome relationship is warranted. Second, we recognize that using administrative health‐care records for dementia ascertainment may result in misclassification, especially in underdetection of dementia 41 . Worldwide there are barriers to receiving a diagnosis of a dementing disease, 48 an inherent limitation of studying dementia that impacts all research in this field.…”

Section: Discussionmentioning

confidence: 99%

“…We further classified dementia as AD, vascular dementia, or other/unspecified dementia including frontotemporal dementia, dementia with Lewy bodies, or all others. Our prior research indicates that UPDB administrative health records from 1996 to 2008 have 71% sensitivity and 81% specificity for all‐cause dementia diagnoses compared to gold‐standard research diagnoses 41 …”

Section: Methodsmentioning

confidence: 99%

“…Our prior research indicates that UPDB administrative health records from 1996 to 2008 have 71% sensitivity and 81% specificity for all‐cause dementia diagnoses compared to gold‐standard research diagnoses. 41 …”

Section: Methodsmentioning

confidence: 99%

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Hypertensive disorders of pregnancy and subsequent risk of Alzheimer's disease and other dementias

Schliep,

Shaaban,

Meeks

et al. 2023

Alz & Dem Diag Ass & Dis Mo

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Introduction:Women with hypertensive disorders of pregnancy (HDP) have an increased risk of cardiovascular disease. Whether HDP is also associated with later-life dementia has not been fully explored.Methods: Using the Utah Population Database, we performed an 80-year retrospective cohort study of 59,668 parous women.Results: Women with, versus without, HDP, had a 1.37 higher risk of all-cause dementia (95% confidence interval [CI]: 1.26, 1.50) after adjustment for maternal age at index birth, birth year, and parity. HDP was associated with a 1.64 higher risk of vascular dementia (95% CI: 1.19, 2.26) and 1.49 higher risk of other dementia (95% CI: 1.34, 1.65) but not Alzheimer's disease dementia (adjusted hazard ratio = 1.04; 95% CI: 0.87, 1.24). Gestational hypertension and preeclampsia/eclampsia showed similar increasedThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Hypertensive disorders of pregnancy and subsequent risk of Alzheimer's disease and other dementias

Schliep,

Shaaban,

Meeks

et al. 2023

Alz & Dem Diag Ass & Dis Mo

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“…International variations in the recording of dementia or AD as the UCOD can be further divided into variations in the underreporting of dementia or AD as a COD and variations in the recording of dementia or AD in part I of a death certificate. Several cohort studies have identified an underreporting of dementia or AD as a COD on death certificates 26–31 . Physicians in hypothetical countries A through C were more likely than those in Country D to diagnose AD as the COD.…”

Section: Discussionmentioning

confidence: 99%

“…Several cohort studies have identified an underreporting of dementia or AD as a COD on death certificates. [26][27][28][29][30][31] Physicians in hypothetical countries A through C were more likely than those in Country D to diagnose AD as the COD. Furthermore, physicians in hypothetical countries A and B were more likely than those in Country C to record AD in the death certificate resulting in higher recorded AD mortality rates in countries A and B (Fig.…”

Section: With Regard To the Timely Diagnosis Of Dementia And Ad Globa...mentioning

confidence: 95%

International Variations in Dementia and Alzheimer Disease Diagnosis and Certification Habits and Their Associations With Dementia and Alzheimer Disease Mortality

Chi,

Chu,

Chang

et al. 2023

Alzheimer Disease &Amp; Associated Disorders

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Objective: To examine international variations in national diagnosis and certification habits prefer recording dementia (D) versus Alzhiemer disease (AD) as the underlying cause of death (UCOD) and their associations with mortality rates of dementia and AD. Methods: We calculated proportions of D/D+AD and AD/D+AD deaths as proxies of national diagnosis and certification habits. Pearson correlation coefficients (r) were estimated to assess the associations of proportions with the mortality rates of dementia or AD among adults aged 75 to 84 years across 38 countries. Results: The countries with a high preference for recording dementia as the UCOD were Taiwan and Latvia with proportion of D/D+AD deaths of 92% and 88%, respectively, and those with a high preference for recording AD as the UCOD were Slovenia, Turkey, and Poland with proportion of AD/D+AD deaths of 100%, 99%, and 89%, respectively. The r values for the proportions and mortality rate for dementia and AD were 0.67 (95% CI: 0.44-0.81) and 0.46 (95% CI: 0.16-0.68), respectively. Conclusion: We identified a small number of countries with obvious natonal diagnosis and certification habits preferring dementia or AD and had moderate effects on international variations in the mortality rates of dementia and AD.

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Prevalence of treated patients with Alzheimer’s disease: current trends and COVID-19 impact

Olazarán

Carnero-Pardo²,

Fortea

et al. 2023

Alz Res Therapy

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Background There are few updated studies on the prevalence and management of Alzheimer’s disease (AD), which could be underdiagnosed or undertreated. The COVID-19 pandemic may have worsened the deficiencies in the diagnosis and treatment of these patients. Electronic medical records (EMR) offer an opportunity to assess the impact and management of medical processes and contingencies in the population. Objective To estimate AD prevalence in Spain over a 6-year period, based on treated patients, according to usual clinical practice. Additionally, to describe the management of AD-treated patients and the evolution of that treatment during the 2020 COVID-19 pandemic. Methods Retrospective study using the Spanish IQVIA EMR database. Patients treated with donepezil, galantamine, rivastigmine, and/or memantine were included in the study. Annual AD prevalence (2015–2020) was estimated and extrapolated to the national population level. Most frequent treatments and involved specialties were described. To assess the effect of COVID-19, the incidence of new AD cases in 2020 was calculated and compared with newly diagnosed cases in 2019. Results Crude AD prevalence (2015–2020) was estimated at 760.5 per 100,000 inhabitants, and age-standardized prevalence (2020) was 664.6 (male 595.7, female 711.0). Monotherapy was the most frequent way to treat AD (86.2%), in comparison with dual therapy (13.8%); rivastigmine was the most prescribed treatment (37.3%), followed by memantine (36.4%) and donepezil (33.0%). Rivastigmine was also the most utilized medication in newly treated patients (46.7%), followed by donepezil (29.8%), although donepezil persistence was longer (22.5 vs. 20.6 months). Overall, donepezil 10 mg, rivastigmine 9.5 mg, and memantine 20 mg were the most prescribed presentations. The incidence rate of AD decreased from 148.1/100,000 (95% confidence interval [CI] 147.0–149.2) in 2019 to 118.4/100,000 (95% CI 117.5–119.4) in 2020. Conclusions The obtained prevalence of AD-treated patients was consistent with previous face-to-face studies. In contrast with previous studies, rivastigmine, rather than donepezil, was the most frequent treatment. A decrease in the incidence of AD-treated patients was observed during 2020 in comparison with 2019, presumably due to the significant impact of the COVID-19 pandemic on both diagnosis and treatment. EMR databases emerge as valuable tools to monitor in real time the incidence and management of medical conditions in the population, as well as to assess the health impact of global contingencies and interventions.

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How good are medical and death records for identifying dementia?

Cited by 5 publications

References 36 publications

Hypertensive disorders of pregnancy and subsequent risk of Alzheimer's disease and other dementias

Hypertensive disorders of pregnancy and subsequent risk of Alzheimer's disease and other dementias

International Variations in Dementia and Alzheimer Disease Diagnosis and Certification Habits and Their Associations With Dementia and Alzheimer Disease Mortality

Prevalence of treated patients with Alzheimer’s disease: current trends and COVID-19 impact

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