Prevalence of Morbidity at Extreme Old Age in Germany: An Observational Study Using Health Claims Data

Doblhammer, Gabriele; Barth, Alfred

doi:10.1111/jgs.15460

Cited by 10 publications

(13 citation statements)

References 26 publications

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“…Other authors have documented similar findings, suggesting that conditions with high mortality risk are more prevalent in younger age groups [ 34 , 50 ]. A study showed that, at the same age, those living longer had a lower prevalence of most chronic diseases than those who died at an earlier age; the authors reported remarkable differences regarding dementia and chronic heart disease [ 63 ].…”

Section: Discussionmentioning

confidence: 99%

Multimorbidity Clusters in the Oldest Old: Results from the EpiChron Cohort

Ioakeim-Skoufa

Clerencia-Sierra

Moreno-Juste

et al. 2022

IJERPH

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Multimorbidity is challenging for both patients and healthcare systems due to its increasing prevalence and high impact on people’s health and well-being. The risk of multimorbidity increases with age, but there is still more to discover regarding the clinical profile of the oldest old. In this study, we used information from the EpiChron Cohort Study to identify multimorbidity patterns in individuals who died during the period 2010–2019 at the ages of 80–89, 90–99, and ≥100. This cohort links the demographic, clinical, and drug dispensation information of public health system users in Aragón, Spain. We saw a significantly lower number of chronic diseases and drugs and a lower prevalence of polypharmacy in centenarians compared to those aged 80–99. K-means clustering revealed different multimorbidity clusters by sex and age group. We observed clusters of cardiovascular and metabolic diseases, obstructive pulmonary conditions, and neoplasms, amongst other profiles. One in three octogenarian women had a metabolic pattern (diabetes, dyslipidaemia, and other endocrine–metabolic disorders) with the highest number of diseases (up to seven) and prevalence of polypharmacy (64%). We observed clusters of dementia and genitourinary disorders in individuals on medication with anticholinergic activity. Our study offers an opportunity to better understand the urgency of adequately addressing multimorbidity in our older adults.

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Section: Discussionmentioning

confidence: 99%

Multimorbidity Clusters in the Oldest Old: Results from the EpiChron Cohort

Ioakeim-Skoufa

Clerencia-Sierra

Moreno-Juste

et al. 2022

IJERPH

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“…We included 23 major age‐related diseases 20 and risk factors for dementia according to the factors reported by the Lancet Commission 21 (see Table S1 for the respective ICD codes). In addition, we included all medical prescriptions coded by the German version of the ATC classification system on the 3rd level (pharmacological subgroup), and all surgeries based on three‐digit classes from Chapter 5 of the OPS.…”

Section: Methodsmentioning

confidence: 99%

Dementia risk predictions from German claims data using methods of machine learning

Reinke

Doblhammer

Schmid

et al. 2022

Alzheimer's & Dementia

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Introduction We examined whether German claims data are suitable for dementia risk prediction, how machine learning (ML) compares to classical regression, and what the important predictors for dementia risk are. Methods We analyzed data from the largest German health insurance company, including 117,895 dementia‐free people age 65+. Follow‐up was 10 years. Predictors were: 23 age‐related diseases, 212 medical prescriptions, 87 surgery codes, as well as age and sex. Statistical methods included logistic regression (LR), gradient boosting (GBM), and random forests (RFs). Results Discriminatory power was moderate for LR (C‐statistic = 0.714; 95% confidence interval [CI] = 0.708–0.720) and GBM (C‐statistic = 0.707; 95% CI = 0.700–0.713) and lower for RF (C‐statistic = 0.636; 95% CI = 0.628–0.643). GBM had the best model calibration. We identified antipsychotic medications and cerebrovascular disease but also a less‐established specific antibacterial medical prescription as important predictors. Discussion Our models from German claims data have acceptable accuracy and may provide cost‐effective decision support for early dementia screening.

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“…Through a PubMed literature review focused on dementia excess mortality and relative risk spanning 1980 to 2018, we identified 4470 total hits, of which 34 studies were marked for extraction (additional details in supporting information) 23–56 . The data sources included clinical or community‐based cohorts and excluded studies conducted solely in nursing homes.…”

Section: Methodsmentioning

confidence: 99%

Global mortality from dementia: Application of a new method and results from the Global Burden of Disease Study 2019

Nichols¹,

Abd‐Allah²,

Abdoli³

et al. 2021

A&D Transl Res & Clin Interv

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Introduction Dementia is currently one of the leading causes of mortality globally, and mortality due to dementia will likely increase in the future along with corresponding increases in population growth and population aging. However, large inconsistencies in coding practices in vital registration systems over time and between countries complicate the estimation of global dementia mortality. Methods We meta‐analyzed the excess risk of death in those with dementia and multiplied these estimates by the proportion of dementia deaths occurring in those with severe, end‐stage disease to calculate the total number of deaths that could be attributed to dementia. Results We estimated that there were 1.62 million (95% uncertainty interval [UI]: 0.41–4.21) deaths globally due to dementia in 2019. More dementia deaths occurred in women (1.06 million [0.27–2.71]) than men (0.56 million [0.14–1.51]), largely but not entirely due to the higher life expectancy in women (age‐standardized female‐to‐male ratio 1.19 [1.10–1.26]). Due to population aging, there was a large increase in all‐age mortality rates from dementia between 1990 and 2019 (100.1% [89.1–117.5]). In 2019, deaths due to dementia ranked seventh globally in all ages and fourth among individuals 70 and older compared to deaths from other diseases estimated in the Global Burden of Disease (GBD) study. Discussion Mortality due to dementia represents a substantial global burden, and is expected to continue to grow into the future as an older, aging population expands globally.

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Prevalence of Morbidity at Extreme Old Age in Germany: An Observational Study Using Health Claims Data

Cited by 10 publications

References 26 publications

Multimorbidity Clusters in the Oldest Old: Results from the EpiChron Cohort

Multimorbidity Clusters in the Oldest Old: Results from the EpiChron Cohort

Dementia risk predictions from German claims data using methods of machine learning

Global mortality from dementia: Application of a new method and results from the Global Burden of Disease Study 2019

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