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  1. Article ; Online: The incidence, baseline predictors, and outcomes of dementia in an incident cohort of Parkinson's disease and controls.

    Counsell, Carl / Giuntoli, Cinzia / Khan, Qaisar Imran / Maple-Grødem, Jodi / Macleod, Angus D

    Journal of neurology

    2022  Volume 269, Issue 8, Page(s) 4288–4298

    Abstract: Background: There are few long-term data on the incidence, baseline predictors, and outcomes of dementia in Parkinson's disease (PD) from prospective community-based incident cohorts.: Methods: The PINE study prospectively identified all incident PD ... ...

    Abstract Background: There are few long-term data on the incidence, baseline predictors, and outcomes of dementia in Parkinson's disease (PD) from prospective community-based incident cohorts.
    Methods: The PINE study prospectively identified all incident PD patients in Aberdeen along with age-sex-matched, community-based controls who consented to standardized annual life-long follow-up. Each year, a clinical expert reviewed the diagnosis of PD and the presence of dementia according to DSM-IV-based criteria. Age-sex stratified incidence rates for dementia in PD and controls were calculated and compared with hazard ratios (HR) adjusted for age, sex, education, and socioeconomic status. Cox proportional-hazard modelling was used to assess baseline predictors for PD dementia and the influence of dementia on survival and institutionalization.
    Results: 201 patients (mean age 72.6yrs) and 260 controls (mean age 75.4yrs) were followed for median 9.5 years. The incidence of dementia was 7.4 (PD) versus 2.1 (controls) per 100 person-years (adjusted HR 6.0, 95%CI 4.1-8.7), with a sixfold increase from under 60 to over 80 years in PD but no sex difference. Independent baseline predictors of PD dementia were older age at diagnosis, self-reported cognitive symptoms, dream enactment, lower MMSE scores, worse motor UPDRS scores, and the ApoE genotype. PD dementia increased the rates of subsequent death and institutionalization (32.0 and 26.9 per 100 person-years, respectively).
    Conclusion: The incidence of dementia in PD is high, increases markedly with age, is increased in those with baseline subjective cognitive symptoms as well as other established risk factors, and is associated with high rates of death and institutionalization.
    MeSH term(s) Aged ; Cohort Studies ; Dementia/diagnosis ; Humans ; Incidence ; Parkinson Disease/complications ; Parkinson Disease/diagnosis ; Parkinson Disease/epidemiology ; Prospective Studies
    Language English
    Publishing date 2022-03-21
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 187050-6
    ISSN 1432-1459 ; 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
    ISSN (online) 1432-1459
    ISSN 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
    DOI 10.1007/s00415-022-11058-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Identifying dementia using medical data linkage in a longitudinal cohort study: Lothian Birth Cohort 1936.

    Mullin, Donncha S / Stirland, Lucy E / Buchanan, Emily / Convery, Catherine-Anne / Cox, Simon R / Deary, Ian J / Giuntoli, Cinzia / Greer, Holly / Page, Danielle / Robertson, Elizabeth / Shenkin, Susan D / Szalek, Anna / Taylor, Adele / Weatherdon, Georgina / Wilkinson, Tim / Russ, Tom C

    BMC psychiatry

    2023  Volume 23, Issue 1, Page(s) 303

    Abstract: Background: 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 ...

    Abstract Background: 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.
    Methods: 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.
    Results: 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%).
    Conclusions: 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.
    MeSH term(s) Humans ; Female ; Aged ; Cohort Studies ; Longitudinal Studies ; Birth Cohort ; Cognitive Dysfunction ; Information Storage and Retrieval
    Language English
    Publishing date 2023-05-01
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2050438-X
    ISSN 1471-244X ; 1471-244X
    ISSN (online) 1471-244X
    ISSN 1471-244X
    DOI 10.1186/s12888-023-04797-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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