| アブストラクト | BACKGROUND AND PURPOSE: The objectives were to assess the feasibility and validity of using markers of dementia-related health as indicators of dementia progression in primary care, by assessing the frequency with which they are recorded and by testing the hypothesis that they are associated with recognised outcomes of dementia. The markers, in 13 domains, were derived previously through literature review, expert consensus, and analysis of regional primary care records. METHODS: The study population consisted of patients with a recorded dementia diagnosis in the Clinical Practice Research Datalink, a UK primary care database linked to secondary care records. Incidence of recorded domains in the 36 months after diagnosis was determined. Associations of recording of domains with future hospital admission, palliative care, and mortality were derived. RESULTS: There were 30,463 people with diagnosed dementia. Incidence of domains ranged from 469/1000 person-years (Increased Multimorbidity) to 11/1000 (Home Pressures). An increasing number of domains in which a new marker was recorded in the first year after diagnosis was associated with hospital admission (hazard ratio for >/=4 domains vs. no domains = 1.24; 95% confidence interval = 1.15-1.33), palliative care (1.87; 1.62-2.15), and mortality (1.57; 1.47-1.67). Individual domains were associated with outcomes with varying strengths of association. CONCLUSIONS: Feasibility and validity of potential indicators of progression of dementia derived from primary care records are supported by their frequency of recording and associations with recognised outcomes. Further research should assess whether these markers can help identify patients with poorer prognosis to improve outcomes through stratified care and targeted support. |
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| ジャーナル名 | European journal of neurology |
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| 投稿日 | 2020/12/31 |
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| 投稿者 | Rathod-Mistry, Trishna; Marshall, Michelle; Campbell, Paul; Bailey, James; Chew-Graham, Carolyn A; Croft, Peter; Frisher, Martin; Hayward, Richard; Negi, Rashi; Robinson, Louise; Singh, Swaran; Sumathipala, Athula; Thein, Nwe; Walters, Kate; Weich, Scott; Jordan, Kelvin P |
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| 組織名 | School of Medicine, Keele University, Keele, UK.;Midlands Partnership NHS Foundation Trust, Stafford, UK.;School of Pharmacy and Bioengineering, Keele University, Keele, UK.;Institute of Health and Society and Newcastle University Institute for Ageing,;Newcastle Upon Tyne, UK.;Division of Mental Health and Wellbeing, Warwick Medical School, University of;Warwick, Coventry, UK.;Research Department of Primary Care & Population Health, University College;London, London, UK.;Mental Health Research Unit, School of Health and Related Research, University of;Sheffield, Sheffield, UK.;Centre for Prognosis Research, Keele University, Keele, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33378599/ |
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