| アブストラクト | Increasing numbers of people living with dementia (PLWD), and a pressured health and social care system, will exacerbate inequalities in mortality for PLWD. There is a dearth of research examining multiple factors in mortality risk among PLWD, including application of large administrative datasets to investigate these issues. This study explored variation mortality risk variation among people diagnosed with dementia between 2002-2016, based on: age, sex, ethnicity, deprivation, geography and general practice (GP) contacts. Data were derived from electronic health records from a cohort of Clinical Practice Research Datalink GP patients in England (n = 142,340). Cox proportional hazards regression modelled mortality risk separately for people with early- and later- onset dementia. Few social inequalities were observed in early-onset dementia; men had greater risk of mortality. For early- and later-onset, higher rates of GP observations-and for later-onset only dementia medications-are associated with increased mortality risk. Social inequalities were evident in later-onset dementia. Accounting for other explanatory factors, Black and Mixed/Other ethnicity groups had lower mortality risk, more deprived areas had greater mortality risk, and higher mortality was observed in North East, South Central and South West GP regions. This study provides novel evidence of the extent of mortality risk inequalities among PLWD. Variance in mortality risk was observed by social, demographic and geographic factors, and frequency of GP contact. Findings illustrate need for greater person-centred care discussions, prioritising tackling inequalities among PLWD. Future research should explore more outcomes for PLWD, and more explanatory factors of health outcomes. |
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| ジャーナル名 | International journal of environmental research and public health |
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| Pubmed追加日 | 2021/12/25 |
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| 投稿者 | Watson, James; Darlington-Pollock, Frances; Green, Mark; Giebel, Clarissa; Akpan, Asangaedem |
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| 組織名 | School of Environmental Sciences, The University of Liverpool, Liverpool L69 7ZT,;UK.;Department of Primary Care and Mental Health, University of Liverpool, Liverpool;L69 3GF, UK.;NIHR ARC NWC, Liverpool L69 3GL, UK.;Liverpool University Hospital NHS FT, Liverpool L7 8XP, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/34949010/ |
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