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R Penfold, T Wilkinson, T Russ, L Stirland, C MacRae, S Shenkin, A Anand, B Guthrie, E Sampson, A MacLullich, 2845 Prevalence and outcomes of recorded dementia: a population-based study of 133,407 older adults using linked routine data sources, Age and Ageing, Volume 54, Issue Supplement_1, January 2025, afae277.070, https://doi.org/10.1093/ageing/afae277.070
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Abstract
Recording dementia diagnoses is essential to ensure appropriate post-diagnostic support and care. We examined the prevalence of recorded dementia in different routine datasets and associations with emergency hospitalisation and mortality.
This retrospective longitudinal cohort study included all adults ≥65 years registered with a Southeast Scotland GP on 1st April 2016. Dementia diagnoses were identified in primary care, hospital discharge and community prescribing records. New diagnoses were considered from 1st April 2016 to 1st April 2020. All individuals were followed up to 23rd October 2023. Cox proportional hazards and Fine-Grey models were used to estimate associations between recorded dementia and death and emergency hospitalisation, respectively. Diagnosis capture in other datasets was examined, accounting for mortality.
On 1st April 2016, 7544/133407 (5.7%) individuals had a recorded dementia diagnosis: 1254 (16.6%) in a single dataset, including 940 (12.5%) only in primary care and 279 (3.7%) in hospital data. Between 1st April 2016 to 1st April 2020, 7359/133,407 (5.8%) had a new diagnosis: 5165 (70.2%) first recorded in primary care, 1634 (22.2%) in hospital and 560 (7.6%) in community prescribing data. People with dementia had higher risks of death [adjusted hazard ratio (HR) 2.46 (95% Confidence Interval (CI) 2.39–2.54)] and emergency hospitalisation [adjusted subdistribution HR 1.58 (95%CI 1.56–1.60)] then those without dementia. People with diagnoses first recorded in hospital had higher mortality rates than those with community diagnoses [<30 days: aHR 8.96 (95%CI 6.94–13.52); >365 days: aHR 1.29 (95%CI 1.19–1.41)]. Only 562 (35.9%) of those with hospital diagnoses had recorded primary care diagnoses within a year.
Dementia is often recorded in single datasets, sometimes only in hospital data. Dementia is associated with adverse prognosis, with highest mortality in those with first diagnoses recorded in hospital. Findings highlight the need for better recording, dataset integration and scrutiny of hospital-based diagnostic pathways to ensure appropriate post-diagnostic support and care.
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