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Incidence and prevalence of dementia in linked administrative health data in Saskatchewan, Canada: a retrospective cohort study

Identifieur interne : 000231 ( Pmc/Curation ); précédent : 000230; suivant : 000232

Incidence and prevalence of dementia in linked administrative health data in Saskatchewan, Canada: a retrospective cohort study

Auteurs : Julie G. Kosteniuk ; Debra G. Morgan ; Megan E. O Onnell ; Andrew Kirk ; Margaret Crossley ; Gary F. Teare ; Norma J. Stewart ; Vanina Dal Bello-Haas [Canada] ; Dorothy A. Forbes ; Anthea Innes [Royaume-Uni] ; Jacqueline M. Quail

Source :

RBID : PMC:4489119

Abstract

Background

Determining the epidemiology of dementia among the population as a whole in specific jurisdictions – including the long-term care population–is essential to providing appropriate care. The objectives of this study were to use linked administrative databases in the province of Saskatchewan to determine the 12-month incidence and prevalence of dementia for the 2012/13 period (1) among individuals aged 45 and older in the province of Saskatchewan, (2) according to age group and sex, and (3) according to diagnosis code and other case definition criteria.

Methods

We used a population-based retrospective cohort study design and extracted data from 10 provincial health databases linked by a unique health services number. The cohort included individuals 45 years and older at first identification of dementia between April 1, 2001 and March 31, 2013 based on case definitions met within any one of four administrative health databases (Hospital Discharge Abstracts, Physician Service Claims, Prescription Drug, and RAI-MDS, i.e., Long-term Care).

Results

A total of 3,270 incident cases of dementia (7.28 per 1,000 PAR) and 13,012 prevalent cases (28.16 per 1,000 PAR) were identified during 2012/13. This study found the incidence rate increased by 2.8 to 5.1 times and the prevalence rate increased by 2.6 to 4.6 times every 10 years after 45 years of age. Overall, the age-standardised incidence rate was significantly lower among females than males (7.04 vs. 7.65 per 1,000 PAR) and the age-standardised prevalence rate was significantly higher among females than males (28.92 vs. 26.53 per 1,000 PAR). Over one-quarter (28 %) of all incident cases were admitted to long-term care before a diagnosis was formally recorded in physician or hospital data, and nearly two-thirds of these cases were identified at admission with impairment at the moderate to very severe level or a disease category of Alzheimer’s disease/other dementia.

Conclusions

Linking multiple sources of registry data contributes to our understanding of the epidemiology of dementia across multiple segments of the population, inclusive of individuals residing in long-term care. This information is foundational for public awareness and policy recommendations, health promotion and prevention strategies, appropriate health resource planning, and research priorities.

Electronic supplementary material

The online version of this article (doi:10.1186/s12877-015-0075-3) contains supplementary material, which is available to authorized users.


Url:
DOI: 10.1186/s12877-015-0075-3
PubMed: 26135912
PubMed Central: 4489119

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PMC:4489119

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Julie G. Kosteniuk
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Debra G. Morgan
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Megan E. O Onnell
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Andrew Kirk
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Margaret Crossley
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Gary F. Teare
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Norma J. Stewart
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Dorothy A. Forbes
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Jacqueline M. Quail
<affiliation>
<nlm:aff id="Aff6">Saskatchewan Health Quality Council, Saskatoon, SK Canada</nlm:aff>
<wicri:noCountry code="subfield">SK Canada</wicri:noCountry>
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<p>Determining the epidemiology of dementia among the population as a whole in specific jurisdictions – including the long-term care population–is essential to providing appropriate care. The objectives of this study were to use linked administrative databases in the province of Saskatchewan to determine the 12-month incidence and prevalence of dementia for the 2012/13 period (1) among individuals aged 45 and older in the province of Saskatchewan, (2) according to age group and sex, and (3) according to diagnosis code and other case definition criteria.</p>
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<title>Methods</title>
<p>We used a population-based retrospective cohort study design and extracted data from 10 provincial health databases linked by a unique health services number. The cohort included individuals 45 years and older at first identification of dementia between April 1, 2001 and March 31, 2013 based on case definitions met within any one of four administrative health databases (Hospital Discharge Abstracts, Physician Service Claims, Prescription Drug, and RAI-MDS, i.e., Long-term Care).</p>
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<p>A total of 3,270 incident cases of dementia (7.28 per 1,000 PAR) and 13,012 prevalent cases (28.16 per 1,000 PAR) were identified during 2012/13. This study found the incidence rate increased by 2.8 to 5.1 times and the prevalence rate increased by 2.6 to 4.6 times every 10 years after 45 years of age. Overall, the age-standardised incidence rate was significantly lower among females than males (7.04 vs. 7.65 per 1,000 PAR) and the age-standardised prevalence rate was significantly higher among females than males (28.92 vs. 26.53 per 1,000 PAR). Over one-quarter (28 %) of all incident cases were admitted to long-term care before a diagnosis was formally recorded in physician or hospital data, and nearly two-thirds of these cases were identified at admission with impairment at the moderate to very severe level or a disease category of Alzheimer’s disease/other dementia.</p>
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<p>Linking multiple sources of registry data contributes to our understanding of the epidemiology of dementia across multiple segments of the population, inclusive of individuals residing in long-term care. This information is foundational for public awareness and policy recommendations, health promotion and prevention strategies, appropriate health resource planning, and research priorities.</p>
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<journal-id journal-id-type="nlm-ta">BMC Geriatr</journal-id>
<journal-id journal-id-type="iso-abbrev">BMC Geriatr</journal-id>
<journal-title-group>
<journal-title>BMC Geriatrics</journal-title>
</journal-title-group>
<issn pub-type="epub">1471-2318</issn>
<publisher>
<publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">26135912</article-id>
<article-id pub-id-type="pmc">4489119</article-id>
<article-id pub-id-type="publisher-id">75</article-id>
<article-id pub-id-type="doi">10.1186/s12877-015-0075-3</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Incidence and prevalence of dementia in linked administrative health data in Saskatchewan, Canada: a retrospective cohort study</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Kosteniuk</surname>
<given-names>Julie G.</given-names>
</name>
<address>
<phone>306-966-8773</phone>
<email>julie.kosteniuk@usask.ca</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Morgan</surname>
<given-names>Debra G.</given-names>
</name>
<address>
<email>debra.morgan@usask.ca</email>
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<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>O’Connell</surname>
<given-names>Megan E.</given-names>
</name>
<address>
<email>megan.oconnell@usask.ca</email>
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<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kirk</surname>
<given-names>Andrew</given-names>
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<address>
<email>andrew.kirk@usask.ca</email>
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<xref ref-type="aff" rid="Aff4"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Crossley</surname>
<given-names>Margaret</given-names>
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<address>
<email>margaret.crossley@usask.ca</email>
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<xref ref-type="aff" rid="Aff5"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Teare</surname>
<given-names>Gary F.</given-names>
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<address>
<email>gteare@hqc.sk.ca</email>
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</contrib>
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<name>
<surname>Stewart</surname>
<given-names>Norma J.</given-names>
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<address>
<email>norma.stewart@usask.ca</email>
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</contrib>
<contrib contrib-type="author">
<name>
<surname>Bello-Haas</surname>
<given-names>Vanina Dal</given-names>
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<address>
<email>vdalbel@mcmaster.ca</email>
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<xref ref-type="aff" rid="Aff8"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Forbes</surname>
<given-names>Dorothy A.</given-names>
</name>
<address>
<email>dorothy.forbes@ualberta.ca</email>
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<xref ref-type="aff" rid="Aff9"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Innes</surname>
<given-names>Anthea</given-names>
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<address>
<email>ainnes@bournemouth.ac.uk</email>
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<xref ref-type="aff" rid="Aff10"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Quail</surname>
<given-names>Jacqueline M.</given-names>
</name>
<address>
<email>jquail@hqc.sk.ca</email>
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<xref ref-type="aff" rid="Aff6"></xref>
</contrib>
<aff id="Aff1">
<label></label>
Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, PO Box 23, 104 Clinic Place, Saskatoon, S7N 2Z4 SK Canada</aff>
<aff id="Aff2">
<label></label>
Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK Canada</aff>
<aff id="Aff3">
<label></label>
Department of Psychology, University of Saskatchewan, Saskatoon, SK Canada</aff>
<aff id="Aff4">
<label></label>
Division of Neurology, College of Medicine, University of Saskatchewan, Saskatoon, SK Canada</aff>
<aff id="Aff5">
<label></label>
Department of Psychology (Professor Emerita), University of Saskatchewan, Saskatoon, SK Canada</aff>
<aff id="Aff6">
<label></label>
Saskatchewan Health Quality Council, Saskatoon, SK Canada</aff>
<aff id="Aff7">
<label></label>
College of Nursing, University of Saskatchewan, Saskatoon, SK Canada</aff>
<aff id="Aff8">
<label></label>
School of Rehabilitation Science, McMaster University, Hamilton, ON Canada</aff>
<aff id="Aff9">
<label></label>
Faculty of Nursing, University of Alberta, Edmonton, AB Canada</aff>
<aff id="Aff10">
<label></label>
Bournemouth University Dementia Institute, Bournemouth University, Dorset, UK</aff>
</contrib-group>
<pub-date pub-type="epub">
<day>3</day>
<month>7</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>3</day>
<month>7</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection">
<year>2015</year>
</pub-date>
<volume>15</volume>
<elocation-id>73</elocation-id>
<history>
<date date-type="received">
<day>1</day>
<month>12</month>
<year>2014</year>
</date>
<date date-type="accepted">
<day>16</day>
<month>6</month>
<year>2015</year>
</date>
</history>
<permissions>
<copyright-statement>© Kosteniuk et al. 2015</copyright-statement>
<license license-type="open-access">
<license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<abstract id="Abs1">
<sec>
<title>Background</title>
<p>Determining the epidemiology of dementia among the population as a whole in specific jurisdictions – including the long-term care population–is essential to providing appropriate care. The objectives of this study were to use linked administrative databases in the province of Saskatchewan to determine the 12-month incidence and prevalence of dementia for the 2012/13 period (1) among individuals aged 45 and older in the province of Saskatchewan, (2) according to age group and sex, and (3) according to diagnosis code and other case definition criteria.</p>
</sec>
<sec>
<title>Methods</title>
<p>We used a population-based retrospective cohort study design and extracted data from 10 provincial health databases linked by a unique health services number. The cohort included individuals 45 years and older at first identification of dementia between April 1, 2001 and March 31, 2013 based on case definitions met within any one of four administrative health databases (Hospital Discharge Abstracts, Physician Service Claims, Prescription Drug, and RAI-MDS, i.e., Long-term Care).</p>
</sec>
<sec>
<title>Results</title>
<p>A total of 3,270 incident cases of dementia (7.28 per 1,000 PAR) and 13,012 prevalent cases (28.16 per 1,000 PAR) were identified during 2012/13. This study found the incidence rate increased by 2.8 to 5.1 times and the prevalence rate increased by 2.6 to 4.6 times every 10 years after 45 years of age. Overall, the age-standardised incidence rate was significantly lower among females than males (7.04 vs. 7.65 per 1,000 PAR) and the age-standardised prevalence rate was significantly higher among females than males (28.92 vs. 26.53 per 1,000 PAR). Over one-quarter (28 %) of all incident cases were admitted to long-term care before a diagnosis was formally recorded in physician or hospital data, and nearly two-thirds of these cases were identified at admission with impairment at the moderate to very severe level or a disease category of Alzheimer’s disease/other dementia.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>Linking multiple sources of registry data contributes to our understanding of the epidemiology of dementia across multiple segments of the population, inclusive of individuals residing in long-term care. This information is foundational for public awareness and policy recommendations, health promotion and prevention strategies, appropriate health resource planning, and research priorities.</p>
</sec>
<sec>
<title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s12877-015-0075-3) contains supplementary material, which is available to authorized users.</p>
</sec>
</abstract>
<kwd-group xml:lang="en">
<title>Keywords</title>
<kwd>Dementia</kwd>
<kwd>Alzheimer’s disease</kwd>
<kwd>Diagnosis</kwd>
<kwd>Prevalence</kwd>
<kwd>Incidence</kwd>
<kwd>Epidemiology</kwd>
<kwd>Primary care</kwd>
<kwd>Hospital</kwd>
<kwd>Long-term care</kwd>
<kwd>Prescription drug</kwd>
</kwd-group>
<custom-meta-group>
<custom-meta>
<meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2015</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
</record>

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