Trends of Dementia among Community-Dwelling Adults in Ontario, Canada, 2010–2015

Vanderkruk, Kayla Rachelle; Eberg, Maria; Mahootchi, Tannaz; Esensoy, Ali Vahit; Seitz, Dallas

doi:10.1159/000508687

Cited by 4 publications

(9 citation statements)

References 35 publications

(53 reference statements)

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“…1). Most patients had multimorbidity and polypharmacy (median disease count [Q1, Q3]: 3 [2, 5]; median medication type [Q1, Q3]: 5 [2, 7]). The demographic and clinical features are shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Based on Pearson’s correlation, the effect size for the relationship between CIRS-G severity index and MMSE appeared to be small ( r = −0.18, p = 0.02). The CCI was rather centralized (median [Q1, Q3]: 6 [5, 7]). MRCI reflected the medication complexity and appeared to be widely ranged (median [Q1, Q3]: 9 [5, 15]).…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, the number of comorbidities increases with age, and it is known that the majority of older adults have 2 or more comorbidities [3]. Comorbidity is even more common in dementia [4, 5], posing greater care burden in managing different chronic conditions and complex regimens.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Comorbidity Burden on Cognitive Decline: A Prospective Cohort Study of Older Adults with Dementia

Kao

Wang

Chen

et al. 2021

Dement Geriatr Cogn Disord

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Introduction: The lack of longitudinal data of comorbidity burden makes the association between comorbidity and cognitive decline inconclusive. We aimed to measure comorbidity and assess its effects on cognitive decline in mild to moderate dementia. Methods: This was a prospective cohort study. The participants were enrolled from the Hualien Tzu Chi Hospital between January 2015 and December 2018. We enrolled 175 older adults with mild to moderate dementia and conducted in-person interviews to follow-up comorbidity and cognitive function annually. The comorbidity burden indices included Cumulative Illness Rating Scale for Geriatrics (CIRS-G), Charlson Comorbidity Index (CCI), and Medication Regimen Complexity Index (MRCI), and cognitive function was measured by Mini-Mental State Examination (MMSE) and clock drawing test. We employed the generalized estimating equations to assess the longitudinal effect of time-varying comorbidity burden on cognitive decline after adjusting for age, sex, and education. Results: Most patients were diagnosed with Alzheimer’s disease (88.6%) and in the early stage of dementia (Clinical Dementia Rating [CDR] = 0.5, 57.1%; CDR = 1, 36.6%). Multimorbidity was common (median: 3), and the top 3 most common comorbidities were osteoarthritis (67.4%), hypertension (65.7%), and hyperlipidemia (36.6%). The severity index of CIRS-G was significantly associated with cognitive decline in MMSE after adjusting for age, sex, and education. CCI and MRCI scores were, however, not associated with cognitive function. Conclusion: The severity index of CIRS-G outperforms CCI and MRCI in reflecting the longitudinal effect of comorbidity burden on cognitive decline in mild to moderate dementia.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Impact of Comorbidity Burden on Cognitive Decline: A Prospective Cohort Study of Older Adults with Dementia

Kao

Wang

Chen

et al. 2021

Dement Geriatr Cogn Disord

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“…Incident cases of dementia and parkinsonism were defined as the first recorded dementia or parkinsonism billing or hospitalization code, respectively. This served as a proxy for incident diagnosis of dementia and parkinsonism similar to previous studies assessing incidence trends of these conditions ascertained using administrative databases [37][38][39] . We created two cohorts to identify cases of dementia and parkinsonism because dementia and parkinsonism require, respectively, a 2-year and 1-year lookforward window for case ascertainment 33,34 .…”

Section: Case Ascertainment For Parkinsonismmentioning

confidence: 99%

Ethnic and Immigrant Variations in the Time Trends of Dementia and Parkinsonism

Wong

Kwong

et al. 2021

Can. J. Neurol. Sci.

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Objective: We assessed long-term incidence and prevalence trends of dementia and parkinsonism across major ethnic and immigrant groups in Ontario. Methods: Linking administrative databases, we established two cohorts (dementia 2001–2014 and parkinsonism 2001–2015) of all residents aged 20 to 100 years with incident diagnosis of dementia (N = 387,937) or parkinsonism (N = 59,617). We calculated age- and sex-standardized incidence and prevalence of dementia and parkinsonism by immigrant status and ethnic groups (Chinese, South Asian, and the General Population). We assessed incidence and prevalence trends using Poisson regression and Cochran–Armitage trend tests. Results: Across selected ethnic groups, dementia incidence and prevalence were higher in long-term residents than recent or longer-term immigrants from 2001 to 2014. During this period, age- and sex-standardized incidence of dementia in Chinese, South Asian, and the General Population increased, respectively, among longer-term immigrants (by 41%, 58%, and 42%) and long-term residents (28%, 7%, and 4%), and to a lesser degree among recent immigrants. The small number of cases precluded us from assessing parkinsonism incidence trends. For Chinese, South Asian, and the General Population, respectively, prevalence of dementia and parkinsonism modestly increased over time among recent immigrants but significantly increased among longer-term immigrants (dementia: 134%, 217%, and 117%; parkinsonism: 55%, 54%, and 43%) and long-term residents (dementia: 97%, 132%, and 71%; parkinsonism: 18%, 30%, and 29%). Adjustment for pre-existing conditions did not appear to explain incidence trends, except for stroke and coronary artery disease as potential drivers of dementia incidence. Conclusion: Recent immigrants across major ethnic groups in Ontario had considerably lower rates of dementia and parkinsonism than long-term residents, but this difference diminished with longer-term immigrants.

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“…An estimated 58 million people worldwide were living with dementia in 2020, a number that is projected to double by 2040 2. Ageing populations and longer survival after diagnosis account for increasing prevalence 3 4. In Canada, more than 670 000 people were estimated to be living with dementia in 2020, including 20 200 people in the province of Saskatchewan 5 6.…”

Section: Introductionmentioning

confidence: 99%

Health service use before and after dementia diagnosis: a retrospective matched case–control study

Kosteniuk

Osman

Osman³

et al. 2022

BMJ Open

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ObjectivesThis study investigated patterns in health service usage among older adults with dementia and matched controls over a 10-year span from 5 years before until 5 years after diagnosis.DesignPopulation-based retrospective matched case–control study.SettingAdministrative health data of individuals in Saskatchewan, Canada from 1 April 2008 to 31 March 2019.ParticipantsThe study included 2024 adults aged 65 years and older living in the community at the time of dementia diagnosis from 1 April 2013 to 31 March 2014, matched 1:1 to individuals without a dementia diagnosis on age group, sex, rural versus urban residence, geographical region and comorbidity.Outcome measuresFor each 5-year period before and after diagnosis, we examined usage of health services each year including family physician (FP) visits, specialist visits, hospital admissions, all-type prescription drug dispensations and short-term care admissions. We used negative binomial regression to estimate the effect of dementia on yearly average health service utilisation adjusting for sex, age group, rural versus urban residence, geographical region, 1 year prior health service use and comorbidity.ResultsAdjusted findings demonstrated that 5 years before diagnosis, usage of all health services except hospitalisation was lower among persons with dementia than persons without dementia (all p<0.001). After this point, differences in higher health service usage among persons with dementia compared to without dementia were greatest in the year before and year after diagnosis. In the year before diagnosis, specialist visits were 59.7% higher (p<0.001) and hospitalisations 90.5% higher (p<0.001). In the year after diagnosis, FP visits were 70.0% higher (p<0.001) and all-type drug prescriptions 29.1% higher (p<0.001).ConclusionsFindings suggest the year before and year after diagnosis offer multiple opportunities to implement quality supports. FPs are integral to dementia care and require effective resources to properly serve this population.

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Trends of Dementia among Community-Dwelling Adults in Ontario, Canada, 2010–2015

Cited by 4 publications

References 35 publications

Impact of Comorbidity Burden on Cognitive Decline: A Prospective Cohort Study of Older Adults with Dementia

Impact of Comorbidity Burden on Cognitive Decline: A Prospective Cohort Study of Older Adults with Dementia

Ethnic and Immigrant Variations in the Time Trends of Dementia and Parkinsonism

Health service use before and after dementia diagnosis: a retrospective matched case–control study

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