Terese Sara Høj Jørgensen1, Christian Torp-Pedersen2, Gunnar H Gislason3, Charlotte Andersson4, Ellen Holm5. 1. 1 Department of Geriatric Medicine, Nykøbing-Falster Hospital, Nykøbing-Falster, Denmark fgl864@alumni.ku.dk. 2. 2 Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark. 3. 3 Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark 4 Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark 5 National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. 4. 3 Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. 5. 1 Department of Geriatric Medicine, Nykøbing-Falster Hospital, Nykøbing-Falster, Denmark.
Abstract
BACKGROUND: Centralization of specialized health care in Denmark has caused increased geographical distance to health-care providers, which may be a barrier for Alzheimer patients to seek health care. We examined the incidence of Alzheimer diagnosis in Denmark between 2000 and 2009 and investigated the association between patients' distance to Alzheimer clinics and Alzheimer diagnoses. METHODS: Data of all individuals aged 65+ years were collected from Danish national registers. Incidences of Alzheimer diagnoses were analysed with joinpoint regression and hazard ratios (HRs) for Alzheimer diagnoses were analysed with Cox regressions. RESULTS: The annual incidence of Alzheimer diagnoses increased with 32.5% [95% confidence interval (CI): 7.1-63.8] among individuals aged 65-74 years from 2000 to 2002 and with 29.1% (95% CI: 11.0-50.2) among individuals aged 75+ years from 2000 to 2003. For both groups, incidence during subsequent years stagnated (0.4%, 95% CI: -1.7 to 2.6; 2.3%, 95% CI: 1.5-6.). From 2008 to 2009, 8605 individuals got an Alzheimer diagnosis. These individuals had a shorter distance to Alzheimer clinics (16.6 vs. 19.1 km, P < 0.001), higher mean age (80.7 vs. 73.7 years, P < 0.001) and were more often women (63.1 vs. 55.9%, P < 0.001). There were inverse associations between distance to Alzheimer clinics and Alzheimer diagnoses (0-19 km: reference; 20-39 km: HR = 0.80, 95% CI: 0.70-0.92; 40-59 km: HR = 0.65, 95% CI: 0.52-0.81). CONCLUSIONS: The incidence of Alzheimer diagnoses stagnated from 2002/03 to 2009 in Denmark--a period during which distances to health-care providers in general increased. The inverse association between geographical distance to Alzheimer clinics and Alzheimer diagnoses suggests that distance exclude a segment of the elderly population from an appropriate diagnostic workup and treatment.
BACKGROUND: Centralization of specialized health care in Denmark has caused increased geographical distance to health-care providers, which may be a barrier for Alzheimerpatients to seek health care. We examined the incidence of Alzheimer diagnosis in Denmark between 2000 and 2009 and investigated the association between patients' distance to Alzheimer clinics and Alzheimer diagnoses. METHODS: Data of all individuals aged 65+ years were collected from Danish national registers. Incidences of Alzheimer diagnoses were analysed with joinpoint regression and hazard ratios (HRs) for Alzheimer diagnoses were analysed with Cox regressions. RESULTS: The annual incidence of Alzheimer diagnoses increased with 32.5% [95% confidence interval (CI): 7.1-63.8] among individuals aged 65-74 years from 2000 to 2002 and with 29.1% (95% CI: 11.0-50.2) among individuals aged 75+ years from 2000 to 2003. For both groups, incidence during subsequent years stagnated (0.4%, 95% CI: -1.7 to 2.6; 2.3%, 95% CI: 1.5-6.). From 2008 to 2009, 8605 individuals got an Alzheimer diagnosis. These individuals had a shorter distance to Alzheimer clinics (16.6 vs. 19.1 km, P < 0.001), higher mean age (80.7 vs. 73.7 years, P < 0.001) and were more often women (63.1 vs. 55.9%, P < 0.001). There were inverse associations between distance to Alzheimer clinics and Alzheimer diagnoses (0-19 km: reference; 20-39 km: HR = 0.80, 95% CI: 0.70-0.92; 40-59 km: HR = 0.65, 95% CI: 0.52-0.81). CONCLUSIONS: The incidence of Alzheimer diagnoses stagnated from 2002/03 to 2009 in Denmark--a period during which distances to health-care providers in general increased. The inverse association between geographical distance to Alzheimer clinics and Alzheimer diagnoses suggests that distance exclude a segment of the elderly population from an appropriate diagnostic workup and treatment.
Authors: Ellen Holm; Katja Kemp Jacobsen; Thea Bang de Lony; Maurice Lembeck; Hanne Pedersen; Charlotte Andersson; Peter Johannsen; Terese Sara Høj Jørgensen; Christian Torp-Pedersen Journal: Alzheimers Dement (N Y) Date: 2022-03-24