Neil Drummond1, Richard Birtwhistle1, Tyler Williamson1, Shahriar Khan1, Stephanie Garies1, Frank Molnar1. 1. Department of Family Medicine (Drummond), University of Alberta, Edmonton, Alta.; Family Medicine and Public Health Services (Birtwhistle), Queen's University, Kingston, Ont.; Department of Community Health Sciences (Williamson), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Medicine (Khan), Queen's University, Kingston, Ont.; Departments of Family Medicine and Community Health Sciences (Garies), University of Calgary, Calgary, Alta.; Division of Geriatric Medicine (Molnar), University of Ottawa and The Ottawa Hospital, Ottawa Hospital Research Institute, Bruyere Research Institute, Ottawa, Ont.
Abstract
BACKGROUND: The proportion of Canadians living with Alzheimer disease and related dementias is projected to rise, with an increased burden on the primary health care system in particular. Our objective was to describe the prevalence and management of dementia in a community-dwelling sample using electronic medical record (EMR) data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), which consists of validated, national, point-of-care data from primary care practices. METHODS: We used CPCSSN data as of Dec. 31, 2012, for patients 65 years and older with at least 1 clinical encounter in the previous 2 years. A validated case definition for dementia was used to calculate the national and provincial prevalence rates, to examine variations in prevalence according to age, sex, body mass index, rural or urban residence, and select comorbid conditions, and to describe patterns in the pharmacologic management of dementia over time at the provincial level. RESULTS: The age-standardized prevalence of dementia among community-dwelling patients 65 years and older was 7.3%. Prevalence estimates increased with age; they also varied between provinces, and upward trends were observed. Dementia was found to be associated with comorbid diabetes, depression, epilepsy and parkinsonism. Most of the patients with dementia did not have a prescription for a dementia-related medication recorded in their EMR between 2008 and 2012 inclusive. Those who had a prescription were most often prescribed donepezil by their primary care provider. INTERPRETATION: Overall prevalence estimates for dementia based on EMR data in this sample managed in primary care were generally in line with previous estimates based on administrative data, survey results or clinical sources.
BACKGROUND: The proportion of Canadians living with Alzheimer disease and related dementias is projected to rise, with an increased burden on the primary health care system in particular. Our objective was to describe the prevalence and management of dementia in a community-dwelling sample using electronic medical record (EMR) data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), which consists of validated, national, point-of-care data from primary care practices. METHODS: We used CPCSSN data as of Dec. 31, 2012, for patients 65 years and older with at least 1 clinical encounter in the previous 2 years. A validated case definition for dementia was used to calculate the national and provincial prevalence rates, to examine variations in prevalence according to age, sex, body mass index, rural or urban residence, and select comorbid conditions, and to describe patterns in the pharmacologic management of dementia over time at the provincial level. RESULTS: The age-standardized prevalence of dementia among community-dwelling patients 65 years and older was 7.3%. Prevalence estimates increased with age; they also varied between provinces, and upward trends were observed. Dementia was found to be associated with comorbid diabetes, depression, epilepsy and parkinsonism. Most of the patients with dementia did not have a prescription for a dementia-related medication recorded in their EMR between 2008 and 2012 inclusive. Those who had a prescription were most often prescribed donepezil by their primary care provider. INTERPRETATION: Overall prevalence estimates for dementia based on EMR data in this sample managed in primary care were generally in line with previous estimates based on administrative data, survey results or clinical sources.
Authors: Andrea Bradford; Mark E Kunik; Paul Schulz; Susan P Williams; Hardeep Singh Journal: Alzheimer Dis Assoc Disord Date: 2009 Oct-Dec Impact factor: 2.703
Authors: Michael E Green; Nandini Natajaran; Denis E O'Donnell; Tyler Williamson; Jyoti Kotecha; Shahriar Khan; Andrew Cave Journal: CMAJ Open Date: 2015-01-13
Authors: Erik Jedenius; Kristina Johnell; Johan Fastbom; Jan Strömqvist; Bengt Winblad; Niels Andreasen Journal: Scand J Prim Health Care Date: 2011-07-11 Impact factor: 2.581
Authors: M Bond; G Rogers; J Peters; R Anderson; M Hoyle; A Miners; T Moxham; S Davis; P Thokala; A Wailoo; M Jeffreys; C Hyde Journal: Health Technol Assess Date: 2012 Impact factor: 4.014
Authors: Nicholas J G Pimlott; Malini Persaud; Neil Drummond; Carole A Cohen; James L Silvius; Karen Seigel; Gary R Hollingworth; William B Dalziel Journal: Can Fam Physician Date: 2009-05 Impact factor: 3.275
Authors: Neil Drummond; Lynn McCleary; Elizabeth Freiheit; Frank Molnar; William Dalziel; Carole Cohen; Diana Turner; Rebecca Miyagishima; James Silvius Journal: Can Fam Physician Date: 2018-11 Impact factor: 3.275
Authors: S Garies; M Cummings; B Forst; K McBrien; B Soos; M Taylor; N Drummond; D Manca; K Duerksen; H Quan; T Williamson Journal: Int J Popul Data Sci Date: 2019-07-29