Anh N Q Pham1,2, Cliff Lindeman2,3, Don Voaklander1, Adrian Wagg4, Neil Drummond1,2. 1. School of Public Health, University of Alberta, Edmonton, Alberta, Canada. 2. Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada. 3. Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada. 4. Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Abstract
BACKGROUND: The dementias are long-term, chronic conditions caused by progressive neurological degeneration. Current literature suggests that cardiovascular disease risk factors may contribute to the onset of dementia; however, evidence of these associations is inconsistent. OBJECTIVES: This study aimed to examine the impact of risk factors on dementia onset in older adults diagnosed and managed in Canadian primary care settings. METHODS: A retrospective cohort study was employed utilizing electronic medical records data in the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). Patients aged 65+ years with no dementia diagnosis at baseline who were followed from 2009 to 2017 with a run-in year to exclude existing undiagnosed dementia cases. Multivariate Cox proportional hazard models were used to estimate risk. RESULTS: Age was associated with an increased incidence risk of dementia in both examined age groups: 65-79 years (13%) and 80+ years (5%). History of depression increased dementia risk by 38% and 34% in the age groups. There were significant associations with lower social deprivation area quintile, smoking history, osteoarthritis, and diabetes mellitus in patients aged 65-79 years but not in those aged 80+ years. Sex, hypertension, obesity, dyslipidemia, and the use of antihypertensive medications and statins were not associated with risk of incident dementia diagnosis. CONCLUSIONS: The association between chronic health conditions and dementia onset is complicated. Primary care electronic medical record data might be useful for research in this topic, though follow-up time is still relatively short to observe a clear causal relationship. Future studies with more complete data may provide evidence for dementia preventive strategies within primary care practice.
BACKGROUND: The dementias are long-term, chronic conditions caused by progressive neurological degeneration. Current literature suggests that cardiovascular disease risk factors may contribute to the onset of dementia; however, evidence of these associations is inconsistent. OBJECTIVES: This study aimed to examine the impact of risk factors on dementia onset in older adults diagnosed and managed in Canadian primary care settings. METHODS: A retrospective cohort study was employed utilizing electronic medical records data in the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). Patients aged 65+ years with no dementia diagnosis at baseline who were followed from 2009 to 2017 with a run-in year to exclude existing undiagnosed dementia cases. Multivariate Cox proportional hazard models were used to estimate risk. RESULTS: Age was associated with an increased incidence risk of dementia in both examined age groups: 65-79 years (13%) and 80+ years (5%). History of depression increased dementia risk by 38% and 34% in the age groups. There were significant associations with lower social deprivation area quintile, smoking history, osteoarthritis, and diabetes mellitus in patients aged 65-79 years but not in those aged 80+ years. Sex, hypertension, obesity, dyslipidemia, and the use of antihypertensive medications and statins were not associated with risk of incident dementia diagnosis. CONCLUSIONS: The association between chronic health conditions and dementia onset is complicated. Primary care electronic medical record data might be useful for research in this topic, though follow-up time is still relatively short to observe a clear causal relationship. Future studies with more complete data may provide evidence for dementia preventive strategies within primary care practice.
Authors: Tyler Williamson; Michael E Green; Richard Birtwhistle; Shahriar Khan; Stephanie Garies; Sabrina T Wong; Nandini Natarajan; Donna Manca; Neil Drummond Journal: Ann Fam Med Date: 2014-07 Impact factor: 5.166
Authors: John A Queenan; Tyler Williamson; Shahriar Khan; Neil Drummond; Stephanie Garies; Rachael Morkem; Richard Birtwhistle Journal: CMAJ Open Date: 2016-01-25