Early presentations of dementia across cultures: Analysis of primary care data from a diverse population Article Swipe
Sedigheh Zabihi
,
Jonathan P. Bestwick
,
Phazha LK Bothongo
,
Qiqi Zhang
,
Christine Carter
,
Moïse Roche
,
Sarah Morgan‐Trimmer
,
Yvonne Birks
,
Mark Wilberforce
,
Ruth Dobson
,
Alastair Noyce
,
John Robson
,
Fiona M Walter
,
Claudia Cooper
,
Charles R. Marshall
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1002/alz.086108
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1002/alz.086108
Background Dementia is associated with a range of non‐cognitive features that can occur during the prodromal phase. Improved recognition of non‐cognitive presentations of dementia could reduce inequalities in dementia diagnosis, particularly if sociocultural factors influence rates of help‐seeking for cognitive symptoms. We aimed to investigate presentations to primary care in the years before dementia diagnosis in a deprived and ethnically diverse population with universal access to health care. Method We conducted a nested case‐control study using electronic health care records on 1,016,277 individuals from primary care practices in East London, UK between 1990 and 2018. Individuals with a diagnosis of dementia were compared to controls without dementia. We ran a matched analysis (four controls matched to each person with dementia according to age and sex) using multivariable logistic regression to assess the associations between pre‐diagnostic presentations to primary care with subsequent diagnosis of dementia. We analysed three time periods (<2, 2‐5, 5‐10) before diagnosis. Result We included 4,137 individuals and 15,754 controls in the matched analysis (51.8% White; 42.7% Black, South Asian and other ethnicities). Neuropsychiatric presentations including depression (odds ratio [OR] = 2.71; 95% CI: 2.33 to 3.16), anxiety (OR = 1.67; 95% CI: 1.46 to 1.92), initiation of antipsychotic medication (as a proxy for psychotic symptoms) (OR = 5.84; 95% CI: 4.80 to 7.11) and insomnia (OR = 1.69; 95% CI: 1.31 to 2.17) were more frequent in the years before dementia diagnosis. Associations were found for autonomic features including constipation (OR = 1.54; 95% CI: 1.39 to 1.71) and incontinence (OR = 2.63; 95% CI: 2.32 to 2.97) up to a decade, and hypotension (OR = 1.89; 95% CI: 1.35 to 2.63) up to five years before dementia diagnosis. Sensory features including hearing loss (OR = 1.36; 95% CI: 1.14 to 1.63), imbalance and dizziness were also associated with subsequent dementia diagnosis. Memory difficulty was more strongly associated with subsequent dementia diagnosis than any non‐cognitive presentation (OR = 51.00; 95% CI: 43.87 to 59.29). Conclusion A range of non‐cognitive presentations are seen during the prodromal period of dementia in a diverse population. Improved recognition of these associations could increase access to dementia diagnosis, through improved recognition of potential presenting symptoms in people from different backgrounds.
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Metadata
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- article
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- en
- Landing Page
- https://doi.org/10.1002/alz.086108
- OA Status
- hybrid
- Related Works
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- OpenAlex ID
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All OpenAlex metadata
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https://openalex.org/W4406030156Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1002/alz.086108Digital Object Identifier
- Title
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Early presentations of dementia across cultures: Analysis of primary care data from a diverse populationWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
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2024-12-01Full publication date if available
- Authors
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Sedigheh Zabihi, Jonathan P. Bestwick, Phazha LK Bothongo, Qiqi Zhang, Christine Carter, Moïse Roche, Sarah Morgan‐Trimmer, Yvonne Birks, Mark Wilberforce, Ruth Dobson, Alastair Noyce, John Robson, Fiona M Walter, Claudia Cooper, Charles R. MarshallList of authors in order
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https://doi.org/10.1002/alz.086108Publisher landing page
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YesWhether a free full text is available
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hybridOpen access status per OpenAlex
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https://doi.org/10.1002/alz.086108Direct OA link when available
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Dementia, Medicine, Odds ratio, Psychiatry, Population, Anxiety, Gerontology, Pediatrics, Clinical psychology, Disease, Internal medicine, Environmental healthTop concepts (fields/topics) attached by OpenAlex
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0Total citation count in OpenAlex
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| abstract_inverted_index.analysis | 112, 166 |
| abstract_inverted_index.compared | 103 |
| abstract_inverted_index.controls | 105, 114, 162 |
| abstract_inverted_index.dementia | 24, 29, 54, 101, 120, 234, 281, 304, 314, 341, 355 |
| abstract_inverted_index.deprived | 58 |
| abstract_inverted_index.features | 10, 241, 284 |
| abstract_inverted_index.frequent | 229 |
| abstract_inverted_index.improved | 358 |
| abstract_inverted_index.included | 157 |
| abstract_inverted_index.increase | 352 |
| abstract_inverted_index.insomnia | 218 |
| abstract_inverted_index.logistic | 128 |
| abstract_inverted_index.strongly | 310 |
| abstract_inverted_index.symptoms | 363 |
| abstract_inverted_index.1,016,277 | 82 |
| abstract_inverted_index.according | 121 |
| abstract_inverted_index.autonomic | 240 |
| abstract_inverted_index.cognitive | 40 |
| abstract_inverted_index.conducted | 71 |
| abstract_inverted_index.dementia. | 107, 144 |
| abstract_inverted_index.diagnosis | 55, 99, 142, 315 |
| abstract_inverted_index.different | 367 |
| abstract_inverted_index.dizziness | 298 |
| abstract_inverted_index.imbalance | 296 |
| abstract_inverted_index.including | 178, 242, 285 |
| abstract_inverted_index.influence | 35 |
| abstract_inverted_index.potential | 361 |
| abstract_inverted_index.practices | 87 |
| abstract_inverted_index.prodromal | 16, 338 |
| abstract_inverted_index.psychotic | 207 |
| abstract_inverted_index.symptoms) | 208 |
| abstract_inverted_index.symptoms. | 41 |
| abstract_inverted_index.universal | 64 |
| abstract_inverted_index.Background | 1 |
| abstract_inverted_index.Conclusion | 328 |
| abstract_inverted_index.associated | 4, 301, 311 |
| abstract_inverted_index.depression | 179 |
| abstract_inverted_index.diagnosis, | 30, 356 |
| abstract_inverted_index.diagnosis. | 154, 235, 282, 305 |
| abstract_inverted_index.difficulty | 307 |
| abstract_inverted_index.electronic | 77 |
| abstract_inverted_index.ethnically | 60 |
| abstract_inverted_index.initiation | 199 |
| abstract_inverted_index.medication | 202 |
| abstract_inverted_index.population | 62 |
| abstract_inverted_index.presenting | 362 |
| abstract_inverted_index.regression | 129 |
| abstract_inverted_index.subsequent | 141, 303, 313 |
| abstract_inverted_index.Individuals | 96 |
| abstract_inverted_index.hypotension | 267 |
| abstract_inverted_index.individuals | 83, 159 |
| abstract_inverted_index.investigate | 45 |
| abstract_inverted_index.population. | 345 |
| abstract_inverted_index.recognition | 19, 347, 359 |
| abstract_inverted_index.Associations | 236 |
| abstract_inverted_index.associations | 133, 350 |
| abstract_inverted_index.backgrounds. | 368 |
| abstract_inverted_index.constipation | 243 |
| abstract_inverted_index.incontinence | 253 |
| abstract_inverted_index.inequalities | 27 |
| abstract_inverted_index.particularly | 31 |
| abstract_inverted_index.presentation | 319 |
| abstract_inverted_index.antipsychotic | 201 |
| abstract_inverted_index.ethnicities). | 175 |
| abstract_inverted_index.multivariable | 127 |
| abstract_inverted_index.presentations | 22, 46, 136, 177, 333 |
| abstract_inverted_index.sociocultural | 33 |
| abstract_inverted_index.case‐control | 74 |
| abstract_inverted_index.help‐seeking | 38 |
| abstract_inverted_index.non‐cognitive | 9, 21, 318, 332 |
| abstract_inverted_index.Neuropsychiatric | 176 |
| abstract_inverted_index.pre‐diagnostic | 135 |
| cited_by_percentile_year | |
| countries_distinct_count | 1 |
| institutions_distinct_count | 15 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/10 |
| sustainable_development_goals[0].score | 0.5299999713897705 |
| sustainable_development_goals[0].display_name | Reduced inequalities |
| citation_normalized_percentile.value | 0.39389406 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |