Abstract
Preventing dementia in elderly individuals is an important public health challenge. While early identification and modification of predictors are crucial, predictors of dementia based on routinely collected healthcare data are not fully understood. We aimed to examine potential predictors of dementia diagnosis using routinely collected claims data. In this retrospective cohort study, claims data from fiscal years 2012 (baseline) and 2016 (follow-up), recorded in an administrative claims database of the medical care system for the elderly (75 years or older) in Niigata prefecture, Japan, were used. Data on baseline characteristics including age, sex, diagnosis, and prescriptions were collected, and the relationship between subsequent new diagnoses of dementia and potential predictors was examined using multivariable logistic regression models. A total of 226,738 people without a diagnosis of dementia at baseline were followed. Of these, 26,092 incident dementia cases were detected during the study period. After adjusting for confounding factors, cerebrovascular disease (odds ratio, 1.15; 95% confidence interval, 1.11–1.18), depression (1.38; 1.31–1.44), antipsychotic use (1.40; 1.31–1.49), and hypnotic use (1.17; 1.11–1.24) were significantly associated with subsequent diagnosis of dementia. Analyses of routinely collected claims data revealed neuropsychiatric symptoms including depression, antipsychotic use, hypnotic use, and cerebrovascular disease to be predictors of new dementia diagnoses.
Highlights
Dementia among elderly people is an important public health concern
We identified 26,092 people who were diagnosed with dementia during the study period; 19,093 were classified as Alzheimer’s disease (ICD-10: F00, G30), 604 as vascular dementia (F01), and 5875 as unspecified dementia (F03) (Table 2)
Depression/antidepressant use was a common significant predictor for Alzheimer’s disease and vascular dementia. These results suggest the usefulness of administrative claims data for identifying new dementia diagnoses
Summary
Dementia among elderly people is an important public health concern. The number of elderly people living with dementia exceeded 50 million worldwide in 2018, and is projected to triple by 2050 [1]. The Hisayama study, which comprised volunteer Japanese residents, reported that the prevalence of dementia among individuals aged ≥65 years increased from 1985 to 2012 for all-cause dementia (from 7% to 11%) and Alzheimer’s disease (from 2% to 7%) [3]. Previous studies have identified some predictors of dementia [4,5,6]. One meta-analysis has identified seven potentially modifiable predictors for dementia: diabetes mellitus, hypertension, obesity, smoking, physical inactivity, cognitive inactivity, and depression [7]
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