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Reporting of clinically diagnosed dementia on death certificates: retrospective cohort study

Background: mortality statistics are a frequently used source of information on deaths in dementia but are limited by concerns over accuracy. Objective: to investigate the frequency with which clinically diagnosed dementia is recorded on death certificates, including predictive factors. Methods: a r...

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Autores principales: Perera, Gayan, Stewart, Robert, Higginson, Irene J., Sleeman, Katherine E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027637/
https://www.ncbi.nlm.nih.gov/pubmed/27146301
http://dx.doi.org/10.1093/ageing/afw077
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author Perera, Gayan
Stewart, Robert
Higginson, Irene J.
Sleeman, Katherine E.
author_facet Perera, Gayan
Stewart, Robert
Higginson, Irene J.
Sleeman, Katherine E.
author_sort Perera, Gayan
collection PubMed
description Background: mortality statistics are a frequently used source of information on deaths in dementia but are limited by concerns over accuracy. Objective: to investigate the frequency with which clinically diagnosed dementia is recorded on death certificates, including predictive factors. Methods: a retrospective cohort study assembled using a large mental healthcare database in South London, linked to Office for National Statistics mortality data. People with a clinical diagnosis of dementia, aged 65 or older, who died between 2006 and 2013 were included. The main outcome was death certificate recording of dementia. Results: in total, 7,115 people were identified. Dementia was recorded on 3,815 (53.6%) death certificates. Frequency of dementia recording increased from 39.9% (2006) to 63.0% (2013) (odds ratio (OR) per year increment 1.11, 95% CI 1.07–1.15). Recording of dementia was more likely if people were older (OR per year increment 1.02, 95% CI 1.01–1.03), and for those who died in care homes (OR 1.89, 95% CI 1.50–2.40) or hospitals (OR 1.14, 95% CI 1.03–1.46) compared with home, and less likely for people with less severe cognitive impairment (OR 0.95, 95% CI 0.94–0.96), and if the diagnosis was Lewy body (OR 0.30, 95% CI 0.15–0.62) or vascular dementia (OR 0.79, 95% CI 0.68–0.93) compared with Alzheimer's disease. Conclusions: changes in certification practices may have contributed to the rise in recorded prevalence of dementia from mortality data. However, mortality data still considerably underestimate the population burden of dementia. Potential biases affecting recording of dementia need to be taken into account when interpreting mortality data.
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spelling pubmed-50276372016-09-21 Reporting of clinically diagnosed dementia on death certificates: retrospective cohort study Perera, Gayan Stewart, Robert Higginson, Irene J. Sleeman, Katherine E. Age Ageing Research Paper Background: mortality statistics are a frequently used source of information on deaths in dementia but are limited by concerns over accuracy. Objective: to investigate the frequency with which clinically diagnosed dementia is recorded on death certificates, including predictive factors. Methods: a retrospective cohort study assembled using a large mental healthcare database in South London, linked to Office for National Statistics mortality data. People with a clinical diagnosis of dementia, aged 65 or older, who died between 2006 and 2013 were included. The main outcome was death certificate recording of dementia. Results: in total, 7,115 people were identified. Dementia was recorded on 3,815 (53.6%) death certificates. Frequency of dementia recording increased from 39.9% (2006) to 63.0% (2013) (odds ratio (OR) per year increment 1.11, 95% CI 1.07–1.15). Recording of dementia was more likely if people were older (OR per year increment 1.02, 95% CI 1.01–1.03), and for those who died in care homes (OR 1.89, 95% CI 1.50–2.40) or hospitals (OR 1.14, 95% CI 1.03–1.46) compared with home, and less likely for people with less severe cognitive impairment (OR 0.95, 95% CI 0.94–0.96), and if the diagnosis was Lewy body (OR 0.30, 95% CI 0.15–0.62) or vascular dementia (OR 0.79, 95% CI 0.68–0.93) compared with Alzheimer's disease. Conclusions: changes in certification practices may have contributed to the rise in recorded prevalence of dementia from mortality data. However, mortality data still considerably underestimate the population burden of dementia. Potential biases affecting recording of dementia need to be taken into account when interpreting mortality data. Oxford University Press 2016-09 2016-09-08 /pmc/articles/PMC5027637/ /pubmed/27146301 http://dx.doi.org/10.1093/ageing/afw077 Text en © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Research Paper
Perera, Gayan
Stewart, Robert
Higginson, Irene J.
Sleeman, Katherine E.
Reporting of clinically diagnosed dementia on death certificates: retrospective cohort study
title Reporting of clinically diagnosed dementia on death certificates: retrospective cohort study
title_full Reporting of clinically diagnosed dementia on death certificates: retrospective cohort study
title_fullStr Reporting of clinically diagnosed dementia on death certificates: retrospective cohort study
title_full_unstemmed Reporting of clinically diagnosed dementia on death certificates: retrospective cohort study
title_short Reporting of clinically diagnosed dementia on death certificates: retrospective cohort study
title_sort reporting of clinically diagnosed dementia on death certificates: retrospective cohort study
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027637/
https://www.ncbi.nlm.nih.gov/pubmed/27146301
http://dx.doi.org/10.1093/ageing/afw077
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