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Partner Bereavement and Detection of Dementia: A UK-Based Cohort Study Using Routine Health Data

BACKGROUND: In the UK, an estimated one third of people with dementia have not received a diagnosis. Good evidence suggests that dementia risk is increased among widowed individuals; however, it is not clear if they are being diagnosed in routine primary care. OBJECTIVE: This study aimed to investig...

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Autores principales: Forbes, Harriet J., Wong, Angel Y.S., Morton, Caroline, Bhaskaran, Krishnan, Smeeth, Liam, Richards, Marcus, Schmidt, Sigrun A.J., Langan, Sinéad M., Warren-Gash, Charlotte
Formato: Online Artículo Texto
Lenguaje:English
Publicado: IOS Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6918907/
https://www.ncbi.nlm.nih.gov/pubmed/31594227
http://dx.doi.org/10.3233/JAD-190571
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author Forbes, Harriet J.
Wong, Angel Y.S.
Morton, Caroline
Bhaskaran, Krishnan
Smeeth, Liam
Richards, Marcus
Schmidt, Sigrun A.J.
Langan, Sinéad M.
Warren-Gash, Charlotte
author_facet Forbes, Harriet J.
Wong, Angel Y.S.
Morton, Caroline
Bhaskaran, Krishnan
Smeeth, Liam
Richards, Marcus
Schmidt, Sigrun A.J.
Langan, Sinéad M.
Warren-Gash, Charlotte
author_sort Forbes, Harriet J.
collection PubMed
description BACKGROUND: In the UK, an estimated one third of people with dementia have not received a diagnosis. Good evidence suggests that dementia risk is increased among widowed individuals; however, it is not clear if they are being diagnosed in routine primary care. OBJECTIVE: This study aimed to investigate if bereavement influenced the probability of having received a dementia diagnosis. METHODS: A population-based cohort study using UK electronic health records, between 1997 and 2017, among 247,586 opposite-sex partners. Those experiencing partner bereavement were matched (age, sex, and date of bereavement) to a non-bereaved person living in a partnership. Multivariate cox regression was performed. RESULTS: Partner bereavement was associated with an increased risk of receiving a diagnosis of dementia in the first three months (hazard ratio (HR) 1.43, 95% CI 1.20–1.71) and first six months (HR 1.24, 95% CI 1.09–1.41), while there was a small reduced risk of getting a dementia diagnosis over all follow-up (HR 0.94, 95% CI 0.89–0.98). CONCLUSIONS: Partner bereavement appears to lead to a short-term increased risk of the surviving partner receiving a diagnosis of dementia, suggesting that bereavement unmasks existing undiagnosed dementia. Over the longer term, however, bereaved individuals are less likely to have a diagnosis of dementia in their health records than non-bereaved individuals.
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spelling pubmed-69189072019-12-20 Partner Bereavement and Detection of Dementia: A UK-Based Cohort Study Using Routine Health Data Forbes, Harriet J. Wong, Angel Y.S. Morton, Caroline Bhaskaran, Krishnan Smeeth, Liam Richards, Marcus Schmidt, Sigrun A.J. Langan, Sinéad M. Warren-Gash, Charlotte J Alzheimers Dis Research Article BACKGROUND: In the UK, an estimated one third of people with dementia have not received a diagnosis. Good evidence suggests that dementia risk is increased among widowed individuals; however, it is not clear if they are being diagnosed in routine primary care. OBJECTIVE: This study aimed to investigate if bereavement influenced the probability of having received a dementia diagnosis. METHODS: A population-based cohort study using UK electronic health records, between 1997 and 2017, among 247,586 opposite-sex partners. Those experiencing partner bereavement were matched (age, sex, and date of bereavement) to a non-bereaved person living in a partnership. Multivariate cox regression was performed. RESULTS: Partner bereavement was associated with an increased risk of receiving a diagnosis of dementia in the first three months (hazard ratio (HR) 1.43, 95% CI 1.20–1.71) and first six months (HR 1.24, 95% CI 1.09–1.41), while there was a small reduced risk of getting a dementia diagnosis over all follow-up (HR 0.94, 95% CI 0.89–0.98). CONCLUSIONS: Partner bereavement appears to lead to a short-term increased risk of the surviving partner receiving a diagnosis of dementia, suggesting that bereavement unmasks existing undiagnosed dementia. Over the longer term, however, bereaved individuals are less likely to have a diagnosis of dementia in their health records than non-bereaved individuals. IOS Press 2019-11-12 /pmc/articles/PMC6918907/ /pubmed/31594227 http://dx.doi.org/10.3233/JAD-190571 Text en © 2019 – IOS Press and the authors. All rights reserved https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) License (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research Article
Forbes, Harriet J.
Wong, Angel Y.S.
Morton, Caroline
Bhaskaran, Krishnan
Smeeth, Liam
Richards, Marcus
Schmidt, Sigrun A.J.
Langan, Sinéad M.
Warren-Gash, Charlotte
Partner Bereavement and Detection of Dementia: A UK-Based Cohort Study Using Routine Health Data
title Partner Bereavement and Detection of Dementia: A UK-Based Cohort Study Using Routine Health Data
title_full Partner Bereavement and Detection of Dementia: A UK-Based Cohort Study Using Routine Health Data
title_fullStr Partner Bereavement and Detection of Dementia: A UK-Based Cohort Study Using Routine Health Data
title_full_unstemmed Partner Bereavement and Detection of Dementia: A UK-Based Cohort Study Using Routine Health Data
title_short Partner Bereavement and Detection of Dementia: A UK-Based Cohort Study Using Routine Health Data
title_sort partner bereavement and detection of dementia: a uk-based cohort study using routine health data
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6918907/
https://www.ncbi.nlm.nih.gov/pubmed/31594227
http://dx.doi.org/10.3233/JAD-190571
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