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Trends in dementia diagnosis rates in UK ethnic groups: analysis of UK primary care data.
Clin Epidemiol. 2018; 10:949-960.CE

Abstract

OBJECTIVES

We compared incidence of dementia diagnosis by white, black, and Asian ethnic groups and estimated the proportion of UK white and black people developing dementia in 2015 who had a diagnosis for the first time in a UK-wide study.

METHODS

We analyzed primary care electronic health records from The Health Improvement Network database between 2007 and 2015 and compared incidence of dementia diagnosis to dementia incidence from community cohort studies. The study sample comprised of 2,511,681 individuals aged 50-105 years who did not have a dementia diagnosis prior to the start of follow-up.

RESULTS

A total of 66,083 individuals had a dementia diagnosis (4.87/1,000 person-years at risk, 95% CI 4.83-4.90); this incidence increased from 3.75 to 5.65/1,000 person-years at risk between 2007 and 2015. Compared with white women, the incidence of dementia diagnosis was 18% lower among Asian women (adjusted incidence rate ratio (IRR) 0.82, 95% CI 0.72-0.95) and 25% higher among black women (IRR 1.25, 95% CI 1.07-1.46). For men, incidence of dementia diagnosis was 28% higher in the black ethnic group (IRR 1.28, 95% CI 1.08-1.50) and 12% lower in the Asian ethnic group (IRR 0.88, 95% CI 0.76-1.01) relative to the white ethnic group. Based on diagnosis incidence in The Health Improvement Network data and projections of incidence from community cohort studies, we estimated that 42% of black men developing dementia in 2015 were diagnosed compared with 53% of white men.

CONCLUSION

People from the black ethnic group had a higher incidence of dementia diagnosis and those from the Asian ethnic group had lower incidence compared with the white ethnic group. We estimated that black men developing dementia were less likely than white men to have a diagnosis of dementia, indicating that the increased risk of dementia diagnosis reported in the black ethnic group might underestimate the higher risk of dementia in this group. It is unclear whether the lower incidence of dementia diagnosis in the Asian ethnic group reflects lower community incidence or underdiagnosis. A cohort study to determine this is needed.

Authors+Show Affiliations

Department of Primary Care and Population Health, University College London, London, UK.Department of Primary Care and Population Health, University College London, London, UK. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.Department of Primary Care and Population Health, University College London, London, UK.Department of Applied Health Research, University College London, London, UK.Social Care Workforce Research Unit, King's College London, London, UK.Division of Psychiatry, University College London, London, UK, claudia.cooper@ucl.ac.uk.Division of Psychiatry, University College London, London, UK, claudia.cooper@ucl.ac.uk.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30123007

Citation

Pham, Tra My, et al. "Trends in Dementia Diagnosis Rates in UK Ethnic Groups: Analysis of UK Primary Care Data." Clinical Epidemiology, vol. 10, 2018, pp. 949-960.
Pham TM, Petersen I, Walters K, et al. Trends in dementia diagnosis rates in UK ethnic groups: analysis of UK primary care data. Clin Epidemiol. 2018;10:949-960.
Pham, T. M., Petersen, I., Walters, K., Raine, R., Manthorpe, J., Mukadam, N., & Cooper, C. (2018). Trends in dementia diagnosis rates in UK ethnic groups: analysis of UK primary care data. Clinical Epidemiology, 10, 949-960. https://doi.org/10.2147/CLEP.S152647
Pham TM, et al. Trends in Dementia Diagnosis Rates in UK Ethnic Groups: Analysis of UK Primary Care Data. Clin Epidemiol. 2018;10:949-960. PubMed PMID: 30123007.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trends in dementia diagnosis rates in UK ethnic groups: analysis of UK primary care data. AU - Pham,Tra My, AU - Petersen,Irene, AU - Walters,Kate, AU - Raine,Rosalind, AU - Manthorpe,Jill, AU - Mukadam,Naaheed, AU - Cooper,Claudia, Y1 - 2018/08/08/ PY - 2018/8/21/entrez PY - 2018/8/21/pubmed PY - 2018/8/21/medline KW - dementia KW - electronic health records KW - ethnicity KW - primary care SP - 949 EP - 960 JF - Clinical epidemiology JO - Clin Epidemiol VL - 10 N2 - OBJECTIVES: We compared incidence of dementia diagnosis by white, black, and Asian ethnic groups and estimated the proportion of UK white and black people developing dementia in 2015 who had a diagnosis for the first time in a UK-wide study. METHODS: We analyzed primary care electronic health records from The Health Improvement Network database between 2007 and 2015 and compared incidence of dementia diagnosis to dementia incidence from community cohort studies. The study sample comprised of 2,511,681 individuals aged 50-105 years who did not have a dementia diagnosis prior to the start of follow-up. RESULTS: A total of 66,083 individuals had a dementia diagnosis (4.87/1,000 person-years at risk, 95% CI 4.83-4.90); this incidence increased from 3.75 to 5.65/1,000 person-years at risk between 2007 and 2015. Compared with white women, the incidence of dementia diagnosis was 18% lower among Asian women (adjusted incidence rate ratio (IRR) 0.82, 95% CI 0.72-0.95) and 25% higher among black women (IRR 1.25, 95% CI 1.07-1.46). For men, incidence of dementia diagnosis was 28% higher in the black ethnic group (IRR 1.28, 95% CI 1.08-1.50) and 12% lower in the Asian ethnic group (IRR 0.88, 95% CI 0.76-1.01) relative to the white ethnic group. Based on diagnosis incidence in The Health Improvement Network data and projections of incidence from community cohort studies, we estimated that 42% of black men developing dementia in 2015 were diagnosed compared with 53% of white men. CONCLUSION: People from the black ethnic group had a higher incidence of dementia diagnosis and those from the Asian ethnic group had lower incidence compared with the white ethnic group. We estimated that black men developing dementia were less likely than white men to have a diagnosis of dementia, indicating that the increased risk of dementia diagnosis reported in the black ethnic group might underestimate the higher risk of dementia in this group. It is unclear whether the lower incidence of dementia diagnosis in the Asian ethnic group reflects lower community incidence or underdiagnosis. A cohort study to determine this is needed. SN - 1179-1349 UR - https://www.unboundmedicine.com/medline/citation/30123007/Trends_in_dementia_diagnosis_rates_in_UK_ethnic_groups:_analysis_of_UK_primary_care_data_ DB - PRIME DP - Unbound Medicine ER -
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