Journal Article

Risk factors for dementia diagnosis in German primary care practices

Kostev, Karel, Bohlken, Jens, Rapp, Michael, Booker, Anke, Jacob, Louis EC

2016

Overview

ABSTRACTBackgroundDementia is a psychiatric condition the development of which is associated with numerous aspects of life. Our aim was to estimate dementia risk factors in German primary care patients. MethodsThe case-control study included primary care patients (70–90 years) with first diagnosis of dementia (all-cause) during the index period (01/2010-12/2014) (Disease Analyzer, Germany), and controls without dementia matched (1:1) to cases on the basis of age, sex, type of health insurance, and physician. Practice visit records were used to verify that there had been 10 years of continuous follow-up prior to the index date. Multivariate logistic regression models were fitted with dementia as a dependent variable and the potential predictors. ResultsThe mean age for the 11,956 cases and the 11,956 controls was 80.4 (SD: 5.3) years. 39.0% of them were male and 1.9% had private health insurance. In the multivariate regression model, the following variables were linked to a significant extent with an increased risk of dementia: diabetes (OR: 1.17; 95% CI: 1.10–1.24), lipid metabolism (1.07; 1.00–1.14), stroke incl. TIA (1.68; 1.57–1.80), Parkinson's disease (PD) (1.89; 1.64–2.19), intracranial injury (1.30; 1.00–1.70), coronary heart disease (1.06; 1.00–1.13), mild cognitive impairment (MCI) (2.12; 1.82–2.48), mental and behavioral disorders due to alcohol use (1.96; 1.50–2.57). The use of statins (OR: 0.94; 0.90–0.99), proton-pump inhibitors (PPI) (0.93; 0.90–0.97), and antihypertensive drugs (0.96, 0.94–0.99) were associated with a decreased risk of developing dementia. ConclusionsRisk factors for dementia found in this study are consistent with the literature. Nevertheless, the associations between statin, PPI and antihypertensive drug use, and decreased risk of dementia need further investigations.

• Publisher: Cambridge University Press,Elsevier Inc
• Subject: Aged / Aged, 80 and over / Alcohol use / Alzheimer / Antihypertensives / Behavior disorders / Cardiovascular diseases / Case-Control Studies / Chronic illnesses / Cognitive impairment / Coronary artery disease / Dementia / Dementia - diagnosis / Dementia - epidemiology / Diabetes / Disease / Disorders / Drug abuse / Drugs / Female / Geriatric psychology / Germany - epidemiology / Health care industry / Health insurance / Humans / Indexes / Male / Medical diagnosis / Mental disorders / Mental health / Mental Status and Dementia Tests / Metabolism / Older people / Paper of the Month / Parkinson's disease / Patients / Physicians / Primary care / Primary Health Care - methods / Primary Health Care - statistics & numerical data / Protective Factors / Risk Factors / Statins / Stroke / Substance abuse