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Risk factors for dementia diagnosis in German primary care practices

Published online by Cambridge University Press:  08 January 2016

Anke Booker ,
Louis EC Jacob ,
Michael Rapp ,
Jens Bohlken  and
Karel Kostev
Anke Booker
Affiliation:
IMS HEALTH, Frankfurt, Germany
Louis EC Jacob
Affiliation:
Department of biology, École Normale Supérieure de Lyon, Lyon, France
Michael Rapp
Affiliation:
Department of Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
Jens Bohlken
Affiliation:
Praxis Bohlken, Berlin, Germany
Karel Kostev*
Affiliation:
IMS HEALTH, Frankfurt, Germany
*
Correspondence should be addressed to: Prof Karel Kostev, IMS HEALTH, Epidemiology, Darmstädter Landstraße 108, 60598 Frankfurt am Main, Germany. Phone: +49-(0)69-66 04-4878; Fax: +49-(0)69-66 04-5878. Email: [email protected].
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Abstract

Background:

Dementia 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.

Methods:

The 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.

Results:

The 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.

Conclusions:

Risk 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.

Keywords

dementiaAlzheimerrisk factorsstatins
Type
Paper of the Month
Information
International Psychogeriatrics , Volume 28 , Issue 7 , July 2016 , pp. 1059 - 1065
Copyright
Copyright © International Psychogeriatric Association 2016 

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References

Bachman, D. L. et al. (1993). Incidence of dementia and probable Alzheimer's disease in a general population: the Framingham study. Neurology, 43, 515–519.Google Scholar
Becher, H., Kostev, K. and Schröder-Bernhardi, D. (2009). Validity and representativeness of the “Disease Analyzer” patient database for use in pharmacoepidemiological and pharmacoeconomic studies. International Journal of Clinical Pharmacology and Therapeutics, 47, 617–626.Google Scholar
Busse, A., Bischkopf, J., Riedel-Heller, S. G. and Angermeyer, M. C. (2003). Mild cognitive impairment: prevalence and incidence according to different diagnostic criteria. Results of the Leipzig Longitudinal study of the aged (LEILA75+). The British Journal of Psychiatry, 182, 449–454.CrossRefGoogle ScholarPubMed
Corder, E. H. et al. (1993). Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer's disease in late onset families. Science, 261, 921–923.Google Scholar
Cummings, J. L. (1988). Intellectual impairment in Parkinson's disease: clinical, pathologic, and biochemical correlates. Journal of Geriatric Psychiatry and Neurology, 1, 24–36.Google Scholar
European Brain Council (2012). Parkinson's Disease Fact Sheet. Available at: http://www.europeanbraincouncil.org.Google Scholar
Food and Drug Administration (2012). Drug Safety Communication: important safety label changes to cholesterol-lowering statin drugs. Available at: http://www.fda.gov/Drugs/DrugSafety/ucm293101.htm.Google Scholar
Gupta, S. and Warner, J. (2008). Alcohol-related dementia: a 21st-century silent epidemic? The British Journal of Psychiatry, 193, 351–353. doi: 10.1192/bjp.bp.108.051425.CrossRefGoogle ScholarPubMed
Haenisch, B. et al. (2015). Risk of dementia in elderly patients with the use of proton pump inhibitors. European Archives of Psychiatry and Clinical Neuroscience, 265, 419–428. doi: 10.1007/s00406-014-0554-0.Google Scholar
Ivan, C. S. et al. (2004). Dementia after stroke: the Framingham study. Stroke A Journal of Cerebral Circulation, 35, 1264–1268. doi: 10.1161/01.STR.0000127810.92616.78.Google Scholar
Jick, H., Zornberg, G. L., Jick, S. S., Seshadri, S. and Drachman, D. A. (2000). Statins and the risk of dementia. The Lancet, 356, 1627–1631.CrossRefGoogle ScholarPubMed
Johnson, M. L. et al. (2012). Antihypertensive drug use and the risk of dementia in patients with diabetes mellitus. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 8, 437–444. doi: 10.1016/j.jalz.2011.05.2414.CrossRefGoogle ScholarPubMed
Kukull, W. A. et al. (2002). Dementia and Alzheimer disease incidence: a prospective cohort study. Archives of Neurology, 59, 1737–1746.Google Scholar
Leibson, C. L. et al. (1997). Risk of dementia among persons with diabetes mellitus: a population-based cohort study. American Journal of Epidemiology, 145, 301–308.Google Scholar
McCullagh, C. D., Craig, D., McIlroy, S. P. and Passmore, A. P. (2001). Risk factors for dementia. Advances in Psychiatric Treatment, 7, 24–31. doi: 10.1192/apt.7.1.24.CrossRefGoogle Scholar
Mindham, R. H., Ahmed, S. W. and Clough, C. G. (1982). A controlled study of dementia in Parkinson's disease. Journal of Neurology, Neurosurgery & Psychiatry, 45, 969–974.Google Scholar
Morris, J. C. et al. (2001). Mild cognitive impairment represents early-stage Alzheimer disease. Archives of Neurology, 58, 397–405.CrossRefGoogle ScholarPubMed
Mukamal, K. J., Kuller, L. H., Fitzpatrick, A. L., Longstreth, W. T., Mittleman, M. A. and Siscovick, D. S. (2003). Prospective study of alcohol consumption and risk of dementia in older adults. The Journal of the American Medical Association, 289, 1405–1413.Google Scholar
Newman, A. B. et al. (2005). Dementia and Alzheimer's disease incidence in relationship to cardiovascular disease in the Cardiovascular health study cohort. Journal of the American Geriatrics Society, 53, 1101–1107. doi: 10.1111/j.1532-5415.2005.53360.x.Google Scholar
OECD/European Union (2014). Dementia prevalence. In Health at a Glance: Europe 2014. Paris: OECD Publishing.Google Scholar
O’Keefe, J. H., Bybee, K. A. and Lavie, C. J. (2007). Alcohol and cardiovascular health: the razor-sharp double-edged sword. Journal of the American College of Cardiology, 50, 1009–1014. doi: 10.1016/j.jacc.2007.04.089.CrossRefGoogle ScholarPubMed
Ott, A., Stolk, R. P., van Harskamp, F., Pols, H. A., Hofman, A. and Breteler, M. M. (1999). Diabetes mellitus and the risk of dementia: the Rotterdam study. Neurology, 53, 1937–1942.Google Scholar
Petersen, R. C., Smith, G. E., Waring, S. C., Ivnik, R. J., Tangalos, E. G. and Kokmen, E. (1999). Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology, 56, 303–308.CrossRefGoogle ScholarPubMed
Rajput, A. H., Offord, K. P., Beard, C. M. and Kurland, L. T. (1987). A case-control study of smoking habits, dementia, and other illnesses in idiopathic Parkinson's disease. Neurology, 37, 226–232.CrossRefGoogle ScholarPubMed
Redberg, R. F. and Katz, M. H., (2012). Healthy men should not take statins. The Journal of the American Medical Association, 307, 1491–1492. doi: 10.1001/jama.2012.423.Google Scholar
Richardson, K. et al. (2013). Statins and cognitive function: a systematic review. Annals of Internal Medicine, 159, 688–697. doi: 10.7326/0003-4819-159-10-201311190-00007.CrossRefGoogle ScholarPubMed
Ritchie, K. and Touchon, J. (2000). Mild cognitive impairment: conceptual basis and current nosological status. The Lancet, 355, 225–228. doi: 10.1016/S0140-6736(99)06155-3.CrossRefGoogle ScholarPubMed
Samii, A., Nutt, J. G. and Ransom, B. R. (2004). Parkinson's disease. The Lancet, 363, 1783–1793. doi: 10.1016/S0140-6736(04)16305-8.CrossRefGoogle ScholarPubMed
Song, Y., Nie, H., Xu, Y., Zhang, L. and Wu, Y. (2013). Association of statin use with risk of dementia: a meta-analysis of prospective cohort studies. Geriatrics & Gerontology International, 13, 817–824. doi: 10.1111/ggi.12044.Google Scholar
Swiger, K. J., Manalac, R. J., Blumenthal, R. S., Blaha, M. J. and Martin, S. S. (2013). Statins and cognition: a systematic review and meta-analysis of short- and long-term cognitive effects. Mayo Clinic Proceedings, 88, 1213–1221. doi: 10.1016/j.mayocp.2013.07.013.CrossRefGoogle Scholar
Taylor, F. et al. (2013). Statins for the primary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews, 1, CD004816. doi: 10.1002/14651858.CD004816.pub5.Google Scholar
WHO (2015). Definition and Statistics on Dementia, Available at: http://www.who.int/features/factfiles/dementia/dementia_facts/en/; last accessed 9 July 2015.Google Scholar
Wolozin, B., Kellman, W., Ruosseau, P., Celesia, G. G. and Siegel, G. (2000). Decreased prevalence of Alzheimer disease associated with 3-hydroxy-3-methyglutaryl coenzyme A reductase inhibitors. Archives of Neurology, 57, 1439–1443.CrossRefGoogle ScholarPubMed
Wong, W. B., Lin, V. W., Boudreau, D. and Devine, E. B. (2013). Statins in the prevention of dementia and Alzheimer's disease: a meta-analysis of observational studies and an assessment of confounding. Pharmacoepidemiology and Drug Safety, 22, 345–358. doi: 10.1002/pds.3381.Google Scholar
Yoshitake, T. et al. (1995). Incidence and risk factors of vascular dementia and Alzheimer's disease in a defined elderly Japanese population: the Hisayama Study. Neurology, 45, 1161–1168.CrossRefGoogle Scholar
Zhou, B., Teramukai, S. and Fukushima, M. (2007). Prevention and treatment of dementia or Alzheimer's disease by statins: a meta-analysis. Dementia and Geriatric Cognitive Disorders, 23, 194–201. doi: 10.1159/000099037.Google Scholar