Survival of people with clinical diagnosis of dementia in primary care: cohort study.

Abstract:

OBJECTIVES:To estimate survival after a diagnosis of dementia in primary care, compared with people without dementia, and to determine incidence of dementia. DESIGN:Cohort study using data from The Health Improvement Network (THIN), a primary care database. SETTING:353 general practices in the United Kingdom providing data to THIN. PARTICIPANTS:All adults aged 60 years or over with a first ever code for dementia from 1990 to 2007 (n=22 529); random sample of five participants without dementia for every participant with dementia matched on practice and time period (n=112 645). MAIN OUTCOME MEASURES:Median survival by age and sex; mortality rates; incidence of dementia by age, sex, and deprivation. RESULTS:The median survival of people with dementia diagnosed at age 60-69 was 6.7 (interquartile range 3.1-10.8) years, falling to 1.9 (0.7-3.6) years for those diagnosed at age 90 or over. Adjusted mortality rates were highest in the first year after diagnosis (relative risk 3.68, 95% confidence interval 3.44 to 3.94). This dropped to 2.49 (2.29 to 2.71) in the second year. The incidence of recorded dementia remained stable over time (3-4/1000 person years at risk). The incidence was higher in women and in younger age groups (60-79 years) living in deprived areas. CONCLUSIONS:Median survival was much lower than in screened populations. These clinically relevant estimates can assist patients and carers, clinicians, and policy makers when planning support for this population. The high risk of death in the first year after diagnosis may reflect diagnoses made at times of crisis or late in the disease trajectory. Late recording of diagnoses of dementia in primary care may result in missed opportunities for potential early interventions.

journal_name

BMJ

authors

Rait G,Walters K,Bottomley C,Petersen I,Iliffe S,Nazareth I

doi

10.1136/bmj.c3584

subject

Has Abstract

pub_date

2010-08-05 00:00:00

pages

c3584

eissn

0959-8138

issn

1756-1833

journal_volume

341

pub_type

杂志文章,多中心研究
  • Weight growth in infants born to mothers who smoked during pregnancy.

    abstract:OBJECTIVE:To determine whether maternal smoking during pregnancy causes impairment in growth after birth. DESIGN:Longitudinal study. SETTING:Six medical university centres of six towns of north, central, and south Italy. SUBJECTS:12,987 babies (10,238 born from non-smoking mothers, 2276 from mothers smoking one to n...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6982.768

    authors: Conter V,Cortinovis I,Rogari P,Riva L

    更新日期:1995-03-25 00:00:00

  • Do neuroleptic drugs hasten cognitive decline in dementia? Prospective study with necropsy follow up.

    abstract:OBJECTIVE:To investigate the contribution of neuroleptic drugs to cognitive decline in dementia. DESIGN:Two year prospective, longitudinal study consisting of interviews every four months, with necropsy follow up. SETTING:Community settings in Oxfordshire. SUBJECTS:71 subjects with dementia, initially living at home...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.314.7076.266

    authors: McShane R,Keene J,Gedling K,Fairburn C,Jacoby R,Hope T

    更新日期:1997-01-25 00:00:00

  • Management of acute diarrhoea in diabetic patients using oral rehydration solutions containing glucose, rice, or glycine.

    abstract:OBJECTIVE:To assess the risk of hyperglycaemia with two standard oral rehydration solutions that contain carbohydrate compared with a carbohydrate free solution during rehydration of diabetic patients with acute diarrhoea. DESIGN:Prospective randomised allocation to one of three oral rehydration solutions (World Healt...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.308.6929.624

    authors: Haider R,Azad Khan AK,Roy SK,Dewan N,Alam AN,Mahalanabis D

    更新日期:1994-03-05 00:00:00

  • Prediction model to estimate presence of coronary artery disease: retrospective pooled analysis of existing cohorts.

    abstract:OBJECTIVES:To develop prediction models that better estimate the pretest probability of coronary artery disease in low prevalence populations. DESIGN:Retrospective pooled analysis of individual patient data. SETTING:18 hospitals in Europe and the United States. PARTICIPANTS:Patients with stable chest pain without ev...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.e3485

    authors: Genders TS,Steyerberg EW,Hunink MG,Nieman K,Galema TW,Mollet NR,de Feyter PJ,Krestin GP,Alkadhi H,Leschka S,Desbiolles L,Meijs MF,Cramer MJ,Knuuti J,Kajander S,Bogaert J,Goetschalckx K,Cademartiri F,Maffei E,Martini

    更新日期:2012-06-12 00:00:00

  • A cognitive behavioural intervention to reduce sexually transmitted infections among gay men: randomised trial.

    abstract:OBJECTIVE:To determine the effectiveness of a brief cognitive behavioural intervention in reducing the incidence of sexually transmitted infections among gay men. DESIGN:Randomised controlled trial with 12 months' follow up. SETTING:Sexual health clinic in London. PARTICIPANTS:343 gay men with an acute sexually tran...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.322.7300.1451

    authors: Imrie J,Stephenson JM,Cowan FM,Wanigaratne S,Billington AJ,Copas AJ,French L,French PD,Johnson AM,Behavioural Intervention in Gay Men Project Study Group.

    更新日期:2001-06-16 00:00:00

  • Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement.

    abstract::Prediction models are developed to aid health care providers in estimating the probability or risk that a specific disease or condition is present (diagnostic models) or that a specific event will occur in the future (prognostic models), to inform their decision making. However, the overwhelming evidence shows that th...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.g7594

    authors: Collins GS,Reitsma JB,Altman DG,Moons KG

    更新日期:2015-01-07 00:00:00

  • Outcome of breech delivery at term.

    abstract:OBJECTIVE:To compare neonatal mortality and morbidity in term infants presenting by the breech and delivered vaginally or by caesarean section. DESIGN:Population based comparison of outcomes. Data derived from the St Mary's maternity information system. SETTING:North West Thames Regional Health Authority, 1988-90. S...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.305.6856.746

    authors: Thorpe-Beeston JG,Banfield PJ,Saunders NJ

    更新日期:1992-09-26 00:00:00

  • Births in Great Britain resulting from assisted conception, 1978-87. MRC Working Party on Children Conceived by In Vitro Fertilisation.

    abstract:OBJECTIVE:To describe the characteristics at birth of children conceived by in vitro fertilisation (IVF) or by gamete intrafallopian transfer (GIFT) and to assess whether they differ from those of children conceived naturally. DESIGN:Survey of children resulting from IVF or GIFT and comparison of their characteristics...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.300.6734.1229

    authors:

    更新日期:1990-05-12 00:00:00

  • Right-left discrimination among medical students: questionnaire and psychometric study.

    abstract:OBJECTIVE:To determine medical students' self awareness and ability to discriminate right from left; to identify characteristics associated with this ability; and to identify any techniques used to aid discrimination. DESIGN:Questionnaire and psychometric study. SETTING:Undergraduate medical school, Northern Ireland....

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.a2826

    authors: Gormley GJ,Dempster M,Best R

    更新日期:2008-12-16 00:00:00

  • Demographic shifts and medical training.

    abstract::The rapid aging of populations in developing countries as compared to those in the developed world has implications for medical training in these places. Moreover, the growing globalization of employment for many health professionals means that demographic shifts have implications for the training of health professio...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.319.7221.1358

    authors: Ebrahim S

    更新日期:1999-11-20 00:00:00

  • Low intensity pulsed ultrasound for bone healing: systematic review of randomized controlled trials.

    abstract::Objective To determine the efficacy of low intensity pulsed ultrasound (LIPUS) for healing of fracture or osteotomy.Design Systematic review and meta-analysis.Data sources Medline, Embase, CINAHL, Cochrane Central Register of Controlled Trials, and trial registries up to November 2016.Study selection Randomized contro...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.j656

    authors: Schandelmaier S,Kaushal A,Lytvyn L,Heels-Ansdell D,Siemieniuk RA,Agoritsas T,Guyatt GH,Vandvik PO,Couban R,Mollon B,Busse JW

    更新日期:2017-02-22 00:00:00

  • Prediction models for diagnosis and prognosis of covid-19 infection: systematic review and critical appraisal.

    abstract:OBJECTIVE:To review and critically appraise published and preprint reports of prediction models for diagnosing coronavirus disease 2019 (covid-19) in patients with suspected infection, for prognosis of patients with covid-19, and for detecting people in the general population at increased risk of becoming infected with...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.m1328

    authors: Wynants L,Van Calster B,Collins GS,Riley RD,Heinze G,Schuit E,Bonten MMJ,Damen JAA,Debray TPA,De Vos M,Dhiman P,Haller MC,Harhay MO,Henckaerts L,Kreuzberger N,Lohman A,Luijken K,Ma J,Andaur CL,Reitsma JB,Sergeant

    更新日期:2020-04-07 00:00:00

  • Pragmatic randomised controlled trial of local corticosteroid injection and naproxen for treatment of lateral epicondylitis of elbow in primary care.

    abstract:OBJECTIVE:To compare the clinical effectiveness of local corticosteroid injection, standard non-steroidal anti-inflammatory drugs, and simple analgesics for the early treatment of lateral epicondylitis in primary care. DESIGN:Multicentre pragmatic randomised controlled trial. SETTING:23 general practices in North Sta...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.319.7215.964

    authors: Hay EM,Paterson SM,Lewis M,Hosie G,Croft P

    更新日期:1999-10-09 00:00:00

  • Is London overbedded?

    abstract:OBJECTIVE:To examine whether there are too many hospital beds in London. DESIGN:Analysis of data from the Hospital In-Patient Enquiry, Mental Health Enquiry, health service indicators, and Emergency Bed Service. SETTING:England, London, and inner London. RESULTS:Hospital admission rates for acute plus geriatric serv...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.306.6883.979

    authors: Jarman B

    更新日期:1993-04-10 00:00:00

  • Safety and effectiveness of first line eflornithine for Trypanosoma brucei gambiense sleeping sickness in Sudan: cohort study.

    abstract:OBJECTIVE:To assess the safety and effectiveness of eflornithine as first line treatment for human African trypanosomiasis. DESIGN:Cohort study. SETTING:Control programme in Ibba, southern Sudan. PARTICIPANTS:1055 adults and children newly diagnosed with second stage disease in a 16 month period. MAIN OUTCOME MEASU...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.39485.592674.BE

    authors: Priotto G,Pinoges L,Fursa IB,Burke B,Nicolay N,Grillet G,Hewison C,Balasegaram M

    更新日期:2008-03-29 00:00:00

  • Prevention of suicide: aspirations and evidence.

    abstract::The Health of the Nation white paper set a target for 15% reduction in overall suicide rates by the year 2000. If the targets are to be achieved interventions must be identified which are of proved effectiveness. This paper examines the evidence on the available interventions and points of access to the population at ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.308.6938.1227

    authors: Gunnell D,Frankel S

    更新日期:1994-05-07 00:00:00

  • Effectiveness and efficiency of different guidelines on statin treatment for preventing deaths from coronary heart disease: modelling study.

    abstract:OBJECTIVE:To examine the potential effectiveness and efficiency of different guidelines for statin treatment to reduce deaths from coronary heart disease in the Canadian population. DESIGN:Modelled outcomes of screening and treatment recommendations of six national or international guidelines--from Canada, Australia, ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.38849.487546.DE

    authors: Manuel DG,Kwong K,Tanuseputro P,Lim J,Mustard CA,Anderson GM,Ardal S,Alter DA,Laupacis A

    更新日期:2006-06-17 00:00:00

  • Routine follow up of breast cancer in primary care: randomised trial.

    abstract:OBJECTIVE:To assess the effect on time to diagnosis of recurrence and on quality of life of transferring primary responsibility for follow up of women with breast cancer in remission from hospital to general practice. DESIGN:Randomised controlled trial with 18 month follow up in which women received routine follow up ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.313.7058.665

    authors: Grunfeld E,Mant D,Yudkin P,Adewuyi-Dalton R,Cole D,Stewart J,Fitzpatrick R,Vessey M

    更新日期:1996-09-14 00:00:00

  • A qualitative study of action plans for asthma.

    abstract:OBJECTIVES:To investigate the perspectives of patients with asthma on the use of an action plan and the implementation of this plan during an asthma attack that culminated in a visit to an emergency department. DESIGN:Qualitative study. SETTING:Tertiary teaching hospital, suburban hospital, and rural hospital. PARTI...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.324.7344.1003

    authors: Douglass J,Aroni R,Goeman D,Stewart K,Sawyer S,Thien F,Abramson M

    更新日期:2002-04-27 00:00:00

  • Prevalence of Chlamydia trachomatis infection in women having cervical smear tests.

    abstract:OBJECTIVE:To determine the prevalence of sexually transmitted diseases in patients with normal and abnormal cervical smears. DESIGN:A prospective study of asymptomatic women with normal cervical smears attending their general practitioner and newly referred patients with abnormal smears attending a colposcopy clinic. ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.302.6768.82

    authors: Smith JR,Murdoch J,Carrington D,Frew CE,Dougall AJ,MacKinnon H,Baillie D,Byford DM,Forrest CA,Davis JA

    更新日期:1991-01-12 00:00:00

  • Birth weight of offspring and mortality in the Renfrew and Paisley study: prospective observational study.

    abstract:OBJECTIVE:To investigate the association between birth weight of offspring and mortality among fathers and mothers in the west of Scotland. DESIGN:Prospective observational study. PARTICIPANTS:794 married couples in Renfrew district of the west of Scotland. MAIN OUTCOME MEASURES:Mortality from all causes and from ca...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.315.7117.1189

    authors: Davey Smith G,Hart C,Ferrell C,Upton M,Hole D,Hawthorne V,Watt G

    更新日期:1997-11-08 00:00:00

  • Accuracy of diagnosis of psychosis on general practice computer system.

    abstract:OBJECTIVES:To determine the accuracy of diagnoses of schizophrenia and non-affective psychosis entered by general practitioners on a computer system. To compare recording of clinical events on computer with written records. DESIGN:Examination of case notes of all patients with a computer diagnosis of psychosis. Search...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.307.6895.32

    authors: Nazareth I,King M,Haines A,Rangel L,Myers S

    更新日期:1993-07-03 00:00:00

  • Lichen planus and liver diseases: a multicentre case-control study. Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED).

    abstract:OBJECTIVE:To assess the association of lichen planus with liver complaints and with known aetiological factors of liver diseases. DESIGN:Multicentre case-control study. Interviews were conducted by trained medical investigators on the basis of a structured questionnaire. At the interview patients and controls were ask...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1136/bmj.300.6719.227

    authors:

    更新日期:1990-01-27 00:00:00

  • Retention in the British National Health Service of medical graduates trained in Britain: cohort studies.

    abstract:OBJECTIVE:To report the percentage of graduates from British medical schools who eventually practise medicine in the British NHS. DESIGN:Cohort studies using postal questionnaires, employment data, and capture-recapture analysis. SETTING:Great Britain. SUBJECTS:32 430 graduates from all British medical schools in ni...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.b1977

    authors: Goldacre MJ,Davidson JM,Lambert TW

    更新日期:2009-06-03 00:00:00

  • Intergenerational 20 year trends in the prevalence of asthma and hay fever in adults: the Midspan family study surveys of parents and offspring.

    abstract:OBJECTIVE:To estimate trends between 1972-6 and 1996 in the prevalences of asthma and hay fever in adults. DESIGN:Two epidemiological surveys 20 years apart. Identical questions were asked about asthma, hay fever, and respiratory symptoms at each survey. SETTING:Renfrew and Paisley, two towns in the west of Scotland....

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.321.7253.88

    authors: Upton MN,McConnachie A,McSharry C,Hart CL,Smith GD,Gillis CR,Watt GC

    更新日期:2000-07-08 00:00:00

  • Influence of moving to the UK on maternal health behaviours: prospective cohort study.

    abstract:OBJECTIVE:To compare health behaviours during pregnancy (smoking and alcohol consumption) and after birth (initiation and duration of breast feeding) between British/Irish white mothers and mothers from ethnic minority groups; and, in mothers from ethnic minority groups, to examine whether indicators of acculturation (...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.39532.688877.25

    authors: Hawkins SS,Lamb K,Cole TJ,Law C,Millennium Cohort Study Child Health Group.

    更新日期:2008-05-10 00:00:00

  • Antiretroviral treatment can reduce the risk of HIV transmission between male partners to 'zero'.

    abstract::The studyA Rodger, V Cambiano, T Bruun, et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet 2019;393:2428-38.This project was funde...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 评论,杂志文章

    doi:10.1136/bmj.l4915

    authors: Cook R,Davidson P,clinical adviser,.,Martin R,NIHR Dissemination Centre.

    更新日期:2019-08-27 00:00:00

  • Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life.

    abstract:OBJECTIVE:To evaluate the effectiveness of an integrated care programme, combining a patient directed and a workplace directed intervention, for patients with chronic low back pain. DESIGN:Population based randomised controlled trial. SETTING:Primary care (10 physiotherapy practices, one occupational health service, ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.c1035

    authors: Lambeek LC,van Mechelen W,Knol DL,Loisel P,Anema JR

    更新日期:2010-03-16 00:00:00

  • Childhood energy intake and adult mortality from cancer: the Boyd Orr Cohort Study.

    abstract:OBJECTIVE:To examine the relation between energy intake in childhood and adult mortality from cancer. STUDY DESIGN:Cohort study. SETTING:16 rural and urban centres in England and Scotland. SUBJECTS:3834 people who took part in Lord Boyd Orr's Carnegie survey of family diet and health in prewar Britain between 1937 a...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.316.7130.499

    authors: Frankel S,Gunnell DJ,Peters TJ,Maynard M,Davey Smith G

    更新日期:1998-02-14 00:00:00

  • Interventions for non-metastatic squamous cell carcinoma of the skin: systematic review and pooled analysis of observational studies.

    abstract:OBJECTIVES:To assess the effects of treatments for non-metastatic invasive squamous cell carcinoma (SCC) of the skin using evidence from observational studies, given the paucity of evidence from randomised controlled trials. DESIGN:Systematic review of observational studies. DATA SOURCES:Medline, Embase, to December ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.f6153

    authors: Lansbury L,Bath-Hextall F,Perkins W,Stanton W,Leonardi-Bee J

    更新日期:2013-11-04 00:00:00