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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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