scholarly journals Association between risk of dementia and very late-onset schizophrenia-like psychosis: a Swedish population-based cohort study

2021 ◽  
pp. 1-9
Author(s):  
J. Stafford ◽  
J. Dykxhoorn ◽  
A. Sommerlad ◽  
C. Dalman ◽  
J. B. Kirkbride ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Late Onset ◽  
International Classification Of Diseases ◽  
Population Based ◽  
High Risk Group ◽  
First Year ◽  
Dementia Diagnosis ◽  
Swedish Population ◽  
Classification Of Diseases

Abstract Background Although the incidence of psychotic disorders among older people is substantial, little is known about the association with subsequent dementia. We aimed to examine the rate of dementia diagnosis in individuals with very late-onset schizophrenia-like psychosis (VLOSLP) compared to those without VLOSLP. Methods Using Swedish population register data, we established a cohort of 15 409 participants with VLOSLP matched by age and calendar period to 154 090 individuals without VLOSLP. Participants were born between 1920 and 1949 and followed from their date of first International Classification of Diseases [ICD], Revisions 8–10 (ICD-8/9/10) non-affective psychotic disorder diagnosis after age 60 years old (or the same date for matched participants) until the end of follow-up (30th December 2011), emigration, death, or first recorded ICD-8/9/10 dementia diagnosis. Results We found a substantially higher rate of dementia in individuals with VLOSLP [hazard ratio (HR): 4.22, 95% confidence interval (95% CI) 4.05–4.41]. Median time-to-dementia-diagnosis was 75% shorter in those with VLOSLP (time ratio: 0.25, 95% CI 0.24–0.26). This association was strongest in the first year following VLOSLP diagnosis, and attenuated over time, although dementia rates remained higher in participants with VLOSLP for up to 20 years of follow-up. This association remained after accounting for potential misdiagnosis (2-year washout HR: 2.22, 95% CI 2.10–2.36), ascertainment bias (HR: 2.89, 95% CI 2.75–3.04), and differing mortality patterns between groups (subdistribution HR: 2.89, 95% CI 2.77–3.03). Conclusions Our findings demonstrate that individuals with VLOSLP represent a high-risk group for subsequent dementia. This may be due to early prodromal changes for some individuals, highlighting the importance of ongoing symptom monitoring in people with VLOSLP.

scholarly journals Association between risk of dementia and very late-onset schizophrenia-like psychosis: a Swedish population-based cohort study

2020 ◽  
Author(s):  
Jean Stafford ◽  
Jennifer Dykxhoorn ◽  
Andrew Sommerlad ◽  
Christina Dalman ◽  
James Bowes Kirkbride ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Late Onset ◽  
International Classification Of Diseases ◽  
Population Based ◽  
High Risk Group ◽  
First Year ◽  
Dementia Diagnosis ◽  
Swedish Population ◽  
Classification Of Diseases

Aims: Although the incidence of psychotic disorders among older people is substantial, little is known about the association with subsequent dementia. We aimed to examine the rate of dementia diagnosis in individuals with VLOSLP compared to those without VLOSLP.Methods: Using Swedish population register data, we established a cohort of 15,409 participants with VLOSLP matched by age and calendar period to 154,090 individuals without VLOSLP. Participants were born between 1920-1949 and followed from their date of first International Classification of Diseases [ICD], Revisions 8-10 (ICD-8/9/10) non-affective psychotic disorder diagnosis after age 60 years old (or the same date for matched participants) until the end of follow-up (30th December 2011), emigration, death, or first recorded ICD-8/9/10 dementia diagnosis. Results: We found a substantially higher rate of dementia in individuals with VLOSLP (hazard ratio (HR):4·22, 95% confidence interval (95%CI):4·05-4·41). Median time-to-dementia-diagnosis was 75% shorter in those with VLOSLP (time ratio:0·25, 95%CI:0·24-0·26). This association was strongest in the first year following VLOSLP diagnosis, and attenuated over time, although dementia rates remained higher in participants with VLOSLP for up to 20 years of follow-up. This association remained after accounting for potential misdiagnosis (2-year washout HR:2·22, 95%CI:2·10-2·36), ascertainment bias (HR:2·89, 95%CI: 2·75-3·04), and differing mortality patterns between groups (subdistribution HR:2·89, 95%CI:2·77-3·03). Conclusion: Our findings demonstrate that individuals with VLOSLP represent a high-risk group for subsequent dementia. This may be due to early prodromal changes for some individuals, highlighting the importance of ongoing symptom monitoring in people with VLOSLP.

scholarly journals Progress of Diabetic Severity and Risk of Dementia

2015 ◽  
Vol 100 (8) ◽  
pp. 2899-2908 ◽  
Author(s):  
Wei-Che Chiu ◽  
Wen-Chao Ho ◽  
Ding-Lieh Liao ◽  
Meng-Hung Lin ◽  
Chih-Chiang Chiu ◽  
...  
Keyword(s):  
Severity Index ◽  
International Classification Of Diseases ◽  
Population Based ◽  
International Classification ◽  
Diabetic Patients ◽  
Research Database ◽  
Classification Of Diseases ◽  
New Onset

Context: Diabetes is a risk factor for dementia, but the effects of diabetic severity on dementia are unclear. Objective: The purpose of this study was to investigate the association between the severity and progress of diabetes and the risk of dementia. Design and Setting: We conducted a 12-year population-based cohort study of new-onset diabetic patients from the Taiwan National Health Insurance Research Database. The diabetic severity was evaluated by the adapted Diabetes Complications Severity Index (aDCSI) from the prediabetic period to the end of follow-up. Cox proportional hazard regressions were used to calculate the hazard ratios (HRs) of the scores and change in the aDCSI. Participants: Participants were 431,178 new-onset diabetic patients who were older than 50 years and had to receive antidiabetic medications. Main Outcome: Dementia cases were identified by International Classification of Diseases, ninth revision, code (International Classification of Diseases, ninth revision, codes 290.0, 290.1, 290.2, 290.3, 290.4, 294.1, 331.0), and the date of the initial dementia diagnosis was used as the index date. Results: The scores and change in the aDCSI were associated with the risk of dementia when adjusting for patient factors, comorbidity, antidiabetic drugs, and drug adherence. At the end of the follow-up, the risks for dementia were 1.04, 1.40, 1.54, and 1.70 (P < .001 for trend) in patients with an aDCSI score of 1, 2, 3, and greater than 3, respectively. Compared with the mildly progressive patients, the adjusted HRs increased as the aDCSI increased (2 y HRs: 1.30, 1.53, and 1.97; final HRs: 2.38, 6.95, and 24.0 with the change in the aDCSI score per year: 0.51–1.00, 1.01–2.00, and > 2.00 vs < 0.50 with P < .001 for trend). Conclusions: The diabetic severity and progression reflected the risk of dementia, and the early change in the aDCSI could predict the risk of dementia in new-onset diabetic patients.

scholarly journals Proteinuria and Psoriasis Risk: A Nationwide Population-Based Study

2021 ◽  
Vol 10 (11) ◽  
pp. 2356
Author(s):  
Eun Hui Bae ◽  
Bongseong Kim ◽  
Su Hyun Song ◽  
Tae Ryom Oh ◽  
Sang Heon Suh ◽  
...  
Keyword(s):  
International Classification Of Diseases ◽  
Population Based ◽  
Renal Outcome ◽  
Persistent Proteinuria ◽  
Inflammatory Dermatosis ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Stage Renal Disease ◽  
End Stage

Psoriasis, a chronic inflammatory dermatosis, has been associated with chronic kidney disease or end-stage renal disease. However, the association of the changes or amount of proteinuria with psoriasis development has not been evaluated. Using the Korean National Health Screening database, we assessed psoriasis development until 2018 in 6,576,851 Koreans who underwent health examinations in 2009 and 2011. Psoriasis was defined using the International Classification of Diseases, 10th revision (ICD-10) code L40. The risk of psoriasis was evaluated according to change in proteinuria (never [Neg (no proteinuria)/Neg], new [Neg/Pos (proteinuria present)], past [Pos/Neg] and persistent [Pos/Pos] proteinuria) and the proteinuria amount. During a median 7.23-year follow-up, 162,468 (2.47%) individuals developed psoriasis. After adjustments, the hazard ratio (HR) for psoriasis was higher in the persistent proteinuria group (1.32 [1.24–1.40]) than in the never proteinuria group. The past proteinuria group showed better renal outcome (1.03 [1.00–1.07]) than the new (1.05 [1.01–1.07]) and never proteinuria (reference, 1.00) groups did. The amount of random urine proteinuria was associated with increased HR for psoriasis. Subgroup analyses for age, sex, estimated glomerular filtration rate (eGFR), hypertension and diabetes showed that the persistent proteinuria group had a higher risk of psoriasis than the never proteinuria group, especially at eGFR < 60 mL/min/1.73 m2. Persistent proteinuria is associated with psoriasis risk, and the proteinuria amount significantly affects psoriasis development.

scholarly journals Incidence of COVID-19 in patients exposed to chloroquine and hydroxychloroquine: results from a population-based prospective cohort in Catalonia, Spain, 2020

2021 ◽  
Vol 26 (9) ◽  
Author(s):  
Rosa Maria Vivanco-Hidalgo ◽  
Israel Molina ◽  
Elisenda Martinez ◽  
Ramón Roman-Viñas ◽  
Adrián Sánchez-Montalvá ◽  
...  
Keyword(s):  
Care Service ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Health Administration ◽  
Risk Of Infection ◽  
Control Cohort ◽  
Male Population ◽  
Classification Of Diseases

Background Several clinical trials have assessed the protective potential of chloroquine and hydroxychloroquine. Chronic exposure to such drugs might lower the risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or severe coronavirus disease (COVID-19). Aim To assess COVID-19 incidence and risk of hospitalisation in a cohort of patients chronically taking chloroquine/hydroxychloroquine. Methods We used linked health administration databases to follow a cohort of patients with chronic prescription of hydroxychloroquine/chloroquine and a control cohort matched by age, sex and primary care service area, between 1 January and 30 April 2020. COVID-19 cases were identified using International Classification of Diseases 10 codes. Results We analysed a cohort of 6,746 patients (80% female) with active prescriptions for hydroxychloroquine/chloroquine, and 13,492 controls. During follow-up, there were 97 (1.4%) COVID-19 cases in the exposed cohort and 183 (1.4%) among controls. The incidence rate was very similar between the two groups (12.05 vs 11.35 cases/100,000 person-days). The exposed cohort was not at lower risk of infection compared with controls (hazard ratio (HR): 1.08; 95% confidence interval (CI): 0.83–1.44; p = 0.50). Forty cases (0.6%) were admitted to hospital in the exposed cohort and 50 (0.4%) in the control cohort, suggesting a higher hospitalisation rate in the former, though differences were not confirmed after adjustment (HR: 1·46; 95% CI: 0.91–2.34; p = 0.10). Conclusions Patients chronically exposed to chloroquine/hydroxychloroquine did not differ in risk of COVID-19 nor hospitalisation, compared with controls. As controls were mainly female, findings might not be generalisable to a male population.

Economic burden of multimorbidity in patients with severe asthma: a 20-year population-based study

Thorax ◽  
2019 ◽  
Vol 74 (12) ◽  
pp. 1113-1119 ◽  
Author(s):  
Wenjia Chen ◽  
Abdollah Safari ◽  
J Mark FitzGerald ◽  
Don D Sin ◽  
Hamid Tavakoli ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Healthcare Costs ◽  
Service Use ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Health Administrative Data ◽  
Classification Of Diseases ◽  
Respiratory Conditions

BackgroundThe economic impact of multimorbidity in severe or difficult-to-treat asthma has not been comprehensively investigated.AimsTo estimate the incremental healthcare costs of coexisting chronic conditions (comorbidities) in patients with severe asthma, compared with non-severe asthma and no asthma.MethodsUsing health administrative data in British Columbia, Canada (1996–2016), we identified, based on the intensity of drug use and occurrence of exacerbations, individuals who experienced severe asthma in an incident year. We also constructed matched cohorts of individuals without an asthma diagnosis and those who had mild/dormant or moderate asthma (non-severe asthma) throughout their follow-up. Health service use records during follow-up were categorised into 16 major disease categories based on the International Classification of Diseases. Incremental costs (in 2016 Canadian Dollars, CAD$1=US$0.75=₤0.56=€0.68) were estimated as the adjusted difference in healthcare costs between individuals with severe asthma compared with those with non-severe asthma and non-asthma.ResultsRelative to no asthma, incremental costs of severe asthma were $2779 per person-year (95% CI 2514 to 3045), with 54% ($1508) being attributed to comorbidities. Relative to non-severe asthma, severe asthma was associated with incremental costs of $1922 per person-year (95% CI 1670 to 2174), with 52% ($1003) being attributed to comorbidities. In both cases, the most costly comorbidity was respiratory conditions other than asthma ($468 (17%) and $451 (23%), respectively).ConclusionsComorbidities accounted for more than half of the incremental medical costs in patients with severe asthma. This highlights the importance of considering the burden of multimorbidity in evidence-informed decision making for patients with severe asthma.

Diagnostic Stability in Patients with First-Episode Psychosis

2005 ◽  
Vol 13 (4) ◽  
pp. 388-392 ◽  
Author(s):  
Homayoun Amini ◽  
Javad Alaghband-Rad ◽  
Abbas Omid ◽  
Vandad Sharifi ◽  
Rozita Davari-Ashtiani ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
International Classification Of Diseases ◽  
First Episode Psychosis ◽  
Classification Systems ◽  
First Episode ◽  
Episode Psychosis ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Dsm Iv

Objective: To examine the short-term stability of Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) and International Classification of Diseases (10th revision; ICD-10) diagnoses in a group of patients with first-episode psychosis. Method: Sixty patients with first-episode psychosis admitted consecutively to Roozbeh Hospital, Tehran, were sampled; their illnesses could not be attributed to any medical or substance-induced conditions. Patients were assessed at the time of discharge from the hospital, and at 3, 6and 12 month intervals following admission. Ateach visit, two psychiatrists made consensusDSM-IV and ICD10 diagnoses, based on all available information. Stability was discerned as the consistency between diagnoses at the time of discharge and at 12 month follow up. Results: Forty-eight patients completed follow up. Affective psychotic disorders and schizophrenia in both classification systems were highly stable. In addition, all patients with DSM-IV brief psychotic disorder and ICD-10 acute and transient psychotic disorders remained the same at follow up. Conclusions: Affective psychoses and schizophrenia, in line with previous findings, remained stable. Diagnoses of brief psychoses were highly stable as well; this could reflect a non-relapsing course ofacute brief psychoses, especially in developing countries.

scholarly journals Risk and predictors of heart failure in sarcoidosis in a population-based cohort study from Sweden

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319129
Author(s):  
Marios Rossides ◽  
Susanna Kullberg ◽  
Johan Grunewald ◽  
Anders Eklund ◽  
Daniela Di Giuseppe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
General Population ◽  
Strong Predictor ◽  
Strong Association ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Clinical Predictors ◽  
Cox Models ◽  
Classification Of Diseases

ObjectivesPrevious studies showed a strong association between sarcoidosis and heart failure (HF) but did not consider risk stratification or risk factors to identify useful aetiological insights. We estimated overall and stratified HRs and identified risk factors for HF in sarcoidosis.MethodsSarcoidosis cases were identified from the Swedish National Patient Register (NPR; ≥2 International Classification of Diseases-coded visits, 2003–2013) and matched to general population comparators. They were followed for HF in the NPR. Treated were cases who were dispensed ≥1 immunosuppressant ±3 months from the first sarcoidosis visit (2006–2013). Using Cox models, we estimated HRs adjusted for demographics and comorbidity and identified independent risk factors of HF together with their attributable fractions (AFs).ResultsDuring follow-up, 204 of 8574 sarcoidosis cases and 721 of 84 192 comparators were diagnosed with HF (rate 2.2 vs 0.7/1000 person-years, respectively). The HR associated with sarcoidosis was 2.43 (95% CI 2.06 to 2.86) and did not vary by age, sex or treatment status. It was higher during the first 2 years after diagnosis (HR 3.7 vs 1.9) and in individuals without a history of ischaemic heart disease (IHD; HR 2.7 vs 1.7). Diabetes, atrial fibrillation and other arrhythmias were the strongest independent clinical predictors of HF (HR 2.5 each, 2-year AF 20%, 16% and 12%, respectively).ConclusionsAlthough low, the HF rate was more than twofold increased in sarcoidosis compared with the general population, particularly right after diagnosis. IHD history cannot solely explain these risks, whereas ventricular arrhythmias indicating cardiac sarcoidosis appear to be a strong predictor of HF in sarcoidosis.

Prevalence and Incidence of Heart Failure Among Urban Patients in China: A National Population-Based Analysis

2021 ◽  
Author(s):  
Hua Wang ◽  
Ke Chai ◽  
Minghui Du ◽  
Shengfeng Wang ◽  
Jian-Ping Cai ◽  
...  
Keyword(s):  
Heart Failure ◽  
Large Scale ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Unique Identifier ◽  
Classification Of Diseases ◽  
Per Capita ◽  
Mean Cost ◽  
Incident Cases

Background: Large-scale and population-based studies of heart failure (HF) incidence and prevalence are scarce in China. The study sought to estimate the prevalence, incidence, and cost of HF in China. Methods: We conducted a population-based study using records of 50.0 million individuals ≥25 years old from the national urban employee basic medical insurance from 6 provinces in China in 2017. Incident cases were individuals with a diagnosis of HF (International Classification of Diseases code, and text of diagnosis) in 2017 with a 4-year disease-free period (2013–2016). We calculated standardized rates by applying age standardization to the 2010 Chinese census population. Results: The age-standardized prevalence and incidence were 1.10% (1.10% among men and women) and 275 per 100 000 person-years (287 among men and 261 among women), respectively, accounting for 12.1 million patients with HF and 3.0 million patients with incident HF ≥25 years old. Both prevalence and incidence increased with increasing age (0.57%, 3.86%, and 7.55% for prevalence and 158, 892, and 1655 per 100 000 person-years for incidence among persons who were 25–64, 65–79, and ≥80 years of age, respectively). The inpatient mean cost per-capita was $4406.8 and the proportion with ≥3 hospitalizations among those hospitalized was 40.5%. The outpatient mean cost per-capita was $892.3. Conclusions: HF has placed a considerable burden on health systems in China, and strategies aimed at the prevention and treatment of HF are needed. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: ChiCTR2000029094.

scholarly journals Diagnostic stability in a Dutch psychosis incidence cohort

2004 ◽  
Vol 185 (6) ◽  
pp. 460-464 ◽  
Author(s):  
Natalie D. Veen ◽  
Jean-Paul Selten ◽  
Diede Schols ◽  
Winfried Laan ◽  
Hans W. Hoek ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Population Based ◽  
Schizophrenic Disorder ◽  
Diagnostic Stability ◽  
Face To Face ◽  
Follow Up Study ◽  
Relative Risks ◽  
Diagnostic Interviews ◽  
The Uk

BackgroundNo study outside the UK has examined the diagnostic stability of psychotic disorders in a population-based sample.AimsTo determine diagnostic stability in a Dutch population-based psychosis incidence cohort, to examine the frequencies of diagnostic shifts to and from schizophrenic disorders and to report the revised relative risks of schizophrenic disorders for immigrants.MethodA 30-month follow-up study assessed the cohort (n=181) by means of face-to-face diagnostic interviews.ResultsDiagnostic stability of schizophrenic disorders was high (91%), but lower for other psychotic disorders. At follow-up, the initial diagnosis was adjusted to schizophrenic disorder more often than that the reverse occurred. Almost half (49%) of the patients who were not initially diagnosed as having a schizophrenic disorder received this diagnosis at follow-up. The relative risks for most immigrant groups were stable.ConclusionsSchizophrenic disorders are underdiagnosed, rather than overdiagnosed, at first presentation.

scholarly journals Stroke in systemic lupus erythematosus: a Swedish population-based cohort study

2017 ◽  
Vol 76 (9) ◽  
pp. 1544-1549 ◽  
Author(s):  
Elizabeth V Arkema ◽  
Elisabet Svenungsson ◽  
Mia Von Euler ◽  
Christopher Sjöwall ◽  
Julia F Simard
Keyword(s):  
Systemic Lupus Erythematosus ◽  
General Population ◽  
Ischaemic Stroke ◽  
Lupus Erythematosus ◽  
Haemorrhagic Stroke ◽  
Population Based ◽  
Incidence Rates ◽  
First Year ◽  
Systemic Lupus ◽  
Swedish Population

ObjectiveTo study the occurrence of ischaemic and haemorrhagic stroke in systemic lupus erythematosus (SLE) compared with the general population by age, sex and time since SLE diagnosisMethodsAdults with incident SLE were identified from the Swedish National Patient Register (NPR, n=3390) and general population comparators from the Total Population Register were matched on age, sex and county (n=16730). Individuals were followed prospectively until first of death, December 2013, emigration or incident stroke (identified from the NPR, Cause of Death Register and the Stroke Register). Incidence rates, rate differences and HR were estimated comparing SLE with non-SLE. Estimates were stratified by sex, age and time since diagnosis.ResultsWe observed 126 strokes in SLE and 304 in the general population. Individuals with SLE had a twofold increased rate of ischaemic stroke compared with the general population (HR 2.2; 95% CI 1.7 to 2.8). The HR for intracerebral haemorrhage was 1.4 (95% CI 0.7 to 2.8). There was effect modification by sex and age, with the highest HRs for females and individuals <50 years old. The HR for ischaemic stroke was highest in the first year of follow-up (3.7; 95% CI 2.1 to 6.5).ConclusionsThe relative risk of ischaemic stroke in SLE was more than doubled compared with the general population, and importantly, the highest relative risks were observed within the first year after SLE diagnosis. Thus, the first encounter with patients presents an opportunity for rheumatologists to screen for risk factors and intervene.

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