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000276087 041__ $$aEnglish
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000276087 1001_ $$0P:(DE-2719)2000026$$aTeipel, Stefan$$b0$$eFirst author$$udzne
000276087 245__ $$aTiming of risk factors, prodromal features, and comorbidities of dementia from a large health claims case-control study.
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000276087 520__ $$aMany risk factors for dementia have been identified, but the timing of risk is less well understood. Here, we analyzed risk factors in a case-control study covering 10 years before an incident dementia diagnosis.We designed a case-control study using insurance claims of outpatient consultations of patients with German statutory health insurance between January 1, 2012, and December 31, 2022. We included patients with an incident diagnosis of dementia and controls without a diagnosis of dementia matched 1:2 for age, sex, region, and earliest year of outpatient encounter. We selected exposures based on previous systematic reviews, case-control and cohort studies reporting on risk factors, comorbidities, and prodromal features of dementia. We calculated the prevalence of risk factors in cases and controls and odds ratios for each year before the index date, along with Bonferroni-corrected confidence intervals, using conditional logistic regression.We identified a total of 1,686,759 patients with incident dementia (mean (SD) age, 82.15 (6.90) years; 61.70% female) and 3,373,518 matched controls (mean (SD) age, 82.15 (6.90) years; 61.70% female). Study participants were followed up for a mean (SD) of 6.6 (2.3) years. Of the 63 risk factors and prodromal features examined, 56 were associated with an increased risk of dementia in all years during the 10th and the 1st year before the index date. These included established risk factors, such as depression, hypertension, hearing impairment, nicotine and alcohol abuse, obesity, hypercholesterolaemia, traumatic brain injury, and diabetes. The greatest risk, with odds ratios greater than 2.5, was conferred by delirium, memory impairment, mental retardation, personality and behavioral disorders, sensory disorders, schizophrenia, and psychosis. Cancer was associated with a reduced risk of dementia.This large case-control study confirmed established risk factors of dementia. In addition, the study identified non-specific diagnoses that showed a steep increase in risk close to the index date, such as psychosis, conduct disorder, and other sensory disorders. Consideration of these diagnoses, which may represent prodromal features rather than risk factors for dementia, may help to identify people with dementia in routine care.
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000276087 650_7 $$2Other$$aBehavioral disorders
000276087 650_7 $$2Other$$aCancer
000276087 650_7 $$2Other$$aDementia incidence
000276087 650_7 $$2Other$$aHealth claims data
000276087 650_7 $$2Other$$aHypertension
000276087 650_7 $$2Other$$aOdds ratio
000276087 650_7 $$2Other$$aRisk trajectory
000276087 650_2 $$2MeSH$$aHumans
000276087 650_2 $$2MeSH$$aFemale
000276087 650_2 $$2MeSH$$aMale
000276087 650_2 $$2MeSH$$aCase-Control Studies
000276087 650_2 $$2MeSH$$aDementia: epidemiology
000276087 650_2 $$2MeSH$$aRisk Factors
000276087 650_2 $$2MeSH$$aProdromal Symptoms
000276087 650_2 $$2MeSH$$aComorbidity
000276087 650_2 $$2MeSH$$aAged, 80 and over
000276087 650_2 $$2MeSH$$aAged
000276087 650_2 $$2MeSH$$aGermany: epidemiology
000276087 650_2 $$2MeSH$$aTime Factors
000276087 650_2 $$2MeSH$$aPrevalence
000276087 7001_ $$aAkmatov, Manas$$b1
000276087 7001_ $$0P:(DE-2719)2810763$$aMichalowsky, Bernhard$$b2$$udzne
000276087 7001_ $$aRiedel-Heller, Steffi$$b3
000276087 7001_ $$aBohlken, Jens$$b4
000276087 7001_ $$aHolstiege, Jakob$$b5
000276087 773__ $$0PERI:(DE-600)2506521-X$$a10.1186/s13195-024-01662-x$$gVol. 17, no. 1, p. 22$$n1$$p22$$tAlzheimer's research & therapy$$v17$$x1758-9193$$y2025
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