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@ARTICLE{Teipel:276087,
      author       = {Teipel, Stefan and Akmatov, Manas and Michalowsky, Bernhard
                      and Riedel-Heller, Steffi and Bohlken, Jens and Holstiege,
                      Jakob},
      title        = {{T}iming of risk factors, prodromal features, and
                      comorbidities of dementia from a large health claims
                      case-control study.},
      journal      = {Alzheimer's research $\&$ therapy},
      volume       = {17},
      number       = {1},
      issn         = {1758-9193},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DZNE-2025-00168},
      pages        = {22},
      year         = {2025},
      abstract     = {Many 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.},
      keywords     = {Humans / Female / Male / Case-Control Studies / Dementia:
                      epidemiology / Risk Factors / Prodromal Symptoms /
                      Comorbidity / Aged, 80 and over / Aged / Germany:
                      epidemiology / Time Factors / Prevalence / Behavioral
                      disorders (Other) / Cancer (Other) / Dementia incidence
                      (Other) / Health claims data (Other) / Hypertension (Other)
                      / Odds ratio (Other) / Risk trajectory (Other)},
      cin          = {AG Teipel / AG Michalowsky},
      ddc          = {610},
      cid          = {I:(DE-2719)1510100 / I:(DE-2719)5000067},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pmc          = {pmc:PMC11736938},
      pubmed       = {pmid:39819557},
      doi          = {10.1186/s13195-024-01662-x},
      url          = {https://pub.dzne.de/record/276087},
}