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Lookup NU author(s): Professor Matthew Prina
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
BackgroundIndividuals from minority ethnic groups in the UK are thought to be at higher risk of developing dementia while facing additional barriers to receiving timely care. However, few studies in the UK have examined if there are ethnic disparities in survival once individuals receive a dementia diagnosis.MethodsWe conducted a retrospective cohort study using electronic health record data of individuals diagnosed with dementia from a large secondary mental healthcare provider in London. Patients from Black African, Black Caribbean, South Asian, White British, and White Irish ethnic backgrounds were followed up for a 10-year period between 01 January 2008 and 31 December 2017. Data were linked to death certificate data from the Office of National Statistics to determine survival from dementia diagnosis. Standardised mortality ratios were calculated to estimate excess deaths in each ethnicity group as compared to the gender- and age-standardised population of England and Wales. We used Cox regression models to compare survival after dementia diagnosis across each ethnicity group.ResultsMortality was elevated at least twofold across all ethnicity groups with dementia compared to the general population in England and Wales. Risk of death was lower in Black Caribbean, Black African, White Irish, and South Asian groups as compared to the White British population, even after adjusting for age, gender, neighbourhood-level deprivation, indicators of mental and physical comorbidities. Risk of death remained lower after additionally accounting for those who emigrated out of the cohort.ConclusionsWhile mortality in dementia is elevated across all ethnic groups as compared to the general population, reasons for longer survival in minority ethnic groups in the UK as compared to the White British group are unclear and merit further exploration. Implications of longer survival, including carer burden and costs, should be considered in policy and planning to ensure adequate support for families and carers of individuals with dementia.Introduction
Author(s): Co Melissa, Mueller C, Maystone R, Das-Munshi J, Prina M
Publication type: Article
Publication status: Published
Journal: Alzheimer's Research & Therapy
Year: 2023
Volume: 15
Online publication date: 29/03/2023
Acceptance date: 05/12/2022
Date deposited: 07/02/2024
ISSN (electronic): 1758-9193
Publisher: BioMed Central Ltd.
URL: https://doi.org/10.1186/s13195-022-01135-z
DOI: 10.1186/s13195-022-01135-z
Data Access Statement: Data are owned by a third party, Maudsley Biomedical Research Centre (BRC) Clinical Records Interactive Search (CRIS) tool, which provides access to anonymised data derived from SLaM electronic medical records. These data can only be accessed by permitted individuals from within a secure frewall (i.e. the data cannot be sent elsewhere), in the same manner as the authors. For more information, please contact cris.administrator@slam.nhs.uk.
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