Incidence of neurological and psychiatric comorbidity over time: a population-based cohort study in Ontario, Canada.
Introduction Comprehensive, population-based investigations of the extent and temporality of associations between common neurological and psychiatric disorders are scarce. Methods This retrospective cohort study used linked health administrative data for Ontarians aged 40–85 years on 1 April 2002, t...
| Publicado en: | Age & Ageing Vol. 51; no. 2; pp. 1 - 12 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Feb2022
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=155493028&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 155493028 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Feb2022 vid: 51 iid: 2 pid: 622 pub: Oxford University Press / USA artinfo: ui: 155493028 10.1093/ageing/afab277 ppf: 1 ppct: 11 formats: tig: atl: Incidence of neurological and psychiatric comorbidity over time: a population-based cohort study in Ontario, Canada. aug: au: Maxwell, Colleen J Maclagan, Laura C Harris, Daniel A Wang, Xuesong Guan, Jun Marrie, Ruth Ann Hogan, David B Austin, Peter C Vigod, Simone N Swartz, Richard H Bronskill, Susan E affil: Schools of Pharmacy and Public Health, Sciences University of Waterloo , Waterloo, Ontario, Canada ICES , Toronto, Ontario, Canada Public Health Sciences , Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada Departments of Internal Medicine and Community Health Sciences , Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba , Winnipeg, Manitoba, Canada Division of Geriatric Medicine , Department of Medicine, Cumming School of Medicine, University of Calgary , Calgary, Alberta, Canada Institute of Health Policy , Management & Evaluation, Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada Women's College Research Institute, Women's College Hospital , Toronto, Ontario, Canada Department of Psychiatry , Temerty Faculty of Medicine, University of Toronto , Toronto, Ontario, Canada Department of Medicine (Neurology) , Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, University of Toronto , Toronto, Ontario, Canada su: Canada Mental illness risk factors Medical quality control Retrospective studies Sex distribution Health Information resources Disease risk factors Psychiatric diagnosis Diagnosis of neurological disorders Neurological disorders Confidence intervals Time Disease incidence Risk assessment Database management Longitudinal method sug: subj: Mental illness risk factors Medical quality control Retrospective studies Sex distribution Health Information resources Disease risk factors Canada Data Processing, Hosting, and Related Services Psychiatric diagnosis Diagnosis of neurological disorders Neurological disorders Confidence intervals Time Disease incidence Risk assessment Database management Longitudinal method keyword: dementia epidemiology older people Parkinson's disease psychiatric disorder stroke dementia epidemiology older people Parkinson's disease psychiatric disorder stroke ab: Introduction Comprehensive, population-based investigations of the extent and temporality of associations between common neurological and psychiatric disorders are scarce. Methods This retrospective cohort study used linked health administrative data for Ontarians aged 40–85 years on 1 April 2002, to estimate the adjusted rate of incident dementia, Parkinson's disease (PD), stroke or mood/anxiety disorder (over 14 years) according to the presence and time since diagnosis of a prior disorder. Sex differences in the cumulative incidence of a later disorder were also examined. Results The cohort included 5,283,546 Ontarians (mean age 56.2 ± 12.1 years, 52% female). The rate of dementia was significantly higher for those with prior PD (adjusted hazard ratio [adjHR] 4.05, 95% confidence interval [CI] 3.99–4.11); stroke (adjHR 2.49, CI 2.47–2.52) and psychiatric disorder (adjHR 1.79, CI 1.78–1.80). The rate of PD was significantly higher for those with prior dementia (adjHR 2.23, CI 2.17–2.30) and psychiatric disorder (adjHR 1.77, CI 1.74–1.81). The rate of stroke was significantly higher among those with prior dementia (adjHR 1.56, CI 1.53–1.58). Prior dementia (adjHR 2.36, CI 2.33–2.39), PD (adjHR 1.80, CI 1.75–1.85) and stroke (adjHR 1.47, CI 1.45–1.49) were associated with a higher rate of an incident psychiatric disorder. Generally, associations were strongest in the 6 months following a prior diagnosis and demonstrated a J-shape relationship over time. Significant sex differences were evident in the absolute risks for several disorders. Conclusions The observed nature of bidirectional associations between these neurological and psychiatric disorders indicates opportunities for earlier diagnosis and interventions to improve patient care. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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