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Cognitive Trajectories in Comorbid Dementia With Schizophrenia or Bipolar Disorder: The South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Case Register

Bendayan, R; Mascio, A; Stewart, R; Roberts, A; Dobson, RJ; (2020) Cognitive Trajectories in Comorbid Dementia With Schizophrenia or Bipolar Disorder: The South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Case Register. The American Journal of Geriatric Psychiatry 10.1016/j.jagp.2020.10.018. (In press). Green open access

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Abstract

Objectives: We aimed to compare trajectories of cognitive performance in individuals diagnosed with dementia with and without severe mental illness (SMI). Design: Retrospective cohort study. Setting: We used data from a large longitudinal mental healthcare case register, the Clinical Record Interactive Search (CRIS), at the South London and Maudsley NHS Foundation Trust (SLaM) which provides mental health services to four south London boroughs. Participants: Our sample (N = 4718) consisted of any individual who had a primary or secondary diagnosis of dementia from 2007 to 2018, was 50 years old or over at first diagnosis of dementia and had at least 3 recorded Mini-Mental State Examination (MMSE) scores. Measurements: Cognitive performance was measured using MMSE. Linear mixed models were fitted to explore whether MMSE trajectories differed between individuals with or without prior/current SMI diagnoses. Models were adjusted by socio-demographics, cardiovascular risk, smoking, and medication. Results and conclusions: Our results showed differences in the rate of change, where individuals with comorbid SMI had a faster decline when compared with those that have dementia without comorbid SMI. However, this association was partially attenuated when adjusted by socio-demographics, smoking and cardiovascular risk factors; and more substantially attenuated when medication was included in models. Additional analyses showed that this accelerated decline might be more evident in individuals with bipolar disorders. Future research to detangle the potential biological underlying mechanisms of these associations is needed

Type: Article
Title: Cognitive Trajectories in Comorbid Dementia With Schizophrenia or Bipolar Disorder: The South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Case Register
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jagp.2020.10.018
Publisher version: https://doi.org/10.1016/j.jagp.2020.10.018
Language: English
Additional information: © 2020 The Authors. Published by Elsevier Inc. on behalf of American Association for Geriatric Psychiatry. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Keywords: Dementia, cognitive decline, electronic health records, severe mental illness
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics > Clinical Epidemiology
URI: https://discovery.ucl.ac.uk/id/eprint/10117377
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