Hallam, Brendan;
(2023)
Understanding the incidence, risk factor profile, and risk of dementia in people presenting with memory concerns and cognitive impairment in United Kingdom primary care.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
AIMS: To understand the incidence, characteristics and management of people with memory concerns and cognitive impairment presenting to United Kingdom (UK) primary care. METHODS: This thesis includes four related studies: Study 1) was a systematic review investigating the management strategies provided by primary care professionals to people with memory concern and cognitive impairment. For the next stages, I carried out a series of cohort and case-control studies using primary care electronic health records. These studies examined 1) Incidence of memory concern and cognitive impairment in the UK, 2) Conversion rate from memory concern and cognitive impairment to diagnosis of dementia, using survival analyses 3) The differences in risk factor characteristics between people with memory concern, cognitive impairment and a matched comparator population without these conditions, using partial-proportional odds. KEY FINDINGS: Systematic review: For non-pharmacological strategies, the most frequent advice primary care professionals (PCPs) provided was to increase physical activity, cognitive stimulation, diet and social stimulation. Incidence: recorded memory concern rates were stable over the last decade, whilst rates of recorded cognitive impairment increased nearly three-fold. Survival analysis: Within three years of followup from the first record of Memory Concern, 45.5% of individuals received a diagnosis of dementia. For people with a record of Cognitive impairment, 51.7% received a dementia diagnosis. Characteristics profile: The results highlighted that people with memory concerns and cognitive impairment were more likely to have diabetes, hearing loss, hypertension, TBI, depression, alcohol misuse or being underweight than people without recorded memory problems. CONCLUSIONS: The combined results included within the thesis progressed the knowledge of people presenting to UK primary with memory concern and cognitive impairment. It provides GPs with a better understanding of the profile of individuals attending a consultation who are more likely to have memory concerns or cognitive impairment, and therefore are at highest risk of developing dementia.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Understanding the incidence, risk factor profile, and risk of dementia in people presenting with memory concerns and cognitive impairment in United Kingdom primary care |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2023. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| 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 Epidemiology and Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10184437 |
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