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Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort

Baker, E; Iqbal, E; Johnston, C; Broadbent, M; Shetty, H; Stewart, R; Howard, R; ... Dobson, RJB; + view all (2017) Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort. PLoS One , 12 (6) 10.1371/journal.pone.0178562. Green open access

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Abstract

BACKGROUND: Modeling trajectories of decline can help describe the variability in progression of cognitive impairment in dementia. Better characterisation of these trajectories has significant implications for understanding disease progression, trial design and care planning. METHODS: Patients with at least three Mini-mental State Examination (MMSE) scores recorded in the South London and Maudsley NHS Foundation Trust Electronic Health Records, UK were selected (N = 3441) to form a retrospective cohort. Trajectories of cognitive decline were identified through latent class growth analysis of longitudinal MMSE scores. Demographics, Health of Nation Outcome Scales and medications were compared across trajectories identified. RESULTS: Four of the six trajectories showed increased rate of decline with lower baseline MMSE. Two trajectories had similar initial MMSE scores but different rates of decline. In the faster declining trajectory of the two, a higher incidence of both behavioral problems and sertraline prescription were present. CONCLUSIONS: We find suggestive evidence for association of behavioral problems and sertraline prescription with rate of decline. Further work is needed to determine whether trajectories replicate in other datasets.

Type: Article
Title: Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0178562
Publisher version: http://dx.doi.org/10.1371/journal.pone.0178562
Language: English
Additional information: © 2017 Baker et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Science & Technology, Multidisciplinary Sciences, Science & Technology - Other Topics, ALZHEIMERS-DISEASE, IMPAIRMENT, PROGRESSION, DEPRESSION, SERTRALINE, DIAGNOSIS, EFFICACY, SAFETY, MODEL
UCL classification: UCL > Provost and Vice Provost Offices
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 Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Health Informatics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Health Informatics > Clinical Epidemiology
URI: https://discovery.ucl.ac.uk/id/eprint/1559293
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