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Comorbidity and dementia: a scoping review of the literature
Frances Bunn, Anne-Marie Burn, Claire Goodman and 5 more
BMC Medicine · 2014
Abstract
Background. Evidence suggests that amongst people with dementia there is a high prevalence of comorbid medical conditions and related complaints. The presence of dementia may complicate clinical care for other conditions and undermine a patient’s ability to manage a chronic condition. The aim of this study was to scope the extent, range and nature of research activity around dementia and comorbidity.
Methods. We undertook a scoping review including all types of research relating to the prevalence of comorbidities in people with dementia; current systems, structures and other issues relating to service organisation and delivery; patient and carer experiences; and the experiences and attitudes of service providers. We searched AMED, Cochrane Library, CINAHL, PubMed, NHS Evidence, Scopus, Google Scholar (searched 2012, Pubmed updated 2013), checked reference lists and performed citation searches on PubMed and Google Scholar (ongoing to February 2014).
Results. We included 54 primary studies, eight reviews and three guidelines. Much of the available literature relates to the prevalence of comorbidities in people with dementia or issues around quality of care. Less is known about service organisation and delivery or the views and experiences of people with dementia and their family carers. There is some evidence that people with dementia did not have the same access to treatment and monitoring for conditions such as visual impairment and diabetes as those with similar comorbidities but without dementia.
Conclusions. The prevalence of comorbid conditions in people with dementia is high. Whilst current evidence suggests that people with dementia may have poorer access to services the reasons for this are not clear. There is a need for more research looking at the ways in which having dementia impacts on clinical care for other conditions and how the process of care and different services are adapting to the needs of people with dementia and comorbidity. People with dementia should be included in the debate about the management of comorbidities in older populations and there needs to be greater consideration given to including them in studies that focus on age-related healthcare issues.
Electronic supplementary material. The online version of this article (doi:10.1186/s12916-014-0192-4) contains supplementary material, which is available to authorized users.
References 94
- 1.
Prince M, Jackson J. World alzheimer report 2009. Alzheimer’s Disease International. 2009.
Not in our library
- 2.
Doraiswamy PM, Leon J, Cummings JL, Marin D, Neumann PJ. Prevalence and impact of medical comorbidity in Alzheimer’s disease. J Gerontol A Biol Sci Med Sci. 2002;57:M173-M177.
Not in our library10.1093/gerona/57.3.m173
- 3.
Kuo TC, Zhao Y, Weir S, Kramer MS, Ash AS. Implications of comorbidity on costs for patients with Alzheimer disease. Med Care. 2008;46:839-846.
Not in our library10.1097/mlr.0b013e318178940b
- 4.
Leon J, Cheng CK, Neumann PJ. Alzheimer’s disease care: costs and potential savings. Health Aff (Millwood). 1998;17:206.
Not in our library10.1377/hlthaff.17.6.206
- 5.
Schubert CC, Boustani M, Callahan CM, Perkins AJ, Carney CP, Fox C, Unverzagt F, Hui S, Hendrie HC. Comorbidity profile of dementia patients in primary care: are they sicker? J Am Geriatr Soc. 2006;54:104-109.
Not in our library10.1111/j.1532-5415.2005.00543.x
- 6.
Richards M, Brayne C. What do we mean by Alzheimer’s disease? BMJ. 2010;341:c4670.
Not in our library10.1136/bmj.c4670
- 7.
Skoog I. Vascular aspects in Alzheimer’s disease. J Neural Transm Suppl. 2000;59:37.
Not in our library10.1007/978-3-7091-6781-6_6
- 8.
Savva GM, Stephan BC, Alzheimer’s Society Vascular Dementia Systematic Review Group. Epidemiological studies of the effect of stroke on incident dementia: a systematic review. Stroke. 2010;41:e41-e46.
Not in our library10.1161/strokeaha.109.559880
- 9.
Biessels GJ, Staekenborg S, Brunner E, Brayne C, Scheltens P. Risk of dementia in diabetes mellitus: a systematic review. Lancet Neurol. 2006;5:64-74.
Not in our library10.1016/s1474-4422(05)70284-2
- 10.
Whitmer RA, Karter AJ, Yaffe K, Quesenberry CP, Selby JV. Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus. JAMA. 2009;301:1565-1572.
Not in our library10.1001/jama.2009.460
- 11.
Keenan TD, Goldacre R, Goldacre MJ. Associations between age-related macular degeneration, Alzheimer disease, and dementia: record linkage study of hospital admissions. JAMA Ophthalmol. 2014;132:63-68.
Not in our library10.1001/jamaophthalmol.2013.5696
- 12.
Sampson EL, Blanchard MR, Jones L, Tookman A, King M. Dementia in the acute hospital: prospective cohort study of prevalence and mortality. Br J Psychiatry. 2009;195:61-66.
Not in our library10.1192/bjp.bp.108.055335
- 13.
Sinclair AJ, Girling AJ, Bayer AJ. Cognitive dysfunction in older subjects with diabetes mellitus: impact on diabetes self-management and use of care services. Diabetes Res Clin Pract. 2000;50:203-212.
Not in our library10.1016/s0168-8227(00)00195-9
- 14.
Fortin M, Soubhi H, Hudon C, Bayliss EA, Van Den Akker M. Multimorbidity’s many challenges. BMJ. 2007;334:1016.
Not in our library10.1136/bmj.39201.463819.2c
- 15.
- 16.
Valderas JM, Starfield B, Sibbald B, Salisbury C, Roland M. Defining comorbidity: implications for understanding health and health services. Ann Fam Med. 2009;7:357-363.
Not in our library10.1370/afm.983
- 17.
Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8:19-32.
Not in our library10.1080/1364557032000119616
- 18.
- 19.
Rumrill PD, Fitzgerald SM, Merchant WR. Using scoping literature reviews as a means of understanding and interpreting existing literature. Work. 2010;35:399-404.
Not in our library10.3233/wor-2010-0998
- 20.
Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies. Health Info Libr J. 2009;26:91-108.
Not in our library10.1111/j.1471-1842.2009.00848.x
- 21.
Bunn F, Goodman C, Brayne C, Norton S, Rait G, Robinson L, Schoeman J. Comorbidity and Dementia: Improving Healthcare for People with Dementia. (CoDem). 2013.
Not in our library
- 22.
Greenhalgh T, Peacock R. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources. BMJ. 2005;331:1064-1065.
Not in our library10.1136/bmj.38636.593461.68
- 23.
Australian Commission on Safety and Quality in Health Care: Evidence for the Safety and Quality Issues Associated with the Care of Patients with Cognitive Impairement in Acute Care Settings: a Rapid Review. Sydney: 2013.
Not in our library
- 24.
Allen K, Stapleton K, McLean F. Dementia and Deafness: an Exploratory Study. 2005.
Not in our library
- 25.
Balfour J, O'Rourke N. Older adults with Alzheimer disease, comorbid arthritis and prescription of psychotropic medications. Pain. 2003;8:198.
Not in our library10.1155/2003/105459
- 26.
Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380:37-43.
Not in our library10.1016/s0140-6736(12)60240-2
- 27.
Bartlett A, Clarke B. An exploration of healthcare professionals’ beliefs about caring for older people dying from cancer with a coincidental dementia. Dementia. 2012;11:559-565.
Not in our library10.1177/1471301212437824
- 28.
Bartlett R, McKeefry D. Rethinking the experiences and entitlements of people with dementia: taking vision into account. J Care Serv Manage. 2011;5:105-114.
Not in our library10.1179/175016811x12966389037637
- 29.
Bayer AJ, Johnston J, Sinclair AJ. Impact of dementia on diabetic care in the aged. J R Soc Med. 1994;87:619-621.
Not in our library10.1177/014107689408701020
- 30.
Bruce DG, Casey GP, Grange V, Clarnette RC, Almeida OP, Foster JK, Ives FJ, Davis TM. Cognitive impairment, physical disability and depressive symptoms in older diabetic patients: the Fremantle Cognition in Diabetes Study. Diabetes Res Clin Pract. 2003;61:59-67.
Not in our library10.1016/s0168-8227(03)00084-6
- 31.
College of Optometrists. C04 Examining the Patient with Dementia or Other Acquired Cognitive Impairment. 2012.
Not in our library
- 32.
Connolly A, Iliffe S, Gaehl E, Campbell S, Drake R, Morris J, Martin H, Purandare N. Quality of care provided to people with dementia: utilisation and quality of the annual dementia review in general practice. Br J Gen Pract. 2012;62:e91-e98.
Not in our library10.3399/bjgp12x625148
- 33.
Curtis LH, Hammill BG, Qualls LG, Dimartino LD, Wang F, Schulman KA, Cousins SW. Treatment patterns for neovascular age-related macular degeneration: analysis of 284 380 Medicare beneficiaries. Am J Ophthalmol. 2012;153:1116-1124.
Not in our library10.1016/j.ajo.2011.11.032
- 34.
Dewing J, Dijk S: What is the current state of care for older people with dementia in general hospitals? A literature review.Dementia 2014, Jan 23 Epub ahead of print.
Not in our library10.1177/1471301213520172
- 35.
Doucet J, Druesne L, Capet C, Gréboval E, Landrin I, Moirot P, Micaud G. Risk factors and management of diabetes in elderly French patients. Diabetes Metab. 2008;34:574-580.
Not in our library10.1016/j.diabet.2008.05.007
- 36.
Feil D, Marmon T, Unutzer J. Cognitive impairment, chronic medical illness, and risk of mortality in an elderly cohort. Am J Geriatr Psychiatry. 2003;11:551-560.
Not in our library10.1097/00019442-200309000-00010
- 37.
Feil DG, Lukman R, Simon B, Walston A, Vickrey B. Impact of dementia on caring for patients’ diabetes. Aging Ment Health. 2011;15:894-903.
Not in our library10.1080/13607863.2011.569485
- 38.
Feil DG, Pearman A, Victor T, Harwood D, Weinreb J, Kahle K, Unutzer J. The role of cognitive impairment and caregiver support in diabetes management of older outpatients. Int J Psychiatry Med. 2009;39:199-214.
Not in our library10.2190/pm.39.2.h
- 39.
Feil DG, Zhu CW, Sultzer DL. The relationship between cognitive impairment and diabetes self-management in a population-based community sample of older adults with Type 2 diabetes. J Behav Med. 2011;35:190-199.
Not in our library10.1007/s10865-011-9344-6
- 40.
Formiga F, Fort I, Robles MJ, Riu S, Sabartes O, Barranco E, Catena J. Comorbidity and clinical features in elderly patients with dementia: differences according to dementia severity. J Nutr Health Aging. 2009;13:423-427.
Not in our library10.1007/s12603-009-0078-x
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