Multi-morbidity, medications and mortality in people with dementia

  • Research type

    Research Study

  • Full title

    A longitudinal study investigating multimorbidity, medications and mortality in people with dementia in Northern Ireland.

  • IRAS ID

    272166

  • Contact name

    Gerard Leavey

  • Contact email

    g.leavey@ulster.ac.uk

  • Sponsor organisation

    Ulster University

  • Duration of Study in the UK

    1 years, 3 months, 28 days

  • Research summary

    In the United Kingdom, among people aged 65 years and over, the prevalence of dementia is 7.1% and with an ageing population, it has been estimated that there will be over 1 million people living with dementia in the United Kingdom by 2025 (Dementia UK: Update, 2014). In people with dementia, multimorbidity, commonly defined as the presence of two or more chronic conditions, is associated with an accelerated decline in daily function (Melis et al., 2013). Comorbid conditions and polypharmacy (multiple medication use) are common in people with dementia (Browne et al., 2017; Clague et al., 2017). \n\nThere is some evidence to suggest that people with dementia and other comorbidities have increased health service use. For example, a retrospective cohort study using data on people with dementia from the Clinical Practice Research Datalink (CPRD) (n=4,999) in the United Kingdom found that 91.7% had one or more additional comorbidities (Browne et al., 2017). Furthermore, people (with dementia) with six or more comorbidities had higher rates of primary care consultations, prescriptions, hospitalisations and a higher risk of death (than people (with dementia) with two or three comorbidities) (Browne et al., 2017). Additionally, concerns have been raised by clincians and families about the efficacy of anti-depressant and anti-psychotic medication for the treatment of mood and agitation, respectively, in this population. Pain is often problematic, it is underdiagnosed and undertreated in this population (Hanson et al. 2018). Dening (2017) notes the repercussions of poor pain management can result in increasing levels of discomfort and distress, delirium, sedation and confusion. Inappropriate prescribing of antipsychotic medications can occur, where behaviours resulting from the distress of pain are misinterpreted (Pryor & Clarke, 2017). However, evidence in these areas is limited. The proposed study will contribute to this area of research by investigating patterns in multimorbidity, trends/prevalence of medications and any trends in mortality in people with dementia in Northern Ireland.\n

  • REC name

    Yorkshire & The Humber - Leeds West Research Ethics Committee

  • REC reference

    19/YH/0334

  • Date of REC Opinion

    30 Sep 2019

  • REC opinion

    Favourable Opinion