Systematic review of prognostic factors and inequalities in poor outcome in people with dementia
- Principal Investigator: Michelle Marshall
- 1 March 2022 to 30 November 2023
- Project No: 574
- Funding round: FR3
Dementia has a major impact on people and their families. At present there is no cure for dementia and so a key goal is to help people manage and live well with dementia. We know that some people appear to have a faster change (or progression) in their dementia after diagnosis, leading to earlier entry into care homes and early death. At the moment we do not know what factors play a role in this change, or what factors may predict who will have a faster change, but this information would be very valuable. If we can find out what these factors are, then this would make it easier to spot early on which people with dementia are at risk of a poorer and faster progression. Being able to identify those at greater risk would give people with dementia and their caregivers a better idea of what to expect in the future and help healthcare professionals better plan the care for them.
In a previous study (the MEDDIP study) we successfully identified markers, recorded around the time of a person’s dementia diagnosis, that relate to their current dementia-related health. These markers can be identified from routine electronic health records that are kept by GPs. Currently though we do not know whether these markers are related to poorer longer-term outcomes such as earlier care home admission or earlier death, or whether other factors exist that are important. The aim of this study is to identify factors that predict poor long-term outcomes such as earlier care home admission or earlier death in people diagnosed with dementia. These factors may include other illnesses (e.g. heart disease) and symptoms (e.g. incontinence), and lifestyle factors like poor diet and smoking which could be changed. It may also include factors such as where someone lives, their ethnicity, and their level of deprivation that may suggest that some groups of people have a potentially unfair and avoidable higher risk of poorer outcomes.
We will identify these factors by reviewing all the evidence from previously published studies in an organised and structured way. From that we can also assess if these factors are similar or different to the markers found in our previous (MEDDIP) study, if they vary by type of dementia (for example Alzheimer’s or Vascular) or are more important for some age groups or ethnic groups. We will discuss our results with dementia researchers, healthcare professionals, and people with dementia and caregivers, to find out if the findings make sense and how they can be applied in routine healthcare to identify those most at risk of poorer longer-term outcomes.
Amount Awarded: £106,637