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Spatiotemporal trends in dementia‐associated deaths, what do the data reveal?
Luisa Parkinson, Finn Lindgren, Tom C. Russ. Alzheimer s & Dementia, 2021-12-01
Topic: Risk, prevention and care in population studies
Abstract Background Data on dementia mortality are routinely collected by governments and used in health research. However, historical underrecording of dementia on death certificates has limited the utility of this widely available data source. Considerable effort has been invested in raising awareness of dementia, increasing diagnosis rates, and improving dementia recording on death certificates. Updated versions of the ICD‐10 rules for coding the underlying cause of death, implemented in Scotland in 2011 and 2017, have increasingly assigned deaths that mention both dementia and respiratory or urinary tract infections towards an underlying cause of dementia, if no other underlying medical condition is mentioned. Since previous cohort studies have shown geographical variation in dementia risk, this study utilises spatiotemporal modelling to investigate changes in dementia‐associated deaths in Scotland. Method Data on dementia and Alzheimer’s deaths and mid‐year population estimates available from the National Records of Scotland for the time period 2000‐2019 were used to build a Bayesian spatiotemporal disease mapping model. The data were grouped by the 32 Council areas and year, whilst stratification by age and gender were built into the model. The analyses were run in R using Integrated Nested Laplace Approximation methodology. Result The data show strong temporal and spatial trends in the relative risk of dementia‐associated death. The relative risk increases progressively over the time period studied, with a 2.3‐fold increase (95% Confidence Interval: 2.1‐2.5) between 2000 and 2019, reaching levels just below predicted dementia prevalence in recent years. The relative risk varies geographically and is highest in Scotland’s industrialised central belt region and lowest in the rural areas and islands, with a relative risk of 1.9 (95% CI: 1.6‐2.3) between the lowest and highest risk Council areas. Conclusion There are factors, other than the step changes in underlying cause of death coding, driving the progressively increasing temporal trend in relative risk of dementia‐associated death. These factors could be a combination of increased dementia awareness, a larger proportion of people being diagnosed, greater recording on death certificates and, possibly, increasing prevalence. The strong spatial variation in relative risk in Scotland indicates that there are geographically‐varying factors affecting this risk.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Parkinson, L., Lindgren, F., & Russ, T. C. (2021). Spatiotemporal trends in dementia‐associated deaths, what do the data reveal? Alzheimer s & Dementia. https://doi.org/10.1002/alz.054409
Vancouver
Parkinson L, Lindgren F, Russ TC. Spatiotemporal trends in dementia‐associated deaths, what do the data reveal? Alzheimer s & Dementia. 2021. doi:10.1002/alz.054409.
BibTeX
@article{parkinson2021-f5b40125,
author = {Parkinson, Luisa and Lindgren, Finn and Russ, Tom C.},
title = {{Spatiotemporal trends in dementia‐associated deaths, what do the data reveal?}},
journal = {Alzheimer s \& Dementia},
year = {2021},
doi = {10.1002/alz.054409},
url = {https://doi.org/10.1002/alz.054409}
}
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Key findings
- Result The data show strong temporal and spatial trends in the relative risk of dementia‐associated death.
- The strong spatial variation in relative risk in Scotland indicates that there are geographically‐varying factors affecting this risk.
Why it matters
This study used Scottish death records to model geographic and time trends in dementia-associated deaths. It is about mortality data and coding, not about treating, curing or preventing Alzheimer's disease.
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Study details
- Study designcohort study
- Evidence strengthModerate
How this study scored 37/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2021 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 7 year(s) since 2021 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Tom C. Russ: h-index 45 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Edinburgh: institution h-index 1,378 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 37 / 100 | — |
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