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Trends in dementia diagnosis rates in UK ethnic groups: analysis of UK primary care data
Pham TM, Petersen I, Walters K, Raine R, Manthorpe J, Mukadam N, Cooper C.. Clinical epidemiology, 2018-08-08
Topic: Risk, prevention and care in population studies
Objectives We compared incidence of dementia diagnosis by white, black, and Asian ethnic groups and estimated the proportion of UK white and black people developing dementia in 2015 who had a diagnosis for the first time in a UK-wide study. Methods We analyzed primary care electronic health records from The Health Improvement Network database between 2007 and 2015 and compared incidence of dementia diagnosis to dementia incidence from community cohort studies. The study sample comprised of 2,511,681 individuals aged 50-105 years who did not have a dementia diagnosis prior to the start of follow-up. Results A total of 66,083 individuals had a dementia diagnosis (4.87/1,000 person-years at risk, 95% CI 4.83-4.90); this incidence increased from 3.75 to 5.65/1,000 person-years at risk between 2007 and 2015. Compared with white women, the incidence of dementia diagnosis was 18% lower among Asian women (adjusted incidence rate ratio (IRR) 0.82, 95% CI 0.72-0.95) and 25% higher among black women (IRR 1.25, 95% CI 1.07-1.46). For men, incidence of dementia diagnosis was 28% higher in the black ethnic group (IRR 1.28, 95% CI 1.08-1.50) and 12% lower in the Asian ethnic group (IRR 0.88, 95% CI 0.76-1.01) relative to the white ethnic group. Based on diagnosis incidence in The Health Improvement Network data and projections of incidence from community cohort studies, we estimated that 42% of black men developing dementia in 2015 were diagnosed compared with 53% of white men. Conclusion People from the black ethnic group had a higher incidence of dementia diagnosis and those from the Asian ethnic group had lower incidence compared with the white ethnic group. We estimated that black men developing dementia were less likely than white men to have a diagnosis of dementia, indicating that the increased risk of dementia diagnosis reported in the black ethnic group might underestimate the higher risk of dementia in this group. It is unclear whether the lower incidence of dementia diagnosis in the Asian ethnic group reflects lower community incidence or underdiagnosis. A cohort study to determine this is needed.
Key findings
- Results A total of 66,083 individuals had a dementia diagnosis (4.87/1,000 person-years at risk, 95% CI 4.83-4.90); this incidence increased from 3.75 to 5.65/1,000 person-years at risk between 2007 and 2015.
- Compared with white women, the incidence of dementia diagnosis was 18% lower among Asian women (adjusted incidence rate ratio (IRR) 0.82, 95% CI 0.72-0.95) and 25% higher among black women (IRR 1.25, 95% CI 1.07-1.46).
- Based on diagnosis incidence in The Health Improvement Network data and projections of incidence from community cohort studies, we estimated that 42% of black men developing dementia in 2015 were diagnosed compared with 53% of white men.
- Conclusion People from the black ethnic group had a higher incidence of dementia diagnosis and those from the Asian ethnic group had lower incidence compared with the white ethnic group.
- We estimated that black men developing dementia were less likely than white men to have a diagnosis of dementia, indicating that the increased risk of dementia diagnosis reported in the black ethnic group might underestimate the higher risk of dementia in this group.
Why it matters
Dementia diagnosis rates in UK primary care rose between 2007 and 2015 and differed by ethnic group, with higher rates in black women and men and lower rates in Asian women. These are patterns of diagnosis, not of disease cause or treatment, and the study estimated that many people with dementia may go undiagnosed.
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Study details
- Study designcohort study
- Participants2,511,681
- Effect sizeRR 1.25; RR 1.28; RR 0.88
- Evidence strengthModerate
How this study scored 66/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Clinical epidemiology) |
| Journal's citation record | 1 / 4 | Clinical Epidemiology: journal h-index 103 (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 | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 4 / 4 | 2,511,681 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 142 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 14.2 citations a year over 10 year(s) since 2018 |
| Impact for its field and year | 3 / 6 | Cited 6.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 5 other studies in this library |
| Still being cited | 3 / 4 | Cited 60 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Claudia Cooper: h-index 66 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University College London: institution h-index 2,029 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 30123007) |
| Free to read | 2 / 2 | Free to read |
| Total | 66 / 100 | — |
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Read the original
- DOI: 10.2147/clep.s152647
- PubMed: 30123007
- Original source →
- Free full text: Clinical Epidemiology →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Pham, T. M., Petersen, I., Walters, K., Raine, R., Manthorpe, J., Mukadam, N., et al. (2018). Trends in dementia diagnosis rates in UK ethnic groups: analysis of UK primary care data. Clinical epidemiology. https://doi.org/10.2147/clep.s152647
Vancouver
Pham TM, Petersen I, Walters K, Raine R, Manthorpe J, Mukadam N, et al. Trends in dementia diagnosis rates in UK ethnic groups: analysis of UK primary care data. Clinical epidemiology. 2018. doi:10.2147/clep.s152647. PMID: 30123007.
BibTeX
@article{pham2018-30123007,
author = {Pham, T. M. and Petersen, I. and Walters, K. and Raine, R. and Manthorpe, J. and Mukadam, N. and Cooper, C.},
title = {{Trends in dementia diagnosis rates in UK ethnic groups: analysis of UK primary care data}},
journal = {Clinical epidemiology},
year = {2018},
doi = {10.2147/clep.s152647},
pmid = {30123007},
url = {https://doi.org/10.2147/clep.s152647}
}
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