Dementia Awareness Week: A Spotlight On Research

This Dementia Awareness Week we’re highlighting a new paper: ‘Population incidence and associated mortality of urinary tract infection in people living with dementia’. Data from this retrospective cohort study were obtained through the Secure Anonymised Information Linkage (SAIL) Databank, and includes the following sources:

  • Welsh Demographic Service Dataset (WDSD), comprising sex, week of birth, date of death
  • Welsh Index for Multiple Deprivation (WIMD), a composite measure of eight domains of deprivation within geographical areas, including housing, education, and access to services.
  • The Welsh Longitudinal General Practice (WLGP) contains information from primary care including diagnoses and prescriptions
  • The Patient Episode Dataset for Wales (PEDW) comprises inpatient diagnoses. Data spanned the study period from 1st January 2000 to 31st December 2021.

This paper investigated adults aged ≥ 50 within the SAIL data sources. Participants entered the study on 1st January 2000 or on the date they turned 50, whichever was sooner, and exited the study on 31st December 2021, when they turned 101, or when a date of death was recorded.

Abstract

OBJECTIVES

Urinary tract infections (UTIs) frequently cause hospitalisation and death in people living with dementia (PLWD). We examine UTI incidence and associated mortality among PLWD relative to matched controls and people with diabetes and investigate whether delayed or withheld treatment further impacts mortality.

METHODS

Data were extracted for n=2,449,814 people aged ≥ 50 in Wales from 2000-2021, with groups matched by age, sex, and multimorbidity. Poisson regression was used to estimate incidences of UTI and mortality. Cox regression was used to study the effects of treatment timing.

RESULTS

UTIs in dementia (HR=2.18, 95%CI [1.88-2.53], p<.0) and diabetes (1.21[1.01-1.45], p=.035) were associated with high mortality, with the highest risk in individuals with diabetes and dementia (both) (2.83[2.40-3.34], p<.0) compared to matched individuals with neither dementia nor diabetes. 5.4% of untreated PLWD died within 60 days of GP diagnosis—increasing to 5.9% in PLWD with diabetes.

CONCLUSIONS

Incidences of UTI and associated mortality are high in PLWD, especially in those with diabetes and dementia. Delayed treatment for UTI is further associated with high mortality.

Graphical abstract

Read more about the research paper here: https://www.sciencedirect.com/science/article/pii/S0163445324001014?via%3Dihub