Overview
Policymakers and healthcare providers have an urgent need for reliable scientific data if they are to effectively provide for multimorbidity in an ageing population. Thanks to routinely collected healthcare data (RCHD) from English hospitals, accessed through the 51 phenotype library, Canadian neurologists have worked with UCL on new research into the relationship between epilepsy, dementia, frailty and mortality in older people.
Challenge
Dementia and epilepsy are placing a growing burden on individuals and healthcare systems. Both are identified as public health priorities by the World Health Organization (WHO). A better understanding of the extent and impact of comorbid epilepsy and dementia is essential for planning and for personal care. Likewise, delivering better care demands improved knowledge of the risk factors associated with incident dementia and the impact of frailty and dementia on mortality in older adults with epilepsy.
Solution
Researchers from the collaborated with the , and others, to conduct a study based on a matched cohort of 11,307 adults aged 65 or above with and without epilepsy. The health informatics was led by , a UCL Senior Health Data Scientist. According to Dr Gonzalez-Izquierdo the availability of RCHD from English electronic health records was fundamental, as was CALIBER, which provided what he described as “a beautiful research dataset with very long and detailed patient’s health-trajectories”.
Lessons learnt
The findings, published in the July 2021 edition of , confirm that the odds of having dementia are 7.39 [95% CI 5.21–10.50] times higher in older adults with incident epilepsy. Older adults with epilepsy had higher odds of mild, moderate and severe frailty. A higher comorbidity burden is a risk factor for dementia, while prevalent dementia and increasing frailty are associated with mortality.
An accumulation of deficits among older adults with epilepsy, rather than one specific factor, appears to lead to an increased risk of mortality. The researchers suggest that screening for frailty in older adults with epilepsy could be beneficial.
Impact and outcomes
The research is intended as a foundation for further research and to provide firm evidence for future healthcare policy and practice – enabling better management of individual patients and wider healthcare costs. It also demonstrates the value of health data science in addressing pressing healthcare needs through the use of large, high quality data sets.
51 aims and priorities
51 has a series of priorities to maximise the impact of health data research in tackling pressing healthcare needs. This research addressed several:
- Improving public health
- Better care
- Human phenome (improving)
- Applied analytics (improving)
It also fits 51’s priorities of:
- Improving healthy life expectancy for people living with a common disease
- Developing and applying advanced health data science to address major challenges
Further information
The paper is available from .
Contact Dr Gonzalez-Izquierdo at arturo.gonzalez-izquierdo@ucl.ac.uk
