CALIBER Vascular dementia phenotype

person Phenotype Vascular dementia
person Type Disease or syndrome
person Data sources Primary care (CPRD), hospital admission data (HES)
person Clinical Terminologies Read, ICD-9, ICD-10
person Valid event date range 01/01/1999 - 01/07/2016
person Sex Female/Male
person Agreed 23.11.2012 (Revision 2)
person Authors Mar Pujades-Rodriguez, Valentina Assi, Arturo Gonzalez-Izquierdo, Tim Wilkinson, Christian Schnier, Cathie Sudlow, Harry Hemingway, William N. Whiteley

Primary Care (incident and prevalent)

In the Clinical Practice Research Datalink (CPRD, primary care data) we ascertained cases by searching for Read terms related to:

Diagnoses
E004100	Arteriosclerotic dementia with delirium
Eu01000	[X]Vascular dementia of acute onset
E004200	Arteriosclerotic dementia with paranoia
Eu01y00	[X]Other vascular dementia
E004300	Arteriosclerotic dementia with depression
Eu01200	[X]Subcortical vascular dementia
E004000	Uncomplicated arteriosclerotic dementia
Eu01300	[X]Mixed cortical and subcortical vascular dementia
Eu01z00	[X]Vascular dementia, unspecified
E004z00	Arteriosclerotic dementia NOS
Eu01.11	[X]Arteriosclerotic dementia
Eu01100	[X]Multi-infarct dementia
E004.00	Arteriosclerotic dementia
E004.11	Multi infarct dementia
Eu01.00	[X]Vascular dementia              
Read terms are hierarhically organized in top-level chapters i.e. chapter G....00 is related to Circulatory System Diseases and sub-headings i.e. heading G2...00 is related to Hypertensive Heart Disease while G3...00 is related to Ischaemic Heart Disease.

Secondary Care (incident and prevalent)

In Hospital Episode Statistics (HES, hospital admission data) we used ICD-10 terms (see below) for diagnosis when marked as the primary diagnosis i.e. the main condition treated or investigated during the relevant episode of healthcare. We used the date of admission to hospital as the date of the event. We additionally searched for OPCS-4 terms indicating releted procedures.

Diagnoses
F01	Vascular dementia
F010	Vascular dementia of acute onset
F011	Multi-infarct dementia
F012	Subcortical vascular dementia
F013	Mixed cortical and subcortical vascular dementia
F018	Other vascular dementia
F019	Vascular dementia, unspecified
I67.3	Binswanger's disease
290.4	Vascular dementia

Mortality data

In mortality data, we used ICD-9 and ICD-10 terms (see below) at any position (underlying or not):

F01	Vascular dementia
F010	Vascular dementia of acute onset
F011	Multi-infarct dementia
F012	Subcortical vascular dementia
F013	Mixed cortical and subcortical vascular dementia
F018	Other vascular dementia
F019	Vascular dementia, unspecified
I67.3	Binswanger's disease
290.4	Vascular dementia

Combining evidence across sources to define and date phenotypes

We defined dementia as the record of one or more diagnostic codes in any of the three data sources at any time and in any position (i.e. dementia was any of the recorded diagnosis in hospital admission or death record). We defined people with corroborating evidence of diagnosis if they had dementia with: (i) more than one record of dementia in the same data source, on different dates; or (ii) a record of dementia in 2 or 3 data sources; or (iii) a record of falls, confusion, memory problems or nursing home admission; or (iv) dementia monitoring codes in primary care; or (v) a referral to a dementia speciality (geriatrics, care of the elderly, psychiatry); or (v) more than one prescription of rivastigmine, galantamine, donepezil, memantine, which are typically used to treat patients with Alzheimer’s disease and sometimes patients with dementia in Parkinson’s disease and dementia with Lewy bodies.
Pujades-Rodriguez, Mar, Valentina Assi, Arturo Gonzalez-Izquierdo, Tim Wilkinson, Christian Schnier, Cathie Sudlow, Harry Hemingway, and William N. Whiteley. "The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England." PloS one 13, no. 6 (2018): e0199026.
Pujades-Rodriguez, Mar, Valentina Assi, Arturo Gonzalez-Izquierdo, Tim Wilkinson, Christian Schnier, Cathie Sudlow, Harry Hemingway, and William N. Whiteley. "The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England." PloS one 13, no. 6 (2018): e0199026.
Pujades-Rodriguez, Mar, Valentina Assi, Arturo Gonzalez-Izquierdo, Tim Wilkinson, Christian Schnier, Cathie Sudlow, Harry Hemingway, and William N. Whiteley. "The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England." PloS one 13, no. 6 (2018): e0199026.