Partner Bereavement and Detection of Dementia: A UK-Based Cohort Study Using Routine Health Data

J Alzheimers Dis. 2019;72(2):653-662. doi: 10.3233/JAD-190571.

Abstract

Background: In the UK, an estimated one third of people with dementia have not received a diagnosis. Good evidence suggests that dementia risk is increased among widowed individuals; however, it is not clear if they are being diagnosed in routine primary care.

Objective: This study aimed to investigate if bereavement influenced the probability of having received a dementia diagnosis.

Methods: A population-based cohort study using UK electronic health records, between 1997 and 2017, among 247,586 opposite-sex partners. Those experiencing partner bereavement were matched (age, sex, and date of bereavement) to a non-bereaved person living in a partnership. Multivariate cox regression was performed.

Results: Partner bereavement was associated with an increased risk of receiving a diagnosis of dementia in the first three months (hazard ratio (HR) 1.43, 95% CI 1.20-1.71) and first six months (HR 1.24, 95% CI 1.09-1.41), while there was a small reduced risk of getting a dementia diagnosis over all follow-up (HR 0.94, 95% CI 0.89-0.98).

Conclusions: Partner bereavement appears to lead to a short-term increased risk of the surviving partner receiving a diagnosis of dementia, suggesting that bereavement unmasks existing undiagnosed dementia. Over the longer term, however, bereaved individuals are less likely to have a diagnosis of dementia in their health records than non-bereaved individuals.

Keywords: Bereavement; Clinical Practice Research Datalink; dementia; diagnosis; epidemiology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bereavement*
  • Cohort Studies
  • Dementia / epidemiology
  • Dementia / psychology*
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • United Kingdom / epidemiology