- Email: [email protected]
DEMENTIA AMONG COMMUNITY-DWELLING, OFF-RESERVE INDIGENOUS POPULATIONS IN ONTARIO
Poster Presentations: Monday, July 17, 2017
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scores in the MMSE (p¼0.036), in delayed recall of BCSB (p¼0.048) and higher scores in the FAQ (p¼0.014). Low education was not predictive of conversion to dementia (p¼0.367). Conclusions: The conversion rate of CIND and MCI to dementia were in lower range when compared to international studies mostly performed in developed countries. Educational level was not a predictor of conversion to dementia. P2-529
MILD COGNITIVE IMPAIRMENT IS, IN CONTRAST TO DEMENTIA, ASSOCIATED WITH AN INCREASED RISK OF CANCER
Kimberly Dieudonnee van der Willik1,2, T. Rikje Ruiter1, M. Kamran Ikram1, Bruno Stricker1, Sanne B. Schagen2, M. Arfan Ikram3, 1Erasmus Medical Center, Rotterdam, Netherlands; 2Netherlands Cancer Institute, Amsterdam, Netherlands; 3Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands. Contact e-mail: k.vanderwillik@ erasmusmc.nl Background: Dementia and cancer are major public health concerns. Previous studies showed an inverse relation between dementia and cancer. However, it is uncertain whether this observation is based on biological mechanisms or if it is due to epidemiological limitations. Mild cognitive impairment (MCI) represents the earliest clinical features of dementia. We investigated the relation between MCI and cancer in addition to the association between dementia and cancer to better understand the nature of this finding. Methods: We assessed the relation between incident dementia and cancer in 13,207 participants of the prospective population-based Rotterdam Study. The association between MCI and cancer was studied in 5,181 persons of this cohort. Only solid and hematological cancer types were included. Cox proportional hazard models were used, adjusting for important confounding factors including age, sex, body mass index, education level, smoking status, and alcohol use. In addition, we excluded the first two and five years of follow-up time to limit the effect of reversed causality. Results: In total 1,404 patients were diagnosed with dementia of whom 63 developed cancer. Dementia was associated with a decreased risk of cancer (hazard ratio (HR) 0$53; 95% CI 0$41-0$68). Seventy seven out of 501 persons with MCI were diagnosed with cancer. Persons with MCI had an increased risk of cancer (HR 1$21; 95% CI 0$95-1$53). The risk of cancer was increased after exclusion of the first two and five years of follow-up time (HR 1$28; 95% CI 0$97-1$68 and HR 1$75; 95% CI 1$21-2$53). The risk of cancer in persons with MCI was significantly higher compared to the risk in dementia patients (P <0.001). Conclusions: In this population-based cohort, MCI is associated with an increased risk of cancer. Our results imply that the previous found decreased risk of cancer in patients with dementia is the result of methodological limitations.
P2-530
DEMENTIA AMONG COMMUNITYDWELLING, OFF-RESERVE INDIGENOUS POPULATIONS IN ONTARIO
Laura A. Warren1, Alexandra Martiniuk2, David Henry1, Amy R. Borenstein3, Nancy Kreiger1, Jennifer Walker4, 1 University of Toronto, Toronto, ON, Canada; 2George Institute, Sydney, Australia; 3University of South Florida, Tampa, FL, USA; 4Centre for Rural and Northern Health Research, Laurentian University, Sudbury, ON, Canada. Contact e-mail: lawarren@gmail. com Background: There is evidence to suggest the burden of dementia may be greater in Indigenous populations than it is in non-Indigenous populations. The objective of this study is to characterize the epidemiology of dementia diagnoses and care in off-reserve, community-dwelling, Ontario Indigenous populations using data from the Canadian Community Health Survey (CCHS) and provincial health insurance claims datasets housed at the Institute of Clinical and Evaluative Sciences (ICES). Methods: We have established a Community Advisory Board (CAB) comprised of five members from a variety of research backgrounds, Indigenous communities and lived experiences to provide leadership, support and direction to all stages of our research. Indigenous and non-Indigenous populations will be identified using the CCHS. We will use a definition of dementia (including Alzheimer’s disease) developed and previously validated by ICES. All analyses will be conducted using SAS 9.3. Differences in prevalence estimates and patterns of care and service usage for Indigenous and non-Indigenous participants will be compared using Chi-square tests for frequencies and t-tests for means. Risk factors for dementia will be identified using PROC GENMOD to build a multivariate logistic model for both Indigenous and non-Indigenous participants. Results: Participant characteristics will be reported as frequencies and proportions for Indigenous and non-Indigenous respondents by sex. Age-specific dementia prevalence estimates will also be reported for each group. Odds ratios will be reported from the final multivariate model for Indigenous and non-Indigenous participants. Differences in frequencies of drug prescirption types (e.g. Donepezil, Galantamine, Memantine, Rivastigmine, Tacrine), hospital admissions, specialist care, home care, and physician visits will be will be identified using Chi-square tests between Indigenous and non-Indigenous participants. Conclusions: This study will be the first of its kind in Ontario. By characterizing the epidemiology of dementia cases and care in community-dwelling, off-reserve, Indigenous populations we hope to identify risk factors, identify patterns of care for dementia health services, and increase awareness of dementia among Indigenous populations in Ontario.
P845
scores in the MMSE (p¼0.036), in delayed recall of BCSB (p¼0.048) and higher scores in the FAQ (p¼0.014). Low education was not predictive of conversion to dementia (p¼0.367). Conclusions: The conversion rate of CIND and MCI to dementia were in lower range when compared to international studies mostly performed in developed countries. Educational level was not a predictor of conversion to dementia. P2-529
MILD COGNITIVE IMPAIRMENT IS, IN CONTRAST TO DEMENTIA, ASSOCIATED WITH AN INCREASED RISK OF CANCER
Kimberly Dieudonnee van der Willik1,2, T. Rikje Ruiter1, M. Kamran Ikram1, Bruno Stricker1, Sanne B. Schagen2, M. Arfan Ikram3, 1Erasmus Medical Center, Rotterdam, Netherlands; 2Netherlands Cancer Institute, Amsterdam, Netherlands; 3Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands. Contact e-mail: k.vanderwillik@ erasmusmc.nl Background: Dementia and cancer are major public health concerns. Previous studies showed an inverse relation between dementia and cancer. However, it is uncertain whether this observation is based on biological mechanisms or if it is due to epidemiological limitations. Mild cognitive impairment (MCI) represents the earliest clinical features of dementia. We investigated the relation between MCI and cancer in addition to the association between dementia and cancer to better understand the nature of this finding. Methods: We assessed the relation between incident dementia and cancer in 13,207 participants of the prospective population-based Rotterdam Study. The association between MCI and cancer was studied in 5,181 persons of this cohort. Only solid and hematological cancer types were included. Cox proportional hazard models were used, adjusting for important confounding factors including age, sex, body mass index, education level, smoking status, and alcohol use. In addition, we excluded the first two and five years of follow-up time to limit the effect of reversed causality. Results: In total 1,404 patients were diagnosed with dementia of whom 63 developed cancer. Dementia was associated with a decreased risk of cancer (hazard ratio (HR) 0$53; 95% CI 0$41-0$68). Seventy seven out of 501 persons with MCI were diagnosed with cancer. Persons with MCI had an increased risk of cancer (HR 1$21; 95% CI 0$95-1$53). The risk of cancer was increased after exclusion of the first two and five years of follow-up time (HR 1$28; 95% CI 0$97-1$68 and HR 1$75; 95% CI 1$21-2$53). The risk of cancer in persons with MCI was significantly higher compared to the risk in dementia patients (P <0.001). Conclusions: In this population-based cohort, MCI is associated with an increased risk of cancer. Our results imply that the previous found decreased risk of cancer in patients with dementia is the result of methodological limitations.
P2-530
DEMENTIA AMONG COMMUNITYDWELLING, OFF-RESERVE INDIGENOUS POPULATIONS IN ONTARIO
Laura A. Warren1, Alexandra Martiniuk2, David Henry1, Amy R. Borenstein3, Nancy Kreiger1, Jennifer Walker4, 1 University of Toronto, Toronto, ON, Canada; 2George Institute, Sydney, Australia; 3University of South Florida, Tampa, FL, USA; 4Centre for Rural and Northern Health Research, Laurentian University, Sudbury, ON, Canada. Contact e-mail: lawarren@gmail. com Background: There is evidence to suggest the burden of dementia may be greater in Indigenous populations than it is in non-Indigenous populations. The objective of this study is to characterize the epidemiology of dementia diagnoses and care in off-reserve, community-dwelling, Ontario Indigenous populations using data from the Canadian Community Health Survey (CCHS) and provincial health insurance claims datasets housed at the Institute of Clinical and Evaluative Sciences (ICES). Methods: We have established a Community Advisory Board (CAB) comprised of five members from a variety of research backgrounds, Indigenous communities and lived experiences to provide leadership, support and direction to all stages of our research. Indigenous and non-Indigenous populations will be identified using the CCHS. We will use a definition of dementia (including Alzheimer’s disease) developed and previously validated by ICES. All analyses will be conducted using SAS 9.3. Differences in prevalence estimates and patterns of care and service usage for Indigenous and non-Indigenous participants will be compared using Chi-square tests for frequencies and t-tests for means. Risk factors for dementia will be identified using PROC GENMOD to build a multivariate logistic model for both Indigenous and non-Indigenous participants. Results: Participant characteristics will be reported as frequencies and proportions for Indigenous and non-Indigenous respondents by sex. Age-specific dementia prevalence estimates will also be reported for each group. Odds ratios will be reported from the final multivariate model for Indigenous and non-Indigenous participants. Differences in frequencies of drug prescirption types (e.g. Donepezil, Galantamine, Memantine, Rivastigmine, Tacrine), hospital admissions, specialist care, home care, and physician visits will be will be identified using Chi-square tests between Indigenous and non-Indigenous participants. Conclusions: This study will be the first of its kind in Ontario. By characterizing the epidemiology of dementia cases and care in community-dwelling, off-reserve, Indigenous populations we hope to identify risk factors, identify patterns of care for dementia health services, and increase awareness of dementia among Indigenous populations in Ontario.