Additional tables for the scoping review

Frances Bunn; Anne-Marie Burn; Claire Goodman; Louise Robinson; Greta Rait; Sam Norton; Holly Bennett; Marie Poole; Johan Schoeman; Carol Brayne

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Bunn F, Burn AM, Goodman C, et al. Comorbidity and dementia: a mixed-method study on improving health care for people with dementia (CoDem). Southampton (UK): NIHR Journals Library; 2016 Feb. (Health Services and Delivery Research, No. 4.8.)

Comorbidity and dementia: a mixed-method study on improving health care for people with dementia (CoDem).

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Appendix 4Additional tables for the scoping review

TABLE 12

Details of studies included in the scoping review

Study ID	Country	Study design	Number of participants	Aims/research questions	Study focus^a	Comorbidity	Age (years)^b	Sex (% female)
Allan et al., 2005⁸⁹ (Allan 2006¹⁶²)	UK	Qualitative	Total: 43 (n = 12 service users with hearing impairment, n = 16 practitioners, n = 8 relatives, n = 7 British Sign Language interpreters)	Consultation exercise looking at issues for people with dementia with hearing loss	V	Hearing impairment	NR	NR
Australian Commission on Safety and Quality in Health Care 2013⁸⁸	Australia	Rapid review	NA	To identify best practice in caring for patients with cognitive impairment in acute hospital settings	S	General	NA	NA
Alshekhlee et al., 2011¹⁵¹	USA	Cohort study	35,557 patients with a diagnosis of dementia; 207 (0.58%) had received thrombolysis	To establish the impact of dementia on hospital mortality and intracerebral haemorrhage rates associated with thrombolysis therapy for AIS	A	Stroke	Most aged > 80	63
Balfour and O’Rourke 2003⁹⁰	Canada	Cross-sectional	Total: 460 PLWD (n = 245 with arthritis, n = 215 no arthritis)	Are patients with Alzheimer’s disease inappropriately prescribed neuroleptics and benzodiazepines	Q	Arthritis	84.33	73
Barnett et al., 2012⁹¹ (Guthrie et al., 2012⁴)	UK	Cross-sectional	1,751,841 patients from database of primary care practices	Examined distribution of multimorbidity and comorbidity in relation to age and socioeconomic deprivation	P	General multimorbidity but includes information on diabetes and stroke	16.6% aged ≥ 65	50.5
Bartlett and McKeefry 2011⁹³ (Bartlett and McKeefry 2009¹⁵⁸)	UK	Qualitative and scoping	7 practitioners, 4 students	To increase knowledge of visual issues and eye health for people with dementia	V	VI	NR	NR
Bartlett and Clarke 2012⁹²	UK	Qualitative	5 HCPs	How HCPs assess the needs of and communicate with a person dying from cancer with a coincidental dementia	V	Cancer	NR	100
Bayer et al., 1994⁹⁴	UK	Prevalence study	26 older people with diabetes (in all but five, diabetes predated dementia)	Impact of dementia on diabetic care	V	Diabetes	Median 78.5 (range 70–91)	73
Beishon et al., 2014¹⁴⁹	NA	Systematic review	Includes six RCTs	Assess the evidence for the treatment of hypertension in older people with dementia	A	Hypertension	≥ 65	NR
Bruce et al., 2003⁹⁵	Australia	Cross-sectional	223 older people with diabetes	Determine whether or not the prevalence of dementia in older diabetics warrants an active screening approach	P	Dementia and depression in people with diabetes	76.5	48.8
Busl et al., 2013¹⁵⁴	USA	Retrospective cross-sectional	153 (13.6% pre-stroke dementia)	To determine whether or not pre-stroke dementia contributed to poor outcomes in stroke patients aged > 80 years who underwent intravenous and/or IAT reperfusion	A	Stroke	86	NR
College of Optometrists 2012⁹⁶	UK	Guidelines	NA	Guidelines for optometrists examining a patient with dementia or cognitive impairment	S	VI	NA	NA
Connolly et al., 2013¹⁶¹ (Connolly et al., 2012⁹⁷)	UK	Observational, cross-sectional review of primary care records	700 PLWD (compared with people without dementia on QOF register)	Evaluate the quality of medical care for vascular diseases provided to people with dementia	Q	Stroke and diabetes	82.1 (43–102)	66
Curtis et al., 2012⁹⁸	USA	Retrospective cohort study	284,380 (with and without dementia)	Examine use of treatments for AMD	Q	VI (AMD)	81	64
Dewing and Dijk 2014⁹⁹	UK	Literature review	NA	Review of the literature on the acute care of PLWD in general hospitals	V, S	General	NA	NA
Doraiswamy et al., 2002¹	USA	Cross-sectional	679 older people with Alzheimer’s disease	Examine the prevalence of comorbid medical illness in Alzheimer’s disease patients	P	General	87	Community 55.6, assisted living 75.8, nursing home 83.5
Doucet et al., 2008¹⁰⁰	France	Cross-sectional	238 older people with diabetes	Identify characteristics of elderly diabetic patients and evaluate relationship between glycaemic control and complications of diabetes	Q	Diabetes	82.2	58
Feil et al., 2003¹⁰¹	USA	Longitudinal cross-sectional	7482 older adults	Examine relationship between cognitive impairment, common chronic medical illnesses and risk of mortality in older people	P	Several but includes diabetes and stroke	51% aged ≥ 85	61
Feil et al., 2009¹⁰³	USA	Longitudinal cross-sectional	51 people with diabetes (n = 27 with caregiver)	Examine role of cognitive impairment and caregiver support in diabetes care adherence and glycaemic control	P, Q	Diabetes	78 (62–90)	0
Feil et al., 2011¹⁰²	USA	Qualitative	21 caregivers of PLWD and diabetes	Explore caregivers’ challenges and quality-of-life issues managing diabetes in PLWD	V	Diabetes	65–90	Majority female (numbers not given)
Feil et al., 2011¹⁰⁴	USA	Cross-sectional database analysis	497,000 veterans with diabetes (with and without cognitive impairment/dementia)	Examine the relationship between management of diabetes and hypoglycaemia in older adults with dementia	P, Q	Diabetes	100% aged > 65, 44% aged > 75	2
Formiga et al., 2009¹⁰⁵	Spain	Prospective population-based survey	515 PLWD	Evaluate comorbidity in elderly with dementia to determine differences according to dementia severity	P	General	81	70
George et al., 2011¹⁰⁶	UK	Systematic review		Examine literature to determine the evidence for the effectiveness of joint geriatric/psychiatric wards	S	General	NA	NA
Gillespie et al., 2014¹⁵³	NA	Systematic review/scoping	10 studies (n = 5 USA, n = 2 UK, n = 2 Australia, n = 1 Canada)	To explore published literature that describes what is known about the role of informal caregivers as they manage medications for older adults and/or PLWD resident in the community	V	General	NR	NR
Gladman et al., 2012¹⁰⁷	UK	Qualitative study (and review)	60 HCPs, 36 patient and carer interviews	Elicit staff and organisational attitudes to dealing with older patients with cognitive impairment, understand the impact on patients, carers and staff and identify potential improvements	V	General	Patients 86.8 (70–99), carers 63 (46–79)	HCPs 80, patients 56
Gold et al., 1996¹⁰⁸	USA	Case–control	52 patients attending a memory clinic (n = 30 dementia, n = 22 cognitive impairment)	Determine prevalence and characteristics of hearing loss and whether screening tools are adequate and patients with Alzheimer’s disease can adequately report hearing problems	P	Hearing loss	NR	83
Goldberg et al., 2013¹⁰⁹	UK	RCT	310 intervention group, 290 control group	Develop and evaluate a best practice model of general hospital acute medical care for older people with cognitive impairment	S	General	Median 85	Intervention group 55, control group 40
Guijarro et al., 2010¹¹⁰	Spain	Cohort	40,482 PLWD	Determine prevalence and clinical characteristics of hospitalised dementia patients	P, Q	Several including cataracts and diabetes	78	NR
Heun et al., 2013¹²	UK	Retrospective case–control	634 with Alzheimer’s disease, 72,244 control group	Differences between Alzheimer’s disease and non-Alzheimer’s disease patients in terms of comorbid diseases at hospital admission and which comorbidities contribute to mortality	P	General	Alzheimer’s disease 85.1 (SE 8.2), control 80.8 (SE 7.4)	Alzheimer’s disease 65, control 51
Hewitt et al., 2010²⁰	UK	Questionnaire survey	1047 older people with type 2 diabetes	Examine knowledge and management of diabetes in older people	P, V	Diabetes	80.9 (75–100)	53.3
Hill et al., 2013¹¹²	UK	Guidance	NA	Highlight importance of recognising relationship between diabetes and dementia, the impact one condition has on the other and maximising the benefits and safety of diabetes treatments while minimising risks	Q	Diabetes	NA	NA
Hoffman et al., 2011¹¹¹	Germany	Cohort	1848 PLWD	Determine whether or not comorbidity and polypharmacy influence prescription of cholinesterase inhibitors in PLWD	Q	General comorbidity but some mention of visual disturbances	78.7	47.6
Holmes et al., 2010¹¹³	UK	Literature review, mapping and case study	10 case study sites: recruited 757 participants in the referred cohort and 975 participants in the comparison cohort	Establish what service models are being used to improve the care of older people with mental health problems in general hospitals and what impact these models might have on outcomes	S	General	80	Comparison cohort 55, referred cohort 64%
Ishii et al., 2008¹¹⁴	Japan	Case series	88 people with VI	Evaluate the influence of cataract surgery on cognitive function and depressive mental status of elderly patients	Q	VI	75.3 (55–93)	64
Jara et al., 2011¹⁴⁴	USA (but UK data)	Retrospective cohort	8124 Alzheimer’s disease cohort, 642,325 non-Alzheimer’s disease cohort	Evaluate the occurrence of cataracts in people with Alzheimer’s disease compared with the general population	P	VI	64+	Alzheimer’s disease cohort 68, non-Alzheimer’s disease cohort 54
Jefferis et al., 2011¹¹⁵	UK	Literature review	NA	What are the implications for practice relating to the benefits of cataract surgery for PLWD?	Q	VI (cataracts)	NA	NA
Jones and Trigg 2007¹¹⁶ (Trigg and Jones 2005⁷³)	UK	Scoping review	NA	Review of research on PLWD and serious sight loss	P, Q	VI	NA	NA
Keenan 2014¹¹⁷	UK	Cohort	65,894 AMD cohort, 168,092 dementia cohort	Are PLWD more or less likely to be admitted to hospital for AMD treatment	Q	VI (AMD)	Majority > 65	61
Lawrence et al., 2009⁷² (Lawrence et al., 2008,¹⁵⁶ 2010,¹⁶⁰ 2011¹⁵⁷)	UK	Qualitative	17 PLWD and VI, 17 family caregivers, 18 HCPs	The experiences and needs of older adults with VI and dementia	V	VI	65–99 (18/19 aged ≥ 75)	63
Löppönen et al., 2004¹¹⁸	Finland	Cross-sectional population-based study	1260 older people, 112 PLWD	Study of undiagnosed diseases in older people with and without dementia	P, Q	Several including diabetes, stroke and VI	64+	58
Lyketsos et al., 2005¹¹⁹	USA	Case–control	695 older people; 149 PLWD, 225 without cognitive impairment, 321 cognitive impairment no dementia	Investigated medical comorbidity in persons with dementia and cognitive impairment	P	General	Dementia 83.89, CIND 82.38, no dementia 79.93	Dementia 64.4, CIND 53.8, no dementia 54.8
MacKenzie et al., 2011¹²⁰	Canada	RCT	56 stroke and MCI patients	Investigate whether nurse case management interventions result in lowered blood pressure	S	Mainly stroke but includes diabetes	59% > 65	30
McCormick et al., 1994¹²¹	USA	Case–control	Total: 375 (n = 154 with dementia, n = 92 with cognitive impairment, n = 129 control group)	Compare comorbidity in Alzheimer’s disease patients and non-Alzheimer’s disease patients	P	General	76	Dementia 68, cognitive impairment 57, control 63
McKeefry and Bartlett 2010¹²² (McKeefry and Bartlett 2010⁷⁴)	UK	Scoping review	NA	To develop guidelines for optometrists for best practice with patients with dementia and sight loss	S	VI	NA	NA
Müther et al., 2010¹²³	Germany	Retrospective matched control study	216 PLWD, 216 matched control subjects without dementia	Are patients with dementia treated differently from patients without dementia?	Q	Several, includes diabetes	dementia group 82.7, non-dementia group 82.2	77.3
Parke et al., 2011¹²⁴	Canada	Scoping review	Included 15 evaluation studies	Scope research on cognitive impairment in older adults who visited the emergency department of an acute care hospital and evaluation of effectiveness of programmes	S	General	65+	NA
Parke et al., 2013¹²⁵	Canada	Qualitative	10 adult–family caregiver dyads, 10 emergency department nurses, 4 nurse practitioners	Identify factors that facilitate or impede safe transitional care in the emergency department for community-dwelling older adults	S, V	General	PLWD 83.17 (77–90), carer 57.81 (51–84)	Not specified
Pendlebury and Rothwell 2009⁶⁹	NA	Systematic review	22 hospital-based and 8 population-based cohorts	Identify the risk factors for dementia and whether or not there are any differences in the risk factors associated with pre-stroke and post-stroke dementia	P	Stroke	NA	NA
Pendlebury et al., 2015¹⁴⁶	UK	Cross-sectional	1236 patients with acute transient ischemic attack or stroke	To determine the impact of study entry criteria on measured rates of pre- and post-event dementia	P	Stroke	75	53
Poblador-Plou et al., 2014¹⁴	Spain	Cross-sectional	72,815 [3971 (5.45%) diagnosed with dementia]	To look at the prevalence of chronic conditions in PLWD	P	General	70 whole sample, 80 PLWD	70
Poland et al., 2014¹⁴⁸	UK	Qualitative	9 carers of PLWD	To identify carers’ views gained from experiences of medication management in dementia	V	General	NR	89
Rabadi et al., 2008¹²⁶	USA	Retrospective analysis	668 (n = 435 with cognitive impairment)	Can stroke patients with cognitive impairment benefit from admission to an acute rehabilitation unit?	S	Stroke	70.3 (22–96)	53
Rait et al., 2010¹²⁷	UK	Cohort	22,529 PLWD, 112,645 matched non-dementia participants. Ratio of 1 : 5 dementia : non-dementia	Estimate survival after diagnosis of dementia in primary care compared with people without dementia and determine incidence of dementia	P, Q	Several including stroke and diabetes	82.2	Dementia 67.9, no dementia 55.8
Sakurai et al., 2010¹²⁸	Japan	Prevalence study	113 PLWD	Investigated prevalence of coexisting diseases in PLWD	P	Several including diabetes	78.6	73
Saposnik et al., 2011¹²⁹	Canada	Retrospective cohort	877 with pre-existing dementia, 877 control subjects (no pre-existing dementia)	Determine if pre-existing dementia is an independent predictor of all-cause mortality and disability after ischaemic stroke	P, Q	Stroke	82	60
Schubert et al., 2006²	USA	Cross-sectional	Total: 3013 (107 PLWD)	Compare the medical comorbidity of older patients with and without dementia in primary care	P	Several including stroke and diabetes	73.4	66.6
Shah et al., 2007¹³⁰	UK	Survey	100 optometry practices	Investigate the accessibility of a sight test for an older person with dementia	Q	VI	NA	NA
Shamy and Jaigobin 2013¹⁵²	Canada	Survey	NR but say they had a response rate of 69%	To better understand the decision-making process surrounding the administration of IV tPA	A	Stroke	Not known	Not known
Sinclair et al., 2000²¹	UK	Case–control	396 with diabetes, 393 matched control subjects	Whether cognitive impairment is associated with changes in self-care behaviour and health service use in older diabetics	Q	Diabetes	Diabetics 74.9, control 74.8	51
Sinclair et al., 2011¹³¹	Europe	Guidance	NA	Support clinical decisions in older people with diabetes and enhance high-quality diabetes care by the use of best available evidence	S	Diabetes	NA	NA
Sinclair et al., 2014¹⁴⁷	UK	Guidance	NA	Outline key steps in integrated care pathway for dementia and diabetes, produce guidance on identifying each condition, deal with potentially hazardous issue of hypoglycaemia and outline important competencies for HCPs in both settings	S	Diabetes	NA	NA
Sloan et al., 2004¹⁵⁵	USA	Cross-sectional (retrospective chart review)	5851 admitted for acute myocardial infarction with dementia, 123,241 admitted for AMI without dementia	Differences in mortality after admission for AMI and in treatments for AMI between patients with and without dementia	S	AMI	Dementia 81.6, no dementia 75.5	Dementia 57.2, no dementia 46.3
Spencer et al., 2013¹³²	UK	Qualitative	Total: 40 (n = 20 from specialist unit, n = 20 standard care)	Examine carers’ views and experiences of delivery of patient care for PLWD in acute general hospital in order to evaluate specialist medical and mental health unit compared with standard hospital wards	V	General	NR	Not clear
Stenvall et al., 2012¹³³	Sweden	RCT	64 patients with fractured neck of femur (n = 28 intervention group, n = 36 control group)	Whether or not a multidisciplinary postoperative intervention programme reduced postoperative complications and improved functional recovery among people with dementia	S	Hip fracture	> 70	Intervention group 79, control group 69
Stephan et al., 2011¹³⁴	UK	Cross-sectional	Total: 13,004 (n = 587 PLWD, n = 319 MCI, n = 608 no cognitive impairment)	Compared the pattern of disease comorbidity across different cognitive groups and whether or not comorbidity is a risk factor for dementia progression	P	Several but includes diabetes and stroke	Dementia group – with health conditions 79.8, no health conditions 81.9	Dementia group – with health conditions 60.1, no health conditions 73.2
Tadros et al., 2013¹³⁵	UK	Retrospective analysis	Not given	Evaluate whether or not implementation of the RAID integrated model improves access to psychiatric assessment and reduces costs of health service provision in an acute hospital	S	General	Mean age of referrals from all wards 65.7; 23% of RAID group and 20% of control group were aged > 75	RAID group 54, comparison group 40
Thorpe et al., 2012¹³⁶	USA	Retrospective cohort	Total: 288,805 (n = 44,717 PLWD)	Examined how recommended monitoring of diabetes differed for people with and without comorbid dementia	P, Q	Diabetes	26% aged 65–69, 48% aged 70–79, 25.9% aged 80+	60
Uhlmann et al., 1989¹³⁸	USA	Case–control	200 with hearing impairment (n = 100 with dementia, n = 100 control subjects)	Whether or not hearing impairment contributes to cognitive dysfunction in older adults	P	Hearing impairment	77	58
Uhlmann et al., 1991¹³⁷	USA	Case–control	87 PLWD, 87 matched control subjects	How impaired visual acuity is associated with dementia and cognitive dysfunction in older adults	P	VI	77	58
Vitry et al., 2010¹³⁹	Australia	Retrospective cohort	20,134 veterans with diabetes (includes people with dementia/cognitive impairment but numbers not clear)	Whether or not the number of comorbid conditions unrelated to diabetes delays therapeutic progression of diabetes treatment	Q	Diabetes	77.3	36
Whitson et al., 2010¹⁴⁰	USA	Cross-sectional	101 people with macular disease	Prevalence of comorbid cognitive impairment among older adults referred to low-vision rehabilitation for macular disease	P	VI (macular disease)	80.1	65
Yochim et al., 2012¹⁴¹	USA	Case series	41 glaucoma patients	Prevalence of cognitive impairment, depression and anxiety in older adults with glaucoma	P	VI	70	70
Zamrini et al., 2004¹⁴²	USA	Case–control	999 people with Alzheimer’s disease	Prevalence of comorbid illness in black and white patients with probable Alzheimer’s disease	P	Several but includes diabetes and eye disease	Female patients 75.1, male patients 73.1	49
Zekry et al., 2008¹⁴³	Switzerland	Cohort	349 inpatients (43.3% dementia, 10.6% MCI)	Comorbid conditions and functional and nutritional status in hospitalised patients with dementia and MCI	P	Several but includes data on stroke and diabetes	85	76
Zhang et al., 2010¹⁴⁵	Australia	Retrospective cohort	17,095 veterans with and without diabetes (4.4% on dementia medication)	Impact of comorbidity on health service utilisation by Australian veterans with diabetes	Q	Diabetes	81	44

: AMI, acute myocardial infarction; IAT, intra-arterial reperfusion therapy; NA, not applicable; NR, not reported; RAID, Rapid Assessment, Interface and Discharge; SE, standard error.
a: P, prevalence; Q, quality of care; S, service organisation and management; V, views and experiences.
b: Unless otherwise stated refers to mean age and range.

TABLE 13

Prevalence studies: information on study populations, recruitment and participation

Study and country	Type of study	Type of population	Eligibility criteria defined?	Method of selection	Nature of population	Number of participants	Participation rate
Barnett et al., 2012,⁹¹ UK (Scotland)	Cross-sectional	General	Alive, permanently registered with a participating practice	National data set	Primary care (about one-third of all Scottish population)	11,139	All patients registered with primary care practice
Bruce et al., 2003,⁹⁵ Australia	Longitudinal cross-sectional	Diabetes	Defined by postcode, age ≥ 70 years, diabetes	Initial 223 members of a cohort of 529 participants	Community-based volunteers who consented to take part	223	Initially recruited 63% of those who were eligible
Doraiswamy et al., 2002,¹ USA	Cross-sectional	Dementia	Diagnosis of Alzheimer’s disease, age ≥ 50 years	From a variety of community health-care sites	Volunteers who consented to take part	679	Not clear
Feil et al., 2003,¹⁰¹ USA	Longitudinal cross-sectional	Cognitive impairment	Geographically defined, age ≥ 65 years	Secondary data analysis of data set from community-based study	Community-based volunteers who consented to take part	7482 (1774 with cognitive impairment)	80% (baseline interview)
Feil et al., 2009,¹⁰³ USA	Longitudinal cross-sectional	Diabetes	Diagnosis of type 2 diabetes, age ≥ 60 years	Electronic medical diagnosis of type 2 diabetes	Geriatric medical clinic	51	Not clear
Feil et al., 2011,¹⁰⁴ USA	Cross-sectional	Diabetes	Veterans aged ≥ 65 with diabetes	Secondary data analysis of research administration database (Veterans Health Administration, Medicare and Medicaid)	Population-based sample – large national health-care system database	497,000	All patients on database
Heun et al., 2013,¹² UK	Retrospective case–control	Dementia	Diagnosis of Alzheimer’s disease, age 70+ years, inpatient care for at least 24 hours	Consecutively admitted inpatients	Hospital	634	All patients who met criteria were included
Hewitt et al., 2010,²⁰ UK	Questionnaire	Diabetes (cognitive impairment)	Type 2 diabetes, age ≥ 75 years, not resident in a nursing home	Secondary data analysis of intervention arm of RCT	Primary care	1047	Not clear
Jara et al., 2011,¹⁴⁴ UK	Retrospective cohort	Dementia	Age ≥ 64 years, at least 24 months’ enrolment, no cataract diagnosis at baseline	National data set	Primary care	650,325 (8124 with dementia)	All patients registered with primary care practice
Löppönen et al., 2004,¹¹⁸ Finland	Cross-sectional	Dementia	Geographically defined, age ≥ 65 years	All those who met criteria invited in random order	Population based	112	82%
Lyketsos et al., 2005,¹¹⁹ USA	Case–control	Dementia/cognitive impairment	Geographically defined, age ≥ 65 years	All those who met criteria invited to participate	Population based	695 (374 with dementia)	90%
McCormick et al., 1994,¹²¹ USA	Case–control	Dementia/cognitive impairment	Age ≥ 60 years, member of HMO, geographically defined	Subsample recruited from database (not clear how chosen)	From HMO database	154	Not clear
Pendlebury et al., 2015¹⁴⁶	Cross-sectional	Stroke	All patients with stroke or TIA	All those with stroke or TIA within defined population area. Recruited through general practice or secondary care	Population based	1236 (from a population of 92,728)	92%
Poblador-Plou et al., 2014,¹⁴ Spain	Cross-sectional	Dementia	Age ≥ 65 years, consulted physician at least once during the 12-month period of the study	Primary care data set (19 primary health-care centres)	Primary care	72,815 (3971 with dementia)	All patients who visit GP at least once during 2008
Rait et al., 2010,¹²⁷ UK	Cohort	Dementia	Age 60+ years with first code for dementia during the study period, at least 6 months of data	National data set (practices that met standards for acceptable levels of data recording)	Primary care	135,174 (22,529 with dementia)	All patients registered with primary care practice
Sakurai et al., 2010,¹²⁸ Japan	Cross-sectional	Dementia	Dementia or MCI	Consecutive outpatients attending memory clinic	Memory clinic	160	Not clear
Saposnik et al., 2011,¹²⁹ Canada	Retrospective cohort	Stroke and dementia	Age ≥ 18 years, first ischaemic stroke	Stroke register	Clinical database	10,658	All stroke patients attending 12 regional stroke centres
Schubert et al., 2006,² USA	Cross-sectional	Dementia	Age ≥ 65, seen primary care physician within 2 year. Excluded nursing home residents and non-English-speaking patients	Primary care practice centres	Primary care	3013 (107 dementia)	Not clear
Stephan et al., 2011,¹³⁴ UK	Cross-sectional	MCI	Age ≥ 65 years	Randomly selected from health authority lists in five areas of the UK	Population based	13,004 (1486 dementia)	Not clear
Uhlmann et al., 1991,¹³⁷ USA	Case–control	Dementia	Age ≥ 65 years, English speaking, eighth grade of higher level of education, ability to complete audiometric evaluation	Computer searches of clinic records	Outpatient clinic	174 (87 dementia)	70%
Whitson et al., 2010,¹⁴⁰ USA	Cross-sectional	VI (macular disease)	Age ≥ 65 years, macular disease diagnoses	All eligible patients attending clinic invited to participate	Outpatient clinic	101	74%
Yochim et al., 2012,¹⁴¹ USA	Case series	VI (glaucoma)	Age ≥ 50 years, diagnosis of glaucoma	All eligible patients attending clinic invited to participate	Outpatient clinic	41	Not reported
Zamrini et al., 2004,¹⁴² USA	Case–control	Dementia	Probable Alzheimer’s disease, black or white (white participants matched non-randomly to black participants)	Computer searches of clinic records	Memory clinic	334	All those eligible during study period
Zekry et al., 2008,¹⁴³ Switzerland	Cohort	Dementia	Age ≥ 75 years. Excluded those with a terminal illness or disorders interfering with psychometric assessment	Random sample of all patients admitted selected each day	Hospital inpatients	349 (188 dementia)	85%
Zhang et al., 2010,¹⁴⁵ Australia	Retrospective cohort	Diabetes	Veterans, age ≥ 65, received prescription for diabetes in previous 6 months	Research administration database (Department of Veterans Affairs)	From database of veterans		All eligible patients on database

: HMO, health maintenance organisation; TIA, transient ischaemic attack.

TABLE 14

Prevalence studies: information on methods for data collection

Study and country	Type of study	Type of population	Method of data collection	How dementia/cognitive impairment defined/assessed?	How diabetes defined/recorded?	How stroke defined/recorded?	How VI defined/recorded?	Other
Barnett et al., 2012,⁹¹ UK (Scotland)	Cross-sectional	General	Electronic medical records	Read code ever recorded	Read code ever recorded	Read code ever recorded	NA
Bruce et al., 2003,⁹⁵ Australia	Longitudinal cross-sectional	Diabetes	Face-to-face interview and clinical examination	MMSE (< 24/30), IQCODE (> 3.61), Cambridge Examination for Mental Disorders of the Elderly and diagnostic examination	Clinical and biochemical assessment
Doraiswamy et al., 2002,¹ USA	Cross-sectional	Dementia	Face-to-face interview and medical records	Diagnostic criteria for probable Alzheimer’s disease (NINADS-ADRDA)	NA	NA	NA	Cumulative Illness Rating Scale–Geriatric
Feil et al., 2003,¹⁰¹ USA	Longitudinal cross-sectional	Cognitive impairment	Face-to-face interview	Modified version of Pfeiffer’s Short Portable Mental Status Questionnaire (SPMSQ)	Self-reported	Self-reported	NA
Feil et al., 2009,¹⁰³ USA	Longitudinal cross-sectional	Diabetes	Face-to-face interview	Cognitive Abilities Screening Instrument (CASI)	Diagnosis confirmed by physician and patient	NA	NA
Feil et al., 2011,¹⁰⁴ USA	Cross-sectional	Diabetes	Medical records	ICD codes	Two or more diabetes-specific ICD codes (ICD-9-CM)	NA	NA
Heun et al., 2013,¹² UK	Retrospective case–control	Dementia	Retrospective data from clinical records	ICD-10 diagnostic category	Registered diagnosis in medical records	Registered diagnosis in medical notes	Registered diagnosis in medical notes
Jara et al., 2011,¹⁴⁴ UK	Retrospective cohort	Dementia	Electronic medical records	Not specified			Cataract-related surgical/diagnostic codes
Löppönen et al., 2004,¹¹⁸ Finland	Cross-sectional	Dementia	Face-to-face interview and clinical examination	Diagnostic criteria for probable Alzheimer’s disease (NINADS-ADRDA), DSM-IV – clinical examination	Diagnosis in medical records and/or history of stroke verified by clinical examination	Diagnosis in medical records and/or treatment with antidiabetic agents and/or fasting plasma glucose level ≥ 7.0 mmol/l	NA
Lyketsos et al., 2005,¹¹⁹ USA	Case–control	Dementia/cognitive impairment	Face-to-face interview and clinical examination	Modified MMSE (3MS) or IQCODE plus clinical examination	Self- or informant response	Self- or informant response
McCormick et al., 1994,¹²¹ USA	Case–control	Dementia/cognitive impairment	Clinical examination and medical records	Diagnostic criteria for probable Alzheimer’s disease (NINADS-ADRDA), DSM-III-R (clinical examination)	Diagnosis in medical records	Diagnosis in medical records	Diagnosis in medical records	Charleston Comorbidity Index
Poblador-Plou et al., 2014,¹⁴ Spain	Cross Sectional	Dementia	Electronic medical records	Expanded Diagnostic Clusters NUR11 category ‘dementia and delirium’	Diagnosis in medical records (ICD codes)	Diagnosis in medical records (ICD codes)	medical records (ICD codes)
Rait et al., 2010,¹²⁷ UK	Cohort	Dementia	Electronic medical records	Read codes	Read codes	Read codes
Sakurai et al., 2010,¹²⁸ Japan	Cross-sectional	Dementia	Face-to-face interview and clinical examination	Diagnostic criteria for probable Alzheimer’s disease (NINADS-ADRDA) – clinical examination	Receiving diabetes therapy or HbA_1c > 5.9% or diagnosis according to ADA guidelines	NA	NA
Saposnik et al., 2011,¹²⁹ Canada	Retrospective cohort	Stroke and dementia	Medical records and clinical examination	Any type of dementia recorded in notes	NA	Canadian Neurological Scale – clinical examination	NA
Schubert et al., 2006,² USA	Cross-sectional	Dementia	Medical records and clinical examination	ICD-10 – clinical examination	Coded ICD diagnosis	Coded ICD diagnosis	NA	Chronic Disease Score
Stephan et al., 2011,¹³⁴ UK	Cross-sectional	MCI	Face-to-face interview	Mayo Clinic criteria for MCI	Self- or information response	Self- or information response
Uhlmann et al., 1991,¹³⁷ USA	Case–control	Dementia	Medical records	Diagnostic criteria for probable Alzheimer’s disease (NINADS-ADRDA)	NA	NA	Snellen and Rosenbaum methods²⁴⁹
Whitson et al., 2010,¹⁴⁰ USA	Cross-sectional	VI (macular disease)	Clinical examination	Telephone Interview for Cognitive Status–Modified, Wechsler Memory Scale–Revised, letter fluency (FAS^a)	NA	NA	Diagnosis in medical records
Yochim et al., 2012,¹⁴¹ USA	Case series	VI (glaucoma)	Data collection face to face or by telephone	California Verbal Learning Test Short Form, verbal fluency test (Delis–Kaplan Executive Function System)			Diagnosis in medical records
Zamrini et al., 2004,¹⁴² USA	Case–control	Dementia	Medical records	Diagnostic criteria for probable Alzheimer’s disease (NINADS-ADRDA)	Diagnosis in medical records	Diagnosis in medical records	Diagnosis in medical records
Zekry et al., 2008,¹⁴³ Switzerland	Cohort	Dementia	Clinical examination and medical records	MMSE and short cognitive evaluation; diagnosis based on clinical criteria (clinical examination)	Diagnosis in medical records	Diagnosis in medical records	Diagnosis in medical records	Charleston Comorbidity Index
Zhang et al., 2010,¹⁴⁵ Australia	Retrospective cohort	Diabetes	Medical claims database	Database information on whether or not medication for dementia was dispensed	ICD codes

: ADA, American Diabetes Association; Revised; DSM-III-R, Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition Revised HbA_1c, glycated haemoglobin; ICD, International Classification of Diseases; ICD-9-CM, International Classification of Diseases, 9th Revision, Clinical Modification; ICD-10, International Classification of Diseases, 10th Revision; IQCODE, Informant Questionnaire for Cognitive Decline in the Elderly; NA, not applicable; NINADS–ADRDA, National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer’s Disease and Related Disorders Association.
a: Letters used in the letter fluency test (FAS).²⁵⁰

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Bunn F, Burn AM, Goodman C, et al. Comorbidity and dementia: a mixed-method study on improving health care for people with dementia (CoDem). Southampton (UK): NIHR Journals Library; 2016 Feb. (Health Services and Delivery Research, No. 4.8.) Appendix 4, Additional tables for the scoping review.
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