London, Sabina R., Chen, Shanquan, Sidhom, Emad, Lewis, Jonathan R., Wolverson, Emma, Cardinal, Rudolf N., Roalf, David, Mueller, Christoph and Underwood, Benjamin R. (2024) Predicting patients with dementia most at risk of needing psychiatric in-patient or enhanced community care using routinely collected clinical data: retrospective multi-site cohort study. The British Journal of Psychiatry, 224 (6). pp. 221-229. ISSN 0007-1250

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Abstract

Background
Dementia is a common and progressive condition whose prevalence is growing worldwide. It is challenging for healthcare systems to provide continuity in clinical services for all patients from diagnosis to death.

Aims
To test whether individuals who are most likely to need enhanced care later in the disease course can be identified at the point of diagnosis, thus allowing the targeted intervention.

Method
We used clinical information collected routinely in de-identified electronic patient records from two UK National Health Service (NHS) trusts to identify at diagnosis which individuals were at increased risk of needing enhanced care (psychiatric in-patient or intensive (crisis) community care).

Results
We examined the records of a total of 25 326 patients with dementia. A minority (16% in the Cambridgeshire trust and 2.4% in the London trust) needed enhanced care. Patients who needed enhanced care differed from those who did not in age, cognitive test scores and Health of the Nation Outcome Scale scores. Logistic regression discriminated risk, with an area under the receiver operating characteristic curve (AUROC) of up to 0.78 after 1 year and 0.74 after 4 years. We were able to confirm the validity of the approach in two trusts that differed widely in the populations they serve.

Conclusions
It is possible to identify, at the time of diagnosis of dementia, individuals most likely to need enhanced care later in the disease course. This permits the development of targeted clinical interventions for this high-risk group.

Item Type:	Article
Identifier:	10.1192/bjp.2024.14
Keywords:	Dementias/neurodegenerative diseases ; mental health services ; epidemiology ; clinical interventions ; intensive support
Subjects:	Medicine and health > Clinical medicine > Dementia Medicine and health > Mental health
Date Deposited:	12 Jun 2026
Dates:	Date Publication status 13 May 2024 Published Online
School, department or research centre:	School of Medicine and Biosciences The Geller Institute of Ageing and Memory
Keywords:	Dementias/neurodegenerative diseases ; mental health services ; epidemiology ; clinical interventions ; intensive support
URI:	https://repository.uwl.ac.uk/id/eprint/15042

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