BMJ Open. 2026 Aug 28;16(8):e115438. doi: 10.1136/bmjopen-2025-115438.
ABSTRACT
OBJECTIVES: To characterise demographics, comorbidities, co-medications and healthcare resource utilisation (HCRU) in patients newly diagnosed with Alzheimer’s disease (AD) in England using published and validated AD algorithms.
DESIGN: Observational cohort study.
SETTING: Real-world data in England from the Clinical Practice Research Datalink Aurum primary care database linked to the Hospital Episode Statistics secondary care database.
PARTICIPANTS: Two disease-based algorithms (Imfeld et al and Douros et al) and one medication-based algorithm (Schroeder et al) were selected from the literature to identify patients with AD. The index period for patient selection was from 1 January to 31 December 2019. Patients were grouped into three non-mutually exclusive cohorts reflecting these algorithms (cohorts A-C), then patients aged ≥60 years were further grouped into three subcohorts (subcohorts 1-3). Subcohort 1 included 9826 patients, subcohort 2 included 10 265 patients and subcohort 3 included 7355 patients.
PRIMARY OUTCOME MEASURES: Demographics, comorbidities, co-medications and HCRU present up to and including the date of cohort qualification were described.
RESULTS: Across subcohorts 1-3, mean age at index ranged from 81 to 83 years, and most patients were female (59%-63%) and White (93%). Common comorbidities were hypertension (67%-71%), asthma and chronic obstructive pulmonary disease (60%-63%) and arthritis and osteoarthritis (51%-53%). Common co-medications were analgesics (87%-89%), systemic corticosteroids (83%-84%) and anti-inflammatory and anti-rheumatic agents (81%-82%). Up to 34% of patients had a specialist referral or visit, with up to 18% involving a neurologist. In the 12 months prior to and including the index date, up to 46% of patients had an emergency department visit or inpatient visit for any cause.
CONCLUSIONS: In England, most newly diagnosed patients with AD were White females in their early 80s with common comorbidities including hypertension, asthma, chronic obstructive pulmonary disease, arthritis and osteoarthritis. This study addresses a critical evidence gap by quantifying the England-specific burden of comorbidity, polypharmacy, and HCRU among patients with AD using multiple validated and published AD algorithms. Findings were broadly consistent across the three subcohorts identified using disease-based and medication-based algorithms, strengthening internal validity of the study and demonstrating that the findings are robust to the method of AD case definition. This study provides a novel insight into the real-world AD population in England, and findings may help healthcare professionals to identify patients living with AD, understand patients’ needs and tailor treatment strategies.
PMID:42665355 | DOI:10.1136/bmjopen-2025-115438
