Public Health.

Area of Science:

• Neurology and Public Health
• Gerontology
• Epidemiology

Background:

• Multimorbidity and accumulation of long-term conditions (LTCs) across the lifespan are linked to increased dementia risk.
• Understanding LTC prevalence in real-world clinical settings is crucial for dementia prevention strategies.

Purpose of the Study:

• To characterize the accumulation of LTCs in a memory clinic population.
• To compare LTC prevalence between a real-world memory clinic cohort (Oxford Brain Health Clinic - OBHC) and a large population cohort (UK Biobank - UKB).

Main Methods:

• Retrospective analysis of primary care records for 190 NHS memory clinic patients (OBHC).
• Extraction and grouping of 31 prioritized LTCs, with comparison to UK Biobank data.
• Exclusion of UK Biobank participants younger than 65 or deceased before 65; supplementary analysis included only dementia patients.

Main Results:

• OBHC patients averaged 4 comorbid diagnoses before clinic visits; osteoarthritis and hypertension were most common.
• Psychiatric conditions were prevalent in early adulthood, while cardiovascular conditions accumulated most rapidly in midlife.
• Arthritis, depression, and IBS were more prevalent in OBHC than UKB; OBHC dementia patients had lower prevalences of hypertension, cardiovascular disease, and anemia compared to UKB.

Conclusions:

• Significant differences exist in LTC prevalence between real-world patient samples and large population cohorts.
• Harmonizing comparable data across research and clinical cohorts is essential for understanding multimorbidity's impact on brain health.
• Findings highlight the need for personalized interventions informed by diverse cohort data.