{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:30:30Z","timestamp":1792524630855,"version":"4.5.0"},"reference-count":81,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"unspecified","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,24]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To characterise demographics, comorbidities, co-medications and healthcare resource utilisation (HCRU) in patients newly diagnosed with Alzheimer\u2019s disease (AD) in England using published and validated AD algorithms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Real-world data in England from the Clinical Practice Research Datalink Aurum primary care database linked to the Hospital Episode Statistics secondary care database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Two disease-based algorithms (Imfeld\n                      <jats:italic>et al<\/jats:italic>\n                      and Douros\n                      <jats:italic>et al<\/jats:italic>\n                      ) and one medication-based algorithm (Schroeder\n                      <jats:italic>et al<\/jats:italic>\n                      ) 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\u2013C), then patients aged \u226560 years were further grouped into three subcohorts (subcohorts 1\u20133). Subcohort 1 included 9826 patients, subcohort 2 included 10\u2009265 patients and subcohort 3 included 7355 patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>Demographics, comorbidities, co-medications and HCRU present up to and including the date of cohort qualification were described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across subcohorts 1\u20133, mean age at index ranged from 81 to 83 years, and most patients were female (59%\u201363%)\u2009and White (93%). Common comorbidities were hypertension (67%\u201371%), asthma and chronic obstructive pulmonary disease (60%\u201363%) and arthritis and osteoarthritis (51%\u201353%). Common co-medications were analgesics (87%\u201389%), systemic corticosteroids (83%\u201384%) and anti-inflammatory and anti-rheumatic agents (81%\u201382%). 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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\u2019 needs and tailor treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-115438","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T11:05:36Z","timestamp":1787915136000},"page":"e115438","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Characterising patients with Alzheimer\u2019s disease in England: a cohort study using data from Clinical Practice Research Datalink linked to Hospital Episode Statistics"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0717-7963","authenticated-orcid":false,"given":"Ana Sofia","family":"Afonso","sequence":"first","affiliation":[{"name":"Eli Lilly Nederland B.V, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista Marie","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company, Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company, Bracknell, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natacha","family":"Carragher","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company, Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Casey","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company, Basingstoke, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niraj","family":"Patel","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company, Basingstoke, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"2026082804050753000_16.8.e115438.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32205-4"},{"key":"2026082804050753000_16.8.e115438.2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13016"},{"key":"2026082804050753000_16.8.e115438.3","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1007\/s40120-021-00272-1","article-title":"Estimating progression rates across the spectrum of alzheimer\u2019s disease for amyloid-positive individuals using national alzheimer\u2019s coordinating center data","volume":"10","author":"Potashman","year":"2021","journal-title":"Neurol Ther"},{"key":"2026082804050753000_16.8.e115438.4","doi-asserted-by":"crossref","unstructured":"DeTure MA , Dickson DW . 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