Prevalence of neurological conditions across the continuum of care based on interRAI assessments.
BACKGROUND
Although multiple studies have estimated the prevalence of neurological conditions in the general Canadian population, limited research exists regarding the proportion affected with these conditions in non-acute health care settings in Canada. Data from standardized clinical assessments based on the interRAI suite of instruments were used to estimate the prevalence of eight neurological conditions across the continuum of care including Alzheimer's disease, Parkinson's disease, epilepsy, traumatic brain injury, multiple sclerosis, cerebral palsy, Huntington's disease, and amyotrophic lateral sclerosis.


METHODS
Cohorts of individuals receiving care in nursing homes (N=103,820), home care (N=91,021), complex continuing care (N=10,581), and psychiatric hospitals (N=23,119) in Canada were drawn based on their most recent interRAI assessment within each sector for a six-month period in 2010. These data were linked to the Discharge Abstract Database and National Ambulatory Care Reporting System data sets to develop five different case definition scenarios for estimating prevalence.


RESULTS
The conditions with the highest estimated prevalences in these care settings in Canada were Alzheimer's disease and related dementias, Parkinson's disease, epilepsy, and traumatic brain injury. However, there were notable cross-sector differences in the prevalence of each condition, and regional variations. Prevalence estimates based on acute hospital administrative data alone were substantially lower for all conditions evaluated.


CONCLUSIONS
The proportion of persons with neurological conditions in non-acute health care settings in Canada is substantially higher than is generally reported for the general population. It is essential for these care settings to have the expertise and resources to respond effectively to the strengths, preferences, and needs of the growing population of persons with neurological conditions. The use of hospital or emergency department records alone is likely to substantially underestimate the true prevalence of neurological conditions across the continuum of care. However, interRAI assessment records provide a helpful source of information for obtaining these estimates in nursing home, home care, and mental health settings.
School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada. omdanila@uwaterloo.ca.
Oana
O
Danila
John P
JP
Hirdes
Colleen J
CJ
Maxwell
Ruth Ann
RA
Marrie
Scott
S
Patten
Tamara
T
Pringsheim
Nathalie
N
Jetté
D000544:Alzheimer Disease / Q000453:epidemiology / Q000628:therapy; D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology / Q000628:therapy; D001930:Brain Injuries / Q000453:epidemiology / Q000628:therapy; D002170:Canada / Q000453:epidemiology; D002547:Cerebral Palsy / Q000453:epidemiology / Q000628:therapy; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D004827:Epilepsy / Q000453:epidemiology / Q000628:therapy; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D006816:Huntington Disease / Q000453:epidemiology / Q000628:therapy; D009103:Multiple Sclerosis / Q000453:epidemiology / Q000628:therapy; D009422:Nervous System Diseases / Q000453:epidemiology* / Q000628:therapy; D009735:Nursing Homes / Q000706:statistics & numerical data; D010300:Parkinson Disease / Q000453:epidemiology / Q000628:therapy; D015995:Prevalence