title: Effect of dementia on receipt of influenza vaccine: a cohort study in French older adults using administrative data: 2007-2012.
abstract: Despite guidelines stating the vaccine benefit in this population, older adults with dementia may be less likely to receive influenza vaccine than cognitively intact older adults. But no study has yet reported on vaccine uptake in patients newly diagnosed with dementia or whether years since dementia diagnosis influences vaccine uptake. We conducted a cohort study in the French Health Insurance database (Echantillon Généraliste de Bénéficiaires) which contains hospital data and claims for a 1/97th random sample of the French population. Diseased subjects were ≥65 years and had a new record of dementia diagnosis between September 1, 2007, and August 31, 2008. Vaccine receipt was measured via influenza vaccine dispensing in community pharmacies. We described influenza vaccination rates up to 2011-2012 and estimated adjusted relative risks (aRR) for vaccine receipt each year using multivariate modified Poisson models controlling for sociodemographics, comorbidities, and health resources use. Four hundred and seven subjects with dementia (mean age 81.8 years, 69.3% females) and 4862 subjects (mean age 75.2 years, 61.3% females) without dementia were included. In 2008-2009, influenza vaccination prevalence was 70.0% (95% CI = [65.3-74.4]) and 70.2% (95% CI = [68.9-71.4]) in subjects with and without dementia, respectively (aRR = 0.93; 95% CI = [0.87-1.00]). In 2009-2010, the aRR was of the same magnitude (aRR = 0.96, 95% CI = [0.90-1.03]), but in 2010-2011 and 2011-2012, the aRR was 1.02 (95% CI = [0.94-1.11]) and 1.05 (95% CI = [0.96-1.14]), respectively. Subjects with dementia had a slightly nonsignificant lower receipt of influenza vaccine in the year following dementia diagnosis than subjects without dementia. In subsequent years, divergent trends were observed in vaccine uptake according to dementia status.
authors.affiliation: UMR 1027, Epidémiologie et Analyses en Santé Publique: Risques, Maladies Chroniques et Handicaps, Inserm, Toulouse, F-31000, France.|Université de Toulouse III, Toulouse, F-31000, France.|Service d'Epidémiologie, CHU Toulouse, Toulouse, F-31000, France.
authors.forename: Adeline
authors.identifier: http://orcid.org/0000-0002-5975-6975
authors.initials: A
authors.lastname: Gallini
authors.affiliation: UMR 1027, Epidémiologie et Analyses en Santé Publique: Risques, Maladies Chroniques et Handicaps, Inserm, Toulouse, F-31000, France.|Université de Toulouse III, Toulouse, F-31000, France.|Service d'Epidémiologie, CHU Toulouse, Toulouse, F-31000, France.
authors.forename: Nicola
authors.initials: N
authors.lastname: Coley
authors.affiliation: UMR 1027, Epidémiologie et Analyses en Santé Publique: Risques, Maladies Chroniques et Handicaps, Inserm, Toulouse, F-31000, France.|Université de Toulouse III, Toulouse, F-31000, France.|Service d'Epidémiologie, CHU Toulouse, Toulouse, F-31000, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Andrieu
authors.affiliation: UMR 1027, Epidémiologie et Analyses en Santé Publique: Risques, Maladies Chroniques et Handicaps, Inserm, Toulouse, F-31000, France.|Université de Toulouse III, Toulouse, F-31000, France.|Service de Pharmacologie Clinique, CHU Toulouse, Toulouse, F-31000, France.
authors.forename: Maryse
authors.initials: M
authors.lastname: Lapeyre-Mestre
authors.affiliation: UMR 1027, Epidémiologie et Analyses en Santé Publique: Risques, Maladies Chroniques et Handicaps, Inserm, Toulouse, F-31000, France.|Université de Toulouse III, Toulouse, F-31000, France.|Service d'Epidémiologie, CHU Toulouse, Toulouse, F-31000, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Gardette
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016208:Databases, Factual / Q000639:trends*; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D011897:Random Allocation; D014611:Vaccination / Q000639:trends*
chemical_list: D007252:Influenza Vaccines
keywords: Alzheimer's disease; care; dementia; influenza; older adults; preventive; vaccine