Treatment pathway analysis of newly diagnosed dementia patients in four electronic health record databases in Europe

Research output: Contribution to journalArticlepeer-review


  • Glen James
  • Estelle Collin
  • Marcus Lawrance
  • Achim Mueller
  • Jana Podhorna
  • And 16 others
  • Liliana Zaremba-Pechmann
  • Peter Rijnbeek
  • Johan van der Lei
  • Paul Avillach
  • Lars Pedersen
  • David Ansell
  • Alessandro Pasqua
  • Mees Mosseveld
  • Solène Grosdidier
  • Usha Gungabissoon
  • Peter Egger
  • Robert Stewart
  • Carlos Celis-Morales
  • Myriam Alexander
  • Gerald Novak
  • Mark Forrest Gordon

Colleges, School and Institutes

External organisations

  • AstraZeneca
  • Servier
  • GlaxoSmithKline
  • Boehringer Ingelheim Pharma GmbH & Co. KG
  • Erasmus MC
  • Harvard Medical School
  • Aarhus Universitet
  • The Health Improvement Network
  • Health Search Database
  • King's College London
  • South London and Maudsley NHS Foundation Trust
  • University of Glasgow
  • Janssen Pharmaceuticals, Inc.
  • Teva Pharmaceuticals Inc.


Purpose: Real-world studies to describe the use of first, second and third line therapies for the management and symptomatic treatment of dementia are lacking. This retrospective cohort study describes the first-, second- and third-line therapies used for the management and symptomatic treatment of dementia, and in particular Alzheimer’s Disease. Methods: Medical records of patients with newly diagnosed dementia between 1997 and 2017 were collected using four databases from the UK, Denmark, Italy and the Netherlands. Results: We identified 191,933 newly diagnosed dementia patients in the four databases between 1997 and 2017 with 39,836 (IPCI (NL): 3281, HSD (IT): 1601, AUH (DK): 4474, THIN (UK): 30,480) fulfilling the inclusion criteria, and of these, 21,131 had received a specific diagnosis of Alzheimer’s disease. The most common first line therapy initiated within a year (± 365 days) of diagnosis were Acetylcholinesterase inhibitors, namely rivastigmine in IPCI, donepezil in HSD and the THIN and the N-methyl-d-aspartate blocker memantine in AUH. Conclusion: We provide a real-world insight into the heterogeneous management and treatment pathways of newly diagnosed dementia patients and a subset of Alzheimer’s Disease patients from across Europe.


Original languageEnglish
JournalSocial Psychiatry and Psychiatric Epidemiology
Publication statusAccepted/In press - 2020


  • Alzheimer’s disease, Dementia, Epidemiology, Real-world data

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