The epidemiology of atopic dermatitis in older adults: A population-based study in the United Kingdom

被引:40
作者
Chan, Leslie N. [1 ]
Magyari, Alexa [2 ]
Ye, Morgan [3 ]
Al-Alusi, Noor A. [1 ]
Langan, Sinead M. [4 ]
Margolis, David [5 ]
McCulloch, Charles E. [6 ]
Abuabara, Katrina [3 ]
机构
[1] Univ Calif San Francisco, Sch Med, San Francisco, CA 94143 USA
[2] Univ Calif Berkeley, Berkeley, CA 94720 USA
[3] Univ Calif San Francisco, Dept Dermatol, San Francisco, CA 94143 USA
[4] London Sch Hyg & Trop Med, Dept Noncommun Dis Epidemiol, London, England
[5] Univ Penn, Dept Dermatol, Perelman Sch Med, Philadelphia, PA 19104 USA
[6] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
基金
美国国家卫生研究院; 英国惠康基金;
关键词
NATIONAL-HEALTH; ECZEMA; PREVALENCE; ASTHMA; ASSOCIATIONS; PROGNOSIS;
D O I
10.1371/journal.pone.0258219
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Atopic dermatitis is known to be common among children, but there are few studies examining the epidemiology across the life course. In particular, there is a paucity of data on atopic dermatitis among older adults. Objective To evaluate participant characteristics, patterns of disease activity and severity, and calendar trends in older adult atopic dermatitis in comparison to other age groups in a large population-based cohort. Methods This was a cohort study of 9,154,936 individuals aged 0-99 years registered in The Health Improvement Network, a database comprised of electronic health records from general practices in the United Kingdom between 1994 and 2013. Atopic dermatitis was defined by a previously validated algorithm using a combination of at least one recorded atopic dermatitis diagnostic code in primary care and two atopic dermatitis therapies recorded on separate days. Cross-sectional analyses of disease prevalence were conducted at each age. Logistic mixed effect regression models were used to identify predictors of prevalent disease over time among children (0-17 years), adults (18-74 years), and older adults (75-99 years). Results Physician-diagnosed atopic dermatitis was identified in 894,454 individuals with the following proportions in each age group: 18.3% of children, 7.7% of adults, and 11.6% of older adults. Additionally, atopic dermatitis prevalence increased across the 2-decade period (beta from linear regression test for trend in the change in proportion per year = 0.005, p = 0.044). In older adults, atopic dermatitis was 27% less common among females (adjusted OR 0.73, 95% CI 0.70-0.76) and was more likely to be active (59.7%, 95% CI 59.5-59.9%) and of higher severity (mean annual percentage with moderate and severe disease: 31.8% and 3.0%, respectively) than in other age groups. Conclusion In a large population-based cohort, the prevalence of physician-diagnosed atopic dermatitis has increased throughout adulthood and was most common among males age 75 years and above. Compared to children ages 0-17 and adults ages 18-74, older adult atopic dermatitis was more active and severe. Because the prevalence of atopic dermatitis among older adults has increased over time, additional characterization of disease triggers and mechanisms and targeted treatment recommendations are needed for this population.
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页数:14
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