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

<h4>Background</h4>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.<h4>Objective</h4>To evaluate participant...

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Autores principales:	Leslie N Chan, Alexa Magyari, Morgan Ye, Noor A Al-Alusi, Sinead M Langan, David Margolis, Charles E McCulloch, Katrina Abuabara
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/977c06348c8449ecb22911b189b39ccb
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spelling	oai:doaj.org-article:977c06348c8449ecb22911b189b39ccb2021-12-02T20:17:16ZThe epidemiology of atopic dermatitis in older adults: A population-based study in the United Kingdom.1932-620310.1371/journal.pone.0258219https://doaj.org/article/977c06348c8449ecb22911b189b39ccb2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258219https://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Objective</h4>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.<h4>Methods</h4>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).<h4>Results</h4>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.<h4>Conclusion</h4>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.Leslie N ChanAlexa MagyariMorgan YeNoor A Al-AlusiSinead M LanganDavid MargolisCharles E McCullochKatrina AbuabaraPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258219 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Leslie N Chan Alexa Magyari Morgan Ye Noor A Al-Alusi Sinead M Langan David Margolis Charles E McCulloch Katrina Abuabara The epidemiology of atopic dermatitis in older adults: A population-based study in the United Kingdom.
description	<h4>Background</h4>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.<h4>Objective</h4>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.<h4>Methods</h4>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).<h4>Results</h4>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.<h4>Conclusion</h4>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.
format	article
author	Leslie N Chan Alexa Magyari Morgan Ye Noor A Al-Alusi Sinead M Langan David Margolis Charles E McCulloch Katrina Abuabara
author_facet	Leslie N Chan Alexa Magyari Morgan Ye Noor A Al-Alusi Sinead M Langan David Margolis Charles E McCulloch Katrina Abuabara
author_sort	Leslie N Chan
title	The epidemiology of atopic dermatitis in older adults: A population-based study in the United Kingdom.
title_short	The epidemiology of atopic dermatitis in older adults: A population-based study in the United Kingdom.
title_full	The epidemiology of atopic dermatitis in older adults: A population-based study in the United Kingdom.
title_fullStr	The epidemiology of atopic dermatitis in older adults: A population-based study in the United Kingdom.
title_full_unstemmed	The epidemiology of atopic dermatitis in older adults: A population-based study in the United Kingdom.
title_sort	epidemiology of atopic dermatitis in older adults: a population-based study in the united kingdom.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/977c06348c8449ecb22911b189b39ccb
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The epidemiology of atopic dermatitis in older adults: A population-based study in the United Kingdom.

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