Proposed approach to fill data gaps on selected chronic diseases: mental disorders and dementia/alzheimer s disease OECD Health Data National Correspondents 8-9 October 2009 1
Background Broad approach on chronic diseases was presented at the 2008 Meeting of OECD Health Data National Correspondents [DELSA/HEA/HD(2008)8] Two criteria were used to select chronic diseases for reporting in OECD Health Data: 1. Disease burden 2. Data feasibility 2
10 leading causes of BOD in high-income countries, 2004 Cause DALYs (millions of years) Percentage of total DALY s 1. Depression (Unipolar depressive disorders) 10.0 8.2 2. Ischaemic heart disease 7.7 6.3 3. Cerebrovascular disease (stroke) 4.8 3.9 4. Alzheimer s and other dementias 4.4 3.6 5. Alcohol use disorders 4.2 3.4 6. Hearing loss, adult onset 4.2 3.4 7. Chronic obstructive pulmonary disease 3.7 3.0 8. Diabetes mellitus 3.6 3.0 9. Trachea, bronchus, lung cancers 3.6 3.0 10. Road traffic accidents 3.1 2.6 3
10 leading causes of BOD in high-income countries, 2004 Cause DALYs (millions of years) Percentage of total DALY s 1. Depression (Unipolar depressive disorders) 10.0 8.2 2. Ischaemic heart disease 7.7 6.3 3. Cerebrovascular disease (stroke) 4.8 3.9 4. Alzheimer s and other dementias 4.4 3.6 5. Alcohol use disorders 4.2 3.4 6. Hearing loss, adult onset 4.2 3.4 7. Chronic obstructive pulmonary disease 3.7 3.0 8. Diabetes mellitus 3.6 3.0 9. Trachea, bronchus, lung cancers 3.6 3.0 10. Road traffic accidents 3.1 2.6 4
Current initiatives in measuring the prevalence of dementia/alzheimer s and mental disorders European Collaboration on Dementia (EuroCoDe), European OECD countries we will hear from Dr Reynish on this work WHO World Mental Health Surveys, including the European Study of the Epidemiology of Mental Disorders (ESEMeD), 12 OECD countries we will hear from Dr Kovess on this work 5
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Data feasibility for prevalence of dementia/alzheimer s disease Many (but not all) OECD countries already have population-based prevalence rates Need to better harmonise definitions and methodologies to enable better comparisons Further work required on the prevalence of different types of dementia, and on data for countries without estimates or whose estimates are restricted to certain settings 7
Data feasibility for prevalence of mental disorders, such as depression and anxiety Many OECD countries have information on the prevalence of mental disorders, usually from population-based surveys But there are numerous comparability problems across countries: 1. Collection instruments differ, e.g. SF-36 and CIDI 2. Disease definitions may differ 3. Use of self-report vs. clinical diagnosis 4. Surveyed populations differ 8
Possible indicators to measure disease prevalence (1) Disease / condition Possible indicators Possible approach / sources Alzheimer s disease and other dementias Prevalence of dementia per 1,000 population (age group to be determined) Results from EuroCoDe (European Collaboration on Dementia), and other international collaborations Add national prevalence estimates for non-european countries, if suitably comparable 9
Possible indicators to measure disease prevalence (2) Disease / condition Possible indicators Possible approach / sources Mental disorders (based on the CIDI instrument) Prevalence (%) of: (i) Any anxiety disorder (ii) Any mood disorder (iii) Any impulse-control disorder (iv) Any substance disorder (v) Any of the above Results from WHO World Mental Health Surveys, including the European Study of the Epidemiology of Mental Disorders (ESEMeD), for 12 OECD countries Results from complementary EC work, e.g. the MINDFUL project, Comparable data from other countries Mental health functioning (based on the SF-36 instrument) Prevalence of: (i) Psychological distress (ii) Psychological impairment (iii) Energy-vitality National results from subscales of SF-36 instrument, which is being administered as a health survey module in many OECD countries, and is included in the European Health Interview Survey (EHIS), which will be administered in 14 OECD countries by 2010 Included in the MINDFUL project database (14-15 OECD countries) Included in the Eurobarometer on an ad hoc basis 10
Proposed next steps Further developmental work to take into account results from international projects Examine data availability and comparability in countries that are not participating in international collaborations 11
Issues for discussion Seek comments from OECD Health Data National Correspondents on the availability of data from their country for the proposed set of indicators on mental disorders and dementia/alzheimer s disease 12