Cited by 105Dementia and Cognitive Impairment ResearchStatistical Methods in EpidemiologyAlzheimer's disease research and treatments

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Impact of referral bias on clinical and epidemiological studies of Alzheimer's disease

Kokmen, Emre, Özsarfati, Yasef, Beard, C.Mary, O'Brien, Peter C., Rocca, Walter A.·1996·Journal of Clinical Epidemiology

DOI 10.1016/0895-4356(95)00031-3

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Abstract

We used the resources of the Rochester Epidemiology Project to compare sociodemographic and clinical characteristics in three groups of Alzheimer's disease patients. The first group included incidence cases occurring among residents of Rochester, Minnesota (population-based series; n = 241). The second group was a sample of patients referred to the Mayo Clinic form the remainder of Minnesota and the four surrounding states (n = 58); the third was a sample referred from the remainder of the United States (n = 94). Patients from Rochester were more frequently women, less highly educated, less commonly white collar workers, more frequently institutionalized, less frequently married, and more often lived along than those in the two referral groups. Patients from Rochester also had a more advanced age of onset of dementia. For occupation, education, and living arrangement, the differences across groups increased with increasing distance of referral. Clinical and epidemiological studies based on patients referred form primary to secondary or tertiary care centers may suffer from severe selection bias.

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Authors: Kokmen, E., Özsarfati, Y., Beard, C. M., O'Brien, P. C., & Rocca, W. A.
Affiliations: Mayo Clinic (US)
Istanbul University-Cerrahpaşa (TR)
Corresponding author: Kokmen, Emre
ORCID: Rocca, Walter A.
Venue: Journal of Clinical Epidemiology
Publisher: Elsevier BV
Published: 1996-01
Volume: 49
Issue: 1
Pages: 79-83
ISSN: 0895-4356 (ISSN-L)
DOI: 10.1016/0895-4356(95)00031-3
OpenAlex: W1989009094
Cited by: 105
References: 26
Citations by year: 2026: 1 · 2025: 2 · 2023: 1 · 2022: 1 · 2021: 9 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 3 · 2016: 8 · 2015: 5 · 2014: 2 · 2013: 4 · 2012: 5
FWCI: 5.33
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Clinical Epidemiology (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute on Aging (AG-08031, P30AG008031, AG-06786, U01AG006786)
National Institute of Neurological Disorders and Stroke (NS17750)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
Keywords: referral bias, selection bias, Alzheimer's disease, dementia, Rochester Epidemiology Project, sociodemographic factors, age of onset, institutionalization, tertiary care hospital, population-based incidence
MeSH terms: Adult, Aged, Aged, 80 and over, Alzheimer Disease, Demography, Female, Humans, Male, Middle Aged, Minnesota, Referral and Consultation, Socioeconomic Factors, Bias, Incidence, Patient Selection

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Impact of referral bias on clinical and epidemiological studies of Alzheimer's disease

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