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Trends of patient referral to a memory clinic and towards earlier diagnosis from 1985–2009

Published online by Cambridge University Press:  01 October 2015

Timo Grimmer ,
Stephanie Beringer ,
Victoria Kehl ,
Panagiotis Alexopoulos ,
Aurel Busche ,
Hans Förstl ,
Oliver Goldhardt ,
Bianca Natale ,
Marion Ortner  and
Henning Peters
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Timo Grimmer*
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 Munich, Germany
Stephanie Beringer
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 Munich, Germany
Victoria Kehl
Affiliation:
Institute for Medical Statistics and Epidemiology, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 Munich, Germany
Panagiotis Alexopoulos
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 Munich, Germany
Aurel Busche
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 Munich, Germany
Hans Förstl
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 Munich, Germany
Oliver Goldhardt
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 Munich, Germany
Bianca Natale
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 Munich, Germany
Marion Ortner
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 Munich, Germany
Henning Peters
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 Munich, Germany
Lina Riedl
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 Munich, Germany
Carola Roßmeier
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 Munich, Germany
Wiebke Valentin
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 Munich, Germany
Janine Diehl-Schmid
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 Munich, Germany
Alexander Kurz
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 Munich, Germany
*
Correspondence should be addressed to: Priv. Doz. Dr. Timo Grimmer, MD, Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Möhlstr. 26, 81675 München, Germany. Phone: +49/89/4140-4262; Fax: + 49/89/4140-4923. Email: [email protected].
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Abstract

Background:

It may be assumed that increased public awareness of dementia due to Alzheimer's disease (AD) together with the availability of efficacious treatment will result in diagnostic evaluation at earlier stages of cognitive decline and diagnosis of dementia due to AD at earlier stages.

Methods:

All persons that were examined at a university based memory clinic, in Germany, between 1985 and 2009 were included.

Results:

In the 3,951 persons identified, linear regression analysis revealed a positive association between Mini Mental State Examination (MMSE) score and year of initial examination (yearIE) (β = 0.266; p < 0.001). In the 1,821 patients diagnosed with dementia due to AD, a positive association between MMSE score and yearIE (β = 0.230; p < 0.001) was revealed. MMSE scores were higher (β = 0.195; p < 0.001) after the introduction of cholinesterase inhibitors in Germany in 1997.

Conclusions:

Diagnostic evaluation of individuals occurred at progressively earlier stages of cognitive decline. Dementia due to AD was diagnosed at progressively earlier stages, and this trend was associated with the availability of efficacious treatment. This is the first study on changes in patient referral and diagnosis based on a continuous 25 years period.

Keywords

Alzheimer’s disease (AD)dementiamini-mental state examination (MMSE)early diagnosistrends of patient referral
Type
2015 IPA Junior Research Awards – Second Prize Winner
Information
International Psychogeriatrics , Volume 27 , Issue 12 , December 2015 , pp. 1939 - 1944
Copyright
Copyright © International Psychogeriatric Association 2015 

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