Patient Variables Associated with the Assignment of a Formal Dementia Diagnosis to Positively Screened Primary Care Patients

Author(s): Tilly Eichler, Jochen Rene Thyrian*, Johannes Hertel, Steffen Richter, Bernhard Michalowsky, Diana Wucherer, Adina Dreier, Ingo Kilimann, Stefan Teipel, Wolfgang Hoffmann.

Journal Name: Current Alzheimer Research

Volume 15 , Issue 1 , 2018

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Abstract:

Background: Main objective was to analyze the associations of patient variables (depression, quality of life, anti-dementia drug treatment, knowledge about dementia) with the assignment of a formal diagnosis of dementia to community-dwelling primary care patients who have screened positive for dementia.

Methods: DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania) is a general practitioner based randomized controlled intervention trial. Present analyses are based on cross-sectional data of 319 positively screened patients (age 70+, living at home) who had not been formally diagnosed with dementia before the screening. The medical diagnoses (ICD-10) were retrieved from the patient's medical records. Depression (Geriatric Depression Scale; GDS), quality of life in Alzheimer's disease (Qol-AD), knowledge about dementia, and anti-dementia drug treatment were assessed after the screening test at the baseline examination.

Results: At the baseline examination, 171 out of 319 patients (54%) had been formally diagnosed with dementia after they have screened positive. Univariate comparisons showed no statistically significant differences between diagnosed and undiagnosed patients regarding depression (GDS≥6: 11% vs. 15%; p=0.396), quality of life (mean (SD): 2.8 (0.3) vs. 2.8 (0.4); p=0.833), and the knowledge about dementia (75% vs. 75%; p>0.999). Patients who had received a formal diagnosis were more often treated with anti-dementia drugs (20% vs. 11%; p=0.040). Multivariate analyses controlled for confounding variables confirmed these findings.

Conclusion: Present findings do not support concerns that the assignment of a formal dementia diagnosis after screening is associated with potential harms. If confirmed in a prospective study, our data would suggest that patients may benefit from being formally diagnosed regarding anti-dementia drug treatment.

Keywords: Dementia, screening, primary care, formal diagnosis of dementia, depression, quality of life, anti-dementia drug treatment, DelpHi-trial.

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Article Details

VOLUME: 15
ISSUE: 1
Year: 2018
Page: [44 - 50]
Pages: 7
DOI: 10.2174/1567205014666170908095707

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