Diagnoseverfahren bei Patienten mit leichten kognitiven Störungen und bei Patienten mit Demenz

Schulz, Mandy; Stillfried, Dominik von; Bohlken, Jens

doi:10.1007/s00115-019-00829-4

Cited by 10 publications

(10 citation statements)

References 40 publications

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“…Our data shows that the majority of PwD (62%) saw a specialist in addition to their GP. Collaborations between GPs and specialists (e.g., psychiatrist or neurologist) can improve the implementation of guideline recommendations with regard to anti-dementia drugs [ 47 , 51 – 54 ].…”

Section: Discussionmentioning

confidence: 99%

Dementia care and the role of guideline adherence in primary care: cross-sectional findings from the DemTab study

et al. 2021

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Background General practitioners (GPs) play a key role in the care of people with dementia (PwD). However, the role of the German Dementia Guideline in primary care remains unclear. The main objective of the present study was to examine the role of guideline-based dementia care in general practices. Methods A cross-sectional analysis of data obtained from the DemTab study was conducted. Descriptive analyses of sociodemographic and clinical characteristics for GPs (N = 28) and PwD (N = 91) were conducted. Adherence to the German Dementia Guideline of GPs was measured at the level of PwD. Linear Mixed Models were used to analyze the associations between adherence to the German Dementia Guideline and GP factors at individual (age, years of experience as a GP, frequency of utilization of guideline, perceived usefulness of guideline) and structural (type of practice, total number of patients seen by a participating GP, and total number of PwD seen by a participating GP) levels as well as between adherence to the German Dementia Guideline and PwD’s quality of life. Results Self-reported overall adherence of GPs was on average 71% (SD = 19.4, range: 25–100). Adherence to specific recommendations varied widely (from 19.2 to 95.3%) and the majority of GPs (79.1%) reported the guideline as only partially or somewhat helpful. Further, we found lower adherence to be significantly associated with higher numbers of patients (γ10 = − 5.58, CI = − 10.97, − 0.19, p = .04). No association between adherence to the guideline and PwD’s quality of life was found (γ10 = −.86, CI = − 4.18, 2.47, p = .61). Conclusion The present study examined the role of adherence to the German Dementia Guideline recommendations in primary care. Overall, GPs reported high levels of adherence. However, major differences across guideline recommendations were found. Findings highlight the importance of guidelines for the provision of care. Dementia guidelines for GPs need to be better tailored and addressed. Further, structural changes such as more time for PwD may contribute to a sustainable change of dementia care in primary care. Trial registration The DemTab trial was prospectively registered with the ISRCTN registry (Trial registration number: ISRCTN15854413). Registered 01 April 2019.

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Section: Discussionmentioning

confidence: 99%

Dementia care and the role of guideline adherence in primary care: cross-sectional findings from the DemTab study

et al. 2021

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“…Analysen von ambulanten Abrechnungsdaten haben jedoch deutliche, regionale Unterschiede hinsichtlich der Versorgung von MmD aufgezeigt [ 3 – 5 ]. So wurde im Jahr 2009 in den neuen Bundesländern überdurchschnittlich oft eine Demenzdiagnose gestellt, während die Raten in Baden-Württemberg und Bayern unterdurchschnittlich ausfielen.…”

Section: Hintergrundunclassified

“…So wurde im Jahr 2009 in den neuen Bundesländern überdurchschnittlich oft eine Demenzdiagnose gestellt, während die Raten in Baden-Württemberg und Bayern unterdurchschnittlich ausfielen. Regionale Unterschiede zeigten sich sowohl bei der Anwendung testpsychologischer und bildgebender Verfahren (Versorgungsatlas; [ 5 ]). Bezüglich der Versorgung von MmD fällt ein Ost-West-Gefälle bei der Verschreibung von Antidementiva sowie ein West-Ost-Gefälle hinsichtlich der Verordnung von Antidepressiva und Antipsychotika auf [ 4 ].…”

Section: Hintergrundunclassified

Die Prävalenz an Demenz erkrankter Menschen in Deutschland – eine bundesweite Analyse auf Kreisebene

et al. 2020

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“…Additional contributing factors are insufficient or general lack of reimbursement in some regions and until now the lack of significant treatment consequences. 16 , 17 However, this is expected to change significantly in the very near future as the use of newly approved treatments will require confirmation of elevated brain amyloid. This need of confirmation will surely trigger an increase in the frequency of LPs, as it is expected that the PET costs and lack of global availability will not change soon, and the very promising blood‐based biomarkers are still in their early steps.…”

Section: Introductionmentioning

confidence: 99%

“…Some of the reasons for this limited use in the clinical setting are its invasiveness and link to more AEs than imaging or blood‐based testing. Additional contributing factors are insufficient or general lack of reimbursement in some regions and until now the lack of significant treatment consequences 16,17 . However, this is expected to change significantly in the very near future as the use of newly approved treatments will require confirmation of elevated brain amyloid.…”

Section: Introductionmentioning

confidence: 99%

Safety and tolerability of lumbar puncture for the evaluation of Alzheimer's disease

Baldaranov

García

Miller

et al. 2023

Alz & Dem Diag Ass & Dis Mo

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Introduction Lumbar puncture (LP) to collect and examine cerebrospinal fluid (CSF) is an important option for the evaluation of Alzheimer's disease (AD) biomarkers but it is not routinely performed due to its invasiveness and link to adverse effects (AE). Methods We include all participants who received at least one LP in the Alzheimer's Disease Neuroimaging Initiative (ADNI) Study. For comparison between groups, two‐sample t ‐tests for continuous, and Pearson's chi‐square test for categorical variables were performed. Results Two hundred twenty‐seven LP‐related AEs were reported by 172 participants after 1702 LPs (13.3%). The mean age of participants who reported at least one AE was 69.79 (standard deviation (SD) 6.3) versus none 72.44 (7.17) years ( p < 0.001) with female predominance (115/172 = 67.4% vs 435/913 = 48%), and had greater entorhinal cortical thickness and hippocampal volume (3.903 (0.782) vs 3.684 (0.775) mm, p = 0.002; 7.38 (1.06) vs 7.05 (1.15) mm 3 , p < 0.001), respectively. Discussion We found that younger age, female sex, and greater thickness of the entorhinal cortex were associated with a higher rate of LP‐related AE reports.

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Diagnoseverfahren bei Patienten mit leichten kognitiven Störungen und bei Patienten mit Demenz

Cited by 10 publications

References 40 publications

Dementia care and the role of guideline adherence in primary care: cross-sectional findings from the DemTab study

Dementia care and the role of guideline adherence in primary care: cross-sectional findings from the DemTab study

Die Prävalenz an Demenz erkrankter Menschen in Deutschland – eine bundesweite Analyse auf Kreisebene

Safety and tolerability of lumbar puncture for the evaluation of Alzheimer's disease

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