Factors influencing time between onset of signs/symptoms and referral for dementia in elderly outpatients

Koskas, P.; Pons-Peyneau, Cécile; Houenou-Quenum, Nadège; Romdhani, Mouna; Gasmi, Mohamed; Galleron, S.; Drunat, O.

doi:10.1016/j.neurol.2017.05.012

Cited by 10 publications

(8 citation statements)

References 32 publications

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“…Moreover, multiple studies indicate that improved nutrition promotes and maintains cognitive performance throughout the adult lifespan [2][3][4]. Lifestyle modifications have the advantage that they can be initiated at any time, as opposed to the inherent compromise of waiting until sufficient cognitive decline has transpired to warrant diagnosis and prescription of pharmacological agents [4,5]. Moreover, individuals and/or their caregivers * Correspondence to: Thomas B. Shea, Department of Biological Sciences, UMass Lowell, Lowell, MA 02154, USA.…”

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confidence: 99%

“…The Dementia Rating Scale (DRS) [29] assesses a variety of cognitive performance across a number of domains from simple to complex such as memory, attention, and conceptualization. As in our prior studies, we sorted individuals based on their performance on the DRS after 3 months of intervention or placebo as intact (≥9), mildly impaired (6-8), moderately impaired (4,5), and severely impaired (≤3) as described in the DRS manual [28].…”

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confidence: 99%

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Relative Efficacy of a Nutritional Intervention on Cognitive Performance Across the Adult Lifespan and During Early Cognitive Decline

Shea

Remington

2019

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A nutritional supplement has maintained or improved cognitive performance for healthy adults and individuals with mild cognitive impairment (MCI). Performance varied between 93 healthy adults aged 18-73 years versus 43 aged 75-85 years and among individuals with MCI. Healthy adult performance was stratified by age and for MCI as "intact" or "impaired" (Dementia Rating Scale guidelines). Some older individuals performed as well as younger individuals. All intact individuals with MCI maintained baseline performance; only impaired individuals receiving the supplement maintained baseline performance. Variation among elderly individuals can preclude observation of efficacy. Supplementation may maintain rather than improve performance for some individuals.

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confidence: 99%

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confidence: 99%

Relative Efficacy of a Nutritional Intervention on Cognitive Performance Across the Adult Lifespan and During Early Cognitive Decline

Shea

Remington

2019

ADR

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“…The Memory Clinic has had a specific database since 2006 (regulated for data protection purposes by the Commision Nationale de l'Informatique et des Libertés, authorization No. 1858079) [10]. All practitioners must complete the database for each patient and have been trained to do this.…”

Section: Populationmentioning

confidence: 99%

“…Practitioners collected information on sociodemographic characteristics including age, gender, marital status, household composition, and years of formal education (educational level with 7 levels: 1 for no school, 2 for 10 years of education, 3 for 14 years of education, 4 for 17 years of education, 5 for 18 years of education, 6 for 20 years of education, and 7 for >20 years of education) [10].…”

Section: Patients' Characteristics Systematically Entered In the Bretmentioning

confidence: 99%

Patients Who Attend Alone at a First Memory Consultation: Are They a Specific Population,or Is It an Instance of Confounding Bias?

2019

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As commonly happens in epidemiological research, none of the reported studies were totally free of methodological problems. Studies have considered the influence of social relationships on dementia, but the mechanisms underlying these associations are not perfectly understood. We look at the possible impact of selection bias. For their first memory consultation, patients may come alone or accompanied by a relative. Our objective is to better understand the impact of this factor by retrospective follow-up of geriatric memory outpatients over several years. All patients over 70 who were referred to Bretonneau Memory Clinic for the first time, between January 2006 and 2018, were included in the study. The patients who came alone formed group 1, the others, whatever type of relative accompanied them, formed group 2. We compared the Mini-Mental State Examination (MMSE) scores of patients; and for all patients who came twice for consultation with at least a 60-day interval, we compared their first MMSE with the MMSE performed at the second consultation. In total, 2,935 patients were included, aged 79.7 ± 8.4 years. Six hundred and twenty-five formed group 1 and 2,310 group 2. We found a significant difference in MMSE scores between the 2 groups of patients; and upon second consultation in group 2, but that difference was minor in group 1. Our finding of a possible confounding factor underlines the complexity of choosing comparison groups in order to minimize selection bias while maintaining clinical relevance.

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“…Daily life for the persons concerned was overshadowed by a sense of uncertainty. It can take an average of 35 months from the person experiencing initial symptoms to referral from primary health care to a memory assessment clinic (Koskas et al, 2018). Lafortune et al (2015) highlighted a fragmented primary health care service which can create barriers for the older adult to access services.…”

Section: Introductionmentioning

confidence: 99%

Embarking on a memory assessment voices of older persons living with memory impairment

et al. 2020

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Aim To describe older persons who had commenced a memory assessment, experiences of living with memory impairment and related symptoms. Background Persons with subjective memory impairment are two times more likely to develop dementia over the years than their peers. Older persons seldom seek help from primary health care clinics solely for subjective memory impairment. Of those who seek help, it can take up to 35 months from the person experiencing initial symptoms to referral to a memory clinic. Further research is needed regarding how older persons live with memory impairment with related symptoms before they receive a memory diagnosis. Method A qualitative study with 23 participants who had commenced a memory assessment in primary care. Semi-structured interviews were held. During the interviews, the Neuropsychiatric Inventory was completed and discussed with the participants. Interview data were analysed using Interpretive Description. Results The results are presented under four themes: Conflicting views about the situation, Unveiling the presence of neuropsychiatric symptoms, Compensating with external and internal strategies to recall and Worrying about self and future. Persons with memory impairment were encouraged by family members or others to seek a memory assessment. Few persons were self-referred as memory impairment was often seen as a part of aging. Polarised viewpoints existed within the families regarding the impact of memory impairment on daily life. The presence of neuropsychiatric symptoms appeared unexplored in the participants seeking a memory assessment. In this study, the majority of participants experienced neuropsychiatric symptoms at the time of contact for a memory assessment. Conclusions Memory problems experienced were often viewed by the person as being part of an aging process. The presence of neuropsychiatric symptoms was not acknowledged as being connected to memory impairment. Contextualising ‘memory impairment’ as a part of a ‘cognitive process’ may help the person in identifying the presence of neuropsychiatric symptoms.

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Factors influencing time between onset of signs/symptoms and referral for dementia in elderly outpatients

Cited by 10 publications

References 32 publications

Relative Efficacy of a Nutritional Intervention on Cognitive Performance Across the Adult Lifespan and During Early Cognitive Decline

Relative Efficacy of a Nutritional Intervention on Cognitive Performance Across the Adult Lifespan and During Early Cognitive Decline

Patients Who Attend Alone at a First Memory Consultation: Are They a Specific Population,or Is It an Instance of Confounding Bias?

Embarking on a memory assessment voices of older persons living with memory impairment

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