Sociodemographic Characteristics, Cognitive Function, and Health-related Quality of Life of Patients Referred to Memory Assessment Services in England

Abstract

Despite strong support for the provision of memory assessment services (MASs) in England and other countries, their effectiveness in improving patient outcomes is uncertain. We aimed to describe change in patients' health related quality of life (HRQL) six months after referral to MASs and to examine associations with patient characteristics and use of postdiagnostic interventions.Data from 883 patients referred to 69 MASs and their informal caregivers (n=569) were collected at referral and 6 months later. Multivariable linear regression was used to examine associations of change in HRQL (DEMQOL, DEMQOL-Proxy) with patient characteristics (age, sex, ethnicity, socioeconomic deprivation and comorbidity) and use of post-diagnostic interventions (anti-dementia medications and non-pharmacological therapies).Mean HRQL improved, irrespective of diagnosis: self-reported HRQL increased 3.4 points (95% CI 2.7 to 4.1), proxy-reported HRQL 1.3 points (95% CI 0.5 to 2.1). HRQL change was not associated with any of the patient characteristics studied. Patients with dementia (54%) receiving anti-dementia drugs reported greater improvement in their HRQL but those using non-pharmacological therapies reported less improvement than those not.HRQL improves in the first 6 months after referral to MASs. Research is needed to determine longer-term sustainability of the benefits and the cost-effectiveness of MASs.

Memory assessment services and health‐related quality of life: 1‐year follow‐up

“…Second, the recruitment rate at baseline was 42%, and only half of participants responded at 12 months. Participants recruited into the study at baseline were slightly younger, more likely to be male and had slightly better cognitive function when compared with referrals who did not take part . At follow‐up, only 3 of 12 characteristics differed between respondents and non‐respondents, and of those 3 only cognitive function at baseline was associated with changes in HRQL.…”

“…Patients referred for a first appointment between September 2014 and April 2015 with sufficient English language to understand the consent process and questionnaires, and their informal caregivers were eligible for inclusion. Each site was asked to recruit up to 25 consecutive new patients …”

Cost-effectiveness of Memory Assessment Services for the diagnosis and early support of patients with dementia in England

“…Unlike previous studies focussing on a single memory clinic (9,13,28), our results are representative of MAS across all regions in the country (14). This economic evaluation is based on rigorous collection of data on different measures of effectiveness (both disease-specific and generic HQRL measures reported by patients and carers), and costs to the NHS, social care, carers and patients (adopting a societal perspective).…”

“…The sample was representative of MAS in England, both geographically and in terms of number of referrals, waiting times for first appointment and accreditation status. Further details on the sample are reported elsewhere (14). The sample reflected the wide diversity of services provided by MASs in terms of size, staffing, provision of post-diagnostic support and followup regimes (17).…”

“…A recent multi-centre observational study followed up a large number of patients attending a representative sample of MAS in England (14). Using data from this large observational study, we have previously reported detailed costs and outcomes associated with MAS (15,16).…”