The clinical characteristics and subtypes of patients with cognitive impairment in memory clinic

Liu, Shuai; Gan, Jinghuan; Hu, Wenzheng; Wang, Xiaodan; Zhu, Han; Du, Xiaoshan; Shi, Zhihong; Huang, Guowei; Ji, Yong

doi:10.1016/j.jocn.2020.10.031

Cited by 6 publications

(5 citation statements)

References 26 publications

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“…AD was based on the National Institute on Aging-Alzheimer's Association criteria by McKhann et al in 2011 (13). Blood tests, the ApoE genotypes, neuroimaging (including CT scans and MRI), and positron emission computed tomography were performed, if necessary, to make the diagnosis (14). Twelve patients were diagnosed with mixed or secondary dementia, 61 patients were lost to follow-up and 54 patients had stopped antidementia drug therapy for more than 1 week and were excluded.…”

Section: Participantsmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Alzheimer's Disease and Other Dementias

Gan

Liu

et al. 2021

Front. Psychiatry

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Introduction: Numerous countries went into lockdown to contain the COVID-19 outbreak, which has impeded follow-up of chronic diseases, such as cognitive impairment (CI). Cognitive and neuropsychiatric changes during the COVID-19 pandemic are neglected in China, which is the world's whistleblower. To investigate the cognitive and neuropsychologic changes in CI, as well as the proportions of rapid cognitive decline (RCD) before and during the COVID-19 pandemic to provide clinical evidence for CI intervention during a public health emergency.Methods: We performed a descriptive and retrospective study based on medical records from the memory clinic of Tianjin Dementia Institute collected through face-to-face evaluations. Information of 205 patients with CI, including patients with mild cognitive impairment and dementia, of whom 131 with Alzheimer's disease (AD) were analyzed and compared to a control group before the COVID-19 pandemic.Results: Among the 205 CI patients, the scores on the Chinese Mini Mental State Examination (C-MMSE), the Montreal Cognitive Assessment (MoCA), activities of daily living (ADLs), and the global Neuropsychiatric Inventory (NPI) were significantly different at the baseline and follow-up evaluations (p < 0.05) after 14.07 (±2.87) months. The same findings were recorded among AD patients, and they exhibited more sleep disturbances at the follow-up than at baseline (32.8 vs. 20.6%, p = 0.035). When compared to the control group, slightly worse performance of cognitive, −1.00 (−4.00, 1.00) from the C-MMSE, −1.00 (−2.00, 0.00) on the MoCA, 1.00 (0.00, 9.00) on ADLs and neuropsychological 0.00 (−1.00, 3.50) on the global NPI profile, at the follow-up were presented, particularly for delusion, agitation, irritability, and appetite disturbances (p < 0.05). Twenty-five (19.1%) AD patients and 48 (36.6%) controls suffered RCD during the COVID-19 pandemic. Moreover, AD patients during the COVID-19 pandemic were 0.408 times (95% confidence interval: 0.232–0.716) less likely to suffer RCD than the control.Conclusion: Confinement might ease the cognitive and neuropsychiatric deterioration of AD patients compared to those not in crisis and help prevent RCD in AD patients.

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Section: Participantsmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Alzheimer's Disease and Other Dementias

Gan

Liu

et al. 2021

Front. Psychiatry

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“…This is 3 times the per capita disposable income of the national residents and 20 times the per capita medical and health expenses (data from the National Bureau of Statistics). The total annual cost of DLB in China is estimated to be approximately US $34.87 billion in 2021, accounting for 0.20% of the country's gross domestic product 2,21,22 . Furthermore, we also found that the greater impact on the total costs, direct medical costs and indirect costs came from ADL and caregivers' subjective burden rather than from age, gender, or neuropsychiatric symptoms.…”

Section: Discussionmentioning

confidence: 60%

Costs of dementia with lewy bodies: A Chinese multicenter cross‐sectional study

Guo

Qing-bo

Zuo

et al. 2022

Int J Geriat Psychiatry

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Introduction Dementia with Lewy bodies (DLB) significantly increases the economic burden on caregivers and society, but few studies have focused on the costs. This study aims to evaluate the current economic costs of DLB and its related factors. Methods A total of 193 patients diagnosed with probable DLB were consecutively enrolled from 6 memory clinics between August 2017 to July 2021. Data were collected from August to December of 2021, patients' per capita annual economic costs related to DLB in the year preceding the interview were evaluated, and factors related to the costs were assessed using regression analysis. Results Patients with DLB led to per capita annual total costs of US $21,378.3 in 2021, with direct medical costs, direct non‐medical costs and indirect costs of US $3471.4, US $3946.4 and US $13,960.5, respectively, accounting for 16.2%, 18.5% and 65.3%, of total costs. Factors related to the costs of DLB showed that impairments in activities of daily living (ADL) and caregivers' subjective burden had a greater impact on the total, direct medical and indirect costs. Conclusion The economic burden of DLB in China is huge, and indirect costs account for the largest proportion, serious impairment of the ADL and the subjective burden of caregivers, which possibly has a greater effect on costs. The substantial contributions made by family members and other unpaid caregivers of DLB should be fully recognized in strategic policy discussions and in case‐level planning and assessments.

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“…International consensus suggests that DLB should be diagnosed when cognitive impairment precedes parkinsonism or begins within a year of parkinsonism and PDD should be diagnosed when parkinsonism precedes cognitive impairment by more than 1 year. Blood tests, the APOE genotypes, neuroimaging (including computerized tomography scans and/or magnetic resonance imaging), and positron emission computed tomography were performed, if necessary, to make the diagnosis [ 17 ]. Therefore, DLB and PDD mentioned in the study were from a probable diagnosis.…”

Section: Methodsmentioning

confidence: 99%

“…Diagnoses were confirmed by a two-specialist panel according to the basic diagnostic flowchart (the same as our previous study [ 17 ]), if there was disagreement between them, the subject would be excluded. Participants were also excluded if they had a major concurrent psychiatric illness or a history of other serious neurological illness, including stroke or alcohol/substance abuse history.…”

Section: Methodsmentioning

confidence: 99%

The presence and co-incidence of geriatric syndromes in older patients with mild-moderate Lewy body dementia

et al. 2022

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Introduction Geriatric symptoms are common in dementia cases, while few studies have focused on these symptoms in Lewy body dementia (LBD). The purpose of this study is to investigate the distributions of Apolipoprotein E (APOE) ε4 and geriatric symptoms, and explore their associaitons in Dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD). Methods A retrospective study with 185 mild-moderate probable DLB (n = 93) and PDD (n = 92) patients was assigned. Demographic and clinical characteristics, neuropsychological assessments, and APOE genotypes were recorded. Description, correlation and logistic regression models were used to analyze the presence of geriatric symptom complaints and their associations with APOE ε4. Results DLB patients displayed more frequency of fluctuating cognition, visual hallucination, rapid eye movement sleep behavior disorder, delusion, depression, anxiety, apathy, and loss of appetite, whereas the PDD cases had constipation, fear of falling, and insomnia more frequently. The APOE ε4 allele was more common in DLB than PDD (29.9% vs. 7.0%, p < 0.001), and the patients with DLB + APOE ε4 (+) were presented more delusions (p = 0.005) and apathy (p = 0.007) than patients with PDD + APOE ε4 (+). We also found that the APOE ε4 allele was significantly associated with hyperhidrosis (OR = 3.472, 95%CI: 1.082–11.144, p = 0.036) and depression (OR = 3.002, 95%CI: 1.079–8.353, p = 0.035) in DLB patients, while there were no significant associations between APOE ε4 allele and the age at visit, the age at onset, scores of MDS-UPDRS III, H&Y stage, ADL, MMSE, MOCA and NPI, as well as the presences of fluctuating cognition, VH, parkinsonism and RBD in both groups. Conclusion The presence and co-incidence of geriatric symptoms are common in patients with mild-moderate LBD. The presence of APOE ε4 allele is associated with hyperhidrosis and depression, but not global cognition, activitives of daily life, motor function and other neuropsychitric symptoms in DLB. These findings improve the awareness of geriatric symptoms, and contribute to the healthcare management of mild-moderate DLB and PDD.

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The clinical characteristics and subtypes of patients with cognitive impairment in memory clinic

Cited by 6 publications

References 26 publications

The Impact of the COVID-19 Pandemic on Alzheimer's Disease and Other Dementias

The Impact of the COVID-19 Pandemic on Alzheimer's Disease and Other Dementias

Costs of dementia with lewy bodies: A Chinese multicenter cross‐sectional study

The presence and co-incidence of geriatric syndromes in older patients with mild-moderate Lewy body dementia

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