Trends in referred patient profiles in a memory clinic over 20 years

Abstract

The increasing numbers of people with dementia in the UK, as well as the associated costs have led to an effort to improve dementia services for the benefit of patients, caregivers and the taxpayer. These efforts have frequently emphasised the importance of early diagnosis in dementia care. We sought to test the hypotheses that the mean cognitive score of new referrals to a secondary care memory assessment service increased while mean age decreased over a period of 20 years. We retrospectively analysed the data of 1476 patients. The passage of time was associated with a significant increase in mean cognitive scores, while there was no association between time and age after controlling for other factors. We suggest that memory services need to be designed to meet the needs of less cognitively impaired patients. In practice this means that using simple screening tests is not sufficient in this group of patients.

Decline in mortality in patients with dementia: Results from a nationwide cohort of 44 258 patients in the Netherlands during 2000 to 2008

“…In our study, we also observed a shift towards an upturn in day clinic visits over the years. A similar pattern was observed in a study by Azam et al 23 This study additionally revealed a significant increase in mean cognitive scores of referrals to secondary care memory clinics over a 20-year period, probably due to increased awareness. This means that patients are referred in less-advanced stages of the disease.…”

Metabolic Syndrome and Cardiovascular Disease Impacts on the Pathophysiology and Phenotype of HIV-Associated Neurocognitive Disorders

“…That is why we think that only immunovirologically controlled PLHIVs with plVL <50 copies/mL can serve to optimally evaluate the true brain consequences of chronic HIV infection. Moreover, cognitive decline should not be evaluated with HAND criteria but rather with defined neuropsychological norms, as widely acknowledged by neurocognitive specialists who use them in memory clinics (Azam et al 2016). To date, none of the numerous VCI criteria has been validated for PLHIVs or may be preferentially chosen.…”

Microalbuminuria: a sentinel of neurocognitive impairment in HIV-infected individuals?

“…The main stumbling block of the Frascati criteria [21] is that they label > 30% of a normative reference population as cognitively impaired, which yields an unreasonably high false-positive proportion of cognitively impaired participants in a study population, due to their lower-than-expected specificity [19,[22][23][24][25]. Because evidence is mounting in support of not using the HAND criteria in the modern cART era in resource-rich settings and the availability of updated standards, we chose to apply the validated, normative datasets threshold of impairment, as widely acknowledged in memory clinics [26]. Raw scores for each cognitive domain test, except the 9-hole peg test, were normalized to age, sex, and educational levels, yielding z scores for analyses.…”