Memory Assessment Service for Manchester, University of Manchester, Manchester, UK.
Int J Geriatr Psychiatry. 2012 Mar;27(3):280-5. doi: 10.1002/gps.2716. Epub 2011 Apr 6.
To compare initial diagnostic hypotheses made by Allied Health Professionals (AHP) (mental health nurses, occupational therapists and social workers) with subsequent formal multidisciplinary formulation based upon the full possession of investigations, neuropsychological tests and brain imaging. Design Prospective analysis.
Prospective analysis.
Home-based assessments, secondary care based multidisciplinary memory clinic.
90 consecutive referrals over a 3-month period.
Fifty eight patients (64.4%) were diagnosed by the multi-disciplinary team as having a dementia. Twenty (34%) were classified as Alzheimer's disease, 28 (49%) of mixed sub-type and 9 (16%) of vascular origin. Together, AHP's were able to detect dementia with 91% accuracy (Kappa 0.81) sensitivity was 0.88 and specificity 0.97. The diagnostic accuracy for each professional group ranged from 88% to 93% (Kappa 74-90%).
In this study, structured initial assessment by AHP's working in a Memory Assessment Service was shown to be an accurate method of determining a diagnosis of cognitive impairment, when compared with formal MDT judgment. It is suggested that such distributed responsibility affords a viable option for the future detection of early dementia.
比较辅助卫生专业人员（心理健康护士、职业治疗师和社会工作者）的初始诊断假设与随后根据全面调查、神经心理学测试和脑成像做出的正式多学科表述。设计：前瞻性分析。设计：前瞻性分析。地点：家庭评估，二级保健为基础的多学科记忆诊所。参与者：3 个月期间连续转诊的 90 例。结果：多学科小组诊断 58 例（64.4%）为痴呆症。20 例（34%）为阿尔茨海默病，28 例（49%）为混合亚型，9 例（16%）为血管性病因。总的来说，AHP 能够以 91%的准确率（Kappa 0.81）检测出痴呆症，敏感性为 0.88，特异性为 0.97。每个专业组的诊断准确性在 88%至 93%之间（Kappa 74-90%）。结论：在这项研究中，与正式的 MDT 判断相比，在记忆评估服务中由 AHP 进行的结构化初始评估被证明是确定认知障碍诊断的准确方法。这表明，这种分布式责任为未来早期痴呆的检测提供了可行的选择。
