College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Can J Neurol Sci. 2012 Nov;39(6):774-81. doi: 10.1017/s0317167100015602.
Patients with dementia benefit from early assessment and diagnosis. In an attempt to identify factors leading to delay in referral, we investigated socio-demographic, clinical, and functional predictors of greater severity of cognitive impairment in dementia patients presenting to a memory clinic in Saskatoon, Saskatchewan.
Data collection began in 2004 at the Rural and Remote Memory Clinic in Saskatoon, where non-institutionalized patients were referred by their family physicians. The patient and caregiver questionnaires and assessments administered at the clinic day appointment provided the socio-demographic, clinical, and functional patient variables, as well as the caregiver stress and burden variables. The dependent variable was patient cognitive impairment, as measured by Modified Mini-Mental State Examination (3MS) scores. Variables underwent univariate linear regression with 3MS scores in order to determine possible associations. A multiple regression analysis was conducted to determine predictors of cognitive impairment severity at clinic presentation.
Our sample included 198 patients (62% female). The mean age was 73.9 years (SD=9.2). We found that an age and gender interaction, years of formal education, Functional Activities Questionnaire score, and Brief Symptom Inventory score were significantly associated with 3MS scores (p<0.05).
Increased cognitive impairment at presentation was predicted by fewer years of formal education, poorer functional ability, and less caregiver psychological distress. There was a significant interaction between age and gender: younger females were more cognitively impaired than younger males at clinic day, while in older patients, males were more cognitively impaired than females.
痴呆患者从早期评估和诊断中受益。为了确定导致转诊延迟的因素，我们调查了萨斯喀彻温省萨斯卡通农村和远程记忆诊所就诊的痴呆患者认知障碍严重程度的社会人口统计学、临床和功能预测因素。
数据收集始于 2004 年，在萨斯卡通农村和远程记忆诊所，由家庭医生转介非住院患者。在诊所就诊日进行的患者和护理人员问卷调查和评估提供了社会人口统计学、临床和功能患者变量，以及护理人员压力和负担变量。因变量是患者的认知障碍，通过改良简易精神状态检查（3MS）评分来衡量。对变量进行单变量线性回归，以确定 3MS 评分的可能关联。进行多元回归分析以确定诊所就诊时认知障碍严重程度的预测因素。
我们的样本包括 198 名患者（62%为女性）。平均年龄为 73.9 岁（标准差=9.2）。我们发现年龄和性别交互作用、正规教育年限、功能活动问卷评分和简明症状问卷评分与 3MS 评分显著相关（p<0.05）。
在就诊时认知障碍增加，预测因素为正规教育年限较少、功能能力较差和护理人员心理困扰较少。年龄和性别之间存在显著的交互作用：年轻女性在就诊日的认知障碍比年轻男性更严重，而在老年患者中，男性的认知障碍比女性更严重。
