Eichler Tilly, Thyrian Jochen René, Hertel Johannes, Michalowsky Bernhard, Wucherer Diana, Dreier Adina, Kilimann Ingo, Teipel Stefan, Hoffmann Wolfgang
German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany; Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.
Alzheimers Dement (Amst). 2015 Mar 29;1(1):87-93. doi: 10.1016/j.dadm.2014.11.007. eCollection 2015 Mar.
Screening could improve recognition of dementia in primary care. We sought to determine the effect of screening for dementia in primary care practices on the formal diagnosis rate; the distribution of differential diagnoses; and the factors associated with receiving a formal diagnosis.
The "Dementia: life- and person-centered help in Mecklenburg-Western Pomerania" is an ongoing general practitioner (GP)-based, randomized, controlled intervention trial. A total of 4064 community dwelling patients (aged ≥70 years) were screened for dementia in 108 GP practices. Of these patients, 692 (17%) had positive screening results (DemTect score <9). Of these 692 patients, 406 (59%) provided informed consent. The analyses included the data from 243 patients with a complete baseline assessment (preliminary data; January 2014).
Of 146 patients without a formal diagnosis of dementia, 72 (49%) received a formal diagnosis after a positive screening outcome (69% with "unspecified dementia"). Female sex was significantly associated with receiving a formal diagnosis (multivariate analyses).
Screening improved the identification of dementia considerably. Because of the risk of receiving a false-positive diagnosis, additional diagnostic assessment should be mandatory.
筛查有助于提高基层医疗中对痴呆症的识别率。我们试图确定在基层医疗实践中进行痴呆症筛查对正式诊断率、鉴别诊断分布以及与获得正式诊断相关的因素的影响。
“痴呆症：梅克伦堡-前波美拉尼亚以生活和患者为中心的帮助”是一项正在进行的基于全科医生（GP）的随机对照干预试验。在108家全科医生诊所对总共4064名社区居住患者（年龄≥70岁）进行了痴呆症筛查。其中，692名（17%）患者筛查结果呈阳性（DemTect评分<9）。在这692名患者中，406名（59%）提供了知情同意。分析纳入了243名进行了完整基线评估患者的数据（初步数据；2014年1月）。
在146名未被正式诊断为痴呆症的患者中，72名（49%）在筛查结果呈阳性后获得了正式诊断（69%为“未特指的痴呆症”）。女性与获得正式诊断显著相关（多变量分析）。
筛查显著提高了痴呆症的识别率。由于存在假阳性诊断的风险，应强制进行额外的诊断评估。
