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新加坡一家记忆诊所患者特征的变化模式

Changing Patterns of Patient Characteristics in a Memory Clinic in Singapore.

作者信息

Phua April Ka Sin, Goh Win King, Suministrado Serrie Platero, Hilal Saima, Ikram Mohammad Kamran, Venketasubramanian Narayanaswamy, Xu Xin, Chen Christopher Li-Hsian

机构信息

Department of Pharmacology, National University of Singapore, Singapore, Singapore; Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore.

Departments of Epidemiology & Neurology, Erasmus Medical Centre, Rotterdam, the Netherlands.

出版信息

J Am Med Dir Assoc. 2016 Sep 1;17(9):863.e9-863.e14. doi: 10.1016/j.jamda.2016.06.002. Epub 2016 Jul 20.

Abstract

OBJECTIVES

Promoting public awareness about dementia has been part of global initiatives in recent years; however, the impact on patterns of patient visits in memory clinics has not been investigated in Asian countries. Hence, the present study sought to investigate longitudinal patterns of patient characteristics among consecutive referrals to a memory clinic in Singapore from 2009 to 2015.

METHODS

Consecutive first-visit patients who attended the National University Hospital memory clinic between 2009 and 2015 through referrals from primary and secondary health care services were included in the study. A retrospective review on patient demographics, clinical diagnosis, and Clinical Dementia Rating (CDR) was performed. Chi-square and logistic regression analyses were conducted to examine the changing patterns of patient characteristics over the 7-year period.

RESULTS

A total of 1075 patients were included in the analysis, among whom 675 (62.8%) were diagnosed with dementia. Over the 7-year period, more dementia-free patients were seen compared to dementia patients (odds ratio [OR] = 1.70, 95% CI = 1.55-1.86). Among patients who visited the memory clinic and were subsequently diagnosed with dementia, an increasing number of mild dementia (CDR = 1) compared to moderate-to-severe dementia (CDR = 2 or 3) cases were found (OR = 1.11, 95% CI = 1.02-1.21).

CONCLUSION

Changing patterns in characteristics of patients visiting the memory clinic were observed, with an increasing number of patients at a less severe stage of disease seeking medical management. These results suggest that efforts to promote awareness of dementia among the public have been effective. Future studies are recommended to confirm the causes and investigate potential consequences of the changing patterns of memory clinic patients.

摘要

目的

提高公众对痴呆症的认识是近年来全球倡议的一部分;然而,亚洲国家尚未对其对记忆门诊患者就诊模式的影响进行调查。因此,本研究旨在调查2009年至2015年新加坡一家记忆门诊连续转诊患者的患者特征纵向模式。

方法

纳入2009年至2015年间通过初级和二级医疗保健服务转诊至国立大学医院记忆门诊的连续首次就诊患者。对患者人口统计学、临床诊断和临床痴呆评定量表(CDR)进行回顾性分析。进行卡方检验和逻辑回归分析,以检验7年间患者特征的变化模式。

结果

共有1075例患者纳入分析,其中675例(62.8%)被诊断为痴呆症。在这7年期间,与痴呆症患者相比,就诊的非痴呆症患者更多(优势比[OR]=1.70,95%置信区间[CI]=1.55-1.86)。在就诊于记忆门诊并随后被诊断为痴呆症的患者中,与中度至重度痴呆(CDR=2或3)病例相比,轻度痴呆(CDR=1)病例的数量有所增加(OR=1.11,95%CI=1.02-1.21)。

结论

观察到记忆门诊患者特征的变化模式,病情较轻阶段寻求医疗管理的患者数量有所增加。这些结果表明,提高公众对痴呆症认识的努力是有效的。建议未来的研究确认这些变化模式的原因并调查记忆门诊患者变化模式的潜在后果。

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