Eichler Tilly, Thyrian Jochen Rene, Hertel Johannes, Richter Steffen, Michalowsky Bernhard, Wucherer Diana, Dreier Adina, Kilimann Ingo, Teipel Stefan, Hoffmann Wolfgang
German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Ellernholzstrasse 1-2, Greifswald D-17487. Germany.
Germany Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Gehlsheimer Str. 20, Rostock D-18147. Germany.
Curr Alzheimer Res. 2018;15(1):44-50. doi: 10.2174/1567205014666170908095707.
Main objective was to analyze the associations of patient variables (depression, quality of life, anti-dementia drug treatment, knowledge about dementia) with the assignment of a formal diagnosis of dementia to community-dwelling primary care patients who have screened positive for dementia.
DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania) is a general practitioner based randomized controlled intervention trial. Present analyses are based on cross-sectional data of 319 positively screened patients (age 70+, living at home) who had not been formally diagnosed with dementia before the screening. The medical diagnoses (ICD-10) were retrieved from the patient's medical records. Depression (Geriatric Depression Scale; GDS), quality of life in Alzheimer's disease (Qol-AD), knowledge about dementia, and anti-dementia drug treatment were assessed after the screening test at the baseline examination.
At the baseline examination, 171 out of 319 patients (54%) had been formally diagnosed with dementia after they have screened positive. Univariate comparisons showed no statistically significant differences between diagnosed and undiagnosed patients regarding depression (GDS≥6: 11% vs. 15%; p=0.396), quality of life (mean (SD): 2.8 (0.3) vs. 2.8 (0.4); p=0.833), and the knowledge about dementia (75% vs. 75%; p>0.999). Patients who had received a formal diagnosis were more often treated with anti-dementia drugs (20% vs. 11%; p=0.040). Multivariate analyses controlled for confounding variables confirmed these findings.
Present findings do not support concerns that the assignment of a formal dementia diagnosis after screening is associated with potential harms. If confirmed in a prospective study, our data would suggest that patients may benefit from being formally diagnosed regarding anti-dementia drug treatment.
主要目的是分析患者变量（抑郁、生活质量、抗痴呆药物治疗、痴呆知识）与对痴呆筛查呈阳性的社区初级保健患者正式诊断为痴呆之间的关联。
DelpHi-MV（痴呆：梅克伦堡-前波美拉尼亚以生活和人为中心的帮助）是一项基于全科医生的随机对照干预试验。目前的分析基于319名筛查呈阳性患者（年龄70岁以上，居家）的横断面数据，这些患者在筛查前未被正式诊断为痴呆。从患者病历中获取医学诊断（ICD-10）。在基线检查的筛查试验后评估抑郁（老年抑郁量表；GDS）、阿尔茨海默病生活质量（Qol-AD）、痴呆知识和抗痴呆药物治疗情况。
在基线检查时，319名患者中有171名（54%）在筛查呈阳性后被正式诊断为痴呆。单因素比较显示，在抑郁（GDS≥6：11%对15%；p = 0.396）、生活质量（均值（标准差）：2.8（0.3）对2.8（0.4）；p = 0.833）和痴呆知识（75%对75%；p>0.999）方面，已诊断和未诊断患者之间无统计学显著差异。接受正式诊断的患者更常接受抗痴呆药物治疗（20%对11%；p = 0.040）。控制混杂变量的多因素分析证实了这些发现。
目前的研究结果不支持关于筛查后正式诊断痴呆与潜在危害相关的担忧。如果在前瞻性研究中得到证实，我们的数据将表明患者可能会从正式诊断中在抗痴呆药物治疗方面获益。
