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12 年间老年医学主导的记忆门诊患者特征变化。

The Changing Profile of Patients in a Geriatric Medicine Led Memory Clinic over 12 Years.

机构信息

Philip Yap Lin Kiat, Affiliation: Khoo Teck Puat Hospital, Department of Geriatric Medicine, Singapore, 90 Yishun Central, Singapore 768828, Email:

出版信息

J Nutr Health Aging. 2019;23(3):310-315. doi: 10.1007/s12603-019-1161-6.

Abstract

OBJECTIVES

Memory clinics play an important role in enabling early dementia diagnosis and intervention. Few studies have investigated the changing patient profiles at memory clinics over time. We studied the trend of patient characteristics in a geriatric medicine-led memory clinic over 12 years to improve services and care to meet their needs.

SETTING AND PARTICIPANTS

Data from 2340 first-visit patients seen at a memory clinic from 2005-2017 were extracted from a registered database and analysed.

DESIGN

ANOVA, Pearson chi-square and non-parametric tests were used to describe and compare between patients with dementia (PWD) and patients with no dementia (PND).

MEASUREMENTS

Data included diagnoses of dementia and mild cognitive impairment, age, education, MMSE scores and comorbidities.

RESULTS

Patients averaged 77.2 ± 8.3 years of age with mean MMSE score of 16.2 ± 6.7. Those diagnosed with dementia were older (78.3 ± 7.9 years) and almost half (48.4%) had moderate or moderately severe dementia (FAST 5-6). Over time, there was a growing proportion of patients with mild cognitive impairment (MCI) and mild Alzheimer's dementia. Many PWD had co-morbidities of hypertension (65.9%), hyperlipidemia (55.1%), diabetes (33.5%) and 28.4% were frail.

CONCLUSIONS

The findings call for services to better diagnose and manage patients at the earlier stages of cognitive impairment and provide holistic interventions for those with frailty and other co-morbidities. The continued rise in number of patients presenting to memory clinics provides impetus to expedite integration of tertiary-based memory clinics with primary and community care providers to better support PWD and their families.

摘要

目的

记忆门诊在实现早期痴呆诊断和干预方面发挥着重要作用。很少有研究调查过随着时间的推移,记忆门诊患者的变化情况。我们研究了一家老年医学主导的记忆诊所 12 年来的患者特征趋势,以改善服务和护理,满足他们的需求。

地点和参与者

从 2005 年至 2017 年在记忆诊所就诊的 2340 名初诊患者的数据从注册数据库中提取并进行分析。

设计

使用方差分析、皮尔逊卡方检验和非参数检验描述和比较痴呆患者(PWD)和非痴呆患者(PND)之间的差异。

测量

数据包括痴呆和轻度认知障碍的诊断、年龄、教育程度、MMSE 评分和合并症。

结果

患者平均年龄为 77.2±8.3 岁,平均 MMSE 评分为 16.2±6.7。诊断为痴呆的患者年龄较大(78.3±7.9 岁),近一半(48.4%)为中度或重度痴呆(FAST 5-6)。随着时间的推移,轻度认知障碍(MCI)和轻度阿尔茨海默病痴呆患者的比例逐渐增加。许多 PWD 合并有高血压(65.9%)、高血脂(55.1%)、糖尿病(33.5%),28.4%为虚弱。

结论

这些发现呼吁服务机构更好地诊断和管理认知障碍早期阶段的患者,并为虚弱和其他合并症患者提供整体干预措施。越来越多的患者到记忆诊所就诊,这促使加快将三级记忆诊所与初级和社区护理提供者整合,以更好地支持 PWD 及其家属。

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