未确诊痴呆症患者的特征：威尔士认知功能障碍综合评估研究的结果。
Characteristics of people living with undiagnosed dementia: findings from the CFAS Wales study.
机构信息
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Wales Institute for Social and Economic Research and Data, Cardiff University, Cardiff, UK.
出版信息
BMC Geriatr. 2022 May 10;22(1):409. doi: 10.1186/s12877-022-03086-4.
BACKGROUND
Many people living with dementia remain undiagnosed, with diagnosis usually occurring long after signs and symptoms are present. A timely diagnosis is important for the wellbeing of the person living with dementia and the family, allowing them to plan and have access to support services sooner. The aim of this study was to identify demographic characteristics and neuropsychiatric symptoms associated with being undiagnosed, which may help clinicians be more aware of signs that could be indicative of early-stage or undetected dementia.
METHODS
This cross-sectional study uses data from waves 1 and 2 (two years apart) of the Cognitive Function and Ageing Studies Wales (CFAS Wales). CFAS Wales participants were included who had a study assessment of dementia, as determined by the Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT) algorithm and by expert assessment, and who had had their primary care records checked for a clinical diagnosis of dementia. We identified 19 people with a diagnosis of dementia and 105 people living with undiagnosed dementia, and explored demographic characteristics and the presence or absence of a range of neuropsychiatric symptoms in the undiagnosed population using logistic regression.
RESULTS
Findings suggest that people living with dementia who have better cognition, have more years of education, or live in more deprived areas are less likely to have a diagnosis. In terms of neuropsychiatric symptoms, depression and sleep problems were associated with being undiagnosed. Apathy was common across all people living with dementia, but those with a diagnosis were more likely to have severe apathy.
CONCLUSIONS
This study has clinical practice implications as the findings may help clinicians be more aware of characteristics and symptoms of people who are undiagnosed or who are at greater risk of remaining undiagnosed, enabling them to be more vigilant in picking up signs of dementia at an earlier stage.
背景
许多患有痴呆症的人未被诊断，通常在出现症状很久之后才被诊断出来。及时诊断对患者及其家人的福祉非常重要，这使他们能够更早地计划并获得支持服务。本研究的目的是确定与未被诊断相关的人口统计学特征和神经精神症状，这可能有助于临床医生更清楚地了解可能表明早期或未被发现的痴呆症的迹象。
方法
本横断面研究使用来自威尔士认知功能和衰老研究（CFAS Wales）第 1 波和第 2 波（相隔两年）的数据。包括了在通过自动老年评估计算机辅助分类（AGECAT）算法和专家评估确定有痴呆症研究评估且已检查初级保健记录以确定痴呆症临床诊断的情况下患有痴呆症的参与者。我们确定了 19 名诊断为痴呆症的人和 105 名患有未被诊断的痴呆症的人，使用逻辑回归探讨了未被诊断人群的人口统计学特征和一系列神经精神症状的存在或不存在。
结果
研究结果表明，认知能力较好、受教育程度较高或居住在较贫困地区的痴呆症患者更不可能被诊断出来。就神经精神症状而言，抑郁和睡眠问题与未被诊断有关。冷漠在所有痴呆症患者中都很常见，但被诊断为痴呆症的患者更有可能患有严重的冷漠。
结论
本研究具有临床实践意义，因为研究结果可能有助于临床医生更清楚地了解未被诊断或更有可能未被诊断的患者的特征和症状，使他们能够更早地发现痴呆症的迹象。
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