BACKGROUND: Primary care should be the place for the early detection of mild cognitive impairment (MCI) and dementia; however, a considerable proportion of these processes remain undetected at this setting. Family doctors may not have enough time or expertise for cognitive testing. The utility of clinical variables, other than cognitive tests, has hardly been investigated. OBJECTIVES: To explore the diagnostic and prognostic value of the variables that are usually collected in the medical history of patients with suspected cognitive impairment. METHODS: In this cohort study, people aged ≥ 50 years were prospectively searched for cognitive decline of unknown aetiology by seven primary care physicians (PCP) during their practice. The baseline assessment included demographic variables, symptom-related variables, medical and psychiatric co-morbidity, family history of dementia and neurological exam. The diagnosis was made by a neurologist at baseline and after 1 year. RESULTS: One hundred and seventy-six patients were analysed of whom 81 (46.0%) had MCI and 18 (10.2%) had dementia at baseline. After 1 year, 8 (9.9%) MCI patients had progressed to dementia, but 48 (59.3%) had reverted to normal cognition. Old age, source of symptoms (informant or PCP), short duration and low education were associated with MCI or dementia at baseline; low education predicted progression to dementia in MCI patients and less chronic medical conditions and younger age predicted reversion from MCI to normal cognition (P < 0.05, adjusted regression models). CONCLUSION: Clinical data usually collected on medical history by PCP are useful to detect patients with MCI and dementia and also to predict MCI outcome.
BACKGROUND: Primary care should be the place for the early detection of mild cognitive impairment (MCI) and dementia; however, a considerable proportion of these processes remain undetected at this setting. Family doctors may not have enough time or expertise for cognitive testing. The utility of clinical variables, other than cognitive tests, has hardly been investigated. OBJECTIVES: To explore the diagnostic and prognostic value of the variables that are usually collected in the medical history of patients with suspected cognitive impairment. METHODS: In this cohort study, people aged ≥ 50 years were prospectively searched for cognitive decline of unknown aetiology by seven primary care physicians (PCP) during their practice. The baseline assessment included demographic variables, symptom-related variables, medical and psychiatric co-morbidity, family history of dementia and neurological exam. The diagnosis was made by a neurologist at baseline and after 1 year. RESULTS: One hundred and seventy-six patients were analysed of whom 81 (46.0%) had MCI and 18 (10.2%) had dementia at baseline. After 1 year, 8 (9.9%) MCI patients had progressed to dementia, but 48 (59.3%) had reverted to normal cognition. Old age, source of symptoms (informant or PCP), short duration and low education were associated with MCI or dementia at baseline; low education predicted progression to dementia in MCI patients and less chronic medical conditions and younger age predicted reversion from MCI to normal cognition (P < 0.05, adjusted regression models). CONCLUSION: Clinical data usually collected on medical history by PCP are useful to detect patients with MCI and dementia and also to predict MCI outcome.
Authors: Hanna Kaduszkiewicz; Marion Eisele; Birgitt Wiese; Jana Prokein; Melanie Luppa; Tobias Luck; Frank Jessen; Horst Bickel; Edelgard Mösch; Michael Pentzek; Angela Fuchs; Sandra Eifflaender-Gorfer; Siegfried Weyerer; Hans-Helmut König; Christian Brettschneider; Hendrik van den Bussche; Wolfgang Maier; Martin Scherer; Steffi G Riedel-Heller Journal: Ann Fam Med Date: 2014 Mar-Apr Impact factor: 5.166
Authors: Carmen Paz Suárez-Araujo; Patricio García Báez; Ylermi Cabrera-León; Ales Prochazka; Norberto Rodríguez Espinosa; Carlos Fernández Viadero; For The Alzheimer's Disease Neuroimaging Initiative Journal: Comput Math Methods Med Date: 2021-06-21 Impact factor: 2.238
Authors: Perminder S Sachdev; Darren M Lipnicki; John Crawford; Simone Reppermund; Nicole A Kochan; Julian N Trollor; Wei Wen; Brian Draper; Melissa J Slavin; Kristan Kang; Ora Lux; Karen A Mather; Henry Brodaty Journal: PLoS One Date: 2013-03-27 Impact factor: 3.240
Authors: Yong S Shim; Dong Won Yang; Bora Yoon; Yunhwan Lee; Chang Hyung Hong; Sang Won Seo; Soo Jin Yoon; Jee Hyang Jeong; Moon Ho Park; Seong Hye Choi; Seong Yoon Kim Journal: Dement Neurocogn Disord Date: 2016-10-18
Authors: Sam T Creavin; Susanna Wisniewski; Anna H Noel-Storr; Clare M Trevelyan; Thomas Hampton; Dane Rayment; Victoria M Thom; Kirsty J E Nash; Hosam Elhamoui; Rowena Milligan; Anish S Patel; Demitra V Tsivos; Tracey Wing; Emma Phillips; Sophie M Kellman; Hannah L Shackleton; Georgina F Singleton; Bethany E Neale; Martha E Watton; Sarah Cullum Journal: Cochrane Database Syst Rev Date: 2016-01-13
Authors: Michael M Copenhaver; Victoria Sanborn; Roman Shrestha; Colleen B Mistler; Matthew C Sullivan; John Gunstad Journal: Drug Alcohol Depend Date: 2021-04-24 Impact factor: 4.852
Authors: Jolien Janssen; Paula S Koekkoek; Eric P Moll van Charante; L Jaap Kappelle; Geert Jan Biessels; Guy E H M Rutten Journal: BMC Fam Pract Date: 2017-12-16 Impact factor: 2.497