Brian Draper1,2, Monica Cations3,4, Fiona White3, Julian Trollor5,6, Clement Loy7, Henry Brodaty3,8,5, Perminder Sachdev3,5,9, Peter Gonski10, Apo Demirkol11, Robert G Cumming7, Adrienne Withall4. 1. Dementia Collaborative Research Centre - ABC, School of Psychiatry, University of NSW, Sydney, NSW, Australia. b.draper@unsw.edu.au. 2. Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia. b.draper@unsw.edu.au. 3. Dementia Collaborative Research Centre - ABC, School of Psychiatry, University of NSW, Sydney, NSW, Australia. 4. School of Public Health and Community Medicine, UNSW, Sydney, NSW, Australia. 5. Centre for Healthy Brain Ageing, UNSW Australia, Sydney, NSW, Australia. 6. Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Australia, Sydney, NSW, Australia. 7. Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia. 8. Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia. 9. Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia. 10. Division of Aged and Extended Care (Southcare), Sutherland Hospital, South Eastern Sydney Local Health District, Sydney, NSW, Australia. 11. The Langton Centre, South Eastern Sydney Local Health District, Drug and Alcohol Services, Surry Hills, NSW, Australia.
Abstract
OBJECTIVE: The objective of this study is to identify factors determining the time to diagnosis for young-onset dementia (YOD), defined as dementia with symptom onset before age 65 years, by mapping the diagnostic pathways. METHODS: Participants were recruited via healthcare professionals, community support organisations or were self-referred. Information was obtained by interviews with the person with YOD and their carer, and medical record reviews. Clinical dementia diagnoses were independently ratified by consensus review. RESULTS: Participants included 88 people with YOD (mean age of onset = 55.4 years), due to Alzheimer's disease (AD) (53.4%, n = 47), frontotemporal dementia (FTD) (15.9%, n = 14) and other causes (30.7%, n = 27). Median time from symptom onset to first consultation was 2.3 years, to dementia diagnosis 3.2 years, to family awareness of dementia diagnosis 3.5 years and to final diagnosis of the type of dementia 4.7 years. Non-dementia diagnoses occurred in 48.9%, including depression (30.7%) and mild cognitive impairment (MCI) (17.0%). Participants with younger age of onset had significantly longer time to first consultation and family awareness of the dementia diagnosis. The time to dementia diagnosis was significantly longer when the participant presented with MCI or depression and when the dementia was other than AD or FTD. MCI was associated with significantly longer time to family awareness of dementia diagnosis. CONCLUSIONS: Factors impacting on time to diagnosis vary with the stage of diagnosis in YOD. Longer time to dementia diagnosis occurred in people who were younger at symptom onset, when MCI or depression was present, and in dementias other than AD and FTD.
OBJECTIVE: The objective of this study is to identify factors determining the time to diagnosis for young-onset dementia (YOD), defined as dementia with symptom onset before age 65 years, by mapping the diagnostic pathways. METHODS:Participants were recruited via healthcare professionals, community support organisations or were self-referred. Information was obtained by interviews with the person with YOD and their carer, and medical record reviews. Clinical dementia diagnoses were independently ratified by consensus review. RESULTS:Participants included 88 people with YOD (mean age of onset = 55.4 years), due to Alzheimer's disease (AD) (53.4%, n = 47), frontotemporal dementia (FTD) (15.9%, n = 14) and other causes (30.7%, n = 27). Median time from symptom onset to first consultation was 2.3 years, to dementia diagnosis 3.2 years, to family awareness of dementia diagnosis 3.5 years and to final diagnosis of the type of dementia 4.7 years. Non-dementia diagnoses occurred in 48.9%, including depression (30.7%) and mild cognitive impairment (MCI) (17.0%). Participants with younger age of onset had significantly longer time to first consultation and family awareness of the dementia diagnosis. The time to dementia diagnosis was significantly longer when the participant presented with MCI or depression and when the dementia was other than AD or FTD. MCI was associated with significantly longer time to family awareness of dementia diagnosis. CONCLUSIONS: Factors impacting on time to diagnosis vary with the stage of diagnosis in YOD. Longer time to dementia diagnosis occurred in people who were younger at symptom onset, when MCI or depression was present, and in dementias other than AD and FTD.
Authors: Karri Suvila; Elizabeth L McCabe; Arttu Lehtonen; Joseph E Ebinger; Joao A C Lima; Susan Cheng; Teemu J Niiranen Journal: Hypertension Date: 2019-07-01 Impact factor: 10.190
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