P.064 Sex differences in patients referred to a rural and remote memory clinic

Background: Dementia is more prevalent in women. Sex differences exist as the disease progresses (e.g. males are more likely to become aggressive). In many medical illnesses (e.g. cardiac disease), there are differences in presentation between men and women. The current study explores sex differences at the patients’ initial presentation to the Rural and Remote Memory Clinic (RRMC). Methods: Patients were referred to the RRMC in Saskatoon, Saskatchewan. Cognitive and demographic data were collected. Questionnaires included cognitive (e.g. Mini-Mental Status Examination) and daily living (e.g. Instrumental Activities of Daily Living) assessments. Results: Three hundred and seventy-five (159 male, 216 female) patients participated. Of these patients, 146 (49 male, 97 female) were diagnosed with Alzheimer’s disease. Males and females presented to the clinic at similar ages. Females were more likely to have a son or daughter caregiver and to live alone. Males were more likely to be currently working and to be a former smoker. No statistically significant differences were found for cognitive assessment scores. Conclusions: Analysis of the initial presentation of patients to the RRMC revealed females and males had similar presentation in measures of cognitive impairment. This may be reassuring for patients and their families knowing their family member, regardless of sex, is receiving equivalent referral to receive care.

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Does Day Length Affect Cognitive Performance in Memory Clinic Patients?

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100011884 ◽

2011 ◽

Vol 38 (3) ◽

pp. 461-464 ◽

Cited By ~ 6

Author(s):

Catherine Lacny ◽

Andrew Kirk ◽

Debra G. Morgan ◽

Chandima Karunanayake

Keyword(s):

Cognitive Performance ◽

Daily Temperature ◽

Day Length ◽

Remote Memory ◽

Initial Assessment ◽

Memory Clinic ◽

Rural And Remote ◽

The Mean ◽

The Relationship

Objective:To determine whether day length affects cognitive performance in rural and remote memory clinic patients.Methods:A rural and remote memory clinic in Saskatoon, Saskatchewan provided an opportunity to examine how cognitive performance on the Mini-Mental State Exam (MMSE) is influenced by day length. Saskatchewan is an ideal location to test this association as day length varies greatly both seasonally and geographically. Following an initial assessment by the Rural and Remote Memory Clinic (RRMC) team in Saskatoon, patient follow-up appointments were performed either in-person or via telehealth videoconference. At each follow-up appointment the clinic neurologist administered the MMSE. The relationship between day length and MMSE scores at the sixweek follow-up appointment was analyzed in 154 patients. The mean daily temperature was controlled for in the analysis. Bivariate correlate and linear regression analyses were conducted.Results:There was no significant association between MMSE scores and either minutes of day length or mean daily temperature.Conclusion:Day length does not appear to have significant effect on cognitive performance of rural and remote memory clinic patients.

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Characteristics of Young-Onset and Late-Onset Dementia Patients at a Remote Memory Clinic

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2020.8 ◽

2020 ◽

Vol 47 (3) ◽

pp. 320-327

Author(s):

Jennifer F. W. Wong ◽

Andrew Kirk ◽

Landon Perlett ◽

Chandima Karunanayake ◽

Debra Morgan ◽

...

Keyword(s):

Late Onset ◽

Remote Memory ◽

Memory Clinic ◽

Rural And Remote ◽

Caregiver Support ◽

Young Onset ◽

Highly Educated ◽

Dementia Patients ◽

Patient Groups ◽

Late Onset Dementia

ABSTRACT:Background:Young-onset dementia (YOD) is defined as the onset of dementia symptoms before the age of 65 years and accounts for 2–8% of dementia. YOD patients and their caregivers face unique challenges in diagnosis and management. We aimed to compare the characteristics of rural YOD and late-onset dementia (LOD) patients at a rural and remote memory clinic in Western Canada.Methods:A total of 333 consecutive patients (YOD = 61, LOD = 272) at a rural and remote memory clinic between March 2004 and July 2016 were included in this study. Each patient had neuropsychological assessment. Health, mood, function, behaviour and social factors were also measured. Both groups were compared using χ2 tests and independent sample tests.Results:YOD patients were more likely to be married, employed, current smokers and highly educated. They reported fewer cognitive symptoms, but had more depressive symptoms. YOD patients were less likely to live alone and use homecare services. YOD caregivers were also more likely to be a spouse and had higher levels of distress than LOD caregivers. Both YOD and LOD patient groups were equally likely to have a driver’s licence.Conclusions:Our findings indicate YOD and LOD patients have distinct characteristics and services must be modified to better meet YOD patient needs. In particular, the use of homecare services and caregiver support may alleviate the higher levels of distress found in YOD patients and their caregivers. Additional research should be directed to addressing YOD patient depression, caregiver distress and barriers to services.

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P.002 Quality of life across types of dementia in rural and remote memory clinic patients

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2019.104 ◽

2019 ◽

Vol 46 (s1) ◽

pp. S14

Author(s):

M Kushneriuk ◽

A Kirk ◽

C Karunanayake ◽

DG Morgan ◽

ME O’Connell

Keyword(s):

Quality Of Life ◽

Lewy Body Dementia ◽

Remote Memory ◽

Memory Clinic ◽

Rural And Remote ◽

Patient Demographics ◽

Included Patient ◽

Patient Variables ◽

One Way Anova

Background: Quality of life (QOL) is of great importance in dementia. We examined QOL across types of dementia in patients presenting to a rural and remote memory clinic (RRMC). Methods: This analysis included 343 RRMC patients seen between 2004 and 2016. Patients were diagnosed with mild cognitive impairment (MCI, n=74), frontotemporal dementia (FTD, n=42), Alzheimer’s disease (AD, n=187), vascular dementia (VD, n=22), or Lewy Body dementia (DLB, n=18). Patients and caregivers completed questionnaires at their initial visit. Data collection included patient-rated patient QOL (QOL-PT), caregiver-rated patient QOL (QOL-CG), MMSE score, age, and other patient demographics. Statistical analysis assessed patient variables and differences in QOL across types of dementia using one-way ANOVA, χ2 tests, and t-tests. Results: QOL-PT did not differ by diagnosis, whereas QOL-CG did. QOL-CG was significantly higher in MCI (34.6±7.1) compared to FTD (30.9±5.2) and AD (31.7±5.9). QOL-PT and QOL-CG differed in certain dementia types. QOL-PT was significantly higher than QOL-CG in MCI (QOL-PT=37.3±5.0, QOL-CG=35.3±7.3), FTD (QOL-PT=37.2±6.1, QOL-CG=31.7±5.5), and AD (QOL-PT=37.0±9.7, QOL-CG=32.1±5.9). Conclusions: We found that QOL-PT does not differ across dementia types, QOL-CG is higher in MCI compared to FTD and AD, and patients rate their own QOL higher than their caregivers do in MCI, FTD, and AD.

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P.019 Trends in medication use over eleven years in patients presenting to a rural and remote memory clinic

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2016.125 ◽

2016 ◽

Vol 43 (S2) ◽

pp. S25-S26

Author(s):

R Verity ◽

A Kirk

Keyword(s):

Medication Use ◽

Significant Decline ◽

Remote Memory ◽

Anticholinergic Medication ◽

Memory Clinic ◽

Rural And Remote ◽

Anticholinergic Medications ◽

To Come ◽

Spearman’S Correlation ◽

Over Time

Background: Anticholinergic and sedating medications are generally contraindicated in those with cognitive decline. We examined trends in medication use by patients presenting to a rural and remote memory clinic (RRMC) between March 2004 and June 2015 to determine whether patterns of medication use have changed. Methods: The first 445 patients seen at the RRMC between 2004 and 2015 were included in this analysis. Medication lists were collected at the patient’s initial visit, and it was noted whether patients were taking anticholinergic or potentially sedating drugs. Statistical analysis (Spearman’s Correlation) was conducted to examine trends in medication use over time. Results: Ninety-one patients (20.5%) were taking at least one anticholinergic medication. There was a statistically significant decline (25.0% in 2004 to 12.5% in 2014) in percentage of patients presenting with anticholinergic medications over the eleven years of this study (Spearman’s correlation coefficient=-0.64, p=0.035). Conclusions: The most encouraging statistic to come from this study is a decline in anticholinergic medication use in this rural population. Prescribers must be properly informed to ensure that the number of medications per patient does not continue to rise, that medications are used only as necessary, and that potentially deleterious medications are avoided.

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