scholarly journals P.003 Differences between younger and older dementia patients at a rural and remote memory clinic

2019 ◽  
Vol 46 (s1) ◽  
pp. S14
Author(s):  
J Wong ◽  
A Kirk ◽  
L Perlett ◽  
C Karunanayake ◽  
D Morgan ◽  
...  
Keyword(s):  
Late Onset ◽  
Remote Memory ◽  
Caregiver Distress ◽  
Memory Clinic ◽  
Rural And Remote ◽  
Caregiver Support ◽  
Highly Educated ◽  
Dementia Patients ◽  
Barriers To Services ◽  
Late Onset Dementia

Background: Young-onset 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. 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. 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.

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

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.

scholarly journals Does Day Length Affect Cognitive Performance in Memory Clinic Patients?

2011 ◽  
Vol 38 (3) ◽  
pp. 461-464 ◽  
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.

O2-13-04: Prevalence of etiologies of early-onset and late-onset dementia at the Memory Clinic, Siriraj Hospital, Thailand

2012 ◽  
Vol 8 (4S_Part_7) ◽  
pp. P263-P263
Author(s):  
Vorapun Senanarong ◽  
S. Chaichanettree ◽  
N. Aoonkaew ◽  
Chatchawan Rattanabannakit ◽  
S. Udomphathurak
Keyword(s):  
Early Onset ◽  
Late Onset ◽  
Memory Clinic ◽  
Siriraj Hospital ◽  
Late Onset Dementia

scholarly journals Anosognosia in Early- and Late-Onset Dementia and Its Association With Neuropsychiatric Symptoms

2021 ◽  
Vol 12 ◽  
Author(s):  
Manuela Tondelli ◽  
Chiara Galli ◽  
Giulia Vinceti ◽  
Luigi Fiondella ◽  
Simone Salemme ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Disease Progression ◽  
Frontotemporal Dementia ◽  
Late Onset ◽  
Neuropsychiatric Symptoms ◽  
Diagnostic Delay ◽  
Early Onset Dementia ◽  
Dementia Patients ◽  
Clinical Variants ◽  
Late Onset Dementia

Background: The symptom anosognosia or unawareness of disease in dementia has mainly been studied in patients with late-onset dementia (LOD, ≥65 years), whereas little is known on whether it is also present in patients with early-onset dementia (EOD, <65 years). We aimed at investigating differences in anosognosia between LOD and EOD, by also studying its association with different clinical variants of EOD and the presence of neuropsychiatric symptoms.Methods: A total of 148 patients, 91 EOD and 57 LOD, were recruited and underwent extended clinical assessment and caregiver interview that included questionnaires aimed at measuring anosognosia and neuropsychiatric symptoms. Differences in anosognosia between EOD and LOD and between subgroups with different clinical variants were investigated, as well as correlation between anosognosia and neuropsychiatric symptoms. A regression analysis was applied to explore the association between anosognosia and development of neuropsychiatric symptoms during disease progression.Results: Median levels of anosognosia were not significantly different between EOD and LOD. Anosognosia increased overtime with disease progression and was higher in frontotemporal dementia patients or, more precisely, in frontotemporal dementia and Alzheimer's disease variants associated with involvement of the frontal lobes. Higher levels of early anosognosia were associated with higher frequency and severity of subsequent neuropsychiatric symptoms, in particular apathy, later in the course of the disease.Conclusion: Anosognosia is a frequent symptom of EOD, occurring in 94.5% of all-cause EOD, and it is associated with higher risk of developing neuropsychiatric symptoms during disease progression. Recognising anosognosia may be helpful for clinicians and families to reduce diagnostic delay and improve disease managment.

scholarly journals Patients with young-onset dementia in an older people's mental health service

2020 ◽  
pp. 1-5
Author(s):  
Michael Yeung ◽  
Katherine MacFarland ◽  
Vincent Mlilo ◽  
Nathan Dean ◽  
Benjamin R. Underwood
Keyword(s):  
Late Onset ◽  
Rare Condition ◽  
Service Level ◽  
Case Review ◽  
Young Onset ◽  
Dementia Patients ◽  
Level Data ◽  
Diagnosis Of Dementia ◽  
Young Onset Dementia ◽  
Late Onset Dementia

Aims and method Currently, no separate service exists for patients with young-onset dementia in Cambridgeshire. These patients are managed together with late-onset dementia patients within old age psychiatry services. To inform service design, we sought to characterise young-onset dementia patients in our population. We first analysed service-level data and supplemented this with a detailed case review of 90 patients. Results Young-onset dementia remains a relatively rare condition. Only a small proportion of those referred for assessment receive a diagnosis of dementia. Data collected on presenting complaints, comorbidities, medication and Health of the Nation Outcome Scales scores associated young-onset dementia with a greater incidence of depression than late-onset dementia. Outcomes in the two groups did not appear to differ. Clinical implications The data presented here do not suggest a need to create a separate service. Practitioners should be aware of the increased incidence of depression observed in this group.

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

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.

scholarly journals Less Education Predicts Anticholinesterase Discontinuation in Dementia Patients

2013 ◽  
Vol 40 (5) ◽  
pp. 684-690 ◽  
Author(s):  
Solin Saleh ◽  
Andrew Kirk ◽  
Debra G. Morgan ◽  
Chandima Karunanayake
Keyword(s):  
Logistic Regression ◽  
Cholinesterase Inhibitor ◽  
Formal Education ◽  
Remote Memory ◽  
Outcome Variable ◽  
Drug Discontinuation ◽  
Memory Clinic ◽  
Dementia Patients ◽  
Functional Factors ◽  
Institutionalized Patients

Abstract:Objective:We investigated patient socio-demographic, clinical and functional factors predicting cholinesterase inhibitor discontinuation by patients presenting to a memory clinic in Saskatoon, Saskatchewan.Methods:Data collection began in March 2004 at the Rural and Remote Memory Clinic where family physicians referred their non-institutionalized patients. Neurological and neuropsychological assessment, patient and caregiver questionnaires provided the socio-demographic, clinical and functional variables. Univariate logistic regression analysis was used to examine possible associations between each independent variable and the binary outcome variable of treatment discontinuation. Multivariate logistic regression was used to determine predictors of cholinesterase inhibitor discontinuation within six months of drug initiation.Results:Our sample consisted of the first 63 patients (60.3% female) for whom we prescribed a cholinesterase inhibitor. The mean age at clinic day was 74.56 years (SD=7.78). We found that years of formal education was the only variable significantly associated with cholinesterase inhibitor discontinuation by six months. The more years of formal education, the lower the rate of drug discontinuation by six months.Conclusions:Likelihood of cholinesterase inhibitor discontinuation by six months was predicted by fewer years of formal education.

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

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.

Differences between men and women referred to a rural and remote memory clinic

2017 ◽  
Vol 381 ◽  
pp. 671
Author(s):  
A. Kirk ◽  
O. Philippon ◽  
C. Karunanayake ◽  
D. Morgan
Keyword(s):  
Remote Memory ◽  
Memory Clinic ◽  
Rural And Remote ◽  
Men And Women

scholarly journals Dementia in Southeast Asia: influence of onset-type, education, and cerebrovascular disease

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Ashwati Vipin ◽  
Vaynii Satish ◽  
Seyed Ehsan Saffari ◽  
Wilbur Koh ◽  
Levinia Lim ◽  
...  
Keyword(s):  
Southeast Asia ◽  
Cerebrovascular Disease ◽  
Late Onset ◽  
Age At Onset ◽  
Consecutive Series ◽  
Memory Clinic ◽  
Onset Type ◽  
Dementia Patients ◽  
Common Diagnosis ◽  
Global Cognition

Abstract Background Southeast Asia represents 10% of the global population, yet little is known about regional clinical characteristics of dementia and risk factors for dementia progression. This study aims to describe the clinico-demographic profiles of dementia in Southeast Asia and investigate the association of onset-type, education, and cerebrovascular disease (CVD) on dementia progression in a real-world clinic setting. Methods In this longitudinal study, participants were consecutive series of 1606 patients with dementia from 2010 to 2019 from a tertiary memory clinic from Singapore. The frequency of dementia subtypes stratified into young-onset (YOD; <65 years age-at-onset) and late-onset dementia (LOD; ≥65 years age-at-onset) was studied. Association of onset-type (YOD or LOD), years of lifespan education, and CVD on the trajectory of cognition was evaluated using linear mixed models. The time to significant cognitive decline was investigated using Kaplan-Meier analysis. Results Dementia of the Alzheimer’s type (DAT) was the most common diagnosis (59.8%), followed by vascular dementia (14.9%) and frontotemporal dementia (11.1%). YOD patients accounted for 28.5% of all dementia patients. Patients with higher lifespan education had a steeper decline in global cognition (p<0.001), with this finding being more pronounced in YOD (p=0.0006). Older patients with a moderate-to-severe burden of CVD demonstrated a trend for a faster decline in global cognition compared to those with a mild burden. Conclusions There is a high frequency of YOD with DAT being most common in our Southeast Asian memory clinic cohort. YOD patients with higher lifespan education and LOD patients with moderate-to-severe CVD experience a steep decline in cognition.

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