Article
What are factors associated with receiving diagnosis of a dementia specialist in primary care?
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Authors
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Urs Strohmaier
- Deutsches Zentrum für neurodegenerative Erkrankungen (DZNE) e.V., Rostock, Germany
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Jochen René Thyrian
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Greifswald, Germany
| Published: | September 26, 2017 |
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Outline
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Background: Dementia is turning out to be one of the major challenges for health-care systems in western societies. 24 million people are affected nowadays and the number is expected to double every 20 years. According to current guidelines the key for treatment and care is a state-of the art diagnosis. In Germany however, not every person with dementi ain primary care is diagnosed by a specialist for various reasons. The aim of this presentation is to compare people with dementia in primary care that have been diagnosed by a dementia specialist with people being treated soley in routine care.
Methods: This analysis is part of the DelpHi-study, an intervention trial to test the efficacy of an intervention in primary care. A sample of 485 patients of general practitioners in residency took part in this study. A comprhensive assessment including sociodemographics, clinical and other health-related variables was conducted in all patients. We divided the sample into 2 groups according to a patient had consulted a specialist of the neuro-psychiatric profession in the last 12 months or not. We approacched these specialists and asked for imaging data of these patients.
We analysed the association between consultancy of sdpecialsists and age, sex, functional ability, partnership status, cognitive status and depressive symptoms using logistic regression analyses. Furthermore, we re-analyzed MR-images using easy-to-learn and applicable scores (Fazekas, Schelten and Wahlund)
Results: There is an association between visit to a specialsist and age (younger) and functional ability (less impaired). We could not support the literature about a gender bias in receiviing specialist care. However, we found a mismatch between cognitive testing results, diagnoses and the re-analyzed scores on the MR-images. Results can be discussed in the light of over-/ undertreatment and the need to identify indicators for specialist treatment. Easy to learn analyzing technics for imaging diagnostics could be one approach.
