Journal
CANADIAN GERIATRICS JOURNAL
Volume 21, Issue 2, Pages 152-156Publisher
MULTIMED INC
DOI: 10.5770/cgj.21.297
Keywords
memory clinic; symptom duration; referral; dementia; mild cognitive impairment
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Funding
- Fondation de l'Institut de geriatrie de Montreal
- Council of Physicians, Dentists and Pharmacists of the Institut universitaire de geriatrie de Montreal
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Background Early assessment of cognitive symptoms is an issue in geriatrics. This study investigated the delay from the onset of cognitive symptoms to initial clinical assessment and its associations with patients' sociodemographic and clinical characteristics. Methods This is a cross-sectional retrospective study using medical chart review of 316 patients referred for assessment to a university-affiliated memory clinic. Symptom duration was self-reported by patients/carers. Severity of symptoms assessed by the MoCA and FAST instruments was compared according to delay duration (>= 3 years vs. <3 years) using chi-squared tests. Logistic regression was used to determine the association between patients' characteristics and long symptom duration (>= 3 years). Results At the initial assessment, 29.4% of patients reported experiencing cognitive symptoms for >= 3 years. They were more likely to have MoCA scores <= 17 (47.8 vs. 34.1%; p=.023) and FAST scores >= 5 (21.5 vs. 10.8%; p=.012). They were also significantly older than 75 years (75-84 yr: OR=2.22 [95% CI: 1.11-4.41]; >= 85 yr: 4.36 [2.08-9.11]), presented more depressive symptoms (2.37 [1.40-4.02]), and were less likely to live alone (0.55 [0.31-0.96]). Conclusions A significant proportion of patients had cognitive symptoms for years when initially assessed, which delayed diagnosis and management. Stigma, depression, and compensatory help from carers may contribute to this delay.
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