Subjective memory complaints in general practice predicts future dementia: a 4-year follow-up study

被引:77
作者
Waldorff, Frans Boch [1 ,2 ]
Siersma, Volkert [1 ]
Vogel, Asmus [2 ]
Waldemar, Gunhild [2 ]
机构
[1] Univ Copenhagen, Res Unit Gen Practice, Sect Gen Practice, Dept Publ Hlth, Copenhagen, Denmark
[2] Copenhagen Univ Hosp, Memory Disorders Res Grp, Dept Neurol, Rigshosp, Copenhagen, Denmark
关键词
memory complaints; memory disorders; dementia; family practice; epidemiology; COGNITIVE IMPAIRMENT; ALZHEIMERS-DISEASE; ELDERLY SUBJECTS; OLDER-PEOPLE; COMMUNITY; PERFORMANCE; POPULATION; DETERIORATION; INDIVIDUALS; ASSOCIATION;
D O I
10.1002/gps.3765
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objective Many older patients in general practice have subjective memory complaints (SMC); however, not all share this information with their general practitioner (GP). The association between SMC and future cognitive decline or dementia is not clear, especially in a general practice population. The aim of this study was to determine the risk for receiving a subsequent hospital-based dementia diagnosis on the basis of patients' reports of SMC in a primary care setting. Methods Prospective cohort survey with 4-year register-based follow-up in general practice. All 17 practices with a total of 24 GPs working in the inner district of Copenhagen municipality, Denmark. A total of 40?865 patients were listed, and 2934 were 65 years or older. Cox proportional hazard models were used to examine the influence of risk factors for hospital-based dementia diagnosis. Results A total of 758 non-nursing home residents aged 65?years and older consulted their GP in October and November 2002, and, when asked, 177 (24%) reported memory problems, and 50 (6.6%) received a hospital-based dementia diagnosis within the 4-years follow-up. SMC had an adjusted Hazard Ratio (HR) of 2.27 for subsequent dementia diagnosis. Other statistical significant covariates were Mini Mental State Examination?<?24 (HR 3.97), age (HR 2.73 for 7584?years and HR 3.75 for 85+ years) and receiving home care (HR 3.24) Conclusions This study indicates that the presence of SMC in an older general practice population is a significant independent predictor for subsequent hospital-based dementia diagnosis. Thus, the GP could consider inquiring for memory complaints to identify vulnerable older patients. Copyright (C) 2012 John Wiley & Sons, Ltd.
引用
收藏
页码:1180 / 1188
页数:9
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