Wijma, D. (Dorine) (2012) Beschrijvend onderzoek GeheugenCentrum Zwolle Patiëntkarakteristieken, diagnoses en de waarde van beeldvormend onderzoek. thesis, Medicine.
Full text available on request.Abstract
Introduction : Dementia is a large and increasing problem. The Netherlands have an increasing number of memory clinics and in 2009 the MemoryCentre Zwolle was established. We estimate that nearly half of patients with dementia from the Zwolle region in the MemoryCenter is seen. Hence the MemoryCenter plays an important role in the diagnosis of dementia. Purpose: To get insight in the characteristics of the patients referred to the MemoryCentre and find out which diagnoses were made. We also wanted to investigate the value of imaging for making the distinction between the different subtypes of dementia. Methods – We analyzed 804 patients who were referred and diagnosed in the MemoryCentre, in a period between September 2009 and June 2012, in a cross-sectional study. The analyzed variables were: general patient information, medical history, family history, education, intoxications, physical and neurological examination, Mini-Mental State Examination (MMSE), laboratory result, result of the CT-/MRI-scan, diagnosis and treatment. Results; The median age was 78.5 (quartiles: 71-84). 57.3% were female. 55.9% have cardiovascular disease (CVD) or hypertension, 24.0% diabetes mellitus. 28.4% have a family member with dementia. 58.7% (n=454) were diagnosed with dementia, 20.8% with MCI, 12.9% with another diagnose and in 7.5% they found no pathology. Patients in the dementia group were significantly older than patients in all other groups. Patients in the MCI group were significantly older than patients with other diagnoses or without pathology. Among patients with dementia, Alzheimer’s dementia was diagnosed in 38.3%, 37.9% had a mixed dementia. In 46.6% of patients with AD, there was also CVD or hypertension. When we add those patients to the group with mixed dementia, than even 54.4% had mixed AD/vascular dementia (VaD). Imaging was done in 34.5% of patients. The abnormalities found on CT-scan did not differ significantly between the different subtypes of dementia (p-value=0.46), the same for MRI-scan (p-value=0.68). But patients with dementia had more often white matter lesions (p-value=0.000) or atrophy (p-value=0.001) than other patients. Conclusion: The majority of patients seen in the MemoryCenter were diagnosed with dementia and in 54.4% mixed AD/VaD were diagnosed. This can mean that AD and VaD, in accordance with the pathophysiology, must be combined into one type of dementia. Risk factors for dementia such as CVD, apart from age and hypertension, were not significantly more common in patients with dementia. Imaging was in our population not valuable for distinguishing the different subtypes of dementia. To evaluate these findings, cooperation with other memory clinics is proposed to further investigate the patient characteristics and value of imaging.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Kamper, Dr. A.M. internist ouderengeneeskunde |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:00 |
| Last Modified: | 25 Jun 2020 11:00 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2013 |
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