Leemhuis, E.J. (2013) Een diagnostische evaluatie van de polikliniek geheugenstoornissen in het Medisch Spectrum Twente. thesis, Medicine.
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Abstract
Background: Due to an ageing population and the availability of pharmacotherapy the request for early detection of dementia is increasing. Multidisciplinary memory clinics (MC) respond to this demand and focus on diagnosis and treatment of patients with cognitive impairment. Besides many similarities, there are also differences between the clinics in design, diagnostic outcomes and the use of diagnostic tests. Little is known about the benefit of combinations of diagnostic tests in the diagnosis of dementia. Objective: The aim of this study is to determine the outcomes of the MC of the Medisch Spectrum Twente in Enschede. Secondary, we investigate the contribution of combinations of diagnostic tests in relation to diagnosis formation. Methods: A retrospective observational study was performed for patients with cognitive complaints visiting the MC between January 2010 and July 2012. Data of demographic characteristics, diagnosis, diagnostic tests and treatments were collected and analysed. Results: The study population contains 214 patients, of which 47.7% had dementia. In 16.4% of the patients, no objective cognitive impairment was found. Alzheimer’s Disease (AD) was the most common etiological diagnosis (65.6%) and in only 6.9% an etiological diagnosis could not be performed. In the subgroup of patients with clinical possibility of AD a cognitive screening test and MRI, and if necessary an additional neuropsychological examination, were an appropriate combination for distinguishing AD from no-AD (AUC 0.877). The most frequent treatments were prescribing cholinesterase inhibitors (37.9%), referral to another medical specialist (25.7%), calming (22.9%), non-pharmacological treatments (19.2%) and follow-up (16.8%). Conclusions: The MC operates as a secondary referral centre on neurological basis, causing a substantial part of patients without objective cognitive impairment or dementia. The diagnostic outcomes are in general consistent with other publications. A cognitive screening test and MRI, and if necessary a neuropsychological examination, are together an appropriate combination for diagnosing or excluding the diagnosis AD. This multidisciplinary approach appears to be effective, because a great diversity of diagnoses was found and only in a small amount of patients an etiological diagnosis could not be established. Structural psychiatric assessment appears also valuable in our clinic.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Hageman, Dr. G. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:40 |
| Last Modified: | 25 Jun 2020 10:40 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/173 |
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