The cause analysis of low rate for dementia diagnosis in outpatient clinic / 中华老年医学杂志

ABSTRACT

Objective To investigate the cause of low rate for dementia diagnosiss in out-patient clinic.Methods All outpatients between September 15,2009 and December 25,2009 were screened by IQCODE,MMSE and neuropsychological examination.Diagnosis of dementia and its subtype were confirmed according to DSM-IV-TR,NINCDS-ADRDA,and NINDS-AIREN criteria.The caregivers of dementia patients were interviewed with questionnaire.Results There were 8,042 outpatients in the period and 1716 patients completed IQCODE,317 completed MMSE,72 completed a set of neuropsychological test.41 patients were diagnosed as dementia which composed of 23 cases of AD (56.1％),12 cases of vascular dementia(29.3％),2 cases of mixed dementia(4.9％),4 cases of other types of dementia(9.7％),and the prevalence of dementia at age of over 55 years was 1.8％ in out-patient clinics.Among the patients,18 cases were mild dementia (43.9％),19 moderate dementia (46.3 ％ ) and 4 severe dementia (9.8 ％).Four patients(9.8 ％ ) were diagnosed as dementia by case history,15 patients(36.5％) were diagnosed as dementia by clinic doctors,while 22 patients (53.7％) were diagnosed as dementia in the survey.35 caregivers finished questionaire,and 10 caregivers(28.6％) had no knowledge about dementia,22(62.8％) caregivers had a few knowledge and 3(8.6％) caregivers had lots of knowledge.19 (46.3％) dementia patients went to see a doctor with cognitive impairment and 22 (53.7 ％) with other symptoms.The reasons for delay in seeing a doctor included that caregivers considered the impairment of cognition as a result of normal aging (54.3％),patients rejected to see a doctor(14.3％),caregivers considered no treatment for dementia (5.7 ％),and there was economic reason ( 2.9％),inconvenient (8.5 ％) and others ( 14.3 ％).Conclusions The visiting rate of dementia patients in china is very low and many demented patients do not receive early diagnosis and treatment.Patients' delay may contribute to the lack of knowledge of caregivers,and to doctor's ignore of the cognitive impairment.