BACKGROUND: The goal of the study is to evaluate the sensitivity of Czech physicians to the early diagnosis of dementia in patients with memory impairment. METHODS: A retrospective observational study was designed. We have reviewed the electronic medical records of patients who have been hospitalized for the first time due to dementia of any type at the Kromeriz Mental hospital from January 1, 2012 to December 31, 2013 (24-month period). Pluralistic methods combining the qualitative and quantitative approach were used in this study. RESULTS: Dementia of any type was diagnosed in 125 patients in the monitored period. The mean time between patient memory complaints and his / her admission to our facility for their first hospitalization due to dementia was 7.1 years (+- 3.7 years). Most patients with dementia had no prior outpatient treatment of their memory impairment (56.2%); a minority of patients (43.8%) had treatment of their memory impairment by an outpatient physician. CONCLUSION: The sensitivity of Czech physicians to the early diagnosis of dementia is very low. Any delay in starting the treatment of dementia means a worsened effectiveness of this treatment, a worsened quality of life of patients with dementia and their caregivers. Our recommendations for both the early diagnosis and treatment of dementia should be involved in guidelines and should become a part of the pregraduate and postgraduate education of all physicians.

1 Dept of Psychogeriatry Mental hospital Kromeriz Kromeriz Czech Republic ; 2 Dept of Social Medicine and Public Health Faculty of Medicine Palacky University Olomouc Czech Republic

3 Center of Longevity Faculty of Humanities Charles University Prague Czech Republic

4 Dept of Psychiatry Jessenius Faculty of Medicine in Martin Comenius University in Bratislava Slovak Republic

Zobrazit více v PubMed

Halley LJ, Smyth KA (2013). Human culture and the future dementia epidemic: crisis or crossroads? Neurology, 80(20): 1824–1825. PubMed

Hampel H, Prvulovic D, Teipel S et al. (2011) The future of Alzheimer’s disease: the next 10 years. Prog. Neurobiol, 95(4): 718–728. PubMed

Holmerová I, Vanková H, Jurasková B (2011). Biogerontology in the Czech Republic. Biogerontology, 12(1): 31–35. PubMed

Azam B, Whitfield TJ, Radford D, Dontham SG, Stevens T, Dannhauser T, Walker Z (2014). Trends in referred patient profiles in a memory clinic over 20 years. Dementia (London), 2014. June 16. pii: 1471301214539691. [Epub ahead of print]. PubMed

Dorsey ER, George BP, Leff B, Willis AW (2013). The coming crisis: obtaining care for the growing burden of neurodegenerative conditions. Neurology, 80(21): 1989–1996 PubMed PMC

Holmerová I, Jurasková B, Kalvach Z, Rohanová E, Rokosová M, Vanková H (2007). Dignity and palliative care in dementia. J Nutr Health Aging, 11(6): 489–494. PubMed

Vanková H, Holmerová I, Andel R, Veleta P, Janecková H. (2008). Functional status and depressive symptoms among older adults from residential care facilities in the Czech Republic. Int J Geriatr Psychiatry, 23(5): 466–471. PubMed

Luzny J. (2012). Gerontopsychiatrie. [Textbook of Psychogeriatry in Czech languge]. 1st ed. Triton, Prague, pp. 28–29.

Holmerová I, Koopmans R, SkelaSavič B, Egervári A, Hermann B, Ruseckiene R, Tolson D (2012). Advancing long term care: central European perspectives. J Am Med Dir Assoc, 13(7): 578–580. PubMed

Luzny J (2013). Quality of life in patients with dementi. [Article in Czech language]. Cesk Slov Neurol N, 76/109(1): 90–95.

Pandiani L, Souêtre A (2009). Latest trends in preventive medicine: highlights of the PreMed 2008 meeting, 6 - 7 June 2008, Monza, Italy. Expert Opin Med Diagn, 3(2): 207–210. PubMed

Fiedler U, Wiltfang J, Peters N, Benninghoff J (2012). Advances in the diagnostics of Alzheimer’s disease. Nervearzt, 83(5): 661–673. PubMed

Wolz R, Julkunen V, Koikkalainen J, Niskanen E, Zhang DP, Rueckert D, Soininen H, Lötjönen J (2011). Multi-method analysis of MRI images in early diagnostics of Alzheimer’s disease. PLoS One, 6(10): 213–219. PubMed PMC

Mosconi L, Berti V, Glodzik L, Pupi A, De Santi S, de Leon MJ (2010). Pre-clinical detection of Alzheimer’s disease using FDG-PET, with or without amyloid imaging. J Alzheimers Dis, 20(3): 843–854. PubMed PMC

Lužný J. Staging in neurodegenerative dementias. [Article in Czech language]. Geri Gero, 2(3): 142.

Makoul G, Curry RH, Tang PC (2001). The use of electronic medical records: communication patterns in outpatient encounters. J Am Med Inform Assoc, 8(6): 610–615. PubMed PMC

Weitzman EA, Miles MB (1995). Computer programs for qualitative data analysis. 1st ed. CA Sage, Thousand oaks, pp. 65–78.

Miles MB, Huberman MA (1994). Qualitative analysis: an expanded sourcebook. 2nd edition. CA Sage, Thousand oaks, pp. 655–683.

Folstein MF, Folstein SE, McHugh PR. (1975). A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res, 1975; 12(3): 189–198. PubMed

Viscogliosi G, Marigliano V (2013). Alzheimer´s disease: how far have we progressed? Lessons learned from diabetes mellitus, metabolic syndrome, and inflammation. J Am Geriatr Soc, 61(5): 845–846. PubMed

Sokol EW (2013). National plan to address Alzheimer’s disease offers hope for new home care and hospice provisions. Caring, 32(1): 24–27. PubMed

Feldman H, Gauthier S, Hecker J, Vellas B, Hux M, Xu Y, Schwam EM, Shah S, Mastey V (2004). Economic evaluation of donepezil in moderate to severe Alzheimer disease. Neurology, 63(4): 644–650. PubMed

Jönsson L, EriksdotterJönhagen M, Kilander L, Soininen H, Hallikainen M, Waldemar G, Nygaard H, Andreasen N, Winblad B, Wimo A (2006). Determinants of costs of care for patients with Alzheimer’s disease. Int J Geriatr Psychiatry, 21(5): 449–459. PubMed

López-Pousa S, Garre-Olmo J, Turon-Estrada A et al. (2004). Cost relation between severity of Alzheimer’s disease and cognitive and functional impairment. Med Clin (Barc.), 122(20): 767–772. PubMed

Wimo A, Ballard C, Brayne C, Gauthier S, Handrle R, Jones RW, Jonsson L, Khachaturian AS, Kramberg M (2014). Health economic evaluation of treatments for Alzheimer’s disease: impact of new diagnostic criteria. J Intern Med, 275(3): 304–316. PubMed

Viloria A (2011). Predementia Alzheimer´s disease. Benefits of early diagnostics. Rev Esp Geriatr Gerontol, 46 Suppl 1: 47–54. PubMed

Scuvee-Moreau J, Kurz X, Dresse A; National Dementia Economic Study Group (2002). The economic impact of dementia in Belgium: results of the National Dementia Economic Study (NADES). Acta Neurol Belg, 102(3): 104–113. PubMed

de Vugt ME, Verhey FR(2013). The impact of early dementia diagnosis and intervention on informal caregivers. Prog Neurobiol, 110: 54–62. PubMed

Phung TK, Waltoft BL, Kessing LV, Mortensen PB, Waldemar G (2010). Time trend in diagnosingdementia in secondary care. Dement Geriatr Cogn Disord, 29(2): 146–153. PubMed

Villars H, Oustric S, Andrieu S et al. (2010). The primary care physician and Alzheimer’s disease: an international position paper. J Nutr Health Aging, 14(2): 110–120. PubMed

Iliffe S, Koch T, Jain P, Lefford F, Wong G, Warner A, Wilcock J (2012). Developing an educational intervention on dementiadiagnosis and management in primary care for the EVIDEM-ED trial. Trials, 22; 13: 142–149. PubMed PMC

Hospitalizations and Mortality of Individuals with Dementia: Evidence from Czech National Registers

DEMDATA: The Austrian-Czech institutional long term care project - design and protocol of a two-centre cross sectional study