MEMORY BROUGHT TO MIND. FIVE-YEAR FOLLOW-UP OF CASE FINDING AND INTERVENTION OF DEMENTIA IN A SWEDISH PRIMARY HEALTH CARE DISTRICT
S. Josefsson, M. Kjellmark, P. Adenmark, E. Karlsson, R. Åstrand, E. Trell
J Prev Alz Dis 2015;2(1):17-23
BACKGROUND: In an urban/rural primary health care (PHC) district a five-year integrated project of early detection and management of cognitive disorders was made in collaboration between home care (HC) and family practice services using a single-item case-finding and intervention approach.
OBJECTIVES: To assess feasibility, outcome and morbidity over a 5-year period.
DESIGN, SETTING AND PARTICIPANT: In autumn 2008, the question “Have you experienced memory difficulties or been told of them by family members?” was mailed to all eligible persons > 75 years of age (n=367) in the urban/rural Vålberg HC and PHC district (population = 5073). 320 (= 87%; 184 no and 136 yes) responded and 117 yes-responders came for further examination. In the follow-up, all diagnoses up till November 2013 were collected and compared anonymously in both yes and no answerers.
RESULTS: 114 completed examination. 29 showed low risk of cognitive impairment, 39 moderate and 46 high. Definitive diagnosis was obtained in 34 of the latter: 10 cognitive impairment, 16 Alzheimer’s disease, 5 non-specific, 2 vascular and 1 alcoholic dementia. During follow-up no further dementia diagnoses occurred in the low, two in the moderate, and none in the high-risk group, versus 12 in the no responders. Age and mortality were significantly higher in the high-risk group. Co-morbidity was very frequent but did not differ between the groups.
CONCLUSIONS: Population response and compliance were excellent; the single-item direct question approach gave workable results with in particular high negative predictive power persisting over the five-year follow-up period, and can be applied in early case-finding, prevention and intervention of cognitive impairment in an integrated local HC, PHC and Hospital setting.
S. Josefsson ; M. Kjellmark ; P. Adenmark ; E. Karlsson ; R. Åstrand ; E. Trell (2015): MEMORY BROUGHT TO MIND. FIVE-YEAR FOLLOW-UP OF CASE FINDING AND INTERVENTION OF DEMENTIA IN A SWEDISH PRIMARY HEALTH CARE DISTRICT. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2015.43