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O2‐13‐05: Reversion from mild cognitive impairment to cognitively intact is associated with medically reversible causes for cognitive decline rather than overt instability in the diagnosis of mild cognitive impairment
Author(s) -
Jicha Gregory,
Singhal Divvya,
Hack Nawaz,
Abner Erin,
Schmitt Frederick,
Kryscio Richard
Publication year - 2012
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2012.05.700
Subject(s) - dementia , disease , depression (economics) , cognition , pediatrics , cognitive decline , medicine , confounding , retrospective cohort study , psychology , psychiatry , audiology , clinical psychology , economics , macroeconomics
Background: Background: The memory clinic at Siriraj Hospital is the first memory clinic in Thailand and has been providing a service to Thai patients with memory compliant for 10 years. Both early dementia (EOD, aged less than 65 years old) and late onset dementia (LOD, aged 65 and above) receives medical services here. Objectives: To find the prevalence and etiology of EOD and LOD at the memory clinic at Siriraj Hospital. Methods: Patients living in the community from the memory clinic at Siriraj Hospital diagnosed with dementia or mild cognitive impairment (MCI). The dementia are defined at baseline as Alzheimer’s disease (AD) early or late onset, frontotemporal dementia (FTD), vascular dementia (VaD), mixed (AD and VaD) and other dementia. Patient characteristics were explored. Results: Of the 1052 patients enrolled, 916 were eligible for analysis. Two hundred and seventy one (271/1052, 22.6%) were aged less than 65 years old. 342 (28.6%) had AD, 160 (13.4%) had VaD, 59 (4.9%) had mixed AD and VaD, 26 (2.2%) had dementia with Lewy bodies (DLB), 16 (1.3%) had Parkinson disease dementia (PDD), 17 (1.4% had normal pressure hydrocephalus (NPH), 21(1.8%) had frontotemporal dementia (FTD), 9(0.8%) had alcohol related dementia, 8 (0.7%) had neurosyphilitic dementia, 3 (0.3%) had post traumatic dementia, 1 (0.1%) had dementia from hypothyroidism,33(2.8%) had dementia of unknown causes, 49 (4.1%) had other dementia, 142 (11.9%) had MCI, and 30 (2.5%) had benign forgetfulness. Chief complaints leading to medical consultation are memory loss (73.6%), behavioral problems (20%), gait problem (2.2%), psychosis (0.6%), and other (3.5%). Mean Thai mental state examination score of the patients in the memory clinic was 19.39 (7.20).Mean Functional Assessment Questionnaire (FAQ) score was 13.63 (9.87). Mean number of neuropsychiatric symptoms from the Neuropsychiatric Inventory (NPI) was 2.59 (2.34). 42.8% had more than 6 years of education. In the EOD group (n 1⁄4 188), the common disorders were AD (30.85%), VaD (25%), mixed AD&VaD (4.79%), FTD(7.98%), NPH (2.66%), DLB (1.06%), and PDD (2.13%). In the LOD group (n 1⁄4 556), the common etiologies were AD (51.08%), VaD (20.32%), mixed AD&VaD (8.99%), DLB (4.32%), PDD (2.16%), NPH (2.16%), and FTD (1.08%). Conclusions: The data from memory clinic at Siriraj Hospital provide important information on differences between EOD and LOD. Though, AD is the commonest etiology in both diagnosis groups in this cohort.