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P1‐542: THE IMPACT OF HURRICANE MARIA ON PERCEIVED NEEDS OF PUERTO RICANS 65 YEARS AND OLDER AT RISK FOR DEMENTIA USING THE HESPER SCALE
Author(s) -
Gonzalez Ramirez Ginette N.,
Da Silva Ian,
Oppenheimer Lawrence,
Aranda Sebastian,
Torres Eric,
Abreu Ricardo,
Pérez Arturo,
Rodriguez Glorimar,
Valentin Eric Miranda,
Rivera Horacio Serrano,
Jiménez-Velazquez Ivonne Z.
Publication year - 2019
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.2019.06.1147
Subject(s) - dementia , stressor , scale (ratio) , distress , population , gerontology , catchment area , medicine , affect (linguistics) , mental health , psychology , psychiatry , environmental health , clinical psychology , geography , disease , drainage basin , cartography , communication , pathology
Background: Frontotemporal dementia (FTD) is a neurodegenerative disorder characterized by progressive, profound behavioral changes and/or language deficits associated with progressive loss of independence. The insidious onset of symptoms and clinical heterogeneity often lead to a diagnostic delay and significant burden for affected families (Olney NT, et al. 2017). The evaluation of clinical scenarios, including patient presentation, diagnosis, and clinical follow up is key to better understanding this heterogenous population. Using a large Electronic Health Record (EHR) population from the US, we sought to describe the journey of patients who ultimately received an FTD diagnosis and to explore patient, provider, clinical settings and health care factors associated with diagnosis.Methods: A descriptive cohort study was conducted using an Optum (OptumAnalytics) de-identified longitudinal EHR dataset with 38million individuals aged 18 years, across the US, between 2007 and 2017. FTD, including all variants, was defined using a complex algorithm of ICD9 and ICD10 codes. Demographics of FTD patients were determined. Comorbidities, as well as provider and clinical encounter types at time of first diagnosis and in the five years before and/or after diagnosis, were examined. Results: 4,672 FTD patients (female: 49.4%, male: 50.3%) were identified, of which 4% were African American and 85% were Caucasian. Age at FTD diagnosis ranged from 20 to 89 years. The top three providers at the time of diagnosis were neurologists (48.5%), internists (30.1%), and family physicians (22.6%). Major depressive disorders were the most common comorbidity among the youngest age category (18-44) whereas hypertension, and lipid disorders were the most common among patients of older ages (45-64 and >65 years). Within the study period (2007-2017), among the FTD patients who had clinical encounters, we observed an average of 3.5 emergency room visits per patient, an average of 2.8 inpatient visits per patient, and that 26% of the patients had deceased. Conclusions: These results provide valuable insights into understanding the journey of people diagnosed with FTD and the disease impact that will inform strategies for efficient clinical development of new treatments for a disorder with limited precedence.