PMID- 32362213 OWN - NLM STAT- MEDLINE DCOM- 20210430 LR - 20211109 IS - 1502-7724 (Electronic) IS - 0281-3432 (Print) IS - 0281-3432 (Linking) VI - 38 IP - 2 DP - 2020 Jun TI - Characteristics of patients assessed for cognitive decline in primary healthcare, compared to patients assessed in specialist healthcare. PG - 107-116 LID - 10.1080/02813432.2020.1753334 [doi] AB - Objective: The aim of this study was to describe patients assessed for cognitive decline in primary healthcare, compared to patients assessed in specialist healthcare and to examine factors associated with depression.Design: This was an observational study.Setting: Fourteen outpatient clinics and 33 general practitioners and municipality memory teams across Norway.Subjects: A total of 226 patients assessed in primary healthcare and 1595 patients assessed in specialist healthcare outpatient clinics.Main outcome measures: Cornell scale for depression in dementia (CSDD), Mini-Mental Status Examination (MMSE), Clock drawing test, Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), Instrumental Activities of Daily Living, Personal Self-Maintenance Scale, Relatives' stress scale (RSS), and Neuropsychiatric Inventory Questionnaire (NPI-Q)Results: Patients assessed in primary healthcare were older (mean age 81.3 vs 73.0 years), less educated, had poorer cognition (MMSE median 22 vs 25), more limitations in activities of daily living (ADL), more behavioural and psychological symptoms of dementia (BPSD), more depressive symptoms (CSDD median 7 vs 5), more often lived alone (60% vs 41%) and were more often diagnosed with dementia (86% vs 47%) compared to patients diagnosed in specialist healthcare. Depression was associated with female gender, older age, more severe decline in cognitive functioning (IQCODE, OR 1.65), higher caregiver burden (RSS, OR 1.10) and with being assessed in primary healthcare (OR 1.53).Conclusion: Post-diagnostic support tailored to patients diagnosed with dementia in primary healthcare should consider their poor cognitive function and limitations in ADL and that these people often live alone, have BPSD and depression.Key pointsPeople diagnosed in Norwegian primary healthcare had more needs than people diagnosed in specialist healthcare. * They were older, less educated, had poorer cognitive functioning and activity limitations, more often lived alone, and had more BPSD and depression. * Depression was associated with being female, older, having cognitive decline, being assessed in primary care and the caregiver experiencing burden * Post diagnostic support for people with dementia should be tailored to the individual's symptoms and needs. FAU - Michelet, Mona AU - Michelet M AD - Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tonsberg, Norway. AD - Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway. AD - Faculty of Medicine, University of Oslo, Oslo, Norway. FAU - Lund, Anne AU - Lund A AD - Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, OsloMet - Oslo Metropolitan University, Oslo, Norway. FAU - Strand, Bjorn Heine AU - Strand BH AD - Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tonsberg, Norway. AD - Norwegian Institute of Public Health, Oslo, Norway. FAU - Engedal, Knut AU - Engedal K AD - Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tonsberg, Norway. AD - Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway. FAU - Selbaek, Geir AU - Selbaek G AD - Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tonsberg, Norway. AD - Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway. AD - Faculty of Medicine, University of Oslo, Oslo, Norway. FAU - Bergh, Sverre AU - Bergh S AD - Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tonsberg, Norway. AD - Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway. LA - eng PT - Comparative Study PT - Journal Article PT - Observational Study DEP - 20200502 PL - United States TA - Scand J Prim Health Care JT - Scandinavian journal of primary health care JID - 8510679 SB - IM MH - Activities of Daily Living MH - Aged MH - Aged, 80 and over MH - Ambulatory Care Facilities MH - Cognition MH - Cognitive Dysfunction/complications/*diagnosis/psychology MH - Dementia/complications/*diagnosis/psychology MH - Depression/complications/*diagnosis MH - Diagnostic Services MH - Female MH - General Practice MH - *General Practitioners MH - *Geriatric Assessment MH - Humans MH - Male MH - Mass Screening MH - Middle Aged MH - Norway MH - *Primary Health Care MH - Psychiatric Status Rating Scales MH - Referral and Consultation MH - Severity of Illness Index MH - *Specialization MH - Surveys and Questionnaires PMC - PMC8570739 OTO - NOTNLM OT - Dementia OT - activities of daily living OT - depression OT - diagnostic services OT - primary health care COIS- No potential conflict of interest was reported by the authors. EDAT- 2020/05/05 06:00 MHDA- 2021/05/01 06:00 PMCR- 2020/05/02 CRDT- 2020/05/05 06:00 PHST- 2020/05/05 06:00 [pubmed] PHST- 2021/05/01 06:00 [medline] PHST- 2020/05/05 06:00 [entrez] PHST- 2020/05/02 00:00 [pmc-release] AID - 1753334 [pii] AID - 10.1080/02813432.2020.1753334 [doi] PST - ppublish SO - Scand J Prim Health Care. 2020 Jun;38(2):107-116. doi: 10.1080/02813432.2020.1753334. Epub 2020 May 2.