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Fortschr Neurol Psychiatr 2015; 83(10): 563-567
DOI: 10.1055/s-0041-108097
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Unterscheiden sich die Einstellungen von MCI-Patienten einer Gedächtnissprechstunde von denen einer Versorgerpraxis?

Differences in Attitudes of Patients with Mild Cognitive Impairment Towards Early Diagnosis at a University Clinic and a Specialist Physician’s Office
J. Bohlken
1   BVDN, Praxis Bohlken, Berlin
,
T. Köbe
2   NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin
,
L. M. Dietz
2   NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin
,
M. A. Rapp
3   Kognitionswissenschaften, Sozial- und Präventivmedizin, Potsdam
,
T. Kohlmann
4   Community Medicine, Universität Greifswald
,
A. Flöel
2   NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin
› Institutsangaben
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Publikationsverlauf

15. Juli 2015

22. Oktober 2015

Publikationsdatum:
20. November 2015 (online)

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Zusammenfassung

Ziel der Studie: Untersuchung der Einstellungsmuster von Patienten mit leichter kognitiver Störung hinsichtlich Diagnostik in unterschiedlichen Versorgungssituationen.

Methodik: Vergleichende Befragung von 129 Patienten in einer Universitätsambulanz (n = 38) und einer Facharztpraxis (n = 91) über ihre Einstellung zur Demenz-Frühdiagnostik und Bereitschaft zur Liquordiagnostik.

Ergebnisse: Die Bereitschaft zur Liquordiagnostik war in der Universitätsambulanz höher als in der Facharztpraxis (p = 0,040), die generelle Bereitschaft zu Frühdiagnostik vergleichbar hoch.

Schlussfolgerung: Unterschiedliche Einstellungen von Patienten mit leichter kognitiver Störung sollten in unterschiedlichen Versorgungssituationen Berücksichtigung finden.

Abstract

Aim: To examine the attitude of patients with mild cognitive impairment to diagnostics under different healthcare settings.

Methodology: A comparative survey was carried out of 38 patients at a university outpatient clinic and 91 patients at a specialist practice with regard to their attitudes towards early diagnosis of dementia and willingness to undergo CSF analysis.

Results: Willingness to undergo CSF analysis was higher among the patients at the university outpatient unit than those at the specialist practice (p = 0.040), and willingness to undergo early diagnosis was comparable high in both groups.

Conclusion: Different attitudes of patients with mild cognitive impairment should be reflected in different healthcare settings.

Schlüsselwörter

Demenz - Früherkennung - Patienteneinstellungen - Liquorpunktion

Key words

dementia - early diagnosis - attitudes - lumbar puncture
 

  • Literatur

  • 1 Rountree SD, Atri A, Lopez OL et al. Effectiveness of antidementia drugs in delaying Alzheimer’s disease progression. Alzheimers Dement 2013; 9: 338-345
    CrossrefPubMedGoogle Scholar
  • 2 Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde (DGPPN), and Deutsche Gesellschaft für Neurologie eds. Diagnose- und Behandlungsleitlinie Demenz. Heidelberg: Springer Medizinverlag; 2010
    Google Scholar
  • 3 Gertz H, Kurz A. Diagnose ohne Therapie. Frühdiagnostik der Alzheimer-Krankheit im Stadium der leichten kognitiven Beeinträchtigung. Nervenarzt 2011; 82: 1151-1159
    CrossrefPubMedGoogle Scholar
  • 4 Jessen F. Therapy for patients with dementia: Treatment strategies in the elderly. Internist (Berl) 2014; 55: 769-774
    CrossrefPubMedGoogle Scholar
  • 5 Dubois B, Feldman HH, Jacova C et al. Revising the definition of Alzheimer’s disease: a new lexicon. Lancet Neurol 2010; 9: 1118-1127
    CrossrefPubMedGoogle Scholar
  • 6 Jack CR, Knopmann DS et al. Hypothetical model of dynamic biomarkers of the Alzheimer’s pathological cascade. Lancet Neurology 2010; 9: 119-128
    CrossrefPubMedGoogle Scholar
  • 7 Sperling RA, Aisen PS, Beckett LA et al. Toward defining the preclinical stages of Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7: 280-292
    CrossrefPubMedGoogle Scholar
  • 8 Jessen F, Wiese B, Bachmann C. German Study on Aging, Cognition and Dementia in Primary Care Patients Study Group et al. Prediction of dementia by subjective memory impairment: effects of severity and temporal association with cognitive impairment. Arch Gen Psychiatry 2010; 67: 414-422
    CrossrefPubMedGoogle Scholar
  • 9 Albert MS et al. The diagnosis of mild cognitive impairment due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer`s & Dementia 2011; 7: 270-279
    PubMedGoogle Scholar
  • 10 Jagust WJ, Bandy D, Chen K. Alzheimer’s Disease Neuroimaging Initiative et al. The Alzheimer’s Disease Neuroimaging Initiative positron emission tomography core. Alzheimers Dement 2010; 6: 221-229
    CrossrefPubMedGoogle Scholar
  • 11 Nordberg A. Amyloid plaque imaging in vivo: current achievement and future prospects. Eur J Nucl Med Mol Imaging 2008; 35 (Suppl. 01) S46-S50
    CrossrefPubMedGoogle Scholar
  • 12 Dickerson BC, Wolk DA. Alzheimer’s Disease Neuroimaging Initiative. Biomarker-based prediction of progression in MCI: Comparison of AD signature and hippocampal volume with spinal fluid amyloid-β and tau. Front Aging Neurosci 2013; 5: 55
    PubMedGoogle Scholar
  • 13 Jack Jr CR, Holtzman DM. Biomarker modeling of Alzheimer’s disease. Neuron 2013; 80 (06) 1347-1358
    CrossrefPubMedGoogle Scholar
  • 14 Risacher SL, Saykin AJ. Neuroimaging and other biomarkers for Alzheimer’s disease: the changing landscape of early detection. Annu Rev Clin Psychol 2013; 9: 621628
    PubMedGoogle Scholar
  • 15 Schulz M, Bohlken J, Hering R et al. Diagnostische und therapeutische Leistungsdichte von neu erkrankten, zu Hause lebenden Patienten mit Demenz. Berlin: Zentralinstitut für die kassenärztliche Versorgung in Deutschland (Zi) – Versorgungsatlas; 2014 http://www.versorgungsatlas.de/themen/alle-analysen-nach-datum-sortiert/?tab=6&uid=48 (Zugang am 25.02.2015)
    PubMedGoogle Scholar
  • 16 Kalbe E, Kessler J, Calabrese P et al. DemTect: a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia. Int J Geriat Psychiatry 2004; 19: 136-143
    CrossrefPubMedGoogle Scholar
  • 17 Kessler J, Markowitsch HJ, Denzler P. Mini-Mental-Status-Test (MMST). Göttingen: Beltz Test GMBH; 2000. [Deutsche Adaption]
    Google Scholar
  • 18 Beck AT, Brown GK et al. Beck-Depressions-Inventar-FS (BDI-FS). Manual. Deutsche Bearbeitung von Sören Kliem & Elmar Brähler: Pearson Assessment: Frankfurt am Main; 2013
    Google Scholar
  • 19 Yesavage JA, Brink TL et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1983; 39: 37-39
    PubMedGoogle Scholar
  • 20 Karlawish J, Rubright J, Casarett D et al. Older adults’ attitudes toward noncompetent subjects participating in Alzheimers research. Am J Psychiatry 2009; 166: 182-188
    CrossrefPubMedGoogle Scholar
  • 21 Boustani M, Perkins AJ, Fox C et al. Who refuses the diagnostic assessment for dementia in primary care?. Int J Geriatr Psychiatry 2006; 21: 556-563
    CrossrefPubMedGoogle Scholar
  • 22 Schmidtke K. Lumbalpunktion in der Demenzabklärung: Die Liquorpunktion ist unentbehrlich. Kontra 2014; 85: 478-479
    PubMedGoogle Scholar
  • 23 Schulz JB. Lumbalpunktion in der Demenzabklärung: Die Liquorpunktion ist unentbehrlich. Nervenarzt 2014; 85: 476-477
    CrossrefPubMedGoogle Scholar
  • 24 Luck T, Luppa M, Sieber J et al. Attitudes of the German general population toward early diagnosis of dementia--results of a representative telephone survey. PLoS One 2012; 7: e50792 DOI: 10.1371/journal.pone.0050792.
    CrossrefPubMedGoogle Scholar
  • 25 Galvin JE, Fu Q, Nguyen JT. Psychosocial determinants of intention to screen for Alzheimer’s disease. Alzheimers Dement 2008; 4: 353-360
    CrossrefPubMedGoogle Scholar
  • 26 Fowler NR, Boustani MA, Frame A et al. Effect of patient perceptions on dementia screening in primary care. J Am Geriatr Soc 2012; 60: 1037-1043
    CrossrefPubMedGoogle Scholar
  • 27 Justiss MD, Boustani M, Fox C et al. Patients’ attitudes of dementia screening across the Atlantic. Int J Geriatr Psychiatry 2009; 24: 632-637
    CrossrefPubMedGoogle Scholar
  • 28 Robinson SM, Canavan M, O’Keeffe ST. Preferences of older people for early diagnosis and disclosure of Alzheimer’s disease (AD) before and after considering potential risks and benefits. Arch Gerontol Geriatr 2014; 14: S0167-S0177
    PubMedGoogle Scholar
  • 29 Kaduszkiewicz H, Eisele M, Wiese B et al. Study on Aging, Cognition, and Dementia in Primary Care Patients (AgeCoDe) Study Group.Prognosis of mild cognitive impairment in general practice: results of the German AgeCoDe study. Ann Fam Med 2014; 12: 158-165
    CrossrefPubMedGoogle Scholar
  • 30 Reiber H, Lange P. Zerr I Neurochemical Dementia Diagnostics – Inerlaboratory Variation of Analysis, Reference Rnges and Interpretations. J Alzheimers Dis Parkinsonims 2014; 4: 147-156
    PubMedGoogle Scholar
  • 31 Visser P et al. Disclosure of Alzheimer’s disease biomarker status in subjects with mild cognitive impairment. Biomarkers Med 2012; 6: 1263-1269
    PubMedGoogle Scholar
  • 32 Clionsky M, Clionsky E. Dementia Screening: Saying No to the USPSTF and Yes to Brief Cognitive Evaluation. J Alzheimers Dis Parkinsonism 2014; 4: e132
    PubMedGoogle Scholar
  • 33 Ballard C, Bannister C, Solis M et al. The prevalence, associations and symptoms of depression amongst dementia sufferers. J Affect Disord 1996; 36: 135-144
    CrossrefPubMedGoogle Scholar