Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-18T08:04:24.221Z Has data issue: false hasContentIssue false

Time to diagnosis in young-onset dementia as compared with late-onset dementia

Published online by Cambridge University Press:  28 May 2012

D. van Vliet
Affiliation:
School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University Medical Centre, Maastricht, The Netherlands
M. E. de Vugt*
Affiliation:
School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University Medical Centre, Maastricht, The Netherlands
C. Bakker
Affiliation:
Florence, Mariahoeve, Centre for Specialized Care in Young-Onset Dementia, The Hague, The Netherlands Department of Primary and Community Care: Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen, Medical Centre, Nijmegen, The Netherlands
Y. A. L. Pijnenburg
Affiliation:
Alzheimer Centre and Department of Neurology, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands
M. J. F. J. Vernooij-Dassen
Affiliation:
Department of Primary and Community Care: Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen, Medical Centre, Nijmegen, The Netherlands Alzheimer Centre Nijmegen, Radboud University Nijmegen, Medical Centre, Nijmegen, The Netherlands Kalorama Foundation, Beek-Ubbergen, The Netherlands Scientific Institute for Quality of Healthcare, Radboud University Nijmegen, Medical Centre, Nijmegen, The Netherlands
R. T. C. M. Koopmans
Affiliation:
Department of Primary and Community Care: Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen, Medical Centre, Nijmegen, The Netherlands Alzheimer Centre Nijmegen, Radboud University Nijmegen, Medical Centre, Nijmegen, The Netherlands
F. R. J. Verhey
Affiliation:
School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University Medical Centre, Maastricht, The Netherlands
*
*Address for correspondence: M. E. de Vugt, Ph.D., Maastricht University Medical Centre, School for Mental Health and Neuroscience/Alzheimer Centre Limburg, Department of Psychiatry and Psychology, PO Box 5800, 6202 AZ Maastricht, The Netherlands. (Email: [email protected])

Abstract

Background

The extent to which specific factors influence diagnostic delays in dementia is unclear. Therefore, the aim of the present study was to compare duration from symptom onset to diagnosis for young-onset dementia (YOD) and late-onset dementia (LOD) and to assess the effect of age at onset, type of dementia, gender, living situation, education and family history of dementia on this duration.

Method

Data on 235 YOD and 167 LOD patients collected from caregivers from two prospective cohort studies were used. Multiple linear regression analysis was performed.

Results

The duration between symptom onset and the diagnosis of YOD exceeded that of LOD by an average of 1.6 years (2.8 v. 4.4 years). Young age and being diagnosed with frontotemporal dementia were related to increases in the time to diagnosis. Subjects with vascular dementia experienced shorter time to diagnosis.

Conclusions

There is a need to raise special awareness of YOD to facilitate a timely diagnosis.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aalten, P, van Valen, E, de Vugt, ME, Lousberg, R, Jolles, J, Verhey, FRJ (2006). Awareness and behavioral problems in dementia patients: a prospective study. International Psychogeriatrics 18, 317.CrossRefGoogle ScholarPubMed
APA (2000). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). American Psychiatric Association: Washington, DC.Google Scholar
Bamford, C, Eccles, M, Steen, N, Robinson, L (2007). Can primary care record review facilitate earlier diagnosis of dementia? Family Practice 24, 108116.CrossRefGoogle ScholarPubMed
Braak, H, Braak, E (1997). Frequency of stages of Alzheimer-related lesions in different age categories. Neurobiology of Aging 18, 351357.CrossRefGoogle ScholarPubMed
Cahill, S, Clark, M, Walsh, C, O'Connell, H, Lawlor, B (2006). Dementia in primary care: the first survey of Irish general practitioners. International Journal of Geriatric Psychiatry 21, 319324.CrossRefGoogle ScholarPubMed
CBO (2005). Richtlijn: Diagnostiek en medicamenteuze behandeling van dementie (Directive: Diagnosis and drug treatment of dementia) (http://www.cbo.nl/Downloads/387/rldement2005.pdf). Accessed 3 March 2012.Google Scholar
Chow, TW, Pio, FJ, Rockwood, K (2011). An international needs assessment of caregivers for frontotemporal dementia. Canadian Journal of Neurological Sciences 38, 753757.CrossRefGoogle ScholarPubMed
Cordery, R, Harvey, R, Frost, C, Rossor, M (2002). National survey to assess current practices in the diagnosis and management of young people with dementia. International Journal of Geriatric Psychiatry 17, 124127.CrossRefGoogle ScholarPubMed
Eefsting, JA, Boersma, F, Van Den Brink, W, Van Tilburg, W (1996). Differences in prevalence of dementia based on community survey and general practitioner recognition. Psychological Medicine 26, 12231230.CrossRefGoogle ScholarPubMed
Erkinjuntti, T (1994). Clinical criteria for vascular dementia: the NINDS-AIREN criteria. Dementia 5, 189192.Google ScholarPubMed
Eustace, A, Bruce, I, Coen, R, Cunningham, C, Walsh, C, Walsh, JB, Coakley, D, Lawlor, BA (2007). Behavioural disturbance triggers recognition of dementia by family informants. International Journal of Geriatric Psychiatry 22, 574579.CrossRefGoogle ScholarPubMed
Hansen, EC, Hughes, C, Routley, G, Robinson, AL (2008). General practitioners' experiences and understandings of diagnosing dementia: factors impacting on early diagnosis. Social Science and Medicine 67, 17761783.CrossRefGoogle ScholarPubMed
Harris, PB, Keady, J (2004). Living with early onset dementia: exploring the experience and developing evidence-based guidelines for practice. Alzheimer's Care Quarterly 5, 111122.Google Scholar
Holzer, C, Warshaw, G (2000). Clues to early Alzheimer dementia in the outpatient setting. Archives of Family Medicine 9, 10661070.CrossRefGoogle ScholarPubMed
Iliffe, S, Manthorpe, J (2004). The hazards of early recognition of dementia: a risk assessment. Aging and Mental Health 8, 99105.Google Scholar
Iliffe, S, Wilcock, J, Haworth, D (2006). Obstacles to Shared care for patients with dementia: a qualitative study. Family Practice 23, 353362.CrossRefGoogle ScholarPubMed
Kelley, BJ, Boeve, BF, Josephs, KA (2009). Cognitive and noncognitive neurological features of young-onset dementia. Dementia and Geriatric Cognitive Disorders 27, 564571.CrossRefGoogle ScholarPubMed
Koller, D, Eisele, M, Kaduszkiewicz, H, Schon, G, Steinmann, S, Wiese, B, Glaeske, G, van den Bussche, H (2010). Ambulatory health services utilization in patients with dementia – is there an urban–rural difference? International Journal of Health Geographics 9, 59.CrossRefGoogle ScholarPubMed
Leung, KK, Finlay, J, Silvius, JL, Koehn, S, McCleary, L, Cohen, CA, Hum, S, Garcia, L, Dalziel, W, Emerson, VF, Pimlott, NJG, Persaud, M, Kozak, J, Drummond, N (2011). Pathways to diagnosis: exploring the experiences of problem recognition and obtaining a dementia diagnosis among Anglo-Canadians. Health and Social Care in the Community 19, 372381.CrossRefGoogle ScholarPubMed
Luscombe, G, Brodaty, H, Freeth, S (1998). Younger people with dementia: diagnostic issues, effects on carers and use of services. International Journal of Geriatric Psychiatry 13, 323330.3.0.CO;2-O>CrossRefGoogle ScholarPubMed
Mackenzie, CS, Gekoski, WL, Knox, VJ (2006). Age, gender, and the underutilization of mental health services: the influence of help-seeking attitudes. Aging and Mental Health 10, 574582.CrossRefGoogle ScholarPubMed
Marsden, CD, Harrison, MJ (1972). Outcome of investigation of patients with presenile dementia. British Medical Journal 2, 249252.CrossRefGoogle ScholarPubMed
McKeith, IG (2006). Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the Consortium on DLB International Workshop. Journal of Alzheimer's Disease 9, 417423.CrossRefGoogle Scholar
McKhann, G, Drachman, D, Folstein, M, Katzman, R, Price, D, Stadlan, EM (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology 34, 939944.CrossRefGoogle ScholarPubMed
McMurtray, A, Clark, DG, Christine, D, Mendez, MF (2006). Early-onset dementia: frequency and causes compared to late-onset dementia. Dementia and Geriatric Cognitive Disorders 21, 5964.CrossRefGoogle ScholarPubMed
Mendez, MF (2006). The accurate diagnosis of early-onset dementia. International Journal of Psychiatry in Medicine 36, 401412.CrossRefGoogle ScholarPubMed
Mesulam, MM, Grossman, M, Hillis, A, Kertesz, A, Weintraub, S (2003). The core and halo of primary progressive aphasia and semantic dementia. Annals of Neurology 54 (Suppl. 5), S11S14.CrossRefGoogle ScholarPubMed
Neary, D, Snowden, JS, Gustafson, L, Passant, U, Stuss, D, Black, S, Freedman, M, Kertesz, A, Robert, PH, Albert, M, Boone, K, Miller, BL, Cummings, J, Benson, DF (1998). Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology 51, 15461554.CrossRefGoogle ScholarPubMed
Papageorgiou, SG, Kontaxis, T, Bonakis, A, Kalfakis, N, Vassilopoulos, D (2009). Frequency and causes of early-onset dementia in a tertiary referral center in Athens. Alzheimer Disease and Associated Disorders 23, 347351.CrossRefGoogle Scholar
Passant, U, Elfgren, C, Englund, E, Gustafson, L (2005). Psychiatric symptoms and their psychosocial consequences in frontotemporal dementia. Alzheimer Disease and Associated Disorders 19, S15S18.CrossRefGoogle ScholarPubMed
Pentzek, M, Wollny, A, Wiese, B, Jessen, F, Haller, F, Maier, W, Riedel-Heller, SG, Angermeyer, MC, Bickel, H, Masch, E, Weyerer, S, Werle, J, Bachmann, C, Zimmermann, T, van den Bussche, H, Abholz, H-H, Fuchs, A (2009). Apart from nihilism and stigma: what influences general practitioners' accuracy in identifying incident dementia. American Journal of Geriatric Psychiatry 17, 965975.CrossRefGoogle ScholarPubMed
Picard, C, Pasquier, F, Martinaud, O, Hannequin, D, Godefroy, O (2011). Early onset dementia: characteristics in a large cohort from academic memory clinics. Alzheimer Disease and Associated Disorders 25, 203205.CrossRefGoogle Scholar
Ramakers, IHGB, Visser, PJ, Bittermann, AJN, Ponds, RWHM, van Boxtel, MPJ, Verhey, FRJ (2009). Characteristics of help-seeking behaviour in subjects with subjective memory complaints at a memory clinic: a case–control study. International Journal of Geriatric Psychiatry 24, 190196.CrossRefGoogle Scholar
Ratnavalli, E, Brayne, C, Dawson, K, Hodges, JR (2002). The prevalence of frontotemporal dementia. Neurology 58, 16151621.CrossRefGoogle ScholarPubMed
Reilly, J, Rodriguez, AD, Lamy, M, Neils-Strunjas, J (2010). Cognition, language, and clinical pathological features of non-Alzheimer's dementias: an overview. Journal of Communication Disorders 43, 438452.CrossRefGoogle ScholarPubMed
Reisberg, B, Ferris, SH, de Leon, MJ, Crook, T (1982). The Global Deterioration Scale for assessment of primary degenerative dementia. American Journal of Psychiatry 139, 11361139.Google ScholarPubMed
Ridha, B, Josephs, KA (2006). Young-onset dementia: a practical approach to diagnosis. Neurologist 12, 213.CrossRefGoogle ScholarPubMed
Ron, MA, Toone, BK, Garralda, ME, Lishman, WA (1979). Diagnostic accuracy in presenile dementia. British Journal of Psychiatry 134, 161168.CrossRefGoogle ScholarPubMed
Rosness, TA, Haugen, PK, Passant, U, Engedal, K (2008). Frontotemporal dementia – a clinically complex diagnosis. International Journal of Geriatric Psychiatry 23, 837842.CrossRefGoogle ScholarPubMed
Rossor, MN, Fox, NC, Mummery, CJ, Schott, JM, Warren, JD (2010). The diagnosis of young-onset dementia. Lancet Neurology 9, 793806.CrossRefGoogle ScholarPubMed
Salloway, S, Correia, S (2009). Alzheimer disease: time to improve its diagnosis and treatment. Cleveland Clinic Journal of Medicine 76, 4958.CrossRefGoogle ScholarPubMed
Sampson, EL, Warren, JD, Rossor, MN (2004). Young onset dementia. Postgraduate Medical Journal 80, 125139.CrossRefGoogle ScholarPubMed
Shinagawa, S, Toyota, Y, Ishikawa, T, Fukuhara, R, Hokoishi, K, Komori, K, Tanimukai, S, Ikeda, M (2008). Cognitive function and psychiatric symptoms in early- and late-onset frontotemporal dementia. Dementia and Geriatric Cognitive Disorders 25, 439444.CrossRefGoogle ScholarPubMed
Tedstone Doherty, D, Kartalova-O'Doherty, Y (2010). Gender and self-reported mental health problems: predictors of help seeking from a general practitioner. British Journal of Health Psychology 15, 213228.CrossRefGoogle ScholarPubMed
Tijhuis, MA, Peters, L, Foets, M (1990). An orientation toward help-seeking for emotional problems. Social Science and Medicine 31, 989995.CrossRefGoogle ScholarPubMed
van Vliet, D, Bakker, C, Koopmans, RT, Vernooij-Dassen, MJ, Verhey, FR, de Vugt, ME (2010). Research protocol of the NeedYD-study (Needs in Young onset Dementia): a prospective cohort study on the needs and course of early onset dementia. BMC Geriatrics 10, 13.CrossRefGoogle ScholarPubMed
van Vliet, D, de Vugt, ME, Bakker, C, Koopmans, RT, Pijnenburg, YA, Vernooij-Dassen, MJ, Verhey, FR (2011). Caregivers' perspectives on the pre-diagnostic period in early onset dementia: a long and winding road. International Psychogeriatrics. Published online 1 July 2011. doi:10.1017/S1041610211001013.CrossRefGoogle ScholarPubMed
Vernooij-Dassen, MJFJ, Moniz-Cook, ED, Woods, RT, De Lepeleire, J, Leuschner, A, Zanetti, O, de Rotrou, J, Kenny, G, Franco, M, Peters, V, Iliffe, S (2005). Factors affecting timely recognition and diagnosis of dementia across Europe: from awareness to stigma. International Journal of Geriatric Psychiatry 20, 377386.CrossRefGoogle ScholarPubMed
Werner, P, Stein-Shvachman, I, Korczyn, AD (2009). Early onset dementia: clinical and social aspects. International Psychogeriatrics 21, 631636.CrossRefGoogle ScholarPubMed
Wilkinson, D, Stave, C, Keohane, D, Vincenzino, O (2004). The role of general practitioners in the diagnosis and treatment of Alzheimer's disease: a multinational survey. Journal of International Medical Research 32, 149159.CrossRefGoogle ScholarPubMed
Williams, T, Cameron, I, Deardon, T (2001). From pillar to post – a study of younger people with dementia. Psychiatric Bulletin 25, 384387.CrossRefGoogle Scholar