“Her şeyi unutuyorum!” İkinci Basamak bir Nöroloji Kliniğine Unutkanlık ile Başvuranların Tanısal Sınıflaması, İzmir, Türkiye
Abstract
Amaç: Bir ikinci basamak nöroloji kliniğine unutkanlık yakınmasıyla başvuran olgularda öznel bellek yakınmaları (ÖBY), diğer nörolojik hastalık (DNH) ya da psikiyatrik bozukluk (PB) tanılarının sıklığını belirlemek ve olguların karakteristik özelliklerini karşılaştırmaktır. Gereç ve Yöntem: Bu kesitsel araştırmada Nisan 2017 ve Eylül 2018 arasında ikinci basamak tek bir nöroloji polikliniğine unutkanlık yakınması ile başvuran 464 hastanın verisi toplanmıştır. Tanı grupları ÖBY, DNH ya da PB tanıları olarak sınıflandırılmıştır. Ana tanı grupları için yaş ve cinsiyete göre düzeltilmiş Multinomial Lojistik Regresyon modeli uygulanmıştır. Bulgular: Başvuranların yarısından azı bir DNH tanı grubunda yer almıştır (%44.4) ve bu tanı grubunun oranı genç yaş grubunda (<65) daha düşüktür (%7.8). DNH varlığı ile karşılaştırıldığında yaştaki bir yıllık artış ÖBY’de %14.5 (OR: 0.9, %95 GA: 0.8-0.9), PB’de %14.8 (OR: 0.9, %95 GA: 0.8-0.9) azalma ile ilişkilidir. DNH varlığına göre kadınlarda ÖBY varlığı erkeklerin 2.6 katıdır (%95 GA: 1.4-5.0). Sonuç: Bu araştırma ikinci basamak bir nöroloji kliniğine unutkanlık yakınması ile başvuranların yarıdan azında DNH hastalık tanısı konduğunu, bilişsel yetilerde nesnel azalmanın gösterilmediği grupların çoğunlukla genç ve kadınlardan oluştuğunu göstermiştir. ÖBY/PB başvurularının yüksekliği ve cinsiyet dağılımındaki farklılık tüm basamaklarda nitelikli hizmet için vazgeçilmez olan sevk zincirinin yokluğunu düşündürür.
References
- Aarts, S., van den Akker, M., Hajema, K. J., van Ingen, A. M., Metsemakers, J. F. M., … van Boxtel, M. P. J. (2011). Multimorbidity and its relation to subjective memory complaints in a large general population of older adults. International Psychogeriatrics, 23(4), 616–624. https://doi.org/10.1017/S1041610210002024
- Arslantaş, H., Gültekin, B. K., Söylemez, A., & Dereboy, F. (2010). Bir üniversite hastanesi psikiyatri polikliniğine ilk kez başvuran hastaların damgalamayla ilgili inanç, tutum ve davranışları. Adnan Menderes Üniversitesi Tıp Fakültesi Dergisi, 11(1). http://adudspace.adu.edu.tr:8080/xmlui/handle/11607/1852
- Chen, S. T., Siddarth, P., Ercoli, L. M., Merrill, D. A., Torres-Gil, F., & Small, G. W. (2014). Modifiable risk factors for Alzheimer disease and subjective memory impairment across age groups. PloS One, 9(6), e98630. https://doi.org/10.1371/journal.pone.0098630
- Etters, L., Goodall, D., & Harrison, B. E. (2008). Caregiver burden among dementia patient caregivers: A review of the literature. Journal of the American Academy of Nurse Practitioners, 20(8), 423–428. https://doi.org/10.1111/j.1745-7599.2008.00342.x
- Fillit, H., & Green, A. (2021). Aducanumab and the FDA — where are we now? Nature Reviews Neurology, 17(3), 129–130. https://doi.org/10.1038/s41582-020-00454-9
- Gorno-Tempini, M. L., Hillis, A. E., Weintraub, S., Kertesz, A., Mendez, M., … Grossman, M. (2011). Classification of primary progressive aphasia and its variants. Neurology, 76(11), 1006–1014. https://doi.org/10.1212/WNL.0b013e31821103e6
- Hao, L., Wang, X., Zhang, L., Xing, Y., Guo, Q., … Han, Y. (2017). Prevalence, Risk Factors, and Complaints Screening Tool Exploration of Subjective Cognitive Decline in a Large Cohort of the Chinese Population. Journal of Alzheimer’s Disease: JAD, 60(2), 371–388. https://doi.org/10.3233/JAD-170347
- Harper, L., Barkhof, F., Fox, N. C., & Schott, J. M. (2015). Using visual rating to diagnose dementia: A critical evaluation of MRI atrophy scales. Journal of Neurology, Neurosurgery, and Psychiatry, 86(11), 1225–1233. https://doi.org/10.1136/jnnp-2014-310090
- Jessen, F., Amariglio, R. E., van Boxtel, M., Breteler, M., Ceccaldi, M., … Subjective Cognitive Decline Initiative (SCD-I) Working Group. (2014). A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer’s disease. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 10(6), 844–852. https://doi.org/10.1016/j.jalz.2014.01.001
- Jonker, C., Geerlings, M. I., & Schmand, B. (2000). Are memory complaints predictive for dementia? A review of clinical and population-based studies. International Journal of Geriatric Psychiatry, 15(11), 983–991.
I forget everything! Diagnostic Classification of Applicants with Forgetfulness to a Secondary Care Neurology Clinic, Izmir, Turkey
Abstract
Objective: To determine the frequency of subjective cognitive decline (SCD), other neurological diseases (OND), and psychiatric disorder (PD), diagnosis among patients admitted with forgetfulness to a secondary care neurology clinic and compare their characteristic features. Materials and Methods: This cross-sectional study collected data from 464 patients who were admitted with forgetfulness complaints to a single neurology outpatient clinic in a secondary care hospital in Turkey between April 2017 and September 2018. Diagnostic groups were classified as SCD, OND or PD diagnosis. Age and gender-adjusted multinomial regression model was fit for the major diagnostic group. Results: Among admissions less than the half of the applicants were diagnosed with OND (44.4%) and it was lower in the younger age group (< 65, 7.8%). One-year increase in age decreased the risk of SCD by 14.5% (Odds Ratio (OR): 0.9, 95% CI: 0.8-0.9) and risk of PD by 14.8% (OR: 0.9, 95% CI: 0.8 - 0.9) relative to a OND diagnosis. Among women, SCD was 2.6 times higher (95% CI: 1.4 - 5.0) than men relative to OND. Conclusion: This study shows that more than a half of the admissions are not associated with an OND and, the population admitted to neurology clinics with forgetfulness complaints without objective deficits for cognitive decline were younger on average and the majority were women. The high number of SCD/PD admissions to a neurology clinic and gender imbalance imply lack of the referral system which is crucial for the quality of care at all levels.
References
- Aarts, S., van den Akker, M., Hajema, K. J., van Ingen, A. M., Metsemakers, J. F. M., … van Boxtel, M. P. J. (2011). Multimorbidity and its relation to subjective memory complaints in a large general population of older adults. International Psychogeriatrics, 23(4), 616–624. https://doi.org/10.1017/S1041610210002024
- Arslantaş, H., Gültekin, B. K., Söylemez, A., & Dereboy, F. (2010). Bir üniversite hastanesi psikiyatri polikliniğine ilk kez başvuran hastaların damgalamayla ilgili inanç, tutum ve davranışları. Adnan Menderes Üniversitesi Tıp Fakültesi Dergisi, 11(1). http://adudspace.adu.edu.tr:8080/xmlui/handle/11607/1852
- Chen, S. T., Siddarth, P., Ercoli, L. M., Merrill, D. A., Torres-Gil, F., & Small, G. W. (2014). Modifiable risk factors for Alzheimer disease and subjective memory impairment across age groups. PloS One, 9(6), e98630. https://doi.org/10.1371/journal.pone.0098630
- Etters, L., Goodall, D., & Harrison, B. E. (2008). Caregiver burden among dementia patient caregivers: A review of the literature. Journal of the American Academy of Nurse Practitioners, 20(8), 423–428. https://doi.org/10.1111/j.1745-7599.2008.00342.x
- Fillit, H., & Green, A. (2021). Aducanumab and the FDA — where are we now? Nature Reviews Neurology, 17(3), 129–130. https://doi.org/10.1038/s41582-020-00454-9
- Gorno-Tempini, M. L., Hillis, A. E., Weintraub, S., Kertesz, A., Mendez, M., … Grossman, M. (2011). Classification of primary progressive aphasia and its variants. Neurology, 76(11), 1006–1014. https://doi.org/10.1212/WNL.0b013e31821103e6
- Hao, L., Wang, X., Zhang, L., Xing, Y., Guo, Q., … Han, Y. (2017). Prevalence, Risk Factors, and Complaints Screening Tool Exploration of Subjective Cognitive Decline in a Large Cohort of the Chinese Population. Journal of Alzheimer’s Disease: JAD, 60(2), 371–388. https://doi.org/10.3233/JAD-170347
- Harper, L., Barkhof, F., Fox, N. C., & Schott, J. M. (2015). Using visual rating to diagnose dementia: A critical evaluation of MRI atrophy scales. Journal of Neurology, Neurosurgery, and Psychiatry, 86(11), 1225–1233. https://doi.org/10.1136/jnnp-2014-310090
- Jessen, F., Amariglio, R. E., van Boxtel, M., Breteler, M., Ceccaldi, M., … Subjective Cognitive Decline Initiative (SCD-I) Working Group. (2014). A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer’s disease. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 10(6), 844–852. https://doi.org/10.1016/j.jalz.2014.01.001
- Jonker, C., Geerlings, M. I., & Schmand, B. (2000). Are memory complaints predictive for dementia? A review of clinical and population-based studies. International Journal of Geriatric Psychiatry, 15(11), 983–991.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | October 4, 2022 |
| Submission Date | December 22, 2021 |
| Published in Issue | Year 2022 Volume: 11 Issue: 3 |
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