The Worried Well? Characteristics of Cognitively Normal Patients Presenting to a Rural and Remote Memory Clinic

Verity, Ryan; Kirk, Andrew; O’Connell, Megan E; Karunanayake, Chandima; Morgan, Debra

doi:10.1017/cjn.2017.267

Cited by 17 publications

(39 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…5 As there are no definitive predictors of who will develop dementia and who will not, it is important to create a Will, Power of Attorney, and Advanced Healthcare Directive when one is still in good health. 21 Limitations to this study include a relatively small sample size and a cross-sectional study design where patient follow-up is not reported. Longitudinal follow-up would benefit future research in this area.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Factors Associated with Having a Will, Power of Attorney, and Advanced Healthcare Directive in Patients Presenting to a Rural and Remote Memory Clinic

Lee

Kirk

Kirk³

et al. 2019

Can. J. Neurol. Sci.

Self Cite

View full text Add to dashboard Cite

ABSTRACT:Background: A Will, Power of Attorney, and Advanced Healthcare Directive are critical to guide decision-making in patients with dementia. We identified characteristics that are associated with the existence of these documents in patients who presented to a rural and remote memory clinic (RRMC). Methods: Ninety-five consecutive patients were included in this study. Patients and caregivers completed questionnaires on initial presentation to the RRMC and patients were asked if they had legal documents. Patients also completed neuropsychological testing. Statistical analysis (t-test and χ2 test) was performed to identify significant variables. Results: Seventy (73.7%) patients had a Will, 62 (65.3%) had a Power of Attorney, and 21 (22.1%) had an Advanced Healthcare Directive. Having a Will was associated with good quality of life (p = 0.001), living alone or with a spouse or partner only (p = 0.034), poor verbal fluency (p = 0.055), and European ethnicity (p = 0.028). Factors associated with having a Power of Attorney included good quality of life (p = 0.031), living alone or with a spouse or partner only (p = 0.053), and poor verbal fluency (p = 0.015). Old age (p = 0.015), poor verbal fluency (p = 0.023), and greater severity of cognitive and functional impairment (p = 0.023) were associated with having an Advanced Healthcare Directive. Conclusions: Our results indicate that poor quality of life, good performance on verbal fluency, Indigenous ethnicity, and living with others are associated with a lower likelihood of legal documents in patients with dementia. These factors can help physicians identify patients at risk of leaving their legal affairs unattended to. Physicians should discuss the creation of legal documents early on in patients with signs of dementia.

show abstract

Section: Discussionmentioning

confidence: 99%

“…19 More information on the RRMC is available elsewhere. [18][19][20][21][22][23][24][25][26][27][28] Decision-making is an increasingly important issue for patients with dementia. As the rates of dementia rise, more patients will experience irreversible cognitive incapacity and a loss of autonomy.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Having a Will, Power of Attorney, and Advanced Healthcare Directive in Patients Presenting to a Rural and Remote Memory Clinic

Lee

Kirk

Kirk³

et al. 2019

Can. J. Neurol. Sci.

Self Cite

View full text Add to dashboard Cite

show abstract

“…19 The RRMC is a one-stop clinic and consists of an interdisciplinary team including a neurologist, neuropsychology team, physical therapist, dietician, and nurse for the streamlined assessment and management of suspected dementia cases. 19,20 Each new patient receives a standard diagnostic examination that consists of bloodwork, a non-contrast CT scan, multiple neuropsychological tests and additional investigations as indicated. 20 Using this approach, the time to diagnosis is shortened, with the goal of a diagnosis, treatment recommendation and counselling by the end of the 1-day visit.…”

Section: Introductionmentioning

confidence: 99%

“…19,20 Each new patient receives a standard diagnostic examination that consists of bloodwork, a non-contrast CT scan, multiple neuropsychological tests and additional investigations as indicated. 20 Using this approach, the time to diagnosis is shortened, with the goal of a diagnosis, treatment recommendation and counselling by the end of the 1-day visit. Each patient with a diagnosis will have a follow-up session with the memory clinic at 6 weeks, 12 weeks and then every 6 months thereafter, and more often as required.…”

Section: Introductionmentioning

confidence: 99%

“…13 More information on the RRMC can be found in earlier publications. 13,[19][20][21][22][23] Due to the unique challenges that younger patients with dementia face, we aimed to study the differences between young patients (<65 years) and older patients (≥65 years) referred to the RRMC in Saskatchewan. The findings from our study will provide information on how to better understand this younger subset of rural dementia patients for improved care and management.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Characteristics of Young-Onset and Late-Onset Dementia Patients at a Remote Memory Clinic

Wong

Kirk

Perlett

et al. 2020

Can. J. Neurol. Sci.

Self Cite

View full text Add to dashboard Cite

ABSTRACT:Background:Young-onset dementia (YOD) is defined as the onset of dementia symptoms before the age of 65 years and accounts for 2–8% of dementia. YOD patients and their caregivers face unique challenges in diagnosis and management. We aimed to compare the characteristics of rural YOD and late-onset dementia (LOD) patients at a rural and remote memory clinic in Western Canada.Methods:A total of 333 consecutive patients (YOD = 61, LOD = 272) at a rural and remote memory clinic between March 2004 and July 2016 were included in this study. Each patient had neuropsychological assessment. Health, mood, function, behaviour and social factors were also measured. Both groups were compared using χ2 tests and independent sample tests.Results:YOD patients were more likely to be married, employed, current smokers and highly educated. They reported fewer cognitive symptoms, but had more depressive symptoms. YOD patients were less likely to live alone and use homecare services. YOD caregivers were also more likely to be a spouse and had higher levels of distress than LOD caregivers. Both YOD and LOD patient groups were equally likely to have a driver’s licence.Conclusions:Our findings indicate YOD and LOD patients have distinct characteristics and services must be modified to better meet YOD patient needs. In particular, the use of homecare services and caregiver support may alleviate the higher levels of distress found in YOD patients and their caregivers. Additional research should be directed to addressing YOD patient depression, caregiver distress and barriers to services.

show abstract

Worried well and Covid-19: Re-emergence of an old quandary

Chatterjee

Vora²,

Malathesh

et al. 2020

Asian Journal of Psychiatry

View full text Add to dashboard Cite

The Worried Well? Characteristics of Cognitively Normal Patients Presenting to a Rural and Remote Memory Clinic

Abstract: We observed a pattern of differences unfold between the "worried well" patients and those with cognitive disease. No one variable was pathognomonic of a "worried well" patient. However, taking all the above into account when evaluating a patient may help clinically.

Cited by 17 publications

References 36 publications

Factors Associated with Having a Will, Power of Attorney, and Advanced Healthcare Directive in Patients Presenting to a Rural and Remote Memory Clinic

Factors Associated with Having a Will, Power of Attorney, and Advanced Healthcare Directive in Patients Presenting to a Rural and Remote Memory Clinic

Characteristics of Young-Onset and Late-Onset Dementia Patients at a Remote Memory Clinic

Worried well and Covid-19: Re-emergence of an old quandary

Contact Info

Product

Resources

About