English summaries
How were the national statements of best practice followed in the chain of care of patients with memory problems in Central Finland?
Julkaistu 21.05.2010 00.01
Background
In 2006 a national statement of best practice for the diagnosis and care of Alzheimer’s disease was published in Finland. Based on this, local practical recommendations for early diagnosis, treatment and care of patients with memory problems and dementia were issued in the Central Finland Health Care District. As a collaboration project we studied how the recommendations were followed in practice in 2008. We were especially interested in finding out how the early memory symptoms were recognized and what diagnostic procedures were carried out.
Methods
In 2008, a structured questionnaire was completed for every new memory patient in five memory clinics within the Central Finland Health Care District with a population of around 265 000.
Results
A total of 710 new memory patients were detected. The mean age was 76 years, and females accounted for 65%. The mean MMSE was 22/30. Patients recognized the first memory symptoms in 23% and relatives in 70% of cases. The average time from the initial symptoms to the first memory clinic visit was 26 months. In all referrals an MMSE or CERAD result was mentioned, and a brain CT or MRI scan was done before the visit in 73% of the referred patients. A diagnosis of Alzheimer’s disease or a combination of Alzheimer and vascular dementia was made in 62%. An acetylcholinesterase inhibitor or memantine was started in nearly all these patients. Mild cognitive impairment (MCI) was diagnosed in 18%.
Conclusions
New memory patients were relatively well detected in Central Finland. The results of the different examinations were reported in most referrals as recommended. There were exceptions as well, and referral practices should be improved by further education and perhaps by the use of a structured electronic referral system.
Pertti Karppi M.D., Ph.D., Geriatrician, Mikkeli Central Hospital E-mail: pertti.karppi@esshp.fi
Terhi Rahkonen, Aimo Rissanen, Sointu Puuronen, Katariina Kalliopohja, Jaana Suhonen
Finnish Medical Journal 2010;65:1833–1838
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