PDF(Pubmed)
Abstract：
BACKGROUND: The rapidly increasing socioeconomic strain caused by dementia represents a significant public health concern. Regional dementia centers (RDCs) have been established nationwide, and they aim to provide timely screening and diagnosis of dementia. This study investigated the clinical characteristics and progression of patients diagnosed with Alzheimer\'s dementia (AD), who underwent treatment in RDCs or conventional community-based hospital systems.
METHODS: This retrospective single-center cohort study included patients who were diagnosed with AD between January 2019 and March 2022. This study compared two groups of patients: the hospital group, consisting of patients who presented directly to the hospital, and the RDC group, those who were referred to the hospital from the RDCs in Pohang city. The clinical courses of the patients were monitored for a year after AD diagnosis.
RESULTS: A total of 1,209 participants were assigned to the hospital (n = 579) or RDC group (n = 630). The RDC group had a mean age of 80.1 years ± 6.6 years, which was significantly higher than that of the hospital group (P < 0.001). The RDC group had a higher proportion of females (38.3% vs. 31.9%; P = 0.022), higher risk for alcohol consumption (12.4% vs. 3.3%; P < 0.001), and greater number of patients who discontinued treatment 1 year after diagnosis (48.3% vs. 39.0%; P = 0.001). In the linear regression model, the RDC group was independently associated with the clinical dementia rating sum of boxes increment (β = 22.360, R²\\n = 0.048, and P < 0.001).
CONCLUSIONS: Patients in the RDC group were older, had more advanced stages of conditions, and exhibited a more rapid rate of cognitive decline than patients diagnosed through the conventional hospital system. Our results suggested that RDC contributed to the screening of AD in a local region, and further nationwide study with the RDC database of various areas of Korea is needed.
METHODS: This retrospective single-center cohort study included patients who were diagnosed with AD between January 2019 and March 2022. This study compared two groups of patients: the hospital group, consisting of patients who presented directly to the hospital, and the RDC group, those who were referred to the hospital from the RDCs in Pohang city. The clinical courses of the patients were monitored for a year after AD diagnosis.
RESULTS: A total of 1,209 participants were assigned to the hospital (n = 579) or RDC group (n = 630). The RDC group had a mean age of 80.1 years ± 6.6 years, which was significantly higher than that of the hospital group (P < 0.001). The RDC group had a higher proportion of females (38.3% vs. 31.9%; P = 0.022), higher risk for alcohol consumption (12.4% vs. 3.3%; P < 0.001), and greater number of patients who discontinued treatment 1 year after diagnosis (48.3% vs. 39.0%; P = 0.001). In the linear regression model, the RDC group was independently associated with the clinical dementia rating sum of boxes increment (β = 22.360, R²\\n = 0.048, and P < 0.001).
CONCLUSIONS: Patients in the RDC group were older, had more advanced stages of conditions, and exhibited a more rapid rate of cognitive decline than patients diagnosed through the conventional hospital system. Our results suggested that RDC contributed to the screening of AD in a local region, and further nationwide study with the RDC database of various areas of Korea is needed.
摘要：
背景：由痴呆症引起的迅速增加的社会经济压力代表了重大的公共卫生问题。在全国范围内建立了区域痴呆症中心（RDC）。他们旨在及时筛查和诊断痴呆症。这项研究调查了诊断为阿尔茨海默痴呆（AD）患者的临床特征和进展，在RDC或传统的社区医院系统中接受治疗的人。
方法：这项回顾性单中心队列研究包括2019年1月至2022年3月诊断为AD的患者。本研究比较两组患者:医院组,由直接到医院就诊的病人组成，和RDC小组，那些从浦项市RDC转诊到医院的人。在AD诊断后一年监测患者的临床病程。
结果：共有1,209名参与者被分配到医院（n=579）或RDC组（n=630）。RDC组的平均年龄为80.1岁±6.6岁，明显高于医院组(P<0.001)。RDC组女性比例较高(38.3%vs.31.9%；P=0.022），饮酒风险较高(12.4%vs.3.3%；P<0.001），更多的患者在诊断后1年停止治疗(48.3%vs.39.0%；P=0.001）。在线性回归模型中，RDC组与临床痴呆评分框增量之和独立相关(β=22.360,R²\n=0.048,P<0.001).
结论：RDC组患者年龄较大，有更先进的条件阶段，与通过常规医院系统诊断的患者相比，认知能力下降的速度更快。我们的结果表明，RDC有助于在当地地区筛查AD，需要在韩国各地区的RDC数据库中进行进一步的全国性研究。
方法：这项回顾性单中心队列研究包括2019年1月至2022年3月诊断为AD的患者。本研究比较两组患者:医院组,由直接到医院就诊的病人组成，和RDC小组，那些从浦项市RDC转诊到医院的人。在AD诊断后一年监测患者的临床病程。
结果：共有1,209名参与者被分配到医院（n=579）或RDC组（n=630）。RDC组的平均年龄为80.1岁±6.6岁，明显高于医院组(P<0.001)。RDC组女性比例较高(38.3%vs.31.9%；P=0.022），饮酒风险较高(12.4%vs.3.3%；P<0.001），更多的患者在诊断后1年停止治疗(48.3%vs.39.0%；P=0.001）。在线性回归模型中，RDC组与临床痴呆评分框增量之和独立相关(β=22.360,R²\n=0.048,P<0.001).
结论：RDC组患者年龄较大，有更先进的条件阶段，与通过常规医院系统诊断的患者相比，认知能力下降的速度更快。我们的结果表明，RDC有助于在当地地区筛查AD，需要在韩国各地区的RDC数据库中进行进一步的全国性研究。
