The Lost Years: Delay Between the Onset of Cognitive Symptoms and Clinical Assessment at a Memory Clinic

  • Jean-Sébastien Claveau Université de Montréal
  • Nancy Presse Institut universitaire de gériatrie de Montréal
  • Marie-Jeanne Kergoat Université de Montréal; Institut universitaire de gériatrie de Montréal
  • Juan Manuel Villalpando Université de Montréal; Institut universitaire de gériatrie de Montréal
Keywords: memory clinic, symptom duration, referral, dementia, mild cognitive impairment

Abstract

Background

Early assessment of cognitive symptoms is an issue in geriatrics. This study investigated the delay from the onset of cognitive symptoms to initial clinical assessment and its associations with patients’ sociodemographic and clinical characteristics.

Methods

This is a cross-sectional retrospective study using medical chart review of 316 patients referred for assessment to a university-affiliated memory clinic. Symptom duration was self-reported by patients/carers. Severity of symptoms assessed by the MoCA and FAST instruments was compared according to delay duration (≥3 years vs. <3 years) using chi-squared tests. Logistic regression was used to determine the association between patients’ characteristics and long symptom duration (≥3 years).

Results

At the initial assessment, 29.4% of patients reported experiencing cognitive symptoms for ≥3 years. They were more likely to have MoCA scores ≤17 (47.8 vs. 34.1%; p=.023) and FAST scores ≥5 (21.5 vs. 10.8%; p=.012). They were also significantly older than 75 years (75-84 yr: OR=2.22 [95%CI: 1.11–4.41]; ≥85 yr: 4.36 [2.08–9.11]), presented more depressive symptoms (2.37 [1.40-4.02]), and were less likely to live alone (0.55 [0.31–0.96]).

Conclusions

A significant proportion of patients had cognitive symptoms for years when initially assessed, which delayed diagnosis and management. Stigma, depression, and compensatory help from carers may contribute to this delay.

Author Biographies

Jean-Sébastien Claveau, Université de Montréal
Département de médecine, Faculté de médecine
Nancy Presse, Institut universitaire de gériatrie de Montréal
Centre de recherche
Marie-Jeanne Kergoat, Université de Montréal; Institut universitaire de gériatrie de Montréal
Département de médecine, Faculté de médecin; Centre de recherche
Juan Manuel Villalpando, Université de Montréal; Institut universitaire de gériatrie de Montréal
Département de médecine, Faculté de médecin; Centre de recherche
Published
2018-07-09
How to Cite
Claveau, J.-S., Presse, N., Kergoat, M.-J., & Villalpando, J. M. (2018). The Lost Years: Delay Between the Onset of Cognitive Symptoms and Clinical Assessment at a Memory Clinic. Canadian Geriatrics Journal, 21(2), 152-156. https://doi.org/10.5770/cgj.21.297
Section
Original Research