Details

Autor(en) / Beteiligte

• Chiew, Hui Jin
• Choong, Tanya‐Marie Yuen Oi
• Chua, Esther Vanessa
• Mei, Nyu Mei
• Lim, Linda Lay Hoon
• Ng, Kok Pin
• Ng, Adeline Su Lyn
• Ting, Simon Kang Seng
• Hameed, Shahul
• Kandiah, Nagaendran

Titel

Assessing and improving primary care physician confidence in the recognition of young‐onset and atypical dementia: A pilot intervention: Other innovative programs and practices

Ist Teil von

• Alzheimer's & dementia, 2020-12, Vol.16 (S8)

Erscheinungsjahr

2020

Link zum Volltext

Quelle

Wiley Journals

Beschreibungen/Notizen

• Abstract Background Young‐onset dementia (YOD) is defined as dementia with symptom onset below 65 years. The heterogeneous symptomatology of YOD can lead to delayed recognition and referral by primary care physicians (PCPs). Data from our tertiary referral centre in Singapore show that atypical presentations of YOD are more likely be referred and diagnosed at a later stage of disease than typical amnestic Alzheimer disease (AD) dementia. Method We piloted a structured, multimodal training programme to assess and increase the confidence of PCPs in the recognition of YOD and atypical dementia. The programme combined lectures, case studies and interactive workshops in 4 half‐day modules conducted between September 2019‐January 2020 (Module 1: clinical approach to cognitive impairment, overview of cognitive disorders and AD; Module 2: YOD, atypical and reversible causes of dementia; Module 3: cognitive assessment tools; Module 4: management of dementia, with a focus on YOD). Faculty included 6 cognitive neurologists and 4 dementia care nurses. 28 PCPs involved in dementia care in primary care memory clinics from all regions of Singapore were enrolled by invitation in mid‐2019. Prior to module 1, PCPs completed an anonymized questionnaire with 15 questions assessing their confidence in the recognition, diagnosis and management of YOD on a 5‐point Likert scale. An identical follow‐up questionnaire was administered upon completion of the programme. Results 20 baseline and 20 follow‐up questionnaire responses were obtained. The PCPs had a mean of 1.93 (SD 2.10) years of dementia care experience. At baseline, they were significantly more confident in recognizing symptoms of typical elder‐onset AD (70% confident, 10% very confident) compared to YOD (30% confident) or atypical/non‐AD dementia (15% confident), (p<0.001). Upon programme completion, PCPs reported significantly increased confidence in recognition of YOD (70% confident, 15% very confident; p<0.001) and atypical/non‐AD dementia (75% confident, 10% very confident; p<0.001). These findings persisted even when stratified by years of dementia care experience. Conclusion A structured, multimodal training programme was effective in improving PCP confidence in the recognition of YOD and atypical dementia. Follow‐up assessment of PCP knowledge and longitudinal monitoring of referral trends will help to determine its long‐term efficacy.