Clinical Study
The clinical characteristics of 2,789 consecutive patients in a memory clinic in China

https://doi.org/10.1016/j.jocn.2011.05.003Get rights and content

Abstract

To explore the clinical characteristics of the Memory Clinic patients at Huashan Hospital and to provide suggestions for future research, we retrospectively reviewed the demographic, cognitive and aetiological data from 2,789 consecutive patients who attended the Memory Clinic of the Department of Neurology at Huashan Hospital from April 2003 to April 2008. The demographical distribution of the patients was as follows: there were more females (58%) than males; 58% of the patients were older than 70 years of age; and most patients (77%) had six or more years of education. The distribution of the diagnoses was as follows: degenerative or vascular dementia, 46.4%; mild cognitive impairment, 22.8%; subjective cognitive impairment, 21.7%; neurosis, 3.3%; organic cognitive impairment, 3.9%; unspecified dementia, 1.2%; and pure amnesia, 0.7%. These results showed that older patients with relatively high levels of education comprised the majority of our sample and a high percentage of the patients showed absent or mild cognitive impairment. Accordingly, future studies should focus on early diagnosis and treatment for dementia. Detailed neuropsychological tests and follow-up assessments are becoming increasingly important in the diagnosis of memory diseases in China.

Introduction

In Shanghai, people who were 65 years old or older accounted for 7.2% of the population in 1979, and this proportion increased to 19.6% by the end of 2005, primarily due to a decline in birth rate and longer life expectancy.1 To meet the increasing demand for the diagnosis and treatment of memory diseases in an aging society, the Neurology Department at Huashan Hospital formed its own Memory Clinic in 1996. Prior to March 2003, clinic patients had been tested using the Chinese version of the Mini-Mental State Examination (MMSE)2 and the Chinese version of the Wechsler Memory Scale-I (WMS-RC).3 Between 1999 and 2003, we tested the reliability and validity of a neuropsychological battery of tests (see methods) and established the cutoff values and age- and education-adjusted normative data in Shanghai. Since the first formal implementation of this assessment from April 2003 to April 2008, 2,789 patients have attended our Memory Clinic. To provide suggestions for future research, the demographic, cognitive and aetiological data of these patients were reviewed.

Section snippets

Patients

This study reviewed the data from 2,789 consecutive patients of the Memory Clinic of Huashan Hospital from April 2003 to April 2008. Most of the patients noticed cognitive decline and presented to the clinic of their own accord. The other patients, most of whom were illiterate or old, were referred by their caregivers.

Diagnostic assessment

The basic diagnostic flowchart is shown in Fig. 1. For all patients, the MMSE, neurological physical examinations, psychiatric evaluations, including anxiety and depression

The demographic characteristics of the 2,789 patients

The demographic characteristics of the 2,789 patients are shown in Fig. 2. There were more females (58%) than males. Most of the patients (about 92%) were literate; 15% were educated for 1 to 5 years, 23% for 6 to 8 years, 30% for 8 to 12 years, and 24% for more than 12 years. Another subset of patients (8%) did not receive any education. The distribution of patients in the various age groups was as follows: 145 (5.2%) were less than 50 years old, 415 (14.9%) were between 50 and 59 years old,

Discussion

In this study we report the demographic, cognitive and aetiological data from 2,789 consecutive patients who attended the Memory Clinic of the Department of Neurology at Huashan Hospital from April 2003 to April 2008. The data we report here do not represent entirely the general elderly population in China. First, the Memory Clinic is located in the centre of Shanghai, and most of the participants lived near the hospital, so they did not qualify as a random sample of a community

Acknowledgements

The study is supported by The Natural Science Foundation of China (number: 30570601) and Science and Technology Commission of Shanghai Municipality (08411951000, 09DZ1950400).

References (20)

  • R. Katzman et al.

    A Chinese version of the mini-mental state examination; impact of illiteracy in a Shanghai dementia survey

    J Clin Epidemiol

    (1988)
  • K.A. Jellinger et al.

    Neuropathological evaluation of mixed dementia

    J Neurol Sci

    (2007)
  • X.M. Cheng et al.

    Study and policy suggestions on the impact of ageing population on health in Shanghai

    Health Economics Res

    (2007)
  • Y.X. Gong

    Wechsler memory scale-revised in China

    (1989)
  • Q.H. Guo et al.

    Norm of auditory verbal learning test in the normal aged in Chinese community

    Chin J Clin Psychol

    (2007)
  • Q.H. Guo et al.

    A comparison study of mild cognitive impairment with 3 memory tests among Chinese individuals

    Alz Dis Assoc Dis

    (2009)
  • Q.H. Zhao et al.

    Category verbal fluency test in identification and differential diagnosis of dementia

    Chin J Clin Psychol

    (2007)
  • Q.H. Guo et al.

    Boston naming test using by Chinese elderly, patient with mild cognitive impairment and Alzheimer’s dementia

    Chin Ment Health J

    (2006)
  • Q.H. Guo et al.

    A study of validity of a new scoring system of clock drawing test

    Chin J Neurol

    (2008)
  • Q.H. Guo et al.

    Application of eight executive tests in participants at Shanghai communities

    Chin J Behav Med Sci

    (2007)
There are more references available in the full text version of this article.

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