Analysis of diagnostic and treatment errors in dementia syndrome in real clinical practice (based on data from an observational study in Novosibirsk)

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Abstract

Background: The development of dementia significantly impairs the quality of life of patients and their families and places a heavy socioeconomic burden on society as a whole. The medical community faces the clear challenge of diagnosing and treating dementia as early as possible.

Objective: Evaluation of the effectiveness of early diagnosis and a comprehensive approach to prescribing pathogenetically based drug and non-drug therapy.

Materials and method: An observational case-control study was conducted by analyzing the outpatient records of 100 patients diagnosed with chronic cerebral ischemia and dementia syndrome. All patients were referred to the city dementia center for consultation from a healthcare facilities in Novosibirsk. They were examined by a neurologist, assessed for daily activities, and underwent extensive neuropsychological testing, including the Mini-Mental State Examination (MMSE), the «clock,» and literal and categorical associations. All patients underwent neuroimaging (MRI).

Results: Based on the results of an in-depth study, the diagnosis was clarified: 78 patients had moderate Alzheimer’s disease (AD) of mixed origin (neurodegenerative and vascular), 12 patients had mild dementia with Lewy bodies (DLB), and 10 patients had vascular dementia (VD): 6 patients with a mild dementia and 4 with a moderate dementia. The main challenges of early diagnosis and late prescription of antidementia medications are highlighted. A review of non-pharmacological methods for dementia treatment is provided.

About the authors

Svetlana N. Duma

Research Institute for Therapy and Preventive Medicine – Branch of the Federal Research Center, Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences

Author for correspondence.
Email: Duma.svetlana@yandex.ru

Dr. Sci. (Med.), Head of the Scientific Advisory Department, Research Institute of Therapy and Preventive Medicine, Head of the City Dementia Center, Neurologist, Senior Researcher

Russian Federation, Novosibirsk

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