J Korean Med Sci.  2023 Aug;38(33):e257. 10.3346/jkms.2023.38.e257.

Clinical Characteristics and Followup Assessment in Patients Diagnosed With Alzheimer’s Dementia Through Regional Dementia Centers and Conventional Hospital System

• Jeong E
• Park D
• Lee SY
• Kim H
• Kwon HD
• Kim MC
• Park KW

• KMID: 2545209
• DOI: http://doi.org/10.3346/jkms.2023.38.e257

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 communitybased 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, R ² = 0.048, and P < 0.001).
Conclusion
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.

Keyword

Alzheimer’s Dementia; Dementia; Health Policy; Regional Medical Programs

Figure

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  Fig. 1 Flow chart of patient inclusion.AD = Alzheimer’s dementia, RDC = regional dementia center.

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  Fig. 2 The flow of AD diagnosis in each group.AD = Alzheimer’s dementia, RDC = regional dementia center.

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