Observational studyJournal of primary care & community health
Diagnosis and Management of Alzheimer's Disease in Primary Care: A Real-World Study in Ontario, Canada.
Observational study in Journal of primary care & community health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo understand the real-world clinical practice patterns and variation in Alzheimer's disease (AD) diagnostic and screening tool utilization by primary care physicians (PCPs), including tools used for assessing dementia/AD severity and subsequent treatment patterns.
methodsThis retrospective observational study used de-identified primary care data from electronic medical records (EMR) data provided by the researchers from Queen's University, Ontario, Canada from August 2011 to August 2021. Individuals ≥50 years old with dementia or AD were identified using AD and dementia-related diagnostic codes, medications, and keywords searched using natural language processing (NLP) and Artificial Intelligence (AI) algorithms from EMR chart notes. Diagnostic and screening tools included scales, neuroimaging, and laboratory tests. Medications examined were cholinesterase inhibitors, memantine, antidepressants, and antipsychotics.
resultsThe study cohort included 417 individuals with all-cause dementia (mean [standard deviation: SD] age: 78.86 [0.19] years), and 71 individuals with AD (mean [SD] age: 76.13 [1.07]). The most-used scale was the Montreal Cognitive Assessment (MoCA; dementia: 53.2%, AD: 84.5%). The mean [SD] frequency of MoCA administration doubled in the year following AD index date compared to the year prior (0.29 [0.82] to 0.67 [1.19] times per patient-year). Severity scores, often unspecified, suggested various stages of cognitive impairment. Among the medications examined, cholinesterase inhibitors were prescribed in 27.8% (n = 116) and 57.8% (n = 41) of people with dementia and AD, respectively. Antidepressants were the most frequently prescribed medication examined (dementia: 49.6%; AD: 71.8%).
conclusionPCPs play an important role in the early detection and management of dementia/AD. As new biomarkers and therapies emerge for early AD, there is a need for connected health system data to guide PCPs through the early diagnostic process.
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