The role of units for diagnosis and evaluation of cognitive disorders and behavioural disorders in the early diagnosis of Alzheimer’s disease. Analysis of 962 consecutive cases seen 19961997 in the Fundación ACE
Objectives. The objective of this study was to identify the most relevant clinico-epidemiological, demographic, social, neuropsychological and neurological data seen in this Special Unit for Diagnosis and Evaluation of Cognitive Disorders and dementias during the period 1996-1997, and to evaluate the efficacy of this type of unit within the health system. This is a specific resource in the social-health programme ‘Vida als Anys’ of the Health Department of the Generalitat of Catalunya, with the objective of a multidisciplinary approach and continued treatment for this type of disorder which requires integral, global intervention integrated in the system, since it is of major social importance. Patients and methods. This unit for diagnosis, in the Barcelone Health Region, deals with an area with approximately 285,481 inhabitants over the age of 65. In a longitudinal study of this population, we considered 962 persons, seen consecutively during this period, of an average age of 80 years and with a marked predominance of women. With regard to diagnosis, 54% of the patients had symptoms compatible with dementia; Alzheimer’s disease was the most frequent diagnosis, followed by vascular and mixed dementias. During this period, 6,431 medical interventions were carried out, of which 3,805 were to reach the overall diagnosis, 1,023 to give medical information to the patient’s relatives and 1,603 were follow-up visits. This unit handled a total of 322 social-health interventions. Conclusions. We consider that this specific resource, highly qualified, with professional means of diagnosis and administration, can offer the public health system integral attention to the patient and continued planning of treatment, being recognized as a service for referral from Primary and Specialized Care
Pacientes y métodos Esta unidad de diagnóstico, ubicada en la Región Sanitaria de Barcelona, abarca una área con una población aproximada de 285.481 habitantes mayores de 65 años. En el estudio longitudinal de nuestra población, se analizan 962 sujetos que se han visitado consecutivamente en este período, con una edad media de 80 años y un franco predominio de mujeres. En lo referente a diagnósticos, el 54% de los pacientes mostraron una sintomatología clínica compatible con demencia; la enfermedad de Alzheimer ha sido la más frecuente, seguida de las demencias vascular y mixta. Durante este período se han realizado un total de 6.431 actos médicos, de los que 3.805 se dedicaron a la realización del diagnóstico global, 1.023 a la devolución de la información médica a los familiares y 1.603 fueron visitas sucesivas. Esta unidad ha gestionado un total de 322 acciones sociosanitarias.
Conclusiones Consideramos que este recurso específico, altamente cualificado, con capacidad profesional diagnóstica y de gestión, ofrece al sistema público de salud atención integral al enfermo y planificación de las intervenciones ‘ad continuum’, siendo reconocido como un servicio de referencia para la Atención Primaria y Especializada
