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Differences in diag...
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Garcia-Ptacek, SaraKarolinska Institutet,Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
(författare)
Differences in diagnostic process, treatment and social Support for Alzheimer's dementia between primary and specialist care : resultss from the Swedish Dementia Registry
- Artikel/kapitelEngelska2017
Förlag, utgivningsår, omfång ...
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2016-11-03
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Oxford University Press (OUP),2017
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printrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:su-142716
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https://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-142716URI
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https://doi.org/10.1093/ageing/afw189DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:135465055URI
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https://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-34688URI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
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Background: the increasing prevalence of Alzheimer's dementia (AD) has shifted the burden of management towards primary care (PC). Our aim is to compare diagnostic process and management of AD in PC and specialist care (SC). Design: cross-sectional study. Subjects: a total of, 9,625 patients diagnosed with AD registered 2011-14 in SveDem, the Swedish Dementia Registry. Methods: descriptive statistics are shown. Odds ratios are presented for test performance and treatment in PC compared to SC, adjusted for age, sex, Mini-Mental State Examination (MMSE) and number of medication. Results: a total of, 5,734 (60%) AD patients from SC and 3,891 (40%) from PC. In both, 64% of patients were women. PC patients were older (mean age 81 vs. 76; P < 0.001), had lower MMSE (median 21 vs. 22; P < 0.001) and more likely to receive home care (31% vs. 20%; P < 0.001) or day care (5% vs. 3%; P < 0.001). Fewer diagnostic tests were performed in PC and diagnostic time was shorter. Basic testing was less likely to be complete in PC. The greatest differences were found for neuroimaging (82% in PC vs. 98% in SC) and clock tests (84% vs. 93%). These differences remained statistically significant after adjusting for MMSE and demographic characteristics. PC patients received less antipsychotic medication and more anxiolytics and hypnotics, but there were no significant differences in use of cholinesterase inhibitors between PC and SC. Conclusion: primary and specialist AD patients differ in background characteristics, and this can influence diagnostic work-up and treatment. PC excels in restriction of antipsychotic use. Use of head CT and clock test in PC are areas for improvement in Sweden.
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Nilsson Modeer, IngridDivision of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
(författare)
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Kåreholt, IngemarKarolinska Institutet,Stockholms universitet,Centrum för forskning om äldre och åldrande (ARC), (tills m KI),Jönköping University, Sweden,HHJ. ARN-J (Aging Research Network - Jönköping),HHJ, Institutet för gerontologi,Aging Research Center, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet and Stockholm University, Stockholm, Sweden(Swepub:hj)karing
(författare)
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Fereshtehnejad, Seyed-MohammadKarolinska Institutet,Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
(författare)
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Farahmand, BahmanDivision of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
(författare)
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Religa, DorotaKarolinska Institutet,Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
(författare)
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Eriksdotter, MariaKarolinska Institutet,Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
(författare)
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Karolinska InstitutetDivision of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Age and Ageing: Oxford University Press (OUP)46:2, s. 314-3190002-07291468-2834
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