ENGLISH ABSTRACT
JOURNAL ARTICLE
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[The specialist-referred patients represent 42% of the activity of an academic memory clinic].

OBJECTIVES: Evaluate demographic and aetiological characteristics of patients referred by specialist doctors (neurologists, geriatricians and psychiatrists) to an Academic Memory Clinic in Lyon, for the year 2008. These specialist-referred patients (SRP) constitute a specific mission of the French Academic Memory Clinics.

METHODS: The outpatients consecutively referred in 2008 to our memory clinic by any persons (patients, families, general practitioners, specialist doctors) were all evaluated using clinical, neuropsychological and imaging information. We examined the distribution of patients diagnosis and differences in gender, education, and cognitive severity (MMSE). For each patient, diagnoses used clinical criteria at the first visit, and ranged from normal subjects to cognitive impaired patients with or without dementia.

RESULTS: Among 384 patients, 160 (41.7%; 68 men and 92 women) were referred by specialist doctors. These 160 SRP were younger (P<0.0001) but did not differ from other patients on gender (P=0.55) nor Mini Mental State Examination (P=0.15). SRP were more often demented than the non-referred patients (respectively, 64.4% vs 39.7%; P=0.0001), and the demented SRP had less often Alzheimer's disease (AD) (30.1% vs 65.6%; P=0,0001). Dementia was present in 64.4% of the 160 SRP: among the 160, AD was the most frequent cause (19.4%), followed by Lewy body dementia (11.3%), neurological diseases (12.5% - multiple sclerosis, vascular cognitive impairment, epilepsy) and Mild Cognitive Impairment (10%). Normal subjects were present in 8.1% of the SRP.

DISCUSSION: As compared to non-SRP, SRP are younger, more demented (64,4%) and more prone to have non-AD dementia (69,9%). However, AD represented the most frequent diagnosis (19.4% of SRP).

CONCLUSION: SRP are an important part of the activity of an Academic Memory Clinic in Lyon. As compared to GPs, young and demented patients are more likely to be sent in a specialized referral center by specialist doctors.

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