Diagnosis in an early‐onset dementia clinic in the period 2016‐2021 and impact of COVID‐19 pandemic

Abstract

AbstractBackgroundThe diagnosis of early‐onset neurodegenerative dementias (<65 years) can represent a challenge due to their lower frequency respect to late‐onset dementias and atypical forms of presentation. Cognitive impairment has emerged as a frequent complaint after COVID‐19 infection.MethodWe retrospectively reviewed (2016‐2021) the demographic and clinical data of the new referrals at our early onset dementia clinic (Hospital Clínic Barcelona). We used Fisher’s Exact test and ANOVA in Stata/IC 16.1 to analyze differences between patients visited in 2021, 2020 and the period 2016‐2019.ResultWe evaluated 296 patients in 2021, 104 in 2020 and 98 patients/year in 2016‐2019. In 2021, patients had an age at onset (AAO) of 50.1 years, lower than 2020 (53.4) and the period 2016‐2019 (53.0) (p<0.05). The percentage of women in 2021 (69.6%) was higher than 2020 (57.7) and 2016‐2019 (56.0) (p<0.05). Diagnostic delay was lower in 2021 (2.1 years) than 2020 (3.3) and 2016‐2019 (3.0) (p<0.05). No differences were found in Minimental (MMSE) scores (Table 1).In the period 2016‐2021, the number of neurodegenerative diseases (ND) remained steady, the number of subjective cognitive decline (SCD) decreased and the number of non neurodegenerative causes (NNC) experienced a large increase (Table 1), representing 77.7% of visits in 2021.We did not find differences in the type of ND diagnosis in each period (Figure 1A). ND subgroups did not show differences in AAO, sex or MMSE. In 2021, NND presented lower AAO, higher percentage of women, lower diagnostic delay (Figure 1B) and higher MMSE scores than previous years. No differences were found in the SCD group.Cognitive impairment after Covid‐19 accounted for 16.7% of NND in 2020 (n = 8, AAO 50.6 (11.8), 62.5% female, MMSE 26.8(2.3)) and 66.6% of NND in 2021 (n = 153, AAO 49,0 (10.0), 80.1% female, MMSE 27.8 (2.6)).ConclusionIn 2021 we visited approximately three times more patients than in 2016‐2020, among which we observed an increase in NND, mainly patients with cognitive impairment after Covid‐19. On contrast, we found a similar number of ND diagnosis and reduction in SCD.