Predictors of Severity of Cognitive Impairment in Rural Patients Presenting to a Memory Clinic (P01.089)

Abstract

Objective: To identify predictors of more severe cognitive impairment at initial presentation to a memory clinic in Saskatchewan. Background The literature suggests that patients with dementia and their families benefit from early assessment and diagnosis, yet those living in rural communities are disproportionately vulnerable to barriers in accessing dementia care. Design/Methods: Data collection began in 2004 at the Rural and Remote Memory Clinic in Saskatoon SK, where patients were referred by their family physicians. The questionnaires and assessments administered at the clinic-day appointment provided socio-demographic, clinical and functional variables. Socio-demographic variables included: age, sex, marital status, years of formal education, ancestry, number of people living with patient, number of comorbidities, time on clinic wait list, duration of symptoms, family history of dementia, and a measure of 9ruralness9. Caregiver-rated patient functional status was assessed by the Functional Activities Questionnaire (FAQ) and the Neuropsychiatric Inventory Scale. Caregiver burden was assessed through the Zarit Burden Interview; caregiver psychological distress through the Brief Symptom Inventory (BSI). The dependent variable was patient cognitive impairment, measured by Modified Mini-Mental State Examination (3MS) scores. Univariate and multiple linear regression analyses were conducted to determine predictors of cognitive impairment severity at clinic presentation. Results: Our sample included 198 patients (62% female). The mean age was 73.9 years (SD=9.2). We found that age and gender interaction, years of formal education, FAQ score, and BSI score were significantly associated with 3MS scores (p Conclusions: Increased cognitive impairment was predicted by fewer years of formal education, poorer functional ability, and less caregiver psychological distress. With respect to the age and gender interaction, younger females were more cognitively impaired than younger males at clinic day. In older patients, males were more cognitively impaired. Supported by: The Mach-Gaensslen Foundation. Disclosure: Dr. Lacny has nothing to disclose. Dr. Kirk has nothing to disclose. Dr. Morgan has nothing to disclose. Dr. Karunanayake has nothing to disclose.