Factors influencing time between onset of signs/symptoms and referral for dementia in elderly outpatients

Background The few studies that have focused on Time between Onset of Signs and Symptoms and Referral (TOSR) for dementia to a memory center suggest a substantial delay of 1–3 years. This delay has a negative impact on both patients’ and their caregivers’ quality of life. Objective This study aimed to evaluate this delay and the factors associated with it in a cohort of community-dwelling elderly people attending a memory clinic, as well as assess the impact of the Third French National Alzheimer Plan (2008–2012). Methods All patients referred to the Bretonneau Memory Clinic for the first time between January 2006 (the clinic has maintained a specific database since then) and March 2016 were included in the study. Results Of the 8543 patients attending our Memory Clinic during the study period, 3353 attending for the first time and with complete data were included. Briefly, their ages were 82 ± 7 years, and 67.2% were female; MMSE score was 21.2 ± 6.6, IADL was 4.06 ± 0.78 and the social-needs category of the Groupes Iso Ressources (GIR); Iso-Resource Group (IRG) scale was 4.04 ± 0.37. The TOSR was, on average, 35.4 ± 30.24 months, and increased after implementation of the Third French National Alzheimer Plan, from 26.68 ± 26.28 months before 2009 to 40.08 ± 31.2 months after 2009. Age and MMSE were associated with TOSR, but not the type of dementia, household composition and social characteristics. Also, there was a shorter TOSR for mild cognitive impairment than for dementia patients. Conclusion Our results emphasize the need for more education and information among the general public about the early signs of cognitive impairment, especially in elderly people.