title: Measuring the decline of a population of people with early-onset dementia in Lothian, Scotland.
abstract: OBJECTIVE
  To seek differences in the pattern of decline between groups of patients with early-onset dementia of varying aetiologies (clinically defined) on the basis of the investigation of their different clinical profiles.
  
  
  METHODS
  A cohort of 126 live patients with dementia diagnosed before the age of 65, of various aetiologies, were identified using the Lothian Psychiatric Case Register. Each person was seen for two assessments approximately 1 year apart.
  
  
  METHODS
  Patients were either in long-term care (NHS or other) or at home, usually in the care of relatives.
  
  
  METHODS
  Of 126 cases (53 male, 73 female, mean age at referral 58 years), 114 met the diagnostic criteria for DSM-III-R dementia: 60 Alzheimer's type dementia; 13 multi-infarct dementia; 14 alcohol-related dementia; with 25 in a mixed group of overlapping categories and two in 'other' dementia types. By the second assessment, 18 cases had died and two cases refused reassessment.
  
  
  METHODS
  The data collected included: demographic; behavioural and psychopathological; neurocognitive; neurological; and genetic. Change was assessed.
  
  
  RESULTS
  The alcohol group was distinguished from the other groups by its generally milder profile of impairment and a pattern of change indicating some areas of improvement in the follow-up period.
  
  
  CONCLUSIONS
  There are limitations in the instruments used to measure change in this group of patients; at present, measures of change in dementing illnesses cater predominantly for an elderly population with Alzheimer's disease.
authors.affiliation: Royal Edinburgh Hospital, UK.
authors.forename: K
authors.initials: K
authors.lastname: Woodburn
authors.forename: E
authors.initials: E
authors.lastname: Johnstone
mesh_terms: D000328:Adult; D017668:Age of Onset; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003704:Dementia / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards*; D011604:Psychoses, Alcoholic / Q000175:diagnosis; D012044:Regression Analysis; D012074:Remission Induction; D012606:Scotland / Q000453:epidemiology