title: Regional variation on the presentation of Alzheimer's disease patients in memory clinics within Europe: data from the ICTUS study.
abstract: This study set out to describe the variations within Europe for Alzheimer's disease (AD) patients with regards to clinical and socio-demographic features, co-morbidities, drug treatment, and psychosocial care. 1,379 mild to moderate AD subjects from the ICTUS study were clustered into four geographic regions according to WHO-classification of European countries. Northern patients showed the mildest severity of dementia (MMSE: 21.6 +/- 3.7, p< 0.001), received the lowest rate of concomitant psychotropic drug treatment (24.3%, p< 0.001), and appeared to be healthier than patients in the rest of Europe. Western subjects were diagnosed earliest (0.5 +/- 0.9 month, p< 0.001), received the highest rate of formal care (45.0%, p< 0.001), and had the highest rates of antidementia drug treatment (60.4%, p< 0.001). Southern subjects had the shortest education period (5.6 +/- 4.0, p< 0.001), the most severe cognitive decline in MMSE: 19.8 +/- 4.0, $p<$ 0.001 and ADAScog: 24.2 9.6, p< 0.001 and received less antidementia drug treatment (37.6%; p< 0.001), lived more often with their caregivers (74.4%, p< 0.001), and had the highest caregiver burden (22.6 +/- 15.2, p=0.049). Eastern AD subjects received more concomitant psychopharmacological drugs (68.6%, p< 0.001), caregivers were more often different (18.6%, p< 0.001) from spouse or offspring, caregiver burden was lowest (18.7 +/- 12.4, p=0.049), nearly all subjects received only informal care (95.7%, p< 0.001) and were affected more by co-morbidities. Overall, these data show differences in socio-demographic and clinical characteristics between AD patients from four European geographical regions. The presentation and management of AD in Europe appears to differ according to European regions and likely reflects differences in cultural factors and health politics.
authors.affiliation: Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.
authors.forename: Lucrezia
authors.initials: L
authors.lastname: Hausner
authors.forename: Lutz
authors.initials: L
authors.lastname: Frölich
authors.forename: Virginie
authors.initials: V
authors.lastname: Gardette
authors.forename: Emma
authors.initials: E
authors.lastname: Reynish
authors.forename: Pierre-Jean
authors.initials: PJ
authors.lastname: Ousset
authors.forename: Sandrine
authors.initials: S
authors.lastname: Andrieu
authors.forename: Bruno
authors.initials: B
authors.lastname: Vellas
authors.lastname: On Behalf Of The Ictus-Eadc Study Group
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000523:psychology; D017028:Caregivers / Q000523:psychology; D003431:Cross-Cultural Comparison; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008569:Memory Disorders / Q000453:epidemiology* / Q000523:psychology; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D012649:Self Concept; D019371:Topography, Medical; D055815:Young Adult