title: Management of suspected Alzheimer's disease patients by specialist physicians at the first visit in Spain: First Consultation Study.
abstract: OBJECTIVE
  To assess the management of suspected Alzheimer's disease (AD) patients at the first visit by Spanish specialist physicians.
  
  
  METHODS
  Epidemiological, cross-sectional and multicenter study. A total of 200 specialists (neurologists, psychiatrists and geriatricians) from hospitals and specialized centers across Spain included a total of 1851 patients of both sexes older than 18 years suspected to be suffering from AD. Data of clinical and demographic characteristics, methods of diagnosis, treatments and follow-up were collected in one visit.
  
  
  RESULTS
  The mean age of the population was 75.2 ± 7.9 years. The most frequent symptoms were difficulty in performing familiar tasks (76.7%), memory loss (76.0%) and misplacing items (72.7%). The assessment of suspected AD subjects included: neurological examination (walk apraxia [10.8%] and extrapyramidal signs [10.7%]), evaluation of cognition (mean of the Mini-Mental State Examination score was 19.9 ± 5.2 [mild AD]), function and behavior, and supplementary diagnostic tests (blood test [90%] and computerized axial tomography [66.8%]). In total, 69.5% of the patients were diagnosed with AD according to Spanish Society of Neurology criteria. Principal treatment was cholinesterase inhibitors (87.8%). The mean time for follow-up visit: 4 ± 2.4 months; with the same physician (95.5%), neurologist (68.2%), psychiatrist (19%) and geriatrician (11.7%).
  
  
  CONCLUSIONS
  Several possible areas are amenable to improvement by means of reducing the time to diagnosis, increasing the number of patients treated with nonpharmacological therapy, and providing more information on the benefits of treatment, care and providing the best therapeutic options available. In this study, almost half of the patients took 1-3 years to visit a physician after appearance of the first symptoms. Significant differences were observed between the medical specialty and treatments provided; nevertheless, the majority of physicians used cholinesterase inhibitors (87.8%) as the principal treatment.
authors.affiliation: Hospital La Magdalena, Castellón, Spain.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Martínez Lozano
authors.forename: Carlos
authors.initials: C
authors.lastname: Guzmán Quilo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000188:drug therapy*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D016021:Epidemiologic Studies; D005260:Female; D005853:Geriatrics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009462:Neurology; D009483:Neuropsychological Tests; D058007:Physicians, Primary Care; D011570:Psychiatry; D012017:Referral and Consultation; D013030:Spain; D013038:Specialization
chemical_list: D002800:Cholinesterase Inhibitors