title: Predictors of cognitive impairment severity in rural patients at a memory clinic.
abstract: OBJECTIVE
  Patients with dementia benefit from early assessment and diagnosis. In an attempt to identify factors leading to delay in referral, we investigated socio-demographic, clinical, and functional predictors of greater severity of cognitive impairment in dementia patients presenting to a memory clinic in Saskatoon, Saskatchewan.
  
  
  METHODS
  Data collection began in 2004 at the Rural and Remote Memory Clinic in Saskatoon, where non-institutionalized patients were referred by their family physicians. The patient and caregiver questionnaires and assessments administered at the clinic day appointment provided the socio-demographic, clinical, and functional patient variables, as well as the caregiver stress and burden variables. The dependent variable was patient cognitive impairment, as measured by Modified Mini-Mental State Examination (3MS) scores. Variables underwent univariate linear regression with 3MS scores in order to determine possible associations. A multiple regression analysis was 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 an age and gender interaction, years of formal education, Functional Activities Questionnaire score, and Brief Symptom Inventory score were significantly associated with 3MS scores (p<0.05).
  
  
  CONCLUSIONS
  Increased cognitive impairment at presentation was predicted by fewer years of formal education, poorer functional ability, and less caregiver psychological distress. There was a significant interaction between age and gender: younger females were more cognitively impaired than younger males at clinic day, while in older patients, males were more cognitively impaired than females.
authors.affiliation: College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. chl093@mail.usask.ca
authors.forename: Catherine
authors.initials: C
authors.lastname: Lacny
authors.forename: Andrew
authors.initials: A
authors.lastname: Kirk
authors.forename: Debra G
authors.initials: DG
authors.lastname: Morgan
authors.forename: Chandima
authors.initials: C
authors.lastname: Karunanayake
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001921:Brain / Q000000981:diagnostic imaging; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D011237:Predictive Value of Tests; D011859:Radiography; D012044:Regression Analysis; D012189:Retrospective Studies; D012424:Rural Population; D011795:Surveys and Questionnaires; D015898:Tomography Scanners, X-Ray Computed