Inadequate diagnostic evaluation in young patients registered with a diagnosis of dementia: a nationwide register-based study.
BACKGROUND
Establishing a diagnosis of dementia in young patients may be complex and have significant implications for the patient. The aim of this study was to evaluate the quality of the diagnostic work-up in young patients diagnosed with dementia in the clinical routine.


METHODS
Two hundred patients were randomly selected from 891 patients aged ≤65 years registered with a diagnosis of dementia for the first time in 2008 in Danish hospitals, and 159 medical records were available for review. Three raters evaluated their medical records for the completeness of the diagnostic work-up on which the diagnosis of dementia had been based, using evidence-based guidelines for the diagnostic evaluation of dementia as reference standards.


RESULTS
According to the rater review, only 111 (70%) patients met the clinical criteria for dementia. An acceptable diagnostic work-up including all items of recommended basic diagnostic evaluation was performed in only 24%, although more often (28%) in the subgroup of patients where dementia was confirmed by raters.


CONCLUSIONS
This first nationwide study of unselected young patients registered with a diagnosis of dementia indicated that the concept of dementia may be misinterpreted by clinicians and that a diagnosis of dementia in the young is only rarely based on a complete basic diagnostic work-up, calling for increased competency.
Memory Disorders Research Group, Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Denmark.
Lise Cronberg
LC
Salem
Memory Disorders Research Group, Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Denmark.
Birgitte Bo
BB
Andersen
Memory Disorders Research Group, Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Denmark.
T Rune
TR
Nielsen
Memory Disorders Research Group, Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Denmark.
Jette
J
Stokholm
Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
Martin Balslev
MB
Jørgensen
Memory Disorders Research Group, Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Denmark.
Gunhild
G
Waldemar
Diagnosis of dementia; Quality of diagnostic work-up; Young patients