Four years’ experience in an early‐onset dementia clinic in Barcelona

• DOI: 10.1002/alz.037911
• Publication Date: 2020-12-07T19:02:19Z
• Authors: José Contador; Adrià Tort‐Merino; Mircea Balasa; Neus Falgàs; Jaume Olives; Magdalena Castellví; Jordi Juncà; Sergi Borrego‐Écija; Beatriz Bosch; Guadalupe Fernánd...; Oscar Ramos‐Campoy; Anna Antonell; Raquel Sanchez‐Valle; Albert Lladó
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

AbstractBackgroundEarly‐onset dementia (EOD; <65 years) raises both diagnostic and social/health care challenges. Services for dementia are often designed for the elderly and might have difficulties supplying EOD needs. Clinical and epidemiological data are needed for care planning.MethodWe aim to describe the demographic and the clinical characteristics of all the new referrals to our EOD clinic during the last 4 years (2016‐2019). Clinical charts were reviewed retrospectively. Both, sporadic and genetic cases were included in the analysis. We evaluate the type of symptoms, type and frequency of ancillary tests requested and final diagnosis.ResultsWe evaluated 477 new early‐onset patients [mean age at consultation (MAC) 54.6 years (SD=±9.6), 56% female] during this period. The aim of the first visit was genetic counseling in 17.8% [MAC 48.3(±13.3), 55.3% female] and evaluation of sporadic cases in 82.2% [MAC 56(±8), 56.1% female] [Figures 1 & 2]. Among sporadic cases, memory complains were the main symptom (67.1%), followed by behavioral (13%) and language disturbance (11.2%). Complete neuropsychological evaluation was performed in 61.2%, CSF biomarkers in 30.9%, PET‐FDG in 22.4%, PET‐amyloid in 12.5% and genetic testing in 10.5%. Subjective Cognitive Decline (SCD) was diagnosed in 51.8% of these sporadic cases [MAC 54.2(±8), 63.5% female, Mean MMSE 27(±4)], while an abnormal cognition was found in the 48.2% [MAC 58(±7.5), 48.1% female, Mean MMSE 23(±6)]. Regarding EOD causes, 54% was due to neurodegenerative dementias [MAC 60(±5.5), 47.1% females, MMSE 22(±6)] and 46% to non‐neurodegenerative [MAC 55.5(±8.8), 49.4% female, Mean MMSE 25(±5)]. EOD mean time to diagnosis was 3.1 years (±3.75) with no differences between groups (p=0,207). In neurodegenerative dementias, AD constitutes 51% [MAC 61.6(±4), 51.9% female, Mean MMSE 20(±6)] and Frontotemporal lobular degeneration (FTLD) 34.3% [MAC 58.5(±5.3), 45,7% female, Mean MMSE 24(±5)].ConclusionSCD is a frequent diagnosis among new referrals to EOD clinics. AD is the most frequent neurodegenerative EOD, followed by FTLD. Non‐neurodegenerative causes of EOD are frequent and heterogeneous. Long delay until diagnosis suggests that new care policies are needed to identify EOD in early stages.