Journal List > Dement Neurocogn Disord > v.13(4) > 1120737

Dement Neurocogn Disord. 2014 Dec;13(4):117-120. Korean.
Published online Dec 31, 2014.  https://doi.org/10.12779/dnd.2014.13.4.117
© 2014 Korean Dementia Association
The Consideration about Usefulness of Mass Screening for Dementia
Hojin Choi, M.D.,*, Hee-Jin Kim, M.D.,*, Kyoung Hee Kim, M.D., Seong-il Oh, M.D.,§ and Seung Hyun Kim, M.D.*,
*Department of Neurology, Hanyang University College of Medicine, Seoul, Korea.
Seongdong-gu Community Public Health Center, Seoul, Korea.
Seongdong-gu Regional Center for Dementia, Seoul, Korea.
§Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

Address for correspondence: Seung Hyun Kim, M.D. Department of Neurology, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 133-792, Korea. Tel: +82-2-2290-8371, Fax: +82-2-2296-8370, Email: kimsh1@hanyang.ac.kr
Received Nov 10, 2014; Revised Nov 21, 2014; Accepted Nov 21, 2014.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Background

With the increasing elderly population in Korea, the number of dementia patients is estimated to reach nearly a million by 2027. To resolve this problem, centers for dementia were established in Korea since 2007 and mass screening for dementia proceeded in these center. This research was the analysis of the results of mass screening in Seongdong-gu center for dementia.

Methods

From July 2007 to December 2013, we registered 23,186 persons at Seongdong-gu center for dementia and all individuals were aged 60 and older. They classified the subjects into cognitive impairment group and normal group by Korean version Mini-Mental State Examination (K-MMSE). Next, the cognitive impairment group was assorted by Consortium to Establish a Registry for Alzheimer's Disease Korean version (CERAD-K) and the examination of two neurologists. We investigated the prevalence of dementia and the usefulness mass screening of dementia among that data.

Results

A total of 23,186 subjects were enrolled, of which 3,286 were cognitive impairment group, and 1,856 were diagnosed with dementia finally. The mean age was 77.1 years, 67% were female and the mean education level was 6.3 years. Disease incidence of dementia was lower year by year, but this went up when we focused the group who has high risk of dementia. Especially, the sharp decline was observed in complete enumeration dementia screening test about the specific age group.

Conclusions

These results could suggest that we should focus on the group who has high risk of dementia in screening for dementia and it requires a more judicious approach.

Keywords: Dementia; Mass screening; Disease incidence

Tables


Table 1
Demographics and status of subjects
Click for larger image


Table 2
The results of mass screening for dementia in Seongdong-gu center for dementia
Click for larger image


Table 3
The results of mass screening for dementia in Seoul metropolitan center for dementia
Click for larger image


Table 4
The results of complete enumeration dementia screening test about the age of 70 in Seongdong-gu
Click for larger image

References
1. Alzheimer Disease International. World Alzheimer Report 2009.
2. The Ministry of Health Wefare and Family Affairs. Nationwide study on the prevalence of dementia in Korean elders. Seoul: The Ministry; 2008.
3. Park HK, Na DL, Han SH, Kim JY, Cheong HK, Kim SY, et al. Clinical Characteristics of a Nationwide Hospital-based Registry of Mild-to-Moderate Alzheimer's Disease Patients in Korea: a CREDOS (Clinical Research Center for Dementia of South Korea) study. J Korean Med Sci 2011;26:1219–1226.
4. UK National Screening Committee. Alzheimer's disease: the UK NSC policy on Alzheimer's disease screening in adults. 2010
5. Brunet MD, McCartney M, Heath I, Tomlinson J, Gordon P, Cosgrove J, et al. Open letter to the prime minister and chief medical officer for England. There is no evidence base for proposed dementia screening. BMJ 2012;345:e8588.
6. Department of Health. Policy improving care for people with dementia. 2013
7. Chinthapalli K. Reward doctors for early diagnosis of dementia, says think tank. BMJ 2012;345:e8533.
8. Kang Y, Kim D, Na DL. A normative study of the Korean Mini-Mental State Examination. J Korean Neurol Assoc 2003;22 Suppl 3:235.
9. Choi H, Kim HJ, Park KB, Park HM, Kim SH. The Results of Complete Enumeration Survey of the Cognitive Screening Test in the People Aged 60 and Older in Absolute Poverty of the Local Community. Dement Neurocogn Disord 2011;10:112–116.
10. Yoon B, Shim YS, Kim YD, Lee KO, Na SJ, Hong YJ, et al. Who Takes Care of Patients with Dementia in Korea: A Study on the Present State of Patients with Dementia Living Alone and Primary Caregivers. Dement Neurocogn Disord 2012;11:13–17.
11. Ritchie K, Kildea D. Is senile dementia "age-related" or "ageing-related"?-evidence from meta-analysis of dementia prevalence in the oldest old. Lancet 1995;346:931–934.
12. Brunet MD. Targets for dementia diagnoses will lead to overdiagnosis. BMJ 2014;348:g2224.
13. Le Couteur DG, Doust J, Creasey H, Brayne C. Political drive to screen for pre-dementia: not evidence based and ignores the harms of diagnosis. BMJ 2013;347:f5125.
14. Meeuwsen EJ, Melis RJ, Van Der Aa GC, Goluke-Willemse GA, De Leest BJ, Van Raak FH, et al. Effectiveness of dementia follow-up care by memory clinics or general practitioners: randomised controlled trial. BMJ 2012;344:e3086.
15. Flicker LA, Ford AH, Beer CD, Almeida OP. Memory loss. Med J Aust 2012;196:114–117.
16. Masoodi N. Review: cholinesterase inhibitors do not reduce progression to dementia from mild cognitive impairment. Ann Intern Med 2013;158:JC2–JC3.
17. Gill SS, Anderson GM, Fischer HD, Bell CM, Li P, Normand SL, et al. Syncope and its consequences in patients with dementia receiving cholinesterase inhibitors: a population-based cohort study. Arch Intern Med 2009;169:867–873.
18. Winblad B, Gauthier S, Scinto L, Feldman H, Wilcock GK, Truyen L, et al. Safety and efficacy of galantamine in subjects with mild cognitive impairment. Neurology 2008;70:2024–2035.
19. Le Couteur DG, Robinson M, Leverton A, Creasey H, Waite L, Atkins K, et al. Adherence, persistence and continuation with cholinesterase inhibitors in Alzheimer's disease. Australas J Ageing 2012;31:164–169.
20. Boustani M, Perkins AJ, Monahan P, Fox C, Watson L, Hopkins J, et al. Measuring primary care patients' attitudes about dementia screening. Int J Geriatr Psychiatry 2008;23:812–820.
21. Justiss MD, Boustani M, Fox C, Katona C, Perkins AJ, Healey PJ, et al. Patients' attitudes of dementia screening across the Atlantic. Int J Geriatr Psychiatry 2009;24:632–637.