Characteristics and diagnostic profile of patients seeking dementia care in a memory clinic in Hong Kong.

Sheng, Bun; Law, Chun Bon; Yeung, Kwan Mo

BACKGROUND Seeking medical advice for dementia involves an understanding of norms, values and attitudes towards care-giving and inter-dependency, which are culturally bounded. We hypothesize that local culture and socioeconomic structure affect our Chinese patients who present with forgetfulness to our memory clinic. METHODS A retrospective case notes review was undertaken on 454 consecutive patients referred to the memory clinic at Princess Margaret Hospital, Hong Kong. RESULTS 385 patients were diagnosed with dementia and 27 had mild cognitive impairment. Reversible dementia was identified in 24 patients and normal cognition in 18. In patients with dementia, 55.8% had Alzheimer's disease, 26.2% had vascular dementia, 6.0% had other irreversible dementia, 5.2% had dementia with Lewy bodies, 4.9% had undetermined dementia and 1.8% had frontotemporal dementia. The median duration from symptom onset to medical consultation was two years; 66.5% had advanced disease with initial Mini-mental State Examination scores < or = 17. On their first visit, 85% of patients were living in the community; after two years this proportion had fallen to 63%. CONCLUSIONS Dementia patients in Hong Kong apparently enjoy a long subclinical period and only seek medical attention at late stages. Local Chinese culture and socioeconomic backgrounds could be the main reasons that underlie these observations.