Persons aged 70 years and older with memory complaints Mental and Behavioural Disorders
Conditions
Interventions
Current interventions as of 13/07/2023:
Intervention:
For the primary care arm, the diagnostic procedures are described in the Dementia Guideline of the Dutch College of General Practitioners. The mi
Sponsors
Radboud University Nijmegen Medical Centre
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: All patients 70 years and older consulting the GP with memory problems are eligible if the patient and GP consider starting diagnostic evaluation
Exclusion criteria
Exclusion criteria: 1. Patients are excluded if referral is clearly indicated due to suspicion of an uncommon form of dementia or another brain disease with accompanying memory problems, based on history or focal signs on neurological examination, such as extrapyramidal signs, hemiparesis or Babinski’s sign 2. Patients are also excluded if the GP considers referral undesirable, e.g. in case of concomitant terminal illness (added 20/11/2024) If patients do not want to be randomized, they are invited to participate in the prospective cohort study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Current primary outcome measures as of 22/10/2025: Daily functioning measured using the Amsterdam Instrumental Activities of Daily Living Questionnaire Short Version (A-iADL-Q-SV). Both primary and secondary outcomes are measured at baseline, 6 months, 18 months and 24 months (four time points including baseline) or until attrition due to death, because the relatively short diagnostic trajectories are likely to have long-term consequences due to disease management decisions following diagnosis. _____ Previous primary outcome measure as of 20/11/2024: Daily functioning measured using the Amsterdam Instrumental Activities of Daily Living Questionnaire Short Version (A-iADL-Q-SV). Both primary and secondary outcomes are measured at baseline, 6 months, 18 months and (24-)30 months (four time points including baseline) or until attrition due to death, because the relatively short diagnostic trajectories are likely to have long-term consequences due to disease management decisions following diagnosis. In case of institutionalization, primary outcome assessment continues, other outcomes if feasible and appropriate. _____ Previous primary outcome measure as of 13/07/2023: Daily functioning measured using the Amsterdam Instrumental Activities of Daily Living Questionnaire Short Version (A-iADL-Q-SV). Both primary and secondary outcomes are measured at baseline, 6 months, 18 months and 30 months (four time points including baseline) or until attrition due to death, because the relatively short diagnostic trajectories are likely to have long-term consequences due to disease management decisions following diagnosis. In case of institutionalization, primary outcome assessment continues, other outcomes if feasible and appropriate. _____ Previous primary outcome measure: Daily functioning measured using the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-iADL-Q). Both primary and secondary outcomes are measured at baseline, 6 months, 18 months and 30 | — |
Secondary
| Measure | Time frame |
|---|---|
| Current secondary outcome measures as of 22/10/2025: 1. Diagnostic accuracy, measured using the first dementia diagnosis as the index diagnosis and the diagnosis at 24 months as the reference standard. 2. Time to dementia diagnosis assessed based on information available in electronic medical records 3. Acute admissions and time to institutionalization (months): information available in electronic medical records 4. (Time to) mortality reported by caregiver or general practitioner 5. Quality of life measured using EQ-5D 6. Costs measured using Resource Utilization in Dementia (RUD) 7. Cognition measured using the short cognitive screening test Mini-Mental State Examination (MMSE) 8. Behavior measured using the Neuro-Psychiatric Inventory Questionnaire (NPI-Q) 9. Mood measured using the Geriatric Depression Scale (GDS-15) 10. Caregiver burden measured using perseverance time Both primary and secondary outcomes are measured at baseline, 6 months, 18 months and 24 months (four time points including baseline) or until attrition due to death, because the relatively short diagnostic trajectories are likely to have long-term consequences due to disease management decisions following diagnosis. A short questionnaire will be administered to caregivers who decline to complete the A-IADL-Q-SV at follow-up. It collects a minimal dataset on mortality, changes in residence, and hospital admissions/ER visits, using questions from the RUD _____ Previous secondary outcome measures as of 20/11/2024: 1. Diagnostic accuracy, measured using the first dementia diagnosis as the index diagnosis and the diagnosis at 30 months as the reference standard. Dementia diagnosis will be assessed using an algorithmic approach, with all clinical information available in electronic medical records. 2. Time to dementia diagnosis assessed based on information available in electronic medical records 3. Acute admissions and time to institutionalization (months): information available in electron | — |
Countries
Netherlands
Contacts
Public ContactDemi Ronner
Outcome results
None listed