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Primary vs. Subspecialty Care

A Structured Follow-Up of Dementia Patients and Their Caregivers

Received March 10, 1999; revised August 20, 1999; accepted September 20, 1999. From the Division of Geriatric Psychiatry and University Behavioral Healthcare, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway, New Jersey. Address correspondence to Dr. Aupperle, University of Medicine and Dentistry of New Jersey, 667 Hoes Lane, P.O. Box 1392, Piscataway, NJ 08855-1392.

All dementia patients and their caregivers who had received a University-based comprehensive evaluation and a diagnosis of Alzheimer's disease during 1997 (N=80) were surveyed 1 year after their initial assessment. Of the original cohort, 72.5% were contacted, and two subgroups were defined: 31 patients were being seen only by their primary care physicians (MED), and 27 patients were being treated in addition by a geriatric psychiatry faculty member (GERO). There were statistically significant differences between the two groups (MED vs. GERO, respectively) at follow-up in terms of: 1) hospitalization (39% vs. 15%; P<0.05); 2) cognitive status (P<0.05); and 3) prescription of donepezil at follow-up (35% vs. 64%; P<0.005). These differences need to be assessed in a larger-scale prospective study.

Key Words: Health Services • Alzheimer's Disease • Long-Term Care