Authors (including presenting author) :
Ng CW(1), Lau WMV(1), So L M(1)
Affiliation :
(1) Department of Occupational Therapy, Kwong Wah Hospital
Introduction :
The prevalence rates of dementia rose dramatically in the period of ten years from 103,433 in 2009 to 332,668 in 2039 among people aged 60 and above with dementia (Yu et al, 2012). This huge service demand for patients with cognitive impairment would lead to long medical outpatient consultation waiting time. Meanwhile, the waiting time for a new appointment of Memory Clinic or Geriatric Clinic service is more than years. Early detection and intervention of MCI and dementia are critical. It allows patients and their caregivers to plan for their future care.
Objectives :
To investigate the effectiveness of early OT intervention to patients with cognitive impairment while waiting for the first appointment of the Memory Clinic and Geriatric Clinic
Methodology :
A “Pre-test” to “Post-test” design was employed. Subjects were (1) Patients with dementia or cognitive impairment (2) waiting for Memory Clinic or Geriatric Clinic consultation services while without any community services. Interventions are provided according to the severity of cognitive impairment. Outcome measures were (1) Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) or Hong Kong version of 5-mins Montreal Cognitive Assessment (HK-5 mins MoCA), (2) Functional Ambulation Classification (MFAC), (3) self-care status, (4) Behavioural Psychological Symptoms of Dementia (BPSD), and living status.
Result & Outcome :
From 2019 to 2022, 103 patients were recruited. The mean age was 78.77 and 61.2% were females. 14.6% were diagnosed with dementia and 85.4% were diagnosed with cognitive impairment. 60.2% and 39.8% of patients were waiting for Geriatric Clinic and Memory Clinic respectively. The mean score of MoCA percentile range are significantly increased from 2.26 to 2.51 in intervention group (p=0.01). The mean score of MoCA percentile range significantly reduced from 2.07 to 1.83 in control group (p=0.01). The MoCA percentile range was defined by the cut off scores above 16th, 16th to 7th, 7th to 2nd and below 2nd percentile by age and education which were derived from the MoCA and MoCA 5 minutes protocol. Improvement or decline in cognition depends on early provision of OT intervention. No significant difference found in both mobility function, self-care status, BPSD and living status (p=0.80, p=0.99, p=0.28, p=0.55).
Conclusion:
It was identified that cognitive function deteriorated during the waiting time for a Memory Clinic or Geriatric Clinic. It may increase caregiver stress and burden and may finally lead to institutionalization. In conclusion, early OT interventions for patients with different levels of cognitive impairment are crucial in improving cognitive function.
