The Worried Well? Characteristics of Cognitively Normal Patients Presenting to a Rural and Remote Memory Clinic

Abstract

Introduction: In an effort to better understand why cognitively normal patients were referred to a memory clinic, we sought to identify features of worried well patients to better identify those more likely to be cognitively normal. Methods: In total, 375 consecutive patients referred by primary care practitioners to a Rural and Remote Memory Clinic were categorized into two groups based on their neurologic diagnosis, worried well (cognitively normal, N=81) or other (patients with any neurologic diagnosis, N=294). Data collected included: age, sex, years of formal education, Mini-Mental Status Examination score from initial visit, Center for Epidemiologic Studies Depression Scale score, Self-Rating of Memory Scale, alcohol consumption, marital status, hours per week of work, past medical history, sleep concerns, and family history of memory concerns. The two groups were compared using t-tests and χ 2 tests. The same comparison was done between the same set of worried well patients (cognitively normal, N=81) and the subgroup of patients with a diagnosis of Alzheimer's disease (N=146) from the other group. Results: Significant differences included younger age, more formal education, more frequently having previous psychiatric diagnosis and more self-reported alcohol consumption in the worried well group. The worried well and Alzheimer's disease comparison had the same significant differences as the worried well and other comparison. Conclusion: We observed a pattern of differences unfold between the worried well patients and those with cognitive disease. No one variable was pathognomonic of a worried well patient. However, taking all the above into account when evaluating a patient may help clinically.