Current status of professional memory clinics, inpatient services, and health professionals in China

Abstract

Introduction: This study aims to explore the current status of dementia-specific diagnosis and treatment in China.

Methods: This national survey was conducted in mainland China from September 2022 to February 2023, with strong support from the Cognitive Disorders Group of the Chinese Society of Neurology, Chinese Medical Association.

Results: Among 2721 hospitals surveyed, 244 (8.97%) have dementia-specific clinics (DSCs) and 166 (6.10%) have dementia-specific inpatient departments (DSIDs). Almost all hospitals have brain structural imaging capabilities and basic hematological examinations, but dementia-specific medical staff (DSMS) equipped for DSCs or DSIDs are rare. The proportion of patients with cognitive impairment receiving care through a DSCs or DSIDs is low, and most patients present with advanced (moderate to severe) disease.

Conclusion: The survey shows that the proportion of DSCs and DSIDs is low, and the regional distribution varies significantly. Trained DSMS and specialized facilities for the diagnosis and treatment of dementia are inadequate.

Highlights: This study was a multi-center national research to comprehensively investigate the distribution and features of dementia-specific clinics and inpatient departments in mainland China, given that the limited literature was available regarding the dementia-specific centers. The study points to significant regional differences in the distribution of cognitive-specific clinics and inpatient departments in mainland China. More centers in Eastern Regions compared to Western Regions, a greater presence in provincial capitals as opposed to other cities, and a predominance of tertiary hospitals over non-tertiary ones. The aim is to provide data support for advancements in medical research within this field. Domestic dementia patients have inadequate access to specialized medical resources and expert assistance, which significantly contrasts with the growing number of dementia cases in China.

Keywords: China; cognitive impairment; dementia; memory clinic; national survey.

FIGURE 1

The distribution of DSCs and DSIDs in participated hospitals. This figure showed the number of DSCs (green) and DSIDs (blue) in the 2721 tertiary hospitals we surveyed. There were 79 tertiary hospitals only setting up DSCs, one tertiary hospital only setting up DSIDs, and 165 tertiary hospitals setting up both DSCs and DSIDs. DSCs, dementia‐specific clinics; DSIDs, dementia‐specific inpatient departments

FIGURE 2

The distribution of DSCs (left) and inpatient departments (right) in Mainland China. According to geographic region, we use red to represent the Eastern Region, blue to represent the Central Region, and green to represent the Western Region. At the bottom of the figure, the measurement value represents the proportion (%), and all colors from light to dark indicate the proportion from low to high. Left part: In Eastern Chinese Mainland, Beijing has the highest proportion (26.40%) of dementia‐specific clinics, followed by Zhejiang province (22.45%), Shanghai (18.31%), and Tianjin (14.81%). In the Central Chinese Mainland, Henan Province has the highest proportion (15.13%) of dementia‐specific clinics, followed by Jiangxi province (11.84%), Shanxi province (11.59%), and Jilin province (7.58%). The proportion of dementia‐specific clinics in Western Chinese Mainland is the highest in The Ningxia Hui Autonomous Region (21.05%), followed by Chongqing (10.87%), Sichuan province (10.84%), and Yunnan province (8.77%). Right part: Zhejiang province has the highest proportion of DSIDs in Eastern Chinese Mainland (15.31%), followed by Tianjin (14.81%), Guangdong province (9.36%), and Beijing (8.00%). The proportion of DSIDs in Central Chinese Mainland is the highest in Henan province (15.13%), followed by Jiangxi province (11.84%), Shanxi province (8.70%) and Anhui province (5.10%). The proportion of DSIDs in Western Chinese Mainland is the highest in The Ningxia Hui Autonomous Region (15.79%), followed by Chongqing (10.87%), Sichuan province (9.64%), and Yunnan province (5.26%). DSCs, dementia‐specific clinics; DSIDs, dementia‐specific inpatient departments

FIGURE 3

The main subtypes of dementia in Mainland China. AD, Alzheimer's disease; DLB, dementia with Lewy bodies; FTLD, frontotemporal lobar degeneration; ODs, other dementias; VaD, vascular dementia

FIGURE 4

Dementia severity of patients with cognitive impairment at consultation in Mainland China. CDR, Clinical Dementia Rating Scale