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| Author | : Walter George Bradley |
| Publisher | : |
| Total Pages | : 1672 |
| Release | : 2004 |
| Genre | : Diagnosis |
| ISBN | : 9780750674690 |
New edition, completely rewritten, with new chapters on endovascular surgery and mitochrondrial and ion channel disorders.
| Author | : Anna Segernäs Kvitting |
| Publisher | : Linköping University Electronic Press |
| Total Pages | : 89 |
| Release | : 2019-09-20 |
| Genre | : |
| ISBN | : 9176850374 |
Background Age is the greatest risk factor for developing dementia and the total number of people aged 60 years and above is expected to more than double globally from 2013 to 2050 (1). Primary health care (PHC) is important for basic diagnostic evaluations. Objective test measurements have been shown to be more reliable than a patient's subjective memory complaints in dementia assessments (2). However, several studies indicate the low use of objective cognitive screening tools in dementia diagnostics in PHC (3). Some general practitioners (GPs) do not perceive today’s cognitive instruments as helpful in the diagnostic process and administration problems have been reported in PHC (4, 5). The overall aim of this thesis was to investigate the accuracy of several cognitive tests used in dementia assessments in PHC, especially among older patients: A Quick Test of Cognitive Speed (AQT), Cognistat and Cognitive Assessment Battery (CAB). The normative values of the Mini Mental Status Examination (MMSE) in the oldest old was also studied. Methods The studies included in this thesis are from two different study populations. Studies I, II and IV. Patients with and without cognitive symptoms were recruited from four primary health care centres in Sweden between 2007 and 2009.Study III. The Elderly in Linköping Screening Assessment (ELSA 85) cohort-population examined people born in 1922 in the municipality of Linköping, Sweden. Results Study I. Results showed that AQT is a usable test for dementia diagnosis in PHC. Sensitivity for AQT is superior to the Clock Drawing Test (CDT), equivalent to MMSE and the combination MMSE and CDT. The AUC for AQT was 0.773, valued good enough. Study II. Overall, the results for Cognistat in this study are superior to MMSE and CDT, also in combination. Cognistat is promising for improved dementia diagnosis in PHC with a quick and easily administered multi-domain test for dementia assessments. Study III. This study presents valuable information about normative MMSE data for the oldest patients. Results, suggest using the 25th percentile in MMSE of 25 to 26 points, and indicate that MMSE 26 is as a reasonable cut-off for cognitive decline and further medical evaluation in older persons aged from 85 to 93 years. Study IV. In summary, the additive value of the CAB test in dementia investigations in PHC is not obvious. In addition to questionable accuracy, the test is quite time consuming and normative values are scarce. By introducing the numerical sum (CABsum) the accuracy was increased. Conclusion In conclusion, objective cognitive tests are an important part of dementia diagnosis in PHC and there is a need for improved instruments and norm-values. From our results, several cognitive quick tests are usable in PHC - MMSE, AQT and Cognistat - but they have some disadvantages. MMSE 26 is a reasonable cut-off for cognitive decline in the oldest patients 85 to 93 years from a well-educated population with quite good socioeconomic. There is a great interest in finding short and better multi-domain instruments but the additive value of CAB in dementia investigations in PHC is questionable.
| Author | : |
| Publisher | : |
| Total Pages | : 28 |
| Release | : 1999 |
| Genre | : Cognition |
| ISBN | : 9780969464570 |
The Folstein mini-mental state examination (MMSE) is the most widely used screening test of cognition in older adults. The Standardized mini-mental state examination (SMMSE) provides clear, explicit administration and scoring guidelines.
| Author | : National Academies of Sciences Engineering and Medicine |
| Publisher | : |
| Total Pages | : |
| Release | : 2022-04-26 |
| Genre | : |
| ISBN | : 9780309495035 |
As the largest generation in U.S. history - the population born in the two decades immediately following World War II - enters the age of risk for cognitive impairment, growing numbers of people will experience dementia (including Alzheimer's disease and related dementias). By one estimate, nearly 14 million people in the United States will be living with dementia by 2060. Like other hardships, the experience of living with dementia can bring unexpected moments of intimacy, growth, and compassion, but these diseases also affect people's capacity to work and carry out other activities and alter their relationships with loved ones, friends, and coworkers. Those who live with and care for individuals experiencing these diseases face challenges that include physical and emotional stress, difficult changes and losses in their relationships with life partners, loss of income, and interrupted connections to other activities and friends. From a societal perspective, these diseases place substantial demands on communities and on the institutions and government entities that support people living with dementia and their families, including the health care system, the providers of direct care, and others. Nevertheless, research in the social and behavioral sciences points to possibilities for preventing or slowing the development of dementia and for substantially reducing its social and economic impacts. At the request of the National Institute on Aging of the U.S. Department of Health and Human Services, Reducing the Impact of Dementia in America assesses the contributions of research in the social and behavioral sciences and identifies a research agenda for the coming decade. This report offers a blueprint for the next decade of behavioral and social science research to reduce the negative impact of dementia for America's diverse population. Reducing the Impact of Dementia in America calls for research that addresses the causes and solutions for disparities in both developing dementia and receiving adequate treatment and support. It calls for research that sets goals meaningful not just for scientists but for people living with dementia and those who support them as well. By 2030, an estimated 8.5 million Americans will have Alzheimer's disease and many more will have other forms of dementia. Through identifying priorities social and behavioral science research and recommending ways in which they can be pursued in a coordinated fashion, Reducing the Impact of Dementia in America will help produce research that improves the lives of all those affected by dementia.
| Author | : Babak Tousi |
| Publisher | : Springer |
| Total Pages | : 417 |
| Release | : 2017-12-06 |
| Genre | : Medical |
| ISBN | : 3319564846 |
This manual takes a multidisciplinary approach to neurological disorders in the elderly. Comprehensive and practical, it includes the most recent diagnostic criteria and immediately accessible visual care paths including the latest pharmacologic and non-pharmacologic interventions. Covering a range of modalities, from the importance and impact of each disease to diagnostic criteria, genetics, laboratory and imaging findings, treatment and care paths, this book focuses on neurological conditions that occur commonly in older persons or which have a striking effect on their lives. The common types of dementias, Parkinson’s disease and related disorders, rapidly progressive diseases, seizure disorders and multiple sclerosis are covered. Issues commonly affecting this population, such as neurobehavioral symptoms and caregiver issues, are discussed. Neuro-Geriatrics: A Clinical Manual is aimed at any physician who treats the elderly with neurological disorders: neurologists, geriatricians and geriatric psychiatrists, both specialists and general practitioners.
| Author | : Institute of Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 316 |
| Release | : 2008-08-27 |
| Genre | : Medical |
| ISBN | : 0309131952 |
As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.
| Author | : Andrew E. Budson |
| Publisher | : John Wiley & Sons |
| Total Pages | : 676 |
| Release | : 2011-09-09 |
| Genre | : Psychology |
| ISBN | : 1444344099 |
The reference is a broad-ranging review of Alzheimer's disease and other dementias from both basic and clinical neuroscience perspectives; it provides scientists and medical professionals with an extensive introduction and an up-to-date review of cutting-edge scientific advances. Brings the reader up-to-date with cutting-edge developments in this exciting and fast-paced field Summarizes the most recent developments in the fields of Alzheimer's disease and dementia Brings together articles from a prominent and international group of contributors Encompasses a unique range of topics, combining basic molecular perspectives and cognitive neurosciences
| Author | : National Academies of Sciences, Engineering, and Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 473 |
| Release | : 2015-12-29 |
| Genre | : Medical |
| ISBN | : 0309377722 |
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
| Author | : A. J. Larner |
| Publisher | : Springer |
| Total Pages | : 351 |
| Release | : 2016-11-30 |
| Genre | : Medical |
| ISBN | : 3319447750 |
This revised and updated second edition provides a practical and structured overview of some of the most commonly used and easily available cognitive screening instruments applicable in the outpatient clinic and bedside setting. It now includes additional chapters on AD8 and also methodological aspects of systematic cognitive screening instrument assessment from the Cochrane Dementia and Cognitive Improvement Group. Expert authors from around the world equip the reader with clear instructions on the usage of each screening instrument, its strengths and weaknesses, and the time required for administration. Rules on scoring are also provided, such as how to correct for variations in the patient’s age or education, and suggested cut-off scores. Cognitive Screening Instruments: A Practical Approach, Second Edition is aimed at both clinicians and professionals in disciplines allied to medicine who are called upon to assess patients with possible cognitive disorders, including neurologists, old age psychiatrists, neuropsychologists, primary care physicians, dementia support workers, and members of memory assessment teams.
| Author | : American Psychiatric Association |
| Publisher | : American Psychiatric Pub |
| Total Pages | : 220 |
| Release | : 2016 |
| Genre | : Medical |
| ISBN | : 0890426775 |
The guideline offers clear, concise, and actionable recommendation statements to help clinicians to incorporate recommendations into clinical practice, with the goal of improving quality of care. Each recommendation is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms.
