Dementia Diagnostics In Primary Care
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Dementia Diagnostics In Primary Care
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Author : Anna Segernäs Kvitting
language : en
Publisher: Linköping University Electronic Press
Release Date : 2019-09-20
Dementia Diagnostics In Primary Care written by Anna Segernäs Kvitting and has been published by Linköping University Electronic Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-09-20 with categories.
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.
Diagnosis And Risk Management In Primary Care
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Author : Wilfrid Treasure
language : en
Publisher: CRC Press
Release Date : 2017-10-02
Diagnosis And Risk Management In Primary Care written by Wilfrid Treasure and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-10-02 with Medical categories.
'Medical technology is beneficial for well researched dangerous diseases. However, most symptoms that people bring to their primary care physician have no single clearly identifiable cause: investigations and drugs do more harm than good - and also waste resources - ' - Wilfrid Treasure Diagnosis and Risk Management in Primary Care teaches that adopting an evidence-based approach to primary care improves patient care and treatment outcomes. It demonstrates that brief clinical assessments, repeated if necessary, allow effective diagnosis while avoiding the costs and complications associated with more advanced testing. Adopting a fresh approach, this book sets consultation skills alongside evidence-based information by both itemising the specific techniques and facts that are needed in the consulting room, and providing detailed information on odds and likelihood ratios to quantify risk and deal with uncertainty. This book provides food for thought, and helps doctors develop communication skills that support their personal styles of consulting, encouraging a more traditional, intuitive treatment. It provides a map of the consultation and a compass to navigate through symptoms, signs and evidence - listening to their patients with one ear and, with the other, to the reflective inner voice of reason. General Practitioner Specialist Trainees and their teachers will find much of interest, as will established General Practitioners with an interest in maintaining traditional models of care. Undergraduate medical students and candidates for the MRCGP will find this an ideal reader for the clinical skills assessment. 'What a breath of fresh air to find an author capable of putting the patient back at the centre of the consultation and who is able to entertain at the same time as he informs and to stimulate critical reflection while nudging us in the direction of a rigorous approach to diagnosis, and the assessment and communication of risk.' From the foreword by Roger Jones
Diagnosis Management And Treatment Of Dementia
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Author :
language : en
Publisher:
Release Date : 1999
Diagnosis Management And Treatment Of Dementia written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999 with Dementia categories.
Abc Of Dementia
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Author : Bernard Coope
language : en
Publisher: John Wiley & Sons
Release Date : 2020-05-29
Abc Of Dementia written by Bernard Coope and has been published by John Wiley & Sons this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-05-29 with Medical categories.
ABC of Dementia is a practical guide, written with the needs of professionals in training in mind. Its aim is to enable readers to explore attitudes towards dementia, and find the knowledge and skills required in the important task of supporting the lives of people with dementia and their carers. This new edition is designed to assist students and practitioners working within both primary and secondary care settings with the diagnosis, treatment and provision of care. It covers the causes of dementia, diagnostic assessment, early intervention, pharmacological treatment, person-centred care, legal and ethical issues, and more. This resource has been thoroughly revised to reflect the most recent research and evidence-based practice. New and expanded content addresses dementia and frailty in care homes, explores the role of technology in the treatment of dementia, discusses working with minority groups, and examines case studies. Aids healthcare professionals in developing the knowledge, skills and confidence to care for those with dementia Highlights the importance of person-centred care and the effects of dementia on families and carers Describes the cognitive changes and neurological disorders central to dementia Addresses the needs of younger people developing dementia Provides guidance on managing dementia in primary care, the acute hospital and end-of-life care settings Covers the Neuropsychiatric Symptoms of Dementia (NPSD) Features numerous full-colour photographs and illustrations ABC of Dementia is a must-have for healthcare students, general practitioners, and other healthcare professionals caring for people with dementia. It will also be of interest to members of the general public who wish to know more about dementia.
Alzheimer S Disease And Its Variants
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Author : Richard Caselli
language : en
Publisher: OUP USA
Release Date : 2010-11-25
Alzheimer S Disease And Its Variants written by Richard Caselli and has been published by OUP USA this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010-11-25 with Medical categories.
The number of patients with dementia is rising in proportion to the aging of our population; therefore, by 2050 the prevalence of Alzheimer's disease is expected to triple, risking the integrity of the entire U.S. healthcare economy. More NIH dollars are spent on Alzheimer's disease research than on any other neurological disease and our available fund of information has commensurately accelerated. Whereas 30 years ago little distinction was made between different forms of dementia, clinicians now distinguish multiple degenerative and vascular syndromes, each with their own etiologic, therapeutic and prognostic implications. New genetic insights reach the popular press on a regular basis. Consequently Alzheimer's disease (and related disorders) has become a special concern to the majority of the population whose main avenue of care lies with the primary care physician. The primary care physician (general internist, family practitioner, nurse practitioner), geriatrician, and geriatric psychiatrist are the target audiences for this book; in short anyone who is not a neurological expert who provides dementia-related care. As the primary care physician is the target audience for this title, the volume begins with a discusion of how to produce an effective diagnosis through a series of precise, easy- to- follow steps. Additional sections detail the current research state of each of the major individual dementia diseases that the general clinician frequently encounters. The last section procides a clinically focused 'how to' guide for treatment including symptom-directed pharmacotherapy, as well as an up-to-date summary of ongoing major therapeutic trials and an assessment non-pharmacological management issues such as driving and end-of- life considerations. Aiming to be clear, consice and practical, this volume provides the essential information in dementia related care, from disease diagnosis to symptom management. Because it uses the most up-to-date dementia research available, this volume will become a close companion of the primary care physician, who seeks direct answers to the common questions and issues that arise in the diagnosis and management of patients with dementia.
Standardized Mini Mental State Examination
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Author :
language : en
Publisher:
Release Date : 1999
Standardized Mini Mental State Examination written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999 with Cognition categories.
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.
Emerging Technologies For Diagnosing Alzheimer S Disease
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Author : Marianne Boenink
language : en
Publisher: Springer
Release Date : 2016-09-13
Emerging Technologies For Diagnosing Alzheimer S Disease written by Marianne Boenink and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-09-13 with Social Science categories.
This book explores international biomedical research and development on the early diagnosis of Alzheimer's disease. It offers timely, multidisciplinary reflections on the social and ethical issues raised by promises of early diagnostics and asks under which conditions emerging diagnostic technologies can be considered a responsible innovation. The initial chapters in this edited volume provide an overview and a critical discussion of recent developments in biomedical research on Alzheimer's disease. Subsequent contributions explore the values at stake in current practices of dealing with Alzheimer's disease and dementia, both within and outside the biomedical domain. Novel diagnostic technologies for Alzheimer's disease emerge in a complex and shifting field, full of controversies. Innovating with care requires a precise mapping of how concepts, values and responsibilities are filled in through the confrontation of practices. In doing so, the volume offers a practice-based approach of responsible innovation that is also applicable to other fields of innovation.
Primary Care In Practice
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Author : Oreste Capelli
language : en
Publisher: BoD – Books on Demand
Release Date : 2016-05-11
Primary Care In Practice written by Oreste Capelli and has been published by BoD – Books on Demand this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-05-11 with Medical categories.
The development of the Chronic Care Model (CCM) for the care of patients with chronic diseases has focused on the integration of taking charge of the patient and his family within primary care. The major critical issues in the implementation of the CCM principles are the non-application of the best practices, defined by EBM guidelines, the lack of care coordination and active follow-up of clinical outcomes, and by inadequately trained patients, who are unable to manage their illnesses. This book focuses on these points: the value of an integrated approach to some chronic conditions, the value of the care coordination across the continuum of the illness, the importance of an evidence-based management, and the enormous value of the patients involvement in the struggle against their conditions, without forgetting the essential role of the caregivers and the community when the diseases become profoundly disabling.
Diagnosis And Management Of Dementia
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Author : Gordon K. Wilcock
language : en
Publisher: Oxford : Oxford University Press
Release Date : 1999
Diagnosis And Management Of Dementia written by Gordon K. Wilcock and has been published by Oxford : Oxford University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999 with Medical categories.
Organised services for those with memory disorders are growing. This growth is stimulated by an increase in the number of people with memory problems and by an increased appreciation of the complexity of the needs of such patients. Further growth is likely, especially now that we appear to have crossed the threshold of effective treatment for many patients with dementia. With these advances has come the recognition of the necessity for an interdisciplinary approach to management. Diagnosis and Management of Dementia: A Manual for Memory Disorders Teams is an edited volume covering all aspects of the operation of a memory disorders team. It is aimed at all those working in the dementia or memory disorders team, whether in a clinic or a community setting. The book is divided into three sections. Section one takes the reader through the practical details of setting up and organising a clinic, from timetabling, through managing information, to the assessments needed and the opportunities such a service provides. Section two deals with the diagnostic process; and section three addresses management issues, from carer support, pharmacological and physiological interventions, through managing common problems, to the role of the primary care physician. An Appendix contains the results of a survey to the memory disorder services. This survey provides the reader with examples of other services and demonstrates the wide variation in how these services operate. The Manual is unique in that it combines up to date thinking on diagnosis and management with practical and helpful ideas on how to run a dementia or memory disorders service.
Alzheimer S Disease And Its Variants
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Author : Richard J. Caselli
language : en
Publisher:
Release Date : 2010
Alzheimer S Disease And Its Variants written by Richard J. Caselli and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010 with Alzheimer's disease categories.
The number of patients with dementia is rising in proportion to the aging of our population; therefore, by 2050 the prevalence of Alzheimer's disease is expected to triple, risking the integrity of the entire U.S. healthcare economy. More NIH dollars are spent on Alzheimer's disease research than on any other neurological disease and our available fund of information has commensurately accelerated. Whereas 30 years ago little distinction was made between different forms of dementia, clinicians now distinguish multiple degenerative and vascular syndromes, each with their own etiologic, therapeutic and prognostic implications. New genetic insights reach the popular press on a regular basis. Consequently Alzheimer's disease (and related disorders) has become a special concern to the majority of the population whose main avenue of care lies with the primary care physician. The primary care physician (general internist, family practitioner, nurse practitioner), geriatrician, and geriatric psychiatrist are the target audiences for this book; in short anyone who is not a neurological expert who provides dementia-related care. As the primary care physician is the target audience for this title, the volume begins with a discusion of how to produce an effective diagnosis through a series of precise, easy- to- follow steps. Additional sections detail the current research state of each of the major individual dementia diseases that the general clinician frequently encounters. The last section procides a clinically focused 'how to' guide for treatment including symptom-directed pharmacotherapy, as well as an up-to-date summary of ongoing major therapeutic trials and an assessment non-pharmacological management issues such as driving and end-of- life consideration. Aiming to be clear, consice and practical, this volume provides the essential information in dementia related care, from disease diagnosis to symptom management.