Dissertations / Theses on the topic 'Dementia – Diagnosis'
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1
Dooley, Jemima Mary Beatrice. "Communicating a diagnosis of dementia." Thesis, University of Exeter, 2016. http://hdl.handle.net/10871/27939.
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Background: There has been a rise in dementia awareness, with policy changes leading to increased diagnosis rates. However, the stigma of dementia is likely to cause challenges in diagnostic communication. This is complicated by the effect of dementia on cognitive functioning. The aims of this study were to (1) identify how diagnoses of dementia are communicated, (2) identify how people with dementia respond to the diagnosis, and (3) explore doctors’ perspectives on dementia diagnosis delivery. Methodology: A systematic literature review was conducted. Twenty doctors from 9 memory clinics across 4 NHS trusts participated. Eighty-one dementia diagnosis feedback meetings were video-recorded. Conversation analysis was used to identify patterns in diagnosis delivery. Four focus groups with the participating doctors were analysed using thematic analysis (inter-rater reliability 0.89). Findings: The literature review highlighted the dilemma of communicating both sensitively and honestly with people with dementia, as well as challenges stemming from cognitive impairment. This was also evident in diagnostic communication. Prior to diagnosis doctors elicited patient orientation to the meeting purpose (“do you know why you’re here?) and perspective into symptoms (“how is your memory?”). The majority of patients displayed some confusion as to the meeting purpose and offered non-medicalised explanations for their symptoms. Doctors attempted to address this through repeated explication of test results and statements of the clinic purpose. Dementia was always explicitly named. Diagnoses were often delivered indirectly (“that is dementia”), a practice to manage patient resistance and negative responses. However, over 40% were delivered directly (“you have dementia”), especially when patients were more cognitively impaired. Doctors pursued non-minimal responses to diagnosis, apparently to obtain perspective before progressing to treatment. However, resistance was not always addressed and prognosis was often avoided. Doctors highlighted pressure to make diagnoses and an aim to emphasise “living well” rather than discussing prognosis. Conclusion: The findings of this study highlighted the delicate balance between minimising likely resistance and distress and maximising understanding in the context of cognitive impairment. Instilling hope is evidently a priority for doctors. The diagnosis meeting is just one part of the journey of the person with dementia, and sufficient pre- and post-diagnosis support is integral.
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Verhey, Franciscus Rochus Jozef. "Dementia, depression and forgetfulness clinical studies of the early diagnosis and the differential diagnosis of dementia /." Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Maastricht University [Host], 1993. http://arno.unimaas.nl/show.cgi?fid=5854.
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Everitt, Alaina. "Differential Scoring Patterns on the Clock Drawing Test: a Comparison of Vascular Dementia and Alzheimer's Dementia." Thesis, University of North Texas, 2006. https://digital.library.unt.edu/ark:/67531/metadc5283/.
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This study examined differences in scoring patterns among those diagnosed with Alzheimer's dementia and vascular dementia on the clock-drawing test. Archival clock drawing data was retrieved on 279 patients presenting at a county hospital-based memory clinic. Analysis of drawings was based on frequency of qualitative errors, as well as an overall quantitative score. Mean comparisons found those patients with Alzheimer's dementia to perform worse on both quantitative and qualitative scoring measures. However, Pearson's chi-squared test revealed a significantly higher rate of spacing errors among subjects with vascular dementia. Such lends support to my hypothesis that impaired executive functioning in vascular dementia patients would lead to poor qualitative performance. Logistic regression found significant predictive ability for the qualitative criteria in diagnosis (χ2 = 25.49, p < .001), particularly the rate of omission (z = 8.96, p = .003) and addition errors (z = 7.58, p = .006). Such findings hold important implications for the use of qualitative criteria in cognitive screening assessments.
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Aslaksen, Jonasson Alexander, and Alfred Wahlforss. "Diagnosis of Dementia using Transformer Models." Thesis, KTH, Skolan för elektroteknik och datavetenskap (EECS), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-279226.
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Dementia is a syndrome of illnesses resulting in cognitive decline, severely impacting the lives of those afflicted as well as their loved ones. The most common form of dementia is Alzheimer's disease, with roughly 10 million new cases each year. In this study we examine different machine learning models and approaches aimed to aid healthcare professionals in early diagnosis of Alzheimer's disease, potentially automating parts of the diagnostic process. We evaluate our models on the Pitt corpus of the Dementia Bank dataset, using 10-fold cross validation. We compare the BERT and RoBERTa transformer models, and find that both models achieve high accuracy, precision, and specificity. The highest accuracy is achieved by RoBERTa, reaching an accuracy of 86.72%, a precision of 90.69% and a specificity of 90.53%. Furthermore, we explore the viability of using automated speech recognition for automatic transcription of audio samples from patient meetings. RoBERTa achieves an accuracy of 83.59% using transcripts generated by Google's automatic speech recognition, suggesting such methods may be viable for automating certain parts of the diagnostic process. In addition to the exploration of transformer models and their viability for dementia diagnostics, this paper provides a market analysis of a potential automated diagnostics tool utilizing transformer models. The analysis is based on a literature study and on two interviews; one with the CEO of a start-up providing automated dementia tests for healthcare professionals, and one with a psychologist researching dementia as well as potential methods of early diagnosis of dementia. With the interviews and literature study as a basis, we use the SWOT framework, and PEST analysis along with Porter's five forces framework to analyse the current market potential for such an automated tool. Despite detecting several obstacles and difficulties prior to market entry, we find significant potential for such a product given the current state of the market.Demens är ett syndrom av sjukdomar som orsakar kognitiv nedsättning och påverkar både de drabbade och deras familjer. Den vanligaste typen av demens ar Alzheimers sjukdom, med cirka 10 miljoner nya fall per ar. I denna studie undersöker vi olika maskininlärningsmodeller och tillvägagångssätt i syfte att underlätta får sjukvårdspersonal att ställa en tidig diagnos, och möjligtvis att även kunna automatisera vissa delar av diagnosprocessen. Vi utvärderar vara modeller på Pittcorpuset i DementiaBank-datasetet och använder 10-delad korsvalidering. Vi jämför två transformer-modeller: BERT och RoBERTa, och finner att bada modeller åstadkommer goda resultat avseende noggrannhet, precision, specificitet och sensitivitet. Den högsta noggrannheten uppnås av RoBERTa, på 86.72%, en precision på 90.69%, och en specificitet på 90.53%. Vidare undersöker vi gångbarheten i att använda automatisk taligenkänning for automatiserad transkribering av ljudinspelningar från patientmoten. RoBERTa uppnår da en noggrannhet på 83.59% när den använder transkriberad text från Googles automatiska taligenkänningstjänst, vilket tyder på att sådana metoder kan vara gångbara for att automatisera vissa delar av den diagnostiska processen. Förutom undersökning av transformermodeller bidrar detta verk även med en marknadsanalys av marknadspotentialen får ett verktyg får automatiserad demensdiagnostik. Analysen baseras på en litteraturstudie och två intervjuer; en med en VD får en start-upp som erbjuder liknande tjänster, och en intervju med en forskare inom demens. Med litteraturstudien och de två intervjuerna som grund analyserar vi marknadspotentialen med tre ramverk: Porters fem krafter, PEST-analys och SWOTanalys. Vi fastslår att det trots flertal hinder och svårigheter får marknadsinträde finns det stor potential och en stor efterfrågan på en sådan produkt.
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McKeith, Ian G. "The clinical diagnosis of Lewy body dementia." Thesis, University of Newcastle Upon Tyne, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.333615.
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Smith, Fiona. "The experience of receiving a diagnosis of dementia." Thesis, University of Sheffield, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.412460.
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Green, Alison Jane Ellen. "Brain-specific proteins in the diagnosis of dementia." Thesis, University College London (University of London), 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.313354.
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Taylor, Rachel Jane. "Being given a diagnosis of dementia : the experiences of people with dementia and people who care for someone with dementia." Thesis, Open University, 1996. http://oro.open.ac.uk/57649/.
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This study explores the issues raised for people with dementia and their carers when they receive a diagnosis of dementia. Previous research suggests that more people with dementia than other serious illnesses such as cancer will not be told their diagnosis. The implications of this for the way that people with dementia adjust psychologically to their situation are reviewed. It is suggested that the complex illness concept and the particular nature of dementia as an illness influence communication about it The research had three groups of participants. Twenty-six people caring for a relative with dementia completed a short survey. Two people with dementia and seven people caring for someone with dementia were interviewed face-to-face to gather in-depth information about their experiences of receiving and coping with a diagnosis. Grounded theory was used to analyse the interviews and a descriptive summary of the survey was produced. The survey confirmed that many people with dementia do not get told their diagnosis. The interviews described the issues raised for people with dementia, such as the feelings raised for them by having dementia and highlighted their ways of coping with dementia. The interviews with carers suggested that if sharing was an issue, the carers tried to strike a balance between remaining honest and protecting the person from the implications of the knowledge. Maintaining a sense of hope for the person seemed to be very important. A critical discussion of the methodology is presented. The implications for future research and the clinical relevance of the research are also discussed.
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Mychalkiw, Wasyl. "Short-term visual retention as an index of dementia." Thesis, Keele University, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.279822.
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Douglas, Jane E. "Living with and beyond dementia : a phenomenological investigation of young people's lived experience with dementia and the transition from pre-diagnosis through diagnosis and beyond to living well with dementia." Thesis, Edinburgh Napier University, 2017. http://researchrepository.napier.ac.uk/Output/1032617.
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Younger People with Dementia (YPwD) are those who receive a diagnosis of dementia under the age of 65. In Scotland the number of people with dementia who meet this definition is approximately 3200 (Alzheimer Scotland, 2017). The purpose of this study was to explore the human experience of living with dementia at a younger age and to consider interpretations of well-being as defined by the subjective experience of the participants. At the start of this study there was limited quality research available which explored the lives and experiences of YPwD. At that time there was some recognition within professional groups and practitioners that YPwD would benefit from age appropriate services. This study used an Interpretive Phenomenological design to explore the experiences of YPwD and used in-depth qualitative interviews with eight people who were diagnosed with dementia under the age of 65, to capture their journey through pre-diagnosis, diagnosis and beyond. Interpretive Phenomenological Analysis was utilised for the primary analysis. A secondary analysis was then conducted with the initial findings using Self-determination Theory, Basic Psychological Needs Theory, autonomy, competence and relatedness to identify areas of well-being. The study identified four superordinate themes situated within a four phase transition pathway, which identified how a diagnosis of dementia impacted on the person and the process they underwent following diagnosis. These are:pre-diagnosis phase, living in a changing world, awareness of the changing self, discombobulation; diagnostic phase, anger and relief, the fragmented self, consideration; post diagnostic phase, the challenge of learning to livewith dementia as a younger person, the evolving self, assimilation; and the phase living well beyond dementia, consolidated self, consolidation. The study highlighted that while having a diagnosis of dementia at a younger age is a challenging and devastating experience, it is possible to live a good and productive life beyond the diagnosis of dementia. The secondary analysis using Self-determination Theory, Basic Psychological Needs Theory identified that where the basic psychological needs were supported, this enabled participants to embrace their lives living with and beyond dementia with improved wellbeing. The findings suggest that the basic psychological needs were thwarted in the pre-diagnostic phase and during and immediately after diagnosis, creating feelings of ill-being. The study acknowledges the strong sense of identity around the younger person with dementia and suggests that this group perceive their dementia, and the support they need to live with the condition to be a different experience to that of older people. The ability of a number of the participants to live an active life within a supported community cannot be underestimated, and suggests that this area of care and support needs to be evaluated in light of the changing needs of people living with dementia, particularly those who are diagnosed at such an early part of their lifecycle.
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Huang, Chaorui. "Mild cognitive impairment : neuroimaging markers for early diagnosis of dementia /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-633-2/.
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Duchesne, Simon. "Computer aided diagnosis in temporal lobe epilepsy and Alzheimer's dementia." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=100354.
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Computer aided diagnosis within neuroimaging must rely on advanced image processing techniques to detect and quantify subtle signal changes that may be surrogate indicators of disease state. This thesis proposes two such novel methodologies that are both based on large volumes of interest, are data driven, and use cross-sectional scans: appearance-based classification (ABC) and voxel-based classification (VBC).The concept of appearance in ABC represents the union of intensity and shape information extracted from magnetic resonance images (MRI). The classification method relies on a linear modeling of appearance features via principal components analysis, and comparison of the distribution of projection coordinates for the populations under study within a reference multidimensional appearance eigenspace. Classification is achieved using forward, stepwise linear discriminant analyses, in multiple cross-validated trials. In this work, the ABC methodology is shown to accurately lateralize the seizure focus in temporal lobe epilepsy (TLE), differentiate normal aging individuals from patients with either Alzheimer's dementia (AD) or Mild Cognitive Impairment (MCI), and finally predict the progression of MCI patients to AD. These applications demonstrated that the ABC technique is robust to different signal changes due to two distinct pathologies, to low resolution data and motion artifacts, and to possible differences inherent to multi-site acquisition.
The VBC technique relies on voxel-based morphometry to identify regions of grey and white matter concentration differences between co-registered cohorts of individuals, and then on linear modeling of variables extracted from these regions. Classification is achieved using linear discriminant analyses within a multivariate space composed of voxel-based morphometry measures related to grey and white matter concentration, along with clinical variables of interest. VBC is shown to increase the accuracy of prediction of one-year clinical status from three to four out of five TLE patients having undergone selective amygdalo-hippocampectomy. These two techniques are shown to have the necessary potential to solve current problems in neurological research, assist clinical physicians with their decision-making process and influence positively patient management.
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Chan, Dennis Chun Fei. "Structural and neuropsychological investigations in the diagnosis of early dementia." Thesis, University of Cambridge, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.611487.
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Clarnette, Roger M. "Predictors of cognitive decline in those with subjective memory complaint." University of Western Australia. School of Psychiatry and Clinical Neurosciences, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0245.
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[Truncated abstract] Background: Dementia, largely due to Alzheimer's disease (AD), is a major public health problem. The early identification of disease is an important challenge for clinicians because treatment of AD is now available. A simple and accurate means of stratifying risk for AD and identifying early disease is needed so that risk factor modification and treatment can occur optimally. To date, despite many attempts, an accurate means of standardising an approach to the assessment of subtle cognitive symptoms has not been developed. A subjective complaint of poor memory has been identified as a possible marker for underlying brain disease. This study examines the utility of neuropsychological scores, homocysteine levels, APOE genotyping and brain imaging as predictors of cognitive decline in individuals with subjective memory complaint (SMC). Method Eighty subjects with SMC were recruited from memory clinics and the community (MC: 1). Forty-two control subjects were also examined (MC: 0). CAMDEX was used to describe baseline clinical features. The CAMCOG was used as a global test of cognition and was administered annually for four years. At baseline, neuropsychological testing was administered. Cranial CT scanning, measurement of plasma homocysteine and APOE genotyping were completed. Categorical variables were analysed using chi-square according to Pearson's method. Continuous data was analysed using Student's t-tests and Mann-Whitney tests. A logistic regression model was used to identify independent contributors to the presence of memory complaint. Participants were then matched for age, gender and time to follow-up (up for three years) to determine longitudinal predictors of cognitive decline. ... Baseline CAMCOG scores were greater in the control group (MC:0 = 98.3 ? 2.8, MC:1 94.2 ? 5.5, Z ?4.46, p 0.000). There were no differences in neuropsychological scores, concentration of total plasma homocysteine, APOE genotype or brain scan measurements. Using the Wald stepwise selection method, logistic regression could not be established due to non-convergence regardless of whether or not the continuous variables were re-coded into dichotomous variables. A matching process that created 32 pairs of controls/subjects allowed follow-up analysis. The controls showed significant improvement with time on the CAMCOG unlike subjects (mean ? SD, controls 1.5 ?-3.0, Z - 2.61, p 0.01, subjects 0.2 ? 3.2, Z ? 0.24, p 0.81). The logistic regression analysis showed that group membership could not be defined by any single independent variable. When group membership was abandoned and those with stable scores were compared to those who declined no clear meaningful independent predictors of decline apart from age were identified. Conclusions: Methodological issues such as small sample size and inadequate follow up duration were identified that may have precluded identification of predictive factors for cognitive decline. The results indicate that complaints of memory problems are not associated with established risk factors for Alzheimer's disease and fail to predict objective cognitive decline over three years. Future studies should continue trying to identify robust predictors of cognitive decline in later life.
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Gilley, David William. "Depression on cortical and subcortical dementia syndromes." Diss., Virginia Tech, 1990. http://hdl.handle.net/10919/39755.
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The concept of subcortical dementia predicts higher rates of depressive symptomatology in dementia syndromes with predominant subcortical pathology. This hypothesis was evaluated by comparing the frequency and severity of depressive symptomatology in three diagnostic conditions: Alzheimer's disease (AD) (n=30) I subcortical vascular disease (SVD) (n=30), and Parkinson's disease (PD) (n=30). While AD and PD are prototypical exemplars of cortical and subcortical dementia syndromes respectively, SVD provides a test of the generality of the hypothesis as a subcortical neurodegenerative condition whose pathology is not confined to a single subcortical nucleus. A secondary aim of the study was to compare assessment methods for the ascertainment of depressive symptomatology. Assessment methods included the Hamilton Rating Scale for depression derived from interview with the patient's primary caregiver (HRSCG) and from interview with the patient (HRSEX), and the self-report Geriatric Depression Scale.
The severity of current depressive symptomatology across the three neurodegenerative disorders followed a consistent pattern across each method of assessment. Specifically, scores on self-report (GDS) , examiner ratings (HRSEX), and caregiver ratings (HRSCG) of depression were most severe in patients with Parkinson's disease (PD) , intermediate in subcortical vascular disease (SVD), and least severe in Alzheimer's the ascertainment of depressive symptomatology.
Assessment methods included the Hamilton Rating Scale for depression derived from interview with the patient's primary caregiver (HRSCG) and from interview with the patient (HRSEX), and the self-report Geriatric Depression Scale.
The severity of current depressive symptomatology across the three neurodegenerative disorders followed a consistent pattern across each method of assessment. Specifically, scores on self-report (GDS), examiner ratings (HRSEX), and caregiver ratings (HRSCG) of depression were most severe in patients with Parkinson's disease (PD) , intermediate in subcortical vascular disease (SVD), and least severe in Alzheimer'sPh. D.
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Gove, Dianne Marie. "GPs, stigma and the timely diagnosis of dementia : a qualitative exploration : the implications of general practitioners' perceptions of dementia as a stigma for timely diagnosis." Thesis, University of Bradford, 2012. http://hdl.handle.net/10454/5667.
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Background: The focus of this study is on how far GPs' perceptions of dementia map onto the components and contributing factors to stigma as described by Link and Phelan (2001; 2006) and Jones et al. (1984). Aim: The study explores GPs' perceptions of dementia as a stigma, develops a specific conceptualization of the stigma of dementia and considers implications for timely diagnosis. Methods: Data from twenty-three GPs in northern England were collected by semistructured telephone interviews. Within the context of a qualitative design, a combined process of grounded theory and framework analysis was adopted to collect and analyse data. Results: The findings reveal that GPs' perceptions of dementia map onto Link and Phelan and Jones' identification of contributing factors and components of stigma and may hinder timely diagnosis. Three themes emerged reflecting a dynamic process of making sense of dementia, relating perceptions to oneself and considering the consequences of dementia. Within those themes, certain categories had particular salience for GPs, namely the characteristics of the attribute, existential anxiety and discrimination. The themes and categories are inter-related and can be considered as parts of a system. Perceived lack of reciprocity could be detected in most categories which suggests that it is influential in the social construction of the stigma of dementia. Conclusion: The data suggest that current conceptualizations of stigma are insufficient to fully account for the stigma of dementia. A specific conceptualization of the stigma of dementia is proposed and the implications of GPs' perceptions for timely diagnosis are discussed.
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Gove, Dianne M. "GPs, stigma and the timely diagnosis of dementia : a qualitative exploration. The implications of general practitioners' perceptions of dementia as a stigma for timely diagnosis." Thesis, University of Bradford, 2012. http://hdl.handle.net/10454/5667.
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Background
The focus of this study is on how far GPs¿ perceptions of dementia map onto
the components and contributing factors to stigma as described by Link and
Phelan (2001; 2006) and Jones et al. (1984).
Aim
The study explores GPs¿ perceptions of dementia as a stigma, develops a
specific conceptualization of the stigma of dementia and considers implications
for timely diagnosis.
Methods
Data from twenty-three GPs in northern England were collected by semistructured
telephone interviews. Within the context of a qualitative design, a
combined process of grounded theory and framework analysis was adopted to
collect and analyse data.
Results The findings reveal that GPs¿ perceptions of dementia map onto Link and
Phelan and Jones¿ identification of contributing factors and components of
stigma and may hinder timely diagnosis. Three themes emerged reflecting a
dynamic process of making sense of dementia, relating perceptions to oneself
and considering the consequences of dementia. Within those themes, certain
categories had particular salience for GPs, namely the characteristics of the
attribute, existential anxiety and discrimination. The themes and categories are
inter-related and can be considered as parts of a system. Perceived lack of
reciprocity could be detected in most categories which suggests that it is
influential in the social construction of the stigma of dementia.
Conclusion
The data suggest that current conceptualizations of stigma are insufficient to
fully account for the stigma of dementia. A specific conceptualization of the
stigma of dementia is proposed and the implications of GPs¿ perceptions for
timely diagnosis are discussed.
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Sivananthan, Saskia Nikali. "Diagnosis & disruption : understanding guideline-consistent dementia care and patterns of transitions experienced by individuals with dementia." Thesis, University of British Columbia, 2015. http://hdl.handle.net/2429/52306.
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Introduction Early detection and management, as outlined in dementia guidelines, can improve outcomes and potentially reduce the number of transitions experienced between care-facilities. The objectives of this thesis were to : conduct a critical assessment of the literature on actual versus guideline-consistent dementia care; use population-level data to examine variations in receipt of guideline-consistent dementia care; understand longitudinal patterns of transitions and the factors that contribute to transitions; and assess if receipt of guideline-consistent dementia care and/or high quality primary care are associated with the number of transitions experienced.
Method
Population-level administrative data in British Columbia were used to identify cohorts of individuals newly diagnosed with dementia in 2001/02 and 2009/10. Dementia guidelines were used to characterize clinical care individuals could receive. The proportion of patients diagnosed with dementia in 2009/10 who received guideline-consistent dementia care and the probability that patient characteristics affected the likelihood of receiving each process was assessed. Those diagnosed with dementia in 2001/02 were followed forward 10-years after the first point of diagnosis and points of care when transitions were highest as well as factors that contribute to those transitions were assessed. The association of receipt of guideline-consistent dementia care and/or high quality primary care with the number of transitions experienced in the year of diagnosis was assessed using negative binomial regression.
Results
Older patients were less likely to receive guideline-consistent dementia care. A quarter of the cohort received an antipsychotic or non-recommended benzodiazepine. Individuals living within rural health-authorities or of low income were more likely to receive antipsychotic treatment. Transitions were highest in the year of diagnosis and at end-of-life, driven by acute hospitalizations. Higher morbidity, living within rural health-authorities, and having behavioural symptoms associated with dementia were strongly associated with the number of transitions experienced. Lastly, receipt of guideline-consistent dementia care and high quality primary care, independently, were associated with fewer transitions across care settings.
Conclusion
Patterns of inequality by age and income may signal barriers to guideline-consistent dementia care. The spike in transitions in the year following diagnosis highlights a distressing period for individuals with dementia, but suggests a useful target for interventions.Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate
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Rudge, John. "Early onset frontotermporal dementia and alzheimers disease: diagnosis, treatment and care." Thesis, Rudge, John (2007) Early onset frontotermporal dementia and alzheimers disease: diagnosis, treatment and care. Professional Doctorate thesis, Murdoch University, 2007. https://researchrepository.murdoch.edu.au/id/eprint/468/.
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This research investigated two groups of patients diagnosed with dementia before the age of sixty-five. The patients were diagnosed with Alzheimer's Disease (AD, n = 25) and Frontotemporal Dementia (FTD, n = 37). Patients were assessed for approximately 3 years. The study found that FTD is a valid and useful diagnostic category, and can be reliably differentiated from AD. A combination of behavioural, neurological, and neuropsychological assessments were found to be complementary in the early and accurate diagnosis of early-onset dementia, and the differential diagnosis of FTD from AD. FTD patients were found to have relatively preserved visuo-spatial abilities compared to the AD patients. Problems associated with administering neuropsychological tests to early-onset dementia patients were highlighted. FTD patients were found to deteriorate more rapidly than AD patients, and to have significantly increased behavioural disturbances throughout the course of the illness in comparison with the AD patients. Practical guidelines to assist with care and management of early-onset dementia patients were presented. A strengths-based model of care was outlined. Individualised assessments and care plans were recommended for the development and provision of humane services to early-onset dementia patients. Issues surrounding providing palliative care were discussed.
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Rudge, John. "Early onset frontotermporal dementia and alzheimers disease : diagnosis, treatment and care." Murdoch University, 2007. http://wwwlib.murdoch.edu.au/adt/browse/view/adt-MU20090424.143035.
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This research investigated two groups of patients diagnosed with dementia before the age of sixty-five. The patients were diagnosed with Alzheimers Disease (AD, n = 25) and Frontotemporal Dementia (FTD, n = 37). Patients were assessed for approximately 3 years. The study found that FTD is a valid and useful diagnostic category, and can be reliably differentiated from AD. A combination of behavioural, neurological, and neuropsychological assessments were found to be complementary in the early and accurate diagnosis of early-onset dementia, and the differential diagnosis of FTD from AD. FTD patients were found to have relatively preserved visuo-spatial abilities compared to the AD patients. Problems associated with administering neuropsychological tests to early-onset dementia patients were highlighted. FTD patients were found to deteriorate more rapidly than AD patients, and to have significantly increased behavioural disturbances throughout the course of the illness in comparison with the AD patients. Practical guidelines to assist with care and management of early-onset dementia patients were presented. A strengths-based model of care was outlined. Individualised assessments and care plans were recommended for the development and provision of humane services to early-onset dementia patients. Issues surrounding providing palliative care were discussed.
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Harris, Rebekah Lynn. "Neurocognitive implications of diabetes on dementia as measured by an extensive neuropsychological battery." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc9774/.
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Diabetes is a disease with a deleterious pathology that currently impacts 4.5 million individuals within the United States. This study examined the ability of a specific neuropsychological battery to identify and classify dementia type, investigated the impact of diabetes on cognition and analyzed the ability of the memory measures of the 7 Minute Screen (7MS) and the Rey-Osterrieth Recall to correctly categorize dementia type when not used in combination with a full battery. The battery in addition to exhaustive patient history, medical chart review and pertinent tests were used in initial diagnosis. Results indicated the battery was sufficient in the identification and classification of dementia type. Within the sample, diabetes did not appear to significantly impact overall battery results whereby only two measures were minimally affected by diabetes. Finally, the memory measures of the 7MS and the Rey-Osterrieth Recall were sufficient to predict membership into the Alzheimer's (AD) and vascular dementia (VD) groups with 86.4% accuracy. The classification percentage dropped to 68.3% with addition of the mild cognitive impairment category. The full battery correctly classified AD and VD dementia 87.5% and appeared to be the most robust.
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Plugge, Leonard André. "EVINCE a neuropsychiatric desktop expert system for the diagnosis of dementia /." [Maastricht : Maastricht : Rijksuniversiteit Limburg] ; University Library, Maastricht University [Host], 1992. http://arno.unimaas.nl/show.cgi?fid=5686.
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Heal, Harriet C. "The diagnosis of dementia - do we tell the sufferer, and why?" Thesis, University of East Anglia, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.320836.
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Bennasar, Mohamed. "Clinical decision support system for early detection and diagnosis of dementia." Thesis, Cardiff University, 2014. http://orca.cf.ac.uk/73073/.
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Dementia is a syndrome caused by a chronic or progressive disease of the brain, which affects memory, orientation, thinking, calculation, learning ability and language. Until recently, early diagnosis of dementia was not a high priority, since the related diseases were considered untreatable and irreversible. However, more effective treatments are becoming available, which can slow the progress of dementia if they are used in the early stages of the disease. Therefore, early diagnosis is becoming more important. The Clock Drawing Test (CDT) and Mini Mental State Examination (MMSE) are well-known cognitive assessment tests. A known obstacle to the wider usage of the CDT assessments is the scoring and interpretation of the results. This thesis introduces a novel diagnostic Clinical Decision Support System (CDSS) based on CDT which can help in the diagnosis of three stages of dementia. It also introduces the advanced methods developed for the interpretation and analysis of CDTs. The data used in this research consist of 604 clock drawings produced by dementia patients and healthy individuals. A comprehensive catalogue of 47 visual features within CDT drawings is proposed to enhance the sensitivity of the CDT in diagnosing the early stages of dementia. These features are selected following a comprehensive analysis of the available data and the most common CDT scoring systems reported in the medical literature. These features are used to build a new digitised dataset necessary for training and validating the proposed CDSS. In this thesis, a novel feature selection method is proposed for the study of CDT feature significance and to define the most important features in diagnosing dementia. iii A new framework is also introduced to analyse the temporal changes in the CDT features corresponding to the progress of dementia over time, and to define the first onset symptoms. The proposed CDSS is designed to differentiate between four cognitive function statuses: (i) normal; (ii) mild cognitive impairment or mild dementia; (iii) moderate or severe dementia; and (vi) functional. This represents a new application of the CDT, as it was previously used only to detect the positive dementia cases. Diagnosing mild cognitive impairment or early stage dementia using CDT as a standalone tool is a very challenging task. To address this, a novel cascade classifier is proposed, which benefits from combining CDT and MMSE to enhance the overall performance of the system. The proposed CDSS diagnoses the CDT drawings and places them into one of three cognitive statuses (normal or functional, mild cognitive impairment or mild dementia, and moderate or severe dementia) with an accuracy of 78.34 %. Moreover, the proposed CDSS can distinguish between the normal and the abnormal cases with accuracy of 89.54 %. The achieved results are good and outperform most of CDT scoring systems in discriminating between normal and abnormal cases as reported in existing literature. Moreover, the system shows a good performance in diagnosing the CDT drawings into one of the three cognitive statuses, even comparing well with the performance of dementia specialists. The research has been granted ethical approval from the South East Wales Research Ethics Committee to employ anonymised copies of clock drawings and copies of Mini Mental State Examination made by patients during their examination by the memory team in Llandough hospital, Cardiff.
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Lopes, Jéssica Sousa. "FTIR, a potential tool to dementia diagnosis trough analysis of plasma." Master's thesis, Universidade de Aveiro, 2016. http://hdl.handle.net/10773/16149.
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Mestrado em Biomedicina MolecularNowadays it is still difficult to perform an early and accurate diagnosis of dementia, therefore many research focus on the finding of new dementia biomarkers that can aid in that purpose. So scientists try to find a noninvasive, rapid, and relatively inexpensive procedures for early diagnosis purpose. Several studies demonstrated that the utilization of spectroscopic techniques, such as Fourier Transform Infrared Spectroscopy (FTIR) and Raman spectroscopy could be an useful and accurate procedure to diagnose dementia. As several biochemical mechanisms related to neurodegeneration and dementia can lead to changes in plasma components and others peripheral body fluids, blood-based samples and spectroscopic analyses can be used as a more simple and less invasive technique. This work is intended to confirm some of the hypotheses of previous studies in which FTIR was used in the study of plasma samples of possible patient with AD and respective controls and verify the reproducibility of this spectroscopic technique in the analysis of such samples. Through the spectroscopic analysis combined with multivariate analysis it is possible to discriminate controls and demented samples and identify key spectroscopic differences between these two groups of samples which allows the identification of metabolites altered in this disease. It can be concluded that there are three spectral regions, 3500-2700 cm -1, 1800-1400 cm-1 and 1200-900 cm-1 where it can be extracted relevant spectroscopic information. In the first region, the main conclusion that is possible to take is that there is an unbalance between the content of saturated and unsaturated lipids. In the 1800-1400 cm-1 region it is possible to see the presence of protein aggregates and the change in protein conformation for highly stable parallel β-sheet. The last region showed the presence of products of lipid peroxidation related to impairment of membranes, and nucleic acids oxidative damage. FTIR technique and the information gathered in this work can be used in the construction of classification models that may be used for the diagnosis of cognitive dysfunction.
Atualmente, não é possível fazer um diagnóstico precoce e diferencial da doença de Alzheimer, deste modo, é necessário encontrar biomarcadores que o permitam. Para isso, os cientistas tentam encontrar um procedimento nãoinvasivo, rápido, e relativamente barato. Os resultados de vários estudos demonstraram que a utilização de técnicas espectroscópicas, tais como a Espectroscopia de Infravermelho Transformada de Fourier (FTIR) e / ou espectroscopia de Raman, podem ser ferramentas úteis para diagnosticar a DA. Uma vez que, na DA, alguns mecanismos bioquímicos podem levar a mudanças em componentes do plasma, podem então ser utilizadas amostras de sangue nas análises espectroscópicas o que torna a técnica simples e menos invasiva. Com este trabalho pretende-se confirmar algumas das hipóteses de estudos anteriores em que o FTIR foi usado no estudo de amostras de plasma de possíveis doentes com DA e respetivos controlos e verificar a reprodutibilidade desta técnica espectroscópica na análise deste tipo de amostras. Através da análise espectroscopia combinada com análise multivariada é possível discriminar as amostras controlos e dementes e identificar as principais diferenças espectroscópicas entre estes dois grupos de amostras que permitem identificar os metabolitos alterados nesta patologia. Pode-se concluir que existem três regiões espectrais, 3500-2700 cm-1, 18001400 cm-1 e 1200-900 cm-1 onde se pode extrair informação espectroscópica relevante. Na primeira região, a principal conclusão que é possível tirar é que há um desequilíbrio entre o teor de lípidos saturados e insaturados. Na região entre 1800-1400 cm-1, é possível observar a presença de agregados de proteínas e a alteração na conformação das proteínas para folha β paralela altamente estável. A última região revelou a presença de produtos de peroxidação lipídica relacionados com a insuficiência de membranas, e danos oxidativos nos ácidos nucleicos. A técnica de FTIR e a informação reunida neste trabalho pode ser utilizada na construção de modelos de classificação que possam vir a ser utilizados para o diagnóstico de disfunções cognitivas.
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Surendranathan, Ajenthan. "Lewy body dementia and the role of inflammation." Thesis, University of Cambridge, 2018. https://www.repository.cam.ac.uk/handle/1810/283243.
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Background: Lewy body dementia (LBD), consisting of Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB), is known to make up more than 15% of dementia cases at autopsy, however the clinical prevalence rate is reported to be much lower at around 5-6%. Difficulties with diagnosis and/or lack of specific treatments may contribute to this difference. This study investigated the diagnosis and management pathways of LBD and whether inflammation could play a role in the pathophysiology and hence provide a route for future diagnostic and treatment pathways. Methods: Clinical diagnostic rates of LBD in clinics across several NHS trusts in East Anglia were reviewed, followed by an in-depth notes review of patients identified with LBD together with age and gender matched controls. A literature review of the current evidence for inflammation in LBD, preceded a case control study to investigate further. Nineteen DLB patients together with 16 age and gender matched healthy controls underwent [11C]PK11195 PET imaging, and the same cohorts, plus an additional 10 matched control subjects underwent peripheral cytokine analysis. Results: The clinical prevalence rate of LBD was low compared to the known pathology rates, with delays identified in the diagnosis of DLB compared to other dementia subtypes. Delays were also seen between the onset of dementia symptoms and the clinical diagnosis of dementia in Parkinson's disease (PD). The literature review identified studies providing evidence of inflammation in PD but few studies had been carried out in DLB. PET imaging revealed microglial activation negatively correlated with disease severity in DLB, suggesting inflammation occurs early in the disease. DLB patients also showed evidence of differences in cytokine levels compared to healthy controls. Conclusion: The study showed evidence of inflammatory changes in DLB, providing a potential target for treatment and/or biomarkers, that could assist in increasing clinical diagnostic rates.
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Unadkat, Shreena. "Group singing for couples where one partner has a diagnosis of dementia." Thesis, Canterbury Christ Church University, 2015. http://create.canterbury.ac.uk/13855/.
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There is an emerging interest in the literature base around the use of group singing in dementia care. Although studies indicate positive outcomes, limited research has been carried out from a relational perspective. Additionally, theoretical underpinnings of the reported benefits have yet to be explored. This study aims to investigate the key theoretical mechanisms underlying the experience of group singing. Interview data from seventeen couples who sing together in a group is analysed using grounded theory method. Several key aspects of group singing are presented, namely that the positive experience of the act of singing combined with effective group facilitation enables equal participation and a powerful group effect. A further benefit of new learning and creativity is explored. Implications for clinical practice and possible directions for future research are outlined.
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Elson, Paul. "Breaking the news to carers that their relative suffers from dementia : an exploratory study." Thesis, Bangor University, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.318071.
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Nägga, Katarina. "Aspects on clinical diagnosis of dementia, with focus on biological markers / Katarina Nägga." Linköping, 2004. http://www.bibl.liu.se/liupubl/disp/disp2004/med839s.pdf.
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Mukadam, N. "The EAST-Dem study : encouraging access for South Asians to timely dementia diagnosis." Thesis, University College London (University of London), 2017. http://discovery.ucl.ac.uk/1560934/.
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BACKGROUND: People from Black and Minority Ethnic backgrounds tend to seek help later in the course of dementia than people from the majority ethnic population. Aim: To develop an intervention to encourage people from South Asian backgrounds to seek help earlier for memory problems and test its acceptability and feasibility. Methods: I systematically reviewed the literature and analysed routinely collected data to find interventions which improved dementia diagnostic rates. I then completed my qualitative study with South Asian community members to inform the development of an intervention to encourage earlier help seeking for memory difficulties by South Asian people. After piloting, I tested the intervention in a pilot cluster randomised controlled trial (RCT) with South Asian patients from participating GP practices. Primary outcomes were: 1. Feasibility - recruitment and retention rates 2. Acceptability - rating on a Likert scale. Results: No trials to increase dementia diagnosis rates have been successful, but rates increased significantly after implementation of the English National Dementia Strategy. South Asian community members said that understanding, through a story, that dementia was a physical illness, would normalise dutiful family members seeking interventions. I developed a bilingual leaflet and trilingual DVD with this content. I recruited and randomised 8 GP practices; 78/102 (76%) patients who allowed me to contact them, consented to the study (37 treatment-as-usual and 41 intervention). 76 (97%) participated in follow-up. 37/41 (90%) who received the intervention found it acceptable. Conclusion: I designed the first culturally-appropriate intervention to encourage help-seeking for dementia in the South Asian population. Participants found it acceptable. It was feasible to recruit and follow-up participants. A full-scale RCT would require a very large number of GP practices to participate so is likely to be expensive. It may be preferable to make this acceptable and simple intervention available and disseminate it.
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Gatten, Shauna L. "Clinical differentiation of mental disorders in the eldery : validation of the CAMDEX." Virtual Press, 1993. http://liblink.bsu.edu/uhtbin/catkey/862267.
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The present series of investigations examined the diagnostic accuracy of the Cognitive Examination (CAMCOG) from the Cambridge Mental Disorders of the Elderly Examination (CAMDEX) in the differential diagnosis of various dementing conditions. Specifically, this study examined: (a) the degree to which the CAMCOG would differentiate normal individuals from patients with Alzheimer's Disease (AD) and from those suffering from non-AD dementing conditions, (b) the extent to which the CAMCOG would distinguish between patients suffering from organic dementing conditions, those having functional psychiatric disorders, and normal persons, and (c) whether the CAMCOG would offer an improvement in diagnostic accuracy over a widely used screening instrument (i.e., the Mini-Mental Status Examination, MMSE) when attempting to differentially diagnose dementing patients and normal cohorts.A review of the literature was presented with an emphasis on the difficulties in establishing differential diagnosis, inaccuracies in diagnosis, the importance of improved diagnostic accuracy, and the use of neuropsychological measures in the assessment and diagnosis of patients suffering from dementing illnesses. Further, research relevant to ancillary diagnostic techniques, the various neuropsychologicalapproaches used in evaluating and diagnosing mental disorders in the elderly, and studies investigating the utility of specific cognitive/neuropsychological measures in the differential diagnosis of dementing diseases was presented.The results of these investigations revealed that the CAMCOG provides excellent diagnostic sensitivity and specificity when differentiating normal persons from clinically diagnosed AD patients and when distinguishing between individuals with an organic-dementing condition and normal adults. The CAMCOG was found to be less effective in differentiating AD and non-AD dementia patients and in distinguishing between patients suffering from organic dementia versus specified psychiatric disorders. Finally, the CAMCOG demonstrated a slight improvement in diagnostic accuracy over the Mini-Mental Status Examination. These results were discussed in terms of their support for the utility of the CAMCOG as an excellent screening measure when used to differentiate patients suffering from various dementia-producing disease states and normal persons.Department of Educational Psychology
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Noggle, Chad A. "Differential diagnosis of Alzheimer dementia and depression using the Dean-Woodcock Neuropsychological Assessment System." Virtual Press, 2006. http://liblink.bsu.edu/uhtbin/catkey/1344193.
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This study investigated the utility of the cognitive measures of the Dean-Woodcock Neuropsychological Assessment System (D-WNAS) in the differential diagnosis of Alzheimer dementia (AD) from depression. Past research has found an overlap of symptoms in the early stages of AD and those found in geriatric depression. In both instances, patients are likely to report memory loss, attention deficits, and mood disturbances. As a result of this similarity, differentially diagnosing one from another is a vexing problem for the clinical practitioner. Although a number of screening measures have been offered, none have proven to be clinically useful. Some have proposed this is the result of reliance upon use of single-factor measures. Indeed, many have proposed a multiple factor assessment model would be of more utility in diagnosing AD and depression. Considering the importance of an accurate diagnosis in treatment, this study utilized a multiple factor cognitive model offered by the Dean-Woodcock Neuropsychological Assessment System to differentiate AD from depression.Specifically, subtest scores of the Woodcock-Johnson III - Tests of Cognitive Ability (WJ-III; cognitive measure of the Dean-Woodcock Neuropsychological Assessment System) were compared. Participants (n = 172) fell into one of three groups (i.e. Depressed, Demented, or Normal) based on the diagnoses of a board certified neurologist and neuropsychologist. Results showed clinical groups performed more poorly than normal participants on tests of the WJ-III. In addition, AD participants differed significantly from depressed participants on the Visual Matching and Spatial Relations tests of the WJ-III. However, in all, the WJ-III demonstrated a classification hit rate of less than 70%. Although groups were found to differ in specific ways, the classification hit rate of the WJ-III suggested it could not differentially diagnose AD from depression alone.Department of Educational Psychology
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Kixmiller, Jeffrey S. "Subtyping patients with Senile Dementia of the Alzheimer type using cluster analysis." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/833474.
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The purpose of this study was to determine if distinct subgroups of patients with Senile Dementia of the Alzheimer Type (SDAT) could be identified using seven scales of the Cognitive Behavior Rating Scale (CBRS). Ward's method of cluster analysis was used to group 104 patients with a probable diagnosis of SDAT into subtypes.The following three clusters were identified: (a) Moderately Impaired, (b) Severely Impaired, and (c) Emotionally Intact which displayed differences in symptom severity. Clusters could be partially defined by the amount of time they had been diagnosed with the disease. Differences in the cluster's configuration of scores had little/no descriptive utility. Subsequent discrimination analyses indicated that patient demographics were not as useful as the CBRS in classification of patients.This study provided evidence for the CBRS's ability to differentially portray SDAT patients' profiles. Results provide partial support for a stage model of SDAT. Implications of existing subgroups in SDAT are discussed as they pertain to patient management issues.Department of Counseling Psychology and Guidance Services
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Marková, Veronika. "Potential Neurophysiological Biomarkers for the Diagnosis of Age-related Neurodegenerative Diseases." Thesis, Högskolan i Skövde, Institutionen för biovetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-18839.
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The global population with dementia is rapidly increasing around the world.The major risk factor for dementia is aging. There is currently no treatmentavailable and the cost of symptomatic treatment is high. There is a growinginterest in possible clinical applications of non-invasive methods that are safeand easy-to-perform in diagnosis of dementia. The purpose of this paper is toinvestigate the usage of transcranial magnetic stimulation (TMS) withelectroencephalography (EEG) to diagnose dementia in early stages of thedisease. Early diagnosis is needed to reduce the costs of symptomatic care.When investigating the usage of TMS-EEG technology, we will look at how wecan distinguish dementia in different neurodegenerative diseases between eachother. More research is needed to suggest an accurate parameters fordiagnosis of dementia with this type of technology.
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Abrahams-Salaam, Fatima. "A molecular investigation of a mixed ancestry family displaying dementia and movement disorders." Thesis, Stellenbosch : Stellenbosch University, 2008. http://hdl.handle.net/10019.1/2432.
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Thesis (MScMedSc (Biomedical Sciences. Molecular Biology and Human Genetics))--Stellenbosch University, 2008.A South African family of Mixed Ancestry presented with a rapidly progressive dementia and a movement disorder which affected a number of individuals across three generations. The initial symptoms included personality changes and tremors that escalated to severe dementia and eventually a completely bedridden state. It was determined that the mean age at onset was in the third decade of life and affected individuals died within 10-15 years after the onset of symptoms. The aim of the present study was to elucidate the genetic cause of the disorder in this family and to further investigate the patho-biology of the disease. Mutations that could possibly cause the observed phenotype in this family were screened for. These included loci implicated in Huntington’s disease, Parkinson’s disease, Dentatorubral-Pallidoluysian Atrophy, Spinocerebellar ataxias (types 1, 2, 3, 6, and 7), Huntington’s disease-like 2 (HDL2) and several mitochondrial disorders. Single-strand Conformation Polymorphism (SSCP) analysis and direct sequencing were used to detect possible mutations while genotyping on an ABI genetic analyser was used to detect disorders caused by repeat expansions. Haplogroup and Short Tandem Repeats (STRs) analyses of the Y-chromosome and mitochondrial DNA of one affected family member was used to determine the family’s genetic ancestry. Reverse transcriptase polymerase chain reaction (RT- PCR) and complementary DNA (cDNA) analyses of the Junctophlin-3 (JPH3) gene was performed to provide information on the expression profile of this gene. After the exclusion of several genetic loci it was shown that this family had HDL2. This is a rare disease caused by a CAG/CTG repeat expansion in an alternatively spliced version of the JPH3 gene. HDL2 occurs almost exclusively in individuals of Black African ancestry. The genetic ancestry data suggested that the family member was most likely of South African Mixed Ancestry making this the first reported family of South African Mixed Ancestry with HDL2. A pilot study investigated the repeat distribution amongst three South African sub-populations in order to determine whether there was a bias in the repeat distribution that possibly predisposes Black Africans to develop the disease. The results showed a statistically significant difference (P= 0.0014) in the distribution of the repeats between the Black African and Caucasian cohorts. However, no conclusions could be drawn as to whether Black Africans harboured larger repeats that predisposes them to developing HDL2. The expanded repeat is located in an alternatively spliced version of the JPH3 mRNA. Interestingly, this repeat is not present in the mouse homologue of the gene although the rest of the genomic sequence is highly conserved across the human, mouse and chimpanzee genomes. Using foetal brain cDNA and PCR primers designed to be specific for different JPH3 isoforms, independent confirmation of the presence of two JPH3 mRNA transcripts (the full length and a shorter alternatively spliced version) was provided. In the absence of brain tissue from an HDL2-affected individual, it was investigated whether both JPH3 mRNA transcripts could be detected in lymphocytes. Using RNA isolated from the transformed lymphocytes of two HDL2-affected family members, real-time PCR was attempted. These experiments produced inconclusive results and required further optimisation. Further RT-PCR experiments for JHP3 expression in different tissues (brain and other) obtained from HDL2-affected individuals would be of interest. The present study identified the first Mixed Ancestry family with HDL2. This family will now be able to request genetic counselling and pre-symptomatic testing for all at-risk family members. Aspects of this study provided independent confirmation of characteristics of the mutated gene. More research on HDL2 will be crucial in understanding the pathogenesis of this disease.
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Voss, Sarah. "Cognitive deficits in dementia : evaluation and application of a neuropsychological test battery in the differential diagnosis of Alzheimer's disease and vascular dementia." Thesis, University of Bristol, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.289560.
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Küster, Olivia Caroline [Verfasser]. "Challenging dementia : cognitive and neural plasticity in early diagnosis and intervention / Olivia Caroline Küster." Ulm : Universität Ulm, 2018. http://d-nb.info/1159636699/34.
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Küster, Olivia [Verfasser]. "Challenging dementia : cognitive and neural plasticity in early diagnosis and intervention / Olivia Caroline Küster." Ulm : Universität Ulm, 2018. http://d-nb.info/1159636699/34.
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Harper, L. "Maximising the diagnostic value of structural MRI in the diagnosis of dementia : a comprehensive study of post-mortem proven cases." Thesis, University College London (University of London), 2015. http://discovery.ucl.ac.uk/1473622/.
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This thesis investigates the use of atrophy patterns from structural brain imaging to distinguish different dementia pathologies, including Alzheimer's disease, dementia with Lewy bodies and frontotemporal dementia pathologies. Using gold standard histopathology to stratify groups, analysis is based on 3D-T1-weighted imaging acquired during life in patients who attended clinic in one of three European centres. As well as comparison of disease groups with healthy controls, more clinically relevant comparisons between disease groups are performed to identify features that may be useful for differential diagnosis. The image analysis techniques used in this thesis range from simple visual assessment to more advanced machine learning. Visual rating scales were found to be reliable, quick to perform, and when used in combination, could achieve diagnostic accuracy equal to unstructured visual assessment by dementia experts. Voxel based morphometry, used to provide a comprehensive estimate of global patterns of atrophy in pathologically distinct dementias, confirmed findings in the literature based on clinical data, and identified novel regions of interest for further study. A fully automated diagnostic approach using multi-atlas segmentation propagation and support vector classifiers, revealed brain volume differences between pathologically distinct groups, yet with several technical limitations to address. Since histopathological diagnosis is rare in such a large, pathologically diverse cohort, this thesis also considers opportunities to develop the dataset into a shared resource for the dementia research community. To this end, a web application was developed to allow the data to be shared between collaborating centres, with plans to adapt this into a teaching resource. In summary, this thesis uses a variety of analysis techniques to identify imaging features that may be useful for the differential diagnosis of dementia pathologies. Various opportunities are explored to maximise the value that can be derived from this unique and valuable dataset.
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Alexjuk, Eva Joanna. "Journey from dementia diagnosis to final bereavement : an exploration of the fluctuating perceptions of self experienced by family caregivers of people with dementia." Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/31372.
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Few research studies have examined the panoramic landscape of family caregivers from dementia diagnosis to the final bereavement of the person with dementia for whom they are caring. The route and pathways of care undertaken during a caregiver's journey will be individual to each person, yet invariably there will be some similarities as to how they anticipate, approach and mange this journey. From the caregiver's perspective, caring for someone with dementia is related to more than the cognitive loss experienced by their family member, there are many losses involved, This research study aims to explore the complex emotional experiences of thirty caregivers in relation to sense of self. change, grief, loss and bereavement, to elucidate a deeper understanding of the lived experience, the perceived and understood reality of the experiential journey of caregivers. To explore the experiences of caregiving, this research study uses a hermeneutic phenomenological approach and draws on an adaptation of the theoretical framework of anticipatory grief and loss by Fulton and Fulton (1971) and Fulton and Gottesman (1980). The study uses a convenience sample and semi structured interview format and involves two non-comparative participant groups of family caregivers living in urban and rural communities within the North East of England. Group one comprises of twenty bereaved participants, nineteen of whom are spousal caregivers and one adult-caregiving daughter, who were interviewed once to explicated a retrospective perspective of the caring experience. Group two comprises of ten participants, nine spousal caregivers and one adult-caregiving daughter, who are currently caring for a family member living with an advanced stage experience of dementia. Group two participants were interviewed on three occasions across an eighteen-month time period to explore the retrospective and prospective experience of their caregiving role. The analysis of data reveals expressions of change, grief and loss within a complex and tri-dimensional landscape. Within this landscape, participants highlight defined periods of their journey, particularly with regard to their experience of a protracted middle period, which they referred to as being "the long road". However, intersecting with this layered landscape, the analysis of data also reveals a key aspect of caregiving - the emergence of a conceptual framework involving three interconnected yet fluctuating schemas of self experienced by participants. the first scheme, the individual 'me-self'. related to the participant's perception of their core self and envisaged sense of self. the second schema, the 'relationship-self', illustrates participant's physical and psychological experiences and bonded connection between themselves and the cared-for spousal partner or parent, as well as other family members and care workers. The third schema, the 'caregiving-self', is associated with the acquisition and undertaking of their role of familial caregiver. The findings of this study highlight the 'lived-world' experience of family caregivers as being a journey which subjects them to a cyclical maelstrom of emotion and fluctuating perception of their schemas of self.
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Gibson, Allison K. "Examining the Experiences of Caregivers During the Diagnosis of Alzheimer’s Disease and Related Dementias." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1275071723.
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Hawkins, Jayne Isabelle. "Younger people with dementia : does the impact of diagnosis pose a threat to self-identity?" Thesis, University of Leeds, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.416312.
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Atcha, Maaria. "Access to dementia diagnosis and support in a diverse South Asian community : a qualitative study." Thesis, Lancaster University, 2018. http://eprints.lancs.ac.uk/127056/.
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Although members of the United Kingdom (UK) South Asian population appear to have an elevated risk of developing dementia, this population accesses dementia services less frequently, compared with the majority white population. The disparity between the prevalence of people with dementia and the reported incidence of dementia, especially among South Asian populations (the UK‟s largest ethnic minority), is of concern to public health service providers. This study aimed to identify the socio-cultural issues in accessing dementia services in the population living in Blackburn with Darwen [BwD], in the Northwest of England. This qualitative study explores how members of the BwD South Asian Indian and Pakistani population perceive dementia, and how their family members engage with local dementia care services and with healthcare professionals providing dementia services. Data collection included: three focus groups with thirteen people involved in a community project; two interviews with people living with dementia and their family members; and eight interviews with nine dementia services healthcare professionals [HCPs]. The data was analysed using thematic analysis. The findings suggest that members of the South Asian population are under-represented in dementia diagnostic services. Firstly, this appears to be due to a lack of knowledge in the Muslim South Asian Indian and Pakistani community about the nature of dementia. Various negative perceptions of dementia, influenced by cultural beliefs, were also identified which lead to people with dementia being stigmatised and hidden from public view by their families. This may explain why health professionals report that this population seeks help at a later stage of the illness, and thus there is an argument for public health services to develop culturally relevant outreach programmes.
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Billette, Ornella [Verfasser]. "Improving cognitive testing in the context of dementia$dtools for an earlier and better-characterized diagnosis of Alzheimer's dementia and Primary Progressive Aphasia / Ornella Billette." Magdeburg : Universitätsbibliothek Otto-von-Guericke-Universität, 2018. http://d-nb.info/1219965448/34.
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Lee, Hyunsook. "Comparative study of carers of older people with dementia in Scotland and Korea." Thesis, University of Edinburgh, 2011. http://hdl.handle.net/1842/9796.
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This study aims to explore Scottish and Korean carers‘ attitudes towards the diagnosis of dementia in their relative, family care, community care and to residential care in Scotland and Korea respectively, also under examination was the origin of different carers‘ attitudes between Scotland and Korea. The dominant argument between previous Western and Eastern comparative studies on attitudes, has been that culture made the difference. In other words, the cultural factor was recognised as a main determinant of attitudes towards a diagnosis of dementia, towards social services at home and residential care in Asian societies, including Korea. This thesis starts with the question: Does culture really explain the phenomenon of Asian people‘s attitudes towards dementia? Indeed the tradition of filial piety has been changing and now seems to be rather weak in modern Asian society. In particular, contemporary Korea is modernised and westernised, as a result, many older people live apart from their adult children and their nuclear families. This study asserts that Confucianism is a much less significant factor than differences in social policy. In other words, this thesis focuses not on Confucianism, but on the impact of institutions on carers‘ attitudes towards dementia. Finally, this thesis explores this argument through the following research question: What are the origins of different carers‘ attitudes between Scotland and Korea? In order to develop this argument, this thesis has carried out interviews with 14 Scottish carers and 28 Korean carers; and adopted a qualitative approach that would yield a rich exploration and deeper understanding of the different attitudes between carers in Scotland and Korea. Based on this data, this thesis examines carers‘ attitudes towards the diagnosis of dementia (chapter 3), family care (chapter 4), community care (chapter 5), and residential care (chapter 6). Each chapter analyses similarities and differences in attitudes in Scotland and Korea from the point of view of culture or the social welfare system. To conclude, these findings explain that the origin of carers‘ attitudes in this study is based on social policy rather than culture. In other words, the Korean carers‘ attitudes and behaviours towards diagnosis and long-term care services are rooted in the residual welfare system rather than Confucianism. Likewise, this study found that Confucianism has a less significant influence than social policy on carers‘ attitudes towards the utilisation of health care, community care and residential care. Unlike previous studies on East Asia, that argue for a cultural explanation, this study of Korean carers demonstrates that the residual welfare system is more persuasive than the cultural approach derived from Confucianism . This study contributes to the comparative study of Scotland and Korea as well as being a qualitative study in Korea. In addition, it will provide a new perspective on attitudes towards studies on East Asia. Moreover, the study will suggest political implications through the exploration of the carers‘ attitudes towards dementia diagnosis, social services at home and residential care. It also can provide lessons on dementia and dementia care from different experiences in Scotland and Korea.
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Lindau, Maria. "Clinical differentiation between frontotemporal dementia and Alzheimer's disease : psychometric, behavioral, neuroimaging and neurophysiological information /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-430-5/.
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Haigh, Anne-Marie Francoise. "The Alzheimer's Disease Life Events Study." Thesis, Oxford Brookes University, 2009. http://radar.brookes.ac.uk/radar/items/9c1acdb7-0df9-4046-ec50-810f9122e1d0/1.
Full textAbstract:
The Alzheimer's Disease Life Events study examines whether there is a relationship between life events and Alzheimer's disease (AD). The ADLE study uses a mixed methods approach to answer the central research question:Are life events a risk factor for Alzheimer's disease? The central research question uses the following theory questions to examine:1. Is there a difference between the number of life events between patients and controls, using the Life Events and Difficulties Schedule (LEDS)(Brown and Harris, 1978) as a measurement tool?2. Is there a difference in the way (i.e. positive, neutral and negative) life events are discussed and in the range of emotions expressed when discussing life events between the patients and controls? 3. Are there any differences in the narrative constructions of life events, as interpreted by the Biographic Narrative Interpretive Method (BNIM)(Wengraf, 2001, 2008) between the patient and control groups? 4. Can the differences, between the patient and control groups, in the narratives be developed into a diagnostic marker? 5. Can the Emotion Word Coding (EWC)(Danner et aI., 2000) be used as a diagnostic marker by being applied to text collected from patients and controls over a period of decades? The ADLE study found that the patient group had experienced more life events in comparison with the control group as defined by the LEOS (Brown and Harris, 1978), and that the patient group had experienced more bereavements under the age of 51 years. The evidence supports the association between life events and AD.Even though there were significantly more life events experienced by the patients, the EWC (Danner et aI., 2001) found significantly fewer discussions expressing emotion bythe patients, particularly the negatively described ones. The range of negative and positive words used to describe the life events was significantly fewer too. This implies that the ways the patients express emotions about life events is substantially different from the controls. This finding was mirrored in the thematic field analysis of the BNIM interviews (Wengraf, 2001, 2008), which found differences in the content and structure of the narratives, and the emotional expression in the narratives about life events. A tool has been constructed using the differences between patients and controls to contribute to the early diagnosis of AD. In addition, the ADLE study has contributed to a gap in the knowledge about life events and AD.
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McCafferty, Aileen. "Getting a needed but unwanted answer : the meaning and impact of a dementia diagnosis for spousal caregivers." Thesis, University of Edinburgh, 2008. http://hdl.handle.net/1842/3301.
Full textAbstract:
Current recommendations by the Scottish Intercollegiate Guidelines Network (Guideline 86) emphasise the need for diagnostic and post-diagnostic information and support provided to people with dementia and their family members to be tailored to meet their needs. Whilst there is a wealth of literature quantifying attitudes towards diagnosis disclosure and satisfaction with practice, there is a lack of research which looks at the impact and meaning of a dementia diagnosis for familial caregivers, despite recognition that psychological reactions to a diagnostic disclosure are critical to understand to provide appropriate information and caregiver support (Carpenter & Dave, 2004). Using a qualitative methodology, the aim of the present study was to explore the meaning of a dementia diagnosis in a spousal partner and living with the early, post-diagnostic stage. Method Individual semi-structured interviews were carried out with 8 spouses of older adults, recently diagnosed with a dementia condition. All interviews were transcribed verbatim and analysed using Interpretative Phenomenological Analysis (Smith, 1996). Findings Five super-ordinate themes emerged from the interviews: Getting an Answer ( You just need to get a name put to it ); Losses and Changes for Self; Changes in the Marital Relationship (Threats to Coupledom); Limiting the Emotional Impact of Diagnosis, and Preserving Normality. Conclusions Participant accounts suggest a dementia diagnosis is something viewed as needed but is associated with unwanted implications; posing a threat to the self and the marital relationship. Post diagnosis, spouses engage in a process of making sense of and protecting themselves against the impact of changes and sensed losses. It is recommended that post-diagnostic services should aim to support spousal caregivers 2 as they manage these experienced and anticipated losses. Appropriate support at this time may lessen the risk of psychological distress and carer difficulties at later stages. Suggestions for future research include the need for longitudinal research starting at the time of diagnosis to explore whether the meaning and impact of a dementia diagnosis for spousal caregivers shift over time.
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Davis, Tommy E. Jr. "The Effectiveness of the Geriatric Depression Scale to Distinguish Apathy From Depression in Alzheimer's Disease and Related Dementias." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc9109/.
Full textAbstract:
Early detection of Alzheimer's disease (AD) and related dementias in the elderly is critical for improving treatment methods and is a necessary component for improving public health interventions. One of the earliest and most common behavioral syndromes of AD is apathy and is associated with executive dysfunction. Apathy in AD is often misdiagnosed as depression due to an overlap in symptoms. Studies that have found depression to be associated with executive dysfunction have not always controlled for the presence of apathy. The Geriatric Depression Scale (GDS) is a widely used instrument designed to assess depression in the elderly. This study utilized the GDS and a set of standard neuropsychological instruments to investigate the relationship between apathy, depression, and executive functions in individuals with AD and related dementias. The first objective of this study was to determine if apathy has a greater impact on executive functions compared to depression in AD and related dementias. The second objective was to determine the effectiveness of the GDS as a screen for apathy. The results of the analyses did not support the hypotheses. However, exploratory analyses suggested a possible non-linear relationship with apathy and various levels of dementia severity. Exploratory analysis also suggested mean levels of endorsement for apathy varied by diagnosis. Further research is warranted to investigate this relationship and the GDS endorsement patterns for caregivers regarding their impression of the demented individual.
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See, Shiu-king Eric, and 施兆景. "The use of neural network analysis of PET-CT brain scan regional ¹⁸F-FDG metabolism in diagnosis and prognosis of dementia subjects." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hub.hku.hk/bib/B50712780.
Full textAbstract:
The elderly population (those aged 65 years or older) in Hong Kong is expected to increase from approximately 13% in 2009 to 28% by 2039. With this rapid growth of elders, it raises attention to prevent and treat chronic diseases of aging. Dementia is particularly concerned because the short term memory loss and other cognitive malfunctions lead to a loss of independent function that has a extensive impact on individuals, families, health and social welfare systems. Currently over 70,000 people endure dementia in Hong Kong and expect quadruple rises by 2036. In order to cope with these diseases, accurate diagnosis is very useful, particular at early stage when treatment outcomes are most effective.
Numerous studies have found that AD and other dementias could alter brain metabolism significantly. AD patients usually present the posterior cingulated and parietotemporal cortices hypometabolism and spread into the frontal lobes in advanced disease. In contrast, FTD patients show manifestly hypometabolism in the frontal and anterior temporal cortices, while DLB patients present hypometabolism in the posterior brain comprising primarily the parietoocipital regions. Theoretically, 18F-FDG PET scan can help in the early diagnosis of AD and other dementias by highlighting these decreased FDG uptake cortex regions before MRI or CT scans can detect any structural damage.
This is a retrospective chart review study. Patients who had received FDG brain PET-CT scan previously had their regional brain metabolism quantitated using a software call Cortex-ID and clinical laboratory tests. The study is
* To develop a Neural Network (NN) that can diagnose the various types of dementia using Brain PET-CT scan, testing accuracy of NN versus an expert and,
* To see if the NN can correlate with the clinical severity of the disease as reflected by MMSE score.
Finally, three neural networks have been designed and they all fulfill all the required specifications.published_or_final_version
Diagnostic Radiology
Master
Master of Medical Sciences