Journal articles: 'Dementia – Diagnosis'

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Salardini, Arash. "Interpretation of Biomarker Data in Diagnosis of Primary Dementias." Seminars in Neurology 39, no. 02 (March 29, 2019): 200–212. http://dx.doi.org/10.1055/s-0039-1683380.

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AbstractIn the last few years, an improved understanding of dementia biomarkers has significantly increased the diagnostic accuracy for dementias. The National Institutes of Health Biomarkers Definitions Working Group defines a biomarker as “a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention.” In the field of dementia, a biomarker is a biological measure pointing to a specific dementing pathology. Dementia biomarkers may also serve as surrogates for disease progression and as endpoints in clinical trials. Dementia biomarkers are best characterized for Alzheimer's disease, which is the most common form of primary dementia. The current “biological” conception of Alzheimer's disease is based on consideration of three biomarkers: amyloid, tau, and “neurodegeneration.” The status of these biomarkers may be determined by cerebrospinal fluid clinical chemistry or imaging. Biomarkers for other primary dementias are less reliable and rely chiefly on structural and functional imaging. When appropriate, genetic testing may help with diagnostic certainty in hereditary forms of dementia.

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Chahyani, Wiwit Ida, and Murni Sri Hastuti. "Mixed Dementia: Tinjauan Diagnosis dan Tatalaksana." Muhammadiyah Journal of Geriatric 1, no. 2 (January 5, 2021): 46. http://dx.doi.org/10.24853/mujg.1.2.46-51.

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Latar Belakang: Prevalensi demensia saat ini semakin meningkat, mengenai usia diatas 65 tahun dan risikonya meningkat 2 kali setiap penambahan usia 5 tahun. Salah satu bentuk demensia adalah mixed dementia. Diagnosis mixed dementia sangat sulit dan memberikan tantangan tersendiri bagi para klinisi. Pada artikel ini, penulis ingin membahas mengenai tinjauan diagnosis dan tatalaksana mixed dementia. Hasil: Diagnosis mixed dementia dapat menggunakan beberapa kriteria yaitu International Classification of Diseases and Health Related Problems 10th Revision (ICD-10), the Alzheimer’s Disease Diagnostic and Treatment Centers (ADDTC), dan the National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et l’Enseignement en Neurosciences (NINDS-AIREN). Tatalaksana mixed dementia berupa terapi farmakologi untuk gejala gangguan kognitif dengan pemberian golongan inhibitor kolinesterase dan antagonis NMDA. Terapi farmakologi untuk gangguan psikis dan perilaku dengan antipsikotik atau antidepresan. Managemen faktor risiko hipertensi, konsumsi nutrisi yang sehat, dan olah raga teratur sebagai upaya preventif dan mencegah progresivitas mixed dementia. Kesimpulan: Diagnosis mixed dementia meliputi gejala demensia Alzheimer dan demensia pada penyakit serebrovaskuler. Tatalaksana mixed dementia meliputi terapi gangguan kognitif, psikis, dan perilaku, serta tatalaksana faktor risiko penyakit serebrovaskuler. Dibutuhkan penelitian lebih lanjut serta adanya konsensus diagnosis dan tatalaksana mixed dementia baik nasional maupun internasional agar tercapai tatalaksana secara komprehensif.

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Snowden, JS. "Neuropsychological evaluation and the diagnosis and differential diagnosis of dementia." Reviews in Clinical Gerontology 9, no. 1 (February 1999): 65–72. http://dx.doi.org/10.1017/s0959259899009168.

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Dementia has traditionally been viewed as a global, undifferentiated impairment of intellect and memory. The implication is that patients with dementia share a common clinical syndrome. It is, however, now recognized that different dementing diseases give rise to distinct patterns of mental change, reflecting differences in the topographical distribution of pathological change within the brain. Contrary to the traditional view, analysis of the characteristics of dementia can contribute substantially to differential diagnosis. Indeed, since many patients with a dementing illness exhibit few physical signs, evaluation of the mental changes may be critical to diagnostic accuracy. With the advent of new therapies for dementia, precise diagnosis has become increasingly important. Moreover, understanding of patients’ symptom pattern provides a rational basis for patient management and for advice to carers.

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de Mendonça Lima, C. A. "Diagnosis and differential diagnosis of dementia." European Psychiatry 26, S2 (March 2011): 2108. http://dx.doi.org/10.1016/s0924-9338(11)73811-1.

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The European prevalence of dementias will increase of 40% during the next 40 years, with serious effects on families, communities and healthcare systems (1).A correct diagnosis of dementia is the first step to plan treatment, care and support. There is no single test to identify the cause of dementia. The diagnostic process involves, medical history, mental status exam, physical exam, laboratory tests, psychiatric and (neuro)psychological tests and assessment of individual's functioning. An image of brain is suitable.There is an idea that this diagnostic process can only be realized by highly specialized staff. WHO has recently published the mhGAP Intervention Guide for use in non-specialized health-care settings by health-care providers working at first- and second-level facilities. It includes guidance on evidence-based interventions to make the diagnosis and manage a number of priority conditions, including dementia (2).The recent progress in pathological process understanding of Alzheimer's disease (AD), may help to the proposal of new research criteria that reconceptualise the diagnosis around both a specific pattern of cognitive changes and structural/biological evidence of Alzheimer's pathology (3).These two recent developments are significant contributions to increase the accessibility to a proper diagnosis and care of dementia around the world.

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Mahalingam, Sowmya, and Ming-Kai Chen. "Neuroimaging in Dementias." Seminars in Neurology 39, no. 02 (March 29, 2019): 188–99. http://dx.doi.org/10.1055/s-0039-1678580.

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AbstractDementia is a global health issue, the burden of which will worsen with an increasingly aging population. Alzheimer's disease (AD) is the most common dementia, with 50 to 60% of all dementias attributable to AD alone, while the rest are mostly due to frontotemporal lobar dementia, dementia with Lewy bodies, Parkinson's disease dementia, and vascular dementia. Diagnosis of dementias is made clinically with the aid of other testing modalities including neuroimaging. While the role of imaging has traditionally been to exclude reversible causes of dementia, positron emission tomography (PET) with 18-fluorine fluorodeoxyglucose and magnetic resonance imaging now are increasingly used more for definitive diagnosis of dementia in the prodromal stages and to aid with formulating the differential diagnoses. Introduction of molecular imaging modalities such as amyloid PET and tau PET have improved diagnostic certainty in the clinical trial setting and promise to find their way into the clinic in the near future. In this review, we will focus on the multimodality imaging of dementias especially AD and its differential diagnoses.

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Maxfield, Molly, Allie Peckham, Dara James, Laura Lathrop, and Amy Fiske. "ANTICIPATED SUICIDAL AND DEATH IDEATION IN RESPONSE TO AN IMAGINED DEMENTIA DIAGNOSIS." Innovation in Aging 6, Supplement_1 (November 1, 2022): 781. http://dx.doi.org/10.1093/geroni/igac059.2824.

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Abstract Alzheimer’s disease and related dementias are prevalent, incurable, and highly impactful diagnoses. Dementias are therefore feared diagnoses. Dementia-related anxiety (DRA) is anxiety about a current or future diagnosis of dementia and the associated complex symptoms. In a mixed methods study, semi-structured interviews were conducted to identify causes of DRA and revealed that numerous adults anticipated suicidal or death ideation if diagnosed with dementia. Fifty cognitively healthy, community-dwelling adults aged 58 to 89 (M = 70.92, SD = 6.08; 64% female) were recruited from a university participant registry and Memory Clinic. Among participants endorsing anticipated suicidal or death ideation, responses ranged from active plans, including interest in physician-assisted suicide, to more passive wishes to hasten death rather than continue to live with dementia. Within reports of both anticipated suicidal and death ideation, subthemes emerged, including the concern about becoming a burden to others in more advanced stages of dementia, the devaluation of life or the self with dementia, and the desire for (and anticipated thwarting of) control and independence. Statements of anticipated suicidal and death ideation were contingent on a future dementia diagnosis and may reflect errors in affective forecasting. Nevertheless, given the prevalence of dementias and older adults’ elevated rates of suicide, the intersection of these two public health issues warrants greater attention and further investigation.

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Tierney, M. C., W. G. Snow, and R. H. Fisher. "Dementia diagnosis." Neurology 39, no. 11 (November 1, 1989): 1560. http://dx.doi.org/10.1212/wnl.39.11.1560.

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Rai, G. S., and I. Blackman. "Dementia Diagnosis." Clinical Gerontologist 19, no. 4 (December 9, 1998): 68–70. http://dx.doi.org/10.1300/j018v19n04_07.

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9

Testa, H. J., J. S. Snowden, D. Neary, R. A. Shields, A. W. I. Burjan, M. C. Prescott, B. Northen, and P. Goulding. "The Use of [99mTc]-HM-PAO in the Diagnosis of Primary Degenerative Dementia." Journal of Cerebral Blood Flow & Metabolism 8, no. 1_suppl (December 1988): S123—S126. http://dx.doi.org/10.1038/jcbfm.1988.42.

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The clinical value of single photon emission computed tomography (SPECT) in the differential diagnosis of dementia due to cerebral atrophy was evaluated by comparing the pattern of distribution [99mTc]–HM-PAO in three dementing conditions. Imaging was carried out in 26 patients with suspected Alzheimer's disease, 14 with dementia of the frontal-lobe type, and 13 with progressive supranuclear palsy. Images were evaluated and reported without knowledge of clinical diagnosis with respect to regions of reduced uptake of tracer. Reduced uptake in the posterior cerebral hemispheres was characteristic of Alzheimer's disease, while selective anterior hemisphere abnormalities characterized both dementia of the frontal-lobe type and progressive supranuclear palsy. The latter conditions could be distinguished on the basis of the appearance of integrity of the rim of the frontal cortex. The technique has an important role in the differentiation of degenerative dementias.

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Chertkow, H., H. Bergman, H. M. Schipper, A. M. Clarfield, S. Gauthier, S. Fontaine, and R. Bouchard. "Assessment of Suspected Dementia." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 28, S1 (May 2001): S28—S41. http://dx.doi.org/10.1017/s0317167100001189.

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At the Second Canadian Consensus Conference on Dementia (CCCD) (February, 1998), a group of neurologists, geriatricians, and psychiatrists met to consider guidelines for evaluation of dementia in Canada. This review paper formed a background paper for their discussion of dementia diagnosis. These experts from across the country concluded that diagnosis of suspected dementia cases continued to rest on skilled clinical assessment. Mental status exam, preferably in some quantifiable form, has become an essential part of the assessment. Selected laboratory tests are advisable in all cases (CBC, TSH, electrolytes, calcium, and glucose), but the CCCD continued to advise that CT scanning was mandatory only in selected cases where clinical findings pointed to another possibility besides Alzheimer’s disease. The growing list of other diagnostic measures with potential usefulness in diagnosis of Alzheimer’s disease or dementia in general was reviewed, but the evidence was judged as insufficient to support routine use of these tests by physicians. As new treatments for Alzheimer’s disease become available, neurologists face new diagnostic challenges - differentiating Mild Cognitive Impairment, Frontotemporal dementias and Mixed dementias, and Lewy Body Dementia. Guidelines to aid in differential diagnosis are presented.

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Torian, Lucia, Emily Davidson, George Fulop, Laura Sell, and Howard Fillit. "The Effect of Dementia on Acute Care in a Geriatric Medical Unit." International Psychogeriatrics 4, no. 2 (September 1992): 231–39. http://dx.doi.org/10.1017/s1041610292001066.

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Treatment of dementia costs billions of dollars in long-term care and community services every year. Dementia also burdens the acute care system and may contribute to financial problems for hospitals serving large numbers of demented elderly. In a specialized geriatric medical unit devoted to acute care of the frail elderly, Alzheimer's disease and vascular and mixed dementias afflicted 63% of inpatients and were associated with excess consumption of nursing resources, complications of treatment, nosocomial infections, lengthy hospitalizations, and financial losses to the hospital. Due in part to the effects of dementia on mobility, continence, and nutrition, demented patients suffered more frequently from life-threatening infections, sepsis, iatrogenic disease, and prolonged hospital stays. Hospital losses were 75% higher for demented patients than for nondemented patients.Dementia affected the majority of acute care patients in this study. However, it was rarely coded as an admitting diagnosis, even though it may have been the proximate cause of the medical morbidity which led to the acute hospitalization. In addition, despite the significant impact of dementia on the hospital course and costs, it was a factor in hospital reimbursement in less than one third of cases. The results indicate that dementia was not considered to be an acute diagnosis, nor was it recognized as a complex medical illness. The impact of dementia on acute hospitalization, including the mechanisms by which dementia prolongs the hospital stay, requires further investigation.

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Sianturi, Aditya Gloria Monalisa. "Stadium, Diagnosis, dan Tatalaksana Penyakit Alzheimer." Majalah Kesehatan Indonesia 2, no. 2 (October 25, 2021): 39–44. http://dx.doi.org/10.47679/makein.202132.

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Dementia is a general term for loss of memory that can occur along with behavioral or psychological symptoms in patients. The first cause of dementia patients is Alzheimer's disease. Alzheimer’s disease is a brain degenerative disease and the most common cause of dementia. In Alzheimer’s disease, there are three development stages, which is stage 1, stage 2, and stage 3 with different clinical symptoms at each stage. There are several clinical criteria for establishing a definitive diagnosis of Alzheimer’s disease and also support examinations have to be carried out. Until now, Alzheimer’s treatment has not been cured. Giving some pharmacotherapy only to reduce the progression of Alzheimer’s disease. Demensia merupakan hilangnya ingatan yang bisa timbul bersama dengan gejala gangguan perilaku maupun psikologis pada seseorang. Penyebab pertama penderita demensia adalah penyakit Alzheimer. Penyakit Alzheimer adalah penyakit degeneratif otak dan penyebab paling umum dari demensia. Pada penyakit Alzheimer terdapat beberapa stadium perkembangan penyakit Alzheimer yaitu stadium 1, stadium 2, dan stadium 3 dengan gejala klinik yang berbeda di setiap stadium. Terdapat beberapa kriteria klinis dalam penegakan diagnosis definitif penyakit Alzheimer serta harus dilakukan pemeriksaan penunjang. Pada tatalaksana penyakit Alzheimer hingga saat ini memang belum dapat disembuhkan, Pemberian obat-obatan hanya untuk mengurangi progresifitas penyakit Alzheimer.

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Swanson, Keith A., and Ryan M. Carnahan. "Dementia and Comorbidities: An Overview of Diagnosis and Management." Journal of Pharmacy Practice 20, no. 4 (August 2007): 296–317. http://dx.doi.org/10.1177/0897190007308594.

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The term “dementia” describes various neurodegenerative disorders that effect cognition, including Alzheimer disease, vascular dementia, and others. This article reviews the diagnosis and management of common types of dementia and comorbidities. Dementias are differentiated clinically by history, symptom presentation, and exclusion of other causes through laboratory and imaging studies. Cholinesterase inhibitors are useful but may not be effective for all types of dementia and provide only modest benefits. Certain medical comorbidities may increase the risk of dementia, although genetics are also important in its etiology. Psychiatric comorbidities in dementia include delirium, which is treated primarily by addressing underlying medical disorders, but antipsychotics can be useful for symptom management and patient comfort. Nonpharmacologic interventions are first-line treatments for other psychiatric comorbidities, although drug therapy may be useful in some cases. The management of patients with dementia presents many challenges and will continue to do so unless agents with pronounced disease-modifying capabilities are developed.

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Calvó-Perxas, Laia, María Aguirregomozcorta, Isabel Casas, Margarita Flaqué, Marta Hernàndez, Marta Linares, Yolanda Silva, Marta Viñas, Secundino López-Pousa, and Josep Garre-Olmo. "Rate of dementia diagnoses according to the degree of aging of the population." International Psychogeriatrics 27, no. 3 (October 2, 2014): 419–27. http://dx.doi.org/10.1017/s1041610214002130.

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ABSTRACTBackground:There is a lack of information regarding geographical differences in the incidence and prevalence of dementia diagnosis according to the degree of aging of the population. The objectives of this study were to analyze the rate of dementia diagnoses, and to compare the dementia subtypes and the clinical characteristics of the patients depending on the degree of aging of their municipalities.Methods:We used data from the Registry of Dementias of Girona (ReDeGi), containing the cases of dementia diagnosed in the memory clinics of the Health Region of Girona, in Catalonia (Spain), during 2007–2012. The municipalities were classified by a cluster analysis as aged or young municipalities according to their proportion of older people using population ageing indicators. The incidence rates of dementia diagnosis in each type of municipality were compared.Results:The ReDeGi registered 4,314 cases in the municipalities under surveillance. The clinical incidence of dementia was lower in aged municipalities (4.5 vs. 6.1 cases per 1,000 person-years aged 65 and over). Patients from young municipalities had an increased frequency of behavioral and psychological symptoms of dementia.Conclusions:The environment may influence the clinical manifestations of dementia that predispose people to visit health specialists and obtain a diagnosis.

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Davis, Laura, and Tom Dening. "Diagnostic, management and nursing challenges of less common dementias: Parkinsonian dementias and Huntington's disease." British Journal of Neuroscience Nursing 17, no. 2 (April 2, 2021): 68–76. http://dx.doi.org/10.12968/bjnn.2021.17.2.68.

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Background: Although most cases of dementia are caused by Alzheimer's disease or vascular dementia, around 10-15% of cases are due to other disorders, including dementias with Parkinsonian features, Huntington's disease, frontotemporal dementia, human immunodeficiency virus (HIV), and alcohol. Aims: These less common dementias are important as they may have differing clinical features and require different approaches to diagnosis and management. This paper seeks to provide relevant information for nurses about symptoms, diagnosis and management of some of the less common dementias. Methods: This is one of two connected papers, and provides a clinical overview of Parkinsonian dementias and Huntington's disease. It provides a narrative, rather than systematic, review of the literature. Findings: Parkinsonian dementias comprise Parkinson's disease dementia, dementia with Lewy bodies and so-called Parkinson's-plus syndromes (multi-system atrophy, progressive supranuclear palsy, and corticobasal degeneration). Huntington's disease is an inherited neuropsychiatric condition. Each has a distinctive clinical picture, with combinations of cognitive, neuropsychiatric and neurological symptoms but approaches to treatment and care are essentially supportive. Conclusions: Nurses have an essential role in supporting people with dementia, as well their families and carers, throughout the course of dementia from diagnosis to end of life care. They are often best placed and have the necessary skills to create appropriate care plans and to provide care management.

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Livingston, Gill, Karen Sax, Jo Willison, Bob Blizard, and Anthony Mann. "The Gospel Oak Study stage II: the diagnosis of dementia in the community." Psychological Medicine 20, no. 4 (November 1990): 881–91. http://dx.doi.org/10.1017/s0033291700036588.

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SynopsisAn attempt was made to assess in detail subjects screened as suffering from dementia among a North London community sample of elderly people. Forty-eight (80 %) subjects were interviewed, 7 (12%) were found to have died and 5 (8%) either refused interview or were lost to follow-up. By clinicians' diagnosis of the 48 interviewed, 22 subjects (46%) had probable Alzheimer's disease, one had multi-infarct dementia, five had mixed dementia, five had secondary dementia, 10 had a dementia which could not be further classified and 5 were not demented. No subject had a reversible condition. The prevalence rate for clinical dementia was 6·1 %, and for Alzheimer's disease 3·1 %. According to AGECAT diagnosis the prevalence of organicity was 5·7%. The AGECAT diagnoses and psychiatrists' diagnoses were significantly associated (P < 0·003) and AGECAT was more likely to identify as organic those subjects with dementia diagnosed by psychiatrists as Alzheimer's disease, than those not so diagnosed (P < 0·04). A short psychometric battery, including the MMSE in two versions, was administered and its acceptability to a community sample evaluated. This detailed clinical investigation showed that the Dementia Diagnostic Scale of the Short-CARE was a specific predictor of clinical dementia or death at the time of follow-up, whereas the more inclusive Organic Brain Syndrome scale was a more satisfactory first phase screening instrument.

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Benke, Thomas, and Elfriede Karner. "The Neuropsychological Assessment of Dementia." CNS Spectrums 7, no. 5 (May 2002): 371–75. http://dx.doi.org/10.1017/s109285290001782x.

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ABSTRACTIt has become standard practice to base the diagnosis of dementia on the combination of neuropsychological and non-behavioral findings. The present article provides a short, clinically oriented synopsis of the targets, investigational procedures, and difficulties of the modern neuropsychological approach to the diagnosis of dementia. Over the years, neuropsychology has developed assessment tools to evaluate the cognitive and behavioral abnormalities of many dementias. Validated tests of memory, language, executive, and other cognitive functions are used to screen for dementia and identifying certain dementia profiles. Behavioral assessment procedures are available for non-cognitive neurodegenerative alterations. At present, problems arise mainly with the behavioral heterogeneity of certain dementia syndromes. Especially problamatic are discrimination of age-associated or mild cognitive impairments from incipient dementia and the impact of psychiatric symptoms on cognitive functions. It is concluded that neuropsychology offers a valuable contribution to the diagnosis and differential diagnosis of dementia.

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Sandilyan, Malarvizhi Babu, and Tom Dening. "Diagnosis of dementia." Nursing Standard 29, no. 43 (June 24, 2015): 36–41. http://dx.doi.org/10.7748/ns.29.43.36.e9441.

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Grossberg, George T. "DIAGNOSIS OF DEMENTIA." American Journal of Geriatric Psychiatry 7 (September 1999): 15. http://dx.doi.org/10.1097/00019442-199911001-00048.

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Nicholl, C. "Diagnosis of dementia." BMJ 338, jun08 3 (June 9, 2009): b1176. http://dx.doi.org/10.1136/bmj.b1176.

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DiSantostefano, Jan. "Dementia Diagnosis Coding." Journal for Nurse Practitioners 14, no. 3 (March 2018): 148–52. http://dx.doi.org/10.1016/j.nurpra.2017.09.019.

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Byszewski, Anna M., Frank J. Molnar, Faranak Aminzadeh, Marg Eisner, Fauzia Gardezi, and Raewyn Bassett. "Dementia Diagnosis Disclosure." Alzheimer Disease & Associated Disorders 21, no. 2 (April 2007): 107–14. http://dx.doi.org/10.1097/wad.0b013e318065c481.

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Meiran, Nachshon. "Diagnosis of Dementia." Archives of Neurology 53, no. 10 (October 1, 1996): 1043. http://dx.doi.org/10.1001/archneur.1996.00550100129022.

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Brigadeiro, D., J. Nunes, T. Ventura Gil, and P. Costa. "Perfusion SPECT in the Differential Diagnosis of Dementia." European Psychiatry 41, S1 (April 2017): S627. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1017.

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Dementia is a syndrome–usually of a chronic or progressive nature–in which there is deterioration in cognitive function beyond what might be expected from normal ageing (WHO). As the world population ages, the number of people afflicted with dementing illnesses will increase. This neurodegenerative disease is one of the major causes of disability and dependency among older people worldwide. Brain single-photon emission computed tomography (SPECT) allows the study of regional cerebral blood flow, providing functional information. Each of the different types of dementia has a distinct blood flow pattern that is revealed with SPECT imaging and which can be used for differential diagnoses. This imaging technique can also be used to differentiate dementia from pseudodementia. The use of SPECT has been recommended in various guidelines to help in differential diagnosis of dementia. The National Institute for Health and Clinical Excellence in the UK recommend the use of SPECT or positron emission tomography (PET) to help differentiate Alzheimer's disease (AD) from frontotemporal dementia and vascular dementia when there is diagnostic doubt (NICE, 2006). The European Federation of the Neurological Societies guidelines for diagnosis also supports the use of FDG-PET (18F fluorodeoxyglucose positron emission tomography) or perfusion SPECT when clarifying a diagnosis of AD. This review describes the utility of perfusion SPECT in differential diagnosis of neurodegenerative dementias.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Henderson, Theodore A. "The diagnosis and evaluation of dementia and mild cognitive impairment with emphasis on SPECT perfusion neuroimaging." CNS Spectrums 17, no. 4 (August 29, 2012): 176–206. http://dx.doi.org/10.1017/s1092852912000636.

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As the world population ages, the incidence of dementing illnesses will dramatically increase. The number of people afflicted with dementia is expected to quadruple in the next 50 years. Since the neuropathology of the dementias precedes clinical symptoms often by several years, earlier detection and intervention could be key steps to mitigating the progression and burden of these diseases. This review will explore methods of evaluating, differentiating, and diagnosing the multiple forms of dementia. Particular emphasis will be placed on the diagnosis of mild cognitive impairment—the precursor to dementia. Anatomical imaging; cerebrospinal fluid markers; functional neuroimaging, such as positron emission tomography and single photon emission tomography; and molecular imaging, such as amyloid marker imaging, will be assessed in terms of sensitivity and specificity. Cost will also be a consideration, as the growing population afflicted with dementia represents an increasingly large financial encumbrance to the healthcare systems of every nation. In the face of expensive new markers and limited availability of cyclotrons, single photon emission computer tomography (SPECT) provides relatively high sensitivity and specificity at a comparatively low overall cost.

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Morgan, Debra, Melanie Funk, Margaret Crossley, Jenny Basran, Andrew Kirk, and Vanina Dal Bello-Haas. "The Potential of Gait Analysis to Contribute to Differential Diagnosis of Early Stage Dementia: Current Research and Future Directions." Canadian Journal on Aging / La Revue canadienne du vieillissement 26, no. 1 (2007): 19–32. http://dx.doi.org/10.3138/1457-2411-v402-62l1.

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ABSTRACTEarly differential diagnosis of dementia is becoming increasingly important as new pharmacologic therapies are developed, as these treatments are not equally effective for all types of dementia. Early detection and differential diagnosis also facilitates informed family decision making and timely access to appropriate services. Information about gait characteristics is informative in the diagnostic process and may have important implications for discriminating among dementia subtypes. The aim of this review paper is to summarize existing research examining the relationships between gait and dementia, including gait classification systems and assessment tools, gait patterns characteristic of different dementias (Alzheimer's disease, vascular dementia, dementia with Lewy Bodies, and fronto-temporal dementia), and the utility of gait analysis in early-stage diagnosis. The paper concludes with implications for future research.

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Feldman, H., and A. Kertesz. "Diagnosis, Classification and Natural History of Degenerative Dementias." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 28, S1 (May 2001): S17—S27. http://dx.doi.org/10.1017/s0317167100001177.

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The release of the first approved medications for the treatment of Alzheimer’s disease in Canada has highlighted the renewed need and importance of diagnostic accuracy and understanding of the spectrum of the dementias. The epidemiological scope of the problem of dementia in Canada including risk factors, caregiving patterns and costs of care have been well-characterized through the Canadian Study of Health and Aging (CSHA 1991-1996) with some of the key findings reviewed here. Beyond Alzheimer’s disease the phenotypes and genotypes of the other degenerative dementias have been emerging with proposed operational diagnostic criteria that should facilitate their recognition in clinical practice. This paper reviews the clinical phenotypes of the most common causes of dementia with a proposed classification scheme and with discussion of their relevance from a differential treatment standpoint. This paper served as a background document for the working group of the Consensus Conference on Dementia (C3D) in February 1998 and has been revised subsequently for this publication.

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Davis, Laura, Zarina Karim, and Tom Dening. "Diagnostic, management and nursing challenges of less common dementias: Frontotemporal dementia, alcohol-related dementia, HIV dementia and prion diseases." British Journal of Neuroscience Nursing 18, no. 1 (February 2, 2022): 26–37. http://dx.doi.org/10.12968/bjnn.2022.18.1.26.

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Background: Most cases of dementia are due to Alzheimer's disease or vascular dementia, but attention on these disorders means that other important causes of dementia may be relatively neglected. About 10–15% of people with dementia have other diagnoses, and there are numerous causes of the less common types of dementia. Aims: This paper provides information about the causes, symptoms, diagnosis and nursing management of some of the different types of less common dementias, with the aim of helping nurses to provide better care to patients and families affected. Methods: This is one of two connected papers and provides a narrative review of the literature on the clinical presentation of frontotemporal dementia, HIV dementia, prion dementias and alcohol-related dementia. Findings: Frontotemporal dementia has important clinical subtypes with distinct different presentations; for example, predominantly behavioural symptoms or progressive language dysfunction. Alcohol-related dementia is one of several types of alcohol-related brain damage. This is important as, with abstinence, its progression may be halted or even to some extent improved. HIV dementia has become less common since the introduction of effective antiretroviral therapy, but, nonetheless, the less severe picture of HIV-associated cognitive dysfunction remains prevalent despite treatment. Prion dementias encompass sporadic, familial and acquired Creutzfeldt-Jakob disease and are incurable, therefore requiring extensive palliative care. Conclusions: These forms of dementia all have different symptoms and courses from common types of dementia, such as Alzheimer's disease. It is important for nurses to be aware that dementia may have several causes and that people with different dementias will have different needs. Nonetheless, the general skills of nurses in supporting patients and families remain essential in order to develop appropriate care plans and to provide individualised, person-centred care.

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Chiong, Winston, Amy Y. Tsou, Zachary Simmons, Richard J. Bonnie, and James A. Russell. "Ethical Considerations in Dementia Diagnosis and Care." Neurology 97, no. 2 (July 12, 2021): 80–89. http://dx.doi.org/10.1212/wnl.0000000000012079.

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Alzheimer disease and other dementias present unique practical challenges for patients, their families, clinicians, and health systems. These challenges reflect not only the growing public health effect of dementia in an aging global population, but also more specific ethical complexities including early loss of patients' capacity to make decisions regarding their own care, the stigma often associated with a dementia diagnosis, the difficulty of balancing concern for patients' welfare with respect for patients' remaining independence, and the effect on the physical, emotional, and financial well-being of family caregivers. Caring for patients with dementia requires respecting patient autonomy while acknowledging progressively diminishing decisional capacity and continuing to provide care in accordance with other core ethical principles (beneficence, justice, and nonmaleficence). Whereas these ethical principles remain unchanged, neurologists must reconsider how to apply them given changes across multiple domains including our understanding of disease, clinical and legal tools for addressing manifestations of illness, our expanding awareness of the crucial role of family caregivers in providing care and maintaining patient quality of life, and societal conceptions of dementia and individuals' personal expectations for aging. This revision to the American Academy of Neurology's 1996 position statement summarizes ethical considerations that often arise in caring for patients with dementia; although it addresses how such considerations influence patient management, it is not a clinical practice guideline.

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Li, Xia, Qi Qiu, Yinghua Yang, Ling Sun, MinJun Jiang, chunling Gu, Ming Cui, and Xiang Lin. "BUILDING A CONTINUOUS DEMENTIA MANAGEMENT MODEL IN COMMUNITIES OF SHANGHAI." Innovation in Aging 3, Supplement_1 (November 2019): S444. http://dx.doi.org/10.1093/geroni/igz038.1665.

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Abstract Over 10 million people with Alzheimer’s disease or related dementias (ADRD) live in China. In Shanghai, the prevalence of ADRD is about 3-4% among aged 60 or older, and approximately 70-85% have never been diagnosed. This study reported the pilot testing results of a dementia management model launched by Shanghai Mental Health Center to build dementia friendly communities. The dementia management model links screening, diagnosis, care planning, treatment, and services, to improve dementia literacy and standard diagnosis rate. About 3,786 senior residents were screened using the AD 8 and MoCA scales. The cognitively intact group was suggested for annual check-up, while at -risk groups were referred to formal diagnosis and intervention. About 125 older adults with a mild cognitive impairment diagnosis were provided referrals for cognitive training, and 109 diagnosed with dementia were provided medical and social interventions. This management model adds to dementia awareness and education.

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Ludin. "Diagnosis and differential diagnosis of dementia." Therapeutische Umschau 56, no. 2 (February 1, 1999): 74–78. http://dx.doi.org/10.1024/0040-5930.56.2.74.

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Die Kriterien und Probleme bei der Diagnostik dementieller Syndrome werden geschildert. Aus neurologischer Sicht werden die wichtigsten Differentialdiagnosen dargestellt, wobei besonderes Gewicht auf potentiell behandelbare Krankheiten und Syndrome gelegt wird.

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La Rue, Asenath, and Lissy F. Jarvik. "Cognitive Function and Prediction of Dementia in Old Age." International Journal of Aging and Human Development 25, no. 2 (September 1987): 79–89. http://dx.doi.org/10.2190/dv3r-pbjq-e0ft-7w2b.

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Longitudinal changes in cognitive functioning were examined for a sample of aging twins, some of whom developed dementia while others did not. Individuals who were judged to be demented at a mean age of eighty-five years had achieved lower scores on most tests twenty years prior to diagnosis, and experienced greater declines in vocabulary and forward digit span over time, than those surviving to a comparable age without dementia. These trends were observed for individuals with mild, as well as moderate-to-severe, dementia and were unrelated to physical health status or premorbid activity patterns. It is suggested that dementing illness may develop very slowly, and that the likelihood of exhibiting clinically significant dementia may vary with premorbid intellectual level.

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Amjad, Halima, Marcela Blinka, Jennifer Aufill, and Quincy Samus. "Dementia Diagnosis and Challenges in Minority Populations." Innovation in Aging 4, Supplement_1 (December 1, 2020): 161–62. http://dx.doi.org/10.1093/geroni/igaa057.525.

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Abstract Alzheimer’s disease and related dementias are underdiagnosed in the United States, with potentially higher rates of underdiagnosis among minority groups. Our objective was to examine perceptions of dementia, the utility and timeliness of diagnosis, and experiences obtaining diagnosis and care in minorities. We recruited 17 family caregivers of African American (n=11), Latino (n=3), and Asian (n=3) persons with dementia (PWD) to complete surveys and semi-structured interviews. Caregivers were mostly female (n=14), children of PWD (n=14), and had greater than high school education (n=16). Mean PWD age at diagnosis was 76 years (range 63-90) with mean 17 months from symptom observation to diagnosis (range 0.5-36 months). Interview themes were coded using a grounded theory approach. Emerging themes related to concerns prior to diagnosis, diagnosis experiences, timeliness of diagnosis, ways to improve diagnosis and care, familiarity with dementia, and stigma. Poor memory was the most common early concern; caregivers also noted behavioral symptoms, weight loss, family stress, and PWD vulnerability. Caregivers recalled key moments when they knew something was wrong. Primary care was the most frequent starting point in diagnosis; longstanding primary care relationships both facilitated and hindered diagnosis. Nine of the 17 caregivers felt diagnosis was delayed. Caregivers preferred clinicians who were forthcoming with the diagnosis and what to expect and noted the importance of family meetings or counseling. Prior experience or knowledge of dementia was common. Caregiver perspectives and experiences elicited in this study may be translated to interventions and clinical practices that proactively detect and address dementia in minorities.

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Quinn, Terence J., and Jenny McCleery. "Diagnosis in vascular dementia, applying ‘Cochrane diagnosis rules’ to ‘dementia diagnostic tools’." Clinical Science 131, no. 8 (April 6, 2017): 729–32. http://dx.doi.org/10.1042/cs20170025.

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In this issue of Clinical Science, Biesbroek and colleagues describe recent work on magnetic resonance imaging (MRI)-based cerebral lesion location and its association with cognitive decline. The authors conclude that diagnostic neuroimaging in dementia should shift from whole-brain evaluation to focused quantitative analysis of strategic brain areas. This commentary uses the review of lesion location mapping to discuss broader issues around studies of dementia test strategies. We draw upon work completed by the Cochrane Dementia and Cognitive Improvement Group designed to improve design, conduct and reporting of dementia biomarker studies.

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Gottfries, C. G. "Classifying Organic Mental Disorders and Dementia—A Review of Historical Perspectives." International Psychogeriatrics 3, S1 (March 1991): 9–17. http://dx.doi.org/10.1017/s1041610205001092.

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The concept of dementia should not be used synonymously with the concept of organic mental disorders. By definition, according to DSM-III and ICD-10, dementia is a syndrome which includes memory impairment. The severity of the disorder is disabling and the course is chronic. Differential diagnosis includes age-associated memory impairment (AAMI), delirium, and depressive disorders. The dementias may be subdivided into four groups: idiopathic (primary degenerative dementias), vascular, secondary, and others. The idiopathic dementias are those in which etiology is assumed to be found within the brain itself. The main subgroup is Alzheimer-type dementia. The vascular dementias are those in which the blood supply to the brain is insufficient. Multi-infarct dementia (MID) is the prototype. In secondary dementias, somatic disorders either within or external to the brain cause the dementia.

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BRAATEN, ALYSSA J., THOMAS D. PARSONS, ROBERT McCUE, ALFRED SELLERS, and WILLIAM J. BURNS. "NEUROCOGNITIVE DIFFERENTIAL DIAGNOSIS OF DEMENTING DISEASES: ALZHEIMER'S DEMENTIA, VASCULAR DEMENTIA, FRONTOTEMPORAL DEMENTIA, AND MAJOR DEPRESSIVE DISORDER." International Journal of Neuroscience 116, no. 11 (January 2006): 1271–93. http://dx.doi.org/10.1080/00207450600920928.

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Enache, D., S. M. Fereshtehnejad, P. Cermakova, S. Garcia-Ptacek, I. Kåreholt, K. Johnell, D. Religa, et al. "Antidepressants and mortality risk in a dementia cohort – data from SveDem, the Swedish Dementia Registry." European Psychiatry 33, S1 (March 2016): S85. http://dx.doi.org/10.1016/j.eurpsy.2016.01.039.

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BackgroundThe association between mortality risk and use of antidepressants in people with dementia is unknown.ObjectiveTo describe the use of antidepressants in people with different dementia diagnoses and to explore mortality risk associated with use of antidepressants 3 years before a dementia diagnosis.MethodsStudy population included 20,050 memory clinic patients from Swedish Dementia Registry diagnosed with incident dementia. Data on antidepressants dispensed at the time of dementia diagnosis and during three-year period before dementia diagnosis was obtained from the Swedish Prescribed Drug Register. Cox regression models were used.ResultsDuring a median follow-up of 2 years from dementia diagnosis, 25.8% of dementia patients died. A quarter (25.0%) of patients were on antidepressants at the time of dementia diagnosis while 21.6% used antidepressants at some point during a three-year period before a dementia diagnosis. Use of antidepressant treatment for 3 consecutive years before a dementia diagnosis was associated with a lower mortality risk for all dementia disorders (HR: 0.82, 95% CI: 0.72–0.94) and in Alzheimer's disease (HR: 0.61, 95% CI: 0.45–0.83). There were no significant associations between use of antidepressant treatment and mortality risk in other dementia diagnoses.ConclusionAntidepressant treatment is common among patients with dementia. Use of antidepressants during prodromal stages may reduce mortality in dementia and specifically in Alzheimer's disease.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Choi, Seong Hye. "Clinical Diagnosis of Dementia." Journal of Korean Diabetes 13, no. 3 (2012): 133. http://dx.doi.org/10.4093/jkd.2012.13.3.133.

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Fleming, Kevin C., Andrea C. Adams, and Ronald C. Petersen. "Dementia: Diagnosis and Evaluation." Mayo Clinic Proceedings 70, no. 11 (November 1995): 1093–107. http://dx.doi.org/10.4065/70.11.1093.

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Hamdy, Ronald C. "The Diagnosis of Dementia." Southern Medical Journal 100, no. 12 (December 2007): 1184–85. http://dx.doi.org/10.1097/smj.0b013e318157f4cf.

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Sikdar, S. "Diagnosis of vascular dementia." British Journal of Psychiatry 180, no. 5 (May 2002): 466. http://dx.doi.org/10.1192/bjp.180.5.466.

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Hinton, Ladson, Carol Franz, and Jeffrey Friend. "Pathways to Dementia Diagnosis." Alzheimer Disease & Associated Disorders 18, no. 3 (July 2004): 134–44. http://dx.doi.org/10.1097/01.wad.0000127444.23312.ff.

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Briggs, R., C. McHale, D. Fitzhenry, D. O’Neill, and S. P. Kennelly. "Dementia, disclosing the diagnosis." QJM: An International Journal of Medicine 111, no. 4 (September 19, 2017): 215–16. http://dx.doi.org/10.1093/qjmed/hcx181.

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Folstein, Marshal F. "DIFFERENTIAL DIAGNOSIS OF DEMENTIA." Psychiatric Clinics of North America 20, no. 1 (March 1997): 45–57. http://dx.doi.org/10.1016/s0193-953x(05)70392-0.

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Mulley, G. P. "Differential diagnosis of dementia." BMJ 292, no. 6533 (May 31, 1986): 1416–18. http://dx.doi.org/10.1136/bmj.292.6533.1416.

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Clark, A. "Differential diagnosis of dementia." BMJ 293, no. 6538 (July 5, 1986): 47. http://dx.doi.org/10.1136/bmj.293.6538.47.

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Rai, G. S., and G. Wright. "Differential diagnosis of dementia." BMJ 293, no. 6538 (July 5, 1986): 47. http://dx.doi.org/10.1136/bmj.293.6538.47-a.

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Parker, N. E. "Differential diagnosis of dementia." BMJ 293, no. 6538 (July 5, 1986): 47–48. http://dx.doi.org/10.1136/bmj.293.6538.47-b.

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Chary, T. K. N., M. W. P. Carney, I. Chanarin, M. Laundy, E. H. Reynolds, and B. Toone. "Differential diagnosis of dementia." BMJ 293, no. 6538 (July 5, 1986): 48. http://dx.doi.org/10.1136/bmj.293.6538.48-a.

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Sharp, P. F., H. G. Gemmell, F. W. Smith, J. Besson, and K. Tan. "Differential diagnosis of dementia." BMJ 293, no. 6538 (July 5, 1986): 48–49. http://dx.doi.org/10.1136/bmj.293.6538.48-b.

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Journal articles on the topic 'Dementia – Diagnosis'

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