scholarly journals Dementia screening: an audit of screening for reversible causes of dementia

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S81-S81
Author(s):  
Kim Herbert ◽  
Elspeth Richardson ◽  
Adam Daly ◽  
Christine Carswell
Keyword(s):  
Blood Glucose ◽  
National Standard ◽  
Screening Tests ◽  
Full Blood Count ◽  
Blood Tests ◽  
Dementia Screening ◽  
Memory Problems ◽  
Care Assessment ◽  
Full Complement ◽  
With Memory

AimsThis audit aimed to assess to what extent patients being referred for assessment of memory problems were receiving appropriate screening for reversible causes. We considered the blood tests recommended by the National Institute for Clinical Excellence (NICE).BackgroundResearch into ‘reversible dementias’ identified numerous common underlying causes. As a result of this NICE complied comprehensive guidance on investigations which should be performed in the initial stages of assessing patients with memory problems, ideally at a primary care level. These investigations are also crucial at the point of secondary care assessment in order to make a confident diagnosis.MethodDetails of patients referred by their GP to the Older Adult CMHT with memory problems over a one month period were collected. We then used the local laboratory database to note whether each of the eight recommended blood tests had been performed in the preceding 6 months. We measured this against an agreed standard of 95%.After the first cycle of data collection we prepared business-card sized ‘aide memoirs’ for GPs that could serve as a quick reminder. These were sent out to all GPs in the area along with a letter outlining the audit findings.ResultOverall 31 patients were included in the first cycle. 15 patients had all 8 dementia blood screens (48%), 13 (42%) had some of the recommended tests and 3 patients had no screening tests at all (10%). On average patients had 76.6% of the recommended bloods completed. The most commonly completed tests were Full Blood Count (FBC) and Urea & Electrolytes (U&Es), with blood Glucose being the most frequently omitted.In cycle 2, 20 patients were included. Of these patients, 10 had the full complement of screening bloods (50%); 8 had some tests completed (40%) and 2 patients had no screening tests complete (10%). On average 76% of tests were completed. There was an improvement in the rate of completion of both Glucose and Liver Function Tests from cycle1.ConclusionThis audit demonstrated that current practice does not meet the national standard in general. Our intervention produced a modest improvement in the proportion of patients who received a full complement of dementia screening tests, as well as increasing the rate of patients receiving a blood glucose as part of their screening. It would likely be beneficial to consider further intervention and a 3rd audit cycle in due course.

scholarly journals It Has Not Been a Good Day: Managing Difficult Behaviors of Relatives With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 639-639
Author(s):  
Karen Roberto ◽  
Brandy Renee McCann ◽  
Tina Savla ◽  
Emily Hoyt ◽  
Rosemary Blieszner ◽  
...  
Keyword(s):  
Behavior Management ◽  
Service Providers ◽  
Management Strategies ◽  
Educational Interventions ◽  
Community Dwelling ◽  
Behavior Understanding ◽  
Supportive Environment ◽  
Memory Problems ◽  
Appropriate Care ◽  
With Memory

Abstract Most family caregivers provide appropriate care and a supportive environment for their older relatives with dementia (PwD), yet the stress and strain associated with caregiving can trigger potentially harmful responses. Although much has been written about dealing with memory problems, researchers know less about how caregivers cope with difficult behaviors such as hallucinations, violent outbursts, or refusing food, medicine, or bathing. Interviews with 30 relatives providing care to community-dwelling PwD in rural Virginia revealed that caregivers typically used four behavior management strategies: reasoning with PwD; redirecting PwD’s attention; forceful actions, such as shouting at PwD; and withdrawing from interactions. Forceful management strategies and withdrawing from interactions were usually employed after reasoning and redirection failed to elicit desired behavior. Understanding whether caregivers’ expectations of PwD’s capacities are realistic, and why and when caregivers use various behavior management strategies, can help service providers develop appropriate educational interventions for frustrated caregivers.

SCREENING FOR DEMENTIA: IS 1 SIMPLE QUESTION THE ANSWER?

2015 ◽  
Vol 86 (11) ◽  
pp. e4.152-e4
Author(s):  
Baba Aji ◽  
Andrew Larner
Keyword(s):  
Memory Impairment ◽  
Seizure Type ◽  
Subjective Memory ◽  
Subjective Memory Impairment ◽  
The Past ◽  
Dementia Screening ◽  
Memory Problems ◽  
Simple Question ◽  
Screening Question

ObjectiveTo examine the diagnostic utility of the dementia screening question from the DoH Dementia CQUIN document (2012) in consecutive patients in a dedicated epilepsy clinic, individuals in whom memory complaints are common.Results100 consecutive outpatients (M:F=61:39, median age 44.5 years) were asked ‘Have you been more forgetful in the past 12 months to the extent that it has significantly affected your life?’, as advocated in the Dementia CQUIN document. There was a 48% yes response. No patient was adjudged to have dementia. Comparing the yes/no groups, there was no difference in sex ratio, age, seizure type, or use of antiepileptic drugs (monotherapy versus polytherapy). Those answering yes were more likely to be follow-up than new patients. Intergroup difference in epilepsy duration showed a trend to longer duration in the yes group. The most common examples of memory problems volunteered were forgetting to attend appointments, take medications, or switch off appliances, suggestive of attentional rather than mnestic problems.ConclusionsThese data suggest that the Dementia CQUIN screening question has very low specificity, and hence will identify many false positives, with risk of overdiagnosis of dementia in individuals with purely subjective memory impairment.

scholarly journals Sensitivity and specificity of the Bamberg Dementia Screening Test’s (BDST) full and short versions: brief screening instruments for geriatric patients that are suitable for infectious environments

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Wolfgang Trapp ◽  
Susanne Röder ◽  
Andreas Heid ◽  
Pia Billman ◽  
Susanne Daiber ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Short Form ◽  
Neuropsychological Testing ◽  
Screening Tests ◽  
Fine Motor ◽  
Consecutive Series ◽  
Diagnostic Quality ◽  
Dementia Screening ◽  
Increased Risk ◽  
Diagnosis Of Dementia

Abstract Background Currently, many patients suffering from dementia do not have a diagnosis when admitted to geriatric hospitals. This is the case despite an increased risk of complications affecting the length of stay and outcome. Unfortunately, many dementia screening tests cannot be used on geriatric inpatients, who are often bedridden. Therefore, we aimed at evaluating the diagnostic accuracy of a small battery of bedside tasks that require minimal vision and fine motor skills in patients with suspected dementia. Methods In this prospective study, the Bamberg Dementia Screening Test (BDST) was administered to a consecutive series of 1295 patients referred for neuropsychological testing. The diagnosis of dementia was confirmed in 1159 and excluded in 136 patients. Sensitivity and specificity for the first subtest (ultra-short form), the first two subtests (short form), and the total score of the BDST were obtained via receiver operating characteristic curves and compared with the sensitivity and specificity values of the Mini-Mental Status Examination (MMSE). Results The overall diagnostic quality of the BDST was superior to the MMSE for mild Alzheimer’s dementia (sensitivity and specificity = .94 (95% CI .92 to .96) and .82 (95% CI .75 to .88) vs. .79 (95% CI .76 to .83) and .88 (95% CI .82 to .93)) as well as for other subtypes of mild dementia (sensitivity and specificity = .91 (95% CI .88 to .94) and .82 (95% CI .75 to .88) vs. .72 (95% CI .67 to .76) and .88 (95% CI .82 to .93)). Even the short form of the BDST was comparable to the MMSE regarding sensitivity and specificity. For moderate dementia, it was possible to identify dementia cases with sufficient and excellent diagnostic quality by using the ultra-short and the short form. Conclusions The BDST is able to detect dementia in geriatric hospital settings. If the adaptive algorithm is used, administration time can be reduced to less than 2 min in most cases. Because no test materials have to be exchanged, this test is particularly suitable for infectious environments where contact between the examiner and the person being tested should be minimized.

Accuracy and precision assessment of a new blood glucose monitoring system

2016 ◽  
Vol 54 (1) ◽  
Author(s):  
Li-Nong Ji ◽  
Li-Xin Guo ◽  
Li-Bin Liu
Keyword(s):  
Blood Glucose ◽  
Glucose Concentration ◽  
Blood Glucose Concentration ◽  
Venous Blood ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Blood Samples ◽  
Glucose Testing ◽  
Blood Tests ◽  
Accuracy And Precision

AbstractBlood glucose self-monitoring by individuals with diabetes is essential in controlling blood glucose levels. The International Organization for Standardization (ISO) introduced new standards for blood glucose monitoring systems (BGMS) in 2013 (ISO 15197: 2013). The CONTOUR PLUSThis study evaluated the accuracy and precision of CONTOUR PLUS BGMS in quantitative glucose testing of capillary and venous whole blood samples obtained from 363 patients at three different hospitals.Results of fingertip and venous blood glucose measurements by the CONTOUR PLUS system were compared with laboratory reference values to determine accuracy. Accuracy was 98.1% (96.06%–99.22%) for fingertip blood tests and 98.1% (96.02%–99.21%) for venous blood tests. Precision was evaluated across a wide range of blood glucose values (5.1–17.2 mmol/L), testing three blood samples repeatedly 15 times with the CONTOUR PLUS blood glucose meter using test strips from three lots. All within-lot results met ISO criteria (i.e., SD<0.42 mmol/L for blood glucose concentration <5.55 mmol/L; CV<7.5% for blood glucose concentration ≥5.55 mmol/L). Between-lot variations were 1.5% for low blood glucose concentration, 2.4% for normal and 3.4% for high.Accuracy of both fingertip and venous blood glucose measurements by the CONTOUR PLUS system was >95%, confirming that the system meets ISO 15197: 2013 requirements.

scholarly journals Prevalence of Metabolic Syndrome in Adults in Yazd 2014-2015: Results of Yazd Health Study (Yahs)

2020 ◽  
Author(s):  
Vida Mozaffari-Khosravi ◽  
Masoud Mirzaei ◽  
Hassan Mozaffari-Khosravi
Keyword(s):  
Metabolic Syndrome ◽  
Blood Glucose ◽  
Central Obesity ◽  
Fasting Blood Glucose ◽  
Health Study ◽  
Postal Code ◽  
General Obesity ◽  
Blood Samples ◽  
Blood Tests ◽  
Over 40 Years

Introduction: Metabolic syndrome is a series of disorders such as central obesity, hypertriglyceridemia, decreasing HDL, abnormal blood glucose and hypertension that ultimately lead to the risk of cardiovascular disease, diabetes and other problems. The aim of this study was to determine the prevalence of this syndrome among adults in Yazd. Methods: This study was performed using the data of the recruitment phase of "Yazd Health Study" (YaHS). More than 10,000 residents (aged 20-69 years) of Yazd Greater Area have participated in this prospective cohort study. Lifestyle data, disease history, and blood tests have been recorded. Sampling was cluster random based on the postal code of the residents of Yazd Greater Area. Out of the 10,000 participants in the study, approximately 4,000 people gave blood samples to the lab in the first phase and their data were used to calculate the syndrome. Metabolic syndrome was defined based on the ATP III criteria. Data were analyzed by SPSS Version 16. Results: The overall prevalence of syndrome was 33.3%. The prevalence had a significant relationship with age, age over 40 years, reaching to the highest level of over 50%. The prevalence in women was 39.9%, more than men, with 25.9%. Frequency of abnormal components of the syndrome was respectively waist circumference or abdominal obesity (47.1%), diastolic or systolic blood pressure (43.7%), triglyceride (41.6%), HDL (39.5%) and fasting blood glucose (21.7). 67.5% and 91.7% of those with syndrome were obese or overweight, respectively. Conclusion: The study showed that the prevalence of metabolic syndrome, especially in women and those over 50 years old, is higher than other studies. General obesity, central obesity and hypertension are the most important components of metabolic syndrome in Yazd, which requires proper interventions.

PiTaSu: wearable interface for assisting senior citizens with memory problems

2011 ◽  
Vol 10 (4) ◽  
Author(s):  
Goshiro Yamamoto ◽  
Tomohiro Kuroda ◽  
Daisuke Yoshitake ◽  
Seamus Hickey ◽  
Jaakko Hyry ◽  
...  
Keyword(s):  
Senior Citizens ◽  
Memory Problems ◽  
Wearable Interface ◽  
With Memory

scholarly journals Unmet care needs are common among community-dwelling older people with memory problems in Finland

2019 ◽  
pp. 140349481989080 ◽  
Author(s):  
Mari S. Aaltonen ◽  
Lina H. Van Aerschot
Keyword(s):  
Home Care ◽  
Older People ◽  
Home Care Services ◽  
Community Dwelling ◽  
Care Needs ◽  
Care Services ◽  
Memory Problems ◽  
More Care ◽  
Community Dwelling Older People ◽  
With Memory

Aims: Ageing in place has become a policy priority. Consequently, residential care has been reduced, and more older people with multiple care needs reside at home with the help of informal care and home care services. An increasing share of these people has memory disorders. We examined the extent to which memory problems, in addition to other individual characteristics, are associated with unmet care needs among community-dwelling older people. Methods: The study employed cross-sectional survey data from community-dwelling people aged 75+ collected in 2010 and 2015, analysed using binary logistic regression analysis. The study population consisted of people who had long-term illnesses or disabilities that limited their everyday activities ( N = 1928). Nine per cent reported substantial memory problems. Of these, 35.7% had a proxy respondent. Results: People with memory problems have more care needs than those with other types of disability or illness. They receive more care but still have more unmet needs than others. About a quarter of people with memory problems reported that they did not receive enough help. This result did not change significantly when the proxy responses were excluded. Even a combination of informal and formal home care was insufficient to meet their needs. Conclusions: Insufficient care for people with memory problems implies a serious demand for further development of home care services. The care needs of this population are often complex. Unmet needs represent a serious risk to the well-being of people with memory disorders, and may also create an extensive burden on their informal caregivers.

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