scholarly journals Driving in Somerset

2000 ◽  
Vol 24 (8) ◽  
pp. 304-306 ◽  
Author(s):  
Stefan Jan Kolowski ◽  
Jackie Rossiter

Aims and MethodsThe number of drivers on our roads with dementia is likely to increase as the elderly population grows. We performed a retrospective analysis of patients referred to our Memory Clinic in Taunton who were still driving despite a high suspicion of dementia.ResultsTwenty per cent of the patients were still driving at the time of their assessment. Ten per cent had a diagnosis of Alzheimer's disease and 10% mild cognitive impairment. The patients and/or carers stated that the patient had not been told to stop driving and none of the referral letters documented any advice about driving.Clinical ImplicationsReferrers should advise all patients with possible dementia to refrain from driving until assessment by a specialist team is completed. They should be informed of the risk of medico-legal consequences if they continue to drive.

2020 ◽  
Author(s):  
Francesco Iodice ◽  
Valeria Cassano ◽  
Paolo Maria Rossini

Abstract This article reviews the main articles that have been published so far about the direct and indirect effects of the COVID-19 pandemic on a particularly fragile population represented by the healthy elderly people as well as those with Mild Cognitive Impairment and Alzheimer's disease. Such populations have been among the most affected in the early stages of the pandemic due to the direct effects of the virus and numerous indirect effects now emerge and will have to be carefully assessed over time. The pandemic associated to COVID-19 has shifted most of the health resources to the emergency area and has consequently left the three main medical areas that dealing with the elderly population (oncology, time-dependent diseases and degenerative disease) temporarily “uncovered”. In the phase following the emergency, it will be crucial to guarantee to each area the economic and organizational resources to quickly return to the level of support of the pre-pandemic state. The emergency phase represented an important moment of discussion on the possibilities of telemedicine which will inevitably become increasingly important but all the limits of its use in the elderly population have to be considered. In the post-lockdown recovery phase, alongside the classic medical evaluation, the psychological evaluation must become even more important for doctors caring about people with cognitive decline.


2018 ◽  
Vol 15 (2) ◽  
pp. 104-110 ◽  
Author(s):  
Shohei Kato ◽  
Akira Homma ◽  
Takuto Sakuma

Objective: This study presents a novel approach for early detection of cognitive impairment in the elderly. The approach incorporates the use of speech sound analysis, multivariate statistics, and data-mining techniques. We have developed a speech prosody-based cognitive impairment rating (SPCIR) that can distinguish between cognitively normal controls and elderly people with mild Alzheimer's disease (mAD) or mild cognitive impairment (MCI) using prosodic signals extracted from elderly speech while administering a questionnaire. Two hundred and seventy-three Japanese subjects (73 males and 200 females between the ages of 65 and 96) participated in this study. The authors collected speech sounds from segments of dialogue during a revised Hasegawa's dementia scale (HDS-R) examination and talking about topics related to hometown, childhood, and school. The segments correspond to speech sounds from answers to questions regarding birthdate (T1), the name of the subject's elementary school (T2), time orientation (Q2), and repetition of three-digit numbers backward (Q6). As many prosodic features as possible were extracted from each of the speech sounds, including fundamental frequency, formant, and intensity features and mel-frequency cepstral coefficients. They were refined using principal component analysis and/or feature selection. The authors calculated an SPCIR using multiple linear regression analysis. Conclusion: In addition, this study proposes a binary discrimination model of SPCIR using multivariate logistic regression and model selection with receiver operating characteristic curve analysis and reports on the sensitivity and specificity of SPCIR for diagnosis (control vs. MCI/mAD). The study also reports discriminative performances well, thereby suggesting that the proposed approach might be an effective tool for screening the elderly for mAD and MCI.


2020 ◽  
pp. 1-14
Author(s):  
Yi-Wen Bao ◽  
Anson C.M. Chau ◽  
Patrick Ka-Chun Chiu ◽  
Yat Fung Shea ◽  
Joseph S.K. Kwan ◽  
...  

Background: With the more widespread use of 18F-radioligand-based amyloid-β (Aβ) PET-CT imaging, we evaluated Aβ binding and the utility of neocortical 18F-Flutemetamol standardized uptake value ratio (SUVR) as a biomarker. Objective: 18F-Flutemetamol SUVR was used to differentiate 1) mild cognitive impairment (MCI) from Alzheimer’s disease (AD), and 2) MCI from other non-AD dementias (OD). Methods: 109 patients consecutively recruited from a University memory clinic underwent clinical evaluation, neuropsychological test, MRI and 18F-Flutemetamol PET-CT. The diagnosis was made by consensus of a panel consisting of 1 neuroradiologist and 2 geriatricians. The final cohort included 13 subjective cognitive decline (SCD), 22 AD, 39 MCI, and 35 OD. Quantitative analysis of 16 region-of-interests made by Cortex ID software (GE Healthcare). Results: The global mean 18F-Flutemetamol SUVR in SCD, MCI, AD, and OD were 0.50 (SD-0.08), 0.53 (SD-0.16), 0.76 (SD-0.10), and 0.56 (SD-0.16), respectively, with SUVR in SCD and MCI and OD being significantly lower than AD. Aβ binding in SCD, MCI, and OD was heterogeneous, being 23%, 38.5%, and 42.9% respectively, as compared to 100% amyloid positivity in AD. Using global SUVR, ROC analysis showed AUC of 0.868 and 0.588 in differentiating MCI from AD and MCI from OD respectively. Conclusion: 18F-Flutemetamol SUVR differentiated MCI from AD with high efficacy (high negative predictive value), but much lower efficacy from OD. The major benefit of the test was to differentiate cognitively impaired patients (either SCD, MCI, or OD) without AD-related-amyloid-pathology from AD in the clinical setting, which was under-emphasized in the current guidelines proposed by Amyloid Imaging Task Force.


2021 ◽  
Author(s):  
Gea Pandhita ◽  
Prasila Darwin ◽  
Bety Lakhsmi

Abstract Background: The increase in the elderly population in a developing country like Indonesia will increase people with cognitive impairment. Mild Cognitive Impairment (MCI) is the most common cognitive impairment among the elderly. However, some health workers are not satisfied with the current tools for detecting MCI in the community.Objective: This study intends to develop a novel, easy, and accurate method for early detection of MCI of the elderly population in the community in Indonesia.Methods: This study analyzed the database of 110 elderly population in East Jakarta, Indonesia. We explored several brief neuropsychiatric battery and developed a neuropsychiatric score to detect MCI.Results: The abnormal verbal semantic fluency test (p = 0.000), the existence of subjective memory complaints (p = 0.007), and low education level (p = 0.049) were found to be good predictors to detect MCI. The neuropsychiatric score, a combination of those variables, with a cut-off point of 2, has good accuracy to detect MCI (Sensitivity = 91.20%; Specificity = 78.9%).Conclusion: The neuropsychiatric score is a novel, easy, and accurate method for early detection of MCI of the elderly population in the community in Indonesia.


2020 ◽  
Vol 34 (2) ◽  
pp. 156-162 ◽  
Author(s):  
George S. Vlachos ◽  
Mary H. Kosmidis ◽  
Mary Yannakoulia ◽  
Efthimios Dardiotis ◽  
Georgios Hadjigeorgiou ◽  
...  

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