Global Perspectives on Brief Cognitive Assessments for Dementia Diagnosis

2021 ◽  
pp. 1-13
Author(s):  
Elena Tsoy ◽  
Alissa Bernstein Sideman ◽  
Stefanie D. Piña Escudero ◽  
Maritza Pintado-Caipa ◽  
Suchanan Kanjanapong ◽  
...  
Keyword(s):  
Older Adult ◽  
Adult Population ◽  
Dementia Diagnosis ◽  
Cognitive Assessments ◽  
Middle Income ◽  
Global Perspectives ◽  
Dementia Patients ◽  
Diagnosis Of Dementia ◽  
Theme Identification ◽  
Diagnostic Decision Making

Background: Timely diagnosis of dementia is a global healthcare priority, particularly in low to middle income countries where rapid increases in older adult populations are expected. Objective: To investigate global perspectives on the role of brief cognitive assessments (BCAs) in dementia diagnosis, strengths and limitations of existing measures, and future directions and needs. Methods: This is a qualitative study of 18 dementia experts from different areas of the world. Participants were selected using purposeful sampling based on the following criteria: 1) practicing in countries with projected growth of older adult population of over 100%by 2050; 2) expertise in dementia diagnosis and treatment; 3) involvement in clinical practice and training; and 4) recognition as a national dementia expert based on leadership positions within healthcare system, research, and/or policy work. Participants were individually interviewed in their language of choice over secure videoconference sessions. Interviews were analyzed by a multidisciplinary team using theme identification approach. Results: Four domains with subthemes emerged illustrating participants’ perspectives: 1) strengths of BCAs; 2) limitations of BCAs; 3) needs related to the use of BCAs; and 4) characteristics of an ideal BCA. While most experts agreed that BCAs were important and useful for dementia diagnosis, the themes emphasized the need for development and validation of novel measures that are sensitive, psychometrically sound, and culturally appropriate. Conclusion: BCAs are important for guiding diagnosis and care for dementia patients. Findings provide a roadmap for novel BCA development to assist in diagnostic decision making for clinicians serving a rapidly growing and diverse dementia population.

Standardising Dementia Diagnosis Across Linguistic and Educational Diversity: Study Design of the Indian Council of Medical Research-Neurocognitive Tool Box (ICMR-NCTB)

2019 ◽  
Vol 26 (2) ◽  
pp. 172-186
Author(s):  
Gowri K. Iyer ◽  
Avanthi Paplikar ◽  
Suvarna Alladi ◽  
Aparna Dutt ◽  
Meenakshi Sharma ◽  
...  
Keyword(s):  
Medical Research ◽  
Test Battery ◽  
Diagnostic Tools ◽  
Indian Languages ◽  
Dementia Diagnosis ◽  
Middle Income ◽  
Indian Council ◽  
Diagnosis Of Dementia ◽  
Neurocognitive Test ◽  
Educational Diversity

AbstractObjectives:While the burden of dementia is increasing in low- and middle-income countries, there is a low rate of diagnosis and paucity of research in these regions. A major challenge to study dementia is the limited availability of standardised diagnostic tools for use in populations with linguistic and educational diversity. The objectives of the study were to develop a standardised and comprehensive neurocognitive test battery to diagnose dementia and mild cognitive impairment (MCI) due to varied etiologies, across different languages and educational levels in India, to facilitate research efforts in diverse settings.Methods:A multidisciplinary expert group formed by Indian Council of Medical Research (ICMR) collaborated towards adapting and validating a neurocognitive test battery, that is, the ICMR Neurocognitive Tool Box (ICMR-NCTB) in five Indian languages (Hindi, Bengali, Telugu, Kannada, and Malayalam), for illiterates and literates, to standardise diagnosis of dementia and MCI in India.Results:Following a review of existing international and national efforts at standardising dementia diagnosis, the ICMR-NCTB was developed and adapted to the Indian setting of sociolinguistic diversity. The battery consisted of tests of cognition, behaviour, and functional activities. A uniform protocol for diagnosis of normal cognition, MCI, and dementia due to neurodegenerative diseases and stroke was followed in six centres. A systematic plan for validating the ICMR-NCTB and establishing cut-off values in a diverse multicentric cohort was developed.Conclusions:A key outcome was the development of a comprehensive diagnostic tool for diagnosis of dementia and MCI due to varied etiologies, in the diverse socio-demographic setting of India.

Dental fear and anxiety in an older adult population

1991 ◽  
Vol 19 (2) ◽  
pp. 120-124 ◽  
Author(s):  
David Locker ◽  
Andree Liddell ◽  
David Burman
Keyword(s):  
Older Adult ◽  
Adult Population ◽  
Dental Fear ◽  
Fear And Anxiety ◽  
Older Adult Population

scholarly journals Collage technique may provide new perspectives for Alzheimer patients by exploring messages from their inner world

2009 ◽  
Vol 3 (4) ◽  
pp. 299-302 ◽  
Author(s):  
Mitsue Meguro ◽  
Junichi Ishizaki ◽  
Kenichi Meguro
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Early Stage ◽  
Cognitive Assessments ◽  
Dementia Patients ◽  
Inner World

Abstract Although the collage art technique has been introduced as a psychotherapeutic method, it has not been fully applied in dementia. Objectives: To analyze characteristics of the collage articles produced by patients with Alzheimer's disease (AD). Methods: Twenty AD patients were asked to select and place several clippings as they wished. The MMSE was used for cognitive assessments. Results: Simplification and poor organization in their articles were found. The themes of one patient were found to change according to behavior. We discussed the images of the articles, especially spiritual images in the early stage and family images in the later stage. Conclusions: We concluded that the collage technique could provide new perspectives for dementia patients by exploring messages from their inner world.

scholarly journals Why Are Native Hawaiians Underrepresented in Hawai‘i's Older Adult Population? Exploring Social and Behavioral Factors of Longevity

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Lana Sue Ka‘opua ◽  
Kathryn L. Braun ◽  
Colette V. Browne ◽  
Noreen Mokuau ◽  
Chai-Bin Park
Keyword(s):  
Older Adult ◽  
Native Hawaiian ◽  
Adult Population ◽  
Historical Trauma ◽  
Health Indicators ◽  
Native Hawaiians ◽  
Future Research ◽  
Behavioral Factors ◽  
Poverty Level ◽  
Older Adult Population

Native Hawaiians comprise 24.3% of Hawai‘i's population, but only 12.6% of the state's older adults. Few published studies have compared health indicators across ethnicities for the state's older adult population or focused on disparities of Native Hawaiian elders. The current study examines data from two state surveillance programs, with attention to cause of death and social-behavioral factors relevant to elders. Findings reveal that Native Hawaiians have the largest years of productive life lost and the lowest life expectancy, when compared to the state's other major ethnic groups. Heart disease and cancer are leading causes of premature mortality. Native Hawaiian elders are more likely to report behavioral health risks such as smoking and obesity, live within/below 100–199% of the poverty level, and find cost a barrier to seeking care. Indicated is the need for affordable care across the lifespan and health services continuum. Future research might explain behavioral factors as influenced by social determinants, including historical trauma on Native Hawaiian longevity.

scholarly journals Understanding How Socioeconomic Inequalities Drive Inequalities In COVID-19 Infections

2021 ◽  
Author(s):  
Rachid Laajaj ◽  
Duncan Webb ◽  
Danilo Aristizabal ◽  
Eduardo Behrentz ◽  
Raquel Bernal ◽  
...  
Keyword(s):  
Process Model ◽  
Adult Population ◽  
Policy Implications ◽  
Primary Data ◽  
Socioeconomically Disadvantaged ◽  
Infection Rates ◽  
Middle Income ◽  
Individual Level ◽  
Disadvantaged Groups ◽  
The Poor

Abstract Background: Across the world, the COVID-19 pandemic has disproportionately affected economically disadvantaged groups. This differential impact has numerous possible explanations, each with significantly different policy implications. We examine, for the first time in a low- or middle-income country, which mechanisms best explain the disproportionate impact of the virus on the poor. Methods: We use primary data from the CoVIDA project, including the results of 59,770 RT-PCR tests in Bogotá, targeted on a mostly asymptomatic adult population June 2020 to March 3rd, 2021. This is combined with administrative data that covers all reported cases in Bogotá. We estimate a number of parameters that are likely to drive inequality in COVID-19 infection rates across socioeconomic groups, then use these estimates in an individual-level branching process model of the epidemic. We use counterfactual scenarios to estimate the relative importance of different channels for explaining inequality in infection rates. Findings: Total infections and inequalities in infections are largely driven by inequalities in the ability to work remotely and in within-home secondary attack rates. Inequalities in isolation behavior are less important but non-negligible, while access to testing and contract-tracing plays practically no role. Interventions that mitigate transmission are found to be more effective when targeted on socioeconomically disadvantaged groups.Interpretation: Socioeconomically disadvantaged groups are particularly vulnerable to COVID-19 infections, and this appears to be primarily driven by the need to work out of home, higher transmission within home, and to some extent, the ability to isolate when needed. Policies that can successfully reduce these channels of transmission among the poor are likely to have large benefits.

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