Challenges to the recognition and assessment of Alzheimer's disease in American Indians of the southwestern United States

Griffin-Pierce, Trudy; Silverberg, Nina; Connor, Donald J.; Jim, Minnie; Peters, Jill; Kaszniak, Alfred W.; Sabbagh, Marwan N.

doi:10.1016/j.jalz.2007.10.012

Cited by 28 publications

(32 citation statements)

References 44 publications

(52 reference statements)

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“…Participants attributed this phenomenon, in part, to a lack of knowledge about dementia and available treatments. This is in keeping with the current literature, which notes that First Nations persons do not always recognize that dementia signs and symptoms need to be treated, due to a belief within the community that losing one's cognitive abilities is a natural part of aging (Henderson & Henderson, 2002 ;Griffi n-Pierce et al, 2008 ). It has also been noted that health care providers may need to establish trust with First Nations clients in order for them to begin sharing information relevant to their health status (Kelly & Brown, 2002 ).…”

Section: Integrating Study Results With the Literaturesupporting

confidence: 80%

Formal Dementia Care among First Nations in Southwestern Ontario

Finkelstein

Forbes

Richmond³

2012

Can. J. Aging

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This article explores how dementia care is provided to First Nations communities in southwestern Ontario. Data were collected through in-depth interviews with health care providers and analysed using a constructivist grounded-theory methodology. Two interrelated frameworks for understanding dementia care were identified: a care delivery framework and a knowledge framework. The care delivery framework identified care goals, care elements being provided, care barriers, and strategies and solutions to deliver care and overcome barriers. The knowledge framework defined four groups of knowledge stakeholders: persons with dementia, informal care providers, formal care providers, and the First Nations community. It identified the knowledge each stakeholder held or needed and processes of sharing - or failing to share - knowledge in dementia care. Several barriers, many created by a lack of knowledge, negatively impacted dementia care. However, health care professionals had effective strategies for providing care, designed to overcome barriers and which encompassed elements of knowledge sharing.

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Section: Integrating Study Results With the Literaturesupporting

confidence: 80%

Formal Dementia Care among First Nations in Southwestern Ontario

Finkelstein

Forbes

Richmond³

2012

Can. J. Aging

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“…It is imperative that at-risk LGBT older adults be assessed early for cognitive impairment, Alzheimer’s disease, and other dementias and that physicians inform them directly of a diagnosis. Patients from other marginalized populations (e.g., racial and ethnic minority patients) often do not seek physician consultation early in the disease process because they are unsure about the severity of the problem, feel changes are normal due to aging, feel challenged discussing forgetfulness with their loved ones, or are uncomfortable confronting the prospect of dementia (Clark et al, 2005; Griffin-Pierce et al, 2008). Similar factors are likely at play for LGBT older adults and their families and caregivers.…”

Section: Key Competencies and Priority Needsmentioning

confidence: 99%

Cognitive Impairment, Alzheimer’s Disease, and Other Dementias in the Lives of Lesbian, Gay, Bisexual and Transgender (LGBT) Older Adults and Their Caregivers: Needs and Competencies

et al. 2016

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Cognitive impairment, Alzheimer’s disease, and other dementias are important health concerns for older adults. As a marginalized and growing segment of the older adult population, lesbian, gay, bisexual, and transgender (LGBT) older adults face distinct risk factors related to cognitive impairment and dementias, including social isolation, discrimination, barriers to health care access, limited availability of and support for caregivers, and higher rates of certain chronic illnesses. We examine cognitive impairment and dementias among LGBT older adults, describe their unique risk factors, and outline key competencies for health care and human service providers to ensure culturally relevant care for LGBT older adults experiencing cognitive impairment, Alzheimer’s disease, or other dementias, as well as their caregivers, families, and communities. Implications include developing an awareness of the context of LGBT older adults’ lives and relationships, the importance of early detection and support, and the development of policies and practices that promote community-level advocacy and education.

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“…Objective cognitive impairment may be present in almost 50% of individuals with subjective memory complaints [25,26] , warranting clinicians to further investigate selfreports. Identifying valid measures of subjective cognitive impairment may therefore prove useful and have the potential to overcome some of the limitations related to the cross-cultural validity of objective cognitive assessment tools [27][28][29] .…”

Section: Introductionmentioning

confidence: 99%

The Sensitivity and Specificity of Subjective Memory Complaints and the Subjective Memory Rating Scale, Deterioration Cognitive Observee, Mini-Mental State Examination, Six-Item Screener and Clock Drawing Test in Dementia Screening

Ramlall¹,

Chipps²,

Bhigjee³

et al. 2013

Dement Geriatr Cogn Disord

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Background:The effectiveness of dementia screening depends on the availability of suitable screening tools with good sensitivity and specificity to confidently distinguish normal agerelated cognitive decline from dementia. The aim of this study was to evaluate the discriminant validity of 7 screening measures for dementia. Methods: A sample of 140 participants aged ≥60 years living in a residential facility for the aged were assessed clinically and assigned caseness for dementia using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revised diagnostic criteria. Sensitivity and specificity of a selection of the following screening measures were tested using receiver operating characteristic (ROC) analysis for individual and combined tests: the Mini-Mental State Examination (MMSE), Six-Item Screener (SIS), Subjective Memory Complaint, Subjective Memory Complaint Clinical (SMCC), Subjective Memory Rating Scale (SMRS), Deterioration Cognitive Observee (DECO) and the Clock Drawing Test (CDT). Results: Using ROC analyses, the SMCC, MMSE and CDT were found to be 'moderately accurate' in screening for dementia with an area under the curve (AUC) >0.70. The AUCs for the SIS (0.526), SMRS (0.661) and DECO (0.687) classified these measures as being 'less accurate'. At recommended cutoff scores, the SMCC had a sensitivity of 90.9% and specificity of 45.7%; the MMSE had a sensitivity of 63.6% and a specificity of 76.0%, and the CDT had a sensitivity of 44.4% and a specificity of 88.9%. Combining the SMCC and MMSE did not improve their predictive power except for a modest increase when using the sequential rule. Conclusion: The SMCC is composed of valid screening questions that have high sensitivity, are simple to administer and ideal for administration at the community or primary health care level as a first level of 'rule-out' screening. The MMSE can be included at a second stage of screening at the general hospital level and the CDT in specialist clinical settings. Sequential use of the SMCC and MMSE will improve the specificity of the former and the sensitivity of the latter.

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Challenges to the recognition and assessment of Alzheimer's disease in American Indians of the southwestern United States

Cited by 28 publications

References 44 publications

Formal Dementia Care among First Nations in Southwestern Ontario

Formal Dementia Care among First Nations in Southwestern Ontario

Cognitive Impairment, Alzheimer’s Disease, and Other Dementias in the Lives of Lesbian, Gay, Bisexual and Transgender (LGBT) Older Adults and Their Caregivers: Needs and Competencies

The Sensitivity and Specificity of Subjective Memory Complaints and the Subjective Memory Rating Scale, Deterioration Cognitive Observee, Mini-Mental State Examination, Six-Item Screener and Clock Drawing Test in Dementia Screening

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