“…Detailed comparator studies as well as comprehensive reviews addressing tests used for assessing cognitive status in AD and other dementias are published (87)(88)(89)(90)(91)(92)(93)(94)(95)(96)(97). Neuropsychologic tests may be organized by cognitive, functional, or behavioral domains (or their combinations) including activities of daily living (ADLQ), short mental status tests (MMSE, MoCA), brief dementia batteries (RBANS), behavioral symptoms (NPI-Q), clinical ratings (CDR), mood (Beck Depression Inventory II), IQ (Wechsler), executive function (Stroop test), visuoperceptual (drawing a clock), language or calculation (BDAE), and episodic memory (paragraph recall, word-list learning, Rey-Osterreith Complex Figure).…”
Dementia is an umbrella term-caused by a large number of specific diagnoses, including several neurodegenerative disorders. Alzheimer's disease (AD) is now the most common cause of dementia in advanced countries, while dementia due to neurosyphilis was the leading cause a century ago. Many challenges remain for diagnosing dementia definitively. Some of these include variability of early symptoms and overlap with similar disorders, as well as the possibility of combined, or mixed, etiologies in some cases. Newer technologies, including the incorporation of PET neuroimaging and other biomarkers (genomics and proteomics), are being incorporated into revised diagnostic criteria. However, the application of novel diagnostic methods at clinical sites is plagued by many caveats including availability and access. This review surveys new diagnostic methods as well as remaining challenges-for clinical care and clinical research.
“…Detailed comparator studies as well as comprehensive reviews addressing tests used for assessing cognitive status in AD and other dementias are published (87)(88)(89)(90)(91)(92)(93)(94)(95)(96)(97). Neuropsychologic tests may be organized by cognitive, functional, or behavioral domains (or their combinations) including activities of daily living (ADLQ), short mental status tests (MMSE, MoCA), brief dementia batteries (RBANS), behavioral symptoms (NPI-Q), clinical ratings (CDR), mood (Beck Depression Inventory II), IQ (Wechsler), executive function (Stroop test), visuoperceptual (drawing a clock), language or calculation (BDAE), and episodic memory (paragraph recall, word-list learning, Rey-Osterreith Complex Figure).…”
Dementia is an umbrella term-caused by a large number of specific diagnoses, including several neurodegenerative disorders. Alzheimer's disease (AD) is now the most common cause of dementia in advanced countries, while dementia due to neurosyphilis was the leading cause a century ago. Many challenges remain for diagnosing dementia definitively. Some of these include variability of early symptoms and overlap with similar disorders, as well as the possibility of combined, or mixed, etiologies in some cases. Newer technologies, including the incorporation of PET neuroimaging and other biomarkers (genomics and proteomics), are being incorporated into revised diagnostic criteria. However, the application of novel diagnostic methods at clinical sites is plagued by many caveats including availability and access. This review surveys new diagnostic methods as well as remaining challenges-for clinical care and clinical research.
“…50 In the primary care setting, abbreviated or brief cognitive instruments such as abbreviated versions of the Montreal Cognitive Assessment (MoCA) and Mini-Cog are recommended in persons with symptoms of dementia. 46,51…”
Dementia is one of the most costly, disabling diseases associated with ageing, yet it remains underdiagnosed in primary care. In this article, we present the comprehensive approach illustrated with a classical case for diagnosing dementia which can be applied by healthcare professionals in primary care. This diagnostic approach includes history taking and physical examination, cognitive testing, informant interviews, neuropsychological testing, neuroimaging, and the utility of cerebrospinal fluid biomarkers. For the differential diagnosis of cognitive impairment, the differences and similarities among normal ageing, mild cognitive impairment, depression, and delirium are highlighted. As primary care physicians are playing an increasingly prominent role in the caring of elderly patients in an ageing population, their role in the diagnosis of
“…2 Tỷ lệ mắc sa sút trí tuệ ở người cao tuổi tại cộng đồng trên thế giới và Việt Nam khoảng 4,5 -10%, và tăng dần theo tuổi. [3][4][5] Ước tính số người cao tuổi bị sa sút trí tuệ trên toàn cầu có thể tăng từ 25 triệu năm 2000 đến 63 triệu vào năm 2030 và 114 triệu vào năm 2050 6 . Năm…”
Nghiên cứu nhằm đánh giá giá trị của trắc nghiệm đánh giá trạng thái tâm thần tối thiểu (MMSE) bản Tiếng Việt trong sàng lọc sa sút trí tuệ ở người cao tuổi tại cộng đồng. Nghiên cứu cắt ngang trên 111 người cao tuổi được chọn ngẫu nhiên tại 3 xã thuộc huyện Ba Vì, Hà Nội. Đối tượng nghiên cứu được phỏng vấn bằng trắc nghiệm MMSE và sau đó được đánh giá lại bằng bộ câu hỏi thần kinh tâm lý đầy đủ theo tiêu chuẩn chẩn đoán DSM - 5. Kết quả cho thấy diện tích dưới đường cong ROC của trắc nghiệm MMSE là 0,89 (95% CI: 0,78 - 1). Điểm cắt tối ưu để chẩn đoán sa sút trí tuệ dựa vào trắc nghiệm MMSE là 19/20 với độ nhạy 0,75 và độ đặc hiệu 0,93. Tại điểm cắt 23/24, trắc nghiệm MMSE có độ nhạy, và độ đặc hiệu lần lượt là 0,88 và 0,72, với 32,4% người cao tuổi có khả năng mắc sa sút trí tuệ. Tỷ lệ hiện mắc sa sút trí tuệ theo tiêu chuẩn DSM - 5 là 7,2%. MMSE có giá trị cao trong sàng lọc sa sút trí tuệ ở người cao tuổi tại cộng đồng ở Việt Nam với ngưỡng điểm 23/24.
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