Dementia Assessment and Management Protocol for Doctors in Nepal

Jha, Alok; Sapkota, Nidesh

doi:10.31729/jnma.567

Cited by 15 publications

(22 citation statements)

References 9 publications

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“…One described the use of the mhGAP-IG in the Eastern Mediterranean, in new community mental health services in Gaza and the West Bank, without presenting any evaluations, or details of how the mhGAP-IG was tailored to the setting 33. Another study described the adaptation of the mhGAP-IG dementia module for the Nepalese context, alongside cognitive assessment tools, postdiagnostic carer support and treatment protocols 34. The authors expressed the intention to evaluate its acceptability, suitability and impact, but did not report any evaluation data or details on how contextualisation took place.…”

Section: Resultsmentioning

confidence: 99%

WHO Mental Health Gap Action Programme (mhGAP) Intervention Guide: a systematic review of evidence from low and middle-income countries

Keynejad

Dua

Barbui

et al. 2017

Evid Based Mental Health

220

206

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Data were extracted from included papers, but heterogeneity prevented meta-analysis. Findings:We conducted a systematic review of evidence to date, of mhGAP-IG implementation and evaluation in LMICs. 33 included studies reported 15 training courses, nine clinical implementations, three country contextualisations, three economic models, two uses as control interventions and one use to develop a rating scale. Our review identified the importance of qualitative reports of contextual challenges in the field, alongside detailed protocols, qualitative studies and randomised controlled trials. Conclusions:The mhGAP-IG literature is substantial, relative to other published evaluations of clinical practice guidelines: an important contribution to a neglected field.3

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Section: Resultsmentioning

confidence: 99%

WHO Mental Health Gap Action Programme (mhGAP) Intervention Guide: a systematic review of evidence from low and middle-income countries

Keynejad

Dua

Barbui

et al. 2017

Evid Based Mental Health

220

206

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“…In Nepal, the population of people aged 60 years and above is 2.1 million (8%) [4]. They are at high risk of developing dementia in next few years [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Translation and cross-cultural adaptation of the Nepali version of the Rowland universal dementia assessment scale (RUDAS)

Nepal

Shrestha

Acharya

2019

J Patient Rep Outcomes

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Background Mild Cognitive Impairment (MCI) is a transitional state between normal cognition and dementia during ageing process. Early screening of elderly for MCI can help for early prevention and treatment of dementia. Rowland Universal Dementia Assessment Scale (RUDAS) is a brief cognitive assessment tool with excellent psychometric properties and is particularly useful in culturally and linguistically diverse (CALD) populations. The purpose of this study was to translate RUDAS into Nepali and to evaluate internal consistency of Nepali version of RUDAS. Methods RUDAS was translated to Nepali following recommended guidelines for translation and cross-cultural adaptation of patient reported measures. The pre-final Nepali version of RUDAS was tested on 30 elderly and appropriate changes were made by expert committee. The final Nepali version of RUDAS was developed and was administered on 100 elderly populations (mean age 67.70) to assess internal consistency. Results The rating of the participants upon their understanding of each 6 items of Nepali version of RUDAS on a 10-point Likert scale received a good score of more than 8 except ‘cube drawing’ which only received a mean score of 5.5. Additionally, only 8(27%) elderly have responded to the item ‘cube drawing’. The preference test was done and cube drawing was replaced by stick design test. Nepali version of RUDAS showed acceptable internal consistency with Cronbach’s alpha 0.7. Conclusion The results of our study presents translated and cross-culturally adapted Nepali version of RUDAS that has been proved to be an appropriate assessment tool for screening cognitive impairment among elderly. Electronic supplementary material The online version of this article (10.1186/s41687-019-0132-3) contains supplementary material, which is available to authorized users.

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“…5 Secondly, in the context of post-diagnostic education and training protocol for dementia caregivers, the authors rightly pointed out that physical exercise is crucial for improving or at least maintaining motor performances and minimizing the risk of falling. 1 Unfortunately, if they do so at all, patients tend to participate in training groups not adapted to the particular cognitive and motoric deficits of people with dementia. It would be desirable, if dementia caregivers in Nepal took into consideration that people with mild to moderate dementia could profit considerably from a progressive resistance and functional-balance training carried out twice weekly (e.g.…”

mentioning

confidence: 99%

Re: Dementia Assessment and Management Protocol for Doctors in Nepal

Hofmeister¹

2017

J Nepal Med Assoc

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Dear Editor, I thank Jha and Sapkota for their interesting article, "Dementia assessment and management protocol for doctors in Nepal", published in a recent issue of the JNMA. 1 I wish to make two additional comments regarding physical activity and exercise, both of which are essential for the prevention and treatment of dementia diseases.Firstly, apart from dual-task deficits, motor and functional deficits are key early markers of dementia (e.g. ambulatory difficulties, limited forward flexion of the torso when getting up from a chair). 2,3 A decline of functional and motor performances due to dementia is known to be the most common reason why elderly people develop a need for long-term care. In my opinion, validated functional performance tests such as the "Timed up-and-go test (TUG)" and "Five-times-sit-to-stand" test (FTSS) should therefore also be implemented as part of dementia assessment and the management protocol for Nepal. The test-retest reliability values for the quick and feasible TUG and FTSS have proven to be excellent or good, respectively, in older people with dementia. 4 There is a negative association between each of the motor tools for assessing functional mobility or lower-limb strength and global cognitive performance. 5Secondly, in the context of post-diagnostic education and training protocol for dementia caregivers, the authors rightly pointed out that physical exercise is crucial for improving or at least maintaining motor performances and minimizing the risk of falling. 1 Unfortunately, if they do so at all, patients tend to participate in training groups not adapted to the particular cognitive and motoric deficits of people with dementia. It would be desirable, if dementia caregivers in Nepal took into consideration that people with mild to moderate dementia could profit considerably from a progressive resistance and functional-balance training carried out twice weekly (e.g. walking, getting up from/sitting down on a chair, shifting of weight when standing, tiptoeing while holding on to the back of a chair, climbing stairs), combined with an individual dual-task training (e.g. walking while solving an arithmetic task such as counting backwards in increments of three). 2,3 From a methodical point of view, training adjusted to dementia-related requirements should include simple, clearly structured exercises. These should be conveyed through dementia-specific verbal and nonverbal communication (e.g. brief instructions, positive wording, mirroring of movements, tactile support). 3

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Dementia Assessment and Management Protocol for Doctors in Nepal

Cited by 15 publications

References 9 publications

WHO Mental Health Gap Action Programme (mhGAP) Intervention Guide: a systematic review of evidence from low and middle-income countries

WHO Mental Health Gap Action Programme (mhGAP) Intervention Guide: a systematic review of evidence from low and middle-income countries

Translation and cross-cultural adaptation of the Nepali version of the Rowland universal dementia assessment scale (RUDAS)

Re: Dementia Assessment and Management Protocol for Doctors in Nepal

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