Extrinsic and Intrinsic Help-Seeking Motivation in the Assessment of Cognitive Decline

Haußmann, Robert; Mayer-Pelinski, René; Borchardt, Maike; Beier, Fabrice; Helling, Franziska; Buthut, Maria; Meissner, Gisa; Lange, Jan de; Zweiniger, Anne; Donix, Markus

doi:10.1177/1533317518755332

Cited by 7 publications

(4 citation statements)

References 30 publications

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“…Third, MMSE scores were not adjusted for educational level. Finally, there is a lack of information collected on different factors known to be related to help-seeking intentions, such as personal exposure to AD, the perception of social support, disease knowledge, motivational aspects, and cultural and race factors ( 13 , 33–35 ).…”

Section: Discussionmentioning

confidence: 99%

Medical help-seeking intentions among patients with early Alzheimer’s disease

Villarejo-Galende,

García-Arcelay,

Piñol-Ripoll

et al. 2023

Front. Psychiatry

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BackgroundLimited information is available on the active process of seeking medical help in patients with Alzheimer’s disease (AD) at early stages. The aim of this study was to assess the phenomenon of medical help-seeking in early AD and to identify associated factors.MethodsA multicenter, non-interventional study was conducted including patients of 50–90 years of age with prodromal or mild AD (National Institute on Aging/Alzheimer’s Association criteria), a Mini-Mental State Examination (MMSE) score ≥ 22, and a Clinical Dementia Rating-Global score (CDR-GS) of 0.5–1.0. A multivariate logistic regression analysis was conducted.ResultsA total of 149 patients were included. Mean age (SD) was 72.3 (7.0) years, 50.3% were female, and 87.2% had a CDR-GS score of 0.5. Mean disease duration was 1.4 (1.8) years. Ninety-four (63.1%) patients sought medical help, mostly from neurologists. Patients with help-seeking intentions were mostly female (60.6%) with a CDR-GS score of 0.5 (91.5%) and had a greater awareness of diagnosis, poorer quality of life, more depressive symptoms, and a more severe perception of their condition than their counterparts. Lack of help-seeking intentions was associated with male sex (p = 0.003), fewer years of education (p = 0.005), a low awareness of diagnosis (p = 0.005), and a low emotional consequence of the condition (p = 0.016).ConclusionUnderstanding the phenomenon of active medical help-seeking may facilitate the design of specific strategies to improve the detection of cognitive impairment, especially in patients with a lower level of educational attainment and poor awareness of their condition.

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Section: Discussionmentioning

confidence: 99%

Medical help-seeking intentions among patients with early Alzheimer’s disease

Villarejo-Galende,

García-Arcelay,

Piñol-Ripoll

et al. 2023

Front. Psychiatry

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“…Consistent with our prior data on the diagnostic value of clinical parameter compositions [16], we utilized a discriminance analysis [17] to investigate whether individual performance across different neurocognitive domains would differentiate between the diagnostic groups "depressive MCI (dMCI)", "amnestic MCI (aMCI)," and "other" (MCI; neither depressive nor amnestic). We further performed a multivariate analysis of variance (MANOVA) to control for age-specific effects on group discrimination for each parameter included in the discriminance analysis.…”

Section: Statistical Analysesmentioning

confidence: 98%

Neurocognitive Profiles in Affective and Amnestic Mild Cognitive Impairment

Haußmann

Mayer-Pelinski

Beier

et al. 2019

SN Compr. Clin. Med.

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Differentiating mild cognitive impairment due to a depressive episode from early neurodegeneration is challenging among older people. Although neuropsychological tests are routine diagnostic assessments in the evaluation of cognitive decline, in contrast to dementia syndromes, they are often perceived as non-specific in the differentiation of affective and neurodegenerative mild cognitive impairment. Furthermore, depression may represent not only a risk factor for developing dementia but also a prodromal symptom of incipient neurodegeneration. In a university memory disorder clinic setting, we investigated 90 middle-aged and older individuals (57.8% women) suffering from mild cognitive impairment, presenting with or without current or previous depressive disorder. Using discriminance analysis and a multivariate analysis of variance, we show that impairments in executive functioning and attention were predictive towards cognitive impairment developed during a depressive episode. Reduced verbal fluency was also predictive towards depression-associated cognitive impairment, whereas memory was relatively preserved in these patients. Our data suggest that in addition to biological markers, specific neuropsychological profiles can be helpful to separate different etiologies of mild cognitive impairment.

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“…Health access barriers to HS (e.g., transportation, lack of specialized care, limited resources) for memory concerns are particularly heightened in traditionally underserved populations such as minoritized race and ethnic groups, as well as rural populations. 32,62,[69][70][71][72][73][74][75] For instance, a recent literature review exploring cross-cultural differences in dementia found that minoritized ethnic older adults tended to present with worse cognition and at later stages of dementia than non-Hispanic Whites at the time of their first evaluation, 42 suggesting distinctive HS barriers between these 2 groups, among other factors (e.g., illness perception differences, culturally associated beliefs, personal beliefs, language proficiency, level of acculturation, etc.) 42,48,76 .…”

Section: Health Access Barriers Related To Hsmentioning

confidence: 99%

Virtual Assessment as a Way to Reduce Help-seeking Barriers in Older Adults With Subjective Cognitive Decline

Kann,

Zeiger,

Rizer

et al. 2023

Alzheimer Disease &Amp; Associated Disorders

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Subjective cognitive decline (SCD), a potential early marker for neurodegenerative disease such as Alzheimer’s disease, is common among older adults. Although it is often regarded as a personal health concern, most individuals with SCD do not seek help from a health care professional. Help-seeking (HS) is a complex, individualized process with significant life-course implications, and older adults often face several barriers to HS across personal, socioeconomic, and cultural domains. The pandemic exacerbated these barriers by imposing additional limitations on in-person care. In response, virtual assessment became a popular method to conduct remote care. We provide a narrative review of the challenges and triumphs that came with the transition from in-person, pen-paper cognitive assessments to virtual cognitive assessments. In addition, we address the impact virtual assessment had in tackling barriers that previously limited individuals with SCD from formal HS. We argue that virtual cognitive assessment helps alleviate health access barriers to HS (e.g., cost, transportation, and physician availability) and allows individuals with different coping styles to undergo assessment within more convenient environments. We hope the findings presented in this review inform health care practice, public education, and future research targeted towards the use of virtual assessment to facilitate HS in older adults with SCD.

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Extrinsic and Intrinsic Help-Seeking Motivation in the Assessment of Cognitive Decline

Cited by 7 publications

References 30 publications

Medical help-seeking intentions among patients with early Alzheimer’s disease

Medical help-seeking intentions among patients with early Alzheimer’s disease

Neurocognitive Profiles in Affective and Amnestic Mild Cognitive Impairment

Virtual Assessment as a Way to Reduce Help-seeking Barriers in Older Adults With Subjective Cognitive Decline

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