Guidelines for the evaluation of dementia and age-related cognitive change.

,

doi:10.1037/a0024643

Cited by 54 publications

(27 citation statements)

References 27 publications

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“…The American Psychological Association acknowledged the potential benefit of administering technology based assessments for individuals of limited mobility, while recognizing potential limitations for older adults who do not routinely use computers [30]. Espeland [4] reported higher rates of incomplete data as subjects became older, or had less experience with computers.…”

Section: Discussionmentioning

confidence: 99%

Functional imaging of cognition in an old-old population: A case for portable functional near-infrared spectroscopy

et al. 2017

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In this study, functional near-infrared spectroscopy (fNIRS) was used to record brain activation during cognitive testing in older individuals (88±6yo; N = 19) living in residential care communities. This population, which is often associated with loss of personal independence due to physical or cognitive decline associated with aging, is also often under-represented in neuroscience research because of a limited means to participate in studies which often take place in large urban or university centers. In this study, we demonstrate the feasibility and initial results using a portable 8-source by 4-detector fNIRS system to measure brain activity from participants within residential care community centers. Using fNIRS, brain signals were recorded during a series of computerized cognitive tests, including a Symbol Digit Coding test (SDC), Stroop Test (ST), and Shifting Attention Test (SAT). The SDC and SAT elicited greater activity in the left middle frontal region of interest. Three components of the ST produced increases in the right middle frontal and superior frontal, and left superior frontal regions. An association between advanced age and increased activation in the right middle frontal region was observed during the incongruent ST. Although none of the participants had clinical dementia based on the short portable mental status questionnaire, the group performance was slightly below age-normed values on these cognitive tests. These results demonstrate the capability for obtaining functional neuroimaging measures in residential settings, which ultimately may aid in prognosis and care related to dementia in older adults.

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Section: Discussionmentioning

confidence: 99%

Functional imaging of cognition in an old-old population: A case for portable functional near-infrared spectroscopy

et al. 2017

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“…First, the lack of valid biomarkers forces healthcare providers to diagnose dementia based on the presence of specific symptoms and the elimination of other conditions with similar symptoms. To arrive at a clinical diagnosis of dementia, a combination of basic assessments,—including physical, psychopathological and basic neuropsychological examinations—are recommended [ 12 , 13 ]. For the basic neuropsychological diagnosis, different short screening tests such as the Mini Mental Status Examination (MMSE) [ 14 , 15 ], the DemTect [ 16 ] and the Clock Drawing Test [ 17 ] are recommended.…”

Section: Introductionmentioning

confidence: 99%

People with dementia in nursing home research: a methodological review of the definition and identification of the study population

et al. 2016

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BackgroundThere are various definitions and diagnostic criteria for dementia, leading to discrepancies in case ascertainment in both clinical practice and research. We reviewed the different definitions, approaches and measurements used to operationalize dementia in health care studies in German nursing homes with the aim of discussing the implications of different approaches.MethodsWe conducted a systematic search of the MEDLINE and CINAHL databases to identify pre-2016 studies conducted in German nursing homes that focused on residents with dementia or cognitive impairment. In- or exclusion of studies were consented by all authors; data extraction was independently carried out by 2 authors (RP, SJ). The studies’ sampling methods were compared with respect to their inclusion criteria, assessment tools and methods used to identify the study population.ResultsWe summarized case ascertainment methods from 64 studies. Study participants were identified based on a diagnosis that was evaluated during the study, or a recorded medical dementia diagnosis, or a recorded medical diagnosis either with additional cognitive screenings or using screening tests exclusively. The descriptions of the diagnostics that were applied to assess a diagnosis of dementia were not fully transparent in most of the studies with respect to either a clear reference definition of dementia or applied diagnostic criteria. If reported, various neuropsychological tests were used, mostly without a clear rationale for their selection.ConclusionPragmatic considerations often determine the sampling strategy; they also may explain the variances we detected in the different studies. Variations in sampling methods impede the comparability of study results. There is a need to consent case ascertainment strategies in dementia studies in health service research in nursing homes. These strategies should consider resource constraints and ethical issues that are related to the vulnerable population of nursing home residents. Additionally, reporting about dementia studies in nursing homes need to be improved. If a diagnosis cannot be evaluated based on either ICD or DSM criteria, the study population may not be reported as having dementia. If a diagnosis is evaluated based on ICD or DSM criteria within the study, there is a need for more transparency of the diagnostic process.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0249-7) contains supplementary material, which is available to authorized users.

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“…Additionally, in vivo measures such as CSF and serum amyloid, CSF pTau, and PET studies are not performed routinely in hospital settings. To this end, neurologists, psychiatrists, and geriatricians typically rely on a combination of clinical interviews, physical examinations, laboratory tests, neuroimaging (CT, MRI, SPECT) studies, and neuropsychological assessments as part of the diagnostic workup [18,19].…”

Section: Dementia Diagnosismentioning

confidence: 99%

Hit or Miss? Diagnostic contributions of neuropsychological assessment in patients with suspected dementia

Pinsker¹,

Lo²,

Haslam³

et al. 2018

IJCNMH

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Objectives: Accurate early diagnosis of dementia has important implications for prognosis, treatment, and management. In hospital settings, neuropsychological assessment is frequently included in the diagnostic work-up for dementia, particularly in clinically ambiguous cases. However, the diagnostic contributions of neuropsychological testing in this population are not well established. This paper reports the findings from a preliminary study examining the diagnostic utility of such assessment in patients with suspected dementia. Methods:A retrospective review of hospital medical records was performed for 84 patients who underwent neuropsychological assessment for diagnostic purposes within a five-year time frame. A proxy measure of diagnostic accuracy was obtained using the level of agreement between the neuropsychologist's opinion and the most recent working diagnosis of the medical treatment provider, allowing a minimum follow-up period of twelve months. Results:Using defined clinical coding criteria to account for differences between clinical conditions (e.g., mild neurocognitive disorder) and underlying pathology (e.g., Alzheimer's disease), the baseline diagnosis of the neuropsychologist concurred with the most recent diagnosis of the treatment provider in 88% of cases with an exact match in 77% of cases. Follow-up neuropsychological assessments over time did not lead to a significant improvement in diagnostic accuracy. Conclusion:A high level of diagnostic agreement emerged between neuropsychology and treating medical consultant opinions, independent of available neuroimaging evidence. The findings highlight the contribution of neuropsychological testing in the diagnosis of dementia in hospital settings. Replication of these results is required using prospective designs, larger samples, multiple sites, and autopsy confirmed diagnoses.

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Guidelines for the evaluation of dementia and age-related cognitive change.

Cited by 54 publications

References 27 publications

Functional imaging of cognition in an old-old population: A case for portable functional near-infrared spectroscopy

Functional imaging of cognition in an old-old population: A case for portable functional near-infrared spectroscopy

People with dementia in nursing home research: a methodological review of the definition and identification of the study population

Hit or Miss? Diagnostic contributions of neuropsychological assessment in patients with suspected dementia

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