&lt;p&gt;Dementia Diagnoses and Treatment in Geriatric Ward Patients: A Cross-Sectional Study in Poland&lt;/p&gt;

Wojszel, Zyta Beata

doi:10.2147/cia.s281723

Cited by 5 publications

(3 citation statements)

References 45 publications

(47 reference statements)

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“…This makes decreasing functional independence a sensitive marker for early detection of neurocognitive impairment, similar to other studies. 15,16,40 However, with a low correlation between neurocognitive impairment and functionality and most of the participants in this study remaining functionally independent (slightly and completely no dependence) despite having a severe neurocognitive impairment, it makes functionality a poorer predictor of neurocognitive impairment. Therefore, additional methods for early diagnosis of neurocognitive impairment are highly suggested, which may include (i) facilitating routine screening for dementia with simple diagnostic tools for cognitive decline, (ii) making it routine to report neurocognitive scores for every elderly person attending a healthcare facility, or (iii) having a high index of suspicion in the presences of commonly identified risk factors.…”

Section: Discussionmentioning

confidence: 67%

Prevalence of Severe Neurocognitive Impairment and Its Association with Socio-Demographics and Functionality Among Ugandan Older Persons: A Hospital-Based Study

Atim

Kaggwa

Mamun³

et al. 2021

CIA

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Background:The prevalence of neurocognitive disorders, especially dementia, is rising due to an increase in longevity. Early detection and diagnosis of neurocognitive impairments are important for early interventions and appropriate management of reversible causes, especially by the primary health workers. However, this study aimed to determine the prevalence and associated factors of severe neurocognitive impairment among elderly persons attending a tertiary hospital in Uganda. Methods: This cross-sectional survey was conducted in a Ugandan hospital setting, where older adults go for treatment for their chronic health problems. Following the inclusion criteria, interviews were conducted, where information about socio-demographics was collected, whereas neurocognitive impairment and functionality were assessed by Mini-Mental State Examination and Barthel Index, respectively. Chi-square test, Pearson correlation test, and logistic regression were performed to determine the factors associated with severe neurocognitive impairment. Results: A total of 507 elderly persons aged 60 years and above were enrolled in this study (mean age 68.62 ±7.95 years), and the prevalence of severe neurocognitive impairment was 28.01%. Advanced age, female gender, lower education level, and functional dependency were significantly associated with severe neurocognitive impairment. Conclusion:Severe neurocognitive impairment is prevalent among Ugandan hospital attending elderlies with functional dependency. This suggests a need to routinely screen cognitive disorders among older persons who visit the healthcare facilities with other physical complaints to enable early detection and treatment of reversible causes of neurocognitive impairment, such as depression and delirium to enable better functionality.

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Section: Discussionmentioning

confidence: 67%

Prevalence of Severe Neurocognitive Impairment and Its Association with Socio-Demographics and Functionality Among Ugandan Older Persons: A Hospital-Based Study

Atim

Kaggwa

Mamun³

et al. 2021

CIA

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“…Taking OACs can reduce the risk of embolism, but it also increases the risk of bleeding. Therefore, whether to take OACs should be judged by the patient's health situation (38). If AF develops during the first year after ACS and there is an indication for thromboembolic prevention with anticoagulation, OACs should be started.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the CHA2DS2-VASc Score for the Prediction of Death in Elderly Patients With Coronary Artery Disease and Atrial Fibrillation

Wang

Dong

et al. 2021

Front. Cardiovasc. Med.

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Purpose: Coronary artery disease (CAD) and atrial fibrillation (AF) often coexist and lead to a much higher risk of mortality in the elderly population. The aim of this study was to investigate whether the CHA2DS2-VASc score could predict the risk of death in elderly patients with CAD and AF.Methods: Hospitalized patients aged ≥65 years with a diagnosis of CAD and AF were recruited consecutively. Patients were divided into 5 groups according to the CHA2DS2-VASc score (≤2, =3, =4, =5, and ≥6). At least a 1-year follow-up was carried out for the assessment of all-cause death.Results: A total of 1,579 eligible patients were recruited, with 582 all-cause deaths (6.86 per 100 patient-years) occurring during a follow-up of at least 1 year. With the increase in the CHA2DS2-VASc score, the 1-year and 5-year survival rate decreased (96.4% vs. 95.7% vs. 94.0% vs. 86.5% vs. 85.7%, respectively, P < 0.001; 78.4% vs. 68.9% vs. 64.6% vs. 55.5% vs. 50.0%, respectively, P < 0.001). Compared with the patients with CHA2DS2-VASc score <5, for patients with CHA2DS2-VASc score ≥5, the adjusted hazard ratio for death was 1.78 (95% CI: 1.45–2.18, P < 0.001). The predictive values of the CHA2DS2-VASc score ≥5 for in-hospital (C-index = 0.66, 95% CI: 0.62–0.69, P < 0.001), 1-year (C-index = 0.65, 95% CI: 0.63–0.67, P < 0.001) and 5-year (C-index = 0.60, 95% CI: 0.59–0.61, P < 0.001) death were in comparable.Conclusion: In elderly patients with concomitant CAD and AF, the CHA2DS2-VASc score can be used to predict death with moderate accuracy.

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“…Since family physicians (FPs) act as gatekeepers of the care pathway, they should have the capacity to detect early cognitive decline, provide information and appropriate referral to specialists, and reduce the use of harmful or ineffective interventions (3). Despite the attention to a timely diagnosis, in Italy and other European countries dementia is underrecognized and under-managed in primary care settings (4)(5)(6), and cognitive decline is often not mentioned in the medical records until it is indicative of a serious condition (7). A previous experience from a study (the REMIND study) in the Health Authority (HA) of Milan in Northern Italy revealed difficulties in the ability of FPs to early recognize cognitive decline and provide appropriate referral to a specialized service.…”

Section: Introductionmentioning

confidence: 99%

Educational interventions to improve detection and management of cognitive decline in primary care—An Italian multicenter pragmatic study

Lombardi

Chipi²,

Arenella³

et al. 2022

Front. Psychiatry

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IntroductionTimely detection of cognitive decline in primary care is essential to promote an appropriate care pathway and enhance the benefits of interventions. We present the results of a study aimed to evaluate the effectiveness of an educational intervention addressed to Italian family physicians (FPs) to improve timely detection and management of cognitive decline.Materials and methodsWe conducted a pre-post study in six Italian health authorities (HAs) involving 254 FPs and 3,736 patients. We measured process and outcome indicators before the intervention (1 January 2014 to 31 December 2016) and after the intervention (1 January 2018 to 31 December 2019). One interactive face-to-face session workshop was delivered by local cognitive disorders and dementia specialists and FP advisors at each HA, in the period September 2017–December 2017. The session focused on key messages of the local Diagnostic and Therapeutic Care Pathway (DTCP) or regional guidelines: (a) the role of the FP for a timely suspicion of cognitive decline is fundamental; (b) when cognitive decline is suspected, the role of the FP is active in the diagnostic work-up; (c) FP’s knowledge on pharmacological and non-pharmacological interventions is essential to improve the management of patients with cognitive decline.ResultsAn overall improvement in diagnostic procedures and management of patients with cognitive decline by FPs after the intervention was observed. The number of visits per year performed by FPs increased, and the time interval between the first FP consultation and the diagnosis was optimized. Neuroleptic use significantly decreased, whereas the use of benzodiazepines remained steadily high. Non-pharmacological interventions, or use of support services, were underrepresented even in the post-intervention. Differences among the participating HAs were identified and discussed.DiscussionResults from this study suggest the success of the educational intervention addressed to FPs in improving early detection and management of cognitive decline, highlighting the importance to continue medical education in this field. At the same time, further initiatives of care pathway dissemination and implementation should promote strategies to enhance interactions between primary and secondary care optimizing the collaboration between FPs and specialists.

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<p>Dementia Diagnoses and Treatment in Geriatric Ward Patients: A Cross-Sectional Study in Poland</p>

Cited by 5 publications

References 45 publications

Prevalence of Severe Neurocognitive Impairment and Its Association with Socio-Demographics and Functionality Among Ugandan Older Persons: A Hospital-Based Study

Prevalence of Severe Neurocognitive Impairment and Its Association with Socio-Demographics and Functionality Among Ugandan Older Persons: A Hospital-Based Study

Assessment of the CHA2DS2-VASc Score for the Prediction of Death in Elderly Patients With Coronary Artery Disease and Atrial Fibrillation

Educational interventions to improve detection and management of cognitive decline in primary care—An Italian multicenter pragmatic study

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