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A methodological critique of the National Institute of Aging and Alzheimer’s Association Guidelines for Alzheimer’s disease, dementia, and mild cognitive impairments
- Authors:
- GARRETT Mario D., VALLE Ramon
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 15(2), 2016, pp.239-254.
- Publisher:
- Sage
In 2011, the U.S. National Institute on Aging published guidelines for clinical diagnostics for Alzheimer’s disease dementia. These guidelines define a continuum with three stages—an early, pre-clinical stage with no symptoms, followed by mild cognitive impairment, and a final stage of Alzheimer’s disease dementia. This methodological critique examines the validity of this continuum. No studies exist showing the progression of these biomarkers to Alzheimer’s disease. There is also a lack of empirical evidence showing how biomarkers determine mild cognitive impairment, which has multiple etiologies. The guidelines fail to explain anomalies where there are biomarkers but no expression of Alzheimer’s disease. (Publisher abstract)
Semantic dementia, a long, sad, lonely journey
- Author:
- LAMONT Myra
- Journal article citation:
- Journal of Dementia Care, 22(5), 2014, pp.29-31.
- Publisher:
- Hawker
The author shares the story of her husband Archie's altered diagnosis, from Alzheimer's disease to semantic dementia (a type of fronto-temporal dementia), the lack of professional awareness and support they have encountered along the way. (Publisher abstract)
A future state of mind: facing up to the dementia challenge
- Authors:
- BROUGHTON Nida, KEOHANE Nigel, SHORTHOUSE Ryan
- Publisher:
- Social Market Foundation
- Publication year:
- 2012
- Pagination:
- 84p.
- Place of publication:
- London
In the context of forecasts of an increase in the number of people with dementia as the UK population ages, and the launch of the Dementia Challenge by the Prime Minister in 2012, this report looks at diagnosis and early diagnosis of people with dementia. It is based on an extensive literature review, qualitative research involving semi-structured interviews with patients diagnosed with Alzheimer's and their carers or relatives, and quantitative analysis. It notes that evidence suggests that diagnosis is important, and considers the benefits of early diagnosis of dementia, how the UK's diagnosis performance compares internationally and how England performs compared to the devolved administrations. It identifies and discusses patient and professional barriers to early diagnosis. It concludes by proposing policies to improve the early diagnosis rate.
Personality changes in Alzheimer's disease: a systematic review
- Authors:
- WAHLIN Tarja-Brita Robins, BYRNE Gerald J.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 26(10), October 2011, pp.1019-1029.
- Publisher:
- Wiley
People with Alzheimer's disease (AD) commonly exhibit changes in personality that sometimes precedes other early clinical manifestations such as cognitive impairment and mood changes. Early identification of personality change might therefore assist with diagnosis of AD. The objective of this paper is to provide a systematic review of the literature to examine the nature and extent of change as the mean difference in score before and after the diagnosis of AD. The findings showed a mean increase in neuroticism of 10–20 T scores, a decrease of the same magnitude in extraversion, consistently reduced openness and agreeableness, and a marked decrease in conscientiousness of about 20–30 T scores. These changes were systematic and consistent. The article concludes that conscientiousness
An introduction to Alzheimer's disease
- Author:
- ALZHEIMER'S SOCIETY
- Publisher:
- Alzheimer's Society
- Publication year:
- 2010
- Pagination:
- 25p.
- Place of publication:
- London
This booklet provides a concise, straight forward introduction to Alzheimer’s disease, the most common cause of dementia. It is written to help anyone affected by Alzheimer's disease including, those with dementia, friends and family members, and professionals, to understand the condition. The contents include: causes, symptoms and diagnosis of Alzheimer's disease; treatment and care; support
Mild cognitive impairment: international perspectives
- Editors:
- TUOKKO Holly A., HULTSCH David F., (eds.)
- Publisher:
- Taylor and Francis
- Publication year:
- 2006
- Pagination:
- 319p.
- Place of publication:
- New York
... together these differing perspectives on MCI for the first time. This volume provides a comprehensive resource for clinicians, researchers, and students involved in the study, diagnosis, treatment, and rehabilitation of people with MCI. Clinical investigators initially defined mild cognitive impairment (MCI) as a transitional condition between normal aging and the early stages of Alzheimer’s disease
Diagnostic accuracy of 123I-FP-CIT SPECT in possible dementia with Lewy bodies
- Authors:
- OBREIN John T., et al
- Journal article citation:
- British Journal of Psychiatry, 194(1), January 2009, pp.34-39.
- Publisher:
- Cambridge University Press
Of 44 people with possible dementia with Lewy bodies at baseline, at follow-up the diagnosis for 19 people was probable dementia with Lewy bodies (43%), in 7 people non-Lewy body dementia (16%) and for 18 individuals it remained possible dementia with Lewy bodies (41%). Of the 19 who at follow-up were diagnosed with probable dementia with Lewy bodies, 12 had abnormal scans at baseline (sensitivity 63%); all 7 individuals with a possible diagnosis who were diagnosed as having Alzheimer’s disease at follow-up had normal scans (specificity 100%). These findings confirm the diagnostic accuracy of 123I-FP-CIT SPECT in distinguishing Lewy body from non-Lewy body dementia and also suggest a clinically useful role in diagnostically uncertain cases, as an abnormal scan in a person with possible
Frontotemporal dementia - a clinically complex diagnosis
- Authors:
- ROSNESS Tor Atle, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(8), August 2008, pp.837-842.
- Publisher:
- Wiley
This study aimed to compare the time taken to establish a clinical diagnosis of Frontotemporal dementia (FTD) relative to a diagnosis of early onset Alzheimer's dementia (AD). The data came from 89 patients under the age of 65 years, 52 of whom met the Manchester-Lund criteria for Frontotemporal dementia; 20 of these came from Lund University Hospital in Sweden. The other 32 patients with FTD along with 37 subjects who fulfilled the ICD-10 criteria for early onset Alzheimer's disease were recruited from four memory clinics and two neurology departments in Norway. For FTD patients in Norway it took 59.2 months (SD 36.1) from the onset of illness until a clinical FTD diagnosis was made. The corresponding time period for FTD patients in Sweden is 49.5 months (SD 24.5) and for AD patients in Norway 39.1 months (SD 19.9). The time from the first visit to a medical doctor until a diagnosis was made for the FTD patients in Norway was 34.5 months (SD 22.6), for the Swedish FTD patients 23.1 months (SD 22.4) and for the AD patients 25.9 months (SD 13.1). In all, 71% of FTD patients and 30% of AD patients initially received a non-dementia diagnosis. More knowledge about early presenting cognitive and behavioural signs of FTD is needed in both primary and secondary health care to reduce the time period needed to establish a clinical diagnosis of FTD.
Differentiation of semantic dementia and Alzheimer's disease using the Addenbrooke's Cognitive Examination (ACE)
- Authors:
- DAVIES R. Rhys, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(4), April 2008, pp.370-375.
- Publisher:
- Wiley
The Addenbrooke's Cognitive Examination (ACE) is a simple diagnostic tool bridging the gap between the very brief Mini Mental State Exam (MMSE) and much longer test batteries used by neuropsychologists which has proven extremely popular internationally. This study aimed to assess the ability of the ACE to differentiate semantic dementia (SD) from Alzheimer's disease (AD). The ACE was administered to three groups: SD patients (n = 40) and two separate groups of AD patients (n = 40 in each), matched for overall ACE or MMSE score. Significant differences were found between SD and both AD groups for the ACE sub-scores of naming, reading and orientation in time. Discriminant analysis (SD versus AD) led to the formulation of a semantic index (naming plus reading minus scores for serial-7s, orientation in time and drawing). Application of the semantic index to the patient data found values of less than zero to be predictive of SD rather than AD with 88% sensitivity and 90% specificity. Validation analysis in an independent sample of 24 SD and AD patients proved even more favourable. The overall ACE score is known to be a sensitive, and specific, indicator of early neurodegenerative dementia; this study shows that the ACE can also be used to detect SD through application of the semantic index.
When the future comes
- Author:
- MICKEL Andrew
- Journal article citation:
- Community Care, 1.05.08, 2008, pp.310-31.
- Publisher:
- Reed Business Information
... says better information is crucial to early diagnosis.