651
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Neuroscience-driven discovery and development of sleep therapeutics. Pharmacol Ther 2014; 141:300-34. [DOI: 10.1016/j.pharmthera.2013.10.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 10/25/2013] [Indexed: 01/18/2023]
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652
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Wimo A, Ballard C, Brayne C, Gauthier S, Handels R, Jones RW, Jonsson L, Khachaturian AS, Kramberger M. Health economic evaluation of treatments for Alzheimer's disease: impact of new diagnostic criteria. J Intern Med 2014; 275:304-16. [PMID: 24605810 DOI: 10.1111/joim.12167] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The socio-economic impact of Alzheimer's disease (AD) and other dementias is enormous, and the potential economic challenges ahead are clear given the projected future numbers of individuals with these conditions. Because of the high prevalence and cost of dementia, it is very important to assess any intervention from a cost-effectiveness viewpoint. The diagnostic criteria for preclinical AD suggested by the National Institute on Aging and Alzheimer's Association workgroups in combination with the goal of effective disease-modifying treatment (DMT) are, however, a challenge for clinical practice and for the design of clinical trials. Key issues for future cost-effectiveness studies include the following: (i) the consequences for patients if diagnosis is shifted from AD-dementia to predementia states, (ii) bridging the gap between clinical trial populations and patients treated in clinical practice, (iii) translation of clinical trial end-points into measures that are meaningful to patients and policymakers/payers and (iv) how to measure long-term effects. To improve cost-effectiveness studies, long-term population-based data on disease progression, costs and outcomes in clinical practice are needed not only in dementia but also in predementia states. Reliable surrogate end-points in clinical trials that are sensitive to detect effects even in predementia states are also essential as well as robust and validated modelling methods from predementia states that also take into account comorbidities and age. Finally, the ethical consequences of early diagnosis should be considered.
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Affiliation(s)
- A Wimo
- Department of Neurobiology, Care Sciences and Society, Alzheimer's Disease Research Center, Karolinska Institutet, Stockholm, Sweden; Centre for Research & Development, Uppsala University/County of Gävleborg, Gävle, Sweden
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653
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Biessels GJ, Strachan MWJ, Visseren FLJ, Kappelle LJ, Whitmer RA. Dementia and cognitive decline in type 2 diabetes and prediabetic stages: towards targeted interventions. Lancet Diabetes Endocrinol 2014; 2:246-55. [PMID: 24622755 DOI: 10.1016/s2213-8587(13)70088-3] [Citation(s) in RCA: 382] [Impact Index Per Article: 38.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Type 2 diabetes is associated with dementia, and also with more slight cognitive decrements. In this Review we discuss trajectories from normal cognition to dementia in people with type 2 diabetes, and explore opportunities for treatment. Slight diabetes-associated cognitive decrements and dementia affect different age groups and show a different evolution. These cognitive entities should therefore not be regarded as a continuum, although their effects might be additive. Vascular damage is a key underlying process in both entities. Glucose-mediated processes and other metabolic disturbances might also have a role. No treatment has been established, but management of vascular risk factors and optimisation of glycaemic control could have therapeutic benefit. We identify possible opportunities for intervention to improve cognitive outcomes in people with type 2 diabetes, and suggest how treatment can be tailored to individual risk profiles and comorbidities.
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Affiliation(s)
- Geert Jan Biessels
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands.
| | | | - Frank L J Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, Netherlands
| | - L Jaap Kappelle
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
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654
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Shenkin SD, Russ TC, Ryan TM, MacLullich AMJ. Screening for dementia and other causes of cognitive impairment in general hospital in-patients. Age Ageing 2014; 43:166-8. [PMID: 24280009 DOI: 10.1093/ageing/aft184] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Susan D Shenkin
- Department of Geriatric Medicine, University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4TJ, UKTel: (+44) 1312426481; Fax: (+44) 1312426370
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655
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Caracciolo B, Xu W, Collins S, Fratiglioni L. Cognitive decline, dietary factors and gut–brain interactions. Mech Ageing Dev 2014; 136-137:59-69. [DOI: 10.1016/j.mad.2013.11.011] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 11/16/2013] [Accepted: 11/28/2013] [Indexed: 02/08/2023]
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656
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Annweiler C, Karras SN, Anagnostis P, Beauchet O. Vitamin D supplements: a novel therapeutic approach for Alzheimer patients. Front Pharmacol 2014; 5:6. [PMID: 24478705 PMCID: PMC3904112 DOI: 10.3389/fphar.2014.00006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 01/08/2014] [Indexed: 02/01/2023] Open
Affiliation(s)
- Cedric Annweiler
- Department of Geriatric Medicine, UPRES EA 4638, University Hospital Angers, France ; Robarts Research Institute, University of Western Ontario London, ON, Canada
| | - Spyridon N Karras
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Panagiotis Anagnostis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Olivier Beauchet
- Department of Geriatric Medicine, UPRES EA 4638, University Hospital Angers, France
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657
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Marciniak R, Sheardova K, Cermáková P, Hudeček D, Sumec R, Hort J. Effect of meditation on cognitive functions in context of aging and neurodegenerative diseases. Front Behav Neurosci 2014; 8:17. [PMID: 24478663 PMCID: PMC3903052 DOI: 10.3389/fnbeh.2014.00017] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 01/11/2014] [Indexed: 12/31/2022] Open
Abstract
Effect of different meditation practices on various aspects of mental and physical health is receiving growing attention. The present paper reviews evidence on the effects of several mediation practices on cognitive functions in the context of aging and neurodegenerative diseases. The effect of meditation in this area is still poorly explored. Seven studies were detected through the databases search, which explores the effect of meditation on attention, memory, executive functions, and other miscellaneous measures of cognition in a sample of older people and people suffering from neurodegenerative diseases. Overall, reviewed studies suggested a positive effect of meditation techniques, particularly in the area of attention, as well as memory, verbal fluency, and cognitive flexibility. These findings are discussed in the context of MRI studies suggesting structural correlates of the effects. Meditation can be a potentially suitable non-pharmacological intervention aimed at the prevention of cognitive decline in the elderly. However, the conclusions of these studies are limited by their methodological flaws and differences of various types of meditation techniques. Further research in this direction could help to verify the validity of the findings and clarify the problematic aspects.
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Affiliation(s)
- Rafał Marciniak
- International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Katerina Sheardova
- International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Pavla Cermáková
- International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic ; Alzheimer's Disease Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden
| | - Daniel Hudeček
- International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Rastislav Sumec
- International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Jakub Hort
- International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic ; Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol , Prague , Czech Republic
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658
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Imtiaz B, Tolppanen AM, Kivipelto M, Soininen H. Future directions in Alzheimer's disease from risk factors to prevention. Biochem Pharmacol 2014; 88:661-70. [PMID: 24418410 DOI: 10.1016/j.bcp.2014.01.003] [Citation(s) in RCA: 152] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 12/30/2013] [Accepted: 01/03/2014] [Indexed: 12/21/2022]
Abstract
The increase in life expectancy has resulted in a high occurrence of dementia and Alzheimer's disease (AD). Research on AD has undergone a paradigm shift from viewing it as a disease of old age to taking a life course perspective. Several vascular, lifestyle, psychological and genetic risk factors influencing this latent period have been recognized and they may act both independently and by potentiating each other. These risk factors have consequently been used to derive risk scores for predicting the likelihood of dementia. Despite population differences, age, low education and vascular risk factors were identified as key factors in all scoring systems. Risk scores can help to identify high-risk individuals who might benefit from different interventions. The European Dementia Prevention Initiative (EDPI), an international collaboration, encourages data sharing between different randomized controlled trials. At the moment, it includes three large ongoing European trials: Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), Prevention of Dementia by Intensive Vascular Care (preDIVA), and Multidomain Alzheimer Prevention study (MAPT). Recently EDPI has developed a "Healthy Aging through Internet Counseling in Elderly" (HATICE) program, which intends to manage modifiable risk factors in an aged population through an easily accessible Internet platform. Thus, the focus of dementia research has shifted from identification of potential risk factors to using this information for developing interventions to prevent or delay the onset of dementia as well as identifying special high-risk populations who could be targeted in intervention trials.
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Affiliation(s)
- Bushra Imtiaz
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland
| | - Anna-Maija Tolppanen
- Research Center for Comparative Effectiveness and Patient Safety (RECEPS) and School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Miia Kivipelto
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland; Aging Research Center (ARC), Karolinska Institute and Stockholm University, Stockholm, Sweden
| | - Hilkka Soininen
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland; Neurocenter Neurology, Kuopio University Hospital, Kuopio, Finland.
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659
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Mukadam N, Livingston G, Rantell K, Rickman S. Diagnostic rates and treatment of dementia before and after launch of a national dementia policy: an observational study using English national databases. BMJ Open 2014; 4:e004119. [PMID: 24413352 PMCID: PMC3902654 DOI: 10.1136/bmjopen-2013-004119] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To assess the 2009 National Dementia Strategy's (NDS) impact on dementia diagnosis and treatment. SETTING AND PARTICIPANTS Primary care data for England before and after launch of the NDS. PRIMARY OUTCOME MEASURES We used nationally available data to estimate the trends over time in rates of dementia diagnoses recorded on the Quality Outcomes Framework (QOF) in Primary Care Trusts (PCT) and antidementia medication prescriptions from 2006/2007 (the first available figures) and the associated increase in cost relative to all other prescriptions. To establish PCT general practitioner (GP) QOF dementia recording validity, we correlated it with medication prescription using the NIC (net ingredient cost). RESULTS Regression analysis showed that dementia diagnosis rate was lower prior to launch of the NDS and increased significantly after it was launched. The number of antidementia prescriptions and the cost of antidementia drugs relative to total PCT prescribing costs increased significantly after 2009. GP recording of dementia diagnosis correlated highly with prescription of cholinesterase inhibitors and memantine in the same area (p<0.001 each year). CONCLUSIONS The launch of the NDS was associated with a significant increase in dementia diagnosis rates and prescriptions of antidementia drugs. We cannot establish the causality but this was a change from the prelaunch pattern. Further assessment of any intervention to increase the diagnoses should include an assessment of harm as well as potential benefit.
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Affiliation(s)
- Naaheed Mukadam
- Mental Health Sciences Unit, UCL, Charles Bell House, London, UK
| | - Gill Livingston
- Mental Health Sciences Unit, UCL, Charles Bell House, London, UK
| | | | - Sam Rickman
- Mental Health Sciences Unit, UCL, Charles Bell House, London, UK
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660
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Reitz C, Mayeux R. Alzheimer disease: epidemiology, diagnostic criteria, risk factors and biomarkers. Biochem Pharmacol 2014; 88:640-51. [PMID: 24398425 DOI: 10.1016/j.bcp.2013.12.024] [Citation(s) in RCA: 757] [Impact Index Per Article: 75.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 12/20/2013] [Accepted: 12/20/2013] [Indexed: 12/20/2022]
Abstract
The global prevalence of dementia is as high as 24 million, and has been predicted to quadruple by the year 2050. In the US alone, Alzheimer disease (AD) - the most frequent cause of dementia characterized by a progressive decline in cognitive function in particular the memory domain - causes estimated health-care costs of $ 172 billion per year. Key neuropathological hallmarks of the AD brain are diffuse and neuritic extracellular amyloid plaques - often surrounded by dystrophic neurites - and intracellular neurofibrillary tangles. These pathological changes are frequently accompanied by reactive microgliosis and loss of neurons, white matter and synapses. The etiological mechanisms underlying these neuropathological changes remain unclear, but are probably caused by both environmental and genetic factors. In this review article, we provide an overview of the epidemiology of AD, review the biomarkers that may be used for risk assessment and in diagnosis, and give suggestions for future research.
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Affiliation(s)
- Christiane Reitz
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, United States; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, United States; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Richard Mayeux
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, United States; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, United States; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, United States; Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY, United States; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, United States.
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661
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Bennett DA, Arnold SE, Valenzuela MJ, Brayne C, Schneider JA. Cognitive and social lifestyle: links with neuropathology and cognition in late life. Acta Neuropathol 2014; 127:137-50. [PMID: 24356982 PMCID: PMC4054865 DOI: 10.1007/s00401-013-1226-2] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 11/17/2013] [Accepted: 11/30/2013] [Indexed: 12/26/2022]
Abstract
Many studies report an association of cognitive and social experiential factors and related traits with dementia risk. Further, many clinical-pathologic studies find a poor correspondence between levels of neuropathology and the presence of dementia and level of cognitive impairment. The poor correspondence suggests that other factors contribute to the maintenance or loss of cognitive function, with factors associated with the maintenance of function referred to as neural or cognitive reserve. This has led investigators to examine the associations of cognitive and social experiential factors with neuropathology as a first step in disentangling the complex associations between these experiential risk factors, neuropathology, and cognitive impairment. Despite the consistent associations of a range of cognitive and social lifestyle factors with cognitive decline and dementia risk, the extant clinical-pathologic data find only a single factor from one cohort, linguistic ability, related to AD pathology. Other factors, including education, harm avoidance, and emotional neglect, are associated with cerebrovascular disease. Overall, the associations are weak. Some factors, such as education, social networks, and purpose in life, modify the relation of neuropathology to cognition. Finally, some factors such as cognitive activity appear to bypass known pathologies altogether suggesting a more direct association with biologic indices that promote person-specific differences in reserve and resilience. Future work will first need to replicate findings across more studies to ensure the veracity of the existing data. Second, effort is needed to identify the molecular substrates of neural reserve as potential mediators of the association of lifestyle factors with cognition.
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Affiliation(s)
- David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA,
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662
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Affiliation(s)
- Eric B Larson
- From the Group Health Research Institute and the Departments of Medicine and Health Services, University of Washington - both in Seattle (E.B.L.); the Departments of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California, San Francisco, and the San Francisco Veterans Affairs (VA) Medical Center - both in San Francisco (K.Y.); and the Division of General Medicine, VA Ann Arbor Center for Clinical Management Research, and the Institute for Social Research, Institute of Gerontology, and Institute for Healthcare Policy and Innovation, University of Michigan - all in Ann Arbor (K.M.L.)
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663
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White SM. Ethical and legal aspects of anaesthesia for the elderly. Anaesthesia 2013; 69 Suppl 1:45-53. [DOI: 10.1111/anae.12519] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2013] [Indexed: 11/30/2022]
Affiliation(s)
- S. M. White
- Brighton and Sussex University Hospitals NHS Trust; Brighton East Sussex UK
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664
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Ritchie CW, Wells K, Ritchie K. The PREVENT research programme--a novel research programme to identify and manage midlife risk for dementia: the conceptual framework. Int Rev Psychiatry 2013; 25:748-54. [PMID: 24423227 DOI: 10.3109/09540261.2013.869195] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
It is clear that the neurodegenerative disease processes which cause dementias are initiated many years before the onset of symptoms. In people with mild cognitive impairment there is already good evidence available to suggest that many of the key pathologies are well established. The PREVENT research programme seeks to understand the origin point and sequence of pathological changes which lead to dementia. It also aims to determine what clinical, environmental and genetic factors increase (or decrease) the risk of these changes initiating and developing. From this data we will be able to develop risk models that can be applied both in clinical practice and research which illustrate the chances a given individual has of developing clinical symptoms of neurodegenerative disease. Once these risks are identified and the sequence of pathological events are characterized; interventions to remove risk or reduce the impact of a risk can be undertaken, as can studies of agents which specifically target the earliest or most up-stream pathological processes. This paper provides the conceptual framework for the PREVENT programme and other similar studies interrogating people in midlife with a view to providing empirical evidence to inform intervention studies and better clinical practice.
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665
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Abstract
Vascular cognitive impairment defines alterations in cognition, ranging from subtle deficits to full-blown dementia, attributable to cerebrovascular causes. Often coexisting with Alzheimer's disease, mixed vascular and neurodegenerative dementia has emerged as the leading cause of age-related cognitive impairment. Central to the disease mechanism is the crucial role that cerebral blood vessels play in brain health, not only for the delivery of oxygen and nutrients, but also for the trophic signaling that inextricably links the well-being of neurons and glia to that of cerebrovascular cells. This review will examine how vascular damage disrupts these vital homeostatic interactions, focusing on the hemispheric white matter, a region at heightened risk for vascular damage, and on the interplay between vascular factors and Alzheimer's disease. Finally, preventative and therapeutic prospects will be examined, highlighting the importance of midlife vascular risk factor control in the prevention of late-life dementia.
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Affiliation(s)
- Costantino Iadecola
- Brain and Mind Research Institute, Weill Cornell Medical College, New York, NY 10021, USA.
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666
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de Rotrou J, Wu YH, Mabire JB, Moulin F, de Jong LW, Rigaud AS, Hanon O, Vidal JS. Does cognitive function increase over time in the healthy elderly? PLoS One 2013; 8:e78646. [PMID: 24244332 PMCID: PMC3823862 DOI: 10.1371/journal.pone.0078646] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 09/15/2013] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND In dementia screening, most studies have focused on early cognitive impairment by comparing patients suffering from mild dementia or mild cognitive impairment with normal subjects. Few studies have focused on modifications over time of the cognitive function in the healthy elderly. The objective of the present study was to analyze the cognitive function changes of two different samples, born > 15 years apart. METHOD A first sample of 204 cognitively normal participants was recruited in the memory clinic of Broca hospital between 1991 and 1997. A second sample of 177 cognitively normal participants was recruited in 2008-2009 in the same institution. Both samples were from the same districts of Paris and were assessed with the same neuropsychological test battery. Mean cognitive test scores were compared between 1991 and 2008 samples, between < 80 years old and ≥ 80 years old in 1991 and 2008 samples, and finally between subjects < 80 year old of 1991 sample and subjects ≥ 80 years old of the 2008 sample. Means were compared with T-tests stratified on gender, age-groups and educational level. RESULTS Cognitive scores were significantly higher in the 2008 sample. Participants < 80 years old outperformed those ≥ 80 in both samples. However, participants < 80 years old in 1991 sample and subjects ≥ 80 in the 2008 sample, born on average in 1923, performed mostly identically. CONCLUSION This study showed a significant increase of cognitive scores over time. Further, contemporary octogenarians in the later sample performed like septuagenarians in the former sample. These findings might be consistent with the increase in life expectancy and life span in good health. The study highlights the necessity to take into account factors which may contaminate and artificially inflate the age-related differences in favor of younger to the older adults.
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Affiliation(s)
- Jocelyne de Rotrou
- Service de Gérontologie, Hôpital Broca, Assistance Publique-Hôpitaux de Paris, Paris, France
- Equipe d’Accueil 4468, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Ya-Huei Wu
- Service de Gérontologie, Hôpital Broca, Assistance Publique-Hôpitaux de Paris, Paris, France
- Equipe d’Accueil 4468, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jean-Bernard Mabire
- Service de Gérontologie, Hôpital Broca, Assistance Publique-Hôpitaux de Paris, Paris, France
- Equipe d’Accueil 4430, Université Paris Ouest, Nanterre, France
| | - Florence Moulin
- Service de Gérontologie, Hôpital Broca, Assistance Publique-Hôpitaux de Paris, Paris, France
- Equipe d’Accueil 4468, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Laura W. de Jong
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Anne-Sophie Rigaud
- Service de Gérontologie, Hôpital Broca, Assistance Publique-Hôpitaux de Paris, Paris, France
- Equipe d’Accueil 4468, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Olivier Hanon
- Service de Gérontologie, Hôpital Broca, Assistance Publique-Hôpitaux de Paris, Paris, France
- Equipe d’Accueil 4468, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jean-Sébastien Vidal
- Service de Gérontologie, Hôpital Broca, Assistance Publique-Hôpitaux de Paris, Paris, France
- Equipe d’Accueil 4468, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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667
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Abstract
Ageing increases the risks of dementia and there are an estimated 667,000 people in England living with dementia. Less than half have a formal diagnosis. Community nurses are now being asked to screen older people for dementia under the Commissioning for Quality and Innovation framework. This article provides a brief explanation of common screening tools and explains the community nurse's role in identifying people who may have undiagnosed dementia.
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668
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Fox C, Lafortune L, Boustani M, Dening T, Rait G, Brayne C. Screening for dementia--is it a no brainer? Int J Clin Pract 2013; 67:1076-80. [PMID: 23952529 DOI: 10.1111/ijcp.12239] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 06/05/2013] [Indexed: 11/28/2022] Open
Abstract
As people are living longer, dementia is becoming a significant issue for society. Dementia is now recognised as a major concern in society, and the numbers of people estimated to have dementia in the UK population appear to have stabilised at around 700,000 . Globally, 35.6 million people are estimated to meet criteria for dementia, a number predicted to double every 20 years . Given the absence of treatments that significantly alter the natural history of the clinical syndrome of dementia, there has been increased emphasis on early diagnosis, with research exploring assessment tools and biomarkers that might predict with certainty a particular clinical outcome. At the same time, there has been pressure to focus on biomedical profiles, which assume a very close link between the pathobiology and the manifest clinical syndrome.
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Affiliation(s)
- C Fox
- Department of Psychological Sciences, Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Norwich, UK
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669
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Affiliation(s)
- Sube Banerjee
- Brighton and Sussex Medical School, University of Sussex, Brighton BN1 9RY, UK.
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670
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