Age-associated memory impairment and Alzheimer's disease

[Cognitive disorders and dementias in the private practice of specialists: pilot study of a self-assessment survey]

OBJECTIVES

To know about the features of cognitive disorders and dementias in the private practice of specialists and these doctor's skills on that area.

METHOD

In this pilot study, self-assessment questionnaires were delivered to neurologists of São Paulo State and 196 (22.8%) were respondents.

RESULTS

Many neurologists are involved, besides the private practice, with teaching (61.5%) and/or research (59.5%) activities. Most of them assessed as not good the training on cognitive disorders and dementias they had had during both the graduate (77.3%) and residence (63.1%) courses; nevertheless 60.8% self rated their knowledge on that subject as satisfactory and 83.0% declared their interest on it as at least equal to other areas. The most frequent cognitive complaints occurring as primary reason for appointment are memory loss (73.0%) and attention/concentration deficits (48.0%). Dementia of Alzheimer type (54.9%) and vascular dementia (23.0%) are the most frequent ones in the neurologist private practice.

CONCLUSION

Cognitive disorders and dementias represent a significant proportion in the neurological private practice. Although they had not had a good training on the area of cognitive disorders and dementias, the respondent neurologists demonstrated great interest on it.

Mild cognitive impairment--a review of prevalence, incidence and outcome according to current approaches

OBJECTIVE

Mild cognitive impairment is associated with an increased risk of developing dementia. However, agreement needs to be reached on clearly specified diagnostic criteria for mild cognitive impairment. The present paper critically reviews the different constructs of mild cognitive impairment on the basis of the available empirical evidence.

METHOD

All published papers on mild cognitive impairment during the last 15 years on Medline and other databases were reviewed.

RESULTS

Age-specific prevalence and incidence rates according to the different constructs as well as the prognostic significance of the different constructs concerning the development of dementia are reported. Furthermore, a brief summary of recent research on possible risk factors for a negative course of mild cognitive impairment is provided.

CONCLUSION

As there is no construct to date that pools all efforts of defining mild cognitive impairment, the review provides suggestions for an agreement on constructive terminology and research practice.

Cognitive impairment in elderly who are not yet demented

Patients with neuropathological changes of Alzheimer disease may not be demented during initial evaluation of memory disturbance. Understanding current issues regarding the patient with incipient degenerative dementia should help identify those at greatest risk for progression and may help delay onset of symptoms.