The Takeda three colors combination test: a screening test for detection of very mild Alzheimer's disease

Analyzing the chance of developing dementia among geriatric people: a cross-sectional pilot study in Bangladesh

AIM

Alzheimer's disease is the most common form of dementia, representing 60-80% of cases, and ageing is the primary risk factor for the development of Alzheimer's disease. The objective of this study was to examine the chance of developing dementia (i.e. mild cognitive impairment (MCI), Alzheimer's disease) among geriatric people in Bangladesh.

METHODS

This study included 390 adult citizens of Bangladesh (age range: 60-70 years). The Takeda Three Colors Combination (TTCC) test was used to detect the prevalence of MCI and mild dementia among the subjects, and then the Clinical Dementia Rating was used to determine the level of dementia.

RESULTS

The subjects who were aged 60-65 years included 154 with MCI, 76 with mild dementia, 1 with moderate dementia, 4 with severe dementia, and 29 without dementia. The subjects who were aged 66-70 years included 75 with MCI, 36 with mild dementia, 0 with moderate dementia, 2 with severe dementia, and 13 without dementia. The sensitivity of the TTCC was 75% and 58% for the mild dementia and MCI groups, respectively, and the specificity was 52%. The odds ratio of incorrect responses to the TTCC was 3.42 (95% confidence interval: 1.63-7.21) for subjects with mild dementia compared those without dementia. However, the TTCC outcomes revealed no significant differences between the MCI and non-dementia groups. The results showed no significant associations between cognitive decline/developing dementia and social status/occupation.

CONCLUSION

The outcomes of this study indicated that most of the subjects had MCI or mild dementia and were farmers aged 60-65 years.

Factors Affecting Intention to Undergo Dementia Screening

BACKGROUND

In the present study, we focused on the main perception-related factors that affect people's intention to undergo dementia screening.

METHODS

The 344 subjects that answered all the survey questions were included in the analysis. Data on the following variables were collected: Basic attributes such as age, sex, years of education, and number of people in the household; degree of intention to undergo dementia screening; degree of awareness of the seriousness of the consequences of dementia; degree of awareness that the person may someday develop dementia; degree of awareness of their ability to prevent dementia; availability of social support; degree of knowledge of lifestyle habits that can prevent dementia; role in the community and purpose in life.

RESULTS

There were 110 people in the strong intention group and 234 people in the weak intention group. On univariate analysis, awareness of seriousness, awareness of morbidity, preventability, and knowledge of preventative lifestyle were statistically significant at a significance level of 5%, and these variables tended to be higher in the strong intention group as compared to that in the weak intention group. These were entered in the logistic regression analysis as the explanatory variables, and intention to undergo screening was entered as the objective variable. The results indicated that awareness of seriousness and knowledge of preventative lifestyle had significant influence on intention to undergo screening.

CONCLUSION

The above results suggested that to increase the intention to undergo dementia screening, psychoeducation that encourages people to understand the serious consequences of dementia, efforts to spread awareness of the risk factors for dementia, and promotion of lifestyle factors that are preventative may be effective.

Paradigm Shifts in Ophthalmic Diagnostics

PURPOSE

Future advances in ophthalmology will see a paradigm shift in diagnostics from a focus on dysfunction and disease to better measures of psychophysical function and health. Practical methods to define genotypes will be increasingly important and non-invasive nanotechnologies are needed to detect molecular changes that predate histopathology.

METHODS

This is not a review nor meant to be comprehensive. Specific topics have been selected to illustrate the principles of important paradigm shifts that will influence the future of ophthalmic diagnostics. It is our impression that future evaluation of vision will go beyond visual acuity to assess ocular health in terms of psychophysical function. The definition of disease will incorporate genotype into what has historically been a phenotype-centric discipline. Non-invasive nanotechnologies will enable a paradigm shift from disease detection on a cellular level to a sub-cellular molecular level.

RESULTS

Vision can be evaluated beyond visual acuity by measuring contrast sensitivity, color vision, and macular function, as these provide better insights into the impact of aging and disease. Distortions can be quantified and the psychophysical basis of vision can be better evaluated than in the past by designing tests that assess particular macular cell function(s). Advances in our understanding of the genetic basis of eye diseases will enable better characterization of ocular health and disease. Non-invasive nanotechnologies can assess molecular changes in the lens, vitreous, and macula that predate visible pathology. Oxygen metabolism and circulatory physiology are measurable indices of ocular health that can detect variations of physiology and early disease.

CONCLUSIONS

This overview of paradigm shifts in ophthalmology suggests that the future will see significant improvements in ophthalmic diagnostics. The selected topics illustrate the principles of these paradigm shifts and should serve as a guide to further research and development. Indeed, successful implementation of these paradigm shifts in ophthalmology may provide useful guidance for similar developments in all of healthcare.