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Alzola P, Carnero C, Bermejo-Pareja F, Sánchez-Benavides G, Peña-Casanova J, Puertas-Martín V, Fernández-Calvo B, Contador I. Neuropsychological Assessment for Early Detection and Diagnosis of Dementia: Current Knowledge and New Insights. J Clin Med 2024; 13:3442. [PMID: 38929971 PMCID: PMC11204334 DOI: 10.3390/jcm13123442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
Dementia remains an underdiagnosed syndrome, and there is a need to improve the early detection of cognitive decline. This narrative review examines the role of neuropsychological assessment in the characterization of cognitive changes associated with dementia syndrome at different states. The first section describes the early indicators of cognitive decline and the major barriers to their identification. Further, the optimal cognitive screening conditions and the most widely accepted tests are described. The second section analyzes the main differences in cognitive performance between Alzheimer's disease and other subtypes of dementia. Finally, the current challenges of neuropsychological assessment in aging/dementia and future approaches are discussed. Essentially, we find that current research is beginning to uncover early cognitive changes that precede dementia, while continuing to improve and refine the differential diagnosis of neurodegenerative disorders that cause dementia. However, neuropsychology faces several barriers, including the cultural diversity of the populations, a limited implementation in public health systems, and the adaptation to technological advances. Nowadays, neuropsychological assessment plays a fundamental role in characterizing cognitive decline in the different stages of dementia, but more efforts are needed to develop harmonized procedures that facilitate its use in different clinical contexts and research protocols.
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Affiliation(s)
- Patricia Alzola
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, 37005 Salamanca, Spain;
| | - Cristóbal Carnero
- Neurology Department, Granada University Hospital Complex, 18014 Granada, Spain
| | - Félix Bermejo-Pareja
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Institute of Health Carlos III, 28029 Madrid, Spain
- Institute of Research i+12, University Hospital “12 de Octubre”, 28041 Madrid, Spain
| | | | | | | | | | - Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, 37005 Salamanca, Spain;
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Kumagai R, Sonoda Y, Kowa H. Survey on the current situation for early diagnosis of dementia and contributing factors in Japan. Psychogeriatrics 2024; 24:312-321. [PMID: 38221643 DOI: 10.1111/psyg.13075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/20/2023] [Accepted: 12/27/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Early diagnosis of dementia is important for both initiation of non-pharmacological activities to slow cognitive decline as well as the development of disease-modifying drugs; however, it appears there may be a tendency for formal diagnosis to be delayed. Since the current status of diagnosis in Japan is unclear, we conducted a survey with family caregivers of patients with dementia using questionnaires and interviews to investigate the factors regarding the dementia diagnosis process in Japan. METHODS We distributed questionnaires to family caregivers of people with dementia and conducted additional follow-up interviews with approximately half of them. We calculated odds ratios for the time to diagnosis using logistic regression analysis for each characteristic from the questionnaire data. We also created co-occurrence networks from the interview data in order to provide qualitative context to the questionnaire data. RESULTS We collected 68 questionnaires and conducted 32 interviews. The median time to diagnosis was 12 months, and logistic regression analysis showed a significant trend toward shorter time to diagnosis in the absence of other caregivers. In addition, there were significant differences in age, relationship with patients and the time from the first visit to the final diagnosis between groups with and without other caregivers. CONCLUSIONS The results of this study suggest that the presence or absence of other caregivers may affect caregivers' behaviour and the time taken to receive a diagnosis of dementia. These findings indicate it may be beneficial to predict inhibiting factors and change approaches based on caregivers' and patients' background to promote early diagnosis.
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Affiliation(s)
- Ryoko Kumagai
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
- Centre for Preventing Dementia, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Yuma Sonoda
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
- Advanced Research Center for Well-being, Kobe University, Kobe, Japan
| | - Hisatomo Kowa
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
- Centre for Preventing Dementia, Kobe University Graduate School of Health Sciences, Kobe, Japan
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Xue B, Luo C, Luo X. Attitudes toward dementia screening and influential factors in older adults in China. Psychogeriatrics 2023; 23:211-221. [PMID: 36457142 DOI: 10.1111/psyg.12918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/29/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Dementia will likely be an ongoing concern for future generations, and according to the World Health Organization, two-thirds of dementia cases are missed diagnoses. We aimed to explore the attitudes of older adults toward dementia screening and the related influencing factors. METHODS A multicentre cross-sectional study was conducted. Data were collected using questionnaires between 2020 December and 2021 June from five provinces in China. The study included older adults aged 60 years or older, living in China. A sociodemographic questionnaire and the Perceptions Regarding Investigational Screening for Memory in Primary Care scale were used to assess attitudes toward and influencing factors of dementia screening. RESULTS A total of 279 participants completed the questionnaires. The results revealed housing status as a positive factor in the acceptance dimension, while high income was the primary positive factor in the benefits of screening dimension. Having religious beliefs, low income, and never participating in social activities were positive factors for the stigma dimension. Widowed marital status and participation in social activities were negative factors for the independence dimension, while having religious beliefs positively influenced the suffering dimension. CONCLUSIONS This study showed that participants held a relatively positive attitude toward dementia screening, although they had concerns about stigma and negative impact on independence. Further studies are required to develop intervention strategies to help older adults improve their attitudes and quality of life, promote cognitive health, and facilitate healthy ageing.
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Affiliation(s)
- Bing Xue
- School of Nursing, Wuhan University, Wuhan, China
| | - Chang Luo
- School of Artificial Intelligence of Jianghan University, Wuhan, China
| | - Xianwu Luo
- School of Nursing, Wuhan University, Wuhan, China
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Abe M, Tsunawaki S, Dejonckheere M, Cigolle CT, Phillips K, Rubinstein EB, Matsuda M, Fetters MD, Inoue M. Practices and perspectives of primary care physicians in Japan and the United States about diagnosing dementia: a qualitative study. BMC Geriatr 2021; 21:540. [PMID: 34635089 PMCID: PMC8503990 DOI: 10.1186/s12877-021-02457-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 08/30/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND While dementia is a common problem in Japan and the US, primary care physicians' practices and perspectives about diagnosing dementia in these different healthcare systems are unknown. METHODS Qualitative research was conducted in an ethnographic tradition using semi-structured interviews and thematic analysis in primary care settings across Japan and in the Midwest State of Michigan, US. Participants were a total of 48 primary care physicians, 24 each from Japan and the US participated. Both groups contained a mixture of geographic areas (rural/urban), gender, age, and years of experience as primary care physicians. RESULTS Participants in Japan and the US voiced similar practices for making the diagnosis of dementia and held similar views about the desired benefits of diagnosing dementia. Differences were found in attitudes about the appropriate timing of formally diagnosing dementia. Japanese physicians tended to make a formal diagnosis when problems that would benefit from long-term care services emerged for family members. US physicians were more proactive in diagnosing dementia in the early stages by screening for dementia in health check-ups and promoting advance directives when the patients were still capable of decision-making. Views about appropriate timing of diagnostic testing for dementia in the two systems reflect what medical or nursing care services physicians can use to support dementia patients and caregivers. CONCLUSIONS Benefits of making the diagnosis included the need to activate the long-term care services in Japan and for early intervention and authoring advance directives in the US. Testing to establish an early diagnosis of dementia by primary care physicians only partly relates to testing and treatment options available. Benefits of making the diagnosis included the need to activate the long-term care services in Japan and for early intervention and authoring advance directives in the US.
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Affiliation(s)
- M Abe
- Department of Family and Community Medicine, Hamamatsu University School of Medicine, Shizuoka, Hamamatsu, Japan
| | - S Tsunawaki
- Omaezaki Family Medicine Center, Shizuoka, Omaezaki, Japan
- Shizuoka Family Medicine Program, Shizuoka, Hamamatsu, Japan
| | - M Dejonckheere
- Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI, 48104, USA
| | - C T Cigolle
- Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI, 48104, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- VA Ann Arbor Healthcare System (VAAHS) Geriatric Research Education and Clinical Center (GRECC), Ann Arbor, MI, USA
| | - K Phillips
- VA Ann Arbor Healthcare System (VAAHS) Geriatric Research Education and Clinical Center (GRECC), Ann Arbor, MI, USA
| | - E B Rubinstein
- Department of Sociology and Anthropology, North Dakota State University, Fargo, North Dakota, USA
| | - M Matsuda
- Shizuoka Family Medicine Program, Shizuoka, Hamamatsu, Japan
- Kikugawa Family Medicine Center, Shizuoka, Kikugawa, Japan
| | - M D Fetters
- Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI, 48104, USA.
- The School of Health Humanities, Peking University Health Science Center, Beijing, China.
| | - M Inoue
- Department of Family and Community Medicine, Hamamatsu University School of Medicine, Shizuoka, Hamamatsu, Japan
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