Early Dementia Screening and Treatment

A special issue of Diagnostics (ISSN 2075-4418).

Deadline for manuscript submissions: closed (30 October 2015) | Viewed by 45983

Special Issue Editor

Department of Human Sciences, Loughborough University, Loughborough LE11 3TU, Leicestershire, UK
Interests: early diagnoses and modifiable risk and protective factors (e.g., hormones, exercise and nutrition) for dementia and age-related cognitive decline; development and validation of cognitive tests and computerized diagnostic systems
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Special Issue Information

Dear Colleagues,

Dementia is a growing problem worldwide due to an ageing population. The majority of dementia cases are expected to reside in developing countries with few resources such as medically trained staff and instruments. Easy to apply, cheap and valid screening tests for a cross cultural assessment are thus needed. Several reviews have suggested that early treatment may be most successful. This Special Issue includes several papers by experts discussing best diagnostic tests for early dementia including neuropsychological and biomarker tests and treatments which have been shown to be successful for early dementia.

Prof. Dr. Eef Hogervorst
Guest Editor

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Keywords

  • dementia screening
  • diagnostics
  • biomarkers
  • cognitive tests
  • early treatment

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Published Papers (7 papers)

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Research

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794 KiB  
Article
Cluster Analysis of Physical and Cognitive Ageing Patterns in Older People from Shanghai
by Stephan Bandelow, Xin Xu, Shifu Xiao and Eef Hogervorst
Diagnostics 2016, 6(1), 11; https://doi.org/10.3390/diagnostics6010011 - 22 Feb 2016
Cited by 3 | Viewed by 5835
Abstract
This study investigated the relationship between education, cognitive and physical function in older age, and their respective impacts on activities of daily living (ADL). Data on 148 older participants from a community-based sample recruited in Shanghai, China, included the following measures: age, education, [...] Read more.
This study investigated the relationship between education, cognitive and physical function in older age, and their respective impacts on activities of daily living (ADL). Data on 148 older participants from a community-based sample recruited in Shanghai, China, included the following measures: age, education, ADL, grip strength, balance, gait speed, global cognition and verbal memory. The majority of participants in the present cohort were cognitively and physically healthy and reported no problems with ADL. Twenty-eight percent of participants needed help with ADL, with the majority of this group being over 80 years of age. Significant predictors of reductions in functional independence included age, balance, global cognitive function (MMSE) and the gait measures. Cluster analysis revealed a protective effect of education on cognitive function that did not appear to extend to physical function. Consistency of such phenotypes of ageing clusters in other cohort studies may provide helpful models for dementia and frailty prevention measures. Full article
(This article belongs to the Special Issue Early Dementia Screening and Treatment 2016)
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672 KiB  
Article
Association between APOE ε4 Genotype and Memory Impairment in Elderly with Normal Global Cognitive Assessment
by Yuda Turana, Yvonne Suzy Handajani and Nelly T Widjaja
Diagnostics 2015, 5(4), 615-623; https://doi.org/10.3390/diagnostics5040615 - 15 Dec 2015
Cited by 5 | Viewed by 4596
Abstract
Aim: Early prediction using cognitive evaluation tools that are less influenced by education level is beneficial for dementia screening. This study investigated the relationship between Word List Memory Immediate Recall (WLM IR) and the Saving Score (SS) with having the APOE ε4 risk [...] Read more.
Aim: Early prediction using cognitive evaluation tools that are less influenced by education level is beneficial for dementia screening. This study investigated the relationship between Word List Memory Immediate Recall (WLM IR) and the Saving Score (SS) with having the APOE ε4 risk allele in the elderly with normal global cognitive assessment. Methods: A cross-sectional study on 105 subjects ≥60 years with normal MMSE scores who met inclusion criteria. Memory impairment (MI) if: WLM IR score on the third trial <8 or an SS score <80%. Results: The majority of the subjects were female (68.6%), 65 ± 7.1 years, had undertaken formal education for <6 years (56.2%), had MI (81%), and the APOE ε4 genotype was detected in 24.8% of subjects. There was a significant relationship between APOE ε4 and lower WLMIR (p = 0.02, OR 7.92, CI 95% (1.00–62.38)). Conclusions: WLM IR score is lower in elderly people with the APOE ε4 despite their normal global cognitive assessment results, and these scores were not influenced by education level. Further research needs to confirm that the WLM IR can be used to screen for early dementia. Full article
(This article belongs to the Special Issue Early Dementia Screening and Treatment)
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Article
Performance-Based Cognitive Screening Instruments: An Extended Analysis of the Time versus Accuracy Trade-off
by Andrew J. Larner
Diagnostics 2015, 5(4), 504-512; https://doi.org/10.3390/diagnostics5040504 - 27 Nov 2015
Cited by 14 | Viewed by 5173
Abstract
Early and accurate diagnosis of dementia is key to appropriate treatment and management. Clinical assessment, including the use of cognitive screening instruments, remains integral to the diagnostic process. Many cognitive screening instruments have been described, varying in length and hence administration time, but [...] Read more.
Early and accurate diagnosis of dementia is key to appropriate treatment and management. Clinical assessment, including the use of cognitive screening instruments, remains integral to the diagnostic process. Many cognitive screening instruments have been described, varying in length and hence administration time, but it is not known whether longer tests offer greater diagnostic accuracy than shorter tests. Data from several pragmatic diagnostic test accuracy studies examining various cognitive screening instruments in a secondary care setting were analysed to correlate measures of test diagnostic accuracy and test duration, building on the findings of a preliminary study. High correlations which were statistically significant were found between one measure of diagnostic accuracy, area under the receiver operating characteristic curve, and surrogate measures of test duration, namely total test score and total number of test items/questions. Longer cognitive screening instruments may offer greater accuracy for the diagnosis of dementia, an observation which has possible implications for the optimal organisation of dedicated cognitive disorders clinics. Full article
(This article belongs to the Special Issue Early Dementia Screening and Treatment)
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Article
Risk Factors for Possible Dementia Using the Hopkins Verbal Learning Test and the Mini-Mental State Examination in Shanghai
by Xin Xu, Shifu Xiao, Tri Budi Rahardjo and Eef Hogervorst
Diagnostics 2015, 5(4), 487-496; https://doi.org/10.3390/diagnostics5040487 - 23 Nov 2015
Cited by 3 | Viewed by 6318
Abstract
Using a combination of the Hopkins Verbal Learning Test (HVLT) and the Mini-Mental State Examination (MMSE), we investigated the prevalence of possible dementia (DEM) in community-dwelling elderly in Shanghai. Subsequently, we investigated significant risk factors for DEM and generated a DEM self-checklist for [...] Read more.
Using a combination of the Hopkins Verbal Learning Test (HVLT) and the Mini-Mental State Examination (MMSE), we investigated the prevalence of possible dementia (DEM) in community-dwelling elderly in Shanghai. Subsequently, we investigated significant risk factors for DEM and generated a DEM self-checklist for early DEM detection and case management. We found that among a total of 521 participants using a HVLT cut-off score of <19 and a MMSE cut-off score of <24, a total of 69 DEM cases were identified. Risk factors, such as advanced age (≥68 years), low education (no or primary level), self-reported history of hypertension, and self-reported subjective memory complaints (SMC) were significantly predictive of DEM. The presence of ≥3 out of four of the above mentioned risk factors can effectively discriminate DEM cases from non-DEM subjects. Full article
(This article belongs to the Special Issue Early Dementia Screening and Treatment)
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Article
Beyond Screening: Can the Mini-Mental State Examination be Used as an Exclusion Tool in a Memory Clinic?
by Xin Xu, Eddie Chong, Saima Hilal, Mohammad Kamran Ikram, Narayanaswamy Venketasubramanian and Christopher Chen
Diagnostics 2015, 5(4), 475-486; https://doi.org/10.3390/diagnostics5040475 - 04 Nov 2015
Cited by 8 | Viewed by 6898
Abstract
This study explores whether the Mini-Mental State Examination (MMSE) could reliably exclude definite dementia and dementia-free cases from requiring more extensive neuropsychological investigations in memory clinic settings in Singapore. Patients with memory complaints referred for possible dementia underwent the MMSE, followed by standardized [...] Read more.
This study explores whether the Mini-Mental State Examination (MMSE) could reliably exclude definite dementia and dementia-free cases from requiring more extensive neuropsychological investigations in memory clinic settings in Singapore. Patients with memory complaints referred for possible dementia underwent the MMSE, followed by standardized neuropsychological and clinical assessments which led to a consensus diagnosis. MMSE cut-off points were derived stratified for education (less and equal/above primary level). Results show that after education stratification, using an optimal Positive Likelihood Ratio (PLR) and optimal Negative Likelihood Ratio (NLR), a higher percentage of patients were correctly identified as having dementia or dementia-free, with minimal misclassification rate. The finding suggests the MMSE can be used to exclude patients not requiring full neuropsychological assessments in a memory clinic. Full article
(This article belongs to the Special Issue Early Dementia Screening and Treatment)
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Review

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475 KiB  
Review
Early Dementia Screening
by Peter K. Panegyres, Renee Berry and Jennifer Burchell
Diagnostics 2016, 6(1), 6; https://doi.org/10.3390/diagnostics6010006 - 21 Jan 2016
Cited by 55 | Viewed by 14963
Abstract
As the population of the world increases, there will be larger numbers of people with dementia and an emerging need for prompt diagnosis and treatment. Early dementia screening is the process by which a patient who might be in the prodromal phases of [...] Read more.
As the population of the world increases, there will be larger numbers of people with dementia and an emerging need for prompt diagnosis and treatment. Early dementia screening is the process by which a patient who might be in the prodromal phases of a dementing illness is determined as having, or not having, the hallmarks of a neurodegenerative condition. The concepts of mild cognitive impairment, or mild neurocognitive disorder, are useful in analyzing the patient in the prodromal phase of a dementing disease; however, the transformation to dementia may be as low as 10% per annum. The search for early dementia requires a comprehensive clinical evaluation, cognitive assessment, determination of functional status, corroborative history and imaging (including MRI, FDG-PET and maybe amyloid PET), cerebrospinal fluid (CSF) examination assaying Aβ1–42, T-τ and P-τ might also be helpful. Primary care physicians are fundamental in the screening process and are vital in initiating specialist investigation and treatment. Early dementia screening is especially important in an age where there is a search for disease modifying therapies, where there is mounting evidence that treatment, if given early, might influence the natural history—hence the need for cost-effective screening measures for early dementia. Full article
(This article belongs to the Special Issue Early Dementia Screening and Treatment)
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676 KiB  
Review
Prevalence of Behavioural and Psychological Symptoms of Dementia in Individuals with Learning Disabilities
by Rajal Devshi, Sarah Shaw, Jordan Elliott-King, Eef Hogervorst, Avinash Hiremath, Latha Velayudhan, Satheesh Kumar, Sarah Baillon and Stephan Bandelow
Diagnostics 2015, 5(4), 564-576; https://doi.org/10.3390/diagnostics5040564 - 02 Dec 2015
Cited by 31 | Viewed by 7426
Abstract
A review of 23 studies investigating the prevalence of Behavioural and psychological symptoms of dementia (BPSD) in the general and learning disability population and measures used to assess BPSD was carried out. BPSD are non-cognitive symptoms, which constitute as a major component of [...] Read more.
A review of 23 studies investigating the prevalence of Behavioural and psychological symptoms of dementia (BPSD) in the general and learning disability population and measures used to assess BPSD was carried out. BPSD are non-cognitive symptoms, which constitute as a major component of dementia regardless of its subtype Research has indicated that there is a high prevalence of BPSD in the general dementia population. There are limited studies, which investigate the prevalence of BPSD within individuals who have learning disabilities and dementia. Findings suggest BPSDs are present within individuals with learning disabilities and dementia. Future research should use updated tools for investigating the prevalence of BPSD within individuals with learning disabilities and dementia. Full article
(This article belongs to the Special Issue Early Dementia Screening and Treatment)
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