Dementia diagnosis and management: a narrative review of changing practice

Koch, Tamar; Iliffe, Steve

doi:10.3399/bjgp11x588493

Cited by 45 publications

(42 citation statements)

References 41 publications

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“…Policymakers should act cautiously in giving the impression that rapid diagnosis is always possible or desirable. The settings in which the diagnostic process is carried out need to be considered, as policymakers accept, 15 and more time may be needed to address individual needs for information, 43 and to tailor advice in this process of 'reflection and adaptation', when immediate reactions to the diagnosis may have had a chance to evolve. 3 The quality standard for dementia promoted by NICE advises that 'local data collection' will be the means to ensure that its quality standards around information and personalised support are being met.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

“…Alternatively, some of the problems of communication might be mitigated by situating memory assessment services in primary care settings that are familiar to individuals and their carers. [42][43][44] Policymakers and commissioners need to understand the diagnostic 'journey', which could inform any refreshing or evaluation of the National Dementia Strategy. Policymakers should act cautiously in giving the impression that rapid diagnosis is always possible or desirable.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

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From forgetfulness to dementia: clinical and commissioning implications of diagnostic experiences

Manthorpe¹,

Samsi²,

Campbell³

et al. 2013

Br J Gen Pract

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Section: Comparison With Existing Literaturementioning

confidence: 99%

Section: Comparison With Existing Literaturementioning

confidence: 99%

From forgetfulness to dementia: clinical and commissioning implications of diagnostic experiences

Manthorpe¹,

Samsi²,

Campbell³

et al. 2013

Br J Gen Pract

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“…[14][15][16][17][18][19][20][21][22] Over the last few years, several systematic reviews have found that the evidence of CM's effects on service use and clinical outcomes is weak. [23][24][25][26][27][28] None of them specifically focused on the needs of patients and caregivers, however. [23][24][25][26][27][28] Patients with dementia and their caregivers who already receive professional care still report unmet needs.…”

Section: Vladimir Khanassov MD Msc Isabelle Vedel Md Phdmentioning

confidence: 99%

Section: Vladimir Khanassov MD Msc Isabelle Vedel Md Phdmentioning

confidence: 99%

“…[23][24][25][26][27][28] None of them specifically focused on the needs of patients and caregivers, however. [23][24][25][26][27][28] Patients with dementia and their caregivers who already receive professional care still report unmet needs.29 Moreover, they feel that their own opinion is not taken into account. 30 In line with the patient-centered care paradigm, 31,32 it is important to identify the needs felt by the patient and the caregiver [33][34][35] and to determine the extent to which CM interventions respond to their needs.…”

mentioning

confidence: 99%

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Family Physician–Case Manager Collaboration and Needs of Patients With Dementia and Their Caregivers: A Systematic Mixed Studies Review

Khanassov

Vedel

2016

Ann Fam Med

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PURPOSE Dementia case management (CM) in primary care is a complex intervention aimed at identifying the various needs of patients with dementia and their caregivers, as well as the organization and coordination of care. A key element of CM is the collaboration of family physicians with case managers. We conducted a systematic mixed-studies review to identify the needs of the patientcaregiver dyad and the effects of CM. METHODSWe searched MEDLINE, PsycINFO, and EMBASE up to October 2014, regardless of the study design. Our main outcomes were needs of patients and their caregivers and the effects of CM on these needs. We used narrative syntheses to develop a taxonomy of needs and to describe the effects of CM on those needs. We used meta-analysis to calculate the prevalence of needs and the standardized mean differences to evaluate the effects of CM on the needs identified.RESULTS Fifty-four studies were included. We identified needs of the patientcaregiver dyad and needs of the patient and caregiver individually. CM addressed the majority of the identified needs. Still, some very common needs (eg, early diagnosis) are overlooked while other needs (eg, education on the disease) are well addressed. Fully establishing the value of CM is difficult given the small number of studies of CM in primary care.CONCLUSIONS There is good evidence that case managers, in collaboration with family physicians, have a pivotal role in addressing the needs of the patientcaregiver dyad. 2016;14:166-177. doi: 10.1370/afm.1898. Ann Fam Med INTRODUCTIONT he proportion of people with dementia is growing dramatically. According to the US Alzheimer's Association, by 2030, 50% of Americans aged 65 years and older will be diagnosed with dementia. 1 In Canada in 2011, 747,000 Canadians lived with cognitive impairment.2 Today, the combined costs are $33 billion per year, 1 and they are projected to increase to $872 billion by 2038. 3,4 Worldwide, dementia is the main contributor to disability-adjusted life years (11.2%), representing a greater burden than cerebral vascular accident (9.5%), heart disease (5.0%), or cancer (2.4%). 5People with dementia need help with challenging changes in behavior, memory, physical disability, and mood. 6 The main source of help is family caregivers, who often suffer from the burdens of caregiving and from depression and health problems. 7 It has been shown that early intervention makes the greatest difference in management of symptoms. 1 The World Health Organization states that it would be challenging to intervene without effective involvement of primary care. 8 Dementia case management (CM) interventions are becoming a central component of primary health care organizations in North America and Europe. [9][10][11][12] According to the 167Case Management Society of America, case management is "a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs through communi...

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Educational interventions for improving the skills of medical practitioners to detect, diagnose, and manage people with cognitive impairment and dementia

Belisario

Tudor

Sumalinog

et al. 2013

Cochrane Database of Systematic Reviews

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Dementia diagnosis and management: a narrative review of changing practice

Cited by 45 publications

References 41 publications

From forgetfulness to dementia: clinical and commissioning implications of diagnostic experiences

From forgetfulness to dementia: clinical and commissioning implications of diagnostic experiences

Family Physician–Case Manager Collaboration and Needs of Patients With Dementia and Their Caregivers: A Systematic Mixed Studies Review

Educational interventions for improving the skills of medical practitioners to detect, diagnose, and manage people with cognitive impairment and dementia

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