Diagnosing cognitive impairment and dementia in primary health care - a more active approach is needed

Abstract

less than half of the patients with dementia had their diagnosis documented in primary care medical records. Documentation increased in more advanced dementia. The diagnostic evaluations for reversible causes of dementia were insufficient in primary care, and they were done at a late phase of cognitive impairment.

Use of Standardized Uptake Value Ratios Decreases Interreader Variability of [18F] Florbetapir PET Brain Scan Interpretation

“…4,14,19 Com-parison of SUVr between the EMCI and LMCI groups did not demonstrate a significant difference. Our findings demonstrate that cases that had complete interreader agreement as positive for significant ␤-amyloid deposition with the aid of semiquantitative analysis but not complete agreement when qualitatively assessed had an interreader mean SUVr value of 1.32 Ϯ 0.0 (n ϭ 3).…”

“…2,3 The ability to noninvasively detect cortical ␤-amyloid deposition could considerably improve clinical diagnosis because Ͼ33% of patients with early signs of AD will be inaccurately identified. 4 Fluorine-18 florbetapir, a recently developed ␤-amyloid plaque positron-emission tomography imaging agent, rapidly en-ters the brain and specifically binds to cortical fibrillar ␤-amyloid. 5,6 Pathologic findings demonstrate the high sensitivity (87%), specificity (95%), and accuracy (90%) of [ 18 F] florbetapir in the detection of moderate-to-frequent cortical ␤-amyloid plaque by using the Consortium to Establish a Registry for Alzheimer's Disease criteria.…”

Translation and cultural adaptation for Portuguese Brazilian language of the Vellore instrument for screening cognitive

“…15 Consideramos o instrumento Vellore uma ferramenta adequada para a abordagem direta ao paciente e ao cuidador, reforçando o papel do cuidador como agente ativo, para supervisionar fatores de risco de vulnerabilidade do idoso. 16 As informações sobre o desempenho nas atividades de vida diária, por não serem influenciadas pela escolaridade, fornecem dados cruciais para a detecção precoce de comprometimento cognitivo na população de baixa escolaridade.…”

Combined instruments for the screening of dementia in older people with low Education

“…This strategy could be easily implemented for epidemiological community studies as well as for primary health care, where a more active approach for dementia screening is needed as Lopponen et al 26 stated. Although two of the combination rules tested (the mixed rule and the weighted sum) were not easy to implement in clinical routine, the results found with the "And" rule also yielded promising results.…”