Quality improvement in neurology

Foster, Norman L.; Bondi, Mark W.; Das, Rohit R.; Foss, Mary; Hershey, Linda A.; Koh, Steve; Logan, Rebecca; Poole, Chris; Sood, Anil K.; Thothala, Niranjan; Wicklund, Meredith; Yu, M.; Bennett, Amy; Wang, David

doi:10.1212/wnl.0000000000008259

Cited by 36 publications

(14 citation statements)

References 45 publications

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“…at a health fair), the organization does distinguish routine cognitive assessments under a clinician’s care from population‐wide screening and encourages such routine assessments [ 71 ]. The AAN also recommends, as a quality measure, an annual assessment of cognitive health in all patients 65 years and older seen in neurologic practice, and considers annual cognitive screenings in this population consistent with high‐quality care, given that age itself is a significant risk factor for cognitive decline and MCI is increasingly prevalent with older age [ 131 ].…”

Section: Towards Timeliness and Accuracy: Pragmatic Aspects Of Clinical Care Informed By Developing Models Of Admentioning

confidence: 99%

“…Although principles of good AD management are beyond the scope of this article, in general, patients with early AD should be counselled on nonpharmacologic interventions to mitigate further cognitive decline [ 81 , 86 , 131 ]. Patients should also be considered for pharmacologic therapy, particularly once DMTs become available [ 86 , 87 , 155 ].…”

Section: Towards Timeliness and Accuracy: Pragmatic Aspects Of Clinical Care Informed By Developing Models Of Admentioning

confidence: 99%

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Practical recommendations for timely, accurate diagnosis of symptomatic Alzheimer’s disease (MCI and dementia) in primary care: a review and synthesis

et al. 2021

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Section: Towards Timeliness and Accuracy: Pragmatic Aspects Of Clinical Care Informed By Developing Models Of Admentioning

confidence: 99%

Section: Towards Timeliness and Accuracy: Pragmatic Aspects Of Clinical Care Informed By Developing Models Of Admentioning

confidence: 99%

Practical recommendations for timely, accurate diagnosis of symptomatic Alzheimer’s disease (MCI and dementia) in primary care: a review and synthesis

et al. 2021

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“…Improved medical care and lifestyle continue to increase life span and with it age-related brain disorders (1). The American Academy of Neurology has recently recommended an annual cognitive health assessment for patients 65 years and older (2). The rationale behind this recommendation asserts that brain diseases may be delayed or prevented if detected at early stages and that certain risks associated with compromised brain health are modifiable (3).…”

Section: Introductionmentioning

confidence: 99%

Brain Network Integrity Changes in Subjective Cognitive Decline: A Possible Physiological Biomarker of Dementia

Fogel¹,

Levy-Lamdan²,

Zifman³

et al. 2021

Front. Neurol.

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Objective: The current study seeks to illustrate potential early and objective neurophysiological biomarkers of neurodegenerative cognitive decline by evaluating features of brain network physiological performance and structure utilizing different modalities.Methods: This study included 17 clinically healthy individuals with self-reported cognitive decline (Subjective Cognitive Decline group, SCD, no objective finding of cognitive decline), 12 individuals diagnosed with amnestic Mild Cognitive Impairment (aMCI), 11 individuals diagnosed with Dementia, and 15 healthy subjects. All subjects underwent computerized cognitive performance testing, MRI scans including T1 for gray matter (GM) volume quantification, DTI for quantification of white matter (WM) microstructure fractional anisotropy (FA) and mean diffusivity (MD), and brain network function evaluation using DELPHI (TMS-EEG) measures of connectivity, excitability, and plasticity.Results: Both DELPHI analysis of network function and DTI analysis detected a significant decrease in connectivity, excitability, and WM integrity in the SCD group compared to healthy control (HC) subjects; a significant decrease was also noted for aMCI and Dementia groups compared to HC. In contrast, no significant decrease was observed in GM volume in the SCD group compared to healthy norms, a significant GM volume decrease was observed only in objectively cognitively impaired aMCI subjects and in dementia subjects.Conclusions: This study results suggest that objective direct measures of brain network physiology and WM integrity may provide early-stage biomarkers of neurodegenerative-related changes in subjects that have not yet displayed any other objective measurable cognitive or GM volume deficits which may facilitate early preventive care for neurodegenerative decline and dementia.

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“…In some cases, the aging population is screened for detection of these signs of dementia (cf., Foster et al, 2019 ). However, in most cases, it is the aging individual’s own awareness of a subjective decrease in cognitive functioning (leading to increased difficulty or inability to cope with daily activities) or the detection of impoverished performance by a close observer that triggers an initial examination by a general practitioner ( Moore et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

The Role of Brief Global Cognitive Tests and Neuropsychological Expertise in the Detection and Differential Diagnosis of Dementia

Riello

Rusconi

Treccani

2021

Front. Aging Neurosci.

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Dementia is a global public health problem and its impact is bound to increase in the next decades, with a rapidly aging world population. Dementia is by no means an obligatory outcome of aging, although its incidence increases exponentially in old age, and its onset may be insidious. In the absence of unequivocal biomarkers, the accuracy of cognitive profiling plays a fundamental role in the diagnosis of this condition. In this Perspective article, we highlight the utility of brief global cognitive tests in the diagnostic process, from the initial detection stage for which they are designed, through the differential diagnosis of dementia. We also argue that neuropsychological training and expertise are critical in order for the information gathered from these omnibus cognitive tests to be used in an efficient and effective way, and thus, ultimately, for them to fulfill their potential.

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Quality improvement in neurology

Abstract: Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

Cited by 36 publications

References 45 publications

Practical recommendations for timely, accurate diagnosis of symptomatic Alzheimer’s disease (MCI and dementia) in primary care: a review and synthesis

Practical recommendations for timely, accurate diagnosis of symptomatic Alzheimer’s disease (MCI and dementia) in primary care: a review and synthesis

Brain Network Integrity Changes in Subjective Cognitive Decline: A Possible Physiological Biomarker of Dementia

The Role of Brief Global Cognitive Tests and Neuropsychological Expertise in the Detection and Differential Diagnosis of Dementia

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