Limits...
Clinical features and multidisciplinary approaches to dementia care.

Grand JH, Caspar S, Macdonald SW - J Multidiscip Healthc (2011)

Bottom Line: These cognitive and behavioral impairments pose considerable challenges to individuals with dementia, along with their family members and caregivers.Four primary dementia classifications have been defined according to clinical and research criteria: 1) Alzheimer's disease; 2) vascular dementias; 3) frontotemporal dementias; and 4) dementia with Lewy bodies/Parkinson's disease dementia.Future research goals are outlined, with a call to action for social policy initiatives that promote preventive lifestyle behaviors, and healthcare programs that will support the growing number of individuals affected by dementia.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, University of Victoria, Victoria, BC, Canada;

ABSTRACT
Dementia is a clinical syndrome of widespread progressive deterioration of cognitive abilities and normal daily functioning. These cognitive and behavioral impairments pose considerable challenges to individuals with dementia, along with their family members and caregivers. Four primary dementia classifications have been defined according to clinical and research criteria: 1) Alzheimer's disease; 2) vascular dementias; 3) frontotemporal dementias; and 4) dementia with Lewy bodies/Parkinson's disease dementia. The cumulative efforts of multidisciplinary healthcare teams have advanced our understanding of dementia beyond basic descriptions, towards a more complete elucidation of risk factors, clinical symptoms, and neuropathological correlates. The characterization of disease subtypes has facilitated targeted management strategies, advanced treatments, and symptomatic care for individuals affected by dementia. This review briefly summarizes the current state of knowledge and directions of dementia research and clinical practice. We provide a description of the risk factors, clinical presentation, and differential diagnosis of dementia. A summary of multidisciplinary team approaches to dementia care is outlined, including management strategies for the treatment of cognitive impairments, functional deficits, and behavioral and psychological symptoms of dementia. The needs of individuals with dementia are extensive, often requiring care beyond traditional bounds of medical practice, including pharmacologic and non-pharmacologic management interventions. Finally, advanced research on the early prodromal phase of dementia is reviewed, with a focus on change-point models, trajectories of cognitive change, and threshold models of pathological burden. Future research goals are outlined, with a call to action for social policy initiatives that promote preventive lifestyle behaviors, and healthcare programs that will support the growing number of individuals affected by dementia.

No MeSH data available.


Related in: MedlinePlus

Differential diagnostic considerations for dementia.Abbreviations: AD, Alzheimer’s disease; DLB, dementia with Lewy bodies; FTD, frontotemporal dementia; MCI, mild cognitive impairment; PDD, Parkinson’s disease dementia; VaD, vascular dementia.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3104685&req=5

f3-jmdh-4-125: Differential diagnostic considerations for dementia.Abbreviations: AD, Alzheimer’s disease; DLB, dementia with Lewy bodies; FTD, frontotemporal dementia; MCI, mild cognitive impairment; PDD, Parkinson’s disease dementia; VaD, vascular dementia.

Mentions: This triad of features is common to most dementias, with the differentiation of subtypes based on clinical presentation, the presence of comorbid symptoms, and other aspects of the individual’s history and examination.7,8,14 Individuals with dementia tend to present to specialist healthcare services (eg, neurologist, neuropsychologist, memory disorders clinic) only when symptoms begin to interfere with everyday activities and functioning. Depending upon the stage of disease progression, the patient is often unable to provide an accurate history and may deny any presence of impairments. Therefore, a detailed history from a reliable primary informant (eg, family, caregiver) is essential to provide collateral information of previous baseline functioning, symptom onset, and supportive evidence of changes in cognitive and behavioral functioning.15 Depending on the dementia subtype, there is wide variability in rates of decline from person to person and in the rapidity with which the disease process develops. Nevertheless, all dementias are degenerative and progressive. Early detection and the differential diagnosis of dementia subtype, disease complexity, and sequelae requires skilled clinical judgment and is based on multiple sources of information (see Figure 3).16


Clinical features and multidisciplinary approaches to dementia care.

Grand JH, Caspar S, Macdonald SW - J Multidiscip Healthc (2011)

Differential diagnostic considerations for dementia.Abbreviations: AD, Alzheimer’s disease; DLB, dementia with Lewy bodies; FTD, frontotemporal dementia; MCI, mild cognitive impairment; PDD, Parkinson’s disease dementia; VaD, vascular dementia.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3104685&req=5

f3-jmdh-4-125: Differential diagnostic considerations for dementia.Abbreviations: AD, Alzheimer’s disease; DLB, dementia with Lewy bodies; FTD, frontotemporal dementia; MCI, mild cognitive impairment; PDD, Parkinson’s disease dementia; VaD, vascular dementia.
Mentions: This triad of features is common to most dementias, with the differentiation of subtypes based on clinical presentation, the presence of comorbid symptoms, and other aspects of the individual’s history and examination.7,8,14 Individuals with dementia tend to present to specialist healthcare services (eg, neurologist, neuropsychologist, memory disorders clinic) only when symptoms begin to interfere with everyday activities and functioning. Depending upon the stage of disease progression, the patient is often unable to provide an accurate history and may deny any presence of impairments. Therefore, a detailed history from a reliable primary informant (eg, family, caregiver) is essential to provide collateral information of previous baseline functioning, symptom onset, and supportive evidence of changes in cognitive and behavioral functioning.15 Depending on the dementia subtype, there is wide variability in rates of decline from person to person and in the rapidity with which the disease process develops. Nevertheless, all dementias are degenerative and progressive. Early detection and the differential diagnosis of dementia subtype, disease complexity, and sequelae requires skilled clinical judgment and is based on multiple sources of information (see Figure 3).16

Bottom Line: These cognitive and behavioral impairments pose considerable challenges to individuals with dementia, along with their family members and caregivers.Four primary dementia classifications have been defined according to clinical and research criteria: 1) Alzheimer's disease; 2) vascular dementias; 3) frontotemporal dementias; and 4) dementia with Lewy bodies/Parkinson's disease dementia.Future research goals are outlined, with a call to action for social policy initiatives that promote preventive lifestyle behaviors, and healthcare programs that will support the growing number of individuals affected by dementia.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, University of Victoria, Victoria, BC, Canada;

ABSTRACT
Dementia is a clinical syndrome of widespread progressive deterioration of cognitive abilities and normal daily functioning. These cognitive and behavioral impairments pose considerable challenges to individuals with dementia, along with their family members and caregivers. Four primary dementia classifications have been defined according to clinical and research criteria: 1) Alzheimer's disease; 2) vascular dementias; 3) frontotemporal dementias; and 4) dementia with Lewy bodies/Parkinson's disease dementia. The cumulative efforts of multidisciplinary healthcare teams have advanced our understanding of dementia beyond basic descriptions, towards a more complete elucidation of risk factors, clinical symptoms, and neuropathological correlates. The characterization of disease subtypes has facilitated targeted management strategies, advanced treatments, and symptomatic care for individuals affected by dementia. This review briefly summarizes the current state of knowledge and directions of dementia research and clinical practice. We provide a description of the risk factors, clinical presentation, and differential diagnosis of dementia. A summary of multidisciplinary team approaches to dementia care is outlined, including management strategies for the treatment of cognitive impairments, functional deficits, and behavioral and psychological symptoms of dementia. The needs of individuals with dementia are extensive, often requiring care beyond traditional bounds of medical practice, including pharmacologic and non-pharmacologic management interventions. Finally, advanced research on the early prodromal phase of dementia is reviewed, with a focus on change-point models, trajectories of cognitive change, and threshold models of pathological burden. Future research goals are outlined, with a call to action for social policy initiatives that promote preventive lifestyle behaviors, and healthcare programs that will support the growing number of individuals affected by dementia.

No MeSH data available.


Related in: MedlinePlus