Dementia has been widely debated from the perspectives of biomedicine and social psychology. This book broadens the debate to consider the experiences of men and women with dementia from a ...sociopolitical perspective. It brings to the fore the concept of social citizenship, exploring what it means within the context of dementia and using it to re-examine the issue of rights, status(es), and participation. Most importantly, the book offers fresh and practical insights into how a citizenship framework can be applied in practice. It will be of interest to health and social care professionals, policy makers, academics and researchers and people with dementia and family carers may find it revitalising.
An exploration of the representational culture of
Alzheimer's disease and how media technologies shape our ideas of
cognition and aging
With no known cause or cure despite a century of research,
...Alzheimer's disease is a true medical mystery. In Mediating
Alzheimer's , Scott Selberg examines the nature of this
enduring national health crisis by looking at the disease's
relationship to media and representation. He shows how collective
investments in different kinds of media have historically shaped
how we understand, treat, and live with this disease.
Selberg demonstrates how the cognitive abilities that
Alzheimer's threatens-memory, for example-are integrated into the
operations of representational technologies, from Polaroid
photographs to Post-its to digital artificial intelligence.
Focusing on a wide variety of media technologies, such as
neuroimaging, art therapy, virtual reality, and social media, he
shows how these cognitively oriented media ultimately help define
personhood for people with Alzheimer's. Media have changed the
practices of successful aging in the United States, and Selberg
takes us deep into how technologies like digital brain-training and
online care networks shape ideas of cognition and healthy
aging.
Packed with startlingly fresh insights, Mediating
Alzheimer's contributes to debates around bioethics, the labor
of caregiving, and a national economy increasingly invested in
communication and digital media. Probing the very technologies that
promise to save and understand our brains, it gives us new ways of
understanding Alzheimer's disease and aging in America.
In Fragile Brains Kathleen Taylor looks at the genetic and lifestyle factors currently linked to the development of dementia, focusing on important new research on how the immune system operates in ...the brain.
Dementia is a progressive global cognitive impairment syndrome. In 2010, more than 35 million people worldwide were estimated to be living with dementia. Some people with mild cognitive impairment ...(MCI) will progress to dementia but others remain stable or recover full function. There is great interest in finding good predictors of dementia in people with MCI. The Mini-Mental State Examination (MMSE) is the best-known and the most often used short screening tool for providing an overall measure of cognitive impairment in clinical, research and community settings.
To determine the accuracy of the Mini Mental State Examination for the early detection of dementia in people with mild cognitive impairment SEARCH METHODS: We searched ALOIS (Cochrane Dementia and Cognitive Improvement Specialized Register of diagnostic and intervention studies (inception to May 2014); MEDLINE (OvidSP) (1946 to May 2014); EMBASE (OvidSP) (1980 to May 2014); BIOSIS (Web of Science) (inception to May 2014); Web of Science Core Collection, including the Conference Proceedings Citation Index (ISI Web of Science) (inception to May 2014); PsycINFO (OvidSP) (inception to May 2014), and LILACS (BIREME) (1982 to May 2014). We also searched specialized sources of diagnostic test accuracy studies and reviews, most recently in May 2014: MEDION (Universities of Maastricht and Leuven, www.mediondatabase.nl), DARE (Database of Abstracts of Reviews of Effects, via the Cochrane Library), HTA Database (Health Technology Assessment Database, via the Cochrane Library), and ARIF (University of Birmingham, UK, www.arif.bham.ac.uk). No language or date restrictions were applied to the electronic searches and methodological filters were not used as a method to restrict the search overall so as to maximize sensitivity. We also checked reference lists of relevant studies and reviews, tracked citations in Scopus and Science Citation Index, used searches of known relevant studies in PubMed to track related articles, and contacted research groups conducting work on MMSE for dementia diagnosis to try to locate possibly relevant but unpublished data.
We considered longitudinal studies in which results of the MMSE administered to MCI participants at baseline were obtained and the reference standard was obtained by follow-up over time. We included participants recruited and clinically classified as individuals with MCI under Petersen and revised Petersen criteria, Matthews criteria, or a Clinical Dementia Rating = 0.5. We used acceptable and commonly used reference standards for dementia in general, Alzheimer's dementia, Lewy body dementia, vascular dementia and frontotemporal dementia.
We screened all titles generated by the electronic database searches. Two review authors independently assessed the abstracts of all potentially relevant studies. We assessed the identified full papers for eligibility and extracted data to create two by two tables for dementia in general and other dementias. Two authors independently performed quality assessment using the QUADAS-2 tool. Due to high heterogeneity and scarcity of data, we derived estimates of sensitivity at fixed values of specificity from the model we fitted to produce the summary receiver operating characteristic curve.
In this review, we included 11 heterogeneous studies with a total number of 1569 MCI patients followed for conversion to dementia. Four studies assessed the role of baseline scores of the MMSE in conversion from MCI to all-cause dementia and eight studies assessed this test in conversion from MCI to Alzheimer´s disease dementia. Only one study provided information about the MMSE and conversion from MCI to vascular dementia. For conversion from MCI to dementia in general, the accuracy of baseline MMSE scores ranged from sensitivities of 23% to 76% and specificities from 40% to 94%. In relationship to conversion from MCI to Alzheimer's disease dementia, the accuracy of baseline MMSE scores ranged from sensitivities of 27% to 89% and specificities from 32% to 90%. Only one study provided information about conversion from MCI to vascular dementia, presenting a sensitivity of 36% and a specificity of 80% with an incidence of vascular dementia of 6.2%. Although we had planned to explore possible sources of heterogeneity, this was not undertaken due to the scarcity of studies included in our analysis.
Our review did not find evidence supporting a substantial role of MMSE as a stand-alone single-administration test in the identification of MCI patients who could develop dementia. Clinicians could prefer to request additional and extensive tests to be sure about the management of these patients. An important aspect to assess in future updates is if conversion to dementia from MCI stages could be predicted better by MMSE changes over time instead of single measurements. It is also important to assess if a set of tests, rather than an isolated one, may be more successful in predicting conversion from MCI to dementia.
lost in space Feddersen, Eckhard; Lüdtke, Insa
2014, 2014-09-05
eBook
Dementia presents immense challenges - both for individuals as well as for society as a whole. More than 35 million people all over the world currently live with dementia, a number that is expected ...to double by 2050. This also has implications for architecture and urban planning because dementia often affects people's sense of orientation and their ability to perceive space. How can homes, apartments, public buildings, outdoor spaces, neighbourhoods and cities, as well as environments and infrastructure, be designed to meet the needs of people with dementia as well as those of their caregivers? And can a consideration of the problems of dementia lead to a better understanding of space that can improve architecture and the built environment for us all? This book addresses these and other questions in a series of professional essays that examine the specific requirements for different disciplines. In addition, international case study projects illustrate the breadth of current actual solutions. The book is intended as a guide for all those involved in the design and planning process - architects, interior designers, engineers, town planners, local authorities and clients - and as a reader for the users themselves: for people with dementia, their family and friends, and all those in their social environment.
Advances in neuroimaging have enabled greater understanding of the progression of cerebral degenerative processes associated with ageing‐related dementias. Leukoaraiosis or rarefied white matter (WM) ...originally described on computed tomography is one of the most prominent changes which occurs in older age. White matter hyperintensities (WMH) evident on magnetic resonance imaging have become commonplace to describe WM changes in relation to cognitive dysfunction, types of stroke injury, cerebral small vessel disease and neurodegenerative disorders including Alzheimer's disease. Substrates of WM degeneration collectively include myelin loss, axonal abnormalities, arteriolosclerosis and parenchymal changes resulting from lacunar infarcts, microinfarcts, microbleeds and perivascular spacing. WM cells incorporating astrocytes, oligodendrocytes, pericytes and microglia are recognized as key cellular components of the gliovascular unit. They respond to ongoing pathological processes in different ways leading to disruption of the gliovascular unit. The most robust alterations involve oligodendrocyte loss and astrocytic clasmatodendrosis with displacement of the water channel protein, aquaporin 4. These modifications likely precede arteriolosclerosis and capillary degeneration and involve tissue oedema, breach of the blood–brain barrier and induction of a chronic hypoxic state in the deep WM. Several pathophysiological mechanisms are proposed to explain how WM changes commencing with haemodynamic changes within the vascular system impact on cognitive dysfunction. Animal models simulating cerebral hypoperfusion in man have paved the way for several translational opportunities. Various compounds with variable efficacies have been tested to reduce oxidative stress, inflammation and blood–brain barrier damage in the WM. Our review demonstrates that WM degeneration encompasses multiple substrates and therefore more than one pharmacological approach is necessary to preserve axonal function and prevent cognitive impairment.
This article is part of the Special Issue “Vascular Dementia”.
In this review, we discuss disintegration of the cellular components of the gliovascular unit in the white matter. This has consequences on blood–brain barrier integrity and is a strong correlate of white matter damage associated with cognitive impairment. Animal models of cerebral hypoperfusion replicate several features of white matter changes in man. They have been valuable in identifying various agents which target oxidative stress, inflammation and BBB damage.
This article is part of the Special Issue “Vascular Dementia”.
Dementia is the most common type of neurodegenerative disorder. Non- Alzheimer's and Atypical Dementia concentrates on each form of dementia individually, considering symptoms, diagnosis and ...treatment * Focuses on non-Atypical Dementia * Multidisciplinary approach to diagnosis and management * Allows development of management and care plan strategies * Practical approach including case studies * Written by a world-renowned editorial team
•42 trials including 8249 participants are enrolled in our meta-analysis.•A traditional and net meta-analysis was performed to test the diagnostic value of NfL.•NfL increases in all kinds of ...neurodegenerative disease compared to healthy controls.•NfL in CSF and blood differentiates neurodegenerative dementia from healthy controls.•NfL concentration is ranked among neurodegenerative dementia using cluster analysis.
The diagnostic value of neurofilament light chain protein in neurodegenerative dementia diseases is still controversial. A systematic literature search was performed to identify relevant case-control studies conducted through October 2018. Traditional and net meta-analyses were performed based on 42 studies that tested the diagnostic performance of neurofilament light chain protein (NfL) concentration in CSF and serum/plasma from patients with neurodegenerative dementia. CSF and serum/plasma NfL levels were significantly increased in patients with neurodegenerative dementia diseases. Network meta-analysis showed a significant reduction in CSF NfL levels during mild cognitive impairment, whereas an increase was observed in vascular dementia compared to Alzheimer’s disease. Surface under the cumulative ranking curve and cluster analysis showed that the NfL concentration in CSF (vascular dementia, frontotemporal dementia, and Alzheimer’s disease) and serum/plasma (frontotemporal dementia and Alzheimer’s disease) ranked first among neurodegenerative dementia diseases. NfL is an important biomarker that can help clinical neurologists make early diagnoses of neurodegenerative diseases, so patients can receive prompt treatment.
PDF
