Screening for cognitive impairment, Alzheimer's disease and other dementias: opinions of European caregivers, payors, physicians and the general public.
ABSTRACT The IMPACT survey queried physicians, caregivers, payors and members of the general public from 5 European countries (France, Germany, Italy, Spain and the United Kingdom) regarding their opinions towards screening for Alzheimer's disease (AD) as part of a 30-minute Web-based questionnaire conducted between April and May 2009. A larger proportion of caregivers (84%) and members of the general public (80%) than of physicians (56%) or payors (40%) viewed routine screening for AD as extremely or very important (P < 0.001 for caregivers or general public vs physicians or payors). When asked if everyone should be routinely screened for AD at age 65, a smaller proportion of physicians (42%) and payors (44%) than members of the general public (81%) or caregivers (80%) agreed (P < 0.001 for caregivers or general public vs physicians or payors). These opinions were generally consistent across the 5 countries for each respondent group. A notable exception was physician respondents from Italy, where most generalists and specialists actually favoured screening. Overall, generalists had a more positive attitude towards screening than specialists. The most frequently cited reason given by those who did not favour routine screening at age 65 was screening inaccuracy. This article discusses these results in relation to what screening is, when to screen and the barriers to screening. Despite the majority of IMPACT respondents being in favour of screening for AD, the evidence to support the introduction of population screening for cognitive impairment is not available; however, the importance of optimal identification of AD and other dementias in primary care should be a priority for community health professionals and payors. In order to do this effectively, further work is required to identify good assessment guidelines for use during opportunistic screening for cognitive impairment in primary care.
SourceAvailable from: Angelo Bianchetti
Article: Raccomandazioni dell’Associazione Italiana di Psicogeriatria (AIP) e della Società Italiana Neurologia delle Demenze (SINDEM) sulla diagnosi precoce della Malattia di Alzheimer. [Recommendations of the Italian Psychogeriatric Association (AIP) and Italian Society for the Study of Dementia (SINDEM) on Early Diagnosis of Alzheimer Disease][Show abstract] [Hide abstract]
ABSTRACT: In the paper are presented the recommendations of the Italian Psychogeriatric Association (AIP) and Italian Society for the Study of Dementia (SINDEM) on Early Diagnosis of Alzheimer Disease. The paper summarizes the discussion among the Italian specialists involved in the study and care of persons with dementia, and presents the consensus of the experts of the two societies about the use of new criteria proposed for the diagnosis of dementia in the clinical practice. After having critically revised the scientific evidence, the panel reached a final agreement on several related issues and proposed a set of practical clinical recommendations.
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ABSTRACT: A large proportion of dementia cases are still undiagnosed. Although early dementia care has been hypothesized to benefit both patients and families, evidence-based benefits are lacking. Thus, investigating the benefits for newly demented persons according to their recourse to care in the "real life" appears critical.Alzheimer's & dementia: the journal of the Alzheimer's Association 08/2014; DOI:10.1016/j.jalz.2014.04.512 · 17.47 Impact Factor
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ABSTRACT: Studies suggest that most people support screening for and disclosure of dementia, but it is not clear whether respondents have reflected on the benefits and risks of diagnosis. In this study, preferences, rated on a 7-point Likert scale, for diagnosis, disclosure and screening for AD were measured before and after discussion of the potential benefits and hazards of diagnosis in 132 hospital and community subjects in Galway, Ireland. At baseline the percentages with a positive attitude (Likert rating of 5-7) were 79.6% for diagnosis, 85.7% for disclosure and 59.3% for screening. On follow-up, there was no significant change in disclosure responses (12 more positive, 18 more negative, 102 unchanged (p=0.2), 78.1% positive attitude) while there were significant declines in ratings for diagnosis (11 more positive, 27 more negative, 94 unchanged (p=0.03), 69.1% with positive attitude) and screening (10 more positive, 35 more negative, 87 unchanged (p<0.0001), 42.1% positive attitude). In conclusion, although most people want to 'know' if they have AD, there is a diminishing degree of support from disclosure to diagnostic assessment to screening. Preferences for diagnosis and screening decline when respondents have the opportunity to consider the consequences of their decision.Archives of Gerontology and Geriatrics 11/2014; 59(3):607-612. DOI:10.1016/j.archger.2014.07.010 · 1.53 Impact Factor