Contributors
PHILIP B. GORELICK, MD, MPH (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - November 18, 2022 Category: Geriatrics Source Type: research
Contents
Philip B. Gorelick and Farzaneh A. Sorond (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - November 18, 2022 Category: Geriatrics Source Type: research
Forthcoming Issues
Geriatric Dental Medicine (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - November 18, 2022 Category: Geriatrics Source Type: research
The Burden of Dementia Spectrum Disorders and Associated Comorbid and Demographic Features
Dementia spectrum disorders (DSDs) are a major cause of mortality and disability worldwide. DSDs encompass a large group of medical conditions that all ultimately lead to major functional and cognitive decline and disability. Demographic and comorbid conditions that are associated with DSDs have significant prognostic and preventive implications. In this article, we will discuss the global and regional burden of DSDs and cover key demographic and clinical conditions linked with DSDs. In the absence of disease-modifying treatments, the role of primary prevention has become more prominent. Implementation of preventive measur...
Source: Clinics in Geriatric Medicine - October 21, 2022 Category: Geriatrics Authors: Behnam Sabayan, Kathryn A. Wyman-Chick, Sanaz Sedaghat Source Type: research
Office- and Bedside-based Screening for Cognitive Impairment and the Dementias
Elderly patients and their families are concerned about the patients ’ cognitive abilities, and cognitive screening is an efficient diagnostic tool, as long as clinicians administer the screens in a standardized manner and interpret the screen results accurately. The following brief summary reviews commonly used screening instruments and provides information about how to interpret screening test results. It concludes by showing how cognitive screening fits into a four-step process (Education, Screening, Follow-up, and Referral) of how to respond to patients with cognitive concerns. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 18, 2022 Category: Geriatrics Authors: David L. Nyenhuis, Jaclyn Reckow Source Type: research
Formal Neuropsychological Testing
Neuropsychologists evaluate patients for cognitive decline and dementia, using validated psychometric tests, along with behavioral observation, record review, clinical interview, and information about psychological functioning, to evaluate brain –behavior relationships and aid in differential diagnosis and treatment planning. Also considered are premorbid functioning, education, sex, socioeconomic status, primary language, culture, and race-related health disparities when selecting tests, interpreting performance, and providing a diagnost ic impression. Neuropsychologists provide diagnostic clarity, explain symptoms and ...
Source: Clinics in Geriatric Medicine - October 18, 2022 Category: Geriatrics Authors: Victor A. Del Bene, Adam Gerstenecker, Ronald M. Lazar Source Type: research
Brain Networks, Clinical Manifestations, and Neuroimaging of Cognitive Disorders
In this article, we briefly discuss imaging modalities used in clinical settings for neuroanatomical characterization and for diagnosis of the underlying disease. We then discuss how each neuroimaging tool can be used in the context of clinical syndromes. The major underlying causes relevant to our discussion include Alzheimer disease, Lewy body disease, cerebrovascular disease, frontotemporal degeneration, autoimmune diseases, and systemic or metabolic derangements. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 18, 2022 Category: Geriatrics Authors: Borna Bonakdarpour, Clara Takarabe Source Type: research
Neuropathology of the Common Forms of Dementia
Dementias encompass a range of debilitating neurologic conditions. Here, we summarize the neuropathology of common forms of dementia, focusing on Alzheimer disease (AD) and related dementias. AD is part of a spectrum of neurodegenerative diseases that consists of various protein inclusions (ie, proteinopathies) but other brain abnormalities are also related to dementia. Beta-amyloid and tau aggregates are hallmarks of AD. Other tissue substrates include Lewy bodies, TDP-43 inclusions, vascular brain lesions, and mixed pathologies. This review highlights the complexity of neurodegenerative and other disease substrates and s...
Source: Clinics in Geriatric Medicine - October 18, 2022 Category: Geriatrics Authors: Rupal I. Mehta, Julie A. Schneider Source Type: research
Vascular and Nonvascular Mechanisms of Cognitive Impairment and Dementia
Aging, familial gene mutations, and genetic, environmental, and modifiable lifestyle risk factors predispose individuals to cognitive impairment or dementia by influencing the efficacy of multiple, often interdependent cellular and molecular homeostatic pathways mediating neuronal, glial, and vascular integrity and, ultimately, cognitive status. This review summarizes data from foundational and recent breakthrough studies to highlight common and differential vascular and nonvascular pathogenic mechanisms underlying the progression of Alzheimer disease, vascular dementia, frontotemporal dementia, and dementia with Lewy bodi...
Source: Clinics in Geriatric Medicine - October 18, 2022 Category: Geriatrics Authors: Betul Kara, Marcia N. Gordon, Mahsa Gifani, Anne M. Dorrance, Scott E. Counts Source Type: research
The Role of Vascular Risk Factors in Cognitive Impairment and Dementia and Prospects for Prevention
One of the most challenging clinical expressions of population aging is cognitive impairment and dementia. Among risk factors for the development of dementia, modifiable vascular risk factors have emerged as contributors to both vascular and nonvascular types of dementia. Epidemiologic studies have been particularly informative in understanding the link between vascular risks and dementia across the life course. We discuss vascular risks for dementia and cognitive impairment and practical management recommendations. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 18, 2022 Category: Geriatrics Authors: Simin Mahinrad, Farzaneh Sorond, Philip B. Gorelick Source Type: research
Treatment of Vascular and Neurodegenerative Forms of Cognitive Impairment and Dementias
Ideally, dementia care should be provided by a collaborative team. Eligible patients should be treated with the cognitive-enhancing medications, the cholinesterase inhibitors and memantine. For most of the common causes of dementia, there are no disease-modifying medications, with the exception that vascular dementia can be prevented by treating vascular risk factors to prevent stroke. There is hope that Alzheimer disease can be treated by using monoclonal antibodies that target amyloid beta, although more trials are needed. Holistic, patient-centered care can enhance quality and extend the time that the patient can live s...
Source: Clinics in Geriatric Medicine - October 18, 2022 Category: Geriatrics Authors: Landon Perlett, Eric E. Smith Source Type: research
Harmonizing Ethno-Regionally Diverse Datasets to Advance the Global Epidemiology of Dementia
Understanding dementia and cognitive impairment is a global effort needing data from multiple sources across diverse ethno-regional groups. Methodological heterogeneity means that these data often require harmonization to make them comparable before analysis. We discuss the benefits and challenges of harmonization, both retrospective and prospective, broadly and with a focus on data types that require particular sorts of approaches, including neuropsychological test scores and neuroimaging data. Throughout our discussion, we illustrate general principles and give examples of specific approaches in the context of contempora...
Source: Clinics in Geriatric Medicine - October 18, 2022 Category: Geriatrics Authors: Darren M. Lipnicki, Ben C.P. Lam, Louise Mewton, John D. Crawford, Perminder S. Sachdev Source Type: research
Blood and Cerebrospinal Fluid Biomarkers in Vascular Dementia and Alzheimer ’s Disease
The Maintenance of brain health is a lifelong process whereby potentially deleterious exposures such as cardiovascular risks, amyloid beta, and phosphorylated tau may adversely affect the brain decades before there are clinical manifestations. Thus, the early structural and neuropathological foundation for the development of cognitive impairment and its allied features later in life may provide precursor targets such that interventions may be applied to prevent or slow cognitively impairing processes if the underlying mechanism(s) can be addressed in time. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 18, 2022 Category: Geriatrics Authors: Philip B. Gorelick Source Type: research
Diagnostic and Management Strategies for Common Neurobehavioral and Psychiatric Disturbances Among Patients with Cognitive Impairment and the Dementias
Neurobehavioral and neuropsychiatric symptoms are highly prevalent among individuals diagnosed with cognitive impairment or dementia and impact the quality of life for patients and caregivers alike. Diagnosis and management of these conditions (including primarily depression, anxiety, apathy, psychosis, agitation, and aggression) is crucial to optimal patient care outcomes in clinical practice. The present article provides a practical review of diagnostic approaches and management strategies for behavioral and neuropsychiatric disorders arising in patients with cognitive impairment, up to and including dementia. (Source: C...
Source: Clinics in Geriatric Medicine - October 18, 2022 Category: Geriatrics Authors: Akashleena Mallick, Alessandro Biffi Source Type: research
Preface
During the past 40 years, we have witnessed a substantial transformation of the dementia landscape. Once thought to be largely a consequence of “cerebrovascular insufficiency,” the dementias later became recognized as a group of disorders predominantly characterized as neurodegenerative in nature, with Alzheimer disease (AD) being the leading cause. In the 1990s, fueled by Decade of the Brain legislation in the United States, there was a concerted effort to better understand AD and its key underlying neuropathologic manifestations: neuronal death, neurofibrillary tangles, and amyloid plaques. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 18, 2022 Category: Geriatrics Authors: Philip B. Gorelick, Farzaneh A. Sorond Source Type: research
