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Risk score developed from routinely collected data by primary healthcare practitioners is useful to rule out dementia in 60-79 year-olds
Commentary on: Walters K, Hardoon S, Petersen I, et al.. Predicting dementia risk in primary care: development and validation of the Dementia Risk Score using routinely collected data. BMC Medicine 2016;14:6 . Context In spite of major repercussions on the life of patients and caregivers, dementia remains a neglected domain in primary care setting. Previous studies have shown that only a third of new dementia cases occurring in the general population were referred to a specialist1 and that too at a severe stage of the disease, 25% of cases were ignored.2 A great proportion of primary care practitioners (PCPs) consider deme...
Source: Evidence-Based Medicine - September 22, 2016 Category: Internal Medicine Authors: Dartigues, J. F., Helmer, C. Tags: EBM Diagnosis, Health policy, General practice / family medicine, Drugs: cardiovascular system, Dementia, Drugs: CNS (not psychiatric), Stroke, Memory disorders (psychiatry), Psychiatry of old age, Health service research Source Type: research

The use of a portable three-lead ECG monitor to detect atrial fibrillation in general practice.
CONCLUSIONS: The inexpensive portable PEM device recording diagnosed AF with a high sensitivity and specificity. KEY POINTS Simple ECG monitors could be useful to identify atrial fibrillation and thereby lead to a better prevention of stroke. The PEM device was easy to use and 95.7% of the recordings were technically acceptable for detecting atrial fibrillation. The PEM device has a high sensitivity and specificity in detecting atrial fibrillation compared to a standard 12-lead ECG. Further studies should evaluate the clinical usefulness of the PEM device, e.g. to detect intermittent atrial fibrillation. PMID: 2740915...
Source: Primary Care - July 12, 2016 Category: Primary Care Authors: Kristensen AN, Jeyam B, Riahi S, Jensen MB Tags: Scand J Prim Health Care Source Type: research

General practice based psychosocial interventions for supporting carers of people with dementia or stroke: a systematic review
Particularly with ageing populations, dementia and stroke and their resultant disability are worldwide concerns. Much of the support for people with these conditions comes from unpaid carers or caregivers. The...
Source: BMC Family Practice - January 15, 2016 Category: Primary Care Authors: Nan Greenwood, Ferruccio Pelone and Anne-Marie Hassenkamp Source Type: research

An Unusual Stroke-like Clinical Presentation of Creutzfeldt-Jakob Disease: Acute Vestibular Syndrome
Conclusions: To our knowledge, this is the first report of an initial presentation of Creutzfeldt-Jacob disease closely mimicking vestibular neuritis, expanding the known clinical spectrum of prion disease presentations. Despite the initial absence of neurological signs, the central lesion location was differentiated from a benign peripheral vestibulopathy at the first visit using simple bedside vestibular tests. Familiarity with these tests could help providers prevent initial misdiagnosis of important central disorders in patients presenting vertigo or dizziness.
Source: The Neurologist - April 1, 2015 Category: Neurology Tags: Case Report/Case Series Source Type: research

Enhanced invitation methods to increase uptake of NHS health checks: study protocol for a randomized controlled trial
DiscussionThe research will provide evidence on whether asking individuals to complete a preliminary questionnaire, by using the QBE, is effective in increasing uptake of Health Checks and whether an incentive alters questionnaire return rates as well as uptake of Health Checks. The trial interventions can be readily translated into routine service delivery if they are shown to be cost-effective.Trial registration: Current Controlled Trials ISRCTN42856343. Date registered: 21.03.2013.
Source: Trials - August 30, 2014 Category: Journals (General) Authors: Alice ForsterCaroline BurgessLisa McDermottAlison WrightHiten DodhiaMark ConnerJane MillerCaroline RudisillVictoria CorneliusMartin Gulliford Source Type: research

A transitional care model for low-income older adults does not reduce readmission rates or emergency department visits during care transitions
Commentary on: Ohuabunwa U, Jordan Q, Shah S, et al.. Implementation of a care transitions model for low-income older adults: a high-risk, vulnerable population. J Am Geriatr Soc 2013;61:987–92. Implications for practice and research A relatively simple, low-cost care transition intervention can encourage low-income, predominantly African-American elders to better utilise primary care, posthospital discharge. An adequately powered study is needed in order to enable stronger conclusions to be drawn, particularly regarding the model's impact on hospital re-admission and emergency department (ED) visits. Studies benefit...
Source: Evidence-Based Nursing - June 17, 2014 Category: Nursing Authors: Nadash, P. Tags: Health policy, General practice / family medicine, Care of the older person, Dementia, Stroke, Hypertension, Memory disorders (psychiatry), Health service research, Diabetes, Metabolic disorders Source Type: research

The inter-contact interval: a new measure to define frequent attenders in primary care
Background: Frequent attenders receive much attention in primary care research. Defining frequent attendance is crucial for an adequate view on this group of demanding patients. We aimed to develop a purely contact-based definition of "frequent attendance" and to apply it to real patients. Methods: From electronic records of 123 general practices in Germany, patients' inter-contact intervals (ICI) between two consecutive doctor-patient-contacts were calculated in this retrospective observational study. ICI less than 7 days were labelled "frequent attendance", patients with 60% or more of such intervals "frequent attenders ...
Source: BMC Family Practice - October 23, 2013 Category: Primary Care Authors: Johannes HauswaldtWolfgang HimmelEva Hummers-Pradier Source Type: research

Risk of incident stroke in patients with Alzheimer disease or vascular dementia
Conclusions: Patients with VD, but not AD, have a markedly higher risk of developing an ischemic stroke than those without dementia. In patients with AD, but not VD, use of atypical antipsychotic drugs was associated with an increased risk of TIA.
Source: Neurology - September 2, 2013 Category: Neurology Authors: Imfeld, P., Bodmer, M., Schuerch, M., Jick, S. S., Meier, C. R. Tags: All Cerebrovascular disease/Stroke, Alzheimer's disease, Vascular dementia, Case control studies, Incidence studies ARTICLE Source Type: research

Why acupuncture is giving sceptics the needle
Acupuncture has been prescribed by half of Britain's doctors, but after 3,000 clinical trials its efficacy remains unproven. So is the NHS making a grave error in supporting this ancient treatment?• Are vitamin pills a sham? Q&A with Dr. Paul OffitYou can't get crystal healing on the NHS. The Department of Health doesn't fund faith healing. And most doctors believe magnets are best stuck on fridges, not patients. But ask for a treatment in which an expert examines your tongue, smells your skin and tries to unblock the flow of life force running through your body with needles and the NHS will be happy to oblige.The govern...
Source: Guardian Unlimited Science - July 26, 2013 Category: Science Authors: David Derbyshire Tags: Culture Health Science and scepticism Features NHS Alternative medicine The Observer Source Type: news

The DAISY psychosocial intervention does not improve outcomes in patients with mild Alzheimer's disease or their carers
Question Question: What are the effects of a semitailored multicomponent intervention for patients with mild Alzheimer's disease and their carers? Patients: In total, 330 patients with recently diagnosed mild Alzheimer's disease living in the community and their caregivers. Other inclusion criteria: age ≥50 years, DSM-IV dementia, probable Alzheimer's disease (National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria) or Lewy body dementia (McKeith criteria), diagnosis in past 12 months, mini-mental state exam...
Source: Evidence-Based Mental Health - January 9, 2013 Category: Psychiatry & Psychology Authors: Mittelman, M. S. Tags: Clinical trials (epidemiology), General practice / family medicine, Neurology, Dementia, Alzheimer's type, Psychiatry of old age, Epidemiology Therapeutics Source Type: research

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