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Chapter 2 - Diagnosing Dementia

from Section 1 - Essential Background Knowledge

Published online by Cambridge University Press:  25 October 2024

Simon Gerhand
Affiliation:
Hywel Dda Health Board, NHS Wales
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Summary

The process of diagnosing dementia and MCI is considered in depth in this chapter, drawing on criteria outlined in the DSM-V and ICD-11. This covers ways of assessing the two central components of a dementia diagnosis, namely the extent to which there has been a change in cognitive ability and whether there has been a change in everyday function. The contribution of neuropsychological assessment is explained, along with the use of cognitive screening measures. The difference between dementia and MCI is covered, along with how you differentiate between the two. There is also discussion of what background information to record, specifically in relation to factors which could affect cognitive function. The chapter finishes with a decision tree outlining the process involved in distinguishing between the two presentations. Having established whether dementia is present, how to determine the likely type of dementia is discussed in subsequent chapters.

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Chapter
Information
The Neuropsychology of Dementia
A Clinician's Manual
, pp. 15 - 33
Publisher: Cambridge University Press
Print publication year: 2024

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References

Albert, M. S., DeKosky, S. T., Dickson, D., et al. (2011). The diagnosis of mild cognitive impairment due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 7 (3), 270–9.CrossRefGoogle ScholarPubMed
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. Washington, DC, American Psychiatric Association.Google Scholar
Antonelli Incalzi, R., Marra, C., Giordano, A., et al. (2003). Cognitive impairment in chronic obstructive pulmonary disease. Journal of Neurology, 250(3), 325–32.CrossRefGoogle ScholarPubMed
Barnett, J. H., Blackwell, A. D., Sahakian, B. J., & Robbins, T. W. (2015). The Paired Associates Learning (PAL) test: 30 years of CANTAB translational neuroscience from laboratory to bedside in dementia research. In Robbins, T. W. & Sahakian, B. J. (Eds.), Translational Neuropsychopharmacology: Current Topics in Behavioral Neurosciences (pp. 449–74). Cham: Springer.Google Scholar
Bayer, A. J. (2018). The role of biomarkers and imaging in the clinical diagnosis of dementia. Age and Ageing, 47, 641–3.CrossRefGoogle ScholarPubMed
Beach, T. G., Monsell, S. E., Phillips, L. E., & Kukull, W. (2012). Accuracy of the clinical diagnosis of Alzheimer disease at National Institute on Aging Alzheimer Disease Centers, 2005–2010. Journal of Neuropathology & Experimental Neurology, 71, 266–73.CrossRefGoogle ScholarPubMed
Beynon, R., Sterne, J. A., Wilcock, G., et al. (2012). Is MRI better than CT for detecting a vascular component to dementia? A systematic review and meta-analysis. BMC Neurology, 12, 110.CrossRefGoogle Scholar
Borson, S., Scanlan, J., Brush, M., Vitaliano, P., & Dokmak, A. (2000). The Mini-Cog: A cognitive ‘vital signs’ measure for dementia screening in multi-lingual elderly. International Journal of Geriatric Psychiatry, 15, 1021–7.3.0.CO;2-6>CrossRefGoogle ScholarPubMed
Boustani, M., Campbell, N., Munger, S., Maidment, I., & Fox, C. (2008). Impact of anticholinergics on the aging brain: A review and practical application. Aging Health, 4(3), 311–20.CrossRefGoogle Scholar
Brodaty, H., Pond, D., Kemp, N. M., et al. (2002). The GPCOG: A new screening test for dementia designed for general practice. Journal of the American Geriatrics Society, 50 (3), 530–4.CrossRefGoogle ScholarPubMed
Bucks, R., Ashworth, D., Wilcock, G., & Siegfried, K. (1996). Assessment of activities of daily living in dementia: development of the Bristol Activities of Daily Living Scale. Age and Ageing, 25, 113–20.CrossRefGoogle ScholarPubMed
Clark, C. M., & Ewbank, D. C. (1996). Performance of the dementia severity rating scale: a caregiver questionnaire for rating severity in Alzheimer disease. Alzheimer Disease and Associated Disorders, 10(1), 31–9.Google Scholar
DeBettignies, B. H., Mahurin, R. K., & Pirozzolo, F. J. (1990). Insight for impairment in independent living skills in Alzheimer’s disease and multi-infarct dementia. Journal of Clinical and Experimental Neuropsychology, 12, 355–63.CrossRefGoogle ScholarPubMed
Elvevag, B., & Goldberg, T. E. (2000). Cognitive impairment in schizophrenia is the core of the disorder. Critical Reviews in Neurobiology, 14, 121.CrossRefGoogle ScholarPubMed
Farias, S. T., Munga, S. D., Reed, B. R., et al. (2008). The measurement of everyday cognition (ECog): Scale development and psychometric properties. Neuropsychology, 22 (4), 531–44.CrossRefGoogle ScholarPubMed
Fisher, A. G. (1994). Assessment of Motor and Processing Skill. Unpublished test manual. Department of Occupational Therapy, Colorado State University, Fort Collins. CO.Google Scholar
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12 (3), 189–98.Google Scholar
Giebel, C. M., & Challis, D. (2017). Sensitivity of the mini-mental state examination, Montreal cognitive assessment and the Addenbrooke’s cognitive examination III to everyday activity impairments in dementia: An exploratory study. International Journal of Geriatric Psychiatry, 32 (10), 1085–93.CrossRefGoogle ScholarPubMed
Harper, L., Barkhof, F., Scheltens, P., Schott, J., & Fox, N. (2014). An algorithmic approach to structural imaging in dementia. Journal of Neurology, Neurosurgery and Psychiatry, 85, 692–8.CrossRefGoogle ScholarPubMed
Hart, R. P., Wade, J. B., & Martelli, M. F. (2003). Cognitive impairment in patients with chronic pain: The significance of stress. Current Science Inc, 7, 116–26.CrossRefGoogle ScholarPubMed
Harvey, P. D., & Keefe, R. S. (2001). Studies of cognitive change in patients with schizophrenia following novel antipsychotic treatment. American Journal of Psychiatry, 158(2), 176–84.CrossRefGoogle ScholarPubMed
Hobus, P. P. M., Boshuizen, H. P. A., & Schmidt, H. G. (1990). Expert-novice differences in the role of contextual factors in early medical diagnosis. Paper presented at the Annual Meeting of the American Educational Research Association (Boston, MA, 16–20 April 1990).Google Scholar
Hodges, J. R., & Larner, A. J. (2017). Addenbrooke’s Cognitive Examinations: ACE, ACE-R, ACE-III, ACEapp, and M-ACE. In Larner, A. J (Ed.) Cognitive Screening Instruments: A Practical Approach, Second Edition. Berlin: Springer, pp. 109–37.Google Scholar
Hsieh, S., Schubert, S., Hoon, C., Mioshi, E., & Hodges, J. R. (2013). Validation of the Addenbrooke’s cognitive examination III in frontotemporal dementia and Alzheimer’s disease. Dementia and Geriatric Cognitive Disorders, 36(3–4), 242–50.CrossRefGoogle ScholarPubMed
Jorm, A. F. (1994). A short from of the Informant Questionnaire on Cognitive Decline in the Elderly (QICODE): Development and cross-validation. Psychological Medicine, 24 (1), 145–53.CrossRefGoogle Scholar
Jorm, A. F., Scott, R., & Jacomb, P. A. (1989). Assessment of cognitive decline in dementia by informant questionnaire. International Journal of Geriatric Psychiatry, 4, 35–9.CrossRefGoogle Scholar
Kalish, V. B., Gillham, J. E., & Unwin, B. K. (2014). Delirium in older persons: Evaluation and management. American Family Physician, 90 (3), 150–8.Google ScholarPubMed
Katzman, R., Brown, T., & Fuld, P., et al. (1983) Validation of a short orientation–memory–concentration test of cognitive impairment. American Journal of Psychiatry, 40 (6), 734–9.Google Scholar
Kolodner, J. (1983). Towards an understanding of the role of experience in the evolution form novice to expert. International Journal of Man-Machine Studies, 19 (5), 497518.CrossRefGoogle Scholar
Lenehan, M. E., Klekociuk, S. Z., & Summers, M. J. (2012). Absence of a relationship between subjective memory complaint and objective memory impairment in mild cognitive impairment (MCI): Is it time to abandon subjective memory complaint as an MCI diagnostic criterion? International Psychogeriatrics, 24 (9), 1505–14.CrossRefGoogle ScholarPubMed
Lin, F. R., Metter, E. J., O’Brien, R. J., et al. (2011). Hearing loss and incident dementia. Archives of Neurology, 68 (2), 214–20.CrossRefGoogle ScholarPubMed
Liu, C. M., & Lee, C. T. C. (2019). Association of hearing loss with dementia. JAMA Network Open, 2(7), e198112.CrossRefGoogle ScholarPubMed
Lodeiro-Fernández, L., Lorenzo-López, L., Maseda, A., et al. (2015). The impact of hearing loss on language performance in older adults with different stages of cognitive function. Clinical Interventions in Aging, 695702.Google Scholar
MacKenzie, N. E., Kowalchuk, C., Agarwal, S. M., et al. (2018). Antipsychotics, metabolic adverse effects, and cognitive function in schizophrenia. Frontiers in Psychiatry, 9, 622.CrossRefGoogle ScholarPubMed
Macnamara, A., Schinazi, V. R., Chen, C., Coussens, S., & Loetscher, T. (2021). Vision impairments reduce cognitive test performance. Nature Aging, 1, 975–6.CrossRefGoogle ScholarPubMed
Mara, C., Cappa, A., & Fuso, L. (2003). Cognitive impairment in chronic obstructive pulmonary disease: A neuropsychological and spect study. Journal of Neurology, 250 (3), 325–32.Google Scholar
Mathuranath, P. S., Nestor, P. J., Berrio, G. E., Rakowicz, W., & Hodges, J. R. (2000). A brief cognitive test battery to differentiate Alzheimer’s disease and frontotemporal dementia. Neurology, 55 (11), 1613–20.CrossRefGoogle ScholarPubMed
McKeith, I. G., Boeve, B. F., & Dickson, D. W., et al. (2017). Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology, 89, 88100.CrossRefGoogle ScholarPubMed
Merriam-Webster (2020). Merriam-Webster’s Dictionary and Thesaurus: Revised and Updated. Springfield: Merriam-Webster Incorporated.Google Scholar
Moelter, S. T., Glenn, M. A., Xie, S. X., et al. (2015). The Dementia Severity Rating Scale predicts clinical dementia rating sum of boxes scores. Alzheimer Disease and Associated Disorders, 29(2), 158–60.CrossRefGoogle ScholarPubMed
Nasreddine, Z. S., Phillips, N. A., Bédirian, V., et al. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695–9.CrossRefGoogle Scholar
National Institute of Clinical Excellence (NICE) (2018). Dementia: Assessment, management and support for people living with dementia and their carers. https://www.nice.org.uk/guidance/ng97.Google Scholar
Orleans-Foley, S., Isaacs, J., & Cook, L. (2018). Neuroimaging for dementia diagnosis Guidance from the London Dementia Clinical Network. www.england.nhs.uk/london/wp-content/uploads/sites/8/2019/09/Neuroimaging-for-dementia-diagnosis-London-Dementia-Clinical-Network.pdf.Google Scholar
Parfenov, V. A., Zakharov, V. V., Kabaeva, A. R., & Vakhnina, N. V. (2020). Subjective cognitive decline as a predictor of future cognitive decline: A systematic review. Dementia & Neuropsychologia, 14(3), 248–57.CrossRefGoogle ScholarPubMed
Pfeffer, R. I., Kurosaki, T. T., Harrah, C. H., Jr., et al. (1982). Measurement of functional activities in older adults in the community. Journal of Gerontology, 37 (3), 323–9.CrossRefGoogle ScholarPubMed
Rikkert, M. G., Tona, K. D., Janssen, L., et al. (2011). Validity, reliability, and feasibility of clinical staging scales in dementia: a systematic review. American Journal of Alzheimer’s Disease and Other Dementias, 26(5), 357–65.Google ScholarPubMed
Salluh, J. I., Wang, H., Schneider, E. B., et al. (2015). Outcome of delirium in critically ill patients: systematic review and meta-analysis. British Medical Journal (Clinical research ed.), 350, h2538.Google ScholarPubMed
Schubert, C., Denmark, T. K., Crandall, B., Grome, A., & Pappas, J. (2013). Characterizing novice-expert differences in macrocognition: An exploratory study of cognitive work in the emergency department. Annals of Emergency Medicine, 61 (1), 96109.CrossRefGoogle ScholarPubMed
Scott, J., Spector, A., Orrell, M., et al. (2017). Limited validity of the Hospital Anxiety and Depression Scale (HADS) in dementia: Evidence from a confirmatory factor analysis. International Journal of Geriatric Psychiatry, 32 (7), 805–13.Google Scholar
Shin, S. Y., Katz, P., Wallhagen, M., & Julian, L. (2012). Cognitive impairment in persons with rheumatoid arthritis. Arthritis Care & Research, 64 (8), 1144–50.CrossRefGoogle ScholarPubMed
Siciliano, M., Chiorri, C., Passaniti, C., et al. (2019). Comparison of alternate and original forms of the Montreal Cognitive Assessment (MoCA): An Italian normative study. Neurological Sciences, 40(4), 691702.CrossRefGoogle ScholarPubMed
Tomaszewski Farias, S., Mungas, D., Harvey, D. J., et al. (2011). The measurement of everyday cognition: Development and validation of a short form of the Everyday Cognition scales. Alzheimer’s & Dementia, 7 (6), 593601.CrossRefGoogle Scholar
Vogels, R. L., Oosterman, J. M., Van Harten, B., et al. (2007). Profile of cognitive impairment in chronic heart failure. Journal of the American Geriatrics Society, 55 (11), 1764–70.CrossRefGoogle ScholarPubMed
Winblad, B., Palmer, K., Kivipelto, M., et al. (2004). Mild cognitive impairment – beyond controversies, towards a consensus: Report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine, 256(3), 240–6.CrossRefGoogle Scholar
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandanavia, 67, 361–70.CrossRefGoogle ScholarPubMed

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  • Diagnosing Dementia
  • Simon Gerhand, Hywel Dda Health Board, NHS Wales
  • Book: The Neuropsychology of Dementia
  • Online publication: 25 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781009025911.003
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  • Diagnosing Dementia
  • Simon Gerhand, Hywel Dda Health Board, NHS Wales
  • Book: The Neuropsychology of Dementia
  • Online publication: 25 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781009025911.003
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Diagnosing Dementia
  • Simon Gerhand, Hywel Dda Health Board, NHS Wales
  • Book: The Neuropsychology of Dementia
  • Online publication: 25 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781009025911.003
Available formats
×