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Background: The focus on early detection of dementia and Mild Cognitive Impairment (MCI) diagnosis has entered the clinics' daily routine. However, there exist epistemic uncertainty and moral concerns whether early detection and prediction of dementia is clinically meaningful for the people affected, primarily due to the lack of effective treatment options. Methods: In this study, we adopted qualitative research methods. Twelve face-to-face interviews with tested persons with MCI and early dementia and five focus groups with family caregivers were conducted in Germany in order to explore and analyze their understanding and assessments of early detection and prediction of dementia in memory clinics. Results: Our study revealed that there was much uncertainty among the participants diagnosed with MCI especially when compared to the participants with an early dementia diagnosis. Their uncertainty concerned the meaning of a 'MCI' diagnosis as well as the validity of specific biomarker test results. Moreover, we identified different lines of moral issues for and against the tests among the participants. They include a) inter-familiar conflicts of interest in the initial phase of memory problems, b) the hope for (future) therapy and prevention, c) the desire for easier access to experts in memory clinics, d) advance planning, e) stigmatization, as well as, f) suicide as an option to avoid the future loss of self-determination. Conclusions: Current clinical and communication strategies only partly address the perspectives and needs of the affected. A standardized and ethically reflected procedure of the information provided by professionals before testing and afterwards, during disclosure, seems necessary. Further, longitudinal studies are needed to improve our knowledge about the experiences tested persons and family caregivers have with different levels of stigma. [ABSTRACT FROM AUTHOR]

Dementia is the most prevalent degenerative disease in seniors in which progression can be prevented or delayed by early diagnosis. In this study, we proposed a two-layer model inspired by the method used in dementia support centers for the early diagnosis of dementia and using machine learning techniques. Data were collected from patients who received dementia screening from 2008 to 2013 at the Gangbuk-Gu center for dementia in the Republic of Korea. The data consisted of the patient's gender, age, education, the Mini-Mental State Examination in the Korean version of the CERAD Assessment Packet (MMSE-KC) for dementia screening test, and the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) for the dementia precise test. In the proposed model, MMSE-KC data are initially classified into normal and abnormal. In the second stage, CERAD-K data are used to classify dementia and mild cognitive impairment. The performance of each algorithm is compared with that of Naive Bayes, Bayes Network, Begging, Logistic Regression, Random Forest, Support Vector Machine (SVM) and Multilayer Perceptron (MLP) using Precision, Recall and F-measure. Comparing the F-measure values of normal, mild cognitive impairment (MCI), and dementia, the MLP was the highest in the F-measure values of normal with 0.97, while the SVM appear to be the highest in MCI and dementia with 0.739. Using the proposed early diagnosis model for dementia reduces the time and economic burden and can help simplify the diagnosis method for dementia. [ABSTRACT FROM AUTHOR]

Objectives: Memory clinics (MCs) are multidisciplinary teams involved with early diagnosis and treatment of people with dementia. The main aim of this study was to gain more insight into the development of MCs in the Netherlands since 1998. Methods: In 1998, 2004 and 2009, an MC survey with questions about patient groups, organisation and working procedures of the MC were sent to all MCs in the Netherlands. Results: The number of MCs increased from 12 in 1998, to 43 in 2004 and to 63 in 2009. In 2009, MCs were better embedded with other regional care and were delivering services for dementia with less emphasis on university-based research. While dementia was still the most common syndromal diagnosis, the proportion of subjects diagnosed with milder memory problems increased to 39%. Diagnostic tools, blood assessments and brain imaging were used in nearly all the facilities. There was an increase both in the use of extensive neuropsychological assessments and in the use of cerebrospinal fluid diagnostics. Conclusion: MCs in the Netherlands have outgrown the primarily university-based setting, have focussed less on scientific research, and have taken a place in the regular care of people with cognitive problems and people in early phases of dementia. [ABSTRACT FROM AUTHOR]

Purpose: The Early Diagnosis Dyadic Intervention (EDDI) program provides a structured, time-limited protocol of one-on-one and dyadic counseling for family caregivers and care receivers who are in the early stages of dementia. The goals and procedures of EDDI are based on previous research suggesting that dyads would benefit from an intervention that increases the care receiver's active participation in his or her care plan, develops positive communication patterns between the caregiver and care receiver, increases knowledge and understanding about available services, and assists the dyad through the emotional turbulence of a diagnosis of Alzheimer's disease or other dementing condition. Design and Methods: EDDI was developed in response to research and clinical findings that suggested that care dyads in the early stages of dementia and dementia care are able to engage in a dialogue about future preferences for care, and that this discussion could address some of the uncertainty and worry experienced by each member of the dyad. As part of a feasibility trial, 31 dyads participated in the EDDI program. Measures were obtained on the intervention's implementation, including the number of sessions attended, caregiver and care receiver ratings of treatment acceptability and effectiveness, and counselor ratings of treatment effectiveness. Results: Participant and counselor evaluations of the EDDI protocol indicated that the intervention was acceptable and satisfactory to the caregivers, care receivers, and counselors, and that the intervention's goals and objectives were achievable. Implications: These findings indicate that individuals with early-stage dementia and their family caregivers are able to participate in and benefit from a structured intervention that focuses on care planning for future needs. [ABSTRACT FROM AUTHOR]

To validate the Clock Drawing Test (CDT) as a screening method for detecting mild cognitive impairment (MCI) and to find the appropriate scoring protocol and its cutoff point, we compared the sensitivity and specificity of three CDT protocols. Subjects included 219 outpatients with memory complaints, who were attending the geriatric memory clinic. Cahn's protocol, with a cutoff point of 7, was more successful at differentiating clinically diagnosed MCI subjects from normal elderly individuals, with higher sensitivity (74.7%) and specificity (75.6%), than were the other protocols. The CDT, as a handy screening method, may be useful for clinicians to reliably identify subjects with MCI, and it may contribute to early detection of dementia. [ABSTRACT FROM AUTHOR]