scholarly journals P.011 Standardized Processes for Addressing Driving Cessation in the Memory Clinic

2021 ◽  
Vol 48 (s3) ◽  
pp. S22-S23
Author(s):  
A Henri-Bhargava ◽  
C Bell ◽  
D Thompson ◽  
M Bibok ◽  
J Nikolejsin ◽  
...  
Keyword(s):  
Road Safety ◽  
Cognitive Disorders ◽  
Driving Ability ◽  
Accurate Information ◽  
Memory Clinic ◽  
Driving Cessation ◽  
Dementia Patients ◽  
License Revocation

Background: Discussions around driving cessation between clinicians and dementia patients are challenging. Patients view giving up their license as losing their independence. We sought to develop a tool that enables standardized and consistent driving messaging across clinicians working in a specialist memory clinic, across the span of cognitive disorders Methods: We developed a driving recommendations generator that allows clinicians to produce information handouts personalized to individual patient capabilities and needs. Clinicians select from a list of established recommendations that were developed with neurologist and geriatrician input, and consistent with provincial requirements. Recommendations cover patients’ current driving ability, road safety examinations, alternate transportation, and license revocation. Early driving retirement is emphasized and encouraged, to proactively support patients’ choices, safety and independence. Recommendation and handouts are printed for the patients. Results: Patients reported that the recommendations were easy to read and understand, and helped them to implement physician suggestions. All surveyed clients recommended continuing to provide such recommendations to future patients and families. Clinicians agreed that the tool helped them to save time, and simplified the process of finding accurate information to provide patients. Conclusions: Clinicians have found the system timesaving and useful for simplifying the process of providing helpful, informative resources for patients.

scholarly journals Driving and Dementia: Workshop Module on Communicating Cessation to Drive

2017 ◽  
Vol 20 (4) ◽  
pp. 241-245
Author(s):  
Anna Byszewski ◽  
Barbara Power ◽  
Linda Lee ◽  
Glara Gaeun Rhee ◽  
Robert Parson ◽  
...  
Keyword(s):  
Health Professionals ◽  
Positive Impact ◽  
Communication Strategies ◽  
Emotional Reactions ◽  
Accurate Information ◽  
Driving Cessation ◽  
Ovid Medline ◽  
Online Tools ◽  
Background Material ◽  
The Subject

BackgroundFor persons with dementia (PWD), driving becomes very dangerous. Physicians in Canada are legally responsible to report unfit drivers and then must disclose that decision to their patients. That difficult discussion is fraught with challenges: physicians want to maintain a healthyrelationship; patients often lack insight into their cognitive loss and have very strong emotional reactions to the loss of their driving privileges. All of which may stifle the exchange of accurate information. The goal of this project was to develop a multimedia module that would provide strategies and support for health professionals having these difficult conversations.MethodsLiterature search was conducted of Embase and OVID MedLine on available driving and dementia tools, and on websites of online tools for communication strategies on driving cessation. A workshop module was developed with background material, communication strategies, links to resources and two videos demonstrating the “bad” then the “good” ways of managing this emotionally charged discussion.ResultsWhen the module was tested with internal medicine trainees, results demonstrated that confidence increased significantly (p < .001), and comfort and willingness in discussing the subject improved.ConclusionThis project demonstrated the positive impact of the module on improving health professionals’ attitude and readiness to communicate driving cessation to PWD.

Music Engagement Questionnaire Development for Individuals with Dementia or Other Cognitive Impairments

2018 ◽  
Author(s):  
Tina Poon
Keyword(s):  
Cognitive Deficits ◽  
Cognitive Impairments ◽  
Cognitive Disorders ◽  
Questionnaire Development ◽  
Self Report ◽  
Third Party ◽  
Validity And Reliability ◽  
Dementia Patients ◽  
Everyday Living

Previous literature has shown the importance of music engagement in everyday living, particularly for regulating emotions and enhancing the quality of life. However, the benefits individuals derive from music vary based on degree and method of use. Current measures of music engagement are designed for healthy populations and rely heavily on introspective self-report. Unfortunately, special populations with cognitive deficits, such as dementia patients, cannot accurately report introspective emotions and mood. Thus, there is a need for a more concrete behavioural-based measure suitable for reporting by a third party. The current study addressed these issues by developing a music engagement questionnaire suitable for dementia patients. The questionnaire will be tested with a large sample of adults with a range of ages. Furthermore, the questionnaire will undergo statistical analysis to determine validity and reliability. The result will be a measure of music engagement suitable for use with participants who suffer from dementia or other cognitive disorders.

scholarly journals Characteristics of Young-Onset and Late-Onset Dementia Patients at a Remote Memory Clinic

2020 ◽  
Vol 47 (3) ◽  
pp. 320-327
Author(s):  
Jennifer F. W. Wong ◽  
Andrew Kirk ◽  
Landon Perlett ◽  
Chandima Karunanayake ◽  
Debra Morgan ◽  
...  
Keyword(s):  
Late Onset ◽  
Remote Memory ◽  
Memory Clinic ◽  
Rural And Remote ◽  
Caregiver Support ◽  
Young Onset ◽  
Highly Educated ◽  
Dementia Patients ◽  
Patient Groups ◽  
Late Onset Dementia

ABSTRACT:Background:Young-onset dementia (YOD) is defined as the onset of dementia symptoms before the age of 65 years and accounts for 2–8% of dementia. YOD patients and their caregivers face unique challenges in diagnosis and management. We aimed to compare the characteristics of rural YOD and late-onset dementia (LOD) patients at a rural and remote memory clinic in Western Canada.Methods:A total of 333 consecutive patients (YOD = 61, LOD = 272) at a rural and remote memory clinic between March 2004 and July 2016 were included in this study. Each patient had neuropsychological assessment. Health, mood, function, behaviour and social factors were also measured. Both groups were compared using χ2 tests and independent sample tests.Results:YOD patients were more likely to be married, employed, current smokers and highly educated. They reported fewer cognitive symptoms, but had more depressive symptoms. YOD patients were less likely to live alone and use homecare services. YOD caregivers were also more likely to be a spouse and had higher levels of distress than LOD caregivers. Both YOD and LOD patient groups were equally likely to have a driver’s licence.Conclusions:Our findings indicate YOD and LOD patients have distinct characteristics and services must be modified to better meet YOD patient needs. In particular, the use of homecare services and caregiver support may alleviate the higher levels of distress found in YOD patients and their caregivers. Additional research should be directed to addressing YOD patient depression, caregiver distress and barriers to services.

scholarly journals Post-Mortem diagnosis of dementia by informant interview

2010 ◽  
Vol 4 (2) ◽  
pp. 138-144 ◽  
Author(s):  
Renata Eloah de Lucena Ferretti ◽  
Antonio Eduardo Damin ◽  
Sonia Maria Dozzi Brucki ◽  
Lilian Schafirovits Morillo ◽  
Tibor Rilho Perroco ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Cognitive Disorders ◽  
High Specificity ◽  
Aging Brain ◽  
Cognitively Impaired ◽  
Memory Clinic ◽  
Postmortem Diagnosis ◽  
Specificity And Sensitivity ◽  
Diagnosis Of Dementia ◽  
Normal Cognition

Abstract The diagnosis of normal cognition or dementia in the Brazilian Brain Bank of the Aging Brain Study Group (BBBABSG) has relied on postmortem interview with an informant. Objectives: To ascertain the sensitivity and specificity of postmortem diagnosis based on informant interview compared against the diagnosis established at a memory clinic. Methods: A prospective study was conducted at the BBBABSG and at the Reference Center for Cognitive Disorders (RCCD), a specialized memory clinic of the Hospital das Clínicas, University of São Paulo Medical School. Control subjects and cognitively impaired subjects were referred from the Hospital das Clínicas to the RCCD where subjects and their informants were assessed. The same informant was then interviewed at the BBBABSG. Specialists' panel consensus, in each group, determined the final diagnosis of the case, blind to other center's diagnosis. Data was compared for frequency of diagnostic equivalence. For this study, the diagnosis established at the RCCD was accepted as the gold standard. Sensitivity and specificity were computed. Results: Ninety individuals were included, 45 with dementia and 45 without dementia (26 cognitively normal and 19 cognitively impaired but non-demented). The informant interview at the BBBABSG had a sensitivity of 86.6% and specificity of 84.4% for the diagnosis of dementia, and a sensitivity of 65.3% and specificity of 93.7% for the diagnosis of normal cognition. Conclusions: The informant interview used at the BBBABSG has a high specificity and sensitivity for the diagnosis of dementia as well as a high specificity for the diagnosis of normal cognition.

Information for dementia patients and their caregivers: What information does a memory clinic pass on, and to whom?

2003 ◽  
Vol 7 (1) ◽  
pp. 34-38 ◽  
Author(s):  
M. J. F. J. Vernooij-Dassen ◽  
H. P. J. Van Hout ◽  
K. L. M. Hund ◽  
W. H. L. Hoefnagels ◽  
R. P. T. M. Grol
Keyword(s):  
Memory Clinic ◽  
Dementia Patients

scholarly journals Behavioral, Environmental and Pharmacotherapy Challenges in Dementia during COVID-19 Pandemic: Solutions and Management Issues

2021 ◽  
Author(s):  
Fatemeh Mohammadian ◽  
Marjan Moghadamnia ◽  
Ali Talebi ◽  
Niayesh Mohebbi
Keyword(s):  
Health Care Providers ◽  
Elderly Population ◽  
Cognitive Disorders ◽  
Behavioral Symptoms ◽  
Care Providers ◽  
Medical Centers ◽  
Dementia Patients ◽  
Age Related ◽  
Cognitive Disorders And Dementia ◽  
Management Issues

With the increase in the world's elderly population, age-related disorders such as cognitive disorders and dementia have increased in this group, and with the onset of the COVID-19 pandemic in 2019, many of the world's rules and regulations have changed, and personal protection recommendations against infection have been recommended by various medical centers, which is very challenging for patients with dementia and can even lead to the development or exacerbation of behavioral symptoms in their everyday life. On the other hand, caregivers of dementia patients are exposed to the burden of disease caused by the stress of transmitting infection along with the usual care needed for dementia patients, which has definitely increased this time during the pandemic. Therefore, caregivers of dementia patients, both at home and in care centers, need the advice to care for patients and prevent pandemic physical and psychological complications on themselves and their patients. Regarding the administration of drugs effective on COVID-19 infection and the possibility of their interaction with drugs prescribed in patients with dementia or cognitive complications, delirium, and exacerbation of dementia, there is a need for solutions that are briefly reviewed in this report. It is hoped to provide assistance and support in providing services and care to dementia patients, health care providers, and physicians.

scholarly journals Uncertainty estimation on road safety analysis using bayesian deep neural networks

2021 ◽  
Author(s):  
Guangyuan Pan ◽  
Chen Qili ◽  
Fu Liping ◽  
Yu Ming ◽  
Muresan Matthew
Keyword(s):  
Neural Networks ◽  
Traffic Engineering ◽  
Road Safety ◽  
Deep Neural Networks ◽  
Surface Condition ◽  
Uncertainty Estimation ◽  
Public Confidence ◽  
Accurate Information ◽  
Crash Prediction ◽  
First Time

Deep neural networks have been successfully used in many different areas of traffic engineering, such as crash prediction, intelligent signal optimization and real-time road surface condition monitoring. The benefits of deep neural networks are often uniquely suited to solve certain problems and can offer improvements in performance when compared to traditional methods. In collision prediction, uncertainty estimation is a critical area that can benefit from their application, and accurate information on the reliability of a model’s predictions can increase public confidence in those models. Applications of deep neural networks to this problem that consider these effects have not been studied previously. This paper develops a Bayesian deep neural network for crash prediction and examines the reliability of the model based on three key methods: layer-wise greedy unsupervised learning, Bayesian regularization and adapted marginalization. An uncertainty equation for the model is also proposed for this domain for the first time. To test the performance, eight years of car collision data collected from Highway 401, Canada, is used, and three experiments are designed.

scholarly journals Elderly drivers with dementia – how do experts and relatives assess their safety risk?

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
B Reime ◽  
N Pilgram ◽  
T Bertsche
Keyword(s):  
Public Health ◽  
Road Safety ◽  
Best Practice ◽  
Qualitative Content Analysis ◽  
Qualitative Interviews ◽  
Retirement Age ◽  
Safety Risk ◽  
Family Doctors ◽  
Elderly Drivers ◽  
Dementia Patients

Abstract Background Demographic change increases the proportion of car drivers over the age of 70. With increasing age, the likelihood of developing a form of dementia increases. In Germany, about 1.6 million people suffer from dementia. Surveys among dementia patients showed that about two-thirds said they held a valid driving licence and just under half reported still actively driving. We explored whether and to what extent motorists with dementia are putting road safety at risk and how relatives deal with the driving behaviour of their elders. Methods Semi-structured qualitative interviews were conducted with seven experts from the fields of police, gerontology and geriatrics as well as with 16 relatives of patients with different stages of dementia. All interviews were then transcribed. The analyses based on the qualitative content analysis (Mayring 2015) with MAXQDA. Results The experts regarded elderly drivers with dementia as a public health relevant safety risk. Among those elders who are affected by dementia the awareness of the problem often is limited and not rarely they are characterized by an unsafe driving style. Experts from Austria and Switzerland supported the concept of a mandatory dementia assessment for elderly drivers while experts from Germany did not. Relatives reported very similar descriptions of their elderly’s driving characteristics. Furthermore, the cognitive and motor limitations associated with dementia often are not noticed by both patients themselves and their relatives. Conclusions Representative studies are needed to test which measures, such as a mandatory dementia check from retirement age, are likely to improve the safety of older drivers with dementia. Family doctors and GPs should address and educate dementia patients in relation to their risk of accidents. Relatives should receive information material on how to communicate with their elderlys on this topic to maximize safety while avoiding conflict. Key messages The prevalence of elderly drivers with dementia is unknown. Representative studies are needed to test best practice appoaches for harm reduction in drivers with dementia.

scholarly journals Less Education Predicts Anticholinesterase Discontinuation in Dementia Patients

2013 ◽  
Vol 40 (5) ◽  
pp. 684-690 ◽  
Author(s):  
Solin Saleh ◽  
Andrew Kirk ◽  
Debra G. Morgan ◽  
Chandima Karunanayake
Keyword(s):  
Logistic Regression ◽  
Cholinesterase Inhibitor ◽  
Formal Education ◽  
Remote Memory ◽  
Outcome Variable ◽  
Drug Discontinuation ◽  
Memory Clinic ◽  
Dementia Patients ◽  
Functional Factors ◽  
Institutionalized Patients

Abstract:Objective:We investigated patient socio-demographic, clinical and functional factors predicting cholinesterase inhibitor discontinuation by patients presenting to a memory clinic in Saskatoon, Saskatchewan.Methods:Data collection began in March 2004 at the Rural and Remote Memory Clinic where family physicians referred their non-institutionalized patients. Neurological and neuropsychological assessment, patient and caregiver questionnaires provided the socio-demographic, clinical and functional variables. Univariate logistic regression analysis was used to examine possible associations between each independent variable and the binary outcome variable of treatment discontinuation. Multivariate logistic regression was used to determine predictors of cholinesterase inhibitor discontinuation within six months of drug initiation.Results:Our sample consisted of the first 63 patients (60.3% female) for whom we prescribed a cholinesterase inhibitor. The mean age at clinic day was 74.56 years (SD=7.78). We found that years of formal education was the only variable significantly associated with cholinesterase inhibitor discontinuation by six months. The more years of formal education, the lower the rate of drug discontinuation by six months.Conclusions:Likelihood of cholinesterase inhibitor discontinuation by six months was predicted by fewer years of formal education.

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