scholarly journals Dissonant dementia: neuropsychiatry, awareness, and contradictions in cognitive decline

Author(s):  
James Rupert Fletcher ◽  
Carol Maddock

AbstractThis paper presents an analysis of contemporary neuropsychiatric meaning-making regarding dementia, encompassing distinct beliefs, practices and objects, and the peculiarities of its fragmented public manifestations. First, some core neuropsychiatric beliefs are discussed, arguing that the designation of those beliefs as exceptional truths engenders an imperialist ethic whereby the beliefs must be spread into other populations. Second, the enactment of this spread through dementia awareness is considered, whereby people are presented as having wrong beliefs to justify the promotion of alternative correct knowledge. Third, some emerging contradictions within neuropsychiatric dementia are outlined, as moves toward early diagnosis and “living well” sit uneasily beside notions of dementia as a frightening epidemic. The paper concludes that this produces dissonant dementia wherein contradictory meanings are held together. Finally, it is suggested that this dissonance will likely continue, underpinned by specific interests.

2016 ◽  
Vol 16 (5) ◽  
pp. 649-663 ◽  
Author(s):  
Louise Hardwick

This paper draws on Paul Ricoeur’s theory of interpretation to highlight aspects of the existential realities that emerge woven within the narratives of people living with Multiple Sclerosis (MS). It aims to give social workers and other professionals involved in inter-disciplinary care insight into the meaning-making process and the existential realities interwoven in accounts of lived experience, thereby validating this aspect of experience. To support this approach it also aims to make explicit the method used and interpretation applied to elicit these features. Ten adults with MS from across the North of England were recruited to tell their story related to the onset of, and adjustment to MS. Two of the narratives are presented, and through these, the method used for interpretation derived from the theory of Paul Ricoeur is demonstrated. What emerge, threaded within the events told in a triptych of past, present and future life envisaged, are glimpses of existential realities that evoke universal recognition such as abandonment, loss, acceptance; solidarity, aloneness, suffering and finally calm. The paper concludes that, given chronic conditions like MS often predispose existential deliberation, it is important that these dimensions of lived experience are acknowledged in professional encounters that seek to manage the condition and support people living well with it.


2006 ◽  
Vol 19 (4) ◽  
pp. 767-777 ◽  
Author(s):  
Burcu Balam Yavuz ◽  
Servet Ariogul ◽  
Mustafa Cankurtaran ◽  
Kader Karli Oguz ◽  
Meltem Halil ◽  
...  

Background: The aim of this study is to compare the results of magnetic resonance (MR) imaging, particularly the decline in hippocampal volume, of patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) with healthy age-matched controls, to examine the reliability of hippocampal volumetry in the early diagnosis of AD and the correlation of the severity of hippocampal atrophy with the severity of cognitive decline.Methods: Twenty-six AD, 22 MCI and 15 normal cognitive status (NCS) patients were scanned with a 3 Tesla MR scanner. Hippocampus volumes were detected manually by Osiris 4.18.Results: Multivariate regression analysis, which was performed to adjust the covariate effects of education, age, gender, hypertension and diabetes mellitus, showed that hippocampal atrophy was correlated with AD and MCI for right hippocampus; AD, MCI and age for left hippocampus independent of other parameters. A second regression analysis revealed that MMSE was correlated with hippocampal volume.Conclusions: Hippocampal volumetry can be used in early diagnosis of cognitive impairment, as well as grading cognitive decline.


2019 ◽  
Vol 21 (1) ◽  
pp. 101-108 ◽  

This paper considers ethical issues related to early diagnosis and all forms of prevention of Alzheimer disease and related conditions. It offers a critical view of the current state of scientific, clinical, and social responses to the growing number of older people with cognitive challenges, and suggests how priorities going forward should be different from those receiving most attention today. We begin with a review of global policy efforts, consider the fundamental goals of prevention, examine issues surrounding early diagnosis, explore more deeply values associated with efforts to prevent age associated cognitive decline, and conclude by considering often unexplored ethical issues that contextualize the field and should influence our approaches to the future.


2016 ◽  
Vol 12 ◽  
pp. P1152-P1153
Author(s):  
Walter Maetzler ◽  
Bertrand Rochat ◽  
Baptiste Grund ◽  
Christian Deuschle ◽  
Claudia Schulte ◽  
...  

2021 ◽  
Vol 13 ◽  
Author(s):  
Yingying Zhu ◽  
Dong Pan ◽  
Lei He ◽  
Xiaoming Rong ◽  
Honghong Li ◽  
...  

Introduction: To develop appropriate strategies for early diagnosis and intervention of cognitive impairment, the identification of minimally invasive and cost-effective biomarkers for the early diagnosis of cognitive impairment is crucial and desirable. Therefore, the CHina registry study on cOgnitive imPairment in the Elderly (HOPE) study is designed to investigate the natural course of cognitive decline and explore the clinical, imaging, and biochemical markers for the detection and diagnosis of cognitive impairment on its earliest stage.Methods: Approximately 5,000 Chinese elderly aged more than 50 years were recruited from Sun Yat-sen Memorial Hospital, Sun Yat-sen University in Guangzhou, China by the year 2024. All subjects were invited to complete the clinical assessment, neuropsychological assessment, the biological samples collection (blood and cerebrospinal fluid (CSF)], magnetic resonance imaging (MRI) examination, and optional amyloid and tau PET. The follow-up survey was conducted every 1 year to repeat these assessments for 20 years. To better clarify the relationship between potential risk factors and endpoint events [changes in cognitive score or incidence of mild cognitive impairment (MCI) and/or dementia], appropriate statistical methods were used to analyze the data, including but not limited to, such as linear mixed-effect model, competing risk model, or the least absolute shrinkage and selection operator model.Significance: The CHina registry study on cOgnitive imPairment in the Elderly study is designed to explore the longitudinal changes in characteristics of participants with cognitive decline and to identify potential plasma and imaging biomarkers with cost-benefit and scalability advantages. The results will enable broader clinical access and efficient population screening and then improve the development of treatment and the quality of life for cognitive impairment at the early stage.Trial registration number: NCT04360200.


Retos ◽  
2019 ◽  
pp. 605-612
Author(s):  
Alberto Moreno-Doña ◽  
Sergio Toro Arévalo ◽  
Fernando Gómez-Gonzalvo

No existe un único enfoque adecuado para establecer los criterios que han de definir la formación inicial de maestros(as). Ello debido a que cada orientación responde a unos intereses que se legitiman y a otros que se niegan. Existe una tendencia, cada vez mayor, a construir y normalizar un conocimiento técnico entre el alumnado universitario de los grados de magisterio. Siempre desde una lógica epistemológica eurocéntrica que se fundamenta en algunas evidencias científico-pedagógicas. Muchas regiones del planeta están adoptando este tipo de perspectivas como propias y, al mismo tiempo, negando otras formas de habitar la escuela y otros conocimientos que no poseen una base científica europea. De esta forma, se deslegitiman propuestas pedagógicas realizadas desde los márgenes, puesto que la lógica colonial europea deshumaniza a las personas que habitan estos espacios debido a las relaciones de poder existentes en el eje Norte-Sur. Por esto se reflexiona y analiza una lógica decolonial de la pedagogía de educación física que centre sus acciones en el buen vivir, en la exploración de la vida en sintonía con lo natural, en la reciprocidad con los otros seres vivos y en la transformación de los límites espaciotemporales de la formación de maestros(as) a través de la acción colectiva y desde un posicionamiento ético y político basado en la autogestión. Es por esto por lo que proponemos una práctica educativa transgresora de las normas educativas imperantes y que transita hacia un devenir educativo basado en los aprendizajes encarnados, situados y contextualizados para la formación de los futuros maestros(as) de educación física.Abstract. There is no single adequate approach for establishing the criteria that should define pre-service teacher education. This is due to the fact that each orientation answers to specific interests (legitimizing some of them while denying others). There is a currently growing tendency to construct and normalize technical knowledge among students who are becoming teachers, always from a Eurocentric epistemological logic based on scientific-pedagogical evidence. Many regions on the planet are adopting this approach as their own and, at the same time, they are denying other forms of experiencing School and knowledge without a European scientific basis. By doing so, they are discrediting pedagogical proposals presented from the margins, as the European colonial logic dehumanizes people living in these regions due to the existing power relations in the North-South axis. This is the reason why a decolonial pedagogical logic is reflected upon and analyzed in the field of physical education. This logic focuses on “living well”, on exploring life in harmony with natural elements, on the reciprocity with other living beings, and on the transformation of the time-space limits for teachers’ education via collective actions and from an ethical and political position based on self-management. That is why we propose an educational experience that transgresses the dominant educational rules and that travels towards an educational development based on incarnated learning, located and contextualized for the education of future PE teachers.


2019 ◽  
Vol 21 (1) ◽  
pp. 101-108

This paper considers ethical issues related to early diagnosis and all forms of prevention of Alzheimer disease and related conditions. It offers a critical view of the current state of scientific, clinical, and social responses to the growing number of older people with cognitive challenges, and suggests how priorities going forward should be different from those receiving most attention today. We begin with a review of global policy efforts, consider the fundamental goals of prevention, examine issues surrounding early diagnosis, explore more deeply values associated with efforts to prevent age associated cognitive decline, and conclude by considering often unexplored ethical issues that contextualize the field and should influence our approaches to the future.


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