Disease Awareness, Cognitive Decline, and Communication in Persons with Mild Cognitive Impairment and Caregivers

2015 ◽  
pp. 254-270
Author(s):  
Yvonne Yueh-Feng Lu ◽  
Mary Guerriero Austrom
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Family Caregivers ◽  
Cognitive Changes ◽  
Case Examples ◽  
Disease Awareness ◽  
Meaningful Activity ◽  
Potential Benefits ◽  
Pilot Intervention ◽  
Family Centered

The purpose of this chapter, which is based on our pilot research, is four-fold: 1) to describe the awareness of persons with mild cognitive impairment (PwMCI) of their cognitive changes and meaning of the diagnosis, and their family caregivers' perceptions of the same; 2) to identify PwMCI's concerns about living with MCI; 3) to discuss PwMCI and caregiver perceptions of a patient- and family-centered daily enhancement of meaningful activity (DEMA) program; and 4) to describe the potential benefits of DEMA using case examples. Discussion is based on findings from interviews with PwMCI and family caregivers designed to explore awareness of cognitive changes and the diagnosis, as well as experiences living with MCI. In addition, results from three focus groups to assess content validity and acceptability of the program and from a pilot intervention study to evaluate the feasibility and acceptability of the program contributed to the discussion. Findings support further testing of DEMA in larger and more diverse samples.

Protective preparation: a process central to family caregivers of persons with mild cognitive impairment

2017 ◽  
Vol 30 (3) ◽  
pp. 375-384 ◽  
Author(s):  
Ching-Lin Wang ◽  
Li-Min Kuo ◽  
Yi-Chen Chiu ◽  
Hsiu-Li Huang ◽  
Huei-Ling Huang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Family Caregivers ◽  
Caregiver Burden ◽  
Family Caregiving ◽  
Healthcare Providers ◽  
Theory Approach ◽  
Face To Face ◽  
The Family ◽  
The Impact

ABSTRACTBackground:To develop a theoretical model explaining the longitudinal changes in the caregiving process for family caregivers of persons with mild cognitive impairment (MCI) in Taiwan.Methods:A longitudinal, grounded theory approach using in-depth face-to-face interviews and an open-ended interview guide. We conducted 42 interviews over a two-year period; each participant was interviewed at least once every six months. All participants were interviewed in their home. The participants total of 13 family caregivers of persons with MCI.Results:One core theme emerged: “protective preparation.” This reflected the family caregiving process of preparation for a further decline in cognitive function, and protection from the impact of low self-esteem, accidents, and symptoms of comorbidities for the family member with MCI. Protective preparation contained three components: ambivalent normalization, vigilant preparation, and protective management.Conclusions:Interventions to help family caregivers manage the changes in persons with MCI can reduce caregiver burden. Our findings could provide a knowledge base for use by healthcare providers to develop and implement strategies to reduce caregiver burden for family caregivers of persons with MCI.

Mild Cognitive Impairment: An Overview

CNS Spectrums ◽  
2008 ◽  
Vol 13 (1) ◽  
pp. 45-53 ◽  
Author(s):  
Ronald C. Petersen ◽  
Selamawit Negash
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Normal Aging ◽  
Future Research ◽  
Community Based ◽  
Cognitive Changes ◽  
Nutritional Interventions ◽  
Transitional State ◽  
Research Perspectives ◽  
Early Dementia

ABSTRACTMild cognitive impairment (MCI) refers to the transitional state between the cognitive changes of normal aging and very early dementia. MCI has generated a great deal of research from both clinical and research perspectives. Several population- and community-based studies have documented an accelerated rate of progression to dementia and Alzheimer's disease in individuals diagnosed with MCI. Clinical subtypes of MCI have been proposed to broaden the concept and include prodromal forms of a variety of dementias. An algorithm is presented to assist the clinician in identifying subjects and subclassifying them into the various types of MCI. Progression factors, including genetic, neuroimaging, biomarker, and clinical characteristics, are discussed. Neuropathological studies indicating an intermediate state between normal aging and early dementia in subjects with MCI are presented. The recently completed clinical trials as well as neuropsychological and nutritional interventions are discussed. Finally, the clinical utility of MCI, and directions for future research are proposed.

scholarly journals How early can we diagnose Alzheimer disease (and is it sufficient)?

Neurology ◽  
2018 ◽  
Vol 91 (9) ◽  
pp. 395-402 ◽  
Author(s):  
Ronald C. Petersen
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Alzheimer Disease ◽  
Clinical Symptoms ◽  
Amyloid Plaques ◽  
Clinical Syndrome ◽  
Cognitive Changes ◽  
Diagnostic Capability ◽  
Final Answer ◽  
Made In

A seismic shift in our understanding of the ability to diagnose Alzheimer disease (AD) is occurring. For the last several decades, AD has been a clinical–pathologic diagnosis, and this conceptualization of the disease has served the field well. Typically, the clinician would identify a syndrome such as mild cognitive impairment or dementia, and label the condition as “probable AD” since the diagnosis of definite AD could not be made until an autopsy revealed the presence of amyloid plaques and tau-based neurofibrillary tangles. However, with the advent of biomarkers for AD including neuroimaging and CSF, the identification of AD pathology can be made in life, which greatly enhances the ability of clinicians to be precise about the underlying etiology of a clinical syndrome. Hypothetical models of the temporal relation among the pathologic elements and the clinical symptoms have been proposed and have influenced the field enormously. This has enabled clinicians to be specific about the underlying cause of a given clinical syndrome. As such, the diagnostic capability of the clinician is evolving. However, AD pathology is only a component of the puzzle describing the causes of cognitive changes in aging. Most often, there is a multitude of pathologic entities contributing to the neuropathologic explanation of cognitive changes in aging. AD changes contribute important elements to the diagnosis, but the final answer is more complex. The field of aging and dementia will have to incorporate these additional elements.

Use of Magnetic Resonance Imaging to Identify Mild Cognitive Impairment: Who Should Be Imaged?

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S16) ◽  
pp. 18-20 ◽  
Author(s):  
Liana G. Apostolova
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Clinical Care ◽  
Neuropsychological Testing ◽  
The Elderly ◽  
Cognitive Change ◽  
Normal Aging ◽  
Cognitive Changes ◽  
New Information

Problems with memory are a very common complaint in the elderly and are not synonymous with dementia. Some degree of cognitive decline, manifested as greater difficulty in learning and retrieving new information for instance, develops with normal aging. Thus many older patients do not perform at the same level they did when they were younger but they do perform well when compared to their peers. For many, cognitive change ends at this stage and they proceed to lead normal, healthy, dementia-free lives.The cohort that has cognitive changes beyond what is expected in normal aging but does not yet meet criteria for dementia concerns clinicians greatly as many of these patients eventually become demented. These patients usually go through a latent stage in which neurodegenerative pathology silently spreads in the brain. Once there is enough pathological burden, cognitive decline beyond what is expected for normal aging can be detected by formal neuropsychological testing. Frequently such patients go through a state called mild cognitive impairment (MCI). In this state patients are still functionally intact and live independently, but show cognitive impairment relative to the age- and education-adjusted norms.The MCI state in itself is a prominent risk factor for developing dementia. Most patients with amnestic MCI develop Alzheimer’s disease (AD) dementia over time. At six years, as many as 80% progress to AD. Thus, MCI is a very important topic of research and an increasingly important topic of clinical care.

scholarly journals Cost Template for Meaningful Activity Intervention for Mild Cognitive Impairment

2013 ◽  
Vol 27 (2) ◽  
pp. 88-95 ◽  
Author(s):  
Yvonne Yueh-Feng Lu ◽  
Tamilyn Bakas ◽  
Joan E. Haase
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Meaningful Activity

A Précis of Recent Advances in the Neuropsychology of Mild Cognitive Impairment(s) in Parkinson's Disease and a Proposal of Preliminary Research Criteria

2011 ◽  
Vol 17 (3) ◽  
pp. 393-406 ◽  
Author(s):  
Alexander I. Tröster
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Diagnostic Criteria ◽  
Executive Dysfunction ◽  
Cognitive Change ◽  
Cognitive Changes ◽  
Preliminary Research ◽  
Research Criteria

AbstractCognitive changes of Parkinson's disease (PD) manifest earlier and are more heterogeneous than previously appreciated. Approximately one-third of patients have at least mild cognitive changes at PD diagnosis, and subtle changes might be appreciable among those at risk for PD. Executive dysfunction is the most common cognitive change, but other phenotypes exist. Pathobiologic and potential prognostic differences among cognitive phenotypes remain poorly understood. Progress in the neuropsychology, epidemiology and pathobiology of mild cognitive impairment (MCI) in PD is hampered by lack of diagnostic criteria. This study proposes preliminary research criteria for two categories of PD non-dementia cognitive impairment. (JINS, 2011,17, 393–406)

scholarly journals Spatial variation of perfusion MRI reflects cognitive decline in mild cognitive impairment and early dementia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Catherine A. Morgan ◽  
Tracy R. Melzer ◽  
Reece P. Roberts ◽  
Kristina Wiebels ◽  
Henk J. M. M. Mutsaerts ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Deficit ◽  
Subjective Cognitive Decline ◽  
Vascular Health ◽  
Cognitive Changes ◽  
Early Dementia ◽  
Arterial Transit Time ◽  
Magnetic Resonance Imaging Mri

AbstractCerebral blood flow (CBF) measured with arterial spin labelling (ASL) magnetic resonance imaging (MRI) reflects cerebral perfusion, related to metabolism, and arterial transit time (ATT), related to vascular health. Our aim was to investigate the spatial coefficient of variation (sCoV) of CBF maps as a surrogate for ATT, in volunteers meeting criteria for subjective cognitive decline (SCD), amnestic mild cognitive impairment (MCI) and probable Alzheimer’s dementia (AD). Whole-brain pseudo continuous ASL MRI was performed at 3 T in 122 participants (controls = 20, SCD = 44, MCI = 45 and AD = 13) across three sites in New Zealand. From CBF maps that included all grey matter, sCoV progressively increased across each group with increased cognitive deficit. A similar overall trend was found when examining sCoV solely in the temporal lobe. We conclude that sCoV, a simple to compute imaging metric derived from ASL MRI, is sensitive to varying degrees of cognitive changes and supports the view that vascular health contributes to cognitive decline associated with Alzheimer’s disease.

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