Cost effectiveness of diagnostic methods for dementia patients
- Conditions
- Mental and behavioral disorders
- Registration Number
- KCT0002072
- Lead Sponsor
- Koera University Guro Hospital
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Recruiting
- Sex
- All
- Target Recruitment
- 900
The diagnosis of dementia due to Alzheimer’s disease from the National Institute on Aging-Alzheimer’s Association
¦ Dementia is diagnosed when there are cognitive or behavioral (neuropsychiatric) symptoms that:
1. Interfere with the ability to function at work or at usual activities; and
2. Represent a decline from previous levels of functioning and performing; and
3. Are not explained by delirium or major psychiatric disorder;
4. Cognitive impairment is detected and diagnosed through a combination of (1) history-taking from the patient and a knowledgeable informant and (2) an objective cognitive assessment, either a bedside” mental status examination or neuropsychological testing. Neuropsychological testing should be performed when the routine history and bedside mental status examination cannot provide a confident diagnosis.
5. The cognitive or behavioral impairment involves a minimum of two of the following domains:
a. Impaired ability to acquire and remember new information
b. Impaired reasoning and handling of complex tasks, poor judgment
c. Impaired visuospatial abilities
d. Impaired language functions
e. Changes in personality, behavior, or comportment
¦ Probable Alzheimer's disease: Core clinical criteria
Probable Alzheimer's disease is diagnosed when the patient
1.Meets criteria for dementia described earlier in the text, and in addition, has the following characteristics:
A. Insidious onset. Symptoms have a gradual onset over months to years, not sudden over hours or days;
B. Clear-cut history of worsening of cognition by report or observation; and
C. The initial and most prominent cognitive deficits are evident on history and examination in one of the following categories.
a. Amnestic presentation
b. Nonamnestic presentations:
? Language presentation
? Visuospatial presentation
? Executive dysfunction
D. The diagnosis of probable Alzheimer's disease should not be applied when there is evidence of (a) substantial concomitant cerebrovascular disease, defined by a history of a stroke temporally related to the onset or worsening of cognitive impairment; or the presence of multiple or extensive infarcts or severe white matter hyperintensity burden; or (b) core features of Dementia with Lewy bodies other than dementia itself; or (c) prominent features of behavioral variant frontotemporal dementia; or (d) prominent features of semantic variant primary progressive aphasia or nonfluent/agrammatic variant primary progressive aphasia; or (e) evidence for another concurrent, active neurological disease, or a non-neurological medical comorbidity or use of medication that could have a substantial effect on cognition.
¦ Possible Alzheimer's disease: Core clinical criteria
A diagnosis of possible Alzheimer's disease should be made in either of the circumstances mentioned in the following paragraphs.
1. Atypical course
Atypical course meets the core clinical criteria in terms of the nature of the cognitive deficits for Alzheimer's disease, but either has a sudden onset of cognitive impairment or demonstrates insufficient historical detail or objective cognitive documentation of progressive decline
2. Etiologically mixed presentation
Etiologically mixed presentation meets all core clinical criteria for Alzheimer's disease but has evidence of (a) concomitant cerebrovascular disease, defined by a history of stroke temporally related to the onset or worsening of cognitive impairment; or the presence of multiple or
1. has altered consciousness such as delirium or confusion
2. has infectious or inflammatory brain diseases (viral or fungal infection, syphilis, and etc.)
3. has evidence of serious cerebrovascular pathology within 3 months
4. currently has a major psychiatric illnesses such as a major depressive diorder or bipolar disorder
5. has depressive symptoms that may affect cognitive function according to Geriatric Depression Scale
6. has medical illness that could cause cognitive decline
7. in use of medication that could affect cognitive dysfunction
Study & Design
- Study Type
- Observational Study
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method cost-effectiveness
- Secondary Outcome Measures
Name Time Method Prediction and accuracy of diagnosis