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      The Bamberg Dementia Screening Test (BDST) – First Evidence Regarding the Diagnostic Usability of a “True Bedside” Test for Geriatric Inpatients

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          Abstract

          Abstract. Due to physical limitations (e. g. difficulties in reading and writing), geriatric inpatients are often not able to complete relevant dementia screening tests. The Bamberg Dementia Screening Test (BDST) is a new dementia screening measure that can be administered in a few minutes as “true bedside” – test. 150 patients suffering from mild cognitive impairment (MCI) and mild or moderate dementia as well as a control sample of 40 cognitively unimpaired participants completed the BDST and the CERAD-Plus test battery. High correlations of BDST-subscores with CERAD subtests of corresponding content and between the total scores of the two tests could be found. Using the BDST, mild dementia and MCI patients could be discriminated from healthy controls with high sensitivity and specificity.

          Der Bamberger Demenz Screening Test (BDST) – Erste empirische Evidenz hinsichtlich der Brauchbarkeit eines „true bedside“ Tests für geriatrische Patienten

          Zusammenfassung. Patienten geriatrischer Stationen sind, da sie z. B. aufgrund ihrer körperlichen Einschränkungen schlecht zeichnen, lesen oder schreiben können, oft nicht in der Lage, klassische Demenzscreenings zu bearbeiten. Beim Bamberger Demenz Screening Test (BDST) handelt es sich um ein neu entwickeltes Screeningverfahren, das in wenigen Minuten als Bedside-Test durchführbar ist. 150 Patienten mit leichter kognitiver Störung (MCI), leichter und mittelschwerer Demenz sowie einer Kontrollgruppe von 40 unbeeinträchtigten Personen wurden der BDST und die CERAD-Plus Testbatterie vorgegeben. Es finden sich hohe Korrelationen der BDST-Subscores mit den inhaltlich entsprechenden CERAD Subtests sowie zwischen den Gesamtscores der beiden Verfahren. Mittels des BDST konnte zudem mit hoher Sensitivität und Spezifität zwischen gesunden Personen, Personen mit leichter kognitiver Störung (MCI) und Personen mit dementiellem Syndrom differenziert werden.

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          Mild cognitive impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI Working Group of the European Consortium on Alzheimer's Disease.

          Mild cognitive impairment (MCI) was proposed as a nosological entity referring to elderly people with mild cognitive deficit but no dementia. MCI is a heterogeneous clinical entity with multiple sources of heterogeneity. The concept of MCI was reviewed and a diagnostic procedure with three different stages was proposed by the European Consortium on Alzheimer's Disease Working Group on MCI. Firstly, MCI should correspond to cognitive complaints coming from the patients or their families; the reporting of a relative decline in cognitive functioning during the past year by a patient or informant; cognitive disorders as evidenced by clinical evaluation; absence of major repercussions on daily life; and absence of dementia. These criteria, similar to those defined during an international workshop in Stockholm, make it possible to identify an MCI syndrome, which is the first stage of the diagnostic procedure. Secondly, subtypes of MCI had to be recognised. Finally, the aetiopathogenic subtype could be identified. Identifying patients at a high risk for progression to dementia and establishing more specific and adapted therapeutic strategies at an early stage, together with more structured overall management, is made possible by the diagnostic procedure proposed.
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            Annual Incidence of Alzheimer Disease in the United States Projected to the Years 2000 Through 2050

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              Clinical and cost effectiveness of services for early diagnosis and intervention in dementia.

              This paper analyses the costs and benefits of commissioning memory services for early diagnosis and intervention for dementia. A model was developed to examine potential public and private savings associated with delayed admissions to care homes in England as a result of the commissioning of memory services. The new services would cost around pound sterling 220 million extra per year nationally in England. The estimated savings if 10% of care home admissions were prevented would by year 10 be around pound sterling 120 million in public expenditure (social care) and pound sterling 125 million in private expenditure (service users and their families), a total of pound sterling 245 million. Under a 20% reduction, the annual cost would within around 6 years be offset by the savings to public funds alone. In 10 years all people with dementia will have had the chance to be seen by the new services. A gain of between 0.01 and 0.02 QALYs per person year would be sufficient to render the service cost-effective (in terms of positive net present value). These relatively small improvements seem very likely to be achievable. These analyses suggest that the service need only achieve a modest increase in average quality of life of people with dementia, plus a 10% diversion of people with dementia from residential care, to be cost-effective. The net increase in public expenditure would then, on the assumptions discussed and from a societal perspective, be justified by the expected benefits. This modelling presents for debate support for the development of nationwide services for the early identification and treatment of dementia in terms of quality of life and overall cost-effectiveness.
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                Author and article information

                Journal
                znp
                Zeitschrift für Neuropsychologie
                Hogrefe AG, Bern
                1016-264X
                1664-2902
                2015
                : 26
                : 3
                : 161-170
                Affiliations
                [ 1 ]Sozialstiftung Bamberg, Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Bamberg
                Author notes
                Dr. Wolfgang Trapp, Sozialstiftung Bamberg, Klinik für Psychiatrie, Psychosomatik und Psychotherapie, St.-Getreu-Straße 18, 96049 Bamberg, Germany
                Article
                znp_26_3_161
                10.1024/1016-264X/a000154
                6fd38c6a-e354-4d2f-847c-4083967dd65f
                Copyright @ 2015
                History
                Categories
                Original Article

                Psychology,Neurology,Neurosciences,Clinical Psychology & Psychiatry
                mild cognitive impairment,Mild Cognitive Impairment,Screening,screening,diagnostic,Gedächtnis,Diagnostik,Geriatrie,Demenz,memory,geriatrics,dementia

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