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Social psychologists have documented that feeling good about ourselves and maintaining positive self-esteem is a powerful motivator of human behavior (Tavris & Aronson, 2008). In the United States, members of the predominant culture typically think very highly of themselves and view themselves as good people who are above average on many desirable traits (Ehrlinger, Gilovich, & Ross, 2005). Often, our behavior, attitudes, and beliefs are affected when we experience a threat to our...
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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
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Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
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Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
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In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
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Screening for Cognitive Impairment in Geriatrics.

Ziqi Wang1, Birong Dong2

  • 1Department of Neurology, Chengdu Fifth People's Hospital, No. 33 Mashi Street, Chengdu, Sichuan, China 611130.

Clinics in Geriatric Medicine
|October 20, 2018
PubMed
Summary

Screening for cognitive impairment in older adults uses various tools, categorized by length and method. While helpful, these assessments may pose risks, requiring careful consideration in geriatric care.

Keywords:
AssessmentCognitive impairmentDementiaEarly detection of diseaseGeriatricsNeuropsychologyScreening

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Area of Science:

  • Geriatric Medicine
  • Neuropsychology
  • Cognitive Science

Background:

  • Cognitive impairment is a significant concern in geriatrics.
  • Numerous instruments exist for screening cognitive impairment.
  • Existing tools vary in format and application.

Purpose of the Study:

  • To categorize and review instruments for cognitive impairment screening in geriatrics.
  • To highlight the importance of tailored screening based on individual needs.
  • To acknowledge potential harms associated with cognitive screening in this population.

Main Methods:

  • Categorization of screening tools into very brief, brief, self-administered, and test batteries.
  • Identification of tests targeting specific cognitive domains (e.g., memory, executive function) per DSM-V criteria.
  • Consideration of diverse clinical settings, disease stages, and patient conditions.

Main Results:

  • Screening instruments are broadly classified into four main groups.
  • Specific tests address six key cognitive domains, aligning with diagnostic criteria.
  • The choice of screening tool should be individualized based on context and patient factors.
  • Potential negative consequences of screening in geriatric populations were noted.

Conclusions:

  • A variety of cognitive impairment screening tools are available for geriatric populations.
  • Tool selection should be adapted to specific clinical contexts and individual patient needs.
  • The potential for harm necessitates caution when implementing cognitive screening in older adults.