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Related Concept Videos

Dementia01:30

Dementia

159
Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
The progression of dementia is generally gradual....
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Alzheimer's Disease: Overview01:26

Alzheimer's Disease: Overview

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Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
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Alzheimer's Disease: Treatment01:22

Alzheimer's Disease: Treatment

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Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
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Parkinson's Disease: Overview01:15

Parkinson's Disease: Overview

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Neurodegenerative disorders are progressive diseases that cause irreversible damage and loss to neurons in specific brain areas. Examples of these disorders include Parkinson's disease, Alzheimer's disease, Multiple Sclerosis (MS), and Amyotrophic Lateral Sclerosis (ALS). These disorders share characteristics such as proteinopathies, selective neuronal vulnerability, and a complex interplay between genetic and environmental factors. The primary therapeutic goal for these conditions is...
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Documentation of Nursing Diagnosis01:10

Documentation of Nursing Diagnosis

1.3K
The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
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Nursing Diagnosis01:22

Nursing Diagnosis

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Following assessment, a nursing diagnosis is the next step in the nursing process. It begins after the nurse has collected and recorded the patient data. The purpose of diagnosing is to identify how the client responds to actual or potential health processes, identify factors that bestow or that cause health problems, the etiologies, and identify resources or strengths the individual, group, or community can draw on to prevent or resolve problems.
The nursing diagnosis focuses on evidence-based...
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Updated: Aug 30, 2025

The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease
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Prognostication in dementia.

Sinthana U Ramsey1, Robert M Arnold2

  • 1Section of Palliative Care and Medical Ethics, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.

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PubMed
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Understanding dementia progression is key. This chapter explores prognosis markers, palliative care, and communication strategies like the ADAPT model for better end-of-life care planning in dementia patients.

Keywords:
CommunicationDementiaGoals of carePrognostication

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Area of Science:

  • Gerontology
  • Neurology
  • Palliative Care

Background:

  • Dementia is a progressive, irreversible illness and a leading global cause of death.
  • Current treatments offer limited impact on mortality.
  • Understanding disease trajectory and prognosis is crucial for patient care.

Purpose of the Study:

  • To discuss the trajectory and variability of dementia progression.
  • To identify markers associated with poorer prognosis.
  • To explore palliative care models and communication strategies for discussing prognosis.

Main Methods:

  • Review of dementia trajectory and prognostic markers.
  • Discussion of hospitalization impact on prognosis.
  • Analysis of end-of-life palliative care/hospice eligibility models, including the Functional Assessment Staging tool.
  • Introduction of the Ask, Discover, Anticipate, Provide, Track (ADAPT) model for prognosis discussions.

Main Results:

  • Prognosis in dementia is variable and influenced by factors like nutrition, pneumonia, and comorbidities.
  • Hospitalization can significantly impact dementia prognosis.
  • The ADAPT model provides a structured approach for discussing prognosis with patients and proxies.
  • Prognosis is best discussed in functional terms due to dementia progression variability.

Conclusions:

  • Early advance care planning in dementia allows for greater patient involvement.
  • Effective communication strategies are essential for navigating end-of-life care discussions in dementia.
  • Focusing on functional decline aids in discussing prognosis and planning care for dementia patients.