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Related Concept Videos

Dementia01:30

Dementia

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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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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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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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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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Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
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Related Experiment Video

Updated: Apr 2, 2026

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
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A Multicomponent Approach to Screening for Dementia in Older Hospitalized Patients.

Zaldy S Tan1,2,3, Nabeel Qureshi2, Nancy L Sicotte1

  • 1Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Journal of the American Geriatrics Society
|April 1, 2026
PubMed
Summary

Hospital-wide cognitive screening for older adults is feasible and increases dementia detection. This program improved diagnosis consistency and can enhance care for those with cognitive impairment.

Keywords:
4ATAD8cognitive impairmentdementia screeningdisparities

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Area of Science:

  • Geriatric Medicine
  • Neurology
  • Healthcare Management

Background:

  • Dementia and cognitive impairment are prevalent in hospitalized older adults, often undetected, leading to adverse outcomes and care disparities.
  • Systematic inpatient cognitive screening is not widely implemented in U.S. hospitals.
  • This study addresses the need for effective inpatient cognitive screening strategies.

Purpose of the Study:

  • To evaluate the feasibility, reach, and outcomes of a hospital-wide cognitive screening program.
  • To assess the integration of electronic health record (EHR) algorithms with nurse-administered cognitive assessments.
  • To identify factors associated with screening completion and positive findings in older hospitalized adults.

Main Methods:

  • An observational study was conducted across eight inpatient units from June 2023 to November 2024.
  • A multicomponent program integrated EHR dementia diagnosis algorithms with 4AT and AD8 cognitive assessments.
  • Screening activity, positivity rates, and sociodemographic/clinical factors were analyzed.

Main Results:

  • 83.3% of 11,180 hospitalizations were screened.
  • 18.0% had prior dementia diagnoses; 4.3% screened positive for potential dementia, 9.0% for cognitive impairment.
  • Older adults (85+) and Black patients showed higher positive screening rates, with consistent completion across demographics.

Conclusions:

  • Inpatient cognitive screening is feasible and effectively increases the detection of potential dementia.
  • This systematic approach can lead to more consistent dementia diagnosis and potentially improve care for older adults.
  • The program demonstrated high screening completion rates with no significant introduction of new disparities.