Dementia and Geriatric Cognitive Disorders Extra最新文献

{"title":"Social Networks, Community Engagement, and Cognitive Impairment among Community-Dwelling Chinese Older Adults","authors":"Jinlei Li, Zijuan Wang, Z. Lian, Zhikai Zhu, Yuanli Liu","doi":"10.1159/000502090","DOIUrl":"https://doi.org/10.1159/000502090","url":null,"abstract":"Aims: To examine the association of social networks and community engagement with cognitive impairment among community-dwelling Chinese older adults. Methods: From November 2017 to May 2018, we selected 1,115 elderly individuals from 3 Chinese communities (Beijing, Hefei, and Lanzhou) using a random-cluster sampling method, and recorded data on demographics, social network characteristics, community activities, and cognitive function. The odds ratios (ORs) of these associations were adjusted for potential confounders in logistic regression models. Results: The prevalence of cognitive impairment was 25.7% (n = 287). An adequate social network (OR 0.55; 95% confidence interval [CI] 0.33–0.91) and enough social support from friends (OR 0.43; 95% CI 0.29–0.62) were negatively associated with cognitive impairment. Family support was not significantly associated with cognitive impairment (OR 0.64; 95% CI 0.34–1.21). Taking part in elderly group travel, communication with others using WeChat, and community activities such as Tai Chi and walking together were negatively associated with cognitive impairment. Conclusion: Social network characteristics and community engagement were found to be related to cognitive function among community-dwelling Chinese elderly adults.","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"9 1","pages":"330 - 337"},"PeriodicalIF":2.3,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000502090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41504763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Properties of the Czech Version of the Falls Efficacy Scale-International in Patients with Early-Stage Dementia","authors":"Helena Kisvetrová, D. Školoudík, R. Herzig, K. Langová, Petra Kurková, J. Tomanová, Yukari Yamada","doi":"10.1159/000501676","DOIUrl":"https://doi.org/10.1159/000501676","url":null,"abstract":"Introduction: A fear of falling marks an important psychological factor connected with a reduction in the life space of people with dementia. The Czech version of the Falls Efficacy Scale-International (FES-I) has not been validated in patients with early-stage dementia. Methods: The tests were administered to 282 patients with early-stage dementia. The test battery included the following: the FES-I, the Short Physical Performance Battery, the Geriatric Depression Scale, the Bristol Activity Daily Living Scale, and the Quality of Life-Alzheimer’s Disease Scale. Internal reliability (Cronbach’s α and intraclass correlation [ICC]), Pearson’s and Spearman’s correlations, exploratory factor analysis, and a t test for independent samples were used for statistical analyses. Results: The Czech version of the FES-I had excellent internal and test-retest reliability (Cronbach’s α = 0.98, ICC = 0.90; 95% CI 0.82–0.94). Factor analysis suggested 2 relevant factors. A significantly higher FES-I score was associated with patients with early-stage dementia who were older (p = 0.003) or female (p = 0.001), lived alone (p = 0.0001), spent >8 h a day alone (p = 0.032), used mobility aids (p < 0.0001), or had severe hearing (p = 0.004) or vision impairment (p < 0.0001) or a lower education (r = –0.16, p = 0.007). Conclusion: The Czech version of the FES-I had very good reliability and validity and may be useful in future cross-cultural comparisons in research among patients with early-stage dementia.","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"9 1","pages":"319 - 329"},"PeriodicalIF":2.3,"publicationDate":"2019-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000501676","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41803041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy, Safety, and Tolerability of Switching from Oral Cholinesterase Inhibitors to Rivastigmine Transdermal Patch with 1-Step Titration in Patients with Mild to Moderate Alzheimer's Disease: A 24-Week, Open-Label, Multicenter Study in Japan","authors":"Kengo Ueda, S. Katayama, T. Arai, Nobuo Furuta, S. Ikebe, Y. Ishida, K. Kanaya, S. Ouma, H. Sakurai, M. Sugitani, Makio Takahashi, Toshihisa Tanaka, N. Tsuno, Y. Wakutani, Ankita Shekhawat, Ayan Das Gupta, Kazuki Kiyose, Kazuhiro Toriyama, Yu Nakamura","doi":"10.1159/000501364","DOIUrl":"https://doi.org/10.1159/000501364","url":null,"abstract":"Background: Few studies have investigated treatment options for patients with Alzheimer’s disease (AD) showing a poor response to oral cholinesterase inhibitors (ChEIs) in Japan. Objective: To investigate the efficacy and safety of switching from oral ChEIs to rivastigmine transdermal patch in patients with AD. Methods: In this multicenter, open-label, phase IV study in outpatient clinics in Japan, patients with mild-moderate AD who had a poor response to or experienced difficulty in continuing donepezil or galantamine were switched to rivastigmine transdermal patch (5 cm2; loaded dose 9 mg, delivery rate 4.6 mg/24 h) with a 1-step titration in week 4 (10 cm2; loaded dose 18 mg, delivery rate 9.5 mg/24 h), which was continued for 4 weeks in the titration period and 16 weeks in a maintenance period. The primary endpoint was the change in Mini-Mental State Examination (MMSE) total score from baseline to week 24. Results: A total of 118 patients were enrolled and switched to rivastigmine, of which 102 completed the 24-week study. The MMSE total score was essentially unchanged during the study, with a least-square mean change (SD) of −0.35 (2.64) at week 24 (p = 0.1750). Exploratory analysis with a mixed-effect model comparing changes in MMSE between the pre- and post-switch periods suggested that switching to rivastigmine prevented a worsening of MMSE. Application site skin reactions/irritations occurred in 30.5% of patients overall, in 22.0% in the 8-week titration period, and in 10.2% in the 16-week maintenance period. Conclusion: Within-class switching from an oral ChEI to rivastigmine transdermal patch might be an efficacious and tolerable option for AD patients showing a poor or limited response to a prior oral ChEI.","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"9 1","pages":"302 - 318"},"PeriodicalIF":2.3,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000501364","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43041201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of the Cognitive Assessment Battery in a Primary Care Population","authors":"A. S. Kvitting, Maria M. Johansson, J. Marcusson","doi":"10.1159/000501365","DOIUrl":"https://doi.org/10.1159/000501365","url":null,"abstract":"Background: There are several cognitive assessment tools used in primary care, e.g., the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment. The Cognitive Assessment Battery (CAB) was introduced as a sensitive tool to detect cognitive decline in primary care. However, primary care validation is lacking. Therefore, we investigated the accuracy of the CAB in a primary care population. Objective: To investigate the accuracy of the CAB in a primary care population. Methods: Data from 46 individuals with cognitive impairment and 33 individuals who visited the primary care with somatic noncognitive symptoms were analyzed. They were investigated with the MMSE, the CAB, and a battery of neuropsychological tests; they also underwent consultation with a geriatric specialist. The accuracy of the CAB was assessed using c-statistics and the area under the receiver operating characteristic curve (AUC) was used to quantify the binary outcomes (“no cognitive impairment” or “cognitive impairment”). Results: The “cognitive impairment” group was significantly different from the unimpaired group for all the subtests of the CAB. When accuracy was based on binary significant reduction or not in one or several domains of the CAB, the AUC varied between 0.685 and 0.772. However, when a summation or logistic regression of several subcategories was performed, using the numerical values for each subcategory, the AUC was >0.9. For comparison, the AUC for the MMSE was 0.849. Conclusions: The accuracy of the CAB in a primary care population is poor to good when using binary cutoffs. Accuracy can be improved to high when using a summation or logistic regression of the numerical data of the subcategories. Considering CAB time, lack of adequate age norms, and a good accuracy for the MMSE, implementation of the CAB in primary care is not recommended at present based on the results of this study.","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"9 1","pages":"294 - 301"},"PeriodicalIF":2.3,"publicationDate":"2019-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000501365","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43248331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Responding to Varying Levels of Certainty about Pain in People with Dementia after Initial Pain Assessment","authors":"Mohammad J Rababa, M. Aldalaykeh","doi":"10.1159/000501030","DOIUrl":"https://doi.org/10.1159/000501030","url":null,"abstract":"Introduction: Pain is still inadequately treated in people with dementia (PWD) due to the complexity of assessing it. Pain assessment in PWD is still challenging because of patient-related or nurse-related factors. The patient-related factors have been studied extensively. However, the nurse-related factors, e.g., nurses’ certainty regarding suspected pain in PWD, have been given little attention by researchers. Purpose: This study aims to investigate how the degree of nurses’ certainty is compromised after pain assessment and how this affects levels of pain and agitation in PWD. Method: A descriptive, correlational design was used, and a convenience sample of 104 nursing home residents with dementia were recruited. Results: This study found that nurses’ certainty after the pain assessment mediates the relationship between the type of pain assessment and patient outcomes when the nurses had a high initial certainty. When nurses had a low initial certainty, their certainty after the assessment and the type of assessment predicted the levels of pain and agitation in PWD. Conclusion: Understanding how nurses’ certainty can be compromising after pain assessment and how this relates to pain management in PWD is crucial.","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"9 1","pages":"271 - 280"},"PeriodicalIF":2.3,"publicationDate":"2019-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000501030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49298652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Chronic Obstructive Pulmonary Disease and Dementia: Systematic Review and Meta-Analysis of Cohort Studies","authors":"Ying Wang, Xiaotong Li, Biying Wei, T. Tung, P. Tao, Ching-Wen Chien","doi":"10.1159/000496475","DOIUrl":"https://doi.org/10.1159/000496475","url":null,"abstract":"Background: Chronic obstructive pulmonary disease (COPD) is a common disease among the elderly, which has been linked to cognitive decline. However, the relationship between COPD and dementia remains unclear. Summary: We conducted a systematic literature review by searching databases such as Pubmed, Embase, EBSCO, and Cochrane Library (from inception to April 18, 2018) for studies on COPD that also investigated the prevalence of dementia. We found 3 cohort studies including a total of 39,392 COPD patients. Then we applied the Newcastle-Ottawa Scale to evaluate the risk of bias. Key Messages: COPD patients faced a higher risk of dementia (HR 1.46; 95% CI 1.22–1.75; p < 0.001). Subgroup analysis on gender determined that the association between COPD and dementia was stronger in male patients (HR 1.49, 95% CI 1.20–1.86, p < 0.001) than in female patients (HR 1.41, 95% CI 1.27–1.57, p < 0.001). A subset study of patients aged >65 years revealed that the HR was greater for patients aged ≥75 years (HR 1.46, 95% CI 1.07–2.00, p = 0.02) than for those aged 65–74 years (HR 1.40, 95% CI 1.28–1.53, p < 0.001). The cohort studies included were from similar population-based databases, suggesting possible regional limitations and publication bias.","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"9 1","pages":"250 - 259"},"PeriodicalIF":2.3,"publicationDate":"2019-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000496475","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45252238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between Frailty and Delirium among Older Patients Admitted to an Emergency Department.","authors":"Sandra Choutko-Joaquim,&nbsp;Nadine Tacchini-Jacquier,&nbsp;Géraldine Pralong D'Alessio,&nbsp;Henk Verloo","doi":"10.1159/000499707","DOIUrl":"10.1159/000499707","url":null,"abstract":"<p><strong>Background: </strong>Switzerland's demographic trends show, as elsewhere on the planet, increasing numbers of older and very old adults. This suggests that its healthcare system will suffer serious repercussions, including in the use of care and especially the use of emergency services. Significant numbers of older adults will be at risk of developing multiple chronic conditions including one or more geriatric syndromes, such as frailty and delirium. Few studies to date have documented associations between frailty and delirium.</p><p><strong>Aim: </strong>To explore the relationships between frailty and delirium in older adult patients consulting (<i>n</i> = 114) at an emergency department (ED) in Switzerland.</p><p><strong>Method: </strong>A cross-sectional study was conducted in a peripheral hospital ED in the French-speaking part of Switzerland. Frailty was assessed using the Tilburg Frailty Indicator (TFI). Delirium was assessed using the Confusion Assessment Method (CAM). Participants' cognitive states were assessed using the 6-item Cognitive Impairment Test (6CIT) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQ-CODE), completed by the participant's most significant informal caregiver.</p><p><strong>Results: </strong>The mean participant age was 77.6 years (SD = 7.7); the majority of the subjects were women (54%). The participants took an average of 4.7 different medications a day (SD = 3.2, median = 4). More than half (62%) of the participants were frail; 2 and 14% presented signs and symptoms of delirium and subsyndromal delirium, respectively. A weak but significant association between scores for frailty and delirium (<i>p</i> < 0.05) was demonstrated, and clinical observation confirmed this. A 4-h follow-up measurement of delirium in the ED revealed no significant or clinical difference.</p><p><strong>Conclusion: </strong>Although the literature describes strong associations between frailty and delirium in surgical units and community care settings, the present study only demonstrated a weak-to-moderate association between frailty and delirium in our ED.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"9 2","pages":"236-249"},"PeriodicalIF":2.3,"publicationDate":"2019-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000499707","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37420242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Activities of Daily Living/Instrumental Activities of Daily Living to Accurately Determine Severity of Moderate and Severe Alzheimer's Disease: Comparison of Assessments by Receiver Operating Characteristic Curve and Discriminant Analyses.","authors":"Yukiko Suzuki,&nbsp;Koji Teruya,&nbsp;Hideki Mochizuki,&nbsp;Akira Nagasawa,&nbsp;Tomoko Kondo,&nbsp;Nobuaki Shimoda","doi":"10.1159/000500019","DOIUrl":"https://doi.org/10.1159/000500019","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to determine Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADL) evaluations that will enable better understanding of the severity of Alzheimer's disease (AD).</p><p><strong>Methods: </strong>AD patients were evaluated by Functional Independence Measure (FIM), Hyogo Activities of Daily Living Scale (HADLS), and Assessment of Motor and Process Skills (AMPS) to identify the assessments that will enable highly precise discrimination of AD Clinical Dementia Rating (CDR) 2 (moderate) and CDR3 (severe) using receiver operating characteristic (ROC) curve and discriminant analyses.</p><p><strong>Results: </strong>The participants were 75 AD patients (CDR2 = 50, mean age = 80.3 ± 5.9 years; CDR3 = 25, mean age = 78.3 ± 9.0 years). The evaluation methods consisted of FIM, HADLS, and AMPS. The results were divided into FIM-M, FIM-C, HADLS-ADL, HADLS-IADL, AMPS-motor skills, and AMPS-process skills. The values for the area under the curve (AUC) were compared by ROC curve and discriminant analyses. AUC values for FIM-C and AMPS-process skills were 0.956 and 0.947, respectively. With these two evaluations only, values ≥0.9 were shown. Moreover, the AUC of the discrimination score (combination of the FIM-C and AMPS-process skills) was significantly higher than those for FIM-M, FIM-C, HADLS-ADL, HADLS-IADL, and AMPS-motor skills.</p><p><strong>Conclusions: </strong>The results demonstrated that evaluation by FIM-C and AMPS-process skills methods was useful for discriminating between CDR2 (moderate) and CDR3 (severe) AD. Moreover, the results indicated that these two evaluation methods enabled more accurate determination of severity and the spared capabilities of AD patients.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"9 2","pages":"227-235"},"PeriodicalIF":2.3,"publicationDate":"2019-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000500019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37132760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testing Episodic Memory in Elderly Subjects: Not as Simple as It Looks.","authors":"Leo Boelaarts,&nbsp;Sascha R A Meyer,&nbsp;Philip Scheltens,&nbsp;Jos F M de Jonghe","doi":"10.1159/000499836","DOIUrl":"https://doi.org/10.1159/000499836","url":null,"abstract":"<p><strong>Background/aims: </strong>The available episodic memory tests are not specifically constructed to examine older subjects. Their use in outpatient memory clinics may result in aborted test administration. We used a strict adherence to the test protocol in cognitively healthy, amnestic mild cognitive impairment (aMCI), and Alzheimer's disease dementia subjects to assess the possibility of preventing this.</p><p><strong>Methods: </strong>This is a cross-sectional study in memory outpatient subjects with a mean age of 74.5 years. Primary study outcomes were: number of missing values and test results in the Visual Association Test (VAT) and the 15 Word Test (15WT).</p><p><strong>Results: </strong>A strict adherence to the test protocol resulted in a 10-fold decrease in the number of missing values in the VAT. For the 15WT this could not be realized mostly because the test was deemed too demanding for 1 in 6 patients.</p><p><strong>Conclusions: </strong>This study is one of the few examining the applicability of well-known episodic memory tests in older subjects. A strict adherence to the test protocol reduced the number of missing values. Floor effects were stronger for the 15WT than for the VAT. Results favor the use of the VAT in senior subjects and show the unsuitability of the 15WT in this group.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"9 2","pages":"207-216"},"PeriodicalIF":2.3,"publicationDate":"2019-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000499836","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37119448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Considerations in Physician-Assisted Death for Probable Alzheimer's Disease: Decision-Making Capacity, Anosognosia, and Suffering.","authors":"Jaime D Mondragón,&nbsp;Latife Salame,&nbsp;Arnoldo Kraus,&nbsp;Peter Paul De Deyn","doi":"10.1159/000500183","DOIUrl":"https://doi.org/10.1159/000500183","url":null,"abstract":"<p><strong>Background: </strong>Requests for physician-assisted death (PAD) in patients with cognitive impairment are complex and require careful consideration. Of particular difficulty is determination of whether the request is voluntary and well considered.</p><p><strong>Results: </strong>Euthanasia and physician-assisted suicide (PAS) are both legal in The Netherlands, Luxemburg, Colombia, and Canada. Euthanasia is legal in Belgium, while PAS is legal in Switzerland and Oregon, Washington, Montana, Vermont, and California (USA). Upon a PAD request, evaluation of the capacity to consent medical treatment is relevant for the decision-making process, while evaluation of testamentary capacity is appropriate before an advance euthanasia directive is written. Anosognosia assessment throughout the Alzheimer's disease continuum provides essential and relevant information regarding the voluntary and well-considered nature of the PAD request; meanwhile, early assessment of hypernosognosia or subjective cognitive decline assists in formulation of a clinical prognosis. Furthermore, the assessment of physical and psychological suffering should incorporate verbal and nonverbal cues as well as consideration of the psychosocial factors that might affect due care criteria.</p><p><strong>Conclusion: </strong>The clinical approach to a PAD request should consider the legal framework and the decision-making capacity, assess memory deficit awareness and the perception of suffering, and evaluate mental competency when considered pertinent.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"9 2","pages":"217-226"},"PeriodicalIF":2.3,"publicationDate":"2019-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000500183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37132759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}