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J Alzheimers Dis. 2019;72(2):363-372. doi: 10.3233/JAD-190461.

Toward a Sequential Strategy for Diagnosing Neurocognitive Disorders: A Consensus from the "Act On Dementia" European Joint Action.

Author information

1
Clinical and Research Memory Centre of Lyon, Civil Hospices of Lyon, INSERM U1028, UMR CNRS 5292, Lyon, France.
2
Claude Bernard University, Lyon I, Lyon, France.
3
French Federation of Clinical and Research Memory Centre of Lyon, Lyon, France.
4
National Centre for Disease Prevention and Health Promotion, National Institute of Health, Roma, Italy.
5
Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, T-nsberg, Norway.
6
Medical University of Lublin, Lublin, Poland.
7
Bulgarian Society of Dementia, Sofia, Bulgaria.
8
Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.
9
Alzheimer Europe Association, Luxembourg-Ville, Luxembourg.
10
University of Washington School of Medicine, Seattle, Washington, and Dementia Care Research and Consulting, Palm Springs, CA, USA.

Abstract

Neurocognitive disorders causing progressive cognitive, functional, and behavioral impairment remain underdiagnosed. The needs for a timely diagnosis are now widely acknowledged since person-centered care helps to preserve life quality and prevent crises. One powerful barrier to detection in primary care is the lack of an easy-to-follow stepwise approach, grounded in evidence and consistent with high-quality specialty practice. To help fill this gap, the current European Joint Action proposes a graduated diagnosis strategy tailored to the patients' needs and wills, clarifying appropriate components for primary and specialty care. This strategy considers a first evaluation in primary care that may detect a neurocognitive disorder, that would lead to a second evaluation step allowing etiological diagnosis hypotheses performed mostly by the specialist. A third evaluation stage considering some biological, electrophysiological, or neuroimaging complementary techniques would be proposed to atypical cases or patients willing to consider access to research.

KEYWORDS:

Alzheimer’s disease; detection; diagnosis; general practitioner; memory; neurocognitive disorder

PMID:
31594224
DOI:
10.3233/JAD-190461

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