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Article type: Review Article
Authors: Krolak-Salmon, Pierrea; b; c; * | Maillet, Audreyb | Vanacore, Nicolad | Selbaek, Geire | Rejdak, Konradf | Traykov, Latchezarg | Politis, Antoniosh | Georges, Jeani | Borson, Sooj | Leperre-Desplanques, Armellea; b
Affiliations: [a] Clinical and Research Memory Centre of Lyon, Civil Hospices of Lyon, INSERM U1028, UMR CNRS 5292, Lyon, France | [b] Claude Bernard University, Lyon I, Lyon, France | [c] French Federation of Clinical and Research Memory Centre of Lyon, Lyon, France | [d] National Centre for Disease Prevention and Health Promotion, National Institute of Health, Roma, Italy | [e] Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, T–nsberg, Norway | [f] Medical University of Lublin, Lublin, Poland | [g] Bulgarian Society of Dementia, Sofia, Bulgaria | [h] Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece | [i] Alzheimer Europe Association, Luxembourg-Ville, Luxembourg | [j] University of Washington School of Medicine, Seattle, Washington, and Dementia Care Research and Consulting, Palm Springs, CA, USA
Correspondence: [*] Correspondence to: Pr. Pierre Krolak-Salmon, Clinical and Research Memory Centre of Lyon, Civil Hospices of Lyon, INSERM U1028, UMR CNRS 5292, Lyon, France. Tel.: +33 4 72 43 20 50; Fax: +33 4 72 43 20 54; E-mail: [email protected].
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
DOI: 10.3233/JAD-190461
Journal: Journal of Alzheimer's Disease, vol. 72, no. 2, pp. 363-372, 2019
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