Psychiatry - August 2008 - (Page 51)

Update on Alzheimer’s psychiatrist should continue to maximize social interaction, both therapeutically and pharmacologically, as much as possible. SCREENING PATIENTS FOR MINIMAL COGNITIVE IMPAIRMENT AND AD When patients present with complaints of poor memory, psychiatrists should first determine whether they have minimal cognitive impairment (MCI) or early AD. Psychiatrists may do this initially by using a brief, less sensitive screening test, such as the Mini-Cog, which includes simply a clock drawing and delayed recall. If the results of this test are normal, then a longer, more sensitive test, such as the Montreal Cognitive Assessment (MoCA) or the Mini-Mental State Examination (MSSI) should be pursued.5–7 If the results of both tests are normal, the psychiatrist can (at least temporarily) reassure these patients. If the results of the tests are “positive” for MCI or AD, the psychiatrist should then refer these patients for additional testing. If a patient tests normal on both tests but is still fearful, the psychiatrist should inform the patient about online computer testing.8 These online tests have significant limitations since they are not clinically administered, and the psychiatrist should explain this to the patient. These tests, however, have greater sensitivity in some areas, and if the results are negative, this may further reassure the patient. Prior to any type of screening, the psychiatrist should inform the patient about the possible outcomes and discuss the pros and cons of knowing the results of the screening.9 An important benefit to undergoing screening that can be [AUGUST] Improving the Quality of Life in Patients with Alzheimer’s Disease by Edmund Howe, MD, JD Psychiatry (Edgemont) 2008;5(8):51–56 INTRODUCTION Alzheimer’s disease (AD) is a devastating illness with no cure, and because of this, improving the quality of life of patients with AD at every stage of the disease should be a primary concern of psychiatrists. In this article, I discuss several ways that psychiatrists can improve the quality of life of patients with AD. It is emphasized throughout the article that at all stages of AD, a patient’s quality of life can be determined not only by the extent of his or her cognitive decline, but by his or her social interactions with others.1–4 Thus, the Psychiatry 2008 51

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Psychiatry - August 2008 Editor’s Message Editorial Advisory Board Contents Borderline Personality Disorder: Are Proliferative Symptoms Characteristic? Short-acting versus Long-acting Medications for the Treatment of ADHD Baby Stimuli and the Parent Brain: Functional Neuroimaging of the Neural Substrates of Parent-Infant Attachment These Boots Are Made for Stalking: Characteristics of Female Stalkers Managing Attention Deficit Hyperactivity Disorder in the Emergency Department Obstructive Sleep Apnea, Hypoxia, and Metabolic Syndrome in Psychiatric and Nonpsychiatric Settings Improving the Quality of Life in Patients with Alzheimer’s Disease The Process of Getting New Drugs to Market Journal Watch Classified Advertising Information for Authors

Psychiatry - August 2008

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