LAM Extra for General Practicioners

[How to detect it? Dementia screening in primary care]

KÁLMÁN János, PAPP Edina, PÁKÁSKI Magdolna

FEBRUARY 18, 2014

LAM Extra for General Practicioners - 2014;6(01)

[The early stage of dementia, the diagnostic and clinical importance of prodromal stages of dementia have been increasingly recognised in the past few years. Nowa­days, simple, rapid, easy to use cognitive screening tests are available, such as the recently developed Early Mental Test and the standardised Mini-Mental State Exami­nation, Clock Drawing Test, which could help general practicioners in the recommended regular dementia screening. The aim of this review is to help general practicioners understand the nature and importance of prodromal and manifest stages of dementia syndromes, and to summarise the characteristics, advantages and disadvantages of dementia screening tests that can be used in primary care. In addition, practical hints are also integrated regarding the diagnosis, screening and referral of persons with high risk for dementia. ]



Further articles in this publication

LAM Extra for General Practicioners



[Gastrointestinal disease is often overlooked or simply forgotten as a cause of osteoporosis. In a number of gastrointestinal diseases, sometimes because of the medicines used for their treatment, malabsorption syndrome may occur. Malabsorption might lead to insufficient absorption of calcium, phosphate, magnesium, vitamin D, vitamin K and proteins, which can cause osteopenia, osteoporosis and osteomalacia. In this paper, we aim to review the gastroenterological diseases that can lead to osteoporosis and treatment strategies.]

LAM Extra for General Practicioners

[About vitamin D - let’s combine!]


[Vitamin D deficiency is a worldwide health problem. On the basis of the recommendations of the latest vitamin D consensus conference, we would like to draw attention to the significance of prevention as well as the recognition and treatment of vitamin D deficiency. We mention that some antipo-rotics designated “prefix” or “combi” are available that may ensure adequate calcium and vitamin D intake, thus improving patient’s adherence.]

LAM Extra for General Practicioners

[Contact lens wear ]


[The improvement of contact lens materials and types have made it possible to use contact lenses for visual rehabilitation besides optical and cosmetic use, The high oxygen permeability of contact lenses have extended the age limits for contact lens wear and encouraged clinicians to use them for therapeutic purposes, especially for pain relief and aiding cornea epithelialisation. Con­tact lenses can be worn safely for years if rules of hygiene are followed. Their use is most frequently abandoned because of contact lens related dry eye. Despite the high oxigen permeability, their prolonged wear increases the risk of inflammation.]

All articles in the issue

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Clinical Neuroscience

[The application of RBANS (Repeatable Battery for the Assessment of Neuropsychological Status) in neurocognitive testing of patients suffering from schizophrenia and dementia]

JUHÁSZ Levente Zsolt, KEMÉNY Katalin, LINKA Emese, SÁNTHA Judit, BARTKÓ György

[Introduction - The purpose of our study was to find out whether the Hungarian adaptation of the RBANS (Repeatable Battery for the Assessment of Neuropsychological Status), a brief neurocognitive screening test, is appropriate for the differentation of healthy and non-healthy subject groups, or for the detection of differences between the cognitive performance of patient groups. Patients and method - The test battery was administrated to 38 healthy subjects, 69 schizophrenic patients, and 18 patients suffering from dementia (10 probable Alzheimer-type and eight vascular dementia). Results - There was a significant decrease of performance in all patient groups compared to the healthy group. In the schizophrenic group, the test indicated a deterioration of functioning in all cognitive areas. The patient group with Alzheimer-type dementia performed only slightly better than the schizophrenic group, because the fall of performance was not significant only one of the cognitive areas (in the visuo-spatial tasks) when compared to the healthy group. There was no difference between the performance of patients with vascular dementia and that of healthy subjects in direct memory, verbal and visuo-spatial tasks. The test results indicated an even deterioration of cognitive areas in patients with Alzheimer-type dementia. As for the vascular dementia group, the most vulnerable area proved to be that of attention, while their verbal functions were relatively spared. The deterioration in other cognitive functions shown by schizophrenic subjects was more moderate, but still significant. A comparison of the RBANS scores of the schizophrenic patients in our study and the result of an American study was also carried out. The global indeces showed no difference; only the pattern of the sub-scales was a little different. Conclusion - The Hungarian version of the RBANS seems appropriate for the differentiation of healthy and deteriorated cognitive performance in a Hungarian patient population.]

Hungarian Radiology

[Az emlődaganatok radiológiai vizsgálatának újdonságai Onco Update, 2007]


[Experiences about the breast diagnostic methods are accumulating year-to-year, rapidly. Therefore the current examination algorithm is changing continuously. New diagnostic and therapeutic modalities are entering into the daily practice. Some of them became obsolete, so far their application is becoming a faulty decision. Some other methods become obligatory steps in the diagnostics. These are the reasons why the up-to-date knowledge of the literature is mandatory. Systematic review of the most recent articles of the last two years (January 2005-December 2006) of breast radiological diagnostics and the actual place of the imaging and interventional methods are presented. The following topics are summarized: breast cancer screening with conventional and digital mammography, computer assisted diagnostics (CAD), high risk patients' screening, US, MRI, MSCT, PET/CT, diagnostic interventions, differential diagnostics, percutaneous tumour ablation, therapy-related questions in the diagnostic work up.]

Lege Artis Medicinae

[The effects of angiotensin receptor blockers on the nervous system in hypertension and dementia]


[The renin-angiotensin system (RAS) is one of the most important mechanisms regarding the pathomechanism and treatment of hyprtension. The most of the elements of the RAS are found in the nervous system too. The effect of angiotensin converting enzyme inhibitors and angiotensin receptor blockers (ARBs) is based on the inhibition of the RAS. ARBs might have a special role in the central nervous system because they do not decrease the production of angiotensin but inhibit its harmful effects mediated through the AT1 receptor while allowing the stimulation of AT2 receptors with resulting pleiotrophic actions. Hypertension is the most important risk factor for stroke and has a negative effect on cognitive functions. Antihypertensive treatment has an effect on the nervous system; in addition to the consequences of the reduced blood pressure, ARBs might provide additional advantages in stroke and dementia prevention.]

LAM Extra for General Practicioners



[Statins have become crucial components of the therapy of cardiovascular diseases. Beyond their cholesterol-lowering effect, statins turned out to have further beneficial effects on various vascular mechanisms. One of the best known effects is antithrombotic capacity, which is related partly to platelet function and partly to the coagulation cascade. Besides experimental observations, interventional clinical trials have also demonstrated that statins have an antithrombotic effect both in arterial and venous thrombosis. Regarding the effects of statins on dementia, previous studies with relatively small sample sizes had controversial results. Recently, two observational studies of tens of thousands of elderly patients reported that statins reduce the incidence of nonvascular dementia. Evaluation of the data revealed that statins have pleiotropic effects in this case, too. The results discussed here shed light on new benefits of statin therapy used for reducing cardiovascular mortality, namely the prevention of thrombotic events and dementia. These benefits are related to the antithrombotic and anti-inflammatoric capacity of statins.]

Journal of Nursing Theory and Practice

[Associated factors of independency in older adults with cognitive impairment living in a long term care institute]


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