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Published on: January 3, 2012
by Susan L. Mitchell, MD, MPH; Betty S. Black, PhD; Mary Ersek, RN, PhD, Laura C. Hanson, MD, MPH; Susan C. Miller, PhD, Greg A. Sachs, MD, Joan M. Teno, MS, MS; R. Sean Morrison, MD for Annals of Internal Medicine:
Advanced Dementia: State of the Art and Priorities for the Next Decade
Dementia is a leading cause of death in the United States. This article outlines the current understanding of advanced dementia and identifies research priorities for the next decade. Research over the past 25 years has largely focused on describing the experience of patients with advanced dementia.
This work has delineated abundant opportunities for improvement, including greater recognition of advanced dementia as a terminal illness, better treatment of distressing symptoms, increased access to hospice and palliative care services, and less use of costly and aggressive treatments that may be of limited clinical benefit.
Addressing those opportunities must be the overarching objective for the field in the coming decade. Priority areas include designing and testing interventions that promote high-quality, goal-directed care; health policy research to identify strategies that incentivize cost-effective and evidence-based care; implementation studies of promising interventions and policies; and further development of disease-specific outcome measures. There is great need and opportunity to improve outcomes, contain expenditures, reduce disparities, and better coordinate care for the millions of persons in the United States who have advanced dementia.
Parkinson’s disease (PD) mainly affects the body’s motor system. It’s symptoms – which result from the long-term degeneration of the central nervous system – occur over time and include shaking, difficulty walking, slow movements, and rigidity. People with...
Creativity is a broad concept that is often characterized by the ability to perceive the world in novel ways, to make connections between seemingly unrelated phenomena, and to generate innovative and useful solutions. While creativity was...
Hormones are regulatory substances produced by various glands (such as the thyroid, pituitary, ovaries, and adrenal) that stimulate specific cells in the body. They are carried by the blood to different parts of the body...
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