Development and testing of an intervention to increase staff knowledge and confidence in responding to health anxiety in the context of cognitive decline: a pilot study.

BACKGROUND: Memory complaint in the absence of organic pathology is a common phenomenon accounting for up to one third of patients presenting to memory clinics. Health anxiety has been specifically linked to dementia worry and repeated presentations to the National Health Service (NHS). Providing reassurance that an individual does not have dementia appears ineffective in reducing presentations to primary and secondary care services. AIMS: This study sought to evaluate and establish the effectiveness of a 1-hour pilot training workshop to enhance healthcare professionals' knowledge and confidence to those with health anxiety around cognitive decline. METHOD: The one-session pilot training workshop was developed and informed by previous work and consultation with the 2Gether NHS Foundation Trust Memory Assessment Service staff. The training workshop was then evaluated by employing an idiosyncratic self-report questionnaire. Participants completed the questionnaire prior to and after the training workshop. RESULTS: Pre- and post-training questionnaires revealed that the pilot training workshop was effective in increasing perceived knowledge and confidence in staff responding to patients presenting with health anxiety and co-occurring subjective memory complaints. CONCLUSIONS: The findings suggest that healthcare professionals may benefit from training in identifying and addressing health-anxious individuals with subjective memory complaints. This may have implications in the provision of psychologically informed care offered in a memory assessment service. Recommendations are made for further enhancing the effectiveness of staff training and promoting alternative service treatment pathways.

Incomplete Hippocampal Inversion and Its Relationship to Hippocampal Subfield Volumes and Aging.

BACKGROUND AND PURPOSE: Incomplete hippocampal inversion (IHI) is an atypical anatomical pattern presented by the hippocampus. It is associated with several neuropathological conditions and is thought to be a factor of susceptibility to hippocampal sclerosis and loss of volume. The volume loss of hippocampus is an inevitable consequence of aging, and when accelerated it is commonly considered an imaging biomarker of Alzheimer's disease dementia. METHODS: We have studied the relationship between IHI and hippocampal subfield volumes in a cohort of 60 healthy participants of 49-87 years of age. The presence and severity of IHI and hippocampal subfield volumes were quantified from T2 magnetic resonance (MR) images acquired at 3T. RESULTS: It was found that IHI presented in 23.3% of participants. Right unilateral IHI was rare (two cases, 3.3%) in comparison to left unilateral IHI (nine cases, 15%), with three (5%) of participants showing bilateral IHI. No significant relationships between the whole hippocampal volumes and IHI were observed. Instead, significant relationships between the volumes of the left and right cornu ammonis subfield-1 (CA1) and IHI scores were evident. CONCLUSIONS: The rates of IHI prevalence in the current cohort are similar to those previously reported in healthy cohorts. The IHI severity is related to hippocampal subfield volumes, most notably the CA1, which is a novel finding with potential implications in research on aging and dementia.