Vulnerability of caregivers of people with a neurodegenerative disease: a synthesis.

The aging of the population and the increasing of the neurodegenerative pathologies encourage the current policies in health to further promote the home maintenance for dependent elderly people. Therefore, informal caregivers provide a substantial assistance to the medical team by monitoring home care. These volunteer caregivers who play an essential role in the survival of our health system however may expose to dangers of systematic assistance. In order to better understand the plural risks which caregivers are likely to face, this paper proposes a critical analysis of the consequences of caregiving on health and quality of life and summarizes factors that contribute to vulnerability - protection of caregivers. It seems caregivers will present very heterogeneous reactions in the way they are considering the care situation. Facing to many difficulties encountered, caregivers are dealing with their skills and adopt personal coping strategies. There is thus a wide range of fragility profiles and needs among caregivers. Better taking into account the multiple components of aid relationships paves the way toward possible new care perspectives by recognizing the specific needs of each caregiver with respect for its uniqueness. In this way only, we can effectively contribute to challenge one of the important and actual social issue: the prevention of global exhaustion of caregivers of people with neurodegenerative disease.

Validity of the five-word test for the evaluation of verbal episodic memory and dementia in a memory clinic setting.

BACKGROUND: The five-word test (FWT) uses semantic clues to optimize the encoding and retrieval of 5 items. Our objective was to assess the validity of the FWT as a measure of episodic memory when compared with the Free and Cued Selective Reminding Test (FCSRT), and its ability to distinguish participants with any dementia and especially Alzheimer disease (AD) from those with only subjective complaints. METHODS: Two hundred participants with Mini-Mental State Examination (MMSE) >15 were prospectively evaluated. The sum of the immediate and delayed free recalls of the FWT is called the free recall score (FRS). The sum of the immediate free, immediate cued, delayed free, and delayed cued recalls is called the total recall score (TRS). A total weighted score (TWS) is calculated using this formula: (free recalls × 2) + cued recalls. RESULTS: The correlation between FRS and the free recall scores of the FCSRT and between TRS and the total recall scores of the FCSRT was significant (r (s) ranges from .74-.84, P < .001). Area under the receiver--operating characteristic (ROC) curves of the MMSE, FRS, TRS, and TWS were not statistically different. A TWS at a cutoff value ≤15 could discriminate any dementia from subjective complaints with a sensitivity of 75% and a specificity of 95.9% or AD from subjective complaints with a sensitivity of 90.2% and a specificity of 95.9%. CONCLUSION: The FWT is a valid test of verbal episodic memory. It is useful to discriminate dementia especially AD from isolated subjective complaints.

Right anterior temporal lobe atrophy and person-based semantic defect: a detailed case study.

We report a new case of a right temporal pole variant of frontotemporal dementia (Rtv-FTLD), MD, who presented a slowly progressive deterioration of the recognition of familiar and famous people. We thoroughly investigated MD's face processing and semantic abilities, including a neuroimaging investigation. This analysis revealed a cross-modal person-based deficit together with a more general semantic alteration. However, there was no evidence of impairment in face perception, including holistic processing, or of an abnormal pattern of brain activation in face-sensitive cortical areas. We discuss the nature of face processing in the Rtv-FTLD and the context of a person-based semantic defect.