New app could help N.B. doctors take the guesswork out of diagnosing dementia

MONCTON, N.B. – A professor of clinical neuropsychology at the University of Moncton says a computer application she developed could help doctors better predict the risk of dementia — and take some of the pressure off New Brunswick’s medical system.

Sarah Pakzad has spent the last seven years researching and working on the Neurocognitive Frailty Index, which would help healthcare professionals guide patients through tests that would assess risk factors for dementia.

She said all too often, patients who are at a low risk for dementia are put on a waiting list to see a specialist, clogging up resources and taking time away from patients who are at a higher risk.

“It’s going to help family physicians and nurse practitioners to help distinguish the patients who are at risk, or high risk, of developing dementia, in comparison with those who have a low risk but have similar symptoms,” said Pakzad.

She said memory problems can be a symptom of mental health disorders like anxiety and depression, so it’s difficult to gauge whether or not someone is at risk for dementia based on that symptom alone.

The index draws information from a database of over 25,000 patients over the age of 50 and would produce a percentage probability of the patient developing dementia.

Pakzad said the index is more than 90 per cent accurate.

“This is the first time we have an index that’s reliable, useful, and easy to work with,” she said.

Pakzad hopes to finish the app’s design within the next year.

In her research, she surveyed 800 family physicians in New Brunswick about how they deal with patients who may have dementia.

Many doctors told her they’re ill-equipped to diagnose dementia and don’t know what to do when people complain about memory and cognitive issues.

She said this creates frustration for patients, some of whom may have spent hours in a waiting room.

“Often they are hearing, ‘No, no, that’s okay, when you’re getting old, it’s just normal to have memory problems,’” she said, adding “No, that’s not okay.”

Bruno Battistini, CEO and scientific director of the New Brunswick Health Research Foundation, which provided much of the funding for the project, said this is a big gap in the province’s health-care system.

“Medical doctors don’t have, necessarily, the training … to do what we call cognitive assessments,” he said. “This is a more specialized thing done by a geriatrician.”

He said the issue lies in the fact that there’s only one geriatrician per 100,000 people in New Brunswick.

Battistini hopes the app will help unclog waiting lists for people in search of a specialist by ruling out those who are at a low risk of dementia.

New Brunswick Medical Society CEO Anthony Knight said supports for patients with dementia exist in New Brunswick, but the system is struggling to keep up with the demand.

“It’s a growing trend, the diagnosis of dementia, among seniors and other individuals. Our nursing home system is strained, for sure, to manage the complexities associated with dementia care,” he said.

It will still be a while before the application will be available for doctors to use, but Pakzad said she’s looking forward to seeing what healthcare professionals think.

 

http://www.news1130.com/2018/04/29/new-app-could-help-n-b-doctors-take-the-guesswork-out-of-diagnosing-dementia/

Binge drinking rising at ‘worrisome’ rate in Canada, University of Calgary study finds

Some 20 per cent of Canadians are binge drinking — a trend that has been increasing in all age groups, but especially among young people, a study has found.

“I think it’s extraordinarily high,” the study’s lead author, Dr. Andrew Bulloch of the University of Calgary, said Wednesday.

“It’s worrisome because binge drinking is associated with traffic crashes, sexual violence, homicide and accidents in general,” Bulloch added.

From 1996 to 2013, the number of women binge drinking increased from seven to 14 per cent, and men from 21 to 26 per cent.

When it comes to young adults — aged 18 to 24 — the percentage of binge drinkers skyrockets to almost 40 per cent.

“I think it’s a cultural thing, I think it has to do with happy hour, and with acceptability of drinking a lot in a short period of time,” Bulloch told The Homestretch.

Also, alcohol is becoming more affordable, more available, and especially more effectively advertised, he added.

 

The study defined binge drinking as having five or more drinks at one sitting at least once a month for a year — a consistent measure used in epidemiological studies since the 1960s.

Binge drinking is different from alcohol dependence, which is more of a daily occurrence.

“But we think that binge drinking is a bad sign and can lead down the road to alcohol dependence,” Bulloch said.

He also noted that it puts a burden on the healthcare system, and is associated with depression and suicide.

“People that are depressed tend to self-medicate, both with cigarettes and also alcohol. But what’s a little more surprising is that people that drink heavily are more likely to get depressed, so the relationship is actually reciprocal,” Bulloch said.

The Canadian results mirror studies in the U.S. and U.K.

National guidelines for Canada suggest that men should not drink more than 20 drinks a week, and women 15.

Bulloch says the government should take steps to curb alcohol advertising, including casual signage outside pubs that say, “Happy Hour begins at 3 o’clock.”

Researchers were able to study the data based on a series of cross-sectional national health surveys carried out by Statistics Canada about every two years over the 17-year period.

The study was published in the October edition of CMAJ Open.

 

http://www.cbc.ca/news/canada/calgary/canada-binge-drinking-calgary-study-1.3823420