Attachment C. Comparison of Mental and Functional Notes: Data extracted from studies and assembled by guideline panel. Analytic scheme adapted from Nierenberg AA, Feinstein AR. How to evaluate a diagnostic marker test. Lessons learned from the rise and fall of dexamethasone suppression test. JAMA 1988; 259(11):1699-1702. Tests with Z scores of 1.96 or higher are significantly better than the "reference" test (MMSE) in distinguishing case patients from control subjects. = Numbers in boldface are randomized average effect size (RAVD); numbers in italics are mean effect size (D). Phase II = moderate to severe dementia in case patients, no comorbidity in control subjects. = mild to severe dementia in case patients, no comorbidity in control subjects. Phase IV = mild to severe dementia in case patients, comorbidity in control subjects. Attachment D. Resources for Health Professionals, When a diagnosis of dementia is made, the patient and family members have serious issues to consider. Although followup beyond this point is desirable, it cannot be ensured. For this reason, the visit during which the diagnosis is given is an appropriate time for the clinician to mention relevant issues, which include but are not restricted to long-term financial, legal, and medical planning. The following list of resources can be helpful to families when they are ready to confront the many implications of a diagnosis of dementia. A consumer version of this guideline is also available (see inside back cover for ordering information). Administration on Aging The Administration on Aging (AoA) coordinates delivery of services specified by the Older Americans Act. Services are coordinated and provided through 57 State agencies and 657 areas. Agencies on Aging (AAAs). The range of services provided by each AAA varies, but all include nutrition services, access services, in-home services, and community services. Addresses and phone numbers of State and area AAAs may be obtained from the national office: Administration on Aging Department of Health and Human Services 330 Independence Avenue, SW Washington, DC 20201 (202) 619-1006 (202) 619-7586 fax Internet address: http://www.aoa.dhhs.gov The Elder Care Locator provides a toll-free access number to locate State agency networks. Elder Care Locator Alzheimer's Disease Centers The National Institute on Aging, a component of the National Institutes of Health, supports 28 Alzheimer's Disease Centers across the country. This program provides clinical services, conducts basic and clinical research, disseminates professional and public information, and sponsors educational activities. A growing number of satellite clinics associated with this program are helping to expand diagnostic and treatment services in rural and minority communities and collect research data from a more diverse population. For information, contact the ADEAR Center (see below). Alzheimer's Association The Alzheimer's Association is a national voluntary organization with 220 local chapters and more than 2,000 support groups. The Alzheimer's Association funds research, promotes public awareness, advocates legislation for patients and families, and provides support services, including support groups, adult day care programs, respite care programs, and telephone helplines through its national, local chapter, and volunteer network. Alzheimer's Association 919 North Michigan Avenue Suite 100 Chicago, IL 60611-1676 (312) 335-8700 800-272-3900 for information and local chapter referrals nationwide (24-hour telephone line) Internet address: http://www.alz.org Alzheimer's Disease Education and Referral Center The Alzheimer's Disease Education and Referral (ADEAR) Center, a service of the National Institute on Aging, provides information and publications on Alzheimer's disease for health professionals, people with Alzheimer's disease and their families, and the public. The ADEAR Center serves as a national resource for information on diagnosis, treatment issues, patient care, caregiver needs, longterm care, education, research, and ongoing programs. In addition, the Center provides referrals to national and State resources. For information, contact: Alzheimer's Disease Education and Referral Center P.O. Box 8250 Silver Spring, MD 20907-8250 Internet address: adear@alzheimers.org The Corporation for National Service The Corporation for National and Community Service is a public corporation that administers Federal service programs, including AmeriCorps, the Foster Grandparent Program, and the Senior Companion Program (SCP), which provides supportive services to adults with physical, emotional, and health limitations. A major emphasis of the SCP is preventing or delaying institutionalization. Foster Grandparent volunteers work with children, including those with disabilities. AmeriCorps members address a range of local health issues. Attachment D. (continued) The address and phone number for regional offices may be obtained through the main office in Washington, DC. Corporation for National Service Office of Public Liaison 1201 New York Avenue, NW Other Resources American Association of Retired Persons (AARP), Washington, DC, (202) 434-2277; 800-424-3410. AARP Pharmacy Price Quote Center, 800-456-2226 American Bar Association Commission on Legal Problems of the Elderly, Washington, DC, (202) 662-8690 Children of Aging Parents, Levittown, PA, (215) 945-6900 Consortium to Establish a Registry for Alzheimer's Disease (CERAD), National Association for Continence, Spartanburg, SC, 800-BLADDER Insurance Consumer Helpline, Washington, DC, 800-942-4242 Medicare Hotline, Baltimore, MD, 800-638-6833 Medicare Beneficiaries Defense Fund, New York, NY, (212) 869-3850; 800-333-4114 National Citizens' Coalition for Nursing Home Reform, Washington, DC, (202) 332-2275 National Hospice Organization, Arlington, VA, (703) 243-5900; 800-658-8898 National Parkinson's Foundation, 800-327-4545, Miami, FL (East Coast); and 800-522-8855, Encino, CA (West Coast) National Stroke Association, Englewood, CO, (303) 771-1700; 800-STROKES. Social Security Information, 800-772-1213 (open 7 am-7 pm in all time zones) U.S. Department of Veterans Affairs, Regional Office, Veterans Assistance, Washington, DC, (202) 418-4343; 800-827-1000. |