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IJERPH
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Promoting Mentation: Assessment and Support for Dementia, Depression and Delirium
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Promoting Mentation: Assessment and Support for Dementia, Depression and Delirium

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 5343

Special Issue Editors

Dr. Peter Reed

E-Mail Website
Guest Editor
1.Sanford Center for Aging, School of Medicine, University of Nevada, Reno, NV 89557, USA
2. School of Public Health, University of Nevada, Reno, NV 89557, USA
Interests: public health and aging; dementia care and support; long-term care; geriatrics workforce
Dr. Jennifer Carson

E-Mail Website
Guest Editor
Dementia Engagement, Education, and Research (DEER) Program, School of Public Health, University of Nevada, Reno, NV 89557, USA
Interests: public health and aging; dementia care and support; long-term care; geriatrics workforce

Special Issue Information

Dear Colleagues,

Cognitive and emotional health have long been recognized as essential dimensions of overall quality of life and well-being, particularly among elders. In Age-Friendly Health Systems encouraged by the Institute for Healthcare Improvement (IHI) and the John A. Hartford Foundation, these dimensions are highlighted as one of the 4Ms used for high-quality elder care, known as ‘Mentation’. A focus on mentation has brought attention to all aspects of the function and well-being of a person’s mind, including a goal of identifying and treating dementia, depression, and delirium. For this Special Issue, we invite articles focusing on each of these three conditions from both a clinical and community-based public health perspective. Across the conditions of dementia, depression, and delirium, this Speical Issue seeks to provide the latest insights in evidence-based clinical practice, including assessment, early detection, and care, as well as innovative efforts to educate primary care providers to increase their competency in geriatrics. Furthermore, we will explore community-based models associated with the education, care, and support of people living with dementia, depression, and delirium, as well as their care partners. We will also include papers relating to community-based participatory research to affect postiive community change to support the well-being of adults experiencing limitations in mentation. We hope you will consider submitting your latest work exploring aspects of mentation from community-based public health perspectives.

Dr. Peter Reed
Dr. Jennifer Carson
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • dementia
  • depression
  • delirium
  • early detection and diagnosis
  • comprehensive assessment
  • community-based supports and services
  • community-based participatory research
  • caregiver support
  • provider education

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Published Papers (5 papers)

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Research

10 pages, 536 KiB  
Article
What Guides Organizations’ Current Dementia-Related Practices Across Four Canadian Provinces?
by Maria Baranowski, Nancy Jokinen, Leslie Udell, Sandy Stemp, Tracey Berman and Shahin Shooshtari
Int. J. Environ. Res. Public Health 2025, 22(5), 688; https://doi.org/10.3390/ijerph22050688 (registering DOI) - 26 Apr 2025
Viewed by 72
Abstract
We conducted a survey to learn what guides current dementia-related practice to support community-dwelling adults with intellectual and developmental disabilities who may be experiencing dementia in Canada. We invited organizations working in health, disability, or senior sectors in 4 Canadian provinces to complete [...] Read more.
We conducted a survey to learn what guides current dementia-related practice to support community-dwelling adults with intellectual and developmental disabilities who may be experiencing dementia in Canada. We invited organizations working in health, disability, or senior sectors in 4 Canadian provinces to complete an online cross-sectional survey between April and July 2023. A total of 173 people completed the survey, representing 125 unique organizations, and nearly half resided in Ontario. The most common support and services provided to adults with intellectual and developmental disabilities and their families were related to residential care, day programming, and group home living. Half of our survey respondents reported that they followed dementia-related practice guidelines. The most common guideline followed and early detection tool used were from the National Task Group on Intellectual Disabilities and Dementia Practices and the National Task Group-Early Detection and Screen for Dementia, respectively. Lack of awareness about guidelines and detection tools, challenges to implement the same, and organizational needs for future training and service provision were identified. Commitment to resources to monitor adults with IDD who may be experiencing dementia is recommended to provide meaningful support and service to them and their families. Full article
(This article belongs to the Special Issue Promoting Mentation: Assessment and Support for Dementia, Depression and Delirium)
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14 pages, 1624 KiB  
Article
Integrating AAA Care Coordinators in Primary Care for Dementia Support: Implementation Challenges and Lessons Learned
by Mary C. Ehlman, Suzanne Leahy, Reagan Lawrence and Della Evans
Int. J. Environ. Res. Public Health 2025, 22(4), 506; https://doi.org/10.3390/ijerph22040506 - 26 Mar 2025
Viewed by 867
Abstract
Patient, provider, and community barriers challenge dementia diagnosis and management in primary care. Interventions emphasizing EHR-based workflows with minimal provider training are insufficient to address these challenges. To improve early detection, dementia care, and the global health of caregivers and patients living with [...] Read more.
Patient, provider, and community barriers challenge dementia diagnosis and management in primary care. Interventions emphasizing EHR-based workflows with minimal provider training are insufficient to address these challenges. To improve early detection, dementia care, and the global health of caregivers and patients living with dementia, interventions must take a more comprehensive approach, addressing provider education and helping families be aware of the community supports available. Methods: Through a retrospective evaluation utilizing secondary data sources, researchers examine the results of a dementia care intervention that involved a clinical workflow, semiannual dementia training, and the integration of a care coordinator from an Area Agency on Aging (AAA) into the primary care team. Results: Seventeen caregivers received education and referrals to support during the intervention year and again in the final year. This represented 5.3% of the 322 patients diagnosed with dementia and with medical visits at the three clinics in 2023 During the last two grant years, there also was a large increase in provider referrals; thus, dementia care referrals decreased in proportion to patient referrals overall. Conclusions: Utilizing AAA care coordinators is a promising model for addressing health-related social needs in primary care. Yet, findings point to the complexities that remain in managing dementia in this setting. Full article
(This article belongs to the Special Issue Promoting Mentation: Assessment and Support for Dementia, Depression and Delirium)
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17 pages, 531 KiB  
Article
“I Must Be the One to Change; He’s Doing the Best He Can”: Care Partner Evaluation Results from a Four-Part, In-Person, Dementia Community Education Program
by Olivia C. Rubio, Erica K. Husser, Rollin Wright, Diane Berish, Janice Whitaker, Marie Boltz and Donna Fick
Int. J. Environ. Res. Public Health 2025, 22(2), 295; https://doi.org/10.3390/ijerph22020295 - 17 Feb 2025
Viewed by 460
Abstract
We created a comprehensive, four-part, in-person, interactive community education series to teach informal, unpaid care partners of persons living with dementia (PLWD) how to support their PLWD, negotiate common day-to-day challenges, and navigate predictable situations that arise as the disease progresses over time. [...] Read more.
We created a comprehensive, four-part, in-person, interactive community education series to teach informal, unpaid care partners of persons living with dementia (PLWD) how to support their PLWD, negotiate common day-to-day challenges, and navigate predictable situations that arise as the disease progresses over time. The purpose of this qualitative study was to explore the series impact on participant knowledge, care practices, and perceptions of caregiving. Inspired by the U.S. Medicare Cognitive Assessment and Care Plan Service visit and the 4Ms of the Age-Friendly Health Systems Framework, our curriculum focused on (1) expanding knowledge about the disease and disease progression, (2) developing skills to better connect and work with PLWD, (3) self-care for care partners, and (4) sharing resources to support future planning. The program was delivered in three communities in Central Pennsylvania (one rural, one small, and one medium metropolitan) and was attended by 146 individuals. Both session and final qualitative evaluation data were assessed using thematic analysis and five major categories emerged: lessons learned, activating new knowledge, impact and changes, assuming responsibility is challenging, and I need more help. Ongoing education, emotional support, and access to quality assistance for long-term planning are all needed and require sustained support. Full article
(This article belongs to the Special Issue Promoting Mentation: Assessment and Support for Dementia, Depression and Delirium)
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10 pages, 652 KiB  
Article
Cost-Effectiveness Analysis of Telehealth and In-Person Primary Care Visits for People Living with Alzheimer’s Disease-Related Disorders in the State of Nevada
by Yonsu Kim, Jay J. Shen, Ian Choe, Jerry Reeves, David Byun, Iulia Ioanitoaia-Chaudhry, Leora Frimer, Pengfeng Jin, Maryam Tabrizi, Hee-Taik Kang, Jae-Woo Lee, Claire Sieun Lee, Tae-Ha Chung, Yena Hwang, Ian Park, Hayden Leung, Jenna Park and Ji Won Yoo
Int. J. Environ. Res. Public Health 2024, 21(10), 1381; https://doi.org/10.3390/ijerph21101381 - 18 Oct 2024
Viewed by 1656
Abstract
To people living with Alzheimer’s Disease-Related Disorders (ADRD), timely and coordinated communication is essential between their informal caregivers and healthcare providers. In provider shortage areas, for example, the state of Nevada, telehealth can be an effective primary care delivery alternative to in-person visits. [...] Read more.
To people living with Alzheimer’s Disease-Related Disorders (ADRD), timely and coordinated communication is essential between their informal caregivers and healthcare providers. In provider shortage areas, for example, the state of Nevada, telehealth can be an effective primary care delivery alternative to in-person visits. To evaluate the cost-effectiveness of telehealth visits for people living with ADRD in the state of Nevada, a decision-analytic Markov model was developed from healthcare system perspectives with a 10-year horizon/1-year cycle. To estimate the effects of demographic and geographic parameters on the Markov model, race parameters were divided into non-Hispanic White individuals vs. others and location parameters were divided into urban vs. rural. A 12-item short-version Zarit Burden Interview (ZBI-12) was applied to measure the informal caregiver burdens of non-institutionalized people living with ADRD. The values of mortality rate and healthcare utilization were obtained from healthcare systems’ publicly available payor administrative data and Nevada State Inpatient/Emergency Department datasets. Among urban-residing non-Hispanic White individuals, the Incremental Cost-Effectiveness Ratio (ICER) per modified ZBI-12 indicated a cost saving of USD 9.44 with telehealth visits; among urban-residing racial minorities, the ICER per modified ZBI-12 indicated a cost saving of USD 29.26 with in-person visits; and among rural residents, the ICER per modified ZBI-12 indicated a cost-saving of USD 320.93 with telehealth visits. Distributional differences in the cost-saving effects of telehealth primary care were noted in line with racial and geographic parameters. Workforce and caregiver training is necessary for reducing distributional differences, especially among urban-residing racial monitories living with ADRD in the provider shortage area of the state of Nevada. Full article
(This article belongs to the Special Issue Promoting Mentation: Assessment and Support for Dementia, Depression and Delirium)
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8 pages, 4866 KiB  
Article
Design and Development of Virtual Reality Application Implementing Age-Friendly Care and the 4Ms: A Quality Improvement Project
by Sweta Tewary, Oksana Shnayder, Marie Dezine and Naushira Pandya
Int. J. Environ. Res. Public Health 2024, 21(10), 1279; https://doi.org/10.3390/ijerph21101279 - 25 Sep 2024
Viewed by 1518
Abstract
Introduction: With an increase in the aging population, the application of evidence-based practice in geriatric education can strengthen knowledge, skills, and clinical experience for healthcare students caring for older adults. The Age-Friendly Health System (AFHS) is one of the frameworks founded on providing [...] Read more.
Introduction: With an increase in the aging population, the application of evidence-based practice in geriatric education can strengthen knowledge, skills, and clinical experience for healthcare students caring for older adults. The Age-Friendly Health System (AFHS) is one of the frameworks founded on providing evidence-based and low-risk care centered on what matters most to older adults, their families, and caregivers. Virtual reality (VR) platforms are gaining popularity due to their ability to provide an immersive, hands-on learning experience resembling an actual medical practice or care setting. Immersive learning enhances students’ sensory perceptions, promoting an innovative and engaging way of acquiring concepts that are difficult to teach in real life. This study aimed to design, develop, implement, and evaluate a case-based training module highlighting AFHS and educating medical students on the 4Ms approach in geriatric care (What Matters, Medication, Mentation, and Mobility). Methodology: The project was a feasibility study completed in two phases. Phase one included planning and developing a case-based scenario incorporating the 4Ms of AFHS. Phase two included implementing and evaluating the VR training module into the geriatric curriculum for medical students. Results: The final VR case displays a hospital and post-acute setting where an elderly patient is admitted for a hip fracture. Students learn how to triage and treat patients from admission to discharge while demonstrating their knowledge of AFHSs. Approximately 10% of students completed the evaluation survey, and preliminary results indicate significant knowledge change in pre-post scenario-based training on an AFHS. Conclusions: The VR education platform and embedded scenario promise an innovative adaptation of technology in learning the concepts of the 4Ms of AFHSs. However, future studies should explore VR education with clinical assessment evaluation to ensure competence in providing age-friendly care. Full article
(This article belongs to the Special Issue Promoting Mentation: Assessment and Support for Dementia, Depression and Delirium)
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