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Barriers and Facilitators for Guidelines with Depression and Anxiety in Parkinson’s Disease or Dementia. Can J Aging 2018; 37:185-199. [PMID: 29618389 DOI: 10.1017/s0714980818000053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
RÉSUMÉNotre principal objectif était de comprendre les barrières et les facilitateurs associés à l’application de guides de pratique clinique (GPC) de haute qualité pour la dépression et l’anxiété chez les patients atteint de démence ou de la maladie de Parkinson (MP). Des groupes de discussion et des entrevues ont été réalisés avec des participants atteints de démence ou de la MP, leurs soignants et les médecins impliqués dans les soins de ces patients à Calgary (Alberta). Le cadre conceptuel des domaines théoriques et le Behaviour Change Wheel ont été utilisés pour guider la collecte des données et l’analyse du cadre conceptuel. Au total, 33 médecins, 7 patients et leurs aidants ont participé à l’étude. Les barrières et les facilitateurs pour l’application des recommandations des GPC liées au diagnostic, à la gestion et à l’utilisation des lignes directrices ont été rapportés. L’insuffisance des données concernant les troubles anxieux et dépressifs dans la démence et la MP constituaient un thème dominant dans les résultats. Ce constat était particulièrement évident en matière de troubles anxieux. Les patients ont aussi mentionné des difficultés à communiquer leurs symptômes et à accéder aux services. Bien que des guides de pratiques soient disponibles, les médecins éprouvent quelques difficultés dans l’application de certaines recommandations, ces difficultés étant surtout dues au manque de données probantes disponibles.
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102
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Orgeta V, Tabet N, Nilforooshan R, Howard R. Efficacy of Antidepressants for Depression in Alzheimer's Disease: Systematic Review and Meta-Analysis. J Alzheimers Dis 2018; 58:725-733. [PMID: 28505970 PMCID: PMC5467718 DOI: 10.3233/jad-161247] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Depression is common in people with Alzheimer’s disease (AD) affecting overall outcomes and decreasing quality of life. Although depression in AD is primarily treated with antidepressants, there are few randomized controlled trials (RCTs) assessing efficacy and results have been conflicting. Objectives: To systematically review evidence on efficacy of antidepressant treatments for depression in AD. Methods: Systematic review and meta-analysis of double blind RCTs comparing antidepressants versus placebo for depression in AD. We searched MEDLINE, CINAHL, EMBASE, PsycINFO, the Cochrane Controlled Trials Register and on line national and international registers. Primary outcomes were treatment response and depressive symptoms. Secondary outcomes were cognition, acceptability, and tolerability. Risk of bias was also assessed. Results: Seven studies met inclusion criteria. Three compared sertraline with placebo; one compared both sertraline and mirtazapine to placebo; imipramine, fluoxetine, and clomipramine were evaluated in one study each. In terms of response to treatment (6 studies, 297 patients treated with antidepressants and 223 with placebo), no statistically significant difference between antidepressants and placebo was found (odds ratio (OR) 1.95, 95% CI 0.97–3.92). We found no significant drug-placebo difference for depressive symptoms (5 studies, 311 patients, SMD –0.13; 95% CI –0.49 to 0.24). Overall quality of the evidence was moderate because of methodological limitations in studies and the small number of trials. Conclusion: Despite the importance of depression in people with AD, few RCTs are available on efficacy of antidepressants, limiting clear conclusions of their potential role. There is a need for further high quality RCTs.
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Affiliation(s)
- Vasiliki Orgeta
- Correspondence to: Dr. Vasiliki Orgeta, Alzheimer’s Society Senior Fellow, Senior Research Associate, University College London, Division of Psychiatry, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK. Tel.: +44 020 7679 9294; Fax: +44 020 7679 9426; E-mail:
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103
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Does the MIND diet decrease depression risk? A comparison with Mediterranean diet in the SUN cohort. Eur J Nutr 2018. [DOI: 10.1007/s00394-018-1653-x] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Tuijt R, Livingston G, Gould RL, Jones R, Verdaguer ES, Orgeta V. IDEA intervention to prevent depressive symptoms and promote well-being in early-stage dementia: protocol for a randomised controlled feasibility study. BMJ Open 2018; 8:e021074. [PMID: 29439085 PMCID: PMC5879789 DOI: 10.1136/bmjopen-2017-021074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Depressive symptoms are common among people with dementia, impacting quality of life and cognitive and functional decline. Currently, little is known about the acceptability and feasibility of psychological interventions for people with mild dementia, with recent reviews identifying the need for further evidence. Developing and evaluating psychological interventions to prevent and treat these symptoms is, therefore, an important clinical and research priority. This protocol describes a study testing the acceptability and feasibility of a manual-based behavioural activation (BA) intervention for preventing and treating depressive symptoms in people with mild dementia. The aim of this study is to explore the feasibility of conducting a pragmatic multicentre randomised controlled trial of clinical effectiveness of an eight-session intervention. The Intervention to prevent Depressive symptoms and promote well-being in EArly-stage dementia (IDEA) programme supports people with dementia and their family carers in identifying and scheduling enjoyable and meaningful activities. METHODS AND ANALYSIS Sixty people who have received a diagnosis of dementia of any type in the last 6 months will be recruited via memory clinics. Further criteria are a Mini-Mental State Examination score of ≥20, and a family carer who can assist with the intervention. Consenting participants will be randomised in a ratio of 2:1 to BA or to treatment as usual. Analyses will estimate parameters such as rates of recruitment, retention and number of sessions completed. Questionnaires measuring depressive symptoms and quality of life for both the person with dementia and their carer will be completed at baseline, 3 and 6 months. Qualitative interviews will explore acceptability of the intervention, study procedures and experiences of the sessions. ETHICS AND DISSEMINATION This study received a favourable ethical opinion from the London Camberwell St Giles Research Ethics Committee (16/LO/0540). We will disseminate findings at key conferences, the Alzheimer's Society and University College London websites and local stakeholder events. TRIAL REGISTRATION NUMBER ISRCTN75503960; Pre-results.
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Affiliation(s)
- Remco Tuijt
- Division of Psychiatry,
University College London, London, UK
| | - Gill Livingston
- Division of Psychiatry,
University College London, London, UK
| | - Rebecca L Gould
- Division of Psychiatry,
University College London, London, UK
| | - Rebecca Jones
- Division of Psychiatry,
University College London, London, UK
| | | | - Vasiliki Orgeta
- Division of Psychiatry,
University College London, London, UK
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105
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Gasser AI, Salamin V, Zumbach S. Dépression de la personne âgée ou maladie d’Alzheimer prodromique : quels outils pour le diagnostic différentiel ? Encephale 2018; 44:52-58. [DOI: 10.1016/j.encep.2017.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 02/25/2017] [Accepted: 03/01/2017] [Indexed: 01/23/2023]
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106
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Tsoi KKF, Chan JYC, Ng YM, Lee MMY, Kwok TCY, Wong SYS. Receptive Music Therapy Is More Effective than Interactive Music Therapy to Relieve Behavioral and Psychological Symptoms of Dementia: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2018; 19:568-576.e3. [PMID: 29396186 DOI: 10.1016/j.jamda.2017.12.009] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 12/11/2017] [Accepted: 12/13/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Music therapy is demonstrated to be effective to relieve the agitation among people with dementia, but the comparative effectiveness of methods of music engagement for people with dementia is uncertain. OBJECTIVE To evaluate the effects on cognitive functions and behavioral symptoms between interactive and receptive music therapies for people with dementia. METHODS Prospective studies evaluating interactive and receptive music therapies were identified from the OVID databases, included MEDLINE, EMBASE, PsycINFO, and CINAHL. Supplementary search was conducted in Google Scholar. The primary outcome focused on cognitive function; the secondary outcomes were apathy, anxiety, depressive symptoms, agitation, and other behavioral problems. All outcomes were measured by the standard assessment tools. The heterogeneity of studies was examined, and the effects were pooled by meta-analysis. Quality of studies and risk of bias were assessed. RESULTS Thirty-eight trials involving 1418 participants with dementia were included. The mean age ranged from 75 to 90 years, and the percentage of male participants ranged from 6% to 83%. No significant difference was found between participants receiving interactive or receptive music therapy and usual care in cognitive function; the mean difference (MD) of Mini-Mental State Examination was 0.18 [95% confidence interval (CI) -1.34 to 1.69], and -0.15 (95% CI -0.55 to 0.25), respectively. Participants with receptive music therapy had significant decrease in agitation (Cohen-Mansfield Agitation Inventory: MD = -7.99, 95% CI -5.11 to -0.87) and behavioral problems (Neuropsychiatric Inventory: MD = -3.02 95% CI -5.90 to -0.15) compared to usual care, while no significant difference was found between interactive music therapy and usual care in behavioral problems and psychiatric symptoms. CONCLUSIONS This study demonstrated that receptive music therapy could reduce agitation, behavioral problems, and anxiety in older people with dementia, and appears to be more effective than interactive music therapy. It is easy and convenient to implement receptive music therapy; therefore, we recommended the use of receptive music therapy in nursing homes, day care centers, and client homes.
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Affiliation(s)
- Kelvin K F Tsoi
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong; Stanley Ho Big Data Decision Analytics Research Center, The Chinese University of Hong Kong, Hong Kong.
| | - Joyce Y C Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Yiu-Ming Ng
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Mia M Y Lee
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Timothy C Y Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Samuel Y S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
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Abstract
Alzheimer's disease, the commonest cause of dementia, is a growing global health concern with huge implications for individuals and society. In this review, current understanding of the epidemiology, genetics, pathology and pathogenesis of Alzheimer's disease is outlined, before its clinical presentation and current treatment strategies are discussed. Finally, the review discusses how our enhanced understanding of Alzheimer pathogenesis, including the recognition of a protracted preclinical phase, is informing new therapeutic strategies with the aim of moving from treatment to prevention.
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Affiliation(s)
- C A Lane
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - J Hardy
- Reta Lila Weston Research Laboratories, Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - J M Schott
- Dementia Research Centre, UCL Institute of Neurology, London, UK
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Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, Ballard C, Banerjee S, Burns A, Cohen-Mansfield J, Cooper C, Fox N, Gitlin LN, Howard R, Kales HC, Larson EB, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbæk G, Teri L, Mukadam N. Dementia prevention, intervention, and care. Lancet 2017; 390:2673-2734. [PMID: 28735855 DOI: 10.1016/s0140-6736(17)31363-6] [Citation(s) in RCA: 3419] [Impact Index Per Article: 488.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 01/20/2017] [Accepted: 01/25/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Gill Livingston
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK.
| | | | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London, UK
| | - Sergi G Costafreda
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Jonathan Huntley
- Division of Psychiatry, University College London, London, UK; Department of Old Age Psychiatry, King's College London, London, UK
| | - David Ames
- National Ageing Research Institute, Parkville, VIC, Australia; Academic Unit for Psychiatry of Old Age, University of Melbourne, Kew, VIC, Australia
| | | | - Sube Banerjee
- Centre for Dementia Studies, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Alistair Burns
- Centre for Dementia Studies, University of Manchester, Manchester, UK
| | - Jiska Cohen-Mansfield
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Heczeg Institute on Aging, Tel Aviv University, Tel Aviv, Israel; Minerva Center for Interdisciplinary Study of End of Life, Tel Aviv University, Tel Aviv, Israel
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Nick Fox
- Dementia Research Centre, University College London, Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Laura N Gitlin
- Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD, USA
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Helen C Kales
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; VA Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA
| | - Karen Ritchie
- Inserm, Unit 1061, Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, University of Montpellier, Montpellier, France; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Kenneth Rockwood
- Centre for the Health Care of Elderly People, Geriatric Medicine Dalhousie University, Halifax, NS, Canada
| | - Elizabeth L Sampson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Quincy Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview, Johns Hopkins University, Baltimore, MD, USA
| | - Lon S Schneider
- Department of Neurology and Department of Psychiatry and the Behavioural Sciences, Keck School of Medicine, Leonard Davis School of Gerontology of the University of Southern California, Los Angeles, CA, USA
| | - Geir Selbæk
- Norwegian National Advisory Unit on Aging and Health, Vestfold Health Trust, Tønsberg, Norway; Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway; Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Linda Teri
- Department Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, WA, USA
| | - Naaheed Mukadam
- Division of Psychiatry, University College London, London, UK
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Barton K, Johnson I, Mountford A. Development of a psychosocial group intervention for individuals with mild cognitive impairment (innovative practice). DEMENTIA 2017; 19:1325-1332. [DOI: 10.1177/1471301217741007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A diagnosis of mild cognitive impairment is associated with an increase in anxiety and depression and a decrease in psychological well-being. Despite this, individuals with mild cognitive impairment may not receive the appropriate support needed to manage the emotional and practical elements of their diagnosis. A psychosocial group intervention based on the ‘Recovery Model’ was developed in order to meet these needs. Outcome data from a trial of this group intervention indicated it was successful in meeting its aims.
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Affiliation(s)
- Karen Barton
- Birmingham Solihull Mental Health National Health Service Foundation Trust, Birmingham, UK
| | - Ian Johnson
- Birmingham Solihull Mental Health National Health Service Foundation Trust, Birmingham, UK
| | - Amy Mountford
- Birmingham Solihull Mental Health National Health Service Foundation Trust, Birmingham, UK
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Ford AH, Almeida OP. Management of Depression in Patients with Dementia: Is Pharmacological Treatment Justified? Drugs Aging 2017; 34:89-95. [PMID: 28074409 DOI: 10.1007/s40266-016-0434-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Depression in the context of dementia is common and contributes to poorer outcomes in individuals and those who care for them. Non-pharmacological treatments are the preferred initial approach to managing these symptoms but data in support of these are scarce. There are a number of pharmacological treatment options available to clinicians but efficacy is uncertain and concern about potential side effects in an aging and vulnerable population needs to be taken into consideration. This review aims to provide a concise overview of pharmacological treatments for depression in dementia. Antidepressants are the mainstay of pharmacological treatment for clinically significant depression in the general population but evidence to support their use in dementia is mixed. Trials of antidepressants should generally be reserved for individuals with depression where the symptoms are distressing and surpass the threshold for major depression. Acetylcholinesterase inhibitors and memantine are effective in the symptomatic treatment of Alzheimer's disease but current evidence does not support their use to treat depressive symptoms in dementia. Similarly, antipsychotics and mood stabilizers have no proven efficacy for depression and the risk of adverse effects seems to outweigh any potential benefit. Pain can be a frequent problem in dementia and may have significant effects on behavior and mood. Preliminary evidence supports a role of adequate analgesia in improving mood in people with dementia.
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Affiliation(s)
- Andrew H Ford
- School of Psychiatry and Clinical Neurosciences (M573), Western Australian Centre for Health and Ageing (M573), Harry Perkins Institute of Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | - Osvaldo P Almeida
- School of Psychiatry and Clinical Neurosciences (M573), Western Australian Centre for Health and Ageing (M573), Harry Perkins Institute of Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
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Erdal A, Flo E, Selbaek G, Aarsland D, Bergh S, Slettebo DD, Husebo BS. Associations between pain and depression in nursing home patients at different stages of dementia. J Affect Disord 2017; 218:8-14. [PMID: 28456075 DOI: 10.1016/j.jad.2017.04.038] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 04/17/2017] [Accepted: 04/20/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pain is associated with depression in nursing home patients with dementia. It is, however, unclear whether pain increases depression. Therefore we evaluated the prospective associations between pain and depressive symptoms in nursing home patients at different stages of cognitive impairment. METHODS Two longitudinal studies were combined, including 931 patients (≥65 years) from 65 nursing homes. One study assessed patients at admission, with 6-month follow-up (2012-2014). The other study assessed residents with varying lengths of stay, with 4-month follow-up (2014-2015). Patients were assessed with the Mini-Mental State Examination, the Mobilisation-Observation-Behaviour-Intensity-Dementia-2 Pain Scale, and the Cornell Scale for Depression in Dementia. RESULTS At baseline, 343 patients (40% of 858 assessed) had moderate to severe pain, and 347 (38% of 924) had depression. Pain increased the risk of depression (OR 2.35, 95% CI 1.76-3.12). Using mixed model analyses, we found that a 1-point increase in pain was associated with a .48 increase in depression (p<.001). This association persisted in mild, moderate, and severe cognitive impairment. In those recently admitted, depressive symptoms decreased over time, and having less pain at follow-up was associated with a decrease in depressive symptoms (within-subject effect; p=.042). LIMITATIONS The two cohorts had different inclusion criteria, which may reduce generalisability. The study design does not allow conclusions on causality. CONCLUSIONS Pain and depressive symptoms are associated in patients with dementia. Because reduced pain is associated with less depressive symptoms, these patients should be assessed regularly for untreated pain. The benefit of analgesic treatment should be weighed carefully against the potential for adverse effects.
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Affiliation(s)
- Ane Erdal
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway.
| | - Elisabeth Flo
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Geir Selbaek
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway; National Advisory Unit on Ageing and Health, Tønsberg, Norway; Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Centre for Age-related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Sverre Bergh
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway; National Advisory Unit on Ageing and Health, Tønsberg, Norway
| | - Dagrun D Slettebo
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway
| | - Bettina S Husebo
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway; Municipality of Bergen, Bergen, Norway
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Aras YG, Tunç A, Güngen BD, Güngen AC, Aydemir Y, Demiyürek BE. The effects of depression, anxiety and sleep disturbances on cognitive impairment in patients with chronic obstructive pulmonary disease. Cogn Neurodyn 2017; 11:565-571. [PMID: 29147148 DOI: 10.1007/s11571-017-9449-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 07/08/2017] [Accepted: 07/26/2017] [Indexed: 10/19/2022] Open
Abstract
The purpose of this study was to investigate the effects of depression, anxiety and sleep disturbances on cognitive functions in chronic obstructive pulmonary disease (COPD) patients. In this prospective case-control study, demographic data, smoking history, depression, anxiety, sleep quality and cognitive status of 48 COPD patients and 36 healthy volunteers aged 40-90 years were recorded. The Beck depression inventory (BDI), the Beck anxiety inventory (BAI), and Pittsburgh Sleep Quality Index (PSQI) were used to assess depression, anxiety and sleep quality, respectively in COPD patients. Cognitive performance was studied by the mini-mental state examination. The mean age of patients with COPD was 65.3 ± 9.4 years, and disease duration was 9.6 ± 7.8 years. Male sex ratio, smoking, BDI score, BAI score, total PSQI score, sleep latency, sleep duration, average use of sleep aids and sleep disturbances in patients with COPD were significantly higher than the control group (p < 0.05). When cognitive impairment was compared by age, FVC, FEV, FEV/FVC, PEF values and smoking, no statistically significant relationship was found (p > 0.05). A statistically significant relationship was established between cognitive impairment and severity of disease, presence of anxiety, presence of depression and sleep quality. In our study, we found that sleep disorders, depression and anxiety comorbid with COPD increased cognitive impairment as well as the severity of disease. We believe that this finding is important in terms of reducing the risk of cognitive impairment, preventing misdiagnosis and treatment of the aforementioned comorbid diseases.
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Affiliation(s)
- Yesim Güzey Aras
- Department of Neurology, Research and Training Hospital, Sakarya University, 54100 Adapazarı, Sakarya Turkey
| | - Abdülkadir Tunç
- Department of Neurology, Bezmi Alem Vakıf University, İstanbul, İstanbul Turkey
| | - Belma Doğan Güngen
- Department of Neurology, Research and Training Hospital, Sakarya University, 54100 Adapazarı, Sakarya Turkey
| | - Adil Can Güngen
- Department of Pulmonology, Research and Training Hospital, Sakarya University, Adapazarı, Sakarya Turkey
| | - Yusuf Aydemir
- Department of Pulmonology, Research and Training Hospital, Sakarya University, Adapazarı, Sakarya Turkey
| | - Bekir Enes Demiyürek
- Department of Neurology, Research and Training Hospital, Sakarya University, 54100 Adapazarı, Sakarya Turkey
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Kawada T. Sleep duration and cognitive impairment in older adults. Aging Clin Exp Res 2017; 29:817. [PMID: 27682434 DOI: 10.1007/s40520-016-0631-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 09/15/2016] [Indexed: 10/20/2022]
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Prevalence, Patterns, and Predictors of Depression Treatment among Community-Dwelling Elderly Individuals with Dementia in the United States. Am J Geriatr Psychiatry 2017; 25:803-813. [PMID: 28392190 DOI: 10.1016/j.jagp.2017.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 03/02/2017] [Accepted: 03/03/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Co-occurring dementia and depression exerts a substantial burden on the elderly. This study utilizes data from a nationally representative cohort of community-dwelling individuals 65 years and older to examine the prevalence, patterns, and predictors of depression treatment among elderly individuals with co-occurring dementia and depression. DESIGN Retrospective, cross-sectional study. SETTING Multiple years of Medical Expenditure Panel Survey (2002, 2004, 2006, 2008, 2010, and 2012) data. PARTICIPANTS The study sample consisted of elderly (age ≥65 years) individuals who 1) had dementia, 2) were alive during the calendar year, and 3) had co-occurring depression. MEASUREMENTS The dependent variable of this study was depression treatment, identified by antidepressant medication with or without psychotherapy use. Individual level factors associated with depression treatment among elderly individuals with dementia and co-occurring depression were evaluated by conducting multinomial logistic regression. RESULTS Co-occurring depression prevalence among community-dwelling elderly individuals with dementia was approximately 22%. An overwhelming majority (nearly 88%) of the study sample reported receipt of depression treatment. Antidepressants only and combination therapy (antidepressant with psychotherapy) was reported by 75% and 13%, respectively, of the study sample. Age, race/ethnicity, marital status, limitations of instrumental activities of daily living, perceived mental health status, and pain were significantly associated with the reporting of receipt of depression treatment. CONCLUSIONS An overwhelming majority of the study sample received depression treatment and several subgroup differences (such as in terms of age) existed in terms of reporting the use of depression treatment was observed.
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High-sensitivity neuroimaging biomarkers for the identification of amnestic mild cognitive impairment based on resting-state fMRI and a triple network model. Brain Imaging Behav 2017; 13:1-14. [DOI: 10.1007/s11682-017-9727-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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116
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Cleutjens FA, Spruit MA, Ponds RW, Vanfleteren LE, Franssen FM, Dijkstra JB, Gijsen C, Wouters EF, Janssen DJ. The Impact of Cognitive Impairment on Efficacy of Pulmonary Rehabilitation in Patients With COPD. J Am Med Dir Assoc 2017; 18:420-426. [DOI: 10.1016/j.jamda.2016.11.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 11/22/2016] [Accepted: 11/22/2016] [Indexed: 10/20/2022]
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Chen BJ, Ueberham U, Mills JD, Kirazov L, Kirazov E, Knobloch M, Bochmann J, Jendrek R, Takenaka K, Bliim N, Arendt T, Janitz M. RNA sequencing reveals pronounced changes in the noncoding transcriptome of aging synaptosomes. Neurobiol Aging 2017; 56:67-77. [PMID: 28499146 DOI: 10.1016/j.neurobiolaging.2017.04.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 03/31/2017] [Accepted: 04/08/2017] [Indexed: 12/12/2022]
Abstract
Normal aging is associated with impairments in cognitive functions. These alterations are caused by diminutive changes in the biology of synapses, and ineffective neurotransmission, rather than loss of neurons. Hitherto, only a few studies, exploring molecular mechanisms of healthy brain aging in higher vertebrates, utilized synaptosomal fractions to survey local changes in aging-related transcriptome dynamics. Here we present, for the first time, a comparative analysis of the synaptosomes transcriptome in the aging mouse brain using RNA sequencing. Our results show changes in the expression of genes contributing to biological pathways related to neurite guidance, synaptosomal physiology, and RNA splicing. More intriguingly, we also discovered alterations in the expression of thousands of novel, unannotated lincRNAs during aging. Further, detailed characterization of the cleavage and polyadenylation factor I subunit 1 (Clp1) mRNA and protein expression indicates its increased expression in neuronal processes of hippocampal stratum radiatum in aging mice. Together, our study uncovers a new layer of transcriptional regulation which is targeted by aging within the local environment of interconnecting neuronal cells.
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Affiliation(s)
- Bei Jun Chen
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Uwe Ueberham
- Paul-Flechsig-Institute for Brain Research, University of Leipzig, School of Medicine, Leipzig, Germany
| | - James D Mills
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Ludmil Kirazov
- Paul-Flechsig-Institute for Brain Research, University of Leipzig, School of Medicine, Leipzig, Germany; Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Evgeni Kirazov
- Paul-Flechsig-Institute for Brain Research, University of Leipzig, School of Medicine, Leipzig, Germany; Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Mara Knobloch
- Paul-Flechsig-Institute for Brain Research, University of Leipzig, School of Medicine, Leipzig, Germany
| | - Jana Bochmann
- Paul-Flechsig-Institute for Brain Research, University of Leipzig, School of Medicine, Leipzig, Germany
| | - Renate Jendrek
- Paul-Flechsig-Institute for Brain Research, University of Leipzig, School of Medicine, Leipzig, Germany
| | - Konii Takenaka
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicola Bliim
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Thomas Arendt
- Paul-Flechsig-Institute for Brain Research, University of Leipzig, School of Medicine, Leipzig, Germany
| | - Michael Janitz
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia.
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118
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Goodarzi Z, Ismail Z. A practical approach to detection and treatment of depression in Parkinson disease and dementia. Neurol Clin Pract 2017; 7:128-140. [PMID: 28409063 PMCID: PMC5386841 DOI: 10.1212/cpj.0000000000000351] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 02/13/2017] [Indexed: 01/11/2023]
Abstract
PURPOSE OF REVIEW To review the available evidence for the detection and management of depression in Parkinson disease (PD) and dementia. RECENT FINDINGS Depression is a common comorbidity in those with PD or dementia, and leads to increased morbidity. There are several available and accurate tools for the detection of depression in PD (e.g., Geriatric Depression Scale) and dementia (e.g., Cornell Scale for Depression in Dementia). Treatment of depression depends on patient preference, severity of depression, comorbidities, and available resources. Despite variable evidence, the use of nonpharmacologic strategies to manage depression is suggested. Pharmacologic management is guided by modest evidence in PD and dementia, but also informed by the management of late-life depression (LLD). SUMMARY There is evidence to guide the diagnosis and management of depression in PD or dementia. However, more research is required in this field to better inform clinical decision-making.
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Affiliation(s)
- Zahra Goodarzi
- Department of Medicine, Section of Geriatric Medicine (ZG), Department of Psychiatry (ZI), and Department of Clinical Neurosciences (ZI), University of Calgary and Alberta Health Services; and the Hotchkiss Brain Institute (ZI) and The Mathison Centre for Mental Health Research and Education (ZI), University of Calgary, Canada
| | - Zahinoor Ismail
- Department of Medicine, Section of Geriatric Medicine (ZG), Department of Psychiatry (ZI), and Department of Clinical Neurosciences (ZI), University of Calgary and Alberta Health Services; and the Hotchkiss Brain Institute (ZI) and The Mathison Centre for Mental Health Research and Education (ZI), University of Calgary, Canada
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119
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Goodarzi ZS, Mele BS, Roberts DJ, Holroyd-Leduc J. Depression Case Finding in Individuals with Dementia: A Systematic Review and Meta-Analysis. J Am Geriatr Soc 2017; 65:937-948. [PMID: 28152174 DOI: 10.1111/jgs.14713] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare the diagnostic accuracy of depression case finding tools with a criterion standard in the outpatient setting among adults with dementia. DESIGN Systematic review and meta-analysis. SETTING Studies of older outpatients with dementia. PARTICIPANTS Elderly outpatients (clinic and long-term care) with dementia (N = 3,035). MEASUREMENTS Prevalence of major depression and diagnostic accuracy measures including sensitivity, specificity, and likelihood ratios. RESULTS From the 11,539 citations, 20 studies were included for qualitative synthesis and 15 for a meta-analysis. Tools included were the Montgomery Åsberg Depression Rating Scale, Cornell Scale for Depression in Dementia (CSDD), Geriatric Depression Scale (GDS), Center for Epidemiologic Studies Depression Scale (CES-D), Hamilton Depression Rating Scale (HDRS), Single Question, Nijmegen Observer-Rated Depression Scale, and Even Briefer Assessment Scale-Depression. The pooled prevalence of depression in individuals with dementia was 30.3% (95% CI = 22.1-38.5). The average age was 75.2 (95% CI = 71.7-78.7), and mean Mini-Mental State Examination scores ranged from 11.2 to 24. The diagnostic accuracy of the individual tools was pooled for the best-reported cutoffs and for each cutoff, if available. The CSDD had a sensitivity of 0.84 (95% CI = 0.73-0.91) and a specificity of 0.80 (95% CI = 0.65-0.90), the 30-item GDS (GDS-30) had a sensitivity of 0.62 (95% CI = 0.45-0.76) and a specificity 0.81 (95% CI = 0.75-0.85), and the HDRS had a sensitivity of 0.86 (95% CI = 0.63-0.96) and a specificity of 0.84 (95% CI = 0.76-0.90). Summary statistics for all tools across best-reported cutoffs had significant heterogeneity. CONCLUSION There are many validated tools for the detection of depression in individuals with dementia. Tools that incorporate a physician interview with patient and collateral histories, the CSDD and HDRS, have higher sensitivities, which would ensure fewer false-negatives.
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Affiliation(s)
- Zahra S Goodarzi
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Bria S Mele
- Quest University Canada, Squamish, British Columbia, Canada
| | - Derek J Roberts
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada.,Department of Surgery, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Jayna Holroyd-Leduc
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
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120
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Ai Y, Sun K, Hu H. Bibliometric analysis of papers on mild cognitive impairment nursing in China. Int J Nurs Sci 2017; 4:73-79. [PMID: 31406722 PMCID: PMC6626079 DOI: 10.1016/j.ijnss.2016.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 08/22/2016] [Accepted: 10/31/2016] [Indexed: 11/16/2022] Open
Abstract
Purpose To supply further references by analyzing the status of research on mild cognitive impairment nursing in China. Methods Papers on mild cognitive impairment nursing published between 2005 and 2014 were collected from China National Knowledge Infrastructure, Wanfang Data, and China Biological Medicine database, while their publication dates, journals, and types were subjected to a bibliometric analysis using NoteExpress and Excel. Results A total of 68 papers were collected from the selected databases. The number of papers on mild cognitive impairment nursing increased annually. The selected papers were published in 44 journals, 55.88% of them were published in core journals, 35.29% received funding support, 35.29% were published by hospitals affiliated to colleges, 47.06% were published by other local hospitals, author collaboration is 2.66, and 66.18% showed co-authorship. These papers covered a wide range of topics, but were only conducted based on clinical interventions. Around 29.41% of these papers had a citation frequency of over 5, the highest citation frequency was 29, and the highest h-index was 23. Conclusion Beijing and Shanghai established core author groups for mild cognitive impairment nursing research. These studies should focus on the community and psychological nursing of such impairment. Targeted nursing interventions on different types of mild cognitive impairment should be adopted, new avenues for research should be opened, and various research methods should be introduced.
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Affiliation(s)
- Yating Ai
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Kaili Sun
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Hui Hu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
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121
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Rehm IC, Stargatt J, Willison AT, Reser MP, Bhar SS. Cognitive Behavioral Therapy for Older Adults With Anxiety and Cognitive Impairment: Adaptations and Illustrative Case Study. J Cogn Psychother 2017; 31:72-88. [PMID: 32755919 DOI: 10.1891/0889-8391.31.1.72] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Anxiety is a prevalent condition in older adults with neurocognitive disorders such as dementia. Interventions based on cognitive behavioral therapy (CBT) appear to be an emerging area of treatment innovation for treating anxiety in older adults with cognitive impairment. Drawing on the empirical literature on CBT for late-life anxiety and recent trials of CBT for anxiety in persons with mild-to-moderate dementia, this article provides an overview of the customization of CBT to the needs of older adults with anxiety and cognitive impairment. Adaptations for assessment, case conceptualization, socialization, therapeutic alliance, and treatment strategies are discussed. A case study to illustrate implementation of these adaptations is presented. Limitations to the current state of the literature on the efficacy and feasibility of CBT for anxiety in older adults with cognitive impairment are identified, and future directions for treatment research are proposed.
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Affiliation(s)
- Imogen C Rehm
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Jennifer Stargatt
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Aaron T Willison
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Maree P Reser
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Sunil S Bhar
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
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122
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Xiu S, Zheng Z, Guan S, Zhang J, Ma J, Chan P. Serum uric acid and impaired cognitive function in community-dwelling elderly in Beijing. Neurosci Lett 2016; 637:182-187. [PMID: 27890742 DOI: 10.1016/j.neulet.2016.11.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 10/12/2016] [Accepted: 11/02/2016] [Indexed: 01/05/2023]
Abstract
The relationship between serum uric acid (sUA) and cognitive function is contradictory. This study assessed the association between sUA and cognitive impairment in 10,039 community-dwelling subjects aged ≥55years living in Beijing, China. Participants underwent determination of sUA and an evaluation of cognitive function using the scholarship-adjusted Mini-Mental State Examination (MMSE): MMSE ≤17 for illiterates; MMSE≤20 for primary school graduates (≥6years of education); and MMSE≤24 for junior school graduates or above (≥9years of education). Among the 10016 persons with valid MMSE scores, the prevalence of cognitive impairment was 9.14%. A multivariate logistic regression model including demographic, clinical and genetic parameters was performed to assess the relationship between sUA and cognitive impairment. Persons with cognitive impairment had lower sUA levels than those with normal cognitive function: (302.30±82.80 vs. 312.20±84.01μmol/L, p=0.001). After adjusting for age, sex, lifestyle, relevant diseases and the apolipoprotein E (APOE) ε4 allele, stepwise logistic regression showed that participants with higher levels of sUA had a lower risk of cognitive impairment (hazard ratio (HR): 0.78; 95% confidence interval (CI): 0.62-0.96; p=0.022). In this baseline cross-sectional population-based sample, high levels of sUA were associated with a decreased risk of cognitive impairment.
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Affiliation(s)
- Shuangling Xiu
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China; Department of Geriatrics, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Zheng Zheng
- Department of Neurobiology, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China; Department of Geriatrics, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China; Parkinson's Disease Center of Beijing Institute for Brain Disorders, Beijing 100053, China; Key Laboratory on Neurodegenerative Disease of Ministry of Education, Beijing 100053, China; Beijing Key Laboratory for Parkinson's Disease, Beijing 100053, China
| | - Shaochen Guan
- Evidence-Based Medicine Center, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
| | - Jin Zhang
- Department of Neurobiology, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China; Department of Geriatrics, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Jinghong Ma
- Department of Neurology, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Piu Chan
- Department of Neurobiology, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China; Department of Geriatrics, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China; Department of Neurology, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China; Parkinson's Disease Center of Beijing Institute for Brain Disorders, Beijing 100053, China; Key Laboratory on Neurodegenerative Disease of Ministry of Education, Beijing 100053, China; Beijing Key Laboratory for Parkinson's Disease, Beijing 100053, China.
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123
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Lamotte G, Shah RC, Lazarov O, Corcos DM. Exercise Training for Persons with Alzheimer's Disease and Caregivers: A Review of Dyadic Exercise Interventions. J Mot Behav 2016; 49:365-377. [PMID: 27870597 DOI: 10.1080/00222895.2016.1241739] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Alzheimer's disease (AD) is the most common form of dementia and the prevalence will increase dramatically in the next decades. Although exercise has shown benefits for people with dementia due to AD as well as their caregivers, the impact of a dyadic exercise intervention including both groups as study participants remains to be determined. The authors review the current clinical evidence for dyadic exercise interventions, which are exercise regimens applied to both the person with dementia and the caregiver. A total of 4 controlled trials were reviewed. This review shows that dyadic exercise interventions are feasible and may produce a positive effect on functional independence and caregiver burden. However, there was insufficient evidence to support a benefit of dyadic exercise intervention on cognitive performance and on behavioral and neuropsychiatric symptoms in participants with dementia due to AD. A dyadic exercise intervention improves functional independence and caregiver burden. However, there is a need for well-designed randomized controlled clinical trials to confirm these benefits and to investigate several important points such as the effects of a dyadic exercise intervention on cognitive and noncognitive outcomes of AD, the optimal intensity of exercise training, and the cost effectiveness of such a program.
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Affiliation(s)
- Guillaume Lamotte
- a Department of Neurology , MedStar Georgetown University Hospital , Washington , DC
| | - Raj C Shah
- b Rush Alzheimer's Disease Center, Rush University , Chicago , Illinois
| | - Orly Lazarov
- c Department of Anatomy and Cell Biology , College of Medicine, The University of Illinois at Chicago , Chicago , Illinois
| | - Daniel M Corcos
- d Department of Physical Therapy and Human Movement Sciences , Feinberg School of Medicine, Northwestern University , Chicago , Illinois.,e Department of Neurological Sciences , Rush University Medical Center , Chicago , Illinois
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Abstract
Since anxiety in patients with dementia is a complex, understudied phenomenon, this paper presents clinicians' experiences of anxiety in this population. Semi-structured interviews were conducted with seven clinicians experienced with dementia in elderly patients (65 years and above), and then evaluated via qualitative content analysis. Analysis revealed three main categories: A reaction to loss and worries, symptoms of anxiety and depression interfere with each other, and anxiety in dementia-a multidisciplinary task. Anxiety in this population is perhaps best understood as a reaction to loss and worries, and existential in nature by the participants. Care interventions can reduce or prevent anxiety symptoms in this population. However, when anxiety co-exists with depression it might be difficult to attenuate these symptoms through care measures alone. To better identify and treat the condition, valid dementia-specific anxiety-screening instruments are necessary.
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Affiliation(s)
- Alka R Goyal
- Section of Old Age Psychiatry, Vestre Viken Hospital trust, Norway; Norwegian National Advisory Unit on Aging and Health, Norway; Centre of Old Age Psychiatry Research, Innlandet Hospital Trust, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Aging and Health, Norway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Aging and Health, Norway
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125
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Ułamek-Kozioł M, Czuczwar SJ, Pluta R. Nutrients and mild cognitive impairment: Food for thought. Nutrition 2016; 32:910-2. [DOI: 10.1016/j.nut.2016.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 01/04/2016] [Accepted: 01/08/2016] [Indexed: 11/28/2022]
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126
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Ford AH, Almeida OP. Psychological treatment for depression and anxiety associated with dementia and mild cognitive impairment. Br J Psychiatry 2015; 207:286-7. [PMID: 26429681 DOI: 10.1192/bjp.bp.115.166595] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Depression and anxiety are commonly associated with cognitive impairment. A systematic review of psychological treatments that appears in this issue of the Journal highlights the current paucity of good-quality data, but suggests these interventions hold promise. Given the increasing burden of dementia in our community, novel adequately powered randomised controlled trials in this area are urgently needed.
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Affiliation(s)
- Andrew H Ford
- Andrew H. Ford, MBChB, FRANZCP, PhD, Osvaldo P. Almeida, MD, FRANZCP, PhD, WA Centre for Health & Ageing, Centre for Medical Research and School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia
| | - Osvaldo P Almeida
- Andrew H. Ford, MBChB, FRANZCP, PhD, Osvaldo P. Almeida, MD, FRANZCP, PhD, WA Centre for Health & Ageing, Centre for Medical Research and School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia
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