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Klůzová Kráčmarová L, Černíková KA, Stolaríková K, Kisvetrová H. Perceptions of dignity in home-dwelling patients with early-stage dementia through the lens of the Patient Dignity Inventory: a longitudinal study. Aging Ment Health 2024:1-9. [PMID: 39084246 DOI: 10.1080/13607863.2024.2381808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 07/10/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVES Dignity of patients with early-stage dementia (PwESD) is a core value of person-centered care. To evaluate the effectiveness of the intervention programs targeted at this population, a reliable tool that would measure dignity in PwESD is needed. Based on a qualitative analysis of how PwESD perceive and experience dignity, this study aims to determine the adequacy of the Czech version of the Patient Dignity Inventory (PDI-CZ) for this patient population. METHOD The sample from two outpatient clinics in Czechia included home-dwelling individuals aged 60 years or older with mild dementia. In the first interview (T1), there were 21 respondents; 10 of whom participated in the second interview (T2) that was conducted after 12 months. The qualitative material was analyzed using a deductive approach based on the PDI-CZ domains. RESULTS Thematic analysis shows that the PwESD thematized all domains of the PDI-CZ in their interviews and their views of dignity were stable over time. Some experiences were not considered in the PDI-CZ (such as lowered support of the society, lowered ability to advocate for oneself, or feeling of not suitable living conditions). CONCLUSION When developing a revised version of the tool, items that reflect missing views of dignity should be included.
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Affiliation(s)
- Lucie Klůzová Kráčmarová
- Olomouc University Social Health Institute, Sts. Cyril and Methodius Faculty of Theology, Palacky University Olomouc, Olomouc, Czech Republic
| | - Kristýna A Černíková
- The Department of Christian Education, Sts. Cyril and Methodius Faculty of Theology, Palacky University Olomouc, Olomouc, Czech Republic
| | | | - Helena Kisvetrová
- Centre for Research and Science, Faculty of Health Sciences, Palacky University Olomouc, Olomouc, Czech Republic
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Griffith EE, Robbins PA, Ferede BT, Bentley-Edwards KL. Religious participation is associated with fewer dementia diagnoses among Black people in the United States. Am J Hum Biol 2024:e24125. [PMID: 38940191 DOI: 10.1002/ajhb.24125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 05/17/2024] [Accepted: 06/19/2024] [Indexed: 06/29/2024] Open
Abstract
INTRODUCTION Black people had the highest prevalence of Alzheimer's disease and related dementias (ADRD) of any racial/ethnic group in the United States (US) as of 2020. As racial disparities in the prevalence of ADRD are being investigated, more evidence is necessary to determine the pathways and mechanisms that either slow ADRD progression or improve quality of life for those affected. Religion/spirituality (R/S) has been shown to affect health outcomes but has rarely been studied as a possible pathway for reducing ADRD risk. Crucially, Black people also report higher levels of R/S than other racial/ethnic groups in the United States. This research asks if R/S affects ADRD risk among Black adults and if any effects persist after controlling for hypertension. METHODS We conducted a secondary data analysis drawing from the Health and Retirement Study (HRS), a nationally representative longitudinal dataset with an oversampling of Black adults. RESULTS We used logistic regression analysis to demonstrate how R/S has an ameliorating impact on ADRD risk among Black people, even after controlling for hypertension. Those who never attended religious services had 2.37 higher odds of being diagnosed with ADRD than those who attended more than once a week. Further, as R/S attendance increased, ADRD risk decreased linearly. CONCLUSION These findings demonstrate the importance that existing cultural networks (e.g., R/S) can have for reducing ADRD burden for Black people and has important implications for the role of R/S in shaping ADRD symptomatology.
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Affiliation(s)
- Eric E Griffith
- Center for the Study of Aging and Human Development, Duke University, Durham, USA
- Samuel Dubois Cook Center on Social Equity, Duke University, Durham, USA
| | - Paul A Robbins
- Samuel Dubois Cook Center on Social Equity, Duke University, Durham, USA
- Department of Human Development and Family Science, Purdue University, West Lafayette, USA
| | - Bethlehem T Ferede
- Samuel Dubois Cook Center on Social Equity, Duke University, Durham, USA
| | - Keisha L Bentley-Edwards
- Samuel Dubois Cook Center on Social Equity, Duke University, Durham, USA
- Department of Medicine, Duke University, Durham, USA
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Slachevsky A, Grandi F, Thumala D, Baez S, Santamaria-García H, Schmitter-Edgecombe M, Parra MA. A Multidimensional, Person-Centered Framework for Functional Assessment in Dementia: Insights from the 'What', 'How', 'To Whom', and 'How Much' Questions. J Alzheimers Dis 2024; 99:1187-1205. [PMID: 38758997 PMCID: PMC11178450 DOI: 10.3233/jad-230376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
Dementia is a syndrome characterized by cognitive and neuropsychiatric symptoms associated with progressive functional decline (FD). FD is a core diagnostic criterion for dementia, setting the threshold between its prodromal stages and the full-blown disease. The operationalization of FD continues to generate a great deal of controversy. For instance, the threshold of FD for the diagnosis of dementia varies across diagnostic criteria, supporting the need for standardization of this construct. Moreover, there is a need to reconsider how we are measuring FD to set boundaries between normal aging, mild cognitive impairment, and dementia. In this paper, we propose a multidimensional framework that addresses outstanding issues in the assessment of FD: i) What activities of daily living (ADLs) are necessary to sustain an independent living in aging? ii) How to assess FD in individuals with suspected neurocognitive disorders? iii) To whom is the assessment directed? and iv) How much does FD differentiate healthy aging from mild and major neurocognitive disorders? Importantly, the To Whom Question introduces a person-centered approach that regards patients and caregivers as active agents in the assessment process of FD. Thus, once impaired ADLs have been identified, patients can indicate how significant such impairments are for them in daily life. We envisage that this new framework will guide future strategies to enhance functional assessment and treatment of patients with dementia and their caregivers.
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Affiliation(s)
- Andrea Slachevsky
- Gerosciences Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN) Neurology Department, Hospital del Salvador & Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department – ICBM, Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Providencia, Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Fabrissio Grandi
- Gerosciences Center for Brain Health and Metabolism (GERO), Santiago, Chile
- School of Psychology, Universidad de los Andes, Santiago, Chile
| | - Daniela Thumala
- Gerosciences Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Psychology Department, Faculty of Social Sciences, Universidad de Chile, Santiago, Chile
| | - Sandra Baez
- Universidad de los Andes, Bogotá, Colombia
- Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), Trinity College Dublin (TCD), Dublin, Ireland
| | - Hernando Santamaria-García
- Pontificia Universidad Javeriana, PhD Program of Neuroscience, Bogotá, Colombia
- Center for Brain and Memory Intellectus. Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Maureen Schmitter-Edgecombe
- Herbert L. Eastlick Distinguished Professor in the Department of Psychology, Washington State University, Pullman, WA, USA
| | - Mario A. Parra
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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Toso F, Brankaert R, Hendriks N, Lenaerts L, Wilkinson A. Reflecting on Living Labs as Multi-Stakeholder Collaborative Networks to Evaluate Technological Products for People Living with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1673. [PMID: 36767050 PMCID: PMC9914846 DOI: 10.3390/ijerph20031673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/30/2022] [Accepted: 01/04/2023] [Indexed: 06/18/2023]
Abstract
Dementia is a growing societal challenge putting pressure on care systems across Europe. Providing supporting technology for people living with dementia, referring to both people with dementia and their caregivers, is an important strategy to alleviate pressure. In this paper, we present lessons learned from the Interreg NWE Project Certification-D, in which we evaluated technological products with people living with dementia, using a Living Lab approach. Living Labs were set up in five different countries to conduct field evaluations at the homes of people living with dementia. Via an open call products from small to medium enterprises across northwestern Europe were selected to be evaluated in the Living Labs. In this paper, we describe the setup of and reflection on Living Labs as multi-stakeholder collaboration networks to evaluate technological products in the context of dementia. We reflect on the experiences and insights from the Living Lab researchers to execute and operate the Living Labs in such a sensitive setting. Our findings show that Living Labs can be used to conduct field evaluations of products, that flexibility is required to adopt a Living Lab in various care settings with different stakeholder compositions and expertise, and that Living Lab researchers serve as both a linking pin and buffer between people living with dementia and companies and thereby support the adoption of technological products. We close the paper with a proposal of best practices to encourage inclusivity in, and scalability of, Living Labs in the context of dementia.
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Affiliation(s)
- Francesca Toso
- Human Centred Design (HCD) Group, Department of Design, Production and Management, Faculty of Engineering Technology (ET), University of Twente, Horst Complex, 7522 LV Enschede, The Netherlands
- Systemic Change Group, Department of Industrial Design, Eindhoven University of Technology, Atlas Building, 5612 AE Eindhoven, The Netherlands
| | - Rens Brankaert
- Systemic Change Group, Department of Industrial Design, Eindhoven University of Technology, Atlas Building, 5612 AE Eindhoven, The Netherlands
- Health Innovations & Technology, Fontys School of Allied Health Professions, Dominee Theodor Fliednerstraat 2, 5631 BN Eindhoven, The Netherlands
| | - Niels Hendriks
- Interactions Research Group, LUCA School of Arts, C-Mine 5, 3600 Genk, Belgium
| | - Lieke Lenaerts
- Interactions Research Group, LUCA School of Arts, C-Mine 5, 3600 Genk, Belgium
| | - Andrea Wilkinson
- Interactions Research Group, LUCA School of Arts, C-Mine 5, 3600 Genk, Belgium
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Zimmerman S, Fazio S. Measurement to improve care and outcomes for persons with Alzheimer's disease and dementia. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12359. [PMID: 36226047 PMCID: PMC9530694 DOI: 10.1002/trc2.12359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Sheryl Zimmerman
- Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Sam Fazio
- Alzheimer's AssociationChicagoIllinoisUSA
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Huizenga J, Scheffelaar A, Fruijtier A, Wilken JP, Bleijenberg N, Van Regenmortel T. Everyday Experiences of People Living with Mild Cognitive Impairment or Dementia: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10828. [PMID: 36078544 PMCID: PMC9518176 DOI: 10.3390/ijerph191710828] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/23/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
Increasing attention has been paid to the 'voice' of people living with mild cognitive impairment (MCI) or dementia, but there is a lack of clarity about how everyday life is perceived from this insider's perspective. This study aimed to explore the everyday life experiences, challenges and facilitators of individuals with MCI and dementia living at home. A scoping review of qualitative studies, guided by the Joanna Briggs Institute Reviewers Manual, was conducted. Eight databases were searched, resulting in 6345 records, of which 58 papers published between 2011 and 2021 were included. Analysis was carried out by descriptive content analysis. Findings were categorized into seven spheres of everyday life: experiences related to the condition, self, relationships, activities, environment, health and social care and public opinions. The results show many disruptions and losses in everyday life and how people try to accommodate these changes. In all areas of everyday life, people show a deep desire to have reciprocal relationships, stay engaged through participation in activities and have a sense of belonging in the community. However, more research is needed on the factors that promote and impede the sense of reciprocity and belonging.
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Affiliation(s)
- Jacoba Huizenga
- Institute of Social Work, HU University of Applied Sciences Utrecht, 3507 LC Utrecht, The Netherlands
- Research Center Social Innovation, HU University of Applied Sciences Utrecht, 3507 LC Utrecht, The Netherlands
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands
| | - Aukelien Scheffelaar
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands
| | - Agnetha Fruijtier
- Research Center Social Innovation, HU University of Applied Sciences Utrecht, 3507 LC Utrecht, The Netherlands
| | - Jean Pierre Wilken
- Research Center Social Innovation, HU University of Applied Sciences Utrecht, 3507 LC Utrecht, The Netherlands
| | - Nienke Bleijenberg
- Research Center Healthy & Sustainable Living, HU University of Applied Sciences Utrecht, 3507 LC Utrecht, The Netherlands
- Department Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Tine Van Regenmortel
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands
- HIVA—Research Institute for Work and Society, Faculty of Social Sciences, University of Leuven, B-3000 Leuven, Belgium
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