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Gibson LL, Weintraub D, Lemmen R, Perera G, Chaudhuri KR, Svenningsson P, Aarsland D. Risk of Dementia in Parkinson's Disease: A Systematic Review and Meta-Analysis. Mov Disord 2024. [PMID: 39036849 DOI: 10.1002/mds.29918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/17/2024] [Accepted: 06/24/2024] [Indexed: 07/23/2024] Open
Abstract
Estimates of the risk of dementia in Parkinson's disease (PDD) vary widely. We aimed to review the incidence of PDD and in a meta-analysis estimate the pooled annual incidence and relative risk of PDD while also exploring factors that may contribute to heterogeneity between studies. Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed and MEDLINE and EMBASE were searched for articles reporting the number of cases of dementia in a population, followed longitudinally, with a minimum of 100 dementia-free Parkinson's disease (PD) patients at baseline. Meta-analyses and meta-regressions were used to estimate the pooled incidence rate of PDD and the relative risk of PDD versus healthy controls (HC). A total of 32 studies were identified, 25 reporting the incidence of PDD and 10 reporting the relative risk of PDD versus HC. The pooled incidence rate of PDD was 4.45 (95% confidence interval [CI], 3.91-4.99) per 100 person-years at risk, equating to a 4.5% annual risk of dementia in a PD prevalent population. The relative risk of PDD was estimated to be 3.25 (95% CI, 2.62-4.03) times greater than HC. Factors contributing to study heterogeneity and disparities in the estimated risk of PDD include the age of patients, year of recruitment, and study location. Significant gaps remain with no studies identified in several geographical regions. Future studies should stratify by age and standardize reporting to reduce overall heterogeneity. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Lucy L Gibson
- Centre for Healthy Brain Ageing, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Daniel Weintraub
- Department of Psychiatry and Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
- Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Roos Lemmen
- Centre for Healthy Brain Ageing, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Gayan Perera
- Centre for Healthy Brain Ageing, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Kallol Ray Chaudhuri
- Department of Basic and Clinical Neuroscience, Parkinson Foundation International Centre of Excellence, Kings College Hospital and Kings College London, London, UK
| | - Per Svenningsson
- Basic and Clinical Neuroscience, King's College London, London, UK
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Dag Aarsland
- Centre for Healthy Brain Ageing, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
- Centre for Age-Related Disease, Stavanger University Hospital, Stavanger, Norway
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Dreo J, Jug J, Pavlovčič T, Ogrin A, Demšar A, Aljaž B, Agatić F, Marusic U. Comparative Performance of Five Cognitive Screening Tests in a Large Sample of Seniors. Dement Geriatr Cogn Disord 2024:1-10. [PMID: 39008953 DOI: 10.1159/000540225] [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: 01/08/2024] [Accepted: 07/02/2024] [Indexed: 07/17/2024] Open
Abstract
INTRODUCTION Recent introductions of disease-modifying treatments for Alzheimer's disease have re-invigorated the cause of early dementia detection. Cognitive "paper and pencil" tests represent the bedrock of clinical assessment, because they are cheap, easy to perform, and do not require brain imaging or biological testing. Cognitive tests vary greatly in duration, complexity, sociolinguistic biases, probed cognitive domains, and their specificity and sensitivity of detecting cognitive impairment (CI). Consequently, an ecologically valid head-to-head comparison seems essential for evidence-based dementia screening. METHOD We compared five tests: Montreal cognitive assessment (MoCA), Alzheimer's disease assessment scale-cognitive subscale (ADAS), Addenbrooke's cognitive examination (ACE-III), euro-coin handling test (Eurotest), and image identification test (Phototest) on a large sample of seniors (N = 456, 77.9 ± 8 years, 71% females). Their specificity and sensitivity were estimated in a novel way by contrasting each test's outcome to the majority outcome across the remaining tests (comparative specificity and sensitivity calculation [CSSC]). This obviates the need for an a priori gold standard such as a clinically clear-cut sample of dementia/MCI/controls. We posit that the CSSC results in a more ecologically valid estimation of clinical performance while precluding biases resulting from different dementia/MCI diagnostic criteria and the proficiency in detecting these conditions. RESULTS There exists a stark trade-off between behavioral test specificity and sensitivity. The test with the highest specificity had the lowest sensitivity, and vice versa. The comparative specificities and sensitivities were, respectively: Phototest (97%, 47%), Eurotest (94%, 55%), ADAS (90%, 68%), ACE-III (72%, 77%), MoCA (55%, 95%). CONCLUSION Assuming a CI prevalence of 10%, the shortest (∼3 min) and the simplest instrument, the Phototest, was shown to have the best overall performance (accuracy 92%, PPV 66%, NPV 94%).
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Affiliation(s)
| | - Jan Jug
- BrainTrip, Ljubljana, Slovenia
| | | | | | | | - Barbara Aljaž
- BrainTrip, Ljubljana, Slovenia
- Faculty of Computer Science, University of Ljubljana, Ljubljana, Slovenia
| | | | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea University, Maribor, Slovenia
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Chen CYA, Chiu CC, Huang CY, Cheng YC, Huang MC, Kuo PH, Chen WY. Cluster analysis dissecting cognitive deficits in older adults with major depressive disorder and the association with neurofilament light chain. BMC Geriatr 2024; 24:344. [PMID: 38627748 PMCID: PMC11020442 DOI: 10.1186/s12877-024-04960-z] [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] [Received: 08/30/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Cognitive impairment is a growing problem with increasing burden in global aging. Older adults with major depressive disorder (MDD) have higher risk of dementia. Neurofilament light chain (NfL) has been proven as a potential biomarker in neurodegenerative disease, including dementia. We aimed to investigate the association between cognitive deficits and NfL levels in older adults with MDD. METHODS In this cross-sectional study, we enrolled 39 MDD patients and 15 individuals with mild neurocognitive disorder or major neurocognitive disorder, Alzheimer's type, as controls, from a tertiary psychiatric hospital. Both groups were over age 65 and with matched Mini-Mental State Examination (MMSE) score. Demographic data, clinical variables, and plasma NfL levels were obtained. We used cluster analysis according to their cognitive profile and estimated the correlation between plasma NfL levels and each cognitive domain. RESULTS In the MDD group, participants had higher rate of family psychiatry history and current alcohol use habit compared with controls. Control group of neurocognitive disorders showed significantly lower score in total MMSE and higher plasma NfL levels. Part of the MDD patients presented cognitive deficits clustered with that of neurocognitive disorders (cluster A). In cluster A, the total MMSE score (r=-0.58277, p=0.0287) and the comprehension domain (r=-0.71717, p=0.0039) were negatively correlated to NfL levels after adjusting for age, while the associations had not been observed in the other cluster. CONCLUSIONS We noted the negative correlation between NfL levels and cognition in MDD patients clustered with neurodegenerative disorder, Alzheimer's type. NfL could be a promising candidate as a biomarker to predict subtype of patients in MDD to develop cognitive decline. Further longitudinal studies and within MDD cluster analysis are required to validate our findings for clinical implications.
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Affiliation(s)
- Cynthia Yi-An Chen
- Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chih-Chiang Chiu
- Department of Psychiatry, Taipei City Psychiatric Center, Songde branch, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cho-Yin Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Songde branch, Taipei City Hospital, Taipei, Taiwan
| | - Ying-Chih Cheng
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan
| | - Ming-Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Songde branch, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Wen-Yin Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Songde branch, Taipei City Hospital, Taipei, Taiwan.
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan.
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Zuin M, Brombo G, Polastri M, Romagnoli T, Cervellati C, Zuliani G. Variability in Alzheimer's disease mortality from European vital statistics, 2012-2020. Int J Geriatr Psychiatry 2024; 39:e6068. [PMID: 38429957 DOI: 10.1002/gps.6068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/06/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Data regarding the trends in Alzheimer's disease (AD) mortality in the modern European Union (EU-27) member states are lacking. We assess the sex- and age-specific trends in AD mortality in the EU-27 member states between years 2012 and 2020. METHODS Data on cause-specific deaths and population numbers by sex for each country of the EU-27 were retrieved through publicly available European Statistical Office (EUROSTAT) dataset from 2012 to 2020. AD-related deaths were ascertained when the ICD-10 code G30 was listed as the primary cause of death in the medical death certificate. To calculate annual trends, we assessed the average annual percent change (AAPC) with relative 95% confidence intervals (CIs) using Joinpoint regression. RESULTS During the study period, 751,493 deaths (1.7%, 233,271 males and 518,222 females) occurred in the EU-27 because of AD. Trends in the proportion of AD-related deaths per 1000 total deaths slightly increased from 16.8% to 17.5% (p for trend <0.001). The age-adjusted mortality rate was higher in women over the entire study period. Joinpoint regression analysis revealed a stagnation in age-adjusted AD-related mortality from 2012 to 2020 among EU-27 Member States (AAMR: -0.1% [95% CI: -1.8-1.79], p = 0.94). Stratification by Country showed relevant regional disparities, especially in the Northern and Eastern EU-27 member states. CONCLUSIONS Over the last decade, the age-adjusted AD-related mortality rate has plateaued in EU-27. Important disparities still exist between Western and Eastern European countries.
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Affiliation(s)
- Marco Zuin
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Gloria Brombo
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Michele Polastri
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Tommaso Romagnoli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Carlo Cervellati
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Giovanni Zuliani
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
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Delgado-Álvarez A, Delgado-Alonso C, Valles-Salgado M, Gil-Moreno MJ, Fernández-Romero L, Matías-Guiu J, Matias-Guiu JA. Normative Data in Cross-Cultural Neuropsychological Instruments in Spaniards and Colombians Living in Spain. J Alzheimers Dis 2023; 96:1231-1241. [PMID: 37927267 DOI: 10.3233/jad-230866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
BACKGROUND Cross-Cultural Dementia Screening (CCD), Rowland Universal Dementia Assessment Scale (RUDAS), and European Cross-cultural Neuropsychological Test Battery (CNTB) are three novel neuropsychological instruments developed from a cross-cultural perspective to reduce the impact of culture in cognitive assessment and improve the assessment in diverse populations. OBJECTIVE We aimed to collect and present normative data on these tests in a majority population sample (Spaniards living in Spain) and in a minority population sample (Colombians living in Spain). METHODS CCD, RUDAS, and CNTB were administered to a group of 300 cognitively healthy participants (150 Spaniards and 150 Colombians). Linear regression modeling strategy was used to provide adjusted norms for demographic factors and to explore the influence of these factors on test performance. RESULTS Most of the CCD and CNTB scores were predicted by age and years of education, with some tests only predicted by age or showing a ceiling effect. The comparison of normative data between the two samples confirmed the favorable cross-cultural properties of these instruments, with only some differences in processing speed and executive functioning scores. CONCLUSIONS Our study finds a comparable influence of demographic factors in both populations on the performance of CCD, RUDAS, and CNTB, confirming their adequate cross-cultural properties. We provide normative data for these tests in Spaniards and Colombians living in Spain.
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Affiliation(s)
- Alfonso Delgado-Álvarez
- Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Madrid, Spain
- Department of Biological and Health Psychology, Faculty of Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Cristina Delgado-Alonso
- Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Madrid, Spain
| | - María Valles-Salgado
- Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Madrid, Spain
| | - María José Gil-Moreno
- Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Madrid, Spain
| | - Lucía Fernández-Romero
- Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Madrid, Spain
| | - Jorge Matías-Guiu
- Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Madrid, Spain
| | - Jordi A Matias-Guiu
- Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Madrid, Spain
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Conte FP, Okely JA, Hamilton OK, Corley J, Page D, Redmond P, Taylor AM, Russ TC, Deary IJ, Cox SR. Cognitive Change Before Old Age (11 to 70) Predicts Cognitive Change During Old Age (70 to 82). Psychol Sci 2022; 33:1803-1817. [PMID: 36113037 PMCID: PMC9660354 DOI: 10.1177/09567976221100264] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Identifying predictors of cognitive decline in old age helps us understand its mechanisms and identify those at greater risk. Here, we examined how cognitive change from ages 11 to 70 is associated with cognitive change at older ages (70 to 82 years) in the Lothian Birth Cohort 1936 longitudinal study (N = 1,091 at recruitment). Using latent-growth-curve models, we estimated rates of change from ages 70 to 82 in general cognitive ability (g) and in three cognitive domains: visuospatial, memory, and processing speed. We found that g accounted for 71.3% of interindividual change variance. Greater cognitive gain from ages 11 to 70 predicted slower decline in g over 12 subsequent years (β = 0.163, p = .001), independently of cognitive level in childhood and at age 70, and domain-specific change beyond g. These results contribute to the goal of identifying people at higher risk of age-related cognitive decline.
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Affiliation(s)
- Federica P. Conte
- Department of Psychology, University of
Milano-Bicocca
- Lothian Birth Cohorts Group, The
University of Edinburgh
- Federica P. Conte, University of
Milano-Bicocca, Department of Psychology
| | - Judith A. Okely
- Lothian Birth Cohorts Group, The
University of Edinburgh
- Department of Psychology, The
University of Edinburgh
| | - Olivia K. Hamilton
- Lothian Birth Cohorts Group, The
University of Edinburgh
- Department of Psychology, The
University of Edinburgh
| | - Janie Corley
- Lothian Birth Cohorts Group, The
University of Edinburgh
- Department of Psychology, The
University of Edinburgh
| | - Danielle Page
- Lothian Birth Cohorts Group, The
University of Edinburgh
- Department of Psychology, The
University of Edinburgh
| | - Paul Redmond
- Lothian Birth Cohorts Group, The
University of Edinburgh
- Department of Psychology, The
University of Edinburgh
| | - Adele M. Taylor
- Lothian Birth Cohorts Group, The
University of Edinburgh
- Department of Psychology, The
University of Edinburgh
| | - Tom C. Russ
- Lothian Birth Cohorts Group, The
University of Edinburgh
- Alzheimer Scotland Dementia Research
Centre, The University of Edinburgh
- Division of Psychiatry, Centre for
Clinical Brain Sciences, The University of Edinburgh
| | - Ian J. Deary
- Lothian Birth Cohorts Group, The
University of Edinburgh
- Department of Psychology, The
University of Edinburgh
| | - Simon R. Cox
- Lothian Birth Cohorts Group, The
University of Edinburgh
- Department of Psychology, The
University of Edinburgh
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Riedel O, Braitmaier M, Langner I. Dementia in health claims data: The influence of different case definitions on incidence and prevalence estimates. Int J Methods Psychiatr Res 2022:e1947. [PMID: 36168670 DOI: 10.1002/mpr.1947] [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: 07/02/2022] [Revised: 09/07/2022] [Accepted: 09/16/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The epidemiology of dementia subtypes including Alzheimer's disease (AD) and vascular dementia (VD) and their reliance on different case definitions ("algorithms") in health claims data are still understudied. METHODS Based on health claims data, prevalence estimates (per 100 persons), incidence rates (IRs, per 100 person-years), and proportions of AD, VD, and other dementias (oD) were calculated. Five algorithms of increasing strictness considered inpatient/outpatient diagnoses (#1, #2), antidementia drugs (#3) or supportive diagnostics (#4, #5). RESULTS Algorithm 1 detected 213,409 cases (#2: 197,400; #3: 48,688; #4: 3033; #5: 3105), a prevalence for any dementia of 3.44 and an IR of 1.39 (AD: 0.80/0.21, VD: 0.79/0.31). The prevalence decreased by algorithms for any dementia (#2: 3.19; #3: 0.75; #4: 0.04; #5: 0.05) as did IRs (#2: 1.13; #3: 0.18; #4: 0.05, #5: 0.05). Algorithms 1-2, and 4-5 revealed similar proportions of AD (23.3%-26.6%), VD (19.9%-23.2%), and oD (53.1%-53.8%), algorithm 3 estimated 45% (AD), 12.1% (VD), and 43.0% (oD). CONCLUSIONS Health claims data show lower estimates of AD than previously reported, due to markedly lower prevalent/incident proportions of patients with corresponding codes. Using medication in defining dementia potentially improves estimating the proportion of AD while supportive diagnostics were of limited use.
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Affiliation(s)
- Oliver Riedel
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Malte Braitmaier
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Ingo Langner
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
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Ge T, Yuan Y. Herpes Simplex Virus Infection Increases Beta-Amyloid Production and Induces the Development of Alzheimer's Disease. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8804925. [PMID: 36093396 PMCID: PMC9453006 DOI: 10.1155/2022/8804925] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/30/2022]
Abstract
Background Alzheimer's disease, a neurodegenerative memory disease, primarily results from the formation of amyloid plaques (Aβ) that gradually inhibit neuron communications. The entire mechanism of Aβ production remains unclear to date, and it is of particular interest among scientists to find out the exact mechanism that leads to amyloid precursor protein (APP) cleavage through the amyloidogenic pathway so that effective treatments can be developed. Method 2 sets of experiments with the use of human H4-N cell lines are proposed to fully investigate the validity of the hypothesis. All of the experiments would involve immunoblotting of Aβ using an anti-Aβ antibody, and the results would be analyzed with the assistance of an image analyzer. A significant amount of Aβ would be expected to be present in the cytoplasm of cells with herpes simplex virus (HSV-1) applied, as APP endocytosis would be induced by HSV-1, which leads to higher Aβ levels inside the cell. Results In this paper, a new hypothesis is presented on how HSV-1 infection initiates APP endocytosis and causes an increase in APP cleavage and Aβ production inside the cells. It is also hypothesized that increased Aβ peptides exit the cell via exocytosis, therefore, leading to the development of Alzheimer's disease. The findings will support the hypothesis if intracellular Aβ concentration is significantly higher after the introduction of dHSV-1 and subsequently if extracellular Aβ concentration becomes higher without TeNT exocytosis inhibition. Conclusion The results of this study would provide valuable insights into the mechanisms underlying Alzheimer's disease and open new scopes of research for its potential treatments. Further studies on virus infection and the development of memory diseases should be conducted to investigate possible correlations.
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Affiliation(s)
- Tianfang Ge
- Canadian International School, Singapore, Singapore 649414
| | - Yufei Yuan
- Department of Systems Pharmacology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
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Gamble LD, Matthews FE, Jones IR, Hillman AE, Woods B, Macleod CA, Martyr A, Collins R, Pentecost C, Rusted JM, Clare L. Characteristics of people living with undiagnosed dementia: findings from the CFAS Wales study. BMC Geriatr 2022; 22:409. [PMID: 35538522 PMCID: PMC9088129 DOI: 10.1186/s12877-022-03086-4] [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: 02/03/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background Many people living with dementia remain undiagnosed, with diagnosis usually occurring long after signs and symptoms are present. A timely diagnosis is important for the wellbeing of the person living with dementia and the family, allowing them to plan and have access to support services sooner. The aim of this study was to identify demographic characteristics and neuropsychiatric symptoms associated with being undiagnosed, which may help clinicians be more aware of signs that could be indicative of early-stage or undetected dementia. Methods This cross-sectional study uses data from waves 1 and 2 (two years apart) of the Cognitive Function and Ageing Studies Wales (CFAS Wales). CFAS Wales participants were included who had a study assessment of dementia, as determined by the Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT) algorithm and by expert assessment, and who had had their primary care records checked for a clinical diagnosis of dementia. We identified 19 people with a diagnosis of dementia and 105 people living with undiagnosed dementia, and explored demographic characteristics and the presence or absence of a range of neuropsychiatric symptoms in the undiagnosed population using logistic regression. Results Findings suggest that people living with dementia who have better cognition, have more years of education, or live in more deprived areas are less likely to have a diagnosis. In terms of neuropsychiatric symptoms, depression and sleep problems were associated with being undiagnosed. Apathy was common across all people living with dementia, but those with a diagnosis were more likely to have severe apathy. Conclusions This study has clinical practice implications as the findings may help clinicians be more aware of characteristics and symptoms of people who are undiagnosed or who are at greater risk of remaining undiagnosed, enabling them to be more vigilant in picking up signs of dementia at an earlier stage. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03086-4.
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Affiliation(s)
- Laura D Gamble
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
| | - Fiona E Matthews
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Ian R Jones
- Wales Institute for Social and Economic Research and Data, Cardiff University, Cardiff, UK
| | - Alex E Hillman
- Department of Public Health, Policy and Social Sciences, College of Health and Human Sciences, Swansea University, Swansea, UK
| | - Bob Woods
- Dementia Services Development Centre Wales, School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Catherine A Macleod
- Dementia Services Development Centre Wales, School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Anthony Martyr
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Rachel Collins
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Claire Pentecost
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | | | - Linda Clare
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK.,NIHR Applied Research Collaboration South-West Peninsula, Exeter, UK
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10
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Absence of an Association between Macular Degeneration and Young-Onset Dementia. J Pers Med 2022; 12:jpm12020291. [PMID: 35207778 PMCID: PMC8878331 DOI: 10.3390/jpm12020291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/29/2022] [Accepted: 02/15/2022] [Indexed: 12/10/2022] Open
Abstract
A few population-based studies have reported an association between prior age-related macular degeneration and senile dementia. No study has explored a possible link between prior macular degeneration and young-onset dementia (YOD). This case–control study aimed to evaluate the association of YOD with prior macular degeneration diagnosed in the 5-year period before their index date. Data for this retrospective observational study were retrieved from Taiwan’s National Health Insurance (NHI) dataset. A total of 36,577 patients with newly diagnosed YOD from January 2010 to December 2017 were identified as the study cohort, assigning their diagnosis date as their index date. Comparison patients were identified by propensity score-matching (three per case, n = 109,731 controls) from the remaining NHI beneficiaries of the period, their index date being the date of their first ambulatory care claim in the year of diagnosis of their matched YOD case. Chi-square test revealed no significant difference in the prevalence of prior macular degeneration between cases and controls (1.1% vs. 1.0%, p = 0.111). Conditional logistic regression analysis also showed an unadjusted odds ratio (OR) for prior macular degeneration of 1.098 among cases relative to controls (95% CI: 0.9797–1.232). Adjusted analysis confirmed that YOD was not associated with prior macular degeneration, adjusted odds ratio 1.098 (95% CI = 0.979–1.232). We conclude that patients with macular degeneration are not at increased risk for YOD.
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Abstract
Dementia poses important medical and societal challenges, and of all health risks people face in life, dementia is one of the most feared. Recent research indicates that up to about 40% of all cases of dementia might be preventable. A series of environmental, social, and medical risk-factors have been identified that should be targeted from midlife onwards when people are still cognitively healthy. At first glance, this seems not merely advisable, but even imperative. However, these new developments trigger a series of new ethical questions and concerns which have hardly been addressed to date. Pro-active ethical reflection, however, is crucial to ensure that the interests and well-being of those affected, ultimately all of us, are adequately respected. This is the goal of the current contribution. Against the background of a concrete case in primary dementia prevention, it provides a systematic overview of the current ethical literature and sketches an ethical research agenda. First, possible benefits of increased well-being must be balanced with the burdens of being engaged in particularly long-term interventions for which it is unclear whether they will ever pay out on a personal level. Second, while knowledge about one's options to maintain brain health might empower people, it might also undermine autonomy, put high social pressure on people, medicalize healthy adults, and stigmatize those who still develop dementia. Third, while synergistic effects might occur, the ideals of dementia prevention might also conflict with other health and non-health related values people hold in life.
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Affiliation(s)
- Dorothee Horstkötter
- MHeNS School for Mental Health and Neuroscience, Department of Health, Ethics and Society, Maastricht University, Maastricht, The Netherlands
| | - Kay Deckers
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
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ElKholy N, Tawfik HM, Ebeid S, Madkor ORE, Hamza SA. A model of cognitive evaluation battery for diagnosis of mild cognitive impairment and dementia in educated and illiterate Egyptian elderly people. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00223-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The high illiteracy rates in the North African and Middle Eastern region make direct cognitive testing challenging. Validated instruments for dementia in Arabic language are lacking specially those targeting low-educated subjects.
Objectives
The aim of this study was to develop a cognitive evaluation battery suitable for both educated and illiterate Egyptian elderly people.
Design
A cross-sectional study was conducted. Setting: Ain-Shams University geriatric and ophthalmology wards, geriatrics outpatient clinic, and geriatric clubs. Participants: 159 male and female participants aged ≥ 60 years were recruited.
Measurements
Cut-off points were determined according to DSM-IV criteria for dementia and MMSE scores which divided the participants into 3 quadrants as normal, having mild cognitive impairment and having dementia then application of the new battery test was done.
Results
Test re-test reliability ranged from adequate to high in most of its tests with r ≥ 0.7. There was a statistical significance between all battery tests when divided into normal and dementia according to DSM IV criteria except in digit span forward length, digit span backward length, stimulus cue of confrontation naming and judgment. Means and standard deviations were calculated for each battery subset, for the whole sample, for low-educated group and group with > 9 years education according to three quadrants of MMSE.
Conclusion
A new valid and reliable neurocognitive evaluation battery that can differentiate between normal, mild cognitive impairment, and dementia in both educated and illiterate subjects under the name of Ain Shams Cognitive Assessment (ASCA) scale is now available.
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Kaur D, Bucholc M, Finn DP, Todd S, Wong-Lin K, McClean PL. Multi-time-point data preparation robustly reveals MCI and dementia risk factors. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2020; 12:e12116. [PMID: 33088897 PMCID: PMC7560502 DOI: 10.1002/dad2.12116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/05/2020] [Accepted: 09/16/2020] [Indexed: 12/25/2022]
Abstract
Introduction Conflicting results on dementia risk factors have been reported across studies. We hypothesize that variation in data preparation methods may partially contribute to this issue. Methods We propose a comprehensive data preparation approach comparing individuals with stable diagnosis over time to those who progress to mild cognitive impairment (MCI)/dementia. This was compared to the often-used "baseline" analysis. Multivariate logistic regression was used to evaluate both methods. Results The results obtained from sensitivity analyses were consistent with those from our multi-time-point data preparation approach, exhibiting its robustness. Compared to analysis using only baseline data, the number of significant risk factors identified in progression analyses was substantially lower. Additionally, we found that moderate depression increased healthy-to-MCI/dementia risk, while hypertension reduced MCI-to-dementia risk. Discussion Overall, multi-time-point-based data preparation approaches may pave the way for a better understanding of dementia risk factors, and address some of the reproducibility issues in the field.
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Affiliation(s)
- Daman Kaur
- Northern Ireland Centre for Stratified Medicine Biomedical Sciences Research Institute Clinical Translational Research and Innovation Centre (C-TRIC) Altnagelvin Hospital Site Ulster University Derry/Londonderry Northern Ireland UK
| | - Magda Bucholc
- Intelligent Systems Research Centre School of Computing Engineering and Intelligent Systems Ulster University Derry/Londonderry Northern Ireland UK
| | - David P Finn
- Pharmacology and Therapeutics School of Medicine Galway Neuroscience Centre National University of Ireland Galway University Road Galway Republic of Ireland
| | - Stephen Todd
- Altnagelvin Area Hospital Western Health and Social Care Trust Derry/Londonderry Northern Ireland UK
| | - KongFatt Wong-Lin
- Intelligent Systems Research Centre School of Computing Engineering and Intelligent Systems Ulster University Derry/Londonderry Northern Ireland UK
| | - Paula L McClean
- Northern Ireland Centre for Stratified Medicine Biomedical Sciences Research Institute Clinical Translational Research and Innovation Centre (C-TRIC) Altnagelvin Hospital Site Ulster University Derry/Londonderry Northern Ireland UK
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Dinkel F, Trujillo-Rodriguez D, Villegas A, Streffer J, Mercken M, Lopera F, Glatzel M, Sepulveda-Falla D. Decreased Deposition of Beta-Amyloid 1-38 and Increased Deposition of Beta-Amyloid 1-42 in Brain Tissue of Presenilin-1 E280A Familial Alzheimer's Disease Patients. Front Aging Neurosci 2020; 12:220. [PMID: 32848702 PMCID: PMC7399638 DOI: 10.3389/fnagi.2020.00220] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/22/2020] [Indexed: 01/01/2023] Open
Abstract
Familial Alzheimer's Disease (FAD) caused by Presenilin-1 (PS1) mutations is characterized by early onset, cognitive impairment, and dementia. Impaired gamma secretase function favors production of longer beta-amyloid species in PS1 FAD. The PS1 E280A mutation is the largest FAD kindred under study. Here, we studied beta-amyloid deposits in PS1 E280A FAD brains in comparison to sporadic Alzheimer's disease (SAD). We analyzed cortices and cerebellum from 10 FAD and 10 SAD brains using immunohistochemistry to determine total beta-amyloid, hyperphosphorylated tau (pTau), and specific beta-amyloid peptides 1-38, 1-40, 1-42, and 1-43. Additionally, we studied beta-amyloid subspecies by ELISA, and vessel pathology was detected with beta-amyloid 1-42 and truncated pyroglutamylated beta-amyloid antibodies. There were no significant differences in total beta-amyloid signal between SAD and FAD. Beta-amyloid 1-38 and 1-43 loads were increased, and 1-42 loads were decreased in frontal cortices of SAD when compared to FAD. Beta-amyloid species assessment by ELISA resembled our findings by immunohistochemical analysis. Differences in beta-amyloid 1-38 and 1-42 levels between SAD and FAD were evidenced by using beta-amyloid length-specific antibodies, reflecting a gamma secretase-dependent shift in beta-amyloid processing in FAD cases. The use of beta-amyloid length-specific antibodies for postmortem assessment of beta-amyloid pathology can differentiate between SAD and PS1 FAD cases and it can be useful for identification of SAD cases potentially affected with gamma secretase dysfunction.
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Affiliation(s)
- Felix Dinkel
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf - UKE, Hamburg, Germany
| | | | - Andres Villegas
- Neuroscience Group of Antioquia, Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | - Johannes Streffer
- Johnson & Johnson Pharmaceutical Research and Development, Janssen Pharmaceutica, Beerse, Belgium
| | - Marc Mercken
- Johnson & Johnson Pharmaceutical Research and Development, Janssen Pharmaceutica, Beerse, Belgium
| | - Francisco Lopera
- Neuroscience Group of Antioquia, Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | - Markus Glatzel
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf - UKE, Hamburg, Germany
| | - Diego Sepulveda-Falla
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf - UKE, Hamburg, Germany
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15
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Sobral M, Pestana M. Virtual reality and dementia: A bibliometric analysis. THE EUROPEAN JOURNAL OF PSYCHIATRY 2020. [DOI: 10.1016/j.ejpsy.2020.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Laukkanen JA, Kunutsor SK. Is maintaining or improving fitness key for dementia prevention? LANCET PUBLIC HEALTH 2019; 4:e541-e542. [DOI: 10.1016/s2468-2667(19)30202-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 09/30/2019] [Indexed: 12/25/2022]
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Heger I, Deckers K, van Boxtel M, de Vugt M, Hajema K, Verhey F, Köhler S. Dementia awareness and risk perception in middle-aged and older individuals: baseline results of the MijnBreincoach survey on the association between lifestyle and brain health. BMC Public Health 2019; 19:678. [PMID: 31159779 PMCID: PMC6545627 DOI: 10.1186/s12889-019-7010-z] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 05/20/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The total number of people with dementia is increasing worldwide, due to our aging society. Without a disease-modifying drug available, risk reduction strategies are to date the only promising way to reduce dementia incidence in the future. Substantial evidence exists that lifestyle factors contribute to the risk of dementia, such as physical exercise, mental activity and (non-)smoking. Still, most people seem unaware of a relationship between lifestyle and brain health. This paper investigates dementia literacy and knowledge of modifiable risk and protective factors of dementia in a Dutch population-based sample. METHODS An online-survey was carried out among 590 community-dwelling people between 40 and 75 years old in the Province of Limburg, the Netherlands. The total group comprises both of a provincial sample (n = 381) and a sample of three specific districts within the province (n = 209). Dementia awareness and knowledge about 12 risk and protective factors was assessed with items derived from the British Social Attitudes (BSA) survey, supplemented with custom items developed by the research team. RESULTS The majority of participants (56%) were unaware of a relationship between lifestyle and dementia risk. Most individuals identified low cognitive activity, physical inactivity and unhealthy diet as dementia risk factors. Particular gaps in knowledge existed with regard to major cardiovascular risk factors such as hypertension, hypercholesterolemia and coronary heart disease. Although the level of awareness varied by age and level of education, most people (70%) were eager to learn more about the topic of brain health, and indicated to be interested in using eHealth (54%) to measure or improve brain health. CONCLUSIONS Most people still are unaware of the relation between lifestyle and brain health, indicating the need for public health campaigns. Increasing awareness in the general population about the presence of modifiable dementia risk and protective factors is a crucial first step prior to implementation of preventative measures. Targeting specific subgroups, such as individuals with low socioeconomic status and low health literacy, is essential for the reach and effect of a prevention campaign. Outcome of this study was the rationale for an awareness campaign in The Netherlands, called "MijnBreincoach" ("MyBraincoach").
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Affiliation(s)
- Irene Heger
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Kay Deckers
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Martin van Boxtel
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - KlaasJan Hajema
- GGD Zuid-Limburg, Postbus 33, 6400 AA Heerlen, The Netherlands
| | - Frans Verhey
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
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Andersson EK, Dellkvist H, Bernow Johansson U, Skär L. Relatives' experiences of sharing a written life story about a close family member with dementia who has moved to residential care: An interview study. Nurs Open 2019; 6:276-282. [PMID: 30918679 PMCID: PMC6419116 DOI: 10.1002/nop2.208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/30/2018] [Accepted: 09/03/2018] [Indexed: 11/10/2022] Open
Abstract
AIM The aim of this study was to describe relatives' experiences of sharing a written life story about a close family member with dementia who has moved to residential care. DESIGN An explorative descriptive qualitative design was used. METHODS The data were collected using semi-structured interviews with a purposeful sample of eight relatives and analyzed using a qualitative content analysis. RESULTS Results show that creating and sharing the life story of a close family member could help relatives handle grief and stress. It was perceived as an important, yet difficult, task to ensure that the close family member got good quality care. The creation of a meaningful life story takes time and requires cooperation with family members and other significant people.
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Affiliation(s)
| | - Helén Dellkvist
- Department of HealthBlekinge Institute of TechnologyKarlskronaSweden
- Karlskrona MunicipalityKarlskronaSweden
| | - Ulrika Bernow Johansson
- Department of HealthBlekinge Institute of TechnologyKarlskronaSweden
- Karlskrona MunicipalityKarlskronaSweden
| | - Lisa Skär
- Department of HealthBlekinge Institute of TechnologyKarlskronaSweden
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Galvin A, Helmer C, Coureau G, Amadeo B, Rainfray M, Soubeyran P, Dartigues JF, Pérès K, Bellera C, Delva F, Mathoulin-Pélissier S. Determinants of functional decline in older adults experiencing cancer (the INCAPAC study). J Geriatr Oncol 2019; 10:913-920. [PMID: 30902591 DOI: 10.1016/j.jgo.2019.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/28/2019] [Accepted: 03/11/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Previous studies have reported on the higher risk of functional decline among older patients with cancer. However, few have focused on factors of functional decline in older persons with cancer and are mainly hospital-based and focus on consequences of cancer treatment. The aim of the study was to identify determinants of functional decline in older subjects with cancer in a population-based study. METHODS Using cancer registries, we identified older subjects (age ≥ 65 years) with cancer in three prospective cohort studies from Gironde, a French department. Functional status was measured using the Instrumental Activities of Daily Living (IADL) and the basic Activities of Daily Living (ADL) scales, and functional decline was measured between cancer pre- and post-diagnosis visits. Studied variables were demographic and socioeconomic (age at diagnosis, sex, living alone, education), cancer-related (stage at diagnosis, treatment received), smoking status, health-related (polypharmacy, depressive symptomatology), and geriatric-specific (cognitive impairment or dementia). Analyses were performed using logistic regression models. RESULTS Age (≥85 years), cognitive impairment or dementia, and advanced stage at diagnosis were associated with a higher risk of ADL limitations, whether considering death or not. Age (≥85 years), education and polypharmacy were associated with a higher risk of ADL and/or IADL limitations. CONCLUSIONS We identified factors that could impact on ADL and/or IADL limitations in older patients with cancer. The information on these determinants is useful in clinical settings to identify patients with cancer at high risk of functional decline.
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Affiliation(s)
- Angéline Galvin
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, F-33000 Bordeaux, France.
| | - Catherine Helmer
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Leha team, UMR 1219, F-33000 Bordeaux, France
| | - Gaëlle Coureau
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, F-33000 Bordeaux, France; Department of Public Health, Bordeaux University Hospital, F-3300 Bordeaux, France
| | - Brice Amadeo
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, F-33000 Bordeaux, France
| | - Muriel Rainfray
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, F-33000 Bordeaux, France; Department of Clinical Gerontology, Bordeaux University Hospital, F-33604 Pessac, France
| | - Pierre Soubeyran
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Vinco team, UMR 1218, F-33000 Bordeaux, France; Department of Medical Oncology, SIRIC Bordeaux Research Integrate Oncology, Institut Bergonié, F-33000 Bordeaux, France
| | - Jean-François Dartigues
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Leha team, UMR 1219, F-33000 Bordeaux, France
| | - Karine Pérès
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Sepia team, UMR 1219, F-33000 Bordeaux, France
| | - Carine Bellera
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, F-33000 Bordeaux, France; Clinical and Epidemiological Research Unit, INSERM CIC1401, Institut Bergonie, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Fleur Delva
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, F-33000 Bordeaux, France; Department of Public Health, Bordeaux University Hospital, F-3300 Bordeaux, France
| | - Simone Mathoulin-Pélissier
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, F-33000 Bordeaux, France; Clinical and Epidemiological Research Unit, INSERM CIC1401, Institut Bergonie, Comprehensive Cancer Center, F-33000 Bordeaux, France
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Abstract
Research into cognitive reserve (CR) and dementia is advancing rapidly. This
paper analyses the intellectual structure, emerging trends and relevant shifts
in the development of available knowledge. Data collected from the
Web-of-Science produced an expanded network of 564 articles and 12,504 citations
in the 1998-2017 period. The co-citation network visualized was characterized by
a scientometric review using CiteSpace. The results revealed that author Stern Y
had the highest number of publications and citations. The network of journals,
institutions and countries showed a central-peripheral structure with Neurology,
Harvard University and the USA ranked first, respectively. While cognitive
reserve remains the most prominent area of research in this field, studies
related to functional ability, executive control, mortality data and reserve
mechanisms have grown considerably. The identification of critical articles and
the development of emerging trends highlights new insights in the area of
research, better communicating key findings and facilitating the exploration of
data.
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Affiliation(s)
- Maria Helena Pestana
- PhD, University Institute of Lisbon (ISCTE-IUL), Lisbon, Portugal. Research and Education Unit on Ageing (UNIFAI, ICBAS, UP)
| | - Margarida Sobral
- PhD, Psychogeriatrics Service, Hospital Magalhães Lemos, Porto, Portugal. Research and Education Unit on Ageing (UNIFAI, ICBAS, UP). CINTESIS - Center for Health Technology and Services Research (FM, UP)
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Lu H, Wang XD, Shi Z, Yue W, Zhang Y, Liu S, Liu S, Zhao L, Xiang L, Zhang Y, Guan Y, Su W, Li Z, Wang J, Wisniewski T, Ji Y. Comparative analysis of cognitive impairment prevalence and its etiological subtypes in a rural area of northern China between 2010 and 2015. Sci Rep 2019; 9:851. [PMID: 30696930 PMCID: PMC6351643 DOI: 10.1038/s41598-018-37286-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 12/03/2018] [Indexed: 11/09/2022] Open
Abstract
The purpose of this study was to evaluate changes in the prevalence and risk factors of cognitive impairment (CI) by analyzing and comparing two cross-sectional epidemiological surveys of CI and its subtypes were performed in a rural area of northern China between 2010 and 2015. Residents aged ≥60 years were drawn in northern China. The Mini Mental State Examination (MMSE) is recommended to test for CI. Dementia was further categorised into Alzheimer’s disease (AD), vascular dementia (VaD), and dementia caused by other diseases (ODs). Mild cognitive impairment (MCI) was classified into MCI caused by AD (MCI-A), MCI caused by VaD (MCI-VD), and MCI caused by ODs (MCI-O). The prevalence of CI increased in China. The prevalence of all-cause CI was 30·5% (22.9% MCI and 7.6% dementia) in 2010. The prevalence of all-cause CI was 38.3% (27.8% MCI and 10.5% dementia) in 2015. Similar increases were observed for the prevalence of subtypes of dementia and MCI. These findings suggest an increasing prevalence of CI and its subtypes in China, which may be related to alterations in sociodemographic factors, vascular risk factors and lifestyle changes over time in these cohorts.
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Affiliation(s)
- Hui Lu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Xiao-Dan Wang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Zhihong Shi
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Wei Yue
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Ying Zhang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Shuai Liu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Shuling Liu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Lei Zhao
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Lei Xiang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Yajing Zhang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Yalin Guan
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Wenhua Su
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Zhiyong Li
- Tianjin Jixian County Health Bureau, Tianjin, China
| | - Jinhuan Wang
- Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin, China
| | - Thomas Wisniewski
- New York University School of Medicine, Department of Neurology, Psychiatry and Pathology, New York, N.Y., USA
| | - Yong Ji
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China.
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Jørgensen LB, Thorleifsson BM, Selbæk G, Šaltytė Benth J, Helvik AS. Physical diagnoses in nursing home residents - is dementia or severity of dementia of importance? BMC Geriatr 2018; 18:254. [PMID: 30348091 PMCID: PMC6198432 DOI: 10.1186/s12877-018-0943-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 10/10/2018] [Indexed: 11/23/2022] Open
Abstract
Background Dementia and physical morbidity are primary reasons for nursing home admission globally. However, data on physical morbidity in nursing home residents with and without dementia are scarce. The first aim of the present study was to explore whether presence and severity of dementia were related to the number of physical diagnoses in nursing home residents. The second aim was to explore if the severity of dementia was associated with having registered the most frequent complexes of physical diagnoses when controlling for physical health and demographic factors. Methods A total of 2983 Norwegian nursing home residents from two cross-sectional samples from 2004/2005 and 2010/2011 were included in the analysis. By the use of assessment scales, the severity of dementia (Clinical Dementia Rating), physical health (General Medical Health Rating), activities of daily living (Physical Self-Maintenance Scale) and neuropsychiatric symptoms (Neuropsychiatric Inventory Nursing Home) were determined. Physical diagnoses and medications were assembled from the medical records. The physical diagnoses were categorized into complexes, using the ICD-10 chapters. Linear mixed models and generalized linear mixed models were estimated. Results Residents with dementia were registered with fewer physical diagnoses than residents without dementia. The frequency of physical diagnoses decreased with increasing severity of dementia. Cardiovascular, musculoskeletal and endocrine, nutritional and metabolic diagnoses were the most common complexes of physical diagnoses in individuals with and without dementia. The odds of having cardiovascular and musculoskeletal diagnoses increased for males and decreased for females with increasing severity of dementia, in contrast to endocrine diagnoses where the odds increased for both genders. Conclusion Increasing severity of dementia in nursing home residents may complicate the diagnostics of physical disease. This might reflect a need for more attention to the registration of physical diagnoses in nursing home residents with dementia.
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Affiliation(s)
- Live Bredholt Jørgensen
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Berit Marie Thorleifsson
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jūratė Šaltytė Benth
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Anne-Sofie Helvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,St Olavs University Hospital, Trondheim, Norway
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Törpel A, Herold F, Hamacher D, Müller NG, Schega L. Strengthening the Brain-Is Resistance Training with Blood Flow Restriction an Effective Strategy for Cognitive Improvement? J Clin Med 2018; 7:E337. [PMID: 30304785 PMCID: PMC6210989 DOI: 10.3390/jcm7100337] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/04/2018] [Accepted: 10/05/2018] [Indexed: 02/07/2023] Open
Abstract
Aging is accompanied by a decrease in physical capabilities (e.g., strength loss) and cognitive decline. The observed bidirectional relationship between physical activity and brain health suggests that physical activities could be beneficial to maintain and improve brain functioning (e.g., cognitive performance). However, the exercise type (e.g., resistance training, endurance training) and their exercise variables (e.g., load, duration, frequency) for an effective physical activity that optimally enhance cognitive performance are still unknown. There is growing evidence that resistance training induces substantial brain changes which contribute to improved cognitive functions. A relative new method in the field of resistance training is blood flow restriction training (BFR). While resistance training with BFR is widely studied in the context of muscular performance, this training strategy also induces an activation of signaling pathways associated with neuroplasticity and cognitive functions. Based on this, it seems reasonable to hypothesize that resistance training with BFR is a promising new strategy to boost the effectiveness of resistance training interventions regarding cognitive performance. To support our hypothesis, we provide rationales of possible adaptation processes induced by resistance training with BFR. Furthermore, we outline recommendations for future studies planning to investigate the effects of resistance training with BFR on cognition.
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Affiliation(s)
- Alexander Törpel
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, Zschokkestr. 32, 39104 Magdeburg, Germany.
| | - Fabian Herold
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, 39120 Magdeburg, Germany.
| | - Dennis Hamacher
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, Zschokkestr. 32, 39104 Magdeburg, Germany.
| | - Notger G Müller
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, 39120 Magdeburg, Germany.
- Center for Behavioral Brain Sciences (CBBS), Universitätsplatz 2, 39106 Magdeburg, Germany.
- Department of Neurology, Medical Faculty, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany.
| | - Lutz Schega
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, Zschokkestr. 32, 39104 Magdeburg, Germany.
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Galvin A, Helmer C, Coureau G, Amadeo B, Joly P, Sabathé C, Monnereau A, Baldi I, Rainfray M, Soubeyran P, Delva F, Mathoulin-Pélissier S. Determinants of cancer treatment and mortality in older cancer patients using a multi-state model: Results from a population-based study (the INCAPAC study). Cancer Epidemiol 2018; 55:39-44. [DOI: 10.1016/j.canep.2018.04.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 04/25/2018] [Accepted: 04/26/2018] [Indexed: 11/30/2022]
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26
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Kiđemet‐Piskač S, Babić Leko M, Blažeković A, Langer Horvat L, Klepac N, Sonicki Z, Kolenc D, Hof PR, Boban M, Mimica N, Borovečki F, Šimić G. Evaluation of cerebrospinal fluid phosphorylated tau 231 as a biomarker in the differential diagnosis of Alzheimer's disease and vascular dementia. CNS Neurosci Ther 2018; 24:734-740. [PMID: 29453935 PMCID: PMC6047904 DOI: 10.1111/cns.12814] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/09/2018] [Accepted: 01/10/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The diagnosis of either Alzheimer's disease (AD) or vascular dementia (VaD) is still largely based on clinical guidelines and exclusion of other diseases that may lead to dementia. AIMS In this study, we assessed whether the use of sensitive and specific biomarkers such as phosphorylated tau proteins could contribute to an earlier and more accurate diagnosis of AD and VaD, as well as to their differentiation. MATERIAL AND METHODS A total of 198 patients, of which 152 had AD, 28 VaD, and 18 were healthy controls (HC), were included in the analyses. We analyzed cerebrospinal fluid (CSF) levels of total tau protein (t-tau), tau protein phosphorylated at threonine 231 (p-tau231), and factor score (FS) determined by combination of p-tau231 and Mini-Mental State Examination (MMSE) in patients with AD and VaD, as well as in HC. We tested the diagnostic accuracy of these biomarkers in the CSF and FS (p-tau231, MMSE) in differentiating AD from VaD and HC. RESULTS Total tau levels were significantly elevated in subjects with AD compared to HC, as well as in VaD subjects compared to HC. DISCUSSION p-tau231 levels were significantly higher in patients with ADvsHC as well in patients with VaD vsHC. p-tau231 levels did not distinguish AD from VaD patients. Importantly, FS(p-tau231 and MMSE) showed statistically significant differences in the distribution of subjects with AD and VaD. CONCLUSION These results indicate that FS (p-tau231 and MMSE) has a strong potential to provide an early distinction between AD and VaD.
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Affiliation(s)
| | - Mirjana Babić Leko
- Department of NeuroscienceCroatian Institute for Brain ResearchUniversity of Zagreb School of MedicineZagrebCroatia
| | | | - Lea Langer Horvat
- Department of NeuroscienceCroatian Institute for Brain ResearchUniversity of Zagreb School of MedicineZagrebCroatia
| | - Nataša Klepac
- Department of NeurologyUniversity Hospital Centre “Zagreb”University of Zagreb School of MedicineZagrebCroatia
| | - Zdenko Sonicki
- Department of Medical Statistics, Epidemiology and Medical InformaticsSchool of Public Health “Andrija Štampar”University of Zagreb School of MedicineZagrebCroatia
| | - Danijela Kolenc
- Department of PathologyUniversity of Zagreb School of MedicineZagrebCroatia
| | - Patrick R. Hof
- Fishberg Department of NeuroscienceRonald M. Loeb Center for Alzheimer's Disease, and Friedman Brain InstituteIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Marina Boban
- Department of NeurologyUniversity Hospital Centre “Zagreb”University of Zagreb School of MedicineZagrebCroatia
| | - Ninoslav Mimica
- University Psychiatric Hospital VrapčeUniversity of Zagreb School of MedicineZagrebCroatia
| | - Fran Borovečki
- Department of NeurologyUniversity Hospital Centre “Zagreb”University of Zagreb School of MedicineZagrebCroatia
| | - Goran Šimić
- Department of NeuroscienceCroatian Institute for Brain ResearchUniversity of Zagreb School of MedicineZagrebCroatia
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Zhang J, Liu J, Li J, Zhang C, Qu M. Non-invasive brain stimulation for improving cognitive function in people with dementia and mild cognitive impairment. Hippokratia 2018. [DOI: 10.1002/14651858.cd013065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jing Zhang
- Xuanwu Hospital, Capital Medical University; Department of Neurology; No. 45, Changchun Street Beijing Beijing China 100053
| | - Jia Liu
- Xuanwu Hospital, Capital Medical University; Department of Neurology; No. 45, Changchun Street Beijing Beijing China 100053
| | - Jie Li
- People's Hospital of Deyang City; Department of Neurology; No.173, Taishan North Road Deyang Sichuan China 618000
| | - Canfei Zhang
- The First Affiliated Hospital of Henan University of Science and Technology; Department of Neurology; No. 24, Jinghua Road Luoyang Henan Province China 471003
| | - Miao Qu
- Xuanwu Hospital, Capital Medical University; Department of Neurology; No. 45, Changchun Street Beijing Beijing China 100053
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28
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Sopina E, Sørensen J. Decision modelling of non-pharmacological interventions for individuals with dementia: a systematic review of methodologies. HEALTH ECONOMICS REVIEW 2018; 8:8. [PMID: 29582186 PMCID: PMC6755571 DOI: 10.1186/s13561-018-0192-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 03/15/2018] [Indexed: 05/30/2023]
Abstract
OBJECTIVES The main objective of this study is to conduct a systematic review to identify and discuss methodological issues surrounding decision modelling for economic evaluation of non-pharmacological interventions (NPIs) in dementia. METHODS A systematic search was conducted for publications using decision modelling to investigate the cost-effectiveness of NPIs for individuals with dementia. Search was limited to studies in English. Studies were excluded if they evaluated interventions aimed only at caregivers of patients with dementia, or if they only included economic evaluation alongside an RCT without additional modelling. RESULTS Two primary, five secondary and three tertiary prevention intervention studies were identified and reviewed. Five studies utilised Markov models, with others using discrete event, regression-based simulation, and decision tree approaches. A number of challenging methodological issues were identified, including the use of MMSE-score as the main outcome measure, limited number of strategies compared, restricted time horizons, and limited or dated data on dementia onset, progression and mortality. Only one of the three tertiary prevention studies explicitly considered the effectiveness of pharmacological therapies alongside their intervention. CONCLUSIONS Economic evaluations of NPIs in dementia should utilise purposefully-developed decision models, and avoid models for evaluation of pharmaceuticals. Broader outcome measures could be a way to capture the wide impact of NPIs for dementia in future decision models. It is also important to account for the effects of pharmacological therapies alongside the NPIs in economic evaluations. Access to more localised and up-to-date data on dementia onset, progression and mortality is a priority for accurate prediction.
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Affiliation(s)
- Elizaveta Sopina
- Centre of Health Economics (COHERE), Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, 5000 Odense, Denmark
| | - Jan Sørensen
- Centre of Health Economics (COHERE), Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, 5000 Odense, Denmark
- Healthcare Outcomes Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
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Tsolaki M, Gkioka M, Verykouki E, Galoutzi N, Kavalou E, Pattakou-Parasyri V. Prevalence of Dementia, Depression, and Mild Cognitive Impairment in a Rural Area of the Island of Crete, Greece. Am J Alzheimers Dis Other Demen 2017; 32:252-264. [PMID: 28468554 PMCID: PMC10852845 DOI: 10.1177/1533317517698789] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The studies on the prevalence of dementia, depression, and mild cognitive impairment (MCI) in Greece are sparse and show major variations of prevalence depending on geographical areas, nutritional habits, and the way of living. The aim of this door-to-door study was to find the prevalence of dementia, depression, and MCI in a rural Greek population. Four hundred and forty-three individuals older than 61years following the application of specific criteria were diagnosed with: normal cognition, depression, MCI with and without depression, and dementia with and without depression. Four diagnostic methods were used, 2 of which included Mungas correction for age and education. After Mungas adjustment, the results were as follows-depression: 33.9%; MCI: 15.3%; MCI with depression: 8.6%; dementia: 2.0%; and dementia with depression: 7.2%. Dementia is less prevalent compared to global data and other Greek areas. Mild cognitive impairment is more prevalent than dementia. High percentages of depression may be related to low education.
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Affiliation(s)
- Magda Tsolaki
- Department of Neurology, “G.H. Papanikolaou”, School of Medicine, Aristotle University of Thessaloniki, Greece
- Greek Alzheimer Association and Related Disorders, Thessaloniki, Greece (GAARD)
| | - Mara Gkioka
- Department of Neurology, “G.H. Papanikolaou”, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Eleni Verykouki
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Laboratory of Hygiene, School of Medicine, Aristotle University of Thessaloniki, Greece
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30
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Holst A, Skär L. Formal caregivers’ experiences of aggressive behaviour in older people living with dementia in nursing homes: A systematic review. Int J Older People Nurs 2017; 12. [DOI: 10.1111/opn.12158] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 05/17/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Adelheid Holst
- Faculty of Professional Studies; Nord University; Bodø Norway
| | - Lisa Skär
- Department of Health; Blekinge Institute of Technology; Karlskrona Sweden
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31
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Lee YL, Hu HY, Huang LY, Chou P, Chu D. Periodontal Disease Associated with Higher Risk of Dementia: Population-Based Cohort Study in Taiwan. J Am Geriatr Soc 2017; 65:1975-1980. [DOI: 10.1111/jgs.14944] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Ya-Ling Lee
- Department of Dentistry; School of Dentistry, National Yang-Ming University; Taipei Taiwan
- Institute of Public Health and Community Medicine Research Center; National Yang-Ming University; Taipei Taiwan
- Department of Dentistry; Taipei City Hospital; Taipei Taiwan
| | - Hsiao-Yun Hu
- Institute of Public Health and Community Medicine Research Center; National Yang-Ming University; Taipei Taiwan
- Department of Education and Research; Taipei City Hospital; Taipei Taiwan
| | - Li-Ying Huang
- Institute of Public Health and Community Medicine Research Center; National Yang-Ming University; Taipei Taiwan
- Department of Community Medicine; Taipei City Hospital, Zhongxing Branch; Taipei Taiwan
| | - Pesus Chou
- Institute of Public Health and Community Medicine Research Center; National Yang-Ming University; Taipei Taiwan
| | - Dachen Chu
- Institute of Public Health and Community Medicine Research Center; National Yang-Ming University; Taipei Taiwan
- Faculty of Medicine; School of Medicine, National Yang-Ming University; Taipei Taiwan
- Department of Health Care Management; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
- Department of Neurosurgery; Taipei City Hospital; Taipei Taiwan
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32
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Griep Y, Hanson LM, Vantilborgh T, Janssens L, Jones SK, Hyde M. Can volunteering in later life reduce the risk of dementia? A 5-year longitudinal study among volunteering and non-volunteering retired seniors. PLoS One 2017; 12:e0173885. [PMID: 28301554 PMCID: PMC5354395 DOI: 10.1371/journal.pone.0173885] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 02/28/2017] [Indexed: 12/02/2022] Open
Abstract
We propose that voluntary work, characterized by social, physical and cognitive activity in later life is associated with fewer cognitive problems and lower dementia rates. We test these assumptions using 3-wave, self-reported, and registry data from the 2010, 2012, and 2014 Swedish National Prescribed Drug Register. We had three groups of seniors in our data: 1) no volunteering (N = 531), 2) discontinuous volunteering (N = 220), and 3) continuous volunteering (N = 250). We conducted a path analysis in Mplus to investigate the effect of voluntary work (discontinuously and continuously) on self-reported cognitive complaints and the likelihood of being prescribed an anti-dementia treatment after controlling for baseline and relevant background variables. Our results indicated that seniors, who continuously volunteered, reported a decrease in their cognitive complaints over time, whereas no such associations were found for the other groups. In addition, they were 2.44 (95%CI [1.86; 3.21]) and 2.46 (95%CI [1,89; 3.24]) times less likely to be prescribed an anti-dementia treatment in 2012 and 2014, respectively. Our results largely support the assumptions that voluntary work in later life is associated with lower self-reported cognitive complaints and a lower risk for dementia, relative to those who do not engage, or only engage episodically in voluntary work.
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Affiliation(s)
- Yannick Griep
- Department of Psychology, University of Calgary, Calgary, Canada
| | | | - Tim Vantilborgh
- Work and Organizational Psychology (WOPs), Vrije Universiteit Brussel, Brussel, Belgium
| | | | | | - Martin Hyde
- Centre for Innovative Ageing, Swansea University, Swansea, United Kingdom
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33
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Trautwein S, Scharpf A, Barisch-Fritz B, Niermann C, Woll A. Effectiveness of a 16-Week Multimodal Exercise Program on Individuals With Dementia: Study Protocol for a Multicenter Randomized Controlled Trial. JMIR Res Protoc 2017; 6:e35. [PMID: 28258048 PMCID: PMC5357320 DOI: 10.2196/resprot.6792] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/14/2016] [Accepted: 02/08/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The increasing prevalence of dementia in the next decades is accompanied by various societal and economic problems. Previous studies have suggested that physical activity positively affects motor and cognitive skills in individuals with dementia (IWD). However, there is insufficient evidence probably related to several methodological limitations. Moreover, to date adequate physical activity interventions specifically developed for IWD are lacking. OBJECTIVE This study aims to investigate the effectiveness of a multimodal exercise program (MEP) on motor and cognitive skills in IWD in a high-quality multicenter trial. METHODS A multicenter randomized controlled trial with baseline and postassessments will be performed. It is planned to enroll 405 participants with dementia of mild to moderate stage, aged 65 years and older. The intervention group will participate in a 16-week ritualized MEP especially developed for IWD. The effectiveness of the MEP on the primary outcomes balance, mobility, and gait will be examined using a comprehensive test battery. Secondary outcomes are strength and function of lower limbs, activities of daily living, and cognition (overall cognition, language, processing speed, learning and memory, and visual spatial cognition). RESULTS Enrollment for the study started in May 2015. It is planned to complete postassessments by the beginning of 2017. Results are expected to be available in the first half of 2017. CONCLUSIONS This study will contribute to enhancing evidence for the effects of physical activity on motor and cognitive skills in IWD. Compared to previous studies, this study is characterized by a dementia-specific intervention based on scientific knowledge, a combination of motor and cognitive tasks in the intervention, and high standards regarding methodology. Findings are highly relevant to influence the multiple motor and cognitive impairments of IWD who are often participating in limited physical activity. TRIAL REGISTRATION German Clinical Trials Register DRKS00010538; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00010538 (Archived by WebCite at http://www.webcitation.org/6oVGMbbMD).
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Affiliation(s)
- Sandra Trautwein
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Andrea Scharpf
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Bettina Barisch-Fritz
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Christina Niermann
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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34
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Morhardt D. Educating medical students on Alzheimer's disease and related disorders: An overview of the Northwestern University Buddy Program. DEMENTIA 2016. [DOI: 10.1177/147130120600500311] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Darby Morhardt
- Cognitive Neurology and Alzheimer's Disease Center,Northwestern
University Feinberg School of Medicine,675 N. St.
Clair,#20–100,Chicago,Illinois 60611,USA
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35
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Is lipoprotein (a) protective of dementia? Eur J Epidemiol 2016; 31:1149-1152. [DOI: 10.1007/s10654-016-0184-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 07/08/2016] [Indexed: 01/07/2023]
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36
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Riedel O, Klotsche J, Wittchen HU. Overlooking Informal Dementia Caregivers' Burden. Res Gerontol Nurs 2016; 9:167-74. [DOI: 10.3928/19404921-20160531-02] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 05/16/2016] [Indexed: 11/20/2022]
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37
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Wen YH, Wu SS, Lin CHR, Tsai JH, Yang P, Chang YP, Tseng KH. A Bayesian Approach to Identifying New Risk Factors for Dementia: A Nationwide Population-Based Study. Medicine (Baltimore) 2016; 95:e3658. [PMID: 27227925 PMCID: PMC4902349 DOI: 10.1097/md.0000000000003658] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Dementia is one of the most disabling and burdensome health conditions worldwide. In this study, we identified new potential risk factors for dementia from nationwide longitudinal population-based data by using Bayesian statistics.We first tested the consistency of the results obtained using Bayesian statistics with those obtained using classical frequentist probability for 4 recognized risk factors for dementia, namely severe head injury, depression, diabetes mellitus, and vascular diseases. Then, we used Bayesian statistics to verify 2 new potential risk factors for dementia, namely hearing loss and senile cataract, determined from the Taiwan's National Health Insurance Research Database.We included a total of 6546 (6.0%) patients diagnosed with dementia. We observed older age, female sex, and lower income as independent risk factors for dementia. Moreover, we verified the 4 recognized risk factors for dementia in the older Taiwanese population; their odds ratios (ORs) ranged from 3.469 to 1.207. Furthermore, we observed that hearing loss (OR = 1.577) and senile cataract (OR = 1.549) were associated with an increased risk of dementia.We found that the results obtained using Bayesian statistics for assessing risk factors for dementia, such as head injury, depression, DM, and vascular diseases, were consistent with those obtained using classical frequentist probability. Moreover, hearing loss and senile cataract were found to be potential risk factors for dementia in the older Taiwanese population. Bayesian statistics could help clinicians explore other potential risk factors for dementia and for developing appropriate treatment strategies for these patients.
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Affiliation(s)
- Yen-Hsia Wen
- From the School of Pharmacy, College of Pharmacy, Kaohsiung Medical University (Y-HW, S-SW); Department of Psychiatry (J-HT) and Department of Neurology (Y-PC), Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University (PY); and Department of Computer Science and Engineering, National Sun Yat-sen University (C-HRL, K-HT), Kaohsiung, Taiwan
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Kunutsor SK, Laukkanen JA. Gamma glutamyltransferase and risk of future dementia in middle-aged to older Finnish men: A new prospective cohort study. Alzheimers Dement 2016; 12:931-941. [DOI: 10.1016/j.jalz.2016.03.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 02/02/2016] [Accepted: 03/01/2016] [Indexed: 01/04/2023]
Affiliation(s)
- Setor K. Kunutsor
- School of Clinical Sciences; University of Bristol, Southmead Hospital; Bristol UK
| | - Jari A. Laukkanen
- Institute of Public Health and Clinical Nutrition; University of Eastern Finland; Finland
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Saha MR, Dey P, Begum S, De B, Chaudhuri TK, Sarker DD, Das AP, Sen A. Effect of Acacia catechu (L.f.) Willd. on Oxidative Stress with Possible Implications in Alleviating Selected Cognitive Disorders. PLoS One 2016; 11:e0150574. [PMID: 26949964 PMCID: PMC4780764 DOI: 10.1371/journal.pone.0150574] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 02/17/2016] [Indexed: 01/16/2023] Open
Abstract
In human body, several categories of degenerative processes are largely determined by free radicals originating in cell. Free radicals are also known to have correlated with a variety of cognitive disorders (CDs) resulting in neuronal injury and eventually to death. Alzheimer's disease (AD) and Parkinson's disease (PD) are such kind of killer CDs that occur due to dysfunction of cholinergic and dopaminergic neurons. Plant parts of Ginkgo biloba, Bacopa monnieri etc. are being used for the treatment of cognitive disorders in several countries. The present study was aimed to explore the detailed antioxidant and anti-cholinesterase activity of Acaciacatechu leaf (ACL) over CDs. Gas chromatography-Mass spectroscopy (GC-MS) analysis and Nuclear Magnetic Resonance (NMR) were employed to identify the bioactive components present in ACL. Furthermore, the extract was evaluated to check the cytotoxic effects of ACL on normal cells. Amongst several antioxidant assays, DPPH assay, hydroxyl radical, nitric oxide radical and hypochlorous acid inhibitory activities were found to be greater in ACL than that of the respective standards while other assays exhibited a moderate or at per inhibitory activity with standards. Total phenolic and flavonoid content were also found to be present in decent amount. In addition, we found, a greater acetylcholinesterase (AChE) inhibitory activity of ACL when compared to other medicinally important plants, indicating its positive effect over CDs. Forty one bioactive components were explored through GC-MS. Of these, gallic acid, epicatechin, catechin, isoquercitrin etc. were found, which are potent antioxidant and a few of them have anti-neurodegenerative properties. Eventually, ACL was found to be nontoxic and safer to consume. Further studies with animal or human model however, would determine its efficacy as a potential anti-schizophrenic drug.
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Affiliation(s)
- Manas Ranjan Saha
- Molecular Cytogenetics Laboratory, Department of Botany, University of North Bengal, Siliguri, 734013, India
| | - Priyankar Dey
- Cellular Immunology Laboratory, Department of Zoology, University of North Bengal, Siliguri, 734013, India
| | - Sainiara Begum
- Phytochemistry and Pharmacognosy Research Laboratory, Department of Botany, University of Calcutta, 35 Ballygunge Circular Road, Kolkata, 700019, India
| | - Bratati De
- Phytochemistry and Pharmacognosy Research Laboratory, Department of Botany, University of Calcutta, 35 Ballygunge Circular Road, Kolkata, 700019, India
| | - Tapas Kr. Chaudhuri
- Cellular Immunology Laboratory, Department of Zoology, University of North Bengal, Siliguri, 734013, India
| | - Dilip De Sarker
- Department of Botany, Raiganj University, Raiganj, 733134, India
| | - Abhaya Prasad Das
- Taxonomy and Envioronmental Biology Laboratory, Department of Botany, University of North Bengal, Siliguri, 734013, India
| | - Arnab Sen
- Molecular Cytogenetics Laboratory, Department of Botany, University of North Bengal, Siliguri, 734013, India
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Krolak-Salmon P, Roubaud C, Finne-Soveri H, Riolacci-Dhoyen N, Richard G, Rouch I, Leperre-Desplanques A, Dauphinot V. Evaluation of a mobile team dedicated to behavioural disorders as recommended by the Alzheimer Cooperative Valuation in Europe joint action: observational cohort study. Eur J Neurol 2016; 23:979-88. [PMID: 26945537 DOI: 10.1111/ene.12975] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 01/18/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Preventing behavioural crises appears to be crucial to promote quality of life of the patient-caregiver dyad, to reduce inappropriate hospitalizations and to delay institutionalization. The Alzheimer Cooperative Valuation in Europe promotes mobile care to prevent patients from severe behavioural and psychological symptoms in dementia. This study assessed the potential efficacy of a mobile team for Alzheimer's disease on hospitalization sparing and behavioural disorder reduction. METHODS A cohort study was set up from 1 January 2012 to 31 December 2013 by the Clinical and Research Memory Centre of Lyon (France). It included patients with behavioural and psychological symptoms living at home or in a nursing home. An interview explored the alternative patient pathways used by general practitioners (GPs) if the mobile team had not existed (hospitalization sparing). The Neuropsychiatry Inventory score was assessed at inclusion and 30 days later. The sample included 424 consecutive patients with Alzheimer's disease or related disorders and behavioural disorders at any cognitive and functional stage of the disease, taken in charge by the mobile team. RESULTS Amongst the 424 patients (84.0 ± 7.2 years), 220 (51.9%) hospitalizations were considered by their GPs and 181 (82.3%) were avoided. The Neuropsychiatric Inventory score declined after mobile team intervention (45.8-29.9, P < 0.001). Sleep and appetite disorders, endangered situation and caregiver burnout were associated with higher risk of hospitalization at 30 days. CONCLUSIONS The mobile team for Alzheimer's disease allows a high proportion of hospitalizations related to behavioural disorders to be avoided and may help to reduce behavioural disorders.
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Affiliation(s)
- P Krolak-Salmon
- Clinical and Research Memory Centre of Lyon (CMRR), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France.,Clinical Research Centre (CRC) - VCF (Aging - Brain - Frailty), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France.,University Lyon 1, Lyon, France.,INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Centre, Brain Dynamics and Cognition Team, Lyon, France
| | - C Roubaud
- Clinical and Research Memory Centre of Lyon (CMRR), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France
| | - H Finne-Soveri
- Ageing and Services Unit, National Institute of Health and Welfare (THL), Helsinki, Finland
| | | | - G Richard
- Clinical and Research Memory Centre of Lyon (CMRR), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France
| | - I Rouch
- Clinical and Research Memory Centre of Lyon (CMRR), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France
| | | | - V Dauphinot
- Clinical and Research Memory Centre of Lyon (CMRR), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France.,University Lyon 1, Lyon, France
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Sobral M, Pestana MH, Paúl C. Cognitive reserve and the severity of Alzheimer's disease. ARQUIVOS DE NEURO-PSIQUIATRIA 2016; 73:480-6. [PMID: 26083882 DOI: 10.1590/0004-282x20150044] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 01/24/2015] [Indexed: 01/26/2023]
Abstract
Alzheimer's disease (AD) is a clinical syndrome caused by neurodegeneration and characterized by a progressive deterioration in cognitive ability and capacity for independent living. Cognitive reserve (CR) describes the capacity of the adult brain to cope with the effects of the neurodegenerative process and to minimize the clinical manifestation of pathology of dementia. The aim of this study was to evaluate the association of CR and the severity of AD. Method This study was cross-sectional. Functional and neuropsychological abilities of 75 outpatients with probable AD diagnosis were evaluated. Patients completed two questionnaires, "Participation in leisure activities throughout life" and CR Questionnaire.Result The relationship between Clinical Dementia Rating (CDR) and the level of CR was statistically significant (likelihood ratio (LR), p = 0.015).Conclusion The level of CR influenced the severity of dementia. This study suggests that AD patients with higher CR may benefit against cognitive decline after diagnosis of AD.
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Affiliation(s)
| | - Maria Helena Pestana
- Unidade de Investigação e Formação sobre Adultos e Idosos, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Constança Paúl
- Unidade de Investigação e Formação sobre Adultos e Idosos, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
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Helvik AS, Engedal K, Wu B, Benth JŠ, Corazzini K, Røen I, Selbæk G. Severity of Neuropsychiatric Symptoms in Nursing Home Residents. Dement Geriatr Cogn Dis Extra 2016; 6:28-42. [PMID: 26933438 PMCID: PMC4772643 DOI: 10.1159/000442250] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
We aimed at assessing time shift in the severity of neuropsychiatric symptoms (NPS) in nursing home residents between 2004/2005 and 2010/2011 and associations between NPS and socio-demographic variables, physical health status, dementia severity, and the use of psychotropic drugs. The Neuropsychiatric Inventory Nursing Home Version was used in 2004/2005 (n = 1,163) and 2010/2011 (n = 1,858). Linear mixed model analysis was applied. There was no time shift in the severity of apathy, psychosis, and affective symptoms, but agitation did exhibit a time shift. Agitation was less severe in 2010/2011 than in 2004/2005 in residents with a Clinical Dementia Rating (CDR) sum of boxes score ≤4, and more severe in residents with a CDR sum of boxes score >16. Higher CDR sum of boxes scores and use of psychotropic medication were associated with more severe apathy, agitation, psychosis, and affective symptoms. Poor physical health was associated with more severe apathy, psychosis, and affective symptoms. Women had more severe agitation and less severe affective symptoms than men. A longer stay in a nursing home was associated with more severe agitation and less severe affective symptoms. In conclusion, agitation was less severe in 2010/2011 than in 2004/2005 among nursing home residents with a milder degree of dementia, and more severe in residents with severe dementia.
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Affiliation(s)
- Anne-Sofie Helvik
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Norway; St. Olav's University Hospital, Trondheim, Norway; Norwegian National Advisory Unit on Aging and Health, Vestfold Health Trust, Tønsberg, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Aging and Health, Vestfold Health Trust, Tønsberg, Norway
| | - Bei Wu
- Duke Center for the Study of Aging and Human Development, Duke University School of Nursing, Durham, N.C., USA; Duke Global Health Institute, Durham, N.C., USA
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, Campus Ahus, Norway; HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway; Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Kirsten Corazzini
- Duke Center for the Study of Aging and Human Development, Duke University School of Nursing, Durham, N.C., USA
| | - Irene Røen
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - 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
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Helvik AS, Engedal K, Benth JŠ, Selbæk G. Prevalence and Severity of Dementia in Nursing Home Residents. Dement Geriatr Cogn Disord 2016; 40:166-77. [PMID: 26138271 DOI: 10.1159/000433525] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/20/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS The aim of this study was to compare the presence and severity of dementia in two large cross-sectional samples of nursing home residents from 2004/2005 and 2010/2011. METHODS Demographic information as well as data on the type of nursing home unit, length of stay before assessment, physical health, regularly used prescribed drugs and Clinical Dementia Rating scale scores were used in the analyses. Logistic and linear regression models for hierarchical data were estimated. RESULTS The odds of the occurrence and of a greater severity of dementia were higher in 2010/2011 than in 2004/2005. Independent of the time of study, married men had more severe dementia than single men, and single women had more severe dementia than single men. CONCLUSION The findings may reflect the increase in the need for more nursing home beds designed for people with dementia between 2004/2005 and 2010/2011.
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Affiliation(s)
- Anne-Sofie Helvik
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Daghighi MH, Poureisa M, Ahmadi P, Reshadatjoo M, Golestani S, Naghavi-Behzad M, Karkon-Shayan F. Serum thyroid-stimulating hormone level and relation with size of hippocampus in patients with mild cognitive disorders. Niger Med J 2016; 57:353-356. [PMID: 27942104 PMCID: PMC5126749 DOI: 10.4103/0300-1652.193862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Cognitive disorders and dementia are common problems, and Alzheimer's disease is one of the major leading causes of death worldwide. Thyroid hormone disorders as a common problem effect on hippocampus size which as a prognostic factor in dementia. The aim of the present study was to investigate the relationship between serum thyroid-stimulating hormone (TSH) level and the size of hippocampus in patients with mild cognitive disorders. Materials and Methods: In a descriptive-analytical study, 41 patients with symptoms of mild cognitive disorders whom referred to take the brain magnetic resonance image (MRI) in a radiology center under the direction of Tabriz University of Medical Sciences (Tabriz, Iran) were evaluated. The right and left hippocampal and brain volume was calculated by MRI at coronal T1-weighted. Serum TSH level was also measured in these patients. Correlation between serum TSH level and hippocampal volume size was evaluated. Results: Male to female ratio was 1.05:1 with mean age of 54.09 ± 3.11 years. Mean serum TSH level of patients was 1.55 ± 1.45 uU/ml. The right and left hippocampal volumes were 1.61 ± 0.42 and 1.62 ± 0.39 ml, respectively. There were slight negative correlations between the right and left hippocampal volumes with TSH level (r = −0.133 and r = −0.092, respectively). Correlations between the right and left hippocampal volumes with TSH level were not statistically significant (P = 0.406, P = 0.566, respectively). Conclusion: Based on findings of the present study, there was a weak negative correlation between serum level of TSH with the right and left hippocampal and brain volume ratio, but the correlation was not statistically significant. It seems that controlling of clinical or subclinical hypothyroidism may have a role in slowing of dementia progression and also have a preventive role.
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Affiliation(s)
| | - Masoud Poureisa
- Department of Radiology and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Pegah Ahmadi
- Department of Radiology and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahmoud Reshadatjoo
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sahar Golestani
- Department of Radiology and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Naghavi-Behzad
- Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farid Karkon-Shayan
- Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
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Gallucci M, Spagnolo P, Aricò M, Grossi E. Predictors of Response to Cholinesterase Inhibitors Treatment of Alzheimer's Disease: Date Mining from the TREDEM Registry. J Alzheimers Dis 2016; 50:969-79. [PMID: 26836164 DOI: 10.3233/jad-150747] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The pharmacological treatment of Alzheimer's disease (AD) is based largely on cholinesterase inhibitors (ChEI). OBJECTIVE To investigate whether or not some non-pharmacological and contextual factors measured prior to starting treatment such as past occupation, lifestyles, marital status, degree of autonomy and cognitive impairment, living alone or with others, and the degree of brain atrophy are associated with a better response to ChEI treatment. METHODS Eighty-four AD and six AD with cerebrovascular disease (AD + CVD) outpatients of Treviso Dementia (TREDEM) Registry, with an average cholinesterase inhibitors treatment length of four years, were considered. The outpatients had undergone a complete evaluation and some non-pharmacological and contextual factors were collected. We defined responder a patient with a delta score T0 - T1 equal or inferior to 2.0 points per year of MMSE and a non-responder a patient with a delta score T0 - T1 superior to 2.0 points per year. In order to identify hidden relationships between variables related to response and non-response, we use a special kind of artificial neural network called Auto-CM, able to create a semantic connectivity map of the variables considered in the study. RESULTS A higher cognitive profile, a previous intellectual occupation, healthier lifestyles, being married and not living alone, a higher degree of autonomy, and lower degree of brain atrophy at baseline resulted in affecting the response to long-term ChEI therapy. CONCLUSION Non-pharmacological and contextual factors appear to influence the effectiveness of treatment with ChEI in the long term.
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Affiliation(s)
- Maurizio Gallucci
- Cognitive Impairment Center, Local Health Authority 9 of Treviso, Treviso, Italy
| | - Pierpaolo Spagnolo
- Cognitive Impairment Center, Local Health Authority 9 of Treviso, Treviso, Italy
| | - Maria Aricò
- Cognitive Impairment Center, Local Health Authority 9 of Treviso, Treviso, Italy
| | - Enzo Grossi
- Villa Santa Maria Institute, Tavernerio, Italy
- Semeion Research Centre of Sciences of Communication, Rome, Italy
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[Users and utilization of support groups among caregivers of dementia patients : Results of a naturalistic observational study]. Z Gerontol Geriatr 2015; 50:14-20. [PMID: 26667126 DOI: 10.1007/s00391-015-1002-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 11/09/2015] [Accepted: 11/26/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Caring for patients with Alzheimer's disease (AD) is frequently associated with an increased burden for the caregiving relatives (CG). While therapeutic options and low threshold assistance offers for a reduction of the burden have become well established, data on the utilization of support groups (SG) are still lacking. MATERIAL AND METHODS In the outpatient neurological and psychiatric routine treatment, AD patients were enrolled with their accompanying CG in a 2-stage study. Firstly, each patient was clinically documented by the treating physician and each CG was asked to fill out a questionnaire on the current care situation at the patient's home. In stage two, each CG was additionally assessed with a standardized interview and screened for depression with the depression screening questionnaire (DSQ). Each CG also rated the current CG burden, life satisfaction and health condition on a visual analogue scale (VAS). RESULTS Overall, 14.8 % of CGs attended an SG. The CGs who visited an SG showed a tendency to report a severe CG burden more often than CGs who did not (71.9 % vs. 56.3 %, p = 0.060) and more frequently a lower satisfaction with life (33.3 vs. 17.2 %, p < 0.01). They also reported higher rates of verbal and physical aggression by the patients (51.5 % vs. 34.0 %, p < 0.05 and 39.4 % vs. 12.7 %, p < 0.01, respectively) and appraised their health condition to be lower (VAS score 66.0 % vs. 54.0, p < 0.01). Depressive disorders occurred in both groups at similar rates (54.1 % and 42.1 %, p = 0.317). CONCLUSION The data suggest that the decision to join an SG is influenced more by behavioral and non-cognitive symptoms of the AD rather than its duration or severity.
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Abstract
BACKGROUND Dementia is a significant public health problem. One non-pharmacological therapy that has shown its effectiveness is reminiscence, which is a psychological intervention designed to address issues of particular relevance to older adults. The aim of this study was to examine the benefits of an integrative reminiscence program in elderly people with dementia. METHODS A quasi-experimental design and purposeful sampling were conducted at two retirement homes. Forty-two elderly adults with dementia were studied to measure the effect of the therapy (23 in the experimental group and 19 in the control group). The treatment group activity was held in 10 sessions. RESULTS The treatment group significantly improved their depressive symptoms and self-acceptance, positive relations with others, autonomy, and environmental mastery. CONCLUSIONS This study provides support for the effectiveness of integrative reminiscence therapy (RT) as an intervention in people with dementia, especially in reducing depressive symptoms and improving psychological well-being, with the therapy being effective on personal and emotional variables.
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Murata A, Mayumi T, Muramatsu K, Ohtani M, Matsuda S. Effect of dementia on outcomes of elderly patients with hemorrhagic peptic ulcer disease based on a national administrative database. Aging Clin Exp Res 2015; 27:717-25. [PMID: 25708828 DOI: 10.1007/s40520-015-0328-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 02/10/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Little information is available on the effect of dementia on outcomes of elderly patients with hemorrhagic peptic ulcer disease at the population level. AIMS This study aimed to investigate the effect of dementia on outcomes of elderly patients with hemorrhagic peptic ulcer based on a national administrative database. METHODS A total of 14,569 elderly patients (≥80 years) who were treated by endoscopic hemostasis for hemorrhagic peptic ulcer were referred to 1073 hospitals between 2010 and 2012 in Japan. We collected patients' data from the administrative database to compare clinical and medical economic outcomes of elderly patients with hemorrhagic peptic ulcers. Patients were divided into two groups according to the presence of dementia: patients with dementia (n = 695) and those without dementia (n = 13,874). RESULTS There were no significant differences in in-hospital mortality within 30 days and overall mortality between the groups (odds ratio; OR 1.00, 95 % confidence interval; CI 0.68-1.46, p = 0.986 and OR 1.02, 95 % CI 0.74-1.41, p = 0.877). However, the length of stay (LOS) and medical costs during hospitalization were significantly higher in patients with dementia compared with those without dementia. The unstandardized coefficient for LOS was 3.12 days (95 % CI 1.58-4.67 days, p < 0.001), whereas that for medical costs was 1171.7 US dollars (95 % CI 533.8-1809.5 US dollars, p < 0.001). CONCLUSIONS Length of stay and medical costs during hospitalization are significantly increased in elderly patients with dementia undergoing endoscopic hemostasis for hemorrhagic peptic ulcer disease.
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Affiliation(s)
- Atsuhiko Murata
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan.
| | - Toshihiko Mayumi
- Department of Emergency Medicine, University of Occupational, Environmental and Health, Kitakyushu, Fukuoka, Japan
| | - Keiji Muramatsu
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Makoto Ohtani
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Shinya Matsuda
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
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Prevalence of Dementia and Cognitive Complaints in the Context of High Cognitive Reserve: A Population-Based Study. PLoS One 2015; 10:e0138818. [PMID: 26390288 PMCID: PMC4577122 DOI: 10.1371/journal.pone.0138818] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 09/03/2015] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES This study aimed to assess the prevalence of dementia and cognitive complaints in a cross-sectional sample of Luxembourg seniors, and to discuss the results in the societal context of high cognitive reserve resulting from multilingualism. METHODS A population sample of 1,377 people representative of Luxembourg residents aged over 64 years was initially identified via the national social insurance register. There were three different levels of contribution: full participation in the study, partial participation, and non-participation. We examined the profiles of these three different samples so that we could infer the prevalence estimates in the Luxembourgish senior population as a whole using the prevalence estimates obtained in this study. RESULTS After careful attention to the potential bias and of the possibility of underestimation, we considered the obtained prevalence estimates of 3.8% for dementia (with corresponding 95% confidence limits (CL) of 2.8% and 4.8%) and 26.1% for cognitive complaints (CL = [17.8-34.3]) as trustworthy. CONCLUSION Based on these findings, we postulate that high cognitive reserve may result in surprisingly low prevalence estimates of cognitive complaints and dementia in adults over the age of 64 years, which thereby corroborates the longer disability-free life expectancy observed in the Luxembourg population. To the best of our knowledge, this study is the first to report such Luxembourgish public health data.
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Kao LT, Sheu JJ, Lin HC, Tsai MC, Chung SD. Association between sepsis and dementia. J Clin Neurosci 2015; 22:1430-3. [PMID: 26165470 DOI: 10.1016/j.jocn.2015.02.035] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 02/25/2015] [Indexed: 01/15/2023]
Abstract
In this study, we explored the association between sepsis and dementia using a population-based dataset in Taiwan and a case-control design. The relationship between severe systemic infections and dementia is still unclear. Data for this case-control study were taken from the Taiwan Longitudinal Health Insurance Database 2000. This study included 5955 patients with dementia and 5955 sex and age-matched healthy controls. We performed conditional logistic regressions to examine the association of dementia with previously diagnosed sepsis. We found that 168 (1.41%) of the sampled people had been hospitalized for treatment of sepsis before the index date, 122 patients (2.05%) and 46 controls (0.77%; p<0.001). The conditional logistic regression indicated that patients with dementia were more likely to have been previously diagnosed with sepsis than controls after adjusting for monthly income, urbanization level, hyperlipidemia, and diabetes (odds ratio [OR] 2.60; 95% confidence interval [CI] 1.84-3.66). We also found that dementia was associated with prior sepsis regardless of sex (males: adjusted OR 3.17; 95% CI 1.76-5.68; females: adjusted OR 2.27; 95% CI 1.48-3.47). We concluded that patients with dementia had a higher odds of previous sepsis compared to the control group.
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Affiliation(s)
- Li-Ting Kao
- Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan; Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Jau-Jiuan Sheu
- Department of Neurology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Herng-Ching Lin
- School of Health Care Administration, Taipei Medical University, 250 Wu-Hsin Street, Taipei 110, Taiwan; Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
| | - Ming-Chieh Tsai
- School of Health Care Administration, Taipei Medical University, 250 Wu-Hsin Street, Taipei 110, Taiwan; Division of Gastroenterology, Department of Internal Medicine, General Cathay Hospital, Taipei, Taiwan
| | - Shiu-Dong Chung
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
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