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Mo W, Liu X, Yamakawa M, Koujiya E, Takeya Y, Shigenobu K, Adachi H, Ikeda M. Prevalence of sleep disturbances in people with mild cognitive impairment: A systematic review and meta-analysis. Psychiatry Res 2024; 339:116067. [PMID: 38964141 DOI: 10.1016/j.psychres.2024.116067] [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: 11/18/2023] [Revised: 05/28/2024] [Accepted: 06/27/2024] [Indexed: 07/06/2024]
Abstract
This review was performed to determine sleep disturbance prevalence in individuals with mild cognitive impairment (MCI). The MEDLINE, Embase, Cochrane Library, CINAHL, PsycINFO, and Web of Science databases were systematically searched from inception to January 20, 2024. Fifty-two studies fulfilling the eligibility criteria were included. However, six of these studies were excluded from data synthesis due to poor methodological quality. The subjective sleep disturbance prevalence among all individuals with MCI was 35.8 % (95 % CI: 31.9-39.7) across 44 studies, and the objective sleep disturbance prevalence was 46.3 % (95 % CI: 36.3-56.3) across 6 studies. Five studies examined TST and WASO, while three assessed SE. Among all potential objective assessments of sleep disturbance prevalence, only TST, WASO, and SE could be meta-analyzed in MCI because of the limited number of studies available. The estimated sleep disturbance prevalence differed significantly according to measurement method, geographical region, and research design. However, the data source did not significantly influence prevalence estimates. In meta-regression analysis, publication year, participant age, percentage of females, and study quality did not predict prevalence. As subjective and objective sleep disturbances are common in people with MCI, effective intervention strategies should be developed to alleviate them.
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Affiliation(s)
- Wenping Mo
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Xiaoji Liu
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Miyae Yamakawa
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan; The Japan Centre for Evidence-Based Practice: A JBI Centre of Excellence, Osaka, Japan.
| | - Eriko Koujiya
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yasushi Takeya
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Kazue Shigenobu
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Osaka, Japan; Asakayama General Hospital, Osaka, Japan
| | - Hiroyoshi Adachi
- Health and Counseling Center, Osaka University, Osaka, Japan; Department of Psychiatry, Graduate School of Medicine, Osaka University
| | - Manabu Ikeda
- Department of Psychiatry, Graduate School of Medicine, Osaka University
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Berger A, Castilhos RM, Ismail Z, Camozzato A. Prevalence of psychotic symptoms in mild cognitive impairment: A systematic review and meta-analysis. Ageing Res Rev 2024; 100:102431. [PMID: 39029803 DOI: 10.1016/j.arr.2024.102431] [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: 09/21/2023] [Revised: 07/15/2024] [Accepted: 07/15/2024] [Indexed: 07/21/2024]
Abstract
INTRODUCTION Neuropsychiatric symptoms may impact prognosis in individuals with mild cognitive impairment (MCI); however, data on frequency of psychotic symptoms are sparse. METHODS We searched MEDLINE, EMBASE, PsychoINFO from inception to June 2023. We included studies reporting patients with MCI prevalence of (delusions and/or hallucinations. Random effects model were performed to estimate the prevalence, and subgroup and meta-regression analyses were performed to explore heterogeneity. RESULTS Of 3145 records identified, 36 studies were included, enrolling 20,426 patients. Overall prevalence of hallucinations was 1.78 % (95 % CI, 1.17 - 2.71) and delusions 3.84 % (95 % CI, 2.71 - 5.42), both with significant heterogeneity (/2 = 90 %). Prevalence of hallucinations and delusions were lower when measured by NPI scales and in population-based samples. DISCUSSION Delusions and hallucinations occur in MCI patients at low rates. Prevalence can be partially explained by the assessment method, sample source and study heterogeneity.
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Affiliation(s)
- Aline Berger
- Programa de Pós-Graduação em Ciências Médicas da Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | | | - Zahinoor Ismail
- Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK; Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences, Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - Analuiza Camozzato
- Programa de Pós-Graduação em Ciências Médicas da Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
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Ferreira DA, Macedo LBC, Foss MP. Neuropsychiatric symptoms as a prodromal factor in Alzheimer's type neurodegenerative disease: A scoping review. Clin Neuropsychol 2024; 38:1031-1059. [PMID: 37881945 DOI: 10.1080/13854046.2023.2273574] [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] [Received: 05/21/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023]
Abstract
Objective: Identifying neuropsychiatric symptoms (NPS) can aid in the early detection of Alzheimer's disease (AD); however, there is still a need for a greater consensus. This review aims to delineate the predominant NPS, compile a comprehensive list of the most commonly employed NPS assessment tools, and corroborate the principal findings regarding the link between NPS and neuropsychological assessment and neurobiological substrates. Methods: To conduct this scoping review, we followed the Preferred Reporting Items for Systematic Reviews guidelines and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We searched for relevant articles published between 2017 and 2023 in MEDLINE, PsycINFO, PubMed, Web of Science, and Cochrane Library. Results: Of the 61 eligible articles, depression, anxiety, and apathy were the main NPSs. The Neuropsychiatric Inventory Questionnaire and Neuropsychiatric Inventory were the primary assessment tools used to evaluate NPS. Correlations between NPS severity and neurobiological markers were considered clinically significant. Furthermore, clinical procedures prioritized the use of global cognitive screening tools, assessments of executive functions, and functionality evaluations. Conclusion: Standardization of procedures is necessary because of the diversity of methods. The data show that NPS can predict the etiology, severity, form, and type of disease progression, serving as a precursor sign of AD. The results of the most common cognitive screening tools and NPS instruments provided an interesting overview of future clinical approaches.
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Affiliation(s)
- Diego Alves Ferreira
- Department of Neuroscience and Behavior Science, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Lorena Barbosa Cunha Macedo
- Faculty of Philosophy, Sciences, and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Maria Paula Foss
- Department of Neuroscience and Behavior Science, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
- Faculty of Philosophy, Sciences, and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Cheng YT, Xin GK, Wang YL, Tan FY, Yuan L, Zhang Y, Liu Y, Ni CP. The current status of apathy in patients with dementia and its factors: A systematic review. Geriatr Nurs 2024; 58:290-297. [PMID: 38848610 DOI: 10.1016/j.gerinurse.2024.05.022] [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] [Received: 01/19/2024] [Revised: 05/14/2024] [Accepted: 05/22/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVE To systematically evaluate the current status of apathy in dementia patients and its associated factors. METHODS We searched Chinese and English databases to collect studies on the associated factors of apathy in patients with dementia from inception to March 14, 2023. Two researchers independently screened the literature, evaluated the quality, and extracted the data RESULTS: A total of 20 studies were included, and the incidence of apathy in patients with dementia ranged from 21 % to 90 %. According to the model of apathy proposed by Massimo in 2018, the associated factors were divided into individual factors for dementia patients, caregiver factors, and environmental factors. The individual factors of apathy in patients with dementia mainly include demographic characteristics, the severity of cognitive impairment, a combination of other behavioral and psychological symptoms of dementia, acute medical problems or adverse drug reactions, unmet needs, and malnutrition. Caregiver factors mainly include emotional expressions of hostility or criticism towards dementia patients and caregivers' expectations for a better life in the future. Environmental factors mainly include too high or too low stimulation and a lack of daytime activities CONCLUSIONS: Existing studies have shown that the incidence of apathy in dementia patients is high and is affected by multi-dimensional factors. There are more studies on individual factors in dementia patients and fewer studies on caregivers and environmental factors. In the future, a large number of high-quality studies are needed to demonstrate the mechanism of apathy in dementia patients and to find more related factors.
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Affiliation(s)
- Yue-Tong Cheng
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China
| | - Gong-Kai Xin
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China
| | - Ye-Lv Wang
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China
| | - Feng-Ying Tan
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China
| | - Lei Yuan
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China
| | - Yu Zhang
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China; Department of Nephrology, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, PR China
| | - Yu Liu
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China
| | - Cui-Ping Ni
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China.
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Leng M, Han S, Sun Y, Zhu Z, Zhao Y, Zhang Y, Yang X, Wang Z. Identifying care problem clusters and core care problems of older adults with dementia for caregivers: a network analysis. Front Public Health 2023; 11:1195637. [PMID: 37637827 PMCID: PMC10449331 DOI: 10.3389/fpubh.2023.1195637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/20/2023] [Indexed: 08/29/2023] Open
Abstract
Background A shift in research interest from separate care problem to care problem clusters among caregivers of people living with dementia may contribute to a better understanding of dementia care. However, the care problems network among caregivers of people living with dementia are still unknown. This study aimed to identify care problem clusters and core care problems, and explore demographic variables associated with these care problem clusters among caregivers of people living with dementia. Methods Participants were recruited through memory clinics and WeChat groups. The principal component analysis was applied to identify care problem clusters. The network analysis was conducted to describe the relationships among care problems and clusters. Multiple linear models were used to explore the associated factors for the occurrence of the overall care problems and top three central care problem clusters. Results A total of 1,012 carer-patient pairs were included in the analysis. Nine care problem clusters were identified. In the entire care problem network, "deterioration in activities of daily living" was the most core care problem cluster across the three centrality indices, followed by "verbal and nonverbal aggression" and "loss of activities of daily living." Variables including marital status, years of dementia diagnosis, number of dementia medication type, and caregiver's educational attainment were associated with the prevalence of these three care problem clusters. Conclusion Our study suggests that there is a need to evaluate care problem clusters for the improvement of care problem management among people living with dementia. It is particularly important to include assessment and treatment of core care problem as an essential component of the dementia care.
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Affiliation(s)
- Minmin Leng
- Department of Nursing, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- School of Nursing, Peking University, Beijing, China
| | - Shuyu Han
- School of Nursing, Peking University, Beijing, China
| | - Yue Sun
- School of Nursing, Peking University, Beijing, China
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai, China
| | - Yajie Zhao
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yizhu Zhang
- School of Nursing, Peking University, Beijing, China
| | - Xianxia Yang
- School of Public Health, Wuhan University, Wuhan, China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, China
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Tahami Monfared AA, Stern Y, Doogan S, Irizarry M, Zhang Q. Understanding Barriers Along the Patient Journey in Alzheimer's Disease Using Social Media Data. Neurol Ther 2023; 12:899-918. [PMID: 37060417 PMCID: PMC10195971 DOI: 10.1007/s40120-023-00472-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/21/2023] [Indexed: 04/16/2023] Open
Abstract
INTRODUCTION We speculated that social media data from Alzheimer's disease (AD) stakeholders (patients, caregivers, and clinicians) could identify barriers along the patient journey in AD, and that insights gained may help devise strategies to remove barriers, and ultimately improve the patient journey. METHODS Our sample was drawn from a repository of social media posts extracted from 112 public sources between January 1998 and December 2021 using natural language processing text-mining algorithms. The patient journey was classified into three phases: (1) early signs/experiences (Early Signs); (2) screening/assessment/diagnosis (Screening); and (3) treatment/management (Treatment). In the Early Signs phase, issues/challenges derived from a conceptual AD identification framework (ADIF) were examined. In subsequent phases, behavioral/psychiatric challenges, access/barriers to health care, screening/diagnostic methods, and symptomatic treatments for AD were identified. Posts were classified by AD stakeholder type or disease stage, if possible. RESULTS We identified 225,977 AD patient journey-related social media posts. Anxiety was a predominant issue/challenge in all patient journey phases. In the Screening and Treatment phases combined, access/barriers to care were described in 16% of posts; unwillingness/resistance to seeking care was a major barrier (≥ 75% of access-related posts across all stakeholders). Commonly identified structural barriers (e.g., affordability/cost, geography/transportation/distance) were more common in patient/caregiver posts than clinician posts. Among Screening-related posts, imaging/scans were commonly mentioned by all stakeholders; biomarkers were more commonly mentioned by patients than clinicians. Treatment-related concerns were identified in 17% of stakeholder-specified posts that named pharmacological agents/classes for the symptomatic management of AD. CONCLUSION This descriptive analysis of out-of-clinic experiences reflected in AD social media posts found that unwillingness/resistance to seeking care was a key barrier, followed by structural barriers to health care, such as affordability/cost. Insights from the lived experiences of AD stakeholders are valuable and highlight the need to improve the patient journey in AD and ease patient and caregiver burden.
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Affiliation(s)
- Amir Abbas Tahami Monfared
- Eisai, Inc., 200 Metro Blvd, Nutley, NJ, 07110, USA.
- Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
| | - Yaakov Stern
- Cognitive Neuroscience Division, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, USA
| | | | | | - Quanwu Zhang
- Eisai, Inc., 200 Metro Blvd, Nutley, NJ, 07110, USA
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