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Beber BC, Alves EV, Pereira N, d'Ávila Freitas MI, Silagi ML, Fagundes Chaves ML, Lawlor B. Awareness and knowledge of dementia and its communication disorders amongst Brazilian speech and language therapists. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024. [PMID: 38899837 DOI: 10.1111/1460-6984.13079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 05/16/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Speech and language therapists (SLTs) play an important role in assessing and rehabilitating communication disorders in people with dementia, but there is evidence to suggest that they do not receive appropriate training to provide management and support during their training. AIM To investigate the level of awareness and knowledge that practising SLTs from Brazil have about dementia and their role in the care of dementia through an online survey. METHODS & PROCEDURES An online survey tool was developed to collect information from practising Brazilian SLTs regarding their knowledge about dementia, awareness about their role in the care of people with dementia, and opinions on how SLTs may be better prepared to work in the dementia field. The survey was disseminated via social media, websites, and e-mail lists of researchers and stakeholders. OUTCOMES & RESULTS A total of 227 SLTs completed the survey. Participants showed good knowledge of dementia in general, while their answers were less accurate on primary progressive aphasia. Regarding the awareness by SLTs of their role in the care of people with dementia, most agreed or strongly agreed that SLTs could help people in the diagnosis, treatment and prevention of dementia (> 80%). However, fewer participants agreed or strongly agreed that they felt confident in contributing to the treatment and diagnosis process of dementia (about 50%). To improve the training of SLTs in Brazil, most participants believed that it would be necessary to improve the teaching of dementia at the undergraduate speech and language therapy curriculum level and to develop recommendations or guidelines about speech and language therapy practice in dementia. CONCLUSIONS & IMPLICATIONS The results of this survey point to a need for improvement in the knowledge and confidence of Brazilian SLTs about dementia. To reach this goal, targeted training courses and applied practice opportunities should be embedded within university curricula and training programmes. WHAT THIS PAPER ADDS What is already known on the subject Many studies confirm the importance of speech and language therapy in the non-pharmacological treatment of people with dementia. However, other evidence suggests to a possible lack of training for Brazilian SLTs, especially in the curriculum of undergraduate courses. What this paper adds to existing knowledge This study reveals that Brazilian SLTs have substantial knowledge of dementia and recognize the significance of their role in treating people with dementia. However, a minority expressed confidence in their ability to assess and treat people with dementia. What are the potential or actual clinical implications of this work? The findings of this research demonstrate that Brazilian SLTs have good knowledge of dementia and endorse their professional role in dementia care; however, they lack confidence in their own skills and expertise in diagnostic assessment and treatment of dementia. Interventions aimed at boosting the SLT's confidence level could lead to improved patients outcomes and overall quality of care within clinical settings.
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Affiliation(s)
- Bárbara Costa Beber
- Department of Speech, Language and Hearing Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Emily Viega Alves
- Department of Speech, Language and Hearing Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Natalie Pereira
- Department of Speech, Language and Hearing Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Isabel d'Ávila Freitas
- Department of Speech, Language and Hearing Sciences, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Marcela Lima Silagi
- Department of Speech, Language and Hearing Sciences, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Márcia Lorena Fagundes Chaves
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Brian Lawlor
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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Katariya RA, Sammeta SS, Kale MB, Kotagale NR, Umekar MJ, Taksande BG. Agmatine as a novel intervention for Alzheimer's disease: Pathological insights and cognitive benefits. Ageing Res Rev 2024; 96:102269. [PMID: 38479477 DOI: 10.1016/j.arr.2024.102269] [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: 01/17/2024] [Revised: 03/01/2024] [Accepted: 03/08/2024] [Indexed: 03/24/2024]
Abstract
Alzheimer's disease (AD) is a devastating neurodegenerative disorder characterized by progressive cognitive decline and a significant societal burden. Despite extensive research and efforts of the multidisciplinary scientific community, to date, there is no cure for this debilitating disease. Moreover, the existing pharmacotherapy for AD only provides symptomatic support and does not modify the course of the illness or halt the disease progression. This is a significant limitation as the underlying pathology of the disease continues to progress leading to the deterioration of cognitive functions over time. In this milieu, there is a growing need for the development of new and more efficacious treatments for AD. Agmatine, a naturally occurring molecule derived from L-arginine, has emerged as a potential therapeutic agent for AD. Besides this, agmatine has been shown to modulate amyloid beta (Aβ) production, aggregation, and clearance, key processes implicated in AD pathogenesis. It also exerts neuroprotective effects, modulates neurotransmitter systems, enhances synaptic plasticity, and stimulates neurogenesis. Furthermore, preclinical and clinical studies have provided evidence supporting the cognition-enhancing effects of agmatine in AD. Therefore, this review article explores the promising role of agmatine in AD pathology and cognitive function. However, several limitations and challenges exist, including the need for large-scale clinical trials, optimal dosing, and treatment duration. Future research should focus on mechanistic investigations, biomarker studies, and personalized medicine approaches to fully understand and optimize the therapeutic potential of agmatine. Augmenting the use of agmatine may offer a novel approach to address the unmet medical need in AD and provide cognitive enhancement and disease modification for individuals affected by this disease.
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Affiliation(s)
- Raj A Katariya
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur, Maharashtra 441002, India
| | - Shivkumar S Sammeta
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur, Maharashtra 441002, India
| | - Mayur B Kale
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur, Maharashtra 441002, India
| | - Nandkishor R Kotagale
- Government College of Pharmacy, Kathora Naka, VMV Road, Amravati, Maharashtra 444604, India
| | - Milind J Umekar
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur, Maharashtra 441002, India
| | - Brijesh G Taksande
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur, Maharashtra 441002, India.
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Dimitriou NK, Nousia A, Georgopoulou EN, Martzoukou M, Liampas I, Dardiotis E, Nasios G. Language and Communication Interventions in People with Alzheimer's Disease: A Systematic Review. Healthcare (Basel) 2024; 12:741. [PMID: 38610163 PMCID: PMC11011709 DOI: 10.3390/healthcare12070741] [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: 01/12/2024] [Revised: 03/20/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Although language impairment is frequently observed in patients with Alzheimer's disease (pwAD), targeted language rehabilitation is often overlooked. The present study reviews published evidence on the impact of language training, either alone or in combination with cognitive training, on cognitive outcomes in pwAD. A systematic search of PubMed, Google Scholar, and Cochrane was carried out, including studies published from inception to November 2023. A total of eight research articles (four randomized controlled trials and four observational studies) met the inclusion criteria: six assessed language training combined with cognitive training and two evaluated language rehabilitation alone. Regarding language and non-language (mainly memory, attention, and executive functions) outcomes, there was a consensus among studies that language rehabilitation (alone or in combination with cognitive training) yields positive results. Some of the articles also explored the impact on patients' and their caregivers' quality of life, with all but one showing improvement. Consequently, the combination of language and cognitive training leads to improvements across various cognitive domains. However, limited evidence supports the value of sole language rehabilitation. This conclusion is influenced by heterogeneity among studies (different types and duration of interventions, small participant sets, various assessment tools), and, thus, further research is warranted.
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Affiliation(s)
- Nefeli K. Dimitriou
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece; (N.K.D.); (E.-N.G.); (G.N.)
| | - Anastasia Nousia
- Department of Speech and Language Therapy, University of Peloponnese, 24100 Kalamata, Greece;
| | - Eleni-Nefeli Georgopoulou
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece; (N.K.D.); (E.-N.G.); (G.N.)
| | - Maria Martzoukou
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41100 Larissa, Greece;
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41100 Larissa, Greece;
| | - Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece; (N.K.D.); (E.-N.G.); (G.N.)
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Rudisch DM, Krasko MN, Barnett DGS, Mueller KD, Russell JA, Connor NP, Ciucci MR. Early ultrasonic vocalization deficits and related thyroarytenoid muscle pathology in the transgenic TgF344-AD rat model of Alzheimer's disease. Front Behav Neurosci 2024; 17:1294648. [PMID: 38322496 PMCID: PMC10844490 DOI: 10.3389/fnbeh.2023.1294648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/01/2023] [Indexed: 02/08/2024] Open
Abstract
Background Alzheimer's disease (AD) is a progressive neurologic disease and the most common cause of dementia. Classic pathology in AD is characterized by inflammation, abnormal presence of tau protein, and aggregation of β-amyloid that disrupt normal neuronal function and lead to cell death. Deficits in communication also occur during disease progression and significantly reduce health, well-being, and quality of life. Because clinical diagnosis occurs in the mid-stage of the disease, characterizing the prodrome and early stages in humans is currently challenging. To overcome these challenges, we use the validated TgF344-AD (F344-Tg(Prp-APP, Prp-PS1)19/Rrrc) transgenic rat model that manifests cognitive, behavioral, and neuropathological dysfunction akin to AD in humans. Objectives The overarching goal of our work is to test the central hypothesis that pathology and related behavioral deficits such as communication dysfunction in part manifest in the peripheral nervous system and corresponding target tissues already in the early stages. The primary aims of this study are to test the hypotheses that: (1) changes in ultrasonic vocalizations (USV) occur in the prodromal stage at 6 months of age and worsen at 9 months of age, (2) inflammation as well as AD-related pathology can be found in the thyroarytenoid muscle (TA) at 12 months of age (experimental endpoint tissue harvest), and to (3) demonstrate that the TgF344-AD rat model is an appropriate model for preclinical investigations of early AD-related vocal deficits. Methods USVs were collected from male TgF344-AD (N = 19) and wildtype (WT) Fischer-344 rats (N = 19) at 6 months (N = 38; WT: n = 19; TgF344-AD: n = 19) and 9 months of age (N = 18; WT: n = 10; TgF344-AD: n = 8) and acoustically analyzed for duration, mean power, principal frequency, low frequency, high frequency, peak frequency, and call type. RT-qPCR was used to assay peripheral inflammation and AD-related pathology via gene expressions in the TA muscle of male TgF344-AD rats (n = 6) and WT rats (n = 6) at 12 months of age. Results This study revealed a significant reduction in mean power of ultrasonic calls from 6 to 9 months of age and increased peak frequency levels over time in TgF344-AD rats compared to WT controls. Additionally, significant downregulation of AD-related genes Uqcrc2, Bace2, Serpina3n, and Igf2, as well as downregulation of pro-inflammatory gene Myd88 was found in the TA muscle of TgF344-AD rats at 12 months of age. Discussion Our findings demonstrate early and progressive vocal deficits in the TgF344-AD rat model. We further provide evidence of dysregulation of AD-pathology-related genes as well as inflammatory genes in the TA muscles of TgF344-AD rats in the early stage of the disease, confirming this rat model for early-stage investigations of voice deficits and related pathology.
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Affiliation(s)
- Denis Michael Rudisch
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, United States
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, UW School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- UW Institute for Clinical and Translational Research, UW School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Maryann N Krasko
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, United States
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, UW School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - David G S Barnett
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, UW School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Kimberly D Mueller
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, United States
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - John A Russell
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, UW School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Nadine P Connor
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, United States
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, UW School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Michelle R Ciucci
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, United States
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, UW School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, United States
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Pless A, Ware D, Saggu S, Rehman H, Morgan J, Wang Q. Understanding neuropsychiatric symptoms in Alzheimer's disease: challenges and advances in diagnosis and treatment. Front Neurosci 2023; 17:1263771. [PMID: 37732300 PMCID: PMC10508352 DOI: 10.3389/fnins.2023.1263771] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/21/2023] [Indexed: 09/22/2023] Open
Abstract
Neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) affect up to 97% of AD patients, with an estimated 80% of current AD patients experiencing these symptoms. Common AD-associated NPS include depression, anxiety, agitation, aggression, and apathy. The severity of NPS in AD is typically linked to the disease's progression and the extent of cognitive decline. Additionally, these symptoms are responsible for a significant increase in morbidity, mortality, caregiver burden, earlier nursing home placement, and greater healthcare expenditure. Despite their high prevalence and significant impact, there is a notable lack of clinical research on NPS in AD. In this article, we explore and analyze the prevalence, symptom manifestations, challenges in diagnosis, and treatment options of NPS associated with AD. Our literature review reveals that distinguishing and accurately diagnosing the NPS associated with AD remains a challenging task in clinical settings. It is often difficult to discern whether NPS are secondary to pathophysiological changes from AD or are comorbid psychiatric conditions. Furthermore, the availability of effective pharmaceutical interventions, as well as non-pharmacotherapies for NPS in AD, remains limited. By highlighting the advance and challenges in diagnosis and treatment of AD-associated NPS, we aspire to offer new insights into the complexity of identifying and treating these symptoms within the context of AD, and contribute to a deeper understanding of the multifaceted nature of NPS in AD.
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Affiliation(s)
- Andrew Pless
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Destany Ware
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Shalini Saggu
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Hasibur Rehman
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - John Morgan
- Department of Neurology, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Qin Wang
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
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Hockley A, Moll D, Littlejohns J, Collett Z, Henshall C. Do communication interventions affect the quality-of-life of people with dementia and their families? A systematic review. Aging Ment Health 2023; 27:1666-1675. [PMID: 37079782 DOI: 10.1080/13607863.2023.2202635] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/03/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVES Speech, language and communication difficulties are prevalent in all dementia subtypes and are likely to considerably impact the quality-of-life of people with dementia and their families. Communication interventions provided by trained professionals are recommended for this population, but little is known about their quality-of-life outcomes. This review aims to explore the quality-of-life outcomes of communication-related interventions for people with dementia and their families. METHODS Seven databases were systematically searched. Reference lists from included studies and relevant systematic reviews were also hand-searched. Primary research with quantitative quality-of-life outcomes were included. Narrative analysis was utilised to identify key intervention features and to describe quality-of-life outcomes. RESULTS 1,174 studies were identified. Twelve studies were eligible for inclusion. Studies were heterogeneous in location, participant group, methodologies, interventions and outcome measures. Four studies reported increased quality-of-life for people with dementia following intervention. No studies reported increased quality-of-life for family members. CONCLUSION Further research is needed in this area. The studies which reported improved quality-of-life involved multi-disciplinary approaches to intervention, involvement of family caregivers, and functional communication intervention. However, data is limited so results should be interpreted with caution. The standardised use of a communication-focused quality-of-life outcome measure would improve sensitivity and comparability of future studies.
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Affiliation(s)
- Anna Hockley
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Deborah Moll
- Research and Development, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Jemima Littlejohns
- Research and Development, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Zoe Collett
- Research and Development, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Catherine Henshall
- Research and Development, Oxford Health NHS Foundation Trust, Oxford, UK
- Oxford Institute for Nursing, Midwifery and Allied Health Research, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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Jeong JH, Hong GL, Jeong YG, Lee NS, Kim DK, Park JY, Park M, Kim HM, Kim YE, Yoo YC, Han SY. Mixed Medicinal Mushroom Mycelia Attenuates Alzheimer's Disease Pathologies In Vitro and In Vivo. Curr Issues Mol Biol 2023; 45:6775-6789. [PMID: 37623247 PMCID: PMC10453438 DOI: 10.3390/cimb45080428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/10/2023] [Accepted: 08/13/2023] [Indexed: 08/26/2023] Open
Abstract
Alzheimer's disease (AD) is characterized by memory impairment and existence of amyloid-β (Aβ) plaques and neuroinflammation. Due to the pivotal role of oxidative damage in AD, natural antioxidative agents, such as polyphenol-rich fungi, have garnered scientific scrutiny. Here, the aqueous extract of mixed medicinal mushroom mycelia (MMMM)-Phellinus linteus, Ganoderma lucidum, and Inonotus obliquus-cultivated on a barley medium was assessed for its anti-AD effects. Neuron-like PC12 cells, which were subjected to Zn2+, an Aβ aggregator, were employed as an in vitro AD model. The cells pretreated with or without MMMM were assayed for Aβ immunofluorescence, cell viability, reactive oxygen species (ROS), apoptosis, and antioxidant enzyme activity. Then, 5XFAD mice were administered with 30 mg/kg/day MMMM for 8 weeks and underwent memory function tests and histologic analyses. In vitro results demonstrated that the cells pretreated with MMMM exhibited attenuation in Aβ immunofluorescence, ROS accumulation, and apoptosis, and incrementation in cell viability and antioxidant enzyme activity. In vivo results revealed that 5XFAD mice administered with MMMM showed attenuation in memory impairment and histologic deterioration such as Aβ plaque accumulation and neuroinflammation. MMMM might mitigate AD-associated memory impairment and cerebral pathologies, including Aβ plaque accumulation and neuroinflammation, by impeding Aβ-induced neurotoxicity.
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Affiliation(s)
- Ji Heun Jeong
- Armed Forces Medical Research Institute (AFMRI), Daejeon 34059, Republic of Korea;
| | - Geum-Lan Hong
- Department of Anatomy, College of Medicine, Konyang University, Daejeon 35365, Republic of Korea; (G.-L.H.); (Y.G.J.); (N.S.L.); (D.K.K.)
| | - Young Gil Jeong
- Department of Anatomy, College of Medicine, Konyang University, Daejeon 35365, Republic of Korea; (G.-L.H.); (Y.G.J.); (N.S.L.); (D.K.K.)
| | - Nam Seob Lee
- Department of Anatomy, College of Medicine, Konyang University, Daejeon 35365, Republic of Korea; (G.-L.H.); (Y.G.J.); (N.S.L.); (D.K.K.)
| | - Do Kyung Kim
- Department of Anatomy, College of Medicine, Konyang University, Daejeon 35365, Republic of Korea; (G.-L.H.); (Y.G.J.); (N.S.L.); (D.K.K.)
| | - Jong Yea Park
- Giunchan Co., Ltd., Cheonan 31035, Republic of Korea; (J.Y.P.); (M.P.); (H.M.K.); (Y.E.K.)
| | - Mina Park
- Giunchan Co., Ltd., Cheonan 31035, Republic of Korea; (J.Y.P.); (M.P.); (H.M.K.); (Y.E.K.)
| | - Hyun Min Kim
- Giunchan Co., Ltd., Cheonan 31035, Republic of Korea; (J.Y.P.); (M.P.); (H.M.K.); (Y.E.K.)
| | - Ya El Kim
- Giunchan Co., Ltd., Cheonan 31035, Republic of Korea; (J.Y.P.); (M.P.); (H.M.K.); (Y.E.K.)
| | - Yung Choon Yoo
- Department of Microbiology, College of Medicine, Konyang University, Daejeon 35365, Republic of Korea;
| | - Seung Yun Han
- Department of Anatomy, College of Medicine, Konyang University, Daejeon 35365, Republic of Korea; (G.-L.H.); (Y.G.J.); (N.S.L.); (D.K.K.)
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Brown EL, Ruggiano N, Allala SC, Clarke PJ, Davis D, Roberts L, Framil CV, Muñoz MTH, Hough MS, Bourgeois MS. Developing a Memory and Communication App for Persons Living With Dementia: An 8-Step Process. JMIR Aging 2023; 6:e44007. [PMID: 36920462 PMCID: PMC10131779 DOI: 10.2196/44007] [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: 11/02/2022] [Revised: 01/28/2023] [Accepted: 02/25/2023] [Indexed: 02/27/2023] Open
Abstract
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.3928/19404921-20210825-02.
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Affiliation(s)
- Ellen L Brown
- Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, FL, United States
| | - Nicole Ruggiano
- School of Social Work, The University of Alabama, Tuscaloosa, AL, United States
| | - Sai Chaithra Allala
- Knight Foundation School of Computing and Information Sciences, Florida International University, Miami, FL, United States
| | - Peter J Clarke
- Knight Foundation School of Computing and Information Sciences, Florida International University, Miami, FL, United States
| | - Debra Davis
- Knight Foundation School of Computing and Information Sciences, Florida International University, Miami, FL, United States
| | - Lisa Roberts
- Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, FL, United States
| | - C Victoria Framil
- Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, FL, United States
| | | | - Monica Strauss Hough
- Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, FL, United States
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Xiao L, Gregoric C, Gordon S, Ullah S, Goodwin-Smith I, Muir-Cochrane E, Blunt S. Comparisons on factors affecting residents fulfilling self-determination in ethno-specific and mainstream nursing homes: a qualitative study. BMC Geriatr 2023; 23:81. [PMID: 36750926 PMCID: PMC9903278 DOI: 10.1186/s12877-023-03800-w] [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: 05/24/2022] [Accepted: 02/03/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Studies revealed that supporting residents fulfilling self-determination is positively associated with their health, wellbeing and quality of life. Cross-cultural care poses significant challenges for nursing home residents to fulfil their self-determination in control of own care and maintaining meaningful connections with others. The aim of the study was to compare factors affecting residents fulfilling self-determination in ethno-specific and mainstream nursing homes. METHODS A qualitative descriptive approach was applied to the study. Culturally competent care and person-centred care were employed as guiding frameworks. Individual interviews or a focus group with residents and family members were conducted to collect data. RESULTS In total, 29 participants participated in the study. Three main themes were identified: communicating needs and preferences; mastering own care; and maintaining meaningful relationships. Each theme includes sub-themes that detail similarities and differences of factors affecting residents fulfilling self-determination in the two type nursing homes. Findings indicate that residents from both types of nursing homes experienced challenges to communicate their care needs and preferences in daily care activities. Moreover, residents or their representatives from both types of nursing homes demonstrated motivation and competence to master residents' care based on their individual preferences, but also perceived that their motivation was not always supported by staff or the nursing home environment. Residents' competence in mastering their care activities in ethno-specific nursing homes was based on the condition that they were given opportunities to use a language of choice in communication and staff and the nursing home demonstrated culturally competent care for them. In addition, ethno-specific nursing homes showed more recourse to support residents to maintain meaningful relationships with peers and others. CONCLUSIONS Culturally competent care created by staff, nursing homes and the aged care system is a basic condition for residents from ethnic minority groups to fulfil self-determination. In addition, person-centred care approach enables residents to optimise self-determination.
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Affiliation(s)
- Lily Xiao
- College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide, South Australia, 5042, Australia.
| | - Carolyn Gregoric
- grid.1014.40000 0004 0367 2697College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide, South Australia 5042 Australia
| | - Sue Gordon
- grid.1014.40000 0004 0367 2697Flinders University, Adelaide, Australia
| | - Shahid Ullah
- grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Ian Goodwin-Smith
- grid.1014.40000 0004 0367 2697College of Business, Government & Law, Flinders University, Adelaide, Australia
| | - Eimear Muir-Cochrane
- grid.1014.40000 0004 0367 2697College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide, South Australia 5042 Australia
| | - Sara Blunt
- Kalyra Communities, Adelaide, South Australia Australia
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Gambella E, Valenza S, Giulietti MV, Gagliardi C, Civerchia P, Fabbietti P, Lattanzio F, Pelliccioni G. "The Community That Takes Care of Itself": A Feasibility Study to Support Families Caring for a Loved One With Alzheimer Disease. FAMILY & COMMUNITY HEALTH 2022; 45:238-246. [PMID: 35985024 DOI: 10.1097/fch.0000000000000333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This pilot project was aimed at supporting those families caring at home for loved ones suffering from Alzheimer dementia. Fourteen dyads of "caregivers-loved ones with dementia" were recruited and assigned either to the experimental group (n = 7) or to the control group (n = 7). The experimental group attended a training course, an Alzheimer Café, a self-help group for caregivers, and the support from a volunteer and professional nurse in-home visits, while the control group's dyads attended a standard intervention. To investigate the effects of this integrated and interprofessional model of care, caregivers completed the Caregiver Burden Inventory and 2 ad hoc structured questions to evaluate whether quality of life of the dyads was changed. Moreover, the caregivers of the experimental group completed the Self-Assessment Single Questionnaire, version 6 (Q-UAV6). Only caregivers of the experimental group reported a significant reduction in burden and an improved quality of life of the dyad. They also showed a greater acceptance of the disease, became experts in the care of their loved ones, and improved their relationship. The creation of a service integration network of professionals, volunteers, and families has been shown to be useful in supporting those families caring at home for loved ones suffering from Alzheimer dementia.
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Affiliation(s)
- Elena Gambella
- Department of Neurology (Ms Gambella and Drs Giulietti, Civerchia, and Pelliccioni), Centre for Socio-Economic Research on Ageing (Ms Gagliardi), Laboratory of Geriatric Pharmacoepidemiology (Mr Fabbietti), and Scientific Direction (Dr Lattanzio), IRCCS INRCA-National Institute of Health & Science on Ageing, Ancona, Italy; and Department of Hospital Psychology, Ospedali Riuniti Marche Nord, Pesaro, Italy (Dr Valenza)
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11
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Overen CK, Larsson M, Hillestad AH, Eriksen S. Process of pain assessment in people with dementia living in nursing homes: a scoping review protocol. BMJ Open 2022; 12:e063230. [PMID: 36171025 PMCID: PMC9528625 DOI: 10.1136/bmjopen-2022-063230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Pain is a common symptom in people with dementia; untreated, it reduces quality of life and causes suffering. People with dementia living in nursing homes most often have dementia in moderate to severe stages. The cognitive impairment, including language and communication difficulties, challenges pain assessment. Since pain is a subjective experience, self-reporting is the gold standard of assessment methods. Healthcare professionals are advised to help people with dementia communicate about their pain. The proposed scoping review is the first step in the development of a systematic pain assessment model for people with dementia living in nursing homes. The scoping review aims to identify, categorise and summarise knowledge on how pain assessment processes in this population are described in the literature, with a special focus on self-reporting. METHODS AND ANALYSIS The scoping review will be conducted following the six-stage framework developed by Arksey and O'Malley, in addition to recent methodological developments. Systematic searches in CINAHL, Embase, Medline and PsycInfo will be conducted. The protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklists, and the scoping review will adhere to the PRISMA-ScR checklist. The review will include research that concerns assessment of pain in people with dementia living in nursing homes. Studies will be evaluated for quality and ethical standards. The analysis process will follow Bradbury-Jones et al's PAGER framework. Patterns will be formed using thematic analysis. An overview of advances, gaps, evidence for practice and research recommendations associated with each pattern will be prepared. The research questions and results will be presented to and discussed in a reference group comprising nursing home residents, relatives, healthcare professionals and nursing home managers. ETHICS AND DISSEMINATION The scoping review aims to collect and summarise data from available publications and does not require ethical approval. The final manuscript will be submitted to a peer-reviewed, open-access journal. REGISTRATION IN OPEN SCIENCE FRAMEWORK: https://osf.io/8kaf5/.
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Affiliation(s)
- Caroline Kreppen Overen
- Institute of Health Sciences, Department of Nursing, Karlstad University, Faculty of Health, Science and Technology, Karlstad, Sweden
- Bachelor Education in Nursing, Lovisenberg Diaconal University College, Oslo, Norway
| | - Maria Larsson
- Institute of Health Sciences, Department of Nursing, Karlstad University, Faculty of Health, Science and Technology, Karlstad, Sweden
| | | | - Siren Eriksen
- Bachelor Education in Nursing, Lovisenberg Diaconal University College, Oslo, Norway
- Norwegian National Centre for Ageing and Health, Tønsberg, Norway
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12
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Almeida VN, Radanovic M. Semantic processing and neurobiology in Alzheimer's disease and Mild Cognitive Impairment. Neuropsychologia 2022; 174:108337. [DOI: 10.1016/j.neuropsychologia.2022.108337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/17/2022] [Accepted: 07/17/2022] [Indexed: 11/28/2022]
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Liang X, Batsis JA, Zhu Y, Driesse TM, Roth RM, Kotz D, MacWhinney B. Evaluating Voice-Assistant Commands for Dementia Detection. COMPUT SPEECH LANG 2022; 72:101297. [PMID: 34764541 PMCID: PMC8577405 DOI: 10.1016/j.csl.2021.101297] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Early detection of cognitive decline involved in Alzheimer's Disease and Related Dementias (ADRD) in older adults living alone is essential for developing, planning, and initiating interventions and support systems to improve users' everyday function and quality of life. In this paper, we explore the voice commands using a Voice-Assistant System (VAS), i.e., Amazon Alexa, from 40 older adults who were either Healthy Control (HC) participants or Mild Cognitive Impairment (MCI) participants, age 65 or older. We evaluated the data collected from voice commands, cognitive assessments, and interviews and surveys using a structured protocol. We extracted 163 unique command-relevant features from each participant's use of the VAS. We then built machine-learning models including 1-layer/2-layer neural networks, support vector machines, decision tree, and random forest, for classification and comparison with standard cognitive assessment scores, e.g., Montreal Cognitive Assessment (MoCA). Our classification models using fusion features achieved an accuracy of 68%, and our regression model resulted in a Root-Mean-Square Error (RMSE) score of 3.53. Our Decision Tree (DT) and Random Forest (RF) models using selected features achieved higher classification accuracy 80-90%. Finally, we analyzed the contribution of each feature set to the model output, thus revealing the commands and features most useful in inferring the participants' cognitive status. We found that features of overall performance, features of music-related commands, features of call-related commands, and features from Automatic Speech Recognition (ASR) were the top-four feature sets most impactful on inference accuracy. The results from this controlled study demonstrate the promise of future home-based cognitive assessments using Voice-Assistant Systems.
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Affiliation(s)
- Xiaohui Liang
- Department of Computer Science, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125-3393 USA
| | - John A Batsis
- Division of Geriatric Medicine, University of North Carolina at Chapel Hill, 5017 Old Clinic Building, Chapel Hill, NC 27599 USA
| | - Youxiang Zhu
- Department of Computer Science, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125-3393 USA
| | - Tiffany M Driesse
- Division of Geriatric Medicine, University of North Carolina at Chapel Hill, 5017 Old Clinic Building, Chapel Hill, NC 27599 USA
| | - Robert M Roth
- Department of Psychiatry, Geisel School of Medicine at Dartmouth/DHMC, Lebanon, NH 03756 USA
| | - David Kotz
- Department of Computer Science, Dartmouth College, Hanover, NH 03755 USA
| | - Brian MacWhinney
- Department of Psychology, Carnegie Mellon University, 5000 Forbes Avenue Pittsburgh, PA 15213 US
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Brown EL, Ruggiano N, Roberts L, Clarke PJ, Davis DL, Agronin M, Geldmacher DS, Hough MS, Muñoz MTH, Framil CV, Yang X. Integration of Health Information Technology and Promotion of Personhood in Family-Centered Dementia Care: Intervention Trial. Res Gerontol Nurs 2021; 14:225-234. [PMID: 34542347 DOI: 10.3928/19404921-20210825-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Alzheimer's disease and related dementias (ADRD) often result in communication deficits that can lead to negative health outcomes as well as complications for caregiving and clinical care. Although augmentative and alternative communication (AAC) devices have demonstrated efficacy in assisting persons living with dementia (PLWD) in communicating, few devices offer customization for the person's care preferences (e.g., clothing, food, activities) or are designed for integration into clinical care and caregiving. To address this issue, our research team is developing a novel electronic AAC prototype with a touchscreen to promote communication and personhood for PLWD. The current article describes the development of this technology and uses the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 Statement to describe the clinical trial that is planned to test its efficacy. TARGETS PLWD and their care partners. INTERVENTION DESCRIPTION Use of AAC Plus to promote communication and personhood for PLWD. MECHANISMS OF ACTION AAC Plus will provide PLWD and care partners a way to communicate PLWD's daily preferences and provide clinical data for health care providers. OUTCOMES Determine whether enhanced communication of daily preferences of PLWD will improve quality of life of PLWD and their care partners. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04571502 (Date of registration October 1, 2020). [Research in Gerontological Nursing, 14(5), 225-234.].
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15
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Levy-Storms L, Chen L. Communicating emotional support: family caregivers' visits with residents living with dementia in nursing homes. J Women Aging 2020; 32:389-401. [PMID: 32684113 DOI: 10.1080/08952841.2020.1787787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study characterized emotional connections between largely female caregivers and female care recipients with dementia living in nursing homes with the research question: How does interpersonal communication between family caregivers and older adults with dementia convey enacted emotional support? Ten dyads (8 with at least one female) of regularly-involved family caregivers (7 female; 3 male) and their relatives with dementia (5 female; 5 male) were videotaped. Qualitatively, three themes emerged: 1) distinct conversational topics, 2) shared physical proximity and silence, and 3) catalysts for natural interaction. These findings may help improve the quality of life of these predominantly female dyads.
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Affiliation(s)
- Lené Levy-Storms
- Departments of Social Welfare & Medicine/Geriatrics, UCLA, USA.,Department of Social Work, School of Social Development and Public Policy, Fudan University , China
| | - Lin Chen
- Departments of Social Welfare & Medicine/Geriatrics, UCLA, USA.,Department of Social Work, School of Social Development and Public Policy, Fudan University , China
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16
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Krein L, Jeon YH, Miller Amberber A. Development of a new tool for the early identification of communication-support needs in people living with dementia: An Australian face-validation study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:544-554. [PMID: 31670440 DOI: 10.1111/hsc.12887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/30/2019] [Accepted: 10/14/2019] [Indexed: 06/10/2023]
Abstract
Language and communication difficulties are common in dementia but limited tools are available for a timely assessment of those individuals who experience these difficulties. The Communication-Support Needs Assessment Tool in Dementia (CoSNAT-D) was developed to assist in (a) the early identification of communication difficulties among people with dementia in the community context; and (b) determining the level of their communication support needs to guide appropriate service access. The CoSNAT-D was developed based on a literature review. The face validity was tested with end-users (people with dementia and support persons of people with dementia) regarding relevance, wording, syntax, appropriateness and comprehensiveness of the items of the tool. Data were collected using semi-structured phone interviews. Seven people with dementia and 15 carers participated in the study. Feedback regarding items' appropriateness was largely positive and minor changes were made to improve comprehensiveness. A new item was added to the original item pool. The interviews highlighted the importance of including people with dementia in the assessment processes and person-centered approaches in this context. The CoSNAT-D presents a first step for the early identification of individual support needs of people living with dementia and communication difficulties who live in the community. Items of the CoSNAT-D have been determined face-valid by end-users. The face-validated version of the tool is currently undergoing further testing to determine additional relevant psychometric properties.
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Affiliation(s)
- Luisa Krein
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia
| | - Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia
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Bjørge H, Kvaal K, Ulstein I. The effect of psychosocial support on caregivers' perceived criticism and emotional over-involvement of persons with dementia: an assessor-blinded randomized controlled trial. BMC Health Serv Res 2019; 19:744. [PMID: 31651321 PMCID: PMC6813966 DOI: 10.1186/s12913-019-4551-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/23/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Many relatives of close family members suffering from dementia have taken on the caregiver role. While intervention studies have revealed promising results on caregiver burden, distress, and depression, there is a lack of knowledge about how caregivers' perceived relationship with their ill family member influences the burden of care. This study examined whether a psychosocial intervention influenced this perceived relationship from the caregivers' perspective. We also explored whether the caregivers' perception of the care receiver's attitude and behavior changed over time, and whether caregiver stress and mood differed following the intervention. METHODS The participating caregivers and care receivers were randomly assigned to a psychosocial intervention comprising education about dementia, counselling and group sessions, or to treatment as usual. The study investigated caregivers' experience of expressed emotion using the Felt Expressed Emotion Rating Scale (FEERS), a self-report questionnaire that captures caregivers' perception of criticism (CC) and emotional over-involvement (EOI) exhibited by the family members with dementia. RESULTS A total of 208 dyads were enrolled in the study. There were no significant differences between the intervention and control groups in the studied variables. Caregivers' perception of CC and EOI was low but fluctuated somewhat, whereas their mood and stress level were stable during the follow-up period. CONCLUSIONS According to the FEERS, the intervention did not influence caregivers' perception of CC and EOI, and there was no difference between the intervention and control groups regarding caregivers' perceived relationship. Despite the increased symptoms of dementia, caregivers' level of distress and mood remained stable, and they seemed to maintain a positive perception of the quality of their relationship with the care receiver. TRIAL REGISTRATION Clinical.Trials.gov Sept. 2009, NCT01287767.
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Affiliation(s)
- Heidi Bjørge
- Faculty of Health Sciences, Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, Pb. 4, St. Olavs plass, N-0130 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kari Kvaal
- Inland Norway University of Applied Sciences, Faculty of Health and Social Sciences, Elverum, Norway
| | - Ingun Ulstein
- The Memory Clinic, Department of Geriatric Medicine, Oslo University Hospital Trust, Ullevål, Oslo, Norway
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18
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Abendstern M, Davies K, Poland F, Chester H, Clarkson P, Hughes J, Sutcliffe C, Challis D. Reflecting on the research encounter for people in the early stages of dementia: Lessons from an embedded qualitative study. DEMENTIA 2019; 19:2732-2749. [DOI: 10.1177/1471301219855295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Gathering meaningful data from people with dementia presents challenges to researchers involved in both qualitative and quantitative studies. Careful planning and implementation are required, including skilful and sympathetic management by the researcher who must pay attention to the cognitive challenges experienced by the person with dementia. These challenges are particularly evident when conducting structured interviews using standardised measures. This paper presents the findings of an embedded qualitative study undertaken within a pragmatic randomised controlled trial. The novel method involves nesting a qualitative analysis within a quantitative study by recording incidental conversation during structured interviews, requiring no additional data collection. The method shone a light on the formal interview process itself, something rarely revealed outside the interview setting. It provided a unique insight into the challenges posed by research participation for people in early-stage dementia. Analysis revealed three main themes relating to dementia as a condition and to the research design. First, people with dementia contributed very few conversational comments during the structured interviews. Second, the context of the interview, that is: managing the conversational interchange, responding to direct and often sensitive questions and making decisions about day-to day-feelings and experiences was difficult for participants to manage. Third, people in early stage dementia struggled with the content of the structured interviews due to their linguistic and cognitive demands. The findings raise questions about how people with dementia are included in research and the methods employed to gather accurate data with minimal inconvenience and stress for research participants.
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Meyer CJ, Koh SSH, Hill AJ, Conway ER, Ryan BJ, McKinnon ER, Pachana NA. Hear–Communicate–Remember: Feasibility of delivering an integrated intervention for family caregivers of people with dementia and hearing impairment via telehealth. DEMENTIA 2019; 19:2671-2701. [DOI: 10.1177/1471301219850703] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose To evaluate the feasibility of Hear–Communicate–Remember, a training programme developed for family caregivers of people with dementia and hearing impairment that integrated hearing, communication and memory strategies, which was intended to be delivered via telehealth. Materials and methods Participants included six dyads consisting of adults with dementia and hearing impairment and their family caregivers. Data collection involved a combination of semi-structured interviews, self-report questionnaires and field notes. Results Analysis of the qualitative interviews revealed four themes: appropriateness of intervention resources, considerations for the delivery of intervention via telehealth, knowledge and application of intervention strategies, and impact of the intervention on day-to-day life. Results from the satisfaction survey indicated that caregiver participants were mostly satisfied with all aspects of the intervention except the use of some technological components. The field notes described challenges with implementation via telehealth. Conclusions Future research involving a cohort comparison study with a larger cohort of dyads is needed to establish treatment efficacy.
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Affiliation(s)
- Carly J Meyer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sheena SH Koh
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Annie J Hill
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Erin R Conway
- School of Allied Health, Australian Catholic University, Brisbane, Australia
| | - Brooke J Ryan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Eril R McKinnon
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Brisbane, Australia
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20
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Volicer L. Review of Programs for Persons Facing Death with Dementia. Healthcare (Basel) 2019; 7:healthcare7020062. [PMID: 30991668 PMCID: PMC6628090 DOI: 10.3390/healthcare7020062] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 04/10/2019] [Accepted: 04/12/2019] [Indexed: 01/05/2023] Open
Abstract
Background: Persons with advanced dementia cannot initiate activities because of the executive dysfunction. The lack of activities was identified as one of the most important factors contributing to behavioral problems of these persons. The unmet needs were boredom/sensory deprivation, loneliness/need for social interaction, and need for meaningful activities. There is a need for activities designed specifically for residents with advanced dementia. Objective: A description of patient’s needs and of programs that intend to maintain quality of life for people with dementia and facing death. Data sources: A literature review of programs used for persons with advanced dementia and residing in long-term facilities, using the PubMed data base and collateral sources. Results: Since palliative care is appropriate for persons with advanced dementia, attention has to be paid to three following important aspects of care: Medical issues, behavioral symptoms, and meaningful activities. Medical interventions should be limited to those which have more benefits than burdens, behavioral symptoms should be distinguished according to the context in which they occur, and treated by non-pharmacological interventions that involve meaningful activities. This review describes four programs that may promote the quality of life in persons with advanced dementia and facing death. They are designed for persons with advanced dementia, taking into account their functional impairments. Most of these programs involve short infrequent sessions. In contrast, Namaste Care is a daily extended program of enhanced nursing care that can provide quality of life until the last breath. Conclusions: It is possible to maintain quality life for people with advanced dementia if a special program of activities is available.
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Affiliation(s)
- Ladislav Volicer
- School of Aging Studies, University of South Florida, Tampa, FL 34639, USA.
- The 3rd Medical Faculty, Charles University, 11000 Prague, Czech Republic.
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Miyanaga R, Poudyal H. Participation of nurses and care workers in the decision-making process for people with dementia in Japan: Discussion paper. Int J Nurs Stud 2019; 96:91-98. [PMID: 30929744 DOI: 10.1016/j.ijnurstu.2019.02.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/12/2019] [Accepted: 02/17/2019] [Indexed: 11/26/2022]
Abstract
Numerous socio-legal factors make the process of surrogate decision-making for people living in dementia very complicated in Japan. In this discussion paper, we argue that the lack of early consultation between patients, surrogate decision-makers and healthcare providers and the overreliance of patients and their families on doctors to assume the decision-making role lead to healthcare practices that may not align with the patient's wishes. Further, we argue that lack of laws on surrogate decision-making, changing family structure and the liabilities associated with the care of people living with dementia contribute to the complexity of the decision-making process in Japan. Finally, given the rapidly changing social and healthcare norms in Japan, we call for greater involvement of nurses and care workers in the decision-making process to ensure patient-centric treatment and care are adopted.
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Affiliation(s)
- Rio Miyanaga
- Department of Nursing, Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - Hemant Poudyal
- Medical Education Center, Department of Diabetes, Endocrinology and Nutrition & Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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22
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Mueller KD, Hermann B, Mecollari J, Turkstra LS. Connected speech and language in mild cognitive impairment and Alzheimer's disease: A review of picture description tasks. J Clin Exp Neuropsychol 2018; 40:917-939. [PMID: 29669461 PMCID: PMC6198327 DOI: 10.1080/13803395.2018.1446513] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The neuropsychological profile of people with mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia includes a history of decline in memory and other cognitive domains, including language. While language impairments have been well described in AD dementia, language features of MCI are less well understood. Connected speech and language analysis is the study of an individual's spoken discourse, usually elicited by a target stimulus, the results of which can facilitate understanding of how language deficits typical of MCI and AD dementia manifest in everyday communication. Among discourse genres, picture description is a constrained task that relies less on episodic memory and more on semantic knowledge and retrieval, within the cognitive demands of a communication context. Understanding the breadth of evidence across the continuum of cognitive decline will help to elucidate the areas of strength and need in terms of using this method as an evaluative tool for both cognitive changes and everyday functional communication. METHOD We performed an extensive literature search of peer-reviewed journal articles that focused on the use of picture description tasks for evaluating language in persons with MCI or AD dementia. We selected articles based on inclusion and exclusion criteria and described the measures assessed, the psychometric properties that were reported, the findings, and the limitations of the included studies. RESULTS 36 studies were selected and reviewed. Across all 36 studies, there were 1, 127 patients with AD dementia and 274 with MCI or early cognitive decline. Multiple measures were examined, including those describing semantic content, syntactic complexity, speech fluency, vocal parameters, and pragmatic language. Discriminant validity widely reported and distinct differences in language were observable between adults with dementia and controls; fewer studies were able to distinguish language differences between typically aging adults and those with MCI. DISCUSSION Our review shows that picture description tasks are useful tools for detecting differences in a wide variety of language and communicative measures. Future research should expand knowledge about subtle changes to language in preclinical AD and Mild Cognitive Impairment (MCI) which may improve the utility of this method as a clinically meaningful screening tool.
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Affiliation(s)
- Kimberly D. Mueller
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison, USA
| | - Bruce Hermann
- Department of Neurology, University of Wisconsin-Madison, USA
| | - Jonilda Mecollari
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison, USA
| | - Lyn S. Turkstra
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, USA
- School of Rehabilitation Science, McMaster University, Canada
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Gerritsen DL, Koopmans RTCM, Walravens V, van Vliet D. Using Video Feedback at Home in Dementia Care: A Feasibility Study. Am J Alzheimers Dis Other Demen 2018; 34:153-162. [PMID: 30352521 PMCID: PMC6463273 DOI: 10.1177/1533317518808021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Video feedback at home (VFH) aims to improve the well-being of informal caregivers and persons with dementia by training the caregiver to communicate successfully. This feasibility study had 2 aims: (1) to investigate possible effects regarding VFH, caregiver self-efficacy and the burden experienced, and the frequency of challenging behavior in persons with dementia, and (2) to perform a process evaluation of barriers and facilitators regarding the use of VFH. The respondents were caregivers of home-dwelling persons with dementia participating in VHF (N = 10), a group of caregivers who declined participating in VFH (N = 18), stakeholders (N = 6), and field experts (N = 55). The assessments performed were Positive and Negative Affect Scales, Cohen-Mansfield Agitation Inventory, Sense of Competence Scale, semistructured interviews, and questionnaires. Results demonstrated that caregivers were satisfied with VFH and that various (sub)scores on questionnaires improved. Caregivers mentioned a reluctance toward being filmed and both caregivers and referrers were unfamiliar with VFH. Recommendations have been made for health-care professionals and researchers to overcome these barriers.
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Affiliation(s)
- Debby L Gerritsen
- 1 Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands.,2 Radboud Alzheimer Centre, Nijmegen, the Netherlands.,3 Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Raymond T C M Koopmans
- 1 Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands.,2 Radboud Alzheimer Centre, Nijmegen, the Netherlands.,4 Joachim en Anna, Centre for Specialized Geriatric Care, Nijmegen, the Netherlands
| | - Veerle Walravens
- 1 Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands.,2 Radboud Alzheimer Centre, Nijmegen, the Netherlands
| | - Deliane van Vliet
- 1 Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands.,2 Radboud Alzheimer Centre, Nijmegen, the Netherlands
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Abstract
Behavioral problems decrease quality of life of people with dementia and their care providers. Three main consequences of dementia are functional impairment and in some cases also mood disorders and psychosis. These consequences, alone or in combination, result in 3 main behavioral problems: apathy, agitation, and rejection of care/aggression. Nonpharmacologic management strategies include meaningful activities and individualized comfort care, for example, Namaste Care. If needed, pharmacologic management should concentrate on treatment of main dementia consequences, especially depression, instead of treating secondary symptoms, for example, insomnia. Use of antipsychotics should be minimized but antipsychotics may be necessary for augmentation of antidepressants.
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[A pilot study into person-centred use of photo's in the communication with people with dementia]. Tijdschr Gerontol Geriatr 2018; 49:147-155. [PMID: 30088252 DOI: 10.1007/s12439-018-0258-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Social contact is important for the wellbeing of people. Dementia can complicate social interaction. In two randomized controlled pilot studies, it was investigated whether viewing different types of images together affects the mood and social interaction of people with moderately severe to severe Alzheimer's dementia residing in nursing homes. At the first intervention participants in the experimental group (n = 10) were shown portraits with positive facial expressions, and the participants in the control group (n = 10) were shown portraits with a neutral facial expression. During the second intervention, the experimental group (n = 10) were shown personalized photos and the control group (n = 10) non-personalized photos. There were no statistically significant differences in mood and the degree of social interaction between the groups. However, calculation of the effect sizes showed that there was a tendency for more positive behavior in viewing neutral portraits and that personalized images had a more positive impact on social interaction, negative behavior, speech and mood.
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Swan K, Hopper M, Wenke R, Jackson C, Till T, Conway E. Speech-Language Pathologist Interventions for Communication in Moderate-Severe Dementia: A Systematic Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:836-852. [PMID: 29554196 DOI: 10.1044/2017_ajslp-17-0043] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 11/28/2017] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of this study is to evaluate the evidence for direct and indirect interventions for communication in people with moderate-severe dementia. METHOD A systematic search of the literature was conducted, as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysed guidelines, across 8 electronic databases. Studies were included if they included direct or indirect interventions, which could be administered by a speech-language pathologist to people with moderate-severe dementia (defined as having Mini-Mental State Examination of ≤ 15; Folstein, Folstein, & McHugh, 1975). Studies also were required to include outcome measures, which reported on communication function or participation and/or well-being related to communication. Included studies were evaluated for methodological quality using the McMaster critical appraisal tool (Law et al., 1998). RESULTS Eleven studies met the inclusion criteria. Ten of these studies related to direct interventions and included cognitive stimulation approaches using group (n = 5) or individual therapy (n = 1); cognitive training, including naming therapy (n = 1) and spaced retrieval training (n = 1); and cognitive rehabilitation approaches using augmentative and alternative communication (n = 2). One study reported an indirect intervention: conversation partner training. Due to the heterogeneity of studies, a meta-analysis was unable to be conducted. A descriptive synthesis of results indicated that interventions generally resulted in positive changes to communication and related quality-of-life outcomes compared with baseline or control groups. CONCLUSIONS Preliminary evidence was found to support communication interventions for people with moderate-severe dementia. The use of cognitive stimulation approaches, which use a group treatment model and conversation, as a therapy medium show promise as direct intervention options. Implications for clinical practice for speech-language pathologists and future research are discussed. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.5985241.
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Affiliation(s)
- Katina Swan
- Gold Coast Health, Speech Pathology Service, Southport, Queensland, Australia
| | - Marie Hopper
- Gold Coast Health, Speech Pathology Service, Southport, Queensland, Australia
| | - Rachel Wenke
- Gold Coast Health, Speech Pathology Service, Southport, Queensland, Australia
- Gold Coast Health, Clinical Governance, Education and Research (Allied Health), Southport, Queensland, Australia
- School of Allied Health Sciences, Griffith University (Adjunct Appointment), Gold Coast, Queensland, Australia
| | - Claire Jackson
- Gold Coast Health, Speech Pathology Service, Southport, Queensland, Australia
| | - Tracy Till
- Gold Coast Health, Speech Pathology Service, Southport, Queensland, Australia
| | - Erin Conway
- School of Allied Health, Australian Catholic University, Banyo, Queensland
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Jones CA, Duffy MK, Hoffman SA, Schultz-Darken NJ, Braun KM, Ciucci MR, Emborg ME. Vocalization development in common marmosets for neurodegenerative translational modeling. Neurol Res 2018; 40:303-311. [PMID: 29457539 PMCID: PMC6083835 DOI: 10.1080/01616412.2018.1438226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 02/03/2018] [Indexed: 10/18/2022]
Abstract
Objectives In order to facilitate the study of vocalizations in emerging genetic common marmoset models of neurodegenerative disorders, we aimed to analyze call-type changes across age in a translational research environment. We hypothesized that acoustic parameters of vocalizations would change with age, reflecting growth of the vocal apparatus and a maturation of control needed to make adult-like calls. Methods Nineteen developing common marmosets were longitudinally video- and audio-recorded between the ages of 1-149 days in a naturalistic setting without any vocalization elicitation protocol. Vocalizations were coded for call type (cry, tsik, trill, phee, and trill-phee) and analyzed for duration (sec), minimum and maximum frequency (Hz), and bandwidth (Hz). Mixed model linear regressions were performed to assess the effects of age on call parameters listed above for each call type. Results Cries decreased in duration (P = 0.038), maximum frequency (P = 0.047), and bandwidth (P = 0.023) with age. Tsik calls decreased in duration (P = 0.002) and increased in minimum frequency (P = 0.004) and maximum frequency (P = 0.005) with age. Trill calls increased in duration (P = 0.003), and trillphee bandwidth (P = 0.031) decreased with age. Discussion Our results demonstrate that development of common marmoset vocalizations is call type dependent and that changes in acoustic parameters can be detected without complex vocalization elicitation paradigms or specialized audio recording equipment. Thus, we demonstrate the feasibility of a naturalistic protocol to collect and objectively analyze marmoset vocalizations longitudinally. This approach may be useful for studying vocal communication deficits in genetic models of neurodegenerative disorders.
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Affiliation(s)
- Corinne A. Jones
- Neuroscience Training Program, (1220 Capitol Court, Madison, WI 53715)
- Wisconsin National Primate Center (1220 Capitol Court, Madison, WI 53715)
- Department of Communication Sciences & Disorders (1975 Willow Drive, Madison, WI 53706
- Department of Surgery (600 Highland Ave., Madison, WI 53792)
| | - Mary K. Duffy
- Wisconsin National Primate Center (1220 Capitol Court, Madison, WI 53715)
| | - Sarah A. Hoffman
- Wisconsin National Primate Center (1220 Capitol Court, Madison, WI 53715)
| | | | - Katarina M. Braun
- Wisconsin National Primate Center (1220 Capitol Court, Madison, WI 53715)
| | - Michelle R. Ciucci
- Neuroscience Training Program, (1220 Capitol Court, Madison, WI 53715)
- Department of Communication Sciences & Disorders (1975 Willow Drive, Madison, WI 53706
- Department of Surgery (600 Highland Ave., Madison, WI 53792)
| | - Marina E. Emborg
- Neuroscience Training Program, (1220 Capitol Court, Madison, WI 53715)
- Wisconsin National Primate Center (1220 Capitol Court, Madison, WI 53715)
- Department of Medical Physics, University of Wisconsin-Madison
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Williams CL, Newman D, Hammar LM. Preliminary study of a communication intervention for family caregivers and spouses with dementia. Int J Geriatr Psychiatry 2018; 33:e343-e349. [PMID: 29105129 DOI: 10.1002/gps.4816] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 09/13/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study was to designed to examine the feasibility and preliminary outcomes of CARE: Caring About Relationships and Emotions, a 10-week, home-based, intervention to support married couples affected by dementia. METHODS Fifteen older couples participated in a single group repeated measures feasibility study. Weekly, video-recorded conversations over 10 weeks were used to rate communication using the Verbal/Nonverbal Interaction Scale for caregivers and care receivers. RESULTS Accounting for mental status of care recipients, the ratio of social to unsocial communication showed a significant improvement across sessions-an average of 4.46 points per session [β = 4.46, t(10) = 1.96, p = .039]. Spouse caregiver (CG) communication showed a significant decrease in the number of disabling communications with approximately .65 decreased comments per session [β = 0.654, t(11) = -2.61, p = .024]. CONCLUSIONS At home dyadic, relationship-focused psychoeducational intervention to improve communication in spouses affected by dementia has the potential to improve communication outcomes. Creative ways of working with couples are needed to help them sustain their relationships and maintain their health.
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Affiliation(s)
| | - David Newman
- College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
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Morello ANDC, Lima TM, Brandão L. Language and communication non-pharmacological interventions in patients with Alzheimer's disease: a systematic review. Communication intervention in Alzheimer. Dement Neuropsychol 2017; 11:227-241. [PMID: 29213519 PMCID: PMC5674666 DOI: 10.1590/1980-57642016dn11-030004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Alzheimer's disease considerably compromises communication skills. Language changes become more prominent as the disease progresses. Deterioration of language and cognition reduces the ability of holding conversations, which has a negative impact on social interaction.
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Affiliation(s)
| | - Tatiane Machado Lima
- Instituto de Psicologia, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre, RS, Brazil
| | - Lenisa Brandão
- Departamento de Saúde e Comunicação Humana, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre, RS Brazil
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Williams CL, Newman D, Hammar LM. Preliminary Psychometric Properties of the Verbal and Nonverbal Interaction Scale: An Observational Measure for Communication in Persons with Dementia. Issues Ment Health Nurs 2017; 38:381-390. [PMID: 28448228 DOI: 10.1080/01612840.2017.1279248] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Little attention has been given to sociable/unsociable communication in persons with dementia despite the importance of these behaviors in maintaining engagement in marital relationships. An observational measure of verbal and nonverbal communication in persons with dementia (Verbal and Nonverbal Interaction Scale-CR) who were engaged in conversations with spouses was tested for reliability and validity. Married persons with dementia were video-recorded at home conversing with spouses over 10 weeks (N = 118 recordings). Reliability [inter-coder (.92), test-retest (r =.61-.77), internal consistency (α =.65 -.79)] were adequate. Following an intervention, the Verbal and Nonverbal Interaction Scale-CR predicted improved communication over 10 weeks. The ratio of sociable to unsociable communication improved by 4.46 points per session [β = 4.46, t(10) = 1.96, p =.039]. VNVIS-CR is recommended to describe sociable and unsociable communication in persons with dementia as they engage in conversations with spouses.
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Affiliation(s)
- Christine L Williams
- a Christine E. Lynn College of Nursing, Florida Atlantic University , Boca Raton , Florida , USA
| | - David Newman
- a Christine E. Lynn College of Nursing, Florida Atlantic University , Boca Raton , Florida , USA
| | - Lena Marmstål Hammar
- b School of Education, Health and Social Studies, Dalarna University , Falun , Sweden
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Savundranayagam MY, Lee C. Roles of Communication Problems and Communication Strategies on Resident-Related Role Demand and Role Satisfaction. Am J Alzheimers Dis Other Demen 2017; 32:116-122. [PMID: 28116913 PMCID: PMC10852836 DOI: 10.1177/1533317517689876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigated the impact of dementia-related communication difficulties and communication strategies used by staff on resident-related indicators of role demand and role satisfaction. Formal/paid long-term care staff caregivers (N = 109) of residents with dementia completed questionnaires on dementia-related communication difficulties, communication strategies, role demand (ie, residents make unreasonable demands), and role satisfaction (measured by relationship closeness and influence over residents). Three types of communication strategies were included: (a) effective repair strategies, (b) completing actions by oneself, and (c) tuning out or ignoring the resident. Analyses using structural equation modeling revealed that communication problems were positively linked with role demand. Repair strategies were positively linked with relationship closeness and influence over residents. Completing actions by oneself was positively linked to role demand and influence over residents, whereas tuning out was negatively linked with influence over residents. The findings underscore that effective caregiver communication skills are essential in enhancing staff-resident relationships.
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Affiliation(s)
- Marie Y. Savundranayagam
- Faculty of Health Sciences, School of Health Studies, Western University, London, Ontario, Canada
| | - Christopher Lee
- Faculty of Health Sciences, School of Health Studies, Western University, London, Ontario, Canada
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Guendouzi J, Savage M. Alzheimer’s Dementia. PERSPECTIVES IN PRAGMATICS, PHILOSOPHY & PSYCHOLOGY 2017. [DOI: 10.1007/978-3-319-47489-2_13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Alberdi A, Aztiria A, Basarab A. On the early diagnosis of Alzheimer's Disease from multimodal signals: A survey. Artif Intell Med 2016; 71:1-29. [PMID: 27506128 DOI: 10.1016/j.artmed.2016.06.003] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/23/2016] [Accepted: 06/07/2016] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The number of Alzheimer's Disease (AD) patients is increasing with increased life expectancy and 115.4 million people are expected to be affected in 2050. Unfortunately, AD is commonly diagnosed too late, when irreversible damages have been caused in the patient. OBJECTIVE An automatic, continuous and unobtrusive early AD detection method would be required to improve patients' life quality and avoid big healthcare costs. Thus, the objective of this survey is to review the multimodal signals that could be used in the development of such a system, emphasizing on the accuracy that they have shown up to date for AD detection. Some useful tools and specific issues towards this goal will also have to be reviewed. METHODS An extensive literature review was performed following a specific search strategy, inclusion criteria, data extraction and quality assessment in the Inspec, Compendex and PubMed databases. RESULTS This work reviews the extensive list of psychological, physiological, behavioural and cognitive measurements that could be used for AD detection. The most promising measurements seem to be magnetic resonance imaging (MRI) for AD vs control (CTL) discrimination with an 98.95% accuracy, while electroencephalogram (EEG) shows the best results for mild cognitive impairment (MCI) vs CTL (97.88%) and MCI vs AD distinction (94.05%). Available physiological and behavioural AD datasets are listed, as well as medical imaging analysis steps and neuroimaging processing toolboxes. Some issues such as "label noise" and multi-site data are discussed. CONCLUSIONS The development of an unobtrusive and transparent AD detection system should be based on a multimodal system in order to take full advantage of all kinds of symptoms, detect even the smallest changes and combine them, so as to detect AD as early as possible. Such a multimodal system might probably be based on physiological monitoring of MRI or EEG, as well as behavioural measurements like the ones proposed along the article. The mentioned AD datasets and image processing toolboxes are available for their use towards this goal. Issues like "label noise" and multi-site neuroimaging incompatibilities may also have to be overcome, but methods for this purpose are already available.
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Affiliation(s)
- Ane Alberdi
- Mondragon University, Electronics and Computing Department, Goiru Kalea, 2, Arrasate 20500, Spain.
| | - Asier Aztiria
- Mondragon University, Electronics and Computing Department, Goiru Kalea, 2, Arrasate 20500, Spain.
| | - Adrian Basarab
- Université de Toulouse, Institut de Recherche en Informatique de Toulouse, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5505, Université Paul Sabatier, 118 Route de Narbonne, 31062 Toulouse, France.
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Delfino LL, Cachioni M. Estratégias comunicativas de cuidadores de idosos com demência: uma revisão sistemática. JORNAL BRASILEIRO DE PSIQUIATRIA 2016. [DOI: 10.1590/0047-2085000000122] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO Objetivo Conduzir uma revisão sistemática de estudos que investigaram estratégias comunicativas utilizadas por cuidadores de idosos com demência, publicados entre 1995 e 2015. Métodos O levantamento de estudos foi feito usando as seguintes palavras-chave “comunicação e cuidador e demência” e “comunicação e cuidador e Alzheimer”, e os termos em inglês “elderspeak and dementia”, “caregiver’s talk and dementia”, “communication and caregiver and dementia” e “communicative and caregiver and Alzheimer”. Desta revisão sistemática, foram excluídos os artigos de intervenção e aqueles que não tinham descrito entre seus objetivos investigar estratégias comunicativas usadas por cuidadores de idosos com demência. Resultados Apenas 22 estudos preencheram os critérios de inclusão. Os estudos revisados mostraram que os cuidadores de idosos com demência utilizam estratégias comunicativas que são ineficazes (por exemplo, comunicação infantilizada; comunicação “controle” e complexa) e eficazes (usar frases simples; dar um comando por vez; realizar perguntas em que a opção de resposta é sim ou não, entre outras). Conclusão É importante avaliar as percepções e avaliações dos cuidadores acerca da eficácia da estratégia utilizada, para que depois sejam ensinadas habilidades de comunicação para cuidadores familiares e cuidadores formais. A comunicação bem-sucedida deve promover a participação dos idosos com demência, contribuindo para manutenção da autonomia e participação tanto dos cuidadores quanto das pessoas acometidas por esse quadro.
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Alushi L, Hammond JA, Wood JH. Evaluation of dementia education programs for pre-registration healthcare students-A review of the literature. NURSE EDUCATION TODAY 2015; 35:992-8. [PMID: 25981137 DOI: 10.1016/j.nedt.2015.04.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 03/24/2015] [Accepted: 04/13/2015] [Indexed: 05/20/2023]
Abstract
OBJECTIVES In an aging society, the number of people living with dementia is rapidly increasing. Health care students receive little input on dementia during their pre-registration education, hence there is a requirement to improve education to work with this client group. The review aimed to focus on education on working with people with dementia for pre-registration healthcare students. DESIGN A comprehensive review of the literature. DATA SOURCES Online databases Medline, PsychInfo, CINAHL, Science Direct and PubMed were used. REVIEW METHODS The studies were selected according to the following criteria: main focus on education and training on working with people with dementia in pre-registration healthcare programs. Reports that described a training program but did not include evaluation were excluded. For inclusion, studies had to be published in English between January 2007 and March 2014. Identified papers were screened and reviewed by the three authors. RESULTS Nine studies met the inclusion criteria. Most studies were based in North America, predominantly in nursing and medical education. Educational interventions chiefly aimed to improve students' knowledge, comfort level and attitudes toward people with dementia. It was shown that theoretical input alone did not give students the necessary skills to work with people with dementia. Educational interventions were most effective when a practice based experience was preceded by theoretical preparation. CONCLUSION Most of the findings were positive, demonstrating the potential to improve students' knowledge, attitude and comfort level, however methods and evaluation were not always sufficiently reported, making them difficult to use or replicate. This review highlights the need for studies with rigorous methods to determine evidence based best practice for all those working with people with dementia in order to provide effective care and improve their quality of life.
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Affiliation(s)
- Ledia Alushi
- Faculty of Health, Social Care and Education, Kingston University & St George's University of London, St George's Healthcare NHS Trust, United Kingdom
| | - John A Hammond
- School of Rehabilitation Sciences, Faculty of Health, Social Care and Education, Kingston University & St George's University of London, United Kingdom
| | - Julia H Wood
- Faculty of Health, Social Care and Education, Kingston University & St George's University of London, United Kingdom.
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Experience of group conversations in rehabilitation medicine: methodological approach and pilot study. ACTA ACUST UNITED AC 2015; 13:96-104. [PMID: 26246888 PMCID: PMC4522023 DOI: 10.1007/s12682-015-0208-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 03/18/2015] [Indexed: 11/07/2022]
Abstract
The restoring of equilibrium after a traumatic event makes it possible to give a new significance to patients’ existence, and healthcare professionals simultaneously find themselves very close to questions of pain and disability. For these reasons, we introduced weekly group meetings of healthcare professionals and patients suffering from vascular, traumatic or neurological accidents, and meetings of professionals only at the Neurocognitive Rehabilitation Day Hospital of the University of Milan Bicocca. The aim of this paper is to identify possible indicators of changes in patients’ existence through a conversational analysis, describing the experience at the light of methodological approach and reporting the results of a pilot observational study. The patient meetings began in October 2011 and led to a process of greater closeness and trust that was expressed by means of words, gestures, emotional participation, and non-verbal communication. The pilot considers the evolution of indicators in a sample of 14 patients for a period of 9 months and a timeframe of 3 months. Supportive interventions decreased while elements of sharing progressively increased, leading to progressive increased consciousness of both self and the disease. The group of professionals found that being together allowed them to distinguish performance as the use of their technical skills from understanding the other and his/her experience as part of their own, and not only linked to the disease. The professionals’ reflections on their experiences led to the emergence of two possible ways of looking at a patient: as somebody other than me or somebody other like me.
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Baglio F, Griffanti L, Saibene FL, Ricci C, Alberoni M, Critelli R, Villanelli F, Fioravanti R, Mantovani F, D’amico A, Cabinio M, Preti MG, Nemni R, Farina E. Multistimulation Group Therapy in Alzheimer’s Disease Promotes Changes in Brain Functioning. Neurorehabil Neural Repair 2014; 29:13-24. [DOI: 10.1177/1545968314532833] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. The growing social emergency represented by Alzheimer’s disease (AD) and the lack of medical treatments able to modify the disease course have kindled the interest in nonpharmacological therapies. Objective. We introduced a novel nonpharmacological approach for people with AD (PWA) named Multidimensional Stimulation group Therapy (MST) to improve PWA condition in different disease domains: cognition, behavior, and motor functioning. Methods. Enrolling 60 PWA in a mild to moderate stage of the disease, we evaluated the efficacy of MST with a randomized-controlled study. Neuropsychological and neurobehavioral measures and functional magnetic resonance imaging (fMRI) data were considered as outcome measures. Results. The following significant intervention-related changes were observed: reduction in Neuropsychiatric Inventory scale score, improvement in language and memory subscales of Alzheimer’s Disease Assessment Scale–Cognitive subscale, and increased fMRI activations in temporal brain areas, right insular cortex, and thalamus. Conclusions. Cognitive-behavioral and fMRI results support the notion that MST has significant effects in improving PWA cognitive-behavioral status by restoring neural functioning.
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Affiliation(s)
| | - Ludovica Griffanti
- IRCCS, Don Gnocchi Foundation, Milan, Italy
- Politecnico di Milano, Milan, Italy
| | | | - Cristian Ricci
- IRCCS, Don Gnocchi Foundation, Milan, Italy
- University of Regensburg, Regensburg, Germany
| | | | | | | | | | | | | | - Monia Cabinio
- IRCCS, Don Gnocchi Foundation, Milan, Italy
- Università degli Studi di Milano, Milan, Italy
| | - Maria Giulia Preti
- IRCCS, Don Gnocchi Foundation, Milan, Italy
- Politecnico di Milano, Milan, Italy
| | - Raffaello Nemni
- IRCCS, Don Gnocchi Foundation, Milan, Italy
- Università degli Studi di Milano, Milan, Italy
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