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Greig Custo MT, Lang MK, Barker WW, Gonzalez J, Vélez-Uribe I, Arruda F, Conniff J, Rodriguez MJ, Loewenstein DA, Duara R, Adjouadi M, Curiel RE, Rosselli M. The association of depression and apathy with Alzheimer's disease biomarkers in a cross-cultural sample. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:849-865. [PMID: 35764422 PMCID: PMC9930412 DOI: 10.1080/23279095.2022.2079414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Cross-cultural differences in the association between neuropsychiatric symptoms and Alzheimer's disease (AD) biomarkers are not well understood. This study aimed to (1) compare depressive symptoms and frequency of reported apathy across diagnostic groups of participants with normal cognition (CN), mild cognitive impairment (MCI), and dementia, as well as ethnic groups of Hispanic Americans (HA) and European Americans (EA); (2) evaluate the relationship between depression and apathy with Aβ deposition and brain atrophy. Statistical analyses included ANCOVAs, chi-squared, nonparametric tests, correlations, and logistic regressions. Higher scores on the Geriatric Depression Scale (GDS-15) were reported in the MCI and dementia cohorts, while older age corresponded with lower GDS-15 scores. The frequency of apathy differed across diagnoses within each ethnicity, but not when comparing ethnic groups. Reduced volume in the rostral anterior cingulate cortex (ACC) significantly correlated with and predicted apathy for the total sample after applying false discovery rate corrections (FDR), controlling for covariates. The EA group separately demonstrated a significant negative relationship between apathy and superior frontal volume, while for HA, there was a relationship between rostral ACC volume and apathy. Apathy corresponded with higher Aβ levels for the total sample and for the CN and HA groups.
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Affiliation(s)
- María T. Greig Custo
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
- Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
| | - Merike K. Lang
- Department of Psychology, Charles E Schmidt College of Science, Florida Atlantic University, Davie, FL, USA
| | - Warren W. Barker
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
- Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
| | - Joanna Gonzalez
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Idaly Vélez-Uribe
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
- Department of Psychology, Charles E Schmidt College of Science, Florida Atlantic University, Davie, FL, USA
| | - Fernanda Arruda
- Department of Psychology, Charles E Schmidt College of Science, Florida Atlantic University, Davie, FL, USA
| | - Joshua Conniff
- Department of Psychology, Charles E Schmidt College of Science, Florida Atlantic University, Davie, FL, USA
| | | | - David A. Loewenstein
- Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
- Department of Psychiatry and Behavioral Sciences and Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ranjan Duara
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
- Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
| | - Malek Adjouadi
- Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
- Center for Advanced Technology and Education, College of Engineering, Florida International University, Miami, FL, USA
| | - Rosie E. Curiel
- Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
- Department of Psychiatry and Behavioral Sciences and Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Mónica Rosselli
- Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
- Department of Psychology, Charles E Schmidt College of Science, Florida Atlantic University, Davie, FL, USA
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Spector A, Abdul Wahab ND, Stott J, Fisher E, Hui EK, Perkins L, Leung WG, Evans R, Wong G, Felstead C. Virtual Group Cognitive Stimulation Therapy for Dementia: Mixed-Methods Feasibility Randomized Controlled Trial. THE GERONTOLOGIST 2024; 64:gnae063. [PMID: 38843088 PMCID: PMC11261826 DOI: 10.1093/geront/gnae063] [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: 10/19/2023] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Cognitive stimulation therapy (CST) is an evidence-based group intervention for people with dementia, with benefits for cognition and quality of life when delivered face-to-face. Many people are unable to attend face-to-face groups for reasons including health and transport issues. This study aimed to assess the feasibility and acceptability of online or "virtual" CST (vCST). RESEARCH DESIGN AND METHODS Single-blind, randomized controlled feasibility design with qualitative interviews. Forty-six people with mild-to-moderate dementia were randomly allocated to attend either 14 sessions of twice-weekly vCST (n = 24) or treatment as usual (TAU, defined as usual care; n = 22) over 7 weeks. Cognition, quality of life, and depression were assessed pre- and posttreatment. Qualitative interviews (n = 16) with participants and carers were analyzed using thematic analysis. RESULTS High levels of attendance, adherence, fidelity to the manual, and completion of outcomes were recorded. Recruitment appeared feasible although randomization may not have been acceptable to some. There were no statistical differences noted between vCST and TAU in any of the outcomes evaluated, although both quantitative and qualitative data indicated acceptability, with qualitative reports of improved outcomes including cognition. DISCUSSION AND IMPLICATIONS vCST appeared feasible to deliver but did not result in any changes in outcomes, as expected from an underpowered feasibility trial. CST is the main psychosocial intervention delivered for dementia in UK memory services and globally, with many services moving towards virtual CST delivery. Therefore, a fully powered RCT of the effectiveness of vCST is feasible and justified.
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Affiliation(s)
- Aimee Spector
- Department of Clinical, Health, and Educational Psychology, University College London, London, UK
| | - Nur Diyanah Abdul Wahab
- Department of Clinical, Health, and Educational Psychology, University College London, London, UK
| | - Joshua Stott
- Department of Clinical, Health, and Educational Psychology, University College London, London, UK
| | - Emily Fisher
- Department of Clinical, Health, and Educational Psychology, University College London, London, UK
| | - Esther K Hui
- Department of Clinical, Health, and Educational Psychology, University College London, London, UK
| | - Luke Perkins
- Department of Clinical, Health, and Educational Psychology, University College London, London, UK
| | - Wing Gi Leung
- Department of Clinical, Health, and Educational Psychology, University College London, London, UK
| | - Rachel Evans
- University of Bangor, North Wales Medical School, Bangor, UK
| | - Gloria Wong
- Department of Social work and Social Administration, University of Hong Kong, Kong Kong, Kong Kong
| | - Cerne Felstead
- Department of Psychology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Pyo J, Lee H, Lee J, Lee D, Yu H, Lim SW, Myung W, Kim DK. Network Structure of Depressive Symptomatology in Elderly with Cognitive Impairment. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:687. [PMID: 38792870 PMCID: PMC11123453 DOI: 10.3390/medicina60050687] [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: 03/08/2024] [Revised: 04/20/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024]
Abstract
Objective and objectives: Patients with cognitive disorders such as Alzheimer's disease (AD) and mild cognitive impairment (MCI) frequently exhibit depressive symptoms. Depressive symptoms can be evaluated with various measures and questionnaires. The geriatric depression scale (GDS) is a scale that can be used to measure symptoms in geriatric age. Many questionnaires sum up symptom scales. However, core symptoms of depression in these patients and connections between these symptoms have not been fully explored yet. Thus, the objectives of this study were (1) to determine core symptoms of two cognitive disorders, Alzheimer's disease and mild cognitive impairment, and (2) to investigate the network structure of depressive symptomatology in individuals with cognitive impairment in comparison with those with Alzheimer's disease. Materials and Methods: This study encompassed 5354 patients with cognitive impairments such as Alzheimer's disease (n 1889) and mild cognitive impairment (n = 3464). The geriatric depression scale, a self-administered questionnaire, was employed to assess depressive symptomatology. Using exploratory graph analysis (EGA), a network analysis was conducted, and the network structure was evaluated through regularized partial correlation models. To determine the centrality of depressive symptoms within each cohort, network parameters such as strength, betweenness, and closeness were examined. Additionally, to explore differences in the network structure between Alzheimer's disease and mild cognitive impairment groups, a network comparison test was performed. Results: In the analysis of centrality indices, "worthlessness" was identified as the most central symptom in the geriatric depression scale among patients with Alzheimer's disease, whereas "emptiness" was found to be the most central symptom in patients with mild cognitive impairment. Despite these differences in central symptoms, the comparative analysis showed no statistical difference in the overall network structure between Alzheimer's disease and mild cognitive impairment groups. Conclusions: Findings of this study could contribute to a better understanding of the manifestation of depressive symptoms in patients with cognitive impairment. These results are expected to aid in identifying and prioritizing core symptoms in these patients. Further research should be conducted to explore potential interventions tailored to these core symptoms in patients with Alzheimer's disease and mild cognitive impairment. Establishing core symptoms in those groups might have clinical importance in that appropriate treatment for neuropsychiatric symptoms in patients with cognitive impairment could help preclude progression to further impairment.
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Affiliation(s)
- Jeehyung Pyo
- Samsung Medical Center, Department of Psychiatry, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea;
| | - Hyukjun Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; (H.L.); (J.L.); (D.L.); (H.Y.); (W.M.)
| | - Jakyung Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; (H.L.); (J.L.); (D.L.); (H.Y.); (W.M.)
| | - Daseul Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; (H.L.); (J.L.); (D.L.); (H.Y.); (W.M.)
| | - Hyeona Yu
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; (H.L.); (J.L.); (D.L.); (H.Y.); (W.M.)
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Shinn-Won Lim
- Department of Health Sciences and Technology, The Samsung Advanced Institute for Health Sciences & Technology Sungkyunkwan University, Seoul 06355, Republic of Korea;
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; (H.L.); (J.L.); (D.L.); (H.Y.); (W.M.)
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Doh-Kwan Kim
- Samsung Medical Center, Department of Psychiatry, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea;
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Holt J, Bhar S, Schofield P, Koder D, Owen P, Seitz D, Bhowmik J. Protocol for a systematic review and meta-analysis of the prevalence of mental illness among nursing home residents. Syst Rev 2024; 13:109. [PMID: 38627826 PMCID: PMC11020180 DOI: 10.1186/s13643-024-02516-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 03/19/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND There is a high prevalence of mental illness in nursing home residents compared to older adults living in the community. This was highlighted in the most recent comprehensive systematic review on the topic, published in 2010. In the context of a rapidly aging population and increased numbers of older adults requiring residential care, this study aims to provide a contemporary account of the prevalence of mental illness among nursing home residents. METHODS This protocol was prepared in line with the PRISMA-P 2015 Statement. Systematic searches will be undertaken across six electronic databases: PubMed, Embase, Web of Science, PsycNET, CINAHL, and Abstracts in Social Gerontology. Peer-reviewed studies published from 2009 onwards which report the prevalence of mental illness within nursing home populations will be included. Database searches will be supplemented by forward and backward citation searching. Titles and abstracts of records will be screened using a semi-automated process. The full text of selected records will be assessed to confirm inclusion criteria are met. Study selection will be recorded in a PRISMA flowchart. A pilot-tested form will be used to extract data from included studies, alongside the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data. A study characteristics and results table will be prepared to present key details from each included study, supported by a narrative synthesis. Random-effects restricted maximum likelihood meta-analyses will be performed to compute pooled prevalence estimates for mental illnesses represented in the identified studies. Heterogeneity will be assessed using Cochran's Q and Higgins' I2 statistics. A Funnel plot and Egger's test will be used to assess publication bias. The GRADE approach will be used to assess the quality of the body of evidence identified. DISCUSSION The study will provide a comprehensive and contemporary account of the prevalence of mental illness among nursing home residents. Meta-analyses will provide robust prevalence estimates across a range of presentations. Key insights will be highlighted, including potential sources of heterogeneity. Implications for residents, researchers, care providers, and policymakers will be noted. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42023456226.
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Affiliation(s)
- Jared Holt
- Department of Psychological Sciences, Swinburne University of Technology, John Street, Hawthorn, VIC, 3122, Australia.
| | - Sunil Bhar
- Department of Psychological Sciences, Swinburne University of Technology, John Street, Hawthorn, VIC, 3122, Australia
| | - Penelope Schofield
- Department of Psychological Sciences, Swinburne University of Technology, John Street, Hawthorn, VIC, 3122, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, John Street, Hawthorn, VIC, 3122, Australia
- Health Services Research and Implementation Sciences, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3052, Australia
- Department of Oncology, Sir Peter MacCallum, The University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | - Deborah Koder
- Department of Psychological Sciences, Swinburne University of Technology, John Street, Hawthorn, VIC, 3122, Australia
| | - Patrick Owen
- Eastern Health Emergency Medicine Program, Melbourne, VIC, Australia
- Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Dallas Seitz
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
| | - Jahar Bhowmik
- Department of Health Science and Biostatistics, Swinburne University of Technology, John Street, Hawthorn, VIC, 3122, Australia
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Sârbu F, Lungu M, Oprea VD, Romila A. Early depressive manifestations in patients with dementia caused by Alzheimer's disease. Exp Ther Med 2024; 27:56. [PMID: 38234622 PMCID: PMC10790160 DOI: 10.3892/etm.2023.12344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/17/2023] [Indexed: 01/19/2024] Open
Abstract
Previous studies on the complex interplay between depression and dementia in patients with Alzheimer's disease revealed that early-life depression is a risk factor for dementia. Both depression and dementia appear to share common etiopathological mechanisms. In the present study, a comprehensive retrospective analysis was performed on a study group of patients with dementia suffering from previously diagnosed depression. The aim was to assess potentially relevant clinical and imaging parameters that can be used to characterize depression as a risk factor for dementia in later life. Statistically significant data correlating cognitive scores with the moment of depression onset and the length of time period to the diagnosis of dementia were identified. Furthermore, at the moment of depression diagnosis, structural cerebral alterations tended to appear more frequently in women compared with men. However, this sex-associated difference is not maintained after the moment of dementia diagnosis. Results from the present study contributed additional data to the evidence supporting a relationship between a history of depression and the occurrence of Alzheimer's disease, discussing relevant clinical and imaging parameters featured in patients with dementia and their inter-relations.
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Affiliation(s)
- Fabiola Sârbu
- Elisabeta Doamna Psychiatric Hospital of Galati, 800179 Galați, Romania
- Faculty of Medicine and Pharmacy, Dunarea de Jos University of Galati, 800216 Galati, Romania
| | - Mihaela Lungu
- Faculty of Medicine and Pharmacy, Dunarea de Jos University of Galati, 800216 Galati, Romania
- St. Apostle Andrei, Clinical Emergency County Hospital, 800578 Galati, Romania
| | - Violeta Diana Oprea
- Faculty of Medicine and Pharmacy, Dunarea de Jos University of Galati, 800216 Galati, Romania
- St. Apostle Andrei, Clinical Emergency County Hospital, 800578 Galati, Romania
| | - Aurelia Romila
- Faculty of Medicine and Pharmacy, Dunarea de Jos University of Galati, 800216 Galati, Romania
- St. Apostle Andrei, Clinical Emergency County Hospital, 800578 Galati, Romania
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Okkels N, Horsager J, Fedorova TD, Knudsen K, Skjærbæk C, Andersen KB, Labrador-Espinosa M, Vestergaard K, Mortensen JK, Klit H, Møller M, Danielsen EH, Johnsen EL, Bekan G, Hansen KV, Munk OL, Damholdt MF, Kjeldsen PL, Hansen AK, Gottrup H, Grothe MJ, Borghammer P. Impaired cholinergic integrity of the colon and pancreas in dementia with Lewy bodies. Brain 2024; 147:255-266. [PMID: 37975822 DOI: 10.1093/brain/awad391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/20/2023] [Accepted: 10/28/2023] [Indexed: 11/19/2023] Open
Abstract
Dementia with Lewy bodies is characterized by a high burden of autonomic dysfunction and Lewy pathology in peripheral organs and components of the sympathetic and parasympathetic nervous system. Parasympathetic terminals may be quantified with 18F-fluoroetoxybenzovesamicol, a PET tracer that binds to the vesicular acetylcholine transporter in cholinergic presynaptic terminals. Parasympathetic imaging may be useful for diagnostics, improving our understanding of autonomic dysfunction and for clarifying the spatiotemporal relationship of neuronal degeneration in prodromal disease. Therefore, we aimed to investigate the cholinergic parasympathetic integrity in peripheral organs and central autonomic regions of subjects with dementia with Lewy bodies and its association with subjective and objective measures of autonomic dysfunction. We hypothesized that organs with known parasympathetic innervation, especially the pancreas and colon, would have impaired cholinergic integrity. To achieve these aims, we conducted a cross-sectional comparison study including 23 newly diagnosed non-diabetic subjects with dementia with Lewy bodies (74 ± 6 years, 83% male) and 21 elderly control subjects (74 ± 6 years, 67% male). We obtained whole-body images to quantify PET uptake in peripheral organs and brain images to quantify PET uptake in regions of the brainstem and hypothalamus. Autonomic dysfunction was assessed with questionnaires and measurements of orthostatic blood pressure. Subjects with dementia with Lewy bodies displayed reduced cholinergic tracer uptake in the pancreas (32% reduction, P = 0.0003) and colon (19% reduction, P = 0.0048), but not in organs with little or no parasympathetic innervation. Tracer uptake in a region of the medulla oblongata overlapping the dorsal motor nucleus of the vagus correlated with autonomic symptoms (rs = -0.54, P = 0.0077) and changes in orthostatic blood pressure (rs = 0.76, P < 0.0001). Tracer uptake in the pedunculopontine region correlated with autonomic symptoms (rs = -0.52, P = 0.0104) and a measure of non-motor symptoms (rs = -0.47, P = 0.0230). In conclusion, our findings provide the first imaging-based evidence of impaired cholinergic integrity of the pancreas and colon in dementia with Lewy bodies. The observed changes may reflect parasympathetic denervation, implying that this process is initiated well before the point of diagnosis. The findings also support that cholinergic denervation in the brainstem contributes to dysautonomia.
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Affiliation(s)
- Niels Okkels
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Jacob Horsager
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Tatyana D Fedorova
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Karoline Knudsen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Casper Skjærbæk
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Katrine B Andersen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Miguel Labrador-Espinosa
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Seville, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | - Janne K Mortensen
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Henriette Klit
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Mette Møller
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Erik H Danielsen
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Erik L Johnsen
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Goran Bekan
- Department of Neurology, Regionshospitalet Gødstrup, 7400 Herning, Denmark
| | - Kim V Hansen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Ole L Munk
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Malene F Damholdt
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Pernille L Kjeldsen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
- Department of Neurology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Allan K Hansen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Nuclear Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Hanne Gottrup
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Michel J Grothe
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Seville, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Per Borghammer
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
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Kusumaningrum FM, Dewi FST, Santosa A, Pangastuti HS, Yeung P. Factors related to quality of life in community-dwelling adults in Sleman Regency, Special Region of Yogyakarta, Indonesia: Results from a cross-sectional study. PLoS One 2024; 19:e0296245. [PMID: 38165996 PMCID: PMC10760755 DOI: 10.1371/journal.pone.0296245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 12/09/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Quality of life studies in low- and middle-income countries have demonstrated the influence of socioeconomic factors on the quality of life (QoL). However, further studies are required to confirm this association in developing countries with rapidly ageing populations. Using Ferrans et al.'s QoL model, this study aimed to identify the factors associated with the QoL of community-dwelling adults in Indonesia. METHODS A cross-sectional study among 546 community-dwelling adults aged 50+ years was conducted in Yogyakarta, Indonesia, in 2018. QoL was measured using the Short Form 12 questionnaire, which consists of a summary of physical and mental health. We performed stepwise logistic regression analyses to determine odds ratios (ORs) with 95% confidence intervals (CIs) and examined the association between the QoL (physical and mental health) and demographic characteristics, socioeconomic status, financial management behaviour, multimorbidity status, nutritional status, cognitive impairment status, depression status, and independence. Statistical significance was set at p<0.05. RESULTS Among the respondents, 15% reported poor physical health, and 9.2% reported poor mental health. Good physical health was significantly associated with the absence of chronic disease (OR 2.39; 95% CI: 1.07-5.33), independence in activities of daily living (OR 3.90; 95% CI 1.57-9.67) and instrumental activities of daily living (OR 4.34; 95% CI 2.28-8.26). Absence of depression was significantly associated with good mental health (OR 2.80; 95% CI 1.3-5.96). CONCLUSION The QoL of community-dwelling adults in Indonesia is associated with activities of daily living and instrumental activities of daily living, as well as the absence of chronic disease and depression. Efforts should be made to prevent chronic disease and delay functional decline through healthy lifestyles and routine physical and mental health screenings.
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Affiliation(s)
- Fitrina Mahardani Kusumaningrum
- Faculty of Medicine, Department of Health Behavior, Public Health and Nursing, Environment and Social Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Faculty of Medicine, Public Health and Nursing, Doctoral Program in Medicine and Health Science, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Fatwa Sari Tetra Dewi
- Faculty of Medicine, Department of Health Behavior, Public Health and Nursing, Environment and Social Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Faculty of Medicine, Public Health and Nursing, Sleman Health and Demographic Surveillance System, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Ailiana Santosa
- Institute of Medicine, Sahlgrenska Academy, School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Heny Suseani Pangastuti
- Faculty of Medicine, Medical-Surgical Nursing Department, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Polly Yeung
- School of Social Work, Massey University, Palmerston North, New Zealand
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Njomboro P, Lekhutlile T. The Effect of Apathy and Depressive Syndromes on Functional Outcomes in Alzheimer's Disease. J Alzheimers Dis 2024; 98:579-591. [PMID: 38427474 DOI: 10.3233/jad-230426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
Background Alzheimer's disease (AD) is the most common cause of dementia. Its initially characterized by progressive short-term memory loss followed by cross-domain cognitive decline in later stages resulting in significant functional deficits and loss of activities of daily living (ADLs) independence. Apathy and depression are frequent neuropsychiatric sequelae in AD, but their contribution to functional deficits is poorly understood. Objective We aimed to quantitatively investigate if apathy and depressive symptoms predict ADLs in AD. We also wanted to fractionate apathy dimensions by factor-analyzing the apathy evaluation scale (AES) and then investigate the dimensions' relation to ADLs. Methods We recruited a sample of 115 patients with probable or possible AD and assessed them for depression, apathy, and ADLs alongside other measures. We hypothesized that apathy and depressive symptoms would predict ADLs and that AES items will load into cognitive, behavioral, and affective factors that would differentially relate to ADLs. Results Our results indicated that apathy symptoms predict ADLs deficits. The AES items resolved into a three-factor solution but the manner of clustering diverged from that proposed by AES authors. When these factors were regressed simultaneously, only behavioral apathy predicted global ADLs. Distinguishing basic from instrumental ADLs showed that behavioral and cognitive apathy symptoms associate with ADLs deficits while affective symptoms do not. Conclusions Our results highlight the influence of apathy on ADLs in AD. This has important implications for patient care considering the high prevalence of apathy in AD and other dementing illnesses.
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Affiliation(s)
- Progress Njomboro
- Department of Psychology, University of Cape Town, Cape Town, South Africa
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Figueiro MG, Pedler D, Plitnick B, Zecena E, Leahy S. Tailored lighting intervention (TLI) for improving sleep-wake cycles in older adults living with dementia. Front Physiol 2023; 14:1290678. [PMID: 38169838 PMCID: PMC10759231 DOI: 10.3389/fphys.2023.1290678] [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: 09/07/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction: Sleep disturbance is a hallmark of Alzheimer's disease and related dementias, and caregiver stress caused by patients' nighttime wandering, injuries, and agitation are frequently at the root of decisions to move them to assisted living facilities, where typically dim institutional lighting can further exacerbate their sleep problems. This study explored the effects of a circadian-effective lighting intervention on actigraphic sleep measures and subjective assessments of sleep disturbance, depression, and sleep-disturbed behaviors. Methods: Fourteen older adult (≥60 years) participants (11 females, mean age = 84.1 [SD 8.9]), all diagnosed with moderate to severe dementia and sleep disturbance, were recruited from 3 assisted living and memory care facilities. Following a crossover, placebo-controlled design, 3 different lighting modes were used to deliver high levels of circadian stimulus to the participants' eyes for two 8-week intervention periods in a counter balanced order with a 4-week washout between the study's 2 conditions (dim light control vs. active intervention). Actigraphy and questionnaire data were collected over 7-day assessment periods that preceded (baseline weeks 1 and 9) and concluded (post-intervention week 9 and 22) the intervention periods. Actigraphic outcomes included sleep duration, sleep time, sleep efficiency, sleep start time, and sleep end time. Subjective assessments included the Cornell Scale for Depression in Dementia (CSDD), Pittsburgh Sleep Quality Index (PSQI), and Sleep Disorders Inventory (SDI) instruments. Results: Under the active condition, sleep duration significantly (p = 0.018) increased and sleep start time significantly (p = 0.012) advanced after the intervention compared to baseline. Also under the active condition, PSQI (p = 0.012), CSDD (p = 0.007), Sleep Disorders Inventory frequency (p = 0.015), and SDI severity (p = 0.015) scores were significantly lower after the intervention compared to baseline. Discussion: This study demonstrates that a circadian-effective lighting intervention delivering bright days and dark nights improves measures of sleep and mood in dementia patients living in controlled environments.
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Affiliation(s)
- Mariana G. Figueiro
- Department of Population Health Science and Policy, Light and Health Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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10
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Okkels N, Horsager J, Labrador-Espinosa M, Kjeldsen PL, Damholdt MF, Mortensen J, Vestergård K, Knudsen K, Andersen KB, Fedorova TD, Skjærbæk C, Gottrup H, Hansen AK, Grothe MJ, Borghammer P. Severe cholinergic terminal loss in newly diagnosed dementia with Lewy bodies. Brain 2023; 146:3690-3704. [PMID: 37279796 DOI: 10.1093/brain/awad192] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/03/2023] [Accepted: 05/23/2023] [Indexed: 06/08/2023] Open
Abstract
Cholinergic changes play a fundamental role in the natural history of dementia with Lewy bodies and Lewy body disease in general. Despite important achievements in the field of cholinergic research, significant challenges remain. We conducted a study with four main objectives: (i) to examine the integrity of cholinergic terminals in newly diagnosed dementia with Lewy bodies; (ii) to disentangle the cholinergic contribution to dementia by comparing cholinergic changes in Lewy body patients with and without dementia; (iii) to investigate the in vivo relationship between cholinergic terminal loss and atrophy of cholinergic cell clusters in the basal forebrain at different stages of Lewy body disease; and (iv) to test whether any asymmetrical degeneration in cholinergic terminals would correlate with motor dysfunction and hypometabolism. To achieve these objectives, we conducted a comparative cross-sectional study of 25 newly diagnosed dementia with Lewy bodies patients (age 74 ± 5 years, 84% male), 15 healthy control subjects (age 75 ± 6 years, 67% male) and 15 Parkinson's disease patients without dementia (age 70 ± 7 years, 60% male). All participants underwent 18F-fluoroetoxybenzovesamicol PET and high-resolution structural MRI. In addition, we collected clinical 18F-fluorodeoxyglucose PET images. Brain images were normalized to standard space and regional tracer uptake and volumetric indices of basal forebrain degeneration were extracted. Patients with dementia showed spatially distinct reductions in cholinergic terminals across the cerebral cortex, limbic system, thalamus and brainstem. Also, cholinergic terminal binding in cortical and limbic regions correlated quantitatively and spatially with atrophy of the basal forebrain. In contrast, patients without dementia showed decreased cholinergic terminal binding in the cerebral cortex despite preserved basal forebrain volumes. In patients with dementia, cholinergic terminal reductions were most severe in limbic regions and least severe in occipital regions compared to those without dementia. Interhemispheric asymmetry of cholinergic terminals correlated with asymmetry of brain metabolism and lateralized motor function. In conclusion, this study provides robust evidence for severe cholinergic terminal loss in newly diagnosed dementia with Lewy bodies, which correlates with structural imaging measures of cholinergic basal forebrain degeneration. In patients without dementia, our findings suggest that loss of cholinergic terminal function occurs 'before' neuronal cell degeneration. Moreover, the study supports that degeneration of the cholinergic system is important for brain metabolism and may be linked with degeneration in other transmitter systems. Our findings have implications for understanding how cholinergic system pathology contributes to the clinical features of Lewy body disease, changes in brain metabolism and disease progression patterns.
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Affiliation(s)
- Niels Okkels
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Jacob Horsager
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Miguel Labrador-Espinosa
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Seville, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Pernille L Kjeldsen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
- Department of Neurology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Malene F Damholdt
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Janne Mortensen
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Karsten Vestergård
- Department of Neurology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Karoline Knudsen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Katrine B Andersen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Tatyana D Fedorova
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Casper Skjærbæk
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Hanne Gottrup
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Allan K Hansen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Nuclear Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Michel J Grothe
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Seville, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Per Borghammer
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
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11
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Arruda F, Rosselli M, Mejia Kurasz A, Loewenstein DA, DeKosky ST, Lang MK, Conniff J, Vélez-Uribe I, Ahne E, Shihadeh L, Adjouadi M, Goytizolo A, Barker WW, Curiel RE, Smith GE, Duara R. Stability in cognitive classification as a function of severity of impairment and ethnicity: A longitudinal analysis. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-14. [PMID: 37395391 DOI: 10.1080/23279095.2023.2222861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
OBJECTIVE The interaction of ethnicity, progression of cognitive impairment, and neuroimaging biomarkers of Alzheimer's Disease remains unclear. We investigated the stability in cognitive status classification (cognitively normal [CN] and mild cognitive impairment [MCI]) of 209 participants (124 Hispanics/Latinos and 85 European Americans). METHODS Biomarkers (structural MRI and amyloid PET scans) were compared between Hispanic/Latino and European American individuals who presented a change in cognitive diagnosis during the second or third follow-up and those who remained stable over time. RESULTS There were no significant differences in biomarkers between ethnic groups in any of the diagnostic categories. The frequency of CN and MCI participants who were progressors (progressed to a more severe cognitive diagnosis at follow-up) and non-progressors (either stable through follow-ups or unstable [progressed but later reverted to a diagnosis of CN]) did not significantly differ across ethnic groups. Progressors had greater atrophy in the hippocampus (HP) and entorhinal cortex (ERC) at baseline compared to unstable non-progressors (reverters) for both ethnic groups, and more significant ERC atrophy was observed among progressors of the Hispanic/Latino group. For European Americans diagnosed with MCI, there were 60% more progressors than reverters (reverted from MCI to CN), while among Hispanics/Latinos with MCI, there were 7% more reverters than progressors. Binomial logistic regressions predicting progression, including brain biomarkers, MMSE, and ethnicity, demonstrated that only MMSE was a predictor for CN participants at baseline. However, for MCI participants at baseline, HP atrophy, ERC atrophy, and MMSE predicted progression.
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Affiliation(s)
- Fernanda Arruda
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
| | - Mónica Rosselli
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
| | - Andrea Mejia Kurasz
- Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, FL, USA
| | - David A Loewenstein
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Department of Psychiatry and Behavioral Sciences and Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Steven T DeKosky
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Merike K Lang
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
| | - Joshua Conniff
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
| | - Idaly Vélez-Uribe
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Emily Ahne
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
| | - Layaly Shihadeh
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
| | - Malek Adjouadi
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Center for Advanced Technology and Education, College of Engineering, Florida International University, Miami, FL, USA
| | - Alicia Goytizolo
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL
| | - Warren W Barker
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Rosie E Curiel
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Department of Psychiatry and Behavioral Sciences and Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Glenn E Smith
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, FL, USA
| | - Ranjan Duara
- 1Florida Alzheimer's Disease Research Center, Miami Beach and Gainesville, FL, USA
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
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12
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Lemij AA, de Glas NA, Derks MGM, Linthorst-Niers EMH, Guicherit OR, van der Pol CC, Lans TE, van Dalen T, Vulink AJE, Merkus JWS, van Gerven L, van den Bos F, Rius Ottenheim N, Liefers GJ, Portielje JEA. Mental health outcomes in older breast cancer survivors: Five-year follow-up from the CLIMB study. Eur J Cancer 2023; 187:87-95. [PMID: 37130464 DOI: 10.1016/j.ejca.2023.04.001] [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: 02/19/2023] [Revised: 03/28/2023] [Accepted: 04/01/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND There is a lack of information on mental health outcomes for the increasing older population. Therefore, the aim of the current study is to assess depressive symptoms, loneliness, and apathy in older patients with breast cancer within the first 5 years after diagnosis. METHODS Women aged ≥70 years with early-stage breast cancer were included. Multivariate linear mixed models were used to assess longitudinal changes in symptoms of depression (according to the 15-item Geriatric Depression Scale), loneliness (according to the De Jong Gierveld Loneliness Scale) and apathy (according to the Starkstein Apathy Scale) over time at 3, 9, 15, 27 and 60 months follow-up. RESULTS In total, 299 patients were included (mean [standard deviation (SD)] age: 75.8 [5.2] years). At 3 months follow-up, shortly after the acute treatment, 10% of patients had significant depressive symptoms, while loneliness and apathy were present in 31% and 41% of all patients, respectively. Depression, loneliness and apathy scores showed no clinically relevant changes over time in the whole cohort. Patients who received adjuvant systemic therapies (i.e. endocrine therapy and/or chemotherapy and/or targeted therapy (trastuzumab)) had similar mental health outcomes as those who did not. However, frail patients had more symptoms (p < 0.001) and were more prone to develop depressive symptoms over time than non-frail patients (p = 0.002). DISCUSSION Depression, loneliness and apathy were frequently observed in older women with breast cancer and did not change over time. Patients who received adjuvant systemic therapies had similar mental health outcomes as those who did not. However, frail patients were at higher risk to experience these symptoms.
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Affiliation(s)
- Annelieke A Lemij
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands; Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Nienke A de Glas
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Marloes G M Derks
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Onno R Guicherit
- Department of Surgery, Haaglanden Medical Center, The Hague, the Netherlands
| | | | - Titia E Lans
- Department of Surgery, Admiraal de Ruyter Hospital, Goes, the Netherlands
| | - Thijs van Dalen
- Department of Surgery, Diakonessenhuis, Utrecht, the Netherlands
| | - Annelie J E Vulink
- Department of Medical Oncology, Reinier de Graaf Gasthuis, Delft, the Netherlands
| | - Jos W S Merkus
- Department of Surgery, Haga Hospital, The Hague, the Netherlands
| | - Leander van Gerven
- Department of Internal Medicine, LangeLand Hospital, Zoetermeer, the Netherlands
| | - Frederiek van den Bos
- Department of Gerontology & Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Gerrit-Jan Liefers
- Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
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13
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Ellison TS, Cappa SF, Garrett D, Georges J, Iwatsubo T, Kramer JH, Lehmann M, Lyketsos C, Maier AB, Merrilees J, Morris JC, Naismith SL, Nobili F, Pahor M, Pond D, Robinson L, Soysal P, Vandenbulcke M, Weber CJ, Visser PJ, Weiner M, Frisoni GB. Outcome measures for Alzheimer's disease: A global inter-societal Delphi consensus. Alzheimers Dement 2023; 19:2707-2729. [PMID: 36749854 PMCID: PMC11010236 DOI: 10.1002/alz.12945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/20/2022] [Indexed: 02/09/2023]
Abstract
INTRODUCTION We aim to provide guidance on outcomes and measures for use in patients with Alzheimer's clinical syndrome. METHODS A consensus group of 20 voting members nominated by 10 professional societies, and a non-voting chair, used a Delphi approach and modified GRADE criteria. RESULTS Consensus was reached on priority outcomes (n = 66), measures (n = 49) and statements (n = 37) across nine domains. A number of outcomes and measurement instruments were ranked for: Cognitive abilities; Functional abilities/dependency; Behavioural and neuropsychiatric symptoms; Patient quality of life (QoL); Caregiver QoL; Healthcare and treatment-related outcomes; Medical investigations; Disease-related life events; and Global outcomes. DISCUSSION This work provides indications on the domains and ideal pertinent measurement instruments that clinicians may wish to use to follow patients with cognitive impairment. More work is needed to develop instruments that are more feasible in the context of the constraints of clinical routine.
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Affiliation(s)
| | - Stefano F. Cappa
- Scuola Universitaria Superiore IUSS Pavia, Pavia, Italy
- Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | | | | | - Takeshi Iwatsubo
- Unit for Early and Exploratory Clinical Development, The University of Tokyo Hospital, Tokyo, Japan
- Department of Neuropathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Joel H. Kramer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA
| | | | - Constantine Lyketsos
- Richman Family Precision Medicine Center of Excellence in Alzheimer’s Disease, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University and Medicine, Baltimore, USA
| | - Andrea B. Maier
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Faculty of Behavioural and Movement Sciences, Department of Human Movement Sciences, Vrije Universiteit, Amsterdam Movement Sciences, Amsterdam, Netherlands
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Centre for Healthy Longevity, National University Health System, Singapore, Singapore
| | - Jennifer Merrilees
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA
| | - John C. Morris
- Department of Neurology, Washington University, St. Louis, Missouri, USA
| | - Sharon L. Naismith
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Flavio Nobili
- UO Clinica Neurologica, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Child and Mother Health, University of Genoa, Genova, Italy
| | - Marco Pahor
- Department of Aging and Geriatric Research, Institute on Aging, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Dimity Pond
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
- European Society of Geriatric Medicine, Dementia Special Interest Group
| | - Mathieu Vandenbulcke
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Geriatric Psychiatry, University Psychiatric Centre KU Leuven, Leuven, Belgium
| | | | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, Netherlands
- Alzheimer Center, Department of Neurology, Neuroscience Campus Amsterdam, Amsterdam University Medical Center, VU Medical Center, Amsterdam, Netherlands
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institute, Stockholm, Sweden
| | - Michael Weiner
- San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Giovanni B. Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Department of Readaptation and Geriatrics, Geneva University and University Hospitals, Geneva, Switzerland
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14
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Mahmoudi M, Noroozian M, Mahboobi M, Vahabi Z, Sharifi F, Etesam F. Validity and reliability of the Persian version of the Cornell Scale for Depression in Dementia. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:352-359. [PMID: 34184597 DOI: 10.1080/23279095.2021.1944862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The current study aimed to evaluate the validity and reliability of the Persian version of the Cornell Scale for Depression in Dementia (CSDD) in 100 patients aged ≥60 with dementia in Tehran, Iran. Test-retest reliability and internal consistency were analyzed through intraclass correlation coefficient and Cronbach's alpha tests, respectively. The validity was assessed in the areas of face, content and structural validity. The Geriatric Depression Scale (GDS) and The Montgomery-Åsberg Depression Rating Scale (MADRS) were also used to determine the convergent validity. The intraclass correlation coefficient (ICC) was equal to or more than 0.8 between the results of determining depression twice via the CSDD. The internal consistency (Cronbach's α = 0.90) was excellent. The factor analysis, identified five main factors (mood-related signs, behavioral disturbance, physical signs, cyclic functions and ideational disturbance), aside from depression, demonstrated the variance to be 37.88%. Evaluating convergent validity showed satisfactory results (p < 0001). Using the MADRS as standard. the best cut-points for the CSDD via the use of the Youden index were scores of 5.5, 10.5 and 16.5 for mild, moderate and severe depression, respectively. The Persian version of the CSDD is sufficient in terms of validity and reliability for screening depression in the elderly with dementia in Iran.
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Affiliation(s)
- Mohammad Mahmoudi
- Department of Geriatric Medicine, Tehran University of Medical Sciences, Ziaeian Hospital, Tehran, Iran
| | - Maryam Noroozian
- Cognitive Neurology and Neuropsychiatry Division, Department of Psychiatry, Tehran University of Medical Sciences, Roozbeh Hospital, Tehran, Iran
| | - Marzieh Mahboobi
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Vahabi
- Department of Geriatric Medicine, Tehran University of Medical Sciences, Ziaeian Hospital, Tehran, Iran
- Cognitive Neurology and Neuropsychiatry Division, Department of Psychiatry, Tehran University of Medical Sciences, Roozbeh Hospital, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Etesam
- Department of Geriatric Medicine, Tehran University of Medical Sciences, Ziaeian Hospital, Tehran, Iran
- Psychosomatic Medicine Research Center, Department of Psychiatry, Tehran University 0f Medical Sciences, Imam Khomeini Hospital, Tehran, Iran
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15
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DesRuisseaux LA, Suchy Y, Franchow EI. Intra-individual variability identifies individuals vulnerable to contextually induced executive lapses. Clin Neuropsychol 2023; 37:322-349. [PMID: 35392764 DOI: 10.1080/13854046.2022.2055651] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Contextual stressors, such as engagement in burdensome emotion regulation known as expressive suppression (ES), can result in transient but clinically meaningful decrement in performance on measures of executive functioning (EF). The goal of the present investigation was to examine whether intra-individual variability (IIV-I), which has been identified as an indicator of cognitive weakness, could serve as a marker of vulnerability to EF decrements due to both naturally-occurring and experimentally-manipulated ES. In Study 1, 180 cognitively healthy older adults completed the Push-Turn-Taptap (PTT) task to assess IIV-I, four Delis-Kaplan Executive Function System (D-KEFS) subtests to assess EF, and the Burden of State Emotion Regulation Questionnaire (B-SERQ) to assess naturally-occurring ES. In Study 2, a subset (n = 81) of participants underwent experimental manipulation to induce ES, followed by second administration of the D-KEFS to examine ES-induced decrements in EF. In Study 1, hierarchical linear regression yielded a significant interaction between ES and IIV-I as predictors of EF performance, demonstrating that high ES was associated with low EF only among individuals with high IIV-I. In Study 2, repeated measures ANOVA demonstrated an interaction between time (pre- vs. post- manipulation), group (ES vs. control), and IIV-I (high vs. low), such that only individuals who exhibited high IIV-I were negatively impacted by the ES manipulation. IIV-I moderates the association between ES and EF, such that only individuals with high IIV-I exhibit vulnerability to the impact of ES. Thus, IIV-I may act as a marker of vulnerability to temporary EF depletion.
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Affiliation(s)
| | - Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Emilie I Franchow
- Department of Psychology, University of Utah, Salt Lake City, UT, USA.,Advocate Aurora Healthcare, Milwaukee, WI, USA
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Burgos-Morelos LP, Rivera-Sánchez JDJ, Santana-Vargas ÁD, Arreola-Mora C, Chávez-Negrete A, Lugo JE, Faubert J, Pérez-Pacheco A. Effect of 3D-MOT training on the execution of manual dexterity skills in a population of older adults with mild cognitive impairment and mild dementia. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-10. [PMID: 36697411 DOI: 10.1080/23279095.2023.2169884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Computerized cognitive training tools are an alternative to preventive treatments related to cognitive impairment and aging. In this study, the transfer of 3D multiple object tracking (3D-MOT) training on manual dexterity concerning fine and gross motor skills in 38 elderly participants, half of them with mild cognitive impairment (MCI) and the other half with mild dementia (MD) was explored. A total of 36 sessions of the 3D-MOT training program were administered to the subjects. The Montreal Cognitive Assessment (MoCA) test was used to assess the baseline cognitive status of the participants. Two batteries of manual motor skills (GPT and MMDT) were applied before and after the 3D-MOT training program. The results showed an interaction effect of training and improvement in manual dexterity tests, from the first training session until the fifteenth session, and after this range of sessions, the interaction effect was lost. However, the training effect continued to the end of the thirty-six-session program. The experimental results show the effect of cognitive training on the improvement of motor skills in older adults. This type of intervention could have a broad impact on the aging population in terms of their attention, executive functions, and therefore, their quality of life.
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Affiliation(s)
- Laura P Burgos-Morelos
- Directorate of Research, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico
| | | | | | - Claudia Arreola-Mora
- Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Adolfo Chávez-Negrete
- Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - J Eduardo Lugo
- Faubert Lab, École d'Optométrie, Université de Montréal, Montreal, Canada
- Facultad de Ciencias Físico-Matemáticas, Benemérita Universidad Autónoma de Puebla, Puebla Pue, Mexico
| | - Jocelyn Faubert
- Faubert Lab, École d'Optométrie, Université de Montréal, Montreal, Canada
| | - Argelia Pérez-Pacheco
- Directorate of Research, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico
- Research and Technological Development Unit (UIDT), Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico
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17
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van der Klei VMGTH, Poortvliet RKE, Bogaerts JMK, Blom JW, Mooijaart SP, Teh R, Muru‐Lanning M, Palapar L, Kingston A, Robinson L, Kerse N, Gussekloo J. Vascular disease and apathy symptoms in the very old: A cross-sectional and longitudinal meta-analysis of individual participant data. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5831. [PMID: 36317267 PMCID: PMC9828503 DOI: 10.1002/gps.5831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/16/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Previous findings suggest a vascular foundation underlying apathy, but transdiagnostic and prospective evidence on vascular apathy is scarce. This study examines the association between vascular disease and the presence and development of apathy symptoms in the very old. METHODS Four cohorts of the Towards Understanding Longitudinal International older People Studies (TULIPS)-consortium were included in a two-staged, individual participant data meta-analysis using generalized linear mixed models. Vascular disease was defined as a history of any clinical atherosclerotic pathology (angina pectoris, myocardial infarction, intermittent claudication, transient ischemic attack, stroke or related surgeries) and was related to apathy symptoms as repeatedly measured by the Geriatric Depression Scale (GDS-3A ≥2) over a maximum of 5 years. RESULTS Of all 1868 participants (median age 85 years old), 53.9% had vascular disease and 44.3% experienced apathy symptoms. Participants with vascular disease had a 76% higher risk of apathy symptoms at baseline (odds ratio (OR) 1.76, 95% confidence interval (CI) 1.32-2.35), irrespective of depressive symptoms and only partially explained by stroke. Conversely, there was no association of vascular disease with the occurrence of apathy symptoms longitudinally, both in those with apathy at baseline (OR 1.00, 95% CI 0.84-1.20) and without (OR 0.96, 95% CI 0.84-1.09). CONCLUSIONS Vascular disease in the very old is associated with apathy symptoms cross-sectionally, but not proven longitudinally, independent of depressive symptoms. These findings query a vascular cause underlying apathy symptoms. However, the consistency of our cross-sectional findings in direction and magnitude across the TULIPS-consortium do emphasize international relevance of the interplay of vascular factors and apathy in advanced age, which meaning needs further unravelling.
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Affiliation(s)
| | | | - Jonathan M. K. Bogaerts
- Department of Public Health and Primary CareLeiden University Medical CenterLeidenThe Netherlands
| | - Jeanet W. Blom
- Department of Public Health and Primary CareLeiden University Medical CenterLeidenThe Netherlands
| | - Simon P. Mooijaart
- Department of Gerontology and GeriatricsLeiden University Medical CenterLeidenThe Netherlands
| | - Ruth Teh
- School of Population HealthUniversity of AucklandAucklandNew Zealand
| | - Marama Muru‐Lanning
- School of Population HealthUniversity of AucklandAucklandNew Zealand
- James Henare Māori Research CentreUniversity of AucklandAucklandNew Zealand
| | - Leah Palapar
- School of Population HealthUniversity of AucklandAucklandNew Zealand
| | - Andrew Kingston
- Population Health Sciences InstituteFaculty of Medical SciencesNewcastle UniversityCampus for Ageing and VitalityNewcastle Upon TyneUK
| | - Louise Robinson
- Population Health Sciences InstituteFaculty of Medical SciencesNewcastle UniversityCampus for Ageing and VitalityNewcastle Upon TyneUK
| | - Ngaire Kerse
- School of Population HealthUniversity of AucklandAucklandNew Zealand
| | - Jacobijn Gussekloo
- Department of Gerontology and GeriatricsLeiden University Medical CenterLeidenThe Netherlands
- Department of Public Health and Primary CareLeiden University Medical CenterLeidenThe Netherlands
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18
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Oprea VD, Marinescu M, Rișcă Popazu C, Sârbu F, Onose G, Romila A. Cardiovascular Comorbidities in Relation to the Functional Status and Vitamin D Levels in Elderly Patients with Dementia. Diagnostics (Basel) 2022; 12:2994. [PMID: 36553001 PMCID: PMC9777340 DOI: 10.3390/diagnostics12122994] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 12/02/2022] Open
Abstract
(1) Background: As dementia is an incurable, multifactorial neurodegenerative disease, we gathered and analyzed a number of patient characteristics, assessing possible correlations that may support early diagnosis and a more accurate prognosis for cognitively impaired patients. (2) Methods: We used standard clinical parameters (cognitive and functional status, comorbidities, and plasma vitamin D levels) in a study group of 162 patients aged above 55 years old. (3) Results: We reported a higher incidence of cardiovascular and metabolic comorbidities in patients with severe or moderate cognitive impairment; a validated correlation between functional status, cognitive status, and serum vitamin D levels; and a more frequently associated profile of neurologic comorbidities in patients with a more significant cognitive deficiency. (4) Conclusions: The present research adds data on the significant correlations of cognitive deficits with cardiovascular, metabolic, and neurologic diseases (and the lack of correlation with osteoarticular illness). Clinicians should make the best use of the current screening and assessment tools (such as the functional scoring of daily activities, cognitive evaluation, and the screening of risk factors). Our data may offer starting points for future in-depth analysis of dementia-modifiable risk factors.
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Affiliation(s)
- Violeta Diana Oprea
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 800216 Galați, Romania; (C.R.P.); (F.S.); (A.R.)
- “St. Apostle Andrei” Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Mihai Marinescu
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 800216 Galați, Romania; (C.R.P.); (F.S.); (A.R.)
- “St. Apostle Andrei” Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Corina Rișcă Popazu
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 800216 Galați, Romania; (C.R.P.); (F.S.); (A.R.)
- “St. Apostle Andrei” Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Fabiola Sârbu
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 800216 Galați, Romania; (C.R.P.); (F.S.); (A.R.)
- “Elisabeta Doamna” Psychiatric Hospital, 800179 Galați, Romania
| | - Gelu Onose
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy in Bucharest, 020021 Bucharest, Romania;
- “Bagdasar Arseni” Clinical Emergency Hospital, 041915 Bucharest, Romania
| | - Aurelia Romila
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 800216 Galați, Romania; (C.R.P.); (F.S.); (A.R.)
- “St. Apostle Andrei” Clinical Emergency County Hospital, 800578 Galați, Romania
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19
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Karolczak K, Kostanek J, Soltysik B, Konieczna L, Baczek T, Kostka T, Watala C. Relationships between Plasma Concentrations of Testosterone and Dihydrotestosterone and Geriatric Depression Scale Scores in Men and Women Aged 60-65 Years-A Multivariate Approach with the Use of Quade's Test. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12507. [PMID: 36231806 PMCID: PMC9566053 DOI: 10.3390/ijerph191912507] [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: 09/10/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
The potential role of testosterone and dihydrotestosterone in the pathogenesis of depression in older subjects is poorly recognized and understood. The current study examines the symptoms of depression in males and females at the age of 60-65 using a short version (15 questions) of the Geriatric Depression Scale (GDS) questionnaire. Blood plasma levels of androgens were estimated by LC/MS/MS. Total GDS score calculated for males were not found to be significantly associated with plasma levels of testosterone or dihydrotestosterone. Older men with higher plasma testosteronemia were more likely to report being in good spirits most of the time, but more willing to stay at home than undertake outside activities. The men with higher plasma levels of dihydrotestosterone also perceived themselves as being in good spirits most of the time. Older men with higher testosterone were more likely to report having more problems with their memory than others. No significant associations were found between plasma levels of androgens and GDS scores in older women; however, some tendencies suggest that testosterone and dihydrotestosterone may act as antidepressants in older women.
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Affiliation(s)
- Kamil Karolczak
- Department of Haemostatic Disorders, Medical University of Lodz, ul. Mazowiecka 6/8, 92-215 Lodz, Poland
| | - Joanna Kostanek
- Department of Haemostatic Disorders, Medical University of Lodz, ul. Mazowiecka 6/8, 92-215 Lodz, Poland
| | - Bartlomiej Soltysik
- Department of Geriatrics, Healthy Aging Research Center (HARC), Medical University of Lodz, pl. Hallera 1, 90-647 Lodz, Poland
| | - Lucyna Konieczna
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, ul. Hallera 107, 80-416 Gdańsk, Poland
| | - Tomasz Baczek
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, ul. Hallera 107, 80-416 Gdańsk, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Healthy Aging Research Center (HARC), Medical University of Lodz, pl. Hallera 1, 90-647 Lodz, Poland
| | - Cezary Watala
- Department of Haemostatic Disorders, Medical University of Lodz, ul. Mazowiecka 6/8, 92-215 Lodz, Poland
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20
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Cammisuli DM, Cipriani G, Giusti EM, Castelnuovo G. Effects of Reminiscence Therapy on Cognition, Depression and Quality of Life in Elderly People with Alzheimer’s Disease: A Systematic Review of Randomized Controlled Trials. J Clin Med 2022; 11:jcm11195752. [PMID: 36233620 PMCID: PMC9570531 DOI: 10.3390/jcm11195752] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/16/2022] [Accepted: 09/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Patients with Alzheimer’s disease (AD) present with cognitive function deterioration, neuropsychiatric symptoms (NPS)—especially depression—and low quality of life (QoL). Management of AD remains difficult, especially in the elderly. Reminiscence therapy (RT) is a well-known cognitive rehabilitation intervention that can be adopted in nursing and residential care homes to restore autobiographical memory, ameliorate NPS, and improve the QoL of people with dementia. However, the evidence-based efficacy of RT for elderly patients with AD remains to be determined. Methods: Here, we synthesized findings of randomized controlled trials (RCTs) exploring the effects of RT on cognition, depression, and QoL in elderly people with AD, according to the most recent PRISMA statement. We searched for RCTs in PubMed, Web of Science, and Cochrane Central Register of Controlled Trials, and in trial registries (i.e., clinicaltrials.gov and International Clinical Trials Registry Platform of the World Health Organization). Two review authors extracted data of interest, with cognition, depression, and QoL measures as outcomes. Results: A total of five articles were included in the final analysis. Findings globally showed that RT, both administered in individual or group sessions at least once a week for 30–35 min over a period of 12 weeks, is effective in supporting global cognition, ameliorating depression, and improving specific aspects of the QoL in elderly people with AD. Conclusions: RT has the potential to be a routine non-pharmacological therapy for elderly people with AD, thanks to its wider effects on the individual in terms of cognitive vitality and emotional status promotion, with positive implications for patient’s daily life. Despite such evidences, caution should be used in findings’ generalizability in relation to the paucity of existing RCTs with long-term follow-up.
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Affiliation(s)
| | - Gabriele Cipriani
- Division of Neurology, Versilia Hospital, 55049 Lido di Camaiore, Italy
| | - Emanuele Maria Giusti
- Istituto Auxologico Italiano IRCCS, Clinical Psychology Research Laboratory, 28824 Verbania, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University, 20123 Milan, Italy
- Istituto Auxologico Italiano IRCCS, Clinical Psychology Research Laboratory, 28824 Verbania, Italy
- Correspondence:
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Hermush V, Ore L, Stern N, Mizrahi N, Fried M, Krivoshey M, Staghon E, Lederman VE, Bar-Lev Schleider L. Effects of rich cannabidiol oil on behavioral disturbances in patients with dementia: A placebo controlled randomized clinical trial. Front Med (Lausanne) 2022; 9:951889. [PMID: 36148467 PMCID: PMC9486160 DOI: 10.3389/fmed.2022.951889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAlmost 90% of patients with dementia suffer from some type of neurobehavioral symptom, and there are no approved medications to address these symptoms.ObjectiveTo evaluate the safety and efficacy of the medical cannabis oil “Avidekel” for the reduction of behavioral disturbances among patients with dementia.Materials and methodsIn this randomized, double-blind, single-cite, placebo-controlled trial conducted in Israel (ClinicalTrials.gov: NCT03328676), patients aged at least 60, with a diagnosis of major neurocognitive disorder and associated behavioral disturbances were randomized 2:1 to receive either “Avidekel,” a broad-spectrum cannabis oil (30% cannabidiol and 1% tetrahydrocannabinol: 295 mg and 12.5 mg per ml, respectively; n = 40) or a placebo oil (n = 20) three times a day for 16 weeks. The primary outcome was a decrease, as compared to baseline, of four or more points on the Cohen-Mansfield Agitation Inventory score by week 16.ResultsFrom 60 randomized patients [mean age, 79.4 years; 36 women (60.0%)], 52 (86.7%) completed the trial (all eight patients who discontinued treatment were from the investigational group). There was a statistically significant difference in the proportion of subjects who had a Cohen-Mansfield Agitation Inventory score reduction of ≥ 4 points at week 16: 24/40 (60.0%) and 6/20 (30.0%) for investigational and control groups, respectively (χ2 = 4.80, P = 0.03). There was a statistically significant difference in the proportion of subjects who had a Cohen-Mansfield Agitation Inventory score reduction of ≥ 8 points at week 16: 20/40 (50%) and 3/20 (15%), respectively (χ2 = 6.42, P = 0.011). The ANOVA repeated measures analysis demonstrated significantly more improvement in the investigational group compared to the control group at weeks 14 and 16 (F = 3.18, P = 0.02). Treatment was mostly safe, with no significant differences in the occurrence of adverse events between the two groups.ConclusionIn this randomized controlled trial, ‘Avidekel’ oil significantly reduced agitation over placebo in patients suffering from behavioral disturbances related to dementia, with non-serious side-effects. Further research is required with a larger sample size.
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Affiliation(s)
- Vered Hermush
- Geriatric Wing, Laniado Hospital, Netanya, Israel
- Technion School of Medicine, Haifa, Israel
- *Correspondence: Vered Hermush,
| | - Liora Ore
- Department of Graduate Studies in Health Systems Management, The Max Stern Yezreel Valley College, Jezreel Valley, Israel
| | - Noa Stern
- Geriatric Wing, Laniado Hospital, Netanya, Israel
- Technion School of Medicine, Haifa, Israel
| | | | - Malki Fried
- Geriatric Wing, Laniado Hospital, Netanya, Israel
| | | | - Ella Staghon
- Geriatric Wing, Laniado Hospital, Netanya, Israel
| | | | - Lihi Bar-Lev Schleider
- Research Department, Tikun-Olam Cannbit Pharmaceuticals, Tel Aviv, Israel
- Clinical Research Center, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva, Israel
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22
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Sârbu F, Oprea VD, Tatu AL, Polea Drima E, Bojincă VC, Romila A. Hereditary Hemorrhagic Telangiectasia Associating Neuropsychiatric Manifestations with a Significant Impact on Disease Management-Case Report and Literature Review. Life (Basel) 2022; 12:1059. [PMID: 35888148 PMCID: PMC9320563 DOI: 10.3390/life12071059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/05/2022] [Accepted: 07/12/2022] [Indexed: 11/28/2022] Open
Abstract
(1) Background: Genetic hereditary hemorrhagic telangiectasia (HHT) is clinically diagnosed. The clinical manifestations and lack of curative therapeutic interventions may lead to mental illnesses, mainly from the depression-anxiety spectrum. (2) Methods: We report the case of a 69-year-old patient diagnosed with HHT and associated psychiatric disorders; a comprehensive literature review was performed based on relevant keywords. (3) Results: Curaçao diagnostic criteria based the HHT diagnosis in our patient case at 63 years old around the surgical interventions for a basal cell carcinoma, after multiple episodes of epistaxis beginning in childhood, but with a long symptom-free period between 20 and 45 years of age. The anxiety-depressive disorder associated with nosocomephobia resulted in a delayed diagnosis and low adherence to medical monitoring. A comprehensive literature review revealed the scarcity of publications analyzing the impact of psychiatric disorders linked to this rare condition, frequently associating behavioral disengagement as a coping strategy, psychological distress, anxiety, depression, and hopelessness. (4) Conclusions: As patients with HHT face traumatic experiences from disease-related causes as well as recurring emergency hospital visits, active monitoring for mental illnesses and psychological support should be considered as part of the initial medical approach and throughout the continuum of care.
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Affiliation(s)
- Fabiola Sârbu
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galati, 800216 Galati, Romania; (F.S.); (E.P.D.); (A.R.)
- “Elisabeta Doamna” Psychiatric Hospital, 800179 Galati, Romania
| | - Violeta Diana Oprea
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galati, 800216 Galati, Romania; (F.S.); (E.P.D.); (A.R.)
- “St. Apostle Andrei” Clinical Emergency County Hospital Galati, 800578 Galati, Romania
| | - Alin Laurențiu Tatu
- Clinical, Medical Department, Dermatology, ReForm UDJ, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galati, 800216 Galati, Romania
- Dermatology Department, Clinical Hospital of Infectious Diseases Saint Parascheva, 800179 Galati, Romania
| | - Eduard Polea Drima
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galati, 800216 Galati, Romania; (F.S.); (E.P.D.); (A.R.)
- “Elisabeta Doamna” Psychiatric Hospital, 800179 Galati, Romania
| | - Violeta Claudia Bojincă
- Internal Medicine Department, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy in Bucharest, 020021 Bucharest, Romania;
- Department of Internal Medicine and Rheumatology, “Sf. Maria” Hospital, 011172 Bucharest, Romania
| | - Aurelia Romila
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galati, 800216 Galati, Romania; (F.S.); (E.P.D.); (A.R.)
- “St. Apostle Andrei” Clinical Emergency County Hospital Galati, 800578 Galati, Romania
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Park SH. Which of the Cornell Scale for Depression in Dementia or the Geriatric Depression Scale is more useful to screen for depression in older adults? Asian J Psychiatr 2022; 72:103147. [PMID: 35533539 DOI: 10.1016/j.ajp.2022.103147] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 05/02/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Depression in older adults is a major disorder that can be triggering, exacerbating, or co-occurring with dementia symptoms. AIM This study compared the diagnostic accuracy of the Cornell Scale for Depression in Dementia (CSDD) and the Geriatric Depression Scale (GDS), a depression screening tool developed for older adults. METHODS Electronic searches were performed on the MEDLINE, EMBASE, CINAHL, and PsycINFO databases using the following keywords: dementia, depression, and CSDD. RESULTS The pooled sensitivity of the CSDD and the GDS was 0.89 and 0.82, the pooled specificity was 0.88 and 0.85, and the summary receiver operating characteristic (SROC) curve was 0.94 and 0.91, respectively. In the subgroup analysis, the CSDD had the highest accuracy in the pooled sensitivity of 0.91, the pooled specificity of 0.87, and the sROC curve of 0.95 in the dementia group, and the GDS was the best in the non-dementia group at 0.88, 0.82, and 0.93, respectively. CONCLUSIONS The CSDD showed high diagnostic accuracy in older adults with dementia, and the GDS in older adults without dementia.
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Affiliation(s)
- Seong-Hi Park
- School of Nursing, Soonchunhyang University, 22 Soonchunhyang-ro, Sinchang-myen, Asan-si, Chungcheongnam-do 31538, Republic of Korea.
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Lilja-Lund O, Nyberg L, Maripuu M, Laurell K. Dual-Task Performance in Older Adults With and Without Idiopathic Normal Pressure Hydrocephalus. Front Aging Neurosci 2022; 14:904194. [PMID: 35707704 PMCID: PMC9190777 DOI: 10.3389/fnagi.2022.904194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 04/27/2022] [Indexed: 11/18/2022] Open
Abstract
Two of the main features of idiopathic normal pressure hydrocephalus (iNPH) are disturbed gait and cognition. These features are typically investigated separately, but here we combined walking with a cognitive task to investigate if older adults with iNPH were more susceptible to dual-task interference on walking than those without iNPH. In total, 95 individuals from the general population participated in our study. Of these, 20 were classified as Possible iNPH (median [interquartile range, IQR] 80 years [75–82.5]) and 75 as Unlikely iNPH (74 years [72–78]). Conversation, 10-m walking, semantic and phonemic verbal fluency were performed either combined or independently. “Stopping walking while talking” was noted. Pairwise comparisons and multiple logistic regression analyses were used. We found that the Possible iNPH group was older, stopped walking more frequently during the conversation, and had a slower single-task pace. The dual-task pace was slower for both groups. Only single-task walking pace could predict Possible iNPH when adjusted for age. We could establish a dual-task cost on gait performance in this sample of older adults from the general population, but the cost was not exclusive for individuals with Possible iNPH. To further assess the value of dual-task testing in iNPH, including observations of stopping walking while talking, a study of a clinical iNPH material with more severe symptoms would be valuable.
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Affiliation(s)
- Otto Lilja-Lund
- Department of Clinical Sciences, Neuroscience, Umeå University, Umeå, Sweden
- *Correspondence: Otto Lilja-Lund,
| | - Lars Nyberg
- Department of Radiation Sciences, Radiology, Umeå University, Umeå, Sweden
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | - Martin Maripuu
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
| | - Katarina Laurell
- Department of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden
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López-Ortiz S, Lista S, Peñín-Grandes S, Pinto-Fraga J, Valenzuela PL, Nisticò R, Emanuele E, Lucia A, Santos-Lozano A. Defining and assessing intrinsic capacity in older people: A systematic review and a proposed scoring system. Ageing Res Rev 2022; 79:101640. [PMID: 35569785 DOI: 10.1016/j.arr.2022.101640] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/30/2022] [Accepted: 05/07/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The World Health Organization has introduced the term 'intrinsic capacity' (IC) as a marker of healthy ageing. However, controversy exists on the definition and assessment of IC. We aimed to review the definitions and methods used for the assessment of IC in older adults. In addition, we proposed a new IC scoring method. METHODS A systematic search was performed in PubMed, Web of Science, Cochrane Library, Scopus and SPORTDiscus (up to February 10th, 2022) for studies assesing IC in older adults (>60 years). RESULTS Thirty-three studies were included. There is overall consensus on the definition of IC as well as on its different dimensions, that is: locomotion, vitality, sensory, cognition and psychological. However, the methods for assessing each of these five dimensions differ substantially across studies and there is no consensus on the best method to compute an eventual global compound score to evaluate IC taking into account all its different dimensions. CONCLUSIONS The IC represents a highly relevant clinical concept that has been unfortunately underutilized. We propose a standardization for the assessment of each dimension of IC, with a global 0 (worst) to 10 (highest) score.
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George G, Fricker M, Todd O, Makowa D, Tembo C, Dotchin C, Gray WK, Walker RW, Mbwele B, Paddick SM. Screening for delirium and dementia in older hospitalised adults in Zambia. J Neurol Sci 2022; 436:120186. [DOI: 10.1016/j.jns.2022.120186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 01/27/2022] [Accepted: 02/11/2022] [Indexed: 10/18/2022]
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Shealy G. Dementia Case Management: Variances and Clinical Pathways for Dementia Case Management. Prof Case Manag 2022; 27:161-165. [PMID: 35363665 DOI: 10.1097/ncm.0000000000000571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Greta Shealy
- Greta Shealy, MSN, RN, has been an RN for more than 35 years, beginning in Obstetrics and the newborn nursery as she followed her husband, Jim, to his U.S. Air Force assignments in California, North Carolina, and South Carolina. Over the past 15 years, her career has taken her out of the hospital and into the community as a Faith Community Nurse, Executive Assistant for her church, a psychiatric home health nurse, and an insurance company chronic disease care manager. She spent 2 years on "sabbatical" as her mother's full-time caregiver and learned firsthand what so many of our clients are going through. Greta is completing her MSN in Case Management through American Sentinel College of Nursing and Health Science at Post University, where she is a member of the graduate student/faculty advisory board. Her story was recently highlighted by the MSN program in their student profiles. She and her husband spend as much time as possible with their four grown children, their families, and their four grandchildren. They currently reside in Clemson, SC, but spend as much time as possible in their camper in any mountain area near water that they can get to. Greta is passionate about the circle of life, especially palliative and end-of-life care, and hopes to use her degree and experience to advocate for people to live and die with dignity
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Chen PJ, Chen KM, Hsu HF, Belcastro F. Types of exercise and training duration on depressive symptoms among older adults in long-term care facilities. Ageing Res Rev 2022; 77:101613. [PMID: 35339704 DOI: 10.1016/j.arr.2022.101613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/15/2022] [Accepted: 03/21/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Depression is associated with a greater risk of disability, cognitive impairment, and suicide. Older adults in long-term care facilities (LTCFs) are more likely to develop depression due to changes in family roles and separation from family members. The aim of this study was to synthesize and analyze the effects of different types of exercise and training duration on depressive symptoms of older adults in LTCFs. METHODS Relevant peer-reviewed journal articles published in English were identified through a search of six electronic databases up to June 2021. RESULTS A total of 25 studies were included in the systematic review and 22 in the meta-analysis. The results of meta-analysis showed that exercise interventions reduced depression in cognitively intact older adults and in cognitively impaired older adults. Both exercising less than 150 min per week or more than 150 min per week, reduced depressive symptoms of older adults. In terms of exercise types, mind-body exercises, exergames, and strength training reduced depressive symptoms. CONCLUSION Exercise has a positive effect on reducing depressive symptoms with mind-body exercises, exergames, and strength training producing the best effect. Regardless of cognitive impairment, older adults in LTCFs benefited from exercise in reducing depressive symptoms.
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Affiliation(s)
- Po-Jung Chen
- Center for Long-Term Care Research, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung, 80708 Taiwan.
| | - Kuei-Min Chen
- College of Nursing, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan; Center for Long-Term Care Research, Kaohsiung Medical University, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Taiwan.
| | - Hui-Fen Hsu
- Center for Long-Term Care Research, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung, 80708 Taiwan.
| | - Frank Belcastro
- Department of Education and Psychology, University of Dubuque, 2000 University Ave., Dubuque, IA 52001, USA.
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Lemij AA, de Glas NA, Derks MGM, Bastiaannet E, Merkus JWS, Lans TE, van der Pol CC, van Dalen T, Vulink AJE, van Gerven L, Guicherit OR, Linthorst-Niers EMH, van den Bos F, Kroep JR, Liefers GJ, Portielje JEA. Discontinuation of adjuvant endocrine therapy and impact on quality of life and functional status in older patients with breast cancer. Breast Cancer Res Treat 2022; 193:567-577. [PMID: 35441273 PMCID: PMC9114046 DOI: 10.1007/s10549-022-06583-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/27/2022] [Indexed: 11/25/2022]
Abstract
Purpose Side effects are the main reason for discontinuation of adjuvant endocrine therapy in older adults. The aim of this study was to examine geriatric predictors of treatment discontinuation of adjuvant endocrine therapy within the first 2 years after initiation, and to study the association between early discontinuation and functional status and quality of life (QoL). Methods Patients aged ≥ 70 years with stage I–III breast cancer who received adjuvant endocrine therapy were included. The primary endpoint was discontinuation of endocrine therapy within 2 years. Risk factors for discontinuation were assessed using univariate logistic regression models. Linear mixed models were used to assess QoL and functional status over time. Results Overall, 258 patients were included, of whom 36% discontinued therapy within 2 years after initiation. No geriatric predictive factors for treatment discontinuation were found. Tumour stage was inversely associated with early discontinuation. Patients who discontinued had a worse breast cancer-specific QoL (b = − 4.37; 95% CI − 7.96 to − 0.78; p = 0.017) over the first 2 years, in particular on the future perspective subscale (b = − 11.10; 95% CI − 18.80 to − 3.40; p = 0.005), which did not recover after discontinuation. Treatment discontinuation was not associated with functional improvement. Conclusion A large proportion of older patients discontinue adjuvant endocrine treatment within 2 years after initiation, but geriatric characteristics are not predictive of early discontinuation of treatment. Discontinuation of adjuvant endocrine therapy did not positively affect QoL and functional status, which implies that the observed poorer QoL in this group is probably not caused by adverse effects of endocrine therapy. Supplementary Information The online version contains supplementary material available at 10.1007/s10549-022-06583-7.
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Affiliation(s)
- Annelieke A Lemij
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Nienke A de Glas
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marloes G M Derks
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Esther Bastiaannet
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jos W S Merkus
- Department of Surgery, Haga Hospital, The Hague, The Netherlands
| | - Titia E Lans
- Department of Surgery, Admiraal de Ruyter Hospital, Goes, The Netherlands
| | | | - Thijs van Dalen
- Department of Surgery, Diakonessenhuis, Utrecht, The Netherlands
| | - Annelie J E Vulink
- Department of Medical Oncology, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Leander van Gerven
- Department of Internal Medicine, LangeLand Hospital, Zoetermeer, The Netherlands
| | - Onno R Guicherit
- Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | | | - Frederiek van den Bos
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Judith R Kroep
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Gerrit Jan Liefers
- Department of Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
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Park SH, Cho YS. Predictive validity of the Cornell Scale for depression in dementia among older adults with and without dementia: A systematic review and meta-analysis. Psychiatry Res 2022; 310:114445. [PMID: 35190341 DOI: 10.1016/j.psychres.2022.114445] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 02/04/2022] [Accepted: 02/12/2022] [Indexed: 12/29/2022]
Abstract
This review analyzes the predictive validity of the Cornell Scale for Depression in Dementia (CSDD), considering cognitive function. Electronic searches were performed using MEDLINE, EMBASE, CINAHL, and PsycINFO databases. Overall, 20 studies were reviewed, including 3,499 older adults, with and without dementia, who satisfied the selection criteria. Participants were stratified into the dementia, non-dementia, and mixed groups, and the diagnostic performance of the CSDD was assessed using receiver operating characteristic (ROC) curves. In the dementia and non-dementia groups, the area under the curve was ≥ 0.9, confirming high accuracy of the test. The pooled sensitivity was the highest in the dementia group (0.87), followed by the mixed group (0.84) and non-dementia group (0.82). In the subgroup analysis based on the Mini-Mental State Examination (MMSE), the ROC curve was 0.90 for older adults with MMSE scores < 15 and 0.87 for those with an MMSE score ≥ 15. Therefore, the CSDD can be considered excellent tool for assessing depression in all older adults, although its predictive ability is better for older adults with dementia compared to that in those without dementia. It can be used as a first-line screening tool for depression, regardless of cognitive function.
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31
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Merizzi A, Biasi R, Zamudio JFÁ, Spagnuolo Lobb M, Di Rosa M, Santini S. A Single-Case Design Investigation for Measuring the Efficacy of Gestalt Therapy to Treat Depression in Older Adults with Dementia in Italy and in Mexico: A Research Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063260. [PMID: 35328948 PMCID: PMC8950193 DOI: 10.3390/ijerph19063260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 02/04/2023]
Abstract
Psychotherapy is one of the evidence-based clinical interventions for the treatment of depression in older adults with dementia. Randomised controlled trials are often the first methodological choice to gain evidence, yet they are not applicable to a wide range of humanistic psychotherapies. Amongst all, the efficacy of the Gestalt therapy (GT) is under-investigated. The purpose of this paper is to present a research protocol, aiming to assess the effects of a GT-based intervention on people with dementia (PWD) and indirect influence on their family carers. The study implements the single-case experimental design with time series analysis that will be carried out in Italy and Mexico. Six people in each country, who received a diagnosis of dementia and present depressive symptoms, will be recruited. Eight or more GT sessions will be provided, whose fidelity will be assessed by the GT fidelity scale. Quantitative outcome measures are foreseen for monitoring participants' depression, anxiety, quality of life, loneliness, carers' burden, and the caregiving dyad mutuality at baseline and follow-up. The advantages and limitations of the research design are considered. If GT will effectively result in the treatment of depression in PWD, it could enrich the range of evidence-based interventions provided by healthcare services.
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Affiliation(s)
- Alessandra Merizzi
- Centre for Socio-Economic Research on Aging, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy;
- Correspondence:
| | - Rosanna Biasi
- Istituto di Gestalt HCC Human Communication Centre Italy, Via S. Sebastiano 38, 96100 Siracusa, Italy; (R.B.); (M.S.L.)
| | | | - Margherita Spagnuolo Lobb
- Istituto di Gestalt HCC Human Communication Centre Italy, Via S. Sebastiano 38, 96100 Siracusa, Italy; (R.B.); (M.S.L.)
| | - Mirko Di Rosa
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy;
| | - Sara Santini
- Centre for Socio-Economic Research on Aging, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy;
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Mele B, Watt J, Wu P, Azeem F, Lew G, Holroyd–Leduc J, Goodarzi Z. Detecting depression in persons living in long-term care: a systematic review and meta-analysis of diagnostic test accuracy studies. Age Ageing 2022; 51:6540127. [PMID: 35231088 DOI: 10.1093/ageing/afac039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE Depressive disorders are common in long-term care (LTC), however, there is no one process used to detect depressive disorders in this setting. Our goal was to describe the diagnostic accuracy of depression detection tools used in LTC settings. METHODS We conducted a systematic review and meta-analysis of diagnostic accuracy measures. The databases PubMed, EMBASE, PsycINFO and CINAHL were searched from inception to 10 September 2021. Studies involving persons living in LTC, assisted living residences or facilities, comparing diagnostic accuracy of depression tools with a reference standard, were included. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess risk of bias. RESULTS We identified 8,463 citations, of which 20 studies were included in qualitative synthesis and 19 in meta-analysis. We identified 23 depression detection tools (including different versions) that were validated against a reference standard. At a cut-off point of 6 on the Geriatric Depression Scale-15 (GDS-15), the pooled sensitivity was 73.6% (95% confidence interval (CI) 43.9%-76.5%), specificity was 76.5% (95% CI 62.9%-86.7%), and an area under the curve was 0.83. There was significant heterogeneity in these analyses. There was insufficient data to conduct meta-analysis of other screening tools. The Nursing Homes Short Depression Inventory (NH-SDI) had a sensitivity ranging from 40.0% to 98.0%. The 4-item Cornell Scale for Depression in Dementia (CSDD) had the highest sensitivity (67.0%-90.0%) for persons in LTC living with dementia. CONCLUSIONS There are 23 tools validated for detection of depressive disorders in LTC, with the GDS-15 being the most studied. Tools developed specifically for use in LTC settings include the NH-SDI and CSDD-4, which provide briefer options to screen for depression. However, more studies of both are needed to examine tool accuracy using meta-analyses.
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Affiliation(s)
- Bria Mele
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer Watt
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Pauline Wu
- Division of Geriatric Medicine, Department of Medicine, University of Calgary, Canada
| | - Feeha Azeem
- Business Management Masters Program, York University, Toronto, Ontario M3J 1P3, Canada
| | - Grace Lew
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jayna Holroyd–Leduc
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Calgary, Canada
- Hotchkiss Brain Institute, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, Calgary, Alberta, Canada
| | - Zahra Goodarzi
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Calgary, Canada
- Hotchkiss Brain Institute, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, Calgary, Alberta, Canada
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Lin SY, Schneider CE, Bristol AA, Clancy M, Sprague SA, Aldridge M, Cortes T, Goldfeld KS, Kutner JS, Mitchell SL, Shega JW, Wu B, Zhu CW, Brody AA. Findings of Sequential Pilot Trials of Aliviado Dementia Care to Inform an Embedded Pragmatic Clinical Trial. THE GERONTOLOGIST 2022; 62:304-314. [PMID: 33377138 PMCID: PMC8827334 DOI: 10.1093/geront/gnaa220] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Many investigators of Alzheimer's disease and related dementias (AD/ADRD) are unfamiliar with the embedded pragmatic clinical trials (ePCTs) and the indispensable pilot phase preceding ePCTs. This paper provides a much-needed example for such a pilot phase and discusses implementation barriers and additional infrastructure and implementation strategies developed in preparation for a nationwide AD/ADRD ePCT. RESEARCH DESIGN AND METHODS Two pilot trials were conducted in 2 hospices sequentially to refine and test Aliviado Dementia Care-Hospice Edition, a complex quality improvement intervention for advanced dementia symptom management. Readiness for the subsequent full-scale ePCT was assessed by three milestones: ≥80% training completion rate ("feasibility"), ≥80% posttraining survey respondents indicating intention for practice changes ("applicability"), and at least 1 Aliviado care plan/assessment instrument administered in ≥75% of dementia patients admitted to home hospice within 1-month posttraining ("fidelity"). RESULTS Participants included 72 interdisciplinary team members and 11 patients with AD/ADRD across the pilots. Feasibility, applicability, and fidelity outcomes (92%, 93%, and 100%, respectively) all surpassed the preestablished milestones (80%, 80%, and 75%). Main implementation challenges were related to hospice staff turnover, integration of the Aliviado toolbox materials within the electronic health records, and hospices' limited research experience and infrastructure. DISCUSSION AND IMPLICATIONS This pilot phase demonstrated feasibility, applicability, and fidelity required to proceed to the full-scale ePCT. Our study findings and discussions of additional infrastructure and implementation strategies developed following the pilot phase can inform researchers and clinicians interested in conducting AD/ADRD-related pilot studies for ePTCs or quality improvement initiatives. CLINICAL TRIALS REGISTRATION NUMBER NCT03681119.
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Affiliation(s)
- Shih-Yin Lin
- Hartford Institute for Geriatric Nursing, NYU Rory Meyers College of Nursing, New York, New York, USA
| | - Catherine E Schneider
- Hartford Institute for Geriatric Nursing, NYU Rory Meyers College of Nursing, New York, New York, USA
| | - Alycia A Bristol
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Maureen Clancy
- MJHS Hospice and Palliative Care, New York, New York, USA
| | - Sara A Sprague
- Providence TrinityCare Hospice, Torrance, California, USA
| | - Melissa Aldridge
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- James J. Peters VA Medical Center, Bronx, New York, USA
| | - Tara Cortes
- Hartford Institute for Geriatric Nursing, NYU Rory Meyers College of Nursing, New York, New York, USA
| | - Keith S Goldfeld
- Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Jean S Kutner
- Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Susan L Mitchell
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Joseph W Shega
- Vitas Healthcare, Miami, Florida, USA
- College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Bei Wu
- Hartford Institute for Geriatric Nursing, NYU Rory Meyers College of Nursing, New York, New York, USA
| | - Carolyn W Zhu
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- James J. Peters VA Medical Center, Bronx, New York, USA
| | - Abraham A Brody
- Hartford Institute for Geriatric Nursing, NYU Rory Meyers College of Nursing, New York, New York, USA
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Clancy U, Ramirez J, Chappell FM, Doubal FN, Wardlaw JM, Black SE. Neuropsychiatric symptoms as a sign of small vessel disease progression in cognitive impairment. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2022; 3:100041. [PMID: 36324402 PMCID: PMC9616231 DOI: 10.1016/j.cccb.2022.100041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/12/2022] [Accepted: 01/16/2022] [Indexed: 11/27/2022]
Abstract
Background Neuropsychiatric symptoms associate cross-sectionally with cerebral small vessel disease but it is not clear whether these symptoms could act as early clinical markers of small vessel disease progression. We investigated whether longitudinal change in Neuropsychiatric Inventory (NPI) scores associated with white matter hyperintensity (WMH) progression in a memory clinic population. Material and methods We included participants from the prospective Sunnybrook Dementia Study with Alzheimer's disease and vascular subtypes of mild cognitive impairment and dementia with two MRI and ≥ 1 NPI. We conducted linear mixed-effects analyses, adjusting for age, atrophy, vascular risk factors, cognition, function, and interscan interval. Results At baseline (n=124), greater atrophy, age, vascular risk factors and total NPI score were associated with higher baseline WMH volume, while longitudinally, all but vascular risk factors were associated. Change in total NPI score was associated with change in WMH volume, χ2 = 7.18, p = 0.007, whereby a one-point change in NPI score from baseline to follow-up was associated with a 0.0017 change in normalized WMH volume [expressed as cube root of (WMH volume cm³ as % intracranial volume)], after adjusting for age, atrophy, vascular risk factors and interscan interval. Conclusions In memory clinic patients, WMH progression over 1-2 years associated with worsening neuropsychiatric symptoms, while WMH volume remained unchanged in those with stable NPI scores in this population with low background WMH burden.
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Affiliation(s)
- Una Clancy
- Brain Research Imaging Centre, Division of Neuroimaging Sciences, Centre for Clinical Brain Sciences, UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | - Joel Ramirez
- Dr. Sandra Black Centre for Brain Resilience & Recovery, LC Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, 2075 Bayview Avenue, Room A4 21, Toronto, ON M4N 3M5, Canada,Corresponding author.
| | - Francesca M. Chappell
- Brain Research Imaging Centre, Division of Neuroimaging Sciences, Centre for Clinical Brain Sciences, UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | - Fergus N. Doubal
- Brain Research Imaging Centre, Division of Neuroimaging Sciences, Centre for Clinical Brain Sciences, UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | - Joanna M. Wardlaw
- Brain Research Imaging Centre, Division of Neuroimaging Sciences, Centre for Clinical Brain Sciences, UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | - Sandra E. Black
- Dr. Sandra Black Centre for Brain Resilience & Recovery, LC Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, 2075 Bayview Avenue, Room A4 21, Toronto, ON M4N 3M5, Canada,Department of Medicine (Neurology), Sunnybrook Health Sciences Centre and Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
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Zilbershlag Y, Ravitz-Ron K, Engel-Yeger B. The Role of Altered Sensory Processing and Its Association with Participation in Daily Activities and Quality of Life among Older Adults in the Community. Occup Ther Health Care 2022; 37:230-247. [PMID: 35034550 DOI: 10.1080/07380577.2022.2025552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
To identify variables that contribute to fall risk in older adults, this study examined the relationship between fall risk, sensory processing, participation in daily activities, and quality of life (QoL). Of the 123 participants, those at high-risk were significantly less able to register sensory input and had increased sensory sensitivity, restricted participation and overall lower QoL. Altered sensory processing was related with risk of falling. Additionally, both sensory process and fall risk were subsequently related with lower daily participation and, together, were related with lower QoL. Thus, sensory processing, participation and QoL assessments need to be included in occupational therapy evaluations and interventions for fall risk among older adults.
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Affiliation(s)
- Yael Zilbershlag
- Department of Occupational Therapy, Faculty of Health Allied Professions, Ono Academic College, Kiryat Ono, Israel
| | - Keren Ravitz-Ron
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Batya Engel-Yeger
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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36
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Chu CH, Quan AML, McGilton KS. Depression and Functional Mobility Decline in Long Term Care Home Residents with Dementia: a Prospective Cohort Study. Can Geriatr J 2021; 24:325-331. [PMID: 34912487 PMCID: PMC8629506 DOI: 10.5770/cgj.24.511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective Assess the association between depression among new long-term care residents (<3 months stay) with dementia and functional mobility decline. Methods A multi-site prospective cohort study was carried out among 26 participants diagnosed with dementia. Functional mobility was measured by Timed-Up-and-Go (TUG) and 2-Minute walk test (2MWT) at baseline, and 60-day post-baseline while participants received usual care. Linear mixed models were applied to examine the association between depression and functional mobility decline. Results Residents experienced a statistically significant decline in functional mobility in as soon as 60 days. Each additional year of age was associated with a 2% increase in TUG. The interaction between depression and time spent in LTC was statistically significant. Age and time living in LTC were significantly associated with functional mobility decline in new residents with dementia. Discussion Further work determining why residents with dementia experience decline in functional mobility at an accelerated rate is needed.
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Affiliation(s)
- Charlene H Chu
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto.,Institute for Life Course and Aging, University of Toronto, Toronto
| | | | - Katherine S McGilton
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON
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37
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Tadokoro K, Yamashita T, Sato J, Omote Y, Takemoto M, Morihara R, Nishiura K, Tani T, Abe K. Chronic Beneficial Effect of Makeup Therapy on Cognitive Function of Dementia and Facial Appearance Analyzed by Artificial Intelligence Software. J Alzheimers Dis 2021; 85:1189-1194. [PMID: 34924394 DOI: 10.3233/jad-215385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Makeup greatly impacts normal social lives but can also be a non-pharmacological form of therapy for dementia. OBJECTIVE To evaluate the therapeutic effect of makeup therapy. METHODS We carried out a prospective interventional study on female nursing home residents with dementia, focusing on the chronic therapeutic effect of makeup therapy. Thirty-four patients who received either only skin care (control group, n = 16) or skin care plus makeup therapy (makeup therapy group, n = 18) once every 2 weeks for 3 months were assessed. RESULTS Three months of makeup therapy significantly improved the Mini-Mental State Examination (MMSE) score compared with control patients ( *p < 0.05). Artificial intelligence (AI) software revealed that the appearance of age decreased significantly in the makeup group compared with the control, especially among patients without depression ( *p < 0.05). Furthermore, a larger AI happiness score was significantly correlated with a greater improvement of ADL in the makeup therapy group (r = 0.43, *p < 0.05). CONCLUSION Makeup therapy had a chronic beneficial effect on the cognitive function of female dementia patients, while the chronic effect of makeup therapy on facial appearance was successfully detected by the present AI software.
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Affiliation(s)
- Koh Tadokoro
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Toru Yamashita
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | | | - Yoshio Omote
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Mami Takemoto
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Ryuta Morihara
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | | | - Tomiko Tani
- Japan Wellness Therapist Association, Osaka, Japan
| | - Koji Abe
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.,National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
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Chan CK, Sieber FE, Blennow K, Inouye SK, Kahn G, Leoutsakos JMS, Marcantonio ER, Neufeld KJ, Rosenberg PB, Wang NY, Zetterberg H, Lyketsos CG, Oh ES. Association of Depressive Symptoms With Postoperative Delirium and CSF Biomarkers for Alzheimer's Disease Among Hip Fracture Patients. Am J Geriatr Psychiatry 2021; 29:1212-1221. [PMID: 33640268 PMCID: PMC8815817 DOI: 10.1016/j.jagp.2021.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES While there is growing evidence of an association between depressive symptoms and postoperative delirium, the underlying pathophysiological mechanisms remain unknown. The goal of this study was to explore the association between depression and postoperative delirium in hip fracture patients, and to examine Alzheimer's disease (AD) pathology as a potential underlying mechanism linking depressive symptoms and delirium. METHODS Patients 65 years old or older (N = 199) who were undergoing hip fracture repair and enrolled in the study "A Strategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients" completed the 15-item Geriatric Depression Scale (GDS-15) preoperatively. Cerebrospinal fluid (CSF) was obtained during spinal anesthesia and assayed for amyloid-beta (Aβ) 40, 42, total tau (t-tau), and phosphorylated tau (p-tau)181. RESULTS For every one point increase in GDS-15, there was a 13% increase in odds of postoperative delirium, adjusted for baseline cognition (MMSE), age, sex, race, education and CSF AD biomarkers (OR = 1.13, 95%CI = 1.02-1.25). Both CSF Aβ42/t-tau (β = -1.52, 95%CI = -2.1 to -0.05) and Aβ42/p-tau181 (β = -0.29, 95%CI = -0.48 to -0.09) were inversely associated with higher GDS-15 scores, where lower ratios indicate greater AD pathology. In an analysis to identify the strongest predictors of delirium out of 18 variables, GDS-15 had the highest classification accuracy for postoperative delirium and was a stronger predictor of delirium than both cognition and AD biomarkers. CONCLUSIONS In older adults undergoing hip fracture repair, depressive symptoms were associated with underlying AD pathology and postoperative delirium. Mild baseline depressive symptoms were the strongest predictor of postoperative delirium, and may represent a dementia prodrome.
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Affiliation(s)
- Carol K Chan
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Frederick E Sieber
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kaj Blennow
- Clinical Neurochemistry Lab, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Sharon K Inouye
- Harvard Medical School, Boston, MA; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA; Aging Brain Center, Hebrew SeniorLife, Boston, MA
| | - Geoffrey Kahn
- Johns Hopkins Bloomberg School of Public Health, Baltimore MD
| | - Jeannie-Marie S Leoutsakos
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD; Johns Hopkins Bloomberg School of Public Health, Baltimore MD
| | - Edward R Marcantonio
- Harvard Medical School, Boston, MA; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA; Aging Brain Center, Hebrew SeniorLife, Boston, MA
| | - Karin J Neufeld
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD; Johns Hopkins University School of Nursing, Baltimore MD
| | - Paul B Rosenberg
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nae-Yuh Wang
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Henrik Zetterberg
- Clinical Neurochemistry Lab, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK; UK Dementia Research Institute at UCL, London, UK
| | - Constantine G Lyketsos
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Esther S Oh
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD; Johns Hopkins University School of Nursing, Baltimore MD.
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Abstract
PURPOSE OF REVIEW This comprehensive review of mood disorders brings together the past and current literature on the diagnosis, evaluation, and treatment of the depressive and bipolar disorders. It highlights the primary mood disorders and secondary neurologic causes of mood disorders that are commonly encountered in a clinical setting. As the literature and our understanding evolve, recent additions to the current literature are important to bring forth to the readers. RECENT FINDINGS Advancements in clinical medicine have strengthened our understanding of the associations of neurologic and psychiatric diseases. This article highlights the medications frequently used with newly identified mood disorders and the common side effects of these medications. A paradigm shift has moved toward newer treatment modalities, such as the use of ketamine, repetitive transcranial magnetic stimulation, and complementary and alternative medicine. The risks and benefits of such therapies, along with medications, are reviewed in this article. SUMMARY Mood disorders are extraordinarily complex disorders with significant association with many neurologic disorders. Early identification of these mood disorders can prevent significant morbidity and mortality associated with them. With further expansion of pharmacologic options, more targeted therapy is possible in improving quality of life for patients.
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Gassner L, Geretsegger M, Mayer-Ferbas J. Effectiveness of music therapy for autism spectrum disorder, dementia, depression, insomnia and schizophrenia: update of systematic reviews. Eur J Public Health 2021; 32:27-34. [PMID: 34595510 PMCID: PMC8846327 DOI: 10.1093/eurpub/ckab042] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Music therapy (MT) aims at maintaining, restoring and furthering
physical/emotional/mental health. This review assesses effectiveness of MT
and its methods for autism spectrum disorder (ASD), dementia, depression,
insomnia and schizophrenia. Methods A search for systematic reviews and health technology assessment reports was
conducted and yielded 139 hits. Given the large amount, we focused on five
frequent diagnostic groups with available Cochrane reviews. A second search
was conducted in four databases. Two authors independently performed study
selection, data extraction and assessed methodological quality. Only trials
with moderate/low risk of bias (RoB) were selected. Results Ten randomized controlled trials (1.248 participants) met inclusion criteria.
For schizophrenia, no studies with low/moderate RoB were found; therefore,
updating was not possible. The Cochrane authors stated that quality of life
(QoL), social functioning, global/mental state improved for schizophrenia,
but not global functioning. For ASD, MT improved behaviour, social
communication, brain connectivity and parent–child relationship. For
depression, mood was enhanced, and for insomnia, sleep quality, stress,
anxiety, total sleep time, disease severity and psychological QoL improved.
MT positively affected mood, neuropsychiatric behaviour, apathy,
communication and physical functions for dementia; behavioural/psychological
symptoms improved only in severe, and memory and verbal fluency only in mild
Alzheimer’s disease. Cognition improved for dementia in one of four
studies. Both active (playing music) and receptive (listening to music)
methods were used for dementia, whereas for ASD and depression, active
methods were applied. For insomnia, only receptive methods were used. Conclusion These findings provide evidence that MT helps patients improving their
physical/psychosocial health. More research investigating long-term effects
is needed.
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Affiliation(s)
- Lucia Gassner
- HTA Austria - Austrian Institute for Health Technology Assessment GmbH, Austria.,Royal Melbourne Institute of Technology, Australia.,University of Vienna, Austria
| | | | - Julia Mayer-Ferbas
- HTA Austria - Austrian Institute for Health Technology Assessment GmbH, Austria
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Holmstrand C, Rahm Hallberg I, Saks K, Leino-Kilpi H, Renom Guiteras A, Verbeek H, Zabalegui A, Sutcliffe C, Lethin C. Associated factors of suicidal ideation among older persons with dementia living at home in eight European countries. Aging Ment Health 2021; 25:1730-1739. [PMID: 32223443 DOI: 10.1080/13607863.2020.1745143] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES This study aimed to investigate the occurrence of suicidal ideation and associated factors in older persons with dementia living at home in eight European countries, and its association with quality of life. Furthermore, changes in suicidal ideation over time were investigated. METHODS This cohort study (n = 1,223) was part of the European "RightTimePlaceCare" project conducted in 2010-2013. Participating countries were Estonia, Finland, France, Germany, the Netherlands, Spain, Sweden and the United Kingdom. Baseline and follow-up data were analysed using bivariate and multivariate logistic regression. RESULTS The occurrence of suicidal ideation in the participating countries varied between 6% and 24%. Factors significantly (p < 0.0018) associated with suicidal ideation using bivariate analysis were: nationality, depressive symptoms, delusions, hallucinations, agitation, anxiety, apathy, disinhibition, irritability, night-time behaviour disturbances, anxiolytics and anti-dementia medication. In the multivariate regression analysis, country of origin, moderate stage of the dementia, depressive and delusional symptoms, and anti-dementia medication were significantly associated with suicidal ideation (p < 0.05). Over time, suicidal ideation decreased from severe to mild or became absent in 54% of the persons with dementia. CONCLUSION It is essential that professionals identify older persons with dementia and suicidal ideation and depressive and other psychological symptoms in order to give them appropriate treatment and provide relief for their informal caregivers. We emphasize the importance of identifying suicidal ideation, irrespective of depressive symptoms, and specifically of paying attention to persons with moderate dementia. Living with the informal caregiver seems to be associated with staying stable without suicidal ideation.
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Affiliation(s)
- Cecilia Holmstrand
- Faculty of Medicine, Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden
| | | | - Kai Saks
- Faculty of Medicine, Department of Internal Medicine, University of Tartu, Tartu, Estonia
| | - Helena Leino-Kilpi
- Department of Nursing Science and Turku University Hospital, University of Turku, Turku, Finland
| | - Anna Renom Guiteras
- Faculty of Health, Department of Nursing Science, University of Witten/Herdecke, Witten, Germany.,Geriatrics Department, University Hospital Parc de Salut Mar, Barcelona, Spain
| | - Hilde Verbeek
- Department of Health Services Research, CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands
| | | | - Caroline Sutcliffe
- Personal Social Services Research Unit, Faculty of Biology, Medicine and Health, Division of Population Health, University of Manchester, Manchester, United Kingdom
| | - Connie Lethin
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden.,Faculty of Medicine, Department of Clinical Sciences, Clinical Memory Research Unit, Lund University, Lund/Malmö, Sweden
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Boltz M, Monturo C, Brockway C, Kuzmik A, Jones JR, Resnick B. Function-Focused Goal Attainment and Discharge Outcomes in Hospitalized Persons With Dementia. J Gerontol Nurs 2021; 47:13-20. [PMID: 34432570 PMCID: PMC9464472 DOI: 10.3928/00989134-20210803-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Hospitalized persons with dementia are at higher risk for functional decline and cognitive loss related to delirium. Family-centered, function-focused care (Fam-FFC) engages the family care partner in education and active participation in function-focused goal setting, implementation, and evaluation to support delirium prevention and abatement and return to baseline physical function. The purpose of the current study was to examine the association of function-focused goal attainment with two discharge outcomes, return to baseline physical function and delirium severity at discharge, in hospitalized persons with dementia. In the ongoing Fam-FFC clinical trial, the majority of goals (N = 433) developed by 134 care partner/patient dyads and nurses address mobility, cognitive stimulation, and self-care. Regression techniques demonstrated that goal attainment was significantly associated with return to baseline function (B = 0.826, Wald = 4.17 [1], p = 0.041) and lower delirium severity at discharge (B = 0.175, t = 2.239, p = 0.027). Results support the contribution of family engagement in promoting functional recovery of hospitalized persons with dementia. [Journal of Gerontological Nursing, 47(9), 13-20.].
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Dahms R, Eicher C, Haesner M, Mueller-Werdan U. Influence of Music Therapy and Music-Based Interventions on Dementia: A Pilot Study. J Music Ther 2021; 58:e12-e36. [PMID: 33948656 DOI: 10.1093/jmt/thab005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
According to national dementia plan in many countries, the music implementation into the daily routine as an adjunctive therapy to medication treatment is common. However, the ability of long-term care facilities to implement individualized music therapy (MT) and music-based interventions is not sufficiently taken into account. This pilot study examined the frequency of use and acceptance of MT and technology-based music interventions (TBMI) as well as the influence of high and low usage of both interventions of dementia on behavioral and psychological symptoms (BPSD) at two timepoints. Furthermore, the influence on the combination of MT and TBMI of dementia within the nursing home setting on BPSD with a focus on agitation, apathy, depression, and quality of life at all timepoints was considered. In the present study, data from 30 people with dementia (PwD) aged on average 81 years were analyzed within an eight-week noncontrolled intervention study, including four-week follow-up. Initial outcome data indicated significant decreases at times T2 and T3 in agitation and apathy among PwD with a high usage of MT and TBMI than among those with a low usage. In general, reductions were obtained from all observed BPSD at all timepoints. Significant results were found only for agitation over time. Considering the demonstrated results, a long-term implementation of music within daily routines in nursing homes for PwD should be strived for.
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Affiliation(s)
- Rebecca Dahms
- Charité - Universitätsmedizin Berlin, Berlin, Germany
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44
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Lauderdale SA, Martin KJ, Oakes KR, Moore JM, Balotti RJ. Pragmatic Screening of Anxiety, Depression, Suicidal Ideation, and Substance Misuse in Older Adults. COGNITIVE AND BEHAVIORAL PRACTICE 2021. [DOI: 10.1016/j.cbpra.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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45
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Nikmat AW, Azhar ZI, Shuib N, Hashim NA. Psychometric Properties of Geriatric Depression Scale (Malay Version) in Elderly with Cognitive Impairment. Malays J Med Sci 2021; 28:97-104. [PMID: 34285648 PMCID: PMC8260072 DOI: 10.21315/mjms2021.28.3.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 01/25/2021] [Indexed: 11/18/2022] Open
Abstract
Background Geriatric Depression Scale (GDS) has been widely used in assessing depression in elderly population. Using the Ministry of Health Malaysia definition for elderly, this study aimed to examine the construct validity and reliability of the GDS (Malay version) in elderly with cognitive impairment in Malaysia. Methods A cross-sectional validation study involving 219 elderlies with cognitive impairment was conducted using universal sampling method. Participants aged 60 years old and above, scored less than 11 for the short mini mental state examination (SMMSE), have sufficient command of the Malay or English language, residing in the government nursing homes and attending memory clinics in government hospitals in Klang Valley were sampled. The GDS-15 English version underwent adaptation, translation, face validation and field testing to produce the Malay version. Psychometric analysis was performed using the exploratory factor analysis and its internal consistency was examined. Results Mean age of participants were 72.61 ± 7.79. Majority were male (50.7%), Malay (50.2%), studied at least until primary school (71.7%) and stayed at nursing homes (50.2%). Construct validity showed significant Bartlett’s test of sphericity (Chi-square = 1,340.058, P < 0.001) and Kaiser-Meyer-Olkin (KMO) test of 0.90. Factor loadings for each item in the depression domain were satisfactory ranging from 0.42 to 0.83. Factor loadings for each item in the psychosocial activities’ domain were satisfactory ranging from 0.53 to 0.76. For the questionnaire reliability analysis, the total Cronbach’s alpha for the final model was satisfactory, with and overall Cronbach’s alpha of 0.89. Cronbach’s alpha value for the depression and psychosocial activities domain was 0.861 and 0.80, respectively. Conclusion The GDS (Malay version) is a valid and reliable tool to screen for depression in elderly with cognitive impairment.
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Affiliation(s)
- Azlina Wati Nikmat
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Zahir Izuan Azhar
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Norley Shuib
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Nurul Azreen Hashim
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
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46
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Lewis C, O’Caoimh R, Patton D, O’Connor T, Moore Z, Nugent LE. Utilisation of a Suite of Screening Tools to Determine Adverse Healthcare Outcomes in an Older Frail Population Admitted to a Community Virtual Ward. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5601. [PMID: 34073916 PMCID: PMC8197352 DOI: 10.3390/ijerph18115601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 11/16/2022]
Abstract
Risk stratification to assess healthcare outcomes among older people is challenging due to the interplay of multiple syndromes and conditions. Different short risk-screening tools can assist but the most useful instruments to predict responses and outcomes following interventions are unknown. We examined the relationship between a suite of screening tools and risk of adverse outcomes (pre-determined clinical 'decline' i.e., becoming 'unstable' or 'deteriorating' at 60-90 days, and institutionalisation, hospitalisation and death at 120 days), among community dwellers (n = 88) after admission to a single-centre, Irish, Community Virtual Ward (CVW). The mean age of patients was 82.8 (±6.4) years. Most were severely frail, with mean Clinical Frailty Scale (CFS) scores of 6.8 ± 1.33. Several instruments were useful in predicting 'decline' and other healthcare outcomes. After adjustment for age and gender, higher frailty levels, odds ratio (OR) 3.29, (p = 0.002), impaired cognition (Mini Mental State Examination; OR 4.23, p < 0.001), lower mobility (modified FIM) (OR 3.08, p < 0.001) and reduced functional level (Barthel Index; OR 6.39, p < 0.001) were significantly associated with clinical 'decline' at 90 days. Prolonged (>30 s) TUG times (OR 1.27, p = 0.023) and higher CFS scores (OR 2.29, p = 0.045) were associated with institutionalisation. Only TUG scores were associated with hospitalisation and only CFS, MMSE and Barthel scores at baseline were associated with mortality. Utilisation of a multidimensional suite of risk-screening tools across a range of domains measuring frailty, mobility and cognition can help predict clinical 'decline' for an already frail older population. Their association with other outcomes was less useful. A better understanding of the utility of these instruments in vulnerable populations will provide a framework to inform the impact of interventions and assist in decision-making and anticipatory care planning for older patients in CVW models.
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Affiliation(s)
- Clare Lewis
- School of Nursing and Midwifery, Royal College of Surgeons Ireland, 123 St Stephen’s Green, Saint Peter’s, D02 YN77 Dublin, Ireland; (D.P.); (T.O.); (Z.M.); (L.E.N.)
| | - Rónán O’Caoimh
- Clinical Sciences Institute, National University of Ireland Galway, Costello Road, H91 TK33 Galway City, Ireland;
- Department of Geriatric Medicine, Mercy University Hospital, Grenville Place, T12 WE28 Cork City, Ireland
| | - Declan Patton
- School of Nursing and Midwifery, Royal College of Surgeons Ireland, 123 St Stephen’s Green, Saint Peter’s, D02 YN77 Dublin, Ireland; (D.P.); (T.O.); (Z.M.); (L.E.N.)
| | - Tom O’Connor
- School of Nursing and Midwifery, Royal College of Surgeons Ireland, 123 St Stephen’s Green, Saint Peter’s, D02 YN77 Dublin, Ireland; (D.P.); (T.O.); (Z.M.); (L.E.N.)
| | - Zena Moore
- School of Nursing and Midwifery, Royal College of Surgeons Ireland, 123 St Stephen’s Green, Saint Peter’s, D02 YN77 Dublin, Ireland; (D.P.); (T.O.); (Z.M.); (L.E.N.)
| | - Linda E. Nugent
- School of Nursing and Midwifery, Royal College of Surgeons Ireland, 123 St Stephen’s Green, Saint Peter’s, D02 YN77 Dublin, Ireland; (D.P.); (T.O.); (Z.M.); (L.E.N.)
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47
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Mangin D, Siu HYH. Deprescribing Antidepressants in Older People - Breaking Up Can Be Hard to Do. Sr Care Pharm 2021; 36:228-237. [PMID: 33879283 DOI: 10.4140/tcp.n.2021.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Every drug review for older people should consider which medicines to continue, but equally important, which medicines can be discontinued. As we age, the balance between potential benefits and potential risks of medications often shifts towards more harm. For example, antidepressants are commonly prescribed in general, but in the older person, they carry specific potential harms. Further, there is data indicating that a substantial proportion of users have no evidence-based indications to continue antidepressants and could be candidates to try stopping treatment. We outline first the imperatives and evidence for deprescribing antidepressants and then finally the practical approaches to deprescribing.
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48
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Park HJ, Lee NG, Kang TW. Fall-related cognition, motor function, functional ability, and depression measures in older adults with dementia. NeuroRehabilitation 2021; 47:487-494. [PMID: 33164957 DOI: 10.3233/nre-203249] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND As the severity of dementia progresses over time, cognition and motor functions such as muscle strength, balance, and gait are disturbed, and they eventually increase the risk of fall in patients with dementia. OBJECTIVE To determine the relationship between the fall risk and cognition, motor function, functional ability, and depression in older adults with dementia. METHODS Seventy-four older adults diagnosed with dementia were recruited. Clinical measurements included the Fall Risk Scale by Huh (FSH), Korean version of the Mini-Mental State Examination (MMSE-K), hand grip strength (HGS), Tinetti Performance Oriented Mobility Assessment (POMA), 10-m walk test (10-MWT), Korean version of the Modified Barthel Index (MBI-K), and the Geriatric Depression Scale (GDS). RESUTLS The MMSE-K was significantly correlated with the FSH, HGS, and the MBI-K, and FSH was significantly correlated with all of the other outcome measures. In particular, the MMSE-K, HGS, POMA, and the MBI-K were negatively correlated with fall history among the FHS sub-items. Additionally, the MMSE sub-item, attention/concentration was associated with the FSH, HGS, POMA, and the MBI-K. CONCLUSIONS These findings suggest that falling is significantly related to impaired cognition, reduced muscle strength, impaired balance, gait, and activities of daily living abilities, and depression in older adults with dementia.
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Affiliation(s)
- Hyun-Ju Park
- Department of physical Therapy, College of Health and Medical Science, Cheongju University, Cheongju, Republic of Korea
| | - Nam-Gi Lee
- Rehabilitation Center, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Tae-Woo Kang
- Department of Physical Therapy, College of Health and Welfare, Woosuk University, Wanju, Republic of Korea
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49
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Park SH, Kwak MJ. Performance of the Geriatric Depression Scale-15 with Older Adults Aged over 65 Years: An Updated Review 2000-2019. Clin Gerontol 2021; 44:83-96. [PMID: 33164674 DOI: 10.1080/07317115.2020.1839992] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This up-to-date systematic review and meta-analysis aimed to examine the predictive validity of the Geriatric Depression Scale-15 (GDS-15) for screening depression in older adults aged over 65 years. METHODS Electronic searches were performed on the MEDLINE, EMBASE, CINAHL, and PsycINFO database using the following keywords: depression, depressive disorder, major, geriatric depression scale, and geriatric depression scale short. The Quality Assessment of Diagnostic Accuracy Studies-2 was applied to assess the risk of bias in diagnostic studies. RESULTS Thirty-one studies that included 8,897 older adults were analyzed. The pooled sensitivity of the GDS-15 was 0.80 (95% CI:0.78 to 0.82), its pooled specificity was 0.79 (95% CI:0.78 to 0.80), the area under the curve (AUC) was 0.89 (SE = 0.01) and the Q* value was 0.82 (SE = 0.01). The subgroup analysis revealed that the pooled sensitivity and specificity of the GDS-15 were higher in older adults with normal cognitive function than in those with cognitive impairment. CONCLUSIONS These finding suggest that the GDS-15 may be more accurate for screening depression in older adults with normal cognitive function. CLINICAL IMPLICATIONS The utility the GDS-15 may be restricted because its diagnostic accuracy is slightly lower among older adults with cognitive impairment.
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Affiliation(s)
- Seong-Hi Park
- School of Nursing, Soonchunhyang University , Asan, South Korea
| | - Mi-Jeong Kwak
- Quality Improvement Team, Korea University Anam Hospital , Seoul, South Korea
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50
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Vigoureux TFD, Nelson ME, Andel R, Small BJ, Davila-Roman AL, Crowe M. Job Strain and Late-Life Cognition: Findings From the Puerto Rican Elderly Health Conditions Study. J Aging Health 2021; 33:273-284. [PMID: 33349101 PMCID: PMC7954124 DOI: 10.1177/0898264320977329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objectives: We examined associations between job strain and cognitive aging in a sample of older Puerto Ricans. Methods: Members of the Puerto Rican Elderly: Health Conditions study, aged 60-100 years at baseline, participated. Job strain indicators were quantified from O*NET (n = 1632) and a matrix of Job Content Questionnaire scores (JCQ; n = 1467). Global cognition was assessed twice across 4 years. Results: Controlling for age, sex, depressive symptoms, financial problems, hypertension, diabetes, childhood economic hardship, low job control and high job strain were consistently associated with greater cognitive decline. Adding education attenuated these associations. High education strengthened the JCQ job control-cognitive change link. Discussion: Low job control and high job strain may accelerate cognitive aging in this population. However, it may be more difficult to disentangle the intersecting roles of education and job strain in cognitive aging among older Puerto Ricans relative to older adults from contiguous United States or Europe.
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Affiliation(s)
| | | | - Ross Andel
- School of Aging Studies, University of South Florida, Tampa, FL
- Department of Neurology, 2nd Medical Faculty and Motol University Hospital, Charles University, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic
| | - Brent J. Small
- School of Aging Studies, University of South Florida, Tampa, FL
| | | | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL
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