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Bermejo-Pareja F, del Ser T. Controversial Past, Splendid Present, Unpredictable Future: A Brief Review of Alzheimer Disease History. J Clin Med 2024; 13:536. [PMID: 38256670 PMCID: PMC10816332 DOI: 10.3390/jcm13020536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/29/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
Background: The concept of Alzheimer disease (AD)-since its histological discovery by Alzheimer to the present day-has undergone substantial modifications. Methods: We conducted a classical narrative review of this field with a bibliography selection (giving preference to Medline best match). Results: The following subjects are reviewed and discussed: Alzheimer's discovery, Kraepelin's creation of a new disease that was a rare condition until the 1970's, the growing interest and investment in AD as a major killer in a society with a large elderly population in the second half of the 20th century, the consolidation of the AD clinicopathological model, and the modern AD nosology based on the dominant amyloid hypothesis among many others. In the 21st century, the development of AD biomarkers has supported a novel biological definition of AD, although the proposed therapies have failed to cure this disease. The incidence of dementia/AD has shown a decrease in affluent countries (possibly due to control of risk factors), and mixed dementia has been established as the most frequent etiology in the oldest old. Conclusions: The current concept of AD lacks unanimity. Many hypotheses attempt to explain its complex physiopathology entwined with aging, and the dominant amyloid cascade has yielded poor therapeutic results. The reduction in the incidence of dementia/AD appears promising but it should be confirmed in the future. A reevaluation of the AD concept is also necessary.
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Affiliation(s)
- Félix Bermejo-Pareja
- CIBERNED, Institute of Health Carlos III, 28029 Madrid, Spain
- Institute of Research i+12, University Hospital “12 de Octubre”, 28041 Madrid, Spain
| | - Teodoro del Ser
- Alzheimer’s Centre Reina Sofia—CIEN Foundation, Institute of Health Carlos III, 28031 Madrid, Spain;
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Cao Y, Wang N, Zhang Q, Shen N, Bai J, Luo X, Liu Y. Effects of cognitive stimulation therapy on patients with dementia: An umbrella review of systematic reviews and meta-analyses. Exp Gerontol 2023; 177:112197. [PMID: 37146891 DOI: 10.1016/j.exger.2023.112197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/20/2023] [Accepted: 05/02/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Dementia is characterized by significant cognitive decline that results in disturbance of daily activities. Increasing number of meta-analyses has examined the efficacy of cognitive stimulation therapy (CST) for dementia. However, there is a lack of comprehensive reports that specifically discuss the strength of evidence to support CST for dementia. PURPOSE This study aimed to summarize evidence regarding the efficacy of CST on people with dementia. DESIGN Umbrella review of systematic reviews and meta-analyses. METHODS We searched Cochrane Library, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, China Biology Medicine disc (CBMdisc), and VIP databases from inception to December 31, 2022. The methodological quality of the identified studies was assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). Studies scoring 9-12 (moderate quality) points or higher were further analyzed using Grades of Recommendations Assessment, Development and Evaluation (GRADE) principles. RESULTS A total of 14 systematic reviews and meta-analyses were included in the umbrella review. The methodological quality of most included reviews was rated as moderate according to AMSTAR 2 rating system. In these studies, we summarized the characteristics of the content, providers, frequency, period and setting of CST, and examined eight health outcomes related to CST, including cognition, depression, behavioral symptoms, quality of life (QoL), activities of daily living (ADL), language and communication, anxiety, and memory. Eleven studies with low to high rating of overall confidence (OC) consistently reported that CST could significantly improve cognition of people with dementia, including high-quality supporting evidence. However, the effect of CST on other health outcomes for people with dementia (e.g., depression, behavioral symptoms, QoL, ADL) is inconsistent, with low- to moderate-quality evidence ratings. Compared with the above results, few studies have reported the effects of CST on communication, anxiety, and memory for people with dementia. CONCLUSIONS In the future, the design and reporting of systematic reviews and meta-analyses should incorporate high-quality research metrics in accordance with AMSTAR 2 criteria. The current review supports CST as an effective treatment for improving cognitive function in patients with dementia. Multi-component interventions are more effective than single-component interventions and need to be delivered regularly. REGISTRATION The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022364259).
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Affiliation(s)
- Yanan Cao
- School of Public Health, Wuhan University, Wuhan 430071, China.
| | - Nana Wang
- Home for The Aged Guangzhou, Guangzhou 510550, China
| | - Qianping Zhang
- School of Nursing, Wuhan University, Wuhan 430071, China
| | - Natalie Shen
- Emory University Rollins School of Public Health, 1520 Clifton Road, Atlanta, GA 30322, USA.
| | - Jinbing Bai
- Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA 30322, USA.
| | - Xianwu Luo
- School of Nursing, Wuhan University, Wuhan 430071, China.
| | - Yanqun Liu
- School of Nursing, Wuhan University, Wuhan 430071, China.
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Calderón C, Bekios-Calfa J, Bekios-Canales N, Véliz-García O, Beyle C, Palominos D, Ávalos-Tejeda M, Domic-Siede M. Application of machine learning techniques for dementia severity prediction from psychometric tests in the elderly population. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-9. [PMID: 36587834 DOI: 10.1080/23279095.2022.2162899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Previous research has shown the benefits of early detection and treatment of dementia. This detection is usually performed manually by one or more clinicians based on reports and psychometric testing. Machine learning algorithms provide an alternative method of prediction that may contribute, with an automated process and insights, to the diagnosis and classification of the severity level of dementia. The aim of this study is to explore the use of neuropsychological data from a reduced version of the Addenbrooke's Cognitive Examination III (ACE-III) to predict absence or different levels of dementia severity using the Global Deterioration Scale (GDS) scores through the implementation of the kNN machine learning algorithm. A sample of 1164 elderly people over sixty years old were evaluated using a reduced version of the ACE-III and the GDS. The kNN classifier provided good accuracies using 15 items from the ACE-III and adequately differentiating people with absence and mild impairment, from those with more severe levels of impairment according to the GDS rating. Our results suggest that the kNN algorithm may be used to automate aspects of clinical cognitive impairment classification in the elderly population.
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Affiliation(s)
- Carlos Calderón
- Núcleo de Investigación en Neurociencia Cognitiva, Afectiva y Neuropsicología, Laboratorio de Neurociencia Cognitiva, Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | - Juan Bekios-Calfa
- Núcleo de Investigación en Neurociencia Cognitiva, Afectiva y Neuropsicología, Escuela de Ingeniería, Universidad Católica del Norte, Coquimbo, Chile
| | - Nikolás Bekios-Canales
- Núcleo de Investigación en Neurociencia Cognitiva, Afectiva y Neuropsicología, Laboratorio de Neurociencia Cognitiva, Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | - Oscar Véliz-García
- Núcleo de Investigación en Neurociencia Cognitiva, Afectiva y Neuropsicología, Laboratorio de Neurociencia Cognitiva, Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | - Christian Beyle
- Departamento de Psicología, Facultad de Ciencias de la Salud, Universidad Católica de Temuco. Temuco, Chile
| | - Diego Palominos
- Núcleo de Investigación en Neurociencia Cognitiva, Afectiva y Neuropsicología, Laboratorio de Neurociencia Cognitiva, Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | - Marcelo Ávalos-Tejeda
- Núcleo de Investigación en Neurociencia Cognitiva, Afectiva y Neuropsicología, Laboratorio de Neurociencia Cognitiva, Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | - Marcos Domic-Siede
- Núcleo de Investigación en Neurociencia Cognitiva, Afectiva y Neuropsicología, Laboratorio de Neurociencia Cognitiva, Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
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Plucińska K, Mody N, Dekeryte R, Shearer K, Mcilroy GD, Delibegovic M, Platt B. High-fat diet exacerbates cognitive and metabolic abnormalities in neuronal BACE1 knock-in mice - partial prevention by Fenretinide. Nutr Neurosci 2022; 25:719-736. [PMID: 32862802 DOI: 10.1080/1028415x.2020.1806190] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective: The β-site APP-cleaving enzyme 1 (BACE1) is a rate-limiting step in β-amyloid (Aβ) production in Alzheimer's disease (AD) brains, but recent evidence suggests that BACE1 is also involved in metabolic regulation. Here, we aimed to assess the effects of highfat diet (HFD) on metabolic and cognitive phenotypes in the diabetic BACE1 knock-in mice (PLB4) and WT controls; we additionally examined whether these phenotypes can be normalized with a synthetic retinoid (Fenretinide, Fen) targeting weight loss.Methods: Five-month old male WT and PLB4 mice were fed either (1) control chow diet, (2) 45%-saturated fat diet (HFD), (3) HFD with 0.04% Fen (HFD + Fen) or (4) control chow diet with 0.04% Fen (Fen) for 10 weeks. We assessed basic metabolic parameters, circadian rhythmicity, spatial habituation (Phenotyper) and working memory (Y-maze). Hypothalami, forebrain and liver tissues were assessed using Western blots, qPCR and ELISAs.Results: HFD feeding drastically worsened metabolism and induced early mortality (-40%) in otherwise viable PLB4 mice. This was ameliorated by Fen, despite no effects on glucose intolerance. In HFD-fed WT mice, Fen reduced weight gain, glucose intolerance and hepatic steatosis. The physiological changes induced in WT and PLB4 mice by HFD (+/-Fen) were accompanied by enhanced cerebral astrogliosis, elevated PTP1B, phopsho-eIF2α and altered hypothalamic transcription of Bace1, Pomc and Mc4r. Behaviourally, HFD feeding exacerbated spatial memory deficits in PLB4 mice, which was prevented by Fen and linked with increased full-length APP, normalized brain Aβ*56 oligomerization and astrogliosis.Conclusions: HFD induces early mortality and worsened cognition in the Alzheimer's-like BACE1 mice- partial prevention was achieved with Fenretinide, without improvements in glucose homeostasis.
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Affiliation(s)
- Kaja Plucińska
- Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
- The Novo Nordisk Foundation Center for Basic Metabolic Research (CBMR), Integrative Physiology and Environmental Influences, University of Copenhagen, Copenhagen, Denmark
| | - Nimesh Mody
- Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Ruta Dekeryte
- Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Kirsty Shearer
- Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - George D Mcilroy
- Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
- The Rowett Institute, University of Aberdeen, Aberdeen, UK
| | - Mirela Delibegovic
- Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Bettina Platt
- Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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Putland E. The (in)accuracies of floating leaves: How people with varying experiences of dementia differently position the same visual metaphor. DEMENTIA 2022; 21:1471-1487. [PMID: 35148618 PMCID: PMC9237850 DOI: 10.1177/14713012211072507] [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] [Indexed: 11/16/2022]
Abstract
Metaphors help shape the social world. Yet, with research and language guidelines focusing primarily on the stigmatising potential of verbal representations, much greater attention is needed regarding visual metaphors' role in perpetuating and challenging particular views of dementia. Through semi-structured interviews and focus groups, this paper explores how people with dementia and their carers and/or loved ones evaluate one prevalent visual metaphor for dementia that maps autumnal trees losing leaves onto the brain/head. Analysis considers three main responses to the metaphor, that: (1) it does not depict dementia; (2) it meaningfully explains a biomedical account of progressive brain deterioration; and (3) it reinforces inaccurate and/or 'hopeless' discourses of what having dementia involves, with individuals suggesting creative alterations to better fit their counter discourses. These findings foreground the importance of attending to subjectivity, nuance and multi-layered discourses within visual metaphors, which can indirectly convey stigmatising representations.
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Fernández-Fleites Z, Broche-Pérez Y, Eccleston C, Jiménez-Puig E, Castillo EF. Sociodemographic factors associated with public knowledge of dementia in a Cuban population. Dement Neuropsychol 2021; 15:470-479. [PMID: 35509797 PMCID: PMC9018078 DOI: 10.1590/1980-57642021dn15-040008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/14/2021] [Indexed: 12/16/2022] Open
Abstract
International organizations estimate that a new dementia is diagnosed every 3 s.
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Abstract
Progress in communication technologies and social isolation caused by the COVID-19 pandemic have supported the acceptance of e-learning. In the e-learning context, gamification has been identified as one of the most promising trends. Many researchers believe in the game elements’ capacity to drive learning, skills acquisition, and changes for more sustainable behavior. However, the literature on the subject is dispersed, addressing behavioral attitudes and elements in an isolated and fragmented way. This study aims to present a framework relating game elements to behavioral attitudes to promote sustainability and ensure quality of learning. The methodology is based on a systematic literature review using the PRISMA protocol, covering the content analysis of 130 articles indexed in the Web of Science database. For the framework construction, the following were identified: behavioral attitudes stimulated by gamification; main game elements and how they relate to each other. Based on this, a framework called 7GOALS (Gamification-Oriented Active Learning Steps) associated with the PDCA (Plan, Do, Check, Act) was established. The proposed structure is multidisciplinary and can be used in any knowledge field that uses gamification. With this, themes such as sustainability can be widely disseminated and leverage changes towards more sustainable behaviors that adhere to the real world.
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Calderón C, Beyle C, Véliz-García O, Bekios-Calfa J. Psychometric properties of Addenbrooke's Cognitive Examination III (ACE-III): An item response theory approach. PLoS One 2021; 16:e0251137. [PMID: 33956900 PMCID: PMC8101956 DOI: 10.1371/journal.pone.0251137] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 04/21/2021] [Indexed: 11/18/2022] Open
Abstract
The Addenbrooke's Cognitive Examination III is one of the most widely used tests to assess cognitive impairment. Although previous studies have shown adequate levels of diagnostic utility to detect severe impairment, it has not shown sensitivity to detect mild decline. The aim of this study was to evaluate the psychometric properties of Addenbrooke's Cognitive Examination III in a large sample of elderly people through Item Response Theory, due to the lack of studies using this approach. A cross-sectional study was conducted with 1164 people from the age of 60 upwards, of which 63 had a prior diagnosis of Alzheimer dementia. The results showed that, globally, the Addenbrooke's Cognitive Examination III possesses adequate psychometrics properties. Furthermore, the information function test shows that the subscales have different sensitivity to different levels of impairment. These results can contribute to determining patterns of cognitive deterioration for the adequate detection of different levels of dementia. An optimized version is suggested which may be an economic alternative in the applied field.
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Affiliation(s)
- Carlos Calderón
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
- * E-mail:
| | - Christian Beyle
- Departamento de Psicología, Universidad Católica de Temuco, Temuco, Chile
| | - Oscar Véliz-García
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | - Juan Bekios-Calfa
- Departamento de Ingeniería en Sistemas y Ciencias de la Computación, Universidad Católica del Norte, Antofagasta, Chile
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Mc Ardle R, Pratt S, Buckley C, Del Din S, Galna B, Thomas A, Rochester L, Alcock L. Balance Impairments as Differential Markers of Dementia Disease Subtype. Front Bioeng Biotechnol 2021; 9:639337. [PMID: 33777910 PMCID: PMC7991998 DOI: 10.3389/fbioe.2021.639337] [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] [Received: 12/08/2020] [Accepted: 01/29/2021] [Indexed: 11/16/2022] Open
Abstract
Background Accurately differentiating dementia subtypes, such as Alzheimer’s disease (AD) and Lewy body disease [including dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD)] is important to ensure appropriate management and treatment of the disease. Similarities in clinical presentation create difficulties for differential diagnosis. Simple supportive markers, such as balance assessments, may be useful to the diagnostic toolkit. This study aimed to identify differences in balance impairments between different dementia disease subtypes and normal aging using a single triaxial accelerometer. Methods Ninety-seven participants were recruited, forming four groups: cognitive impairment due to Alzheimer’s disease (AD group; n = 31), dementia with Lewy bodies (DLB group; n = 26), Parkinson’s disease dementia (PDD group; n = 13), and normal aging controls (n = 27). Participants were asked to stand still for 2 minutes in a standardized position with their eyes open while wearing a single triaxial accelerometer on their lower back. Seven balance characteristics were derived, including jerk (combined, mediolateral, and anterior–posterior), root mean square (RMS; combined, mediolateral, and anterior–posterior), and ellipsis. Mann–Whitney U tests identified the balance differences between groups. Receiver operating characteristics and area under the curve (AUC) determined the overall accuracy of the selected balance characteristics. Results The PDD group demonstrated higher RMS [combined (p = 0.001), mediolateral (p = 0.005), and anterior–posterior (p = 0.001)] and ellipsis scores (p < 0.002) than the AD group (AUC = 0.71–0.82). The PDD group also demonstrated significantly impaired balance across all characteristics (p ≤ 0.001) compared to the controls (AUC = 0.79–0.83). Balance differences were not significant between PDD and DLB (AUC = 0.69–0.74), DLB and AD (AUC = 0.50–0.65), DLB and controls (AUC = 0.62–0.68), or AD and controls (AUC = 0.55–0.67) following Bonferroni correction. Discussion Although feasible and quick to conduct, key findings suggest that an accelerometer-based balance during quiet standing does not differentiate dementia disease subtypes accurately. Assessments that challenge balance more, such as gait or standing with eyes closed, may prove more effective to support differential diagnosis.
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Affiliation(s)
- Ríona Mc Ardle
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Stephanie Pratt
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Christopher Buckley
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Silvia Del Din
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Brook Galna
- School of Biomedical, Nutritional and Sports Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Alan Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Lynn Rochester
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.,Newcastle upon Tyne Hospitals, National Health Service Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Lisa Alcock
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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Newton R, Keady J, Tsekleves E, Adams OBE S. ‘My father is a gardener … ’: A systematic narrative review on access and use of the garden by people living with dementia. Health Place 2021; 68:102516. [DOI: 10.1016/j.healthplace.2021.102516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
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Yemm H, Robinson DL, Paddick SM, Dotchin C, Goodson ML, Narytnyk A, Poole M, Mc Ardle R. Instrumental Activities of Daily Living Scales to Detect Cognitive Impairment and Dementia in Low- and Middle-Income Countries: A Systematic Review. J Alzheimers Dis 2021; 83:451-474. [PMID: 34334407 PMCID: PMC8461665 DOI: 10.3233/jad-210532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND The largest proportion of people with dementia worldwide live in low- and middle- income countries (LMICs), with dementia prevalence continuing to rise. Assessment and diagnosis of dementia involves identifying the impact of cognitive decline on function, usually measured by instrumental activities of daily living (IADLs). OBJECTIVE This review aimed to identify IADL measures which are specifically developed, validated, or adapted for use in LMICs to guide selection of such tools. METHODS A systematic search was conducted (fourteen databases) up to April 2020. Only studies reporting on development, validation, or adaptation of IADL measures for dementia or cognitive impairment among older adults (aged over 50) in LMICs were included. The QUADAS 2 was used to assess quality of diagnostic accuracy studies. RESULTS 22 papers met inclusion criteria; identifying 19 discrete IADL tools across 11 LMICs. These were either translated from IADL measures used in high-income countries (n = 6), translated and adapted for cultural differences (n = 6), or newly developed for target LMIC populations (n = 7). Seven measures were investigated in multiple studies; overall quality of diagnostic accuracy was moderate to good. CONCLUSION Reliability, validity, and accuracy of IADL measures for supporting dementia diagnosis within LMICs was reported. Key components to consider when selecting an IADL tool for such settings were highlighted, including choosing culturally appropriate, time-efficient tools that account for gender- and literacy-bias, and can be conducted by any volunteer with appropriate training. There is a need for greater technical and external validation of IADL tools across different regions, countries, populations, and cultures.
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Affiliation(s)
- Heather Yemm
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- Helen McArdle Nursing and Care Research Institute, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Dame Louise Robinson
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Stella-Maria Paddick
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- Gateshead Health NHS Foundation Trust, Gateshead, UK
| | - Catherine Dotchin
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- Northumbria Healthcare NHS Foundation Trust, Tyne and Wear, UK
| | - Michaela Louise Goodson
- Medical Research Department, Faculty of Medical Sciences, Newcastle University Medicine, Iskandar Puteri, Malaysia
| | - Alla Narytnyk
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Marie Poole
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Ríona Mc Ardle
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
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The Alzheimer case: perceptions, knowledge and the acquisition of information about Alzheimer's disease by middle-aged and older adults in Flanders. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20001221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractAlzheimer's disease (AD) is a major health concern as the world population ages. Yet, few studies have examined what the public over the age of 50 knows about AD. This qualitative study, based on 40 in-depth interviews, examines the knowledge of AD by Flemish people between 50 and 80 years old and their cross-source engagement with information sources. Building on AD media representations and theories on media complementarity and health information behaviour, we find that respondents mostly encounter AD information non-purposively via traditional mass media and interpersonal communication, while the internet is occasionally used to purposefully seek information. Novels, personal experiences/social proximity, public figures and particularly film stand out as channels and sources of AD information, suggesting that fictional narratives, personal experiences and being able to identify with others leave lasting impressions and help to communicate and disperse AD information. However, common misconceptions and gaps in knowledge persist, including AD being considered part of the normal ageing process and old age as well as confusing AD with Parkinson's disease. The biomedical perspective and the tragedy discourse prevail among the majority of respondents, who describe AD in terms of decline, loss and death and as ‘the beginning of the end’. Only a few, typically female respondents, appear aware of the role of individual health behaviour and lifestyle choices to prevent dementia or delay its onset. The misconceptions of AD and gaps in knowledge, as well as the fact that a third of all cases of dementia might be delayed or prevented by managing lifestyle and other risk factors, stress the importance of public educational programmes and the need to emphasise and raise awareness of preventative behaviour. Overall, the findings from this study can be of help to public health communicators and dementia-awareness campaigns, as well as AD training programmes for health-care professionals and family care-givers.
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Akenine U, Barbera M, Beishuizen CR, Fallah Pour M, Guillemont J, Rosenberg A, Coley N, Mangialasche F, Salo L, Savy S, Pols AJ, Andrieu S, Richard E, Soininen H, Moll van Charante E, Kivipelto M. Attitudes of at-risk older adults about prevention of cardiovascular disease and dementia using eHealth: a qualitative study in a European context. BMJ Open 2020; 10:e037050. [PMID: 32764085 PMCID: PMC7412614 DOI: 10.1136/bmjopen-2020-037050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/27/2020] [Accepted: 06/11/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Prevention of cardiovascular disease (CVD) and dementia is a key health priority among older adults. Understanding individuals' attitudes to, the prevention of these conditions, particularly when delivered through novel eHealth tools, could help in designing effective prevention programmes. The aim of the study was to explore the attitudes of older adults at increased risk of CVD and dementia regarding engagement in eHealth self-management prevention programmes, and to describe the facilitators and barriers. DESIGN A qualitative research approach was used. Data were collected through eight focus groups in Finland, France and the Netherlands. Data were analysed following the principles of grounded theory. SETTING AND PARTICIPANTS Forty-four community-dwellers aged 65+ at risk of CVD were recruited from a previous trial cohort in Finland, and through general practices in France and the Netherlands. RESULTS The study identified three categories: access to reliable information, trust in the healthcare providers and burden and stigma of dementia. A core category was also identified: the interactive process of the three categories influencing engagement in self-management prevention programme. The categories were interconnected through an interactive process and influenced by the local healthcare culture and context which shaped them differently, becoming either facilitators or barriers to engage in eHealth self-management prevention programmes. CONCLUSIONS The study emphasises the importance of considering the interactions between the identified categories in this study, grounded in the local healthcare culture and context in further developments of eHealth self-management interventions that aim to prevent CVD and dementia. TRIAL REGISTRATION NUMBER ISRCTN48151589.
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Affiliation(s)
- Ulrika Akenine
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Mariagnese Barbera
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, Kuopio, Finland
| | - Cathrien Rl Beishuizen
- Department of General Practice, Amsterdam UMC/University of Amsterdam, Amsterdam, The Netherlands
| | - Mandana Fallah Pour
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Anna Rosenberg
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, Kuopio, Finland
| | - Nicola Coley
- INSERM, University of Toulouse, Toulouse, France
- Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | - Francesca Mangialasche
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Lotta Salo
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, Kuopio, Finland
| | | | - A Jeannette Pols
- Section of Medical Ethics, Department of General Practice, Amsterdam UMC/University of Amsterdam, Amsterdam, The Netherlands
| | - Sandrine Andrieu
- INSERM, University of Toulouse, Toulouse, France
- Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | - Edo Richard
- Department of Neurology, Amsterdam UMC/University of Amsterdam, Amsterdam, The Netherlands
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hilkka Soininen
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, Kuopio, Finland
- Neurocenter Finland, Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Eric Moll van Charante
- Department of General Practice, Amsterdam UMC/University of Amsterdam, Amsterdam, The Netherlands
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Aging, Karolinska University Hospital, Stockholm, Sweden
- R&D Unit, Stockholms Sjukhem, Stockholm, Sweden
- Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, United Kingdom
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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14
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Do Alzheimer's and Lewy body disease have discrete pathological signatures of gait? Alzheimers Dement 2019; 15:1367-1377. [DOI: 10.1016/j.jalz.2019.06.4953] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/09/2019] [Accepted: 06/12/2019] [Indexed: 12/14/2022]
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15
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Plucińska K, Crouch B, Yeap JM, Stoppelkamp S, Riedel G, Platt B. Histological and Behavioral Phenotypes of a Novel Mutated APP Knock-In Mouse. J Alzheimers Dis 2019; 65:165-180. [PMID: 30040726 DOI: 10.3233/jad-180336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Gene mutations within amyloid precursor protein (APP or AβPP) and/or presenilin 1 (PS1) genes are determinants of familial Alzheimer's disease (fAD) and remain fundamental for experimental models. Here, we generated a neuronal knock-in mouse (PLB2APP) with mutated human APPSwe/Lon and investigated histopathology and behavioral phenotypes. Additionally, PLB2APP mice were cross-bred with a presenilin (PS1A246E) line to assess the impact of this gene combination. Immunohistochemistry determined amyloid-β (Aβ) pathology, astrogliosis (via GFAP labelling), and neuronal densities in hippocampal and cortical brain regions. One-year old PLB2APP mice showed higher levels of intracellular Aβ in CA1, dentate gyrus, and cortical regions compared to PLBWT controls. Co-expression of PS1 reduced hippocampal but elevated cortical Aβ build-up. Amyloid plaques were sparse in aged PLB2APP mice, and co-expression of PS1 promoted plaque formation. Heightened GFAP expression followed the region-specific pattern of Aβ in PLB2APP and PLB2APP/PS1 mice. Behaviorally, habituation to a novel environment was delayed in 6-month-old PLB2APP mice, and overall home-cage activity was reduced in both lines at 6 and 12 months, particularly during the dark phase. Spatial learning in the water maze was impaired in PLB2APP mice independent of PS1 expression and associated with reduced spatial navigation strategies. Memory retrieval was compromised in PLB2APP mice only. Our data demonstrate that low expression of APP is sufficient to drive histopathological and cognitive changes in mice without overexpression or excessive plaque deposition. AD-like phenotypes were altered by co-expression of PS1, including a shift from hippocampal to cortical Aβ pathology, alongside reduced deficits in spatial learning.
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Affiliation(s)
- Kaja Plucińska
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Barry Crouch
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Jie M Yeap
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Sandra Stoppelkamp
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Gernot Riedel
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Bettina Platt
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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16
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Olsen V, Taylor L, Whiteley K, Ellerton A, Kingston P, Bailey J. Exploring public perceptions and understanding of dementia: Analysing narratives from the Mass Observation Project. DEMENTIA 2019; 19:2804-2820. [PMID: 31291784 DOI: 10.1177/1471301219861468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Over 850,000 people living in the United Kingdom have been diagnosed with dementia, yet knowledge about this condition amongst the general population remains relatively poor. Many studies have evaluated the level of public knowledge and understanding about dementia from a research and professional service perspective; however, none have considered this condition from the perspective of the wider public. In this preliminary overview, we analyse and describe high-level narratives collected from 143 respondents to a Dementia Directive commissioned to the Mass Observation Project. These narratives present a perspective on the public knowledge and understanding about dementia not previously considered, where respondents have written openly about their own experiences, and reflected on their perception of the wider public's knowledge and understanding about dementia. This unique perspective importantly enhances our knowledge about the public's understanding and awareness of dementia, and informs the main areas of public concern found in the analysis: care responsibilities, impact on relationships, and fears about developing dementia.
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Affiliation(s)
- Veronica Olsen
- Centre for Ageing and Mental Health, Faculty of Health and Social Care, University of Chester, UK
| | - Lou Taylor
- Centre for Ageing and Mental Health, Faculty of Health and Social Care, University of Chester, UK
| | - Kirsty Whiteley
- Centre for Ageing and Mental Health, Faculty of Health and Social Care, University of Chester, UK
| | - Annie Ellerton
- Centre for Ageing and Mental Health, Faculty of Health and Social Care, University of Chester, UK
| | - Paul Kingston
- Centre for Ageing and Mental Health, Faculty of Health and Social Care, University of Chester, UK
| | - Jan Bailey
- Centre for Ageing and Mental Health, Faculty of Health and Social Care, University of Chester, UK
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17
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Hall A, Brown Wilson C, Stanmore E, Todd C. Moving beyond 'safety' versus 'autonomy': a qualitative exploration of the ethics of using monitoring technologies in long-term dementia care. BMC Geriatr 2019; 19:145. [PMID: 31126240 PMCID: PMC6534927 DOI: 10.1186/s12877-019-1155-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 05/10/2019] [Indexed: 01/01/2023] Open
Abstract
Background Use of monitoring technologies (e.g. wearable or environmental sensors) in long-term care generates extensive ethical debate, primarily about their potential to enhance resident safety weighed against concerns about their impacts upon resident autonomy. There are a number of other ethical aspects which are far less debated, including questions about the monitoring of the workforce, and equality of access to technologies. In this paper, we explore the extent to which remote monitoring of the workforce, and equality of access to technologies, were seen to influence the implementation of monitoring technologies within long-term care facilities. Methods An embedded multiple-case study design was used with three dementia-specialist care facilities in England that had experience using a range of monitoring technologies. Data were collected through 175 h’ observation of daily practice, semi-structured interviews with 36 staff, residents and relatives, and examination of organisational documentation and technology manufacturer literature. Data were analysed using Framework Analysis. Results Use of technologies for workforce monitoring was understood in relation to the ethical obligations to fulfil a duty of care to residents. There was little recognition of any negative implications for the workforce, but staff were susceptible to rumours that technologies were being used for performance management even when this was not the case. There were questions about how far data collected by monitoring technologies could constitute ‘evidence’ of appropriate care delivery. Equality and access to technologies involved a need to compromise between generic designs that were not universally suitable, but were more affordable than bespoke designs. Contracts with suppliers imposed limitations on product choice. Conclusions There is an urgent need for greater consideration of the ethical and legal implications that remote technological monitoring might have upon workforce morale, recruitment and retention. Ensuring variety of technological design to facilitate equitable access for residents is financially extremely challenging. It is possible that considerations of equitable access are not deemed a priority due to the current generation of residents’ low levels of technological familiarity and expectation. It might be overstated and unrealistic to view expensive technologies as the pinnacle of innovative practice in care homes. Electronic supplementary material The online version of this article (10.1186/s12877-019-1155-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alex Hall
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester and Manchester Academic Health Science Centre, Oxford Road, Manchester, UK.
| | | | - Emma Stanmore
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester and Manchester Academic Health Science Centre, Oxford Road, Manchester, UK
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester and Manchester Academic Health Science Centre, Oxford Road, Manchester, UK
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Tierney L, Mason R, Doherty K, Winbolt M, Long M, Robinson A. Workshops on diagnosis and management of dementia for general practitioners: a pre-post intervention study of dementia knowledge. BMJ Open 2019; 9:e027804. [PMID: 30967411 PMCID: PMC6500330 DOI: 10.1136/bmjopen-2018-027804] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/18/2019] [Accepted: 03/06/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess improvements in dementia knowledge among general practitioner (GP) registrars and supervisors following their participation in dementia workshops. DESIGN Pre-post intervention study. SETTING General practice education in Australia. PARTICIPANTS 296 GP registrars and 91 GP supervisors. INTERVENTIONS Registrars participated in a 3-hour face-to-face workshop on diagnosing and managing dementia. Supervisors participated in a 2-hour modified version of the workshop designed to support them in teaching registrars. MAIN OUTCOME MEASURES The Dementia Knowledge Assessment Scale (DKAS) was used to assess overall dementia knowledge as well as knowledge on four subscales (causes and characteristics; communication and behaviour; care considerations; risks and health promotion). Changes in mean scores and the proportion of participants obtaining a threshold score (90th percentile score preworkshop) were used as measures of improvement. RESULTS Few registrars and supervisors identified previous experience of formal dementia education. At baseline, mean dementia knowledge scores were 36 for registrars and 37 for supervisors of a total score of 50. Both groups had significantly improved overall dementia knowledge following the workshop with a mean score of 43. Improvements in knowledge were observed for all four DKAS subscales. Between preworkshop and postworkshop periods, there was an increase in the proportion of registrars and supervisors obtaining the threshold score for total DKAS as well as the four subscales. A significantly higher proportion of registrars compared with supervisors obtained the threshold score postworkshop in the areas of causes and characteristics and risks and health promotion. CONCLUSIONS Prior to the workshop, no differences in overall dementia knowledge were observed between registrars and supervisors. While knowledge improved in all areas for both groups postworkshop, findings from this study suggest the need to include foundational content such as the causes and characteristics of dementia in educational workshops for both trainee and experienced GPs.
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Affiliation(s)
- Laura Tierney
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Tasmania, Australia
| | - Ron Mason
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Tasmania, Australia
| | - Kathleen Doherty
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Tasmania, Australia
| | - Margaret Winbolt
- Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Victoria, Australia
| | - Marita Long
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Tasmania, Australia
| | - Andrew Robinson
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Tasmania, Australia
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Exploring the ‘active mechanisms’ for engaging rural-dwelling older men with dementia in a community technological initiative. AGEING & SOCIETY 2019. [DOI: 10.1017/s0144686x19000357] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractResearch has suggested ecopsychosocial initiatives can promote a sense of wellbeing and inclusion in people with dementia. However, few studies have elucidated the ‘active mechanisms’ whereby such initiatives can achieve these outcomes, so hindering their generalisability. This is particularly pertinent when seeking to support community-dwelling older men with dementia who are reluctant to engage with traditional health and social care initiatives. This paper reports on a study that drew from the principles of Participatory Action Research to explore the ‘active mechanisms’ of a technological initiative for older men (65+ years) with dementia in rural England. An individually tailored, male-only initiative, using off-the-shelf computer game technology (e.g. iPad, Nintendo Wii and Microsoft Kinect) was delivered over a nine-week period. Multiple qualitative methods were employed, including: focus groups, open interviews and extensive reflective field notes, to gather data from the perspective of 22 men, 15 care partners and five community volunteers. The data were analysed thematically and interpreted using a masculinity lens. Three mechanisms contributed to the initiative's success: the use of the technology, the male-only environment and the empowering approach adopted. The paper argues that initiatives aimed at community-dwelling older men with dementia would be advised to consider these gendered experiences and ensure participants can maximise their masculine capital when participating in them, by providing enabling activities, non-threatening environments and empowering approaches of delivery.
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20
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Chiberska D. The use of robotic animals in dementia care: challenges and ethical dilemmas. ACTA ACUST UNITED AC 2018. [DOI: 10.7748/mhp.2018.e1342] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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21
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Holthe T, Halvorsrud L, Karterud D, Hoel KA, Lund A. Usability and acceptability of technology for community-dwelling older adults with mild cognitive impairment and dementia: a systematic literature review. Clin Interv Aging 2018; 13:863-886. [PMID: 29765211 PMCID: PMC5942395 DOI: 10.2147/cia.s154717] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The objective of this review was to obtain an overview of the technologies that have been explored with older adults with mild cognitive impairment and dementia (MCI/D), current knowledge on the usability and acceptability of such technologies, and how people with MCI/D and their family carers (FCs) were involved in these studies. Materials and methods Primary studies published between 2007 and 2017 that explored the use of technologies for community-dwelling people with MCI/D were identified through five databases: MEDLINE, PsycINFO, Embase, AMED, and CINAHL. Twenty-nine out of 359 papers met the criteria for eligibility. We used the Mixed Methods Appraisal Tool for quality assessment. Results A wide range of technologies was presented in the 29 studies, sorted into four domains: 1) safe walking indoors and outdoors; 2) safe living; 3) independent living; and 4) entertainment and social communication. The current state of knowledge regarding usability and acceptability reveals that even if researchers are aware of these concepts and intend to measure usability and acceptability, they seem difficult to assess. Terms such as “user friendliness” and “acceptance” were used frequently. User participation in the 29 studies was high. Persons with MCI/D, FCs, and staff/other older adults were involved in focus groups, workshops, and interviews as part of the preimplementation process. Conclusion Research regarding technologies to support people with MCI/D seems optimistic, and a wide range of technologies has been evaluated in homes with people with MCI/D and their FCs. A major finding was the importance of including people with MCI/D and their FCs in research, in order to learn about required design features to enhance usability and acceptability. Surprisingly, very few studies reported on the consequences of technology use with regard to quality of life, occupational performance, or human dignity.
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Affiliation(s)
- Torhild Holthe
- Faculty of Health, Oslo Metropolitan University, Oslo, Norway
| | - Liv Halvorsrud
- Faculty of Health, Oslo Metropolitan University, Oslo, Norway
| | - Dag Karterud
- Faculty of Health, Oslo Metropolitan University, Oslo, Norway
| | - Kari-Anne Hoel
- Faculty of Health, Oslo Metropolitan University, Oslo, Norway
| | - Anne Lund
- Faculty of Health, Oslo Metropolitan University, Oslo, Norway
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Førsund LH, Grov EK, Helvik AS, Juvet LK, Skovdahl K, Eriksen S. The experience of lived space in persons with dementia: a systematic meta-synthesis. BMC Geriatr 2018; 18:33. [PMID: 29390970 PMCID: PMC5795848 DOI: 10.1186/s12877-018-0728-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 01/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Identifying how persons with dementia experience lived space is important for enabling supportive living environments and creating communities that compensate for the fading capabilities of these persons. Several single studies have explored this topic; however, few studies have attempted to explicitly review and synthesize this research literature. The aim of this systematic meta-synthesis was therefore to interpret and synthesize knowledge regarding persons with dementia's experience of space. METHODS A systematic, computerized search of AgeLine, CINAHL Complete, Embase, Medline and PsycINFO was conducted using a search strategy that combined MeSH terms and text words for different types of dementia with different descriptions of experience. Studies with 1) a sample of persons with dementia, 2) qualitative interviews as a research method and 3) a description of experiences of lived space were included. The search resulted in 1386 articles, of which 136 were identified as eligible and were read and assessed using the CASP criteria. The analysis was inspired by qualitative content analyses. RESULTS This interpretative qualitative meta-synthesis included 45 articles encompassing interviews with 672 persons with dementia. The analysis showed that living in one's own home and living in long-term care established different settings and posed diverse challenges for the experience of lived space in persons with dementia. The material revealed four main categories that described the experience of lived space: (1) belonging; (2) meaningfulness; (3) safety and security; and (4) autonomy. It showed how persons with dementia experienced a reduction in their lived space due to the progression of dementia. A comprehensive understanding of the categories led to the latent theme: "Living with dementia is like living in a space where the walls keep closing in". CONCLUSION This meta-synthesis reveals a process whereby lived space gradually becomes smaller for persons with dementia. This underscores the importance of being aware of the experiences of persons with dementia and the spatial dimensions of their life-world. To sustain person-centred care and support the preservation of continuity and identity, one must acknowledge not only the physical and social environment but also space as an existential experience for persons with dementia.
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Affiliation(s)
- Linn Hege Førsund
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University College of Southeast Norway, Postbox 7053, N- 3007 Drammen, Norway
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Anne-Sofie Helvik
- Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lene Kristine Juvet
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University College of Southeast Norway, Postbox 7053, N- 3007 Drammen, Norway
- The National Institute of Public Health, Oslo, Norway
| | - Kirsti Skovdahl
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University College of Southeast Norway, Postbox 7053, N- 3007 Drammen, Norway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
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Klimova B, Valis M, Kuca K. Exploring assistive technology as a potential beneficial intervention tool for people with Alzheimer's disease - a systematic review. Neuropsychiatr Dis Treat 2018; 14:3151-3158. [PMID: 30532546 PMCID: PMC6247949 DOI: 10.2147/ndt.s181849] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Nowadays, due to the increase in the number of aging population groups, there is also a growth of aging diseases such as Alzheimer's disease (AD), which is a progressive brain disorder that eventually results in death. At the moment, it cannot be cured, only its symptoms can be alleviated both by using pharmacological and non-pharmacological approaches in order to maintain and in some cases even enhance quality of life of people living with AD, as well as their caregivers. One of such non-pharmacological approaches is the use of assistive technology (AT), which can contribute to the improvement and maintenance of the quality of life of both patients and their caregivers. The purpose of this study was to explore what types of AT are mostly used by patients with AD and how these devices can help their caregivers. This was done by conducting a literature review of available sources found in the Web of Science, Scopus, and PubMed. The findings, apart from one study, reveal that AT may have the potential to maintain the quality of life of people with AD, especially in the early stages of the disease, as well as to mitigate the mental and physical burden of their caregivers. The most common types of AT for patients with AD are devices of daily living and safety devices. The less frequent are still telecare devices and devices to support engagement, social participation, and leisure. Future research should focus on the effectiveness of AT on the improvement of patients' symptoms, as well as on the development and use of AT for social interactions, which can be used in patients with AD of different degree of severity and have a positive impact on their behavioral and psychological symptoms.
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Affiliation(s)
- Blanka Klimova
- Department of Applied Linguistics, Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Martin Valis
- Department of Neurology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Kamil Kuca
- Centre for Basic and Applied Research, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic,
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24
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Antelo P, Espinosa P. La influencia del apoyo social en cuidadores de personas con deterioro cognitivo o demencia. REVISTA DE ESTUDIOS E INVESTIGACIÓN EN PSICOLOGÍA Y EDUCACIÓN 2017. [DOI: 10.17979/reipe.2017.0.14.2235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
El apoyo social se define como un conjunto de transacciones que implican ayuda, afecto y afirmación. El objetivo de la investigación ha sido desarrollar un modelo que explique como la frecuencia de cuidados influye en la satisfacción de los cuidadores de personas con deterioro cognitivo o demencia a través de variables como el apoyo social o la sobrecarga. Los resultados obtenidos confirman que la frecuencia de cuidados predice la satisfacción. Asimismo, se demuestra que están mediados por el apoyo social y la sobrecarga, conllevando el primero a una mayor satisfacción y la sobrecarga a una disminución de la misma.
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Werner P, Doron II. Alzheimer's disease and the law: positive and negative consequences of structural stigma and labeling in the legal system. Aging Ment Health 2017; 21:1206-1213. [PMID: 27463564 DOI: 10.1080/13607863.2016.1211989] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To explore the meaning and consequences of labeling on structural stigma in the context of Alzheimer's disease (AD) in the legal system. METHOD This qualitative study was made up of three focus groups including social workers and lawyers (n = 26). Participants were asked to report their experience in circumstances in which persons with AD and their family members engage with the legal system. Thematic analysis using the constant comparative method was used. RESULTS The discussions in the focus groups raised two overall themes. (1) The significance of the medical diagnostic labeling of AD in the legal system and (2) the consequences of labeling of AD within the legal system. This last theme included four sub-themes: (a) negative consequences of labeling; (b) reasons associated with negative consequences of labeling; (c) positive consequences of labeling; and (d) reasons associated with positive consequences of labeling. CONCLUSION Findings of the study provide a first foundation for future research on the meaning and consequences of labeling in legal cases involving persons with AD. They suggest that increasing judges' knowledge about AD and reforming the existing 'status-based' legal capacity legislation might benefit by limiting the legal weight given today to the medical diagnosis.
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Affiliation(s)
- Perla Werner
- a Department of Community Mental Health , University of Haifa , Haifa , Israel
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26
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Swarbrick CM, Sampson E, Keady J. Notes from the hospital bedside: reflections on researcher roles and responsibilities at the end of life in dementia. QUALITY IN AGEING AND OLDER ADULTS 2017. [DOI: 10.1108/qaoa-09-2016-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to explore some of the ethical and practical dilemmas faced by an experienced researcher in undertaking research with a person with dementia (whom we have called Amy). Amy died shortly after a period of observation had ended and the family subsequently consented to the data being shared.
Design/methodology/approach
This individual case study presentation was nested within a larger study conducted in England and Scotland between 2013 and 2014. The overall aim of the main study was to investigate how healthcare professionals and informal carers recognised, assessed and managed pain in patients living with dementia in a range of acute settings.
Findings
The presented case study of Amy raises three critical reflection points: (i) Researcher providing care, i.e. the place and positioning of compassion in research observation; (ii) What do the stories mean? i.e. the reframing of Amy's words, gestures and behaviours as (end of) life review, potentially highlights unresolved personal conflicts and reflections on loss; and (iii) Communication is embodied, i.e. the need to move beyond the recording of words to represent lived experience and into more multi-sensory methods of data capture.
Originality/value
Researcher guidance and training about end of life observations in dementia is presently absent in the literature and this case study stimulates debate in a much overlooked area, including the role of ethics committees.
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27
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Mikhaylova NM. [Organization of out-patient psychiatric care in dementia and cognitive impairment in aged. Part II: Clinical and economic efficacy of memory clinics and Alzheimer's disease centers]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:89-98. [PMID: 28805768 DOI: 10.17116/jnevro20171177189-98] [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: 11/17/2022]
Abstract
The part II of the review is focused on a history of developing of memory clinics and Alzheimer's disease centers as well as on the indices of their activity in various countries and in Russia. Approaches to the evaluation of clinical and economic efficacy of new technologies of organization of care and a role of the national programs in solving of the problem of old age dementias were considered.
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Tziraki C, Berenbaum R, Gross D, Abikhzer J, Ben-David BM. Designing Serious Computer Games for People With Moderate and Advanced Dementia: Interdisciplinary Theory-Driven Pilot Study. JMIR Serious Games 2017; 5:e16. [PMID: 28760730 PMCID: PMC5556257 DOI: 10.2196/games.6514] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 03/26/2017] [Accepted: 05/26/2017] [Indexed: 01/16/2023] Open
Abstract
Background The field of serious games for people with dementia (PwD) is mostly driven by game-design principals typically applied to games created by and for younger individuals. Little has been done developing serious games to help PwD maintain cognition and to support functionality. Objectives We aimed to create a theory-based serious game for PwD, with input from a multi-disciplinary team familiar with aging, dementia, and gaming theory, as well as direct input from end users (the iterative process). Targeting enhanced self-efficacy in daily activities, the goal was to generate a game that is acceptable, accessible and engaging for PwD. Methods The theory-driven game development was based on the following learning theories: learning in context, errorless learning, building on capacities, and acknowledging biological changes—all with the aim to boost self-efficacy. The iterative participatory process was used for game screen development with input of 34 PwD and 14 healthy community dwelling older adults, aged over 65 years. Development of game screens was informed by the bio-psychological aging related disabilities (ie, motor, visual, and perception) as well as remaining neuropsychological capacities (ie, implicit memory) of PwD. At the conclusion of the iterative development process, a prototype game with 39 screens was used for a pilot study with 24 PwD and 14 healthy community dwelling older adults. The game was played twice weekly for 10 weeks. Results Quantitative analysis showed that the average speed of successful screen completion was significantly longer for PwD compared with healthy older adults. Both PwD and controls showed an equivalent linear increase in the speed for task completion with practice by the third session (P<.02). Most important, the rate of improved processing speed with practice was not statistically different between PwD and controls. This may imply that some form of learning occurred for PwD at a nonsignificantly different rate than for controls. Qualitative results indicate that PwD found the game engaging and fun. Healthy older adults found the game too easy. Increase in self-reported self-efficacy was documented with PwD only. Conclusions Our study demonstrated that PwD’s speed improved with practice at the same rate as healthy older adults. This implies that when tasks are designed to match PwD’s abilities, learning ensues. In addition, this pilot study of a serious game, designed for PwD, was accessible, acceptable, and enjoyable for end users. Games designed based on learning theories and input of end users and a multi-disciplinary team familiar with dementia and aging may have the potential of maintaining capacity and improving functionality of PwD. A larger longer study is needed to confirm our findings and evaluate the use of these games in assessing cognitive status and functionality.
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Affiliation(s)
- Chariklia Tziraki
- Melabev - Community Clubs for Eldercare, Research and Development Department, Jerusalem, Israel
| | - Rakel Berenbaum
- Melabev - Community Clubs for Eldercare, Research and Development Department, Jerusalem, Israel
| | - Daniel Gross
- Melabev - Community Clubs for Eldercare, Research and Development Department, Jerusalem, Israel
| | - Judith Abikhzer
- Melabev - Community Clubs for Eldercare, Research and Development Department, Jerusalem, Israel
| | - Boaz M Ben-David
- Communication, Aging and Neuropsychology Lab (CANlab), Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Herzliya, Herzliya, Israel.,Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Rehabilitation Sciences Institute (RSI), Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute (TRI), University of Toronto, Toronto, ON, Canada
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Lee SE, Casado BL. Knowledge of Alzheimer’s disease among Vietnamese Americans and correlates of their knowledge about Alzheimer’s disease. DEMENTIA 2017; 18:713-724. [DOI: 10.1177/1471301217691616] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sang E Lee
- School of Social Work, San Jose State University, USA
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Bermejo-Pareja F, Llamas-Velasco S, Villarejo-Galende A. Alzheimer's disease prevention: A way forward. Rev Clin Esp 2016. [DOI: 10.1016/j.rceng.2016.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bermejo-Pareja F, Llamas-Velasco S, Villarejo-Galende A. Alzheimer's disease prevention: A way forward. Rev Clin Esp 2016; 216:495-503. [PMID: 27325510 DOI: 10.1016/j.rce.2016.05.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/04/2016] [Accepted: 05/09/2016] [Indexed: 01/22/2023]
Abstract
This review proposes a more optimistic view of Alzheimer's disease (AD), in contrast to that contributed by the ageing of the population and the failure of potentially curative therapies (vaccines and others). Treatment failure is likely due to the fact that AD gestates in the brain for decades but manifests in old age. This review updates the concept of AD and presents the results of recent studies that show that primary prevention can reduce the incidence and delay the onset of the disease. Half of all cases of AD are potentially preventable through education, the control of cardiovascular risk factors, the promotion of healthy lifestyles and specific drug treatments. These approaches could substantially reduce the future incidence rate of this disease.
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Affiliation(s)
- F Bermejo-Pareja
- Imas12 (Instituto de Investigación Hospital Universitario 12 de Octubre), Madrid, España; Cátedra Extraordinaria de Alzheimer y enfermedades Neurodegenerativas, Departamento de Medicina, Facultad de Medicina, Universidad Complutense, Madrid, España; CIBERNED, Instituto de Investigación Carlos III, Madrid, España
| | - S Llamas-Velasco
- Imas12 (Instituto de Investigación Hospital Universitario 12 de Octubre), Madrid, España; Departamento de Neurología, Hospital Universitario 12 de Octubre, Madrid, España.
| | - A Villarejo-Galende
- CIBERNED, Instituto de Investigación Carlos III, Madrid, España; Departamento de Neurología, Hospital Universitario 12 de Octubre, Madrid, España
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Førsund LH, Ytrehus S. Finding a place to connect: A qualitative study exploring the influences of the physical and social environments on spouses' opportunities to maintain relationships when visiting a partner with dementia living in long-term care. DEMENTIA 2016; 17:858-879. [PMID: 27316459 DOI: 10.1177/1471301216656087] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this qualitative study was to explore how physical and social environments influence spouses' opportunities to maintain relationships when visiting a partner with dementia living in long-term care. Interviews with 15 spouses whose partners lived in long-term care facilities for persons with dementia, observations of physical environments and participant observations were conducted. The results showed how finding a place for spouses to connect in the long-term care facility was important in maintaining relationships. Access to individual rooms was an important feature that enabled connections throughout the phases of dementia, whereas common areas appeared more difficult to use because small spaces limited private interactions. Health personnel were important in sustaining spouses' abilities to maintain their relationships in long-term care facilities for persons with dementia.
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Affiliation(s)
- Linn Hege Førsund
- Faculty of Health Sciences, University College of Southeast Norway, Norway; Department of Social Work and Health Science, Norwegian University of Science and Technology, Norway
| | - Siri Ytrehus
- The Faculty of Health Studies, Sogn og Fjordane University College, Norway
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Johnston B, Narayanasamy M. Exploring psychosocial interventions for people with dementia that enhance personhood and relate to legacy- an integrative review. BMC Geriatr 2016; 16:77. [PMID: 27044417 PMCID: PMC4820853 DOI: 10.1186/s12877-016-0250-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 03/23/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Epidemiological predictions suggest that dementia will continue to rise and that this will have social and economic ramifications. Effective interventions, beyond pharmacological management are needed. Psychosocial interventions have largely been investigated in relation to carers of people with dementia, or with regards to their ability to manage dementia symptoms, improve cognition, and reduce challenging behaviour. However, since dementia is a life-limiting illness and people with dementia are at risk of having their personhood compromised, psychosocial interventions should seek to enhance personhood, and offer the potential for the person to leave a legacy. METHODS An integrative review was carried out to identify, assess, appraise and synthesise studies featuring interventions, which relate to both personhood and legacy. Search strategies were developed in key databases: MEDLINE; PsycINFO; Embase; Joanna Briggs Institute; CINAHL; Cochrane Database of Systematic Reviews; ASSIA. Grey literature was also identified through free-text searches. RESULTS Thirty six articles were included in the final review, these were tabulated and were assessed based on how the intervention related to personhood and legacy. Classification resulted in three themes being identified: Offering aspects of legacy; Acknowledging the person behind the patient; Facilitating meaningful engagement. Generally, personhood aspects of interventions were well reported, but further research is required to explore legacy potential of psychosocial interventions for people with dementia. CONCLUSION The integrative review provides an overview and exploration of an under-researched area, and provides directions for future research, which will help expand the evidence base and ultimately help improve patient care for people with dementia and their families.
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Affiliation(s)
- Bridget Johnston
- Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, School of Health Sciences, The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, England, UK.
| | - Melanie Narayanasamy
- Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, School of Health Sciences, The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, England, UK
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