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Jhang KM, Wang WF, Hsu KN, Huang SC, Yang SH, Huang LC, Yang YH. A 12-Year Comparison of Alzheimer's Dementia Patients With Their Informants in Taiwan. Am J Alzheimers Dis Other Demen 2023; 38:15333175231218089. [PMID: 38016118 PMCID: PMC10685789 DOI: 10.1177/15333175231218089] [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: 11/30/2023]
Abstract
BACKGROUND To update the characteristics of patients with Alzheimer's disease (AD) and their informants in Taiwan and compare them from 12 years ago. METHODS 1218 patients with AD and their informants were recruited from six hospitals in Taiwan. The uniform data set version 3.0 (UDS3, form A1-A3) were administered. RESULTS Compared with the first registration from 2010-2012 (n = 691), the mean clinical dementia rating sum of boxes score was significantly lower, more patients living independently, and more informants not living together with the patients. A total of 11.2%, 4.1%, 12.8%, and 0.5% of the patients had a reported history of cognitive impairment in their mothers, fathers, siblings, and children, respectively. CONCLUSION Compared with the data from 2010, patients have been diagnosed at a milder disease stage, and their informants used telephone contact more frequently instead of living with the patients. Family histories of cognitive impairment in patients with AD remain frequent.
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Affiliation(s)
- Kai-Ming Jhang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
| | - Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
| | - Kuang-Nan Hsu
- Department of Neurology, Taitung MacKay Memorial Hospital, Taitung, Taiwan
| | - Shang-Chien Huang
- Department of Psychiatry, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | | | - Ling-Chun Huang
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yuan-Han Yang
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Huang LC, Chen MH, Chuu CP, Li KY, Hour TC, Yang YH. Plasma biomarkers and their correlation in adult children of parents with Alzheimer’s disease. Front Aging Neurosci 2022; 14:977515. [PMID: 36110426 PMCID: PMC9468332 DOI: 10.3389/fnagi.2022.977515] [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: 06/24/2022] [Accepted: 08/02/2022] [Indexed: 11/22/2022] Open
Abstract
Family history (FH) of late-onset Alzheimer’s disease (AD) is associated with changes in several cerebrospinal fluid (CSF) biomarkers in cognitively normal individuals. However, potential changes in plasma biomarkers remain unknown. This study aimed to evaluate potential plasma biomarkers and their correlation in cognitively normal adult children (AC) and to compare this data with their AD parents and unrelated non-demented controls (NC). Participants with dementia due to AD, their AC and NC were recruited. Plasma samples were assessed for amyloid beta (Aβ)1–42, Aβ1–40, total tau (T-tau) and phosphorylated tau (P-tau). Kruskal–Wallis test was used for the comparison of this data between the three groups. Spearman rank correlation was used for evaluation of the correlations between Aβ1–40 and Aβ1–42, and T-tau and P-tau in the AD and AC groups. A total of 99 subjects completed the assessment (30 had AD; 38 were AC group; and 31 were NC). Compared with the NC group, there were significantly higher levels of Aβ1–40, P-tau, and P-tau/T-tau ratio, and lower levels of Aβ1–42 and Aβ1–42/Aβ1–40 ratio in the AD and AC groups. The correlation between the level of Aβ1–42 and Aβ1–40 and level of T-tau and P-tau was only observed in the AC but not in the AD group. AC of AD parents demonstrate some indicators of AD like their parents. Disruption to the correlation between Aβ and tau in AD may be a biomarker for the development of AD in AC, which should be examined in a longitudinal cohort.
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Affiliation(s)
- Ling-Chun Huang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Ming-Hui Chen
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Chih-Pin Chuu
- Institute of Cellular and System Medicine, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Kuan-Ying Li
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Tzyh-Chyuan Hour
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Department of Biochemistry, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Yuan-Han Yang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung City, Taiwan
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Huo C, Chen MH, Hour TC, Huang LC, Fong YO, Kuo YY, Yang YH, Chuu CP. Application of Micro-Western Array for Identifying Different Serum Protein Expression Profile among Healthy Control, Alzheimer’s Disease Patients and Patients’ Adult Children. Brain Sci 2022; 12:brainsci12091134. [PMID: 36138870 PMCID: PMC9496696 DOI: 10.3390/brainsci12091134] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 12/03/2022] Open
Abstract
(1) Background: Alzheimer’s disease (AD) is the most common form of dementia. Increased levels of inflammatory proteins have been observed in brain and plasma samples of AD patients; however, it is not clear if other serum proteins correlate to the development or disease progression of AD. (2) Methods: Micro-Western Array (MWA) is a high-throughput antibody-based proteomics system which allows detection of the expression levels of 24–96 different proteins within 6–30 samples simultaneously. We applied MWA to explore potential serum protein biomarkers correlated to the development and progression of AD by examining the difference in serum protein profile of 31 healthy control (HC), 30 patients with AD and 30 patients’ adult children (ACS). (3) Results: Compared to HC, AD and ACS express similar pattern of serum proteins, including higher protein levels of ABCA1, ABCG1, SREBP1 and LXRβ but lower protein levels of ApoD, ApoE, ApoH, c_Myc, COX2 and Hippo-YAP signaling proteins. AD patients had higher serum levels of ABCG1, ApoD, ApoH, COX2, LXRα and YAP, but lower levels of ABCA1, ApoE, c_Myc, LATS1, MST1, MST2, Nanog, NFκB_p50, PPARγ and SREBP2, as compared to ACS. Pearson’s correlation analysis revealed that the protein expression level of ApoE, c_Myc, LATS1, MST2, NFκB p50, PPARγ and SREBP1 was negatively correlated to age, while that of ApoE, c_Myc, LATS1, MST1, MST2, Nanog, NFκB p50 and PPARγ was positively correlated to age. (4) Conclusions: We identified a group of serum proteins which may correlate to disease progression of AD and can be potential diagnostic serum protein biomarkers.
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Affiliation(s)
- Chieh Huo
- Institute of Cellular and System Medicine, National Health Research Institutes, Miaoli 35053, Taiwan
| | - Ming-Hui Chen
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung City 80708, Taiwan
| | - Tzyh-Chyuan Hour
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung City 80708, Taiwan
- Department of Biochemistry, School of Medicine, Kaohsiung Medical University, Kaohsiung City 80708, Taiwan
| | - Ling-Chun Huang
- Department of Biochemistry, School of Medicine, Kaohsiung Medical University, Kaohsiung City 80708, Taiwan
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City 80145, Taiwan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung City 80756, Taiwan
| | - Yi-On Fong
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung City 80756, Taiwan
| | - Ying-Yu Kuo
- Institute of Cellular and System Medicine, National Health Research Institutes, Miaoli 35053, Taiwan
| | - Yuan-Han Yang
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung City 80708, Taiwan
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City 80145, Taiwan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung City 80756, Taiwan
- School of Post-Baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung City 80708, Taiwan
- Correspondence: (Y.-H.Y.); (C.-P.C.); Tel.: +886-7-3162-158 (Y.-H.Y.); +886-37-206-166 (ext. 37300) (C.-P.C.)
| | - Chih-Pin Chuu
- Institute of Cellular and System Medicine, National Health Research Institutes, Miaoli 35053, Taiwan
- Department of Life Sciences, National Central University, Taoyuan City 32031, Taiwan
- PhD Program for Aging, Graduate Institute of Basic Medical Science, China Medical University, Taichung City 40402, Taiwan
- Biotechnology Center, National Chung Hsing University, Taichung City 40227, Taiwan
- Correspondence: (Y.-H.Y.); (C.-P.C.); Tel.: +886-7-3162-158 (Y.-H.Y.); +886-37-206-166 (ext. 37300) (C.-P.C.)
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Sensing Alzheimer’s Disease Utilizing Au Electrode by Controlling Nanorestructuring. CHEMOSENSORS 2022. [DOI: 10.3390/chemosensors10030094] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This paper reports the development of Alzheimer’s disease (AD) sensor through early detection of amyloid-beta (Aβ) (1–42) using simple nanorestructuring of Au sheet plate by oxidation-reduction cycle (ORC) via the electrochemical system. The topology of Au substrates was enhanced through the roughening and Au grains grown by a simple ORC technique in aqueous solutions containing 0.1 mol/L KCl electrolytes. The roughened substrate was then functionalized with the highly specific antibody β-amyloid Aβ (1–28) through HS-PEG-NHS modification, which enabled effective and direct detection of Aβ (1–42) peptide. The efficacy of the ORC method had been exhibited in the polished Au surface by approximately 15% larger electro-active sites compared to the polished Au without ORC. The ORC polished structure demonstrated a rapid, accurate, precise, reproducible, and highly sensitive detection of Aβ (1–42) peptide with a low detection limit of 10.4 fg/mL and a wide linear range of 10−2 to 106 pg/mL. The proposed structure had been proven to have potential as an early-stage Alzheimer’s disease (AD) detection platform with low-cost fabrication and ease of operation.
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Chang CC, Chan L, Chou HH, Yang YW, Chen TF, Chen TB, Chen CI, Yang A, Hu CJ. Effectiveness of the 10 cm 2 Rivastigmine Patch in Taiwanese Patients with Mild-to-Moderate Alzheimer's Dementia: A 48-Week Real-World Observational Study. Adv Ther 2021; 38:5286-5301. [PMID: 34506009 PMCID: PMC8478746 DOI: 10.1007/s12325-021-01893-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/11/2021] [Indexed: 11/28/2022]
Abstract
Introduction The current study aimed to provide data on the effectiveness of the 10 cm2 rivastigmine patch in patients with Alzheimer’s disease (AD) in a real-world setting in Taiwan. Methods This was a 48-week, single-arm, open-label, observational, and post-marketing study conducted across seven centers in Taiwan between May 5, 2016 and July 10, 2017. Eligible patients (aged 55–95 years) treated with the 10 cm2rivastigmine patch were enrolled based on physicians’ judgment and according to the Taiwan reimbursement criteria of the drug. Data were prospectively collected at Week 0 (baseline), Week 24, and Week 48. The primary endpoint was the change in the cognitive assessment screening instrument (CASI) scores at Week 48 versus baseline. The changes from baseline in clinical dementia rating (CDR), mini-mental state examination (MMSE), and neuropsychiatric inventory (NPI) scores were evaluated, as were treatment persistence and the safety profile. Results Of the 285 eligible patients [full analysis set (FAS)], 216 (75.8%) completed the study protocol while 180 (63.2%) persisted on the 10 cm2 rivastigmine patch for the full 48 weeks. At baseline, 89.8% of patients had a CDR score of 0.5 or 1, while the change in CDR score at Week 48 was not significant. In the FAS, both the CASI and MMSE scores had numerical improvement at Week 24 but declined by 2.1 and 0.4 points, respectively, at Week 48 (p = 0.005 and p = 0.022). The increment in NPI scores was not significant. The most common drug-related adverse events (AEs) were pruritus (11.2%), nausea (3.5%), rash (3.2%), and vomiting (2.8%). Conclusions The use of the 10 cm2 rivastigmine patch in the mild stage of AD maintained cognitive function at Week 24 and neuropsychiatric function at Week 48. The treatment persistency and safety profile support the clinical tolerability of the rivastigmine patch in the management of mild-to-moderate AD in Taiwan. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01893-6.
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Affiliation(s)
- Chiung-Chih Chang
- Department of Neurology, Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Lung Chan
- Department of Neurology and Dementia Center, Shung Ho Hospital, School of Medicine, College of Medicine, Taipei Medical University, New Taipei, Taiwan
| | - Hsi-Hsien Chou
- Department of Neurology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Wan Yang
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ting-Bin Chen
- Department of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chin-I Chen
- Department of Neurology, Wan Fang Hospital, Taipei, Taiwan
| | | | - Chaur-Jong Hu
- Department of Neurology and Dementia Center, Shung Ho Hospital, School of Medicine, College of Medicine, Taipei Medical University, New Taipei, Taiwan.
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Hsieh SW, Kim SY, Shim YS, Huang LC, Yang YH. A comparison of sociobehavioral impact on cognitive preservation in Alzheimer's disease between Taiwan and Korea: A cross-national study. Medicine (Baltimore) 2020; 99:e19690. [PMID: 32282723 PMCID: PMC7220150 DOI: 10.1097/md.0000000000019690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Both Taiwan and Korea are developed countries with different cultures. When encountering the issue of dementia, such sociobehavioral factors have various and different impacts on dementia. We aim to assess the cross-national difference of sociobehavioral impact on cognitive preservation in Alzheimer's disease (AD) between Taiwan and Korea.A uniformed data set was administered regarding AD. We evaluated annual cognitive function using the Mini-Mental State Examination (MMSE), Clinical Dementia Rating sum of box (CDR-SB), and CDR for 2 continuous years. Annual change of scores compared with the baseline indicated cognitive change as preservation or decline. We recorded the sociodemographic variables of interest, including education duration, level of independence, living situation, and marital status. Step-wise regression analyses were performed to determine the independent factors for cognitive preservation.In total, 503 participants in Taiwan and 77 participants in Korea were recruited from 2011 to 2014. The baseline demographic characteristics were different in levels of education, living situation, level of independence, and dementia severity between the 2 countries. With follow-up for 2 years, cognitive preservation was associated with CDR staging at baseline and independence [adjusted odds ratio (OR) = 1.657, 95% confidence interval (95% CI) = 1.109-2.477, P = .014] in the Taiwanese population, whereas cognitive preservation was related to living alone (adjusted OR = 3.316, 95% CI = 1.135-9.687, P = .028) in the Korean population. The levels of education showed inconsistency in cognitive preservation in both countries.Cognitive preservation was associated with independence in the Taiwanese population, whereas cognitive preservation was related to living alone in the Korean population. By practicing relevant socioeconomic support, this might contribute to lessening the negative impact of dementia and preserving cognition in different countries.
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Affiliation(s)
- Sun-Wung Hsieh
- Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital
- Department of Neurology, Kaohsiung Medical University Hospital
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sang-Yun Kim
- Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Neurology, Seoul National University, College of Medicine, Seoul
| | - Yong-Soo Shim
- Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Ling-Chun Huang
- Department of Neurology, Kaohsiung Medical University Hospital
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital
| | - Yuan-Han Yang
- Department of Neurology, Kaohsiung Medical University Hospital
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital
- Department of and Master's Program in Neurology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Chinese Mentality Protection Association, Kaohsiung, Taiwan
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A 48-Week, Multicenter, Open-Label, Observational Study Evaluating Oral Rivastigmine in Patients with Mild-to-Moderate Alzheimer's Disease in Taiwan. Adv Ther 2019; 36:1455-1464. [PMID: 30953330 DOI: 10.1007/s12325-019-00939-0] [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] [Received: 10/09/2017] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Rivastigmine is a cholinesterase inhibitor, approved for the treatment of mild-to-moderate dementia of Alzheimer's type. This study assessed the short- and long-term effectiveness and safety of rivastigmine in patients with mild-to-moderate Alzheimer's disease (AD) in a real-world clinical setting in Taiwan. METHODS This was a 48-week, single-arm, open-label, prospective, observational, post-marketing surveillance, multicenter study. The primary outcomes were change from baseline to week 48 in the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR) scores. One-year persistence to treatment, effect on activities of daily living, and incidence of adverse events (AEs) were also assessed. RESULTS Overall, 151 patients were enrolled in the study, of which 91 (60.26%) completed this study. At the end of the study, the mean rivastigmine dose received by the patients was 6.59 mg/day. At week 48, the changes in mean [standard deviation (SD)] MMSE and CDR scores in the intent-to-treat (ITT) population from baseline were - 1.00 (3.8; p = 0.0344) and 0.07 (0.29; p = 0.0403), respectively. The most frequently reported AEs by preferred term were dizziness (12.58%) and nausea (9.27%). No new or unexpected AEs were observed, and 30 (20.13%) patients in the ITT population were on rivastigmine therapy for 1 year without treatment discontinuation. CONCLUSION Despite the low 1-year persistence rate, rivastigmine showed a stabilizing effect on declining cognition in patients with mild-to-moderate AD in a real-world scenario. Rivastigmine is well tolerated at 6.0-9.0 mg/day with no unexpected safety concerns. FUNDING Novartis Co. Ltd., Taipei, Taiwan.
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Liu HY, Yang CT, Wang YN, Hsu WC, Huang TH, Lin YE, Liu CY, Shyu YIL. Balancing competing needs mediates the association of caregiving demand with caregiver role strain and depressive symptoms of dementia caregivers: A cross-sectional study. J Adv Nurs 2017; 73:2962-2972. [DOI: 10.1111/jan.13379] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Hsin-Yun Liu
- Healthy Aging Research Center; Chang Gung University; Taoyuan Taiwan
| | - Ching-Tzu Yang
- School of Nursing; College of Medicine; Chang Gung University; Taoyuan Taiwan
| | - Yu-Nu Wang
- Department of Nursing; Chang Gung University of Science and Technology; Taoyuan Taiwan
| | - Wen-Chuin Hsu
- Dementia Center; Department of Neurology; Chang Gung Memorial Hospital; Taoyuan Taiwan
- School of Medicine; College of Medicine; Chang Gung University; Taoyuan Taiwan
| | - Tzu-Hsin Huang
- Department of Nursing; Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - Yueh-E Lin
- Department of Nursing; Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - Chin-Yi Liu
- School of Nursing; College of Medicine; Chang Gung University; Taoyuan Taiwan
| | - Yea-Ing L. Shyu
- School of Nursing; College of Medicine; Chang Gung University; Taoyuan Taiwan
- Traumatological Division; Department of Orthopedics; Chang Gung Memorial Hospital; Taoyuan Taiwan
- Department of Nursing; Kaohsiung Chang Gung Memorial Hospital; Kaohsiung Taiwan
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Lai CY, Wu MY, Chiang JH, Sun MF, Chen YH, Chang CT, Lin JG, Yen HR. Utilization of Western medicine and traditional Chinese medicine among patients with Alzheimer's disease in Taiwan: a nationwide population-based study. Eur J Neurol 2017; 24:1166-1172. [PMID: 28744942 DOI: 10.1111/ene.13361] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 06/12/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND PURPOSE Large-scale studies of utilization of medical services among patients with Alzheimer's disease (AD) are lacking. We aimed to investigate the usage of Western medicine and traditional Chinese medicine (TCM) among these patients in Taiwan. METHODS We analyzed one million samples from the National Health Insurance Research Database in Taiwan. Patients (n = 1814) newly diagnosed with AD in 2001-2010 were divided into TCM users (n = 528) and non-TCM users (n = 1286). RESULTS Compared with non-TCM users, TCM users were younger, had a higher female:male ratio and higher utilization rate of Western medicine. The median interval between diagnosis and the first TCM consultation was 7.92 months. Donepezil and rivastigmine were commonly prescribed medications. Chinese herbal medicine was the most popular treatment among TCM users. CONCLUSIONS This study revealed the specific usage patterns of TCM and non-TCM medical services among patients with AD. The information could be used for improving the healthcare of patients with AD.
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Affiliation(s)
- C-Y Lai
- School of Chinese Medicine, China Medical University, Taichung.,Department of Emergency Medicine, China Medical University Hospital, Taichung
| | - M-Y Wu
- Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung
| | - J-H Chiang
- Health Data Management Office, China Medical University Hospital, Taichung.,School of Medicine, China Medical University, Taichung
| | - M-F Sun
- School of Chinese Medicine, China Medical University, Taichung.,Department of Chinese Medicine, China Medical University Hospital, Taichung
| | - Y-H Chen
- Graduate Institute of Acupuncture Science, China Medical University, Taichung.,Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung
| | - C-T Chang
- School of Medicine, China Medical University, Taichung.,Kidney Institute and Division of Nephrology, China Medical University Hospital, Taichung
| | - J-G Lin
- School of Chinese Medicine, China Medical University, Taichung
| | - H-R Yen
- School of Chinese Medicine, China Medical University, Taichung.,Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung.,Department of Chinese Medicine, China Medical University Hospital, Taichung.,Research Center for Chinese Herbal Medicine, China Medical University, Taichung.,Department of Biotechnology, Asia University, Taichung, Taiwan
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Yang YH, Meguro K, Kim SY, Shim YS, Yu X, Chen CLH, Wang H, Lam L, Senanarong V, Dominguez J, Lu PY, Lin YT, Hu CJ, Chiu PY, Fuh JL, Wang WF, Yu BC, Li T, Wang MW, Situmeang RFV, Jang JW, Zhang J, Chan WC, Zhou YY, Lou HL, Zhang L, Ye M, Chen X. Impact of Alzheimer's Disease in Nine Asian Countries. Gerontology 2016; 62:425-33. [PMID: 26829322 DOI: 10.1159/000443525] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 12/21/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Asia will soon have the majority of demented patients in the world. OBJECTIVE To assess dementia using a uniform data system to update the current status of dementia in Asia. METHODS A uniformed data set was administered in Taiwan, China, Hong Kong, Korea, Japan, Philippines, Thailand, Singapore, and Indonesia to gather data with regard to Alzheimer's disease (AD) and its related issues for these countries. RESULTS In total, 2,370 AD patients and their caregivers were recruited from 2011 to 2014. The demographic characteristics of these patients and the relationships between patients and caregivers were different among individuals in these countries (p < 0.001). Of note, the family history for having dementia was 8.2% for females in contrast to 3.2% for males. CONCLUSION Our study highlighted the differences in dementia assessment and care in developing versus developed countries. Greater effort with regard to studying dementia, especially in developing countries, is necessary.
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Affiliation(s)
- Yuan-Han Yang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
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11
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Chang YP, Yang CH, Chou MC, Chen CH, Yang YH. Clinical compliance of donepezil in treating Alzheimer's disease in taiwan. Am J Alzheimers Dis Other Demen 2015; 30:346-51. [PMID: 25380803 PMCID: PMC10852549 DOI: 10.1177/1533317514556875] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
BACKGROUND/RATIONALE Adherence to cholinesterase inhibitor (ChEI) is associated with treatment effectiveness in the treatment of Alzheimer's disease (AD). We investigated the clinical adherence to donepezil in Taiwan. METHODS This was a retrospective study. Patients treated with donepezil were recruited from Kaohsiung Medical University Hospital and Kaohsiung Municipal Ta-Tung Hospital from February 2004 to April 2013. We analyzed their treatment duration in months. RESULTS A total of 273 patients were included in our analysis. Sixty-seven patients withdrew from donepezil treatment with mean treatment duration of 28.0 ± 25.9 months. Better initial scores on the Mini-Mental Status Examination (P = .007), Cognitive Abilities Screening Instrument (P = .003), and the Clinical Dementia Rating Scale (CDR) Sum of Boxes (P = .011) were positively associated with clinical adherence. The clinical adherent rate was higher in the CDR-0.5 group than in the CDR-2.0 group with significant difference. CONCLUSION Although there are some limitations in our study, these findings indicate that early intervention with ChEI in patients with AD should be emphasized and may lead to a better clinical adherence.
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Affiliation(s)
- Yun-Ping Chang
- Department of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chiu-Hsien Yang
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan Division of Community Medicine, Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Mei-Chuan Chou
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Chun-Hung Chen
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yuan-Han Yang
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan Department of and Master's Program in Neurology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Chiu YC, Kolanowski AM, Huang CY, Lin LJ, Chang TH, Hsu KH, Hu CJ, Chen YJ. Leisure-time physical activity and neuropsychiatric symptoms of community-dwelling persons with cognitive impairment. Geriatr Nurs 2014; 35:345-50. [PMID: 24836581 DOI: 10.1016/j.gerinurse.2014.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Revised: 03/23/2014] [Accepted: 03/31/2014] [Indexed: 10/25/2022]
Abstract
Physical activities are recommended to reduce neuropsychiatric symptoms of nursing home residents with mild dementia. However, relevant information is not available for community-dwelling persons with cognitive impairment. Therefore, this cross-sectional study examined the effects of leisure-time physical activities on cognitively impaired persons' neuropsychiatric symptoms and their family caregivers' distress. Activities were described in terms of their frequency, duration, number of different types, and energy expenditure. Participants were 58 dyads of persons with cognitive impairment and their family caregivers. Data on leisure-time physical activities and neuropsychiatric symptoms were collected using a 7-Day Physical Activity Recall and Chinese Neuropsychiatric Inventory, respectively. The most frequently reported activity was strolling (70.7%). The mean weekly activity frequency, duration, and energy expenditure were 4.52 (SD=4.27) times, 3.7 (SD=4.38) h, and 771.47 (SD=886.38) kcal, respectively. The number of different activity types negatively and significantly predicted cognitively impaired persons' mood and psychosis as well as family caregivers' distress.
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Affiliation(s)
- Yi-Chen Chiu
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan.
| | - Ann M Kolanowski
- College of Nursing and Hartford Center of Geriatric Nursing Excellence, The Pennsylvania State University, PA, USA
| | - Chien-Ying Huang
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan
| | - Li-Jung Lin
- Graduate Institute of Sports and Leisure Management, National Taiwan Normal University, Taipei, Taiwan
| | - Ting-Huan Chang
- School of Health Policy and Management, College of Health Care and Management, Chung Shan Medical University, Taichung, Taiwan
| | - Kuang-Hung Hsu
- Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan; Department of Health Care Management, College of Management, Chang Gung University, Tao-Yuan, Taiwan
| | - Chaur-Jong Hu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan
| | - Ying-Jen Chen
- Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan
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A walk-in screening of dementia in the general population in Taiwan. ScientificWorldJournal 2014; 2014:243738. [PMID: 24883363 PMCID: PMC4032722 DOI: 10.1155/2014/243738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 04/21/2014] [Indexed: 11/18/2022] Open
Abstract
Alzheimer's disease (AD) has increased in its prevalence due to the increasing aged population. Currently there is no updated data on the prevalence of dementia including its very mild stage in Taiwan. Under the extensive coverage of Mentality Protection Center (MPC), Fo Guang Shan, Taiwan, the volunteers of MPC have conducted the medicine-related services and the screening of dementia by AD8 (ascertainment of dementia 8) that can screen the dementia even at its very mild stage in general population in all Taiwan. From 2011 to 2013, in total, 2,171 participants, 368 in the northern, 549 in the central, 877 in the southern, and 377 in the eastern part, were recruited with the mean age being 66.9 ± 10.2 years old. The ratio of suspected dementia patients, AD8 score greater than or equal to 2, was 13.6% of all recruited participants with their mean AD8 score being 2.9 ± 1.3, mean age being 69.4 ± 10.8 years old, and female predominance being 73.0%. Although this is a screening study, it has extensive coverage of all Taiwan and the use of AD8 is capable of screening very mild dementia. A further study with a randomized sampling to examine the prevalence and incidence of dementia including its very mild stage is encouraged.
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