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Veneziani I, Grimaldi A, Marra A, Morini E, Culicetto L, Marino S, Quartarone A, Maresca G. Towards a Deeper Understanding: Utilizing Machine Learning to Investigate the Association between Obesity and Cognitive Decline-A Systematic Review. J Clin Med 2024; 13:2307. [PMID: 38673581 PMCID: PMC11051247 DOI: 10.3390/jcm13082307] [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: 03/18/2024] [Revised: 04/09/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024] Open
Abstract
Background/Objectives: Several studies have shown a relation between obesity and cognitive decline, highlighting a significant global health challenge. In recent years, artificial intelligence (AI) and machine learning (ML) have been integrated into clinical practice for analyzing datasets to identify new risk factors, build predictive models, and develop personalized interventions, thereby providing useful information to healthcare professionals. This systematic review aims to evaluate the potential of AI and ML techniques in addressing the relationship between obesity, its associated health consequences, and cognitive decline. Methods: Systematic searches were performed in PubMed, Cochrane, Web of Science, Scopus, Embase, and PsycInfo databases, which yielded eight studies. After reading the full text of the selected studies and applying predefined inclusion criteria, eight studies were included based on pertinence and relevance to the topic. Results: The findings underscore the utility of AI and ML in assessing risk and predicting cognitive decline in obese patients. Furthermore, these new technology models identified key risk factors and predictive biomarkers, paving the way for tailored prevention strategies and treatment plans. Conclusions: The early detection, prevention, and personalized interventions facilitated by these technologies can significantly reduce costs and time. Future research should assess ethical considerations, data privacy, and equitable access for all.
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Affiliation(s)
- Isabella Veneziani
- Department of Nervous System and Behavioural Sciences, Psychology Section, University of Pavia, Piazza Botta, 11, 27100 Pavia, Italy (A.G.)
| | - Alessandro Grimaldi
- Department of Nervous System and Behavioural Sciences, Psychology Section, University of Pavia, Piazza Botta, 11, 27100 Pavia, Italy (A.G.)
| | - Angela Marra
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (A.M.); (E.M.); (S.M.); (A.Q.); (G.M.)
| | - Elisabetta Morini
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (A.M.); (E.M.); (S.M.); (A.Q.); (G.M.)
| | - Laura Culicetto
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (A.M.); (E.M.); (S.M.); (A.Q.); (G.M.)
| | - Silvia Marino
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (A.M.); (E.M.); (S.M.); (A.Q.); (G.M.)
| | - Angelo Quartarone
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (A.M.); (E.M.); (S.M.); (A.Q.); (G.M.)
| | - Giuseppa Maresca
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (A.M.); (E.M.); (S.M.); (A.Q.); (G.M.)
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Tannou T, Gzil F, Kennelly SP, Tournoy J, Frisardi V, Soysal P. How do geriatricians evaluate decision-making ability for older adults with cognitive impairment? Results from an European survey. Eur Geriatr Med 2023; 14:953-960. [PMID: 37603190 DOI: 10.1007/s41999-023-00852-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/01/2023] [Indexed: 08/22/2023]
Abstract
CONTEXT The assessment of decision-making ability of older adults with cognitive impairment is a complex challenge that geriatricians often face in relation to risk-taking situations (driving, aging in place, financial decisions, etc.). However, there are no clear and consensual practice guidelines. An overview of current practices and needs seemed necessary. METHODS We co-created and conducted an online survey to describe practice and knowledge, among European geriatricians. The survey was structured in 3 parts: a description of the professional's practice regarding cognitive impairment, a specific questionnaire about everyday risky decision-making evaluation and an investigation of the clinician's knowledge about relevant ethical and legal recommendations. Each part consisted of both multiple choice and open questions, analyzed through descriptive statistics and qualitative analysis methods. RESULTS Based on the responses of 123 geriatricians across Europe, our survey showed that clinical interview is the cornerstone of geriatric assessment of decision-making ability of patients with mild to moderate dementia. When faced with risk-taking dilemma situations, geriatricians tend to favor a context of safety above autonomy, but they can support risky decision-making if it is consistent with the patient's previous lifestyle, depending on the degree of risk to self and others, on the decision-making ability assessed, and if there is some form of shared decision-making. CONCLUSION Assessing decision-making ability is challenging for geriatricians, who in our study relied more on their clinical interview and global cognitive tests than more in-depth evaluations. Supporting independent decision-making, when associated with risk-taking, requires better detection and anticipation shared with the patient environment.
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Affiliation(s)
- Thomas Tannou
- CIUSS Centre-Sud de l'ile de Montréal, Centre de Recherche de l'institut Universitaire de Gériatrie de Montréal, 4565 Rue Queen Mary, Montréal, QC, H3W1W5, Canada.
- Université de Franche-Comté, UR LINC, 25000, Besançon, France.
| | - Fabrice Gzil
- École des Hautes Études en Santé Publique, 35000, Rennes, France
- Espace de Réflexion Éthique d'Ile-de-France, 75000, Paris, France
- Centre de Recherche en Épidémiologie et Santé des Populations, UMR 1018 Inserm/Université Paris Saclay, 94800, Villejuif, France
| | - Seán P Kennelly
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Jos Tournoy
- Gerontology and Geriatrics Unit, Department of Public Health and Primary Care, KU Leuven-University of Leuven, Louvain, Belgium
- Department of Geriatric Medicine, University Hospitals Leuven, Louvain, Belgium
| | - Vincenza Frisardi
- Neuromotor Department, Geriatric Unit, AUSL-IRCCS Reggio Emilia (RE), Louvain, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan Street), Fatih, 34093, Istanbul, Turkey
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Sanlaville C, Loiseau Médecin Généraliste A, Colin C, Salmon PK, Letrilliart L. [General practitioners' views on cognitive disorders diagnosis: a qualitative study]. SOINS. GÉRONTOLOGIE 2021; 26:35-42. [PMID: 34304810 DOI: 10.1016/j.sger.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Diagnosis of cognitive disorders is at medical and ethical stake. The aim of an qualitative study based on interviews was to explore the views of general practitioners on this diagnosis. General practitioners are ambivalent about the relevance and temporality of the diagnosis of cognitive disorders, which could be resolved by a shared decision making at each stage of the diagnostic approach.
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Affiliation(s)
- Claire Sanlaville
- Collège universitaire de médecine générale, université Claude-Bernard Lyon 1, 69008 Lyon, France
| | | | - Cyrille Colin
- Université Claude-Bernard Lyon 1, 69622 Villeurbanne, France; Laboratoire Health services and performance research EA 7425, université Claude-Bernard Lyon 1, 69008 Lyon, France; Pôle Information médicale évaluation recherche, Hospices civils de Lyon, 3 quai des Célestins, 69002 Lyon, France
| | - Pierre-Krolak Salmon
- Centre mémoire, ressources, recherche de Lyon, Institut du vieillissement, Hospices civils de Lyon, Institut national de la santé et de la recherche médicale 1048, Centre national de la recherche scientifique 5292, 69008 Lyon, France; Action conjointe européenne "Act on dementia", université Claude-Bernard Lyon 1, 69008 Lyon, France
| | - Laurent Letrilliart
- Collège universitaire de médecine générale, université Claude-Bernard Lyon 1, 69008 Lyon, France; Laboratoire Health services and performance research EA 7425, université Claude-Bernard Lyon 1, 69008 Lyon, France; Collège universitaire de médecine générale, Université Claude-Bernard Lyon 1, 8 avenue Rockefeller, 69373 Lyon cedex 08, France.
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Frias CE, Risco E, Zabalegui A. Psychoeducational intervention on burden and emotional well-being addressed to informal caregivers of people with dementia. Psychogeriatrics 2020; 20:900-909. [PMID: 33015927 DOI: 10.1111/psyg.12616] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/24/2020] [Accepted: 09/02/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND In dementia it is necessary that a family member become an informal caregiver. This labour has social, physical and emotional repercussions on the caregiver's health. The objective was to assesses the impact of the INFOSA-DEM intervention on burden and emotional well-being among caregivers of people with dementia, evaluating the effects at 3 and 6 months. METHOD We adopted an experimental, non-randomised design with an intervention group and a control group. The intervention group received the intervention and the control group received usual care. The study was carried out in the catchment areas of three centres specialising in the care of people with cognitive impairment in the province of Barcelona. RESULTS At 3 months, there was an improvement with respect to burden in the intervention group with a significant worsening (P < 0.012) in the control group. Similarly, a positive effect on emotional well-being was observed in the intervention group compared with a small negative effect among controls. CONCLUSIONS Programs addressed to informal caregivers based on psychoeducational and cognitive-behavioural therapies are effective in improving quality of life and emotional well-being, and in reducing burden, with a positive effect on the quality of care provided at home.
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Affiliation(s)
- Cindy E Frias
- Department of Nursing, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Ester Risco
- Hospital Pere I Virgili of Barcelona, Barcelona, Spain
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Frias CE, Garcia-Pascual M, Montoro M, Ribas N, Risco E, Zabalegui A. Effectiveness of a psychoeducational intervention for caregivers of People With Dementia with regard to burden, anxiety and depression: A systematic review. J Adv Nurs 2020; 76:787-802. [PMID: 31808211 DOI: 10.1111/jan.14286] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 11/07/2019] [Accepted: 11/27/2019] [Indexed: 11/28/2022]
Abstract
AIM To assess the effectiveness of psychoeducational interventions with respect to burden, anxiety and depression in family caregivers of People With Dementia living at home. BACKGROUND In dementia, the family assumes the role of main caregiver, maintaining the patient in a good state of health. Nevertheless, burden, anxiety and depression may have negative repercussions in caregivers. Therefore, professional supports through psychoeducational programmes are recommended as interventions for improving caregivers' health. DESIGN A quantitative systematic review. DATA SOURCES Electronic searches were performed in CINAHL/AMED/CENTRAL/Web of Science/LILACS/PUBMED from January 2005-August 2018. REVIEW METHODS The review was conducted using the JADAD scale to assess bias risk and the quality of the randomized controlled trials (RCTs) and the CONSORT instrument to assess study quality report. The extracted data were reviewed by independent reviewer pairs. The review was reported using PRISMA. RESULTS A total of 18 RCTs met inclusion criteria. Seven were classified as Technology-based Interventions and 11 as Group-based Interventions. CONCLUSION Psychoeducational interventions for caregivers allow them to increase their knowledge of the illness, develop problem-solving skills and facilitate social support. Technology-based Interventions significantly affect burden while Group-based Interventions affect anxiety, depression, insomnia and burden and quality of life and self-efficacy. IMPACT Research findings can be used to classify caregivers in future interventions according to illness stage to obtain more precise results.
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Affiliation(s)
| | | | | | - Nuria Ribas
- Hospital Clinic of Barcelona, Barcelona, Spain
| | - Ester Risco
- Hospital Clinic of Barcelona, Barcelona, Spain
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De Cola MC, Lo Buono V, Mento A, Foti M, Marino S, Bramanti P, Manuli A, Calabrò RS. Unmet Needs for Family Caregivers of Elderly People With Dementia Living in Italy: What Do We Know So Far and What Should We Do Next? INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2017; 54:46958017713708. [PMID: 28617065 PMCID: PMC5798676 DOI: 10.1177/0046958017713708] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Care of the elderly with dementia represents one of the major challenges for the modern society worldwide. The burden of dementia care often falls on the family members, entailing heavy psychosocial and economic consequences. The aim of this study was to evaluate the caregiver's perspective concerning the support for disease management on behalf of the physicians and the local Sicilian administrations (Italy), and the burden of care and effects on their lifestyle, to propose new prevention strategies and service for managing dementia and caregiver's burden. Fifty-nine caregivers of Italian elderly people with dementia (mean age, 73; age range: 63-83) were interviewed, and 55 of them completed an ad hoc self-report questionnaire composed of 54 multiple-choice questions. Our findings suggest that caregivers need more information on the disease's management, as well as on how to deal with the stress due to the disease burden. Moreover, a negative perception about the services offered from the local administration emerged. Assistive technology (AT) could be useful in promoting interaction between general practitioners and specialized centers for diagnosis, pharmacological and psychosocial treatments, and in saving costs. Moreover, case manager could follow patients and support family members within the care pathway, besides collecting and sharing information among the different health professionals involved. Further studies should be aimed at investigating whether AT and/or the use of specific educational strategies could be the right approach for meeting the needs of families living with dementia.
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Affiliation(s)
| | | | - Agata Mento
- 1 IRCCS Centro Neurolesi "Bonino-Pulejo," Messina, Italy
| | - Mariella Foti
- 1 IRCCS Centro Neurolesi "Bonino-Pulejo," Messina, Italy
| | - Silvia Marino
- 1 IRCCS Centro Neurolesi "Bonino-Pulejo," Messina, Italy
| | | | - Alfredo Manuli
- 1 IRCCS Centro Neurolesi "Bonino-Pulejo," Messina, Italy
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Jafari Navimipour N, Charband Y. Knowledge sharing mechanisms and techniques in project teams: Literature review, classification, and current trends. COMPUTERS IN HUMAN BEHAVIOR 2016. [DOI: 10.1016/j.chb.2016.05.003] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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De Fazio P, Ciambrone P, Cerminara G, Barbuto E, Bruni A, Gentile P, Talarico A, Lacava R, Gareri P, Segura-García C. Depressive symptoms in caregivers of patients with dementia: demographic variables and burden. Clin Interv Aging 2015; 10:1085-90. [PMID: 26170648 PMCID: PMC4494176 DOI: 10.2147/cia.s74439] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Individuals suffering from dementia are affected by a progressive and significant global deterioration and, consequently, might require longer assistance in the advanced stage of the illness. The illness is a great burden on the person who takes care of a patient, namely, the caregiver. This study aims to analyze the presence and relationship of specific sociodemographic variables, subjective burden, and depressive symptoms among caregivers of patients with dementia. METHODS The participants of this study were caregivers at a health care unit for the elderly in southern Italy. An evaluation of the burden of patients with dementia on caregivers was carried out using the Caregiver Burden Inventory (CBI) and depressive symptoms using the Self-Rating Depression Scale (SDS). RESULTS A total of 150 caregivers completed the study. In all, 83 (55%) caregivers showed a total CBI score ≥36, of whom 70% showed pathological depression scores in SDS. According to SDS, 28 (19%) caregivers showed a total CBI score from 24 to 36, of whom 32% were depressed. Depression was present in 5% of the caregivers whose CBI score was <24. Hence, an association between burden and depression was evident (χ(2)=47.446, P<0.001). A multiple linear regression analysis showed that depression (adjusted R(2)=0.622, F=50.123, P<0.001) was associated with higher physical (β=0.666, P=0.001) and developmental (β=0.712, P<0.001) burdens, lower socioeconomic status (β=-4.282; P=0.002), higher level of urbanicity (β=3.070; P=0.012), and advanced age (β=2.132; P=0.08). CONCLUSION Our study confirms the presence of depressive symptoms in a large number of caregivers with high burden. Nevertheless, this study demonstrates that depressive symptoms are mainly associated with sociodemographic variables and, to a lesser degree, physical and developmental burdens.
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Affiliation(s)
- Pasquale De Fazio
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Paola Ciambrone
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Gregorio Cerminara
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Elvira Barbuto
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Antonella Bruni
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Patrizia Gentile
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | | | | | - Pietro Gareri
- Unit for the Elderly, ASP Catanzaro, Catanzaro, Italy
| | - Cristina Segura-García
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
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Zabalegui A, Hamers JPH, Karlsson S, Leino-Kilpi H, Renom-Guiteras A, Saks K, Soto M, Sutcliffe C, Cabrera E. Best practices interventions to improve quality of care of people with dementia living at home. PATIENT EDUCATION AND COUNSELING 2014; 95:175-184. [PMID: 24525223 DOI: 10.1016/j.pec.2014.01.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 01/08/2014] [Accepted: 01/18/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To identify effective interventions which improve quality of care for people with dementia (PwD) living at home. METHODS MEDLINE-(via PubMed), CINAHL, PsycINFO and ISI Web of Science databases were searched. INCLUSION CRITERIA (1) randomized controlled trials; (2) published in English-language, peer-reviewed journals between 1990 and 2012; (3) evaluated strategies to improve quality of care for PwD cared at home; and (4) participants older than 65. RESULTS 23 studies met inclusion criteria. All the studies aimed to improve PwD quality of care and most of them focused on PwD caregivers. Psychoeducational programs are the most frequently assessed interventions and multicomponent interventions produced the most promising results. CONCLUSION Due to the great variety of interventions describing specific samples and contexts, comparison of practice effectiveness is difficult. However, cognitive rehabilitation in PwD is effective when applied at an early stage of the disease. Case managers have demonstrated to reduce PwD institutionalization and the use of other community services. The studies were limited by sample heterogeneity, short follow-up or insufficiently detailed description. PRACTICE IMPLICATIONS To improve PwD homecare, health professionals should educate and support caregivers. Before specific interventional recommendations can be made, further research addressing the limitations of current studies is needed.
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Affiliation(s)
| | - Jan P H Hamers
- Care of Older People at Maastricht University, The Netherlands
| | | | | | | | | | - Maria Soto
- Alzheimer Acute Care Unit, Gérontopôle Toulouse, Department of Geriatric Medicine University Hospital, France
| | | | - Esther Cabrera
- School of Health Sciences at Fundació Tecnocampus Mataró-Maresme Tecnocampus, Spain
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Roden C. [Informed consent to the insertion of a PEG tube in a 53-year-old male patient with highly advanced dementia]. Wien Med Wochenschr 2013; 164:167-71. [PMID: 24158417 DOI: 10.1007/s10354-013-0245-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 10/07/2013] [Indexed: 10/26/2022]
Abstract
In patients with advanced dementia and dysphagia, regular fluid- and food intake together with oral medication can be guaranteed by insertion of a PEG tube. Consent to a treatment in a patient without legal capacity requires nomination of a legal substitute by an Austrian court. The following case report describes the problems associated with this particular situation exposing additional psychosocial stress to closest relatives and to the palliative care team in charge for the patient. This case report describes the legal options together with the finally chosen path of medical treatment which in clinical praxis may not always match.
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Affiliation(s)
- Christian Roden
- Department für Palliativmedizin, Krankenhaus der Barmherzigen Schwestern Ried, Schloßberg 1, 4910, Ried im Innkreis, Österreich,
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