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Tan EYL, Janssen N, Handels R, Ramakers IHGB, Verhey FRJ, van der Flier WM, Melis RJF, Olde Rikkert MGM, Schols JMGA, de Vugt ME. Determinants of quality of life in family caregivers in MCI: a comparison with mild dementia. Aging Ment Health 2023; 27:1983-1989. [PMID: 37310855 DOI: 10.1080/13607863.2023.2220274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 05/18/2023] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The aim of the current study was to investigate the health-related quality of life (HRQol) of the family caregiver in MCI, explore possible determinants and study possible differences with mild dementia. METHODS This secondary data analysis included 145 persons with MCI and 154 persons with dementia and their family caregivers from two Dutch cohort studies. HRQoL was measured with the VAS of the EuroQol-5D-3L version. Regressions analyses were conducted to examine potential demographic and clinical determinants of the caregiver's HRQoL. RESULTS The mean EQ5D-VAS in family caregivers of persons with MCI was 81.1 (SD 15.7), and did not significantly differ from family caregivers in mild dementia (81.9 (SD 13.0)). In MCI, patient measurements were not significantly associated with caregiver mean EQ5D-VAS. Concerning caregiver characteristics, being a spouse and a lower educational level were associated with a lower mean EQ5D-VAS (in a multiple linear regression model: unstandardized B -8.075, p = 0.013 and unstandardized B -6.162, p = 0.037 resp.). In mild dementia, the NPI item irritability showed an association with caregiver EQ5D-VAS in bivariate linear regression analyses. CONCLUSION Results indicate that especially family caregiver characteristics seem to influence family caregiver HRQoL in MCI. Future research should include other potential determinants such as burden, coping strategies and relationship quality.
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Affiliation(s)
- Eva Y L Tan
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Old Age Psychiatry, Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands
| | - Niels Janssen
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Ron Handels
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Inez H G B Ramakers
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Frans R J Verhey
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - René J F Melis
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcel G M Olde Rikkert
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Donders Centre for Medical Neurosciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jos M G A Schols
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Family Medicine and Department of Health Services Research, Caphri, Maastricht, the Netherlands
| | - Marjolein E de Vugt
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Mank A, van Maurik IS, Rijnhart JJM, Rhodius‐Meester HFM, Visser LNC, Lemstra AW, Sikkes SAM, Teunissen CE, van Giessen EM, Berkhof J, van der Flier WM. Determinants of informal care time, distress, depression, and quality of life in care partners along the trajectory of Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12418. [PMID: 37114014 PMCID: PMC10126754 DOI: 10.1002/dad2.12418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/19/2023] [Accepted: 03/01/2023] [Indexed: 04/29/2023]
Abstract
Introduction We evaluated determinants associated with care partner outcomes along the Alzheimer's disease (AD) stages. Methods We included n = 270 care partners of amyloid-positive patients in the pre-dementia and dementia stages of AD. Using linear regression analysis, we examined determinants of four care partner outcomes: informal care time, caregiver distress, depression, and quality of life (QoL). Results More behavioral symptoms and functional impairment in patients were associated with more informal care time and depressive symptoms in care partners. More behavioral symptoms were related with more caregiver distress. Spouse care partners spent more time on informal care and QoL was lower in female care partners. Behavioral problems and subtle functional impairment of the patient predisposed for worse care partner outcomes already in the pre-dementia stages. Discussion Both patient and care partner determinants contribute to the care partner outcomes, already in early disease stages. This study provides red flags for high care partner burden.
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Affiliation(s)
- Arenda Mank
- Alzheimer Center Amsterdam, Department of NeurologyVrije Universiteit AmsterdamAmsterdam UMC VUmcAmsterdamthe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamthe Netherlands
- Amsterdam UMCVrije Universiteit AmsterdamDepartment of Epidemiology and Data ScienceAmsterdam Public Health InstituteAmsterdamthe Netherlands
| | - Ingrid S. van Maurik
- Alzheimer Center Amsterdam, Department of NeurologyVrije Universiteit AmsterdamAmsterdam UMC VUmcAmsterdamthe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamthe Netherlands
- Amsterdam UMCVrije Universiteit AmsterdamDepartment of Epidemiology and Data ScienceAmsterdam Public Health InstituteAmsterdamthe Netherlands
| | | | - Hanneke F. M. Rhodius‐Meester
- Alzheimer Center Amsterdam, Department of NeurologyVrije Universiteit AmsterdamAmsterdam UMC VUmcAmsterdamthe Netherlands
- Department of Internal MedicineGeriatric Medicine SectionVrije Universiteit AmsterdamAmsterdam UMCAmsterdamthe Netherlands
- Department of Geriatric MedicineThe Memory ClinicOslo University HospitalOsloNorway
| | - Leonie N. C. Visser
- Department of Medical PsychologyAmsterdam UMC, AMCUniversity of AmsterdamAmsterdamthe Netherlands
- Amsterdam Public Health Research InstituteQuality of CareAmsterdamthe Netherlands
| | - Afina W. Lemstra
- Alzheimer Center Amsterdam, Department of NeurologyVrije Universiteit AmsterdamAmsterdam UMC VUmcAmsterdamthe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamthe Netherlands
| | - Sietske A. M. Sikkes
- Alzheimer Center Amsterdam, Department of NeurologyVrije Universiteit AmsterdamAmsterdam UMC VUmcAmsterdamthe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamthe Netherlands
| | - Charlotte E. Teunissen
- Amsterdam NeuroscienceNeurodegenerationAmsterdamthe Netherlands
- Neurochemistry LaboratoryDepartment of Clinical ChemistryVrije UniversiteitAmsterdam UMC, VUmcAmsterdamthe Netherlands
| | - Elsmarieke M. van Giessen
- Department of Radiology & Nuclear Medicine Vrije Universiteit AmsterdamAmsterdam UMC, VUmcAmsterdamthe Netherlands
| | - Johannes Berkhof
- Amsterdam UMCVrije Universiteit AmsterdamDepartment of Epidemiology and Data ScienceAmsterdam Public Health InstituteAmsterdamthe Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center Amsterdam, Department of NeurologyVrije Universiteit AmsterdamAmsterdam UMC VUmcAmsterdamthe Netherlands
- Amsterdam NeuroscienceNeurodegenerationAmsterdamthe Netherlands
- Amsterdam UMCVrije Universiteit AmsterdamDepartment of Epidemiology and Data ScienceAmsterdam Public Health InstituteAmsterdamthe Netherlands
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Thurin K, Daffner K, Gale S, Donovan NJ, Urizar JC. Non-Pharmacological Treatments of Neuropsychiatric Symptoms in Mild Cognitive Impairment (MCI). Semin Neurol 2022; 42:192-203. [DOI: 10.1055/s-0042-1742486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractMild cognitive impairment (MCI) is a syndrome defined by objective cognitive deficits that do not impact functional independence. Individuals with MCI develop dementia at an annual rate of 10 to 15%. Neuropsychiatric symptoms (NPS) are common non-cognitive features of neurocognitive disorders and have a major impact on the wellbeing and quality of life of affected individuals and their families. Non-pharmacological interventions for NPS are considered the first-line treatment because of the limited efficacy and side-effect potential of current pharmacological agents. This article summarizes the literature on non-pharmacological treatments for NPS in MCI. The limited number of studies specific to individuals with MCI and its various etiologies, as well as the overall heterogeneity of research design and methodologies, make the evidence base inconclusive. Nevertheless, some studies support psychosocial interventions aimed at individuals with MCI and their caregivers.
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Affiliation(s)
- Kristina Thurin
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Kirk Daffner
- Division of Cognitive and Behavioral Neurology, Department of Neurology, Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Seth Gale
- Division of Cognitive and Behavioral Neurology, Department of Neurology, Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nancy J. Donovan
- Division of Geriatric Psychiatry, Departments of Psychiatry and Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Juan Carlos Urizar
- Division of Geriatric Psychiatry, Departments of Psychiatry and Neurology, Brigham andWomen's Hospital, Harvard Medical School, Boston, Massachusetts
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Popiołek A, Brzoszczyk B, Jarzemski P, Chyrek-Tomaszewska A, Wieczór R, Borkowska A, Bieliński M. Prostate-Specific Antigen and Testosterone Levels as Biochemical Indicators of Cognitive Function in Prostate Cancer Survivors and the Role of Diabetes. J Clin Med 2021; 10:jcm10225307. [PMID: 34830590 PMCID: PMC8619514 DOI: 10.3390/jcm10225307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 11/16/2022] Open
Abstract
Prostate cancer (PC) is one of the most common malignancies in men. The increase in the number of PC survivors is associated with many problems including cognitive impairment. Early detection of such problems facilitates timely protective intervention. This study examined the association between prostate-specific antigen (PSA) or testosterone (T) levels and cognitive function in patients undergoing radical prostatectomy. Such a correlation could help identify patient groups at risk of cognitive impairment. Participants underwent clinical (demographic data, medical history, physical examination, and blood analyses) and neuropsychological assessment (cognitive test battery). Preoperative PSA or T levels were not associated with cognitive function. However, long-term follow-up after prostatectomy showed a strong correlation between PSA levels and the results of verbal memory and executive function tests. A trend toward significance was also observed for visuospatial memory. The levels of free T and total T were not correlated with cognitive function. Only the levels of free T after hormonal treatment were significantly correlated with executive functions. Comorbid diabetes affected these correlations. In conclusion, PSA levels at a distant postoperative time and free T level after hormonal treatment may be biomarkers of cognitive function.
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Affiliation(s)
- Alicja Popiołek
- Department of Clinical Neuropsychology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-067 Bydgoszcz, Poland; (A.C.-T.); (A.B.); (M.B.)
- Department of Internal Diseases, Jan Biziel University Hospital No. 2 in Bydgoszcz, 85-163 Bydgoszcz, Poland;
- Correspondence: ; Tel.: +48-52-585-37-03
| | - Bartosz Brzoszczyk
- Department of Laparoscopic, General, and Oncological Urology, Jan Biziel University Hospital No. 2 in Bydgoszcz, 85-067 Bydgoszcz, Poland; (B.B.); (P.J.)
| | - Piotr Jarzemski
- Department of Laparoscopic, General, and Oncological Urology, Jan Biziel University Hospital No. 2 in Bydgoszcz, 85-067 Bydgoszcz, Poland; (B.B.); (P.J.)
| | - Aleksandra Chyrek-Tomaszewska
- Department of Clinical Neuropsychology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-067 Bydgoszcz, Poland; (A.C.-T.); (A.B.); (M.B.)
- Department of Internal Diseases, Jan Biziel University Hospital No. 2 in Bydgoszcz, 85-163 Bydgoszcz, Poland;
| | - Radosław Wieczór
- Department of Internal Diseases, Jan Biziel University Hospital No. 2 in Bydgoszcz, 85-163 Bydgoszcz, Poland;
| | - Alina Borkowska
- Department of Clinical Neuropsychology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-067 Bydgoszcz, Poland; (A.C.-T.); (A.B.); (M.B.)
| | - Maciej Bieliński
- Department of Clinical Neuropsychology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-067 Bydgoszcz, Poland; (A.C.-T.); (A.B.); (M.B.)
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Su KQ, Liu ST, Yuan J, Li JY, Li RQ, Feng XD. The comparative effectiveness of traditional Chinese medicine exercise therapies in elderly people with mild cognitive impairment: A protocol for a network meta-analysis. Medicine (Baltimore) 2020; 99:e22021. [PMID: 32899055 PMCID: PMC7478642 DOI: 10.1097/md.0000000000022021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 07/31/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) in the elderly is a health problem worldwide. Several clinical trials indicated that traditional Chinese medicine (TCM) exercise therapies can effectively improve MCI, such as Tai Ji, Baduan jin exercise, Liuzi jue, and finger exercise. However, there is still controversy over which therapy is the best for elderly MCI patients. In this study, we aimed to systematically evaluate and compare the effectiveness and safety of these 4 TCM exercise therapies in elderly patients with MCI. METHODS The Web of Science, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Clinical Trials, China National Knowledge Infrastructure, Wangfang database, and Chinese Biomedical Medicine will be comprehensively searched to collect all randomized controlled trials which included elderly participants with MCI receiving TCM exercise therapies through July 2020. Two reviewers will independently screen and evaluate each included study and extract the outcome indexes. ADDIS 1.16.8 software will be used for the network meta-analysis and STATA 14 software will be used for drawing network evidence plots and funnel plots. RESULTS We will use the Bayesian statistical model to conduct a network meta-analysis to rank the effectiveness and safety of these 4 interventions, and use the GRADE approach to interpret the results. CONCLUSION This network meta-analysis will find out the optimal treatment plan for MCI and provide evidence-based bias for clinical treatments decision-making. PROTOCOL REGISTRATION NUMBER INPLASY202070006.
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Affiliation(s)
- Kai-Qi Su
- Henan University of Chinese Medicine
| | | | - Jie Yuan
- Henan University of Chinese Medicine
| | | | - Rui-Qing Li
- Henan University of Chinese Medicine
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, PR China
| | - Xiao-Dong Feng
- Henan University of Chinese Medicine
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, PR China
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