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Brain ventricles, CSF and cognition: a narrative review 脑室、脑脊液与认知:叙述性回顾
IF 2 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2022-04-30 DOI: 10.1111/psyg.12839
Mário Luciano de Mélo Silva Júnior, P. Diniz, Marcos Vinícius de Souza Vilanova, Gabriel Porciúncula Teixeira Basto, M. Valença
The brain ventricles are structures that have been related to cognition since antiquity. They are essential components in the development and maintenance of brain functions. The aging process runs with the enlargement of ventricles and is related to a less selective blood‐cerebrospinal fluid barrier and then a more toxic cerebrospinal fluid environment. The study of brain ventricles as a biological marker of aging is promissing because they are structures easily identified in neuroimaging studies, present good inter‐rater reliability, and measures of them can identify brain atrophy earlier than cortical structures. The ventricular system also plays roles in the development of dementia, since dysfunction in the clearance of beta‐amyloid protein is a key mechanism in sporadic Alzheimer's disease. The morphometric and volumetric studies of the brain ventricles can help to distinguish between healthy elderly and persons with mild cognitive impairment (MCI) and dementia. Brain ventricle data may contribute to the appropriate allocation of individuals in groups at higher risk for MCI‐dementia progression in clinical trials and to measuring therapeutic responses in these studies, as well as providing differential diagnosis, such as normal pressure hydrocephalus. Here, we reviewed the pathophysiology of healthy aging and cognitive decline, focusing on the role of the choroid plexus and brain ventricles in this process.
脑室是自古以来就与认知有关的结构。它们是大脑功能发育和维持的重要组成部分。衰老过程伴随着心室的增大,与选择性较低的血脑屏障和毒性更强的脑脊液环境有关。将脑室作为衰老的生物标志物的研究很有前景,因为它们是神经影像学研究中容易识别的结构,具有良好的评分可靠性,并且它们的测量可以比皮层结构更早地识别脑萎缩。心室系统也在痴呆症的发展中发挥作用,因为β淀粉样蛋白清除功能障碍是散发性阿尔茨海默病的关键机制。脑室的形态计量学和容量研究有助于区分健康的老年人和轻度认知障碍(MCI)和痴呆症患者。在临床试验中,脑室数据可能有助于将个体适当分配到MCI痴呆进展风险较高的群体中,并有助于测量这些研究中的治疗反应,以及提供鉴别诊断,如常压脑积水。在这里,我们回顾了健康衰老和认知能力下降的病理生理学,重点是脉络丛和脑室在这一过程中的作用。
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引用次数: 2
Issue Information 问题信息
IF 2 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2022-04-27 DOI: 10.1111/psyg.12715
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引用次数: 0
A first insight into the clinical manifestation of posttraumatic stress disorder in dementia: a systematic literature review 首次深入了解痴呆患者创伤后应激障碍的临床表现:系统的文献综述
IF 2 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2022-04-26 DOI: 10.1111/psyg.12830
Dorien H E van Dongen, D. Havermans, K. Deckers, M. Olff, F. Verhey, S. Sobczak
Posttraumatic stress disorder (PTSD) is a prevalent disorder worldwide and often co‐occurs in dementia. Both have a major impact on disease burden and quality of life. PTSD may be difficult to recognize in dementia and a structured diagnostic method is lacking. In order to get insight into the clinical diagnostics of PTSD in dementia, this systematic literature review evaluates the clinical presentation of PTSD and other relevant symptoms in people with dementia. PubMed, PsycINFO, Embase, and CINAHL were searched for all publications through 30 December 2021. Articles were included which met the following criteria: (i) description of at least one case with a current diagnosis of dementia and co‐morbid PTSD; (ii) clinical presentation of symptoms being adequately described; (iii) no difference being made between chronic PTSD, PTSD with re‐activation, and delayed onset PTSD. Of the 947 identified abstracts, 13 papers met the inclusion criteria and were included (describing 30 cases). Based on our rating, only one case completely fulfilled the DSM‐5 criteria of PTSD. Avoidance was only described in three cases. Most commonly described symptoms were irritability and anger (E1, 9%), persistent negative emotional state (D4, 9%), and sleep disturbances (E6, 8%). In 93% of the case reports, other symptoms were also described, i.e. memory problems (58%), screaming (33.3%), and wandering (22.2%). People with dementia who have experienced a traumatic event seem to present, based on our rating method, with insufficient symptoms to meet all criteria for a PTSD DSM‐5 diagnosis. The DSM‐5 core symptom of avoidance was absent in most of the cases. Clinical presentation consists mainly of symptoms of irritability, anger, persistent negative emotional state, and sleep disturbances, often accompanied by other symptoms. These findings suggest that older people with dementia may have other symptom presentations than people without dementia.
创伤后应激障碍(PTSD)是一种世界范围内普遍存在的疾病,通常与痴呆共同发生。两者都对疾病负担和生活质量产生重大影响。在痴呆症中,PTSD可能难以识别,并且缺乏结构化的诊断方法。为了深入了解PTSD在痴呆中的临床诊断,本研究对痴呆患者PTSD及其他相关症状的临床表现进行了系统的文献综述。检索PubMed、PsycINFO、Embase和CINAHL截至2021年12月30日的所有出版物。纳入符合以下标准的文章:(i)描述至少一个当前诊断为痴呆和合并PTSD的病例;(ii)充分描述症状的临床表现;(iii)慢性创伤后应激障碍、再激活创伤后应激障碍和延迟性创伤后应激障碍之间没有差异。947篇摘要中,13篇符合纳入标准(描述了30例病例)。根据我们的评分,只有一个病例完全符合PTSD的DSM - 5标准。只有三个案例描述了逃避。最常见的症状是易怒和愤怒(E1, 9%),持续的消极情绪状态(D4, 9%)和睡眠障碍(E6, 8%)。在93%的病例报告中,还描述了其他症状,即记忆问题(58%),尖叫(33.3%)和徘徊(22.2%)。根据我们的评定方法,经历过创伤性事件的痴呆患者似乎没有足够的症状满足PTSD DSM - 5诊断的所有标准。大多数病例不存在DSM - 5逃避的核心症状。临床表现主要有烦躁、愤怒、持续的消极情绪状态、睡眠障碍等症状,常伴有其他症状。这些发现表明,老年痴呆症患者可能比没有痴呆症的人有其他症状表现。
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引用次数: 5
Toward a society where people with dementia ‘living alone’ or ‘being a minority group’ can live well 迈向一个痴呆症患者“独自生活”或“成为少数群体”可以过得很好的社会
IF 2 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2022-04-21 DOI: 10.1111/psyg.12836
Fumiko Miyamae, Tsutomu Taga, T. Okamura, S. Awata
Dear Editor, In 2009, the UK government declared that they were pursuing the groundbreaking concept of ‘living well with dementia’ as a national strategy, at the end of a long flight powered by only the singleengine of ‘dementia prevention’. Following this idea, the Japanese government announced their national dementia strategy, called the New Orange Plan, for the promotion of communities friendly for the elderly, including persons with dementia. In the national dementia strategy, the building of dementia cafés is encouraged to strengthen support for daily life and families in the community. We highly appreciate that the Japanese government is in the process of creating places where people with dementia can interact with society. However, although empirical data are lacking, from a clinical perspective, people with dementia who are living alone often tend to be secluded. In addition, people with dementia who belong to minority groups (e.g., sexual minorities, refugees, immigrants) are less likely to participate in such places. On the other hand, the UK Alzheimer’s Society, which has been promoting living well with dementia, is reaching out to people with dementia who are living alone and those with lesbian, gay, bisexual, transgender, and questioning backgrounds. In addition, Dementia Australia is focusing on support for people with dementia who belong to culturally and linguistically diverse groups. Recently, we had the opportunity to give a lecture on living well with dementia to 48 local welfare commissioners (12 men, 36 women). As part of data collection for a reaction paper we asked if there were any places or activities in the community where the following people could participate: (i) people with dementia who live with their families; (ii) people with dementia who live alone; and (iii) people with dementia who belong to a minority group. The percentages of those who answered ‘yes’ to these questions were 36%, 32%, and 17%, respectively. These results require careful interpretation. First, only about one-third of the respondents knew of any places or activities that people with dementia who live with their families could go or participate in. Because we lacked controls, we could not judge whether this result was high or low compared with the general population. Second, in the case of people with dementia who live alone, the number of places or activities that they can participate in is smaller. Third, people with dementia who belong to a minority group are typically excluded according to the rights of social participation. We believe that psychiatry serves the most disadvantaged and misunderstood individuals in society. Japanese society is now gradually moving toward having dementia-friendly communities where people with dementia can live well; however, the focus is still needed on people with dementia who live alone or are in a minority group because these individuals are often excluded from society.
亲爱的编辑:2009年,英国政府宣布,他们正在追求“与痴呆症一起生活”的突破性概念,并将其作为一项国家战略,这是在“预防痴呆症”这一单一引擎的漫长飞行结束时。根据这一理念,日本政府发表了“新橙色计划”,旨在促进对包括痴呆症患者在内的老年人友好的社区。在国家痴呆症战略中,鼓励建立痴呆症卡,以加强对社区日常生活和家庭的支持。我们高度赞赏日本政府正在创造痴呆症患者可以与社会互动的场所。然而,尽管缺乏经验数据,但从临床角度来看,独居的痴呆症患者往往倾向于与世隔绝。此外,属于少数群体(如性少数群体、难民、移民)的痴呆症患者不太可能参加这些场所。另一方面,英国阿尔茨海默氏症协会(UK Alzheimer 's Society)一直在促进痴呆症患者的健康生活,它正在向独居的痴呆症患者、女同性恋、男同性恋、双性恋、变性人和有问题背景的人伸出援助之手。此外,澳大利亚痴呆症协会正在重点支持文化和语言多样化群体的痴呆症患者。最近,我们有机会对48名地区福利专员(12名男性,36名女性)进行了“如何与痴呆症一起生活”的讲座。作为反应论文数据收集的一部分,我们询问社区中是否有以下人群可以参与的地方或活动:(i)与家人住在一起的痴呆症患者;(ii)独居的痴呆症患者;(三)属于少数群体的痴呆症患者。对这些问题回答“是”的比例分别为36%、32%和17%。这些结果需要仔细解释。首先,只有大约三分之一的受访者知道与家人住在一起的痴呆症患者可以去或参加的地方或活动。由于缺乏对照,我们无法判断该结果与一般人群相比是高还是低。其次,对于独居的痴呆症患者来说,他们可以参加的地方或活动的数量较少。第三,属于少数群体的痴呆症患者通常被排除在社会参与权利之外。我们相信精神病学服务于社会上最弱势和被误解的个体。日本社会现在正逐渐走向痴呆症友好社区,痴呆症患者可以在那里生活得更好;然而,仍然需要把重点放在独居或少数群体的痴呆症患者身上,因为这些人往往被社会排斥在外。
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引用次数: 0
Hippocampal calcification and its effects on cognitive function and symptoms in dementia 海马钙化及其对痴呆患者认知功能和症状的影响
IF 2 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2022-04-20 DOI: 10.1111/psyg.12831
S. Takagi, K. Yamashiro, G. Sugihara, M. Matsuura, Hidehiko Takahashi
Hippocampal calcification (HC), highly prevalent in older people, has not attracted attention until recently. Despite its potential effects on cognition and behaviour, and its possible impact on the diagnosis and severity of dementia, it has not been investigated. This study aimed to evaluate the prevalence of HC and its influence on cognition and behavioural symptoms in patients with dementia.
海马钙化(HC)在老年人中非常普遍,直到最近才引起人们的注意。尽管它对认知和行为有潜在影响,也可能对痴呆症的诊断和严重程度产生影响,但尚未对其进行研究。本研究旨在评估HC的患病率及其对痴呆患者认知和行为症状的影响。
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引用次数: 0
Clinical utility of an assessment scale for engagement in activities for patients with moderate‐to‐severe dementia: additional analysis 中重度痴呆患者参与活动评估量表的临床实用性:附加分析
IF 2 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2022-04-17 DOI: 10.1111/psyg.12835
Hiroyuki Tanaka, R. Umeda, Tatsunari Kurogi, Yuma Nagata, Daiki Ishimaru, Keita Fukuhara, Shunsuke Nakai, Masahiro Tenjin, Takashi Nishikawa
We developed the assessment scale for engagement in activities (ASEA), an assessment tool used to quantify engagement in therapeutic activities for patients with moderate‐to‐severe dementia. In this study, we report additional analyses to confirm the viability of ASEA as a reliable measurement scale.
我们开发了活动参与度评估量表(ASEA),这是一种评估工具,用于量化中重度痴呆患者在治疗活动中的参与度。在这项研究中,我们报告了额外的分析来证实ASEA作为一个可靠的测量量表的可行性。
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引用次数: 0
Experiences of families of people living with frontotemporal dementia: a qualitative systematic review 额颞叶痴呆患者家庭的经验:一项定性的系统回顾
IF 2 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2022-04-16 DOI: 10.1111/psyg.12837
Tamami Shiba, M. Yamakawa, Y. Endo, R. Konno, S. Tanimukai
Frontotemporal dementia (FTD) is characterised by atrophy of the frontal and/or temporal lobes. People with FTD show language and emotional disturbances from onset, and communication problems usually affect people with FTD and their families even before diagnosis. These unique characteristics of FTD are not well understood and create substantial problems for people living with FTD and their families. This review explores the experiences of families of people living with FTD. Studies were selected and screened according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. We searched four bibliographic databases for articles up to February 2021 to identify qualitative data on the experiences of families. The Critical Appraisal Skills Programme checklist for qualitative studies was used to assess all included studies. Of 235 identified articles, we included six studies in the qualitative synthesis. Meta‐ethnography was conducted to interpret families' experiences of people living with FTD. The emergent concepts were synthesised into five themes: Something is wrong with my loved one; No one fully understands; Existential pain of caring for a loved one with FTD; Increased burden owing to specific FTD symptoms; and Forced to adapt to new and unique ways of living with a loved one with FTD. This review highlighted families' confusion and suffering (which began in the early stages of the disease, and sometimes before diagnosis) and the difficulty of communicating with people with FTD. These findings have implications for future practice, as they demonstrate the positive effect on family life of appropriate support that is provided early, rather than after the disease has progressed.
额颞叶痴呆(FTD)的特征是额叶和/或颞叶萎缩。患有FTD的人从一开始就表现出语言和情绪障碍,沟通问题通常在诊断之前就已经影响到FTD患者及其家人。人们对FTD的这些独特特征并没有很好地了解,这给FTD患者及其家人带来了很大的问题。这篇综述探讨了FTD患者家庭的经历。根据系统评价和Meta分析指南的首选报告项目选择和筛选研究。我们在四个书目数据库中检索了截至2021年2月的文章,以确定有关家庭经历的定性数据。定性研究的关键评估技能程序检查表用于评估所有纳入的研究。在235篇鉴定的文章中,我们纳入了6篇定性综合研究。Meta -人种志用于解释FTD患者的家庭经历。这些涌现的概念被合成为五个主题:我爱的人出了问题;没有人完全明白;照顾患有FTD的亲人的存在性痛苦;由于特定的FTD症状加重了负担;被迫适应新的独特的生活方式,与患有FTD的爱人一起生活。这篇综述强调了家庭的困惑和痛苦(这始于疾病的早期阶段,有时在诊断之前)以及与FTD患者沟通的困难。这些发现对未来的实践具有启示意义,因为它们证明了早期提供适当支持对家庭生活的积极影响,而不是在疾病进展之后。
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引用次数: 6
Evaluation of frailty, abuse and depression among community‐dwelling older adults in a nortwest city of Turkey 土耳其西北部城市社区老年人虚弱、虐待和抑郁的评估
IF 2 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2022-04-16 DOI: 10.1111/psyg.12832
Turkan Akyol Guner
This study aimed to evaluate the frailty, abuse, and depression experienced by community‐dwelling older adults and to raise awareness in society about the abuse of the elderly.
本研究旨在评估居住在社区的老年人所经历的虚弱、虐待和抑郁,并提高社会对虐待老年人的认识。
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引用次数: 3
Loneliness and Depression among Community Older Adults during the COVID‐19 Pandemic: A cross‐sectional study COVID - 19大流行期间社区老年人的孤独和抑郁:一项横断面研究
IF 2 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2022-04-08 DOI: 10.1111/psyg.12833
Lana Alhalaseh, Farah Kasasbeh, Mariam Al-Bayati, Lubna Haikal, Kinan Obeidat, Abdallah Abuleil, I. Wilkinson
Social isolation has been recommended for reducing older adults' mortality and severe cases of COVID illness. That has resulted in unavoidable consequences of mental ill‐health. This study aimed to examine the impact of the COVID‐19 lockdown on the development of loneliness and depression and to analyse the factors associated with these conditions among community‐dwelling older adults in Jordan.
建议进行社会隔离,以降低老年人的死亡率和新冠肺炎重症病例。这导致了不可避免的精神疾病后果。本研究旨在研究2019冠状病毒病封锁对约旦社区老年人孤独和抑郁发展的影响,并分析与这些情况相关的因素。
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引用次数: 10
Limbic‐predominant age‐related TDP‐43 encephalopathy characterised by frontotemporal dementia‐like behavioural symptoms 以额颞叶痴呆样行为症状为特征的边缘-显性年龄相关TDP - 43脑病
IF 2 4区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2022-04-01 DOI: 10.1111/psyg.12828
R. Kobayashi, S. Kawakatsu, D. Morioka, Hiroshi Hayashi, Aya Utsunomiya, T. Kabasawa, K. Otani
Ryota KOBAYASHI , Shinobu KAWAKATSU, Daichi MORIOKA, Hiroshi HAYASHI , Aya UTSUNOMIYA, Takanobu KABASAWA and Koichi OTANI Department of Psychiatry and Pathological Diagnostics, Yamagata University School of Medicine, Yamagata, Department of Neuropsychiatry, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu and Department of Occupational Therapy, Fukushima Medical University School of Health Sciences, Fukushima, Japan Correspondence: Ryota Kobayashi, MD, PhD, Department of Psychiatry, Yamagata University School of Medicine, 2-2-2 Iidanishi, Yamagata 990-9585, Japan. Email: ryo.kobayashi@med.id.yamagata-u.ac.jp Disclosure: All authors declare no conflicts of interest for this article.
小林良太、川胜信、盛冈大一、林浩、宇都宫雅、KABASAWA隆信、大谷光一山形大学医学院精神病学与病理诊疗室山形,福岛医科大学会津医学中心神经精神病学室井若松和福岛医科大学健康科学学院职业治疗室,日本福岛ryyota Kobayashi,医学博士,山形大学医学院精神科,2-2-2 Iidanishi,山形990-9585电子邮件:ryo.kobayashi@med.id.yamagata-u.ac.jp披露:所有作者声明本文无利益冲突。
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引用次数: 3
期刊
Psychogeriatrics
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