Pub Date : 2021-12-07eCollection Date: 2021-09-01DOI: 10.1159/000520248
Ingeborg Halse, Guro Hanevold Bjørkløf, Knut Engedal, Geir Selbæk, Maria Lage Barca
Introduction: Knowledge of how perceptions of personal control change over time may provide valuable insights into how people cope with having dementia. The present study aimed to examine change in locus of control over a 12-month period in persons with dementia.
Method: The study included 52 participants with dementia. Locus of control was measured with the Locus of Control of Behavior Scale (LoCB), with higher scores indicating a more external locus of control, interpreted as perceiving less personal control. A ≥5% change on the LoCB was considered clinically meaningful. We recorded sociodemographic characteristics and assessed dementia severity, cognition, ability to function independently in daily activities and physical self-maintenance, depressive symptomatology, and number of prescribed medications. Analyses were performed to examine differences between those with increases (more external) or decreases (less external) in the LoCB score after 12 months and to examine associations between baseline variables and change in the LoCB score.
Results: The mean LoCB score for the total sample did not change after 12 months (baseline mean 29.33 vs. follow-up mean 30.33, p = 0.553); however, 2 subgroups emerged. Using the ≥5% cutoff revealed that the LoCB score changed for 92.3% of the sample, becoming less external (lower LoCB) for 21 participants and more external (higher LoCB) for 27 participants. At baseline, the mean LoBC score was higher in the group that became less external (33.81 vs. 24.56), p = 0.006, while this was reverse at follow-up (23.57 vs. 34.41), p = 0.001. Dementia severity and dependence in physical self-maintenance increased during the 12 months in both groups. Among those becoming more external, we also found a decline in cognition (p = 0.002), an increase in dependence in daily activities (p = 0.003), an increase in the use of prescribed medication, and a decrease in depressive symptomatology (p = 0.003). The baseline LoCB score was the only variable associated with 12-month change in LoCB scores (p = 0.001).
Conclusion: Most participants showed a clinically meaningful change in locus of control after 12 months. Those with more signs of dementia progression reported a decrease in personal control but also a decrease in depressive symptoms. These findings are interesting for our understanding of coping but must be replicated with a larger sample.
{"title":"One-Year Change in Locus of Control among People with Dementia.","authors":"Ingeborg Halse, Guro Hanevold Bjørkløf, Knut Engedal, Geir Selbæk, Maria Lage Barca","doi":"10.1159/000520248","DOIUrl":"10.1159/000520248","url":null,"abstract":"<p><strong>Introduction: </strong>Knowledge of how perceptions of personal control change over time may provide valuable insights into how people cope with having dementia. The present study aimed to examine change in locus of control over a 12-month period in persons with dementia.</p><p><strong>Method: </strong>The study included 52 participants with dementia. Locus of control was measured with the Locus of Control of Behavior Scale (LoCB), with higher scores indicating a more external locus of control, interpreted as perceiving less personal control. A ≥5% change on the LoCB was considered clinically meaningful. We recorded sociodemographic characteristics and assessed dementia severity, cognition, ability to function independently in daily activities and physical self-maintenance, depressive symptomatology, and number of prescribed medications. Analyses were performed to examine differences between those with increases (more external) or decreases (less external) in the LoCB score after 12 months and to examine associations between baseline variables and change in the LoCB score.</p><p><strong>Results: </strong>The mean LoCB score for the total sample did not change after 12 months (baseline mean 29.33 vs. follow-up mean 30.33, <i>p</i> = 0.553); however, 2 subgroups emerged. Using the ≥5% cutoff revealed that the LoCB score changed for 92.3% of the sample, becoming less external (lower LoCB) for 21 participants and more external (higher LoCB) for 27 participants. At baseline, the mean LoBC score was higher in the group that became less external (33.81 vs. 24.56), <i>p</i> = 0.006, while this was reverse at follow-up (23.57 vs. 34.41), <i>p</i> = 0.001. Dementia severity and dependence in physical self-maintenance increased during the 12 months in both groups. Among those becoming more external, we also found a decline in cognition (<i>p</i> = 0.002), an increase in dependence in daily activities (<i>p</i> = 0.003), an increase in the use of prescribed medication, and a decrease in depressive symptomatology (<i>p</i> = 0.003). The baseline LoCB score was the only variable associated with 12-month change in LoCB scores (<i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>Most participants showed a clinically meaningful change in locus of control after 12 months. Those with more signs of dementia progression reported a decrease in personal control but also a decrease in depressive symptoms. These findings are interesting for our understanding of coping but must be replicated with a larger sample.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"11 3","pages":"298-305"},"PeriodicalIF":2.3,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ab/de/dee-0011-0298.PMC8739984.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39963916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-02eCollection Date: 2021-09-01DOI: 10.1159/000519915
Becky Siu Yin Li, Carmen Wing Han Chan, Minjie Li, Irene Kit Yee Wong, Yvonne Hoi Un Yu
Introduction: Behavioral and psychological symptoms of dementia (BPSD) is the most prominent and distressing manifestation for older persons with dementia (PWD) and caregivers. Aromatherapy has demonstrated its effectiveness in managing BPSD in various studies. However, previous studies and systematic reviews have obtained inconsistent findings, and a review of qualitative studies is yet to be conducted.
Method: A mixed-methods systematic review with a convergent segregated approach was performed to evaluate the effectiveness of aromatherapy in improving the BPSD and quality of life (QoL) of PWD and in relieving the distress and burden of caregivers, as well as its safety for PWD. Both published and unpublished quantitative and qualitative studies written in English and Chinese between January 1996 and December 2020 were retrieved from 28 databases, including MEDLINE, EMBASE, and Web of Science, based on the prespecified criteria. The methodological quality was assessed by using critical appraisal tools from the Joanna Briggs Institute. Quantitative synthesis, qualitative synthesis, and integration of quantitative and qualitative evidence were performed.
Results: A total of 12 randomized controlled trials, 10 quasi-experimental studies, and 2 qualitative studies were included in the review. Some inconsistent findings regarding the effectiveness of aromatherapy in reducing the severity of BPSD were observed. Some studies reported that aromatherapy significantly improved the QoL of PWD and relieved the distress and burden of caregivers, promoted a positive experience among caregivers, and had very low adverse effects on PWD (with aromatherapy inhalation reporting no adverse effects).
Conclusion: Aromatherapy, especially in the inhalation approach, could be a potentially safe and effective strategy for managing BPSD. However, more structuralized and comparable studies with sufficient sample size, adherence monitoring, and sound theoretical basis could be conducted to obtain conclusive findings.
引言:痴呆症(BPSD)的行为和心理症状是老年痴呆症(PWD)患者和护理人员最突出和最痛苦的表现。芳香疗法已在各种研究中证明其在管理BPSD方面的有效性。然而,先前的研究和系统综述获得了不一致的结果,定性研究的综述尚待进行。方法:采用融合-分离的混合方法进行系统评价,以评估芳香疗法在改善PWD的BPSD和生活质量(QoL)、减轻护理人员的痛苦和负担方面的有效性及其对PWD的安全性。根据预先指定的标准,从MEDLINE、EMBASE和Web of Science等28个数据库中检索1996年1月至2020年12月期间已发表和未发表的中英文定量和定性研究。方法学质量是通过使用乔安娜·布里格斯研究所的关键评估工具进行评估的。进行了定量合成、定性合成以及定量和定性证据的整合。结果:共纳入12项随机对照试验、10项准实验研究和2项定性研究。关于芳香疗法在降低BPSD严重程度方面的有效性,观察到了一些不一致的发现。一些研究报告称,芳香疗法显著改善了PWD的生活质量,减轻了照顾者的痛苦和负担,促进了照顾者之间的积极体验,并且对PWD的不良反应非常低(吸入芳香疗法报告没有不良反应),这可能是一种潜在的安全有效的BPSD管理策略。然而,可以进行更结构化和可比较的研究,具有足够的样本量、依从性监测和完善的理论基础,以获得结论性的发现。
{"title":"Effectiveness and Safety of Aromatherapy in Managing Behavioral and Psychological Symptoms of Dementia: A Mixed-Methods Systematic Review.","authors":"Becky Siu Yin Li, Carmen Wing Han Chan, Minjie Li, Irene Kit Yee Wong, Yvonne Hoi Un Yu","doi":"10.1159/000519915","DOIUrl":"10.1159/000519915","url":null,"abstract":"<p><strong>Introduction: </strong>Behavioral and psychological symptoms of dementia (BPSD) is the most prominent and distressing manifestation for older persons with dementia (PWD) and caregivers. Aromatherapy has demonstrated its effectiveness in managing BPSD in various studies. However, previous studies and systematic reviews have obtained inconsistent findings, and a review of qualitative studies is yet to be conducted.</p><p><strong>Method: </strong>A mixed-methods systematic review with a convergent segregated approach was performed to evaluate the effectiveness of aromatherapy in improving the BPSD and quality of life (QoL) of PWD and in relieving the distress and burden of caregivers, as well as its safety for PWD. Both published and unpublished quantitative and qualitative studies written in English and Chinese between January 1996 and December 2020 were retrieved from 28 databases, including MEDLINE, EMBASE, and Web of Science, based on the prespecified criteria. The methodological quality was assessed by using critical appraisal tools from the Joanna Briggs Institute. Quantitative synthesis, qualitative synthesis, and integration of quantitative and qualitative evidence were performed.</p><p><strong>Results: </strong>A total of 12 randomized controlled trials, 10 quasi-experimental studies, and 2 qualitative studies were included in the review. Some inconsistent findings regarding the effectiveness of aromatherapy in reducing the severity of BPSD were observed. Some studies reported that aromatherapy significantly improved the QoL of PWD and relieved the distress and burden of caregivers, promoted a positive experience among caregivers, and had very low adverse effects on PWD (with aromatherapy inhalation reporting no adverse effects).</p><p><strong>Conclusion: </strong>Aromatherapy, especially in the inhalation approach, could be a potentially safe and effective strategy for managing BPSD. However, more structuralized and comparable studies with sufficient sample size, adherence monitoring, and sound theoretical basis could be conducted to obtain conclusive findings.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"11 3","pages":"273-297"},"PeriodicalIF":2.3,"publicationDate":"2021-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/76/34/dee-0011-0273.PMC8739377.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39963914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/aims: The behavioral and psychological symptoms of dementia (BPSD) detract from the quality of life of not only dementia patients but also their family members and caregivers. Donepezil is used to treat Alzheimer's disease and is metabolized via cytochrome P450 (CYP) 2D6 and CYP3A4/5. It is controversial whether donepezil improves or exacerbates BPSD. This study investigated the relationships among BPSD, the pharmacokinetics of donepezil including its metabolite, 6-O-desmethyl donepezil, genetic polymorphisms of CYPs and P-glycoprotein, and patient backgrounds in 52 patients with Alzheimer's disease.
Methods: BPSD were assessed using the Neuropsychiatric Inventory (NPI), with scores ≥20 points defined as severe BPSD. Plasma donepezil and 6-O-desmethyl donepezil concentrations were measured using liquid chromatography-tandem mass spectrometry.
Results: Although significant relationships between NPI scores and plasma donepezil concentrations were not seen, none of the 15 patients (29%) with high plasma donepezil concentrations (≥60 ng/mL) developed severe BPSD. Polymorphisms of CYP2D6, CYP3A5, and ABCB1 did not influence NPI scores. There were no significant relationships between NPI and patient background factors such as dosing regimen, concomitant use of other drugs, or laboratory test results. Two patients who underwent multiple blood samplings over 2 years showed an inverse correlation between plasma donepezil concentrations and NPI scores.
Discussion/conclusions: These results indicate that higher plasma concentrations of donepezil contribute to preventing or alleviating rather than developing or deteriorating BPSD.
背景/目的:痴呆症(BPSD)的行为和心理症状不仅影响痴呆症患者的生活质量,而且影响其家庭成员和照顾者的生活质量。多奈哌齐用于治疗阿尔茨海默病,通过细胞色素P450 (CYP) 2D6和CYP3A4/5代谢。多奈哌齐是改善还是加重BPSD仍有争议。本研究对52例阿尔茨海默病患者的BPSD、多奈哌齐及其代谢物6- o -去甲基多奈哌齐的药代动力学、CYPs和p -糖蛋白遗传多态性以及患者背景进行了研究。方法:采用神经精神量表(NPI)对BPSD进行评估,评分≥20分定义为重度BPSD。采用液相色谱-串联质谱法测定血浆多奈哌齐和6- o -去甲基多奈哌齐浓度。结果:虽然NPI评分与血浆多奈哌齐浓度之间没有明显的关系,但15例血浆多奈哌齐浓度高(≥60 ng/mL)的患者(29%)中没有发生严重的BPSD。CYP2D6、CYP3A5和ABCB1的多态性对NPI评分没有影响。NPI与患者背景因素(如给药方案、同时使用其他药物或实验室检查结果)之间没有显著关系。2例患者在2年内多次采血,血浆多奈哌齐浓度与NPI评分呈负相关。讨论/结论:这些结果表明,较高血浆浓度的多奈哌齐有助于预防或减轻BPSD,而不是发展或恶化BPSD。
{"title":"Impact of Plasma Donepezil Concentration on Behavioral and Psychological Symptoms of Dementia in Patients with Alzheimer's Disease.","authors":"Yoshiyuki Kagawa, Yoshiaki Yamamoto, Ayami Ueno, Kengo Inomata, Mayu Tezuka, Takashi Osawa, Yasuharu Yazawa, Toshio Maeda, Tomokazu Obi","doi":"10.1159/000516938","DOIUrl":"https://doi.org/10.1159/000516938","url":null,"abstract":"<p><strong>Background/aims: </strong>The behavioral and psychological symptoms of dementia (BPSD) detract from the quality of life of not only dementia patients but also their family members and caregivers. Donepezil is used to treat Alzheimer's disease and is metabolized via cytochrome P450 (CYP) 2D6 and CYP3A4/5. It is controversial whether donepezil improves or exacerbates BPSD. This study investigated the relationships among BPSD, the pharmacokinetics of donepezil including its metabolite, 6-O-desmethyl donepezil, genetic polymorphisms of CYPs and P-glycoprotein, and patient backgrounds in 52 patients with Alzheimer's disease.</p><p><strong>Methods: </strong>BPSD were assessed using the Neuropsychiatric Inventory (NPI), with scores ≥20 points defined as severe BPSD. Plasma donepezil and 6-O-desmethyl donepezil concentrations were measured using liquid chromatography-tandem mass spectrometry.</p><p><strong>Results: </strong>Although significant relationships between NPI scores and plasma donepezil concentrations were not seen, none of the 15 patients (29%) with high plasma donepezil concentrations (≥60 ng/mL) developed severe BPSD. Polymorphisms of <i>CYP2D6</i>, <i>CYP3A5</i>, and <i>ABCB1</i> did not influence NPI scores. There were no significant relationships between NPI and patient background factors such as dosing regimen, concomitant use of other drugs, or laboratory test results. Two patients who underwent multiple blood samplings over 2 years showed an inverse correlation between plasma donepezil concentrations and NPI scores.</p><p><strong>Discussion/conclusions: </strong>These results indicate that higher plasma concentrations of donepezil contribute to preventing or alleviating rather than developing or deteriorating BPSD.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"11 3","pages":"264-272"},"PeriodicalIF":2.3,"publicationDate":"2021-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8a/8f/dee-0011-0264.PMC8739384.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39963915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-18eCollection Date: 2021-09-01DOI: 10.1159/000519513
Nanako Yamane, Kanto Tsukagoshi, Miharu Hisada, Mina Yamaguchi, Yukiko Suzuki
Aim: The aim of this study was to investigate the level of dementia knowledge and behaviors recognized as dementia-preventive and the practice thereof among healthy older adults who are highly motivated to engage in activities.
Methods: The participants were older adults registered at the Silver Human Resource Center of city A, and participants anonymously filled questionnaires through the aggregation method in January 2020.
Results: The analysis included 78 participants (the effective response rate was 49.7%). All participants were aware of at least 4 dementia-preventive behaviors, and about 80% of all participants practiced at least 1 preventive behavior. Approximately 20% of participants were not practicing preventive behaviors at all. The elderly aged 65 to 74 years had more knowledge about dementia and more types of behavior perceived as dementia-preventive than the elderly aged 75 years and older. There was no significant correlation between the level of dementia knowledge and the number of types of dementia-preventive behaviors.
Conclusions: Healthy older adults were aware of numerous behaviors for dementia prevention, and most older adults practiced preventive behaviors. In contrast, even with a high amount of knowledge about dementia, a small number of healthy older adults did not translate this knowledge into preventative behavioral practices. High levels of dementia knowledge do not translate into preventive behavioral practices.
{"title":"A Survey of Dementia Knowledge and Recognition of Dementia Prevention and Practice in Healthy Older Adults.","authors":"Nanako Yamane, Kanto Tsukagoshi, Miharu Hisada, Mina Yamaguchi, Yukiko Suzuki","doi":"10.1159/000519513","DOIUrl":"https://doi.org/10.1159/000519513","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to investigate the level of dementia knowledge and behaviors recognized as dementia-preventive and the practice thereof among healthy older adults who are highly motivated to engage in activities.</p><p><strong>Methods: </strong>The participants were older adults registered at the Silver Human Resource Center of city A, and participants anonymously filled questionnaires through the aggregation method in January 2020.</p><p><strong>Results: </strong>The analysis included 78 participants (the effective response rate was 49.7%). All participants were aware of at least 4 dementia-preventive behaviors, and about 80% of all participants practiced at least 1 preventive behavior. Approximately 20% of participants were not practicing preventive behaviors at all. The elderly aged 65 to 74 years had more knowledge about dementia and more types of behavior perceived as dementia-preventive than the elderly aged 75 years and older. There was no significant correlation between the level of dementia knowledge and the number of types of dementia-preventive behaviors.</p><p><strong>Conclusions: </strong>Healthy older adults were aware of numerous behaviors for dementia prevention, and most older adults practiced preventive behaviors. In contrast, even with a high amount of knowledge about dementia, a small number of healthy older adults did not translate this knowledge into preventative behavioral practices. High levels of dementia knowledge do not translate into preventive behavioral practices.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"11 3","pages":"256-263"},"PeriodicalIF":2.3,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/63/26/dee-0011-0256.PMC8739939.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39963913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/aims: The aims of this study were to identify the degree of atrophy of the hippocampus in image findings and which cognitive function items should be focused on when treating mild cognitive impairment.
Methods: A total of 66 cases with mild cognitive impairment were included in the study over a 1.5-year observation period. MR images were used to assess hippocampal atrophy, and cognitive function was assessed by the ADASJcog test.
Results: In the mild dementia group, there was a hierarchical difference in the 4 cognitive impairments in which each degree was significantly higher hierarchically. In the normally improved group, memory and act dysfunction was significantly improved, and in deteriorated cases, memory, orientation, and act dysfunction increased significantly. The normally improved group tended to have lighter hippocampal atrophy than the deteriorating group.
Discussion: In early treatment of mild cognitive impairment, it is important to focus on which cognitive items to treat, but there are no reports that present them numerically. Because it is not clear, there may be a risk that dementia may progress due to stunned treatment. It became clear that it was meaningful to show it, and it was the orientation and act function.
Conclusion: It was suggested that hippocampal atrophy should be kept within the normal range and that the key treatment was mainly to improve memory and act dysfunction without reducing orientation function.
{"title":"What Are the Key Points of Treatment for Cases of Mild Cognitive Impairment? Based on the Evaluation of Cognitive Function Tasks in the ADASJcog.","authors":"Yoshihiko Yoshii, Akiko Takahashi, Miyuki Ishizawa","doi":"10.1159/000519765","DOIUrl":"https://doi.org/10.1159/000519765","url":null,"abstract":"<p><strong>Background/aims: </strong>The aims of this study were to identify the degree of atrophy of the hippocampus in image findings and which cognitive function items should be focused on when treating mild cognitive impairment.</p><p><strong>Methods: </strong>A total of 66 cases with mild cognitive impairment were included in the study over a 1.5-year observation period. MR images were used to assess hippocampal atrophy, and cognitive function was assessed by the ADASJcog test.</p><p><strong>Results: </strong>In the mild dementia group, there was a hierarchical difference in the 4 cognitive impairments in which each degree was significantly higher hierarchically. In the normally improved group, memory and act dysfunction was significantly improved, and in deteriorated cases, memory, orientation, and act dysfunction increased significantly. The normally improved group tended to have lighter hippocampal atrophy than the deteriorating group.</p><p><strong>Discussion: </strong>In early treatment of mild cognitive impairment, it is important to focus on which cognitive items to treat, but there are no reports that present them numerically. Because it is not clear, there may be a risk that dementia may progress due to stunned treatment. It became clear that it was meaningful to show it, and it was the orientation and act function.</p><p><strong>Conclusion: </strong>It was suggested that hippocampal atrophy should be kept within the normal range and that the key treatment was mainly to improve memory and act dysfunction without reducing orientation function.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"11 3","pages":"250-255"},"PeriodicalIF":2.3,"publicationDate":"2021-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/38/1b/dee-0011-0250.PMC8739624.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39963912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-23eCollection Date: 2021-09-01DOI: 10.1159/000518233
Jaime D Mondragón, Ramesh Marapin, Peter Paul De Deyn, Natasha Maurits
Introduction: Progression of amnestic mild cognitive impairment (aMCI) to Alzheimer's disease (AD) is a clinical event with highly variable progression rates varying from 10-15% up to 30-34%. Functional connectivity (FC), the temporal similarity between spatially remote neurophysiological events, has previously been reported to differ between aMCI patients who progress to AD (pMCI) and those who do not (i.e., remain stable; sMCI). However, these reports had a short-term follow-up and do not provide insight into long-term AD progression.
Methods: Seventy-nine participants with a baseline and 78 with a 12-month, 51 with a 24-month, and 22 with a +48-month follow-up resting-state fMRI with aMCI diagnosis from the Alzheimer's Disease Neuroimaging Initiative database were included. FC was assessed using the CONN toolbox. Local correlation and group independent component analysis were utilized to compare regional functional coupling and between-network FC, respectively, between sMCI and pMCI groups. Two-sample t tests were used to test for statistically significant differences between groups, and paired t-tests were used to assess cognitive changes over time.
Results: All participants (i.e., 66 sMCI and 19 pMCI) had a baseline and a year follow-up fMRI scan. Progression from aMCI to AD occurred in 19 patients (10 at 12 months, 5 at 24 months, and 4 at >48 months), while 73 MCI patients remained cognitively stable (sMCI). The pMCI and sMCI cognitive profiles were different. More between-network FC than regional functional coupling differences were present between sMCI and pMCI patients. Activation in the salience network (SN) and the default mode network (DMN) was consistently different between sMCI and pMCI patients across time.
Discussion: sMCI and pMCI patients have different cognitive and FC profiles. Only pMCI patients showed cognitive differences across time. The DMN and SN showed local correlation and between-network FC differences between the sMCI and pMCI patient groups at multiple moments in time.
{"title":"Short- and Long-Term Functional Connectivity Differences Associated with Alzheimer's Disease Progression.","authors":"Jaime D Mondragón, Ramesh Marapin, Peter Paul De Deyn, Natasha Maurits","doi":"10.1159/000518233","DOIUrl":"https://doi.org/10.1159/000518233","url":null,"abstract":"<p><strong>Introduction: </strong>Progression of amnestic mild cognitive impairment (aMCI) to Alzheimer's disease (AD) is a clinical event with highly variable progression rates varying from 10-15% up to 30-34%. Functional connectivity (FC), the temporal similarity between spatially remote neurophysiological events, has previously been reported to differ between aMCI patients who progress to AD (pMCI) and those who do not (i.e., remain stable; sMCI). However, these reports had a short-term follow-up and do not provide insight into long-term AD progression.</p><p><strong>Methods: </strong>Seventy-nine participants with a baseline and 78 with a 12-month, 51 with a 24-month, and 22 with a +48-month follow-up resting-state fMRI with aMCI diagnosis from the Alzheimer's Disease Neuroimaging Initiative database were included. FC was assessed using the CONN toolbox. Local correlation and group independent component analysis were utilized to compare regional functional coupling and between-network FC, respectively, between sMCI and pMCI groups. Two-sample <i>t</i> tests were used to test for statistically significant differences between groups, and paired <i>t</i>-tests were used to assess cognitive changes over time.</p><p><strong>Results: </strong>All participants (i.e., 66 sMCI and 19 pMCI) had a baseline and a year follow-up fMRI scan. Progression from aMCI to AD occurred in 19 patients (10 at 12 months, 5 at 24 months, and 4 at >48 months), while 73 MCI patients remained cognitively stable (sMCI). The pMCI and sMCI cognitive profiles were different. More between-network FC than regional functional coupling differences were present between sMCI and pMCI patients. Activation in the salience network (SN) and the default mode network (DMN) was consistently different between sMCI and pMCI patients across time.</p><p><strong>Discussion: </strong>sMCI and pMCI patients have different cognitive and FC profiles. Only pMCI patients showed cognitive differences across time. The DMN and SN showed local correlation and between-network FC differences between the sMCI and pMCI patient groups at multiple moments in time.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"11 3","pages":"235-249"},"PeriodicalIF":2.3,"publicationDate":"2021-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/8c/dee-0011-0235.PMC8543355.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39579424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-17eCollection Date: 2021-09-01DOI: 10.1159/000518234
Hediyeh Baradaran, Alen Delic, J Scott McNally, Matthew Alexander, Jennifer J Majersik, Dennis L Parker, Adam de Havenon
Introduction: We evaluated the association between carotid compliance, a measure of arterial stiffness, to parahippocampal volume (PHV) and hippocampal volume (HV) over 20 years later in the Atherosclerosis Risk in the Community study.
Methods: We included participants with common carotid compliance measurements at visit 1 (1987-1989) and volumetric brain MRI at visit 5 (2011-2013). The primary outcomes are pooled bilateral PHV and HV. We performed linear regression models adjusting for age, sex, vascular risk factors, and total brain volume.
Results: Of the 614 participants, higher compliance was correlated with higher PHV (R = 0.218[0.144-0.291], p < 0.001) and HV (R = 0.181 [0.105-0.255, p < 0.001]). The association was linear and significant after adjusting for confounders. At follow-up MRI, 30 patients with dementia had lower PHV and HV than patients without dementia (p < 0.001 and p < 0.001, respectively).
Conclusion: Carotid compliance is associated with higher PHV and HV when measured 20 years later, further supporting the link between arterial stiffness and cognitive decline.
简介我们在《社区动脉粥样硬化风险研究》(Atherosclerosis Risk in the Community)中评估了衡量动脉僵化程度的颈动脉顺应性与 20 年后海马旁体积(PHV)和海马体积(HV)之间的关系:我们纳入了在第 1 次就诊(1987-1989 年)时测量过颈总动脉顺应性、在第 5 次就诊(2011-2013 年)时进行过脑核磁共振成像测量的参与者。主要结果是双侧 PHV 和 HV 的汇总结果。我们建立了线性回归模型,对年龄、性别、血管风险因素和脑总容量进行了调整:在 614 名参与者中,较高的顺应性与较高的 PHV(R = 0.218[0.144-0.291], p < 0.001)和 HV(R = 0.181[0.105-0.255, p < 0.001])相关。在对混杂因素进行调整后,两者之间的关系呈线性且显著。在随访磁共振成像时,30 名痴呆症患者的 PHV 和 HV 低于非痴呆症患者(分别为 p < 0.001 和 p < 0.001):结论:20年后测量颈动脉顺应性与较高的PHV和HV相关,进一步证实了动脉僵化与认知能力下降之间的联系。
{"title":"Carotid Compliance and Parahippocampal and Hippocampal Volume over a 20-Year Period.","authors":"Hediyeh Baradaran, Alen Delic, J Scott McNally, Matthew Alexander, Jennifer J Majersik, Dennis L Parker, Adam de Havenon","doi":"10.1159/000518234","DOIUrl":"10.1159/000518234","url":null,"abstract":"<p><strong>Introduction: </strong>We evaluated the association between carotid compliance, a measure of arterial stiffness, to parahippocampal volume (PHV) and hippocampal volume (HV) over 20 years later in the Atherosclerosis Risk in the Community study.</p><p><strong>Methods: </strong>We included participants with common carotid compliance measurements at visit 1 (1987-1989) and volumetric brain MRI at visit 5 (2011-2013). The primary outcomes are pooled bilateral PHV and HV. We performed linear regression models adjusting for age, sex, vascular risk factors, and total brain volume.</p><p><strong>Results: </strong>Of the 614 participants, higher compliance was correlated with higher PHV (<i>R</i> = 0.218[0.144-0.291], <i>p</i> < 0.001) and HV (<i>R</i> = 0.181 [0.105-0.255, <i>p</i> < 0.001]). The association was linear and significant after adjusting for confounders. At follow-up MRI, 30 patients with dementia had lower PHV and HV than patients without dementia (<i>p</i> < 0.001 and <i>p</i> < 0.001, respectively).</p><p><strong>Conclusion: </strong>Carotid compliance is associated with higher PHV and HV when measured 20 years later, further supporting the link between arterial stiffness and cognitive decline.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"11 3","pages":"227-234"},"PeriodicalIF":1.4,"publicationDate":"2021-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a4/e4/dee-0011-0227.PMC8543351.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39579422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Most behavioral and psychological symptoms of dementia (BPSD) scales have copyright issues and are difficult for care staff to use in daily care settings because they were primarily designed for physicians. Therefore, an easier tool for care staff is required. This study aimed to develop and validate the BPSD questionnaire 13-item version (BPSD13Q).
Methods: We obtained data from 444 people with dementia living in group homes in Japan using the BPSD plus questionnaire (BPSD + Q; 27-item version) and Neuropsychiatric Inventory Nursing Home version (NPI-NH). We selected appropriate items to make a short-form version of the BPSD + Q and examined the construct validity, internal consistency, and criterion-related validity of the questionnaire.
Results: By the pilot review, research on correlations with similar items from comparable scales, and factor analysis, we reduced 27 items to 13 items (BPSD13Q). The BPSD13Q and BPSD13Q-distress (BPSD13Q-D) showed good internal consistency (Cronbach's α = 0.76 and 0.80, respectively). Moreover, the BPSD13Q was positively correlated with the NPI-NH (r = 0.72, p < 0.001) and BPSD + Q (r = 0.95, p < 0.001). The BPSD13Q-D was positively correlated with the NPI-NH-caregiver distress (r = 0.74, p < 0.001) and BPSD + Q-distress (r = 0.96, p < 0.001).
Conclusion: We developed and validated the BPSD13Q, which is a short-form version of the BPSD + Q and is downloadable. The BPSD13Q may make BPSD evaluations easier for the care staff.
大多数痴呆行为和心理症状(BPSD)量表都有版权问题,护理人员难以在日常护理环境中使用,因为它们主要是为医生设计的。因此,需要为护理人员提供一种更简单的工具。本研究旨在编制并验证BPSD问卷13项版本(BPSD13Q)。方法:采用BPSD + Q问卷(BPSD + Q;27项版本)和神经精神量表养老院版本(NPI-NH)。我们选择合适的项目制作了简短版的BPSD + Q,并对问卷的结构效度、内部一致性和标准相关效度进行了检验。结果:通过试点审查、与可比量表相似条目的相关性研究和因子分析,我们将27个条目减少到13个(BPSD13Q)。BPSD13Q和BPSD13Q-distress (BPSD13Q- d)具有良好的内部一致性(Cronbach’s α分别为0.76和0.80)。BPSD13Q与NPI-NH呈正相关(r = 0.72, p < 0.001),与BPSD + Q呈正相关(r = 0.95, p < 0.001)。BPSD13Q-D与npi - nh -照顾者痛苦(r = 0.74, p < 0.001)、BPSD + q -痛苦(r = 0.96, p < 0.001)呈正相关。结论:我们开发并验证了BPSD13Q,这是BPSD + Q的简化版本,可以下载。BPSD13Q可以使护理人员更容易评估BPSD。
{"title":"Development and Evaluation of the Behavioral and Psychological Symptoms of Dementia Questionnaire 13-Item Version (BPSD13Q).","authors":"Taiga Fuju, Tetsuya Yamagami, Mio Ito, Noriko Naito, Haruyasu Yamaguchi","doi":"10.1159/000518973","DOIUrl":"https://doi.org/10.1159/000518973","url":null,"abstract":"<p><strong>Introduction: </strong>Most behavioral and psychological symptoms of dementia (BPSD) scales have copyright issues and are difficult for care staff to use in daily care settings because they were primarily designed for physicians. Therefore, an easier tool for care staff is required. This study aimed to develop and validate the BPSD questionnaire 13-item version (BPSD13Q).</p><p><strong>Methods: </strong>We obtained data from 444 people with dementia living in group homes in Japan using the BPSD plus questionnaire (BPSD + Q; 27-item version) and Neuropsychiatric Inventory Nursing Home version (NPI-NH). We selected appropriate items to make a short-form version of the BPSD + Q and examined the construct validity, internal consistency, and criterion-related validity of the questionnaire.</p><p><strong>Results: </strong>By the pilot review, research on correlations with similar items from comparable scales, and factor analysis, we reduced 27 items to 13 items (BPSD13Q). The BPSD13Q and BPSD13Q-distress (BPSD13Q-D) showed good internal consistency (Cronbach's α = 0.76 and 0.80, respectively). Moreover, the BPSD13Q was positively correlated with the NPI-NH (<i>r</i> = 0.72, <i>p</i> < 0.001) and BPSD + Q (<i>r</i> = 0.95, <i>p</i> < 0.001). The BPSD13Q-D was positively correlated with the NPI-NH-caregiver distress (<i>r</i> = 0.74, <i>p</i> < 0.001) and BPSD + Q-distress (<i>r</i> = 0.96, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>We developed and validated the BPSD13Q, which is a short-form version of the BPSD + Q and is downloadable. The BPSD13Q may make BPSD evaluations easier for the care staff.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"11 3","pages":"222-226"},"PeriodicalIF":2.3,"publicationDate":"2021-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e7/2d/dee-0011-0222.PMC8543349.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39579505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-16eCollection Date: 2021-09-01DOI: 10.1159/000518922
Marcio Soto-Añari, Loida Camargo, Miguel Ramos-Henderson, Claudia Rivera-Fernández, Lucia Denegri-Solís, Ursula Calle, Nicanor Mori, Ninoska Ocampo-Barbá, Fernanda López, Maria Porto, Nicole Caldichoury-Obando, Carol Saldías, Pascual Gargiulo, Cesar Castellanos, Salomon Shelach-Bellido, Norman López
Background: The COVID-19 pandemic has had a great impact on cognitive health in Latin American older adults, increasing the risk of cognitive impairment and dementia. Our objective was to analyze the prevalence of dementia and the associated factors in Latin American older adults during SARS-CoV-2 pandemic.
Methods: A multicentric first phase cross-sectional observational study was conducted during the SARS-CoV-2 pandemic. Five thousand two hundred and forty-five Latin American adults over 60 years of age were studied in 10 countries: Argentina, Bolivia, Chile, Colombia, Ecuador, Guatemala, Mexico, Peru, the Dominican Republic, and Venezuela. We used the telephone version of Montreal Cognitive Assessment, the "Alzheimer Disease 8" scale for functional and cognitive changes, and the abbreviated version of the Yesavage depression scale. We also asked for sociodemographic and lockdown data. All the evaluation was made by telephone. Cross-tabulations and χ2 tests were used to determine the variability of the prevalence of impairment by sociodemographic characteristics and binary logistic regression to assess the association between dementia and sociodemographic factors.
Results: We observed that the prevalence of dementia in Latin America is 15.6%, varying depending on the country (Argentine = 7.83 and Bolivia = 28.5%). The variables most associated with dementia were race and age. It does not seem to be associated with the pandemic but with social and socio-health factors.
Conclusion: The prevalence of dementia shows a significant increase in Latin America, attributable to a constellation of ethnic, demographic, and socioeconomic factors.
{"title":"Prevalence of Dementia and Associated Factors among Older Adults in Latin America during the COVID-19 Pandemic.","authors":"Marcio Soto-Añari, Loida Camargo, Miguel Ramos-Henderson, Claudia Rivera-Fernández, Lucia Denegri-Solís, Ursula Calle, Nicanor Mori, Ninoska Ocampo-Barbá, Fernanda López, Maria Porto, Nicole Caldichoury-Obando, Carol Saldías, Pascual Gargiulo, Cesar Castellanos, Salomon Shelach-Bellido, Norman López","doi":"10.1159/000518922","DOIUrl":"10.1159/000518922","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has had a great impact on cognitive health in Latin American older adults, increasing the risk of cognitive impairment and dementia. Our objective was to analyze the prevalence of dementia and the associated factors in Latin American older adults during SARS-CoV-2 pandemic.</p><p><strong>Methods: </strong>A multicentric first phase cross-sectional observational study was conducted during the SARS-CoV-2 pandemic. Five thousand two hundred and forty-five Latin American adults over 60 years of age were studied in 10 countries: Argentina, Bolivia, Chile, Colombia, Ecuador, Guatemala, Mexico, Peru, the Dominican Republic, and Venezuela. We used the telephone version of Montreal Cognitive Assessment, the \"Alzheimer Disease 8\" scale for functional and cognitive changes, and the abbreviated version of the Yesavage depression scale. We also asked for sociodemographic and lockdown data. All the evaluation was made by telephone. Cross-tabulations and χ<sup>2</sup> tests were used to determine the variability of the prevalence of impairment by sociodemographic characteristics and binary logistic regression to assess the association between dementia and sociodemographic factors.</p><p><strong>Results: </strong>We observed that the prevalence of dementia in Latin America is 15.6%, varying depending on the country (Argentine = 7.83 and Bolivia = 28.5%). The variables most associated with dementia were race and age. It does not seem to be associated with the pandemic but with social and socio-health factors.</p><p><strong>Conclusion: </strong>The prevalence of dementia shows a significant increase in Latin America, attributable to a constellation of ethnic, demographic, and socioeconomic factors.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"11 3","pages":"213-221"},"PeriodicalIF":2.3,"publicationDate":"2021-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/87/dee-0011-0213.PMC8543347.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39579506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: In ageing population, it is desirable to reduce the impact of cognitive decline on daily life. While various types of dementia-friendly environments have been proposed, the question still remains regarding whether analogue or digital clocks are friendlier for people with dementia. Methods: In clinical practice, we normally use our original clock reading test (10 analogue and 10 digital clocks) to assess patients’ ability to read a clock. In the present study, a retrospective medical record survey was conducted. Fifty-five participants who had done the test were identified. The result of the test was compared between analogue and digital clocks. Additionally, to assess specific ability to read analogue clocks, an “analogue-digital gap” was defined as the difference between patients’ performance for analogue and digital clocks. Univariate and multivariate analyses were conducted to detect significant factors associated with reading ability specific to analogue clocks. Results: The analogue clock proved less readable than the digital clock, even after adjusting for MMSE total score (p = 0.003). Multivariate analysis revealed reading ability of the analogue clock was significantly associated with MMSE calculation and clock drawing test (p = 0.009 and 0.040, respectively). Conclusions: In the present study, the digital clock was friendlier than the analogue clock for patients with dementia. Compared to the digital clock, reading analogue clocks might require more widespread cognition, such as working memory and visuospatial processing. While our finding was a general tendency, and individual assessment is necessary, it might help the development of personalized environmental adjustments.
{"title":"Are Analogue or Digital Clocks Friendlier for People Living with Dementia?","authors":"Akihiro Koreki, Keisuke Kusudo, Hisaomi Suzuki, Shoko Nozaki, Mitsumoto Onaya, Alison Bowes, Mitsuhiro Sado","doi":"10.1159/000518350","DOIUrl":"https://doi.org/10.1159/000518350","url":null,"abstract":"Background: In ageing population, it is desirable to reduce the impact of cognitive decline on daily life. While various types of dementia-friendly environments have been proposed, the question still remains regarding whether analogue or digital clocks are friendlier for people with dementia. Methods: In clinical practice, we normally use our original clock reading test (10 analogue and 10 digital clocks) to assess patients’ ability to read a clock. In the present study, a retrospective medical record survey was conducted. Fifty-five participants who had done the test were identified. The result of the test was compared between analogue and digital clocks. Additionally, to assess specific ability to read analogue clocks, an “analogue-digital gap” was defined as the difference between patients’ performance for analogue and digital clocks. Univariate and multivariate analyses were conducted to detect significant factors associated with reading ability specific to analogue clocks. Results: The analogue clock proved less readable than the digital clock, even after adjusting for MMSE total score (p = 0.003). Multivariate analysis revealed reading ability of the analogue clock was significantly associated with MMSE calculation and clock drawing test (p = 0.009 and 0.040, respectively). Conclusions: In the present study, the digital clock was friendlier than the analogue clock for patients with dementia. Compared to the digital clock, reading analogue clocks might require more widespread cognition, such as working memory and visuospatial processing. While our finding was a general tendency, and individual assessment is necessary, it might help the development of personalized environmental adjustments.","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"11 3","pages":"207-212"},"PeriodicalIF":2.3,"publicationDate":"2021-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d3/f9/dee-0011-0207.PMC8460955.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39569991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}