American Journal of Alzheimers Disease and Other Dementias最新文献

Cerebrovascular disease (CVD) contributes to spatial navigation deficits; however, the everyday outcomes of this association remain unexplored. We investigated whether CVD was a risk for getting lost behavior (GLB) in elderly with mild cognitive impairment (MCI) and mild Alzheimer disease (AD). Getting lost behavior was assessed using a semistructured clinical interview and was associated with white matter lesions (WMLs) in patients with MCI. Specifically, right occipital WMLs increased the odds of GLB by 12 times (P = .03) and right temporal WMLs increased the odds of GLB by 4 times (P = .01), regardless of age, gender, global cognitive impairment, and occipital or medial temporal gray matter atrophy. Hypertension increased the risk of GLB in MCI by contributing to the burden of WMLs. White matter lesions were not associated with GLB in mild AD. Our findings suggest that interventions aimed at reducing GLB in prodromal dementia may involve preventing WMLs by optimizing hypertension control.

Alzheimer's disease (AD) is the most prevalent form of dementia, and age is strongly associated with the incidence of AD. This study aimed to investigate the association between the genotypes of CYP2D6, CYP3A4, and CYP2C9 genes to the clinical efficacy and tolerability of cholinesterase inhibitors (ChEIs) in Chinese patients with AD. One hundred seventy-nine patients with AD with newly prescribed with ChEIs were recruited. The clinical response and tolerability were evaluated at baseline, 3rd-, 6th-, and 12th-month follow-ups and were compared according to their genotypes of CYP2D6, CYP3A4, and CYP2C9. Among patients prescribed with donepezil/galantamine, CYP2D6*10 carriers showed significantly less side effects (P = .009). CYP2D6*10 carriers responded better to ChEIs and resulted in better improvement in Alzheimer's Disease Assessment Scale-Cognitive subscale (P = .027) and Mini-Mental State Examination (P = .012). Further study is required to replicate the finding, and it might be useful for clinicians to decide the medication based on the patients' CYP genotypes.

Objectives: Personalized music playlists are increasingly being utilized in aged care settings. This study aims to investigate how musical features influence the affective response to music of people with probable dementia.

Methods: A factorial experiment (2 × 2 × 3) was conducted to investigate the influence of tempo (fast, slow), mode (major, minor), and lyrics (none, negative, positive). Ninety-nine people with probable dementia were randomly assigned to 3 conditions, listening to 3 personalized playlists. Galvanic skin response and activation of facial action units were measured.

Results: Music with fast tempos increased arousal and reduced enjoyment. Music in minor keys increased activation of the depressor anguli oris, suggesting increased sadness. Lyrics had no significant effect on response.

Discussion: The findings demonstrate that both tempo and mode influenced the response of the listener. As well as accounting for personal preferences, music for people with dementia should be carefully targeted toward the affective outcome desired.

The aim of this study was to investigate the differences between male and female caregivers for patients with dementia in the way they experience various psychosocial parameters such as shame, hostility, and aggression. The sample included 55 caregivers of patients with moderate and severe dementia, whereas the average age was 51 years. Female caregivers were found to experience significantly higher levels of external shame, measured by Other As Shamer scale, than male caregivers, t (53) = 2.54, P < .01. A significant difference was also found between the female and male caregivers regarding their recorded levels of internal shame, measured by Experience of Shame Scale, with female caregivers experiencing more internal shame than their male counterparts, t (53) = 2.11, P < .01. However, no significant differences were found in hostility and aggression between males and females. These results demonstrate the existence of gender differences in the levels of shame experienced by care providers for patients with dementia.

There has been no comparison of excessive daytime sleepiness (EDS) in patients with Alzheimer's disease dementia (AD), dementia with Lewy bodies (DLB), and behavioral variant frontotemporal dementia (bvFTD). We identified patients with mild dementia who met criteria for these disorders who also had the Epworth Sleepiness Scale (ESS) completed. The sample included 17 bvFTD, 111 AD, and 31 DLB. An ESS score ≥10 was considered abnormal and consistent with EDS. Analyses with age and sex as covariates revealed higher mean ESS scores for DLB compared to the other groups (DLB 13.9 [5], bvFTD 9.6 [8], AD 8.8 [5], P < .05). An ESS score ≥10 was significantly more likely to occur in DLB compared to bvFTD or AD (DLB 81% vs bvFTD 47% vs AD 45%, P < .01). In patients with mild dementia, EDS is greatest in DLB and comparably lower in bvFTD and AD.

Aim: The purpose of the study was to determine the prevalence of suicidal ideation and attempts in patients with behavioral variant frontotemporal dementia (bvFTD), evaluating possible risk factors for suicidality.

Methods: Risk of suicide was assessed using the Scale for Suicide Ideation (SSI) in 35 patients with bvFTD and 25 controls.

Results: According to SSI, 40% of patients with bvFTD had suicidal ideation in comparison to 8% of controls ( P = .009). Four patients with bvFTD have attempted suicide versus none control ( P = .006). Patients with bvFTD with suicide risk showed higher levels of anxiety, depression, stress, and hopelessness than patients without suicide risk ( P < .001). Patients who attempted suicide were younger and had a longer disease duration than those with only suicide ideation. Intriguingly, 40% of patients with parkinsonism presented high level of suicide ideation.

Conclusions: Our findings show that patients with bvFTD have a high risk of suicide. Additional studies in larger populations are needed to confirm our results.

Despite substantial staffing and cost implications, the use of constant observation (CO) has been poorly described in the acute care setting. The purpose of this cross-sectional, multicenter, survey study was to assess hospital provider practices regarding the use of CO. Of the 543 surveys distributed, 231 were completed across 5 sites. Most respondents worked on medical units (67.5%), as nurses (49.1%); 44.8% were white; and 75.6% were female. The majority (84.2%) reported at least 1 patient/wk requiring CO. Most frequent indication for CO was dementia with agitation (60.7%), in patients older than 70 (62.3%) and predominantly by nurse assistants (93.9%). Almost half (47.3%) stated they felt pressured to discontinue CO, despite a strong perceived benefit (76%). Enhanced observation (92.6%) was most frequently used to decrease CO. Finally, 77.9% perceived that those performing CO lacked training. Our study highlights the widespread use of CO for hospitalized older adults with dementia.

The present study examined the effects of a telephone-based cognitive behavioral intervention on dementia caregivers' quality of life (QoL). A total of 273 caregivers were randomly assigned to an intervention or control group. The intervention comprised 12 telephone sessions of individual cognitive behavioral therapy (CBT) over 6 months. At baseline, postintervention, and 6-month follow-up, QoL was assessed with the World Health Organization QoL-BREF, which measures perceived QoL for the domains physical health, psychological health, social relationships, and environment as well as overall QoL and satisfaction with general health. Intention-to-treat analyses using latent change models were performed. At postintervention, intervention group participants reported better overall QoL and satisfaction with general health as well as better physical and psychological health compared to control group participants. Together with existing evidence, the results suggest that the telephone CBT intervention does not only reduce impairments but also fosters improvements in health-related QoL.

Art is a system of human communication arising from symbolic cognition, conveying ideas, experiences, and feelings. The goal of this review is to describe the link between painting and dementia. Individuals with neurodegenerative diseases inevitably experience cognitive dysfunction that has the potential to limit and impair the artist's ability to realize their creative and expressive intentions through painting. The strategy to advance our understanding of the neural bases for art is to map locations and nature of neural damage to changes onto artistic production.

Objectives: This study aimed to identify the specific relationship between subdomains of religious variables and cognitive functions in outpatients with Alzheimer's disease (AD).

Methods: We recruited 325 patients with AD from a psychiatry outpatient clinic. The Korean version of the Consortium to Establish a Registry for Alzheimer's Disease and the Duke University Religion Index were used to assess cognitive functions and religiosity. We performed structural equation modeling and partial correlation analysis after controlling for demographic data.

Results: The model in which religiosity beneficially affects cognitive functions showed acceptable model fit (root-mean-square error of approximation = 0.076, Tucker-Lewis index = 0.921, comparative fit index = 0.947). In the partial correlation analysis, organizational religious activity demonstrated positive relationships with memory ( r = 0.144, P = .010), language ( r = 0.149, P = .007), and constructional ability ( r = 0.191 P = .001). Nonorganizational religious activity and intrinsic religiosity were positively associated with memory ( r = 0.115, P = .040; r = 0.140, P = .012) and constructional ability ( r = 0.207, P = .000; r = 0.136, P = .015).

Conclusions: The findings suggest that religiosity positively affects cognitive functions and that each religious variable is related differently to the subdomains of cognitive functions in patients with AD.