American Journal of Alzheimers Disease and Other Dementias最新文献

This study was conducted in order to examine the level of cognitive function of individuals ≥65 years of age with diabetes. The cross-sectional descriptive design was used. The research was carried out in the diabetes polyclinic of a university hospital between June 2016 and January 2018. The study sample consisted of 91 patients. Data were collected with the scale of Montreal Cognitive Assessment (MoCA). The average score of the patients in the MoCA Scale was found to be 19.61 ± 1.70 (min: 15, max: 26). Diabetes is a risk factor for cognitive dysfunction for individuals above 65 years of age. Health professionals regularly monitor the cognitive functions of diabetic patients and use the MoCA scale in these follow-up and plan training and counseling initiatives according to their needs.

Based on stress coping theory, this study investigated whether and how positive aspects of caregiving (PAC) and religiosity buffered the association between caregiving burden and desire to institutionalize (DTI). Secondary data (N = 637) were drawn from the baseline assessment of the Resources for Enhancing Alzheimer's Caregiver Health II project. Descriptive analysis, bivariate correlation, and multiple linear regressions were conducted. The results indicated that higher levels of caregiver burden, daily care bother, and Revised Memory and Behavioral Problem Checklist bother were all significantly associated with higher level of DTI. Both PAC and religious coping were negatively associated with DTI; however, only PAC was significant. Only the interaction between daily care bother and religious coping was significant, which indicated that the harmful effect of daily care bother on DTI was significantly buffered among those who have religiosity. Study findings have important implications for policy makers and for providers who serve dementia family caregivers.

This study compares pain interventions received by nursing home residents with and without dementia. Secondary data analyses of cross-sectional data from 50,673 nursing home residents in New York State were collected by the Minimum Data Set 3.0. Frequency distributions and bivariate analyses with χ² tests were used to organize and summarize the data. Logistic regression analyses were performed to quantify the relationship between dementia and pain interventions. Our results show that residents with dementia had significantly fewer pain assessments and less reported pain presence than their counterparts. After adjusting for covariates, the results indicate that residents with dementia were significantly less likely to receive pro re nata and nonmedication pain intervention. However, there were no significant differences in scheduled pain medication between the 2 groups. To address the gap, we need more research to design a pain assessment tool that can differentiate severity of pain so that appropriate interventions can be applied.

A recent paper (Riley, Evans and Oyebode, 2018) reported that a sense of discontinuity in carers' experience of their spousal relationship with a person with dementia is associated with a greater sense of burden and fewer rewards from the caregiving role. This commentary sets the paper in context by providing a brief overview of research relating to relationship continuity/discontinuity. Factors that may explain why some carers experience continuity but others discontinuity are reviewed. So, too, is the potential impact of continuity/discontinuity on how the carer copes with the challenges of dementia. Possible future research is discussed.

Background: Although cognitive training is effective for people with mild cognitive impairment (MCI), it is not clear which format is more effective.

Objective: To compare the effectiveness of the same language programs when carried out via computer, paper/pencil and orally in people with MCI.

Methods: Seventy-one participants with MCI were randomly classified in 3 experimental and 2 control groups. The experimental groups attended 48 sessions of language training for 6 months. The control groups attended either unstructured sessions or they were on waiting list.

Results: Mixed measures analysis of variance, at the follow-up, showed a significant cognitive abilities improvement among the experimental versus control groups. At the end of the language training, the 3 groups presented improvement in cognitive abilities and daily function, while the control groups remained at the same performance level.

Conclusion: All 3 cognitive language training methods were equally significantly effective.

Background: The French nationwide exhaustive hospital discharge database (PMSI) is used for activity-based payment of hospital services. We hypothesized that the release of articles about alcohol and dementia could influence the identification of these diagnoses in PMSI.

Methods: We analyzed temporal evolution of coding for dementia and other persistent or late-onset cognitive impairment (OPLOCI) due to alcohol and other psychoactive substances in the PMSI database from 2007 to 2017 (285 748 938 inpatient stays). These codings use the International Classification of Diseases, 10th revision (ICD-10).

Results: The number of inpatient stays with dementia and OPLOCI due to alcohol increased from 34 to 1704 from 2007 to 2017. While the number of diagnosed dementias remained stable at around 400 from 2013, the number of OPLOCIs increased 10-fold from 2013 to 2017. This increase was not found with dementia or OPLOCI due to other psychoactive substances than alcohol.

Conclusion: Notoriety of a diagnosis in the literature seems to have an impact on the coding.

Video feedback at home (VFH) aims to improve the well-being of informal caregivers and persons with dementia by training the caregiver to communicate successfully. This feasibility study had 2 aims: (1) to investigate possible effects regarding VFH, caregiver self-efficacy and the burden experienced, and the frequency of challenging behavior in persons with dementia, and (2) to perform a process evaluation of barriers and facilitators regarding the use of VFH. The respondents were caregivers of home-dwelling persons with dementia participating in VHF (N = 10), a group of caregivers who declined participating in VFH (N = 18), stakeholders (N = 6), and field experts (N = 55). The assessments performed were Positive and Negative Affect Scales, Cohen-Mansfield Agitation Inventory, Sense of Competence Scale, semistructured interviews, and questionnaires. Results demonstrated that caregivers were satisfied with VFH and that various (sub)scores on questionnaires improved. Caregivers mentioned a reluctance toward being filmed and both caregivers and referrers were unfamiliar with VFH. Recommendations have been made for health-care professionals and researchers to overcome these barriers.

The relationships between caregiver burden as measured with the Burden Scale for Family Caregivers-short form and 6 characteristics of caregivers caring for patients with dementia were investigated for caregivers from England (n = 36), Finland (n = 42), and Greece (n = 46) using survey data. In all 3 countries, caregiver burden increases with physical problems of the caregiver, emotional problems of the caregiver, and weekly hours of care. Hence, in all 3 countries, special support for informal care is required when these characteristics are at high levels. When the caregiver is a spouse or long-term partner of the person with dementia, lives in the same house as this person, or spends fewer than 20 h/wk for other duties than care, this is associated with less caregiver burden in England but with more caregiver burden in Greece. Accordingly, special support is required for Greek caregivers with these characteristics, but the opposite is true for English caregivers.

Objectives: To evaluate the benefits of TimeSlips, a group creative storytelling intervention used in residential care settings, on quality of life (QOL), interactions with caregivers, and Mini-Mental State Examination (MMSE) scores for persons with varying degrees of dementia severity.

Design: A mixed-methods approach was used weekly over a 6-month period to measure QOL and resident-caregiver relationships.

Setting: A dementia care unit in Pennsylvania.

Participants: Twenty-two residents with mild-to-severe dementia.

Measurements: Dementia severity and QOL were assessed using the MMSE and Greater Cincinnati Chapter Well-Being Observational Tool. Resident-caregiver interactions were analyzed using a modified version of the Quality of Interactions Schedule. Semistructured interviews were conducted upon the study's conclusion.

Results: Quantitatively, participants initially classified with mild-moderate dementia were significantly more likely to experience positive benefits compared to those initially classified with severe dementia. There were no significant changes in dementia severity over time. There was also no change in QOL or resident-caregiver relationships for those with mild-moderate dementia over time, although there was a decrease in certain measures of QOL and resident-caregiver relationships for those with severe dementia. Qualitative analysis identified consistent benefits for residents with both mild-moderate and severe dementia over time.

Conclusions: Mixed-methods analyses helped identify benefits of TimeSlips for persons at all levels of dementia severity, but particularly for those with milder dementia. Such an observation helps demonstrate how arts-based programs like TimeSlips can uniquely benefit people with advanced memory impairments and thereby support QOL.

Background: The aim of this study was to identify white matter structural networks of amnestic mild cognitive impairment (aMCI) dichotomized by β amyloid (Aβ) status and compare them using network-based statistics (NBS).

Methods: Patients underwent whole-brain diffusion-weighted magnetic resonance imaging, detailed neuropsychological test and [¹⁸F]-Florbetaben amyloid positron emission tomography. We performed the NBS analysis to compare the whole-brain white matter structural networks extracted from diffusion tensor images.

Results: One hundred sixteen participants (Aβ- cognitively normal [CN], n = 35; Aβ- aMCI, n = 42; Aβ+ aMCI, n = 39) were included. There was no subnetwork showing significant difference between Aβ+ aMCI and Aβ- aMCI. However, by comparing each aMCI group with control group, we found that supplementary motor areas were common hub regions. Intriguingly, Aβ+ aMCI showed reduced connectivity mainly in the medial frontal regions, while Aβ- aMCI showed somewhat uniform disruption when compared to CN.

Conclusion: Structural network analysis using network-based approach in aMCI may shed light on further understanding of white matter disruption in the prodromal stage of Alzheimer's disease.