To see the other types of publications on this topic, follow the link: Senile dementia – Patients – Family relationships.
Journal articles on the topic 'Senile dementia – Patients – Family relationships'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Senile dementia – Patients – Family relationships.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Wiegersma, Sjoerd, Emmy Van Dongen, and Hans Lomans. "Errors of Free Recall in Senile Dementia." Perceptual and Motor Skills 63, no. 2 (October 1986): 617–18. http://dx.doi.org/10.2466/pms.1986.63.2.617.
Full textAbstract:
Errors made in the free recall of nouns by patients with senile dementia were classified as to their paradigmatic, phonological, or syntagmatic relationships with presented words. Dementia patients at four levels of dementia severity made relatively more paradigmatic errors than normals. Syntagmatic errors only occurred for greater severity. Such errors show the relative preservation in dementia of semantic knowledge about words as well as the decreased paradigmatic and syntagmatic discriminability of words.
2
Sun, Wei, Jinxia Liu, Lihua Liu, and Xiuzhi Wang. "Management Strategy of Alzheimer’s Patients under the Medical-Care Integration Model Based on Big Data Evaluation." BioMed Research International 2022 (October 11, 2022): 1–11. http://dx.doi.org/10.1155/2022/9896935.
Full textAbstract:
In the context of the era of big data, the management of Alzheimer’s patients has aroused widespread concern in the society. What should the elderly and people with dementia do and how the society should accommodate these special groups have aroused heated discussions in the society. The goal of the medical-nursing integration model is to realize the integrated model of medical care-nursing-rehabilitation-old care, and to better satisfy the needs by providing medical services, rehabilitation care, and health management. The medical needs of the elderly can help the elderly maintain a healthy state; the elderly care needs can be better met through elderly care services, and the burden on families and society can be reduced. With the advancement of the medical-care integration model, new solutions have been provided for the management of senile dementia patients. Therefore, under the medical-care integration model, this paper managed Alzheimer’s patients based on the big data algorithm based on association rules and compared it with the management of Alzheimer’s patients under the traditional model, and drew the following conclusions: compared with the management satisfaction of Alzheimer’s patients under the traditional model, family members and patients’ total satisfaction with nursing management under the medical-care integration model was greatly improved; compared with the management of Alzheimer’s patients under the traditional model, the incidence of adverse events in the management of Alzheimer’s patients under the medical-care integration model was greatly reduced, which was reduced to 17.6%; under the medical-care integration model, the anxiety and depression scores of the elderly patients with dementia decreased rapidly; under the medical-care integration model, the living ability of senile dementia patients has been greatly improved; the use of the medical-care integration model to manage senile dementia patients has greatly improved the sleep quality, mental quality, and quality of life of senile dementia patients.
3
Chen, Jiamin, Shuyan Zhao, Qinghong Chen, and Shanglong Yao. "Experience and Insights of Family Caregivers for Patients with Senile Dementia: A Qualitative Study." Health 13, no. 09 (2021): 1010–19. http://dx.doi.org/10.4236/health.2021.139076.
Full text
4
Melkina, L. "Role of district nurse in the organization of care for elderly and senile patients with dementia." Medsestra (Nurse), no. 1 (January 1, 2020): 20–23. http://dx.doi.org/10.33920/med-05-2001-03.
Full textAbstract:
The article is devoted to the study of the problem of dementia in elderly and senile patients and the role of the district nurse in organizing care for patients and helping family members at home. In the practical part, the organization of work in the district and the analysis of statistical indicators in the district for 2018 are shown. Information material for patients and their families in the form of information notes have been created as a result of the work.
5
Theuns, J., and C. Van Broeckhoven. "Genes for Alzheimer Dementia." Acta Neuropsychiatrica 11, no. 2 (June 1999): 60–62. http://dx.doi.org/10.1017/s0924270800036176.
Full textAbstract:
Alzheimer disease (AD), the most common form of dementia in the elderly, is rapidly becoming a major health problem in developed countries where the number of elderly people continuously grows due to improved medical care. Consequently, the number of AD patients is increasing and thus far no effective therapies are available. Clinically the disease can be diagnosed with 90% reliability on the basis of neurological examination, neuropsychological testing and brain imaging techniques. A definite diagnosis, however, requires the post-mortem detection of senile plaques (SPs) and neurofibrillary tangles (NFTs) in the brain. The SPs are extracellular deposits mainly composed of amyloid P (Ap) surrounded by dystrophic neurites. NFT are intraneural inclusions of paired helical filaments composed of hyperphosphorylated tau.Although age is the major risk factor for AD, population survey and family studies have provided substantial evidence that genetic factors are major contributors to the expression of AD.
6
이은희. "A Study on the Level of Family Adaptation to Family Caregivers with Senile Dementia Patients: An Application of the Family Resiliency Model." Korean Journal of Gerontological Social Welfare ll, no. 39 (March 2008): 195–216. http://dx.doi.org/10.21194/kjgsw..39.200803.195.
Full text
7
Pentzek, Michael, Michael Wagner, Heinz-Harald Abholz, Horst Bickel, Hanna Kaduszkiewicz, Birgitt Wiese, Siegfried Weyerer, et al. "The value of the GP’s clinical judgement in predicting dementia: a multicentre prospective cohort study among patients in general practice." British Journal of General Practice 69, no. 688 (October 8, 2019): e786-e793. http://dx.doi.org/10.3399/bjgp19x706037.
Full textAbstract:
BackgroundClinical judgement is intrinsic to diagnostic strategies in general practice; however, empirical evidence for its validity is sparse.AimTo ascertain whether a GP’s global clinical judgement of future cognitive status has an added value for predicting a patient’s likelihood of experiencing dementia.Design and settingMulticentre prospective cohort study among patients in German general practice that took place from January 2003 to October 2016.MethodPatients without baseline dementia were assessed with neuropsychological interviews over 12 years; 138 GPs rated the future cognitive decline of their participating patients. Associations of baseline predictors with follow-up incident dementia were analysed with mixed-effects logistic and Cox regression.ResultsA total of 3201 patients were analysed over the study period (mean age = 79.6 years, 65.3% females, 6.7% incident dementia in 3 years, 22.1% incident dementia in 12 years). Descriptive analyses and comparison with other cohorts identified the participants as having frequent and long-lasting doctor–patient relationships and being well known to their GPs. The GP baseline rating of future cognitive decline had significant value for 3-year dementia prediction, independent of cognitive test scores and patient’s memory complaints (GP ratings of very mild (odds ratio [OR] 1.97, 95% confidence intervals [95% CI] = 1.28 to 3.04); mild (OR 3.00, 95% CI = 1.90 to 4.76); and moderate/severe decline (OR 5.66, 95% CI = 3.29 to 9.73)). GPs’ baseline judgements were significantly associated with patients’ 12-year dementia-free survival rates (Mantel–Cox log rank test P<0.001).ConclusionIn this sample of patients in familiar doctor–patient relationships, the GP’s clinical judgement holds additional value for predicting dementia, complementing test performance and patients’ self-reports. Existing and emerging primary care-based dementia risk models should consider the GP’s judgement as one predictor. Results underline the importance of the GP-patient relationship.
8
Wang, Qiong. "Computer Internet of Things-Based Intelligent Medical System to Be Applied in Home Care of Senile Dementia Patients." Wireless Communications and Mobile Computing 2022 (May 9, 2022): 1–12. http://dx.doi.org/10.1155/2022/1374835.
Full textAbstract:
It was to explore the accuracy of intelligent home medical system based on Internet of Things (IoT) technology and its application value in home care of senile dementia patients. Based on IoT, 5th generation wireless systems (5G), and smart wearable technology, intelligent home medical system was designed from the perspectives of system environment and system design. Smart wearable technology-based wearable smart clothes could recognize and collect electrocardiosignal, breathing signal, body sway signal, and body temperature signal. The data were transmitted to the application layer through the information transmission and processing modules of middle layer, and the extraction accuracy of behavioral features and behavior correct recognition rate of the system were analyzed. 64 senile dementia patients treated in the hospital between January 2019 and June 2020 were selected as the research objects. They were divided into control group (routine family care) and observation group (intelligent medical care system) according to different nursing methods. Each group included 32 cases. Activity of daily living (ADL) scores, nursing satisfaction, and the accidents during care of the patients in two groups before and after care were summarized. The results showed that the behavioral feature extraction accuracy of intelligent home medical system was above 74.59% and its correct recognition rate of different behaviors reached over 98.5%. ADL score in the observation group was lower than that in the control group 3 months after care ( P < 0.05 ). ADL score in the observation group was significantly lower than that in the control group ( P < 0.01 ) 6 months after care. The satisfaction of the observation group was 78.13% (25 cases), which was remarkably higher than that of the control group (31.25%, 10 cases) ( P < 0.001 ). The total satisfaction of the observation group amounted to 93.75% (30 cases), which was higher than that of the control group (68.75%, 22 cases) ( P < 0.01 ). The total incidence of accidents in the control and observation groups was 28.13% and 3.13%, respectively. Obviously, the total incidence of accidents in the observation group was higher than that in the control group ( P < 0.001 ). The above results showed that the established intelligent medical care system demonstrated potential application values in home care, which provided a new idea for the nursing methods for senile dementia patients.
9
Wollney, Easton N., Melissa J. Armstrong, Noheli Bedenfield, Monica Rosselli, Rosie E. Curiel-Cid, Marcela Kitaigorodsky, Ximena Levy, and Carma L. Bylund. "Barriers and Best Practices in Disclosing a Dementia Diagnosis: A Clinician Interview Study." Health Services Insights 15 (January 2022): 117863292211418. http://dx.doi.org/10.1177/11786329221141829.
Full textAbstract:
The vast majority of individuals with dementia want to receive a diagnosis. Research suggests, however, that only a fraction of individuals with dementia receive a diagnosis and patients and families often feel the information is poorly explained. We thus aimed to assess clinician-reported barriers to dementia disclosure and recommendations for giving a dementia diagnosis. To accomplish this, we performed telephone interviews with 15 clinicians from different specialties using a semi-structured interview guide. Transcripts were analyzed thematically. Clinician-reported barriers fit 3 categories: patient and caregiver-related barriers, clinician-related barriers, and barriers related to the triadic interaction. Patient and caregiver-related barriers included lack of social support, misunderstanding the diagnosis, and denial. Clinician barriers included difficulty giving bad news, difficulty communicating uncertainty, and lack of time. Triadic interaction barriers included c hallenges meeting multiple goals or needs and family requests for non-disclosure. Recommendations for best practice included for clinicians to foster relationships, educate patients and family, and take a family-centered approach. Clinicians described recommendations for fostering relationships such as using empathic communication and developing and maintaining connection. Educating patients and families included tailoring communication, explaining how the diagnosis was reached, and following up. Family approaches included meeting with family members prior to delivering the diagnosis and involving the caregiver in the discussion. Findings may inform updated recommendations for best practices when communicating a dementia diagnosis.
10
Sidenkova, A. "Correlation of neurotrophic and neuropsychological parameters in alzheimer’s disease." European Psychiatry 64, S1 (April 2021): S134. http://dx.doi.org/10.1192/j.eurpsy.2021.371.
Full textAbstract:
IntroductionAlzheimer’s disease (AD) is a neurodegenerative pathology that develops mainly in elderly and senile people. Disruption of BDNF transport or suppression of its production appears to be typical for people of old age.ObjectivesObjective: To investigate the influence of Alzheimer’s disease on the secretion of brain factors and correlate with neuropsychological profiles.Methods12 men (2) and women (10) with Alzheimer’s disease were examined. The average age of the subjects was 76.25 + 4.89. Methods: MMSE, ADAS-COG, laboratory - BDNF was performed using the G7611 BDNF Emax (R) ImmunoAssaySystem 5 x 96 wells, BDNF Emax® Immunological test.Results2 patients have mild dementia, 8 patients have moderate dementia, 2 patients have severe dementia. The average age of patients with mild dementia was 72.0 + 1.0. The average MMSE score is 16.7 + 3.4. Correlation analysis showed a close relationship between a pronounced decrease in memory in memory tests (ADAS-COG) and a pronounced decrease in blood BDNF content (r = 0.676). A close statistically significant relationship was found between a low result of the recognition test and a low blood BDNF content (r = 0.598).Conclusionswe assume that blood BDNF is a marker of pathologically accelerated aging of the central nervous system, since low test results for mnestic function are an indicator of severe degeneration in Alzheimer’s diseaseDisclosureNo significant relationships.
11
Delgado, João, Philip H. Evans, Denis Pereira Gray, Kate Sidaway-Lee, Louise Allan, Linda Clare, Clive Ballard, Jane Masoli, Jose M. Valderas, and David Melzer. "Continuity of GP care for patients with dementia: impact on prescribing and the health of patients." British Journal of General Practice 72, no. 715 (January 24, 2022): e91-e98. http://dx.doi.org/10.3399/bjgp.2021.0413.
Full textAbstract:
BackgroundHigher continuity of GP care (CGPC), that is, consulting the same doctor consistently, can improve doctor–patient relationships and increase quality of care; however, its effects on patients with dementia are mostly unknown.AimTo estimate the associations between CGPC and potentially inappropriate prescribing (PIP), and with the incidence of adverse health outcomes (AHOs) in patients with dementia.Design and settingA retrospective cohort study with 1 year of follow-up anonymised medical records from 9324 patients with dementia, aged ≥65 years living in England in 2016.MethodCGPC measures include the Usual Provider of Care (UPC), Bice–Boxerman Continuity of Care (BB), and Sequential Continuity (SECON) indices. Regression models estimated associations with PIPs and survival analysis with incidence of AHOs during the follow-up adjusted for age, sex, deprivation level, 14 comorbidities, and frailty.ResultsThe highest quartile (HQ) of UPC (highest continuity) had 34.8% less risk of delirium (odds ratio [OR] 0.65, 95% confidence interval [CI] = 0.51 to 0.84), 57.9% less risk of incontinence (OR 0.42, 95% CI = 0.31 to 0.58), and 9.7% less risk of emergency admissions to hospital (OR 0.90, 95% CI = 0.82 to 0.99) compared with the lowest quartile. Polypharmacy and PIP were identified in 81.6% (n = 7612) and 75.4% (n = 7027) of patients, respectively. The HQ had fewer prescribed medications (HQ: mean 8.5, lowest quartile (LQ): mean 9.7, P<0.01) and had fewer PIPs (HQ: mean 2.1, LQ: mean 2.5, P<0.01), including fewer loop diuretics in patients with incontinence, drugs that can cause constipation, and benzodiazepines with high fall risk. The BB and SECON measures produced similar findings.ConclusionHigher CGPC for patients with dementia was associated with safer prescribing and lower rates of major adverse events. Increasing continuity of care for patients with dementia may help improve treatment and outcomes.
12
Appleton, Katie, and Antonina Pereira. "Behavioural Changes in Dementia and their Impact on Professional Caregivers: A Grounded Theory Approach." Dementia 18, no. 4 (July 14, 2017): 1479–91. http://dx.doi.org/10.1177/1471301217714654.
Full textAbstract:
Aim The present study aimed to explore the impact that changes in behavioural symptoms of people living with dementia have on professional caregiver and resident relationships. Method A total of 21 interviews were carried out with professional caregivers of people living with dementia. A grounded theory approach was used to investigate everyday experiences of provision of professional care in dementia settings, focussing specifically on the effect of behavioural change on such relationships. Results A core category emerged from this analysis: ‘Developing behaviour in dementia impacts relationships on a personal and professional level’. Discussion Professionals have recognized as part of their everyday practice an eventual deterioration in relationships between themselves as professional caregivers and the residents, but also between the residents and their family members and among residents themselves. Importantly, understanding patients’ behaviour and behavioural change was identified as a crucial factor to achieve and sustain good relationships between professionals and residents suffering with dementia.
13
Sidenkova, A. "BDNF and cognitive function in Alzheimer’s disease." European Psychiatry 65, S1 (June 2022): S652. http://dx.doi.org/10.1192/j.eurpsy.2022.1673.
Full textAbstract:
Introduction Alzheimer’s disease (AD) is a neurodegenerative pathology that develops mainly in elderly and senile people. Disruption of BDNF transport or suppression of its production appears to be typical for people of old age. Objective: To investigate the influence of Alzheimer’s disease on the secretion of brain factors and correlate with neuropsychological profiles. Objectives 12 men (2) and women (10) with Alzheimer’s disease were examined. The average age of the subjects was 76.25 + 4.89. Methods: MMSE, ADAS-COG, laboratory - BDNF was performed using the G7611 BDNF Emax (R) ImmunoAssaySystem 5 x 96 wells, BDNF Emax® Immunological test. Methods 2 patients have mild dementia, 8 patients have moderate dementia, 2 patients have severe dementia. The average age of patients with mild dementia was 72.0 + 1.0. The average MMSE score is 16.7 + 3.4. Results Correlation analysis showed a close relationship between a pronounced decrease in memory in memory tests (ADAS-COG) and a pronounced decrease in blood BDNF content (r = 0.676). A close statistically significant relationship was found between a low result of the recognition test and a low blood BDNF content (r = 0.598). Conclusions We assume that blood BDNF is a marker of pathologically accelerated aging of the central nervous system, since low test results for mnestic function are an indicator of severe degeneration in Alzheimer’s disease. Disclosure No significant relationships.
14
Swain, Sarada Prasanna, Sushree Sangita Behura, and Manoj Kumar Dash. "A comparative study of family burden and quality of life between caregivers of schizophrenia and dementia patients." International Journal Of Community Medicine And Public Health 4, no. 6 (May 22, 2017): 2021. http://dx.doi.org/10.18203/2394-6040.ijcmph20172169.
Full textAbstract:
Background: In chronic mental diseases, as the disease progresses, it carries with tremendous burden both physically and psychologically on the family members, who are usually in the process of caregiving. The quality of life (QOL) of these caregivers is directly related to the subjective and objective burden of the illness. The objective of the study was to assess and compare the level of family burden and QOL between caregivers of Schizophrenia and Dementia patients as well as to find out the relationship between family burden and QOL.Methods: A total of 128 key caregivers (64 caregivers of each group) fulfilling the inclusion criteria purposely selected from the OPD of MHI, S. C. B. Medical College and Neuropsychiatric Consultation Centre, Cuttack. The impact of family burden on key caregivers of dementia and schizophrenia patients was assessed by using family burden interview schedule and the quality of life of key caregivers was assessed by using WHOQOL BREF scale. Data was analysed by using chi-squre, t test and pearson correlation. Data analysis was performed by SPSS.Results: Statistical significant differences (p <0.05) were found in the areas of financial burden, disruptions of family routine activities, family leisure and family interaction between dementia and schizophrenia caregivers. Whereas there was no statistical significant difference (p >0.05) found in different domains of quality of life between these two groups of caregivers. There were significant negative correlations found between family burden and psychological, social relationships and environment domains of quality of life.Conclusions: Caregivers perceived subjective and objective burden ultimately affecting their QOL.
15
Yen, Chia-Ming. "Protocol for constructing a support model for family caregivers of people with dementia: Barriers and requirements." SAGE Open Medicine 7 (January 2019): 205031211882486. http://dx.doi.org/10.1177/2050312118824860.
Full textAbstract:
Background: This report describes a protocol for determining the barriers and requirements of family caregivers for people with dementia. The perspectives of healthcare professionals, family caregivers, and dementia patients will be collected and analyzed to construct a support model of requirements. Methods: An in-depth interview and care diary will be adopted during Phase I. Subsequently, the Delphi technique will be conducted to transform opinions from participants into a group consensus. In total, 38 participants are expected to be recruited from the outpatients of the neurology, psychiatry, geriatrics, and family medicine departments of a medical center in central Taiwan. Five domains are to be examined systematically in terms of the barriers and requirements of family caregivers for people with dementia: (1) knowledge of dementia and care skills to cope with problem behaviors; (2) medication and comorbidity management; (3) family relationships and psychological support; (4) resources and benefits; and (5) education and skills training. Conclusion: Overall, the proposed protocol will construct a support model of requirements for family caregivers, which is expected to provide healthcare professionals, family caregivers, researchers, and policymakers with more concise information and insights into associated problems.
16
Iancu, Andreea Elena, and Cosima Rughiniș. "Emotional socialization and agency: Representations of coping with old age dementia and Alzheimer’s in graphic novels." Sociologie Romaneasca 20, no. 1 (June 30, 2022): 69–107. http://dx.doi.org/10.33788//sr.20.1.4.
Full textAbstract:
This research investigates representations of emotion work and emotional labor in caregiving, in the medium of graphic novels. The study is based on a collection of six contemporary graphic novels that discuss the relationships between older adults who are suffering from dementia or Alzheimer’s and their family caregivers and professional caretakers. Family caregivers are caught in a complicated web of family relationships and new, emerging caregiving roles. We rely on thematic content analysis to identify the main forms of emotional agency, structural constraints and trade-offs in family and professional situations. Emotional agency in caregiving is portrayed as situated, though emerging from divergent definitions of the situations for caretakers and patients; it is embedded in the family system, which is contrastively portrayed with the procedural, less empathic medical institution, and also with the general mass media portrayal of old age. Graphic novels contribute to the emotional socialization of people anticipating situations of suffering, or caring for mental disorders associated with old age.
17
Sidenkova, A. "The structure of the cognitive reserve in Alzheimer’s disease." European Psychiatry 64, S1 (April 2021): S721—S722. http://dx.doi.org/10.1192/j.eurpsy.2021.1911.
Full textAbstract:
IntroductionAlzheimer’s disease is common among the modern population. Emotional support for caregivers and a stable social role contribute to the maintenance of cognitive resources in Alzheimer’s.ObjectivesTo investigate the protective mechanisms that protect the brain from premature agingMethodsClinical, sociologicalResultsViolations of the higher cerebral functions of speech, gnosis, praxis are the neuropsychological basis for the development of psychological symptoms of dementia. Speech disorders, gnosis disorders contribute to the formation of painful ideas, perception disorders, eating disorders and affective symptoms. The level of functional activity is low and does not depend on the state of severe microsocial dementia, total aphasia and apraxia. The social, work, family and marital status of caregivers for patients with moderate to severe dementia is declining. An increase in the degree of dementia can reduce the functional activity of the caregiver. Caregivers often suffer from neurotic, affective and other mental disorders. A person with dementia plays a subordinate role in the family. Changing roles in the family occurs when the patient has delusion, agitation / aggression, anxiety, unstable mood / irritability. In these cases, the interpersonal distance in the “care-patient” pair increases. Caregivers have a high level of emotional involvement in the care process. A change in the role of the family, a change in place of residence, and a high level of “expressive” emotions of the guardian negatively affect the formation of psychosis, anxiety and aberrant behavior in patients with dementia. Microsocial factors influence cognitive retention in dementiaConclusionsProtective psychosocial factors strengthen the cognitive reserveDisclosureNo significant relationships.
18
Yang, Yuan-Han, Kenichi Meguro, Sang-Yun Kim, Yong-Soo Shim, Xin Yu, Christopher Li-Hsian Chen, Huali Wang, et al. "Impact of Alzheimer's Disease in Nine Asian Countries." Gerontology 62, no. 4 (2016): 425–33. http://dx.doi.org/10.1159/000443525.
Full textAbstract:
Background: Asia will soon have the majority of demented patients in the world. Objective: To assess dementia using a uniform data system to update the current status of dementia in Asia. Methods: A uniformed data set was administered in Taiwan, China, Hong Kong, Korea, Japan, Philippines, Thailand, Singapore, and Indonesia to gather data with regard to Alzheimer's disease (AD) and its related issues for these countries. Results: In total, 2,370 AD patients and their caregivers were recruited from 2011 to 2014. The demographic characteristics of these patients and the relationships between patients and caregivers were different among individuals in these countries (p < 0.001). Of note, the family history for having dementia was 8.2% for females in contrast to 3.2% for males. Conclusion: Our study highlighted the differences in dementia assessment and care in developing versus developed countries. Greater effort with regard to studying dementia, especially in developing countries, is necessary.
19
Valente, Letice Ericeira, Annibal Truzzi, Wanderson F. Souza, Gilberto Sousa Alves, Carlos Eduardo de Oliveira Alves, Felipe Kenji Sudo, Maria Elisa O. Lanna, Denise Madeira Moreira, Eliasz Engelhardt, and Jerson Laks. "Health self-perception by dementia family caregivers: sociodemographic and clinical factors." Arquivos de Neuro-Psiquiatria 69, no. 5 (October 2011): 739–44. http://dx.doi.org/10.1590/s0004-282x2011000600003.
Full textAbstract:
Caring for a demented family member has been associated with burden. Studies concerning health self-perception of family caregivers are still scarce. OBJECTIVE: To investigate caregivers perceived health and to look into relationships with patients and caregivers' sociodemographic and clinical data. METHOD: Dyads of dementia outpatients and family caregivers (n=137) were assessed with Mini Mental State Examination, Functional Activities Questionnaire, Neuropsychiatric Inventory and Clinical Dementia Rating. Caregivers answered Sociodemographic Questionnaire, Beck Depression and Anxiety Inventories, Zarit Burden Interview and Maslach Burnout Inventory. RESULTS: Caregivers poor perceived health was associated with emotional exhaustion, burden, depression and anxiety. Logistic regression analyses revealed caregivers' age, anxiety and physical problem as the main predictors of health self-perception. CONCLUSION: Aged family caregivers with anxiety who also report physical problem characterize a group at risk for poor self-perceived health. Evaluation of health self-perception may be useful for designing interventions to improve anxiety and physical health.
20
Bader, S., E. Ellouz, R. Abderrahim, M. Abbas, and K. Mdhaffer. "Socio-demographic and clinical features of patients with dementia attended in the psychiatry department." European Psychiatry 64, S1 (April 2021): S744. http://dx.doi.org/10.1192/j.eurpsy.2021.1971.
Full textAbstract:
IntroductionDementia’s prevalence increases due to population aging, it has become a major public health concern.ObjectivesTo estimate the incidence of dementia and to describe the socio-demographic and clinical profile of patients attended in the psychiatry department of Gabes (Southern of Tunisia).MethodsIt was a retrospective descriptive study including all the patients who attended for the first time in the psychiatry department of Gabes, from the 1st January, 2010 to December 31, 2018, and who were diagnosed with dementia according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Socio-demographic and clinical data were assessed. The Mini Mental State Examination (MMSE) was used as a neuropsychological examination.ResultsWe included 98 patients. The mean annual hospital incidence of dementia was 2.38%. The mean age was 76.5 ± 9.8 years. Patients were married (68%), illiterate (68%) and jobless (42.9%). A family history of dementia was noted in 39.8% of patients. The common cardiovascular comorbidity was high blood pressure (41.8%). Among our patients, 30 (30.6%) were smokers. The mean age of onset of dementia was 73 ± 11 years. The mean duration of untreated dementia was 3 years [3 months to 11 years]. First symptoms were mainly memory disorders (57.3 %) and behavioral disorders (17.3%) The mean MMSE score was 14 ± 4.8. Alzheimer’s disease was the most frequent etiology of dementia (80 cases, 82.7%).ConclusionsOur study shows a high incidence of dementia and made it possible to draw up a socio-demographic and clinical profile of dementia patients.DisclosureNo significant relationships.
21
McHale, Cathy, Martina McGovern, Josephine Dewergifosse, Maria Domsa, Anna McMahon, Fergus Timmons, Julei Greene, et al. "330 Insights into Dementia- An Integrated Care Approach to Family Support." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.213.
Full textAbstract:
Abstract Background The increase in the number of people with dementia in the coming years will be significant and could be as high as 132,000 people by 2041. There is a growing need for enhanced post diagnostic supports for patients living with dementia and their families. We identified the need for a localised educational resource for families and supportive others attending our specialist memory service Methods Staff from the Integrated Care Team, Specialist Memory Service and Primary Care were trained by the Alzheimer’s Society of Ireland to deliver a 6 week ‘Insights Into Dementia’ carers course. Tutors and dementia advisors from the Alzheimer’s Society of Ireland provided in-depth training prior to course delivery and feedback to the facilitators on a weekly basis. The course included advice and education on Dementia; Changing Relationships, Communication; Responding to changes in behaviour; Nutrition; Engaging in activities; Assisting with personal care and Safety in the home. Families gained advice regarding their self-care needs and learned how to access information and support. All services involved worked together to identify, refer and support families with dementia in the local area. The group took place in an accessible location at a time which accommodated families to attend. Each course attendee completed a questionnaire prior to and after commencing the group. Results The group has delivered education and support to 48 families to date. Feedback from participants was very positive with self-reported increase in confidence, knowledge and awareness about dementia. Waiting time to access support has significantly decreased. Every course has led to a support group who meet up on a regular basis in their community. Conclusion This novel collaboration has become a key part of the integrated care pathway we have developed to support people living with dementia and their supportive others in our catchment area. The Integrated Care approach has served to enrich the programme and allow for timely signposting to localised supports.
22
Sidenkova, A. "The psychosocial factors in the formation of symptoms of dementia." European Psychiatry 64, S1 (April 2021): S125. http://dx.doi.org/10.1192/j.eurpsy.2021.351.
Full textAbstract:
IntroductionThe growing prevalence of severe cognitive impairment in populations, the involvement of a significant number of people of working age in the medical, psychological and social problems associated with dementia, the insufficiency and inconsistency of information about the mechanisms of formation of these disorders actualize a comprehensive social study of dementia.Objectivesthe psychosocial mechanisms of the formation of clinical, functional disorders in dementia, to develop comprehensive medical and psychosocial programs to help patients with dementia and those involved in caring for them, based on the proposals of the psychosocial model of dementiaMethodsA selective observational comparative dynamic study of 315 people with Alzheimer’s dementia and 214 people who care for the patients was carried out.ResultsChanges in family-role and social parameters, a high level of “expressed” emotions of caregivers have an adverse effect on the development of psychotic (r = 0.618), affective (r = 0.701), behavioral (r = 0.837) dementia disorders. The degree of adherence to anti-dementia therapy by the caregiver is one of the important factors determining the amount of care received by the patient (r = 0.698). Agitation / aggression (r = 0.761), anxiety (r = 0.562), sleep disturbances (r = 0.521) contribute to increased compliance. The low satisfaction of the caregiver with premorbid (r = 0.698) and current (r = 0.653) relationships with the patient leads to a decrease in the compliance of the caregiver.ConclusionsThe mechanism of psychopathological symptoms, functional disorders is heterogeneous, depending on the biological causes and psychosocial conditions of functioning of patients.DisclosureNo significant relationships.
23
Kagawa, Yoshiyuki, Yoshiaki Yamamoto, Ayami Ueno, Kengo Inomata, Mayu Tezuka, Takashi Osawa, Yasuharu Yazawa, Toshio Maeda, and Tomokazu Obi. "Impact of Plasma Donepezil Concentration on Behavioral and Psychological Symptoms of Dementia in Patients with Alzheimer’s Disease." Dementia and Geriatric Cognitive Disorders Extra 11, no. 3 (December 2, 2021): 264–72. http://dx.doi.org/10.1159/000516938.
Full textAbstract:
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.
24
Larsen, Lill Sverresdatter, Hans Ketil Normann, and Torunn Hamran. "Processes of user participation among formal and family caregivers in home-based care for persons with dementia." Dementia 16, no. 2 (July 27, 2016): 158–77. http://dx.doi.org/10.1177/1471301215584702.
Full textAbstract:
Scandinavian health policy supports prolonged home-based care for people with dementia. User participation is expected to reduce family burden. The aim of this study was to explore how formal and family caregivers experience collaboration while providing home-based dementia care, with a focus on user participation. Seventeen qualitative in-depth interviews were conducted among formal and family caregivers in rural municipalities. The theme identified during this process was ‘negotiating participation in decisions’. This theme was analysed using positioning theory. Concepts such as user participation are ambiguous, and caregivers negotiate positions during decision-making processes. Such negotiations are caused by the problematic relationships among patients’ legal consent, undefined spokespersons and pragmatic care practices. These constant negotiations enable or obstruct collaboration in several situations. User participation as a concept might contribute to conflicts during collaborations. Dialogues about user participation that focus on consent and spokespersons could reduce the burden created by negotiations in practice.
25
Gavin, Nicole, Mu Shan, Shelly Johns, Katherine Judge, and Nicole Fowler. "The Relationship Between Family Caregivers’ Anticipatory Grief and Severity of Dementia." Innovation in Aging 5, Supplement_1 (December 1, 2021): 955–56. http://dx.doi.org/10.1093/geroni/igab046.3449.
Full textAbstract:
Abstract Anticipatory grief is the process of experiencing normal bereavement before the physical death of a significant person. To date, anticipatory grief has been related to higher levels of caregiver depression, anxiety, subjective burden, and poorer problem solving. Additionally, higher levels anticipatory grief are observed in caregivers of those with Alzheimer’s Disease and Related Dementias (ADRD) compared to caregivers of those with mild cognitive impairment, implying a relationship between disease severity and caregiver anticipatory grief. Analyses were performed on data for ADRD caregivers (n=56) enrolled in the IU Telephone Acceptance and Commitment Therapy for Caregiver (TACTICs) trial; an RCT evaluating an ACT intervention for ADRD caregivers with anxiety. Inclusion criteria included identifying as the primary caregiver of an ADRD patient, and clinically significant anxiety (GAD7 score >10). The average age of caregivers was 61.9 years, 41.1% were spouses, 83.9% were white and 14.3% were black. Mean anticipatory grief scores were notably higher (84.6) compared to the previously reported means across the literature (74.9). Using multiple regression models, we determined a caregivers’ anticipatory grief, as measured by the anticipatory grief scale, is not significantly associated with the patients’ dementia severity, as measured by the Dementia Severity Rating Scale (DSRS) (p=0.66), Results revealed that higher levels of caregiver burden, as measured by the Zarit Burden Index, are significantly associated with more anticipatory grief (p< 0.01). Understanding these relationships contributes to a better understanding of ADRD caregivers, identifying “high-risk” caregivers, and informing future interventions and care.
26
Suvanchot, K. Sinsak, and Wipawan Chaoum Pensuksan. "Factors affecting sleep among Thai people with dementia attending an outpatient psychiatric department." Dementia 19, no. 2 (March 1, 2019): 135–47. http://dx.doi.org/10.1177/1471301219833886.
Full textAbstract:
Sleep quality is a well-studied aspect of overall health, especially for those who have other compounded health issues like dementia. This study identified what factors affected sleep quality among Thai people with dementia who attended an outpatient psychiatric department. While we considered factors associated with poor sleep quality, we discussed the impact that family relationship specifically has on sleep quality for this population. A cross-sectional study was conducted among 80 patient–caregiver dyads. All patients were assessed by the TMSE, a neuropsychiatric assessment (Thai Mental State Examination). The PSQI (Pittsburgh Sleep Quality Index) was administered and multiple factors affecting sleep were investigated through face-to-face interviews with each patient and caregiver dyad. Interviews were conducted by a psychiatric nurse at a hospital offering outpatient psychiatric care. A chi-square test, t test, Spearman correlation, Pearson’s correlation, and logistic regression were applied to identify statistically significant associations. Overall, we found that the prevalence of poor sleep in our target population was 70%, with a high sleep score (8.14 ± 4.20). Factors affecting sleep included mental health problems, night-time cough and urinary frequency, pain and fever during the night, sleep environment problems, and stimulant use (63.8%, 57.5%, 47.5%, 20%, and 7.5%, respectively). Other factors previously associated with poor sleep quality in other studies were not associated in this study. Those with perceived poor family relationships are at a 5.57 times greater risk for poor sleep than those with perceived good family relationships. On the contrary, those without mental health problems significantly decreased their overall risk for poor sleep. Further investigation into these associations should be studied. In conclusion, health-care providers are encouraged to consider the impact of family context on sleep quality for people with dementia.
27
Mudrenko, I., O. Potapov, and E. Alswaeer. "The program of complex differentiated medical and psychological rehabilitation of suicidal behavior in dementia." European Psychiatry 64, S1 (April 2021): S829. http://dx.doi.org/10.1192/j.eurpsy.2021.2190.
Full textAbstract:
IntroductionThe course of dementia is accompanied by aggression, wandering, agitation, sexual and eating disorders, suicidal behavior (SB).ObjectivesDevelop and approbate a program of medical and psychological rehabilitation (MPRP) SB in patients with dementia.MethodsIt were treated 199 patients with SB in dementia of which 107 get cured according to the developed programs and 92 people received traditional treatment.ResultsThe program of MPRP combines pharmacotherapy, psychotherapy psychoeducation, psychological training and developed taking into account the mechanisms and predictors of SB. The program included phases: diagnostic phase, phase of active intervention, psychoprophylactic phase. Pathogenetic treatment of dementia was performed with acetylcholinesterase inhibitors and / or NMDA-receptor blockers for 4-6 months. Patients with dementia with a depressive mechanism of SB were additionally prescribed antidepressants from the class of SSRIS for 3-4 months; with the psychotic mechanism of SB – atypical neuroleptics (risperidone, quetiapine) for 2-3 months. The system of psychotherapeutic and psychosocial intervention included rational and family psychotherapy, cognitive training, self-care training and psychoeducation for patients with the cognitive mechanism of SB – art therapy and family psychotherapy, communicative trainings and psychoeducation for patients with the depressive mechanism of SB; crisis psychotherapy and art therapy, social skills training and psychoeducational classes for patients with a psychotic mechanism. Improvement of mental state and reduction of symptoms of SP were diagnosed in 72.9% of patients, and after the use of traditional forms of prevention – only in 40.2% (DC=2.58; MI=0.43, p>0.001).ConclusionsThe results of approbation MPRP program in SB testify to its effectiveness.DisclosureNo significant relationships.
28
Cullen, Karen M., Zoltán Kócsi, and Jonathan Stone. "Pericapillary Haem-Rich Deposits: Evidence for Microhaemorrhages in Aging Human Cerebral Cortex." Journal of Cerebral Blood Flow & Metabolism 25, no. 12 (May 25, 2005): 1656–67. http://dx.doi.org/10.1038/sj.jcbfm.9600155.
Full textAbstract:
In this Post mortem study, we examined haem-rich deposits (HRDs) in patients with and without dementia, using a histochemical label (Prussian blue) to show haem, autofluorescence to detect red blood cells (RBCs), and immunohistochemistry for clotting-related factors and collagen IV. The patients studied had no clinical or Post mortem evidence of macrovascular stroke. To allow examination of the spatial relationships between HRDs and the microvasculature, we cut 45-µm sections. Haem-rich deposits were small (< 200 µm diameter). They were rare in younger (< 50 years) patients but were more common in older (> 70 years) patients, particularly in cerebral cortex, and were most abundant in cases with senile plaques. Wherever HRDs appeared they were perivascular and appeared to form around capillaries or small arterioles. Using a software package (Proxan) developed to outline vessels and HRDs, and to analyse the distances between them, a tight spatial correlation between HRDs and capillaries was shown. In addition, HRDs were rich in von Willebrand factor (vWF), fibrinogen, collagen IV and RBCs. These observations suggest that HRDs are the residua of capillary bleeds (microhaemorrhages), and that microhaemorrhages are a common feature of the aging cerebral cortex, particularly where plaque pathology is present.
29
Ju, Eunae, Melissa Pinto, and Jung-Ah Lee. "Use of Actigraphy on sleep outcomes for dementia family caregivers: an integrative review." Innovation in Aging 5, Supplement_1 (December 1, 2021): 799–800. http://dx.doi.org/10.1093/geroni/igab046.2946.
Full textAbstract:
Abstract Sleep difficulties are one of the foremost health problems that affect family caregivers of dementia patients increasing their risk for a host of mental health problems and hastening dementia patients’ transitions to long-term care facilities. This integrative review aims to describe the objective measurement of sleep quality parameters of family caregivers using actigraphy and how well they are associated with self-reported subjective measures of sleep outcomes and psychological states. A search was performed using PubMed, CINAHL, and PsycInfo including articles from 2011 to 2020. Twenty studies met the inclusion criteria. Five sleep interventions (2 RCTs and 3 pre-post design) were found, including multi-component interventions (e.g., sleep hygiene, walking, day-time light therapy) that used actigraphy and other self-report measures. Duration of wearing actigraphy (wrist band/watch) varied in studies (3-days to 8-weeks). Most studies reported high accuracy and sensitivity of actigraphy. Sleep parameters measured by actigraphy included ‘total sleep time’, ‘sleep efficiency’, ‘deep/light sleep’, or ‘wake time after sleep onset’. In eight studies, sleep parameters measured by actigraphy were significantly associated with sleep outcomes measured by sleep related self-reported scales (Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, all Ps<.05). Eleven studies used actigraphy to examine sleep measures associated with various mental health states (depression, burden, stress, positive/negative affect) and found significant relationships (All Ps <.05). Findings support that use of actigraphy for dementia family caregivers is a valid measure of sleep parameters when compared with their sleep self-reports. Furthermore, it was found that actigraphy sleep measures were significantly associated with psychological outcomes.
30
Sidenkova, Alena. "549 - Psychosocial factors in the formation of non-cognitive symptoms of dementia." International Psychogeriatrics 33, S1 (October 2021): 91. http://dx.doi.org/10.1017/s1041610221002441.
Full textAbstract:
Background:The growing prevalence of severe cognitive impairment in populations, the involvement of a significant number of people of working age in the medical, economic, psychological and social problems associated with late dementia, the insufficiency and inconsistency of information about the mechanisms of formation of these disorders actualize a comprehensive medical and social study of dementia.The goal is to study the psychosocial mechanisms of the formation of clinical, functional disorders in dementia, to develop comprehensive medical and psychosocial programs to help patients with dementia and those involved in caring for them, based on the proposals of the psychosocial model of dementia.Methods:A selective observational comparative dynamic study of 315 people with Alzheimer’s dementia and 214 people who care for the patients was carried out. The study used clinical, clinical, psychopathological, neuropsychological, psychometric, sociometric, and statistical research methods.Results:An increase in the severity of dementia contributes to a significant (p <0.05) increase in the number of patients in a dependent position in the family. The appearance of psychotic (painful ideas [r = 0.589]), behavioral (agitation/aggression [r = 0.654]), affective (anxiety [r = 0.536], unstable mood/irritability [r = 0.581]) symptoms of dementia contribute to family role changes structure and increase interpersonal distance in the dyad “caretaker - patient.” Decreased functional activity of the patient (r = 0.758), development of behavioral disorders (aberrant behavior [r = 0.675], agitation/aggression [r = 0.713], impaired night behavior [r = 0.597]), affective symptoms (anxiety [r = 0.685]) contribute to aggravation of the distress of the caregiver. Those who provide unprofessional care for dementia patients in a statistically significant (p <0.05) majority of cases have a high level of emotional involvement in the care process. Changes in family-role and social parameters, a high level of “expressed” emotions of caregivers have an adverse effect on the development of psychotic (r = 0.618), affective (r = 0.701), behavioral (r = 0.837) dementia disorders. The degree of adherence to anti- dementia therapy by the caregiver is one of the important factors determining the amount of care received by the patient (r = 0.698). Agitation/aggression (r = 0.761), anxiety (r = 0.562), sleep disturbances (r = 0.521) contribute to increased compliance. The low satisfaction of the caregiver with premorbid (r = 0.698) and current (r = 0.653) relationships with the patient leads to a decrease in the compliance of the caregiver.Conclusion:It was revealed that the formation of cognitive impairment is caused by biological factors, their severity depends on the severity of dementia. The mechanism of psychopathological symptoms, functional disorders is heterogeneous, depending on the biological causes and psychosocial conditions of functioning of patients.
31
Balsinha, Conceição, Steve Iliffe, Sónia Dias, and Manuel Gonçalves-Pereira. "431 - DEMENTIA IN PRIMARY CARE AND DOCTOR-PATIENT-CARER INTERACTIONS: PRELIMINARY FINDINGS." International Psychogeriatrics 32, S1 (October 2020): 147. http://dx.doi.org/10.1017/s1041610220002847.
Full textAbstract:
INTRODUCTION: Primary care visits of persons with dementia involve different types of communication, bringing together the patient, the family carer and the general practitioner (GP). A particular challenge is the necessary involvement of a third person (the carer) in patient-doctor encounters (or the patient in carer-doctor encounters, as dementia advances). These triad dynamics should be better understood, as health outcomes are expected to result from or be mediated by them.OBJECTIVE: Our aim is to explore triadic dynamics in Portuguese primary care consultations with persons with dementia, their family carers and GPs.METHODS: This is the first part of an ongoing project (Dementia in Primary Care: the Patient, the Carer and the Doctor in the Medical Encounter - Bayer Investigation Grant | NOVAsaúde Ageing 2018). Consultations with persons with dementia, their carers and GPs (purposive sampling) are audio-recorded, transcribed verbatim and thematically analysed. We report the analysis of interactions of the first six consultations, using NVIVO® software.RESULTS: The most frequent type of interaction was between GPs and carers, followed by interactions involving the whole triad. The patients who had more recent relationships with their GPs tended to participate less, irrespective of the stage of dementia. Carers were the ones most often initiating triadic interactions, and GPs the ones most often terminating them by directly addressing the patients. Doctor-carers interactions were very sparse in some consultations.DISCUSSION AND CONCLUSION: These preliminary findings suggest that doctor-patient interactions may be limited in a number of GPs’ consultations, seemingly compromising patient-centred approaches. Nevertheless, even when GPs were involved in triadic interactions they often tried to address the patient directly. We are looking forward to complete this part of the project: to our knowledge, there is practically no evidence from live-recorded primary care consultations about these triadic dynamics.
32
Truzzi, Annibal, Letice Valente, Eliasz Engelhardt, and Jerson Laks. "The association between caregiver distress and individual neuropsychiatric symptoms of dementia." Dementia & Neuropsychologia 7, no. 3 (September 2013): 286–91. http://dx.doi.org/10.1590/s1980-57642013dn70300009.
Full textAbstract:
ABSTRACT Neuropsychiatric symptoms (NPS) of dementia constitute one of the most related factors to caregiver burden and patients' early institutionalization. Few studies in Brazil have examined which symptoms are associated with higher levels of caregiver distress. Objective: To evaluate the caregiver distress related to individual NPS in familial caregivers of patients with dementia. We also examined which caregiver and patient factors predict caregiver distress associated with NPS. Methods: One hundred and fifty-nine familial caregiver and dementia outpatient dyads were included. The majority of the patients had a diagnosis of Alzheimer's disease (66.7%). Caregivers were assessed with a sociodemographic questionnaire, Beck Anxiety and Depression Inventories, and the Neuropsychiatric Inventory - Distress Scale. Patients were submitted to the Mini-Mental State Examination, Functional Activities Questionnaire, and the Neuropsychiatric Inventory. Spearman's rank correlation was used to assess the relationships between the continuous variables. Multiple linear regression analyses with backward stepping were performed to assess the ability of caregiver and patient characteristics to predict levels of caregiver distress associated with NPS. Results: Apathy (M=1.9; SD=1.8), agitation (M=1.3; SD=1.8), and aberrant motor behavior (AMB) (M=1.2; SD=1.7) were the most distressful NPS. The frequency/severity of NPS was the strongest factor associated with caregiver distress (rho=0.72; p<0.05). Conclusion: The early recognition and management of apathy, agitation and AMB in dementia patients by family members and health professionals may lead to better care and quality of life for both patients and caregivers.
33
Nguyen, Christopher M., Cady Block, John Linck, and Natalie Denburg. "DEVELOPMENT AND VALIDATION OF THE TESTAMENTARY CAPACITY MEASURE AMONG OLDER ADULTS AND PATIENTS WITH DEMENTIA." Innovation in Aging 3, Supplement_1 (November 2019): S705—S706. http://dx.doi.org/10.1093/geroni/igz038.2594.
Full textAbstract:
Abstract As the growth of the population aged 65 and older is projected to be one of the most substantial demographic trends in history, geriatricians and other professionals working with older adults will be regularly consulted for opinion regarding an individual’s testamentary capacity (Brenkel et al., 2018). For individuals with severe cognitive and psychiatric impairment, the reduced capacity to make decision is evident. However, testamentary capacity among individuals with mild or moderate cognitive impairment has been mixed: some patients with mild cognitive impairment may be incapable of will making, while other patients with moderate cognitive impairment may have testamentary capacity (Spar & Garb, 1992). While several measures of testamentary capacity have been developed, these instruments are either not available for clinicians or lacks the sophistication of a comprehensive assessment (Marson, Huthwaite, & Herbert, 2004; Papageorgiou et al., 2018). With increasingly complex modern family structures (e.g., multiple marriages and stepchildren from these relationships), together with a projected largest transfer of wealth in human history about to occur in the next 30 years (Havens and Schervish, 2003), more standardized assessment procedures for testamentary capacity will be valuable for clinicians working with geriatric populations. In this study, healthy community-dwelling older adults and patients with Major Neurocognitive Disorder due to Alzheimer’s disease were recruited to participate in a validation study of a proposed testamentary capacity measure. Preliminary findings and implications are discussed.
34
Scott, T. L., J. Liddle, N. A. Pachana, E. Beattie, and G. K. Mitchell. "Managing the transition to non-driving in patients with dementia in primary care settings: facilitators and barriers reported by primary care physicians." International Psychogeriatrics 32, no. 12 (February 20, 2019): 1419–28. http://dx.doi.org/10.1017/s1041610218002326.
Full textAbstract:
ABSTRACTObjectives:This research addresses dementia and driving cessation, a major life event for affected individuals, and an immense challenge in primary care. In Australia, as with many other countries, it is primarily general practitioners (GPs) who identify changes in cognitive functioning and monitor driving issues with their patients with dementia. Qualitative evidence from studies with family members and other health professionals shows it is a complicated area of practice. However we still know little from GPs about how they manage the challenges with their patients and the strategies that they use to facilitate driving cessation.Methods:Data were collected through five focus groups with 29 GPs at their primary care practices in metropolitan and regional Queensland, Australia. A semi-structured topic guide was used to direct questions addressing decision factors and management strategies. Discussions were audio recorded, transcribed verbatim and thematically analyzed.Results:Regarding the challenges of raising driving cessation, four key themes emerged. These included: (i) Considering the individual; (ii) GP-patient relationships may hinder or help; (iii) Resources to support raising driver retirement; and (iv) Ethical dilemmas and ethical considerations. The impact of discussing driving cessation on GPs is discussed.Conclusions:The findings of this study contribute to further understanding the experiences and needs of primary care physicians related to managing driving retirement with their patients with dementia. Results support a need for programs regarding identification and assessment of fitness to drive, to upskill health professionals and particularly GPs to manage the complex issues around dementia and driving cessation, and explore cost-effective and timely delivery of such support to patients.
35
Bouranis, Nicole, Sherril Gelmon, Elizabeth Needham Waddell, Dawn Richardson, Hyeyoung Woo, and Allison Lindauer. "Improving Dementia Clinical Research Participation: Strategies From a Portland, Oregon, Pilot Study." Innovation in Aging 4, Supplement_1 (December 1, 2020): 57–58. http://dx.doi.org/10.1093/geroni/igaa057.187.
Full textAbstract:
Abstract The NIA’s strategy to improve ADRD clinical research participation emphasizes local community collaboration. Literature that focuses on a person with dementia’s decision to participate in research does not speak to specific state or local factors nor the effects of local efforts. This study aimed to develop strategies to improve dementia research participation in the Portland, OR metropolitan area. A community advisory board comprised of clinicians, researchers, advocates, people with dementia, family caregivers, and older African Americans was established for this project. Thirty-three interviews were conducted with clinicians, researchers, advocates, people with ADRD, and family caregivers. The Robert Wood Johnson Foundation’s Culture of Health Action Framework was used to conceptualize motivation strategies and reflect elements that describe research participation among people with dementia. Strategies were identified to improve dementia clinical research participation: 1) Identify and promote local champions for ADRD clinical research participation; 2) Promote policies and processes that incentive cross-sector collaboration; 3) Recognize caregivers as full research participants; 4) Include people with ADRD and caregivers in the research design process; 5) Offer alternative options to reduce participation burden; 6) Evaluate and improve relationships between healthcare/research staff and patients/participants. These strategies can be used in conjunction with the Culture of Health Action Framework as a roadmap to form organization-community partnerships, facilitate motivation and empowerment, give decision-making power to people with ADRD and promote a local culture of research. Studies should be conducted in a larger context or as pilots in other communities to determine contextual relevance and generalizability for other areas.
36
Mengell, Kirsten, Alyssa Indelicato, Sarah Lawler, Nancy Smith, Sharon Brangman, and Telisa Stewart. "A Virtual Health Library for Dementia Patients and Caregivers to Improve Quality of Information and Communication." Innovation in Aging 4, Supplement_1 (December 1, 2020): 249. http://dx.doi.org/10.1093/geroni/igaa057.802.
Full textAbstract:
Abstract Access to accurate health information is critical for patient decision making and health communication. Unfortunately, there is limited quality health information for dementia patients and their caregivers. A Virtual Health Library (VHL) provided access to credible health information through the electronic medical record (EMR) to reach the dementia patients and their caregivers. A VHL was created and brought together clinicians, caregivers, technology support personnel, public health professionals, and the health sciences library. The team identified areas of interest and met monthly to create VHL materials. Materials included voice-over slides and 1-page educational content that was uploaded to the EMR for patient and caregiver access. A baseline and final questionnaire assessed demographics, empowerment, and shared decision making for both the patient and the caregivers and a pre/post was created for each module to asses knowledge and stratification. Initially, 1331 patients with dementia were recruited for the project from a university geriatrics department. The population had a 28.3% enrollment in the EMR and only 3.8% used the EMR in the past six months. Of this pool, during the initial launch 32 patients and or caregivers completed the baseline within the first week. 98% of respondents were caregivers with an average age of 58.7. With the youngest caregiver 42 and the oldest 88. Of the caregiver’s relationships to the patients is 43.3% their child, 40% their spouse, 10% other family, and 6.7% friends. During the project, participants improved access to health information and became empowered to engage with their healthcare provider.
37
Brandt, Teresa, Theresa Frangiosa, Virginia Biggar, Angela Taylor, Bill Keller, and Vic Abler. "410 - Dementia-related Psychosis Symptoms and Impact from the Patient and Care Partner (Caregiver) Perspective: an Observational, Prospective Study to Describe the Patient Experience." International Psychogeriatrics 32, S1 (October 2020): 126. http://dx.doi.org/10.1017/s104161022000263x.
Full textAbstract:
Background:This study aimed to describe the person-centered experience of symptoms and impact of dementia-related psychosis (DRP) from a patient and care partner (CP) perspective.Methods:This observational, non-interventional, prospective study collected patient experience data to understand the impact of DRP in persons with various dementia subtypes. Qualitative interviews were conducted with persons or their CP who have a clinical diagnosis of all-cause dementia with psychotic symptoms, recruited through physician referrals. The quantitative online survey was completed by persons with self-reported DRP or their CP recruited by advocacy groups: UsAgainstAlzheimer’s and the Lewy Body Dementia Association. CP burden was beyond the scope of this study.Results:Sixteen individuals (1 patient, 15 CP) participated in the qualitative interview. The most commonly reported symptoms of DRP were visual hallucinations (88%), auditory hallucinations (69%), and persecutory delusions (56%). Participants described an impact of DRP on activities of daily living (75%), sleep (63%), family life (56%), and safety concerns (56%).The quantitative portion was completed by 212 participants (26 patients, 186 CP). DRP symptoms most frequently reported by patients were visual hallucinations (89%), auditory hallucinations (54%), and distortion of senses (54%); those reported by CP were paranoid delusions (76%), visual hallucinations (75%), and lack of trust for loved ones (52%). For patients with recent visual hallucinations, 61% of patients and 70% of CP reported experiencing this symptom on a weekly basis. When asked to rank the impact on the patient’s life, patients reported that visual hallucinations were the most impactful symptom whereas CP reported paranoid delusions/false beliefs as most impactful, followed by visual hallucinations. Difficulty differentiating what is real from what is not real, increased anxiety, and effects on personal relationships were the most common types of impacts reported by both patients and CP. Most patients (>40%) were not receiving medications for DRP.Conclusions:Persons with DRP experience hallucinations and delusions that have a substantial impact on their lives. Here, patient experience data demonstrate that there is a need for treatments to reduce the symptoms and impacts of DRP.Study Sponsored By: ACADIA Pharmaceuticals Inc.DisclosuresTF is a consultant with Frangiosa & Associates, LLC.VB and AT have no relevant financial relationships to disclose.TB, BK, and VA are employees of and may hold stock and/or stock options with ACADIA Pharmaceuticals Inc.
38
Konerding, Uwe, Tom Bowen, Paul Forte, Eleftheria Karampli, Tomi Malmström, Elpida Pavi, Paulus Torkki, and Elmar Graessel. "Do Caregiver Characteristics Affect Caregiver Burden Differently in Different Countries?" American Journal of Alzheimer's Disease & Other Dementiasr 34, no. 3 (December 30, 2018): 148–52. http://dx.doi.org/10.1177/1533317518822047.
Full textAbstract:
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.
39
Hsieh, Chia-Jung, Pei-Fang Yin, Chi-Yi Chiu, Yu-Ping Hsiao, and Yu-Ling Hsiao. "Support and Empowerment for Older Adult Spousal Caregiving of People with Mild and Moderate Dementia: A Participatory Action Research." Healthcare 10, no. 3 (March 18, 2022): 569. http://dx.doi.org/10.3390/healthcare10030569.
Full textAbstract:
Background: Little attention has been given to the older adult caregivers of spouses with mild and moderate dementia in the caring dynamics process. The aim of this action research was to develop a program for providing support and empowerment to older adult caregivers of spouses with mild and moderate dementia in the community. Methods: The researchers acted as facilitators, with a view to empowering participants. We recruited participants from a day-care center and two community service stations. Data were collected with semi-structured, in-depth interviews with 19 dementia care dyads and from the notes, reflections, and feedback of collaborative researchers. Relevant themes for content analysis were extracted. Results: Three action cycles were completed over 18 months. The results revealed goals of three cycles: to connect the home situation and effective dialogue as a bridge to the researcher, to confirm the daily needs or expectations of the caregiver and the patient, and to enhance the interactions and quality of life of family members with resources and network. This process was cyclical and repetitive, and it also generated partnerships that built relationships among the interdisciplinary team, families, and researchers. At the same time, team workers formed a cooperative and coordinated family service mechanism to reflect the professional values and practice capabilities. Conclusions: The intervention program was based on the promotion of factors for the caregiver, linking to environmental protective factors, and the stabilization of mental and neurological symptoms of dementia patients, thereby enhancing the response capabilities of home caregivers while meeting the patient’s care needs in life. It is a tool that can effectively be used for support and empowerment in this population.
40
Velakoulis, Dennis, Mark Walterfang, Ramon Mocellin, Christos Pantelis, Brian Dean, and Catriona McLean. "Abnormal Hippocampal Distribution of TDP-43 in Patients With-Late Onset Psychosis." Australian & New Zealand Journal of Psychiatry 43, no. 8 (January 1, 2009): 739–45. http://dx.doi.org/10.1080/00048670903001984.
Full textAbstract:
Objective: Young patients with frontotemporal dementia (FTD) may present with schizophrenia-like psychosis. Few studies have investigated whether FTD-like neuropathological changes are present in schizophrenia. The purpose of the present study was therefore to determine whether FTD-like abnormalities in TARDNA binding protein (TDP-43) and ubiquitin are detectable in hippocampal dentate gyrus of patients with schizophrenia and bipolar disorder. A secondary objective was to identify clinicopathological relationships of any such abnormalities. Methods: Hippocampal sections from 12 patients (nine with schizophrenia and three with bipolar disorder) and 11 control subjects Facility from the National Neural Tissue Resource Centre, Melbourne were blindly rated for the presence or absence of normal TDP-43 staining or ubiquitin-positive neuronal inclusions within the dentate gyrus. The clinical files of all subjects were reviewed for demographic and clinical information. Results: In three patients the normal expression of nuclear TDP-43 staining was not detected. Significantly, all three subjects presented after the age of 50 and had an adult child diagnosed with the same psychiatric disorder. Conclusion: Abnormalities in TDP-43 nuclear expression were identified in patients with late-onset psychosis and a positive family history.
41
Girones, Regina, Jorge Aparicio, and Maria Dolores Torregrosa. "Communication of diagnosis in elderly lung cancer patients: Who is informed, what information is given, and what patients know and want to know." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e20643-e20643. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e20643.
Full textAbstract:
e20643 Background: Lung cancer chemotherapy decisions in patients > 70 years old are complex; in order to integrate patients in the decision-making process, they must be informed. To assess the modes of communication with older lung cancer patients, we prospectively collected data in order to assess patients’ level of knowledge about diagnosis and prognosis. We examined who informed the patient, the information given and what the patient knew and wanted to know. Relationships, among other parameters were presented. Methods: 83 patients diagnosed with lung cancer from January 2006 to February 2008 were recruited from a single center. Logistic regression and multiple imputation methods were used to assess associations between patient information and independent variables. Results: In the majority of cases, families received the diagnosis of lung cancer (92.8%). Family was more protective when the patients were elderly (p: 0,036), depressed (p: 0,054), had dementia (p: 0,03), had poor performance status (p: 0,03) or complied with frailty criteria (p: 0,014). At our institution, physicians who gave cancer diagnoses were not oncologists. We received the patient diagnosed yet. We found that they usually gave cancer diagnosis preferably to family members. Only 27,7% of patients were informed that they had tumors. There was a correlation between age and more protective attitudes on the part of physicians. 73,5% of patients actively solicited information, however elderly and frail patients tended to do so less. Conclusions: A large proportion of elderly lung cancer patients do not receive adequate information about their disease prior to contact with oncologists however they do actively ask for information and speak about cancer with oncologists. Information about cancer is difficult to provide, even in elderly patients.
42
Wang, Jing, and Bei Wu. "Caregiving Arrangements and Health Outcomes of Chinese Older Adults With Disability in Cross-National Settings." Innovation in Aging 4, Supplement_1 (December 1, 2020): 750. http://dx.doi.org/10.1093/geroni/igaa057.2702.
Full textAbstract:
Abstract This symposium focuses on the wellbeing of older adults with disability/cognitive impairment and their family caregivers. More specifically, it aims to understand how familly support, community resources utilization, internal migration, and immigrant status impact older adults’ caregiving arrangement, health outcomes and end-of-life preferences and family caregivers’ caregiving burden in China and the U.S. The first study explored how perceived spousal relationships and support impact dyadic experiences of living with cognitive impairment through a person-centered care lens during a three-year period. The second presentation examined the association between adult children’s support and the trajectories of depressive symptom level among Chinese older adults with disabilities. The third investigated how family relationship and immigrant status matter in advanced care planning (ACP) engagement and end-of-life preferences over burial plan among US-born and foreign-born older Chinese Americans living in Honolulu, Hawaii. The fourth study study explored family caregivers’ caregiving burden for community-dwelling patients with dementia and its associated factors. The last study conducted an inventory of longitudinal aging survey datasets to stimulate research on intersection of migration and caregiving arrangement. It paved the way to use existing high-quality datasets to examine the significant impact of massive rural-to-urban migration on caregiving arrangement among Chinese older adults. This symposium presents empirical evidence of the impact of family, migration and culture-related factors on caregiving arrangement and health outcomes of Chinese older adults. The presenters emphasize the importance of providing family-centered care and design culturally sensitive interventions to improve the health outcomes of older adults.
43
Kolsi, S., S. Hentati, and I. Baati. "Matricide in psychotic patients: About 3 case reports." European Psychiatry 64, S1 (April 2021): S538. http://dx.doi.org/10.1192/j.eurpsy.2021.1435.
Full textAbstract:
IntroductionMatricide is the murder of the mother and it is one the rarest reported homicides with rates varying between 1% and 4% of all murders. In our country, few studies have focused on this issue.ObjectivesTo precise circumstances of matricide in psychotic patients and the offender and victim’s profiles.MethodsWe report three clinical cases who were hospitalized in the department of Psychiatry “A” at the Hedi Chaker university hospital in Sfax, Tunisia, because of non-judicial proceedings for dementia during the year of 2019.ResultsAmong 3 cases, two patients were male and they were aged respectively 26 and 48 years old. The third was female. All of them had very low educational and income levels and they lived with the victim. In 2 cases, the victim-offender relationship was conflictive and there was already exhibited violent behavior towards victim.Two patients had a psychiatric follow-up and many hospitalizations. The diagnoses were schizophrenia and schizoaffective disorder. However, it was a poor compliance and an interruption of treatment. In the third case, the medicolegal procedure was inaugural. His diagnosis was schizophrenia.All the victims were illiterate and unemployed. Their middle age was 64 years.In all cases, the crime was not premeditated, motivated by persecution delusions including the mother. It was committed in the family house while using a blunt object. The post homicide reaction was marked by coldness.ConclusionsMatricide has always been considered one of the most abhorrent crimes. Regular evaluation of psychotic patients’ dangerousness signals is needed to reduce the acting out.Conflict of interestNo significant relationships.
44
Balode, Ineta, and Dzintra Lele-Rozentāle. "Lingvistikas nozīmība veselības aprūpes un medicīnas nozarē. Kopējie izaicinājumi un iespējas veselības aprūpē." Vārds un tā pētīšanas aspekti: rakstu krājums = The Word: Aspects of Research: conference proceedings, no. 24 (December 2, 2020): 243–54. http://dx.doi.org/10.37384/vtpa.2020.24.243.
Full textAbstract:
Dementia is a condition observed in persons afflicted with different brain diseases, first of all, with Alzheimer’s Disease. Alzheimer’s is the most common type of senile dementia. Limited cognitive and lingual capacity and other problems make the affected persons dependent on medical and social help. With the progression of the disease, the economic burden becomes heavy both for the family and society. So far, no effective medical treatment has been discovered, which could stop the decrease in brain capacity. However, early diagnosis of dementia symptoms is important because alternative individual preventive instruments can be implemented to slow down the progression of the disease and prolong the period of the relatively independent existence of patients. The worldwide known MoCA test is one of the most common instruments for testing persons worried about their mental condition and cognitive capacities. The test is translated and partially adapted in several languages, including Latvian. Our analysis was aimed at the question: does the Latvian test version respond to the requirements which are necessary to achieve optimal results. In other words, can it provide an objective rating of a lingual performance by the tested persons? The first critical inventory concerned three relevant parts: the formulation of tasks, the prescribed instructions, and the principles of interpretation of testing results. Several examples demonstrate that some deficits can be observed in all the analysed parts. Some tasks should be better adapted to the Latvian situation so that a lingual or cognitive test would be separated from the test of the-so-called world knowledge. The instructions should be formulated clearly, without using complicated grammatical structures (currently, some of them are more complicated than the tasks), and they should focus on the tasks instead of examiners’ activities. In some cases, the suggested interpretation principles of the test results cannot be seen as reasoned from the linguistic point of view. Some observations indicate that the translation of the test and its requirements or instructions were carried out by a person who does not deal professionally with linguistics. The main conclusion is that the current quality of the Latvian MoCA test needs a critical review and, possibly, complete revision. Thus, the interdisciplinary cooperation between linguists and physicians, as well as joint research, is an actual and necessary precondition for the improvement of health care in Latvia.
45
Mishara, Brian L. "Synthesis of Research and Evidence on Factors Affecting the Desire of Terminally Ill or Seriously Chronically Ill Persons to Hasten Death." OMEGA - Journal of Death and Dying 39, no. 1 (August 1999): 1–70. http://dx.doi.org/10.2190/5yed-ykmy-v60g-l5u5.
Full textAbstract:
Review of empirical studies indicates that suicide is more common in persons suffering from some physical illnesses (e.g., epilepsy, head injuries, Huntington's Chorea, gastrointestinal diseases, AIDS, and cancer), but other chronic diseases and disabilities have not been linked to increased suicide risk (e.g., blindness, senile dementia, multiple sclerosis, and other physical handicaps). The timing of increased suicide risk varies in different illnesses from early presymptomatic stages to the terminal phase. Difficulties in reliably determining when someone is “terminally ill” and problems of the competence of persons with a poor prognosis complicate empirical investigations of euthanasia, assisted suicide, and the desire to hasten death. The role of family and caregivers in end of life decisions needs further clarification. Researchers have found that pain and suffering and quality of life variables may be linked to the desire to die prematurely, particularly in cancer patients. Others find that clinical depression is a major factor. But, since depression is often present, we do not know why a small minority of depressed patients desire and choose to hasten death. Support for alternative hypotheses is examined, including the role of pre-morbid suicidality and depression, individual differences in coping strategies and indirect consequences of the illness. There is a need to clarify links between attitudes, which is the major variable studied, and actual behaviors and decisions. Furthermore, we need theoretical and empirical links between studies of suicide, which is linked to clinical depression and characterized by ambivalence and studies of euthanasia, which is often depicted as rational and with little ambivalence. Evaluative research should be conducted to determine if interventions to reduce the desire for a premature death by suicide, euthanasia, or assisted suicide are effective. In the light of this review, we present several considerations for those involved in proposing changes in public policy concerning euthanasia and assisted suicide.
46
Kipfer, Stephanie, Lorenz Imhof, and Andrea Koppitz. "Inclusion of the personal biography in daily care – a qualitative study / Einbezug der Biographie in den Pflegealltag – eine qualitative Studie." International Journal of Health Professions 3, no. 2 (February 10, 2016): 216–26. http://dx.doi.org/10.1515/ijhp-2016-0016.
Full textAbstract:
Abstract Introduction In Switzerland, 39% of nursing home residents have a dementia related disease. Behavioral symptoms are increasingly observed as dementia progresses. These symptoms impair patients’ quality of life and are distressing to family caregivers and nurses. A person-centered approach, which includes the resident’s individual biography, reduces such symptoms. The most current literature describes how therapists include biographical information in designated therapies. However person-centered care takes place not only in specific activities. Nurses are responsible for their patients’ care 24 hours a day. Aim The goal of this study is to explore how nurses include biographical information in their daily care. Method Data were collected from qualitative interviews with registered nurses (n=10) in a nursing home and analysed according to the Charmaz Grounded Theory approach. Results The inclusion of the personal biography in daily care appears as a continuous, repetitive process with three main categories: “negotiating”, “connecting” and “being-in-good-hands”. Nurses in this study report that they can trigger positive reactions and reduce behavioral symptoms by means of meaningful interventions, when connected to the residents’ biography. Meaningful interventions can support residents in making contact to their current everyday life, acting independently and perceiving self-efficacy (= connecting). To initiate meaningful interventions, nurses need to connect biographical information to current experiences of the resident (= negotiating). This requires a thorough understanding of the residents’ situation. Nurses obtain an in-depth understanding through caring relationships, which are characterized by continuity of care and a mutual dialogue, where needs and experiences are shared, understood and evaluated (= being-in-good-hands).
47
Kontrimiene, Ausrine, Aurelija Blazeviciene, Ida Liseckiene, Gediminas Raila, Leonas Valius, and Lina Jaruseviciene. "Partnership between Primary Health and Social Care Services in the Long-Term Care of Older People with Dementia: A Vignette Study." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 58 (January 2021): 004695802110119. http://dx.doi.org/10.1177/00469580211011933.
Full textAbstract:
Dementia is considered to be a significant cause of disability and dependency for older people worldwide and it raises difficulties in providing adequate formal and informal assistance. Research on the experience of long-term care (LTC)services for older people with dementia is scarce in Eastern European countries. This study aimed to understand the system of care for older people with dementia from the perspective of health and social care workers providing LTC services in Lithuania. A total of 72 primary health care and social care professionals from public and private institutions in Kaunas city participated in this study. One-to-one interviews were conducted with family physicians, community nurses, psychiatrists, psychiatric nurses, and social workers. A vignette situation of 2 fictitious patients with dementia and their informal caregiver was discussed during the interviews. Data were analyzed using thematic analysis by induction approach. The data revealed 2 main themes: LTC provision trajectory, and three-dimensional relationship perception in realization of LTC activities. LTC provision trajectory reflected activities performed as a response to the described situation embracing formal procedures for the endorsement of LTC needs as well as the range of LTC services. The three-dimensional perception of relationships in LTC services’ implementation reflected the participants’ personal approach toward LTC, relationship with different specialists, and the informal caregiver. Our study revealed the potential of complex measures that could be instrumental for the refinement of the caregiving process. First, a change in the additional care requirements endorsement logic is needed, shifting focus from medical diagnosis to functional abilities assessment. Second, to establish clear procedures for formal cooperation between the health and social care sectors in the trajectory of LTC service provision. Finally, to find an adequate balance between LTC and institutional care by creating a more comprehensive range of LTC services. A more consistent and coordinated delivery of services by both health and social care sectors seems to be an untapped resource for the improvement of the LTC potential.
48
Huete Naval, M., L. Reyes Molón, C. Regueiro Martín-Albo, R. Galerón, E. Herrero Pellón, and P. Albarracin. "Impulsive traits and dual pathology in patients with depression and alcohol dependence, a case report." European Psychiatry 65, S1 (June 2022): S464. http://dx.doi.org/10.1192/j.eurpsy.2022.1179.
Full textAbstract:
Introduction Alcohol dependence is one of the most frequent comorbidities in depression. Multiple environmental and neurobiological factors are directly involved in these diseases. In particular, impulsivity is present in many patients with dual pathology and may play a relevant role in its causes, clinical manifestations and prognosis. Objectives To review the relationship between impulsive traits and dual pathology in patients with depression and alcohol dependence. Methods Presentation of a clinical case supported by a non- systematic review of literature containing the key-words “impulsivity”, “depression” and “alcohol dependence”. Results This is a case report of a 43-year-old male with a known history of alcohol dependence and recurrent depression. Interestingly, the patient has a family history of bipolar disorder and alcohol abuse disorder on the paternal side, and frontotemporal dementia on the maternal side. He currently presents a depressive episode associates associated with a significant increase in alcohol consumption. The patient has presented prominent impulsive traits since adolescence that have been aggravated in recent years. This lack of impulse control is described as one of the most relevant factors in relapses in alcohol consumption. Multiple studies correlate the lack of impulse control with a worse prognosis in both alcohol dependence (greater probability of relapses and resistance to treatment) and depression (increased suicide risk). Likewise, an increase in cognitive impulsivity has been observed during depressive episodes, characterized by an inability to inhibit behaviors that have already begun and poor planning capacity, which could lead to a worsening of alcohol abuse. Conclusions Impulsivity traits are related to a worse prognosis in dual pathology due to alcohol and depression, and may present common etiopathogenic mechanisms. Disclosure No significant relationships.
49
Mkhitaryan, E. A., N. M. Vorobieva, O. N. Tkacheva, Yu V. Kotovskaya, N. N. Koberskaya, E. V. Selezneva, and L. N. Ovcharova. "The prevalence of cognitive impairment and their association with socioeconomic, demographic and anthropometric factors and geriatric syndromes in people over 65 years of age: data from the Russian epidemiological study EVKALIPT." Neurology, Neuropsychiatry, Psychosomatics 14, no. 3 (June 20, 2022): 44–53. http://dx.doi.org/10.14412/2074-2711-2022-3-44-53.
Full textAbstract:
Cognitive dysfunction is one of the most common disorders in the elderly and senile age. There are currently 57 million people with dementia worldwide.Objective: to assess cognitive functions, to understand the prevalence of cognitive impairment (CI) and to analyze their associations with socioeconomic, demographic and anthropometric factors and geriatric syndromes in people aged ≥65 years.Patients and methods. Subjects living in 11 regions of the Russian Federation took part in the EVKALIPT epidemiological study. The inclusion criterion was age ≥65 years. Participants were divided into three age groups (65–74 years, 75–84 years, and ≥85 years) according to the protocol. All patients underwent a comprehensive geriatric assessment, comprising a specially designed questionnaire and physical examination. Cognitive functions were assessed using the mini-Cog test. The study included 3545 patients (of which 30% were males) aged 65 to 107 years.Results and discussion. According to the data obtained in our study, CI was detected in 60.8% of the subjects, and severe disorders – in 19.9% (0 or 1 point according to the mini-Cog). Patients with CI had a lower socioeconomic status. One-way regression analysis showed that the risk of CI increased by 10% with increasing age for every 1 year but did not depend on the sex of the subjects. Associated with increased CI risk also were: living alone (by 28%), living in a nursing home (by 90%), widowhood (by 2.2 times) or absence of a partner (by 2.2 times), underweight (by 2.9 times) and normal body weight (by 1.6 times), disability (by 54%), primary (by 4.8 times) and secondary (by 75%) education, bad economic conditions (by 95%). On the contrary, the presence of overweight and obesity reduced the risk of CI by 14 and 24% respectively, living in a family – by 24%, having a spouse – by 55%, divorce – by 29%, having a job – by 73%, higher education and a scientific degree – by 55 and 59%, medium and good economic conditions – by 38 and 52%, respectively. In patients with CI, the incidence of all geriatric syndromes was higher.Conclusion. The frequency of CI among elderly patients was higher compared with data from other studies. The EVKALIPT study was the first to obtain national data on the prevalence and characteristics of CI in persons aged ≥65 years in the general population.
50
C, Roberts, and King J. "A-023 Comparison of Informant Reports of Daily Functioning to Objective Neurocognitive Performances: Activities of Daily Living Questionnaire versus Lawton Activities of Daily Living/Instrumental Activities of Daily Living Scale." Archives of Clinical Neuropsychology 35, no. 6 (August 28, 2020): 813. http://dx.doi.org/10.1093/arclin/acaa068.023.
Full textAbstract:
Abstract Objective Informant reports of daily functioning are often useful when assessing functional skill impairments in neuropsychological dementia evaluations, given potential biases with self-reporting from low insight and/or a reluctance to endorse reduced independence. Two measures of informant functional skill assessments were compared within patients relative to their objective neurocognitive performances. Method Participants included 19 (32% male, 68% female; 21% Hispanic, 69% Caucasian) outpatient older adult dementia evaluations aged 60 to 90 years (Mean age = 74, SD = 7.7) who were accompanied by a family member or caregiver informant. The Activities of Daily Living Questionnaire (ADLQ) and the Lawton Activities of Daily Living and Instrumental Activities of Daily Living Scale (ADL/IADL) informant reports were compared relative to performances on the Hopkins Verbal Learning Test delayed recall trial (HVLT), Trail Making Test Part B (TMTB), CLOX: An Executive Clock Drawing Task (CLOX1), and the Controlled Oral Word Association Test, FAS and Animals (COWAT). Results Simple linear regression analyses indicated the ADLQ significantly predicted both TMTB (β = −.52, 95% CI [−.81, −.23], p < .01; R2 = .47) and HVLT (β = −.38, 95% CI [−.67, −.08], p < .01; R2 = .31) performances. The ADL/IADL scale significantly predicted TMTB performances (β = −.70, 95% CI [−1.1, −.30], p < .01; R2 = .46). A significant correlation was observed between ADLQ and ADL/IADL informant reports (r(17) = .60, p < .01). Conclusion There was a significant linear relationship between both ADLQ and ADL/IADL informant reports with TMTB performances. The ADLQ reports also significantly predicted HVLT performances. No significant relationships were observed between either ADLQ and ADL/IADL reports, and participants’ CLOX1 or COWAT FAS/Animals performances.