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Johnson, John. "Dementis to Dementia." British Journal of Psychiatry 151, no. 4 (October 1987): 562. http://dx.doi.org/10.1192/s0007125000217662.
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Cipriani, Gabriele, Sabrina Danti, Lucia Picchi, Angelo Nuti, and Mario Di Fiorino. "Daily functioning and dementia." Dementia & Neuropsychologia 14, no. 2 (June 2020): 93–102. http://dx.doi.org/10.1590/1980-57642020dn14-020001.
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Abstract. Dementia is characterized by a decline in memory, language, problem-solving and in other cognitive domains that affect a person’s ability to perform everyday activities and social functioning. It is consistently agreed that cognitive impairment is an important risk factor for developing functional disabilities in patients with dementia. Functional status can be conceptualized as the ability to perform self-care, self- maintenance and physical activity. A person with dementia usually requires help with more complex tasks, such as managing bills and finances, or simply maintaining a household. Good functional performance is fundamental for elderly people to maintain independency and avoid institutionalization. The purpose of this review is to describe functional changes in demented patients, evaluating the variability in subgroups of dementias.
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Johnson, Rebecca A., and Jason Karlawish. "A review of ethical issues in dementia." International Psychogeriatrics 27, no. 10 (June 10, 2015): 1635–47. http://dx.doi.org/10.1017/s1041610215000848.
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ABSTRACTDementia raises many ethical issues. The present review, taking note of the fact that the stages of dementia raise distinct ethical issues, focuses on three issues associated with stages of dementia's progression: (1) how the emergence of preclinical and asymptomatic but at-risk categories for dementia creates complex questions about preventive measures, risk disclosure, and protection from stigma and discrimination; (2) how despite efforts at dementia prevention, important research continues to investigate ways to alleviate clinical dementia's symptoms, and requires additional human subjects protections to ethically enroll persons with dementia; and (3) how in spite of research and prevention efforts, persons continue to need to live with dementia. This review highlights two major themes. First is how expanding the boundaries of dementias such as Alzheimer's to include asymptomatic but at-risk persons generate new ethical questions. One promising way to address these questions is to take an integrated approach to dementia ethics, which can include incorporating ethics-related data collection into the design of a dementia research study itself. Second is the interdisciplinary nature of ethical questions related to dementia, from health policy questions about insurance coverage for long-term care to political questions about voting, driving, and other civic rights and privileges to economic questions about balancing an employer's right to a safe and productive workforce with an employee's rights to avoid discrimination on the basis of their dementia risk. The review highlights these themes and emerging ethical issues in dementia.
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Purnakarya, Idral. "Defisiensi Riboflavin dan Demensia pada Usia Lanjut." Kesmas: National Public Health Journal 6, no. 3 (December 1, 2011): 99. http://dx.doi.org/10.21109/kesmas.v6i3.99.
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Demensia Alzheimer menempati urutan kesembilan penyebab kematian di Amerika Serikat. Demensia adalah kondisi yang sering dialami yang berhubungan dengan berbagai faktor dan gaya hidup terutama diet. Penelitian ini bertujuan untuk mengetahui hubungan defisiensi asupan riboflavin (vitamin B12) dengan demensia pada usia lanjut (usila). Penelitian ini menggunakan desain studi cross sectional dan dilaksanakanpada bulan September 2007 sampai dengan Januari 2008. Sampel penelitian adalah 141 lansia berumur lebih dari sama dengan 60 tahun yang diambil secara purposive sampling. Demensia diukur menggunakan kuesioner MMSE (² 24, skor maksimum 30) dan asupan riboflavin diukur menggunakan form Semi Quantitative – FFQ. Penelitian ini memperlihatkanbahwa 47,5% usila mengalami demensia. Hasil uji statistik menunjukkan bahwa terdapat hubungan yang signifikan antara umur, tingkat pendidikan, dan asupan riboflavin dengan kejadian demensia pada usila (nilai p < 0,05).Kata kunci: Demensia, defisiensi riboflavin, usia lanjutAbstractDementia Alzheimer’s was ranked the ninth leading cause of death in The United States. Dementia can not be avoided as related to several factors and lifestyle especially the diet. The objective of this research is to know relation the deficiency of riboflavine (vitamin B12) intake and incidence of dementiaat elderly. A cross-sectional study was conducted betweenSeptember 2007 and January 2008. The sample obtained was 141 elderly which it was conducted to purposive sampling. Dementia was measured by using questionnaire MMSE (² 24, maximum score was 30), and riboflavine intake was measure by Semi Quantitative – FFQ form. This study shows that dementia in elderly was 47,5%. Statistical test showed that Statistical test showed that incidence of dementia had significantly associated with ages, level of education, and riboflavine intake (p value < 0,05).Key words: Dementia, deficiency of riboflavine, elderl
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Torian, Lucia, Emily Davidson, George Fulop, Laura Sell, and Howard Fillit. "The Effect of Dementia on Acute Care in a Geriatric Medical Unit." International Psychogeriatrics 4, no. 2 (September 1992): 231–39. http://dx.doi.org/10.1017/s1041610292001066.
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Treatment of dementia costs billions of dollars in long-term care and community services every year. Dementia also burdens the acute care system and may contribute to financial problems for hospitals serving large numbers of demented elderly. In a specialized geriatric medical unit devoted to acute care of the frail elderly, Alzheimer's disease and vascular and mixed dementias afflicted 63% of inpatients and were associated with excess consumption of nursing resources, complications of treatment, nosocomial infections, lengthy hospitalizations, and financial losses to the hospital. Due in part to the effects of dementia on mobility, continence, and nutrition, demented patients suffered more frequently from life-threatening infections, sepsis, iatrogenic disease, and prolonged hospital stays. Hospital losses were 75% higher for demented patients than for nondemented patients.Dementia affected the majority of acute care patients in this study. However, it was rarely coded as an admitting diagnosis, even though it may have been the proximate cause of the medical morbidity which led to the acute hospitalization. In addition, despite the significant impact of dementia on the hospital course and costs, it was a factor in hospital reimbursement in less than one third of cases. The results indicate that dementia was not considered to be an acute diagnosis, nor was it recognized as a complex medical illness. The impact of dementia on acute hospitalization, including the mechanisms by which dementia prolongs the hospital stay, requires further investigation.
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Sánchez Iglesias, Ana, José Antonio Del Barrio, Josefa González-Santos, Florencio Vicente Castro, Jerónimo González, David Padilla Góngora, Alfredo Jiménez, et al. "MINDFULNESS Y REHABILITACIÓN NEUROCOGNITIVA." International Journal of Developmental and Educational Psychology. Revista INFAD de Psicología. 1, no. 1 (October 2, 2017): 21. http://dx.doi.org/10.17060/ijodaep.2017.n1.v1.895.
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Abstract.MINDFULNESS AND NEUROCOGNITIVE REHABILITATION.Nowadays approximately fifty million persons are suffering from dementia throughout the world according to the latest statistics of the European Commission (2016). Moreover, every year new 7.7 million instances of this disease are detected. At this moment, Alzheimer’s disease would be the most common mental disorder in terms of world population health, in other words, this disease can signify 70% of all dementia. Even now pharmacological treatments are ineffective. Consequently, utilization of non pharmacological therapies is opening a wide range of possibilities aimed to increase prevention and, at the same time, improvement in living standards of careers and relatives of patients with dementia who are usually overburdened. This presentation contains a review about researches on mindfulness (MF) and its implementation like potentially strategies aimed to treat this disorder.Keywords: Dementias, Mindfulness, Neuroimagen, meta-analysis.Resumen.Los últimos datos aportados por la Comisión Europea señalan que la demencia afecta actualmente a casi cincuenta millones de personas en todo el mundo y que cada año se detectan 7.7 millones de nuevos casos. A día de hoy, el Alzheimer es la demencia más padecida por la población mundial pudiendo constituir en términos relativos el 70% de las demencias. En la actualidad no existen tratamientos farmacológicos que den una respuesta definitiva a este tipo de patologías. Las utilizaciones de terapias no farmacológicas abren un amplio abanico de posibilidades desde el ámbito de la prevención, y de la mejora de la calidad de vida en cuidadores y familiares de enfermos con demencia, básicamente con sintomatología de “sobrecarga”. En este articulo hacemos una revisión sobre investigaciones relacionadas con la “atención plena” ( MF) y de su implementación como estrategias potenciales en el abordaje de este tipo de patologías. Los últimos trabajos aportados con técnicas morfométricas por neuroimagen constituyen un importante avance a la hora de intentar aportar evidencia científica en este campo.Palabras clave: Demencias, Mindfulness, Neuroimagen, Meta-análisis, Rehabilitación.
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Prescop, Krista L., Hiroko H. Dodge, Richard K. Morycz, Richard M. Schulz, and Mary Ganguli. "Elders With Dementia Living in the Community With and Without Caregivers: An Epidemiological Study." International Psychogeriatrics 11, no. 3 (September 1999): 235–50. http://dx.doi.org/10.1017/s1041610299005803.
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Background: Previous studies of dementia and family caregiving have focused on individuals seeking diagnosis and treatment, and have rarely been conducted in representative community samples. Identifying demented individuals participating in a community survey, we determined (a) the factors associated with demented elderly living alone; (b) the factors associated with the demented elderly having caregivers; (c) the factors associated with increased levels of burden among caregivers of persons with dementia. Population and Methods: During an epidemiological survey of a mostly rural U.S. community, the authors identified 116 noninstitutionalized elderly individuals with dementia. These individuals were classified into those living alone and those living with others; both groups were further classified into those with an without identifiable family caregivers. Characteristics of both caregivers and care recipients were examined. Results: Approximately a third of the subjects with dementia lived alone, and only half of them had caregivers. The average age of the caregivers was 67.4 years, and 73% of them were women. Almost half of the caregivers were spouses, whereas almost a third were offspring, of the demented individuals. Over two thirds of caregivers lived with the subjects. Female caregivers were significantly younger than male caregivers. Multivariate analyses revealed that subjects with dementia who were living alone were independently and significantly more likely to be women and to have dementias of shorter duration, lesser severity, and lesser functional impairment than those living with others. Demented subjects with caregivers were more likely to have greater dementia severity, functional impairment, and cognitive impairment and more current cognitive and behavioral symptoms than those without caregivers. Demented subjects whose caregivers reported higher levels of burden were more likely to be women and to have greater dementia severity, functional impairment, and cognitive impairment and more current symptoms than those whose caregivers had no/minimal burden. Conclusions: These results draw attention to the problems of persons with dementia living alone, particularly those without caregivers. Our data also provide epidemiological confirmation of previous clinical/volunteer studies of dementia caregiving, as well as a preliminary assessment of need in the community at large. Living arrangements and caregiver issues should be taken into account when planning services for the elderly.
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Moreno Sáez, María del Carmen. "“Impresiones en azul”. La cianotipia como agente catalizador de la mejora psicosocial y fomento de la comunicación de las personas con demencia temprana." Comunitania. Revista Internacional de Trabajo Social y Ciencias Sociales, no. 14 (February 9, 2018): 27. http://dx.doi.org/10.5944/comunitania.14.2.
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“Impresiones en azul” se corresponde con el nombre genérico de varios talleres dentro de un programa de educación artística para personas con demencia temprana, realizados en el Centro de Referencia Estatal de Atención a Personas con Enfermedad de Alzheimer y otras Demencias, de Salamanca, dependiente del IMSERSO. El objetivo de este programa era evaluar si la implementación de actividades artísticas podía ser una estrategia eficaz para promover el bienestar y las capacidades psicosociales, cognitivas y de comunicación de las personas con demencia temprana y, en consecuencia, una manera de mejorar los sistemas de cuidado de los mayores con principios de demencia. Estos talleres consistieron en el desarrollo de una sencilla técnica fotográfica, combinada con nuevas tecnologías. La investigación psicosocial cualitativa fue la metodología utilizada, prevista en tres fases: diseño de las actividades, desarrollo y seguimiento de los mismos y análisis de las producciones artísticas de los asistentes. Las conclusiones a las que se han llegado se pueden resumir en las siguientes: la demencia no ha supuesto problema alguno para el desarrollo de los talleres, el interés demostrado por los pacientes ha sido significativo, obteniendo resultados positivos en relación con su bienestar psicosocial, se ha experimentado un incremento de la comunicación entre los asistentes, tanto en sus relaciones interpersonales, como en su proyección al exterior y, por último, merece la pena destacar los modelos que pueden ser desarrollados en el cuidado de las personas con demencia temprana.“Impressions in blue” is the generic name given to several workshops belonging to an Art Education program targeted to people with early dementia, carried out in the State Centre for the Attention to People with Alzheimer Disease and other Dementias, in Salamanca, dependent on the IMSERSO. The aim of this program was assessing if the implementation of artistic activities could be an efficient strategy for promoting wellbeing and psychosocial, cognitive and communication capacities in people with early dementias and, therefore, improve the caring systems for the elderly with early dementias. These workshops consisted on the development of a simple photographic technique, combined with new technologies. The psychosocial qualitative research was the chosen methodology and was organised in three phases: activities design, development, follow-up and analysis of the artistic productions done by the participants. The conclusions drawn can be outlined as follows: Dementia didn’t cause any problem while developing the workshops; the interest shown by the participants was remarkable, obtaining positive reactions in regard to their psycho-social wellbeing; it was observed an increase in communication amongst the participants, not only in their personal relationships but also in their contact with the outside; lastly, it is worth highlighting the models that can be developed in the early dementia care.
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Davis, Laura, Zarina Karim, and Tom Dening. "Diagnostic, management and nursing challenges of less common dementias: Frontotemporal dementia, alcohol-related dementia, HIV dementia and prion diseases." British Journal of Neuroscience Nursing 18, no. 1 (February 2, 2022): 26–37. http://dx.doi.org/10.12968/bjnn.2022.18.1.26.
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Background: Most cases of dementia are due to Alzheimer's disease or vascular dementia, but attention on these disorders means that other important causes of dementia may be relatively neglected. About 10–15% of people with dementia have other diagnoses, and there are numerous causes of the less common types of dementia. Aims: This paper provides information about the causes, symptoms, diagnosis and nursing management of some of the different types of less common dementias, with the aim of helping nurses to provide better care to patients and families affected. Methods: This is one of two connected papers and provides a narrative review of the literature on the clinical presentation of frontotemporal dementia, HIV dementia, prion dementias and alcohol-related dementia. Findings: Frontotemporal dementia has important clinical subtypes with distinct different presentations; for example, predominantly behavioural symptoms or progressive language dysfunction. Alcohol-related dementia is one of several types of alcohol-related brain damage. This is important as, with abstinence, its progression may be halted or even to some extent improved. HIV dementia has become less common since the introduction of effective antiretroviral therapy, but, nonetheless, the less severe picture of HIV-associated cognitive dysfunction remains prevalent despite treatment. Prion dementias encompass sporadic, familial and acquired Creutzfeldt-Jakob disease and are incurable, therefore requiring extensive palliative care. Conclusions: These forms of dementia all have different symptoms and courses from common types of dementia, such as Alzheimer's disease. It is important for nurses to be aware that dementia may have several causes and that people with different dementias will have different needs. Nonetheless, the general skills of nurses in supporting patients and families remain essential in order to develop appropriate care plans and to provide individualised, person-centred care.
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Lautenschlager, Nicola T., and Ralph N. Martins. "Common versus uncommon causes of dementia." International Psychogeriatrics 17, s1 (September 2005): S27—S34. http://dx.doi.org/10.1017/s1041610205002000.
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When patients present with a dementia syndrome at a young age, the experienced clinician will automatically include uncommon dementias in the diagnostic considerations, as familial uncommon dementias due to genetic mutations frequently present as early-onset dementias. This paper highlights why uncommon dementias due to genetic mutations, although marginal in terms of prevalence numbers in the total population, are of significance in the quest to unravel the underlying cause of common dementias such as Alzheimer's disease (AD), dementia with Lewy bodies (DLB), frontotemporal dementias (FTD) and vascular dementia (VaD).
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Corriveau, Roderick A., Walter J. Koroshetz, Jordan T. Gladman, Sophia Jeon, Debra Babcock, David A. Bennett, S. Thomas Carmichael, et al. "Alzheimer's Disease–Related Dementias Summit 2016: National research priorities." Neurology 89, no. 23 (November 8, 2017): 2381–91. http://dx.doi.org/10.1212/wnl.0000000000004717.
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Goal 1 of the National Plan to Address Alzheimer’s Disease is to prevent and effectively treat Alzheimer disease and Alzheimer disease–related dementias by 2025. To help inform the research agenda toward achieving this goal, the NIH hosts periodic summits that set and refine relevant research priorities for the subsequent 5 to 10 years. This proceedings article summarizes the 2016 Alzheimer's Disease–Related Dementias Summit, including discussion of scientific progress, challenges, and opportunities in major areas of dementia research, including mixed-etiology dementias, Lewy body dementia, frontotemporal degeneration, vascular contributions to cognitive impairment and dementia, dementia disparities, and dementia nomenclature.
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Gottfries, C. G. "Classifying Organic Mental Disorders and Dementia—A Review of Historical Perspectives." International Psychogeriatrics 3, S1 (March 1991): 9–17. http://dx.doi.org/10.1017/s1041610205001092.
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The concept of dementia should not be used synonymously with the concept of organic mental disorders. By definition, according to DSM-III and ICD-10, dementia is a syndrome which includes memory impairment. The severity of the disorder is disabling and the course is chronic. Differential diagnosis includes age-associated memory impairment (AAMI), delirium, and depressive disorders. The dementias may be subdivided into four groups: idiopathic (primary degenerative dementias), vascular, secondary, and others. The idiopathic dementias are those in which etiology is assumed to be found within the brain itself. The main subgroup is Alzheimer-type dementia. The vascular dementias are those in which the blood supply to the brain is insufficient. Multi-infarct dementia (MID) is the prototype. In secondary dementias, somatic disorders either within or external to the brain cause the dementia.
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Chahyani, Wiwit Ida, and Murni Sri Hastuti. "Mixed Dementia: Tinjauan Diagnosis dan Tatalaksana." Muhammadiyah Journal of Geriatric 1, no. 2 (January 5, 2021): 46. http://dx.doi.org/10.24853/mujg.1.2.46-51.
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Latar Belakang: Prevalensi demensia saat ini semakin meningkat, mengenai usia diatas 65 tahun dan risikonya meningkat 2 kali setiap penambahan usia 5 tahun. Salah satu bentuk demensia adalah mixed dementia. Diagnosis mixed dementia sangat sulit dan memberikan tantangan tersendiri bagi para klinisi. Pada artikel ini, penulis ingin membahas mengenai tinjauan diagnosis dan tatalaksana mixed dementia. Hasil: Diagnosis mixed dementia dapat menggunakan beberapa kriteria yaitu International Classification of Diseases and Health Related Problems 10th Revision (ICD-10), the Alzheimer’s Disease Diagnostic and Treatment Centers (ADDTC), dan the National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et l’Enseignement en Neurosciences (NINDS-AIREN). Tatalaksana mixed dementia berupa terapi farmakologi untuk gejala gangguan kognitif dengan pemberian golongan inhibitor kolinesterase dan antagonis NMDA. Terapi farmakologi untuk gangguan psikis dan perilaku dengan antipsikotik atau antidepresan. Managemen faktor risiko hipertensi, konsumsi nutrisi yang sehat, dan olah raga teratur sebagai upaya preventif dan mencegah progresivitas mixed dementia. Kesimpulan: Diagnosis mixed dementia meliputi gejala demensia Alzheimer dan demensia pada penyakit serebrovaskuler. Tatalaksana mixed dementia meliputi terapi gangguan kognitif, psikis, dan perilaku, serta tatalaksana faktor risiko penyakit serebrovaskuler. Dibutuhkan penelitian lebih lanjut serta adanya konsensus diagnosis dan tatalaksana mixed dementia baik nasional maupun internasional agar tercapai tatalaksana secara komprehensif.
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Potashkin, Judith A., Virginie Bottero, Jose A. Santiago, and James P. Quinn. "Bioinformatic Analysis Reveals Phosphodiesterase 4D-Interacting Protein as a Key Frontal Cortex Dementia Switch Gene." International Journal of Molecular Sciences 21, no. 11 (May 27, 2020): 3787. http://dx.doi.org/10.3390/ijms21113787.
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The mechanisms that initiate dementia are poorly understood and there are currently no treatments that can slow their progression. The identification of key genes and molecular pathways that may trigger dementia should help reveal potential therapeutic reagents. In this study, SWItch Miner software was used to identify phosphodiesterase 4D-interacting protein as a key factor that may lead to the development of Alzheimer’s disease, vascular dementia, and frontotemporal dementia. Inflammation, PI3K-AKT, and ubiquitin-mediated proteolysis were identified as the main pathways that are dysregulated in these dementias. All of these dementias are regulated by 12 shared transcription factors. Protein–chemical interaction network analysis of dementia switch genes revealed that valproic acid may be neuroprotective for these dementias. Collectively, we identified shared and unique dysregulated gene expression, pathways and regulatory factors among dementias. New key mechanisms that lead to the development of dementia were revealed and it is expected that these data will advance personalized medicine for patients.
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Zanni, Guido, and Jeannette Wick. "Differentiating Dementias in Long-Term Care Patients." Consultant Pharmacist 22, no. 1 (October 1, 2007): 14–28. http://dx.doi.org/10.4140/tcp.n.2007.14.
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Many long-term care residents are diagnosed with dementia, but dementia appears in many forms. Alzheimer's disease, the most common, is typified by a slow onset and relentless progression to complete incapacitation. Vascular dementia usually appears somewhat abruptly, is associated with vascular comorbidities, and has an unpredictable progression pattern. Lewy body dementia shares features of both Alzheimer's and Parkinson's disease; its hallmarks include fluctuating cognitive performance, visual hallucinations, and extrapyramidal motor symptoms. Frontotemporal dementias are associated less with memory disorders and more with behavioral and language aberrations. Mixed dementia covers those patients who do not have an apparent singular cause of dementia. Pseudodementia is a dementia resulting from underlying causes and is reversible, unlike the aforementioned dementias.
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Brouwers, P., E. Mohr, K. Hildebrand, M. Hendricks, J. J. Claus, I. S. Baron, M. Young, and P. Pierce. "A Novel Approach to the Determination and Characterization of HIV Dementia." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 23, no. 2 (May 1996): 104–9. http://dx.doi.org/10.1017/s0317167100038804.
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ABSTRACT:Background: Neuropsychological studies of the pattern and extent of cognitive impairment in HIV-infected patients have mostly used deviations from control values and/or cut-off scores as criteria for classification of dementia. There is, however, no agreement as to how to define impairment, and classification is imprecise. Method: The current study used a dementia classification matrix, developed with a step-wise linear discriminant analysis of neuropsychological data from patients with primary neurodegenerative dementias, to classify symptomatic HIV patients as demented or non-demented, and further to differentiate cortical and subcortical dementia patterns. Thirty-two male and 2 female patients (mean age 39 ± 2) with symptomatic HIV disease (mean absolute CD4 count 195 ±41) participated in the study. Results: Thirty-five per cent of patients were classified as demented. Of these, 83% showed a subcortical pattern and 17% a cortical profile of deficits. Significant differences between patients classified as subcortically demented and those categorized as normal on neuropsychological measures associated with subcortical integrity further validated the classification. Measures of psychiatric status between subgroups were similar. Conclusion: Since certain treatments may delay or reverse cognitive deficits, the use of an objective classification method based on discriminant analysis may help to identify patients who may benefit from therapy.
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Jones, R. W. "Dementia." Scottish Medical Journal 42, no. 5 (October 1997): 151–53. http://dx.doi.org/10.1177/003693309704200512.
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Dementia in general and Alzheimer's disease in particular represent conditions where new findings are being made rapidly. Some of these developments will lead to progress of increasing clinical value to patients and their carers. This review will begin with some general points about dementia before considering current developments in Alzheimer's disease and other specific dementias in more detail.
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Gjøra, Linda, Bjørn Heine Strand, Sverre Bergh, Ingunn Bosnes, Aud Johannessen, Gill Livingston, Håvard Kjesbu Skjellegrind, and Geir Selbæk. "Prevalence and Determinants of Diagnosed Dementia: A Registry Linkage Study Linking Diagnosis of Dementia in the Population-Based HUNT Study to Registry Diagnosis of Dementia in Primary Care and Hospitals in Norway." Journal of Alzheimer's Disease 99, no. 1 (April 30, 2024): 363–75. http://dx.doi.org/10.3233/jad-240037.
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Background: A timely diagnosis of dementia can be beneficial for providing good support, treatment, and care, but the diagnostic rate remains unknown and is probably low. Objective: To determine the dementia diagnostic rate and to describe factors associated with diagnosed dementia. Methods: This registry linkage study linked information on research-based study diagnoses of all-cause dementia and subtypes of dementias, Alzheimer’s disease, and related dementias, in 1,525 participants from a cross-sectional population-based study (HUNT4 70+) to dementia registry diagnoses in both primary-care and hospital registries. Factors associated with dementia were analyzed with multiple logistic regression. Results: Among those with research-based dementia study diagnoses in HUNT4 70+, 35.6% had a dementia registry diagnosis in the health registries. The diagnostic rate in registry diagnoses was 19.8% among home-dwellers and 66.0% among nursing home residents. Of those with a study diagnosis of Alzheimer’s disease, 35.8% (95% confidence interval (CI) 32.6–39.0) had a registry diagnosis; for those with a study diagnosis of vascular dementia, the rate was 25.8% (95% CI 19.2–33.3) and for Lewy body dementias and frontotemporal dementia, the diagnosis rate was 63.0% (95% CI 48.7–75.7) and 60.0% (95% CI 43.3–75.1), respectively. Factors associated with having a registry diagnosis included dementia in the family, not being in the youngest or oldest age group, higher education, more severe cognitive decline, and greater need for help with activities of daily living. Conclusions: Undiagnosed dementia is common, as only one-third of those with dementia are diagnosed. Diagnoses appear to be made at a late stage of dementia.
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Raz, Limor, Janice Knoefel, and Kiran Bhaskar. "The neuropathology and cerebrovascular mechanisms of dementia." Journal of Cerebral Blood Flow & Metabolism 36, no. 1 (July 15, 2015): 172–86. http://dx.doi.org/10.1038/jcbfm.2015.164.
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The prevalence of dementia is increasing in our aging population at an alarming rate. Because of the heterogeneity of clinical presentation and complexity of disease neuropathology, dementia classifications remain controversial. Recently, the National Plan to address Alzheimer’s Disease prioritized Alzheimer’s disease-related dementias to include: Alzheimer’s disease, dementia with Lewy bodies, frontotemporal dementia, vascular dementia, and mixed dementias. While each of these dementing conditions has their unique pathologic signature, one common etiology shared among all these conditions is cerebrovascular dysfunction at some point during the disease process. The goal of this comprehensive review is to summarize the current findings in the field and address the important contributions of cerebrovascular, physiologic, and cellular alterations to cognitive impairment in these human dementias. Specifically, evidence will be presented in support of small-vessel disease as an underlying neuropathologic hallmark of various dementias, while controversial findings will also be highlighted. Finally, the molecular mechanisms shared among all dementia types including hypoxia, oxidative stress, mitochondrial bioenergetics, neuroinflammation, neurodegeneration, and blood–brain barrier permeability responsible for disease etiology and progression will be discussed.
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Shih, Ying-Jyun, Jiun-Yi Wang, Su-Yuan Chan, and Yung-Jen Yang. "P203: The temporal relationship between dementia and serious traffic accidents: a cohort study of linked national databases." International Psychogeriatrics 35, S1 (December 2023): 189–90. http://dx.doi.org/10.1017/s1041610223003344.
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Objective:The traffic issues have been attracting global attention due to increased occurrence and higher mortality rate in the older population. Many countries have employed different kinds of regulations on the elder drivers depending either on their age or whether being demented. These policy differences left a research gap to identify the temporal relationship between serious traffic accidents (STA) and dementias, which can inform the most appropriate time for policymaking. In the present study, we linked two national databases and performed analyses to explore this problem.Methods:With the grant and supports from the government, the research team combined the databases of STA registries and the whole population dataset of National Health Insurance Research Database to form a 10-year retrospective cohort for analyses. We performed both retrospective and prospective directions to explore the time length between STAs and the diagnoses of dementia depending on the selection of the STA occurrences and dementia diagnoses as outcomes. In addition to descriptive statistical analyses, we also performed inferential statistics to analyse the variables between different types of STAs. A p-value less than 0.05 was set as statistically significant.Results:437516 persons involved in STAs were enrolled for analyses and the mean age was 61.47 years (SD=8.90) with sex ratio (F/M) of 0.62. We divided the samples into three groups: (1) STAs without dementias (95.17%) (2) dementias after STAs (3.40%), and (3) dementias before STAs (1.43%). The mean age of the 3rd group (73.80 years, SD=8.79) was significantly older than the rest two. When comparing these three groups, a preceded dementia diagnosis was a significant risk factor for repeated STAs. (OR: 1.205, 95% CI: 1.100-1.320, p<0.001) Finally, an average length of 2.35 years (SD: 1.60) was found for those who was diagnosed of dementias before the first STA while 2.57 years (SD: 1.69) was noted for the diagnosis of dementia after first STA.Conclusion:In our study, dementia was identified as a significant risk factor for STAs. We further asserted that 2.5 years would be an appropriate time length for the authorities to examine the traffic risks of those who were diagnosed of dementias.
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Davis, Laura, and Tom Dening. "Diagnostic, management and nursing challenges of less common dementias: Parkinsonian dementias and Huntington's disease." British Journal of Neuroscience Nursing 17, no. 2 (April 2, 2021): 68–76. http://dx.doi.org/10.12968/bjnn.2021.17.2.68.
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Background: Although most cases of dementia are caused by Alzheimer's disease or vascular dementia, around 10-15% of cases are due to other disorders, including dementias with Parkinsonian features, Huntington's disease, frontotemporal dementia, human immunodeficiency virus (HIV), and alcohol. Aims: These less common dementias are important as they may have differing clinical features and require different approaches to diagnosis and management. This paper seeks to provide relevant information for nurses about symptoms, diagnosis and management of some of the less common dementias. Methods: This is one of two connected papers, and provides a clinical overview of Parkinsonian dementias and Huntington's disease. It provides a narrative, rather than systematic, review of the literature. Findings: Parkinsonian dementias comprise Parkinson's disease dementia, dementia with Lewy bodies and so-called Parkinson's-plus syndromes (multi-system atrophy, progressive supranuclear palsy, and corticobasal degeneration). Huntington's disease is an inherited neuropsychiatric condition. Each has a distinctive clinical picture, with combinations of cognitive, neuropsychiatric and neurological symptoms but approaches to treatment and care are essentially supportive. Conclusions: Nurses have an essential role in supporting people with dementia, as well their families and carers, throughout the course of dementia from diagnosis to end of life care. They are often best placed and have the necessary skills to create appropriate care plans and to provide care management.
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Lestari, Diana Tri, Muhamad Jauhar, and Ashri Maulida Rahmawati. "Dementia Care Class Meningkatkan Sikap Caregiver Informal dalam Perawatan Demensia Berbasis Masyarakat." Jurnal Litbang: Media Informasi Penelitian, Pengembangan dan IPTEK 19, no. 2 (December 24, 2023): 99–112. http://dx.doi.org/10.33658/jl.v19i2.344.
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ENGLISHDementia develops rapidly as the number of elderly and degenerative diseases increases. Dementia makes the quality of life reduced so it needs efforts to prevent and treat dementia. Handling is carried out comprehensively, so there is a need for informal caregiver capacity building in community-based dementia care. The purpose of this study was to identify the effect of dementia care class on attitudes in community-based dementia care. The study design used pre-experiment with pre and post-test types with the control group. This research was conducted in the Kaliwungu and Dawe Health Center, Kudus Regency from October 2022 to April 2023. The study sample was 24 informal caregivers for each intervention and control group through purposive sampling techniques. The research instrument used the Alzheimer's Disease Knowledge Scale (ADKS) and the Dementia Care Attitude Scale (DCAS). Data analysis using Mann Whitney. The results showed that there was an influence of dementia care class on informal caregiver attitudes in community-based dementia care with a value of p = 0.000 (p < 0.05). These learning models and media can be integrated into elderly posyandu and elderly health programs in health care facilities in community-based dementia management. INDONESIADemensia berkembang dengan cepat dan berat seiring meningkatnya jumlah lansia serta penyakit degeneratif. Demensia membuat kualitas hidup berkurang bahkan disabilitas sehingga perlu upaya pencegahan dan penanganan demensia. Penanganan dilakukan secara menyeluruh, sehingga perlu adanya program peningkatan kapasitas caregiver informal dalam perawatan demensia berbasis masyarakat. Tujuan penelitian ini yaitu mengidentifikasi pengaruh dementia care class terhadap sikap dalam perawatan demensia berbasis masyarakat. Desain penelitian menggunakan pre-eksperimen dengan jenis pre dan post-test with control group. Penelitian ini dilakukan di wilayah Kerja UPTD Puskesmas Kaliwungu dan Dawe Kabupaten Kudus pada bulan oktober 2022-April 2023. Sampel penelitian sebanyak 24 caregiver informal untuk masing-masing kelompok intervensi dan kontrol melalui teknik purposive sampling. Instrument penelitian menggunakan Alzheimer’s Disease Knowledge Scale (ADKS), Dementia Care Attitude Scale (DCAS), dan Kuesioner Self-Confidence about Dementia Care Skills. Analisis data menggunakan Mann Whitney. Hasil penelitian menunjukkan terdapat pengaruh dementia care class terhadap sikap caregiver informal dalam perawatan demensia berbasis masyarakat dengan nilai p=0,000 (p<0,05). Model dan media pembelajaran ini dapat diintegrasikan dalam posyandu lansia dan program kesehatan lansia di fasilitas layanan kesehatan dalam manajemen demensia berbasis masyarakat.
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Mahalingam, Sowmya, and Ming-Kai Chen. "Neuroimaging in Dementias." Seminars in Neurology 39, no. 02 (March 29, 2019): 188–99. http://dx.doi.org/10.1055/s-0039-1678580.
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AbstractDementia is a global health issue, the burden of which will worsen with an increasingly aging population. Alzheimer's disease (AD) is the most common dementia, with 50 to 60% of all dementias attributable to AD alone, while the rest are mostly due to frontotemporal lobar dementia, dementia with Lewy bodies, Parkinson's disease dementia, and vascular dementia. Diagnosis of dementias is made clinically with the aid of other testing modalities including neuroimaging. While the role of imaging has traditionally been to exclude reversible causes of dementia, positron emission tomography (PET) with 18-fluorine fluorodeoxyglucose and magnetic resonance imaging now are increasingly used more for definitive diagnosis of dementia in the prodromal stages and to aid with formulating the differential diagnoses. Introduction of molecular imaging modalities such as amyloid PET and tau PET have improved diagnostic certainty in the clinical trial setting and promise to find their way into the clinic in the near future. In this review, we will focus on the multimodality imaging of dementias especially AD and its differential diagnoses.
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Copeland, J. R. M., Cherie McCracken, M. E. Dewey, K. C. M. Wilson, Mark Doran, Chris Gilmore, Anne Scott, and Bernie Larkin. "Undifferentiated dementia, Alzheimer's disease and vascular dementia: Age- and gender-related incidence in Liverpool." British Journal of Psychiatry 175, no. 5 (November 1999): 433–38. http://dx.doi.org/10.1192/bjp.175.5.433.
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BackgroundDoes incidence of dementia follow the age pattern of prevalence? Is gender a risk factor? Do patterns of incidence differ between dementias?AimsTo assess age-specific incidence rates of undifferentiated dementias, Alzheimer's disease and vascular dementia.Method5222 individuals aged $65 years, were interviewed using the Geriatric Mental State/History and Aetiology Schedule. The AGECAT package was used to identify cases at three interviewing waves at two-year intervals. Diagnoses were made using ICD −10 Research Criteria and validated against neurological and psychological examination, with imaging and neuropathology on unselected subsamples.ResultsIncidence rates of the dementias increase with age. Age patterns are similar between Alzheimer's disease and vascular dementia. Gender appears influential in Alzheimer's disease. In England and Wales, 39 437 new cases of Alzheimer's disease (4.9/1000 person-years at risk); 20 513 of vascular dementia (2.6/1000 person-years) and 155 169 of undifferentiated dementia (19/1000 person-years) can be expected each year.ConclusionsIncidence rates for Alzheimer's disease and vascular dementia appear to behave differently with an increased risk of Alzheimer's disease for women compared to vascular dementia.
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Snowden, Julie S., David Neary, and David M. A. Mann. "Frontotemporal dementia." British Journal of Psychiatry 180, no. 2 (February 2002): 140–43. http://dx.doi.org/10.1192/bjp.180.2.140.
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BackgroundFrontotemporal dementia accounts for up to 20% of cases of dementia in the presenium, yet remains poorly recognised. Diagnostic criteria have been devised to aid clinical diagnosis.AimsTo provide an overview of clinical and pathological characteristics of frontotemporal dementia and its nosological status.MethodsThe review summarises consensus diagnostic criteria for frontotemporal dementia and draws on the authors'clinical experience of 300 frontotemporal dementia cases, and pathological experience of 50 autopsied cases.ResultsFrontotemporal dementia is characterised by pronounced changes in affect and personal and social conduct. Some patients also develop motor neuron disease. Mutations in the tau gene account for some but not all familial cases of frontotemporal dementia.ConclusionsFrontotemporal dementia is a focal form of dementia, which is clinically and pathologically distinct from other dementias. It represents an important model for understanding the functions of the frontotemporal lobes.
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Baker, Zachary, Tetyana Shippee, and Joseph Gaugler. "Speaking of Dementia: How to Refer to Dementia in Racial-Ethnic Minority Community-Facing Communications." Innovation in Aging 5, Supplement_1 (December 1, 2021): 461. http://dx.doi.org/10.1093/geroni/igab046.1782.
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Abstract What do you call “dementia”? In academic writing, researchers often chose the inclusive, “Alzheimer’s Disease and Alzheimer’s Disease Related Dementias (AD/ADRD)”. When referring to the people experiencing dementia, the person-centered language: “persons living with dementia (PLWD)” is preferred. This is a welcome departure from the antiquated disease-centered language of “dementia patients” or “the demented”. Still, AD/ADRD and PLWD may be less fitting in community-facing education or participant recruitment. For instance, community-facing materials may benefit from choosing terms like “memory loss”, “issues related to memory or aging”, or “changes in ability, behavior, or judgment”. In this symposium we present a range of viewpoints focused on how to refer to “dementia” in community-facing materials/conversations. These viewpoints include those of several racial and ethnic groups (i.e., African Americans, African Immigrants, American Indians, Asians, Hispanics/Latinos/as/x/e, and Whites). We also include viewpoints from people interfacing with many different diseases that cause dementia (i.e., Alzheimer’s disease, dementia with Lewy bodies, Early-onset Alzheimer’s disease, and Parkinson’s disease dementia) because of the different manifestations of dementia that can arise from those diseases. Viewpoints were gathered through 1) a nation-wide community advisory board, 2) community conversations with African Immigrants, 3) a national effort to increase the representation of Hispanics/Latinos/as/x/e PLWD in AD/ADRD research, and 4) eight community projects exploring the African American AD/ADRD experience. These talks will present possible terms to use within groups, considerations to increase inclusiveness, issues with translation into native languages, considerations surrounding symptoms that may be most recognizable to community members, and stigmatized terminology.
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Links, K. A., D. Merims, M. A. Binns, M. Freedman, and T. W. Chow. "Prevalence of Primitive Reflexes and Parkinsonian Signs in Dementia." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 37, no. 5 (September 2010): 601–7. http://dx.doi.org/10.1017/s0317167100010763.
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Objective:Primitive reflexes and parkinsonian signs are used by clinicians to differentiate among dementias. We reviewed our clinical sample to determine whether primitive reflexes were more prevalent in frontally-based dementias and whether parkinsonian signs were more common in dementia with Lewy bodies (DLB) than in other types of dementia.Design:We retrospectively reviewed charts from 204 patients with dementia who presented for consultation at Baycrest's Ross Memory Clinic between April, 2003, to December, 2007.Results:A greater proportion of subjects with DLB and dementia of the Alzheimer type with cardiovascular disease had primitive reflexes than subjects with frontotemporal dementia (FTD). Primitive reflexes were not positively predictive of FTD or vascular dementia (VaD). Dementia with Lewy bodies subjects were more likely to have parkinsonian signs than the other dementias, and bradykinesia and rigidity were positively predictive of FTD. The palmomental reflex was the most common primitive reflex in the sample, and cogwheeling was the most common parkinsonian sign. There was no significant difference between early- and late-stage groups in presence of primitive reflexes or parkinsonian signs.Conclusions:Primitive reflexes appear not to be clinically discriminative of frontally-based dementias such as FTD and VaD.
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Salardini, Arash. "An Overview of Primary Dementias as Clinicopathological Entities." Seminars in Neurology 39, no. 02 (March 29, 2019): 153–66. http://dx.doi.org/10.1055/s-0039-1683445.
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AbstractDementia is a state of cognitive dysfunction which leads to functional decline. It is a syndrome caused by several medical and neurological causes, but most cases of dementia are due to “primary dementias.” Primary dementias are neurological diseases whose manifestations are predominantly cognitive. Most primary dementias are caused by neurodegenerative proteinopathies where an accumulation of misfolded proteins leads to neuronal loss, neuroinflammation and glial reaction. Each proteinopathy is characterized by the type of protein implicated in its pathophysiology. Neurodegenerative dementias include the most prevalent cause of dementia—Alzheimer's disease—as well as Lewy body dementia, Parkinson's disease dementia, frontotemporal dementias, and prion diseases. Vascular dementia, especially small vessel disease, though not a neurodegenerative condition, is often grouped together with primary dementias. Each type of proteinopathy, characterized by the location and nature of misfolded protein accumulation, may correspond to a particular clinical phenotype. The correspondence between pathologies and clinical phenotypes is not exclusive, and there is a large degree of overlap. Although in the research setting the clinicopathological construct is on the wane, in the clinic it is the most practical way of approaching primary dementias. In this article, we introduce the clinicopathological construct, the understanding of which will form the basis of the other articles in this volume.
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Mohr, Erich, Denise Walker, Christopher Randolph, Margaret Sampson, and Tilak Mendis. "Utility of Clinical Trial Batteries in the Measurement of Alzheimer's and Huntington's Dementia." International Psychogeriatrics 8, no. 3 (September 1996): 397–411. http://dx.doi.org/10.1017/s1041610296002761.
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Tests used as outcome measures in clinical trials of antidementia agents are not typically employed as part of diagnostic evaluations, and little information exists as to the sensitivity of these tests in terms of either differentiating demented patients from normal individuals or in distinguishing dementias of various types and etiologies. Sensitivity to mild dementia and sensitivity to impairment of various neuropsychological domains are, however, prerequisites for valid use of an instrument as an outcome measure in this context. The present study was undertaken to directly compare six different tests (three traditional psychometric tests and three clinical trial batteries) in terms of their sensitivity to detect and distinguish between mild dementia in patients with either Alzheimer's disease (n = 15) or Huntington's disease (n = 15), when compared to normal controls (n = 15). Tests included the Mattis Dementia Rating Scale, the Mini-Mental State Examination, the Wechsler Memory Scale-Revised, the Alzheimer's Disease Assessment Scale-Cognitive Subscale, the Computerized Drug Research (CDR) Cognitive Assessment System, and the Repeatable Battery for the Assessment of Dementia (RBAD). All of the tests were roughly equivalent in terms of their ability to discriminate normal subjects from mildly demented patients. Only the CDR and RBAD, however, were able to reliably discriminate between the two patient groups. The results are discussed in terms of the applicability of these tests as outcome measures for clinical trials in dementing disorders.
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Malikal Balqis, Ummi, and Junaiti Sahar. "Pengalaman Lansia dengan Demensia Ringan-Sedang Dalam Melakukan Komunikasi dengan Pelaku Rawat: Systematic Review." Jurnal Endurance 4, no. 2 (July 15, 2019): 388. http://dx.doi.org/10.22216/jen.v4i2.4046.
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<p><em>Dementia is a progressive decline in cognitive abilities that characterized by memory loss that affects everyday abilities. One of the most common problems in elderly with dementia is communication problem. The purpose of this systematic review is to explore the experience of elderly with mild-moderate dementia in communicating with caregivers. This article uses the systematic review method to all selected articles. Through this systematic review approach, six selected themes in phenomenology journals explain that elderly with mild-moderate dementia can describe the symptoms of dementia experienced, feelings of loss and stress caused of dementia, negative stigma towards elderly dementia, loss of control and desire to make their own decisions, and problems in interpersonal relationships. The ability of elderly with mild-moderate dementia in communicating their experiences when interacting with caregivers can be a consideration for caregivers in making decisions related to the condition of their experience in elderly with dementia</em></p><p> </p><p><em>Demensia merupakan penurunan secara progresif pada kemampuan kognitif yang ditandai dengan </em><em>kehilangan memori yang mempengaruhi kemampuan sehari-hari. Salah satu masalah yang cukup dominan dirasa pada lansia demensia yaitu masalah di dalam komunikasi. Tujuan dari penulisan ini adalah untuk melihat pengalaman lansia dengan demensia ringan-sedang dalam melakukan komunikasi dengan pelaku rawat. </em><em>Artikel ini menggunakan metode penulisan systematic review </em><em>terhadap artikel terpilih. Melalui pendekatan systematic review ini, enam</em><em> jurnal fenomenologi terpilih menyebutkan bahwa </em><em>tema-tema yang muncul saat lansia dengan demensia ringan-sedang melakukan komunikasi dengan pelaku rawat</em><em>, diantaranya lansia mampu untuk menceritakan gejala demensia yang dialami, perasaan kehilangan dan tertekan, stigma negatif orang lain, kehilangan kendali dan keinginan untuk mengambil keputusan sendiri, serta masalah di dalam hubungan interpersonal</em><em>. Kemampuan lansia dengan demensia ringan-sedang dalam mengungkapkan pengalamannya ketika berinteraksi dengan pelaku rawat dapat menjadi pertimbangan bagi pelaku rawat dalam menentukan keputusan pemberian pelayanan berkaitan dengan kondisi demensia yang dialaminya</em></p>
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Llanes-Álvarez, Carlos, Jesús M. Andrés-de llano, Ana I. Álvarez-Navares, Carlos Roncero, M. Teresa Pastor-Hidalgo, José R. Garmendia-Leiza, Irene Andrés-Alberola, and Manuel A. Franco-Martín. "Hospitalization and Socio-Health Care for Dementia in Spain." Journal of Clinical Medicine 9, no. 12 (November 28, 2020): 3875. http://dx.doi.org/10.3390/jcm9123875.
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Dementias are brain diseases that affect long-term cognitive and behavioral functions and cause a decrease in the ability to think and remember that is severe enough to disturb daily functioning. In Spain, the number of people suffering from dementia is rising due to population ageing. Reducing admissions, many of them avoidable, would be advantageous for patients and care-providers. Understanding the correlation of admission of people with dementia and its trends in hospitalization would help us to understand the factors leading to admission. We conducted a cross-sectional study of the hospital discharge database of Castilla y León from 2005 to 2015, selecting hospitalizations for dementia. Trends in hospitalizations by year and age quartiles were studied by joinpoint regression analysis. 2807 out of 2,717,192 total hospitalizations (0.10%) were due to dementias; the main groups were degenerative dementia (1907) followed by vascular dementia (607). Dementias are not a major cause of hospitalization, but the average stay and cost are high, and many of them seem avoidable. Decreasing trends were detected in hospitalization rates for all dementias except for the group of mild cognitive impairment, which grew. An increasing–decreasing joinpoint detected in 2007 for vascular dementia and the general downward hospitalization trends for most dementias suggest that socio-health measures established since 2007 in Spain might play a key role in reducing hospitalizations.
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Mohr, E., P. Brouwers, J. J. Claus, S. E. Purdon, M. Gagnon, and T. N. Chase. "Differential Classification of Dementia." Behavioural Neurology 8, no. 1 (1995): 23–30. http://dx.doi.org/10.1155/1995/391254.
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In the absence of biological markers, dementia classification remains complex both in terms of characterization as well as early detection of the presence or absence of dementing symptoms, particularly in diseases with possible secondary dementia. An empirical, statistical approach using neuropsychological measures was therefore developed to distinguish demented from non-demented patients and to identify differential patterns of cognitive dysfunction in neurodegenerative disease. Age-scaled neurobehavioral test results (Wechsler Adult Intelligence Scale—Revised and Wechsler Memory Scale) from Alzheimer's (AD) and Huntington's (HD) patients, matched for intellectual disability, as well as normal controls were used to derive a classification formula. Stepwise discriminant analysis accurately (99% correct) distinguished controls from demented patients, and separated the two patient groups (79% correct). Variables discriminating between HD and AD patient groups consisted of complex psychomotor tasks, visuospatial function, attention and memory. The reliability of the classification formula was demonstrated with a new, independent sample of AD and HD patients which yielded virtually identical results (classification accuracy for dementia: 96%; AD versus HD: 78%). To validate the formula, the discriminant function was applied to Parkinson's (PD) patients, 38% of whom were classified as demented. The validity of the classification was demonstrated by significant PD subgroup differences on measures of dementia not included in the discriminant function. Moreover, a majority of demented PD patients (65%) were classified as having an HD-like pattern of cognitive deficits, in line with previous reports of the subcortical nature of PD dementia. This approach may thus be useful in classifying presence or absence of dementia and in discriminating between dementia subtypes in cases of secondary or coincidental dementia.
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Bello, Valeska Maria Eboli, and Rodrigo Rizek Schultz. "Prevalence of treatable and reversible dementias: A study in a dementia outpatient clinic." Dementia & Neuropsychologia 5, no. 1 (March 2011): 44–47. http://dx.doi.org/10.1590/s1980-57642011dn05010008.
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Abstract Dementia is a syndrome characterized by the development of multiple cognitive deficits and behavioral changes that leads to impairment of functional activities. There are primary degenerative, progressive and irreversible dementias, and other dementias resulting from a progressive but potentially reversible dementia of secondary origin. Objective: To assess the prevalence of cases with a diagnosis of potentially reversible dementia at a Behavioral Neurology Outpatient Unit. Methods: A retrospective study based on a review of 340 medical records of patients seen from 1999 to 2009 was conducted. All patients received a thorough diagnostic assessment to verify the etiological hypothesis proposed. Results: Of the 340 patients seen in the study period, 172 (50.5%) were females and 168 (49.5%) males, 90 patients (26.4%) were under 60 years of age, and 250 (73.6%) were over 60 years of age. Alzheimer's disease, with 89 cases (26%), followed by vascular dementia with 39 cases (11.47%), were the leading etiological diagnoses. A total of 193 patients had dementia and 37 of these (19.17%) were found to have potentially reversible dementias, distributed as follows: head injury: 15 patients; alcohol-related dementias: 11 patients; meningoencephalitis: 2 patients; hypothyroidism: 2 patients; neurosyphilis: 2 patients; normal pressure hydrocephalus: 2 patients; AIDS: 1 patient; Korsakoff's syndrome: 1 patient, and Post-anoxic dementia: 1 patient. Conclusions: A significant number of patients were found to have potentially reversible dementias (19.17%). These data show an urgent need for more extensive diagnostic investigation, and indicate the possibility of reversing some dementias, especially cases detected early.
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Maryam, Raden Siti, Junaiti Sahar, Kuntjoro Harimurti, Sutanto Priyo Hastono, Etty Rekawati, and Ni Made Riasmini. "KEDUSIA-RSM: An Android-Based Nursing Model for Dementia Prevention and Better Cognitive Function in Older Adults." Enfermería Global 22, no. 4 (October 1, 2023): 191–216. http://dx.doi.org/10.6018/eglobal.557881.
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Introduction: Elderly people with dementia can become a burden to their family. Knowledge of the risk factors for dementia may lower the negative effects of dementia itself. Using Android-based applications can be helpful to families in preventing dementia and caring for the elderly.Objective: This study aimed to formulate an effective family nursing model through an Android-based application, Keluarga Peduli Demensia – Raden Siti Maryam (KEDUSIA-RSM), to enhance cognitive function and to monitor the risk factors of dementia in the elderly. Methods: This study employed an operational research design in two stages: 1) model development, integrating the study background, literature review, and expert consultation, and 2) model trials comparing pre- and post-test groups to control group. The sampling technique used was composite clustering sampling with the results of 156 samples: 79 families in the intervention group and 77 families in the control group. Results: The first stage resulted in the creation of two of the main components of the KEDUSIA-RSM nursing model: the guidebook and its android-based application; There were significant mean differences in cognitive function and dementia risk factor management between those groups before and four months after intervention model (p value < 0.05). Conclusion: KEDUSIA-RSM is proven to be effective in raising cognitive function and managing risk factors for dementia in the elderly. It is highly recommended to replicate the model, to conduct sustainable training for nurses within the community health field and to develop another study on an iOS-based or web-based app with a similar model. Introducción: Los ancianos con demencia pueden ser una carga para sus familias. El conocimiento de los factores de riesgo de la demencia puede reducir los efectos negativos de la propia demencia. El uso de aplicaciones basadas en Android puede ayudar a las familias a prevenir la senilidad y cuidar a los ancianos.Propósito: Este estudio tiene como objetivo formular un modelo efectivo de enfermería familiar a través de la aplicación Android Dementia Care Family – Raden Siti Maryam (KEDUSIA-RSM), para mejorar la función cognitiva y monitorear los factores de riesgo de demencia en los ancianos.Métodos: Este estudio utilizó un diseño de investigación operativa en dos fases: 1) desarrollo del modelo, integración de los antecedentes del estudio, revisión de la literatura y consulta de expertos, y 2) prueba del modelo piloto que compara los grupos de prueba previa y posterior con el grupo de control. La técnica de muestreo utilizada fue el muestreo por conglomerados compuesto con los resultados de 156 muestras, es decir, 79 familias en el grupo de intervención y 77 familias en el grupo de control.Resultados: La primera etapa produjo dos componentes principales del modelo de enfermería KEDUSIA-RSM, a saber, guías y aplicaciones basadas en Android; hubo una diferencia media significativa en la función cognitiva y el manejo de los factores de riesgo de demencia entre los grupos antes y cuatro meses después del modelo de intervención (valor de p < 0,05).Conclusión: KEDUSIA-RSM ha demostrado ser eficaz para mejorar la función cognitiva y controlar los factores de riesgo de demencia en los ancianos. Es muy recomendable replicar el modelo, realizar capacitación continua para enfermeras en salud pública y desarrollar otros estudios en aplicaciones basadas en iOS o en la web con modelos similares.
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Camicioli, Richard, and Nancy Fisher. "Progress in Clinical Neurosciences: Parkinson's Disease with Dementia and Dementia with Lewy Bodies." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 31, no. 1 (February 2004): 7–21. http://dx.doi.org/10.1017/s0317167100002791.
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Dementia occurs in up to 30% of people with Parkinson's disease and is a major cause of disability. Pathologically, Parkinson's dementia, where dementia follows the onset of parkinsonism by at least one year, overlaps with dementia with Lewy bodies. We review the functional impact, definitions, neuropsychology, epidemiology and pathophysiology of Parkinson's dementia, dementia with Lewy bodies and their overlap. Associated psychiatric and imaging findings are also considered. Lastly, current and emerging approaches to assessment and treatment in patients with these Lewy body associated dementias are presented.
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Tisher, Annya, and Arash Salardini. "A Comprehensive Update on Treatment of Dementia." Seminars in Neurology 39, no. 02 (March 29, 2019): 167–78. http://dx.doi.org/10.1055/s-0039-1683408.
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AbstractTreatment of dementias represents an important but relatively neglected part of neurological care of the elderly population. Individual therapeutic interventions may make only small changes to the quality of life of individuals afflicted with dementia, but when used in combination these interventions synergize and can make a significant difference. Additionally, given the societal scale of the problem of dementia care, the overall impact, in economic and sociological terms, of such therapies is of consequence. Presently there are no disease-modifying treatments for any of the neurodegenerative dementias. Instead, the clinician has several therapeutic tools to mitigate cognitive and behavioral consequences of dementias. There are also strategies to minimize harm to patients with dementia. In this article, we aim to review these tools and place them in the greater context of dementia care.
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Rockwood, Kenneth. "Mixed Dementia: Alzheimer's and Cerebrovascular Disease." International Psychogeriatrics 15, S1 (July 2003): 39–46. http://dx.doi.org/10.1017/s1041610203008949.
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“Mixed dementia” is traditionally defined as Alzheimer's disease with cerebrovascular disease (CVD). Because the risks of both neurodegenerative dementias and cerebrovascular disease increase with age, the mixed dementias are likely the most common. In practice, patients with mixed dementia are diagnosed by one of two routes: Either they have evidence of a neurodegenerative dementia and CVD at the outset, or, they have a classical neurodegenerative presentation but are found to have ischemic lesions by neuroimaging. These facts have implications for the development of evidence-based diagnostic criteria.
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Chertkow, H., H. Bergman, H. M. Schipper, A. M. Clarfield, S. Gauthier, S. Fontaine, and R. Bouchard. "Assessment of Suspected Dementia." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 28, S1 (May 2001): S28—S41. http://dx.doi.org/10.1017/s0317167100001189.
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At the Second Canadian Consensus Conference on Dementia (CCCD) (February, 1998), a group of neurologists, geriatricians, and psychiatrists met to consider guidelines for evaluation of dementia in Canada. This review paper formed a background paper for their discussion of dementia diagnosis. These experts from across the country concluded that diagnosis of suspected dementia cases continued to rest on skilled clinical assessment. Mental status exam, preferably in some quantifiable form, has become an essential part of the assessment. Selected laboratory tests are advisable in all cases (CBC, TSH, electrolytes, calcium, and glucose), but the CCCD continued to advise that CT scanning was mandatory only in selected cases where clinical findings pointed to another possibility besides Alzheimer’s disease. The growing list of other diagnostic measures with potential usefulness in diagnosis of Alzheimer’s disease or dementia in general was reviewed, but the evidence was judged as insufficient to support routine use of these tests by physicians. As new treatments for Alzheimer’s disease become available, neurologists face new diagnostic challenges - differentiating Mild Cognitive Impairment, Frontotemporal dementias and Mixed dementias, and Lewy Body Dementia. Guidelines to aid in differential diagnosis are presented.
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Caramelli, Paulo, Valeska Marinho, Jerson Laks, Marcus Vinicius Della Coletta, Florindo Stella, Einstein Francisco Camargos, Jerusa Smid, et al. "Treatment of dementia: recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology." Dementia & Neuropsychologia 16, no. 3 suppl 1 (September 2022): 88–100. http://dx.doi.org/10.1590/1980-5764-dn-2022-s106en.
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ABSTRACT There is currently no cure for neurodegenerative or vascular dementias, but some pharmacological and non-pharmacological interventions may contribute to alleviate symptoms, slow disease progression and improve quality of life. Current treatment approaches are based on etiology, symptom profile and stage of dementia. This manuscript presents recommendations on pharmacological and non-pharmacological treatments of dementia due to Alzheimer’s disease, vascular cognitive impairment, frontotemporal dementia, Parkinson’s disease dementia, and dementia with Lewy bodies.
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Mikhaylova, N. M. "Old Age Dementia: Clinical Patterns of Progression. Part 1." Psikhiatriya 18, no. 3 (September 20, 2020): 108–20. http://dx.doi.org/10.30629/2618-6667-2020-18-3-108-120.
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Background: the clinical experience testifies to the fact, that the increase of dementia severity in late age occurs quickly in some cases and in others it proceeds slowly, which is reflected in the total duration of the disease and survival. One of the aspects of dementias research is the study of significant differences in dementia progression rates.The objective of the review was to generalize the obtained data on progression rates of late age dementias of various genesis, first of all due to Alzheimer’s disease and its associated disorders.Material and methods: papers in MedLine/PubMed bases from1990 to 2020 were selected and analyzed according to the key words: “old age”, “dementia”, “Alzheimer’s disease”, “vascular dementia”, “progression”, “progression rate”, “disease trajectories”, as well as relevant papers in the references of the analyzed works.Conclusion: the history of research of old age dementias natural course was presented in the review of scientific publications. According to the results of development of progression rates detection methods, singling out of dementias with rapid and slow increase in the severity of cognitive decline was substantiated. Works devoted to the study of frequency and nosological belonging of dementias with different progression rates were considered. In the most recent studies prognostic models with detection of various trajectories of the course of the disease were developed. The concept of various dementias progression rates admittedly has practical meaning for provision of diagnostic and treatment assistance and planning of medical and social support measures for patients with dementia and their families. Differentiation of dementia progression clinical patterns during formation of comparable groups of patients seems appropriate for investigation of new therapy methods, as well as in clinical-biological studies of pathogenesis.
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Maxfield, Molly, Allie Peckham, Dara James, Laura Lathrop, and Amy Fiske. "ANTICIPATED SUICIDAL AND DEATH IDEATION IN RESPONSE TO AN IMAGINED DEMENTIA DIAGNOSIS." Innovation in Aging 6, Supplement_1 (November 1, 2022): 781. http://dx.doi.org/10.1093/geroni/igac059.2824.
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Abstract Alzheimer’s disease and related dementias are prevalent, incurable, and highly impactful diagnoses. Dementias are therefore feared diagnoses. Dementia-related anxiety (DRA) is anxiety about a current or future diagnosis of dementia and the associated complex symptoms. In a mixed methods study, semi-structured interviews were conducted to identify causes of DRA and revealed that numerous adults anticipated suicidal or death ideation if diagnosed with dementia. Fifty cognitively healthy, community-dwelling adults aged 58 to 89 (M = 70.92, SD = 6.08; 64% female) were recruited from a university participant registry and Memory Clinic. Among participants endorsing anticipated suicidal or death ideation, responses ranged from active plans, including interest in physician-assisted suicide, to more passive wishes to hasten death rather than continue to live with dementia. Within reports of both anticipated suicidal and death ideation, subthemes emerged, including the concern about becoming a burden to others in more advanced stages of dementia, the devaluation of life or the self with dementia, and the desire for (and anticipated thwarting of) control and independence. Statements of anticipated suicidal and death ideation were contingent on a future dementia diagnosis and may reflect errors in affective forecasting. Nevertheless, given the prevalence of dementias and older adults’ elevated rates of suicide, the intersection of these two public health issues warrants greater attention and further investigation.
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Bouchard, Rémi W. "Diagnostic Criteria of Dementia." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 34, S1 (March 2007): S11—SS18. http://dx.doi.org/10.1017/s0317167100005497.
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In the past two decades there has been a tremendous effort among clinicians and searchers to improve the diagnostic criteria of the dementias on the basis of the differential neurological and neuropsychological profiles. This was an obligatory requirement for clinical trials and the development of treatments. Over the years it became rapidly evident that the cohorts of patients in studies had some degree of heterogeneity, making it difficult to interpret the results of some studies, particularly in the vascular dementias and the mild cognitive impairment (MCI) group. For example, many sub-types of the vascular group were included in clinical trials, such as the cortical strokes, the lacunar states and the diffuse white matter disease cases, and some of the patients might have had also mixed pathology. In addition, the standard DSM IV criteria for dementia no longer represent our present knowledge of the clinical profile of some of the dementias such as vascular dementia (VaD) and fronto-temporal dementia where the memory impairment is not necessarily the first requirement. To improve the validity of clinical trials and eventually help developing more appropriate treatments, we revised the present diagnostic criteria and made recommendations for some changes in the context of the 2nd Canadian Conference on the Development of Antidementia Therapies, held in 2004 and reviewed in the light of the recent literature as of early 2006. It is expected that in the near future, these dementia criteria for clinical trials will have to be revised again in order to include specific subtypes of the dementias as well as biomarkers, structural and functional imaging.
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Finkel, Sanford I. "New Focus on Behavioral and Psychological Signs and Symptoms of Dementia." International Psychogeriatrics 8, S3 (May 1997): 215–16. http://dx.doi.org/10.1017/s1041610297003360.
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The conceptualization of an international consensus conference for the purpose of beginning to establish an operational definition for “behavioral disturbances of dementia” was born at the 7th International Psychogeriatric Association (IPA) Congress in Sydney, Australia, in November 1995. At that time, a special symposium on “research methodological issues in evaluating behavioral disorders of dementia” took place. From the high level of interest and attendance, it was clear that this matter was a source of great attention and concern by clinicians and researchers working with demented elderly. Although we have been aware that patients with dementias, including Alzheimer's disease (AD), manifest psychotic, depressive, and behavioral symptoms over the course of the illness, such symptoms until recently have elicited little interest or research support. Further, research was hampered by the absence of viable measurements and scales developed for this specific population. In addition, rigorous clinical trials were rare and virtually nonexistent in those with moderate and advanced dementias. Prior to 1992, only seven randomly assigned, double-blind trials in this population had been published, only one in a nursing home setting.
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Takada, Leonel Tadao. "Genetic investigation of dementias in clinical practice." Arquivos de Neuro-Psiquiatria 80, no. 5 suppl 1 (May 2022): 36–41. http://dx.doi.org/10.1590/0004-282x-anp-2022-s103.
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Abstract Background: The field of neurodegenerative dementia genetics has advanced significantly over the past two decades, but there are still more to be discovered (such as the gene mutation in some familial forms of dementia). Objective: to provide a brief review of the most recent discoveries regarding monogenic dementia, and covering the most frequent genetic diseases that can cause dementia (neurodegenerative or not). Methods: a review of the literature will be carried out. Results: neurodegenerative dementias, vascular dementias and leukoencephalopathies caused by single pathogenic variants are presented. Conclusion: The spectrum of clinical presentations for most of the genes discussed is wide, and hence genetic testing in clinic should try to cover as many genes as possible.
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Turner, Mark A., Nicholas F. Moran, and Michael D. Kopelman. "Subcortical dementia." British Journal of Psychiatry 180, no. 2 (February 2002): 148–51. http://dx.doi.org/10.1192/bjp.180.2.148.
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BackgroundDrawing a distinction between cortical and subcortical dementias seems both useful and justified. Recent research has, however, cast doubt on the clinical, neuropsychological, neuroimaging and neuroanatomical basis of the distinction.AimsTo arrive at a reasoned conclusion about the relationship between the two types of dementia and the validity of distinguishing between them.MethodThe historical and recent clinical and scientific literature on subcortical dementia was reviewed.ResultsThe traditional claim that subcortical dementia has distinct clinical manifestations, neuroimaging findings and a neuropathological profile is not altogether borne out by the literature. Some studies show that frontal executive dysfunction and the profile of memory deficits are not significantly different from those seen in Alzheimer's disease. Neuropathological findings also overlap.ConclusionsThe category of subcortical dementia may be clinically useful in highlighting the likelihood that an individual with dementia is more likely to suffer from bradyphrenia and motor difficulties. As neuroscience advances a preoccupation with the distinction may hinder the assessment and treatment of individual cases.
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Levinson, Anthony J. "Dementia prevention: Raising awareness about dementia and risk reduction." Open Access Government 41, no. 1 (January 23, 2024): 40–41. http://dx.doi.org/10.56367/oag-041-11188.
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Dementia prevention: Raising awareness about dementia and risk reduction We hear from Dr Anthony J. Levinson, who is part of an academic group developing evidence-based online resources to complement dementia prevention strategies and support care partners. The prevalence of dementia is increasing as our population ages. From a public health standpoint, we need to continue to try to prevent or delay conditions that lead to dementia while also striving to better support people living with dementia and their family/friend care partners. While age and other factors like genetics are important non-modifiable risk factors, there is increasing evidence that several modifiable risk factors account for up to 40% of dementias. While some factors – such as physical activity – may be familiar to some, other factors, such as hearing loss, blood pressure, or social activity, may be much less well-known to the public as risk factors for dementia. For individuals newly diagnosed with dementia or family/friends trying to support and care for their loved ones, they may have very little knowledge about the condition and what to expect. This is where access to easy-to-understand educational content about dementia can be beneficial.
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Kim, Seon-Jip, Sang Min Park, Hyun-Jae Cho, and Ji Woon Park. "Primary headaches increase the risk of dementias: An 8-year nationwide cohort study." PLOS ONE 17, no. 8 (August 18, 2022): e0273220. http://dx.doi.org/10.1371/journal.pone.0273220.
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Background Headache, a highly prevalent neurological disorder, has consistently been linked with an elevated risk of dementia. However, most studies are focused on the relationship with migraine in limited age groups. Therefore, the objective of this research was to look at the link between various type of headaches and dementias based on longitudinal population-based data. Methods and results Participants diagnosed with headache from 2002 to 2005 were selected and major covariates were collected. The diagnoses of Alzheimer’s disease, vascular dementia, and other dementias were observed from 2006 until 2013. The adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of dementias according to headache type were calculated by Cox proportional hazards regression. A number of 470,652 participants were observed for a mean of 7.6 years (standard deviation: 1.2), for approximately 3.6 million person-years. Both tension type headache (TTH) and migraine elevated the risk of all-cause dementias (TTH, aHR 1.18, 95% CI 1.13–2.24; migraine, aHR 1.18, 95% CI 1.13–2.24). Headaches had a greater influence in females and non-smokers as a risk factor of dementias. Patients with migraine who consumed alcohol had a higher risk of dementia, however this was not true with TTH patients. Among participants without comorbidities, TTH patients were more susceptible to dementia than migraine patients. Headache patients had a higher proportion of females regardless of headache type and approximately 1.5 times more individuals had three or more comorbidities compared to those without headache. Conclusions Headache could be an independent predictor for subsequent dementia risk. Future studies should focus on clarifying pathogenic pathways and possible dementia-related preventive measures in headache populations.
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Salardini, Arash. "Interpretation of Biomarker Data in Diagnosis of Primary Dementias." Seminars in Neurology 39, no. 02 (March 29, 2019): 200–212. http://dx.doi.org/10.1055/s-0039-1683380.
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AbstractIn the last few years, an improved understanding of dementia biomarkers has significantly increased the diagnostic accuracy for dementias. The National Institutes of Health Biomarkers Definitions Working Group defines a biomarker as “a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention.” In the field of dementia, a biomarker is a biological measure pointing to a specific dementing pathology. Dementia biomarkers may also serve as surrogates for disease progression and as endpoints in clinical trials. Dementia biomarkers are best characterized for Alzheimer's disease, which is the most common form of primary dementia. The current “biological” conception of Alzheimer's disease is based on consideration of three biomarkers: amyloid, tau, and “neurodegeneration.” The status of these biomarkers may be determined by cerebrospinal fluid clinical chemistry or imaging. Biomarkers for other primary dementias are less reliable and rely chiefly on structural and functional imaging. When appropriate, genetic testing may help with diagnostic certainty in hereditary forms of dementia.
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Verghese, Joe. "MOTOR PATHWAYS TO DEMENTIA." Innovation in Aging 7, Supplement_1 (December 1, 2023): 281. http://dx.doi.org/10.1093/geroni/igad104.0934.
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Abstract Emerging evidence indicates that non-cognitive manifestations such as gait impairments occur early during dementia. The Motoric Cognitive Risk (MCR) is a pre-dementia syndrome characterized by slow gait and cognitive complaints. MCR is a simple and easily accessible clinical dementia risk assay that does not require cognitive testing. MCR has incremental predictive validity for Alzheimer’s disease and related dementias over its individual cognitive and motoric components. Recent studies from across the world have helped to elucidate the epidemiology, biology, and brain substrates of MCR; paving the way for future interventions to prevent progression to dementia.
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Tang, Kim S. "Protective Effects of Polydatin Against Dementia-Related Disorders." Current Neuropharmacology 19, no. 2 (December 31, 2020): 127–35. http://dx.doi.org/10.2174/1570159x18666200611144825.
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: Dementia is a collection of symptoms affecting a person’s cognition. Dementia is debilitating, and therefore, finding an effective treatment is of utmost importance. Resveratrol, which exhibits neuroprotective effects, has low bioavailability. However, its glucoside polydatin is more bioavailable. Here, the evidence that supports the protective role of polydatin against dementia- related diseases such as Alzheimer’s disease, vascular dementia, alcohol-related dementia, and Lewy body dementias is presented. The beneficial effects of polydatin from a mechanistic perspective are specifically emphasized in this review. Future directions in this area of research are also discussed.