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https://www.readbyqxmd.com/read/28429077/-implementation-of-the-german-s3-guidelines-on-dementia-in-clinical-practice-wish-or-reality
#1
H Lohmann, F Kulessa, H Holling, A Johnen, S Reul, G Lueg, T Duning
BACKGROUND: Published in 2009, the German S3 guidelines on dementia define a milestone in quality improvement of the diagnostics and treatment of dementia. In clinical practice patients suffering from dementia are primarily treated by physicians in private practice; therefore, this study examined how the guidelines are implemented in outpatient clinical settings. Furthermore, it aimed at the identification of behavioral determinants that govern the actual diagnostic and therapeutic approach in clinical practice...
April 20, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28427747/percutaneous-endoscopic-gastrostomy-for-aspiration-pneumonia-a-10-year-single-center-experience
#2
Hiromi Tomioka, Shyuji Yamashita, Nobuaki Mamesaya, Masahiro Kaneko
BACKGROUND: The significance of percutaneous endoscopic gastrostomy (PEG) in patients with aspiration pneumonia is unknown. The purpose of this study was to evaluate the clinical characteristics and outcomes of aspiration pneumonia patients who underwent PEG. METHODS: A retrospective cohort study of consecutive patients hospitalized with pneumonia who underwent PEG from 2005 to 2014. RESULTS: Of 2281 cases of pneumonia, 92 patients with aspiration pneumonia underwent PEG during their hospital stay...
May 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28427333/the-experiences-of-physiotherapists-treating-people-with-dementia-who-fracture-their-hip
#3
A J Hall, R Watkins, I A Lang, R Endacott, V A Goodwin
BACKGROUND: It is estimated that people with dementia are approximately three times more likely to fracture their hip than sex and age matched controls. A report by the Chartered Society of Physiotherapy found that this population have poor access to rehabilitation as inpatients and in the community. A recent scoping review found a paucity of research in this area, indeed there has been no qualitative research undertaken with physiotherapists. In order to address this evidence gap, the aim of this current study was to explore the experiences of physiotherapists treating this population...
April 20, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28416036/exploring-dementia-management-attitudes-in-primary-care-a-key-informant-survey-to-primary-care-physicians-in-25-european-countries
#4
Ferdinando Petrazzuoli, Shlomo Vinker, Tuomas H Koskela, Thomas Frese, Nicola Buono, Jean Karl Soler, Jette Ahrensberg, Radost Asenova, Quintí Foguet Boreu, Gülsen Ceyhun Peker, Claire Collins, Miro Hanževački, Kathryn Hoffmann, Claudia Iftode, Donata Kurpas, Jean Yves Le Reste, Bjørn Lichtwarck, Davorina Petek, Daniel Pinto, Diego Schrans, Sven Streit, Eugene Yee Hing Tang, Athina Tatsioni, Péter Torzsa, Pemra C Unalan, Harm van Marwijk, Hans Thulesius
BACKGROUND: Strategies for the involvement of primary care in the management of patients with presumed or diagnosed dementia are heterogeneous across Europe. We wanted to explore attitudes of primary care physicians (PCPs) when managing dementia: (i) the most popular cognitive tests, (ii) who had the right to initiate or continue cholinesterase inhibitor or memantine treatment, and (iii) the relationship between the permissiveness of these rules/guidelines and PCP's approach in the dementia investigations and assessment...
April 18, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28416030/prevalence-neurobiology-and-treatments-for-apathy-in-prodromal-dementia
#5
Chelsea Sherman, Celina S Liu, Nathan Herrmann, Krista L Lanctôt
BACKGROUND: Apathy, characterized by diminished motivation, is a highly prevalent neuropsychiatric symptom in dementia. However, there is a substantial knowledge gap with regard to prevalence rates, neurobiological underpinnings, and effective treatments for apathy in pre-dementia states, including mild cognitive impairment (MCI) and mild behavioral impairment (MBI). METHODS: We conducted a comprehensive literature search using MEDLINE, Embase, and PsycINFO databases to identify available research on apathy in prodromal dementia...
April 18, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28416027/pharmacological-and-non-pharmacological-treatment-preferences-of-healthcare-professionals-and-proxies-for-challenging-behaviors-in-patients-with-dementia
#6
Sarah I Janus, Jeannette G van Manen, Janine A van Til, Sytse U Zuidema, Maarten J IJzerman
BACKGROUND: Prescribing antipsychotics to patients with neuropsychiatric symptoms is a matter of concern. Physicians have to make treatment decisions for patients with dementia together with proxies and/or nurses. However, it is unknown whether physicians, nurses, and proxies' treatment preferences are aligned; hence this study. METHODS: Sixteen treatment attributes were selected to elicit the preferences of physicians and nurses. Ten of these attributes were used for the proxies...
April 18, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28410658/the-role-of-neuroimaging-in-the-assessment-of-the-cognitively-impaired-elderly
#7
REVIEW
Sara Kollack-Walker, Collin Y Liu, Adam S Fleisher
This article reviews the current diagnostic tools that are available for structural, functional, and molecular imaging of the brain, summarizing some of the key findings that have been reported in individuals diagnosed with Alzheimer disease, mild cognitive impairment, prodromal AD, or other prevalent dementias. Given recent advances in the development of amyloid PET tracers, current guidelines for the use of amyloid PET imaging in patients with cognitive complaints are reviewed. In addition, data addressing the potential value of amyloid PET imaging in the clinical setting are highlighted...
May 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28403144/unhealthy-habits-persist-the-ongoing-presence-of-modifiable-risk-factors-for-disease-in-women
#8
Cassandra Szoeke, Christa Dang, Philippe Lehert, Martha Hickey, Meg E Morris, Lorraine Dennerstein, Stephen Campbell
OBJECTIVES: Vascular disease remains a leading cause of death. There are several vascular risk factors identified that can mitigate development of disease in ageing. We examine reported rates of modifiable risk factors in women responding to an online health questionnaire advertised by popular media. METHODS: A sample of 26 620 women aged over 18 was examined in 2015 with a cross-sectional health questionnaire. The questionnaire included self-reported health, mood, lifestyle and vascular risk factors...
2017: PloS One
https://www.readbyqxmd.com/read/28402533/caregiver-perspectives-about-using-antipsychotics-and-other-medications-for-symptoms-of-dementia
#9
John William Kerns, Jonathan D Winter, Katherine M Winter, Christine C Kerns, Rebecca S Etz
Background and Objectives: To avoid "chemical restraints," policies and guidelines have been implemented to curb the use of medications for behavioral and psychological symptoms of dementia (BPSD). Antipsychotics have been particularly targeted because of their rare severe side effects. Consequently, caregiver directed non-pharmacologic therapies have increased while medication use for BPSD has diminished. Despite such initiatives, however, antipsychotics continue to be prescribed "off-label" for roughly 20% of nursing home patients...
April 11, 2017: Gerontologist
https://www.readbyqxmd.com/read/28398367/-implantable-cardioverter-defibrillator-deactivation-at-the-end-of-life-ethical-clinical-and-communication-issues
#10
Massimo Romanò, Maria Antonella Piga, Roberta Bertona, Roberto Negro, Chiara Ruggeri, Federica Zorzoli, Rosvaldo Villani
The number of cardioverter-defibrillator implants is increasing worldwide, with the main indication being primary prevention of sudden cardiac death. During the follow-up, patients may die from progression of their underlying heart disease or from nonarrhythmic causes, such as malignancies, dementia and lung disease, without receiving appropriate shocks until the last few days or weeks of their life. These events occur roughly in 30% of patients, mainly in the last 24 hours before death. In this case, inappropriate and even appropriate shock deliveries can no longer prolong life and may simply lead to pain and reduced quality of life...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28395917/-compliance-with-recommendations-in-secondary-prevention-of-stroke-in-primary-care
#11
Carmen Tamayo-Ojeda, Neus Parellada-Esquius, Betlem Salvador-González, Pilar Ángeles Oriol-Torón, M Dolores Rodríguez-Garrido, Dolores Muñoz-Segura
OBJECTIVE: Knowing compliance with secondary prevention recommendations of stroke in primary care and to identify factors associated with compliance. DESIGN: Multi-centre cross-sectional. SETTING: Health primary care centres in a metropolitan area (944,280 inhabitants). PARTICIPANTS: Patients aged 18years and over with ischemic brain disease diagnosis prior to 6months before the study. MAIN MEASUREMENTS: Clinical history records of demographic variables, risk factors and cardiovascular comorbidity, drugs, blood pressure values (BP), LDL-cholesterol and medical visits by doctor and nurses after the event...
April 7, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28395245/validation-of-a-dried-blood-spot-method-for-therapeutic-drug-monitoring-of-citalopram-mirtazapine-and-risperidone-and-its-active-metabolite-9-hydroxyrisperidone-using-hplc-ms
#12
Johanna Weber, Stefanie Oberfeld, Andrea Bonse, Klaus Telger, Rainer Lingg, Georg Hempel
Citalopram, mirtazapine and risperidone are frequently prescribed for psychiatric illnesses such as depression and psychosis or for aggressive behavior in elderly patients with dementia. The plasma concentrations vary greatly between patients, especially in elderly patients. Thus, therapeutic drug monitoring (TDM) increases the safety of antipsychotic treatment and a more rapid response to treatment may be achieved. To facilitate TDM, the objectives of this study were to develop and validate a reliable dried blood spot method to simultaneously quantify citalopram, mirtazapine and risperidone including its active metabolite 9-hydroxyrisperidone...
March 27, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28376988/improving-nursing-home-compliance-via-revised-antipsychotic-use-survey-tool
#13
Linda L Bach, Donald L Lazzaretto, Clipper F Young, Paul W Lofholm
OBJECTIVE: To analyze the effect of using a pharmacist-initiated antipsychotic use survey tool on improving nursing home compliance for appropriate antipsychotic use in patients with dementia. DESIGN: Prospective chart review study. SETTING: Two nursing homes in Marin County, California. PARTICIPANTS: Nursing home residents diagnosed with dementia and receiving antipsychotic medication. INTERVENTION: Pharmacist performing survey tool screening for appropriate antipsychotic use based on Centers for Medicare & Medicaid Services guidelines and using information from the survey tool as part of the pharmacist recommendations to the prescriber...
April 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28364258/dementia-care-management-in-primary-care-current-collaborative-care-models-and-the-case-for-interprofessional-education
#14
Adina Dreier-Wolfgramm, Bernhard Michalowsky, Mary Guerriero Austrom, Marjolein A van der Marck, Steve Iliffe, Catherine Alder, Horst Christian Vollmar, Jochen René Thyrian, Diana Wucherer, Ina Zwingmann, Wolfgang Hoffmann
BACKGROUND: Dementia is one of the most prevalent diseases in the older population. Various dementia care models have been developed to address patient's healthcare needs. They can be described as "collaborative care" or "person-centered care". Referring to the needs of the workforce working with persons with dementia, a key element is the use of interprofessional education (IPE). OBJECTIVE: The purpose of this article is to describe different international collaborative care models to define a minimum standard of healthcare professions for collaborative dementia care in primary care...
March 31, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28346296/antipsychotic-drug-use-in-nursing-home-residents-with-and-without-dementia-keep-an-eye-on-the-pro-re-nata-medication
#15
Katharina Allers, Michael Dörks, Guido Schmiemann, Falk Hoffmann
Behavioral and psychological symptoms of dementia often lead to the prescription of antipsychotics, especially in nursing homes, but their use remains controversial. This study aimed to assess antipsychotic drug use in residents with dementia compared with those without dementia. Data were obtained through the cross-sectional 'inappropriate medication in patients with renal insufficiency in nursing homes' (IMREN) study including data from 21 nursing homes. Descriptive statistics were used and factors associated with the prescription of antipsychotics were identified by logistic regression...
March 24, 2017: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28345495/people-with-dementia-as-peer-workers-challenges-and-benefits-a-thematic-analysis-and-nominal-groups-study
#16
Joshua Stott, Joanne Marie Sweeney, Luke Koschalka, Luke O'Connor, Amanda Mwale
BACKGROUND: There are national initiatives to involve service users in service delivery. However, programs employing people with dementia as peer support workers (PSWs) in memory services are in their infancy. This study is the first to explore the challenges and benefits to staff and peers involved in such a program. METHODS: Focus groups, structured based on nominal groups (NG) methodology were run with PSWs and clinical staff from two memory services. In total, there were 12 participants, with three focus groups: PSWs alone (n = 3); staff members alone (n = 6); and PSWs and staff members combined (n = 6)...
March 27, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28330379/patient-self-defined-goals
#17
Sandra Ellen Schellinger, Eric Worden Anderson, Monica Schmitz Frazer, Cindy Lynn Cain
This research, a descriptive qualitative analysis of self-defined serious illness goals, expands the knowledge of what goals are important beyond the physical-making existing disease-specific guidelines more holistic. Integration of goals of care discussions and documentation is standard for quality palliative care but not consistently executed into general and specialty practice. Over 14 months, lay health-care workers (care guides) provided monthly supportive visits for 160 patients with advanced heart failure, cancer, and dementia expected to die in 2 to 3 years...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28325164/development-of-a-decision-making-tool-for-reporting-drivers-with-mild-dementia-and-mild-cognitive-impairment-to-transportation-administrators
#18
Duncan H Cameron, Carla Zucchero Sarracini, Linda Rozmovits, Gary Naglie, Nathan Herrmann, Frank Molnar, John Jordan, Anna Byszewski, David Tang-Wai, Jamie Dow, Christopher Frank, Blair Henry, Nicholas Pimlott, Dallas Seitz, Brenda Vrkljan, Rebecca Taylor, Mario Masellis, Mark J Rapoport
BACKGROUND: Driving in persons with dementia poses risks that must be counterbalanced with the importance of the care for autonomy and mobility. Physicians often find substantial challenges in the assessment and reporting of driving safety for persons with dementia. This paper describes a driving in dementia decision tool (DD-DT) developed to aid physicians in deciding when to report older drivers with either mild dementia or mild cognitive impairment to local transportation administrators...
March 22, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28322203/associations-between-amyloid-%C3%AE-and-white-matter-hyperintensities-a-systematic-review
#19
REVIEW
Austyn Roseborough, Joel Ramirez, Sandra E Black, Jodi D Edwards
INTRODUCTION: This systematic review synthesizes current evidence for associations between cortical amyloid β, visualized on amyloid positron emission tomography imaging, and white matter hyperintensity (WMH) burden on magnetic resonance imaging in healthy elderly adults and individuals with cognitive impairment and dementia. METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) systematic review guidelines, we systematically searched MEDLINE, Embase, Cochrane, and PsycINFO databases from January 2000 to September 2015...
March 16, 2017: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
https://www.readbyqxmd.com/read/28304293/coordinate-based-meta-analysis-of-the-default-mode-and-salience-network-for-target-identification-in-non-invasive-brain-stimulation-of-alzheimer-s-disease-and-behavior-variant-frontotemporal-dementia-networks
#20
Michela Pievani, Lorenzo Pini, Clarissa Ferrari, Francesca B Pizzini, Ilaria Boscolo Galazzo, Chiara Cobelli, Maria Cotelli, Rosa Manenti, Giovanni B Frisoni
BACKGROUND: The accurate choice of the site of non-invasive brain stimulation (NIBS) is an important factor in trial design. OBJECTIVE: Based on the observation that Alzheimer's disease (AD) and behavioral frontotemporal dementia (bvFTD) affect specific large-scale networks, i.e., the default mode network (DMN) and the salience network (SN), respectively, we aimed to identify population-average coordinates of these networks that could be used as potential targets in NIBS trials aiming to modulate these circuits...
March 13, 2017: Journal of Alzheimer's Disease: JAD
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