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https://www.readbyqxmd.com/read/29145549/generational-differences-in-the-5-year-incidence-of-age-related-macular-degeneration
#1
Karen J Cruickshanks, David M Nondahl, Lauren J Johnson, Dayna S Dalton, Mary E Fisher, Guan-Hua Huang, Barbara E Klein, Ronald Klein, Carla R Schubert
Importance: Whether a reported decline in the risk of developing age-related macular degeneration (AMD) continued for people born during the Baby Boom years (1946-1964) or later is unknown. These data are important to plan for ocular health care needs in the 21st century. Objectives: To determine whether the 5-year risk for AMD declined by generation and to identify factors that contributed to improvement in risk. Design, Setting, and Participants: Data came from the longitudinal cohort Beaver Dam Eye Study (March 1, 1988, through September 15, 1990, and March 1, 1993, through June 15, 1995) and the Beaver Dam Offspring Study (June 8, 2005, through August 4, 2008, and July 12, 2010, through March 21, 2013)...
November 16, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29143722/relationship-between-the-number-of-behavioral-symptoms-in-dementia-and-caregiver-distress-what-is-the-tipping-point
#2
Paul B Arthur, Laura N Gitlin, John A Kairalla, William C Mann
BACKGROUND: Behavioral and psychological symptoms of dementia (BPSD) are a primary manifestation of brain dysfunction in dementia and a great challenge in caregiving. While BPSD are historically associated with caregiver distress, it is unclear whether there is an identifiable point where BPSD number is associated with heightened caregiver distress. The purpose of this study was to determine if such a tipping point exists to assist clinicians in identifying caregiver compromise. METHODS: Analyses were performed with three datasets totaling 569 community-dwelling persons with dementia and their caregivers...
November 16, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/29143427/effectiveness-of-educational-program-using-printed-educational-material-on-care-burden-distress-among-staff-of-residential-aged-care-facilities-without-medical-specialists-and-or-registered-nurses-cluster-quasi-randomization-study
#3
Koji Fukuda, Seishi Terada, Mamoru Hashimoto, Katsuyuki Ukai, Ryo Kumagai, Mizue Suzuki, Masahiro Nagaya, Mika Yoshida, Hideyuki Hattori, Kenta Murotani, Kenji Toba
AIM: Behavioral and psychological symptoms of dementia are an important source of distress for caregivers. The aim of the present study was to evaluate the effectiveness of educational intervention using printed educational material for reducing distress induced by behavioral and psychological symptoms of dementia among caregivers working at facilities without medical specialists and/or registered nurses. METHODS: A cluster quasi-randomized, controlled comparative trial was carried out at 17 facilities in Japan...
November 15, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29143189/oral-hygiene-and-oral-health-in-older-people-with-dementia-a-comprehensive-review-with-focus-on-oral-soft-tissues
#4
REVIEW
Suzanne Delwel, Tarik T Binnekade, Roberto S G M Perez, Cees M P M Hertogh, Erik J A Scherder, Frank Lobbezoo
BACKGROUND: The number of older people with dementia and a natural dentition is growing. Recently, a systematic review concerning the oral health of older people with dementia with the focus on diseases of oral hard tissues was published. OBJECTIVE: To provide a comprehensive literature overview following a systematic approach of the level of oral hygiene and oral health status in older people with dementia with focus on oral soft tissues. METHODS: A literature search was conducted in the databases PubMed, CINAHL, and the Cochrane Library...
November 15, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29141448/utilizing-evidence-based-assessment-instruments-to-detect-well-being-and-distress-in-english-and-spanish-speaking-caregivers-of-individuals-affected-by-dementia
#5
Shanna L Burke, Aaron Burgess, Tamara Cadet
Objective The purpose of this study was to examine the most effective and available English and Spanish language caregiver assessments for providers and caregivers. Methods Assessments were included if they screened for caregiving-related concerns, including stress, depression, and caregiving burden and could be administered directly to caregivers in person or online. Results Eighteen assessments are designed to assess caregiver burden, distress, depression, and grief. Six did not have psychometric data to support efficacy but are widely used in clinical and research settings...
January 1, 2017: Dementia
https://www.readbyqxmd.com/read/29140858/computerized-cognitive-testing-in-primary-care-a-qualitative-study
#6
Geneva Millett, Gary Naglie, Ross Upshur, Liisa Jaakkimainen, Jocelyn Charles, Mary C Tierney
Computerized cognitive assessment tools may facilitate early identification of dementia in the primary care setting. We investigated primary care physicians' (PCPs') views on advantages and disadvantages of computerized testing based on their experience with the Computer Assessment of Mild Cognitive Impairment (CAMCI). Over a 2-month period, 259 patients, 65 years and older, from the family practice of 13 PCPs completed the CAMCI. Twelve PCPs participated in an individual interview. Generally, PCPs felt that the relationship between them and their patients helped facilitate cognitive testing; however, they thought available paper tests were time consuming and not sufficiently informative...
November 14, 2017: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/29138202/development-of-a-discussion-tool-to-enable-well-being-by-providing-choices-for-people-with-dementia-a-qualitative-study-incorporating-codesign-and-participatory-action-research
#7
Dianne Patricia Goeman, Marissa Dickins, Steve Iliffe, Dimity Pond, Fleur O'Keefe
OBJECTIVE: To codesign a discussion tool to facilitate negotiation of risk between health professionals, people with dementia and carers. METHODS: A qualitative approach using codesign. Thematic analysis was used to analyse interviews and focus groups with people with dementia, carers, healthcare staff and healthy older people exploring the issue of risk in dementia, the acceptability and development of a discussion tool. RESULTS: Sixty-one participants identified the breadth, depth and complexity of risk in dementia care and the need for individualised solutions...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29138153/deprescribing-antihyperglycemic-agents-in-older-persons-evidence-based-clinical-practice-guideline
#8
Barbara Farrell, Cody Black, Wade Thompson, Lisa McCarthy, Carlos Rojas-Fernandez, Heather Lochnan, Salima Shamji, Ross Upshur, Manon Bouchard, Vivian Welch
OBJECTIVE: To develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper, stop, or switch antihyperglycemic agents in older adults. METHODS: We focused on the highest level of evidence available and sought input from primary care professionals in guideline development, review, and endorsement processes. Seven clinicians (2 family physicians, 3 pharmacists, 1 nurse practitioner, and 1 endocrinologist) and a methodologist comprised the overall team; members disclosed conflicts of interest...
November 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29137700/limitation-of-therapeutic-effort-in-patients-hospitalised-in-departments-of-internal-medicine
#9
R García Caballero, B Herreros, D Real de Asúa, S Gámez, G Vega, L García Olmos
INTRODUCTION: There is little information on the limitation of therapeutic effort (LTE) in patients admitted to hospital internal medicine units. OBJECTIVES: To describe the indicated LTE regimens in the departments of internal medicine and the characteristics of the patients who undergo them. PATIENTS AND METHODS: An observational, descriptive retrospective study was conducted on 4 hospitals of the Community of Madrid. The study collected demographic and comorbidity data and the LTE orders prescribed for all patients who died during a period of 6 months...
November 11, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/29135840/costs-and-burden-associated-with-loss-of-labor-productivity-in-informal-caregivers-of-people-with-dementia-results-from-spain
#10
Marta Farré, Belchin Kostov, Josep Maria Haro, Esther Cabrera, Ester Risco, MCarmen Alvira, Susana Miguel, Adelaida Zabalegui
AIMS: We analyzed indirect costs related to loss of labor productivity (LLP) in informal caregivers (ICs) of people with dementia (PwD) and the associated caregiver burden and patients' clinical variables. METHODS: Multicenter cohort study of PwD and their ICs (n = 287) focused on two groups: (1) home care and (2) institutional long-term care. The costs of LLP were assessed using the Resource Utilization Dementia instrument and a human capital approach. RESULTS: The cost for LLP was 378&OV0556;/month or 4...
November 13, 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/29135358/training-area-agencies-on-aging-case-managers-to-improve-physical-function-mood-and-behavior-in-persons-with-dementia-and-caregivers-examples-from-the-rdad-northwest-study
#11
Susan M McCurry, Rebecca G Logsdon, Kenneth C Pike, David M LaFazia, Linda Teri
The Reducing Disability in Alzheimer's Disease (RDAD) program has been shown to be an effective tool for teaching caregivers strategies to improve mood, behavior, and physical function in persons with dementia. This paper describes how RDAD has been translated and implemented for use by Area Agencies on Aging (AAA) case managers across Washington and Oregon. Modifications to the original RDAD program as part of its community translation included decreasing the number of in-person sessions while preserving all educational content; involving caregivers in exercise activities for themselves as well as acting as exercise coaches for care-receivers; and enrolling persons with cognitive impairment due to mixed etiologies...
November 14, 2017: Journal of Gerontological Social Work
https://www.readbyqxmd.com/read/29134465/current-role-for-biomarkers-in-clinical-diagnosis-of-alzheimer-disease-and-frontotemporal-dementia
#12
REVIEW
Nasim Sheikh-Bahaei, Seyed Ahmad Sajjadi, Aimee L Pierce
Purpose of review Alzheimer's disease (AD) and frontotemporal dementia can often be diagnosed accurately with careful clinical history, cognitive testing, neurological examination, and structural brain MRI. However, there are certain circumstances wherein detection of specific biomarkers of neurodegeneration or underlying AD pathology will impact the clinical diagnosis or treatment plan. We will review the currently available biomarkers for AD and frontotemporal dementia (FTD) and discuss their clinical importance...
November 14, 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/29134450/comorbidity-burden-of-dementia-a-hospital-based-retrospective-study-from-2003-to-2012-in-seven-cities-in-china
#13
Qing-Hua Wang, Xin Wang, Xian-Le Bu, Yan Lian, Yang Xiang, Hong-Bo Luo, Hai-Qiang Zou, Jie Pu, Zhong-He Zhou, Xiao-Ping Cui, Qing-Song Wang, Xiang-Qun Shi, Wei Han, Qiang Wu, Hui-Sheng Chen, Hang Lin, Chang-Yue Gao, Li-Li Zhang, Zhi-Qiang Xu, Meng Zhang, Hua-Dong Zhou, Yan-Jiang Wang
Dementia is increasing dramatically and imposes a huge burden on society. To date, there is a lack of data on the health status of patients with dementia in China. In an attempt to investigate the comorbidity burden of dementia patients in China at the national level, we enrolled 2,938 patients with Alzheimer's disease (AD), vascular dementia (VaD), or other types of dementia, who were admitted to tertiary hospitals in seven regions of China from January 2003 to December 2012. The Charlson Comorbidity Index (CCI) was used to evaluate the comorbidity burden of the patients with dementia...
November 13, 2017: Neuroscience Bulletin
https://www.readbyqxmd.com/read/29133497/comparative-associations-between-measures-of-anti-cholinergic-burden-and-adverse-clinical-outcomes
#14
Wen-Han Hsu, Yu-Wen Wen, Liang-Kung Chen, Fei-Yuan Hsiao
PURPOSE: No consensus has been reached regarding which anticholinergic scoring system works most effectively in clinical settings. The aim of this population-based cohort study was to examine the association between anticholinergic medication burden, as defined by different scales, and adverse clinical outcomes among older adults. METHODS: From Taiwan's Longitudinal Health Insurance Database, we retrieved data on monthly anticholinergic drug use measured by the Anticholinergic Risk Scale (ARS), the Anticholinergic Cognitive Burden Scale (ACB), and the Drug Burden Index - Anticholinergic component (DBI-Ach) for 116,043 people aged 65 years and older during a 10-year follow-up...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133329/involvement-of-people-with-dementia-in-making-decisions-about-their-lives-a-qualitative-study-that-appraises-shared-decision-making-concerning-daycare
#15
Leontine Groen-van de Ven, Carolien Smits, Fuusje de Graaff, Marijke Span, Jan Eefsting, Jan Jukema, Myrra Vernooij-Dassen
OBJECTIVE: To explore how people with dementia, their informal caregivers and their professionals participate in decision making about daycare and to develop a typology of participation trajectories. DESIGN: A qualitative study with a prospective, multiperspective design, based on 244 semistructured interviews, conducted during three interview rounds over the course of a year. Analysis was by means of content analysis and typology construction. SETTING: Community settings and nursing homes in the Netherlands...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29133284/the-association-of-health-literacy-and-electronic-health-literacy-with-self-efficacy-coping-and-caregiving-perceptions-among-carers-of-people-with-dementia-research-protocol-for-a-descriptive-correlational-study
#16
Areti Efthymiou, Nicos Middleton, Andreas Charalambous, Evridiki Papastavrou
BACKGROUND: In the last decade, electronic health (eHealth) literacy has attracted the attention of the scientific community, as it is associated with the self-management of patients with chronic diseases and the quality and cost of care. It is estimated that 80% of people with chronic diseases are cared for at home by a family member, friend, or relative. Informal carers are susceptible to physical and mental health problems, as well as social and financial hardships. Nevertheless, there seems to be a research gap in terms of carers' needs, skills, and available resources in the age of new technologies, with the vital role of eHealth literacy of the carers remaining unexplored...
November 13, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29132353/the-effectiveness-of-community-based-coordinating-interventions-in-dementia-care-a-meta-analysis-and-subgroup-analysis-of-intervention-components
#17
Amy Backhouse, Obioha C Ukoumunne, David A Richards, Rose McCabe, Ross Watkins, Chris Dickens
BACKGROUND: Interventions aiming to coordinate services for the community-based dementia population vary in components, organisation and implementation. In this review we aimed to evaluate the effectiveness of community-based care coordinating interventions on health outcomes and investigate whether specific components of interventions influence their effects. METHODS: We searched four databases from inception to April 2017: Medline, The Cochrane Library, EMBASE and PsycINFO...
November 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29132219/achieving-positive-outcomes-in-complex-cases-the-admiral-nurse-dementia-helpline-innovative-practice
#18
Susan Drayton, Karen H Dening
Carer distress is an all too common factor in caring for someone with dementia, whether living with the person with dementia, or trying to maintain their independence when they are living alone. Providing support for families on many day-to-day issues with immediacy as and when they arise can be very difficult to achieve for services on the ground as carer need can be difficult to anticipate as well as the changing status of the person with dementia. This paper discusses the innovative role of managing complexity on a dementia telephone helpline manned by Admiral Nurses, specialist dementia nurses, in expertly supporting a family over a weekend where there were health concerns of a family member with dementia and a high level of carer distress...
January 1, 2017: Dementia
https://www.readbyqxmd.com/read/29132018/the-provision-of-accredited-higher-education-on-dementia-in-six-european-countries-an-exploratory-study
#19
Simona Hvalič-Touzery, Brigita Skela-Savič, Rhoda Macrae, Anna Jack-Waugh, Debbie Tolson, Amanda Hellström, Wilson de Abreu, Katja Pesjak
BACKGROUND: The World Health Organization has identified developing the knowledge and skills of healthcare professionals who are involved in dementia care as a priority. Most healthcare professionals lack the necessary knowledge, skills and understanding to provide high quality dementia care. While dementia education amongst most UK university health and social care programmes is inconsistent, we know little about the provision of dementia education in European universities. OBJECTIVES: To examine the provision of accredited higher education on dementia in European countries, to illustrate that it is highly variable despite universities being the major provider of education for healthcare professionals internationally...
November 6, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/29130870/modern-technology-to-support-carers-of-care-recipients-with-dementia-or-functional-mental-illness-promising-progress-but-a-long-road-ahead
#20
Nicola T Lautenschlager, Janine Diehl-Schmid, Samantha M Loi, Johannes Mayer, Maria Tensil, Alexander F Kurz
There is no doubt that family carers who look after a family member with dementia or with a functional mental illness fulfill an important role, not only for their loved one, but also for the health and aged care systems of the countries they live in. Due to increasing life expectancy, but also improved healthcare the number of family carers supporting older care recipients with functional mental illness or dementia is on the rise. While the carer role often can offer rewarding experiences caregivers are at increased risk of stress, depression, sleep problems, and often experience poor health outcomes with increased morbidity and mortality (Oyebode, 2003)...
December 2017: International Psychogeriatrics
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