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agitation and dementia

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https://www.readbyqxmd.com/read/28079675/recent-advances-in-the-management-of-neuropsychiatric-symptoms-in-dementia
#1
Orestes V Forlenza, Júlia Cunha Loureiro, Marcos Vasconcelos Pais, Florindo Stella
PURPOSE OF REVIEW: The present article addresses intriguing questions related to the clinical intervention in distinct neuropsychiatric syndromes of patients with dementia. RECENT FINDINGS: We reviewed 154 articles published between 2015 and 2016 targeting psychopharmacological and nonpharmacological interventions, and safety-tolerability concerns. We selected 115 articles addressing the purpose of this study. Of these, 33 were chosen because they were dedicated to subtopics: agitation (42), depression (33), apathy (18), sleep disorders/anxiety (8), and psychosis (4)...
January 12, 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/28067961/quality-of-life-in-relation-to-neuropsychiatric-symptoms-in-alzheimer-s-disease-5-year-prospective-alsova-cohort-study
#2
Kristiina Hongisto, Ilona Hallikainen, Tuomas Selander, Soili Törmälehto, Saku Väätäinen, Janne Martikainen, Tarja Välimäki, Sirpa Hartikainen, Jaana Suhonen, Anne M Koivisto
OBJECTIVE: To examine the association between neuropsychiatric symptoms (NPS) with self- and caregiver-rated Quality of Life (QoL) for patients with Alzheimer's disease (AD) during a 5-year follow-up. METHODS: The ALSOVA 5-year follow-up study included, at baseline, 236 patients with either very mild (Clinical Dementia Rating Scale (CDR) 0.5), or mild (CDR 1) AD, together with their caregivers from three Finnish hospital districts. QoL was evaluated using patient self-reported, and caregiver-rated, QoL in AD (QoL-AD) scores...
January 9, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28057424/sundown-syndrome-sleep-quality-and-walking-among-community-dwelling-people-with-alzheimer-disease
#3
Yen-Hua Shih, Ming-Chyi Pai, Ying-Che Huang, Jing-Jy Wang
PURPOSES: Sundown syndrome and sleep disturbances cause people with Alzheimer disease (PAD) and caregivers suffering. Studies have indicated that physical exercise could have a positive impact on sundown syndrome, yet no research has ever explored the relationship between walking and sundown syndrome. The aims of this study were to examine the relationship between sundown syndrome and sleep quality, and determine whether the severity of dementia, sleep quality, and weekly duration of walking influenced sundown syndrome, and to assess differences in sundown syndrome and sleep quality in relation to the accompanying walker and weekly duration of walking among people with Alzheimer disease living in the community...
January 2, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28035924/the-effect-of-the-association-between-donepezil-and-choline-alphoscerate-on-behavioral-disturbances-in-alzheimer-s-disease-interim-results-of-the-ascomalva-trial
#4
Anna Carotenuto, Raffaele Rea, Enea Traini, Angiola Maria Fasanaro, Giovanna Ricci, Valentino Manzo, Francesco Amenta
BACKGROUND: Behavioral and psychological symptoms of dementia (BPSD) are a group of psychological reactions, psychiatric symptoms, and behaviors commonly found in Alzheimer's disease (AD). Four clusters of BPSD have been described: mood disorders (depression, anxiety, and apathy), psychotic symptoms (delusions and hallucinations), aberrant motor behaviors (pacing, wandering, and other purposeless behaviors), and inappropriate behaviors (agitation, disinhibition, and euphoria). Most of them are attributed to acetylcholine deficiency...
December 30, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28009676/effectiveness-of-meaningful-occupation-interventions-for-people-living-with-dementia-in-residential-aged-care-a-systematic-review
#5
Catherine Travers, Deborah Brooks, Sonia Hines, Maria O'Reilly, Mitchell McMaster, Wei He, Margaret MacAndrew, Elaine Fielding, Lina Karlsson, Elizabeth Beattie
BACKGROUND: The ability to participate in valued activities, whether for work, leisure or family, is an important aspect of personal identity. In dementia, progressive memory loss means that abilities developed over a lifetime begin to be lost as well, contributing to the loss of self and identity. Some studies have reported that activities or interventions tailored to be meaningful to the person with dementia (defined as any activity important to the individual) are more effective in addressing behavioral and psychological symptoms of dementia (BPSD) and improving quality of life (QoL) than those that are not so tailored...
December 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28009620/the-treatment-of-disruptive-vocalization-in-dementia-behavioral-and-psychological-symptoms-of-dementia-with-electroconvulsive-therapy-a-case-series
#6
Timothy Edwin Lau, Prakash Kishor Babani, Lisa Anne McMurray
OBJECTIVE: There is emerging evidence that electroconvulsive therapy (ECT) can help with the behavioral and psychological symptoms of dementia. One of the most distressing behavioral symptoms of dementia is disruptive vocalization. Previous small case series have suggested that antidepressants and ECT can be beneficial for this distressing condition. The aim of this study was to describe the successful use of ECT in treating 5 patients with disruptive vocalization. METHODS: A retrospective chart review of 5 patients with dementia of mixed etiologies was conducted comparing pretreatment and posttreatment scores on the Cohen-Mansfield Agitation Inventory...
December 21, 2016: Journal of ECT
https://www.readbyqxmd.com/read/28001137/covert-medications-act-of-compassion-or-conspiracy-of-silence
#7
Robert C Macauley
As the population in the United States gets older, more people suffer from dementia, which often causes neuropsychiatric symptoms such as agitation and paranoia. This can lead patients to refuse medications, prompting consideration of covert administration (that is, concealing medication in food or drink). While many condemn this practice as paternalistic, deceptive, and potentially harmful, the end result of assuming the "moral high ground" can be increased suffering for patients and families. This article addresses common criticisms of covert medication and presents a detailed algorithm by which to determine whether the practice is ethically permissible in specific cases...
2016: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/27999476/advancing-aged-care-a-systematic-review-of-economic-evaluations-of-workforce-structures-and-care-processes-in-a-residential-care-setting
#8
REVIEW
Tiffany Easton, Rachel Milte, Maria Crotty, Julie Ratcliffe
Long-term care for older people is provided in both residential and non-residential settings, with residential settings tending to cater for individuals with higher care needs. Evidence relating to the costs and effectiveness of different workforce structures and care processes is important to facilitate the future planning of residential aged care services to promote high quality care and to enhance the quality of life of individuals living in residential care. A systematic review conducted up to December 2015 identified 19 studies containing an economic component; seven included a complete economic evaluation and 12 contained a cost analysis only...
2016: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/27936965/avp-786-for-the-treatment-of-agitation-in-dementia-of-the-alzheimer-s-type
#9
Ricardo P Garay, George T Grossberg
Agitation is common and distressing in patients with Alzheimer-type dementia, but safe, effective treatments remain elusive. Psychological treatments are first-line options, but they have limited efficacy. Off-label psychotropic medications are frequently used, but they also have limited effectiveness, and their use may have harmful side effects, including death. Areas covered: This review discusses the history leading to the conception of AVP-786 (deuterated (d6)-dextromethorphan/quinidine), its pharmacokinetic and pharmacodynamic profiles and safety issues, together with an overview of recent clinical trials...
January 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27925607/therapeutic-touch-in-the-management-of-responsive-behavior-in-patients-with-dementia
#10
Ananthavalli Kumarappah, Helen Senderovich
Patients with dementia experience various behavioral symptoms in the course of their illnesses, which greatly affect their quality of life. Current treatment modalities are not always effective, and, thus, nonpharmacological approaches are the preferred first-line therapy for managing such symptoms. They generally address the basic needs of the person with dementia and provide humane care, often producing noticeable improvements in symptoms. Thus, such therapies should precede pharmacological interventions...
October 2016: Advances in Mind-body Medicine
https://www.readbyqxmd.com/read/27917740/delirium-superimposed-on-dementia-phenomenological-differences-between-patients-with-and-without-behavioral-and-psychological-symptoms-of-dementia-in-a-specialized-delirium-unit
#11
Jennifer Abengaña, Mei Sian Chong, Laura Tay
BACKGROUND: Overlap between neuropsychiatric symptoms of dementia and delirium complicates diagnosis of delirium superimposed on dementia (DSD). This study sought to examine differences in delirium presentation and outcomes between DSD patients with and without pre-existing behavioral and psychological symptoms of dementia (BPSD). METHODS: This was a prospective cohort study of older adults with DSD admitted to a specialized delirium unit (December 2010-August 2012)...
December 5, 2016: International Psychogeriatrics
https://www.readbyqxmd.com/read/27914870/co-occurrence-and-predictors-of-three-commonly-occurring-behavioral-symptoms-in-dementia-agitation-aggression-and-rejection-of-care
#12
Scott Seung W Choi, Chakra Budhathoki, Laura N Gitlin
OBJECTIVE: To investigate co-occurrences of agitation, aggression, and rejection of care in community-dwelling families living with dementia. METHODS: Cross-sectional, secondary analysis from a randomized controlled trial testing a nonpharmacological intervention to reduce behavioral symptoms. We examined frequency of occurrence of presenting behaviors at baseline and their combination. Omnibus tests compared those exhibiting combinations of behaviors on contributory factors...
November 3, 2016: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27912905/effects-of-aromatherapy-on-agitation-and-related-caregiver-burden-in-patients-with-moderate-to-severe-dementia-a-pilot-study
#13
Tugce Turten Kaymaz, Leyla Ozdemir
We examined the effects of aromatherapy on agitation in patients with dementia and evaluated related caregiver burden. Patients and their caregivers from two hospitals in Turkey were selected and divided into an intervention group (n = 14) and a control group (n = 14). Patients were stratified according to their dementia phase and intake of antipsychotic medication. The intervention group received aromatherapy via massage and inhalation at home for 4 weeks. The control group received no intervention. Data were collected using the Neuropsychiatric Inventory (NPI), the Cohen-Mansfield Agitation Inventory (CMAI) and the Zarit Burden Interview (ZBI)...
November 29, 2016: Geriatric Nursing
https://www.readbyqxmd.com/read/27911311/risk-factors-and-pathological-substrates-associated-with-agitation-aggression-in-alzheimer-s-disease-a-preliminary-study-using-nacc-data
#14
Simrin Sennik, Tom A Schweizer, Corinne E Fischer, David G Munoz
BACKGROUND: Neuropsychiatric symptoms are common manifestations of Alzheimer's disease (AD). A number of studies have targeted psychosis, i.e., hallucinations and delusions in AD, but few have assessed agitation/aggression in AD. OBJECTIVE: To investigate the risk factors and pathological substrates associated with presence [A(+)] and absence [A(-)] of agitation/aggression (A) in autopsy-confirmed AD. METHODS: Data was collected from the UDS data as of 2015 on the NACC database...
2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27897609/a-video-based-intervention-on-and-evaluation-of-nursing-aides-therapeutic-communication-and-residents-agitation-during-mealtime-in-a-dementia-care-unit
#15
Lené Levy-Storms, Lesley M Harris, Xiao Chen
The researchers conducted a communication training intervention for certified nursing assistants (CNAs). The intervention aimed at improving CNAs' therapeutic techniques for relating to agitated residents during care. This study focused on an in-depth evaluation of mealtime interactions using videos. Sixteen CNAs and 16 residents living with dementia from one long-term care facility were videotaped during mealtime interactions before and after a therapeutic communication training program. Mixed-effect Poisson regression revealed no effect of the intervention as a whole on residents' refusals, but the intervention did improve CNAs' communication...
October 2016: Journal of Nutrition in Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27886013/is-salivary-chromogranin-a-a-valid-psychological-stress-biomarker-during-sensory-stimulation-in-people-with%C3%A2-advanced-dementia
#16
Vanessa Valdiglesias, Ana Maseda, Laura Lorenzo-López, Eduardo Pásaro, José C Millán-Calenti, Blanca Laffon
Salivary chromogranin A (sCgA) is gaining attention as a biomarker of psychological stress. The objective of this work was to determine whether individualized music intervention and multisensory stimulation environment (MSSE) in a Snoezelen room produce changes in sCgA in severely demented older patients, and to assess the possible existence of differences in sCgA levels between the two types of interventions. Older adults with severe dementia (n = 22) were randomly assigned to two intervention groups. They participated in MSSE or individualized music interventions in 30-min weekly sessions for 16 weeks...
2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27864252/predictors-of-care-home-and-hospital-admissions-and-their-costs-for-older-people-with-alzheimer-s-disease-findings-from-a-large-london-case-register
#17
Martin Knapp, Kia-Chong Chua, Matthew Broadbent, Chin-Kuo Chang, Jose-Luis Fernandez, Dominique Milea, Renee Romeo, Simon Lovestone, Michael Spencer, Gwilym Thompson, Robert Stewart, Richard D Hayes
OBJECTIVES: To examine links between clinical and other characteristics of people with Alzheimer's disease living in the community, likelihood of care home or hospital admission, and associated costs. DESIGN: Observational data extracted from clinical records using natural language processing and Hospital Episode Statistics. Statistical analyses examined effects of cognition, physical health, mental health, sociodemographic factors and living circumstances on risk of admission to care home or hospital over 6 months and associated costs, adjusting for repeated observations...
November 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27826189/behavioral-emergency-in-the-elderly-a-descriptive-study-of-patients-referred-to-an-aggression-response-team-in-an-acute-hospital
#18
Daniel Simpkins, Carmelle Peisah, Irene Boyatzis
AIM: The management of severely agitated elderly patients is not easy, and limited guidelines are available to assist practitioners. At a Sydney hospital, an Aggression Response Team (ART) comprising clinical and security staff can be alerted when a staff member has safety concerns. Our aims were to describe the patient population referred for ART calls, reasons for and interventions during ART calls, and complications following them. METHODS: Patients 65 years and older referred for ART calls in the emergency department or wards during 2014 were identified using the Incident Information Management System database and medical records were reviewed...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27819842/low-dose-lithium-treatment-for-agitation-and-psychosis-in-alzheimer-disease-and-frontotemporal-dementia-a-case-series
#19
Davangere P Devanand, Gregory H Pelton, Kristina D'Antonio, Jesse G Strickler, William C Kreisl, James Noble, Karen Marder, Anne Skomorowsky, Edward D Huey
No abstract text is available yet for this article.
November 4, 2016: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/27797086/risk-factors-for-new-onset-delirium-in-patients-with-bloodstream-infections-independent-and-quantitative-effect-of-catheters-and-drainages-a-four-year-cohort-study
#20
Tolga Dittrich, Sarah Tschudin-Sutter, Andreas F Widmer, Stephan Rüegg, Stephan Marsch, Raoul Sutter
BACKGROUND: Bloodstream infections (BSI) and delirium are frequent in critically ill patients. During systemic inflammatory response to BSI, cytokines may interact with neurotransmitters and neuronal receptors driving acute brain dysfunction. However, prospectively collected data on incidence, prediction and impact of delirium in association with BSI are lacking. This study aimed to determine the incidence and predictors of new-onset delirium and its impact on outcome in critically ill adult patients with BSI...
December 2016: Annals of Intensive Care
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