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https://www.readbyqxmd.com/read/28105501/-diagnostics-and-multimodal-treatment-of-depression-in-old-age-new-developments
#1
Gerhard W Eschweiler
Depressive disorders in elderly persons are frequent and can either first be manifested at a younger age and show a recurrent pattern during later life (ICD 10, F33.*) or have an onset beyond 60 years, which is termed late onset depression (LOD). This LOD has a higher tendency to chronification and implies an increased risk of progression, especially to vascular dementia. The multifactorial genesis of depression in old age includes psychosocial, vascular and metabolic factors and requires multimodal therapy modules at the biological and psychosocial level, which is now increasingly being empirically proven...
January 19, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28104596/operationalising-ethical-challenges-in-dementia-research-a-systematic-review-of-current-evidence
#2
Emily West, Astrid Stuckelberger, Sophie Pautex, Janneke Staaks, Marjolein Gysels
BACKGROUND: the worldwide number of dementia cases is increasing, and this is a trend that is expected to continue as a growing proportion of the population ages. However, conducting research with persons suffering from dementia can be fraught due to fears surrounding research risks in vulnerable populations. This can make seeking approval for studies difficult. As research directly involving persons with dementia is key for the development of evidence-based best practice, the development of a coherent ethical strategy to perform such research feasibly and effectively is of paramount importance...
January 18, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28103749/clinical-practice-with-anti-dementia-drugs-a-revised-third-consensus-statement-from-the-british-association-for-psychopharmacology
#3
John T O'Brien, Clive Holmes, Matthew Jones, Roy Jones, Gill Livingston, Ian McKeith, Peter Mittler, Peter Passmore, Craig Ritchie, Louise Robinson, Elizabeth L Sampson, John-Paul Taylor, Alan Thomas, Alistair Burns
The British Association for Psychopharmacology coordinated a meeting of experts to review and revise its previous 2011 guidelines for clinical practice with anti-dementia drugs. As before, levels of evidence were rated using accepted standards which were then translated into grades of recommendation A-D, with A having the strongest evidence base (from randomised controlled trials) and D the weakest (case studies or expert opinion). Current clinical diagnostic criteria for dementia have sufficient accuracy to be applied in clinical practice (B) and both structural (computed tomography and magnetic resonance imaging) and functional (positron emission tomography and single photon emission computerised tomography) brain imaging can improve diagnostic accuracy in particular situations (B)...
December 1, 2016: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28095412/intensive-versus-guideline-blood-pressure-and-lipid-lowering-in-patients-with-previous-stroke-main-results-from-the-pilot-prevention-of-decline-in-cognition-after-stroke-trial-podcast-randomised-controlled-trial
#4
Philip M Bath, Polly Scutt, Daniel J Blackburn, Sandeep Ankolekar, Kailash Krishnan, Clive Ballard, Alistair Burns, Jonathan Mant, Peter Passmore, Stuart Pocock, John Reckless, Nikola Sprigg, Rob Stewart, Joanna M Wardlaw, Gary A Ford
BACKGROUND: Stroke is associated with the development of cognitive impairment and dementia. We assessed the effect of intensive blood pressure (BP) and/or lipid lowering on cognitive outcomes in patients with recent stroke in a pilot trial. METHODS: In a multicentre, partial-factorial trial, patients with recent stroke, absence of dementia, and systolic BP (SBP) 125-170 mmHg were assigned randomly to at least 6 months of intensive (target SBP <125 mmHg) or guideline (target SBP <140 mmHg) BP lowering...
2017: PloS One
https://www.readbyqxmd.com/read/28074217/-nutrition-in-dementia
#5
D Volkert
BACKGROUND: In the course of dementia sooner or later nutritional problems appear, and the question arises which interventions are effective in ensuring adequate nutrition and thus may contribute to the maintenance of health, functionality and independence. OBJECTIVE: This overview presents the state of knowledge regarding nutrition in dementia. METHODS: This work is based on the present guidelines of the European Society for Clinical Nutrition and Metabolism (ESPEN) on nutrition in dementia, which systematically investigated relevant available evidence...
January 10, 2017: Der Internist
https://www.readbyqxmd.com/read/28072381/magnetic-resonance-imaging-and-positron-emission-tomography-in-the-diagnosis-of-neurodegenerative-dementias
#6
REVIEW
A Del Sole, S Malaspina, Alberto Magenta Biasina
Neuroimaging, both with magnetic resonance imaging (MRI) and positron emission tomography (PET), has gained a pivotal role in the diagnosis of primary neurodegenerative diseases. These two techniques are used as biomarkers of both pathology and progression of Alzheimer's disease (AD) and to differentiate AD from other neurodegenerative diseases. MRI is able to identify structural changes including patterns of atrophy characterizing neurodegenerative diseases, and to distinguish these from other causes of cognitive impairment, e...
October 2016: Functional Neurology
https://www.readbyqxmd.com/read/28063859/assessing-palliative-care-content-in-dementia-care-guidelines-a-systematic-review
#7
REVIEW
Pamela Durepos, Abigail Wickson-Griffiths, Afeez Abiola Hazzan, Sharon Kaasalainen, Vasilia Vastis, Lisa Battistella, Alexandra Papaioannou
CONTEXT: Families of persons with dementia continue to report unmet needs during end-of-life. Strategies to improve care and quality of life for persons with dementia include development of clinical practice guidelines (CPG) and an integrative palliative approach. OBJECTIVES: We aimed to assess palliative care content in dementia CPGs in order to identify the presence or limitations of recommendations and discussion pertaining to common issues or domains affected by illness as described by the Canadian Hospice Palliative Care 'Square of Care'...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28062571/performance-of-a-condensed-protocol-that-reduces-effort-and-cost-of-nia-aa-guidelines-for-neuropathologic-assessment-of-alzheimer-disease
#8
Margaret E Flanagan, Desiree A Marshall, Jane B Shofer, Kathleen S Montine, Peter T Nelson, Thomas J Montine, C Dirk Keene
Concerns regarding resource expenditures have been expressed about the 2012 NIA-AA Sponsored Guidelines for neuropathologic assessment of Alzheimer disease (AD) and related dementias. Here, we investigated a cost-reducing Condensed Protocol and its effectiveness in maintaining the diagnostic performance of Guidelines in assessing AD, Lewy body disease (LBD), microvascular brain injury, hippocampal sclerosis (HS), and congophilic amyloid angiopathy (CAA). The Condensed Protocol consolidates the same 20 regions into 5 tissue cassettes at ∼75% lower cost...
January 6, 2017: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/28060001/incidence-of-skin-tears-and-risk-factors-a-systematic-literature-review
#9
Kelly Cristina Strazzieri-Pulido, Giovana Ribau Picolo Peres, Ticiane Carolina Gonçalves Faustino Campanili, Vera Lúcia Conceição de Gouveia Santos
Skin tears are traumatic wounds resulting from friction and shearing forces. Clinical practice strongly indicates that skin tears are a prevalent problem but their incidence is not well established in the literature. This systematic literature review identified and evaluated the available literature on the incidence and risk factors for skin tears in adults and the elderly. Inclusion criteria were epidemiological studies published in English, Spanish, or Portuguese languages from January 1990 through June 2014 and available in full text...
January 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28054240/risk-of-adverse-outcomes-for-older-people-with-dementia-prescribed-antipsychotic-medication-a-population-based-e-cohort-study
#10
Michael Dennis, Laura Shine, Ann John, Amanda Marchant, Joanna McGregor, Ronan A Lyons, Sinead Brophy
INTRODUCTION: Over recent years there has been growing evidence of increased risk of mortality associated with antipsychotic use in older people with dementia. Although this concern combined with limited evidence of efficacy has informed guidelines restricting antipsychotic prescription in this population, the use of antipsycotics remains common. Many published studies only report short-term outcomes, are restricted to examining mortality and stroke risk or have other limitations. The aim of this study was to assess adverse outcomes associated with the use of antipsychotics in older people living with dementia in Wales (UK)...
January 4, 2017: Neurology and Therapy
https://www.readbyqxmd.com/read/28052454/estimated-ventricle-size-using-evans-index-reference-values-from-a-population-based-sample
#11
D Jaraj, K Rabiei, T Marlow, C Jensen, I Skoog, C Wikkelsø
BACKGROUND AND PURPOSE: Evans index is an estimate of ventricular size used in the diagnosis of idiopathic normal-pressure hydrocephalus (iNPH). Values >0.3 are considered pathological and are required by guidelines for the diagnosis of iNPH. However, there are no previous epidemiological studies on Evans index, and normal values in adults are thus not precisely known. We examined a representative sample to obtain reference values and descriptive data on Evans index. METHODS: A population-based sample (n = 1235) of men and women aged ≥70 years was examined...
January 4, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28050656/the-recommendations-of-a-consensus-panel-for-the-screening-diagnosis-and-treatment-of-neurogenic-orthostatic-hypotension-and-associated-supine-hypertension
#12
REVIEW
Christopher H Gibbons, Peter Schmidt, Italo Biaggioni, Camille Frazier-Mills, Roy Freeman, Stuart Isaacson, Beverly Karabin, Louis Kuritzky, Mark Lew, Phillip Low, Ali Mehdirad, Satish R Raj, Steven Vernino, Horacio Kaufmann
Neurogenic orthostatic hypotension (nOH) is common in patients with neurodegenerative disorders such as Parkinson's disease, multiple system atrophy, pure autonomic failure, dementia with Lewy bodies, and peripheral neuropathies including amyloid or diabetic neuropathy. Due to the frequency of nOH in the aging population, clinicians need to be well informed about its diagnosis and management. To date, studies of nOH have used different outcome measures and various methods of diagnosis, thereby preventing the generation of evidence-based guidelines to direct clinicians towards 'best practices' when treating patients with nOH and associated supine hypertension...
January 3, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28001136/covert-administration-of-medication-to-persons-with-dementia-exploring-ethical-dimensions
#13
Jenny M Young, David Unger
The literature, although sparse, reports that covert administration of all types of medications is prevalent in nursing homes. Whether it is ever ethically defensible, however, to administer medications covertly to persons with significant dementia is a complex and contentious question. Some scholars contend that deception is inherently wrong and is never acceptable, while others believe that deception is intrinsic to providing care to persons with dementia. With an aim to begin to reconcile these polarized positions and to objectively study this contentious issue, the authors undertake an ethical analysis of the covert administration of medications by utilizing the principles of respect for autonomy, nonmaleficence, beneficence, and justice...
2016: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/27997604/physical-activity-in-community-dwelling-older-people-a-systematic-review-of-reviews-of-interventions-and-context
#14
Olawale Olanrewaju, Sarah Kelly, Andy Cowan, Carol Brayne, Louise Lafortune
BACKGROUND: The promotion and maintenance of higher physical activity (PA) levels in the older population is an imperative for cognitive and healthy ageing but it is unclear what approaches are best suited to achieve this for the increasing number of older people living in the community. Effective policies should be informed by robust, multi-disciplinary and multi-dimensional evidence, which not only seeks what works, but in 'what context? In addition to evidence on the efficacy and effectiveness of PA for maintaining cognitive health, social contexts such as 'how do we actually get older people to partake in PA?' and 'how do we sustain that activity long-term?' also need highlighting...
2016: PloS One
https://www.readbyqxmd.com/read/27997454/-dementia-friendly-communities-and-being-dementia-friendly-in-healthcare-settings
#15
Shih-Yin Lin
PURPOSE OF REVIEW: This review discusses the concept of 'dementia-friendly communities' and summarizes the latest research and practice around such communities. This review also highlights important topic areas to be considered to promote dementia friendliness in healthcare settings. RECENT FINDINGS: Definitions of 'dementia-friendly communities' reflect the contemporary thinking of living with dementia (e.g., dementia as a disability, equal human rights, a sense of meaning)...
December 16, 2016: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/27986999/-non-pharmacological-treatment-of-dementia-in-geriatric-psychiatry-care-units-scoping-review
#16
Anne Göhner, Michael Hüll, Sebastian Voigt-Radloff
BACKGROUND: The number of persons suffering from dementia will continuously increase in the coming years; therefore, evidence-based interventions are needed in geriatric psychiatric care. When evidence is poor scoping reviews may help to identify knowledge gaps and needs for research. AIM OF THE ARTICLE: To present an overview of clinical trials on non-pharmacological treatment for elderly with dementia in hospitals, wards and nursing homes, specializing in gerontopsychiatric care...
December 16, 2016: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/27951433/interventions-to-improve-communication-between-people-with-dementia-and-nursing-staff-during-daily-nursing-care-a-systematic-review
#17
REVIEW
Mariska Machiels, Silke F Metzelthin, Jan P H Hamers, Sandra M G Zwakhalen
BACKGROUND: To provide adequate nursing care it is important for nursing staff to communicate effectively with people with dementia. Due to their limited communication skills, people with dementia have difficulties in understanding communication and expressing themselves verbally. Nursing staff members often report communication difficulties with people with dementia, which emphasises the urgent need for interventions to improve their communication with people in this specific target group...
November 30, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27937174/providing-optimal-palliative-care-for-persons-living-with-dementia-a-comparison-of-physician-perceptions-in-the-netherlands-and-the-united-kingdom
#18
Kevin Brazil, Karen Galway, Gillian Carter, Jenny T van der Steen
BACKGROUND: The European Association for Palliative Care (EAPC) recently issued a framework that defines optimal palliative care in dementia. However, implementation of the guidelines may pose challenges for physicians working with dementia patients in practice. OBJECTIVE: To measure and compare the perceptions of physicians in two European regions regarding the importance and challenges of implementing recommendations for optimal palliative care in dementia patients...
December 12, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27931251/conflicting-cerebrospinal-fluid-biomarkers-and-progression-to-dementia-due-to-alzheimer-s-disease
#19
Panagiotis Alexopoulos, Lukas Werle, Jennifer Roesler, Nathalie Thierjung, Lena Sophie Gleixner, Igor Yakushev, Nikolaos Laskaris, Stefan Wagenpfeil, Philippos Gourzis, Alexander Kurz, Robert Perneczky
BACKGROUND: According to new diagnostic guidelines for Alzheimer's disease (AD), biomarkers enable estimation of the individual likelihood of underlying AD pathophysiology and the associated risk of progression to AD dementia for patients with mild cognitive impairment (MCI). Nonetheless, how conflicting biomarker constellations affect the progression risk is still elusive. The present study explored the impact of different cerebrospinal fluid (CSF) biomarker constellations on the progression risk of MCI patients...
December 9, 2016: Alzheimer's Research & Therapy
https://www.readbyqxmd.com/read/27929229/the-mental-status-examination
#20
David Norris, Molly S Clark, Sonya Shipley
The mental status examination includes general observations made during the clinical encounter, as well as specific testing based on the needs of the patient and physician. Multiple cognitive functions may be tested, including attention, executive functioning, gnosia, language, memory, orientation, praxis, prosody, thought content, thought processes, and visuospatial proficiency. Proprietary and open-source clinical examination tools are available, such as the Mini-Mental State Examination and the Mini-Cog...
October 15, 2016: American Family Physician
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