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Aggression in Dementia

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https://www.readbyqxmd.com/read/28801438/associations-between-polypharmacy-and-treatment-intensity-for-hypertension-and-diabetes-a-cross-sectional-study-of-nursing-home-patients-in-british-columbia-canada
#1
Rita McCracken, James McCormack, Margaret J McGregor, Sabrina T Wong, Scott Garrison
OBJECTIVES: Describe nursing home polypharmacy prevalence in the context of prescribing for diabetes and hypertension and determine possible associations between lower surrogate markers for treated hypertension and diabetes (overtreatment) and polypharmacy. DESIGN: Cross-sectional study. SETTING: 6 nursing homes in British Columbia, Canada. PARTICIPANTS: 214 patients residing in one of the selected facilities during data collection period...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28795386/dementia-caregiver-burden-a-research-update-and-critical-analysis
#2
REVIEW
Sheung-Tak Cheng
PURPOSE OF REVIEW: This article provides an updated review of the determinants of caregiver burden and depression, with a focus on care demands and especially the differential effects of various neuropsychiatric symptoms or symptom clusters. Moreover, studies on caregivers for frontotemporal and Lewy body dementias were referred to in order to identify differences and similarities with the mainstream literature based largely on Alzheimer caregivers. RECENT FINDINGS: As a group, neuropsychiatric symptoms are most predictive of caregiver burden and depression regardless of dementia diagnosis, but the effects appear to be driven primarily by disruptive behaviors (e...
August 10, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28767715/lafora-disease-in-miniature-wirehaired-dachshunds
#3
Lindsay Swain, Gill Key, Anna Tauro, Saija Ahonen, Peixiang Wang, Cameron Ackerley, Berge A Minassian, Clare Rusbridge
Lafora disease (LD) is an autosomal recessive late onset, progressive myoclonic epilepsy with a high prevalence in the miniature Wirehaired Dachshund. The disease is due to a mutation in the Epm2b gene which results in intracellular accumulation of abnormal glycogen (Lafora bodies). Recent breed-wide testing suggests that the carrier plus affected rate may be as high as 20%. A characteristic feature of the disease is spontaneous and reflex myoclonus; however clinical signs and disease progression are not well described...
2017: PloS One
https://www.readbyqxmd.com/read/28767205/prevalence-and-pharmacotherapy-of-behavioral-and-psychological-symptoms-of-dementia-in-a-geriatric-psychiatry-unit-a-retrospective-analysis
#4
Arnim Quante, Atdhe Sulejmani
Objective: To observe (1) the proportion and nature of behavioral and psychological symptoms of dementia (BPSD) in patients treated at a geriatric psychiatry ward in Germany over a time span of 1 year and (2) the use and effect of various pharmacologic interventions in managing BPSD in a real-world scenario. Methods: This study was a naturalistic, retrospective analysis. Between May 2015 and May 2016, 437 patients aged 65 to 100 years with various psychiatric diseases (including dementia, schizophrenia, and depression) were admitted to a geriatric psychiatry unit in Germany...
July 27, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/28754586/distress-associated-with-dementia-related-psychosis-and-agitation-in-relation-to-healthcare-utilization-and-costs
#5
Donovan T Maust, Helen C Kales, Ryan J McCammon, Frederic C Blow, Amanda Leggett, Kenneth M Langa
OBJECTIVES: Explore the relationship between behavioral and psychological symptoms of dementia (BPSD; specifically, delusions, hallucinations, and agitation/aggression) and associated caregiver distress with emergency department (ED) utilization, inpatient hospitalization, and expenditures for direct medical care. DESIGN/SETTING/PARTICIPANTS: Retrospective cross-sectional cohort of participants with dementia (N = 332) and informants from the Aging, Demographics, and Memory Study, a nationally representative survey of U...
May 25, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28733536/do-cancer-patients-with-dementia-receive-less-aggressive-treatment-in-end-of-life-care-a-nationwide-population-based-cohort-study
#6
Huei-Kai Huang, Jyh-Gang Hsieh, Chia-Jung Hsieh, Ying-Wei Wang
Dementia is a progressive, incurable disease that can deprive patients of the ability to make decisions. This study determines whether dementia influences the medical care that a cancer patient receives at the end of life. We conducted a nationwide population-based cohort study on patients aged ≥20 with newly diagnosed cancer during 2000-2012. After matching to reduce confounders, there were 7,111 patients with and 28,444 without dementia. The adjusted odd ratios (OR) for medical interventions, including intensive care, palliative care, invasive procedures, and advanced diagnostic testing, were calculated for the final month and three months of life by a multiple logistic regression model...
June 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28729192/butyrylcholinesterase-knockout-reduces-fibrillar-%C3%AE-amyloid-and-conserves-18-fdg-retention-in-5xfad-mouse-model-of-alzheimer-s-disease
#7
D R DeBay, G A Reid, I R Macdonald, G Mawko, S Burrell, E Martin, C V Bowen, S Darvesh
Alzheimer's disease (AD) is the most common neurodegenerative disorder causing dementia. One hallmark of the AD brain is the deposition of β-amyloid (Aβ) plaques. AD is also a state of cholinergic dysfunction and butyrylcholinesterase (BChE) associates with Aβ pathology. A transgenic mouse (5XFAD) is an aggressive amyloidosis model, producing Aβ plaques of which BChE also associates. A derived strain (5XFAD/BChE-KO), with the BChE gene knocked out, has significantly lower fibrillar Aβ than 5XFAD mice at the same age...
July 17, 2017: Brain Research
https://www.readbyqxmd.com/read/28705297/the-diagnosis-and-treatment-of-behavioral-disorders-in-dementia
#8
Torsten Kratz
BACKGROUND: Behavioral disorders such as aggressiveness, agitation, delusions, disinhibition, affect lability, and apathy arise in more than 90% of patients with dementia. Behavioral disorders are a major challenge and the greatest stress factor in everyday life for nursing personnel and for family members caring for the patient. METHODS: This review is based on relevant publications retrieved by a selective literature search in the PubMed, Cochrane Library, and German S3 guideline databases with the search terms "behavioral disorders," "non-cognitive disorders," and "challenging behavior," in conjunction with "dementia" and "behavioral and psychological symptoms of dementia...
June 30, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28698646/plasma-biomarkers-are-associated-with-agitation-and-regional-brain-atrophy-in-alzheimer-s-disease
#9
Jung-Lung Hsu, Wei-Ju Lee, Yi-Chu Liao, Jiing-Feng Lirng, Shuu-Jiun Wang, Jong-Ling Fuh
This study investigated the relationships among plasma biomarkers, regional brain atrophy, and clinical symptoms in patients with Alzheimer's disease (AD; n = 177), mild cognitive impairment (MCI; N = 60) and controls (n = 108). The Mini-Mental Status Examination (MMSE), Clinical Dementia Rating (CDR), and Neuropsychiatric Inventory (NPI) subscales were administered to subjects. Magnetic resonance imaging was performed and medial temporal atrophy (MTA) and posterior atrophy (PA) were assessed visually...
July 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28681424/feasibility-study-suggests-no-impact-from-protected-engagement-time-on-adverse-events-in-mental-health-wards-for-older-adults
#10
Toby Smith, Allan Clark, Emily Dodd, Mary-Ellen Khoo, Sarah Heneker, Jane Cross, Rik Cheston, Richard Gray, Chris Fox, Fiona Nolan
Hospital adverse events, such as falls, violence and aggression, security, self-harm, and suicide, are difficult to manage in older people with dementia. The purpose of the present study was to determine whether protected engagement time (PET) resulted in lower adverse events and incidents compared to comparable non-PET wards for people admitted to inpatient older people's mental health wards. Ten inpatient wards for older people were included. Five followed a PET-management pathway, while five continued usual care...
July 6, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28670272/behavioral-and-psychological-symptoms-impact-clinical-competence-in-alzheimer-s-disease
#11
Elodie Bertrand, Eelco van Duinkerken, J Landeira-Fernandez, Marcia C N Dourado, Raquel L Santos, Jerson Laks, Daniel C Mograbi
Decision-making is considered a fundamental aspect of personal autonomy and can be affected in psychiatric and neurologic diseases. It has been shown that cognitive deficits in dementia impact negatively on decision-making. Moreover, studies highlighted impaired clinical competence in neuropsychiatric disorders, such as schizophrenia and bipolar disorder. In this context, the current study explored the relationship between behavioral and psychological symptoms of dementia (BPSD) and clinical competence, especially the capacity to consent to treatment, in Alzheimer's disease (AD)...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/28669575/targeted-interdisciplinary-model-for-evaluation-and-treatment-of-neuropsychiatric-symptoms-a-cluster-randomized-controlled-trial
#12
Bjørn Lichtwarck, Geir Selbaek, Øyvind Kirkevold, Anne Marie Mork Rokstad, Jūratė Šaltytė Benth, Jonas Christoffer Lindstrøm, Sverre Bergh
OBJECTIVE: To determine the effectiveness of the Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) for treatment of moderate to severe agitation in people with dementia. METHODS: In a single-blinded, cluster randomized controlled trial in 33 nursing homes (clusters) from 20 municipalities in Norway, 229 patients (104 patients in 17 nursing homes and 125 patients in 16 nursing homes) were randomized to an intervention or control group, respectively...
June 1, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28664607/formal-caregivers-experiences-of-aggressive-behaviour-in-older-people-living-with-dementia-in-nursing-homes-a-systematic-review
#13
Adelheid Holst, Lisa Skär
AIM: The purpose of this study was to investigate formal caregivers' experiences of aggressive behaviour in older people living with dementia in nursing homes. BACKGROUND: Aggressive behaviour symptoms among older people living with dementia are reported to be prevalent. As aggressive behaviour includes both verbal and physical behaviours, such as kicking, hitting and screaming, it causes an increased burden on formal caregivers. Professionals experiencing this aggression perceived it as challenging, causing physical and psychological damage, leading to anger, stress and depression...
June 30, 2017: International Journal of Older People Nursing
https://www.readbyqxmd.com/read/28660843/rapidly-progressive-fronto-temporal-dementia-ftd-associated-with-frontotemporal-lobar-degeneration-ftld-in-the-presence-of-fused-in-sarcoma-fus-protein-a-rare-sporadic-and-aggressive-form-of-ftd
#14
Nicholas I Bradfield, Catriona McLean, John Drago, David G Darby, David Ames
Fronto-temporal dementia (FTD) associated with Fused in Sarcoma (FUS) protein accumulation is an uncommon cause of FTD with a distinct syndrome of young age onset behavioral variant FTD, without a family history of FTD and caudate atrophy. We present a sporadic case of a 61-year-old patient with mixed features of both behavioral variant FTD with later semantic language dissolution associated with pathologically proven FUS. He was older than usual for FUS pathology, his course was rapidly progressive, and he had atypical language features...
June 29, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28659419/aggressiveness-of-care-following-intracerebral-hemorrhage-in-women-and-men
#15
MULTICENTER STUDY
Rahul Guha, Amelia Boehme, Stacie L Demel, Janet J Li, Xuemei Cai, Michael L James, Sebastian Koch, Carl D Langefeld, Charles J Moomaw, Jennifer Osborne, Padmini Sekar, Kevin N Sheth, E Woodrich, Bradford B Worrall, Daniel Woo, Seemant Chaturvedi
OBJECTIVE: To compare comorbidities and use of surgery and palliative care between men and women with intracerebral hemorrhage (ICH). METHODS: The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study is a prospective, multicenter, case-control study of ICH risk factors and outcomes. We compared comorbidities, treatments, and use of do-not-resuscitate (DNR) orders in men vs women. Multivariate analysis was used to assess the likelihood of ICH surgery and palliative care after adjustment for variables that were p < 0...
July 25, 2017: Neurology
https://www.readbyqxmd.com/read/28653147/-altered-orientation-and-aggressiveness-in-an-89-year-old-woman
#16
M Kowar, A H Jacobs
An 89-year-old woman with Alzheimer's dementia was admitted because of altered orientation, aggressiveness and inability to take care of herself at home. Her patient history indicated that 14 days ago the battery of the pacemaker had be renewed. During that time the patient suffered from psychomotor alterations. Therefore, melperone had been initiated. Inspection of the urine and laboratory findings pointed towards an acute exacerbation of acute intermittent porphyria as a possible cause of the delirium. After discontinuation of melperone with additional parenteral therapy with physiological fluids, the signs of delirium significantly improved...
June 26, 2017: Der Internist
https://www.readbyqxmd.com/read/28632787/risk-of-alzheimer-s-disease-or-dementia-following-a-cancer-diagnosis
#17
Erin J Aiello Bowles, Rod L Walker, Melissa L Anderson, Sascha Dublin, Paul K Crane, Eric B Larson
OBJECTIVE: We evaluated dementia and Alzheimer's disease (AD) risks after a cancer diagnosis in a population-based prospective cohort, the Adult Changes in Thought (ACT) study. METHODS: We followed community-dwelling people aged ≥65 years without dementia at study entry for incident dementia and AD from 1994-2015. We linked study data with cancer registry data and categorized cancer diagnoses as prevalent (diagnosed before ACT study enrollment) or incident (diagnosed during follow-up)...
2017: PloS One
https://www.readbyqxmd.com/read/28620978/comparison-of-healthcare-utilization-and-life-sustaining-interventions-between-elderly-patients-with-dementia-and-those-with-cancer-near-the-end-of-life-a-nationwide-population-based-study-in-taiwan
#18
Yu-Han Chen, Chung-Han Ho, Chien-Cheng Huang, Ya-Wen Hsu, Yueh-Chun Chen, Ping-Jen Chen, Guan-Ting Chen, Jhi-Joung Wang
AIM: Little is known about the pattern of healthcare services for end-of-life patients with dementia (PwD) in East Asia. We compared this pattern between PwD and cancer patients in their last year of life in Taiwan. METHODS: Taiwan's National Health Insurance Research Database was applied for this case-control analysis. The records of patients who had dementia and died between 2002 and 2011 were reviewed. The control group was decedents with cancer. The utilization of hospitalization, emergency department visits and life-sustaining interventions during the last year of life between the two groups were compared...
June 16, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28595662/behavior-and-evolution-of-young-onset-dementia-part-2-beyond-ii-study-an-intervention-study-aimed-at-improvement-in-the-management-of-neuropsychiatric-symptoms-in-institutionalized-people-with-young-onset-dementia
#19
J C L van Duinen-van den IJssel, B Appelhof, S A Zwijsen, M Smalbrugge, F R J Verhey, M E de Vugt, S U Zuidema, R T C M Koopmans, C Bakker
BACKGROUND: Both neuropsychiatric symptoms (NPS) and psychotropic drug use (PDU) are common in institutionalized People with Young Onset Dementia (PwYOD) and can produce negative outcomes such as reduced quality of life and high workload. In community-dwelling PwYOD, NPS are found to be associated with unmet care needs. This emphasizes the importance of a care program for the management of NPS in institutionalized PwYOD that also addresses unmet care needs and PDU. The objectives of the Behavior and Evolution of Young ONset Dementia part 2 (BEYOND-II) study are to develop a care program for the management of NPS in institutionalized PwYOD and to evaluate its effectiveness...
June 9, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28595522/implementation-of-dynamic-lighting-in-a-nursing-home-impact-on-agitation-but-not-on-rest-activity-patterns
#20
Amely Wahnschaffe, Claudia Nowozin, Sven Haedel, Andreas Rath, Stefan Appelhof, Mirjam Münch, Dieter Kunz
Disturbances of circadian rest-activity rhythms in demented patients often culminate in the clinical problem of evening and nighttime agitation. The aim of the current study was to test the impact of a dynamic lighting system on agitation and rest-activity cycles. From midwinter on, a ceiling mounted dynamic lighting system was installed in the common room of a nursing home and programmed to produce high illuminance with higher blue light proportions during the day and lower illuminance without blue light in the evening...
June 7, 2017: Current Alzheimer Research
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