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Aggression in Dementia

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https://www.readbyqxmd.com/read/28179043/measurement-of-agitation-and-aggression-in-adult-and-aged-neuropsychiatric-patients-review-of-definitions-and-frequently-used-measurement-scales
#1
Ladislav Volicer, Leslie Citrome, Jan Volavka
Agitation and aggression in adult psychiatric patients with psychoses and in persons with dementia increase the burden of disease and frequently cause hospitalization. The implementation of currently available management strategies and the development of new ones is hindered by inconsistent terminology that confuses agitation with aggression. This confusion is maintained by many rating scales that fail to distinguish between these two syndromes. We review the frequently used rating scales with a particular focus on their ability to separate agitation from aggression...
February 9, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/28128394/person-centered-primary-care-strategies-for-assessment-of-and-intervention-for-aggressive-behaviors-in-dementia
#2
Anand Desai, Tracy Wharton, Laura Struble, Mary Blazek
With an increase in the number of individuals affected by dementia, it is imperative for health care providers to be well versed in the most effective ways to manage neuropsychiatric symptoms, such as aggression. Aggression can be particularly hard to manage because it creates risk of harm for formal and informal caregivers, and options for medical intervention are complex and situation dependent. Although multiple guidelines for management of aggression in dementia are available in the literature, their scope is widespread and suggested treatments often vary, making decision making difficult to navigate for busy clinicians...
February 1, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28124634/buspirone-for-the-treatment-of-dementia-with-behavioral-disturbance
#3
Maria R Santa Cruz, Priscilla C Hidalgo, Meredith S Lee, Cornelius W Thomas, Suzanne Holroyd
Behavioral disturbances are common but serious symptoms in patients with dementia. Currently, there are no FDA approved drugs for this purpose. There have been case reports and small case series of the use of buspirone. In this retrospective study, we review 179 patients prescribed buspirone for treatment of behavioral disturbance in dementia to better characterize the efficacy and potential side effects. All patients prescribed buspirone for behavioral disturbance due to dementia from a geropsychiatric outreach program were reviewed...
January 26, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28095946/electroconvulsive-therapy-ect-for-treating-agitation-in-dementia-major-neurocognitive-disorder-a-promising-option
#4
Oliver M Glass, Brent P Forester, Adriana P Hermida
BACKGROUND: Agitation in patients with dementia increases caretaker burden, increases healthcare costs, and worsens the patient's quality of life. Antipsychotic medications, commonly used for the treatment of agitation in patients with dementia have a box warning from the FDA for elevated mortality risk. Electroconvulsive therapy (ECT) has made significant advances over the past several years, and is efficacious in treating a wide range of psychiatric conditions. We provide a systematic review of published literature regarding the efficacy of ECT for the treatment of agitation in patients with dementia (major neurocognitive disorder)...
January 18, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28065176/behavioural-and-psychological-symptoms-in-general-hospital-patients-with-dementia-distress-for-nursing-staff-and-complications-in-care-results-of-the-general-hospital-study
#5
J B Hessler, M Schäufele, I Hendlmeier, M N Junge, S Leonhardt, J Weber, H Bickel
AIMS: Little is known about how behavioural and psychological symptoms of dementia (BPSD) manifest in the general hospital. The aim was to examine the frequency of BPSD in general hospitals and their associations with nursing staff distress and complications in care. METHODS: Cross-sectional representative study with 1469 patients aged ≥65, including 270 patients with dementia, of 33 randomly selected general hospitals in Germany. BPSD and complications were reported by nurses...
January 9, 2017: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/28055088/myxedema-psychosis-in-a-patient-with-undiagnosed-hashimoto-thyroiditis
#6
Matthew M Mavroson, Nirav Patel, Eleonora Akker
Myxedema psychosis is uncommon in patients with primary hypothyroidism. Most often, this disease state can be found in patients with Hashimoto thyroiditis or after total thyroidectomy. Chronic hypothyroidism can lead to an insidious onset of psychiatric symptoms in patients, such as dementia, delirium, psychosis, hallucinations, and coma. A 31-year-old man with an unremarkable medical history was brought to the psychiatric emergency department for new-onset aggression, paranoid behavior, and hallucinations for 4 days...
January 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28009676/effectiveness-of-meaningful-occupation-interventions-for-people-living-with-dementia-in-residential-aged-care-a-systematic-review
#7
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/27929804/familial-creutzfeldt-jakob-disease-case-report-and-role-of-genetic-counseling-in-post-mortem-testing
#8
Kristin Clift, Kimberly Guthrie, Eric W Klee, Nicole Boczek, Margot Cousin, Patrick Blackburn, Paldeep Atwal
Here we present a case of an asymptomatic 53-year-old woman who sought genetic testing for Familial Creutzfeldt-Jakob Disease (fCJD) after learning that her mother had fCJD. The patient's mother had a sudden onset of memory problems and rapidly deteriorating mental faculties in her late 70s, which led to difficulties ambulating, progressive non-fluent aphasia, dysphagia and death within ∼1 y of symptom onset. The cause of death was reported as "rapid onset dementia." The patient's family, unhappy with the vague diagnosis, researched prion disorders online and aggressively pursued causation and submitted frozen brain tissue from the mother to the National Prion Disease Surveillance Center, where testing revealed a previously described 5-octapeptide repeat insertion (5-OPRI) in the prion protein gene (PRNP) that is known to cause fCJD...
November 2016: Prion
https://www.readbyqxmd.com/read/27914870/co-occurrence-and-predictors-of-three-commonly-occurring-behavioral-symptoms-in-dementia-agitation-aggression-and-rejection-of-care
#9
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/27911311/risk-factors-and-pathological-substrates-associated-with-agitation-aggression-in-alzheimer-s-disease-a-preliminary-study-using-nacc-data
#10
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/27903306/dementia-care-worker-stress-associations-with-unit-type-resident-and-work-environment-characteristics-a-cross-sectional-secondary-data-analysis-of-the-swiss-nursing-homes-human-resources-project-shurp
#11
Barbara Vogel, Sabina De Geest, Katharina Fierz, Sonja Beckmann, Franziska Zúñiga
BACKGROUND: Although caring for residents with dementia in nursing homes is associated with various stressors for care workers, the role of the unit type, and particularly the proportion of residents with dementia, remains unclear. This study aimed to explore associations between unit type and care worker stress, taking into account additional potential stressors. METHODS: This cross-sectional study was a secondary data analysis in the Swiss Nursing Homes Human Resources Project, which included data from 3,922 care workers from 156 Swiss nursing homes...
December 1, 2016: International Psychogeriatrics
https://www.readbyqxmd.com/read/27857809/delayed-speech-hyperactivity-and-coarse-facies-does-sanfilippo-syndrome-come-to-mind
#12
Ayşe Kartal
Mucopolysaccharidosis Type IIIA (MPS IIIA) or Sanfilippo-A syndrome is caused by a deficiency in lysosomal a-heparan N-sulfatase. Its clinical manifestations include progressive dementia, hyperactivity, and aggressive behavior. Unlike other mucopolysaccharide disorders, the diagnosis of MPS IIIA is challenging in both adults and children. This diagnostic challenge has been associated with the high incidence of false negative results encountered on urinary screening tests. We herein describe Sanfilippo-A syndrome in a pediatric patient who presented with progressive hyperactivity, delayed language, and developmental delay and a negative urine screening test...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27852640/janus-at-the-crossroads-perspectives-on-long-term-care-trajectories-for-older-women-with-dementia-in-a-canadian-context
#13
Denise S Cloutier, Margaret J Penning
PURPOSE OF THE STUDY: Janus, the two-faced, Roman god of beginnings and transitions, is used as a metaphor to explore our personal narratives and our quantitative research on the experiences of older women with dementia in long-term care (LTC). Two research questions are addressed: (a) How do our quantitative data map onto our mothers' experiences? (b) What lessons do our mothers' experiences offer for the care of older women with dementia? DESIGN AND METHODS: Informed by a life-course perspective, we triangulate administrative data on 3,717 women with dementia receiving LTC in British Columbia, Canada, with personal narratives-the stories of our mothers who made the transition from home care into residential (nursing home) care...
February 2017: Gerontologist
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
#14
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/27785004/psen1-l226f-mutation-in-a-patient-with-early-onset-alzheimer-s-disease-in-korea
#15
Eva Bagyinszky, Sun Ah Park, Hyung Jun Kim, Seong Hye Choi, Seong Soo A An, Sang Yun Kim
In this study, we report a first 226leucine (Leu) mutation to phenylalanine (Phe) in (PSEN1, CTC>TTC, L226F) in Asia from a Korean early-onset Alzheimer's disease (EOAD) patient. Polymerase chain reaction (PCR)-single strand conformation polymorphism, sequencing, and in silico predictions were performed. Previously, L226F was reported in EOAD patients by Zekanowski et al and Gómez-Tortosa et al. Disease phenotypes appeared in their thirties, and family history was positive in both cases. In our patient, age of onset was similar (37 years of age), but the mutation seemed to be de novo, since no affected family member was found...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27771698/elder-abuse-in-nursing-homes-do-special-care-units-make-a-difference-a-secondary-data-analysis-of-the-swiss-nursing-homes-human-resources-project
#16
Olivia Blumenfeld Arens, Katharina Fierz, Franziska Zúñiga
BACKGROUND: In special care units (SCUs) for residents with advanced dementia, both personnel and organizations are adapted to the needs of residents. However, whether these adaptations have a preventive effect on elder abuse has not yet been explored. OBJECTIVE: To describe the prevalence of observed emotional abuse, neglect, and physical abuse in Swiss nursing homes, to compare SCUs with non-SCUs concerning the frequency of observed emotional abuse, neglect, and physical abuse, and to explore how resident-related characteristics, staff outcomes/characteristics, and organizational/environmental factors relate to observed elder abuse...
2017: Gerontology
https://www.readbyqxmd.com/read/27756974/managing-behavioural-and-psychological-symptoms-in-dementia
#17
REVIEW
Stephen Macfarlane, Daniel O'Connor
Most patients with dementia have some behavioural and psychological symptoms. While aggression and agitation are easily recognised, symptoms such as apathy may be overlooked. Behavioural and psychological symptoms should be managed without drugs whenever possible. Although there is little evidence to support their use, antipsychotic drugs are often prescribed to people with dementia. Before prescribing it is important to exclude other causes of altered behaviour, such as pain or infection. Some symptoms may be artefacts of memory loss rather than psychosis...
August 2016: Australian Prescriber
https://www.readbyqxmd.com/read/27753980/pl-02-2-perspective-on-elderly-hypertension-in-asia
#18
Yoshihiro Kokubo
Hypertension is one of the strongest risk factor for cardiovascular disease. Recently, accumulating evidence also indicates that hypertension has been linked with non-cardiovascular diseases including dementia, cancer, oral health diseases and so on. In general, elderly individuals tend to have multiple diseases as getting older. Preventing of hypertension is also benefit for other diseases.In the Hisayama Study, hypertension increased the risk of vascular dementia, but were not associated with an increased risk of Alzheimer disease, and that subjects with hypertension in midlife and normotension and hypertension in late-life increased risks of incident vascular dementia...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27743840/teaching-caregivers-of-persons-with-dementia-to-address-pain
#19
Mark E Kunik, A Lynn Snow, Nancy Wilson, Amber B Amspoker, Shubhada Sansgiry, Robert O Morgan, Jun Ying, Gayle Hersch, Melinda A Stanley
OBJECTIVES: To compare the efficacy of Preventing Aggression in Veterans with Dementia (PAVeD) with that of usual care in decreasing incidence of aggression (primary outcome) and pain and improving depression, pleasant events, caregiver burden, and patient-caregiver relationship quality (secondary outcomes). DESIGN: Randomized controlled trial with assessments at baseline and 3, 6, 9, and 12 months SETTING: Houston, TX. PARTICIPANTS: A total of 203 community-dwelling veterans with pain and dementia and their caregivers...
February 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27743677/-prescription-of-antipsychotics-in-elderly-patients-with-dementia-in-a-psychiatric-hospital-impact-of-recommendations-of-the-french-health-authority
#20
X Jégouzo, M Desbordes, S Delègue, G Le Vacon, M Patrick, S Mouchabac
OBJECTIVES: Behavioral and psychological symptoms have a high prevalence in dementia. They include mood disorders, psychotic disorders and behavioral disorders such as aggression or screaming. Despite a number of side effects and an increased mortality, antipsychotic drugs are widely prescribed for treatment of this disorder. In France, this increased risk of mortality led in 2009 to the adoption of guidelines concerning all antipsychotics. The guidelines propose a sensible use of antipsychotics after the establishment of non-pharmacological measures...
October 12, 2016: L'Encéphale
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