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https://www.readbyqxmd.com/read/29776973/challenges-in-end-of-life-dementia-care
#1
REVIEW
Anne A Fetherston, Grace Rowley, Charlotte L Allan
Dementia is a chronic, progressive disease that is now much more widely recognised and treated. Patients with dementia may require palliative care when they reach the end stage of their illness, or they may have mild-moderate cognitive symptoms comorbid with a life-limiting illness. The variety of presentations necessitates a highly individual approach to care planning, and patients should be encouraged to set their own goals and contribute to advanced care planning where possible. Assessment and management of distressing symptoms at the end of life can be greatly helped by a detailed knowledge of the individuals' prior wishes, interdisciplinary communication and recognition of changes in presentation that may result from new symptoms, for example, onset of pain, nutritional deficits and infection...
May 18, 2018: Evidence-based Mental Health
https://www.readbyqxmd.com/read/29772021/analysis-of-risk-factors-for-mild-cognitive-impairment-based-on-word-list-memory-test-results-and-questionnaire-responses-in-healthy-japanese-individuals-registered-in-an-online-database
#2
Masayo Ogawa, Daichi Sone, Kazushi Maruo, Hiroyuki Shimada, Keisuke Suzuki, Hiroshi Watanabe, Hiroshi Matsuda, Hidehiro Mizusawa
Although the development of effective therapeutic drugs and radical treatment options for dementia and Alzheimer's disease (AD) remains urgent, progress in recent clinical trials of AD drugs has been less than adequate. In order to advance the progress of clinical trials, it is necessary to establish more efficient methods of recruitment. In Japan, there are registration systems stratified by mild cognitive impairment and preclinical and clinical stages of early and advanced stage dementia, but there is no registration system for healthy individuals yet...
2018: PloS One
https://www.readbyqxmd.com/read/29768391/prevention-of-late-life-dementia-what-works-and-what-does-not
#3
Philip W Tipton, Neill R Graff-Radford
Advances in the treatment and prevention of disease have contributed to an aging global population. Subsequently, there is an increasing prevalence of age-related conditions such as dementia. There are currently no disease-modifying therapies commercially available. There is a growing emphasis on strategies to prevent dementia from occurring. We have reviewed the relevant literature pertaining to dementia risk and putative prevention factors. We present our findings by summarizing the pertinent items that may play a role in prevention and conclude our recommendations at this time...
May 16, 2018: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29766582/do-community-dwelling-m%C3%A4-ori-and-pacific-peoples-present-with-dementia-at-a-younger-age-and-at-a-later-stage-compared-with-nz-europeans
#4
REVIEW
Sarah Cullum, Katherine Mullin, Irene Zeng, Susan Yates, Vahid Payman, Mark Fisher, Gary Cheung
OBJECTIVE: Ethnicity may affect presentation to clinical services in people with dementia; however, no studies have examined this in Māori or Pacific peoples in New Zealand (NZ). Our objective was to examine the routinely collected clinical data from a memory assessment service in South Auckland to examine the presentation of dementia in the major NZ ethnic groups. METHODS: A total of 360 patients presenting to a memory service with a new diagnosis of dementia were included in this study...
May 15, 2018: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/29766513/nurses-knowledge-and-attitudes-about-dementia-care-systematic-literature-review
#5
REVIEW
Melina Evripidou, Andreas Charalambous, Nicos Middleton, Evridiki Papastavrou
PURPOSE: To explore nurse's knowledge and attitudes toward the care of people with dementia. DESIGN AND METHODS: A systematic review informed by the PRISMA-P (preferred reporting items for systematic reviews and meta-analyses protocols) guidelines in four databases (CINAHL, PsyINFO, Pubmed, Cohrane, EMBASE) using keywords "attitudes," "behaviors," "dementia," "knowledge," and "nurses." Predetermined inclusion criteria were selected...
May 15, 2018: Perspectives in Psychiatric Care
https://www.readbyqxmd.com/read/29764386/parkinson-s-disease-diagnostic-observations-paddo-study-rationale-and-design-of-a-prospective-cohort-study-for-early-differentiation-of-parkinsonism
#6
Anouke van Rumund, Marjolein B Aerts, Rianne A J Esselink, Frederick J A Meijer, Marcel M Verbeek, Bastiaan R Bloem
BACKGROUND: Differentiation of Parkinson's disease (PD) from the various types of atypical parkinsonism (AP) such as multiple system atrophy (MSA), progressive supranuclear palsy (PSP), dementia with Lewy bodies (DLB), corticobasal syndrome (CBS) and vascular parkinsonism (VP), can be challenging, especially early in the disease course when symptoms overlap. A major unmet need in the diagnostic workup of these disorders is a diagnostic tool that differentiates the various disorders, preferably in the earliest disease stages when the clinical presentation is similar...
May 16, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29760644/an-algorithm-for-preclinical-diagnosis-of-alzheimer-s-disease
#7
REVIEW
Tapan K Khan
Almost all Alzheimer's disease (AD) therapeutic trials have failed in recent years. One of the main reasons for failure is due to designing the disease-modifying clinical trials at the advanced stage of the disease when irreversible brain damage has already occurred. Diagnosis of the preclinical stage of AD and therapeutic intervention at this phase, with a perfect target, are key points to slowing the progression of the disease. Various AD biomarkers hold enormous promise for identifying individuals with preclinical AD and predicting the development of AD dementia in the future, but no single AD biomarker has the capability to distinguish the AD preclinical stage...
2018: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29758942/lost-in-translation-finding-our-way-to-effective-alzheimer-s-disease-therapies
#8
Joseph Quinn
Efforts over the past two decades to develop effective disease-modifying treatments for Alzheimer's disease have been disappointing, while parallel efforts in another chronic neurologic disease, multiple sclerosis, have been remarkably productive. In an effort to advance development of therapeutics for Alzheimer's disease, these two fields are contrasted in terms of the utility of animal models, definition of study populations, and utility of biomarkers. Possible solutions are suggested, and the review concludes with description of some active peer-reviewed, publicly funded clinical studies which address some of the identified weaknesses in past clinical trials for age-related dementia...
May 11, 2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29757818/surrogates-experiences-of-engaging-in-physician-orders-for-life-sustaining-treatment-discussions-for-persons-with-advanced-dementia
#9
Hyejin Kim, Christine Bradway, Susan E Hickman, Mary Ersek
BACKGROUND AND PURPOSE: Little is known about surrogates' experiences of engaging in Physician Orders for Life-Sustaining Treatment (POLST) discussions. This study describes family surrogates' experiences when engaging in POLST discussions with primary care providers. METHODS: Semistructured interviews were conducted with 10 family surrogates of individuals with advanced dementia who were enrolled in a Program of All-Inclusive Care for the Elderly or resided in a nursing home...
February 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29755340/glutamate-transporter-glt1-expression-in-alzheimer-disease-and-dementia-with-lewy-bodies
#10
Paula Garcia-Esparcia, Daniela Diaz-Lucena, Marina Ainciburu, Benjamin Torrejón-Escribano, Margarita Carmona, Franc Llorens, Isidro Ferrer
Glutamate transporter solute carrier family 1, member 2 (GLT1/EAAT2), a major modulator of glutamate homeostasis in astrocytes, is assessed in post-mortem human brain samples of frontal cortex area 8 in advanced stages of Alzheimer disease (AD) and terminal stages of dementia with Lewy bodies (DLB) in order to gain understanding of astrogliopathy in diseases manifested by dementia. Glial fibrillary acidic protein (GFAP) mRNA expression is significantly increased in AD but not in DLB, whereas GLT1 , vesicular glutamate transporter 1 ( vGLUT1 ) and aldehyde dehydrogenase 1 family member 1 ( ALDH1L1 ) are not modified in AD and DLB when compared with controls...
2018: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/29746400/mri-of-non-alzheimer-s-dementia-current-and-emerging-knowledge
#11
Massimo Filippi, Federica Agosta
PURPOSE OF REVIEW: The correct classification of non-Alzheimer's dementia is crucial to study disease mechanisms, predict disease progression and test disease-specific treatments. Brain atrophy assessment with morphometric MRI is currently the gold standard for in-vivo localization of neurodegeneration. Structural and functional connectivity biomarkers are becoming increasingly available. This review emphasizes the potential applications of MRI in the main non-Alzheimer's dementia such as dementia with Lewy bodies (DLB) and frontotemporal dementia (FTD)...
May 8, 2018: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29740579/the-role-of-genetics-in-advancing-precision-medicine-for-alzheimer-s-disease-a-narrative-review
#12
REVIEW
Yun Freudenberg-Hua, Wentian Li, Peter Davies
Alzheimer's disease (AD) is the most common type of dementia, which has a substantial genetic component. AD affects predominantly older people. Accordingly, the prevalence of dementia has been rising as the population ages. To date, there are no effective interventions that can cure or halt the progression of AD. The only available treatments are the management of certain symptoms and consequences of dementia. The current state-of-the-art medical care for AD comprises three simple principles: prevent the preventable, achieve early diagnosis, and manage the manageable symptoms...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29738460/patient-derived-ipscs-and-ins-shedding-new-light-on-the-cellular-etiology-of-neurodegenerative-diseases
#13
Bor Luen Tang
Induced pluripotent stem cells (iPSCs) and induced neuronal (iN) cells are very much touted in terms of their potential promises in therapeutics. However, from a more fundamental perspective, iPSCs and iNs are invaluable tools for the postnatal generation of specific diseased cell types from patients, which may offer insights into disease etiology that are otherwise unobtainable with available animal or human proxies. There are two good recent examples of such important insights with diseased neurons derived via either the iPSC or iN approaches...
May 8, 2018: Cells
https://www.readbyqxmd.com/read/29734821/cerebral-microbleeds-in-advanced-dementia-clinical-and-pathological-correlates
#14
Inmaculada Boyano, Ana Ramos, Jorge López-Alvarez, Carolina Mendoza-Rebolledo, Emma Osa-Ruiz, Irene Rodríguez, Almudena Pérez, Eva Alfayate, Belén González, Laura Fernández, Luis Agüera-Ortiz, Alberto Rábano, Javier Olazarán
OBJECTIVE: We conducted a longitudinal study to explore the clinical and pathological correlates of cerebral microbleeds (CMBs) in institutionalized patients with dementia. METHODS: Clinical and magnetic resonance imaging (MRI) data were extracted from 182 nursing home patients (mean age [standard deviation]: 81.3 [6.9], 78.0% female, and 83.4% moderate to severe dementia), which were divided according to the CMBs number and location. One-year follow-up data were obtained from 153 patients, and postmortem pathological diagnosis was available in 40 patients...
January 1, 2018: American Journal of Alzheimer's Disease and Other Dementias
https://www.readbyqxmd.com/read/29732929/drug-development-for-alzheimer-s-disease-review
#15
Kejing Lao, Naichun Ji, Xiaohua Zhang, Wenwei Qiao, Zhishu Tang, Xingchun Gou
Alzheimer's disease (AD) is a chronic neurodegenerative disease, which is considered one of the most intractable medical problems with heavy social and economic costs. The current drugs for AD, including acetylcholinesterase inhibitors (AChEIs) and memantine, a NMDA receptor antagonist, only temporarily ameliorate cognitive decline, but are unable to stop or reverse the progression of dementia. This paper reviewed the recent advance in AD drug development. The drug discovery programs under clinical trials targeting cholinergic system, α7 nicotinic acetylcholine receptors (nAChRs), N-methyl-D-aspartate receptor (NMDAR), β-secretase, γ-secretase modulators, tau, inflammatory mediators and glucagon-like peptide-1 (GLP-1) were discussed...
May 7, 2018: Journal of Drug Targeting
https://www.readbyqxmd.com/read/29725986/efficacy-and-safety-of-analgesic-treatment-for-depression-in-people-with-advanced-dementia-randomised-multicentre-double-blind-placebo-controlled-trial-dep-pain-dem
#16
Ane Erdal, Elisabeth Flo, Dag Aarsland, Clive Ballard, Dagrun D Slettebo, Bettina S Husebo
BACKGROUND: Chronic pain and depression often co-occur, and pain may exacerbate depression in people with dementia. OBJECTIVE: The objective of this study was to assess the efficacy and safety of analgesic treatment for depression in nursing home patients with advanced dementia and clinically significant depressive symptoms. METHODS: We conducted a multicentre, parallel-group, double-blind, placebo-controlled trial in 47 nursing homes, including 162 nursing home patients aged ≥ 60 years with dementia (Mini-Mental State Examination ≤ 20) and depression (Cornell Scale for Depression in Dementia ≥ 8)...
May 3, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29723128/factors-influencing-family-surrogates-intention-with-regard-to-do-not-resuscitate-directive-for-patients-with-dementia
#17
Yu-Chiung Fang, Ming-Chyi Pai, Liang-Chao Wang, Ya-Ping Yang, Chung-Yi Li, Feng-Ping Lee, Jing-Jy Wang
OBJECTIVE: To investigate the prevalence of family surrogates' do-not-resuscitate (DNR) intention for patients with dementia (PwD), and factors influencing family surrogates' decisions. METHODS: This is a descriptive and cross-sectional study. Patients with dementia and their family surrogates from Dementia Outpatient Clinic of a teaching hospital in southern Taiwan were included. Data were collected using chart review and questionnaire survey. Influential factors were analyzed using multiple logistic regression...
April 10, 2018: Clinical Gerontologist
https://www.readbyqxmd.com/read/29720286/impact-of-brief-education-on-healthy-seniors-attitudes-and-healthcare-choices-about-alzheimer-s-disease-and-associated-symptoms
#18
Robyn E Waxman, Barbara J Russell, Oscar C T Iu, Benoit H Mulsant
ABSTRACTObjective:The primary objective of this study was to determine whether a brief education session about Alzheimer's disease (AD) stages and associated behavioral and psychological symptoms of dementia (BPSD) changes healthy seniors' treatment choices. A secondary objective was to determine whether pharmacotherapy to reduce BPSD would be preferred over other potentially more restrictive interventions. METHODS: Participants (n = 32; 8 men; aged > 64years; no self-reported dementia diagnosis) were assigned to one of ten group sessions during which they received information about AD and BPSD...
May 3, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29717622/a-cross-sectional-study-of-family-caregiver-burden-and-psychological-distress-linked-to-frailty-and-functional-dependency-of-a-relative-with-advanced-dementia
#19
Wilson Abreu, Debbie Tolson, Graham A Jackson, Nilza Costa
Psychological health of caregivers of people with dementia is a major public concern. This study sought to determine the relationship between caregiver burden, psychological distress, frailty and functional dependency of a relative with advanced dementia. Persons with dementia and their caregivers (102 dyads) participated in this Portuguese community based cross-sectional study. Data were collected using the Clinical Dementia Rating Scale, a sociodemographic questionnaire, the Zarit Burden Interview, the Brief Symptoms Inventory and the Edmonton Frail Scale...
January 1, 2018: Dementia
https://www.readbyqxmd.com/read/29716885/an-assistive-technology-system-that-provides-personalized-dressing-support-for-people-living-with-dementia-capability-study
#20
Winslow Burleson, Cecil Lozano, Vijay Ravishankar, Jisoo Lee, Diane Mahoney
BACKGROUND: Individuals living with advancing stages of dementia (persons with dementia, PWDs) or other cognitive disorders do not have the luxury of remembering how to perform basic day-to-day activities, which in turn makes them increasingly dependent on the assistance of caregivers. Dressing is one of the most common and stressful activities provided by caregivers because of its complexity and privacy challenges posed during the process. OBJECTIVE: In preparation for in-home trials with PWDs, the aim of this study was to develop and evaluate a prototype intelligent system, the DRESS prototype, to assess its ability to provide automated assistance with dressing that can afford independence and privacy to individual PWDs and potentially provide additional freedom to their caregivers (family members and professionals)...
May 1, 2018: JMIR Medical Informatics
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