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https://www.readbyqxmd.com/read/28214236/are-hospital-ed-transfers-less-likely-among-nursing-home-residents-with-do-not-hospitalize-orders
#1
Taeko Nakashima, Yuchi Young, Wan-Hsiang Hsu
OBJECTIVES: This study aims to examine whether an advance directive "Do Not Hospitalize" (DNH) would be effective in reducing hospital/emergency department (ED) transfers. Similar effects in residents with dementia were also examined. DESIGN: Cross-sectional study. SETTING/SUBJECTS: New York State (NYS) nursing home residents (n = 43,024). MEASUREMENTS AND ANALYSIS: The Minimum Data Set 2.0 was used to address the study aims...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28210868/cognitive-impairment-and-dementia-a-new-emerging-complication-of-type-2-diabetes-the-diabetologist-s-perspective
#2
Rafael Simó, Andreea Ciudin, Olga Simó-Servat, Cristina Hernández
Type 2 diabetes mellitus (T2D) and Alzheimer's disease (AD) are two of the most common diseases of aging around the world. Given the frequency with which T2D and AD occur, the notion that people with T2D may be at increased risk for AD has large societal consequences, and understanding the mechanistic links between these diseases is imperative for the development of effective AD prevention and treatment strategies. Apart from being an accelerator of AD, T2D is associated with a progressive cognitive decline...
February 16, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28203365/polypharmacy-and-inappropriate-medication-use-in-patients-with-dementia-an-underresearched-problem
#3
REVIEW
Carole Parsons
Multimorbidity and polypharmacy are increasingly prevalent across healthcare systems and settings as global demographic trends shift towards increased proportions of older people in populations. Numerous studies have demonstrated an association between polypharmacy and potentially inappropriate prescribing (PIP), and have reported high prevalence of PIP across settings of care in Europe and North America and, as a consequence, increased risk of adverse drug reactions, healthcare utilization, morbidity and mortality...
January 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28202945/left-ventricular-hypertrophy-in-association-with-cognitive-impairment-a-systematic-review-and-meta-analysis
#4
Marios K Georgakis, Andreas Synetos, Constantinos Mihas, Maria A Karalexi, Dimitrios Tousoulis, Sudha Seshadri, Eleni Th Petridou
Left ventricular hypertrophy (LVH) is a marker of prolonged exposure to high blood pressure and a predictor of cardiovascular disease risk. The objective of the current study was to investigate its association with cognitive function. Following standard guidelines, pairs of independent reviewers screened 2359 articles to search for studies that addressed the research question, extracted data and evaluated the quality of the studies using the Newcastle-Ottawa scale; authors were contacted for additional data...
February 16, 2017: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/28195514/blood-brain-barrier-on-a-chip-microphysiological-systems-that-capture-the-complexity-of-the-blood-central-nervous-system-interface
#5
Duc Tt Phan, R Hugh F Bender, Jillian W Andrejecsk, Agua Sobrino, Stephanie J Hachey, Steven C George, Christopher Cw Hughes
The blood-brain barrier is a dynamic and highly organized structure that strictly regulates the molecules allowed to cross the brain vasculature into the central nervous system. The blood-brain barrier pathology has been associated with a number of central nervous system diseases, including vascular malformations, stroke/vascular dementia, Alzheimer's disease, multiple sclerosis, and various neurological tumors including glioblastoma multiforme. There is a compelling need for representative models of this critical interface...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28179815/considering-sex-and-gender-in-alzheimer-disease-and-other-dementias
#6
Jessica L Podcasy, C Neill Epperson
Suffering related to dementia is multifaceted because cognitive and physical functioning slowly deteriorates. Advanced age and sex, two of the most prominent risk factors for dementia, are not modifiable. Lifestyle factors such as smoking, excessive alcohol use, and poor diet modulate susceptibility to dementia in both males and females. The degree to which the resulting health conditions (eg, obesity, type 2 diabetes, and cardiovascular disease) impact dementia risk varies by sex. Depending on the subtype of dementia, the ratio of male to female prevalence differs...
December 2016: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/28177149/relational-citizenship-supporting-embodied-selfhood-and-relationality-in-dementia-care
#7
Pia Kontos, Karen-Lee Miller, Alexis P Kontos
We draw on findings from a mixed-method study of specialised red-nosed elder-clowns in a long-term care facility to advance a model of 'relational citizenship' for individuals with dementia. Relational citizenship foregrounds the reciprocal nature of engagement and the centrality of capacities, senses, and experiences of bodies to the exercise of human agency and interconnectedness. We critically examine elder-clown strategies and techniques to illustrate how relational citizenship can be supported and undermined at the micro level of direct care through a focus on embodied expressions of creativity and sexuality...
February 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28166276/homovanillic-acid-and-5-hydroxyindole-acetic-acid-as-biomarkers-for-dementia-with-lewy-bodies-and-coincident-alzheimer-s-disease-an-autopsy-confirmed-study
#8
Satoru Morimoto, Masaki Takao, Hiroyuki Hatsuta, Yasushi Nishina, Tadashi Komiya, Renpei Sengoku, Yuta Nakano, Akiko Uchino, Hiroyuki Sumikura, Yuko Saito, Kazutomi Kanemaru, Shigeo Murayama
Dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) are the two most common causes of dementia. Both pathologies often coexist, and AD patients with concomitant neocortical LB pathology (referred to as the Lewy body variant of AD) generally show faster cognitive decline and accelerated mortality relative to patients with pure AD. Thus, discriminating among patients with DLB, AD, and coincident DLB and AD is important in clinical practice. We examined levels of homovanillic acid (HVA), 5-hydroxyindole acetic acid (5-HIAA), tau, phosphorylated tau (p-tau), and beta-amyloid (Aβ) 1-42 in cerebrospinal fluid (CSF) to evaluate their viability as biomarkers to discriminate among different forms of dementia...
2017: PloS One
https://www.readbyqxmd.com/read/28165618/experimental-comparison-of-efficacy-for-three-handfeeding-techniques-in-dementia
#9
Melissa K Batchelor-Murphy, Eleanor S McConnell, Elaine J Amella, Ruth A Anderson, Connie W Bales, Susan Silva, Angel Barnes, Cornelia Beck, Cathleen S Colon-Emeric
BACKGROUND: Nursing home (NH) residents who require assistance during mealtimes are at risk for malnutrition. Supportive handfeeding is recommended, yet there is limited evidence supporting use of a specific handfeeding technique to increase meal intake. OBJECTIVES: To compare efficacy of three handfeeding techniques for assisting NH residents with dementia with meals: Direct Hand (DH), Over Hand (OH), and Under Hand (UH). DESIGN: A prospective pilot study using a within-subjects experimental Latin square design with randomization to one of three handfeeding technique sequences...
February 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28164767/nanotechnology-for-alzheimer-disease
#10
Jerzy Leszek, Wai Hei Tse, Jin Zhang, Marco Fidel Ávila-Rodriguez, Vadim V Tarasov, George E Barreto, Sergey O Bachurin, Gjumrakch Aliev
Dementia of Alzheimer disease (AD) type affects memory, thinking and behavior. Researchers believe that changes in the brain may begin 10-20 years before symptoms appear and AD is diagnosed. The need to diagnose and treat the devastating disease at an early stage is critical to manage and treat AD. Unfortunately, the lack of validated biomarkers limits the possibility of the earlier stages of AD. The advance of nanotechnology could offer huge opportunities in early-stage diagnosis and well treatment of AD. Biocompatible nanoparticles with diameter in the range of 1-100 nm could be used as targeted delivery system for drugs (e...
February 3, 2017: Current Alzheimer Research
https://www.readbyqxmd.com/read/28154105/vascular-cognitive-impairment
#11
Martin Dichgans, Didier Leys
Cerebrovascular disease typically manifests with stroke, cognitive impairment, or both. Vascular cognitive impairment refers to all forms of cognitive disorder associated with cerebrovascular disease, regardless of the specific mechanisms involved. It encompasses the full range of cognitive deficits from mild cognitive impairment to dementia. In principle, any of the multiple causes of clinical stroke can cause vascular cognitive impairment. Recent work further highlights a role of microinfarcts, microhemorrhages, strategic white matter tracts, loss of microstructural tissue integrity, and secondary neurodegeneration...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28152167/implementation-of-observational-pain-management-protocol-for-residents-with-dementia-a-cluster-rct
#12
Justina Y W Liu, Claudia K Y Lai
OBJECTIVES: To investigate whether the implementation of the Observational Pain Management Protocol (Protocol) can improve pain management for nursing home residents with dementia. DESIGN: A two-group, single-blinded, cluster-randomized controlled trial. SETTING: Seventeen nursing homes. PARTICIPANTS: Hundred and twenty eight recruited residents with advanced dementia and pain-related diagnoses were allocated to either the control or the experimental conditions based on the randomized group allocated to their home...
February 2, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28142397/effects-on-pain-of-a-stepwise-multidisciplinary-intervention-sta-op-that-targets-pain-and-behavior-in-advanced-dementia-a-cluster-randomized-controlled-trial
#13
Marjoleine Jc Pieper, Jenny T van der Steen, Anneke L Francke, Erik Ja Scherder, Jos Wr Twisk, Wilco P Achterberg
BACKGROUND: Pain in nursing home residents with advanced dementia remains a major challenge; it is difficult to detect and may be expressed as challenging behavior. STA OP! aims to identify physical and other needs as causes of behavioral changes and uses a stepwise approach for psychosocial and pharmacological management which was effective in improving challenging behavior. AIM: To assess whether implementation of the stepwise multidisciplinary intervention also reduces pain and improves pain management...
February 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28140779/social-ecological-perspectives-of-tube-feeding-older-adults-with-advanced-dementia-a-systematic-literature-review
#14
Joy W Douglas, Jeannine C Lawrence, Lori W Turner
Dementia is a progressive, debilitating disease that often results in weight loss, malnutrition, and dehydration. Feeding tubes are often prescribed; however, this practice can lead to complications. The purpose of this systematic review was to examine the use of feeding tubes in elderly demented patients from a social ecological perspective. Results indicated that family members often receive inadequate decision-making education. Many health care professionals lack knowledge of evidence-based guidelines pertaining to feeding tube use...
January 2017: Journal of Nutrition in Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28137957/loss-of-function-mutations-in-the-atp13a2-park9-gene-cause-complicated-hereditary-spastic-paraplegia-spg78
#15
Alejandro Estrada-Cuzcano, Shaun Martin, Teodora Chamova, Matthis Synofzik, Dagmar Timmann, Tine Holemans, Albena Andreeva, Jennifer Reichbauer, Riet De Rycke, Dae-In Chang, Sarah van Veen, Jean Samuel, Ludger Schöls, Thorsten Pöppel, Danny Mollerup Sørensen, Bob Asselbergh, Christine Klein, Stephan Zuchner, Albena Jordanova, Peter Vangheluwe, Ivailo Tournev, Rebecca Schüle
Hereditary spastic paraplegias are heterogeneous neurodegenerative disorders characterized by progressive spasticity of the lower limbs due to degeneration of the corticospinal motor neurons. In a Bulgarian family with three siblings affected by complicated hereditary spastic paraplegia, we performed whole exome sequencing and homozygosity mapping and identified a homozygous p.Thr512Ile (c.1535C > T) mutation in ATP13A2. Molecular defects in this gene have been causally associated with Kufor-Rakeb syndrome (#606693), an autosomal recessive form of juvenile-onset parkinsonism, and neuronal ceroid lipofuscinosis (#606693), a neurodegenerative disorder characterized by the intracellular accumulation of autofluorescent lipopigments...
February 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28137425/cognitive-evaluation-for-the-diagnosis-of-alzheimer-s-disease-based-on-turing-test-and-virtual-environments
#16
Juan Manuel Fernandez Montenegro, Vasileios Argyriou
Alzheimer's screening tests are commonly used by doctors to diagnose the patient's condition and stage as early as possible. Most of these tests are based on pen-paper interaction and do not embrace the advantages provided by new technologies. This paper proposes novel Alzheimer's screening tests based on virtual environments and game principles using new immersive technologies combined with advanced Human Computer Interaction (HCI) systems. These new tests are focused on the immersion of the patient in a virtual room, in order to mislead and deceive the patient's mind...
January 27, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28135810/post-acute-care-facility-as-a-discharge-destination-for-patients-in-need-of-palliative-care-in-brazil
#17
Luiz Guilherme L Soares, André M Japiassu, Lucia C Gomes, Rogéria Pereira
Patients with complex palliative care needs can experience delayed discharge, which causes an inappropriate occupancy of hospital beds. Post-acute care facilities (PACFs) have emerged as an alternative discharge destination for some of these patients. The aim of this study was to investigate the frequency of admissions and characteristics of palliative care patients discharged from hospitals to a PACF. We conducted a retrospective analysis of PACF admissions between 2014 and 2016 that were linked to hospital discharge reports and electronic health records, to gather information about hospital-to-PACF transitions...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28132606/healthcare-decision-making-past-present-and-future-in-light-of-a-diagnosis-of-dementia
#18
Karen Harrison Dening, Michael King, Louise Jones, Elizabeth L Sampson
End-of-life care policy in the UK states that all people should identify their needs, priorities and preferences for end-of-life care in the form of advance care planning. Advance care planning in dementia is less well developed than in some other disease groups such as cancer and, arguably, may be more complex. A person with dementia may lose the capacity to make decisions associated with advance care planning early in the course of the disease, requiring more involvement of family carers. This study explores the 'lived' context to health care decision-making of dyads (the person with dementia and their carer) in respect of past, present and future healthcare decision-making...
January 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28131204/thalamic-involvement-determined-using-vsrad-advance-on-mri-and-easy-z-score-analysis-of-99m-tc-ecd-spect-in-gerstmann-str%C3%A3-ussler-scheinker-syndrome-with-p102l-mutation
#19
Atsuhiko Sugiyama, Noriko Sato, Yukio Kimura, Tomoko Maekawa, Noritaka Wakasugi, Daichi Sone, Mikako Enokizono, Yuji Takahashi, Miho Murata, Hidehiro Mizusawa, Hiroshi Matsuda
Gerstmann-Sträussler-Scheinker syndrome caused by the P102L mutation in the prion protein gene (GSS102) is usually characterized by the onset of slowly progressive cerebellar ataxia, with dementia occurring much later. Because of the relatively long disease course and the prominence of progressive cerebellar ataxia in the early stage, GSS102 is often misdiagnosed as other neurodegenerative disorders. We present two cases of genetically proven GSS102L, both of which present with atrophy and decreased blood flow of the thalamus as determined by voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) advance software and easy Z-score analysis for (99m)Tc-ethyl cysteinate dimer-SPECT, respectively...
February 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28118792/noteworthy-articles-in-2016-for-the-cardiothoracic-anesthesiologist
#20
Dirk J Varelmann, J Daniel Muehlschlegel
Clinical research and outcome studies dominated the publication spectrum for the cardiothoracic anesthesiologist in 2016. Echocardiography is an important tool in the armamentarium of the cardiothoracic anesthesiologist. Technology is advancing at a fast pace: A new method to quantify the regurgitant volume in mitral regurgitation has been described in an experimental model and been validated in humans. Interesting studies on key elements of our daily practice have been published: Does tranexamic acid decrease the transfusion requirements after cardiac surgery? Are patients with a postoperative cognitive deficit at risk for dementia 7...
January 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
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