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incontinence in dementia

Carl P C Chen, Yin-Cheng Huang, Chen-Nen Chang, Jean-Lon Chen, Chih-Chin Hsu, Wan-Ying Lin
Normal pressure hydrocephalus (NPH) was the first type of dementia ever described that can be treated using ventriculoperitoneal shunting surgery. Three typical clinical symptoms of NPH include gait disturbance, progressive cognitive dysfunction, and urinary incontinence. Although there are articles that have discovered several cerebrospinal fluid (CSF) protein biomarkers associated with NPH; however, studies examining individual and total protein concentrations from the ventricular CSF before and after shunting surgery are lacking...
February 1, 2018: Experimental Gerontology
Yuki Nagata, Akiyoshi Hirayama, Satsuki Ikeda, Aoi Shirahata, Futaba Shoji, Midori Maruyama, Mitsunori Kayano, Masahiko Bundo, Kotaro Hattori, Sumiko Yoshida, Yu-Ichi Goto, Katsuya Urakami, Tomoyoshi Soga, Kouichi Ozaki, Shumpei Niida
Background: Alzheimer's disease (AD) is a most common dementia in elderly people. Since AD symptoms resemble those of other neurodegenerative diseases, including idiopathic normal pressure hydrocephalus (iNPH), it is difficult to distinguish AD from iNPH for a precise and early diagnosis. iNPH is caused by the accumulation of cerebrospinal fluid (CSF) and involves gait disturbance, urinary incontinence, and dementia. iNPH is treatable with shunt operation which removes accumulated CSF from the brain ventricles...
2018: Biomarker Research
Serena Nannucci, Valentina Rinnoci, Giovanni Pracucci, Andrew D MacKinnon, Francesca Pescini, Poneh Adib-Samii, Silvia Bianchi, Maria Teresa Dotti, Antonio Federico, Domenico Inzitari, Hugh S Markus, Leonardo Pantoni
BACKGROUND AND PURPOSE: The frequency, clinical correlates, and risk factors of cerebral microbleeds (CMB) in Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) are still poorly known. We aimed at determining the location and number of CMB and their relationship with clinical manifestations, vascular risk factors, drugs, and other neuroimaging features in CADASIL patients. METHODS: We collected clinical data by means of a structured proforma and centrally evaluated CMB on magnetic resonance gradient echo sequences applying the Microbleed Anatomical Rating Scale in CADASIL patients seen in 2 referral centers in Italy and United Kingdom...
2018: PloS One
Doron Garfinkel
Background: The aim of this study was to evaluate efficacy and safety of poly-de-prescribing (PDP) based on the Garfinkel method in older people with polypharmacy. Methods: A longitudinal, prospective, nonrandomized study in Israel was carried out between 2009 and 2016. Comprehensive geriatric assessments were performed at home in people age ⩾66 years consuming ⩾6 prescription drugs. Exclusion criteria were life expectancy <6 months and a seeming unwillingness to cooperate (poor compliance)...
January 2018: Therapeutic Advances in Drug Safety
Yuan Yao, Xiaoping Dong, Hongzhi Guan, Qiang Lu
RATIONALE: Sporadic Creutzfeldt-Jakob disease (sCJD) mainly occurs in the elderly, with the peak age of onset ranging from 55 to 75 years. The symptoms of sCJD are not unique, and laboratory tests such as magnetic resonance imaging (MRI), electroencephalogram (EEG) and cerebrospinal fluid (CSF)14-3-3 protein have low sensitivity or specificity. Therefore, excluding treatable diseases and establishing a diagnosis could be difficult in young patients with suspected sCJD. Recently, real-time quaking-induced conversion (RT-QuIC) has been used in the diagnosis of sCJD, with more than 95% sensitivity and 100% specificity...
December 2017: Medicine (Baltimore)
Drew Payne
No abstract text is available yet for this article.
January 2, 2018: British Journal of Community Nursing
Austin G Hester, Alexander Kretschmer, Gopal Badlani
CONTEXT: Elderly men are an increasing proportion of the aging population in the 21st century. Urinary incontinence reduces the quality of life and increases the burden of care for the aging population. OBJECTIVE: The primary objective of this review is to explore the etiopathology of common causes of incontinence in aging male patients. The focus is on the algorithm of the initial evaluation of these patients from both a primary care and a urologic standpoint. EVIDENCE ACQUISITION: A nonsystematic review of the literature was performed in September 2017...
December 14, 2017: European Urology Focus
Gerald Gartlehner, Sheila V Patel, Cynthia Feltner, Rachel Palmieri Weber, Rachel Long, Kelly Mullican, Erin Boland, Linda Lux, Meera Viswanathan
Importance: Postmenopausal status coincides with increased risks for chronic conditions such as heart disease, osteoporosis, cognitive impairment, or some types of cancers. Previously, hormone therapy was used for the primary prevention of these chronic conditions. Objective: To update evidence for the US Preventive Services Task Force on the benefits and harms of hormone therapy in reducing risks for chronic conditions. Data Sources: MEDLINE, Cochrane Library, EMBASE, and trial registries from June 1, 2011, through August 1, 2016...
December 12, 2017: JAMA: the Journal of the American Medical Association
Joshua Niznik, Xinhua Zhao, Tao Jiang, Joseph T Hanlon, Sherrie L Aspinall, Joshua Thorpe, Carolyn Thorpe
BACKGROUND: Prescribing of medications with anticholinergic properties in older nursing home residents is relatively common, despite an association with an increased risk for falls, delirium, and other outcomes. Few studies have investigated what factors influence different levels of prescribing of these agents. OBJECTIVES: The primary objective was to identify factors associated with low- and high-level anticholinergic burden in nursing home residents. A secondary objective was to examine in detail the contribution of different medications to low versus high burden to aid in determining which drugs to target in interventions...
December 2017: Drugs & Aging
Pilar Perez-Ros, Francisco Miguel Martinez-Arnau, Susana Baixauli-Alacreu, Jose Fermin Garcia-Gollarte, Francisco Tarazona-Santabalbina
INTRODUCTION: Delirium is common in geriatric patients admitted to nursing homes, with an incidence of 22-79% among long-term residents. AIM: To establish a predictive model of the risk of delirium episodes in a sample of elderly people living in nursing homes. MATERIAL AND METHODS: A retrospective, cross-sectional case-control study covering a period of 12 consecutive months (April 2014 - March 2015) was carried out. The included cases had suffered at least one episode of delirium during the study period...
November 20, 2017: Endocrine, Metabolic & Immune Disorders Drug Targets
Laura Cole, Vari M Drennan
Dementia is a distressing condition in which individuals progressively require the support of others. Many people experience problems with incontinence and continence management. The presence of incontinence is influential in decisions for people with dementia to move into a care home. This study, in the interpretative tradition, investigates for the first time the person with dementia's perspective on these problems and their strategies for managing them. We conducted semi-structured conversational interviews with seven people with mild-to-moderate dementia and analysed the transcripts thematically...
January 1, 2017: Dementia
Yousuke Ogata, Akihiko Ozaki, Miho Ota, Yurie Oka, Namiko Nishida, Hayato Tabu, Noriko Sato, Takashi Hanakawa
Idiopathic normal pressure hydrocephalus (iNPH) is characterized by a clinical triad (gait disturbance, dementia, and urinary incontinence), and by radiological findings of enlarged ventricles reflecting disturbance of central spinal fluid circulation. A diagnosis of iNPH is sometimes challenging, and the pathophysiological mechanisms underlying the clinical symptoms of iNPH remain largely unknown. Here, we used an emerging MRI technique, resting-state functional connectivity MRI (rsfcMRI), to develop a subsidiary diagnostic technique and to explore the underlying pathophysiological mechanisms of iNPH...
2017: Frontiers in Neuroscience
Marina Buswell, Claire Goodman, Brenda Roe, Bridget Russell, Christine Norton, Rowan Harwood, Mandy Fader, Danielle Harari, Vari M Drennan, Jo Rycroft Malone, Michelle Madden, Frances Bunn
The prevalence of fecal incontinence (FI) in care homes is estimated to range from 30% to 50%. There is limited evidence of what is effective in the reduction and management of FI in care homes. Using realist synthesis, 6 potential program theories of what should work were identified. These addressed clinician-led support, assessment, and review; the contribution of teaching and support for care home staff on how to reduce and manage FI; addressing the causes and prevention of constipation; how cognitive and physical capacity of the resident affects outcomes; how the potential for recovery, reduction, and management of FI is understood by those involved; and how the care of people living with dementia and FI is integral to the work patterns of the care home and its staff...
September 1, 2017: Journal of the American Medical Directors Association
Kuen Lam, Joseph S K Kwan, Chi Wai Kwan, Alice M L Chong, Claudia K Y Lai, Vivian W Q Lou, Angela Y M Leung, Justina Y W Liu, Xue Bai, Iris Chi
BACKGROUND: Negative effects of restraint use have been well-documented. However, the prevalence of restraints use has been high in long-term care facilities in Hong Kong compared with other countries and this goes against the basic principles of ethical and compassionate care for older people. The present study aimed to review the change in the prevalence of physical and chemical restraint use in long-term care facilities (LTCFs) over a period of 11 years in Hong Kong and to identify the major factors associated with their use...
August 23, 2017: Journal of the American Medical Directors Association
Ralf Suhr, Nils Axel Lahmann
OBJECTIVES: The objective of the study was to determine the prevalence and severity of urinary incontinence and associated factors in patients receiving home care nursing service. METHODS: From June to September 2015, a multicenter cross-sectional study was conducted in 923 patients from 102 home care services throughout Germany. The ICIQ-SF was used to determine the characteristics of UI and its impact on QoL. To determine the risks for UI, demographic and social risks, the Barthel Index and medical diagnoses were determined in descriptive and logistic regression analysis...
August 23, 2017: Aging Clinical and Experimental Research
Claire Goodman, Christine Norton, Marina Buswell, Bridget Russell, Danielle Harari, Rowan Harwood, Brenda Roe, Jo Rycroft-Malone, Vari M Drennan, Mandy Fader, Michelle Maden, Karen Cummings, Frances Bunn
BACKGROUND: Eighty per cent of care home residents in the UK are living with dementia. The prevalence of faecal incontinence (FI) in care homes is estimated to range from 30% to 50%. There is limited evidence of what is effective in the reduction and management of FI in care homes. OBJECTIVE: To provide a theory-driven explanation of the effectiveness of programmes that aim to improve FI in people with advanced dementia in care homes. DESIGN: A realist synthesis...
August 2017: Health Technology Assessment: HTA
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
Wan-Chen Yu, Ming-Yueh Chou, Li-Ning Peng, Yu-Te Lin, Chih-Kuang Liang, Liang-Kung Chen
OBJECTIVE: We evaluated effects of the interrelationship between physical disability and cognitive impairment on long-term mortality of men aged 80 years and older living in a retirement community in Taiwan. METHODS: This prospective cohort study enrolled older men aged 80 and older living in a Veterans Care Home. Those with confirmed diagnosis of dementia were excluded. All participants received comprehensive geriatric assessment, including sociodemographic data, Charlson's Comorbidity Index (CCI), geriatric syndromes, activities of daily living (ADL) using the Barthel index and cognitive function using the Mini-Mental State Examination (MMSE)...
2017: PloS One
Brenda Roe, Claire Goodman, Bridget Russell, Marina Buswell, Christine Norton, Danielle Harari, Rowan Harwood, Jo Rycroft Malone, Vari M Drennan, Mandy Fader, Michelle Maden, Frances Bunn
No abstract text is available yet for this article.
July 21, 2017: Journal of the American Medical Directors Association
Katarzyna Mordarska, Małgorzata Godziejewska-Zawada
The prevalence of both type 2 diabetes and prediabetes increases with advancing age. The most important factors leading to hyperglycaemia are as follows: deficiency of insulin secretion developing with age, and growing insulin resistance caused by a change in body composition and sarcopaenia. Clinical features of diabetes in the elderly could be different. Diabetes in elderly people is often diagnosed with delay due to atypical symptoms (dementia, urinary incontinence) and occurrence of mainly postprandial hyperglycaemia...
June 2017: Przeglad Menopauzalny, Menopause Review
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