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Sample records for aids dementia complex

  1. Early AIDS dementia complex

    International Nuclear Information System (INIS)

    A frequent complication of the acquired immunodeficiency syndrome (AIDS) is AIDS dementia complex (ADC). The authors evaluated seven patients with AIDS (aged 28-55 years, all male) for ADC by psychiatric evaluation, neuropsychological testing, CT scanning, and IMP-SPECT. Six of seven patients exhibited cognitive or behavioral abnormalities. Neuropsychological testing showed general deficits but no cases of explicit dementia. SPECT showed marked abnormalities in two cases: posterior temporal-parietal diminution of tracer uptake in one case (posterior/anterior=0.81) and marked right/left subcortical asymmetry (1.17) in the other. In three additional cases there was asymmetric tracer uptake in the subcortical and parietal regions. CT findings were normal in all seven cases. The authors conclude that functional imaging with the use of IMP-SPECT may be a useful method to follow ADC progression and response to therapy

  2. New MR imaging observation in HIV-related cognitive impairment (AIDS dementia complex)

    International Nuclear Information System (INIS)

    MR findings have been reported on the acquired immunodeficiency syndrome (AIDS) demential complex, but the findings are late relative to clinical signs. This paper reports on a new MR finding observed in patients with human immunodeficiency virus (HIV)-related cognitive impairment studied early in the disease process. Fifty-two patients had a total of 86 MR images. Al images were obtained with a 1.5-T system (protondensity, spin-echo, TR/TE = 2,000/30 [repetition time/echo time, msec]). High-signal lesions were seen in the region of the splenium of the corpus callosum and in the crura of the fornices. The lesions demonstrated no contrast enhancement with Gd-DTPA. Pathologic examination was performed in four patients. The fornix-subcallosal abnormality may have relevance to the memory dysfunction in patients with HIV-related cognitive impairment

  3. High level HIV-1 DNA concentrations in brain tissues differentiate patients with post-HAART AIDS dementia complex or cardiovascular disease from those with AIDS

    Institute of Scientific and Technical Information of China (English)

    GALLIGAN; Derek; C.; LAMERS; Susanna; L.; YU; Stephanie; SHAGRUN; Lamia; SALEMI; Marco; MCGRATH; Michael; S.

    2009-01-01

    Highly active antiretroviral treatment(HAART) has had a significant impact on survival of individuals with acquired immunodeficiency syndrome(AIDS);however,with the longer life-span of patients with AIDS,there is increasing prevalence of AIDS dementia complex(ADC) and other non-AIDS-defining illness,and cardiovascular diseases(CVD) are also common.The influence of these varied disease processes on HIV-1 DNA concentration in brain tissues has not been thoroughly assessed in the post-HAART era.The purpose of the current study is to clarify the impacts of ADC and other complications of HIV disease on the viral load in the brains in AIDS patients with post-HARRT.We examined autopsy specimens from the brains of thirteen patients who died from complications of AIDS with quantitative polymerase chain reaction(QPCR).All but one patient had received HAART prior to death since 1995.Two patients died with severe CVD,multiple cerebrovascular atherosclerosis(CVA) throughout the brain and five patients died with ADC.Six patients had no ADC/CVA.A QPCR was used to measure the presence of HIV-1 DNA in six brain tissues(meninges,frontal grey matter,frontal white matter,temporal subcortex,cerebellum and basal ganglia).In the post-HARRT era,for non-ADC/CVA patients,HIV-1 DNA concentration in brain tissues was statistically higher than that in patients with ADC.In a new finding,two patients who suffered from severe CVD,especially CVA,also had high concentrations of HIV-1 in brain compartments not showing ADC related changes.To our knowledge,this is the first report of a relationship between the CVA and HIV-1 viral burden in brain.The current observations suggest that HAART-resistant HIV reservoirs may survive within ADC lesions of the brain as well as the macrophage rich atherosclerosis,which needs to be confirmed by more AIDS cases with CVA.

  4. HIV-1B gp120 genes from one patient with AIDS dementia complex can affect the secretion of tumor necrosis factor and interleukin in glial cells

    Institute of Scientific and Technical Information of China (English)

    YAN Yu-fen; WANG Zhi-yu; PU Shuang-shuang; WEN Hong-ling; HUANG Tao; SONG Yan-yan; XU Hong-zhi; ZHAO Li

    2011-01-01

    Background HIV-1 infected and immune-activated macrophages and microglia secrete neurotoxins,such as tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β),which play major role in the neuronal death.It has been shown that different HIV-1 variants have varying abilities to elicit secretion of TNF-α by peripheral blood mononuclear cell (PBMC); however,whether the difference of gp120 gene could affect the secretion of TNF-α and IL-1β by glial cells is unknown.The aim of this study was to explore the association between gene diversity and induction of neurotoxic cytokines.Methods In this study,we constructed retroviral vectors MSCV-IRES-GFP/gp120 using HIV-1 gp120 genes isolated from four different tissues of one patient who died of AIDS dementia complex (ADC).Recombinant retroviruses produced by cotransfection of MSCV-IRES-GFP/gp120,pCMV-VSV-G and pUMVC into 293T cells were collected and added into U87 glial cells.Concentrations of TNF-α and IL-1β secreted by transduced U87 cells were assayed with ELISA separately.Results The four HIV-1 gp120 were in the different branch of the neighbor-joining tree.Compared to the pMIG retrovirus (gp120-negative) or U87 cells,all the gp120-positive recombinant retroviruses induced more TNF-α (P <0.01) and IL-1β (P <0.01).In addition,compared with the L/MIG retrovirus,all the three brain gp120-positive recombinant retroviruses induced less TNF-α (P <0.01) and IL-1β (P <0.01).Conclusions HIV-1 gp120 could induce U87 cells secret more TNF-α and IL-1β again.The more important is that difference of HIV-1 gp120,especially cell-tropism may account for the different ability in eliciting secretion of TNF-α and IL-1β,which might supply a novel idea helping understand the pathogenesis of ADC.

  5. EEG and dementia indicators in AIDS patients' Rorschach test

    Directory of Open Access Journals (Sweden)

    G. Fernandes do Prado

    1994-09-01

    Full Text Available We studied the EEG and Rorschach test (RT of nineteen AIDS patients and eight normal people in the same age group. Eight patients presented slow alpha rhythms (8 to 9 Hz; three, not-slow alpha rhythms (>9 to 13Hz; and eight, beta rhythms in background activity. Paroxystic activity, characterized by diffuse theta or delta waves, was present in eleven patients. We observed Oberholzer syndrome (organic dementia diagnosed by RT in ten patients and Piotrowski syndrome (organic dementia diagnosed by RT in eleven patients; six presented both. When considering only the group of AIDS patients, we did not observe a significant relation among slow alpha rhythm, not-slow alpha rhythm and the presence of paroxystic activity with the above-mentioned syndromes. AIDS patients with slow alpha rhythms showed a significantly greater number of Piotrowski syndrome dementia indicators when compared to normal individuals or those with slow alpha rhythms. We did not observe the same with Oberholzer syndrome.

  6. The Complex Picture Test in Dementia

    Directory of Open Access Journals (Sweden)

    K. Gustaw Rothenberg

    2012-10-01

    Full Text Available The newly developed Complex Picture Test (CPT examines main cognitive domains, especially perceptual and visual-spatial abilities. The potential usefulness of the CPT in the assessment of dementia was evaluated. Patients with different forms of dementia [14 vascular dementia (VaD, 30 Alzheimer’s disease (AD, 6 Parkinson’s disease dementia (PDD], 12 subjects with mild cognitive impairment (MCI, and 30 matched controls were examined by the CPT, Mini-Mental State Examination (MMSE, the WAIS-R Digit Span subtest, and the Clock Drawing Test (CDT. The CPT consists of 10 complex pictures, each presenting characteristics paradoxically in opposition to each other. The subjects scored points for naming the object and noticing the paradox. One point was added for commenting on the paradox without prompting (3 points each picture/maximum of 30. CPT scores were significantly higher in the control group (mean ± SD, 29.46 ± 1.43 than in the AD, VaD, MCI, and PDD groups (13.1 ± 2.3, 16.9 ± 3.5, 23.2 ± 1.4, and 23.6 ± 3.4, respectively; p < 0.05. Significant positive correlations between MMSE, Digit Span, CDT, and CPT scores were observed (rho 0.76, 0.35, and 0.56, respectively. These data show perception of complex pictures being compromised in dementia. The correlation between CPT scores and MMSE scores suggests that tests may be used as a brief screening tool for dementia.

  7. Communicating with Patients Who Have Advanced Dementia: Training Nurse Aide Students

    Science.gov (United States)

    Beer, Laura E.; Hutchinson, Susan R.; Skala-Cordes, Kristine K.

    2012-01-01

    The increase of dementia in older adults is changing how medical care is delivered. Recognizing symptoms of pain, managing behaviors, and providing quality of life for people who have advanced dementia requires a new skill set for caregivers. Researchers in this study targeted nurse aide students to test an educational module's effect on students'…

  8. A dementia first aid course for family carers.

    Science.gov (United States)

    Pogson, Richard

    Many people with dementia are cared for by family members, who may receive little advice or support. This article describes a course developed to help carers deal with frustrating and challenging behaviour. PMID:26647481

  9. Precision Medicine: Clarity for the Complexity of Dementia.

    Science.gov (United States)

    Cholerton, Brenna; Larson, Eric B; Quinn, Joseph F; Zabetian, Cyrus P; Mata, Ignacio F; Keene, C Dirk; Flanagan, Margaret; Crane, Paul K; Grabowski, Thomas J; Montine, Kathleen S; Montine, Thomas J

    2016-03-01

    Three key elements to precision medicine are stratification by risk, detection of pathophysiological processes as early as possible (even before clinical presentation), and alignment of mechanism of action of intervention(s) with an individual's molecular driver(s) of disease. Used for decades in the management of some rare diseases and now gaining broad currency in cancer care, a precision medicine approach is beginning to be adapted to cognitive impairment and dementia. This review focuses on the application of precision medicine to address the clinical and biological complexity of two common neurodegenerative causes of dementia: Alzheimer disease and Parkinson disease. PMID:26724389

  10. Dementia

    Science.gov (United States)

    ... Hospitalization and Palliative Care Friends & Family Dating and Marriage Family Planning Mixed-Status Couples Discrimination Legal Issues ... National HIV/AIDS and Aging Awareness Day National Gay Men's HIV/AIDS Awareness Day National Latino AIDS ...

  11. Dementia

    Science.gov (United States)

    ... these changes can affect your memory. Aging may affect memory by changing the way the brain stores information ... for themselves. Dementia may also cause changes in mood and personality. Early on, lapses in memory and clear thinking may bother the person who ...

  12. Decision aids for respite service choices by carers of people with dementia: development and pilot RCT

    Directory of Open Access Journals (Sweden)

    Stirling Christine

    2012-03-01

    Full Text Available Abstract Background Decision aids are often used to assist individuals confronted with a diagnosis of a serious illness to make decisions about treatment options. However, they are rarely utilised to help those with chronic or age related conditions to make decisions about care services. Decision aids should also be useful for carers of people with decreased decisional capacity. These carers' choices must balance health outcomes for themselves and for salient others with relational and value-based concerns, while relying on information from health professionals. This paper reports on a study that both developed and pilot tested a decision aid aimed at assisting carers to make evaluative judgements of community services, particularly respite care. Methods A mixed method sequential study, involving qualitative development and a pilot randomised controlled trial, was conducted in Tasmania, Australia. We undertook 13 semi-structured interviews and three focus groups to inform the development of the decision aid. For the randomised control trial we randomly assigned 31 carers of people with dementia to either receive the service decision aid at the start or end of the study. The primary outcome was measured by comparing the difference in carer burden between the two groups three months after the intervention group received the decision aid. Pilot data was collected from carers using interviewer-administered questionnaires at the commencement of the project, two weeks and 12 weeks later. Results The qualitative data strongly suggest that the intervention provides carers with needed decision support. Most carers felt that the decision aid was useful. The trial data demonstrated that, using the mean change between baseline and three month follow-up, the intervention group had less increase in burden, a decrease in decisional conflict and increased knowledge compared to control group participants. Conclusions While these results must be interpreted with

  13. Nonpharmacological therapies and provision of aids in outpatient dementia networks in Germany: utilization rates and associated factors

    Directory of Open Access Journals (Sweden)

    Wübbeler M

    2015-05-01

    Full Text Available Markus Wübbeler,1 Jochen René Thyrian,1 Bernhard Michalowsky,2 Johannes Hertel,2 Franziska Laporte Uribe,3 Karin Wolf-Ostermann,4 Susanne Schäfer-Walkmann,6 Wolfgang Hoffmann2,5 1Interventional Health Care Research Group, German Center for Neurodegenerative Diseases (DZNE Rostock/Greifswald, 2German Center for Neurodegenerative Diseases (DZNE Rostock/Greifswald, Greifswald, Germany; 3Implementation and Dissemination Research Group, German Center for Neurodegenerative Diseases (DZNE, Witten, Germany; 4Department of Human and Health Science, University of Bremen, Bremen, Germany; 5Epidemiology of Health Care and Community Health, Institute for Community Medicine, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany; 6Institute for Applied Social Sciences, Stuttgart, Germany Background: Nonpharmacological therapies and the provision of aids are described to be supportive in the treatment of persons with dementia (PWDs. These aim to maintain individuals' participation in daily activities as long as possible, to slow the progression of their disease, and to support their independent living at home. However, there is a lack of knowledge about the utilization of therapies and aids among community-dwelling PWDs.Objective: The aims of the study were a to describe the utilization of nonpharmacological therapies and aids among community-dwelling PWDs and b to analyze the factors associated with utilization.Method: As part of a cross-sectional study of n=560 caregivers of PWDs in dementia networks throughout Germany, we assessed sociodemographics, clinical variables, and the utilization of nonpharmacological therapies (physiotherapy [PT], occupational therapy [OT], and aids (sensory, mobility, and others, using face-to-face interviews and questionnaires.Results: Approximately every fourth PWD received PT and every seventh PWD received OT. Sensory aids were utilized by 91.1%, personal hygiene aids by 77.2%, mobility aids by 58.6%, and medical

  14. Microbial translocation is associated with increased monocyte activation and dementia in AIDS patients.

    Directory of Open Access Journals (Sweden)

    Petronela Ancuta

    Full Text Available Elevated plasma lipopolysaccharide (LPS, an indicator of microbial translocation from the gut, is a likely cause of systemic immune activation in chronic HIV infection. LPS induces monocyte activation and trafficking into brain, which are key mechanisms in the pathogenesis of HIV-associated dementia (HAD. To determine whether high LPS levels are associated with increased monocyte activation and HAD, we obtained peripheral blood samples from AIDS patients and examined plasma LPS by Limulus amebocyte lysate (LAL assay, peripheral blood monocytes by FACS, and soluble markers of monocyte activation by ELISA. Purified monocytes were isolated by FACS sorting, and HIV DNA and RNA levels were quantified by real time PCR. Circulating monocytes expressed high levels of the activation markers CD69 and HLA-DR, and harbored low levels of HIV compared to CD4(+ T-cells. High plasma LPS levels were associated with increased plasma sCD14 and LPS-binding protein (LBP levels, and low endotoxin core antibody levels. LPS levels were higher in HAD patients compared to control groups, and were associated with HAD independently of plasma viral load and CD4 counts. LPS levels were higher in AIDS patients using intravenous heroin and/or ethanol, or with Hepatitis C virus (HCV co-infection, compared to control groups. These results suggest a role for elevated LPS levels in driving monocyte activation in AIDS, thereby contributing to the pathogenesis of HAD, and provide evidence that cofactors linked to substance abuse and HCV co-infection influence these processes.

  15. Standardized evaluation of algorithms for computer-aided diagnosis of dementia based on structural MRI: The CADDementia challenge

    OpenAIRE

    Esther E Bron; Smits, Marion; van der Flier, Wiesje M; Vrenken, Hugo; Barkhof, Frederik; Scheltens, Philip; Papma, Janne M.; Steketee, Rebecca M.E.; Orellana, Carolina Méndez; Meijboom, Rozanna; Pinto, Madalena; Meireles, Joana R.; Garrett, Carolina; Bastos-Leite, António J.; Abdulkadir, Ahmed

    2015-01-01

    Algorithms for computer-aided diagnosis of dementia based on structural MRI have demonstrated high performance in the literature, but are difficult to compare as different data sets and methodology were used for evaluation. In addition, it is unclear how the algorithms would perform on previously unseen data, and thus, how they would perform in clinical practice when there is no real opportunity to adapt the algorithm to the data at hand. To address these comparability, generalizability and c...

  16. Pareidolias: complex visual illusions in dementia with Lewy bodies

    OpenAIRE

    Uchiyama, Makoto; Nishio, Yoshiyuki; Yokoi, Kayoko; Hirayama, Kazumi; Imamura, Toru; Shimomura, Tatsuo; Mori, Etsuro

    2012-01-01

    Patients rarely experience visual hallucinations while being observed by clinicians. Therefore, instruments to detect visual hallucinations directly from patients are needed. Pareidolias, which are complex visual illusions involving ambiguous forms that are perceived as meaningful objects, are analogous to visual hallucinations and have the potential to be a surrogate indicator of visual hallucinations. In this study, we explored the clinical utility of a newly developed instrument for evokin...

  17. Neuropsychological study of amyotrophic lateral sclerosis and parkinsonism-dementia complex in Kii peninsula, Japan

    OpenAIRE

    Shindo, Akihiro; Ueda, Yukito; Kuzuhara, Shigeki; Kokubo, Yasumasa

    2014-01-01

    Background The Kii peninsula of Japan is one of the foci of amyotrophic lateral sclerosis and parkinsonism-dementia complex (ALS/PDC) in the world. The purpose of this study is to clarify the neuropsychological features of the patients with ALS/PDC of the Kii peninsula (Kii ALS/PDC). Methods The medical interview was done on 13 patients with Kii ALS/PDC, 12 patients with Alzheimer’s disease, 10 patients with progressive supranuclear palsy, 10 patients with frontotemporal lobar degeneration an...

  18. Principles For Aiding Complex Military Decision Making

    OpenAIRE

    Hutchins, Susan G.; Morrison, Jeffrey G.; Kelly, Richard T.

    1996-01-01

    Paper presented to the Second International Command and Control Research and Technology Symposium, Monterey, Ca. The Tactical Decision Making Under Stress (TADMUS) program is being conducted to apply recent developments in decision theory and human-system interaction technology to the design of a decision support system for enhancing tactical decision making under the highly complex conditions involved in anti-air warfare scenarios in littoral environments. Our goal...

  19. Nervous System Problems and Dementia

    Science.gov (United States)

    ... Language: Fact Sheet 505 Nervous System Problems and Dementia WHAT ARE NERVOUS SYSTEM PROBLEMS? WHAT ARE THE ... of AIDS these were all called “HIV-Associated Dementia.” However, a broader range of problems is showing ...

  20. Complex Chemical Reaction Networks from Heuristics-Aided Quantum Chemistry

    OpenAIRE

    Rappoport, Dmitrij; Galvin, Cooper J.; Zubarev, Dmitry; Aspuru-Guzik, Alan

    2014-01-01

    While structures and reactivities of many small molecules can be computed efficiently and accurately using quantum chemical methods, heuristic approaches remain essential for modeling complex structures and large-scale chemical systems. Here, we present a heuristics-aided quantum chemical methodology applicable to complex chemical reaction networks such as those arising in cell metabolism and prebiotic chemistry. Chemical heuristics offer an expedient way of traversing high-dimensional reacti...

  1. Diabetes, Dementia and Hypoglycemia.

    Science.gov (United States)

    Meneilly, Graydon S; Tessier, Daniel M

    2016-02-01

    We are experiencing an epidemic of both diabetes and dementia among older adults in this country. The risk for dementia appears to be increased in patients with diabetes, and patients with dementia and diabetes appear to be at greater risk for severe hypoglycemia. In addition, there may be an increased risk for developing dementia by older patients with diabetes who have had episodes of severe hypoglycemia, although this issue is controversial. In this article, we review the factors that contribute to the increased risk for dementia in older adults with diabetes and outline the complex relationships between hypoglycemia and dementia. PMID:26778684

  2. Palliative care in advanced dementia; A mixed methods approach for the development of a complex intervention

    Directory of Open Access Journals (Sweden)

    Tookman Adrian

    2008-07-01

    Full Text Available Abstract Background There is increasing interest in improving the quality of care that patients with advanced dementia receive when they are dying. Our understanding of the palliative care needs of these patients and the natural history of advanced disease is limited. Many people with advanced dementia have unplanned emergency admissions to the acute hospital; this is a critical event: half will die within 6 months. These patients have complex needs but often lack capacity to express their wishes. Often carers are expected to make decisions. Advance care planning discussions are rarely performed, despite potential benefits such more consistent supportive healthcare, a reduction in emergency admissions to the acute hospital and better resolution of carer bereavement. Design/Methods We have used the MRC complex interventions framework, a "bottom-up" methodology, to develop an intervention for patients with advanced dementia and their carers aiming to 1 define end of life care needs for both patients and carers, 2 pilot a palliative care intervention and 3 produce a framework for advance care planning for patients. The results of qualitative phase 1 work, which involved interviews with carers, hospital and primary care staff from a range of disciplines, have been used to identify key barriers and challenges. For the exploratory trial, 40 patients will be recruited to each of the control and intervention groups. The intervention will be delivered by a nurse specialist. We shall investigate and develop methodology for a phase 3 randomised controlled trial. For example we shall explore the feasibility of randomisation, how best to optimise recruitment, decide on appropriate outcomes and obtain data for power calculations. We will evaluate whether the intervention is pragmatic, feasible and deliverable on acute hospital wards and test model fidelity and its acceptability to carers, patients and staff. Discussion Results of qualitative phase 1 work

  3. Rapidly progressed acquired immunodeficiency syndrome dementia complex as an initial manifestation.

    Science.gov (United States)

    Takeuchi, Makoto; Nobukuni, Keigo; Takata, Hiroshi; Kawata, Noriko; Hayashibara, Noriko; Ishizu, Hideki; Takahashi, Kiyoshi

    2005-07-01

    We report a patient with acquired immunodeficiency syndrome dementia complex (ADC) that presented human immunodeficiency virus infection as an initial manifestation. A 34-year-old man developed disturbance of consciousness and severe abulia over 3 months. The CD4 lymphocyte count was 7.9/microl, while human immunodeficiency virus RNA in blood amounted to 4.2 x 10(4) copies/ml. T2-weighted magnetic resonance imaging showed diffusely high signal intensity in the deep white matter of both cerebral hemispheres. On the 20th hospital day, the patient died of sepsis caused by methicillin-resistant Staphylococcus aureus. Autopsy findings in the brain included increased glial cells and multinucleated giant cells in cerebral white matter and subcortical gray matter. These features were compatible with ADC. PMID:16093602

  4. Dementia-Related Work Activities of Home Care Nurses and Aides: Frequency, Perceived Competence, and Continuing Education Priorities

    Science.gov (United States)

    Morgan, Debra G.; Kosteniuk, Julie G.; O'Connell, Megan E.; Dal Bello-Haas, Vanina; Stewart, Norma J.; Karunanayake, Chandima

    2016-01-01

    An understanding of the specific dementia learning needs of home care staff is needed to plan relevant continuing education (CE) programs and supports. The study's objective was to examine frequency and perceived competence in performing 20 dementia-related work activities, and identify CE priorities among home care staff. A cross-sectional survey…

  5. The Use of Statistical Parametric Mapping (SPM96 as a Decision Aid in the Differential Diagnosis of Dementia Using 99mTc-HMPAO SPECT

    Directory of Open Access Journals (Sweden)

    A. Barnes

    2000-01-01

    Full Text Available In this study standard patterns of cerebral perfusion based on classifications described in the literature have been chosen and the ability of experienced imaging specialists to categorise the 99mTc HMPAO SPECT scans of patients referred to the department for investigation of dementia has been compared before and after the calculation of Statistical Parametric Maps (SPM—Wellcome Dept of Cognitive Neurology. The primary aim was to investigate whether SPM is an effective decision aid and whether it impacts on the confidence of image reporting. The secondary aim was to examine the influence of SPM on the agreement between image reporting and clinical diagnosis. The results showed that there was a slight decrease in agreement between the imaging specialists after the introduction of additional information from SPM (K = 0.57 to K = 0.5 and that agreement between imaging reporting (including information from SPM and clinical diagnosis was moderate (K = 0.28. This study was able to confirm that SPM is capable of producing meaningful significance maps of individual patients in a routine clinical environment. However, there was no overwhelming evidence that SPM was able to resolve many of the dilemmas associated with the use of SPECT for the differential diagnosis of dementia. In particular, interpretation of SPECT perfusion patterns in dementia is a bigger problem than the initial identification of abnormalities.

  6. Parkinson’s-Dementia Complex and Development of a New Stable Isotope Dilution Assay for BMAA Detection in Tissue

    OpenAIRE

    Snyder, Laura R.; Cruz-Aguado, Reyniel; Sadilek, Martin; Galasko, Douglas; Shaw, Christopher A.; Montine, Thomas J.

    2009-01-01

    β-Methylamino-L-alanine (BMAA) has been proposed as a global contributor to neurodegenerative diseases, including Parkinson-dementia complex (PDC) of Guam and Alzheimer’s disease (AD). The literature on the effects of BMAA is conflicting with some but not all in vitro data supporting a neurotoxic action, and experimental animal data failing to replicate the pattern of neurodegeneration of these human diseases, even at very high exposures. Recently, BMAA has been reported in human brain from i...

  7. Tau and α-Synuclein Pathology in Amygdala of Parkinsonism-Dementia Complex Patients of Guam

    Science.gov (United States)

    Forman, Mark S.; Schmidt, M. Luise; Kasturi, Sanjay; Perl, Daniel P.; Lee, Virginia M.-Y.; Trojanowski, John Q.

    2002-01-01

    Amyotrophic lateral sclerosis/parkinsonism-dementia complex (ALS/PDC) is a progressive neurodegenerative disorder of Chamorro residents of Guam and the Mariana Islands, characterized by abundant neuron loss and tau neurofibrillary pathology similar to that observed in Alzheimer’s disease (AD). A variety of neurodegenerative diseases with tau pathology including ALS/PDC also have α-synuclein positive pathology, primarily in the amygdala. We further characterized the tau and α-synuclein pathology in the amygdala of a large series of 30 Chamorros using immunohistochemical and biochemical techniques. Tau pathology was readily detected in both affected and unaffected Chamorros. In contrast, α-synuclein pathology was detected in 37% of patients with PDC but not detected in Chamorros without PDC or AD. The α-synuclein aggregates often co-localized within neurons harboring neurofibrillary tangles suggesting a possible interaction between the two proteins. Tau and α-synuclein pathology within the amygdala is biochemically similar to that observed in AD and synucleinopathies, respectively. Thus, the amygdala may be selectively vulnerable to developing both tau and α-synuclein pathology or tau pathology may predispose it to synuclein aggregation. Furthermore, in PDC, tau and α-synuclein pathology occurs independent of β-amyloid deposition in amygdala thereby implicating the aggregation of these molecules in the severe neurodegeneration frequently observed in this location. PMID:12000724

  8. The Cost of Complexity in Federal Student Aid: Lessons from Optimal Tax Theory and Behavioral Economics

    OpenAIRE

    Susan M. Dynarski; Judith E. Scott-Clayton

    2006-01-01

    The federal system for distributing student financial aid rivals the tax code in its complexity. Both have been a source of frustration and a focus of reform efforts for decades, yet the complexity of the student aid system has received comparatively little attention from economists. We describe the complexity of the aid system, and apply lessons from optimal tax theory and behavioral economics to show that complexity is a serious obstacle to both efficiency and equity in the distribution of ...

  9. [Revisit to Kii ALS--the innovated concept of ALS-Parkinsonism-dementia complex, clinicopathological features, epidemiology and etiology].

    Science.gov (United States)

    Kuzuhara, Shigeki

    2007-10-01

    The high incidence of amyotrophic lateral sclerosis (ALS) in the residents of Hohara and Kozagawa in the Kii peninsula was reported to have disappeared by early 1980 with its etiology unsolved. However, we found continuous high incidence in Hohara that was neuropathologically characterized by ALS pathology associated with many neurofibrillar tangles (NFTs) similar to Guam ALS. We confirmed existence of neuropathologically-verified parkinsonism-dementia complex (PDC) identical to Guamanian PDC clinically and neuropathologically. The core clinical features consisted of motor neuron signs, parkinsonism and dementia, and patients presented with clinical manifestations of ALS, PDC or PDC followed by ALS. PDC predominated over ALS in incidence. Approximately 70% of patients had family history of ALS/PDC. Neuropathological findings of 12 cases revealed that they were very similar to each others, consisting of many NFTs, no or scanty amyloid plaques, and ALS pathology affecting the upper and lower motor neurons. These findings suggest that ALS and PDC may be different clinical manifestations of a single entity "ALS-parkinsonism-dementia complex". TDP-43 positive inclusions were seen in the neurons of the dentate gyrus and spinal cord in all 6 cases examined. A comparison of age-adjusted prevalence rates in 1967 and 1998 revealed moderate decline of ALS and marked increase of PDC in the latter. The age-adjusted 5-year average incidence rates during 1950 and 2000 showed gradual decline of ALS for 50 years and dramatic increase of PDC after 1990. These findings suggest that the clinical manifestations may have changed in Kii ALS/PDC as in ALS/PDC on Guam, partly because of rapid aging of the population. Gene analyses have so far failed to demonstrate mutations of SOD1, parkin, alpha-synuclein, tau, progranulin, TDP-43 and other genes related to dementia, parkinsonism and motor neuron disease. There have been no differences in drinking water and food between the residents in

  10. Treatable Dementias

    OpenAIRE

    Mahler, Michael E.; Cummings, Jeffrey L.; Benson, D. Frank

    1987-01-01

    Dementia is an acquired impairment of intellect produced by brain dysfunction. In the past, dementia was regarded as inevitably chronic, progressive and irreversible. More recently dementia has been viewed as a clinical syndrome that may be produced by both irreversible and reversible conditions. Recognition of the presence of a dementia syndrome should be followed by an evaluation for potentially treatable causes of the intellectual deterioration. Dementia treatment includes therapy for reve...

  11. AIDS

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000594.htm HIV/AIDS To use the sharing features on this page, ... immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the ...

  12. Mixed Dementia

    Science.gov (United States)

    ... TDP43-related Dementia 2013 Andrew Watt Characterisation of Tau Imaging Ligands for Alzheimer's Disease and other Dementias 2010 Marco Prado The Prion Protein as a Therapeutic Target in Alzheimer's Disease 2007 ...

  13. Other Dementias

    Science.gov (United States)

    ... be hard to diagnose because Parkinson's disease and Alzheimer's disease cause similar symptoms. Scientists think that LBD might be ... other vascular disease risk factors. Other conditions that cause dementia Creutzfeldt-Jakob disease (CJD) Huntington’s disease Secondary dementias ...

  14. Nutrition in Severe Dementia

    OpenAIRE

    Glaucia Akiko Kamikado Pivi; Paulo Henrique Ferreira Bertolucci; Rodrigo Rizek Schultz

    2012-01-01

    An increasing proportion of older adults with Alzheimer's disease or other dementias are now surviving to more advanced stages of the illness. Advanced dementia is associated with feeding problems, including difficulty in swallowing and respiratory diseases. Patients become incompetent to make decisions. As a result, complex situations may arise in which physicians and families decide whether artificial nutrition and hydration (ANH) is likely to be beneficial for the patient. The objective of...

  15. Vascular Dementia

    OpenAIRE

    Maria Alekseyevna Cherdak; O. V. Uspenskaya

    2015-01-01

    Vascular dementia is one of the most common causes of dementia after Alzheimer's disease, causing around 15% of cases. However, unlike Alzheimer's disease, there are no licensed treatments for vascular dementia. Progress in the specialty has been difficult because of uncertainties over disease classification and diagnostic criteria, controversy over the exact nature of the relation between cerebrovascular pathology and cognitive impairment, and the paucity of identifiable tractable treatment ...

  16. Appropriation and dementia in India.

    Science.gov (United States)

    Brijnath, Bianca; Manderson, Lenore

    2011-12-01

    Biomedical technologies like MRI scans offer a way for carers and people with dementia to 'see' pathology, as a means to reorient their perceptions of the body and functionality. Through interpretive and syncretic processes, the MRI and the diagnosis of dementia facilitate the incorporation of the clinical category 'dementia' into social understandings of illness and care in India. Complex shifts occur as families and providers move from socio-cultural explanations of disruption to bio-social etiologies of the disease 'dementia' and then to socio-ecological frameworks of causality. Both the biomedicalisation of illness and the localisation of illness occur as the clinical category 'dementia' is folded into local understandings of illness and care. Through elucidating how the dialectic between biomedical and local knowledge is operationalized, we offer insights into how dementia is absorbed and appropriated into Indian cultural contexts. PMID:21837538

  17. Parkinson-dementia complex and development of a new stable isotope dilution assay for BMAA detection in tissue

    International Nuclear Information System (INIS)

    β-Methylamino-L-alanine (BMAA) has been proposed as a global contributor to neurodegenerative diseases, including Parkinson-dementia complex (PDC) of Guam and Alzheimer's disease (AD). The literature on the effects of BMAA is conflicting with some but not all in vitro data supporting a neurotoxic action, and experimental animal data failing to replicate the pattern of neurodegeneration of these human diseases, even at very high exposures. Recently, BMAA has been reported in human brain from individuals afflicted with PDC or AD. Some of the BMAA in human tissue reportedly is freely extractable (free) while some is protein-associated and liberated by techniques that hydrolyze the peptide bond. The latter is especially intriguing since BMAA is a non-proteinogenic amino acid that has no known tRNA. We attempted to replicate these findings with techniques similar to those used by others; despite more than adequate sensitivity, we were unable to detect free BMAA. Recently, using a novel stable isotope dilution assay, we again were unable to detect free or protein-associated BMAA in human cerebrum. Here we review the development of our new assay for tissue detection of BMAA and show that we are able to detect free BMAA in liver but not cerebrum, nor do we detect any protein-associated BMAA in mice fed this amino acid. These studies demonstrate the importance of a sensitive and specific assay for tissue BMAA and seriously challenge the proposal that BMAA is accumulating in human brain.

  18. Complexity aided design. The FuturICT technological innovation paradigm

    Science.gov (United States)

    Carbone, A.; Ajmone-Marsan, M.; Axhausen, K. W.; Batty, M.; Masera, M.; Rome, E.

    2012-11-01

    "In the next century, planet earth will don an electronic skin. It will use the Internet as a scaffold to support and transmit its sensations. This skin is already being stitched together. It consists of millions of embedded electronic measuring devices: thermostats, pressure gauges, pollution detectors, cameras, microphones, glucose sensors, EKGs, electroencephalographs. These will probe and monitor cities and endangered species, the atmosphere, our ships, highways and fleets of trucks, our conversations, our bodies-even our dreams ....What will the earth's new skin permit us to feel? How will we use its surges of sensation? For several years-maybe for a decade-there will be no central nervous system to manage this vast signaling network. Certainly there will be no central intelligence...some qualities of self-awareness will emerge once the Net is sensually enhanced. Sensuality is only one force pushing the Net toward intelligence". These statements are quoted by an interview by Cherry Murray, Dean of the Harvard School of Engineering and Applied Sciences and Professor of Physics. It is interesting to outline the timeliness and highly predicting power of these statements. In particular, we would like to point to the relevance of the question "What will the earth's new skin permit us to feel?" to the work we are going to discuss in this paper. There are many additional compelling questions, as for example: "How can the electronic earth's skin be made more resilient?"; "How can the earth's electronic skin be improved to better satisfy the need of our society?";"What can the science of complex systems contribute to this endeavour?"

  19. Vascular dementia

    Science.gov (United States)

    ... Alzheimer's Disease, and Dementia . 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 6. Gorelick PB, Scuteri A, Black ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 402. Peterson R, Graff-Radford ...

  20. Nutrition in Severe Dementia

    Directory of Open Access Journals (Sweden)

    Glaucia Akiko Kamikado Pivi

    2012-01-01

    Full Text Available An increasing proportion of older adults with Alzheimer's disease or other dementias are now surviving to more advanced stages of the illness. Advanced dementia is associated with feeding problems, including difficulty in swallowing and respiratory diseases. Patients become incompetent to make decisions. As a result, complex situations may arise in which physicians and families decide whether artificial nutrition and hydration (ANH is likely to be beneficial for the patient. The objective of this paper is to present methods for evaluating the nutritional status of patients with severe dementia as well as measures for the treatment of nutritional disorders, the use of vitamin and mineral supplementation, and indications for ANH and pharmacological therapy.

  1. What to Ask: Dementia

    Science.gov (United States)

    ... Dementia Join our e-newsletter! Resources What to Ask: Dementia Tools and Tips The memory loss and ... about dementia. The following are questions you can ask your healthcare proffesional about dementia. Is memory loss ...

  2. Reversible dementias

    OpenAIRE

    Tripathi, Manjari; Vibha, Deepti

    2009-01-01

    In recent years, more attention has been given to the early diagnostic evaluation of patients with dementia which is essential to identify patients with cognitive symptoms who may have treatable conditions. Guidelines suggest that all patients presenting with dementia or cognitive symptoms should be evaluated with a range of laboratory tests, and with structural brain imaging with computed tomography (CT) or magnetic resonance imaging (MRI). While many of the disorders reported as ‘reversible...

  3. FlexAID: Revisiting Docking on Non-Native-Complex Structures.

    Science.gov (United States)

    Gaudreault, Francis; Najmanovich, Rafael J

    2015-07-27

    Small-molecule protein docking is an essential tool in drug design and to understand molecular recognition. In the present work we introduce FlexAID, a small-molecule docking algorithm that accounts for target side-chain flexibility and utilizes a soft scoring function, i.e. one that is not highly dependent on specific geometric criteria, based on surface complementarity. The pairwise energy parameters were derived from a large dataset of true positive poses and negative decoys from the PDBbind database through an iterative process using Monte Carlo simulations. The prediction of binding poses is tested using the widely used Astex dataset as well as the HAP2 dataset, while performance in virtual screening is evaluated using a subset of the DUD dataset. We compare FlexAID to AutoDock Vina, FlexX, and rDock in an extensive number of scenarios to understand the strengths and limitations of the different programs as well as to reported results for Glide, GOLD, and DOCK6 where applicable. The most relevant among these scenarios is that of docking on flexible non-native-complex structures where as is the case in reality, the target conformation in the bound form is not known a priori. We demonstrate that FlexAID, unlike other programs, is robust against increasing structural variability. FlexAID obtains equivalent sampling success as GOLD and performs better than AutoDock Vina or FlexX in all scenarios against non-native-complex structures. FlexAID is better than rDock when there is at least one critical side-chain movement required upon ligand binding. In virtual screening, FlexAID results are lower on average than those of AutoDock Vina and rDock. The higher accuracy in flexible targets where critical movements are required, intuitive PyMOL-integrated graphical user interface and free source code as well as precompiled executables for Windows, Linux, and Mac OS make FlexAID a welcome addition to the arsenal of existing small-molecule protein docking methods. PMID

  4. A Novel Data-Aided Channel Estimation with Reduced Complexity for TDS-OFDM Systems

    CERN Document Server

    Liu, Ming; Hélard, Jean-François

    2012-01-01

    In contrast to the classical cyclic prefix (CP)-OFDM, the time domain synchronous (TDS)-OFDM employs a known pseudo noise (PN) sequence as guard interval (GI). Conventional channel estimation methods for TDS-OFDM are based on the exploitation of the PN sequence and consequently suffer from intersymbol interference (ISI). This paper proposes a novel dataaided channel estimation method which combines the channel estimates obtained from the PN sequence and, most importantly, additional channel estimates extracted from OFDM data symbols. Data-aided channel estimation is carried out using the rebuilt OFDM data symbols as virtual training sequences. In contrast to the classical turbo channel estimation, interleaving and decoding functions are not included in the feedback loop when rebuilding OFDM data symbols thereby reducing the complexity. Several improved techniques are proposed to refine the data-aided channel estimates, namely one-dimensional (1-D)/two-dimensional (2-D) moving average and Wiener filtering. Fin...

  5. Radiologic diagnostics of dementia

    International Nuclear Information System (INIS)

    Dementia is one of the most common diseases in the elderly population and is getting more and more important with the ageing of the population. A radiologic structural examination with CT or MRI is meanwhile a standard procedure in the diagnostic work up of patients with dementia syndrome. Radiology enables an early diagnosis and a differential diagnosis between different causes of dementia. Because structural changes occur only late in the disease process, a more detailed structural analysis using volumetric techniques or the use of functional imaging techniques is mandatory. These days, structural imaging uses MRI which enables to detect early atrophic changes at the medial temporal lobe with focus on the amygdala hippocampal complex. These changes are also present in the normal ageing process. In patients with Alzheimer's disease, however, they are more rapid and more pronounced. The use of functional imaging methods such as perfusion MRI, diffusion MRI or fMRI allow new insights into the pathophysiologic changes of dementia. The article gives an overview of the current status of structural imaging and an outlook into the potential of functional imaging methods. Detailed results of structural and functional imaging are presented in other articles of this issue. (orig.)

  6. MR spectroscopy in dementia

    International Nuclear Information System (INIS)

    With an increasingly aging population we are faced with the problem of an increasing number of dementia patients. In addition to clinical, neuropsychological and laboratory procedures, MRI plays an important role in the early diagnosis of dementia. In addition to various morphological changes functional changes can also help in the diagnosis and differential diagnosis of dementia. Overall the diagnosis of dementia can be improved by using parameters from MR spectroscopy. This article focuses on MR spectroscopic changes in the physiological aging process as well as on changes in mild cognitive impairment a precursor of Alzheimer's dementia, in Alzheimer's dementia, frontotemporal dementia, vascular dementia and Lewy body dementia. (orig.)

  7. Frontotemporal dementia or frontotemporal lobar degeneration--overview of a group of proteinopathies.

    Science.gov (United States)

    Haberland, Catherine

    2010-03-30

    Frontotemporal dementia is the second most common early onset dementia after Alzheimer disease. Frontotemporal dementias are a complex group of dementias. The clinical diagnosis can be perplexing because of concurring psychiatric and neurologic syndromes. Frontotemporal lobar degeneration, the underlying pathology, represents an emerging group of proteinopathies. Genetic factors play an important part in the etiologies of dementias. This article overviews current defining characteristics of frontotemporal dementias known also as frontotemporal lobar degenerations. PMID:20405665

  8. TGF-β suppression of HBV RNA through AID-dependent recruitment of an RNA exosome complex.

    Directory of Open Access Journals (Sweden)

    Guoxin Liang

    2015-04-01

    Full Text Available Transforming growth factor (TGF-β inhibits hepatitis B virus (HBV replication although the intracellular effectors involved are not determined. Here, we report that reduction of HBV transcripts by TGF-β is dependent on AID expression, which significantly decreases both HBV transcripts and viral DNA, resulting in inhibition of viral replication. Immunoprecipitation reveals that AID physically associates with viral P protein that binds to specific virus RNA sequence called epsilon. AID also binds to an RNA degradation complex (RNA exosome proteins, indicating that AID, RNA exosome, and P protein form an RNP complex. Suppression of HBV transcripts by TGF-β was abrogated by depletion of either AID or RNA exosome components, suggesting that AID and the RNA exosome involve in TGF-β mediated suppression of HBV RNA. Moreover, AID-mediated HBV reduction does not occur when P protein is disrupted or when viral transcription is inhibited. These results suggest that induced expression of AID by TGF-β causes recruitment of the RNA exosome to viral RNP complex and the RNA exosome degrades HBV RNA in a transcription-coupled manner.

  9. The neuropathology and cerebrovascular mechanisms of dementia.

    Science.gov (United States)

    Raz, Limor; Knoefel, Janice; Bhaskar, Kiran

    2016-01-01

    The prevalence of dementia is increasing in our aging population at an alarming rate. Because of the heterogeneity of clinical presentation and complexity of disease neuropathology, dementia classifications remain controversial. Recently, the National Plan to address Alzheimer’s Disease prioritized Alzheimer’s disease-related dementias to include: Alzheimer’s disease, dementia with Lewy bodies, frontotemporal dementia, vascular dementia, and mixed dementias. While each of these dementing conditions has their unique pathologic signature, one common etiology shared among all these conditions is cerebrovascular dysfunction at some point during the disease process. The goal of this comprehensive review is to summarize the current findings in the field and address the important contributions of cerebrovascular, physiologic, and cellular alterations to cognitive impairment in these human dementias. Specifically, evidence will be presented in support of small-vessel disease as an underlying neuropathologic hallmark of various dementias, while controversial findings will also be highlighted. Finally, the molecular mechanisms shared among all dementia types including hypoxia, oxidative stress, mitochondrial bioenergetics, neuroinflammation, neurodegeneration, and blood–brain barrier permeability responsible for disease etiology and progression will be discussed. PMID:26174330

  10. Dementia with Lewy Bodies

    Science.gov (United States)

    ... Awards Enhancing Diversity Find People About NINDS NINDS Dementia With Lewy Bodies Information Page Synonym(s): Lewy Body ... and Information Additional resources from MedlinePlus What is Dementia With Lewy Bodies? Dementia with Lewy bodies (DLB) ...

  11. Lewy Body Dementia Diagnosis

    Science.gov (United States)

    ... Diagnosis Symptoms Treatment Options Help end Lewy body dementia now! Donate Diagnosis An experienced clinician within the ... an experienced diagnostic team skilled in Lewy body dementia. A thorough dementia diagnostic evaluation includes physical and ...

  12. Dealing with Dementia

    Science.gov (United States)

    ... please review our exit disclaimer . Subscribe Dealing with Dementia When Thinking and Behavior Decline Forgetfulness, confusion, or ... could be signs of a condition known as dementia. Dementia is a brain disorder that most often ...

  13. Frontotemporal Dementia (Pick's Disease)

    Science.gov (United States)

    ... Enhancing Diversity Find People About NINDS NINDS Frontotemporal Dementia Information Page Clinical Trials Natural History and Biomarkers ... Information Additional resources from MedlinePlus What is Frontotemporal Dementia ? Frontotemporal dementia (FTD) describes a clinical syndrome associated ...

  14. Diabetes mellitus and the risk of dementia

    OpenAIRE

    Xu, Weili

    2008-01-01

    p>This doctoral thesis investigated the complex relationship between diabetes and the risk of dementia, Alzheimer¡¯s disease (AD) and vascular dementia (VaD), and examined the effect of borderline diabetes on the risk of dementia and AD. The data of this thesis were derived from the Kungsholmen Project (Studies I, II, and III) and from the HARMONY Study (Study IV). The Kungsholmen Project is a community-based prospective study on aging and dementia in people aged ¡Ý75 years ...

  15. The contribution of process tracing to theory-based evaluations of complex aid instruments

    DEFF Research Database (Denmark)

    Beach, Derek; Schmitt, Johannes

    2015-01-01

    This article focuses on methodological challenges in evaluating complex program aid interventions like budget support. We show that recent innovations in process-tracing methodology can help to solve the identified challenges and increase the strength of causal inference made when using case...... studies in demanding settings. For the specific task of evaluating the governance effectiveness of budget support interventions, we developed a more fine-grained causal mechanism for a subset of the comprehensive program theory of budget support. Moreover, based on the informal use of Bayesian logic, we...... remedy some of the problems at hand in much case-study research and increase the inferential leverage in complex within-case evaluation studies....

  16. Coincidental Observation of Global Hypometabolism in the Brain on PET/CT of an AIDS Patient With High-Grade Pulmonary Non-Hodgkin Lymphoma.

    Science.gov (United States)

    Chandra, Piyush; Agrawal, Archi; Purandare, Nilendu; Shah, Sneha; Rangarajan, Venkatesh

    2016-08-01

    AIDS-related dementia complex is the most severe form of cognitive dysfunction in a patient infected with human immunodeficiency virus. The use of FDG PET/CT to diagnose AIDS-related dementia complex has been studied previously and shows various specific metabolic patterns from striatal hypermetabolism in early asymptomatic stage to global hypometabolism in advanced stages. We present a case of a 49-year-old patient with long-standing human immunodeficiency virus infection, where global brain hypometabolism was noted coincidentally on FDG PET/CT done for initial staging of primary pulmonary non-Hodgkin lymphoma. PMID:27280906

  17. Improving the identification of people with dementia in primary care: evaluation of the impact of primary care dementia coding guidance on identified prevalence

    OpenAIRE

    Russell, Paul; Banerjee, Sube; Watt, Jen; Adleman, Rosalyn; Agoe, Belinda; Burnie, Nerida; Carefull, Alex; Chandan, Kiran; Constable, Dominie; Daniels, Mark; Davies, David; Deshmukh, Sid; Huddart, Martin; Jabin, Ashrafi; Jarrett, Penelope

    2013-01-01

    Objective Improving dementia care is a policy priority nationally and internationally; there is a ‘diagnosis gap’ with less than half of the cases of dementia ever diagnosed. The English Health Department's Quality and Outcomes Framework (QOF) encourages primary care recognition and recording of dementia. The codes for dementia are complex with the possibility of underidentification through miscoding. We developed guidance on coding of dementia; we report the impact of applying this to ‘clean...

  18. Centered Kernel Alignment Enhancing Neural Network Pretraining for MRI-Based Dementia Diagnosis

    Science.gov (United States)

    Cárdenas-Peña, David; Collazos-Huertas, Diego; Castellanos-Dominguez, German

    2016-01-01

    Dementia is a growing problem that affects elderly people worldwide. More accurate evaluation of dementia diagnosis can help during the medical examination. Several methods for computer-aided dementia diagnosis have been proposed using resonance imaging scans to discriminate between patients with Alzheimer's disease (AD) or mild cognitive impairment (MCI) and healthy controls (NC). Nonetheless, the computer-aided diagnosis is especially challenging because of the heterogeneous and intermediate nature of MCI. We address the automated dementia diagnosis by introducing a novel supervised pretraining approach that takes advantage of the artificial neural network (ANN) for complex classification tasks. The proposal initializes an ANN based on linear projections to achieve more discriminating spaces. Such projections are estimated by maximizing the centered kernel alignment criterion that assesses the affinity between the resonance imaging data kernel matrix and the label target matrix. As a result, the performed linear embedding allows accounting for features that contribute the most to the MCI class discrimination. We compare the supervised pretraining approach to two unsupervised initialization methods (autoencoders and Principal Component Analysis) and against the best four performing classification methods of the 2014 CADDementia challenge. As a result, our proposal outperforms all the baselines (7% of classification accuracy and area under the receiver-operating-characteristic curve) at the time it reduces the class biasing. PMID:27148392

  19. Filler modification for papermaking with starch/oleic acid complexes with the aid of calcium ions.

    Science.gov (United States)

    Huang, Xiujie; Shen, Jing; Qian, Xueren

    2013-10-15

    To mitigate the negative effect of filler addition on paper strength and improve filler retention, filler modification with hydrogen bonding polymers (e.g., starch) or their composites is an interesting research topic. Differing from previous reports, the concept related to the deposition of starch/oleic acid complexes on precipitated calcium carbonate (PCC) with the aid of calcium ions was demonstrated. The introduction of calcium ions resulted in effective starch deposition. As a result of filler modification, filler retention and the tensile strength of the filled paper were simultaneously improved essentially due to the aggregation of PCC particles in filler modification process as well as improved filler bondability. The concept demonstrated in this brief study may provide an alternative approach to filler bondability enhancement for improved papermaking performances. PMID:23987430

  20. Update on Vascular Dementia.

    Science.gov (United States)

    Khan, Ayesha; Kalaria, Raj N; Corbett, Anne; Ballard, Clive

    2016-09-01

    Vascular dementia (VaD) is a major contributor to the dementia syndrome and is described as having problems with reasoning, planning, judgment, and memory caused by impaired blood flow to the brain and damage to the blood vessels resulting from events such as stroke. There are a variety of etiologies that contribute to the development of vascular cognitive impairment and VaD, and these are often associated with other dementia-related pathologies such as Alzheimer disease. The diagnosis of VaD is difficult due to the number and types of lesions and their locations in the brain. Factors that increase the risk of vascular diseases such as stroke, high blood pressure, high cholesterol, and smoking also raise the risk of VaD. Therefore, controlling these risk factors can help lower the chances of developing VaD. This update describes the subtypes of VaD, with details of their complex presentation, associated pathological lesions, and issues with diagnosis, prevention, and treatment. PMID:27502303

  1. Multi-Infarct Dementia

    Science.gov (United States)

    ... Diversity Find People About NINDS NINDS Multi-Infarct Dementia Information Page Synonym(s): Dementia - Multi-Infarct Table of ... Additional resources from MedlinePlus What is Multi-Infarct Dementia? Multi-infarct dementia (MID) is a common cause ...

  2. Functional Neuroimaging in Dementia

    NARCIS (Netherlands)

    J.M. Papma (Janne)

    2012-01-01

    textabstractDementia refers to a clinical syndrome of cognitive deterioration and difficulty in the performance of activities of daily living. The most common cause of dementia is Alzheimer’s disease (AD), followed by vascular dementia (VaD) at old age and frontotemporal dementia (FTD) at young onse

  3. Development cooperation for health: reviewing a dynamic concept in a complex global aid environment

    Directory of Open Access Journals (Sweden)

    Hill Peter S

    2012-03-01

    Full Text Available Abstract The 4th High Level Forum on Aid Effectiveness, held in Busan, South Korea in November 2011 again promised an opportunity for a "new consensus on development cooperation" to emerge. This paper reviews the recent evolution of the concept of coordination for development assistance in health as the basis from which to understand current discourses. The paper reviews peer-reviewed scientific literature and relevant 'grey' literature, revisiting landmark publications and influential authors, examining the transitions in the conceptualisation of coordination, and the related changes in development assistance. Four distinct transitions in the understanding, orientation and application of coordination have been identified: coordination within the sector, involving geographical zoning, sub-sector specialisation, donor consortia, project co-financing, sector aid, harmonisation of procedures, ear-marked budgetary support, donor agency reform and inter-agency intelligence gathering; sector-wide coordination, expressed particularly through the Sector-Wide Approach; coordination across sectors at national level, expressed in the evolution of Poverty Strategy Reduction Papers and the national monitoring of the Millennium Development Goals; and, most recently, global-level coordination, embodied in the Paris Principles, and the emergence of agencies such as the International Health Partnerships Plus. The transitions are largely but not strictly chronological, and each draws on earlier elements, in ways that are redefined in the new context. With the increasing complexity of both the territory of global health and its governance, and increasing stakeholders and networks, current imaginings of coordination are again being challenged. The High Level Forum in Busan may have been successful in recognising a much more complex landscape for development than previously conceived, but the challenges to coordination remain.

  4. Neuroimaging in Dementia

    OpenAIRE

    Tartaglia, Maria Carmela; Rosen, Howard J.; Miller, Bruce L.

    2011-01-01

    Summary Dementia is a common illness with an incidence that is rising as the aged population increases. There are a number of neurodegenerative diseases that cause dementia, including Alzheimer’s disease, dementia with Lewy bodies, and frontotemporal dementia, which is subdivided into the behavioral variant, the semantic variant, and nonfluent variant. Numerous other neurodegenerative illnesses have an associated dementia, including corticobasal degeneration, Creutzfeldt–Jakob disease, Huntin...

  5. Dysfunctions associated with dementia and their treatment

    Directory of Open Access Journals (Sweden)

    Roksana Malak

    2014-11-01

    Full Text Available [u]International UnderstAID project shows[/u] the role of physiotherapist in patients with dementia as divided into two branches: helping to resolve the physical problems and solving the problems related to dementia. The role of physiotherapist in dementia treatment may be divided into two branches: helping to resolve the physical problems and solving the problems related to dementia. The physical problems consider such aspects as musculoskeletal disorders, mobility dysfunction and pain. Referring to musculoskeletal problems, the interventions of physical therapists should included whole-body progressive resistance exercise training, strengthening, “range-of-motion” and stretching exercises and transfer training. Mobility disorders are associated with physical symptoms such as: rigidity, balance problem, shuffling gait. Decreased mobility can be based on unrelieved pain. These are some crucial scales which are designed to detected the pain. For instance, The Pain Assessment in Advanced Dementia. Transcutaneous Electrical Nerve Stimulation, massage or exercises can be provide to reduce the pain in patients with dementia. Physiotherapy in dementia treatment influences not only physical functions but also the maintenance or progression of cognitive abilities of demented elderly subjects

  6. Automated a complex computer aided design concept generated using macros programming

    International Nuclear Information System (INIS)

    Changing a complex Computer Aided design profile such as car and aircraft surfaces has always been difficult and challenging. The capability of CAD software such as AutoCAD and CATIA show that a simple configuration of a CAD design can be easily modified without hassle, but it is not the case with complex design configuration. Design changes help users to test and explore various configurations of the design concept before the production of a model. The purpose of this study is to look into macros programming as parametric method of the commercial aircraft design. Macros programming is a method where the configurations of the design are done by recording a script of commands, editing the data value and adding a certain new command line to create an element of parametric design. The steps and the procedure to create a macro programming are discussed, besides looking into some difficulties during the process of creation and advantage of its usage. Generally, the advantages of macros programming as a method of parametric design are; allowing flexibility for design exploration, increasing the usability of the design solution, allowing proper contained by the model while restricting others and real time feedback changes

  7. Automated a complex computer aided design concept generated using macros programming

    Science.gov (United States)

    Rizal Ramly, Mohammad; Asrokin, Azharrudin; Abd Rahman, Safura; Zulkifly, Nurul Ain Md

    2013-12-01

    Changing a complex Computer Aided design profile such as car and aircraft surfaces has always been difficult and challenging. The capability of CAD software such as AutoCAD and CATIA show that a simple configuration of a CAD design can be easily modified without hassle, but it is not the case with complex design configuration. Design changes help users to test and explore various configurations of the design concept before the production of a model. The purpose of this study is to look into macros programming as parametric method of the commercial aircraft design. Macros programming is a method where the configurations of the design are done by recording a script of commands, editing the data value and adding a certain new command line to create an element of parametric design. The steps and the procedure to create a macro programming are discussed, besides looking into some difficulties during the process of creation and advantage of its usage. Generally, the advantages of macros programming as a method of parametric design are; allowing flexibility for design exploration, increasing the usability of the design solution, allowing proper contained by the model while restricting others and real time feedback changes.

  8. Computer aided root lesion detection using level set and complex wavelets

    Science.gov (United States)

    Li, Shuo; Fevens, Thomas; Krzyżak, Adam; Jin, Chao; Li, Song

    2007-03-01

    A computer aided root lesion detection method for digital dental X-rays is proposed using level set and complex wavelets. The detection method consists of two stages: preprocessing and root lesion detection. During preprocessing, a level set segmentation is applied to separate the teeth from the background. Tailored for the dental clinical environment, a segmentation clinical acceleration scheme is applied by using a support vector machine (SVM) classifier and individual principal component analysis (PCA) to provide an initial contour. Then, based on the segmentation result, root lesion detection is performed. Firstly, the teeth are isolated by the average intensity profile. Secondly, a center-line zero crossing based candidate generation is applied to generate the possible root lesion areas. Thirdly, the Dual-Tree Complex Wavelets Transform (DT-CWT) is used to further remove false positives. Lastly when the root lesion is detected, the area of root lesion is automatically marked with color indication representing different levels of seriousness. 150 real dental X-rays with various degrees of root lesions are used to test the proposed method. The results were validated by the dentist. Experimental results show that the proposed method is able to successfully detect the root lesion and provide visual assistance to the dentist.

  9. Personality and dementia.

    Science.gov (United States)

    Cipriani, Gabriele; Borin, Gemma; Del Debbio, Alessandro; Di Fiorino, Mario

    2015-03-01

    Personality describes persistent human behavioral responses to broad classes of environmental stimuli. Change in personality may be an early sign of dementia. Our goal was to review scientific literature on the association between personality and dementia. Medline and Google Scholar searches were conducted for relevant articles, chapters, and books published since 1980. Search terms used included personality, dementia, Alzheimer's disease, frontotemporal dementia, dementia with Lewy bodies. People with dementia commonly exhibit changes in personality that sometimes precede the other early clinical manifestations of the condition, such as cognitive impairment. Premorbid personality might be a determining factor so that caricature or exaggeration of original personality emerges as dementia progresses. Although it is generally accepted that these personality changes reflect the impact of progressive brain damage, there are several possible patterns of personality alterations with dementia. Early identification of personality modifications might assist with the timely diagnosis of dementia. PMID:25714255

  10. FDG PET imaging dementia

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Byeong Cheol [Kyungpook National University Medical School and Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2007-04-15

    Dementia is a major burden for many countries including South Korea, where life expectancy is continuously growing and the proportion of aged people is rapidly growing. Neurodegenerative disorders, such as, Alzheimer disease, dementia with Lewy bodies, frontotemporal dementia. Parkinson disease, progressive supranuclear palsy, corticobasal degeneration, Huntington disease, can cause dementia, and cerebrovascular disease also can cause dementia. Depression or hypothyroidism also can cause cognitive deficits, but they are reversible by management of underlying cause unlike the forementioned dementias. Therefore these are called pseudodementia. We are entering an era of dementia care that will be based upon the identification of potentially modifiable risk factors and early disease markers, and the application of new drugs postpone progression of dementias or target specific proteins that cause dementia. Efficient pharmacologic treatment of dementia needs not only to distinguish underlying causes of dementia but also to be installed as soon as possible. Therefore, differential diagnosis and early diagnosis of dementia are utmost importance. F-18 FDG PET is useful for clarifying dementing diseases and is also useful for early detection of the disease. Purpose of this article is to review the current value of FDG PET for dementing diseases including differential diagnosis of dementia and prediction of evolving dementia.

  11. FDG PET imaging dementia

    International Nuclear Information System (INIS)

    Dementia is a major burden for many countries including South Korea, where life expectancy is continuously growing and the proportion of aged people is rapidly growing. Neurodegenerative disorders, such as, Alzheimer disease, dementia with Lewy bodies, frontotemporal dementia. Parkinson disease, progressive supranuclear palsy, corticobasal degeneration, Huntington disease, can cause dementia, and cerebrovascular disease also can cause dementia. Depression or hypothyroidism also can cause cognitive deficits, but they are reversible by management of underlying cause unlike the forementioned dementias. Therefore these are called pseudodementia. We are entering an era of dementia care that will be based upon the identification of potentially modifiable risk factors and early disease markers, and the application of new drugs postpone progression of dementias or target specific proteins that cause dementia. Efficient pharmacologic treatment of dementia needs not only to distinguish underlying causes of dementia but also to be installed as soon as possible. Therefore, differential diagnosis and early diagnosis of dementia are utmost importance. F-18 FDG PET is useful for clarifying dementing diseases and is also useful for early detection of the disease. Purpose of this article is to review the current value of FDG PET for dementing diseases including differential diagnosis of dementia and prediction of evolving dementia

  12. Symptoms of Lewy Body Dementia

    Science.gov (United States)

    ... Lewy body dementia now! Donate Symptoms Lewy body dementia symptoms and diagnostic criteria Every person with LBD ... an umbrella term for two related clinical diagnoses, dementia with Lewy bodies and Parkinson's disease dementia. The ...

  13. Optimizing the mobility of residents with dementia: a pilot study promoting healthcare aide uptake of a simple mobility innovation in diverse nursing home settings

    OpenAIRE

    Slaughter, Susan E; Estabrooks, Carole A

    2013-01-01

    Background Almost 90 percent of nursing home residents have some type of mobility limitation. Many spend most of their waking hours lying in bed or sitting. Such inactivity can negatively affect residents’ health and general well-being. This pilot study aimed to assess (1) the effect of the sit-to-stand activity on mobility outcomes of nursing home residents, (2) the effect of an audit-and-feedback intervention on uptake of the sit-to-stand activity by healthcare aides, and (3) the contextual...

  14. Dementia in Taiwan area

    Institute of Scientific and Technical Information of China (English)

    Yuanhan Yang

    2016-01-01

    Objective:Taiwan has an increasing aging population like other developed areas. The aging population will lead to an increased prevalence of dementia. Methods:This article will reflect the status of dementia in Taiwan, including updated epidemiology, diagnosis, subtypes, and optimal treatment of dementia. Results:The article also describes and interprets the Taiwan Dementia Policy to establish a clear, large view of the current state of management of dementia in Taiwan and future policy implementation. Conclusion:A comprehensive policy to dementia, from the basic researches to clinical care and treatment, is necessary to the increased aged population in Taiwan.

  15. Anosognosia in Dementia.

    Science.gov (United States)

    Wilson, Robert S; Sytsma, Joel; Barnes, Lisa L; Boyle, Patricia A

    2016-09-01

    Progressive decline in memory (and other functions) is the defining feature of late-life dementia but affected individuals are often unaware of this impairment. This article reviews recent research on anosognosia in dementia, including methods of assessing anosognosia, its prevalence and developmental course in dementia, its occurrence in different forms of dementia, neuroimaging findings, and hypothesized component mechanisms. The results suggest that anosognosia is eventually exhibited by nearly all persons with dementia. Its occurrence is robustly associated with common dementia-related pathologies and damage to memory and self-referential brain networks and their interconnections. PMID:27438597

  16. Cerebral blood flow changes in Parkinson's disease associated with dementia

    International Nuclear Information System (INIS)

    Dementia is one of the main non-motor symptoms of Parkinson's disease (PD) and it is diagnosed in about 30% of cases. Its aetiology remains unclear and contributing factors are controversial. Dementia may be more common in old patients with severe motor symptoms and mild cognitive impairment. Clinico-pathological studies show the association between dementia in PD and the age-related group of dementias, such as AD and VaD. A valuable aid in the assessment of dementia in PD is cerebral blood flow (CBF) brain SPECT scanning. It shows three different patterns of rCBF reduction, including frontal lobe hypoperfusion, iu Alzheimer-likel type of hypoperfusion and multiple, vascular defects. The heterogeneity of rCBF reduction may reflect the multifactorial pathophysiology of dementia in PD. It may result from concomitant AD pathology, cerebrovascular disease, destruction of nigro-striato-frontal projection or may be a distinct disease of different aetiology. (author)

  17. Atypical parkinsonism of Japan: amyotrophic lateral sclerosis-parkinsonism-dementia complex of the Kii peninsula of Japan (Muro disease): an update.

    Science.gov (United States)

    Kuzuhara, Shigeki; Kokubo, Yasumasa

    2005-08-01

    An update of the endemic parkinsonism-dementia complex (PDC) frequently associated with amyotrophic lateral sclerosis (ALS) in the high prevalence ALS focus of the Kii peninsula of Japan is presented. The initial symptom was parkinsonian gait or hypobulia/amnesia, which was followed by akinesia, rigidity, occasional tremor, bradyphrenia, abulia and amnesia, and finally by akinetic mutism. In several years, most of the patients developed ALS symptoms such as muscle atrophy, bulbar palsy, and upper motor neuron signs. Magnetic resonance imaging and computed tomography of the brain showed marked atrophy of the temporal and frontal lobes and the cerebral blood flow reduction on single-photon emission computed tomography. Marked loss of nerve cells associated with abundant neurofibrillar tangles (NFTs) in the entire central nervous system, most predominantly in the brainstem and temporal lobe was characteristic. Concomitant ALS pathology involving the upper and lower motor neurons was common, and senile plaques were absent in most cases. NFTs consisted of twisted tubules on electron microscopy. Western blot of tau protein showed three bands consisting of six tau isoforms, similar to those of Alzheimer's disease. A family history of ALS/PDC was recorded in more than 70% of patients, but no abnormal mutation or polymorphism was found in the genes of SOD1, tau, and apolipoprotein E. Familial nature and continuing morbidity of Kii ALS/PDC suggest that genetic factors may be more likely in its pathogenesis. PMID:16092099

  18. HIV-1 associated dementia: symptoms and causes

    OpenAIRE

    Khalili Kamel; Amini Shohreh; Ghafouri Mohammad; Sawaya Bassel E

    2006-01-01

    Abstract Despite the use of highly active antiretroviral therapy (HAART), neuronal cell death remains a problem that is frequently found in the brains of HIV-1-infected patients. HAART has successfully prevented many of the former end-stage complications of AIDS, however, with increased survival times, the prevalence of minor HIV-1 associated cognitive impairment appears to be rising among AIDS patients. Further, HIV-1 associated dementia (HAD) is still prevalent in treated patients as well a...

  19. [Dementia and human inmmunodeficiency virus infection].

    Science.gov (United States)

    Gray, F

    1998-01-01

    HIV-associated neurological manifestations: dementia, myelopathy, and neuropathy, have become one of the commonest causes of neurological disorders in young people. Cognitive impairment develops in about 30 p. 100 of patients with AIDS and frank dementia in 15 to 20 p. 100 with an annual incidence after AIDS of approximatively 7 p. 100. Typically, the onset of dementia is relatively abrupt over a few weeks or months. The clinical manifestations of the encephalopathy now termed "HIV-dementia", suggest predominant subcortical or frontal involvement. Typical presentation includes apathy and inertia, memory loss and cognitive slowing, minor depressive symptoms and withdrawal from usual activities. Neurological examination may show hypertonia of lower limbs, tremor, clonus, frontal release signs and hyperactive reflexes. Terminally, the patient is bedbound, incontinent, abulic or mute with decorticate posturing leading to death over 3 to 6 months. However, a stabilisation and even a regression of the cognitive disorders have been observed following antiretroviral treatment. Radiological features of HIV dementia include both central and cortical atrophy and white matter rarefaction. However they are neither invariable nor specific. Together with CSF examination, they are more important to exclude opportunistic infections. Indeed, although a completely normal CSF profile may reasonably exclude the diagnosis; at present, no single test or combination of tests can reliably diagnose HIV dementia. Although the clinical characteristics of HIV-dementia are now clearly established, its pathogenesis is unclear and its pathological counterpart remains a matter of debate. A number of "HIV-induced" lesions may be found in the brain of AIDS patients and their causative role in HIV-dementia has been considered. They include HIV encephalitis due to productive CNS infection by the virus, diffuse white matter pallor "HIV-leukoencephalopathy" reflecting an abnormality of the blood brain

  20. Sexuality and Dementia

    Science.gov (United States)

    ... A + A You are here Home Sexuality and Dementia Printer-friendly version Coping with Changes in Your ... said Jerry, who cared for his wife with dementia. At a recent conference of the Caregiver Resource ...

  1. Lewy Body Dementia Association

    Science.gov (United States)

    ... promoting scientific advances. Featured LBD Stories & Tributes Dad's Dementia Journey It's been years since my father passed ... I received an email from the Lewy Body Dementia Association about a benefit... Read Story The Lewy ...

  2. Lewy Body Dementia Research

    Science.gov (United States)

    ... Research Abstracts Clinical Trials Help end Lewy body dementia now! Donate Research Links Treating Psychosis in Parkinson’s ... The use of antipsychotic medications in Lewy body dementias is a known challenge. Are the medications helpful ...

  3. Dementia: Diagnosis and Tests

    Science.gov (United States)

    ... our e-newsletter! Aging & Health A to Z Dementia Diagnosis & Tests If you or someone you care ... To determine whether an older adult might have dementia, a healthcare professional will: Ask about the person’s ...

  4. Dementia - daily care

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000030.htm Dementia - daily care To use the sharing features on ... prevent choking. Tips for Talking with Someone with Dementia Keep distractions and noise down: Turn off the ...

  5. Dementia and driving

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000028.htm Dementia and driving To use the sharing features on ... please enable JavaScript. If your loved one has dementia, deciding when they can no longer drive may ...

  6. Parkinson's Disease Dementia

    Science.gov (United States)

    ... TDP43-related Dementia 2013 Andrew Watt Characterisation of Tau Imaging Ligands for Alzheimer's Disease and other Dementias 2010 Marco Prado The Prion Protein as a Therapeutic Target in Alzheimer's Disease 2007 ...

  7. Mycobacterium avium complex (MAC): an unusual potential pathogen in cerebrospinal fluid of AIDS patients Complexo Mycobacterium avium: um patógeno potencial pouco comum no líquido céfalo -raquidiano de pacientes com AIDS

    OpenAIRE

    David Jamil Hadad; Tereza Cristina Petry; Anaenza Freie Maresca; Lucilaine Ferrazoli; Maria Conceição Martins; Maria Cecilia de Almeida Palhares; Walkyria Pereira Pinto; Adauto Castelo Filho; Moises Palaci

    1995-01-01

    Mycobacterium avium complex (MAC) is frequently isolated from patients with late complications of Acquired Immunodeficiency Syndrome (AIDS), especially in North America and Europe. However, its isolation from the central nervous system (CNS) has been seldom reported in these countries. MAC infections in AIDS patients in African and Latin American countries are believed to be uncommon. We report the isolation of MAC from cerebrospinal fluid (CSF) of 11 AIDS patients out of 1723 (0.63%) seen at...

  8. SOLUBLE CD40 LIGAND IN DEMENTIA

    OpenAIRE

    Giunta, B.; Figueroa, K P; Town, T.; Tan, J.

    2009-01-01

    Some 15–20% of the population over the age of 65 years suffer from dementia, currently one of the leading causes of death behind cardiovascular diseases, cancer and cerebrovascular diseases. The major forms of dementia share in common overactivation of the CD40-CD40-L complex, leading to high levels of proinflammatory cytokine production by immune cells of the central nervous system (CNS), including microglia and astrocytes. Consequently, both neuronal survival and signaling are negatively af...

  9. Quantitative Proteomics Identifies Surfactant-Resistant α-Synuclein in Cerebral Cortex of Parkinsonism-Dementia Complex of Guam but Not Alzheimer’s Disease or Progressive Supranuclear Palsy

    Science.gov (United States)

    Yang, Wan; Woltjer, Randall L.; Sokal, Izabela; Pan, Catherine; Wang, Yan; Brodey, Mary; Peskind, Elaine R.; Leverenz, James B.; Zhang, Jing; Perl, Daniel P.; Galasko, Douglas R.; Montine, Thomas J.

    2007-01-01

    Parkinsonism-dementia complex (PDC) remains a significant health burden to the Chamorro population. We tested the hypothesis that quantitative proteomics might provide fresh insight into this enigmatic illness by analyzing proteins resistant to surfactant extraction from patients with Alzheimer’s disease (AD) or PDC and their matched controls using isobaric tags for relative and absolute quantification. In addition to the expected increase in abnormal frontal cortical Aβ peptides, tau, ubiquitin, and apolipoprotein E in AD, and tau in PDC, we identified α-synuclein (SNCA) as a major abnormal protein in PDC but not AD. We confirmed our isobaric tags for relative and absolute quantification findings by enzyme-linked immunosorbent assay in frontal and temporal cortices. We extended our assays to include a limited number of cases of progressive supranuclear palsy (PSP) and dementia with Lewy bodies; we observed increased abnormal tau but not SNCA in PSP, and abnormal SNCA in dementia with Lewy bodies that was quantitatively similar to PDC. Finally, soluble Aβ oligomers were selectively increased in AD but not PDC or PSP. These results show that frontal and temporal cortex in PDC is distinguished from AD and PSP by its accumulation of abnormal SNCA and suggest that PDC be considered a synucleinopathy as well as a tauopathy. PMID:17675576

  10. Dementia beyond 2025: Knowledge and uncertainties.

    Science.gov (United States)

    Kenigsberg, Paul-Ariel; Aquino, Jean-Pierre; Bérard, Alain; Gzil, Fabrice; Andrieu, Sandrine; Banerjee, Sube; Brémond, François; Buée, Luc; Cohen-Mansfield, Jiska; Mangialasche, Francesca; Platel, Hervé; Salmon, Eric; Robert, Philippe

    2016-01-01

    Given that there may well be no significant advances in drug development before 2025, prevention of dementia-Alzheimer's disease through the management of vascular and lifestyle-related risk factors may be a more realistic goal than treatment. Level of education and cognitive reserve assessment in neuropsychological testing deserve attention, as well as cultural, social, and economic aspects of caregiving. Assistive technologies for dementia care remain complex. Serious games are emerging as virtual educational and pleasurable tools, designed for individual and cooperative skill building. Public policies are likely to pursue improving awareness and understanding of dementia; providing good quality early diagnosis and intervention for all; improving quality of care from diagnosis to the end of life, using clinical and economic end points; delivering dementia strategies quicker, with an impact on more people. Dementia should remain presented as a stand-alone concept, distinct from frailty or loss of autonomy. The basic science of sensory impairment and social engagement in people with dementia needs to be developed. E-learning and serious games programs may enhance public and professional education. Faced with funding shortage, new professional dynamics and economic models may emerge through coordinated, flexible research networks. Psychosocial research could be viewed as an investment in quality of care, rather than an academic achievement in a few centers of excellence. This would help provide a competitive advantage to the best operators. Stemming from care needs, a logical, systems approach to dementia care environment through organizational, architectural, and psychosocial interventions may be developed, to help reduce symptoms in people with dementia and enhance quality of life. Dementia-friendly environments, culture, and domesticity are key factors for such interventions. PMID:25740575

  11. Hearing and music in dementia

    OpenAIRE

    Johnson, Julene K.; Chow, Maggie L.

    2015-01-01

    Music is a complex acoustic signal that relies on a number of different brain and cognitive processes to create the sensation of hearing. Changes in hearing function are generally not a major focus of concern for persons with a majority of neurodegenerative diseases associated with dementia, such as Alzheimer disease (AD). However, changes in the processing of sounds may be an early, and possibly preclinical, feature of AD and other neurodegenerative diseases. The aim of this chapter is to re...

  12. Radio elements / bottom salts separation by nano-filtration aided by complexation in a highly saline environment

    International Nuclear Information System (INIS)

    This research thesis addresses the use of a membrane-based technique, nano-filtration, aided or not by complexation, for the processing of highly saline liquid effluents produced by radio-chemical decontamination. The objective is to separate non-radioactive elements (sodium nitrate) from radio-elements (caesium, strontium and actinides) in order to reduce the volume of wastes. Within the perspective of an industrial application, a system to concentrate the effluent is firstly defined. Different nano-filtration membranes are tested and reveal to be insufficient in highly saline environment. A stage of selective complexation of radio-elements is therefore considered before nano-filtration. The main factors affecting performance of nano-filtration-complexation (for a given membrane system) are identified: ionic force, pH, ligand content, trans-membrane pressure. Finally, a nano-filtration pilot is implemented to perform nano-filtration-complexation operations by remote handling on radioactive substances

  13. Music and dementia.

    Science.gov (United States)

    Baird, Amee; Samson, Séverine

    2015-01-01

    There is an increasing incidence of dementia in our aging population, and consequently an urgent need to develop treatments and activities that may alleviate the symptoms of dementia. Accumulating evidence shows that persons with dementia enjoy music, and their ability to respond to music is potentially preserved even in the late or severe stages of dementia when verbal communication may have ceased. Media interest in this topic has contributed to the public perception that music abilities are an "island of preservation" in an otherwise cognitively impaired person with dementia. In this chapter, we review the current literature on music cognition in dementia and show that there has been very scarce rigorous scientific investigation of this issue, and that various types of music memory exist and are differentially impaired in the different types of dementia. Furthermore, we discuss the recent development of music activities as a nonpharmacological treatment for dementia and highlight the methodological limitations of the current literature on this topic. While it has been reported that music activities can improve behavior, (particularly agitation), mood, and cognition in persons with dementia, recent large-scale randomized control studies have questioned the specificity of the effect of music and found that it is no more beneficial than other pleasant activities. Nevertheless, music is unique in its powerful ability to elicit both memories and emotions. This can provide an important link to individual's past and a means of nonverbal communication with carers, which make it an ideal stimulus for persons with dementia. PMID:25725917

  14. Dementia: role of MRI

    International Nuclear Information System (INIS)

    Full text: This presentation will focus on the role of MRI in the diagnosis of dementia and related diseases. We will discuss the following subjects: 1. Systematic assessment of MR in dementia 2. MR protocol for dementia 3. Typical findings in the most common dementia syndrome Alzheimer's disease (AD), Vascular Dementia (VaD), Frontotemporal lobe dementia (FTLD) 4. Short overview of neurodegenerative disorders which may be associated with dementia. The role of neuroimaging in dementia nowadays extends to support the diagnosis of specific neurodegenerative disorders. It is a challenge to the early diagnosis of neurodegenerative diseases such as Alzheimer's disease. Early diagnosis includes recognition of predementia conditions, such as mild cognitive impairment (MCI). Neuroimaging may also be used to assess disease progression and is adopted in current trials investigating MCI and AD. An MR-study of a patient suspected of having dementia must be assessed in a standardized way. First of all, treatable diseases like subdural hematomas, tumors and hydrocephalus need to be excluded. Next we should look for signs of specific dementias such as: Alzheimer's disease (AD): medial temporal lobe atrophy (MTA) and parietal atrophy. Frontotemporal Lobar Degeneration (FTLD): (asymmetric) frontal lobe atrophy and atrophy of the temporal pole. Vascular Dementia (VaD): global atrophy, diffuse white matter lesions, lacunas and 'strategic infarcts' (infarcts in regions that are involved in cognitive function). Dementia with Lewy bodies (DLB): in contrast to other forms of dementia usually no specific abnormalities. So when we study the MR images we should score in a systematic way for global atrophy, focal atrophy and for vascular disease (i.e. infarcts, white matter lesions, lacunas)

  15. Couples with dementia: Positioning the 'we'.

    Science.gov (United States)

    Hydén, Lars-Christer; Nilsson, Elin

    2015-11-01

    The aim of this article is to investigate how spouses in couples with dementia position themselves in relation to each other by analysing their use of pronouns, especially the we. The study uses joint interviews with 11 couples. Based on a quantitative analysis of pronoun use, it is argued that the pronoun we is used by all the spouses; however, it is used less frequently by the spouses with dementia in comparison with healthy spouses. A qualitative analysis of the use of the pronoun we shows that the spouses position, experience and consider themselves as a couple and that they position and experience themselves as individuals in relation to the couple. One of the challenges for couples with dementia is to be able to retain a we in face of the progression of the dementia disease. By positioning themselves in various ways, the spouses establish and negotiate quite a complex and emotionally charged web of relationships. PMID:24339120

  16. Will General Practitioners Be Adequately Prepared to Meet the Complexities of Enhanced Dementia Screening for People with Learning Disabilities and Down Syndrome: Key Considerations

    Science.gov (United States)

    Rowe, Michelle

    2016-01-01

    This article provides a timely response in regard to the Department of Health's current initiative to financially reward GPs to prioritise and undertake dementia screening for people with learning disabilities over the age of 50 years and for people with Down syndrome over the age of 40 years. Whilst GPs are becoming increasingly aware of their…

  17. Dementia: Unique to Older Adults

    Science.gov (United States)

    ... our e-newsletter! Aging & Health A to Z Dementia Unique to Older Adults This section provides information ... Managing Additional Health Problems in Older Adults with Dementia Dementia is rare in adults younger than 60. ...

  18. Dementia and diabetes mellitus

    OpenAIRE

    Pavlović Dragan M.; Pavlović Aleksandra M.

    2008-01-01

    Dementia and Diabetes mellitus (DM) are major health problems nowadays. DM leads to a significant cognitive decline and increases the risk of dementia, mostly Alzheimer's Disease (AD) and vascular dementia (VaD) by 50-100% and 100-150%, respectively. Amyloid beta (Abeta), the main pathogenic factor in AD development, is eliminated by advanced glycation end products (AGEs) and degraded by insulin degrading enzyme (IDE) for which it competes with insulin. Insulin stimulates secretion of Abeta a...

  19. Neuroimaging in Dementia

    OpenAIRE

    Vitali, Paolo; Migliaccio, Raffaella; Agosta, Federica; Rosen, Howard J.; Geschwind, Michael D.

    2008-01-01

    Although dementia is a clinical diagnosis, neuroimaging often is crucial for proper assessment. Magnetic resonance imaging (MRI) and computed tomography (CT) may identify nondegenerative and potentially treatable causes of dementia. Recent neuroimaging advances, such as the Pittsburgh Compound-B (PIB) ligand for positron emission tomography imaging in Alzheimer’s disease, will improve our ability to differentiate among the neurodegenerative dementias. High-resolution volumetric MRI has increa...

  20. Dementia in Qatar

    International Nuclear Information System (INIS)

    Dementia is the major public health problem among the elderly in developed countries and a growing problem in the underdeveloped countries. There are no published data on dementia in any of the Arab countries. The aim of this study was to determine the different subtypes of dementia among Qataris. A retrospective and prospective ongoing hospital based study in which all medical records of the patients with diagnosis of dementia seen at the Hamad General Hospital, Doha, Qatar, between June 1997 and June 2003, whether inpatient and outpatient were reviewed. Dementia was defined according to diagnostic and statistical manual (DSM) IV criteria. Those who had dementia were evaluated by a psychologist, psychiatrist, neurologist and a geriatrician. All had brain computerized tomography, magnetic resonance imaging or both and routine blood test. Finally, they were classified into sub-types according to the cause of dementia. One of 300 patients, 134 fulfilled the inclusion criteria, most of them were illiterate, married and non-smokers. Among those dementia sub-types were: Alzheimer disease (AD) 39 (29%), vascular dementia (VaD) 30 (22%), mixed AD and VaD 20 (15%) and Parkinson's disease with dementia due to other medical conditions. Our stidy showed that AD is more prevalent than VaD. It also showed that patients and their families seek medical help late due to to the general belief among the public that forgetfulness and other associated cognitive impairment are part of normal aging process. The emergence of new drugs and advancement in prevention of cerebrovascular diseases make early diagnosis of dementia sub-type important. A community based study to show the real prevalence and incidence of sub-types of dementia is highly indicated. These data are necessory for planning and setting up community services and health care programs for demented patients. (author)

  1. Cerebral imaging and dementia

    Energy Technology Data Exchange (ETDEWEB)

    Rascol, A.; Celsis, P.; Berry, I.

    1989-02-01

    Modern imaging techniques undoubtedly are of value when applied to the study of dementia. This value, however, varies with the technique utilized, and one must distinguish between acquired and potential knowledge. Morphological imaging with computerized tomography or magnetic resonance detects or confirms certain causes of dementia (tumours, lacunae, hydrocephalus with normal CSF pressure), but it is still not sensitive and specific enough to be very useful in primary dementias. Functional imaging (essentially with emission tomography) has already provided interesting data in the study of degenerative dementia (correlations with neuropsychology, subtyping), but what is most promising is its possibilities in the physiopathological approach of the disease.

  2. Cerebral imaging and dementia

    International Nuclear Information System (INIS)

    Modern imaging techniques undoubtedly are of value when applied to the study of dementia. This value, however, varies with the technique utilized, and one must distinguish between acquired and potential knowledge. Morphological imaging with computerized tomography or magnetic resonance detects or confirms certain causes of dementia (tumours, lacunae, hydrocephalus with normal CSF pressure), but it is still not sensitive and specific enough to be very useful in primary dementias. Functional imaging (essentially with emission tomography) has already provided interesting data in the study of degenerative dementia (correlations with neuropsychology, subtyping), but what is most promising is its possibilities in the physiopathological approach of the disease

  3. Hearing and music in dementia.

    Science.gov (United States)

    Johnson, Julene K; Chow, Maggie L

    2015-01-01

    Music is a complex acoustic signal that relies on a number of different brain and cognitive processes to create the sensation of hearing. Changes in hearing function are generally not a major focus of concern for persons with a majority of neurodegenerative diseases associated with dementia, such as Alzheimer disease (AD). However, changes in the processing of sounds may be an early, and possibly preclinical, feature of AD and other neurodegenerative diseases. The aim of this chapter is to review the current state of knowledge concerning hearing and music perception in persons who have a dementia as a result of a neurodegenerative disease. The review focuses on both peripheral and central auditory processing in common neurodegenerative diseases, with a particular focus on the processing of music and other non-verbal sounds. The chapter also reviews music interventions used for persons with neurodegenerative diseases. PMID:25726296

  4. Development cooperation for health: reviewing a dynamic concept in a complex global aid environment

    OpenAIRE

    Hill, Peter S.; Dodd, Rebecca; Brown, Scott; Haffeld, Just

    2012-01-01

    The 4th High Level Forum on Aid Effectiveness, held in Busan, South Korea in November 2011 again promised an opportunity for a "new consensus on development cooperation" to emerge. This paper reviews the recent evolution of the concept of coordination for development assistance in health as the basis from which to understand current discourses. The paper reviews peer-reviewed scientific literature and relevant 'grey' literature, revisiting landmark publications and influential authors, examin...

  5. Development cooperation for health: reviewing a dynamic concept in a complex global aid environment

    OpenAIRE

    Hill Peter S; Dodd Rebecca; Brown Scott; Haffeld Just

    2012-01-01

    Abstract The 4th High Level Forum on Aid Effectiveness, held in Busan, South Korea in November 2011 again promised an opportunity for a "new consensus on development cooperation" to emerge. This paper reviews the recent evolution of the concept of coordination for development assistance in health as the basis from which to understand current discourses. The paper reviews peer-reviewed scientific literature and relevant 'grey' literature, revisiting landmark publications and influential author...

  6. The Complexity of HIV Persistence and Pathogenesis in the Lung Under Antiretroviral Therapy: Challenges Beyond AIDS

    OpenAIRE

    Almodovar, Sharilyn

    2014-01-01

    Antiretroviral therapy (ART) represents a significant milestone in the battle against AIDS. However, we continue learning about HIV and confronting challenges 30 years after its discovery. HIV has cleverly tricked both the host immune system and ART. First, the many HIV subtypes and recombinant forms have different susceptibilities to antiretroviral drugs, which may represent an issue in countries where ART is just being introduced. Second, even under the suppressive pressures of ART, HIV sti...

  7. Cerebral perfusion scintigraphy and the exploration of dementia syndromes: An illustration with five clinical cases; Scintigraphie cerebrale de perfusion et exploration des syndromes dementiels: illustration a l'aide de cinq cas cliniques

    Energy Technology Data Exchange (ETDEWEB)

    Farid, K.; Perdrisot, R. [Centre Hospitalier Universitaire de Poitiers, Service de Medecine Nucleaire, 86 - Poitiers (France); Habert, M.O. [Centre Hospitalier Universitaire de Pitie-Salpetriere, Service de Medecine Nucleaire, 75 - Paris (France)

    2007-02-15

    The epidemiological evidence suggests that individuals with higher education level have a reduced risk of developing dementia. Because cognitive reserve and its compensation mechanisms may modulate the clinical expression in neuro-degenerative pathology, it is important to study subjects who present mild cognitive disturbance with functional imaging. The cerebral SPECT has been used to determine regional uptake of radiotracer into the brain of patients with cognitive impairment. These abnormalities of blood flow were correlated with cognitive impairment. The cerebral SPECT is also useful to investigate preclinical dementia and to predict the evolution of cognitive disturbance. This article, reports some technical and semeiological notions and illustrate with five clinical cases the scintigraphic aspect of some dementia syndrome. (authors)

  8. Emerging determinants of dementia

    NARCIS (Netherlands)

    R.F.A.G. de Bruijn (Renée)

    2015-01-01

    markdownabstractAbstract The aim of this thesis was two-fold. On the one hand, I wanted to explore the impact of known risk factors on dementia and on the other hand, I aimed to identify novel risk factors. Chapter 2 focuses on the impact of established risk factors of dementia. In Chapter 3, I

  9. Frontotemporal Dementias: Diagnosis

    Science.gov (United States)

    ... to be the second most common cause of early onset dementia. However, because of the wide range of symptoms and their gradual onset, FTD is often initially misdiagnosed as a psychiatric problem, Alzheimer’s disease, Parkinson’s disease or vascular dementia. FTD vs. Alzheimer’s Disease ...

  10. Structure-aided prediction of mammalian transcription factor complexes in conserved non-coding elements

    KAUST Repository

    Guturu, H.

    2013-11-11

    Mapping the DNA-binding preferences of transcription factor (TF) complexes is critical for deciphering the functions of cis-regulatory elements. Here, we developed a computational method that compares co-occurring motif spacings in conserved versus unconserved regions of the human genome to detect evolutionarily constrained binding sites of rigid TF complexes. Structural data were used to estimate TF complex physical plausibility, explore overlapping motif arrangements seldom tackled by non-structure-aware methods, and generate and analyse three-dimensional models of the predicted complexes bound to DNA. Using this approach, we predicted 422 physically realistic TF complex motifs at 18% false discovery rate, the majority of which (326, 77%) contain some sequence overlap between binding sites. The set of mostly novel complexes is enriched in known composite motifs, predictive of binding site configurations in TF-TF-DNA crystal structures, and supported by ChIP-seq datasets. Structural modelling revealed three cooperativity mechanisms: direct protein-protein interactions, potentially indirect interactions and \\'through-DNA\\' interactions. Indeed, 38% of the predicted complexes were found to contain four or more bases in which TF pairs appear to synergize through overlapping binding to the same DNA base pairs in opposite grooves or strands. Our TF complex and associated binding site predictions are available as a web resource at http://bejerano.stanford.edu/complex.

  11. Antidepressants and dementia

    DEFF Research Database (Denmark)

    2009-01-01

    BACKGROUND: It has been suggested that antidepressants may have neuroprotective abilities but it has newer been investigated lately whether treatment with antidepressants reduces the risk of dementia. METHOD: Linkage of registers of all prescribed antidepressants and diagnoses of dementia in...... Denmark during a period from 1995 to 2005. RESULTS: Persons who purchased antidepressants once (N=687,552) had an increased rate of dementia compared to persons unexposed to antidepressants (N=779,831). Nevertheless, the rate of dementia changed over time; thus during the initial prescription periods the...... rate increased with the number of prescriptions but continued long-term antidepressants treatment was associated with a reduction in the rate of dementia, however, not to the same level as the rate for the general population. This pattern was found for all classes of antidepressants (SSRIs, newer non...

  12. THEORETICAL BASICS OF THE DEVELOPMENT AND THE USE OF EDUCATIONAL-METHODICAL COMPLEX OF THE DISCIPLINE "FIRST AID BASICS "

    Directory of Open Access Journals (Sweden)

    V. A. BALABANOV

    2015-01-01

    Full Text Available The transition to a three-level system of higher education in the Russian Federation involves a number of tasks and functions related to the design, creation and organization of educational process, as well as implementation of new educational programs and the formation of a common educational space. Studies of the discipline "Basics of First Aid" as part of the basic educational program on specialty 280705 "Fire Safety" and the development of educational and methodical complex on this discipline are determined by the necessity to train highly qualified personnel in the field of elimination of consequences of emergency situations. Many-year experience in training shows that the teaching methods used for the training of medical staff (medical assistants, nurses, and especially doctors is unsuitable for training non-medical personnel. It is impossible to form a medical thinking within a short period of training, therefore, according to experts, the learning process in a technical college should be based on the principles of algorithmization, standardization and perfection of practical skills to automatic level. The article highlights the issues which determine the place and the role of the educational-methodical complex of the discipline "First Aid Basics" in the learning process, its structure and main functions.

  13. Collage as a Therapeutic Modality for Reminiscence in Patients with Dementia

    Science.gov (United States)

    Woolhiser Stallings, Jessica

    2010-01-01

    Traditional therapy, with its emphasis on verbal communication between therapist and client, may not be appropriate for patients with dementia due to impaired cognitive and verbal abilities. This brief report presents a qualitative study on the use of collage in art therapy to aid in the process of reminiscence in individuals with dementia. Data…

  14. A correlation of clinical, MRI and brain SPECT in dementia

    International Nuclear Information System (INIS)

    Background: Dementia is a clinical syndrome characterised by acquired impairment in multiple neuropsycologic and behavior domains including memory, language, speech, visuospatial ability, cognition and mood/personality. Dementia produces deficits in perfusion reflecting decreased metabolic needs. Neuroimaging techniques help in determining whether the cognitive symptoms are organic and in which pattern of cognitive loss the patient may evolve. AIM: To differentiate various types of Dementia, based on the regional perfusion abnormalities seen in Brain SPECT and correlate this with Clinical and MRI findings. Material and methods: Patients suffering from memory impairment and memory loss were referred to our department for Brain SPECT as a part of work up for Dementia. They had undergone a detailed clinical examination, psychometry, mini mental status examination (MMSE), memory/cognitive testing and an MRI. Brain SPECT was done after injecting Tc 99m ECD (Ethylene Cysteinate Dimer ) and imaging after 45 minutes. The images obtained were reconstructed in a conventional way. The various patterns of perfusion abnormalities seen in the SPECT images was studied and correlated with MRI and clinical findings. The patients were thus classified as having Multi Infarct Dementia, Alzheimer's disease, Fronto-Temporal Dementia and Mixed variety. Results: Twenty One Patients were included in our study from February 2003 to February 2004. The mean age of the patients was 73 years ( 37 to 81). 15 were males and 6 were females. Out of 21 patients, 12 had Multi Infarct Dementia, 4 had Alzheimer's disease, 1 had Fronto- Temporal Dementia and 4 had Mixed variety. Conclusion: Brain SPECT aids in substantiating the clinical findings and in correlation with MRI helps in distinguishing various types of Dementia and thus has prognostic implications and helps in instituting early appropriate treatment to the patient. In our study, the majority of the patients have Multi Infarct Dementia

  15. Operation and validation of the decision aid system 'CAIRE' in complex terrain

    International Nuclear Information System (INIS)

    In cases of nuclear emergencies it is the primary task of emergency response forces and decision making authorities to act properly. Based on telemetric surveillance networks, an advanced automatic on-line decision support system named CAIRE (Computer Aided Response to Emergencies) has been developed and is in operation now at 4 sites as a real time emergency response tool. This tool is designed to provide decision makers with precise radiation exposure data for the population at risk. Depending on the individual layout of the connected telemetric networks, CAIRE is able to satisfy the following main requirements: automatic identification of the source location and of the source term, automatic diagnosis of the actual radiological situation and identification of the endangered area, projection of the radiological situation, delivery of all this information in the form computer graphics. (R.P.)

  16. Carotid blood flow measured by an ultrasonic volume flowmeter in carotid stenosis and patients with dementia.

    OpenAIRE

    UEMATSU, S.; Folstein, M F

    1985-01-01

    The volume flowmeter is a simple, noninvasive Doppler ultrasound technique that provides accurate measurement of carotid artery diameter and flow. The device provides a useful laboratory test that can aid significantly in diagnosis of carotid stenosis and dementia.

  17. Dementia - home care

    Science.gov (United States)

    ... help improve communication skills and prevent wandering. Calming music may reduce wandering and restlessness, ease anxiety, and ... prevent falls Ways to improve bathroom safety The Alzheimer's Association's Safe Return Program requires people with dementia ...

  18. Lewy Body Dementia Glossary

    Science.gov (United States)

    ... as a symptom in brain disorders such as schizophrenia or dementia. Also called Capgras delusion . case management: ... cell that receives various molecules, such as neurotransmitters, hormones, or pharmaceuticals, which subsequently modify the cell's activity. ...

  19. Purification of complex biopharmaceuticals with new processes, advanced analytics and computer-aided process design tools

    OpenAIRE

    Martins, Duarte Lima

    2013-01-01

    Viruses are highly efficient vectors that have been used for vaccination and gene therapy applications. However, their complexity renders downstream process particularly challenging since devices and strategies especially designed for virus purification are still lacking or need further optimization. After an introduction to the challenges of virus purification and the current strategies being employed, this dissertation presents the study of three different stages of the downstream proces...

  20. White matter dementia

    OpenAIRE

    Filley, Christopher M.

    2012-01-01

    White matter dementia (WMD) is a syndrome introduced in 1988 to highlight the potential of cerebral white matter disorders to produce cognitive loss of sufficient severity to qualify as dementia. Neurologists have long understood that such a syndrome can occur, but the dominance of gray matter as the locus of higher function has strongly directed neurobehavioral inquiry to the cerebral cortex while white matter has received less attention. Contemporary neuroimaging has been crucial in enablin...

  1. Young onset dementia

    OpenAIRE

    Sampson, E; Warren, J.; Rossor, M

    2004-01-01

    Young onset dementia is a challenging clinical problem with potentially devastating medical and social consequences. The differential diagnosis is wide, and includes a number of rare sporadic and hereditary diseases. However, accurate diagnosis is often possible, and all patients should be thoroughly investigated to identify treatable processes. This review presents an approach to the diagnosis, investigation, and management of patients with young onset dementia, with particular reference to ...

  2. Pathophysiology of vascular dementia

    OpenAIRE

    Rizzo Claudia; Duro Giovanni; Iemolo Francesco; Castiglia Laura; Hachinski Vladimir; Caruso Calogero

    2009-01-01

    Abstract The concept of Vascular Dementia (VaD) has been recognized for over a century, but its definition and diagnostic criteria remain unclear. Conventional definitions identify the patients too late, miss subjects with cognitive impairment short of dementia, and emphasize consequences rather than causes, the true bases for treatment and prevention. We should throw out current diagnostic categories and describe cognitive impairment clinically and according to commonly agreed instruments th...

  3. [Post Stroke Dementia].

    Science.gov (United States)

    Ihara, Masafumi

    2016-07-01

    Post-stroke dementia (PSD) is a clinical entity that encompasses all types of dementia following an index stroke. Current evidence suggests that 25-30% of ischemic stroke survivors develop immediate or delayed vascular cognitive impairment or vascular dementia. The type of stroke can be either ischemic, hemorrhagic or hypoperfusive. There are multiple risk factors for PSD including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischemic attack or recurrent stroke and depressive illness. Pre-stroke dementia refers to the occurrence of cognitive impairment before the index stroke, which may be caused by a vascular burden as well as insidious neurodegenerative changes. Neuroimaging determinants of dementia after stroke include silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Published clinical trials have not been promising and there is little information on whether PSD can be prevented using pharmacological agents. Control of vascular disease risk and prevention of recurrent strokes are key to reducing the burden of cognitive decline and post-stroke dementia. Modern imaging and analysis techniques will help to elucidate the mechanism of PSD and establish better treatment. PMID:27395459

  4. Early Dementia Screening

    Directory of Open Access Journals (Sweden)

    Peter K. Panegyres

    2016-01-01

    Full Text Available As the population of the world increases, there will be larger numbers of people with dementia and an emerging need for prompt diagnosis and treatment. Early dementia screening is the process by which a patient who might be in the prodromal phases of a dementing illness is determined as having, or not having, the hallmarks of a neurodegenerative condition. The concepts of mild cognitive impairment, or mild neurocognitive disorder, are useful in analyzing the patient in the prodromal phase of a dementing disease; however, the transformation to dementia may be as low as 10% per annum. The search for early dementia requires a comprehensive clinical evaluation, cognitive assessment, determination of functional status, corroborative history and imaging (including MRI, FDG-PET and maybe amyloid PET, cerebrospinal fluid (CSF examination assaying Aβ1–42, T-τ and P-τ might also be helpful. Primary care physicians are fundamental in the screening process and are vital in initiating specialist investigation and treatment. Early dementia screening is especially important in an age where there is a search for disease modifying therapies, where there is mounting evidence that treatment, if given early, might influence the natural history—hence the need for cost-effective screening measures for early dementia.

  5. Autophagy in dementias.

    Science.gov (United States)

    Kragh, Christine Lund; Ubhi, Kiren; Wyss-Coray, Tony; Wyss-Corey, Tony; Masliah, Eliezer

    2012-01-01

    Dementias are a varied group of disorders typically associated with memory loss, impaired judgment and/or language and by symptoms affecting other cognitive and social abilities to a degree that interferes with daily functioning. Alzheimer's disease (AD) is the most common cause of a progressive dementia, followed by dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), (VaD) and HIV-associated neurocognitive disorders (HAND). The pathogenesis of this group of disorders has been linked to the abnormal accumulation of proteins in the brains of affected individuals, which in turn has been related to deficits in protein clearance. Autophagy is a key cellular protein clearance pathway with proteolytic cleavage and degradation via the ubiquitin-proteasome pathway representing another important clearance mechanism. Alterations in the levels of autophagy and the proteins associated with the autophagocytic pathway have been reported in various types of dementias. This review will examine recent literature across these disorders and highlight a common theme of altered autophagy across the spectrum of the dementias. PMID:22150925

  6. Young onset dementia.

    Science.gov (United States)

    Draper, B; Withall, A

    2016-07-01

    Young onset dementia (YOD), where symptoms of dementia have an onset before the age of 65, has become more prominent due to the population increase from the Baby Boomer generation. This clinical perspective examines key issues in the assessment, diagnosis and management of YOD. Challenges in the assessment and diagnosis of YOD are partly due to the diverse range of types of YOD, where degenerative dementias are less common and secondary dementias more common than in late onset dementia. Early symptoms are broad and include depression, behavioural change, neurological disorders, systemic disorders and mild cognitive impairment (MCI). Perceived diagnostic delay may result in frustration and distress in people with YOD and their families. Chronic depression and MCI are associated with longer time to diagnosis, and in these situations, clinicians need to establish appropriate review processes and communicate clearly. A diagnosis of YOD may have marked consequences for a younger person, including early retirement, financial impacts and the psychological challenge of coming to grips with cognitive decline. Partners, children and other supporters often have unmet needs, feel burdened by care and are at high risk of physical and emotional consequences. Concerns about the heritability of dementia may add to family distress. Recent community service developments in Australia for YOD are outlined and the challenges of residential care described. PMID:27405890

  7. Computertomographic studies of dementia

    International Nuclear Information System (INIS)

    It seems to be very complicated even for the experienced neurologist and psychiatrist to correlate the clinical syndrome of dementia to different causing cerebral processes such as a primarily degenerative brain atrophy, a chronic cerebrovascular insufficiency, or other rarer occurring brain diseases unless neurological signs and symptoms do indicate a focal brain lesion. Since computed tomography is able to show both focal and general changes of the brain tissue each patient presenting with a dementia clinically should be undergone such a neuroradiological investigation at least once, and if being negative even repeatedly. Computed tomography is able not only to detect unexpected treatable brain lesions as a cause of dementia for instance tumors, subdural hematomas, and communicating hydrocephalus to expect in about 6% of cases with the clinical diagnosis of dementia, but also it is able to help to make the differentialdiagnosis of the dementia of Alzheimer's and the multi-infarct-type in a high percentage. Nevertheless despite the use of computed tomography the pathogenesis of dementia even though being undoubtful clinically remains obscure in 15% of our material of 367 demented patients studied by computed tomography but presenting with a normal finding. (orig.)

  8. Thinking about Aid Predictability

    OpenAIRE

    Andrews, Matthew; Wilhelm, Vera

    2008-01-01

    Researchers are giving more attention to aid predictability. In part, this is because of increases in the number of aid agencies and aid dollars and the growing complexity of the aid community. A growing body of research is examining key questions: Is aid unpredictable? What causes unpredictability? What can be done about it? This note draws from a selection of recent literature to bring s...

  9. Dementia - behavior and sleep problems

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000029.htm Dementia - behavior and sleep problems To use the sharing ... on this page, please enable JavaScript. People with dementia often have certain problems when it gets dark ...

  10. Dementia due to metabolic causes

    Science.gov (United States)

    ... these chemical abnormalities cause permanent brain damage and dementia. ... Metabolic causes of dementia include: Endocrine disorders, such as Addison disease , Cushing disease Heavy metal exposure, such as to lead, arsenic, ...

  11. Prognosis with dementia in Europe

    DEFF Research Database (Denmark)

    Jagger, C; Andersen, K; Breteler, M M;

    2000-01-01

    The effect of dementia on time to death and institutionalization in elderly populations is of importance to resource planning, as well as to patients and their carers. The authors report a collaborative reanalysis of nine population-based studies conducted in Europe to compare dementia cases and...... for men with dementia was consistently lower than that for women with dementia of the same age group....

  12. A rational approach to dementia.

    OpenAIRE

    Cole, M G

    1980-01-01

    Dementia is a common problem facing all medical practitioners and it frequently results in hospitalization and death. This review provides a framework for dealing with dementia in clinical practice that is based on both traditional concepts and recent advances in the understanding of the problem. Distinguishing at the bedside between dementia and other disorders of intellect is emphasized. The main causes of dementia and their clinical characteristics are reviewed and a rational approach to d...

  13. Senile Dementia and Family Medicine

    OpenAIRE

    Sawa, Russell J.

    1981-01-01

    Senile dementia is an increasingly important disease in family medicine, because our population is growing old. Dementia can have many causes, some of which are reversible. Its definition varies with time, discipline, and country. Correctly diagnosing reversible dementing processes as early as possible may lead to reversal of an otherwise devastating process. This article discusses definition and diagnosis of senile dementia.

  14. [Artistic creativity and dementia].

    Science.gov (United States)

    Sellal, François; Musacchio, Mariano

    2008-03-01

    Artistic creativity can be defined as the ability to produce both innovative and esthetic works. Though most dementias result in a loss of instrumental functions and a deterioration in artistic production, for some established artists, dementia, most often Alzheimer's disease, changed their style and technique but preserved their creativity and prolific artistic drive. Moreover, in some cases, mainly frontotemporal dementia, Parkinson's disease, and very occasionally strokes, the disease may favour the emergence of de novo artistic talent. This phenomenon has been conceptualized as a paradoxical facilitation, a disinhibition of brain areas devoted to visuospatial processing, greater freedom in a patient who becomes less bound by social conventions, enhancement of motivation and pleasure, etc. These neurological cases provide an opportunity to shed some light on the roots of artistic creation. PMID:18364297

  15. Dementia in Down's syndrome.

    Science.gov (United States)

    Ballard, Clive; Mobley, William; Hardy, John; Williams, Gareth; Corbett, Anne

    2016-05-01

    Down's syndrome is the most common genetic cause of learning difficulties, and individuals with this condition represent the largest group of people with dementia under the age of 50 years. Genetic drivers result in a high frequency of Alzheimer's pathology in these individuals, evident from neuroimaging, biomarker, and neuropathological findings, and a high incidence of cognitive decline and dementia. However, cognitive assessment is challenging, and diagnostic methods have not been fully validated for use in these patients; hence, early diagnosis remains difficult. Evidence regarding the benefits of cholinesterase inhibitors and other therapeutic options to treat or delay progressive cognitive decline or dementia is very scarce. Despite close similarities with late-onset Alzheimer's disease, individuals with Down's syndrome respond differently to treatment, and a targeted approach to drug development is thus necessary. Genetic and preclinical studies offer opportunities for treatment development, and potential therapies have been identified using these approaches. PMID:27302127

  16. Pathophysiology of vascular dementia

    Directory of Open Access Journals (Sweden)

    Rizzo Claudia

    2009-11-01

    Full Text Available Abstract The concept of Vascular Dementia (VaD has been recognized for over a century, but its definition and diagnostic criteria remain unclear. Conventional definitions identify the patients too late, miss subjects with cognitive impairment short of dementia, and emphasize consequences rather than causes, the true bases for treatment and prevention. We should throw out current diagnostic categories and describe cognitive impairment clinically and according to commonly agreed instruments that document the demographic data in a standardized manner and undertake a systematic effort to identify the underlying aetiology in each case. Increased effort should be targeted towards the concept of and criteria for Vascular Cognitive Impairment and Post-Stroke Dementia as well as for genetic factors involved, especially as these categories hold promise for early prevention and treatment.

  17. Dementia trials and dementia tribulations: methodological and analytical challenges in dementia research

    OpenAIRE

    Ritchie, Craig W.; Terrera, Graciela Muniz; Quinn, Terence J.

    2015-01-01

    Dementia is a substantial and increasing public health concern. Despite decades of research, a cure or effective preventative treatment for dementia remains elusive. We offer critical review of contemporary dementia research and discuss potential reasons why progress in the field has not been as rapid as in other disciplines. We adopt a broad approach in keeping with the broad nature of the topic. We cover the difficulties inherent in studying dementia from 'bench' to 'bedside' to 'population...

  18. MRI in senile dementia

    International Nuclear Information System (INIS)

    Fourteen patients with senile dementia were studied with a 0.1 Tesla resistive MR scanner. We measured T1 values of 20 areas at the level of basal ganglia and compared with those of 20 normal controls. T1 values were calculated with a 0.2-sec T sub(D) and 1.0 T sub(R). Mean T1 values were significantly longer bilaterally in the posterior limb of internal capsule, frontal gray matter, frontal white matter, temporal white matter and occipital white matter in patients with senile dementia. (author)

  19. Antidepressants and dementia

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Søndergård, Lars; Forman, Julie Lyng; Andersen, Per Kragh

    2009-01-01

    Denmark during a period from 1995 to 2005. RESULTS: Persons who purchased antidepressants once (N=687,552) had an increased rate of dementia compared to persons unexposed to antidepressants (N=779,831). Nevertheless, the rate of dementia changed over time; thus during the initial prescription periods the......-SSRI antidepressants and older antidepressants). All findings were replicated in sub-analyses with Alzheimer's disease as outcome. LIMITATIONS: Methodological reasons for the findings cannot be excluded due to the non-randomized nature of data. CONCLUSIONS: Continued long-term antidepressant treatment was associated...

  20. Parkinson Disease and Dementia.

    Science.gov (United States)

    Garcia-Ptacek, Sara; Kramberger, Milica G

    2016-09-01

    Dementia is a frequent complication of Parkinson disease (PD) with a yearly incidence of around 10% of patients with PD. Lewy body pathology is the most important factor in the development of Parkinson disease dementia (PDD) and there is evidence for a synergistic effect with β-amyloid. The clinical phenotype in PDD extends beyond the dysexecutive syndrome that is often present in early PD and encompasses deficits in recognition memory, attention, and visual perception. Sleep disturbances, hallucinations, neuroleptic sensitivity, and fluctuations are often present. This review provides an update on current knowledge of PDD including aspects of epidemiology, pathology, clinical presentation, management, and prognosis. PMID:27502301

  1. Assessment and management of behavioral and psychological symptoms of dementia

    OpenAIRE

    Kales, Helen C.; Gitlin, Laura N.; Lyketsos, Constantine G

    2015-01-01

    Behavioral and psychological symptoms of dementia include agitation, depression, apathy, repetitive questioning, psychosis, aggression, sleep problems, wandering, and a variety of inappropriate behaviors. One or more of these symptoms will affect nearly all people with dementia over the course of their illness. These symptoms are among the most complex, stressful, and costly aspects of care, and they lead to a myriad of poor patient health outcomes, healthcare problems, and income loss for fa...

  2. Montessori-based dementia care.

    Science.gov (United States)

    Cline, Janet

    2006-10-01

    Montessori-based Dementia Care is an approach used in Alzheimer's care that does not involve chemical or physical restraints. This program works by giving the elder with Alzheimer/Dementia a purpose by getting them involved. When staff/families care for a confused Alzheimer/Dementia patient, who is having behaviors, the Montessori program teaches them to look at what is causing the behavior. When assessing the elder to determine what is causing the behavior, the goal is to find the answer, but the answer cannot be dementia. The goal of the program is to bring meaning to the life of an Alzheimer/Dementia elder. PMID:17111647

  3. [How Treatable is Vascular Dementia?].

    Science.gov (United States)

    Mori, Etsuro

    2016-04-01

    Vascular dementia is an umbrella term, encompassing the pathological changes in the brain due to cerebrovascular disease that result in dementia. Vascular dementia is the second most common form of dementia, after Alzheimer's disease. In this paper, I outline the concept of vascular dementia, the key aspects of the disease that are yet to be clarified, and the current status of clinical trials. Assessing these factors, I discuss how treatable vascular dementia presently is. Use of the term'vascular dementia'is riddled with uncertainties regarding disease classification, and non-standardized diagnostic criteria. There are difficulties in determining the exact relationship between cerebrovascular pathology and cognitive impairment. The comorbid effects of Alzheimer's pathology in some individuals also present an obstacle to reliable clinical diagnosis, and hinder research into effective management approaches. Vascular dementia is preventable and treatable, as there are established primary and secondary prevention measures for the causative cerebrovascular diseases, such as vascular risk factor intervention, antiplatelet therapy, and anticoagulation, amongst others. However, unlike Alzheimer's disease, there are no established symptomatic treatments for vascular dementia. Clinical trials of cholinesterase inhibitors and memantine indicate that they produce small cognitive benefits in patients with vascular dementia, though the exact clinical significance of these is uncertain. Data are insufficient to support the widespread use of these drugs in vascular dementia. Rehabilitation and physical and cognitive exercise may be beneficial, but evidence of cognitive benefit and relief of neuropsychiatric symptoms due to exercise is lacking. PMID:27056862

  4. Creativity and dementia: a review.

    Science.gov (United States)

    Palmiero, Massimiliano; Di Giacomo, Dina; Passafiume, Domenico

    2012-08-01

    In these last years, creativity was found to play an important role for dementia patients in terms of diagnosis and rehabilitation strategies. This led us to explore the relationships between dementia and creativity. At the aim, artistic creativity and divergent thinking are considered both in non-artists and artists affected by different types of dementia. In general, artistic creativity can be expressed in exceptional cases both in Alzheimer's disease and Frontotemporal dementia, whereas divergent thinking decreases in dementia. The creation of paintings or music is anyway important for expressing emotions and well-being. Yet, creativity seems to emerge when the right prefrontal cortex, posterior temporal, and parietal areas are relatively intact, whereas it declines when these areas are damaged. However, enhanced creativity in dementia is not confirmed by controlled studies conducted in non-artists, and whether artists with dementia can show creativity has to be fully addressed. Future research directions are suggested. PMID:22438178

  5. COMPARATIVE EFFECTIVENESS OF MCI and DEMENTIA TREATMENTS IN A COMMUNITY-BASED DEMENTIA PRACTICE

    Science.gov (United States)

    2016-08-04

    Mild Cognitive Impairment; Dementia; Hypoxia; Hyperhomocysteinemia; Vitamin B 12 Deficiency; Iron Deficiency; Anemia; TBI; Neurodegenerative Disorders; Alzheimer's Disease; Vascular Dementia; Brain Injuries; Tauopathies; Parkinson's Disease; Lewy Body Dementia; Frontotemporal Dementia; TDP-43 Proteinopathies

  6. Diet and dementia.

    Science.gov (United States)

    Whalley, Lawrence J; Starr, John M; Deary, Ian J

    2004-09-01

    The ageing brain adapts to the accumulation of damage caused by oxidative stress and inflammation. Adaptive processes include neuroprotective and neurorestorative mechanisms. Individual differences in susceptibility to dementia arise when these mechanisms are impaired or are overwhelmed by the molecular pathology of Alzheimer's disease. Neuroprotection relies upon extrinsic and intrinsic defences. An adequate intake of antioxidant micronutrients (eg, vitamin C and vitamin E) and anti-inflammatory macronutrients (eg, omega-3 polyunsaturated fatty acids) forms an essential component of extrinsic defences against brain ageing. There are many epidemiological data to support an association between an inadequate intake of antioxidants and/or fish oils (an important source of omega-3 polyunsaturated fatty acids) and a greater than expected incidence of late onset dementia. These associations are confounded by established links between poverty, poor diet and failing health, especially in old age. Such links may be sufficient to explain some of the effects of an inadequate diet on the retention of cognitive function and increased risk of dementia in old age. More compelling is the association between increased plasma homocysteine concentration and later increased risk of dementia. This association is possibly caused by an inadequate intake of vitamin B(12)/folate. PMID:15494103

  7. Neuroimaging in dementia

    Energy Technology Data Exchange (ETDEWEB)

    Barkhof, Frederik [VU Univ. Medical Center, Amsterdam (NL). Dept. of Radiology and Image Analysis Center (IAC); Fox, Nick C. [UCL Institute of Neurology, London (United Kingdom). Dementia Research Centre; VU Univ. Medical Center, Amsterdam (Netherlands); Bastos-Leite, Antonio J. [Porto Univ. (Portugal). Dept. of Medical Imaging; Scheltens, Philip [VU Univ. Medical Center, Amsterdam (Netherlands). Dept. of Neurology and Alzheimer Center

    2011-07-01

    Against a background of an ever-increasing number of patients, new management options, and novel imaging modalities, neuroimaging is playing an increasingly important role in the diagnosis of dementia. This up-to-date, superbly illustrated book aims to provide a practical guide to the effective use of neuroimaging in the patient with cognitive decline. It sets out the key clinical and imaging features of the wide range of causes of dementia and directs the reader from clinical presentation to neuroimaging and on to an accurate diagnosis whenever possible. After an introductory chapter on the clinical background, the available ''toolbox'' of structural and functional neuroimaging techniques is reviewed in detail, including CT, MRI and advanced MR techniques, SPECT and PET, and image analysis methods. The imaging findings in normal ageing are then discussed, followed by a series of chapters that carefully present and analyze the key imaging findings in patients with dementias. A structured path of analysis follows the main presenting feature: disorders associated with primary gray matter loss, with white matter changes, with brain swelling, etc. Throughout, a practical approach is adopted, geared specifically to the needs of clinicians (neurologists, radiologists, psychiatrists, geriatricians) working in the field of dementia, for whom this book should prove an invaluable resource. (orig.)

  8. Training in dementia care.

    Science.gov (United States)

    Alberto, Petra

    2014-10-01

    THE RISING number of people with dementia is making more and more demands on the country's healthcare budget, with the cost of caring for this patient group to the NHS in England, Wales and Northern Ireland being about £23 billion a year ( Alzheimer's Society 2012 ). PMID:25270810

  9. Types of Dementia

    Science.gov (United States)

    ... beta-amyloid (plaques) and twisted strands of the protein tau (tangles) as well as evidence of nerve cell ... TDP43-related Dementia 2013 Andrew Watt Characterisation of Tau Imaging Ligands for ... Prion Protein as a Therapeutic Target in Alzheimer's Disease 2007 ...

  10. Neuroimaging in dementia

    International Nuclear Information System (INIS)

    Against a background of an ever-increasing number of patients, new management options, and novel imaging modalities, neuroimaging is playing an increasingly important role in the diagnosis of dementia. This up-to-date, superbly illustrated book aims to provide a practical guide to the effective use of neuroimaging in the patient with cognitive decline. It sets out the key clinical and imaging features of the wide range of causes of dementia and directs the reader from clinical presentation to neuroimaging and on to an accurate diagnosis whenever possible. After an introductory chapter on the clinical background, the available ''toolbox'' of structural and functional neuroimaging techniques is reviewed in detail, including CT, MRI and advanced MR techniques, SPECT and PET, and image analysis methods. The imaging findings in normal ageing are then discussed, followed by a series of chapters that carefully present and analyze the key imaging findings in patients with dementias. A structured path of analysis follows the main presenting feature: disorders associated with primary gray matter loss, with white matter changes, with brain swelling, etc. Throughout, a practical approach is adopted, geared specifically to the needs of clinicians (neurologists, radiologists, psychiatrists, geriatricians) working in the field of dementia, for whom this book should prove an invaluable resource. (orig.)

  11. The relation of blood pressure to dementia in the elderly : A community-based longitudinal study

    OpenAIRE

    Qiu, Chengxuan

    2004-01-01

    This doctoral thesis concerns a community-based, prospective study aimed at investigating the complex relationship between blood pressure (BP) and risk of dementia in a dementia-free cohort (n = 1301) aged >=75 years in Stockholm, Sweden. After baseline survey (1987-1989), the cohort was followed for over 6 years, during which 2 waves of clinical examinations (1991-1993 & 1994-1996) for dementia and Alzheimer's disease (AD) (DSM-III-R diagnostic criteria) were performed. Dat...

  12. PET studies in dementia

    Energy Technology Data Exchange (ETDEWEB)

    Herholz, K. [Neurologische Universitaetsklinik and Max-Planck-Inst. fuer neurologische Forschung, Koeln (Germany)

    2003-04-01

    Measurement of local cerebral glucose metabolism (lCMRGlc) by positron emission tomography (PET) and {sup 18}F-2-fluoro-2-deoxy-D-glucose (FDG) has become a standard technique during the past 20 years and is now available at many university hospitals in all highly developed countries. Many studies have documented a close relation between lCMRGlc and localized cognitive functions, such as language and visuoconstructive abilities. Alzheimer's disease (AD) is characterized by regional impairment of cerebral glucose metabolism in neocortical association areas (posterior cingulate, temporoparietal and frontal multimodal association cortex), whereas primary visual and sensorimotor cortex, basal ganglia, and cerebellum are relatively well preserved. In a multicenter study comprising 10 PET centers (Network for Efficiency and Standardization of Dementia Diagnosis, NEST-DD) that employed an automated voxel-based analysis of FDG PET images, the distinction between controls and AD patients was 93% sensitive and 93% specific, and even in very mild dementia (at Mini Mental Status Examination (MMSE) 24 or higher) sensitivity was still 84% at 93% specificity. Significantly abnormal metabolism in mild cognitive deficit (MCI) indicates a high risk to develop dementia within the next two years. Reduced neocortical glucose metabolism can probably be detected with FDG PET in AD on average one year before onset of subjective cognitive impairment. In addition to glucose metabolism, specific tracers for dopamine synthesis ({sup 18}F-F-DOPA) and for ({sup 11}C-MP4A) are of interest for differentiation among dementia subtypes. Cortical acetylcholine esterase activity (AChE) activity is significantly lower in patients with AD or with dementia with Lewy bodies (DLB) than in age-matched normal controls. In LBD there is also impairment of dopamine synthesis, similar to Parkinson disease. (author) 115 refs.

  13. Apraxias in neurodegenerative dementias

    Directory of Open Access Journals (Sweden)

    Sadanandavalli Retnaswami Chandra

    2015-01-01

    Full Text Available Background: Apraxia is a state of inability to carry out a learned motor act in the absence of motor, sensory or cerebellar defect on command processed through the Praxis circuit. Breakdown in default networking is one of the early dysfunction in cortical dementias and result in perplexity, awkwardness, omission, substitution errors, toying behavior and unrecognizable gestures in response to command with voluntary reflex dissociation where, when unobserved patient will carry out reflex movements normally. Awareness into the organicity of these phenomenas will help in early diagnosis, which will help in initiating appropriate treatment and slowing down the progression of the disease. Aims and Objectives: The aim was to look for the various kinds of apraxias in patients with dementia using appropriate simple tests. Patients and Methods: Three hundred patients satisfying Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for dementia were evaluated in detail with mandatory investigations for dementia followed by testing for ideational, ideomotor, limb-kinetic, buccopharyngeal, dressing apraxia, constructional apraxia and gait apraxias in addition to recording of rare apraxias when present. Results: Alzheimer′s disease showed maximum association with apraxias in all the phases of the disease ideational, ideomotor, dressing and constructional apraxias early and buccopharyngeal and gait apraxia late. Frontotemporal lobe dementia showed buccopharyngeal and gait apraxias late into the disease. Cortical basal ganglionic degeneration showed limb apraxias and diffuse Lewy body disease showed more agnosias and less apraxias common apraxias seen was Ideational and Ideomotor. Conclusion: Recognition of the apraxias help in establishing organicity, categorization, caregiver education, early strategies for treatment, avoiding anti-psychotics and introducing disease modifying pharmacotherapeutic agents and also prognosticating.

  14. PET studies in dementia

    International Nuclear Information System (INIS)

    Measurement of local cerebral glucose metabolism (lCMRGlc) by positron emission tomography (PET) and 18F-2-fluoro-2-deoxy-D-glucose (FDG) has become a standard technique during the past 20 years and is now available at many university hospitals in all highly developed countries. Many studies have documented a close relation between lCMRGlc and localized cognitive functions, such as language and visuoconstructive abilities. Alzheimer's disease (AD) is characterized by regional impairment of cerebral glucose metabolism in neocortical association areas (posterior cingulate, temporoparietal and frontal multimodal association cortex), whereas primary visual and sensorimotor cortex, basal ganglia, and cerebellum are relatively well preserved. In a multicenter study comprising 10 PET centers (Network for Efficiency and Standardization of Dementia Diagnosis, NEST-DD) that employed an automated voxel-based analysis of FDG PET images, the distinction between controls and AD patients was 93% sensitive and 93% specific, and even in very mild dementia (at Mini Mental Status Examination (MMSE) 24 or higher) sensitivity was still 84% at 93% specificity. Significantly abnormal metabolism in mild cognitive deficit (MCI) indicates a high risk to develop dementia within the next two years. Reduced neocortical glucose metabolism can probably be detected with FDG PET in AD on average one year before onset of subjective cognitive impairment. In addition to glucose metabolism, specific tracers for dopamine synthesis (18F-F-DOPA) and for (11C-MP4A) are of interest for differentiation among dementia subtypes. Cortical acetylcholine esterase activity (AChE) activity is significantly lower in patients with AD or with dementia with Lewy bodies (DLB) than in age-matched normal controls. In LBD there is also impairment of dopamine synthesis, similar to Parkinson disease. (author) 115 refs

  15. Cancer and Dementia: It’s Complicated

    OpenAIRE

    Ganguli, Mary

    2015-01-01

    The relationship between dementia and cancer is complex. A wealth of observational data suggests (1) reduced risk of certain cancers in Alzheimer’s and Parkinson’s diseases, and (2) increased risk of other cancers in Parkinson’s disease. These relationships persist despite correcting for reporting artifacts and survival bias. Several potential mechanisms have been proposed and warrant further investigation. Aging is a risk factor for both. Common environmental exposures, such as smoking, may ...

  16. Management of complex knowledge in planning for sustainable development: The use of multi-criteria decision aids

    International Nuclear Information System (INIS)

    The vision of sustainable development entails new and complex planning situations, confronting local policy makers with changing political conditions, different content in decision making and planning and new working methods. Moreover, the call for sustainable development has been a major driving force towards an increasingly multi-stakeholder planning system. This situation requires competence in working in, and managing, groups of actors, including not only experts and project owners but also other categories of stakeholders. Among other qualities, such competence requires a working strategy aimed at integrating various, and sometimes incommensurable, forms of knowledge to construct a relevant and valid knowledge base prior to decision making. Consequently, there lies great potential in methods that facilitate the evaluation of strategies for infrastructural development across multiple knowledge areas, so-called multi-criteria decision aids (MCDAs). In the present article, observations from six case studies are discussed, where the common denominators are infrastructural planning, multi-stakeholder participation and the use of MCDAs as interactive decision support. Three MCDAs are discussed - NAIADE, SCA and STRAD - with an emphasis on how they function in their procedural context. Accordingly, this is not an analysis of MCDA algorithms, of software programming aspects or of MCDAs as context-independent 'decision machines'-the focus is on MCDAs as actor systems, not as expert systems. The analysis is carried out across four main themes: (a) symmetrical management of different forms of knowledge; (b) management of heterogeneity, pluralism and conflict; (c) functionality and ease of use; and (d) transparency and trust. It shows that STRAD, by far, seems to be the most useful MCDA in interactive settings. NAIADE and SCA are roughly equivalent but have their strengths and weaknesses in different areas. Moreover, it was found that some MCDA issues require further

  17. The challenge of supporting care for dementia in primary care

    Directory of Open Access Journals (Sweden)

    Malaz Boustani

    2007-01-01

    Full Text Available Malaz Boustani1,2,3, Cathy Schubert3, Youcef Sennour31Indiana University Center for Aging Research; 2Regenstrief Institute; 3Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USAAbstract: Most patients with dementia receive care within primary care systems and have challenging medical and psychiatric issues. Their dementia related symptoms are often not recognized by the primary care system; they suffer from multiple chronic medical conditions; receive numerous psychotropic medications including anticholinergics; and display clinically relevant behavioral and psychological symptoms. Improving the care for such vulnerable patients demands supporting the primary care system with various resources, including dementia care managers, access to and coordination with interdisciplinary dementia specialists, and a feasible dementia screening and diagnosis process. Understanding primary care clinics as a complex adaptive system may enhance our capacity to deliver a flexible supportive process using the above crucial resources to adequately assess and effectively manage patients with dementia. Such a complex adaptive system process would have the best probability of surviving the unknowable future challenges that will face the primary care system.

  18. Behavioral and Psychological Symptoms of Dementia

    Directory of Open Access Journals (Sweden)

    JoaquimCerejeira

    2012-05-01

    Full Text Available Behavioral and psychological symptoms of dementia (BPSD, also known as neuropsychiatric symptoms, represent a heterogeneous group of non-cognitive symptoms and behaviors occurring in subjects with dementia. BPSD constitute a major component of the dementia syndrome irrespective of its subtype. They are as clinically relevant as cognitive symptoms as they strongly correlate with the degree of functional and cognitive impairment. BPSD include agitation, aberrant motor behavior, anxiety, elation, irritability, depression, apathy, disinhibition, delusions, hallucinations, and sleep or appetite changes. It is estimated that BPSD affect up to 90% of all dementia subjects over the course of their illness, and is independently associated with poor outcomes, including distress among patients and caregivers, long term hospitalization, misuse of medication and increased health care costs. Although these symptoms can be present individually it is more common that various psychopathological features co-occur simultaneously in the same patient. Thus, categorization of BPSD in clusters taking into account their natural course, prognosis and treatment response may be useful in the clinical practice. The pathogenesis of BPSD has not been clearly delineated but it is probably the result of a complex interplay of psychological, social and biological factors. Recent studies have emphasized the role of neurochemical, neuropathological and genetic factors underlying the clinical manifestations of BPSD. A high degree of clinical expertise is crucial to appropriately recognize and manage the neuropsychiatric symptoms in a patient with dementia. Combination of non-pharmacological and careful use of pharmacological interventions is the recommended therapeutic for managing BPSD. Given the modest efficacy of current strategies, there is an urgent need to identify novel pharmacological targets and develop new non-pharmacological approaches to improve the adverse outcomes

  19. Relationship between Dementia Severity and Behavioral and Psychological Symptoms of Dementia in Dementia with Lewy Bodies and Alzheimer's Disease Patients

    OpenAIRE

    Hashimoto, Mamoru; Yatabe, Yusuke; Ishikawa, Tomohisa; Fukuhara, Ryuji; Kaneda, Keiichiro; HONDA, KAZUKI; Yuki, Seiji; Ogawa, Yusuke; Imamura, Toru; Kazui, Hiroaki; Kamimura, Naoto; Shinagawa, Syunichiro; Mizukami, Katsuyoshi; Mori, Etsuro; Ikeda, Manabu

    2015-01-01

    Background/Aims Behavioral and psychological symptoms of dementia (BPSD) are common in the clinical manifestation of dementia. Although most patients with dementia exhibit some BPSD during the course of the illness, the association of BPSD with the stage of dementia remains unclear. It was the aim of this study to evaluate the impact of severity of dementia on the expression of BPSD in patients with dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). Methods Ninety-seven patients wi...

  20. Online resource music and dementia: engelstalig

    NARCIS (Netherlands)

    Kenniscentrum Kunst & Samenleving, .

    2014-01-01

    These web pages contain information for musicians about the work method of Music and Dementia and provides further details concerning related concepts (such as dementia and mentoring) and describes the practical projects of creative workshops for people with dementia.

  1. Cardiovascular medication burden in dementia disorders: a nationwide study of 19,743 dementia patients in the Swedish Dementia Registry

    OpenAIRE

    Cermakova, Pavla; Fereshtehnejad, Seyed-Mohammad; Johnell, Kristina; Winblad, Bengt; Eriksdotter, Maria; Religa, Dorota

    2014-01-01

    Introduction Administration of several cardiovascular drugs has an effect on dementia. We aimed to investigate whether there are differences in the use of cardiovascular medication between different dementia disorders. Methods We obtained information about dementia patients from the Swedish Dementia Registry. Patients were diagnosed with one of these dementia disorders: Alzheimer’s disease (n = 8,139), mixed dementia (n = 5,203), vascular dementia (n = 4,982), Lewy body dementia (n = 605), fr...

  2. Comprehension of wh-questions in a case of mixed dementia

    OpenAIRE

    Salis, Chris; Saddy, J Doug

    2011-01-01

    We investigated processing of wh-questions and declarative sentences with differing syntactic complexity in a case of mixed dementia (FA). FA was impaired in her ability to understand syntactically complex declarative sentences and syntactically complex wh-questions beginning with which but not complex who questions. This profile, novel in dementia, is similar to that reported for people with agrammatic aphasia and discerns a ‘‘fault line’’ of the language system along a syntactic/semantic...

  3. Polyclonal infections due to Mycobacterium avium complex in patients with AIDS detected by pulsed-field gel electrophoresis of sequential clinical isolates.

    OpenAIRE

    Slutsky, A M; Arbeit, R D; Barber, T W; Rich, J.; von Reyn, C F; Pieciak, W; Barlow, M A; Maslow, J.N.

    1994-01-01

    Invasive infection with organisms of the Mycobacterium avium complex (MAC) is common among patients with advanced human immunodeficiency virus infection. In previous studies, we analyzed multiple individual colonies of MAC isolated from specimens obtained at the same time and observed that 14 to 20% of patients are simultaneously infected with more than one strain. In this study, we examined sequential isolates from 12 patients with AIDS who had two or more MAC isolates available from clinica...

  4. Dementia of frontal lobe type.

    OpenAIRE

    Neary, D; Snowden, J S; Northen, B; GOULDING, P.

    1988-01-01

    A significant proportion of patients with presenile dementia due to primary cerebral atrophy do not have Alzheimer's disease. One form of non-Alzheimer dementia may be designated as dementia of frontal lobe type (DFT), on the basis of a characteristic neuropsychological picture suggestive of frontal lobe disorder, confirmed by findings on single photon emission tomography. The case histories of seven patients exemplify the disorder: a presentation of social misconduct and personality change, ...

  5. MRI evaluation of vascular dementia

    Institute of Scientific and Technical Information of China (English)

    Yicheng Liu; Hongxing Zhang; Wei Huang; Wenjun Wan; Hongfen Peng

    2006-01-01

    OBJECTTVE: To explain the association between vascular dementia and the cranial MRI manifestations, and recognize the value of cranial MRI in the early diagnosis of vascular dementia and the assessment of disease conditions.DATA SOURCES: Pubmed database was searched to identify articles about the cranial MRI manifestations of patients with vascular dementia published in English from January 1992 to June 2006 by using the key words of "MRI, vascular dementia". Others were collected by searching the name of journals and title of articles in the Chinese full-text journal database.STUDY SELECTTON: The collected articles were primarily checked, those correlated with the cranial MRI manifestations of patients with vascular dementia were selected, while the obviously irrelative ones were excluded, and the rest were retrieved manually, the full-texts were searched.DATA EXTRACTION: Totally 255 articles were collected, 41 of them were involved, and the other 214 were excluded.DATA SYNTHESIS: MRI can be taken as one of the effective methods for the early diagnosis and disease evaluation of vascular dementia. White matter lesions are the important risk factors of vascular dementia.Vascular dementia is accompanied by the atrophy of related brain sites, but further confirmation is needed to investigate whether there is significant difference. MRI can be used to quantitatively investigate the infarcted sites and sizes of patients with vascular dementia after infarction, but there is still lack of systematic investigation on the association of the infarcted sites and sizes with the cognitive function of patients with vascular dementia.CONCLUSTON: Cranial MRI can detect the symptoms of vascular dementia at early period, so that corresponding measures can be adopted to prevent and treat vascular dementia in time.

  6. Drug development in dementia.

    Science.gov (United States)

    Cunningham, Emma L; Passmore, Anthony P

    2013-11-01

    Dementia is a progressive, irreversible decline in cognition that, by definition, impacts on a patient's pre-existing level of functioning. The clinical syndrome of dementia has several aetiologies of which Alzheimer's disease (AD) is the most common. Drug development in AD is based on evolving pathophysiological theory. Disease modifying approaches include the targeting of amyloid processing, aggregation of tau, insulin signalling, neuroinflammation and neurotransmitter dysfunction, with efforts thus far yielding abandoned hopes and ongoing promise. Reflecting its dominance on the pathophysiological stage the amyloid cascade is central to many of the emerging drug therapies. The long preclinical phase of the disease requires robust biomarker means of identifying those at risk if timely intervention is to be possible. PMID:23707728

  7. Emerging treatments in dementia.

    Science.gov (United States)

    Scheltens, P; van Gool, W A

    1997-01-01

    Dementia is one of the most common organic mental syndromes, usually caused by Alzheimer's disease (AD) or vascular dementia (VD) or both. Regarding AD we review the state or the art of the cholinergic approach and discuss some future options regarding preventive and nonsymptomatic strategies. Therapy for VD will consist mainly in influencing and preventing cerebrovascular pathology, because operational criteria for the diagnosis have only recently been proposed and are being discussed widely. One of the crucial problems here lies in the distinction between VD and AD and the recognition that the two disorders may be coexistent more often than assumed; the role of white matter changes seems to be particularly important. The same goes for the recognition that AD ist not a single entity. The question of heterogeneity may be solved when different therapeutic strategies are found for different subtypes. The focus of future plans should be on preventive strategies combined with an early diagnosis. PMID:9363830

  8. Brain imaging in dementia.

    Science.gov (United States)

    Bonifacio, Guendalina; Zamboni, Giovanna

    2016-06-01

    The introduction of MRI and positron emission tomography (PET) brain imaging has contributed significantly to the understanding of different dementia syndromes. Over the past 20 years these imaging techniques have been increasingly used for clinical characterisation and differential diagnosis, and to provide insight into the effects on functional capacity of the brain, patterns of spatial distribution of different dementia syndromes and their natural history and evolution over time. Brain imaging is also increasingly used in clinical trials, as part of inclusion criteria and/or as a surrogate outcome measure. Here we review all the relatively specific findings that can be identified with different MRI and PET techniques in each of the most frequent dementing disorders. PMID:26933232

  9. Cognitive training for dementia

    OpenAIRE

    Konta, Brigitte; Frank, Wilhelm

    2005-01-01

    The aim of the HTA report is to evaluate the effectiveness of cognitive training methods to treat cognitive disorders of dementia and other diseases with cognitive deficits. For this purpose, a systematic literature search was carried out first based on the DIMDI superbase retrieval. The identified publications were judged and selected by two independent, methodically competent experts. 33 publications were included in the report. Based on the studies for a normal cognitive development in old...

  10. Music and dementia

    OpenAIRE

    Nair BR; Browne W; Marley J; Heim C

    2013-01-01

    Balakrishnan R Nair,1 William Browne,2 John Marley,3 Christian Heim41University of Newcastle and the Centre for Medical Education, HNE Health, Newcastle, NSW, 2Geriatric Medicine, Eastern Health, Melbourne, VIC, 3Faculty of Health Sciences, The University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, QLD, 4Toowong Private Hospital, Brisbane, QLD, AustraliaAbstract: As the population ages, the prevalence of dementia is increasing. Distressing behavioral problems are often p...

  11. Palliative care in advanced dementia.

    Science.gov (United States)

    Merel, Susan E; Merel, Susan; DeMers, Shaune; Vig, Elizabeth

    2014-08-01

    Because neurodegenerative dementias are progressive and ultimately fatal, a palliative approach focusing on comfort, quality of life, and family support can have benefits for patients, families, and the health system. Elements of a palliative approach include discussion of prognosis and goals of care, completion of advance directives, and a thoughtful approach to common complications of advanced dementia. Physicians caring for patients with dementia should formulate a plan for end-of-life care in partnership with patients, families, and caregivers, and be prepared to manage common symptoms at the end of life in dementia, including pain and delirium. PMID:25037291

  12. Effectiveness of environment-based interventions for people with Alzheimer's disease and related dementias.

    Science.gov (United States)

    Padilla, René

    2011-01-01

    A systematic review of evidence for the efficacy of environment-based interventions on the affect, behavior, and performance of people with Alzheimer's disease and related dementias was conducted as part of the American Occupational Therapy Association's Evidence-Based Literature Review Project. Thirty-three reports met inclusion criteria. Results suggest that ambient music, aromatherapy, and Snoezelen are modestly effective in reducingagitation but do not consistently have long-term effects. Visually complex environments that give the illusion of barriers deter people from wandering to unsafe places but do not reduce the urge to wander. Evidence that bright light therapy can aid in regulating mood and the sleep-wake cycle and thus help people remain awake during the day is preliminary. Montessori-based programming can be useful in matching activities to the person's remaining skills. Further research is needed to evaluate the long-term effect, contraindications, and best dosages of these interventions. PMID:22026319

  13. Cognitive training for dementia

    Directory of Open Access Journals (Sweden)

    Konta, Brigitte

    2005-12-01

    Full Text Available The aim of the HTA report is to evaluate the effectiveness of cognitive training methods to treat cognitive disorders of dementia and other diseases with cognitive deficits. For this purpose, a systematic literature search was carried out first based on the DIMDI superbase retrieval. The identified publications were judged and selected by two independent, methodically competent experts. 33 publications were included in the report. Based on the studies for a normal cognitive development in old age a theory that healthy older people have a considerable capacity reserve for an improved performance in abstract abilities of thinking can be assumed. The first symptoms for older people at risk for dementia are a reduced cognitive capacity reserve. Cognitive training methods therefore focus abilities of abstract memory. Apart from types of dementia another two groups of diseases with cognitive deficits were included in the HTA report: cerebral lesions and schizophrenic psychoses. Studies with mild as well as forms of dementia heavy forms including the Alzheimer disease were included. The described training methods were very heterogeneous with regard to their contents, the temporal sequence and the outcome parameter. The studies were methodically partly contestable. Approximately a third of the studies of all publications could show improvements in the cognitive achievements by the training. Three studies concerning cognitive training methods in case of cerebral lesions were included. All three studies demonstrated a significant improvement in the training group in some outcome parameters. Special cognitive training methods were used for the treatment of cognitive deficits at schizophrenic psychoses. The neurocognitive training (NET, the "Cognitive Remediation Therapy" as well as the strategic training with coaching proved to be effective. The studies, however, were hardly comparable and very heterogeneous in detail. Summarising the cognitive training

  14. Mycobacterium avium complex (MAC) isolated from AIDS patients and the criteria required for its implication in disease Complexo Mycobacterium avium (MAC) isolado de pacientes com AIDS e os critérios exigidos para sua implicação em doença

    OpenAIRE

    David Jamil Hadad; Maria Cecília de Almeida Palhares; Anna Luiza Nunes Placco; Carmem Silvia Bruniera Domingues; Adauto Castelo Filho; Lucilaine Ferrazoli; Sueli Yoko Mizuka Ueki; Maria Alice da Silva Telles; Maria Conceição Martins; Moisés Palaci

    1995-01-01

    Before the AIDS pandemia, the Mycobacterium avium complex (MAC) was responsible in most cases for the pneumopathies that attack patients with basic chronic pulmonary diseases such as emphysema and chronic bronchitis36. In 1981, with the advent of the acquired immunodeficiency syndrome (AIDS), MAC started to represent one of the most frequent bacterial diseases among AIDS patients, with the disseminated form of the disease being the major clinical manifestation of the infection8. Between Janua...

  15. Proteomic profiling of cellulase-aid-extracted membrane proteins for functional identification of cellulose synthase complexes and their potential associated- components in cotton fibers.

    Science.gov (United States)

    Li, Ao; Wang, Ruyi; Li, Xianliang; Liu, Mingyong; Fan, Jian; Guo, Kai; Luo, Bing; Chen, Tingting; Feng, Shengqiu; Wang, Yanting; Wang, Bingrui; Peng, Liangcai; Xia, Tao

    2016-01-01

    Cotton fibers are an excellent model for understanding of cellulose biosynthesis in higher plants. In this study, we determined a high cellulose biosynthesis activity in vitro by optimizing biochemical reaction conditions in cotton fibers. By adding a commercial cellulase enzyme into fibers extraction process, we extracted markedly higher levels of GhCESA1 and GhCESA8 proteins and observed an increase in β-1,4-glucan and β-1,3-glucan products in vitro. LC-MS/MS analysis of anti-GhCESA8-immunoprecipitated proteins showed that 19 proteins could be found in three independent experiments including four CESAs (GhCESA1,2,7,8), five well-known non-CESA proteins, one callose synthase (CALS) and nine novel proteins. Notably, upon the cellulase treatment, four CESAs, one CALS and four novel proteins were measured at relatively higher levels by calculating total peptide counts and distinct peptide numbers, indicating that the cellulase-aid-extracted proteins most likely contribute to the increase in β-glucan products in vitro. These results suggest that the cellulase treatment may aid to release active cellulose synthases complexes from growing glucan chains and make them more amenable to extraction. To our knowledge, it is the first time report about the functional identification of the potential proteins that were associated with plant cellulose and callose synthases complexes by using the cellulase-aided protein extraction. PMID:27192945

  16. Untangling tau-related dementia

    OpenAIRE

    Heutink, Peter

    2000-01-01

    textabstractAbundant cytoplasmic inclusions consisting of aggregated hyperphosphorylated protein tau are a characteristic pathological observation in several neurodegenerative disorders such as Alzheimer's disease, Pick's disease, frontotemporal dementia, cortico-basal degeneration and progressive supranuclear palsy. The recent finding that mutations in the tau gene are responsible for frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP-17) has provided convincing evidence ...

  17. [Paraneoplastic Neurological Syndrome with Dementia].

    Science.gov (United States)

    Tanaka, Keiko

    2016-04-01

    Paraneoplastic neurological syndrome with limbic encephalopathy tends to progress rapidly, presenting with physical symptoms such as ataxia or sensory disturbance. However, some affected patients demonstrate amnesia, inactivity, or abnormal behavior, which lead to the diagnosis of dementia. It is important to perform an extensive differential diagnosis with autoantibody-examination and tumor survey, so as not to overlook potentially treatable dementia. PMID:27056857

  18. Animal models of dementia

    DEFF Research Database (Denmark)

    Olsson, I. Anna S.; Sandøe, Peter

    2011-01-01

    are here distinguished. These serve as points of orientation in the following discussion of four more specific ethical questions: Does animal species matter? How effective is disease modelling in delivering the benefits claimed for it? What can be done to minimize potential harm to animals in research? Who......This chapter aims to encourage scientists and others interested in the use of animal models of disease – specifically, in the study of dementia – to engage in ethical reflection. It opens with a general discussion of the moral acceptability of animal use in research. Three ethical approaches...... bears responsibility for the use of animals in disease models?...

  19. [Neurosyphilis and Dementia].

    Science.gov (United States)

    Kato, Hiroko; Ando, Tetsuo

    2016-04-01

    The incidence of neurosyphilis has declined dramatically because of the availability of penicillin. However, in recent years there has been an increase in the occurence of neurosyphilis. General paresis, a form of parenchymatous neurosyphilis, causes dementia. Some of the symptoms include loss of memory, poor understanding and judgment, and behavioral changes. It is important to distinguish general paresis from neurodegenerative disorders such as Alzheimer's disease, because with precise diagnosis and treatment, complete recovery is possible We describe epidemiological data, diagnosis and treatment of neurosyphilis as well as present our cases. PMID:27056849

  20. Teaching Mands to Older Adults with Dementia

    Science.gov (United States)

    Oleson, Chelsey R.; Baker, Jonathan C.

    2014-01-01

    Millions of Americans are diagnosed with dementia, and that number is only expected to rise. The diagnosis of dementia comes with impairments, especially in language. Furthermore, dementia-related functional declines appear to be moderated by environmental variables (Alzheimer's Association, "Alzheimer's & Dementia: The Journal of the…

  1. Dementia with Lewy bodies

    Science.gov (United States)

    Graff-Radford, Jonathan; Murray, Melissa E.; Lowe, Val J.; Boeve, Bradley F.; Ferman, Tanis J.; Przybelski, Scott A.; Lesnick, Timothy G.; Senjem, Matthew L.; Gunter, Jeffrey L.; Smith, Glenn E.; Knopman, David S.; Jack, Clifford R.; Dickson, Dennis W.; Petersen, Ronald C.

    2014-01-01

    Objectives: To investigate clinical, imaging, and pathologic associations of the cingulate island sign (CIS) in dementia with Lewy bodies (DLB). Methods: We retrospectively identified and compared patients with a clinical diagnosis of DLB (n = 39); patients with Alzheimer disease (AD) matched by age, sex, and education (n = 39); and cognitively normal controls (n = 78) who underwent 18F-fluorodeoxyglucose (FDG) and C11 Pittsburgh compound B (PiB)-PET scans. Among these patients, we studied those who came to autopsy and underwent Braak neurofibrillary tangle (NFT) staging (n = 10). Results: Patients with a clinical diagnosis of DLB had a higher ratio of posterior cingulate to precuneus plus cuneus metabolism, cingulate island sign (CIS), on FDG-PET than patients with AD (p load on PiB-PET (p = 0.56). Patients with CIS positivity on visual assessment of FDG-PET fit into the group of high- or intermediate-probability DLB pathology and received clinical diagnosis of DLB, not AD. Higher CIS ratio correlated with lower Braak NFT stage (r = −0.96; p patients with DLB. Identifying biomarkers that measure relative contributions of underlying pathologies to dementia is critical as neurotherapeutics move toward targeted treatments. PMID:25056580

  2. Obesity in Indian subjects with Vascular Dementia

    OpenAIRE

    CHANDRA, Mina; Anand, Kuljeet Singh Anand

    2015-01-01

    ABSTRACT Background: Obesity is considered a public health challenge in South Asia. Obesity is an independent risk factor in vascular dementia. It also contributes to other risk factors of vascular dementia like hypertension, coronary artery disease, dyslipidaemia and diabetes. As the rate of obesity in Indian subjects with vascular dementia is not known, we decided to assess obesity in subjects with vascular dementia. Methods: Subjects with vascular dementia presenting to Mem...

  3. Beyond competence: advance directives in dementia research

    OpenAIRE

    Jongsma, Karin Rolanda; van de Vathorst, Suzanne

    2015-01-01

    Dementia is highly prevalent and incurable. The participation of dementia patients in clinical research is indispensable if we want to find an effective treatment for dementia. However, one of the primary challenges in dementia research is the patients’ gradual loss of the capacity to consent. Patients with dementia are characterized by the fact that, at an earlier stage of their life, they were able to give their consent to participation in research. Therefore, the phase when patients are st...

  4. Chylous Ascites in a Patient with HIV/AIDS: A Late Complication of Mycobacterium avium Complex-Immune Reconstitution Inflammatory Syndrome

    Directory of Open Access Journals (Sweden)

    Imam H. Shaik

    2014-01-01

    Full Text Available Chylous ascites is very rare in HIV/AIDS and its association with Mycobacterium avium complex-immune reconstitution inflammatory syndrome (MAC-IRIS has been rarely reported. Here, we report a case of a young African-American male who developed chylous ascites as a late sequela to immune reconstitution inflammatory syndrome while on treatment for MAC. Antiretroviral drug-naive patients who start HAART in close proximity to the diagnosis of an opportunistic infection and have a rapid decline in HIV RNA level should be monitored for development of IRIS. Although the long term prognosis is poor, early diagnosis and treatment help to improve quality of life.

  5. Biomarkers of aggression in dementia.

    Science.gov (United States)

    Gotovac, Kristina; Nikolac Perković, Matea; Pivac, Nela; Borovečki, Fran

    2016-08-01

    Dementia is a clinical syndrome defined by progressive global impairment of acquired cognitive abilities. It can be caused by a number of underlying conditions. The most common types of dementia are Alzheimer's disease (AD), frontotemporal dementia (FTD), vascular cognitive impairment (VCI) and dementia with Lewy bodies (DLB). Despite the fact that cognitive impairment is central to the dementia, noncognitive symptoms, most commonly described nowadays as neuropsychiatric symptoms (NPS) exist almost always at certain point of the illness. Aggression as one of the NPS represents danger both for patients and caregivers and the rate of aggression correlates with the loss of independence, cognitive decline and poor outcome. Therefore, biomarkers of aggression in dementia patients would be of a great importance. Studies have shown that different genetic factors, including monoamine signaling and processing, can be associated with various NPS including aggression. There have been significant and multiple neurotransmitter changes identified in the brains of patients with dementia and some of these changes have been involved in the etiology of NPS. Aggression specific changes have also been observed in neuropathological studies. The current consensus is that the best approach for development of such biomarkers may be incorporation of genetics (polymorphisms), neurobiology (neurotransmitters and neuropathology) and neuroimaging techniques. PMID:26952705

  6. Improving Well-being and Health for People with Dementia (WHELD): study protocol for a randomised controlled trial

    OpenAIRE

    Whitaker, Rhiannon; Fossey, Jane; Ballard, Clive; Orrell, Martin; Moniz-Cook, Esme; Woods, Robert T; Murray, Joanna; Stafford, Jane; Knapp, Martin; Romeo, Renee; Carlton, Barbara Woodward; Testad, Ingelin; Khan, Zunera

    2014-01-01

    Background People with dementia living in care homes often have complex mental health problems, disabilities and social needs. Providing more comprehensive training for staff working in care home environments is a high national priority. It is important that this training is evidence based and delivers improvement for people with dementia residing in these environments. Well-being and Health for People with Dementia (WHELD) combines the most effective elements of existing approaches to develo...

  7. Music therapy in dementia

    DEFF Research Database (Denmark)

    McDermott, Orii; Crellin, Nadia; Ridder, Hanne Mette Ochsner;

    2013-01-01

    Objective Recent reviews on music therapy for people with dementia have been limited to attempting to evaluate whether it is effective, but there is a need for a critical assessment of the literature to provide insight into the possible mechanisms of actions of music therapy. This systematic review......, five studies investigated hormonal and physiological changes, and five studies focused on social and relational aspects of music therapy. The musical interventions in the studies were diverse, but singing featured as an important medium for change. Conclusions Evidence for short-term improvement...... in mood and reduction in behavioural disturbance was consistent, but there were no high-quality longitudinal studies that demonstrated long-term benefits of music therapy. Future music therapy studies need to define a theoretical model, include better-focused outcome measures, and discuss how the findings...

  8. Robotherapy with Dementia Patients

    Directory of Open Access Journals (Sweden)

    Francisco Martín

    2013-01-01

    Full Text Available Humanoids have increasingly become the focus of attention in robotics research in recent years, especially in service and personal assistance robotics. This paper presents the application developed for humanoid robots in the therapy of dementia patients as a cognitive stimulation tool. The behaviour of the robot during the therapy sessions is visually programmed in a session script that allows music to play, physical movements (dancing, exercises, etc., speech synthesis and interaction with the human monitor. The application includes the control software on board the robot and some tools like the visual script generator or a monitor to supervise the robot behaviour during the sessions. The robot applicationʹs impact on the patientʹs health has been studied. Experiments with real patients have been performed in collaboration with a centre of research in neurodegenerative diseases. Initial results show a slight or mild improvement in neuropsychiatric symptoms over other traditional therapy methods.

  9. Coping with Dementia

    DEFF Research Database (Denmark)

    Sørensen, Lisbeth Villemoes; Waldorff, Frans Boch; Waldemar, Gunhild

    2008-01-01

    -living with a spouse. The analysis revealed that the basic social psychological problem faced by patients with mild AD was their awareness of decline in personal dignity and value. Coping strategies used to meet these problems were adaptations to the altered situation in order to maintain a feeling of well......Abstract The aim of this study was to analyse how patients with mild Alzheimer’s disease (AD) cope with the changes they face concerning everyday life and social relations. This study used a grounded theory approach in the analysis of interview data from 11 persons with mild AD, home......-being. The spouse appeared to be the most important social relation. The most significant worries of the patients were about communication in relation to their spouse, and about the reaction of the spouse to the consequences of the disease. Keywords coping; dementia; everyday life; patients’ perspective; social...

  10. Biomarkers of the Dementia

    Directory of Open Access Journals (Sweden)

    Mikio Shoji

    2011-01-01

    Full Text Available Recent advances in biomarker studies on dementia are summarized here. CSF Aβ40, Aβ42, total tau, and phosphorylated tau are the most sensitive biomarkers for diagnosis of Alzheimer's disease (AD and prediction of onset of AD from mild cognitive impairment (MCI. Based on this progress, new diagnostic criteria for AD, MCI, and preclinical AD were proposed by National Institute of Aging (NIA and Alzheimer's Association in August 2010. In these new criteria, progress in biomarker identification and amyloid imaging studies in the past 10 years have added critical information. Huge contributions of basic and clinical studies have established clinical evidence supporting these markers. Based on this progress, essential therapy for cure of AD is urgently expected.

  11. Prisons must develop dementia strategy.

    Science.gov (United States)

    2016-08-01

    'The prison service badly needs a properly resourced national strategy for its rapidly growing population of older prisoners, to guide its staff in their management of age-related conditions, such as dementia'. PMID:27573969

  12. Association between Frailty and Dementia

    DEFF Research Database (Denmark)

    Kulmala, J; Nykänen, I; Mänty, Minna Regina;

    2014-01-01

    of the participants was assessed using the Cardiovascular Health Study criteria. Cognitive function was assessed with the Mini-Mental State Examination (MMSE). Clinically diagnosed dementia was assessed by specialists using diagnostic criteria. The associations between frailty and cognition were investigated using...... logistic regression. Results: A total of 93 (14%) participants were classified as frail. Cognitive impairment (MMSE score disease, 19 (3%) had vascular dementia, 12 (2%) had.......0-15.9), almost 6 times more likely to have vascular dementia (OR 5.6, 95% CI 1.2-25.8) and over 4 times more likely to have Alzheimer's disease (OR 4.5, 95% CI 2.1-9.6) than persons who were robust. Conclusion: Frailty is strongly associated with cognitive impairment and clinically diagnosed dementia among...

  13. Untangling tau-related dementia

    NARCIS (Netherlands)

    P. Heutink (Peter)

    2000-01-01

    textabstractAbundant cytoplasmic inclusions consisting of aggregated hyperphosphorylated protein tau are a characteristic pathological observation in several neurodegenerative disorders such as Alzheimer's disease, Pick's disease, frontotemporal dementia, cortico-basal

  14. Dementia: Depression and Alzheimer's Disease

    Science.gov (United States)

    MENU Return to Web version Dementia | Depression and Alzheimer’s Disease What is depression? When doctors talk about depression, they mean the medical illness called major depression. Someone who has ...

  15. Dementia - behavior and sleep problems

    Science.gov (United States)

    ... the person during outbursts. Do not take their behavior personally. Try to prevent them from getting hurt ... may be the cause of changes in the behavior of the person who has dementia. You think ...

  16. The Italian Dementia National Plan

    Directory of Open Access Journals (Sweden)

    Teresa Di Fiandra

    2015-12-01

    Full Text Available The Italian Dementia National Plan was formulated in October 2014 by the Italian Ministry of Health in close cooperation with the regions, the National Institute of Health and the three major national associations of patients and carers. The main purpose of this strategy was to provide directive indications for promoting and improving interventions in the dementia field, not limiting to specialist and therapeutic actions, but particularly focusing on the support of patients and families throughout the pathways of care. Four main objectives are indicated: 1 promote health- and social-care interventions and policies; 2 create/strengthen the integrated network of services for dementia based on an integrated approach; 3 implement strategies for promoting appropriateness and quality of care; and 4 improve the quality of life of persons with dementia and their families by supporting empowerment and stigma reduction. These objectives and the pertaining actions are described in the present paper.

  17. Auditory hedonic phenotypes in dementia: A behavioural and neuroanatomical analysis.

    Science.gov (United States)

    Fletcher, Phillip D; Downey, Laura E; Golden, Hannah L; Clark, Camilla N; Slattery, Catherine F; Paterson, Ross W; Schott, Jonathan M; Rohrer, Jonathan D; Rossor, Martin N; Warren, Jason D

    2015-06-01

    Patients with dementia may exhibit abnormally altered liking for environmental sounds and music but such altered auditory hedonic responses have not been studied systematically. Here we addressed this issue in a cohort of 73 patients representing major canonical dementia syndromes (behavioural variant frontotemporal dementia (bvFTD), semantic dementia (SD), progressive nonfluent aphasia (PNFA) amnestic Alzheimer's disease (AD)) using a semi-structured caregiver behavioural questionnaire and voxel-based morphometry (VBM) of patients' brain MR images. Behavioural responses signalling abnormal aversion to environmental sounds, aversion to music or heightened pleasure in music ('musicophilia') occurred in around half of the cohort but showed clear syndromic and genetic segregation, occurring in most patients with bvFTD but infrequently in PNFA and more commonly in association with MAPT than C9orf72 mutations. Aversion to sounds was the exclusive auditory phenotype in AD whereas more complex phenotypes including musicophilia were common in bvFTD and SD. Auditory hedonic alterations correlated with grey matter loss in a common, distributed, right-lateralised network including antero-mesial temporal lobe, insula, anterior cingulate and nucleus accumbens. Our findings suggest that abnormalities of auditory hedonic processing are a significant issue in common dementias. Sounds may constitute a novel probe of brain mechanisms for emotional salience coding that are targeted by neurodegenerative disease. PMID:25929717

  18. The Cost of Dementia in Denmark

    DEFF Research Database (Denmark)

    Kronborg Andersen, C; Søgaard, Jes; Hansen, E;

    1999-01-01

    In a population-based study of dementia, the cost of care for 245 demented elderly and 490 controls matched by age and gender was estimated. Dementia of Alzheimer's type was diagnosed according to the NINCDS-ADRDA criteria, and vascular dementia and other types of dementia were diagnosed according...... to the DSM-IIIR criteria. Severity of dementia was determined by the Clinical Dementia Rating scale. The annual cost of medical care, domestic care, home help, nursing home and special equipment for nondemented patients was DKK 22,000 per person while the cost for very mildly, mildly, moderately and...... severely demented patients was DKK 49,000, DKK 93,000, DKK 138,000 and DKK 206,000, respectively. Except for very mild dementia the cost did not differ between elderly who suffer from Alzheimer's disease and those with other types of dementia. The net cost of dementia is the difference in cost between...

  19. Why did an effective Dutch complex psycho-social intervention for people with dementia not work in the German healthcare context? Lessons learnt from a process evaluation alongside a multicentre RCT

    NARCIS (Netherlands)

    Voigt-Radloff, S.; Graff, M.J.L.; Leonhart, R.; Hull, M.; Olde Rikkert, M.G.M.; Vernooij-Dassen, M.J.F.J.

    2011-01-01

    Background The positive effects of the Dutch Community Occupational Therapy in Dementia programme on patients' daily functioning were not found in a multicentre randomised controlled trial (RCT) in Germany. Objectives To evaluate possible effect modification on the primary outcome within the German

  20. Use of photovoice with people with younger onset dementia.

    Science.gov (United States)

    Evans, David; Robertson, Jacinta; Candy, Allen

    2016-07-01

    Photography is a tool that has been used in research for many years. It allows people to create a record of an event, capture a complex phenomenon or to tell a story with pictures. Because it does not rely on language, it can be used with vulnerable populations who might not normally be included in research. This paper discusses the use of photography as one component of the evaluation strategy for a project that provided an opportunity for people with younger onset dementia to return to the workplace one day per week. Participants in the workplace project used photography to create a record of their experience of returning to the workplace. Based on the nature of the participant's comments, photographs were grouped into four broad areas: impact of dementia, impact on family, the work experience and new friends. Issues related to the use of photography with people who have dementia are explored based on the experiences gained during this project. PMID:24962000

  1. Lewy Body Dementia: Information for Patients, Families, and Professionals

    Science.gov (United States)

    ... of Lewy Body Dementia Types of Lewy Body Dementia Causes and Risk Factors Common Symptoms Diagnosis Treatment and Management Advice for People Living with Lewy Body Dementia Caring for a Person with Lewy Body Dementia ...

  2. Frontotemporal dementia to Alzheimer's disease

    OpenAIRE

    Silveri, Maria Caterina

    2007-01-01

    Behavioral manifestations may dominate the clinical picture of the frontal variant of frontotemporal dementia (fv-FTD) for a long time before the appearance of true cognitive deficits. On the other hand, a deficit in the episodic memory domain represents the main manifestation of Alzheimer's disease (AD), Many behavioral disorders have been described in the clinical course of both FTD and AD; however, apathy and personality changes characterize frontal dementias, while depression dominates in...

  3. Social robots in advanced dementia

    OpenAIRE

    Meritxell Valentí Soler; Luis Agüera-Ortiz; Javier Olazarán Rodríguez; Carolina Mendoza Rebolledo; José María Cañas Plaza; Pablo Martínez Martín

    2015-01-01

    Aims: Testing the effect of the experimental robot-based therapeutic sessions for patients with dementia in: a controlled study of parallel groups of nursing home patients comparing the effects of therapy sessions utilizing a humanoid robot (NAO), an animal-shaped robot (PARO), or a trained dog (DOG), with conventional therapy (CONTROL) on symptoms of dementia; and an experience for patients who attend a day care center, comparing symptom prevalence and severity before and after sessions util...

  4. Dementia presenting with visual complaints

    OpenAIRE

    Koutroumanos, Nikolaos; Clarke, Michael P; Mosimann, Urs Peter

    2009-01-01

    A 78-year-old female developed memory problems after a 2-year history of persistent visual complaints. Ocular pathology did not explain the extent of her perceived visual impairment. Cognitive screening tests found prominent visuo-constructive deficits and a comprehensive dementia assessment revealed the diagnosis of Alzheimer’s disease. This case describes visual complaints as the initial symptom of dementia, pre-dating memory impairment by several years. We discuss clinical signs of cerebra...

  5. The pathobiology of vascular dementia

    OpenAIRE

    Iadecola, Costantino

    2013-01-01

    Vascular cognitive impairment defines alterations in cognition, ranging from subtle deficits to full-blown dementia, attributable to cerebrovascular causes. Often coexisting with Alzheimer’s disease, mixed vascular and neurodegenerative dementia has emerged as the leading cause of age-related cognitive impairment. Central to the disease mechanism is the crucial role that cerebral blood vessels play in brain health, not only for the delivery of oxygen and nutrients, but also for the trophic si...

  6. Breaking It Down Is Better: Haptic Decomposition of Complex Movements Aids in Robot-Assisted Motor Learning

    OpenAIRE

    Klein, Julius; Spencer, Steven J.; Reinkensmeyer, David J

    2012-01-01

    Training with haptic guidance has been proposed as a technique for learning complex movements in rehabilitation and sports, but it is unclear how to best deliver guidance-based training. Here, we hypothesized that breaking down a complex movement, similar to a tennis backhand, into simpler parts and then using haptic feedback from a robotic exoskeleton would help the motor system learn the movement. We also examined how the particular form of the decomposition affected learning. Three groups ...

  7. Diagnosing dementia in Dutch general practice: a qualitative study of GPs’ practices and views

    Science.gov (United States)

    Prins, Agnes; Hemke, Feia; Pols, Jeannette; van Charante, Eric P Moll

    2016-01-01

    Background GPs play an important role in recognising the symptoms of dementia; however, little is known about how they perceive their actual and future role in diagnosing dementia. Aim To explore Dutch GPs’ perceptions of their current position in diagnosing dementia, their reasons for referral to secondary care, and views on the future diagnostic role of GPs. Design and setting A qualitative study among Dutch GPs. Method Eighteen GPs participated in a semi-structured interview that ranged from 20 to 60 minutes. Interviews were transcribed verbatim and thematic analysis was performed. Results GPs reported that their role in the diagnostic phase of identifying people with suspected dementia is limited to recognising cognitive problems and deciding whether a patient needs to be referred for further investigation, or whether care could be organised without specialist diagnosis. GPs indicated that they were likely to refer patients if patients/caregivers or dementia case managers requested it, or if they thought it could have consequences for treatment. Typically, GPs do not see the need for referral when their patients are very old and declining slowly. GPs would welcome a more prominent role in diagnosing dementia in their own practice. Conclusion Diagnosing dementia involves a complex balance between patient and carer preferences, the consequences for treatment and care, and the burden of referral. Dutch GPs favour a stronger involvement in diagnosing dementia provided that both resources and diagnostic algorithms are improved. PMID:27114209

  8. A co-design process developing heuristics for practitioners providing end of life care for people with dementia

    OpenAIRE

    Davies, N; R. Mathew; Wilcock, J.; Manthorpe, J; Sampson, E. L.; Lamahewa, K.; Iliffe, S.

    2016-01-01

    Background: The end of life for someone with dementia can present many challenges for practitioners; such as, providing care if there are swallowing difficulties. This study aimed to develop a toolkit of heuristics (rules-of-thumb) to aid practitioners making end-of-life care decisions for people with dementia. / Methods: An iterative co-design approach was adopted using a literature review and qualitative methods, including; 1) qualitative interviews and focus groups with family carers and 2...

  9. Behavioural Excesses and Deficits Associated with Dementia in Adults Who Have Down Syndrome

    Science.gov (United States)

    Oliver, Chris; Kalsy, Sunny; McQuillan, Sharna; Hall, Scott

    2011-01-01

    Background: Informant-based assessment of behavioural change and difference in dementia in Down syndrome can aid diagnosis and inform service delivery. To date few studies have examined the impact of different types of behavioural change. Methods: The Assessment for Adults with Developmental Disabilities (AADS), developed for this study, assesses…

  10. Developing Personally Relevant Goals for People with Mild Dementia.

    Science.gov (United States)

    Khayum, Becky; Wynn, Rachel

    2015-08-01

    Many speech-language pathologists work in the skilled nursing facility setting and frequently treat patients in subacute rehabilitation who are experiencing mild cognitive deficits as a result of dementia. Treatment of these individuals needs to be carefully differentiated from rehabilitative treatment of a stroke or traumatic brain injury. A "habilitation" approach should be considered, focusing on an individual's preserved strengths and developing patient-centered goals that focus upon the integration of personally relevant stimuli into the care plan. Environmental modification, the use of visual memory aids, counseling, and ongoing family education are also essential components of this approach. This case study is a thorough example of how the habilitation approach can be used to provide intervention for a person with mild dementia. The case study will explain indication for treatment, assessment, goal selection, and research to support the treatment plan. PMID:26190510

  11. Structures of HIV-1 RT-DNA complexes before and after incorporation of the anti-AIDS drug tenofovir

    Institute of Scientific and Technical Information of China (English)

    Tuske,S; Sarafianos,SG; Clark,AD; Ding,JP; Naeger,LK; White,KL; Miller,MD; Gibbs,CS; Boyer,PL; Clark,P; Wang,G; Gaffney,BL; Jones,RA; Jerina,DM; Hughes,SH; Arnold,E

    2005-01-01

    Tenofovir, also known as PMPA, R-9-(2-(phosphonomethoxypropyl)adenine, is a nucleotide reverse transcriptas e(RT) inhibitor. We have determined the crystal structures of two related complexes ofHIV-1 RT with template primer and tenofovir: (i) a ternary complex at a resolution of 3.0 Angstrom of RT crosslinked to a dideoxy-terminated DNA with tenofovir-diphosphate bound as the incoming substrate; and (ii) a RT DNA complex at a resolution of 3,1 Angstrom with tenofovir at the 3 primer terminus. The tenofovir nucleotide in the tenofovir-terminated structure seems to adopt multiple conformations. Some nucleoside reverse transcriptase inhibitors, including 3TC and AZT, have dements (handles) that project beyond the corresponding elements on normal dNTPs (the substrate envelope). HIV-1 RT resistance mechanisms to AZT and 3TC take advantage of these handles; tenofovir's structure lacks handles that could protrude through the substrate envelope to cause resistance.

  12. Can an EASYcare based dementia training programme improve diagnostic assessment and management of dementia by general practitioners and primary care nurses? The design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Lucassen PL

    2008-04-01

    Full Text Available Abstract Background Early diagnosis of dementia benefits both patient and caregiver. Nevertheless, dementia in primary care is currently under-diagnosed. Some educational interventions developed to improve dementia diagnosis and management were successful in increasing the number of dementia diagnoses and in changing attitudes and knowledge of health care staff. However, none of these interventions focussed on collaboration between GPs and nurses in dementia care. We developed an EASYcare-based Dementia Training Program (DTP aimed at stimulating collaboration in dementia primary care. We expect this program to increase the number of cognitive assessments and dementia diagnoses and to improve attitudes and knowledge of GPs and nurses. Methods The DTP is a complex educational intervention that consists of two workshops, a coaching program, access to an internet forum, and a Computerized Clinical Decision Support System on dementia diagnostics. One hundred duos of GPs and nurses will be recruited, from which 2/3 will be allocated to the intervention group and 1/3 to the control group. The effects of implementation of the DTP will be studied in a cluster-randomised controlled trial. Primary outcomes will be the number of cognitive assessments and dementia diagnoses in a period of 9 months following workshop participation. Secondary outcomes are measured on GP and nurse level: adherence to national guidelines for dementia, attitude, confidence and knowledge regarding dementia diagnosis and management; on patient level: number of emergency calls, visits and consultations and patient satisfaction; and on caregiver level: informal caregiver burden and satisfaction. Data will be collected from GPs' electronic medical records, self-registration forms and questionnaires. Statistical analysis will be performed using the MANOVA-method. Also, exploratory analyses will be performed, in order to gain insight into barriers and facilitators for implementation and

  13. Brain lipidomes of subcortical ischemic vascular dementia and mixed dementia.

    Science.gov (United States)

    Lam, Sin Man; Wang, Yuting; Duan, Xinrui; Wenk, Markus R; Kalaria, Raj N; Chen, Christopher P; Lai, Mitchell K P; Shui, Guanghou

    2014-10-01

    Despite its importance as the leading cause of vascular dementia, the primary pathogenic mechanisms in subcortical ischemic vascular dementia (SIVD) have remained elusive. Because of the lack of approved therapeutic agents for SIVD, there is a pressing need to identify novel therapeutic targets. Comparative lipidomic analyses of SIVD and mixed dementia (i.e., SIVD and Alzheimer's disease, MixD) may also confer new insights pertaining to the possible interaction between neurodegenerative and vascular mechanisms in the pathogenesis of dementia. Liquid chromatography coupled to mass spectrometry was used to comprehensively analyze the lipidomes of white and gray matter from the temporal cortex of nondemented controls, SIVD, and MixD subjects. Detailed molecular profiles highlighted the pathologic relevance of gray matter sphingolipid fatty acyl chain heterogeneity in dementia. In addition, the levels of sulfatides and lysobisphosphatidic acids were progressively increased in the temporal cortex gray matter from control to SIVD to MixD. White matter phospholipid profiles indicated possible adaptive mechanisms (i.e., increased unsaturation) to chronic ischemia in SIVD and elevated membrane degradation in MixD. PMID:24684787

  14. Treatment of Frontotemporal Dementia

    Science.gov (United States)

    Boxer, Adam L.

    2016-01-01

    Opinion statement Frontotemporal dementia (FTD) encompasses a spectrum of neurodegenerative diseases with heterogeneous clinical presentations and two predominant types of underlying neuropathology. FTD typically comprises three distinct clinical syndromes: behavioral variant frontotemporal dementia (bvFTD), semantic variant primary progressive aphasia (svPPA), and nonfluent variant primary progressive aphasia (nfvPPA). FTD also frequently overlaps both clinically and neuropathologically with three other neurodegenerative syndromes: corticobasal syndrome (CBS), progressive supranuclear palsy (PSP), and amyotrophic lateral sclerosis (ALS). Each syndrome can be associated with one or more underlying neuropathological diagnoses and are referred to as frontotemporal lobar degeneration (FTLD). Although the various FTD syndromes can substantially differ in terms of clinical symptoms and underlying pathology, the symptoms can be broadly categorized into behavioral, cognitive and motor domains. Currently there are no Food and Drug Administration (FDA) approved therapies for the above syndromes except riluzole for ALS. FTD treatment strategies generally rely on off-label use of medications for symptomatic management, and most therapies lack quality evidence from randomized, placebo-controlled clinical trials. For behavioral symptoms, selective serotonin reuptake inhibitors may be effective, while case reports hint at possible efficacy with antipsychotics or antiepileptics, but use of these latter agents is limited due to concerns regarding side effects. There are no effective therapies for cognitive complaints in FTD, which frequently involve executive function, memory, and language. Motor difficulties associated with FTD may present with parkinsonian symptoms or motor neuron disease, for which riluzole is indicated as therapy. Compared to idiopathic Parkinson’s disease, FTD-related atypical parkinsonism is generally not responsive to dopamine replacement therapies, but a

  15. Dementia-Related and Other Factors to Be Taken into Account When Developing ICT Support for People with Dementia - Lessons from Field Trials

    Science.gov (United States)

    Dröes, Rose-Marie; Bentvelzen, Sanne; Meiland, Franka; Craig, David

    When developing assistive technology for people with dementia it is important to take into account their needs and wishes as well as their cognitive abilities and disabilities. In this chapter we describe how the disabilities accompanying dementia can be taken into account when developing assistive technological devices for this target group. As a case example, we used the COGKNOW project, which specifically focuses on developing ICT support for people with mild dementia in the areas of memory, social contact, daily activities and feelings of safety. Before device development in the first year of the project, workshops and interviews involving 17 persons with dementia and their carers were held to discuss their needs, wishes and disabilities and some background and environmental information were obtained. The main dementia-related disabilities that emerged from this cohort and that proved relevant for the development of an assistive technological device were memory and orientation problems, poor understanding of verbal instruction, difficulty with instrumental daily activities and recognizing/understanding the meaning of pictures. Relevant personal and environmental features were living alone or with a carer, the need for company and social contact, the need for support in doing things for fun, using aids like a walking cane, possessing technological appliances that could not be easily used anymore, living in a house with multiple rooms and levels and feeling insecure when being alone. Taken into account these disabilities, background and environmental features, functional requirements were specified and a device was developed, the COGKNOW Day Navigator Version 1 (CDNv-1). The aim of the CDN was to support people with dementia in reminding, social contact, daily activities and safety in a simple manner. After a development period, the user friendliness and usefulness of this device were assessed via a field test in which the CDNv-1 was tested with 16 people with

  16. Comparative cardiovascular safety of dementia medications

    DEFF Research Database (Denmark)

    Fosbøl, Emil L; Peterson, Eric D; Holm, Ellen;

    2012-01-01

    To compare the cardiovascular safety of currently marketed dementia medications in new users in the United States and Denmark.......To compare the cardiovascular safety of currently marketed dementia medications in new users in the United States and Denmark....

  17. Dementia - what to ask your doctor

    Science.gov (United States)

    What to ask your doctor about dementia; Alzheimer disease- what to ask your doctor; Cognitive impairment - what to ask your doctor ... Alzheimer's Association. Dementia Care Practice Recommendations for ... Setting. 2009. Available at: www.alz.org/national/documents/ ...

  18. Dementia - keeping safe in the home

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000031.htm Dementia - keeping safe in the home To use the ... make sure the homes of people who have dementia are safe for them. Safety Tips for the ...

  19. Seniors' Worsening Depression May Sometimes Predict Dementia

    Science.gov (United States)

    ... to early dementia, a new study suggests. The Dutch study can't prove cause-and-effect, and ... participants developed dementia, including 348 cases of Alzheimer's disease. Only those whose symptoms of depression increased over ...

  20. Epistemics and frontotemporal dementia

    Directory of Open Access Journals (Sweden)

    Peter Muntigl

    2014-04-01

    Full Text Available We explore how patients with the behavioural variant of frontotemporal dementia (bvFTD display different degrees of understanding when reporting on their experience of being ill. Using the methods of conversation analysis, we examine thevideo-recordings of bvFTD patients who had participated in clinical follow-up interviews with a doctor. Patient responses to the doctor’s questions were analyzed with respect to the action undertaken (i.e., confirmation vs. denial and the epistemic stance (i.e., certainty vs. uncertainty that was conveyed. We found that although patient denials of being ill were conveyed with certainty, these patients were unable to elaborate on their denials, thus generating an implication that they are not aware of their illness and its effects on their lives. By contrast, patients who confirmed being ill tended to produce expanded responses that either revealed the patient’s primary access to knowledge or the patient’s difficulty in understanding the doctor’s question.

  1. Depression and the risk for dementia

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2012-01-01

    Depression is associated with increased risk of subsequent development of dementia; however, the nature of the association is still poorly understood. The purpose of the review was based on recent studies to discuss whether depression is a prodromal state of dementia or an independent risk factor...... for dementia, as well as to discuss how the type of depression, the type of dementia, and antidepressant treatment influence the association....

  2. Cumulative Effect of Depression on Dementia Risk

    OpenAIRE

    Olazarán, J.; Trincado, R.; Bermejo-Pareja, F.

    2013-01-01

    Objective. To analyze a potential cumulative effect of life-time depression on dementia and Alzheimer's disease (AD), with control of vascular factors (VFs). Methods. This study was a subanalysis of the Neurological Disorders in Central Spain (NEDICES) study. Past and present depression, VFs, dementia status, and dementia due to AD were documented at study inception. Dementia status was also documented after three years. Four groups were created according to baseline data: never depression (n...

  3. Brain perfusion SPECT in dementia syndromes

    International Nuclear Information System (INIS)

    Aim: Brain perfusion SPECT is used in differential diagnostics of dementia syndromes. First of all the aim is to distinguish vascular dementia from degenerative dementia and to differentiate dementia from delirium, psychiatric syndromes, depression and secondary dementia, which is important in relation to therapy. The purpose of our study was to detect significance of BP SPECT and include it into the diagnostic process in dementia syndromes. Materials and methods: 51 women and 63 men aged 55 - 88 were evaluated in the study. The patients correspond to the general criteria of dementia diagnosis. They were sent to the examination by neurological, internal and psychiatric departments and out-patient departments. All patients were examined by 99mTc ECD SPECT using a double head camera PRISM 200 VP with LEHR collimator. The scintigraphic data were evaluated by the visual and semiquantitative analysis. Results: It was established that most patients in our group had vascular dementia, while Alzheimer's disease was second. In other groups we found out dementia at strategic infarct location, e.g. in gyrus angularis in the dominant hemisphere, frontal temporal lobe dementia and alcoholic dementia. Twenty-four patients had a normal diagnosis. Fifteen of them had a somatic reason of the delirious state and were re-classified into pseudodementia. Nine patients were not diagnostically included and the examination will repeated in four months time. Conclusion: We have found out a good applicability of brain perfusion SPECT in dementia syndromes diagnosis in our work. The best diagnosticable and most specific were the findings in multi-infarct dementia, Alzheimer's disease and frontal temporal lobe dementia. When vascular dementia is concerned we can even distinguish dementia at strategic infarction location, e.g. in thalamus, basal frontal telencefalon, in gyrus angularis of the dominant hemisphere, etc

  4. PROMISING STRATEGIES FOR THE PREVENTION OF DEMENTIA

    OpenAIRE

    Middleton, Laura; Yaffe, Kristine

    2009-01-01

    The incidence and prevalence of dementia is expected to increase several fold in the coming decades. Given that the current pharmaceutical treatment of dementia can only modestly improve symptoms, risk factor modification remains the cornerstone for dementia prevention. Some of the most promising strategies for the prevention of dementia include vascular risk factor control, cognitive activity, physical activity, social engagement, diet, and recognition of depression. In observational studies...

  5. Dementia and rural nuclear medicine

    International Nuclear Information System (INIS)

    Full text: The rapid increase in dementia is directly related to the growing number of aged people in developed countries, such as Australia. This increase heightens the need for accurate dementia diagnosis to ensure treatment resources are appropriately allocated. However, current diagnostic methods are unable to determine specific dementia types limiting the effectiveness of many care plans. The lack of specialist resources in rural Australian communities presents nuclear medicine with an opportunity to make a significant impact on the management of this disease. This investigation aimed to identify how SPECT perfusion imaging could maximise its role in the management of dementia in a rural New South Wales setting. The study reviewed all Technetium 99m HMPAO SPECT brain studies over a three-year period. This included a medical record audit, review of all diagnostic imaging reports and an analysis of referral patterns. The results of this study provide compelling evidence that, even in a rural setting, brain SPECT, in conjunction with neuropsychological testing, offers high accuracy in determining the presence and type of dementia. In addition, the study found more than 30% of referrers had no training in SPECT, emphasising the importance of ensuring that brain SPECT reports, in a rural setting, educate and specify to referrers the significance and exact disease type found in the study. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

  6. Tube feeding patients with dementia.

    Science.gov (United States)

    Chernoff, Ronni

    2006-04-01

    As the population ages, the incidence of dementia increases. All types of dementia, whether they are reversible or irreversible, lead to loss of intellectual function and judgment, memory impairment, and personality changes. The skills to feed oneself, use eating utensils, and consume items recognized as food, thereby maintaining nutrition status, may be lost as dementia progresses. Reports indicate that nutrition status may be maintained when patients are hand fed, but this is labor intensive and therefore expensive. Feeding via a percutaneous endoscopic gastrostomy tube is often chosen as an acceptable alternative. Research indicates that there is little benefit in this population when aggressive nutrition support is instituted. Providing tube feeding to patients with dementia does not necessarily extend life, increase weight, or reduce the incidence of pressure ulcers or aspiration. There are many legal and ethical issues involved in the decision to place a feeding tube in demented patients. The primary issue in patients with dementia may be autonomy and the right of an individual to decide whether or not a tube should be placed at all. Legally, there is clear precedent that the courts see the insertion of a feeding tube as extraordinary care that the patient has the right to refuse. However, much of case law is derived from cases of patients who were in a persistent vegetative state. Advance directives help to determine what the patient would want for himself. Considering all the options before the patient can no longer make decisions is the most desirable course. PMID:16556924

  7. Flavonoids and dementia: an update.

    Science.gov (United States)

    Orhan, I E; Daglia, M; Nabavi, S F; Loizzo, M R; Sobarzo-Sánchez, E; Nabavi, S M

    2015-01-01

    Dementia is a strongly age-related syndrome due to cognitive decline that can be considered a typical example of the combination of physiological and pathological aging-associated changes occurring in old people; it ranges from intact cognition to mild cognitive impairment, which is an intermediate stage of cognitive deterioration, and dementia. The spread of this syndrome has induced to study and try to reduce dementia modifiable risk factors. They include insulin resistance and hyperinsulinaemia, high blood pressure, obesity, smoking, depression, cognitive inactivity or low educational attainment as well as physical inactivity and incorrect diet, which can be considered one of the most important factors. One emerging strategy to decrease the prevalence of mild cognitive impairment and dementia may be the use of nutritional interventions. In the last decade, prospective data have suggested that high fruit and vegetable intakes are related to improved cognitive functions and reduced risks of developing a neurodegenerative process. The protective effects against neurodegeneration could be in part due to the intake of flavonoids that have been associated with several health benefits such as antioxidant and anti-inflammatory activities, increased neuronal signaling, and improved metabolic functions. The present article is aimed at reviewing scientific studies that show the protective effects of flavonoid intake against mild cognitive impairment and dementia. PMID:25515512

  8. [Sleep disorders in dementia patients].

    Science.gov (United States)

    Savaskan, E

    2015-06-01

    Dementia is characterized by cognitive and also behavioral and psychological symptoms of dementia (BPSD). The most prominent BPSD are depression and apathy but sleep disorders also complicate the clinical course of dementia. These symptoms are a severe burden for patients and caregivers and are difficult to treat partly due to comorbidities. Common sleep disorders in dementia are insomnia, hypersomnia, circadian rhythm alterations and aberrant nocturnal motor behavior. Sleep duration and rapid eye movement (REM) sleep are reduced. The diagnostic assessment of sleep disorders should include an evaluation of the underlying risk factors and a detailed sleep history for which several assessment instruments are available. The therapy of sleep disorders of dementia is primarily nonpharmacological: sleep counseling, sleep hygiene regulation, relaxation and psychotherapy techniques are given priority. Pharmacological treatment often has severe side effects in this elderly, vulnerable population and can only be considered if other nonpharmacological options have been unsuccessful. The application of medication should be limited in time and dosage. The pharmacological therapeutic options are critically discussed in detail. PMID:25957245

  9. Why did an effective Dutch complex psycho-social intervention for people with dementia not work in the German healthcare context? Lessons learnt from a process evaluation alongside a multicentre RCT

    OpenAIRE

    Voigt-Radloff, S.; Graff, M.J.L.; Leonhart, R.; Hull, M.; Olde Rikkert, M.G.M.; Vernooij-Dassen, M.J.F.J.

    2011-01-01

    Background The positive effects of the Dutch Community Occupational Therapy in Dementia programme on patients' daily functioning were not found in a multicentre randomised controlled trial (RCT) in Germany. Objectives To evaluate possible effect modification on the primary outcome within the German RCT with regard to (1) participant characteristics, (2) treatment performance and (3) healthcare service utilisation; and (4) to compare the design and primary outcome between the German and the or...

  10. Aid Effectiveness

    DEFF Research Database (Denmark)

    Arndt, Channing; Jones, Edward Samuel; Tarp, Finn

    Controversy over the aggregate impact of foreign aid has focused on reduced form estimates of the aid-growth link. The causal chain, through which aid affects developmental outcomes including growth, has received much less attention. We address this gap by: (i) specifying a structural model of the...... main relationships; (ii) estimating the impact of aid on a range of final and intermediate outcomes; and (iii) quantifying a simplied representation of the full structural form, where aid impacts on growth through key intermediate outcomes. A coherent picture emerges: aid stimulates growth and reduces...

  11. Individual Subject Classification of Mixed Dementia from Pure Subcortical Vascular Dementia Based on Subcortical Shape Analysis

    OpenAIRE

    Kim, Hee Jin; Kim, Jeonghun; Cho, Hanna; Ye, Byoung Seok; Yoon, Cindy W.; Noh, Young; Kim, Geon Ha; Lee, Jae Hong; Kim, Jae Seung; Choe, Yearn Seong; Lee, Kyung-Han; Kim, Chang-Hun; Seo, Sang Won; Weiner, Michael W.; Na, Duk L.

    2013-01-01

    Subcortical vascular dementia (SVaD), one of common causes of dementia, has concomitant Alzheimer's disease (AD) pathology in over 30%, termed “mixed dementia”. Identifying mixed dementia from SVaD is important because potential amyloid-targeted therapies may be effective for treatment in mixed dementia. The purpose of this study was to discriminate mixed dementia from pure SVaD using magnetic resonance imaging (MRI). We measured brain amyloid deposition using the 11C-Pittsburgh compound B po...

  12. Smoking, dementia and cognitive decline in the elderly, a systematic review

    Directory of Open Access Journals (Sweden)

    Burch Lisa

    2008-12-01

    Full Text Available Abstract Background Nicotine may aid reaction time, learning and memory, but smoking increases cardiovascular risk. Cardiovascular risk factors have been linked to increased risk of dementia. A previous meta-analysis found that current smokers were at higher risk of subsequent dementia, Alzheimer's disease, vascular dementia and cognitive decline. Methods In order to update and examine this further a systematic review and meta-analysis was carried out using different search and inclusion criteria, database selection and more recent publications. Both reviews were restricted to those aged 65 and over. Results The review reported here found a significantly increased risk of Alzheimer's disease with current smoking and a likely but not significantly increased risk of vascular dementia, dementia unspecified and cognitive decline. Neither review found clear relationships with former smoking. Conclusion Current smoking increases risk of Alzheimer's disease and may increase risk of other dementias. This reinforces need for smoking cessation, particularly aged 65 and over. Nicotine alone needs further investigation.

  13. Dementia worry and its relationship to dementia exposure, psychological factors, and subjective memory concerns.

    Science.gov (United States)

    Kinzer, Adrianna; Suhr, Julie A

    2016-01-01

    With increased societal awareness of dementia, older adults show increased concern about developing dementia, leading to misidentification of aging-related cognitive glitches as signs of dementia. While some researchers have suggested self-reported cognitive concerns accurately identify older adults with early signs of dementia, there is evidence that subjective cognitive decline is not associated with objective cognitive performance and instead reflects psychological factors consistent with models of health anxiety, including dementia worry. We examined the construct of dementia worry and its relationship to subjective memory concerns in 100 older adults (Mage = 69 years) without signs of dementia, using a recently developed measure of dementia worry. Consistent with hypotheses, dementia worry was related to exposure to dementia, having a high number of depressive or general worry symptoms, and having more memory concerns. Exposure to dementia moderated the relationship of dementia worry to depression and general worry. Furthermore, dementia worry moderated the relationship of objective memory impairment to subjective memory ratings. The results provide further evidence of the role of psychological factors such as dementia worry in subjective memory report and emphasize the need for objective cognitive testing before making determinations about dementia in older adults expressing memory concerns. PMID:26496236

  14. AIDS (image)

    Science.gov (United States)

    AIDS (acquired immune deficiency syndrome) is caused by HIV (human immunodeficiency virus), and is a syndrome that ... life-threatening illnesses. There is no cure for AIDS, but treatment with antiviral medication can suppress symptoms. ...

  15. Hearing Aids

    Science.gov (United States)

    ... more in both quiet and noisy situations. Hearing aids help people who have hearing loss from damage ... your doctor. There are different kinds of hearing aids. They differ by size, their placement on or ...

  16. Hearing Aids

    Science.gov (United States)

    ... electrical nerve impulses and send them to the auditory nerve, which connects the inner ear to the ... prefer. Cleaning makes a difference in hearing aid comfort. A perfectly comfortable hearing aid can become pretty ...

  17. Foreign aid

    DEFF Research Database (Denmark)

    Tarp, Finn

    2008-01-01

    Foreign aid has evolved significantly since the Second World War in response to a dramatically changing global political and economic context. This article (a) reviews this process and associated trends in the volume and distribution of foreign aid; (b) reviews the goals, principles and instituti......Foreign aid has evolved significantly since the Second World War in response to a dramatically changing global political and economic context. This article (a) reviews this process and associated trends in the volume and distribution of foreign aid; (b) reviews the goals, principles and...... institutions of the aid system; and (c) discusses whether aid has been effective. While much of the original optimism about the impact of foreign aid needed modification, there is solid evidence that aid has indeed helped further growth and poverty reduction...

  18. Radiologic diagnostics of dementia; Radiologische Demenzdiagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Essig, M. [Radiologie, Deutsches Krebsforschungszentrum Heidelberg (Germany); Radiologie, Deutsches Krebsforschungszentrum Heidelberg, Im Neuenheimer Feld 280, 69120, Heidelberg (Germany); Schoenberg, S.O. [Institut fuer klinische Radiologie, Ludwig-Maximilians-Universitaet Muenchen (Germany)

    2003-07-01

    Dementia is one of the most common diseases in the elderly population and is getting more and more important with the ageing of the population. A radiologic structural examination with CT or MRI is meanwhile a standard procedure in the diagnostic work up of patients with dementia syndrome. Radiology enables an early diagnosis and a differential diagnosis between different causes of dementia. Because structural changes occur only late in the disease process, a more detailed structural analysis using volumetric techniques or the use of functional imaging techniques is mandatory. These days, structural imaging uses MRI which enables to detect early atrophic changes at the medial temporal lobe with focus on the amygdala hippocampal complex. These changes are also present in the normal ageing process. In patients with Alzheimer's disease, however, they are more rapid and more pronounced. The use of functional imaging methods such as perfusion MRI, diffusion MRI or fMRI allow new insights into the pathophysiologic changes of dementia. The article gives an overview of the current status of structural imaging and an outlook into the potential of functional imaging methods. Detailed results of structural and functional imaging are presented in other articles of this issue. (orig.) [German] Demenzielle Syndrome gehoeren zu den haeufigsten Erkrankungen im hoeheren Lebensalter und werden mit einer Zunahme der Ueberalterung in der Bevoelkerung volkswirtschaftlich immer bedeutender. Die radiologische Untersuchung mittels struktureller CT oder MRT gehoert mittlerweile zur Standardabklaerung jeder demenziellen Symptomatik. Sie dient der Frueherkennung und der Differenzialdiagnostik der verschiedenen Ursachen einer Demenz. Dies gilt insbesondere in Hinblick auf zu erwartende und bereits vorhandene Therapiemoeglichkeiten. Da jedoch strukturelle Veraenderungen erst relativ spaet im Fortschreiten der Erkrankung visualisiert werden koennen, sind detaillierte strukturelle

  19. Prediction of dementia in primary care patients.

    Directory of Open Access Journals (Sweden)

    Frank Jessen

    Full Text Available BACKGROUND: Current approaches for AD prediction are based on biomarkers, which are however of restricted availability in primary care. AD prediction tools for primary care are therefore needed. We present a prediction score based on information that can be obtained in the primary care setting. METHODOLOGY/PRINCIPAL FINDINGS: We performed a longitudinal cohort study in 3.055 non-demented individuals above 75 years recruited via primary care chart registries (Study on Aging, Cognition and Dementia, AgeCoDe. After the baseline investigation we performed three follow-up investigations at 18 months intervals with incident dementia as the primary outcome. The best set of predictors was extracted from the baseline variables in one randomly selected half of the sample. This set included age, subjective memory impairment, performance on delayed verbal recall and verbal fluency, on the Mini-Mental-State-Examination, and on an instrumental activities of daily living scale. These variables were aggregated to a prediction score, which achieved a prediction accuracy of 0.84 for AD. The score was applied to the second half of the sample (test cohort. Here, the prediction accuracy was 0.79. With a cut-off of at least 80% sensitivity in the first cohort, 79.6% sensitivity, 66.4% specificity, 14.7% positive predictive value (PPV and 97.8% negative predictive value of (NPV for AD were achieved in the test cohort. At a cut-off for a high risk population (5% of individuals with the highest risk score in the first cohort the PPV for AD was 39.1% (52% for any dementia in the test cohort. CONCLUSIONS: The prediction score has useful prediction accuracy. It can define individuals (1 sensitively for low cost-low risk interventions, or (2 more specific and with increased PPV for measures of prevention with greater costs or risks. As it is independent of technical aids, it may be used within large scale prevention programs.

  20. Radionuclide brain imaging in acquired immunodeficiency syndrome (AIDS)

    International Nuclear Information System (INIS)

    Infection with the Human Immunodeficiency Virus type 1 (HIV-1) may produce a variety of central nervous system (CNS) symptoms and signs. CNS involvement in patients with the Acquired Immunodeficiency Syndrome (AIDS) includes AIDS dementia complex or HIV-1 associated cognitive/motor complex (widely known as HIV encephalopathy), progressive multifocal leucoencephalopathy (PML), opportunistic infections such as Toxoplasma gondii, TB, Cryptococcus and infiltration by non-Hodgkin's B cell lymphoma. High resolution structural imaging investigations, either X-ray Computed Tomography (CT scan) or Magnetic Resonance Imaging (MRI) have contributed to the understanding and definition of cerebral damage caused by HIV encephalopathy. Atrophy and mainly high signal scattered white matter abnormalities are commonly seen with MRI. PML produces focal white matter high signal abnormalities due to multiple foci of demyelination. However, using structural imaging techniques there are no reliable parameters to distinguish focal lesions due to opportunistic infection (Toxoplasma gondii abscess) from neoplasm (lymphoma infiltration). It is studied the use of radionuclide brain imaging techniques in the investigation of HIV infected patients. Brain perfusion Single Photon Emission Tomography (SPET), neuroreceptor and Positron Emission Tomography (PET) studies are reviewed. Greater emphasis is put on the potential of some radiopharmaceuticals, considered to be brain tumour markers, to distinguish intracerebral lymphoma infiltration from Toxoplasma infection. SPET with 201Tl using quantification (tumour to non-tumour radioactivity ratios) appears a very promising technique to identify intracerebral lymphoma

  1. Radionuclide brain imaging in acquired immunodeficiency syndrome (AIDS)

    Energy Technology Data Exchange (ETDEWEB)

    Costa, D.C.; Gacinovic, S.; Miller, R.F. [London University College Medical School, Middlesex Hospital, London (United Kingdom)

    1995-09-01

    Infection with the Human Immunodeficiency Virus type 1 (HIV-1) may produce a variety of central nervous system (CNS) symptoms and signs. CNS involvement in patients with the Acquired Immunodeficiency Syndrome (AIDS) includes AIDS dementia complex or HIV-1 associated cognitive/motor complex (widely known as HIV encephalopathy), progressive multifocal leucoencephalopathy (PML), opportunistic infections such as Toxoplasma gondii, TB, Cryptococcus and infiltration by non-Hodgkin`s B cell lymphoma. High resolution structural imaging investigations, either X-ray Computed Tomography (CT scan) or Magnetic Resonance Imaging (MRI) have contributed to the understanding and definition of cerebral damage caused by HIV encephalopathy. Atrophy and mainly high signal scattered white matter abnormalities are commonly seen with MRI. PML produces focal white matter high signal abnormalities due to multiple foci of demyelination. However, using structural imaging techniques there are no reliable parameters to distinguish focal lesions due to opportunistic infection (Toxoplasma gondii abscess) from neoplasm (lymphoma infiltration). It is studied the use of radionuclide brain imaging techniques in the investigation of HIV infected patients. Brain perfusion Single Photon Emission Tomography (SPET), neuroreceptor and Positron Emission Tomography (PET) studies are reviewed. Greater emphasis is put on the potential of some radiopharmaceuticals, considered to be brain tumour markers, to distinguish intracerebral lymphoma infiltration from Toxoplasma infection. SPET with {sup 201}Tl using quantification (tumour to non-tumour radioactivity ratios) appears a very promising technique to identify intracerebral lymphoma.

  2. A claims data-based comparison of comorbidity in individuals with and without dementia

    OpenAIRE

    Bauer, Kathrin; Schwarzkopf, Larissa; Graessel, Elmar; Holle, Rolf

    2014-01-01

    Background Multimorbidity is common in advanced age, and is usually associated with negative – yet to some extent preventable – health outcomes. Detecting comorbid conditions is especially difficult in individuals with dementia, as they might not always be able to sufficiently express discomfort. This study compares relevant comorbidity complexes in elderly people with and without dementia, with a particular look at gender- and living environment-specific differences. Moreover, association...

  3. Unique Contribution of Family Functioning in Caregivers of Patients with Mild to Moderate Dementia

    OpenAIRE

    Tremont, Geoffrey; Davis, Jennifer Duncan; Bishop, Duane S.

    2006-01-01

    The relationship between family functioning and dementia caregiving is complex. The present study examined the inter-relationships between family functioning, caregiver burden, and patient characteristics. Participants were 72 live-in, family caregivers of patients with mild (n = 47) or moderate dementia (n = 25). Caregivers completed measures of burden, family functioning, depression, and anxiety. Ratings of patients’ memory/behavior problems and patients’ activities of daily living (ADLs) w...

  4. Dealing with behavioral and psychological symptoms of dementia: a general overview

    OpenAIRE

    Azermai M

    2015-01-01

    Majda Azermai Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium Abstract: Dealing with the behavioral and psychological symptoms of dementia (BPSD) is often complex. Given the controversy with regard to antipsychotics for behavioral problems in people with dementia, there has been a renewed emphasis on nonpharmacological interventions, with progress in the design of the relevant studies. Potential nonpharmacological interventions for BPSD are: cognitive training/stimulation...

  5. Risk of dementia: The Rotterdam Study

    OpenAIRE

    Ott, Alewijn

    1997-01-01

    textabstractDementia is a frequent disorder in the elderly. It is also a distressing condition both for the patient and caregiver. Dementia puts a high claim on health care costs. In the Netherlands about one tenth of the yearly health budget is spent on nursing homes. Dementia is the. main diagnosis in 40% of nursing home patients and coexisting dementia may be the underlying. motive for admittance to a nursing home in patients with other diseases. 1•2 The need for dementia care will probabl...

  6. Mathematical Modeling of Complex Reaction Systems for Computer-Aided Control and its Illustration on Atmospheric Chemistry

    Science.gov (United States)

    Amiryan, A.

    2015-12-01

    Modeling of sequential process has its own importance in Atmospheric Chemistry. Numerical calculations which allow to predict separate stages and components of chemical reaction make possible the reaction management, such is the new and perspective direction in chemical researches. Chemical processes basically pass multiple simple stages where various atoms and radicals participate. The complex chain of chemical reactionary systems complicates their research and the research is impossible without new methods of mathematical simulation and high technologies which allow not only to explain results of experiments but also to predict dynamics of processes. A new program package is suggested for solving research problems of chemical kinetics. The program is tested on different illustrative examples on Atmospheric Chemistry and installed in various scientific and educational institutions.

  7. Cobalamin deficiency, hyperhomocysteinemia, and dementia

    Directory of Open Access Journals (Sweden)

    Steven F Werder

    2010-04-01

    Full Text Available Steven F Werder1,21Kansas University School of Medicine – Wichita, Wichita, KS, USA; 2Community Health Center of Southeast Kansas, Pittsburg, KS, USAIntroduction: Although consensus guidelines recommend checking serum B12 in patients with dementia, clinicians are often faced with various questions: (1 Which patients should be tested? (2 What test should be ordered? (3 How are inferences made from such testing? (4 In addition to serum B12, should other tests be ordered? (5 Is B12 deficiency compatible with dementia of the Alzheimer’s type? (6 What is to be expected from treatment? (7 How is B12 deficiency treated?Methods: On January 31st, 2009, a Medline search was performed revealing 1,627 citations related to cobalamin deficiency, hyperhomocysteinemia, and dementia. After limiting the search terms, all abstracts and/or articles and other references were categorized into six major groups (general, biochemistry, manifestations, associations and risks, evaluation, and treatment and then reviewed in answering the above questions.Results: The six major groups above are described in detail. Seventy-five key studies, series, and clinical trials were identified. Evidence-based suggestions for patient management were developed.Discussion: Evidence is convincing that hyperhomocysteinemia, with or without hypovitaminosis B12, is a risk factor for dementia. In the absence of hyperhomocysteinemia, evidence is less convincing that hypovitaminosis B12 is a risk factor for dementia. B12 deficiency manifestations are variable and include abnormal psychiatric, neurological, gastrointestinal, and hematological findings. Radiological images of individuals with hyperhomocysteinemia frequently demonstrate leukoaraiosis. Assessing serum B12 and treatment of B12 deficiency is crucial for those cases in which pernicious anemia is suspected and may be useful for mild cognitive impairment and mild to moderate dementia. The serum B12 level is the standard initial test

  8. The initial recognition and diagnosis of dementia.

    Science.gov (United States)

    Knopman, D S

    1998-04-27

    Dementia is characterized by a decline in cognition, behavioral disturbances, and interference with daily functioning and independence. Diagnosis is sometimes delayed as patients or family members often misattribute obvious manifestations of cognitive decline to normal aging rather than to the onset of a degenerative disease. Many physicians do not perform mental status examinations or do not use them effectively to detect early symptoms. Clinical markers are available to decrease the difficulty in distinguishing dementia from depression and confusional states such as delirium. Alzheimer's disease (AD) is the most common form of dementia; others include rapidly progressive dementias, dementias associated with strokes and Parkinson's disease, and frontotemporal dementias. Often, AD coexists with other forms of dementia. Sensitivity to early warning signs, interviews with family members, and mental status examinations are essential to early detection of AD, and will prove useful to primary-care physicians who care for older patients. PMID:9617846

  9. Comparison of Hippocampal Volume in Dementia Subtypes

    International Nuclear Information System (INIS)

    Aims. To examine the relationship between different types of dementia and hippocampal volume. Methods. Hippocampal volume was measured using FL3D sequence magnetic resonance imaging in 26 Alzheimer's, vascular dementia, mixed dementia, and normal pressure hydrocephalus patients and 15 healthy controls and also hippocampal ratio, analyzed. Minimental scale was used to stratify patients on cognitive function impairments. Results. Hippocampal volume and ratio was reduced by 25% in Alzheimer's disease, 21% in mixed dementia, 11% in vascular dementia and 5% in normal pressure hydrocephalus in comparison to control. Also an asymmetrical decrease in volume of left hippocampus was noted. The severity of dementia increased in accordance to decreasing hippocampal volume. Conclusion. Measurement in hippocampal volume may facilitate in differentiating different types of dementia and in disease progression. There was a correlation between hippocampal volume and severity of cognitive impairment

  10. Polyclonal infections due to Mycobacterium avium complex in patients with AIDS detected by pulsed-field gel electrophoresis of sequential clinical isolates.

    Science.gov (United States)

    Slutsky, A M; Arbeit, R D; Barber, T W; Rich, J; von Reyn, C F; Pieciak, W; Barlow, M A; Maslow, J N

    1994-01-01

    Invasive infection with organisms of the Mycobacterium avium complex (MAC) is common among patients with advanced human immunodeficiency virus infection. In previous studies, we analyzed multiple individual colonies of MAC isolated from specimens obtained at the same time and observed that 14 to 20% of patients are simultaneously infected with more than one strain. In this study, we examined sequential isolates from 12 patients with AIDS who had two or more MAC isolates available from clinical specimens collected more than 1 week apart; the intervals between the first and last specimens ranged from 8 to 192 (median, 46) days. For each isolate, restriction digests of genomic DNA were analyzed by pulsed-field gel electrophoresis; DNA was prepared by using a protocol, described here in detail, which had been optimized for conditions of bacterial growth and lysis. The pulsed-field gel electrophoresis analysis identified four patients (33%) infected with two different MAC strains. Both M. avium and M. intracellulare were cultured from blood specimens from two patients. In each of the four patients, the second strain was identified from a culture taken within 14 days of the initial study isolate, and in three of these patients, the first strain was detected again in a subsequent culture. These observations suggest that the presence of two different strains among isolates from sequential cultures may reflect ongoing polyclonal infection. We conclude that polyclonal infection with MAC is common among patients with AIDS. The identification of such infections may be critical in the development of effective treatments. Images PMID:7929773

  11. Aid Supplies Over Time

    DEFF Research Database (Denmark)

    Jones, Edward Samuel

    2015-01-01

    What determines how much foreign aid donors provide? Existing answers to this question point to a complex range of influences. However, the tasks of distinguishing between long- and short-run factors, as well as differences between donors, have not been adequately addressed. Taking advantage of...... data spanning nearly 50 years, this paper uses panel cointegration techniques to consider these issues. The analysis provides clear evidence for heterogeneity both between donors and over time, bandwagon effects, and a growing influence of security considerations in aid provision. Domestic...... macroeconomic shocks have a moderate but delayed effect on aid disbursements....

  12. Disparity in Frontal Lobe Connectivity on a Complex Bimanual Motor Task Aids in Classification of Operator Skill Level.

    Science.gov (United States)

    Andreu-Perez, Javier; Leff, Daniel Richard; Shetty, Kunal; Darzi, Ara; Yang, Guang-Zhong

    2016-06-01

    Objective metrics of technical performance (e.g., dexterity, time, and path length) are insufficient to fully characterize operator skill level, which may be encoded deep within neural function. Unlike reports that capture plasticity across days or weeks, this articles studies long-term plasticity in functional connectivity that occurs over years of professional task practice. Optical neuroimaging data are acquired from professional surgeons of varying experience on a complex bimanual coordination task with the aim of investigating learning-related disparity in frontal lobe functional connectivity that arises as a consequence of motor skill level. The results suggest that prefrontal and premotor seed connectivity is more critical during naïve versus expert performance. Given learning-related differences in connectivity, a least-squares support vector machine with a radial basis function kernel is employed to evaluate skill level using connectivity data. The results demonstrate discrimination of operator skill level with accuracy ≥0.82 and Multiclass Matthew's Correlation Coefficient ≥0.70. Furthermore, these indices are improved when local (i.e., within-region) rather than inter-regional (i.e., between-region) frontal connectivity is considered (p = 0.002). The results suggest that it is possible to classify operator skill level with good accuracy from functional connectivity data, upon which objective assessment and neurofeedback may be used to improve operator performance during technical skill training. PMID:26899241

  13. ICC-dementia (International Centenarian Consortium - dementia): an international consortium to determine the prevalence and incidence of dementia in centenarians across diverse ethnoracial and sociocultural groups

    OpenAIRE

    Brodaty, Henry; Woolf, Claudia; Andersen, Stacy; Barzilai, Nir; Brayne, Carol; Cheung, Karen Siu-Lan; Corrada, Maria M.; Crawford, John D; Daly, Catriona; Gondo, Yasuyuki; Hagberg, Bo; Hirose, Nobuyoshi; Holstege, Henne; Kawas, Claudia; Kaye, Jeffrey

    2016-01-01

    Background Considerable variability exists in international prevalence and incidence estimates of dementia. The accuracy of estimates of dementia in the oldest-old and the controversial question of whether dementia incidence and prevalence decline at very old age will be crucial for better understanding the dynamics between survival to extreme old age and the occurrence and risk for various types of dementia and comorbidities. International Centenarian Consortium – Dementia (ICC-Dementia) see...

  14. Caffeine, Diabetes, Cognition, and Dementia

    NARCIS (Netherlands)

    Biessels, Geert Jan

    2010-01-01

    People with diabetes mellitus are at increased risk of cognitive dysfunction. This review explores the relation between caffeine intake, diabetes, cognition and dementia, focusing on type 2 diabetes (T2DM). Epidemiological studies on caffeine/coffee intake and T2DM risk are reviewed. Next, the impac

  15. Frontotemporal dementia and its subtypes

    DEFF Research Database (Denmark)

    Ferrari, Raffaele; Hernandez, Dena G; Nalls, Michael A;

    2014-01-01

    from 2154 patients with FTD and 4308 controls), we did separate association analyses for each FTD subtype (behavioural variant FTD, semantic dementia, progressive non-fluent aphasia, and FTD overlapping with motor neuron disease [FTD-MND]), followed by a meta-analysis of the entire dataset. We carried...

  16. Does lithium protect against dementia?

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Forman, Julie Lyng; Andersen, Per Kragh

    2010-01-01

    OBJECTIVE: To investigate whether treatment with lithium in patients with mania or bipolar disorder is associated with a decreased rate of subsequent dementia. METHODS: Linkage of register data on prescribed lithium in all patients discharged from psychiatric health care service with a diagnosis ...

  17. TRANSLATIONAL RESEARCH IN NEUROLOGY: DEMENTIA

    OpenAIRE

    Honig, Lawrence S.

    2012-01-01

    Dementia disorders are characterized by clinicopathological criteria. Molecular understandings of these disorders, based on immunohistochemical studies, biochemical investigations, genetic approaches, and animal models have resulted in advances in diagnosis. Likewise translational research has allowed application of increasing basic scientific knowledge regarding neurodegeneration, to the rational development of new investigational therapies based on current understanding of disease pathogene...

  18. A protocol for an exploratory phase I mixed-methods study of enhanced integrated care for care home residents with advanced dementia: the Compassion Intervention

    OpenAIRE

    Elliott, M.; Harrington, J.; Moore, K.; Davis, S.; Kupeli, N.; Vickerstaff, V.; Gola, A; Candy, B; Sampson, E. L.; Jones, L.

    2014-01-01

    Introduction In the UK approximately 700 000 people are living with, and a third of people aged over 65 will die with, dementia. People with dementia may receive poor quality care towards the end of life. We applied a realist approach and used mixed methods to develop a complex intervention to improve care for people with advanced dementia and their family carers. Consensus on intervention content was achieved using the RAND UCLA appropriateness method and mapped to sociological theories of p...

  19. Population Surveillance of Dementia Mortality

    Directory of Open Access Journals (Sweden)

    Richard F. Gillum

    2011-04-01

    Full Text Available Geographic and temporal variation in occurrence of dementia within the US has received little attention despite its importance for generation of new etiologic hypotheses and health services research. We examine methodological problems in the use of vital statistics data for assessing variation over time, among states and within states in the US. We analyzed the US multiple cause of death files for 2005–2006 and 1999–2000 US deaths with Alzheimer’s Disease (International Classification of Disease 10th revision code G30 and other dementias (codes F01, F02, R54 coded as underlying or contributing cause of death based on the death certificate. Age-adjusted death rates were computed by year, state or county for persons aged 65 years and over. In 2005–2006 combined, 555,904 total deaths occurred with any dementia type (212,386 for Alzheimer’s disease coded as underlying or contributing cause. Among the states, age-adjusted rates per 100,000 per year varied by two fold ranging from 458 in New York to 921 in Oregon. Similar geographic patterns were seen for Alzheimer’s disease. However, between 1999–2000 and 2005–2006 the US death rate for all dementia increased only from 559 to 695 (24% while that for Alzheimer’s disease doubled from 135 to 266. Use of specific (G30, F01 versus non-specific diagnoses (F02, R54 varied among states and over time, explaining most of the temporal increase in rate of Alzheimer’s disease. Further research is needed to assess artifacts of diagnosis, certification or coding, utilization of health services, versus biological variation as possible causes of temporal and geographic variation to enhance utility of mortality data for dementia monitoring and research.

  20. Neural correlates of visual hallucinations in dementia with Lewy bodies

    OpenAIRE

    Heitz, Camille; Noblet, Vincent; Cretin, Benjamin; Philippi, Nathalie; Kremer, Laurent; Stackfleth, Mélanie; Hubele, Fabrice; Armspach, Jean Paul; Namer, Izzie; Blanc, Frédéric

    2015-01-01

    Introduction The aim of this study was to investigate the association between visual hallucinations in dementia with Lewy bodies (DLB) and brain perfusion using single-photon emission computed tomography. Methods We retrospectively included 66 patients with DLB, 36 of whom were having visual hallucinations (DLB-hallu) and 30 of whom were not (DLB-c). We assessed visual hallucination severity on a 3-point scale of increasing severity: illusions, simple visual hallucinations and complex visual ...

  1. Stroke injury, cognitive impairment and vascular dementia.

    Science.gov (United States)

    Kalaria, Raj N; Akinyemi, Rufus; Ihara, Masafumi

    2016-05-01

    The global burden of ischaemic strokes is almost 4-fold greater than haemorrhagic strokes. Current evidence suggests that 25-30% of ischaemic stroke survivors develop immediate or delayed vascular cognitive impairment (VCI) or vascular dementia (VaD). Dementia after stroke injury may encompass all types of cognitive disorders. States of cognitive dysfunction before the index stroke are described under the umbrella of pre-stroke dementia, which may entail vascular changes as well as insidious neurodegenerative processes. Risk factors for cognitive impairment and dementia after stroke are multifactorial including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischaemic attack or recurrent stroke and depressive illness. Neuroimaging determinants of dementia after stroke comprise silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Until recently, the neuropathology of dementia after stroke was poorly defined. Most of post-stroke dementia is consistent with VaD involving multiple substrates. Microinfarction, microvascular changes related to blood-brain barrier damage, focal neuronal atrophy and low burden of co-existing neurodegenerative pathology appear key substrates of dementia after stroke injury. The elucidation of mechanisms of dementia after stroke injury will enable establishment of effective strategy for symptomatic relief and prevention. Controlling vascular disease risk factors is essential to reduce the burden of cognitive dysfunction after stroke. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock. PMID:26806700

  2. Study of the clinical and the neuroradiological findings in multi-infarct dementia and Alzheimer type dementia

    Energy Technology Data Exchange (ETDEWEB)

    Endo, Riuko (Tokyo Women' s Medical Coll. (Japan))

    1989-06-01

    In forty patients with dementia, a comparison of the clinical and the neuroradiological findings between 15 Alzheimer type dementia (ATD) and 21 multi-infarct dementia (MID) were made. MID had significantly (p<0.01) higher Hachinski's Ischemic Score (HIS) (mean +-S.D., 9.7+-1.8) compared with ATD (3.6+-1.5). The HIS was a useful diagnostic aid in differential diagnosis between the two groups. MID significantly (p<0.01) had cerebrovascular risk factors such as hypertension, diabetes mellitus and increase of platelet aggregation. The morphometric analysis of the ratios of the ventricular dilatation, the cortical atrophy, and the white matter changes was performed on the CT scan and the magnetic resonance imaging. This was the first time the method of having the cortical atrophy analyzed by the ratio of the area of the sylvian sulci and the area of the whole brain had been used. It was found that the degrees of the ventricular dilatation, the cortical atrophy, and the white matter changes were more increased in MID than in ATD (p<0.01{similar to}0.05). In ATD, there was a positive correlation between Hasegawa's Dementia Scale and both the ratios of the ventricular dilatation, and the cortical atrophy (r=-0.62, p<0.05, r=-0.63, p<0.05, respectively). Also a comparative study between MID and 9 patients with multiple infarction, without dementia (MI). MID had the mean infarct numbers of 6.5+-2.5, and MI had 4.1+-2.2. The white matter changes were more increased in MID than MI (p<0.05). The incidence of the dementia was significantly higher in cases with left lenticular nucleus (p<0.01) or main lesions of the white matter in the left frontal lobe (p<0.05), and in cases with bilateral lenticular nucleus (p<0.01), compared to cases without lesions. (J.P.N.).

  3. A study of the clinical and the neuroradiological findings in multi-infarct dementia and Alzheimer type dementia

    International Nuclear Information System (INIS)

    In forty patients with dementia, a comparison of the clinical and the neuroradiological findings between 15 Alzheimer type dementia (ATD) and 21 multi-infarct dementia (MID) were made. MID had significantly (p<0.01) higher Hachinski's Ischemic Score (HIS) (mean ±S.D., 9.7±1.8) compared with ATD (3.6±1.5). The HIS was a useful diagnostic aid in differential diagnosis between the two groups. MID significantly (p<0.01) had cerebrovascular risk factors such as hypertension, diabetes mellitus and increase of platelet aggregation. The morphometric analysis of the ratios of the ventricular dilatation, the cortical atrophy, and the white matter changes was performed on the CT scan and the magnetic resonance imaging. This was the first time the method of having the cortical atrophy analyzed by the ratio of the area of the sylvian sulci and the area of the whole brain had been used. It was found that the degrees of the ventricular dilatation, the cortical atrophy, and the white matter changes were more increased in MID than in ATD (p<0.01∼0.05). In ATD, there was a positive correlation between Hasegawa's Dementia Scale and both the ratios of the ventricular dilatation, and the cortical atrophy (r=-0.62, p<0.05, r=-0.63, p<0.05, respectively). Also a comparative study between MID and 9 patients with multiple infarction, without dementia (MI). MID had the mean infarct numbers of 6.5±2.5, and MI had 4.1±2.2. The white matter changes were more increased in MID than MI (p<0.05). The incidence of the dementia was significantly higher in cases with left lenticular nucleus (p<0.01) or main lesions of the white matter in the left frontal lobe (p<0.05), and in cases with bilateral lenticular nucleus (p<0.01), compared to cases without lesions. (J.P.N.)

  4. A smartphone application to evaluate technology adoption and usage in persons with dementia.

    Science.gov (United States)

    Hartin, Phillip J; Nugent, Chris D; McClean, Sally I; Cleland, Ian; Norton, Maria C; Sanders, Chelsea; Tschanz, JoAnn T

    2014-01-01

    Dementia affects a proportionally large number of the older population, presenting a set of symptoms that cause cognitive decline and negatively affect quality of life. Technology offers an assistive role for some of these symptoms, specifically in addressing forgetfulness. Current works have explored the benefits of reminding technology, which whilst useful is only effective for those who adopt the technology. Therefore it is of merit to establish the individual parameters that characterize an adopter and non-adopter, to better target future interventions and their deployment. To aid the collection of this data a smartphone app was developed for persons with dementia. It has been designed as both a reminder application to help those with dementia accommodate their forgetfulness and a data collection tool to log usage and compliance with reminders. The app has been evaluated by a pre-pilot cohort (n=9) and was found to have a mean reminder acknowledgement of 73.09%. PMID:25571212

  5. Making the animal model for AIDS research more precise: the impact of major histocompatibility complex (MHC) genes on pathogenesis and disease progression in SIV-infected monkeys.

    Science.gov (United States)

    Sauermann, U

    2001-09-01

    Experimentally infected rhesus monkeys serve as an indispensable animal model to assess the pathogenesis, to validate therapy approaches and to develop vaccination strategies against viral diseases such as AIDS threatening the human population. Upon infection with simian immunodeficiency virus (SIV), a retrovirus closely related to the human immunodeficiency virus (HIV), macaques develop clinical manifestations similar to those of HIV-infected humans. As in humans, the disease course is variable. Polymorphic genes of the major histocompatibility complex (MHC) are required for the initiation and regulation of a specific immune response and represent a major host factor accounting for the differential outcome of infection. During the last few years, our understanding of the structure and function of the rhesus macaque MHC has increased substantially. Functional studies have led to the identification of specific SIV and HIV peptide epitopes presented by rhesus macaque MHC molecules. The subsequent development of MHC class I tetramers has allowed further insight into the cellular immune response following SIV-infection. Detailed studies demonstrated that viral escape mutants are generated during the acute and chronic phase of infection and explain why control of viral replication ultimately fails. Furthermore, particular MHC haplotypes which influence disease progression have been discovered. Thus, MHC-typing can have a prognostic potential. The further elucidation of the rhesus macaque MHC and the search for other relevant genes will remain an important task for future research and will stimulate all immunologically-related investigations in macaques. PMID:11899095

  6. Planning for the Future After a Diagnosis of Dementia

    Science.gov (United States)

    ... Planning for the Future After a Diagnosis of Dementia Planning for the Future After a Diagnosis of Dementia If you or a family member has been diagnosed with dementia, it’s important to start planning for the future. ...

  7. Hospice access for individuals with dementia.

    Science.gov (United States)

    McCarty, Catherine Elizabeth; Volicer, Ladislav

    Involvement in a hospice program is important because it may allow individuals with dementia to delay or prevent institutionalization as well as provide psychosocial support for their families. Once used mostly by patients with a terminal cancer, now more than one half of the hospice patients have diagnoses other than cancer. Yet hospice is still underused for individuals dying with advanced dementia. We conducted a pilot study of hospice agencies to determine barriers and characteristics of dementia hospice enrollment. Using a mailed questionnaire and interview, we looked at demographics, accessibility, training, referral sources, and marketing. Our analysis divided the agencies based on dementia census and availability to non-Medicare eligible individuals. Results showed hospices having Bridge and Transition programs had on average 4 times higher Alzheimer's disease (AD) and dementia census than hospices without these programs. The highest rated barriers to hospice use for individuals with dementia were prognosis, education, and finance. PMID:19812416

  8. Clinical Assessment And Diagnosis Of Dementia

    Directory of Open Access Journals (Sweden)

    Srikanth S

    2005-01-01

    Full Text Available Dementia is characterized by progressive decline in an alert individual, leading to loss of independence in day-to-day functioning. It is a generic term for a condition that has various causes and hence myriad clinical presentations. It has to be distinguished from age-related cognitive decline, depression and delirium all of which are common in the elderly population. Detailed history and mental status examination are necessary to identify dementia, fit it into one of the various bedside classifications and pursue the differential diagnosis. This teaching review summarizes current information on definition, differential diagnosis and classification of dementia and presents a brief elaboration of bedside cognitive testing pertaining to dementia. A bird′s eye view of the profiles of various dementia subtypes is also provided so that after reading this article the reader will able to recognize dementia, conduct clinical examination to identify the characteristic cognitive profile and formulate the differential diagnosis with confidence.

  9. Is it possible to prevent dementia?

    Directory of Open Access Journals (Sweden)

    Lautenschlager Nicola T

    2002-01-01

    Full Text Available It is a robust trend that the World's population is growing older. The proportion of elderly compared to other age groups and especially the number of oldest old, above age 85 years, is steadily increasing. One of the most common disorders in later life is dementia, the major cause of functional disability and the need for long-term care. This has prompted intensive research towards identifying risk factors associated with dementia. For current therapeutic intervention of incipient dementia and future prevention trials it is important to identify subjects at high risk of developing dementia. This article reviews clinical and biological findings of the quest to identify pre-dementia in subjects with mild cognitive impairment. It gives an overview of the present knowledge in this area and discusses strategies that may be useful in delaying the onset of dementia.

  10. Hearing Aids

    Science.gov (United States)

    ... prefer the open-fit hearing aid because their perception of their voice does not sound “plugged up.” ... My voice sounds too loud. The “plugged-up” sensation that causes a hearing aid user’s voice to ...

  11. Brand Aid

    DEFF Research Database (Denmark)

    Richey, Lisa Ann; Ponte, Stefano

    A critical account of the rise of celebrity-driven “compassionate consumption” Cofounded by the rock star Bono in 2006, Product RED exemplifies a new trend in celebrity-driven international aid and development, one explicitly linked to commerce, not philanthropy. Brand Aid offers a deeply informed...

  12. Extraordinary Vessels Needling for Vascular Dementia

    Institute of Scientific and Technical Information of China (English)

    YU Jin; LAI Xin-sheng; HUANG Qiu-tang; XIAO Yuan-chun

    2003-01-01

    Purpose To observe the clinical efficacy of extraordinary vessels needling in treating vascular dementia. Method 39 cases vascular dementia were treated by acupoints selected from the eight extraordinary meridians and the time needling techniques such as eight methods of spiritual turtle, in accordance with time period and pattern identifition. Results 2 cases were cured, 30 cases improved and 7 cases failed; the total effective rate was 82.1%. Conclusion Extraordinary vessels needling has positive effects in treating vascular dementia.

  13. Concepts of care for people with dementia

    OpenAIRE

    Greiner, Wolfgang; Willich, Stefan N.; Vauth, Christoph; Roll, Stefanie; Schwarzbach, Christoph; Nocon, Marc; Rieckmann, Nina

    2009-01-01

    Introduction Today there are approximately one million people with dementia in Germany. If current demographic trends continue, this number is likely to rise substantially in the coming years. In the older population, dementia is the most frequent reason for long-term care. Because most forms of dementia cannot be cured, the aim of treatment is to delay disease progression and to maintain functioning and quality of life. Research questions What is the evidence on different a...

  14. Diagnosing dementia: do we get it right?

    OpenAIRE

    Homer, A. C.; Honavar, M; Lantos, P L; Hastie, I R; Kellett, J M; Millard, P H

    1988-01-01

    To find out whether the diagnosis of dementia agreed with findings at necropsy a detailed assessment of 27 elderly patients (mean age 82 (range 70-94] presenting with dementia was conducted at a combined department of geriatric medicine and psychiatry for the elderly. On the basis of the results the cause of the dementia was diagnosed clinically. Neuropathological examinations were performed after death. The clinical diagnosis made during life was not supported by the findings at necropsy in ...

  15. Behavioral and psychological symptoms of dementia

    OpenAIRE

    JoaquimCerejeira; ElizabetaMukaetova-Ladinska

    2012-01-01

    Behavioral and psychological symptoms of dementia (BPSD), also known as neuropsychiatric symptoms, represent a heterogeneous group of non-cognitive symptoms and behaviors occurring in subjects with dementia. BPSD constitute a major component of the dementia syndrome irrespective of its subtype. They are as clinically relevant as cognitive symptoms as they strongly correlate with the degree of functional and cognitive impairment. BPSD include agitation, aberrant motor behavior, anxiety, elatio...

  16. Post stroke dementia and Post stroke depression

    OpenAIRE

    Trkanjec, Zlatko

    2012-01-01

    Stroke is the rapid loss of brain function due to disturbance in the blood supply to the brain causing predominantly motor and sensory symptoms. However, stroke can cause some other symptoms. Post stroke dementia and depression are probably the most important non-motor consequences of stroke. Post stroke dementia and depression are important and often overlooked symptoms following stroke. Treatment options for Post stroke dementia and depression are still limited, therefore diagnosis of Post ...

  17. Depression and Risk of Developing Dementia

    OpenAIRE

    Byers, Amy L.; Yaffe, Kristine

    2011-01-01

    Depression is highly common throughout the life course and dementia is common in late life. The literature suggests an association between depression and dementia, and growing evidence implies that timing of depression may be important to defining the nature of the association. In particular, earlier-life depression or depressive symptoms consistently have been shown to be associated with a 2-fold or greater increase in risk of dementia. In contrast, studies of late-life depression have been ...

  18. A Dementia Case Presenting with Psychotic Symptoms

    Directory of Open Access Journals (Sweden)

    Osman Ozdemir

    2013-06-01

    Full Text Available Dementia is a progressive clinical syndrome in which affected areas of brain function may be affected, such as memory, language, abstract thinking, problem solving and attention. Psychotic symptoms include auditory and visual hallucinations and delusions, which usually occur in the dementia. In this paper, a dementia case presenting with psychotic symptoms is presented. [Cukurova Med J 2013; 38(3.000: 482-486

  19. CT and MRI of dementia disorders

    Energy Technology Data Exchange (ETDEWEB)

    Momoshima, Suketaka; Fujiwara, Hirokazu [Keio Univ., Tokyo (Japan). School of Medicine

    2002-06-01

    Imaging diagnosis plays a critical role in the initial evaluation of dementia disorders despite its limited specificity. The two major causes of dementia are neurodegenerative disorders including Alzheimer disease and diffuse vascular disorders, some of which show characteristic findings on CT and MRI. Although effective treatment is not yet available for most of these entities, there is possibility that early diagnosis by imaging could lead to preventive measures in future. Some illustrative cases of dementia diseases are demonstrated. (author)

  20. CT and MRI of dementia disorders

    International Nuclear Information System (INIS)

    Imaging diagnosis plays a critical role in the initial evaluation of dementia disorders despite its limited specificity. The two major causes of dementia are neurodegenerative disorders including Alzheimer disease and diffuse vascular disorders, some of which show characteristic findings on CT and MRI. Although effective treatment is not yet available for most of these entities, there is possibility that early diagnosis by imaging could lead to preventive measures in future. Some illustrative cases of dementia diseases are demonstrated. (author)

  1. Behavioral symptoms and caregiver burden in dementia

    OpenAIRE

    Shaji, K. S.; George, Roy K.; Prince, Martin J.; K S Jacob

    2009-01-01

    Background: Dementia care in developing countries will continue to be provided by co-resident caregivers at home. Behavioral and Psychological Symptoms of Dementia (BPSD) are difficult to manage at home. Interventions leading to reduction or remission of reduction or remission of BPSD will be of immense help in the management of these patients. Materials and Methods: The nature and prevalence of BPSD in a community sample of patients with dementia was assessed by a clinician. The impact of th...

  2. Therapeutic Architecture: Housing for People with Dementia

    OpenAIRE

    Campbell, Elizabeth Ann

    2005-01-01

    An environment strongly influences the behavior of individuals with dementia. A well designed physical environment can maintain and enhance the ability to function and improve quality of life. My thesis uses a residential environment for people suffering from dementia as the basis for therapeutic intervention. Understanding the physical and psychological effects of architecture on a person with dementia is an important tool in slowing the progression and effects of the disease. The compet...

  3. Vascular risk factors, cognitve decline, and dementia

    OpenAIRE

    Hanon, Olivier

    2008-01-01

    E Duron, Olivier HanonBroca Hospital, Paris, FranceAbstract: Dementia is one of the most important neurological disorders in the elderly. Aging is associated with a large increase in the prevalence and incidence of degenerative (Alzheimer’s disease) and vascular dementia, leading to a devastating loss of autonomy. In view of the increasing longevity of populations worldwide, prevention of dementia has turned into a major public health challenge. In the past decade, several vascular ...

  4. Molecular imaging for the diagnosis of dementia

    International Nuclear Information System (INIS)

    Many radiotracers have been developed to visualize pathological protein accumulation and neurotransmitter deficits in the brains of patients with dementia using positron emission tomography (PET). Recent advances in the development of β-sheet binding agents enabled in vivo detection of senile plaques in Alzheimer's disease. Molecular imaging using these agents would contribute to the early and accurate diagnosis of dementia and monitoring therapeutic effect of anti-dementia drugs. (author)

  5. Dance for Individuals With Dementia.

    Science.gov (United States)

    Lapum, Jennifer L; Bar, Rachel J

    2016-03-01

    The movement and music associated with dance plays an important role in many individuals' lives and can become imprinted upon the body and mind. Dance is thus closely associated with memory because of these deep connections. Without conscious thought, dance has the potential to be initiated as individuals age. In the current article, the authors share narrative reflections about their experiences with, and the potential of, dance as an intervention for aging populations diagnosed with dementia-related diseases. They draw upon their experiences in working with the aging population and a dance program currently being developed by Canada's National Ballet School and Baycrest Health Sciences for individuals with dementia-related diseases in long-term care. The current article is structured as dialogue between the authors because it mimics dance as a dialogical encounter between movement and music, and/or between individuals. PMID:26935188

  6. Car drivers with dementia : different complications due to different aetiologies?

    OpenAIRE

    Piersma, D. Waard, D. de Davidse, R. Tucha, O. & Brouwer,W.

    2015-01-01

    Older drivers with dementia are an at-risk group for unsafe driving. However, dementia refers to various aetiologies and the question is whether dementias of different aetiology have similar effects on driving ability. The literature on the effects of dementia of various aetiologies on driving ability is reviewed. Studies addressing dementia aetiologies and driving were identified through PubMed, PsychINFO and Google Scholar. Early symptoms and prognoses differ between dementias of different ...

  7. CHOLINESTERASE INHIBITORS IN THE TREATMENT OF DEMENTIA ALZHEIMER’S

    OpenAIRE

    Prameidya Primaniar S

    2013-01-01

    Dementia is the loss of intellectual abilities which include decreased ability to think, remember,understand, calculate, concentrate, and find the right words. The causes of dementia areAlzheimer’s, vascular dementia, alcohol. Dementia Alzheimer’s is a dementia type that iscurrently the most commonly found. Cholinesterase inhibitors are one of the therapies used totreat symptoms of cognitive decline and reduce neuropsychiatric symptoms in patient dementiaAlzheimer’s. Several studies have been...

  8. Poststroke dementia in the elderly.

    Science.gov (United States)

    Mackowiak-Cordoliani, Marie-Anne; Bombois, Stéphanie; Memin, Armelle; Hénon, Hilde; Pasquier, Florence

    2005-01-01

    Risk of dementia increases after stroke, and poststroke dementia (PSD) is an important cause of disability in the elderly. The prevalence rates of PSD vary from 12.2% to 31.8% within 3 months to 1 year after stroke, depending on patient populations and the diagnostic criteria used in the numerous studies. Incidence rates of PSD increase with time after the stroke. Although vascular lesions and white matter changes can explain the cognitive disorders seen in stroke patients, an underlying neurodegenerative disorder may contribute to the development of PSD. Cognitive decline may pre-date the stroke and follow a progressive course after the stroke. The vascular and degenerative processes involved share common environmental and genetic risk factors. This review explains the mechanisms of dementia in stroke patients and identifies predictive factors for PSD. The following points are successively considered: (i) demographic characteristics of the patients, including age and level of education; (ii) prestroke cognitive decline; (iii) vascular risk factors, including diabetes mellitus and prior strokes; (iv) stroke characteristics, including severity and location of the vascular lesion; (v) co-morbid disorders; and (vi) abnormalities on brain imaging, including location, size and number of vascular lesions, white matter changes and cerebral atrophy. Older age, prestroke cognitive decline, stroke recurrence, hypoxic-ischaemic disorders, left-side infarcts, strategic infarcts and white matter lesions appear to be the main predictive factors of PSD. Prevention of stroke should reduce the morbidity and mortality associated with PSD. In addition, management of PSD with secondary prevention treatments could reduce occurrence of further strokes. Cholinesterase inhibitors may be beneficial not only in Alzheimer's disease associated with cerebrovascular lesions, but also for the treatment of cholinergic dysfunction arising from pure vascular dementia. Better knowledge of the risk

  9. Social robots in advanced dementia

    Directory of Open Access Journals (Sweden)

    Meritxell eValentí Soler

    2015-09-01

    Full Text Available Aims: Testing the effect of the experimental robot-based therapeutic sessions for patients with dementia in: a controlled study of parallel groups of nursing home patients comparing the effects of therapy sessions utilizing a humanoid robot (NAO, an animal-shaped robot (PARO, or a trained dog (DOG, with conventional therapy (CONTROL on symptoms of dementia; and an experience for patients who attend a day care center, comparing symptom prevalence and severity before and after sessions utilizing NAO and PARO. Methods: In the nursing home, patients were randomly assigned by blocks, based on dementia severity, to one of the 3 therapeutic groups to compare: CONTROL, PARO and NAO (phase 1 and CONTROL, PARO and DOG (phase 2. In the day care center, all patients received therapy with NAO (phase 1 and PARO (phase 2. Therapy sessions were held 2 days/week for 3 months. Evaluation at baseline and follow-up was carried out by blind raters using: the Global Deterioration Scale (GDS, the Severe Mini Mental State Examination (sMMSE, the Mini Mental State Examination (MMSE, the Neuropsychiatric Inventory (NPI, the Apathy Scale for Institutionalized Patients with Dementia Nursing Home version (APADEM-NH, the Apathy Inventory (AI and the Quality of Life Scale (QUALID. Statistical analysis included descriptive statistics and non parametric tests performed by a blinded investigator. Results: In the nursing home, 101 patients (phase 1 and 110 patients (phase 2 were included. There were no significant differences at baseline. The relevant changes at follow-up were: (phase 1 patients in the robot groups showed an improvement in apathy; patients in NAO group showed a decline in cognition as measured by the MMSE scores, but not the sMMSE; the robot groups showed no significant changes between them; (phase 2 QUALID scores increased in the PARO group. In the day care center, 20 patients (phase 1 and 17 patients (phase 2 were included. The main findings were: (phase 1 imp

  10. Who knows, who cares? Dementia knowledge among nurses, care workers, and family members of people living with dementia.

    Science.gov (United States)

    Robinson, Andrew; Eccleston, Claire; Annear, Michael; Elliott, Kate-Ellen; Andrews, Sharon; Stirling, Christine; Ashby, Michael; Donohue, Catherine; Banks, Susan; Toye, Christine; McInerney, Fran

    2014-01-01

    The number of people with dementia is increasing rapidly worldwide. Commensurate with population ageing, the use of nursing homes in Australia (known as residential aged care facilities) for individuals with dementia is growing. As a terminal condition, dementia is best managed by instituting a palliative approach to care. A good knowledge of dementia, including its progression and management, among staff and families of people living with dementia is essential for clear decision making and the provision of appropriate care. Yet there is limited information regarding relative levels of dementia knowledge. This paper reports the results of a study that assessed dementia knowledge among these two cohorts using the Dementia Knowledge Assessment Tool; the study surveyed 279 staff members and 164 family members of residents with dementia. Dementia knowledge deficits were evident in both cohorts across a range of areas. It is critical that dementia knowledge deficits are identified and addressed in order to support evidence-based dementia care. PMID:25265739

  11. Direct costs of dementia in nursing homes

    Directory of Open Access Journals (Sweden)

    Hilma Caravau

    2015-07-01

    Full Text Available Dementia represents an economical burden to societies nowadays. Total dementia expenses are calculated by the sum of direct and indirect costs. Through the stages of the diseases, as the patients may require institutionalization or a formal caregiver, the direct costs tend to increase. This study aims to analyze the direct costs of dementia in Portuguese nursing homes in 2012, compare the spending between seniors with and without dementia, and propose a predictive costs model. The expenses analysis was based on (1 the use of emergency rooms and doctor’s appointments, either in public or private institutions; (2 days of hospitalization; (3 medication; (4 social services use; (5 the need for technical support; and (6 the utilization of rehabilitation services. The sample was composed of 72 people, half with dementia and half without. The average annual expense of a patient with dementia was €15,287 thousand, while the cost of a patient without dementia was about €12,289 thousand. The variables ‘ability to make yourself understood’, ‘self-performance: getting dressed’ and ‘thyroid disorders’ were found to be statistically significant in predicting the expenses’ increase. In nursing homes, in 2012, the costs per patient with dementia were 1, 2 times higher than per patient without dementia.

  12. Coronary artery disease in patients with dementia.

    Science.gov (United States)

    Fowkes, Ross; Byrne, Matthew; Sinclair, Hannah; Tang, Eugene; Kunadian, Vijay

    2016-09-01

    Our population is ageing. The prevalence of dementia is increasing as the population ages. Dementia is known to share many common risk factors with coronary artery disease including age, genetics, smoking, the components of the metabolic syndrome and inflammation. Despite the growing ageing population with dementia, there is underutilization of optimal care (pharmacotherapy and interventional procedures) in this cohort. Given common risk factors and potential benefit, patients with cognitive impairment and dementia should be offered contemporary care. However, further research evaluating optimal care in this patient cohort is warranted. PMID:27159265

  13. White matter dementia in CADASIL.

    Science.gov (United States)

    Filley, C M; Thompson, L L; Sze, C I; Simon, J A; Paskavitz, J F; Kleinschmidt-DeMasters, B K

    1999-03-01

    Cerebral white matter disorders may be associated with profound neurobehavioral dysfunction. We report a 62-year-old man who had a slowly progressive 25-year history of personality change, psychosis, mood disorder, and dementia. Neurologic examination disclosed abulia, impaired memory retrieval, and preserved language, with only minimal motor impairment. Neuropsychological testing found a sustained attention deficit, cognitive slowing, impaired learning with intact recognition, and perseveration. Magnetic resonance imaging of the brain revealed extensive leukoencephalopathy. Right frontal brain biopsy showed ill-defined white matter pallor with hyaline narrowing of white matter arterioles. Granular osmiophilic material adjacent to vascular smooth muscle cells on electron microscopy of a skin biopsy, and an arginine for cysteine replacement at position 169 in the 4 EGF motif of the notch 3 region on chromosome 19q12 established the diagnosis of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). This case illustrates that CADASIL can manifest as an isolated neurobehavioral disorder over an extended time period. The dementia associated with CADASIL closely resembles that which may occur with other white matter disorders, and represents an example of white matter dementia. PMID:10371078

  14. Genomics of Dementia: APOE- and CYP2D6-Related Pharmacogenetics

    Directory of Open Access Journals (Sweden)

    Ramón Cacabelos

    2012-01-01

    Full Text Available Dementia is a major problem of health in developed societies. Alzheimer’s disease (AD, vascular dementia, and mixed dementia account for over 90% of the most prevalent forms of dementia. Both genetic and environmental factors are determinant for the phenotypic expression of dementia. AD is a complex disorder in which many different gene clusters may be involved. Most genes screened to date belong to different proteomic and metabolomic pathways potentially affecting AD pathogenesis. The ε4 variant of the APOE gene seems to be a major risk factor for both degenerative and vascular dementia. Metabolic factors, cerebrovascular disorders, and epigenetic phenomena also contribute to neurodegeneration. Five categories of genes are mainly involved in pharmacogenomics: genes associated with disease pathogenesis, genes associated with the mechanism of action of a particular drug, genes associated with phase I and phase II metabolic reactions, genes associated with transporters, and pleiotropic genes and/or genes associated with concomitant pathologies. The APOE and CYP2D6 genes have been extensively studied in AD. The therapeutic response to conventional drugs in patients with AD is genotype specific, with CYP2D6-PMs, CYP2D6-UMs, and APOE-4/4 carriers acting as the worst responders. APOE and CYP2D6 may cooperate, as pleiotropic genes, in the metabolism of drugs and hepatic function. The introduction of pharmacogenetic procedures into AD pharmacological treatment may help to optimize therapeutics.

  15. Quantitative Electroencephalography as a Diagnostic Tool for Alzheimer's Dementia in Adults with Down Syndrome

    Science.gov (United States)

    Salem, Lise Cronberg; Sabers, Anne; Kjaer, Troels W.; Musaeus, Christian; Nielsen, Martin N.; Nielsen, Anne-Grete; Waldemar, Gunhild

    2015-01-01

    Background Assessment of dementia in individuals with intellectual disability is complex due to great inter-individual variability in cognitive function prior to dementia and a lack of standardized instruments. Studies have indicated that quantitative electroencephalography (qEEG) results may be used as a diagnostic marker for dementia. The aim of this study was to examine the value of qEEG in the diagnostic evaluation of dementia in patients with Down syndrome (DS). Method The study included 21 patients with DS and mild-to-moderate dementia due to Alzheimer's disease (DS-AD) and 16 age-matched adults with DS without cognitive deterioration assessed by the informant-based Dementia Screening Questionnaire in Intellectual Disability (DSQIID). Conventional EEG was performed and analysed quantitatively using fast Fourier transformation. Outcomes were centroid frequency, peak frequency, absolute power, and relative power. Results In several regions of the brain, a significant decrease in the theta-1 band (4-7 Hz) was identified for the centroid frequency. A significant negative correlation was demonstrated between the mean of the centroid frequency of the theta-1 band and the total DSQIID score. Conclusion We found that qEEG can detect a significant decrease in centroid frequency in a sample of patients with DS-AD as compared to a sample of adults with DS and no cognitive deterioration. PMID:26628899

  16. Dementia and Its Implications for Public Health

    Directory of Open Access Journals (Sweden)

    Robert F. Anda, MD, MS

    2006-03-01

    Full Text Available IntroductionWith the aging of the U.S. population, a better understanding of the presentation and impact of dementia is essential to the future of public health. Dementia refers not to a single disorder but to a number of syndromes characterized by diverse behavioral, cognitive, and emotional impairments. Because dementia is costly in terms of both personal suffering and economic loss, an understanding of its prevalence, risk factors, and potential interventions is emerging as an increasingly important facet of public health and health care delivery. Recent advances in the understanding of its presentation, course, and relevant interventions have taken place.MethodsWe identified articles for review primarily by conducting a Medline search using the subject headings dementia, mild cognitive impairment, Alzheimer’s disease, vascular dementia, frontotemporal dementia, and Lewy body dementia. Other relevant studies were elicited through a Medline search using the subject headings mental disorders and stigma. ResultsDementia represents a diverse category of syndromes characterized by deficits in memory, cognitive function, and behavior. Symptoms associated with dementia appear to be distributed along a continuum, with even subsyndromal presentations affecting the health of older adults and meriting intervention. To promote cognitive functioning and independence among older adults, public health interventions need to facilitate both early detection and treatment of dementia. The availability of adult day care and respite services is important in maintaining the health and quality of life of individuals caring for older adults with dementia. Recent advances in the treatment of dementia may slow the course of cognitive decline, thereby enhancing the quality of life of older individuals as well as decreasing costs associated with institutional care.ConclusionDespite the growing availability of pharmacologic and psychosocial interventions that are

  17. Connecting research discovery with care delivery in dementia: the development of the Indianapolis Discovery Network for Dementia

    Directory of Open Access Journals (Sweden)

    Boustani MA

    2012-11-01

    Full Text Available Malaz A Boustani,1–3 Amie Frame,1,2 Stephanie Munger,1,2 Patrick Healey,4 Jessie Westlund,5 Martin Farlow,6,7 Ann Hake,8 Mary Guerriero Austrom,6,9 Polly Shepard,10 Corby Bubp,10 Jose Azar,3 Arif Nazir,3 Nadia Adams,11 Noll L Campbell,1,2,12,13 Azita Chehresa,5 Paul Dexter2,31Indiana University Center for Aging Research, 2Regenstrief Institute, Inc, 3Department of Medicine, Indiana University School of Medicine (IUSM, 4St Vincent Health Network, 5Community Health Network, 6Indiana Alzheimer Disease Center, IUSM, 7Department of Neurology, IUSM, 8Eli Lilly and Company, 9Department of Psychiatry, IUSM, 10The Memory Clinic of Indianapolis, 11Indiana University Health, Indianapolis, IN, USA; 12Department of Pharmacy Practice, Purdue University College of Pharmacy, West Lafayette, IN, USA; 13Department of Pharmacy, Wishard Health Services, Indianapolis, IN, USABackground: The US Institute of Medicine has recommended an integrated, locally sensitive collaboration among the various members of the community, health care systems, and research organizations to improve dementia care and dementia research.Methods: Using complex adaptive system theory and reflective adaptive process, we developed a professional network called the “Indianapolis Discovery Network for Dementia” (IDND. The IDND facilitates effective and sustainable interactions among a local and diverse group of dementia researchers, clinical providers, and community advocates interested in improving care for dementia patients in Indianapolis, Indiana.Results: The IDND was established in February 2006 and now includes more than 250 members from more than 30 local (central Indiana organizations representing 20 disciplines. The network uses two types of communication to connect its members. The first is a 2-hour face-to-face bimonthly meeting open to all members. The second is a web-based resource center (http://www.indydiscoverynetwork.org. To date, the network has: (1 accomplished the

  18. Development of a computer-aided diagnostic system for Alzheimer's disease using magnetic resonance imaging

    OpenAIRE

    Murase, Kenya; Gondo, Naohiko; Soma, Tsutomu

    2016-01-01

    Alzheimer's disease (AD) is the most common type of dementia accompanied with brain atrophy. Structural measurements of brain atrophy in specific brain structures such as hippocampus using magnetic resonance imaging (MRI) have been reported to detect the development of dementia early in the course of the disease. The purpose of this study was to develop a computer-aided diagnostic system for AD using MRI, which is based on the automatic volumetry of segmented brain images and generation of th...

  19. Complexity

    CERN Document Server

    Gershenson, Carlos

    2011-01-01

    The term complexity derives etymologically from the Latin plexus, which means interwoven. Intuitively, this implies that something complex is composed by elements that are difficult to separate. This difficulty arises from the relevant interactions that take place between components. This lack of separability is at odds with the classical scientific method - which has been used since the times of Galileo, Newton, Descartes, and Laplace - and has also influenced philosophy and engineering. In recent decades, the scientific study of complexity and complex systems has proposed a paradigm shift in science and philosophy, proposing novel methods that take into account relevant interactions.

  20. Hearing Aid

    Science.gov (United States)

    ... and Food and Drug Administration Staff FDA permits marketing of new laser-based hearing aid with potential ... feeds Follow FDA on Twitter Follow FDA on Facebook View FDA videos on YouTube View FDA photos ...

  1. Physical Design of a Video Phone for People with Mild Dementia

    OpenAIRE

    Gloor, Mattias

    2010-01-01

    This thesis provides an explanation and description of a new technological product that will directly aid people with Mild Cognitive Impairment (MCI) and Alzheimer Disease (AD): a technologically advanced, yet easy-to-use video phone. If used as intended, this device will make the user’s life much easier and more pleasant. A previous study that will be mentioned later in the paper showed that people with dementia often have problems using ordinary telephones. These problems vary from the inab...

  2. Enteral Nutrition in Dementia: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Joanne Brooke

    2015-04-01

    Full Text Available The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life.

  3. Designing for Quality: The Understanding Dementia MOOC

    Science.gov (United States)

    King, Carolyn; Kelder, Jo-Anne; Doherty, Kathleen; Phillips, Rob; McInerney, Fran; Walls, Justin; Robinson, Andrew; Vickers, James

    2014-01-01

    The introduction of Massive Open Online Courses (MOOCs) as a vehicle for education delivery presents opportunities and challenges. In the context of the Wicking Dementia Research and Education Centre (Wicking Centre), the driver to develop a MOOC was the promise of addressing the international deficit in evidence-based dementia education, as well…

  4. Alzheimer’s Disease and Dementia

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner

    2015-01-01

    people around the world. Alzheimer’s disease and related dementias affect neurocognition and associated functioning, including memory, thinking, behavior, and activities of daily living. Agitation in later stages of dementia is the most significant symptom contributing to patient distress and caregiver...

  5. Enteral nutrition in dementia: a systematic review.

    Science.gov (United States)

    Brooke, Joanne; Ojo, Omorogieva

    2015-04-01

    The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life. PMID:25854831

  6. Dementia in older people: an update.

    Science.gov (United States)

    LoGiudice, D; Watson, R

    2014-11-01

    Dementia is a common condition of the elderly characterised by multiple cognitive deficits resulting in a decline from previous level of function. In the older person, multiple pathologies contribute, including changes commonly seen in Alzheimer disease, dementia with Lewy bodies in addition to vascular changes. Comorbid factors, such as depression, delirium and polypharmacy can contribute to cognitive decline. Novel biomarkers and neuroimaging techniques may assist in the near future to improve accuracy of diagnosis. To date, pharmacological therapies have been largely unsuccessful and provide symptomatic relief only. The timely diagnosis of dementia can facilitate important discussions regarding personal and financial planning and introduce education and supports to the person with dementia and their carers. The person with dementia commonly experiences behavioural and psychological symptoms of dementia that may cause much distress, including to families and carers. Clinical guidelines indicate non-pharmacological approaches as first line measures, including attention to pain, nutrition and the environment. Dementia is recognised as a National Health Priority in Australia, and efforts to target risk factors as preventative measures to delay onset of dementia require further urgent consideration. PMID:25367725

  7. Seniors' Worsening Depression May Sometimes Predict Dementia

    Science.gov (United States)

    ... 158576.html Seniors' Worsening Depression May Sometimes Predict Dementia Study suggests a common underlying cause in some, but not all, cases To use ... say the finding supports prior research suggesting that dementia and certain ... common cause. Wolf-Klein agreed. "Different courses of depression may ...

  8. Recognition of dementia in ancient China.

    Science.gov (United States)

    Liu, Jia; Wang, Lu-Ning; Tian, Jin-Zhou

    2012-12-01

    A search of previous records in the literatures was done to summarize the opinions for dementia in ancient China. The earliest description of dementia was traced in the Yellow emperor's internal classic, a book written 2000 years ago. Hua Tuo (AD 140-208) in Han Dynasty first denominated "dementia" in the book, Hua Tuo Shen Yi Mi Zhuan. The pathogenesis of dementia could be generalized as the insufficiency of Qi, a flowing energy; the stagnation of phlegm, a harmful liquid substance in the body; and the blood stasis, which were also regarded as therapeutic targets. Therefore, we can conclude that dementia has been recognized and investigated in traditional Chinese medicine, which is definitely before the industrial civilization era. PMID:22835605

  9. Prodromal dementia with Lewy bodies.

    Science.gov (United States)

    Fujishiro, Hiroshige; Nakamura, Shinichiro; Sato, Kiyoshi; Iseki, Eizo

    2015-07-01

    Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementing disorder after Alzheimer's disease (AD), but there is limited information regarding the prodromal DLB state compared with that of AD. Parkinson's disease (PD) and DLB share common prodromal symptoms with Lewy body disease (LBD), allowing us to use a common strategy for identifying the individuals with an underlying pathophysiology of LBD. Dysautonomia, olfactory dysfunction, rapid eye movement sleep behavior disorder (RBD) and psychiatric symptoms antedate the onset of dementia by years or even decades in patients with DLB. Although RBD is the most potentially accurate prodromal predictor of DLB, disease progression before the onset of dementia could differ between the prodromal DLB state with and without RBD. Experts who specialize in idiopathic RBD and DLB might need communication in order to clarify the clinical relevance of RBD with the disease progression of DLB. The presence of prodromal LBD symptoms or findings of occipital hypoperfusion/hypometabolism helps us to predict the possible pathophysiological process of LBD in non-demented patients. This approach might provide the opportunity for additional neuroimaging, including cardiac (123) I-metaiodobenzylguanidine scintigraphy and dopamine transporter imaging. Although limited radiological findings in patients with prodromal DLB states have been reported, there is now a need for larger clinical multisite studies with pathological verification. The long prodromal phase of DLB provides a critical opportunity for potential intervention with disease-modifying therapy, but only if we are able to clearly identify the diversity in the clinical courses of DLB. In the present article, we reviewed the limited literature regarding the clinical profiles of prodromal DLB. PMID:25690399

  10. Dementia, death and advance directives.

    OpenAIRE

    Wolff, J.

    2012-01-01

    This article considers the ethics of advance directives, especially in relation to conditions such as dementia. For some choices, such as over whether one's life should end at home or in a hospice, advance directives can be very enlightened and helpful. For others, such as those to end the life of an autonomous subject, against their will, have no moral appeal and would rightly be ignored. In a wide range of intermediate cases, given our typical lack of insight into how changes in our health ...

  11. The 3 D's of geriatric psychiatry: depression, delirium, and dementia.

    Science.gov (United States)

    Dharia, Sheetal; Verilla, Kailen; Breden, Ericka L

    2011-08-01

    A Caucasian female octogenarian with multiple medical problems was admitted to the inpatient geriatric psychiatry unit with intermittent altered mental status and decline in memory. She had been hospitalized four times in the previous three months. She was admitted on more than 10 medications and received more than 20 different medications in this time period. It was determined that she had delirium concurrent with dementia and/or depression. During her hospital stay a urinary tract infection (UTI) was treated, her anticholinergic medications were minimized, and her digoxin dose was adjusted. As her mental status cleared, a workup was completed to differentiate between dementia and depression. She was initially treated with memantine, but as time progressed it became more evident she was experiencing depression and a "pseudodementia," which was treated with sertraline. Her Mini-Mental State Examination returned to 29/30 (her score previously was 26/29). This case demonstrates the complexity of treating an elder individual and the importance of differentiating among delirium, depression, and dementia. The pharmacy team played an active role in medication reconciliation. Additionally, they worked with the medical team to minimize her potentially harmful medications and optimize the treatment of her UTI and depression. PMID:21840820

  12. Swedish assistant nurses' experiences of job satisfaction when caring for persons suffering from dementia and behavioural disturbances. An interview study

    OpenAIRE

    Kristiansen, Lisbeth; Hellzén, Ove; Asplund, Kenneth

    2006-01-01

    Job satisfaction is complex and is an important component in facilitating high quality nursing care. Behavioural and psychological symptoms of dementia (BPSD) can be clustered into one of five syndromes: psychosis, aggression, psychomotor agitation, depression and apathy, and comprise signs and symptoms of disturbed perception, thought content, mood or behaviour that frequently occur in patients with dementia. BPSD can cause tremendous distress both for the patients and for their caregivers a...

  13. Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy in Dementias

    OpenAIRE

    Hsu, Yuan-Yu; Du, An-Tao; Schuff, Norbert; Weiner, Michael W.

    2001-01-01

    This article reviews recent studies of magnetic resonance imaging and magnetic resonance spectroscopy in dementia, including Alzheimer's disease, frontotemporal dementia, dementia with Lewy bodies, idiopathic Parkinson's disease, Huntington's disease, and vascular dementia. Magnetic resonance imaging and magnetic resonance spectroscopy can detect structural alteration and biochemical abnormalities in the brain of demented subjects and may help in the differential diagnosis and early detection...

  14. Prevalence and characteristics of dementia in Parkinson disease

    DEFF Research Database (Denmark)

    Aarsland, Dag; Andersen, Kjeld; Larsen, Jan P;

    2003-01-01

    Few longitudinal studies of dementia in Parkinson disease (PD) have been reported, and the proportion of patients with PD who eventually develop dementia is unknown.......Few longitudinal studies of dementia in Parkinson disease (PD) have been reported, and the proportion of patients with PD who eventually develop dementia is unknown....

  15. SUBDURAL HYGROMA PRESENTING AS DEMENTIA WITH KLUVER-BUCY SYMPTOMS

    OpenAIRE

    Duggal, Harpreet S.; Khess, Christoday R.J.; Nizamie, S. Haque

    1999-01-01

    Dementia is not an uncommon presentation in psychiatric practice. Of the various causes of reversible dementia, subdural hygroma is a lesser-known potentially reversible cause. A case of dementia with Kluver-Bucy symptoms secondary to subdural hygroma is described and implications of Kluver-Bucy symptoms in dementia are discussed.

  16. Endocrine, metabolic, nutritional, and toxic disorders leading to dementia

    Directory of Open Access Journals (Sweden)

    Ghosh Amitabha

    2010-10-01

    Full Text Available One of the first steps toward the correct diagnosis of dementia is to segregate out the nondegenerative dementias from possible degenerative dementias. Nondegenerative dementias could be due to traumatic, endocrine, metabolic, nutritional, toxic, infective, and immunological causes. They could also be caused by tumors, subdural hematomas, and normal pressure hydrocephalus. Many of the nondegenerative dementias occur at an earlier age and often progress quickly compared to Alzheimer′s disease and other degenerative dementias. Many are treatable or preventable with simple measures. This review aims to give an overview of some of the more important endocrine, metabolic, nutritional, and toxic disorders that may lead to dementia.

  17. Prevalence of dementia and major dementia subtypes in Spanish populations: A reanalysis of dementia prevalence surveys, 1990-2008

    Directory of Open Access Journals (Sweden)

    Boix Raquel

    2009-10-01

    Full Text Available Abstract Background This study describes the prevalence of dementia and major dementia subtypes in Spanish elderly. Methods We identified screening surveys, both published and unpublished, in Spanish populations, which fulfilled specific quality criteria and targeted prevalence of dementia in populations aged 70 years and above. Surveys covering 13 geographically different populations were selected (prevalence period: 1990-2008. Authors of original surveys provided methodological details of their studies through a systematic questionnaire and also raw age-specific data. Prevalence data were compared using direct adjustment and logistic regression. Results The reanalyzed study population (aged 70 year and above was composed of Central and North-Eastern Spanish sub-populations obtained from 9 surveys and totaled 12,232 persons and 1,194 cases of dementia (707 of Alzheimer's disease, 238 of vascular dementia. Results showed high variation in age- and sex-specific prevalence across studies. The reanalyzed prevalence of dementia was significantly higher in women; increased with age, particularly for Alzheimer's disease; and displayed a significant geographical variation among men. Prevalence was lowest in surveys reporting participation below 85%, studies referred to urban-mixed populations and populations diagnosed by psychiatrists. Conclusion Prevalence of dementia and Alzheimer's disease in Central and North-Eastern Spain is higher in females, increases with age, and displays considerable geographic variation that may be method-related. People suffering from dementia and Alzheimer's disease in Spain may approach 600,000 and 400,000 respectively. However, existing studies may not be completely appropriate to infer prevalence of dementia and its subtypes in Spain until surveys in Southern Spain are conducted.

  18. Types of Hearing Aids

    Science.gov (United States)

    ... Devices Consumer Products Hearing Aids Types of Hearing Aids Share Tweet Linkedin Pin it More sharing options ... some features for hearing aids? What are hearing aids? Hearing aids are sound-amplifying devices designed to ...

  19. Neuroradiological findings in vascular dementia

    Energy Technology Data Exchange (ETDEWEB)

    Guermazi, Ali; Miaux, Yves; Suhy, Joyce; Pauls, Jon; Lopez, Ria [Synarc, Inc., Department of Radiology Services, San Francisco, CA (United States); Rovira-Canellas, Alex [Hospital General Universitari Vall d' Hebron, Unita de Resonancia Magnetica, Barcelona (Spain); Posner, Holly [Eisai, Inc., Teaneck, NJ (United States)

    2007-01-15

    There are multiple diagnostic criteria for vascular dementia (VaD) that may define different populations. Utilizing the criteria of the National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) has provided improved consistency in the diagnosis of VaD. The criteria include a table listing brain imaging lesions associated with VaD. The different neuroradiological aspects of the criteria are reviewed based on the imaging data from an ongoing large-scale clinical trial testing a new treatment for VaD. The NINDS-AIREN criteria were applied by a centralized imaging rater to determine eligibility for enrollment in 1,202 patients using brain CT or MRI. Based on the above data set, the neuroradiological features that are associated with VaD and that can result from cerebral small-vessel disease with extensive leukoencephalopathy or lacunae (basal ganglia or frontal white matter), or may be the consequence of single strategically located infarcts or multiple infarcts in large-vessel territories, are illustrated. These features may also be the consequence of global cerebral hypoperfusion, intracerebral hemorrhage, or other mechanisms such as genetically determined arteriopathies. Neuroimaging confirmation of cerebrovascular disease in VaD provides information about the topography and severity of vascular lesions. Neuroimaging may also assist with the differential diagnosis of dementia associated with normal pressure hydrocephalus, chronic subdural hematoma, arteriovenous malformation or tumoral diseases. (orig.)

  20. Advance directives in dementia research: A medical ethical inquiry

    OpenAIRE

    Jongsma, Karin

    2016-01-01

    markdownabstractDementia is highly prevalent and incurable. The participation of dementia patients in clinical research is indispensable if we want to find an effective treatment for dementia. However, one of the primary challenges in dementia research is the patients’ gradual loss of the capacity to consent. Patients with dementia are characterized by the fact that, at an earlier stage of their life, they were able to give their consent to participation in research. Therefore, the phase when...

  1. Advanced MR Neuroimaging in Early Stage Presenile Dementia

    OpenAIRE

    Steketee, Rebecca

    2016-01-01

    markdownabstractDementia is a syndrome affecting cognitive functions and behavior, with an overwhelming impact on both patients and caregivers. An estimated number of 35.6 million patients suffers from dementia, with a subset affected before the age of 65 years, i.e. presenile dementia. Establishing the underlying cause of presenile dementia in the early stage proves to be difficult. Morphological brain changes associated with the early stage of dementia are often absent or unspecific on rout...

  2. The Association between Hypertension and Dementia in the Elderly

    OpenAIRE

    Tetsuro Miki; Michiya Igase; Katsuhiko Kohara

    2012-01-01

    Hypertension (HT) and dementia are common disorders in the elderly. HT in the elderly is associated with increased occurrence rates of dementia including Alzheimer's disease (AD) and vascular dementia (VaD). In connection to this, some studies have suggested that HT in old age correlates with the pathogenesis of dementia. Since HT is potentially reversible, a number of randomized trials have examined whether antihypertensive treatment may help in preventing dementia occurrence. We review five...

  3. Origins of Montessori Programming for Dementia.

    Science.gov (United States)

    Camp, Cameron J

    2010-01-01

    The focus of this article is on the evolution of the use of Montessori educational methods as the basis for creating interventions for persons with dementia. The account of this evolution is autobiographical, as the development of Montessori Programming for Dementia (MPD) initially was through the efforts of myself and my research associates. My initial exposure to Maria Montessori's work came as a result of my involvement with my own children's education. This exposure influenced ongoing research on development of cognitive interventions for persons with dementia. A brief description of Montessori's work with children and the educational methods she developed is followed by a description of how this approach can be translated into development of activities for persons with dementia. Assessment tools to document effects of MPD were created, focusing on observational tools to measure engagement and affect during individual and group activities programming for persons with dementia. Examples of the use of MPD by researchers, staff members, and family members are given, as well as examples of how persons with dementia can provide MPD to other persons with dementia or to children. Finally, examples of MPD's dissemination internationally and future directions for research are presented. PMID:23515663

  4. Hospital-diagnosed dementia and suicide

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Zarit, Steven H; Conwell, Yeates

    2008-01-01

    OBJECTIVE: The current study aims to examine the risk of suicide in persons diagnosed with dementia during a hospitalization and its relationship to mood disorders. DESIGN: Event-history analysis using time-varying covariates. SETTING: Population-based record linkage. PARTICIPANTS: All individual...... for older adults. Preventive measures should focus on suicidal ideation after initial diagnosis but also acknowledge that suicides can occur well after a dementia diagnosis has been established....... who are aged 70 or older with dementia have a threefold higher risk than persons with no dementia. The time shortly after diagnosis is associated with an elevated suicide risk. The risk among persons with dementia remains significant when controlling for mood disorders. As many as 26% of the men...... and 14% of the women who died by suicide died within the first 3 months after being diagnosed whereas 38% of the men and 41% of the women died more than 3 years after initial dementia diagnosis. CONCLUSIONS: Dementia, determined during hospitalization, was associated with an elevated risk of suicide...

  5. Characteristics of cerebral glucose utilization in dementia

    International Nuclear Information System (INIS)

    To make clear the characteristics of cerebral glucose utilization in dementia, PET studies with 18F-FDG were carried out. Taking the pattern of 18F-FDG utilization, dementia can be subdivided into two types. One type shows a simultaneous and symmetrical reduction glucose utilization in the posterior part of neocortex covering the temporal, parietal and occipital association cortices. This is referred to as type I. Although this type constitutes only about 1/5 of all dementia patients, it is considered the fundamental type of dementia. Aside from this, there is type wherein a simultaneous and symmetrical reduction in glucose utilization of the neocortex. This is type II. It constitutes about 4/5 of all dementia patients which is far more type I. There are no essential difference in the characteristics of cerebral glucose utilization in AD and MID. However, with regards the mean, AD is lower than MID. Various organic defect in neocortex do not correlate with the global reduction in glucose utilization in dementia patients. These results suggest that the reduction in glucose utilization in dementia may be functional disorder. (author)

  6. Cocaine: A Catalyst for Human Immunodeficiency Virus-Associated Dementia

    Directory of Open Access Journals (Sweden)

    Navneet K Dhillon

    2008-01-01

    Full Text Available Injection drug use has been recognized as a major risk factor for AIDS from the outset of the epidemic. Cocaine, one of the most widely abused drugs in the United States can both impair the functions of macrophages & CD4+ lymphocytes and also activate HIV-1 expression in these cells. Cocaine is a multifactorial agent that acts globally to impair the functioning of brain resident cells through multiple pathways. The drug not only promotes virus replication in macrophages, microglia and astrocytes, but can also upregulate CCR5 coreceptor, and reciprocally inhibit its ligands, thereby increasing virus infectivity. Cocaine is known to modulate astroglial function and activation. Cocaine causes a myriad of toxic responses in the neurons: a it synergizes with viral proteins, Tat and gp120 resulting in exacerbated neuronal apoptosis, b it causes calcium mobilization and, c generation of reactive oxygen species. Additionally, cocaine also exerts potent effects on microvascular permeability, thereby impacting the influx of virus-infected inflammatory cells in brain parenchyma. By amplifying the various arms of the toxic responses that characterize HIV-associated dementia (HAD, cocaine skews the balance in favor of the virus leading to accelerated progression and severity of dementia.

  7. Validation of the 10/66 Dementia Research Group Diagnostic Assessment for Dementia in Arabic

    DEFF Research Database (Denmark)

    Phung, Kieu T T; Chaaya, Monique; Waldemar, Gunhild;

    2014-01-01

    OBJECTIVES: In the North Africa and Middle East region, the illiteracy rates among older people are high, posing a great challenge to cognitive assessment. Validated diagnostic instruments for dementia in Arabic are lacking, hampering the development of dementia research in the region. The study...... aimed at validating the Arabic version of the 10/66 Dementia Research Group (DRG) diagnostic assessment for dementia to determine whether it is suitable for case ascertainment in epidemiological research. METHODS: A total of 244 participants older than 65 years were included, 100 with normal cognition...... and 144 with mild to moderate dementia. Dementia was diagnosed by clinicians according to Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. Depression was diagnosed using the Geriatric Mental State. Trained interviewers blind to the cognitive status of the participants...

  8. Dementia-oriented case management for home-dwelling people with dementia and their family caregivers

    OpenAIRE

    Groenewoud, Hanny; de Lange, Jacomine

    2009-01-01

    Purpose To describe the activities and time spent by casemanagers for home-dwelling people with dementia and their family caregivers in a western region of the Netherlands. Theory People with dementia and their family caregivers go through several transitions in disease, care and social roles. Integrated care for this group is important. In the Dutch Guideline for Integrated Dementia Care (2008), the casemanager is put forward as the vital link in the health-care supply chain for demented peo...

  9. Brand Aid

    DEFF Research Database (Denmark)

    Richey, Lisa Ann; Ponte, Stefano

    2011-01-01

    activists, scholars and venture capitalists, discusses the pros and cons of changing the world by ‘voting with your dollars’. Lisa Ann Richey and Stefano Ponte (Professor at Roskilde University and Senior Researcher at DIIS respectively), authors of Brand Aid: Shopping Well to Save the World, highlight how...

  10. Negotiating Aid

    DEFF Research Database (Denmark)

    Whitfield, Lindsay; Fraser, Alastair

    2011-01-01

    This article presents a new analytical approach to the study of aid negotiations. Building on existing approaches but trying to overcome their limitations, it argues that factors outside of individual negotiations (or the `game' in game-theoretic approaches) significantly affect the preferences of...

  11. Dementia and assisted suicide and euthanasia.

    Science.gov (United States)

    de Beaufort, Inez D; van de Vathorst, Suzanne

    2016-07-01

    The number of dementia patients requesting euthanasia in the Netherlands has increased over the past five years. The issue is highly controversial. In this contribution we discuss some of the main arguments: the nature of suffering, the voluntariness of the request and the role of the physician. We argue that society has a duty to care for patients who suffer from dementia and to make their lives as good and comfortable as possible. We also argue that it can be morally acceptable for those who do not want to continue their life with dementia to choose to die. The choice can be based on good reasons. PMID:27017340

  12. CAIDE Dementia Risk Score and biomarkers of neurodegeneration in memory clinic patients without dementia.

    Science.gov (United States)

    Enache, Daniela; Solomon, Alina; Cavallin, Lena; Kåreholt, Ingemar; Kramberger, Milica Gregoric; Aarsland, Dag; Kivipelto, Miia; Eriksdotter, Maria; Winblad, Bengt; Jelic, Vesna

    2016-06-01

    The aim of this study was to explore cross-sectional associations between Cardiovascular Risk Factors, Aging and Dementia Study (CAIDE) Dementia Risk Score and dementia-related cerebrospinal fluid and neuroimaging biomarkers in 724 patients without dementia from the Memory Clinic at Karolinska University Hospital, Huddinge, Sweden. We additionally evaluated the score's capacity to predict dementia. Two risk score versions were calculated: one including age, gender, obesity, hyperlipidemia, and hypertension; and one additionally including apolipoprotein E (APOE) ε4 carrier status. Cerebrospinal fluid was analyzed for amyloid β (Aβ), total tau, and phosphorylated tau. Visual assessments of medial temporal lobe atrophy (MTA), global cortical atrophy-frontal subscale, and Fazekas scale for white matter changes (WMC) were performed. Higher CAIDE Dementia Risk Score (version without APOE) was significantly associated with higher total tau, more severe MTA, WMC, and global cortical atrophy-frontal subscale. Higher CAIDE Dementia Risk Score (version with APOE) was associated with reduced Aβ, more severe MTA, and WMC. CAIDE Dementia Risk Score version with APOE seemed to predict dementia better in this memory clinic population with short follow-up than the version without APOE. PMID:27143429

  13. Disruption of endocytic trafficking in frontotemporal dementia with CHMP2B mutations

    DEFF Research Database (Denmark)

    Urwin, Hazel; Authier, Astrid; Nielsen, Jørgen Erik;

    2010-01-01

    Mutations in CHMP2B cause frontotemporal dementia (FTD) in a large Danish pedigree, which is termed FTD linked to chromosome 3 (FTD-3), and also in an unrelated familial FTD patient. CHMP2B is a component of the ESCRT-III complex, which is required for function of the multivesicular body (MVB), a...

  14. The process of learning in dementia-carer support programmes: some preliminary observations.

    Science.gov (United States)

    Coates, D

    1995-01-01

    Theories of experiential learning, notably the theory of andragogy, can be used to elucidate the process of learning in dementia-carer support programmes. Such theories attach importance to the positive influence of life experience and maturity, and to the salience of personal issues, but their appropriateness needs to be critically analysed. Stress is a common manifestation among dementia carers and its presence can significantly affect openness to learning. As a result of recent policy changes and of demographic shifts, nurses are likely to be increasingly involved in carer support programmes. They need to be aware of the complex issues addressed in this paper. PMID:7897076

  15. Dementia

    Science.gov (United States)

    ... not dress for situation and weather. Exhibits decreased empathy and inhibition in what he/she does and ... allowable. Give two choices – “Do you want to wear the green shirt or the red shirt today?”  ...

  16. Dementia

    Science.gov (United States)

    ... Station Building #2 Suite 320 290 King of Prussia Road Radnor, PA 19087 info@theaftd.org http:// ... patient or is familiar with that patient's medical history. All NINDS-prepared information is in the public ...

  17. Dementia, death and advance directives.

    Science.gov (United States)

    Wolff, Jonathan

    2012-10-01

    This article considers the ethics of advance directives, especially in relation to conditions such as dementia. For some choices, such as over whether one's life should end at home or in a hospice, advance directives can be very enlightened and helpful. For others, such as those to end the life of an autonomous subject, against their will, have no moral appeal and would rightly be ignored. In a wide range of intermediate cases, given our typical lack of insight into how changes in our health condition will affect us in other ways, we should be very cautious indeed in promoting the use of advance directives in end-of-life decisions, at least where a reasonable quality of life remains. There may be some reasons for giving priority to the earlier autonomous self over a later, contented but non-autonomous self, but these reasons seem far from compelling. PMID:23079306

  18. Dementia at the End of Life

    Science.gov (United States)

    ... Comfort and Care Heath and Aging End of Life: Helping With Comfort and Care Dementia At the End of Life As they reach the end of life, people suffering from conditions like Alzheimer's disease (AD) ...

  19. Individual Music Therapy for Agitation in Dementia

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner; Stige, Brynjulf; Qvale, Liv Gunnhild;

    2013-01-01

    Objectives: Agitation in nursing home residents with dementia leads to increase in psychotropic medication, decrease in quality of life, and to patient distress and caregiver burden. Music therapy has previously been found effective in treatment of agitation in dementia care but studies have been...... methodologically insufficient. The aim of this study was to examine the effect of individual music therapy on agitation in persons with moderate/severe dementia living in nursing homes, and to explore its effect on psychotropic medication and quality of life. Method: In a crossover trial, 42 participants...... with dementia were randomized to a sequence of six weeks of individual music therapy and six weeks of standard care. Outcome measures included agitation, quality of life and medication. Results: Agitation disruptiveness increased during standard care and decreased during music therapy. The difference at −6...

  20. Development of a dementia assessment quality database

    DEFF Research Database (Denmark)

    Johannsen, P.; Jørgensen, Kasper; Korner, A.;

    2011-01-01

    database for dementia evaluation in the secondary health system. One volume and seven process quality indicators on dementia evaluations are monitored. Indicators include frequency of demented patients, percentage of patients evaluated within three months, whether the work-up included blood tests, Mini...... Mental State Examination (MMSE), brain scan and activities of daily living and percentage of patients treated with anti-dementia drugs. Indicators can be followed over time in an individual clinic. Up to 20 variables are entered to calculate the indicators and to provide risk factor variables for the...... data analyses. RESULTS: The database was constructed in 2005 and covers 30% of the Danish population. Data from all consecutive cases evaluated for dementia in the secondary health system in the Capital Region of Denmark are entered. The database has shown that the basic diagnostic work-up programme...

  1. Dementia in hereditary cystatin C amyloidosis

    DEFF Research Database (Denmark)

    Blöndal, H; Guomundsson, G; Benedikz, Eirikur;

    1989-01-01

    Nineteen cases with verified Hereditary Cystatin C Amyloid Angiopathy are presented. All of the cases had one or more cerebrovascular insults starting at the age of 20-41 years and survived from 10 days to 23 years after the first insult. Progressive dementia was a prominent clinical feature in...... seventeen cases of whom two presented with dementia. At the last examination the majority had severe dementia and severely abnormal EEG. Anti-cystatin C positive amyloid vascular and perivascular infiltrates were found. The resulting damage to the microvasculature of the brain and secondary hemorrhages and...... infarctions were considered to be an adequate explanation for the dementia in these cases. Skin biopsies can now probably be used to demonstrate cystatin C positive amyloid deposits conclusively in the tissues of these patients....

  2. Facilitating the discharge of patients with dementia.

    Science.gov (United States)

    2016-09-01

    Significant numbers of older people with dementia use general hospital services, and facilitating the safe discharge of patients with poor cognition, impaired judgement, misperception or reduced risk awareness is challenging for many healthcare professionals. PMID:27581918

  3. Caregiving for Alzheimer's Disease or Other Dementia

    Science.gov (United States)

    ... What's this? Submit Button Caregiving for Person with Alzheimer's Disease or a related Dementia Recommend on Facebook Tweet Share Compartir What is Alzheimer's Disease? Alzheimer's disease is the most common form of ...

  4. Physical Activity and Exercise in Dementia

    Directory of Open Access Journals (Sweden)

    Sefa Lok

    2015-09-01

    Full Text Available Aging is a dynamic process that affects many systems in the body. Cognitive function with aging, including memory, intelligence, personality and behavior are affected at different levels. As time passes, durability of individuals and the amount of physical activity and exercise decrease. Apart from normal aging process, accompanying chronic brain syndrome of dementia will further reduce activities. Physical activity can provide opportunities for individuals with dementia in the path to socialize. Therefore, the role of physical activity and exercise in adapting an active lifestyle to protect the health of individuals with dementia is becoming increasingly important. Physical activity and exercise which would help in improvement of cognitive activity in dementia are briefly reviewed in this article. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(3.000: 289-294

  5. Dementia, distributed interactional competence and social membership.

    Science.gov (United States)

    Gjernes, Trude; Måseide, Per

    2015-12-01

    The article analyzes how a person with dementia playing a guitar collaborates with other people in a joint activity. The analysis shows that a person with dementia may gain social membership in a group of persons with and without dementia through social interaction, collaboration, scaffolding and use of material anchors. It shows that interactional skills as well as skills as guitar player are not only products of a mind-body system, but also a product of collaboration between different actors with different participant statuses in a particular situation. The guitar player's mind emerges in the social context of the joint activity and scaffolding. Scaffolding comes from interactive moves from the other participants without dementia and from the guitar. The guitar represents a material anchor. It is a tool for participation, experiences of pleasure, and coping, but it is also a challenge that requires management of face threatening events. PMID:26568220

  6. Consensus statement on genetic research in dementia

    DEFF Research Database (Denmark)

    Rikkert, M.G. Olde; der, V van; Burns, A.;

    2008-01-01

    In this article, the authors describe how the European Dementia Consensus Network developed a consensus on research ethics in dementia, taking into account the questions posed by the era of genetic research and its new research methods. The consensus process started with a Delphi procedure to...... procedure fuelled the development of the consensus statement, which is presented in this paper. The consensus statement aims to stimulate ethically acceptable research in the field of dementia and the protection of vulnerable elderly patients with dementia from application of inadequate research methods or...... analyze relevant stakeholders' positions by describing their statements on the possibilities and limitations of research into genetic determinants of Alzheimer disease and to describe and analyze the moral desirability of genetic research on Alzheimer disease. The conclusions drawn from the Delphi...

  7. Dementia - what to ask your doctor

    Science.gov (United States)

    What to ask your doctor about dementia; Alzheimer disease- what to ask your doctor; Cognitive impairment - what to ask your doctor ... I use? What is the best way to ask them questions? What is the best way to ...

  8. Auditory hedonic phenotypes in dementia: A behavioural and neuroanatomical analysis

    Science.gov (United States)

    Fletcher, Phillip D.; Downey, Laura E.; Golden, Hannah L.; Clark, Camilla N.; Slattery, Catherine F.; Paterson, Ross W.; Schott, Jonathan M.; Rohrer, Jonathan D.; Rossor, Martin N.; Warren, Jason D.

    2015-01-01

    Patients with dementia may exhibit abnormally altered liking for environmental sounds and music but such altered auditory hedonic responses have not been studied systematically. Here we addressed this issue in a cohort of 73 patients representing major canonical dementia syndromes (behavioural variant frontotemporal dementia (bvFTD), semantic dementia (SD), progressive nonfluent aphasia (PNFA) amnestic Alzheimer's disease (AD)) using a semi-structured caregiver behavioural questionnaire and voxel-based morphometry (VBM) of patients' brain MR images. Behavioural responses signalling abnormal aversion to environmental sounds, aversion to music or heightened pleasure in music (‘musicophilia’) occurred in around half of the cohort but showed clear syndromic and genetic segregation, occurring in most patients with bvFTD but infrequently in PNFA and more commonly in association with MAPT than C9orf72 mutations. Aversion to sounds was the exclusive auditory phenotype in AD whereas more complex phenotypes including musicophilia were common in bvFTD and SD. Auditory hedonic alterations correlated with grey matter loss in a common, distributed, right-lateralised network including antero-mesial temporal lobe, insula, anterior cingulate and nucleus accumbens. Our findings suggest that abnormalities of auditory hedonic processing are a significant issue in common dementias. Sounds may constitute a novel probe of brain mechanisms for emotional salience coding that are targeted by neurodegenerative disease. PMID:25929717

  9. Barriers to treatment: the unique challenges for physicians providing dementia care.

    Science.gov (United States)

    Foster, N L

    2001-01-01

    Evaluating and treating dementia is intellectually demanding and enormously satisfying. However, physicians providing dementia care also confront unique challenges that cause discomfort and overwhelming frustration unless they are recognized and overcome. Physicians must care for individuals who do not adopt the "sick role." They must establish and maintain rapport with patients while also approaching collateral sources to obtain a complete history. They must develop a complex alliance with the patient, caregivers, community agencies, and other health professionals to provide effective treatment. Physicians must relate "bad news" to several people at once who are unequally prepared for it, while dealing with their own diagnostic uncertainty. Furthermore, physicians must honor patient autonomy and balance it with the needs of caregivers. Since the demands of providing dementia care are not typical of most medical practice, the special attributes needed are often not taught to students or adequately reimbursed by health insurance. The quality of dementia care will improve when strategies that address these aspects of care for patients with dementia are widely adopted. PMID:11794447

  10. The repeated appeal to return home in older adults with dementia: developing a model for practice.

    Science.gov (United States)

    Fukui, Sadaaki; Okada, Shinichi; Nishimoto, Yukio; Nelson-Becker, Holly B

    2011-03-01

    Dementia care has been trapped in a "trial and error" type of practice due to difficulty understanding the needs of older adults with severe dementia. Behavioral and Psychological Signs and Symptoms of Dementia (BPSD) can be quite difficult for residential staff. However, some experienced care workers succeed in establishing effective relationships. The goal of this study was to: 1) develop a process to identify needs behind BPSD; 2) find solutions using a team approach; and 3) apply the results to educate new workers. The KJ method was employed to reach decision-making about best practices in residential dementia care. This qualitative method is used to organize group data collected in the field and is based on understanding complex situations. A group process of 12 Japanese care workers experienced in understanding and responding to the "repeated appeal to return home" of residents in nursing care facilities is highlighted along with an illustrative case example. The workgroup met over two years. The study revealed five steps in understanding the needs behind the appeal, which include: (1) Listen to the voice and go with the flow of the behavior; (2) Learn about the inner experience; (3) Learn about the contextual environment of "here and now" situations; (4) Reflect on the care environment; and (5) Find the keyword. This needs identification process has application to other cultural contexts. The implications of this study for practitioners who work with people with dementia in residential settings will be discussed. PMID:21170576

  11. Behavioural and psychological symptoms of dementia in Down syndrome: Early indicators of clinical Alzheimer's disease?

    Science.gov (United States)

    Dekker, Alain D; Strydom, André; Coppus, Antonia M W; Nizetic, Dean; Vermeiren, Yannick; Naudé, Petrus J W; Van Dam, Debby; Potier, Marie-Claude; Fortea, Juan; De Deyn, Peter P

    2015-12-01

    Behavioural and Psychological Symptoms of Dementia (BPSD) are a core symptom of dementia and are associated with suffering, earlier institutionalization and accelerated cognitive decline for patients and increased caregiver burden. Despite the extremely high risk for Down syndrome (DS) individuals to develop dementia due to Alzheimer's disease (AD), BPSD have not been comprehensively assessed in the DS population. Due to the great variety of DS cohorts, diagnostic methodologies, sub-optimal scales, covariates and outcome measures, it is questionable whether BPSD have always been accurately assessed. However, accurate recognition of BPSD may increase awareness and understanding of these behavioural aberrations, thus enabling adaptive caregiving and, importantly, allowing for therapeutic interventions. Particular BPSD can be observed (long) before the clinical dementia diagnosis and could therefore serve as early indicators of those at risk, and provide a new, non-invasive way to monitor, or at least give an indication of, the complex progression to dementia in DS. Therefore, this review summarizes and evaluates the rather limited knowledge on BPSD in DS and highlights its importance and potential for daily clinical practice. PMID:26343344

  12. Tactile Aids

    Directory of Open Access Journals (Sweden)

    Mohtaramossadat Homayuni

    1996-04-01

    Full Text Available Tactile aids, which translate sound waves into vibrations that can be felt by the skin, have been used for decades by people with severe/profound hearing loss to enhance speech/language development and improve speechreading.The development of tactile aids dates from the efforts of Goults and his co-workers in the 1920s; Although The power supply was too voluminous and it was difficult to carry specially by children, it was too huge and heavy to be carried outside the laboratories and its application was restricted to the experimental usage. Nowadays great advances have been performed in producing this instrument and its numerous models is available in markets around the world.

  13. Digital Creativity in Dementia Care Support

    OpenAIRE

    Zachos, K.; Maiden, N.; Pitts, K.; S. Jones; Turner, I.; Rose, M; Pudney, K.; MacManus, J.

    2013-01-01

    This paper reports the application of digital creativity to the care for people with dementia. A digital app was developed for use by staff in residential homes caring for people with dementia. The app invokes a set of computational services to undertake creative work, the results of which are presented to encourage and support cognitive creativity by care staff. The services undertake computational work such as retrieving resolutions to care problems encountered previously, match...

  14. Dementia Resulting From Traumatic Brain Injury

    Science.gov (United States)

    Shively, Sharon; Scher, Ann I.; Perl, Daniel P.; Diaz-Arrastia, Ramon

    2013-01-01

    Traumatic brain injury (TBI) is among the earliest illnesses described in human history and remains a major source of morbidity and mortality in the modern era. It is estimated that 2% of the US population lives with long-term disabilities due to a prior TBI, and incidence and prevalence rates are even higher in developing countries. One of the most feared long-term consequences of TBIs is dementia, as multiple epidemiologic studies show that experiencing a TBI in early or midlife is associated with an increased risk of dementia in late life. The best data indicate that moderate and severe TBIs increase risk of dementia between 2-and 4-fold. It is less clear whether mild TBIs such as brief concussions result in increased dementia risk, in part because mild head injuries are often not well documented and retrospective studies have recall bias. However, it has been observed for many years that multiple mild TBIs as experienced by professional boxers are associated with a high risk of chronic traumatic encephalopathy (CTE), a type of dementia with distinctive clinical and pathologic features. The recent recognition that CTE is common in retired professional football and hockey players has rekindled interest in this condition, as has the recognition that military personnel also experience high rates of mild TBIs and may have a similar syndrome. It is presently unknown whether dementia in TBI survivors is pathophysiologically similar to Alzheimer disease, CTE, or some other entity. Such information is critical for developing preventive and treatment strategies for a common cause of acquired dementia. Herein, we will review the epidemiologic data linking TBI and dementia, existing clinical and pathologic data, and will identify areas where future research is needed. PMID:22776913

  15. Origins of Montessori Programming for Dementia

    OpenAIRE

    Camp, Cameron J

    2010-01-01

    The focus of this article is on the evolution of the use of Montessori educational methods as the basis for creating interventions for persons with dementia. The account of this evolution is autobiographical, as the development of Montessori Programming for Dementia (MPD) initially was through the efforts of myself and my research associates. My initial exposure to Maria Montessori’s work came as a result of my involvement with my own children’s education. This exposure influenced ongoing res...

  16. Some observations on the spectrum of dementia

    OpenAIRE

    Jha Sanjeev; Patel R

    2004-01-01

    A study was designed to generate epidemiological and clinical data on dementia, in a teaching hospital in India. It was conducted on 124 (94 male and 30 female) elderly patients (aged more than 60 years) presenting with clinical syndrome of dementia (DSM-3). Their age range was 64-78 (mean 65.7 4.1) years. Detailed clinical, biochemical, radiological and electrophysiological evaluation was done to establish etiology. Patients with psychiatric ailments, cranial trauma and tumors were exclude...

  17. Seminar: Music Therapy in Dementia Care

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner

    2009-01-01

    This seminar presents music therapy in person centered dementia care. In the first part focus is on research and documentation. How can short term music therapy document changes in symptoms of depression? Is Dementia Care Mapping a valid assessment tool for documenting group music therapy......? In the next part focus is on clinical music therapy – in group work as well as in individual work – and how the music therapist works in the interdisciplinary field....

  18. The Spectrum of Sociopathy in Dementia

    OpenAIRE

    Mendez, Mario F.; Shapira, Jill S.; Saul, Ronald E.

    2011-01-01

    Although well-known from head trauma and acute strokes, sociopathic behavior from dementia is less known and understood. This study reviewed 33 dementia patients who had been in trouble with the law. They were divided into two groups: 22 who committed impulsive sociopathic acts and 11 who committed non-impulsive acts. The impulsive patients demonstrated nonviolent acts, such as dis-inhibited sexual behavior or pathological stealing, and had disproportionate frontal-caudate atrophy on neuroima...

  19. Dental care of patients with dementia

    OpenAIRE

    Nordenram, Gunilla

    1997-01-01

    Dental care of patients with dementia. Clinical and ethical considerations Gunilla Nordenram Department of Clinical Neuroscience and Family Medicine, Division of Geriatric Medicine Huddinge Hospital and School of Dentistry, Division of Geriatric Dentistry, Karolinska Institutet, Stockholm, Sweden, ISBN 91-628-2416-3 To establish guidelines for fair and proper oral care for patients with dementia, the following aims were specified: To develop an appropriate method for ana...

  20. Parkinsonism and Frontotemporal Dementia: The Clinical Overlap

    OpenAIRE

    Espay, Alberto J.; Litvan, Irene

    2011-01-01

    Frontotemporal dementia is commonly associated with parkinsonism in several sporadic (i.e., progressive supranuclear palsy, corticobasal degeneration) and familial neurodegenerative disorders (i.e., frontotemporal dementia associated with parkinsonism and MAPT or progranulin mutations in chromosome 17). The clinical diagnosis of these disorders may be challenging in view of overlapping clinical features, particularly in speech, language, and behavior. The motor and cognitive phenotypes can be...

  1. CAMCOG as a screening instrument for dementia

    DEFF Research Database (Denmark)

    Lolk, A; Nielsen, H; Andersen, K;

    2000-01-01

    The Cambridge Cognitive Examination (CAMCOG) score is correlated with age and sociodemographic variables. The aim of the study was to determine an individualized CAMCOG cut-off score for dementia, taking such correlates into account.......The Cambridge Cognitive Examination (CAMCOG) score is correlated with age and sociodemographic variables. The aim of the study was to determine an individualized CAMCOG cut-off score for dementia, taking such correlates into account....

  2. Can aerobic exercise protect against dementia?

    OpenAIRE

    Neill R Graff-Radford

    2011-01-01

    There are more than 36 million people in the US over the age of 65, and all of them are impacted by the cognitive decline and brain atrophy associated with normal aging and dementia-causing conditions like Alzheimer's disease, Lewy body disease, and vascular dementia. Recently, moderate exercise and improved fitness have been shown to enhance cognition in cognitively normal older persons as well as in individuals who complain of memory difficulty. Additionally, fitness correlates with brain v...

  3. Dementia risk factors for Australian baby boomers

    Directory of Open Access Journals (Sweden)

    Peter K. Panegyres

    2010-07-01

    Full Text Available Baby boomers are individuals born in the years 1946 to 1965. The objective of this paper was to define the risk factors for dementia and Alzheimer’s disease (AD and their relevance to Australian baby boomers, with the aim of providing evidence-based guidelines for dementia prevention. A series of PubMed searches (1994-2010 were conducted with relevant key words. Data was included from the Australian Bureau of Statistics (ABS in relation to baby boomers in Australia. Article titles and abstracts were assessed by two reviewers for inclusion. Searches through ABS revealed no specific study on baby boomers at a national level; information was only available for Western Australia, South Australia and Queensland. A number of genetic and non-genetic risk factors for dementia were identified most of which remain controversial and require further study. We did not identify significant differences in the prevalence and incidence of dementia in those under 65 years in Queensland, South Australia and Western Australia. There were no correlations of risk factors and dementia between the Australian states. Modification of risk factors has not been proven to reduce the incidence and prevalence of dementia and AD in baby boomers. Nevertheless, on available evidence, we recommend: i active management of cardiovascular risk factors such as hypertension; ii the encouragement of a healthy lifestyle (eg, weight reduction, exercise as offering the best pathways to reduce the emerging dementia risk for baby boomers. The implications are that activities promoting a healthy heart might lead to a healthy brain and help to prevent dementia.

  4. Clinical Assessment And Diagnosis Of Dementia

    OpenAIRE

    Srikanth S; Shankar V; Shanbhogue Kamakshi

    2005-01-01

    Dementia is characterized by progressive decline in an alert individual, leading to loss of independence in day-to-day functioning. It is a generic term for a condition that has various causes and hence myriad clinical presentations. It has to be distinguished from age-related cognitive decline, depression and delirium all of which are common in the elderly population. Detailed history and mental status examination are necessary to identify dementia, fit it into one of the various bedside ...

  5. Managing diabetes in people with dementia.

    Science.gov (United States)

    Brown, Joe; Carson, Amanda; Waugh, Anna; Park, Douglas

    Diabetes and dementia may manifest simultaneously: one is potentially life threatening, the other causes severe, progressive loss of memory and cognitive function. Where they coexist, they present nurses with challenges such as administering life-saving interventions to patients who are unable to give informed consent. This article offers guidance on the clinical and ethical challenges involved in blood glucose monitoring and medicines administration in patients with dementia. PMID:26285437

  6. Clinical features and multidisciplinary approaches to dementia care

    Directory of Open Access Journals (Sweden)

    Gr

    2011-05-01

    Full Text Available Jacob HG Grand¹, Sienna Caspar², Stuart WS MacDonald11Department of Psychology, University of Victoria, Victoria, BC, Canada; 2Interdisciplinary Graduate Studies, University of British Columbia, Vancouver, BC, CanadaAbstract: Dementia is a clinical syndrome of widespread progressive deterioration of cognitive abilities and normal daily functioning. These cognitive and behavioral impairments pose considerable challenges to individuals with dementia, along with their family members and caregivers. Four primary dementia classifications have been defined according to clinical and research criteria: 1 Alzheimer’s disease; 2 vascular dementias; 3 frontotemporal dementias; and 4 dementia with Lewy bodies/Parkinson’s disease dementia. The cumulative efforts of multidisciplinary healthcare teams have advanced our understanding of dementia beyond basic descriptions, towards a more complete elucidation of risk factors, clinical symptoms, and neuropathological correlates. The characterization of disease subtypes has facilitated targeted management strategies, advanced treatments, and symptomatic care for individuals affected by dementia. This review briefly summarizes the current state of knowledge and directions of dementia research and clinical practice. We provide a description of the risk factors, clinical presentation, and differential diagnosis of dementia. A summary of multidisciplinary team approaches to dementia care is outlined, including management strategies for the treatment of cognitive impairments, functional deficits, and behavioral and psychological symptoms of dementia. The needs of individuals with dementia are extensive, often requiring care beyond traditional bounds of medical practice, including pharmacologic and non-pharmacologic management interventions. Finally, advanced research on the early prodromal phase of dementia is reviewed, with a focus on change-point models, trajectories of cognitive change, and threshold models of

  7. Neuroimaging and functional assessment in dementia

    International Nuclear Information System (INIS)

    Recent progress in diagnostic imaging techniques has greatly contributed to the elucidation of pathophysiology, as well as differential diagnosis in dementia. In particular, X-ray computed tomography (CT) offers the ability to detect morphological changes of the brain, whereby making it possible to differentiate between cerebrovascular and degenerative dementias. Magnetic resonance imaging (MRI) allows three-dimensional visualization of gyrus atrophy, providing the ability to depict subcortical minor infarcts and white matter lesions. The advent of positron emission tomography (PET) and single photon emission computed tomography (SPECT) has led to a dramatic progression in the search for pathophysiology of dementia. The purpose of this paper is to outline the recent findings of diagnostic imaging modalities, such as X-ray CT, MRI, PET and SPECT, focusing on those in commonly observed cerebrovascular dementia and in degenerative dementias that are projected to increase. Degenerative dementias cover Alzheimer's disease, Pick's disease, Huntington's disease, progressive supranuclear palsy, Parkinson's disease, and normal pressure hydrocephalus. (N.K.) 90 refs

  8. Forget me not: dementia in prison.

    Science.gov (United States)

    Maschi, Tina; Kwak, Jung; Ko, Eunjeong; Morrissey, Mary B

    2012-08-01

    The number of older adults with dementia in U.S. prisons is rapidly rising. Yet, the vast majority of this marginalized subgroup of the aging population is left neglected behind bars without access to adequate medical and mental health care services. We assert that proactive, interdisciplinary collaborative efforts to improve practice, policy, and research and to develop a high-quality evidence-based continuum of care for this aging population are urgently needed. The overarching goals of this paper are to raise awareness of the life and experiences of persons with dementia in prison and to stimulate discussion, research, and advocacy efforts for this forgotten subgroup of older Americans. We describe the growing number of older adults with dementia in U.S. prisons, high-risk factors for dementia present in the prison population, and the life and experience of persons with dementia in the culture and environment of prison that is primarily not designed for them. We review the current state of services and programs for dementia in prison. We conclude by proposing practice, policy, and research-related priority areas and strategies for interdisciplinary gerontological responses. PMID:22230493

  9. Gender Differences in Dementia Spousal Caregiving

    Directory of Open Access Journals (Sweden)

    Minna Maria Pöysti

    2012-01-01

    Full Text Available The proportion of male caregivers is rapidly increasing. However, there are few large scale studies exploring gender differences in the burden or coping with caregiving. We investigated this among caregivers of patients with dementia. The study cohort consisted of 335 dyads of wife-husband couples from two studies including dementia patients and their spousal caregivers. Baseline mini-mental state examination (MMSE, clinical dementia rating scale (CDR, neuropsychiatric inventory (NPI, cornell depression scale and charlson comorbidity index (CCI were used to describe patients with dementia, Zarit burden scale and geriatric depression scale were used to measure experienced burden and depression of caregivers. Mean age of caregivers was 78 years. There were no differences in depression, satisfaction with life, or loneliness according to caregivers' gender. Male caregivers had more comorbidities than females (CCI 1.9 versus 1.1, P<0.001, and the wives of male caregivers had a more severe stage of dementia than husbands of female caregivers (CDR, P=0.048; MMSE14.0 versus 17.7, P<0.001. However, the mean Zarit burden scale was significantly lower among male than female caregivers (31.5 versus 37.5; P<0.001. Lower education of male caregivers tended to be associated with less experienced burden. In conclusion, male caregivers of dementia experienced lower burden than female caregivers despite care recipients' more severe disease.

  10. Frail elderly patients with dementia go too fast

    OpenAIRE

    Iersel, M.B. van; Verbeek, A. L. M.; Bloem, B. R.; Munneke, M.; Esselink, R.A.J.; Rikkert, M G M Olde

    2006-01-01

    The reason why patients with dementia fall more often and sustain more fractures than patients without dementia remains unclear. Therefore, the relationship between dementia and gait velocity as a marker for mobility and falls in a cohort of frail elderly (mean age of 77.3 years) inpatients was assessed. Patients with dementia were expected to walk slower than patients without dementia. A trend was indeed observed: absolute gait velocity of 0.59 m/s in patients with dementia (n = 63) versus 0...

  11. The role of industrial-sanitary laboratory of medical aid station of Federal administration in prophylaxis of emergency situations at the plants of nuclear-energy complex and liquidation of their after-effects

    International Nuclear Information System (INIS)

    On the example of several radiation accidents the author summarized the personal practical experience in organization of work in industrial-sanitary laboratories based at the nuclear energy plants of nuclear-energy complex, in respect of prophylaxis of emergency radiation situations and liquidation of their after-effects. It is pointed out that successful activity in rendering emergency medical aid in emergency situations, caused by radiation accidents, is possible only subject to close contact of science, practical medical care and sanitary service which should become a part of the uniform public health system. 4 refs

  12. AIDS and associated malignancies

    Institute of Scientific and Technical Information of China (English)

    Charles; WOOD; William; HARRINGTON; Jr

    2005-01-01

    AIDS associated malignancies (ARL) is a major complication associated with AIDS patients upon immunosuppression.Chronically immunocompromised patients have a markedly increased risk of developing lymphoproliferative disease. In the era of potent antiretrovirals therapy (ARV), the malignant complications due to HIV- 1 infection have decreased in developed nations where ARV is administered, but still poses a major problem in developing countries where HIV- 1incidence is high and ARV is still not yet widely available. Even in ARV treated individuals there is a concern that the prolonged survival of many HIV- 1 carriers is likely to eventually result in an increased number of malignancies diagnosed.Malignancies that were found to have high incidence in HIV-infected individuals are Kaposi's sarcoma (KS), Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL). The incidence of NHL has increased nearly 200 fold in HIV-positive patients, and accounts for a greater percentage of AIDS defining illness in the US and Europe since the advent of HAART therapy. These AIDS related lymphomas are distinct from their counterparts seen in HIV- 1 seronegative patients.For example nearly half of all cases of ARL are associated with the presence of a gamma herpesvirus, Epstein Barr virus (EBV) or human herpesvirus-8 (HHV-8)/Kaposi's sarcoma associated herpesvirus (KSHV). The pathogenesis of ARLs is complex. B-cell proliferation driven by chronic antigenemia resulting in the induction of polyclonal and ultimately monoclonal lymphoproliferation may occur in the setting of severe immunosuppression.

  13. Neurological Complications of AIDS

    Science.gov (United States)

    ... Diversity Find People About NINDS Neurological Complications of AIDS Fact Sheet Feature Federal domestic HIV/AIDS information ... Where can I get more information? What is AIDS? AIDS (acquired immune deficiency syndrome) is a condition ...

  14. AIDS Epidemiyolojisi

    OpenAIRE

    SÜNTER, A.T.; PEKŞEN, Y.

    2010-01-01

    AIDS was first defined in the United States in 1981. It spreads to nearly all the countries of the world with a great speed and can infect everbody without any differantiation. The infection results in death and there is no cure or vaccine for it, yet. To data given to World Health Organization until July-1994, it is estimated that there are about 1 million patients and about 22 millions HIV positive persons In the world. Sixty percent of HIV positive persons are men and 40% are women. The di...

  15. An updated version of the Weigl discriminates adults with dementia from those with mild impairment and healthy controls☆

    Science.gov (United States)

    Beglinger, Leigh J.; Unverzagt, Frederick W.; Beristain, Xabier; Kareken, David

    2009-01-01

    Dementia screening batteries often fall short on measures of executive functioning. The Weigl Color Form Sorting Test (WCFST) is a candidate for inclusion in such batteries, but can be insensitive to mild disturbance. The WCFST consists of 12 colored geometric shapes and requires the patient to sort the pieces by color or form, and then shift to the other sorting principle unassisted. We created a modified version of the WCFST (the Weigl-R) with increased conceptual complexity by adding two stimulus dimensions (texture and central shapes). The range of scores was also increased by adding the extent of examiner assistance required to achieve a correct sort, ability to verbalize conceptual strategy, and number of perseverations. We administered the Weigl-R to a group of 30 patients with mixed dementias, 34 adults with cognitive impairment without dementia, and 21 healthy controls. The new measure discriminated well between healthy controls and older adults with either cognitive impairment without dementia, or dementia. The Weigl-R may be a useful adjunct to brief dementia batteries but requires further validation. PMID:18093797

  16. An updated version of the Weigl discriminates adults with dementia from those with mild impairment and healthy controls.

    Science.gov (United States)

    Beglinger, Leigh J; Unverzagt, Frederick W; Beristain, Xabier; Kareken, David

    2008-03-01

    Dementia screening batteries often fall short on measures of executive functioning. The Weigl Color Form Sorting Test (WCFST) is a candidate for inclusion in such batteries, but can be insensitive to mild disturbance. The WCFST consists of 12 colored geometric shapes and requires the patient to sort the pieces by color or form, and then shift to the other sorting principle unassisted. We created a modified version of the WCFST (the Weigl-R) with increased conceptual complexity by adding two stimulus dimensions (texture and central shapes). The range of scores was also increased by adding the extent of examiner assistance required to achieve a correct sort, ability to verbalize conceptual strategy, and number of perseverations. We administered the Weigl-R to a group of 30 patients with mixed dementias, 34 adults with cognitive impairment without dementia, and 21 healthy controls. The new measure discriminated well between healthy controls and older adults with either cognitive impairment without dementia, or dementia. The Weigl-R may be a useful adjunct to brief dementia batteries but requires further validation. PMID:18093797

  17. Is postoperative cognitive dysfunction a risk factor for dementia?

    DEFF Research Database (Denmark)

    Steinmetz, J; Siersma, Volkert Dirk; Kessing, L V;

    2013-01-01

    BACKGROUND: /st>Postoperative cognitive dysfunction (POCD) is a common complication in elderly patients after major surgery. An association between POCD and the development of dementia has been suspected. In this study, we assessed if POCD was a risk factor for the occurrence of dementia. METHODS...... surgery, using a neuropsychological test battery. The time of (first) occurrence of dementia after surgery was assessed using the National Patient Register and the Psychiatric Central Research Register. Recorded dementia diagnoses (ICD-8 and ICD-10) were: Alzheimer's disease, vascular dementia......, frontotemporal dementia, or dementia without specification. The risk of dementia according to POCD was assessed in the Cox regression models. RESULTS: /st>A total of 686 patients with a median age of 67 [inter-quartile range (IQR) 61-74] yr were followed for a median of 11.1 (IQR 5.2-12.6) yr. Only 32 patients...

  18. Even a Little Exercise May Help Stave Off Dementia

    Science.gov (United States)

    ... Even a Little Exercise May Help Stave Off Dementia Sedentary seniors more likely to suffer mental decline, ... Couch potatoes have a higher risk of developing dementia in old age, a new study reports. Seniors ...

  19. Is It Lewy Body Dementia or Something Else?

    Science.gov (United States)

    ... Help end Lewy body dementia now! Donate Is It LBD or Something Else? Early and accurate diagnosis ... dementia with Lewy bodies’ (DLB). Symptoms that differentiate it from Alzheimer’s include unpredictable levels of cognitive ability, ...

  20. CHOLINESTERASE INHIBITORS IN THE TREATMENT OF DEMENTIA ALZHEIMER’S

    Directory of Open Access Journals (Sweden)

    Prameidya Primaniar S

    2013-03-01

    Full Text Available Dementia is the loss of intellectual abilities which include decreased ability to think, remember,understand, calculate, concentrate, and find the right words. The causes of dementia areAlzheimer’s, vascular dementia, alcohol. Dementia Alzheimer’s is a dementia type that iscurrently the most commonly found. Cholinesterase inhibitors are one of the therapies used totreat symptoms of cognitive decline and reduce neuropsychiatric symptoms in patient dementiaAlzheimer’s. Several studies have been conducted to demonstrate how the effects of severalclasses of cholinesterase inhibitors in the treatment of dementia Alzheimer’s. Effective dose,dosage and side effects of cholinesterase inhibitors is important to know before deciding to usecholinesterase inhibitors in the treatment of dementia Alzheimer’s.

  1. Research Offers Clues to Dementia with Language Loss

    Science.gov (United States)

    ... centers may help drive a rare form of dementia that causes people to lose their ability to use language, a new study finds. Researchers at Northwestern University in Chicago ... dementia, called primary progressive aphasia (PPA). They compared those ...

  2. Widely Used Heart Drug Tied to Dementia Risk

    Science.gov (United States)

    ... 158678.html Widely Used Heart Drug Tied to Dementia Risk Both warfarin and the atrial fibrillation it's ... fibrillation may have a heightened risk of developing dementia -- and the quality of their drug treatment may ...

  3. Epigenetics of Alzheimer’s Disease and Frontotemporal Dementia

    OpenAIRE

    Veerappan, Chendhore S; Sleiman, Sama; Coppola, Giovanni

    2013-01-01

    This article will review the recent advances in the understanding of the role of epigenetic modifications and the promise of future epigenetic therapy in neurodegenerative dementias, including Alzheimer’s disease and frontotemporal dementia.

  4. Gender differences in the prodromal signs of dementia: memory complaint and IADL-restriction. a prospective population-based cohort.

    Science.gov (United States)

    Pérès, Karine; Helmer, Catherine; Amieva, Hélène; Matharan, Fanny; Carcaillon, Laure; Jacqmin-Gadda, Hélène; Auriacombe, Sophie; Orgogozo, Jean-Marc; Barberger-Gateau, Pascale; Dartigues, Jean-François

    2011-01-01

    Subjective memory complaint (SMC) and restriction in cognitively-complex activities of daily living (such as instrumental ADL) are two early symptoms observed in the prodromal phase of dementia and may represent useful alarm signals for general practitioners for an increased risk of subsequent dementia. We here studied in a large population-based epidemiological cohort on aging, the risk of dementia associated with SMC and restriction in IADL, with a specific interest in a potential interaction by gender. The sample included 2,901 subjects, aged 65 years and over, initially free of dementia and followed over 15 years. After controlling for education, marital status, depressive symptomatology, and global cognition (MMSE), IADL-restriction was associated with an increased risk of dementia only in men (HR = 2.04, 1.27 to 3.29), whereas SMC was not (p = 0.95). The reverse was observed in females, in whom SMC almost doubled the risk of dementia (1.48 to 2.41), with no association with IADL-restriction (p = 0.74). Finally, we distinguished the risk of dementia at short-term (in the first 5 years), mid-term (between 5 and 10 years), and long-term (between 10 and 15 years). In women, SMC was significantly associated with greater risk of dementia whatever the risk period considered, even at longer term (HR = 1.61, p = 0.0216), whereas in men the increased risk was also observed with IADL-restriction and only in the first 5 years. To conclude, women would report the first symptoms very early in the process by SMC, whereas men would tend to later report their difficulties and only in terms of IADL-restriction. PMID:21725162

  5. Vitamin D in dementia prevention.

    Science.gov (United States)

    Annweiler, Cédric

    2016-03-01

    Beyond effects on bone health, vitamin D exerts effects on a variety of target organs, including the brain. The discussion herein presents the state of the art in research on the neurological role of vitamin D and clinical implications among older adults, including implications for dementia onset and progression. Some of the neurosteroid actions of vitamin D include regulation of calcium homeostasis, clearance of amyloid-β peptide, antioxidant and anti-inflammatory effects, and possible protection against the neurodegenerative mechanisms associated with Alzheimer's disease (AD). The correction of age-related hypovitaminosis D and cognitive decline has been reported by various cross-sectional and longitudinal studies reporting associations of lower vitamin D concentrations with brain changes and poorer cognition, specifically with respect to executive dysfunction. Epidemiological studies have consistently shown an association between inadequate dietary intake of vitamin D and cognitive disorders, including greater AD risk. Although there have not been any randomized placebo-controlled trials conducted to examine the effectiveness of vitamin D supplementation to prevent AD, several nonrandomized controlled studies have found that older adults experienced cognitive improvements after 1-15 months of vitamin D supplementation. Therefore, it appears crucial to maintain vitamin D concentrations at sufficiently high levels in order to slow, prevent, or improve neurocognitive decline. PMID:27116242

  6. Comparison of verbal and emotional responses of elderly people with mild/moderate dementia and those with severe dementia in responses to seal robot, PARO

    Directory of Open Access Journals (Sweden)

    Kazue Takayanagi

    2014-09-01

    Conclusion: The elderly people both with mild/moderate dementia and with severe dementia showed greater interest in PARO than in Lion. The results suggest that introducing PARO may increase willingness of the staff members to communicate and work with elderly people with dementia, especially those with mild/moderate dementia who express their demand of communication more than those with severe dementia.

  7. Care pathways for dementia: current perspectives

    Directory of Open Access Journals (Sweden)

    Samsi K

    2014-11-01

    Full Text Available Kritika Samsi, Jill ManthorpeSocial Care Workforce Research Unit, King’s College London, London, UKAbstract: Uncertainty appears to typify the experience of living with dementia. With an uncertain illness trajectory and unpredictable levels of deterioration and stability in symptoms, people with a diagnosis of dementia may live with uncertainty and anxiety and find it hard to make plans or decisions for their future. People with memory problems and caregivers seeking a diagnosis of dementia may also potentially find themselves navigating a labyrinth-like maze of services, practitioners, assessments, and memory tests, with limited understanding of test scores and little information about what support is available. In this context of uncertainty, the apparent clarity and certainty of a “dementia care pathway” may be attractive. However, the term “dementia care pathway” has multiple and overlapping meanings, which can potentially give rise to further confusion if these are ill-defined or a false consensus is presumed. This review distinguishes four meanings: 1 a mechanism for the management and containment of uncertainty and confusion, useful for the professional as well as the person with dementia; 2 a manual for sequencing care activities; 3 a guide to consumers, indicating eligibility for care activities, or a guide to self-management for dementia dyads, indicating the appropriateness of care activities; and 4 a manual for “walking with” the person. Examples of these approaches are presented from UK dementia services with illustrations of existing care pathways and associated time points, specifically focusing on: 1 early symptom identification and first service encounters, 2 assessment process, 3 diagnostic disclosure, 4 postdiagnostic support, and 5 appropriate interventions. We review the evidence around these themes, as well as discuss service pathways and referral routes used by some services in England and internationally. We

  8. Dementia workup. Deciding on laboratory testing for the elderly.

    OpenAIRE

    C. Frank

    1998-01-01

    OBJECTIVE: To review Canadian Consensus Conference on the Assessment of Dementia (CCCAD) guidelines for laboratory evaluation of dementia, and to make recommendations to family physicians based on these guidelines and other literature. DATA SOURCES: English-language data sources from 1992 to March 1997 were searched on MEDLINE using the MeSH headings dementia, dementia/diagnosis, and cognition. Key words relating to specific laboratory tests or conditions, such as neurosyphilis or vitamin B12...

  9. Cortical Lewy body dementia: clinical features and classification.

    OpenAIRE

    Gibb, W R; Luthert, P. J.; Janota, I; Lantos, P. L.

    1989-01-01

    Seven patients, aged 65-72 years, are described with dementia and cortical Lewy bodies. In one patient a Parkinsonian syndrome was followed by dementia and motor neuron disease. In the remaining six patients dementia was accompanied by dysphasia, dyspraxia and agnosia. One developed a Parkinsonian syndrome before the dementia, in three cases a Parkinsonian syndrome occurred later, and in two cases not at all. All patients showed Lewy bodies and cell loss in the substantia nigra, locus coerule...

  10. Aging is a weak but relentless determinant of dementia severity

    OpenAIRE

    Royall, Donald R.; Raymond F. Palmer

    2016-01-01

    Structural Equation Models (SEM) can explicitly distinguish “dementia-relevant” variance in cognitive task performance (i.e., “δ” for dementia). In prior work, δ appears to uniquely account for dementia severity regardless of the cognitive measures used to construct it. In this study, we test δ as a mediator of age's prospective association with future cognitive performance and dementia severity in a large, ethnically diverse longitudinal cohort, the Texas Alzheimer's Research and Care Consor...

  11. Time trend in diagnosing dementia in secondary care

    DEFF Research Database (Denmark)

    Phung, Thien Kieu Thi; Waltoft, Berit Lindum; Kessing, Lars Vedel;

    2010-01-01

    To study the trend of diagnosing dementia in the secondary health care sector over time, we conducted a nationwide longitudinal study of the incidence and prevalence of registered dementia diagnoses in the Danish national hospital registers.......To study the trend of diagnosing dementia in the secondary health care sector over time, we conducted a nationwide longitudinal study of the incidence and prevalence of registered dementia diagnoses in the Danish national hospital registers....

  12. Treatment of Behavioural and Psychological Symptoms in Dementia

    OpenAIRE

    2008-01-01

    Noncognitive symptoms in dementia include many kinds of behavioural and psychological symptoms. Behavioural and psychological symptoms of dementia, BPSD, is quite common problem among individuals with dementia, and often difficult to manage. BPSD can lead to premature institutionalization and decreased quality of life for both the caregiver and the patient. The purpose of this paper is to review and describe the main characteristics of dementia and to get an overall view of the management ...

  13. Imaging Amyloidopathy in Parkinson Disease and Parkinsonian Dementia Syndromes

    OpenAIRE

    Frey, Kirk A.; Petrou, Myria

    2015-01-01

    Dementia arising in patients with Parkinson disease or parkinsonian neurodegeneration comprises a heterogeneous neuropathology. Clinical labeling of patients with both dementia and Parkinson disease is dichotomous, depending on the temporal development of cognitive impairment and motor parkinsonism. Patients with dementia arising first (or within the first year of PD) are classified as dementia with Lewy bodies; patients with PD for more than one year before cognitive decline are classified a...

  14. Blood pressure and dementia in the very old

    OpenAIRE

    Guo, Zhenchao

    1998-01-01

    Blood Pressure and Dementia in the Very Old. An epidemiologic study There is a considerable public health interest in the vascular causes of dementia because they are potentially treatable and preventable. A number of vascular factors may be associated with dementia. Hypertension is supposed to be the most powerful vascular risk factor for dementia because of its contribution to cerebrovascular disease. However, there have only been a few population-based studies about the ...

  15. Death certification after a diagnosis of presenile dementia.

    OpenAIRE

    Newens, A J; Forster, D P; Kay, D W

    1993-01-01

    STUDY OBJECTIVES--To assess the value of death certification for the epidemiological study of dementia, the frequency with which the condition was recorded on death certificates of patients diagnosed with some form of dementia before the age of 65 years was studied. A further objective was to identify variables associated with failure to record dementia on the certificate. DESIGN--A cohort of patients with presenile dementia, differentiated by a clinical algorithm applied to hospital case rec...

  16. HMGCoA-Reductase Inhibitors in Dementia: Benefit or Harm

    OpenAIRE

    Padala, Kalpana P.; Potter, Jane F.; Tsuneya Ikezu

    2009-01-01

    Dementia is a syndrome characterized by a decline in cognitive function. Alzheimer’s disease and cerebro-vascular disease are the most common causes of dementia. Many factors (genetic, life style, vascular etc.) appear to play some role in the development of dementia. Statins significantly reduce vascular disease and could reduce cognitive impairment in later life. Although most cross-sectional and longitudinal studies suggested a lower incidence of dementia in long-term statin users, randomi...

  17. What can imaging tell us about cognitive impairment and dementia?

    OpenAIRE

    Narayanan, Leela; Murray, Alison Dorothy

    2016-01-01

    Dementia is a contemporary global health issue with far reaching consequences, not only for affected individuals and their families, but for national and global socio-economic conditions. The hallmark feature of dementia is that of irreversible cognitive decline, usually affecting memory, and impaired activities of daily living. Advances in healthcare worldwide have facilitated longer life spans, increasing the risks of developing cognitive decline and dementia in late life. Dementia remains ...

  18. Resource Utilization in Dementia a Question of Collaboration

    OpenAIRE

    Jedenius, Erik

    2010-01-01

    This doctoral thesis investigates one disease management program in dementia located in Kalmar, Sweden with regard to the resource utilization. Dementia is a devastating disease which mainly affects the elderly. As the disease progresses the need for support increases. Dementia is one of the most costly diseases in our society. Although our understanding of dementia has advanced we have yet to discover a cure for the disease. Nevertheless with our current knowledge we can ac...

  19. Association between environmental tobacco smoke exposure and dementia syndromes

    OpenAIRE

    Chen, Ruoling; Wilson, Kenneth; Chen, Yang; Zhang, Dongmei; Qin, Xia; He, Meizi; Hu, Zhi; Ma, Ying; Copeland, John R

    2012-01-01

    Objectives Environmental tobacco smoke (ETS) has a range of adverse health effects, but its association with dementia remains unclear and with dementia syndromes unknown. We examined the dose–response relationship between ETS exposure and dementia syndromes. Methods Using a standard method of GMS, we interviewed 5921 people aged ≥60 years in five provinces in China in 2007–2009 and characterised their ETS exposure. Five levels of dementia syndrome were diagnosed using the Automated Geriatric ...

  20. Systematic review of information and support interventions for caregivers of people with dementia

    Directory of Open Access Journals (Sweden)

    Birks Yvonne

    2007-07-01

    Full Text Available Abstract Background Dementia is an important health and social care problem and is one of the main causes of disability in later life. The number of families affected by dementia will dramatically increase over the next five decades. Despite the implications for health and social care services in the future, the overwhelming majority of care for people with dementia takes place away from health care settings. Providing informal care for someone with dementia can be psychologically, physically and financially expensive and a range of health service interventions aimed at supporting and providing information to these carers has developed to help carers meet these demands. This review examines whether information and support interventions improve the quality of life of people caring for someone with dementia. Methods A systematic review examining evidence from randomised controlled trials in which technology, individualised or group-based interventions built around the provision of support and/or information were evaluated. Results Forty-four studies were included in the review. Controlling for the quality of the evidence, we found statistically significant evidence that group-based supportive interventions impact positively on psychological morbidity. However, whilst the improvement was unlikely to be due to chance, the clinical significance of this finding should be interpreted tentatively, due to the difficulties in interpreting the standardised mean difference as a measure of effect and the complex aetiology of depression. No evidence was found for the effectiveness of any other form of intervention on a range of physical and psychological health outcomes. Conclusion There is little evidence that interventions aimed at supporting and/or providing information to carers of people with dementia are uniformly effective. There is a pressing need to ensure that supportive interventions at the development stage are accompanied by good quality

  1. Some observations on the spectrum of dementia

    Directory of Open Access Journals (Sweden)

    Jha Sanjeev

    2004-04-01

    Full Text Available A study was designed to generate epidemiological and clinical data on dementia, in a teaching hospital in India. It was conducted on 124 (94 male and 30 female elderly patients (aged more than 60 years presenting with clinical syndrome of dementia (DSM-3. Their age range was 64-78 (mean 65.7 4.1 years. Detailed clinical, biochemical, radiological and electrophysiological evaluation was done to establish etiology. Patients with psychiatric ailments, cranial trauma and tumors were excluded. The study period was 4.2 years. Multi-infarct dementia (MID was observed to be commonest cause of dementia and was present in 59 (47.6% cases. There were 10 (8% patients each of tuberculosis (TB and neurocysticercosis (NCC. Alcohol-related dementia was present in 13 (10.5%, while malnutrition (Vitamin B12 deficiency was present in 9 (7.2%. Alzheimer′s Disease (AD was present (NINCDS-ADRDA criteria in 6 patients (4.8%. There were 3 (2.4% cases 1 each of Huntington′s disease, Parkinson′s and Normal Pressure Hydrocephalus and 2 each of diabetes, hypothyroidism, hyperthyroidism and Creutzfeldt′ Jakob Disease. We conclude that AD, which is irreversible and common in the west, is relatively uncommon in India as compared to MID, infections and malnutrition, which are potentially treatable.

  2. [Therapy of dementia with antipsychotics and antidepressives].

    Science.gov (United States)

    Frölich, L; Hausner, L

    2015-04-01

    In dementia depressive symptoms, anxiety, hallucinations and delusions often occur and are accompanied by unspecific behavioral changes. A targeted pharmacotherapy is complicated by the underlying cognitive impairment and physical comorbidities. The current review focusses on recent evidence on the use of antidepressives and antipsychotics for psychotic disturbances, agitation and depression in dementia and analyzes currently published randomized controlled clinical trials and meta-analyses. The evidence on the use of antipsychotics for different indications favors risperidone, with lower evidence levels for quetiapine and aripiprazole, whereas haloperidol should be avoided. Increased mortality and the risk of cerebrovascular events due to antipsychotics are of major concern. With respect to antidepressives, the benefit of antidepressive pharmacotherapy in dementia is critically discussed because of limited efficacy and increased side effects; however, selective serotonin reuptake inhibitors (SSRI), such as citalopram and sertraline have demonstrated efficacy on neuropsychiatric behavioral symptoms in general. These conclusions on the risk-benefit ratio of antidepressives and antipsychotics in dementia are in accordance with the recommendations of the German Society of Neurology and German Association for Psychiatry, Psychotherapy and Psychosomatics (DGN/DGPPN) S3 guidelines on the treatment of dementia. PMID:25787724

  3. Beyond competence: advance directives in dementia research.

    Science.gov (United States)

    Jongsma, Karin Rolanda; van de Vathorst, Suzanne

    2015-01-01

    Dementia is highly prevalent and incurable. The participation of dementia patients in clinical research is indispensable if we want to find an effective treatment for dementia. However, one of the primary challenges in dementia research is the patients' gradual loss of the capacity to consent. Patients with dementia are characterized by the fact that, at an earlier stage of their life, they were able to give their consent to participation in research. Therefore, the phase when patients are still competent to decide offers a valuable opportunity to authorize research, by using an advance research directive (ARD). Yet, the use of ARDs as an authorization for research participation remains controversial. In this paper we discuss the role of autonomous decision-making and the protection of incompetent research subjects. We will show why ARDs are a morally defensible basis for the inclusion of this population in biomedical research and that the use of ARDs is compatible with the protection of incompetent research subjects. PMID:26458366

  4. Dementia and functional cerebral imaging a reevaluation

    International Nuclear Information System (INIS)

    New concepts which concerned especially the nosologic classification of dementia as for example Dementia with Lewy Bodies (DLB) incite to revalue the main characteristics of the regional cerebral blood flow measurements studied by SPECT in several forms of dementia. SPECT analysis with 99m-Technetium HMPAO (555 MBq) was performed to 20 patients with probable DLB, 20 patients with probable Alzheimer's disease (AD) and 20 patients with Fronto-Temporal dementia (FTD). Ten pairs of regions of interest were analysed. Tracer uptake was expressed as a cortico-cerebellar activity ratio. Statistical analysis of index of fixation was performed using an univariate analysis of variance, and a selection of significative ROIs was performed using two cut-off values (80 and 82.5 %). In the FTD group, a decrease of HMPAO uptake in frontal cortical regions of interest (internal, lateral and posterior) was observed. In the DLB group the decrease of HMPAO uptake was widespread and concerned all the cortical regions of interest except the posterior frontal and occipital regions. Finally in the AD group there was a limited temporal and parietal hypoperfusion more marked on the left side without frontal hypoperfusion. This last result was obtained whatever the cognitive impairment. Consequently it seems that the frontal hypoperfusion previously reported in AD groups was induced by the fact that patients with DLB were also included because the diagnosis was not established. In conclusion we estimate that SPECT studies could be used more often in clinical research especially for a classification approach of dementia. (authors)

  5. 类获得性免疫缺陷(阴性HIV)“患者”的流行病学调查%Epidemiological investigation of cases with complained AIDS-related complex (HIV negative)

    Institute of Scientific and Technical Information of China (English)

    刘雅琼; 林辉; 于磊; 王清青; 王太武; 马翔宇; 凌华; 吴国辉; 张路

    2013-01-01

    目的 对社区类获得性免疫缺陷(AIDS)综合征(阴性HIV)“患者”进行病因探索.方法 采用定性系统分析筛检国内外相关综合征报道病例,探索类AIDS综合征“患者”临床特征可能的聚类属性;通过现况调查掌握“患者”人群的一般特征和临床特征.结果 定性系统分析显示,目前在世界范围,与类AIDS综合征(阴性HIV)“患者”相似的疾病有2种,即CD4+T淋巴细胞缺陷综合征(ICL)和非结核分枝杆菌感染(NTM感染);通过174例网络调查和52例现场观察,发现“患者”人群以男性为主,青、中年为主;在国内分布地区广泛;主诉症状涉及呼吸道、消化道、皮肤、肌肉、骨骼和神经系统;根据症状特点,病程有急性期和稳定期之分;群体症状及体征为:淋巴结部位肿胀感、骨痛、肌肉“跳”(痛)、淋巴结节、皮肤结节(皮疹)、舌苔白厚、关节弹响、皮肤干燥;52例“患者”检测发现CD4+T淋巴细胞< 500/μL 17例(32.69%)、CD4/CD8比值异常16例(30.77%)、干扰素-γ抗体阳性17例(36.69%)和PPD阳性39例(++~+++,75.00%);高危险性行为是可疑的暴露因素之一.结论 类AIDS综合征(阴性HIV)“患者”现象不能完全用心理因素予以解释,其呈现的临床特征有明显的一致性和规律性,亟待开展深入研究进行分析.%Objective To investigate the possible causes of AIDS-related complex (HIV negative) in community population. Methods Qualitative systematic analysis was used to screen the cases with AIDS-related complex (HIV negative) that had been reported. The possible clustering types of the clinical features of AIDS-related complex were explored based on a cross-section study that had been conducted to observe the personality and clinical features of the cases with AIDS-related complex. Results The qualitative systematic analysis suggested that the idiopathic CD4+ T lymphocytopenia (ICL) and infection of

  6. Prevalence of very mild to severe dementia in Denmark

    DEFF Research Database (Denmark)

    Andersen, K; Lolk, A; Nielsen, H;

    1997-01-01

    The prevalence of dementia has been estimated in several countries and a meta-analysis has shown moderate and severe dementia in people aged 65 years and older to be between 4% and 6%. The Odense study is aiming to estimate the prevalence and incidence of dementia and to identify risk factors....

  7. Genetics Home Reference: CHMP2B-related frontotemporal dementia

    Science.gov (United States)

    ... Conditions CHMP2B-related frontotemporal dementia CHMP2B-related frontotemporal dementia Enable Javascript to view the expand/collapse boxes. ... Open All Close All Description CHMP2B -related frontotemporal dementia is a progressive brain disorder that affects personality, ...

  8. Tools to Detect Delirium Superimposed on Dementia: A Systematic Review

    OpenAIRE

    Morandi, A.; McCurley, J; Vasilevskis, E; Fick, D.; Bellelli, G; Lee, P.; Jackson, J.; Shenkin, S; Trabucchi, M; Schnelle, J; Inouye, S; Ely, W; MacLullich, A

    2012-01-01

    OBJECTIVES: To identify valid tools to diagnose delirium superimposed on dementia. DESIGN: Systematic review of studies of delirium tools that explicitly included individuals with dementia. SETTING: Hospital. PARTICIPANTS: Studies were included if delirium assessment tools were validated against standard criteria, and the presence of dementia was assessed according to standard criteria that used validated instruments. MEASUREMENTS: PubMed, Embase, and Web of Sc...

  9. Mapping chemical structure-activity information of HAART-drug cocktails over complex networks of AIDS epidemiology and socioeconomic data of U.S. counties.

    Science.gov (United States)

    Herrera-Ibatá, Diana María; Pazos, Alejandro; Orbegozo-Medina, Ricardo Alfredo; Romero-Durán, Francisco Javier; González-Díaz, Humberto

    2015-06-01

    Using computational algorithms to design tailored drug cocktails for highly active antiretroviral therapy (HAART) on specific populations is a goal of major importance for both pharmaceutical industry and public health policy institutions. New combinations of compounds need to be predicted in order to design HAART cocktails. On the one hand, there are the biomolecular factors related to the drugs in the cocktail (experimental measure, chemical structure, drug target, assay organisms, etc.); on the other hand, there are the socioeconomic factors of the specific population (income inequalities, employment levels, fiscal pressure, education, migration, population structure, etc.) to study the relationship between the socioeconomic status and the disease. In this context, machine learning algorithms, able to seek models for problems with multi-source data, have to be used. In this work, the first artificial neural network (ANN) model is proposed for the prediction of HAART cocktails, to halt AIDS on epidemic networks of U.S. counties using information indices that codify both biomolecular and several socioeconomic factors. The data was obtained from at least three major sources. The first dataset included assays of anti-HIV chemical compounds released to ChEMBL. The second dataset is the AIDSVu database of Emory University. AIDSVu compiled AIDS prevalence for >2300 U.S. counties. The third data set included socioeconomic data from the U.S. Census Bureau. Three scales or levels were employed to group the counties according to the location or population structure codes: state, rural urban continuum code (RUCC) and urban influence code (UIC). An analysis of >130,000 pairs (network links) was performed, corresponding to AIDS prevalence in 2310 counties in U.S. vs. drug cocktails made up of combinations of ChEMBL results for 21,582 unique drugs, 9 viral or human protein targets, 4856 protocols, and 10 possible experimental measures. The best model found with the original

  10. The importance of music for people with dementia: the perspectives of people with dementia, family carers, staff and music therapists

    OpenAIRE

    McDermott, O.; Orrell, M.; Ridder, H. M.

    2014-01-01

    Objectives: Despite the popularity of music-based interventions in dementia care, there is a limited knowledge of how and why people with dementia find music beneficial for their well-being. A qualitative study was conducted to develop further insights into the musical experiences of people with dementia and explore the meaning of music in their lives.Method: Separate focus groups and interviews with (1) care home residents with dementia and their families, (2) day hospital clients with demen...

  11. Forecasting the Incidence of Dementia and Dementia-Related Outpatient Visits With Google Trends: Evidence From Taiwan

    OpenAIRE

    Wang, Ho-Wei; Chen, Duan-Rung; Yu, Hsiao-Wei; Chen, Ya-Mei

    2015-01-01

    Background Google Trends has demonstrated the capability to both monitor and predict epidemic outbreaks. The connection between Internet searches for dementia information and dementia incidence and dementia-related outpatient visits remains unknown. Objective This study aimed to determine whether Google Trends could provide insight into trends in dementia incidence and related outpatient visits in Taiwan. We investigated and validated the local search terms that would be the best predictors o...

  12. Violent and criminal manifestations in dementia patients.

    Science.gov (United States)

    Cipriani, Gabriele; Lucetti, Claudio; Danti, Sabrina; Carlesi, Cecilia; Nuti, Angelo

    2016-05-01

    Although the older adults have been studied as victims of violence, geriatric patients can display violent behavior. The purpose of the present review was to explore the phenomenon of criminal violations and violent acts in people with dementia. The authors used PubMed to search the MEDLINE database and other sources for original research and review articles on criminal and violent manifestation in demented patients combining the terms "criminal manifestation," "violence, aggressive behavior," "homicide," "suicide" and "homicide-suicide" together with "dementia". Possible biomarkers of violence are considered. The present review highlights the risk factors for violence in patients suffering from dementia, and reviews the literature about criminal violations and homicidal/suicidal behavior in this patient group. Geriatr Gerontol Int 2016; 16: 541-549. PMID:26460091

  13. Alzheimer's disease and other dementias in Canada.

    Science.gov (United States)

    Wong, Suzy L; Gilmour, Heather; Ramage-Morin, Pamela L

    2016-05-18

    This article provides information on Alzheimer's disease and other dementias, using the 2010/2011 Canadian Community Health Survey, the 2011/2012 Survey of Neurological Conditions in Institutions in Canada, and the 2011 Survey on Living with Neurological Conditions in Canada. Among Canadians aged 45 or older, an estimated 0.8% in private households and 45% in long-term residential care facilities had a diagnosis of dementia. Prevalence rose with age. The vast majority of people with dementia in private households received assistance with medical care (81%), housework and home maintenance (83%), meal preparation (88%), emotional support (90%), transportation (92%), and managing care (92%). Among those receiving assistance, 85% relied, at least in part, on family, friends or neighbours. The primary caregiver tended to be a spouse (46%) or an adult child (44%), most of whom were daughters (71%). The majority of primary caregivers lived in the same household (83%) and provided daily care (86%). PMID:27192206

  14. Prevention of Dementia: Focus on Lifestyle

    Directory of Open Access Journals (Sweden)

    Maria Cristina Polidori

    2010-01-01

    Full Text Available The objective of this paper is to summarize current knowledge on the possible advantages of lifestyle interventions, with particular attention to physical fitness, cognitive activity, leisure and social activity as well as nutrition. There is a large amount of published papers providing partial evidence and asserting the need for immediate, appropriate preventive lifestyle measures against dementia and AD development. Nevertheless, there are currently great difficulties in drafting effective guidelines in this field. This depends mainly upon lack of randomized controlled trials assessing benefits versus risks of particular lifestyle interventions strategies. However, due to the rapid increase of dementia burden, lifestyle factors and their amelioration should be already made part of decision making in light of their health-maintaining effects while awaiting for results of well-designed large prospective cohort studies in dementia.

  15. Prediction of Dementia by Hippocampal Shape Analysis

    DEFF Research Database (Denmark)

    Achterberg, H.C.; Lijn, F. van der; Heijer, T. den;

    2010-01-01

    This work investigates the possibility of predicting future onset of dementia in subjects who are cognitively normal, using hippocampal shape and volume information extracted from MRI scans. A group of 47 subjects who were non-demented normal at the time of the MRI acquisition, but were diagnosed...... with dementia during a 9 year follow-up period, was selected from a large population based cohort study. 47 Age and gender matched subjects who stayed cognitively intact were selected from the same cohort study as a control group. The hippocampi were automatically segmented and all segmentations were...... inspected and, if necessary, manually corrected by a trained observer. From this data a statistical model of hippocampal shape was constructed, using an entropy-based particle system. This shape model provided the input for a Support Vector Machine classifier to predict dementia. Cross validation...

  16. [Montessori method applied to dementia - literature review].

    Science.gov (United States)

    Brandão, Daniela Filipa Soares; Martín, José Ignacio

    2012-06-01

    The Montessori method was initially applied to children, but now it has also been applied to people with dementia. The purpose of this study is to systematically review the research on the effectiveness of this method using Medical Literature Analysis and Retrieval System Online (Medline) with the keywords dementia and Montessori method. We selected lo studies, in which there were significant improvements in participation and constructive engagement, and reduction of negative affects and passive engagement. Nevertheless, systematic reviews about this non-pharmacological intervention in dementia rate this method as weak in terms of effectiveness. This apparent discrepancy can be explained because the Montessori method may have, in fact, a small influence on dimensions such as behavioral problems, or because there is no research about this method with high levels of control, such as the presence of several control groups or a double-blind study. PMID:23155599

  17. Where we stand with treating dementia.

    Science.gov (United States)

    Amador, L; Jayaraj, K

    2000-01-01

    Our aging population is growing. As a result, dementia is becoming an ever more prevalent problem--with devastating consequences to the affected persons and their families. In the evaluation of the demented patient, it is crucial to look for and exclude conditions such as depression and other reversible causes of cognitive impairment before branding the patient with a diagnosis of dementia. Drug treatment of AD is not highly successful, although the Food and Drug Administration has approved acetylcholinesterase inhibitors for the treatment of mild to moderate AD. Present-day treatment for dementia focuses mainly on improving or preserving the quality of life of patients and their families, and on treating concomitant psychosocial, behavioral, and medical issues. We are optimistic that new, innovative medications may in the future allow us to treat or even cure Alzheimer's disease and other progressive dementing disorders. PMID:10917038

  18. Clinical practice guidelines for dementia in Australia.

    Science.gov (United States)

    Laver, Kate; Cumming, Robert G; Dyer, Suzanne M; Agar, Meera R; Anstey, Kaarin J; Beattie, Elizabeth; Brodaty, Henry; Broe, Tony; Clemson, Lindy; Crotty, Maria; Dietz, Margaret; Draper, Brian M; Flicker, Leon; Friel, Margeret; Heuzenroeder, Louise Mary; Koch, Susan; Kurrle, Susan; Nay, Rhonda; Pond, C Dimity; Thompson, Jane; Santalucia, Yvonne; Whitehead, Craig; Yates, Mark W

    2016-03-21

    About 9% of Australians aged 65 years and over have a diagnosis of dementia. Clinical practice guidelines aim to enhance research translation by synthesising recent evidence for health and aged care professionals. New clinical practice guidelines and principles of care for people with dementia detail the optimal diagnosis and management in community, residential and hospital settings. The guidelines have been approved by the National Health and Medical Research Council. The guidelines emphasise timely diagnosis; living well with dementia and delaying functional decline; managing symptoms through training staff in how to provide person-centred care and using non-pharmacological approaches in the first instance; and training and supporting families and carers to provide care. PMID:26985848

  19. New SPECT and PET dementia tracers

    International Nuclear Information System (INIS)

    Single photon emission tomography (SPECT) and positron emission tomography (PET) are techniques to study in vivo neurotransmitter systems, neuro inflammation and amyloid deposits in normal human brain and in dementia. These methods used to explore the integrity of dopaminergic, cholinergic and serotonergic systems in Alzheimer's disease and in other dementias allowed to understand how the neurotransmission was modified in these disorders. Progress in the understanding of pathophysiological and clinical signs of dementia requires an evolution of the radioligands used to carry out an increasingly early and differential diagnosis in addition to monitoring the progression of disease and the effects of therapies. New emerging radiotracers for neuro inflammation or amyloid deposits are essential. In this article, new SPECT and PET tracers are presented. (authors)

  20. The role of phytochemicals in the treatment and prevention of dementia.

    Science.gov (United States)

    Howes, Melanie-Jayne R; Perry, Elaine

    2011-06-01

    constituents, that have shown relevant mechanistic effects for dementia and promising clinical data, but require more evidence for their clinical efficacy and safety. Such plants include Ginkgo biloba, which has been extensively studied in numerous clinical trials, with most outcomes showing positive effects on cognitive functions in dementia patients; however, more reliable and consistent clinical data are needed to confirm efficacy. Other plants and their extracts that have produced promising clinical data in dementia patients, with respect to cognition, include saffron (Crocus sativus), ginseng (Panax species), sage (Salvia species) and lemon balm (Melissa officinalis), although more extensive and reliable clinical data are required. Other plants that are used in traditional practices of medicine have been suggested to improve cognitive functions (e.g. Polygala tenuifolia) or have been associated with alleviation of BPSD (e.g. the traditional prescription yokukansan); such remedies are often prescribed as complex mixtures of different plants, which complicates interpretation of pharmacological and clinical data and introduces additional challenges for quality control. Evidence for the role of natural products in disease prevention, the primary but considerably challenging aim with respect to dementia, is limited, but the available epidemiological and clinical evidence is discussed, with most studies focused on ChEIs, nicotine (from Nicotiana species), curcumin, wine polyphenols such as resveratrol and G. biloba. Challenges for the development of phytochemicals as drugs and for quality control of standardized plant extracts are also considered. PMID:21639405

  1. Cholinergic imaging in dementia spectrum disorders.

    Science.gov (United States)

    Roy, Roman; Niccolini, Flavia; Pagano, Gennaro; Politis, Marios

    2016-07-01

    The multifaceted nature of the pathology of dementia spectrum disorders has complicated their management and the development of effective treatments. This is despite the fact that they are far from uncommon, with Alzheimer's disease (AD) alone affecting 35 million people worldwide. The cholinergic system has been found to be crucially involved in cognitive function, with cholinergic dysfunction playing a pivotal role in the pathophysiology of dementia. The use of molecular imaging such as SPECT and PET for tagging targets within the cholinergic system has shown promise for elucidating key aspects of underlying pathology in dementia spectrum disorders, including AD or parkinsonian dementias. SPECT and PET studies using selective radioligands for cholinergic markers, such as [(11)C]MP4A and [(11)C]PMP PET for acetylcholinesterase (AChE), [(123)I]5IA SPECT for the α4β2 nicotinic acetylcholine receptor and [(123)I]IBVM SPECT for the vesicular acetylcholine transporter, have been developed in an attempt to clarify those aspects of the diseases that remain unclear. This has led to a variety of findings, such as cortical AChE being significantly reduced in Parkinson's disease (PD), PD with dementia (PDD) and AD, as well as correlating with certain aspects of cognitive function such as attention and working memory. Thalamic AChE is significantly reduced in progressive supranuclear palsy (PSP) and multiple system atrophy, whilst it is not affected in PD. Some of these findings have brought about suggestions for the improvement of clinical practice, such as the use of a thalamic/cortical AChE ratio to differentiate between PD and PSP, two diseases that could overlap in terms of initial clinical presentation. Here, we review the findings from molecular imaging studies that have investigated the role of the cholinergic system in dementia spectrum disorders. PMID:26984612

  2. Cholinergic imaging in dementia spectrum disorders

    Energy Technology Data Exchange (ETDEWEB)

    Roy, Roman; Niccolini, Flavia; Pagano, Gennaro; Politis, Marios [Institute of Psychiatry, Psychology and Neuroscience, King' s College London, Neurodegeneration Imaging Group, Department of Basic and Clinical Neuroscience, London (United Kingdom)

    2016-07-15

    The multifaceted nature of the pathology of dementia spectrum disorders has complicated their management and the development of effective treatments. This is despite the fact that they are far from uncommon, with Alzheimer's disease (AD) alone affecting 35 million people worldwide. The cholinergic system has been found to be crucially involved in cognitive function, with cholinergic dysfunction playing a pivotal role in the pathophysiology of dementia. The use of molecular imaging such as SPECT and PET for tagging targets within the cholinergic system has shown promise for elucidating key aspects of underlying pathology in dementia spectrum disorders, including AD or parkinsonian dementias. SPECT and PET studies using selective radioligands for cholinergic markers, such as [{sup 11}C]MP4A and [{sup 11}C]PMP PET for acetylcholinesterase (AChE), [{sup 123}I]5IA SPECT for the α{sub 4}β{sub 2} nicotinic acetylcholine receptor and [{sup 123}I]IBVM SPECT for the vesicular acetylcholine transporter, have been developed in an attempt to clarify those aspects of the diseases that remain unclear. This has led to a variety of findings, such as cortical AChE being significantly reduced in Parkinson's disease (PD), PD with dementia (PDD) and AD, as well as correlating with certain aspects of cognitive function such as attention and working memory. Thalamic AChE is significantly reduced in progressive supranuclear palsy (PSP) and multiple system atrophy, whilst it is not affected in PD. Some of these findings have brought about suggestions for the improvement of clinical practice, such as the use of a thalamic/cortical AChE ratio to differentiate between PD and PSP, two diseases that could overlap in terms of initial clinical presentation. Here, we review the findings from molecular imaging studies that have investigated the role of the cholinergic system in dementia spectrum disorders. (orig.)

  3. Genetics of Early-Onset Alzheimer Dementia

    OpenAIRE

    Rosa Rademakers; Marc Cruts; Christine Van Broeckhoven

    2003-01-01

    Alzheimer�s dementia (AD) is the most common degenerative disorder of the central nervous system. Although the onset of dementia is above 65 years of age in the majority of the patients (late-onset AD, LOAD), a small subgroup of patients develops AD before 65 years of age (early-onset AD, EOAD). To date 3 genes responsible for EOAD have been identified: the amyloid precursor protein gene (APP), presenilin 1 (PSEN1) and presenilin 2 (PSEN2). PSEN1 is the most frequently mutated EOAD gene with ...

  4. CSF and plasma vasopressin concentrations in dementia.

    OpenAIRE

    Sørensen, P S; Hammer, M.; Vorstrup, S; Gjerris, F.

    1983-01-01

    In 16 patients with primary degenerative dementia mean CSF vasopressin concentration was lower (0.9 +/- 0.1 pg/ml (mean +/- SEM)) than in 28 control patients (1.3 +/- 0.1 (mean +/- SEM)) (p less than 0.01). In 18 patients with normal pressure hydrocephalus and potentially reversible dementia mean CSF vasopressin concentration (1.2 pg/ml +/- 0.1 (mean +/- SEM)) was not different from that found in controls. Several of the demented patients had inappropriate plasma vasopressin concentrations su...

  5. Research progress of behavioral variant frontotemporal dementia

    Directory of Open Access Journals (Sweden)

    Xiao-hua GU

    2015-07-01

    Full Text Available There is no epidemiological data of frontotemporal dementia (FTD in China. The application of updated diagnostic criteria, publishing of frontotemporal lobar degeneration (FTLD consensus in China, development of multimodal imaging and biomarkers promote the clinical understanding on behavioral variant frontotemporal dementia (bvFTD. There is still no drugs treating FTD approved by U.S. Food and Drug Administration (FDA. Multidisciplinary intervention may delay the progression of bvFTD. DOI: 10.3969/j.issn.1672-6731.2015.07.006

  6. Caring for elderly patients with dementia: nursing interventions

    Directory of Open Access Journals (Sweden)

    Joosse LL

    2013-08-01

    Full Text Available Laura L Joosse,1 Debra Palmer,1 Norma M Lang21University of Wisconsin-Milwaukee, College of Nursing, Milwaukee, WI, USA; 2University of Wisconsin-Milwaukee, College of Nursing, Knowledge Based Nursing Research Initiative, Milwaukee, WI, USAAbstract: Elderly patients suffering from chronic cognitive decline/dementia are susceptible to poor quality of care which further erodes their quality of life. Seemingly benign events can create cascade iatrogenesis in those whose compensatory ability is compromised by impairments in multiple domains. Under recognition, misrecognition, or failure to intervene and manage this vulnerable population leads to suboptimal care. This places them at risk for cognitive decline, functional decline, and challenging behaviors, creating financial and emotional burdens for not only the patients but also family, staff, and organizations that are attempting to provide care. Identifying, managing, and therapeutically responding to confused elderly is complex. Recognizing the challenges makes the development of tools that guide comprehensive assessment planning, interpretation of findings, and treatment plans imperative. Innovative and effective assessment and interventional approaches are present in the literature. This article synthesizes the scientific evidence to guide clinicians to implement in practice.Keywords: dementia, older adults, assessment, intervention, quality of life, elderly, cognitive decline

  7. The importance of music for people with dementia

    DEFF Research Database (Denmark)

    McDermott, Orii; Orrell, Martin; Ridder, Hanne Mette Ochsner

    2014-01-01

    with dementia and explore the meaning of music in their lives.Method: Separate focus groups and interviews with (1) care home residents with dementia and their families, (2) day hospital clients with dementia, (3) care home staff, and (4) music therapists, were conducted. The findings of the thematic analysis...... were investigated further in the light of psychosocial factors with the aim of developing a theoretical model on music in dementia.Results: Six key themes were identified. The accessibility of music for people at all stages of dementia, close links between music, personal identity and life events...

  8. The development of the dementia concept in 19th century

    Directory of Open Access Journals (Sweden)

    Leonardo Caixeta

    2014-07-01

    Full Text Available The dementia concept has been reformulated through its history and the 19th century was remarkable in the construction of this concept as we understand it today. Like other syndromes, much of the history of the dementia concept comes from the attempt to separate it from other nosological conditions, giving it a unique identity. The fundamental elements for the arising of the dementia modern concept were: a correlation of the observed syndrome with organic-cerebral lesions; b understanding of the irreversibility of the dementia evolution; c its relation with human ageing; and d the choice of the cognitive dysfunction as a clinical marker of the dementia concept.

  9. White matter alterations in neurodegenerative and vascular dementia

    International Nuclear Information System (INIS)

    Due to a significant overlap of the two syndromes, differentiation of degenerative dementia of the Alzheimer-type from vascular dementia may be difficult even when imaging studies are available. White matter changes occur in many patients suffering from Alzheimer's disease. Little is known about the impact of white matter changes on the course and clinical presentation of Alzheimer's disease. High sensitivity of MRI in the detection of white matter alterations may account for over-diagnosing vascular dementia. The clinical significance of white matter alterations in dementia is still a matter of debate. The article reviews current concepts about the role of white matter alterations in dementia. (orig.)

  10. Macroeconomic Issues in Foreign Aid

    DEFF Research Database (Denmark)

    Hjertholm, Peter; Laursen, Jytte; White, Howard

    foreign aid, macroeconomics of aid, gap models, aid fungibility, fiscal response models, foreign debt,......foreign aid, macroeconomics of aid, gap models, aid fungibility, fiscal response models, foreign debt,...

  11. Validity of dementia diagnoses in the danish hospital registers

    DEFF Research Database (Denmark)

    Andersen, B.B.; Phung, T.K.T.; Høgh, P.;

    2007-01-01

    Background:The validity of dementia diagnoses in the Danish nationwide hospital registers was evaluated to determine the value of these registers in epidemiological research about dementia. Methods: Two hundred patients were randomly selected from 4,682 patients registered for the first time with a...... dementia diagnosis in the last 6 months of 2003. The patients' medical journals were reviewed to evaluate if they fulfilled ICD-10 and/or DSM-IV criteria for dementia and specific dementia subtypes. The patients who were still alive in 2006 were invited to an interview. Results: One hundred and ninety......-seven journals were available for review and 51 patients were interviewed. A registered diagnosis of dementia was found to be correct in 169 (85.8%) cases. Regarding dementia subtypes, the degree of agreement between the registers and the results of the validating process was low with a kappa of 0.36 (95% CI 0...

  12. Creating Excellence in Dementia Care: A Research Review for Ireland's National Dementia Strategy

    OpenAIRE

    Department of Health

    2012-01-01

    Dementia is a progressive condition that largely affects older people, impacting on their memory, language, ability to communicate, mood and personality. The course of the illness may be gradual and sometimes subtle, as is classically the case in Alzheimerâ?Ts disease. While dementia is a medical condition, recent insights from the psychosocial, sociopolitical and public health perspectives have focused attention on the human, social and economic implications of the disease.   Click h...

  13. Distinct patterns of olfactory impairment in Alzheimer's disease, semantic dementia, frontotemporal dementia and corticobasal degeneration

    OpenAIRE

    Luzzi S, Snowden JS, Neary D, Coccia M, Provinciali L, Lambon Ralph MA.

    2007-01-01

    Performance on tests of odour discrimination, naming, and matching was compared in patients with four distinct forms of neurodegenerative disease: Alzheimer's disease (AD), semantic dementia (SD), frontotemporal dementia (FTD), and corticobasal degeneration (CBD). The SD patients were found to have a severe impairment of identification from olfaction despite having normal discrimination, consistent with the multimodal semantic impairment characteristic of this patient group. The AD patients&#...

  14. Quantitative evaluation of severity of behavioral and psychological symptoms of dementia in patients with vascular dementia

    OpenAIRE

    Pan, Wei-Dong; Yoshida, Sohei; Liu, Qian; Wu, Chun-Lan; Wang, Jun; Zhu, Jin; Cai, Ding-Fang

    2013-01-01

    To quantitatively evaluate severity of behavioral and psychological symptoms of dementia (BPSD) for vascular dementia (VD). Changes of 51 patients with VD in BPSD between the first and 24th week were assessed using the Neuropsychiatric Inventory (NPI) and the behavioral pathology in Alzheimer’s disease (BEHAVE-AD) rating scale, in detrended fluctuation analysis (DFA) represented by diurnal activity (DA), evening activity (EA), and nocturnal activity (NA), and the relationships were analyzed. ...

  15. Individual subject classification of mixed dementia from pure subcortical vascular dementia based on subcortical shape analysis.

    Directory of Open Access Journals (Sweden)

    Hee Jin Kim

    Full Text Available Subcortical vascular dementia (SVaD, one of common causes of dementia, has concomitant Alzheimer's disease (AD pathology in over 30%, termed "mixed dementia". Identifying mixed dementia from SVaD is important because potential amyloid-targeted therapies may be effective for treatment in mixed dementia. The purpose of this study was to discriminate mixed dementia from pure SVaD using magnetic resonance imaging (MRI. We measured brain amyloid deposition using the 11C-Pittsburgh compound B positron emission tomography (PiB-PET in 68 patients with SVaD. A PiB retention ratio greater than 1.5 was considered PiB(+. Hippocampal and amygdalar shape were used in the incremental learning method to discriminate mixed dementia from pure SVaD because these structures are known to be prominently involved by AD pathologies. Among 68 patients, 23 (33.8% patients were positive for PiB binding. With use of hippocampal shape analysis alone, PiB(+ SVaD could be discriminated from PiB(- SVaD with 77.9% accuracy (95.7% sensitivity and 68.9% specificity. With use of amygdalar shape, the discrimination accuracy was 75.0% (87.0% sensitivity and 68.9% specificity. When hippocampal and amygdalar shape were analyzed together, accuracy increased to 82.4% (95.7% sensitivity and 75.6% specificity. An incremental learning method using hippocampal and amygdalar shape distinguishes mixed dementia from pure SVaD. Furthermore, our results suggest that amyloid pathology and vascular pathology have different effects on the shape of the hippocampus and amygdala.

  16. Use of water in aiding olefin/paraffin (liquid + liquid) extraction via complexation with a silver bis(trifluoromethylsulfonyl)imide salt

    International Nuclear Information System (INIS)

    Highlights: • Silver-based ILs used as olefin extracting agents for olefin/paraffin mixtures. • Each extraction process is based on the olefin complexation and solvation. • The presence of water influences positively each extraction process. • Each extraction process was evaluated by DFT calculations, NMR, IR and Raman. • LLE data were then correlated by using the UNIQUAC model. - Abstract: This paper describes the extraction of C5–C8 linear α-olefins from olefin/paraffin mixtures of the same carbon number via a reversible complexation with a silver salt (silver bis(trifluoromethylsulfonyl)imide, Ag[Tf2N]) to form room temperature ionic liquids [Ag(olefin)x][Tf2N]. From the experimental (liquid + liquid) equilibrium data for the olefin/paraffin mixtures and Ag[Tf2N], 1-pentene showed the best separation performance while C7 and C8 olefins could only be separated from the corresponding mixtures on addition of water which also improves the selectivity at lower carbon numbers like the C5 and C6, for example. Using infrared and Raman spectroscopy of the complex and Ag[Tf2N] saturated by olefin, the mechanism of the extraction was found to be based on both chemical complexation and the physical solubility of the olefin in the ionic liquid ([Ag(olefin)x][Tf2N]). These experiments further support the use of such extraction techniques for the separation of olefins from paraffins

  17. HIV and AIDS

    Science.gov (United States)

    ... Got Homework? Here's Help White House Lunch Recipes HIV and AIDS KidsHealth > For Kids > HIV and AIDS ... actually the virus that causes the disease AIDS. HIV Hurts the Immune System People who are HIV ...

  18. HIV-AIDS Connection

    Science.gov (United States)

    ... Content Marketing Share this: Main Content Area The HIV-AIDS Connection AIDS was first recognized in 1981 ... cancers. Why is there overwhelming scientific consensus that HIV causes AIDS? Before HIV infection became widespread in ...

  19. Heart attack first aid

    Science.gov (United States)

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle becomes ...

  20. AIDS.gov

    Science.gov (United States)

    ... Hospitalization and Palliative Care Friends & Family Dating and Marriage Family Planning Mixed-Status Couples Discrimination Legal Issues ... National HIV/AIDS and Aging Awareness Day National Gay Men's HIV/AIDS Awareness Day National Latino AIDS ...

  1. Breathing difficulties - first aid

    Science.gov (United States)

    Difficulty breathing - first aid; Dyspnea - first aid; Shortness of breath - first aid ... Breathing difficulty is almost always a medical emergency. An exception is feeling slightly winded from normal activity, ...

  2. Heart attack first aid

    Science.gov (United States)

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle ...

  3. Nosebleed, First Aid

    Science.gov (United States)

    ... and rashes clinical tools newsletter | contact Share | Nosebleed, First Aid A A A First Aid for Nosebleed: View ... of the nose, causing bleeding into the throat. First Aid Guide The following self-care measures are recommended: ...

  4. Unconsciousness - first aid

    Science.gov (United States)

    Loss of consciousness - first aid; Coma - first aid; Mental status change; Altered mental status ... has a change in mental status, follow these first aid steps: Call or tell someone to call 911 . ...

  5. Splinter, First Aid

    Science.gov (United States)

    ... and rashes clinical tools newsletter | contact Share | Splinter, First Aid A A A First Aid for Splinter: View ... wet, it makes the area prone to infection. First Aid Guide Self-care measures to remove a splinter ...

  6. Relationship between dementia and nutrition-related factors and disorders: an overview.

    Science.gov (United States)

    Salerno-Kennedy, Rossana; Cashman, Kevin D

    2005-03-01

    This review gives a brief overview of the main types of dementia and summarizes current thinking on the relationship between nutritional-related factors and disorders, and dementia. Dementia is a multi-factor pathological condition, and nutrition is one factor that may play a role on its onset and progression. An optimal intake of nutrients doesn't protect people from dementia. However, studies in this area show that inadequate dietary habits, which are of particular concern in elderly populations, may increase the risk of developing a number of age-related diseases, including disorders of impaired cognitive function. They show that a deficiency in essential nutrients, such as certain B complex vitamins, can result in hyperhomocysteinemia, a well-known risk factor for atherosclerosis and recently associated with cognitive impairment in old age. A deficiency of antioxidants such as vitamins C and E, and beta-carotene, as well as nutrition-related disorders like hypercholesterolemia, hypertension, and diabetes, may also have some role in cognitive impairment. These factors can be present for a long time before cognitive impairment becomes evident, therefore they could be potentially detected and corrected in a timely manner. PMID:15929630

  7. Interprofessional curriculum development achieves results: Initial evidence from a dementia-care protocol.

    Science.gov (United States)

    Annear, Michael James; Goldberg, Lynette R; Lo, Amanda; Robinson, Andrew

    2016-05-01

    This report describes the outcomes of a five-day, protocol-based interprofessional education (IPE) initiative to prepare undergraduate medical, nursing, and paramedic students for collaborative work with adults with dementia. Clinical placements provided a structured and supervised IPE experience for 127 students in two Residential Aged Care Facilities (RACFs) in Hobart, Australia, during 2013 and 2014. The IPE activity was based on a seven-step protocol formulated by an interprofessional team of educators and aged care practitioners that revolved around collaborative assessments of adults with complex health needs. This article describes the IPE protocol and presents the results of a pre- and post-placement attitude questionnaire and knowledge quiz administered to evaluate student attitudes towards IPE and knowledge of dementia. Data suggest that a five-day, supervised, and protocol-based IPE experience in a dementia-care setting can inculcate positive changes in student attitudes about collaborative practice and may encourage dementia-related learning outcomes. PMID:27029913

  8. Vital conversations with family in the nursing home: preparation for end-stage dementia care.

    Science.gov (United States)

    Reinhardt, Joann P; Chichin, Eileen; Posner, Laurie; Kassabian, Simon

    2014-01-01

    Family members of persons with advanced dementia may be asked to make complex treatment decisions without having adequate knowledge regarding the risks and benefits. This 6-month, prospective, randomized trial tested the effect of an intervention consisting of a face-to-face, structured conversation about end-of-life care options with family members of nursing home residents with advanced dementia. A comparison group received only social contact via telephone. Structured conversations between a palliative care team and intervention group family members included goals of care and how best to achieve those goals, and provision of psychosocial support. Psychosocial support was also provided via telephone at three 2-month intervals. Family members participated in three telephone interviews: baseline, 3, and 6 months. Specific advance directives for persons with dementia were extracted from medical records. Results showed that intervention families had higher satisfaction with care than comparison families at the 6-month time point, and they were more likely to have decided on medical options listed in residents' advance directives (Do Not Resuscitate, Intubate, Hospitalize) over time. Study findings reinforce the need for increased education and support for families around issues of end-of-life care decisions for advanced dementia. PMID:24835382

  9. Occult CSF flow disturbance of patients with Alzheimer type dementia and vascular dementia

    International Nuclear Information System (INIS)

    We report results of Iotrolan CT-cisternography on 41 demented patients (13 males and 28 females) to find 'occult normal pressure hydrocephalus'. These patients were suspected to have CSF flow disturbance from clinical symptoms and simple brain CT scan findings. Their average age, duration of dementia, and score of Hasegawa's dementia scale (HDS) were 76.2 years, 5.9 years, 9.5/32.5,respectively. Before performing CT-cisternography, clinical diagnosis for their dementia were vascular dementia in 18 patients. Alzheimer type dementia in 12, suspect of NPH in 5, and other diagnoses in 6. From the results of cisternography, we found 13 patients with CSF flow disturbance (contrast material remained in the ventricle more than 48 hours after injection), and 17 patients with normal CSF flow. The former showed lower scores of HDS, higher urinary incontinence scores and smaller areas of the interhemispheric fissure on CT scan than the latter. But the former showed no significant difference from the latter in the average age, duration of dementia and width of the ventricles. (author)

  10. Senile dementia of the Binswanger type: a vascular form of dementia in the elderly

    Energy Technology Data Exchange (ETDEWEB)

    Roman, G.C.

    1987-10-02

    Computed tomography and magnetic resonance imaging in the elderly have demonstrated the common occurrence of deep white-matter lesions in the aging brain. These radiologic lesions (leukoaraiosis) may represent an early marker of dementia. At autopsy, an ischemic periventricular leukoencephalopathy (Binswanger's disease) has been found in most cases. The clinical spectrum of Binswanger's disease appears to range from asymptomatic radiologic lesions to dementia with focal deficits, frontal signs, pseudobulbar palsy, gait difficulties, and urinary incontinence. The name senile dementia of the Binswanger type (SDBT) is proposed for this poorly recognized, vascular form of subcortical dementia. The SDBT probably results from cortical disconnections most likely caused by hypoperfusion. In contrast, multi-infarct dementia is correlated with multiple large and small strokes that cause a loss of over 50 to 100 mL of brain volume. The periventricular white matter is a watershed area irrigated by long, penetrating medullary arteries. Risk factors for SDBT are small-artery diseases, such as hypertension and amyloid angiopathy, impaired autoregulation of cerebral blood flow in the elderly, and periventricular hypoperfusion due to cardiac failure, arrhythmias, and hypotension. The SDBT may be a potentially preventable and treatable form of dementia.

  11. Senile dementia of the Binswanger type: a vascular form of dementia in the elderly

    International Nuclear Information System (INIS)

    Computed tomography and magnetic resonance imaging in the elderly have demonstrated the common occurrence of deep white-matter lesions in the aging brain. These radiologic lesions (leukoaraiosis) may represent an early marker of dementia. At autopsy, an ischemic periventricular leukoencephalopathy (Binswanger's disease) has been found in most cases. The clinical spectrum of Binswanger's disease appears to range from asymptomatic radiologic lesions to dementia with focal deficits, frontal signs, pseudobulbar palsy, gait difficulties, and urinary incontinence. The name senile dementia of the Binswanger type (SDBT) is proposed for this poorly recognized, vascular form of subcortical dementia. The SDBT probably results from cortical disconnections most likely caused by hypoperfusion. In contrast, multi-infarct dementia is correlated with multiple large and small strokes that cause a loss of over 50 to 100 mL of brain volume. The periventricular white matter is a watershed area irrigated by long, penetrating medullary arteries. Risk factors for SDBT are small-artery diseases, such as hypertension and amyloid angiopathy, impaired autoregulation of cerebral blood flow in the elderly, and periventricular hypoperfusion due to cardiac failure, arrhythmias, and hypotension. The SDBT may be a potentially preventable and treatable form of dementia

  12. FDG-PET improves accuracy in distinguishing frontotemporal dementia and Alzheimer's disease.

    Science.gov (United States)

    Foster, Norman L; Heidebrink, Judith L; Clark, Christopher M; Jagust, William J; Arnold, Steven E; Barbas, Nancy R; DeCarli, Charles S; Turner, R Scott; Koeppe, Robert A; Higdon, Roger; Minoshima, Satoshi

    2007-10-01

    Distinguishing Alzheimer's disease (AD) and frontotemporal dementia (FTD) currently relies on a clinical history and examination, but positron emission tomography with [(18)F] fluorodeoxyglucose (FDG-PET) shows different patterns of hypometabolism in these disorders that might aid differential diagnosis. Six dementia experts with variable FDG-PET experience made independent, forced choice, diagnostic decisions in 45 patients with pathologically confirmed AD (n = 31) or FTD (n = 14) using five separate methods: (1) review of clinical summaries, (2) a diagnostic checklist alone, (3) summary and checklist, (4) transaxial FDG-PET scans and (5) FDG-PET stereotactic surface projection (SSP) metabolic and statistical maps. In addition, we evaluated the effect of the sequential review of a clinical summary followed by SSP. Visual interpretation of SSP images was superior to clinical assessment and had the best inter-rater reliability (mean kappa = 0.78) and diagnostic accuracy (89.6%). It also had the highest specificity (97.6%) and sensitivity (86%), and positive likelihood ratio for FTD (36.5). The addition of FDG-PET to clinical summaries increased diagnostic accuracy and confidence for both AD and FTD. It was particularly helpful when raters were uncertain in their clinical diagnosis. Visual interpretation of FDG-PET after brief training is more reliable and accurate in distinguishing FTD from AD than clinical methods alone. FDG-PET adds important information that appropriately increases diagnostic confidence, even among experienced dementia specialists. PMID:17704526

  13. Self awareness and personality change in dementia

    OpenAIRE

    Rankin, K; Baldwin , E.; Pace-Savitsky, C; Kramer, J.; Miller, B.

    2005-01-01

    Background: Loss of insight is a core diagnostic criterion for frontotemporal dementia (FTD), whereas failure to recognise cognitive deficits and unawareness of disease (anosognosia) are well established findings in Alzheimer's disease (AD). However, self awareness of personality has not been quantified in these patient groups.

  14. Anesthesia for the patient with dementia

    DEFF Research Database (Denmark)

    Funder, Kamilia S; Steinmetz, Jacob; Rasmussen, Lars S

    2010-01-01

    With a growing aging population, more patients suffering from dementia are expected to undergo surgery, thus being exposed to either general or regional anesthesia. This calls for specific attention ranging from the legal aspects of obtaining informed consent in demented patients to deciding on the...

  15. Nonliteral language in Alzheimer dementia: a review.

    Science.gov (United States)

    Rapp, Alexander M; Wild, Barbara

    2011-03-01

    The use of nonliteral language in clinical assessment, especially testing the patients' ability to interpret proverbs, has a long tradition in psychiatry. However, its diagnostic sensitivity and specificity in dementias is not yet clear. The aim of this review article is to examine the current evidence on nonliteral/figurative language (proverb, metaphor, metonymy, idiom, irony, sarcasm) comprehension in Alzheimer's disease and related disorders. A comprehensive literature search identified 25 studies (16 proverb, 3 metaphor, 0 metonymy, 5 idiom, 3 sarcasm) on nonliteral language comprehension in dementia. Studies predominantly indicate a deficit. Most studies investigated Alzheimer's dementia. Applied correctly, nonliteral language is a worthwhile diagnostic tool to evaluate language and abstract thinking in dementias. During assessment, familiarity testing (e.g., by asking "are you familiar with the proverb XY") is obligatory. Still, future research is needed in several areas: evidence on decline of nonliteral language over the course of the illness is limited. So far, almost no studies delineated proverb comprehension in high risk populations such as patients with mild cognitive impairment. Currently, there is a lack of studies addressing performance in direct comparison to relevant differential diagnosis like older-age depression, delirium, brain lesion, or other psychiatric conditions. PMID:21241530

  16. Art Therapy with Geriatric Dementia Clients.

    Science.gov (United States)

    Kahn-Denis, Kathleen B.

    1997-01-01

    Describes how art therapy can be used with an elderly population experiencing a wide range of cognitive impairments. Claims that the evocative nature of art allows older adults with dementia to become expressive and bypass some of their cognitive deficits. Focuses on evaluation, nonverbal communication, sensory exploration, and self-reflective…

  17. Does midlife obesity really lower dementia risk?

    OpenAIRE

    Pareja Galeano, Helios; Sanchís-Gomar, Fabián; Alis, Rafael; Morán, María; Lucía Mulas, Alejandro

    2015-01-01

    Letter about: Qizilbash, N., Gregson, J., & Pocock, S. (2015). Does midlife obesity really lower dementia risk? The Lancet Diabetes & Endocrinology, 3(7), 501-502. 9,185 JCR (2014) Q1, posición 6 de 128 (Endocrinology & Metabolism) UEM

  18. [Dementia: the importance of psychosocial interventions

    NARCIS (Netherlands)

    Koopmans, R.T.C.M.

    2006-01-01

    The number of people suffering from dementia in The Netherlands is expected to rise from 175,000 in 2006 to 400,000 by the year 2050. Stella Braam recently wrote a book in which she described the experiences of her father, a former psychologist with the attitudes and knowledge of professionals conce

  19. Forget Me Not: Dementia in Prison

    Science.gov (United States)

    Maschi, Tina; Kwak, Jung; Ko, Eunjeong; Morrissey, Mary B.

    2012-01-01

    The number of older adults with dementia in U.S. prisons is rapidly rising. Yet, the vast majority of this marginalized subgroup of the aging population is left neglected behind bars without access to adequate medical and mental health care services. We assert that proactive, interdisciplinary collaborative efforts to improve practice, policy, and…

  20. Proton pump inhibitors and risk of dementia

    Science.gov (United States)

    Thongprayoon, Charat; Panjawatanan, Panadeekarn; Ungprasert, Patompong

    2016-01-01

    Background Proton pump inhibitors (PPIs) are one of the most commonly prescribed medications. Recent studies have raised a concern over increased risk of dementia among PPIs users but the results of those studies were inconsistent. We conducted this systematic review and meta-analysis to summarize all available data. Methods A literature search was performed in MEDLINE and EMBASE database from inception to April 2016. Observational studies that reported risk of dementia among PPIs users compared with non-users were included. Point estimates were extracted from individual studies and pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random-effect, generic inverse variance method. Results Four studies were included in the analysis. Pooled RR of dementia among PPIs users compared with non-users was 1.08 (95% CI, 0.82–1.43). Sensitivity analysis including only cohort studies demonstrated a higher risk with pooled RR of 1.44 (95% CI, 1.36–1.52). Conclusions Our study demonstrated an increased risk of dementia among PPIs users. Whether this association is causal requires further investigations. PMID:27429966

  1. [Euthanasia in advanced dementia: a moral impossibility].

    Science.gov (United States)

    Keizer, A A Bert

    2013-01-01

    Advance directives containing a request for euthanasia in cases of severely debilitating dementia are of no use. In such an advanced stage of the disease, the doctor would have to administer lethal medication to a patient who does not realise what is happening to him/her. The Dutch Euthanasia Act is ambivalent about this possibility. PMID:23777970

  2. Dementia caused by radiogenic cerebral late necroses

    International Nuclear Information System (INIS)

    Cerebral damage caused by radiation continues to be a hazard in modern radiotherapy. Dementia may develop, among other diseases, due to bilateral late radionecroses of the diencephalon and of mediobasal temporal lobe areas, e.g. after radiotherapy of the pituitary gland. (orig.)

  3. Anesthesia for the patient with dementia

    DEFF Research Database (Denmark)

    Funder, Kamilia S; Steinmetz, Jacob; Rasmussen, Lars S

    With a growing aging population, more patients suffering from dementia are expected to undergo surgery, thus being exposed to either general or regional anesthesia. This calls for specific attention ranging from the legal aspects of obtaining informed consent in demented patients to deciding on the...

  4. Tuberose sclerosis complex: analysis of growth rates aids differentiation of renal cell carcinoma from atypical or minimal-fat-containing angiomyolipoma

    Energy Technology Data Exchange (ETDEWEB)

    Patel, U. [Department of Radiology, St George' s Hospital, London (United Kingdom)]. E-mail: uday.patel@stgeorges.nhs.uk; Simpson, E. [Department of Radiology, St George' s Hospital, London (United Kingdom); Kingswood, J.C. [Department of Clinical Genetics, St George' s Hospital, London (United Kingdom); Saggar-Malik, A.K. [Department of Clinical Genetics, St George' s Hospital, London (United Kingdom)

    2005-06-01

    AIM: To study the radiological characteristics of renal masses in individuals with tuberous sclerosis complex (TSC) using serial CT, and to examine how renal cell carcinoma (RCC) may be differentiated from indeterminate cysts or masses. METHODS: This was a retrospective study of 12 cases of TSC in which dedicated renal CT followed after US had demonstrated cystic or sonographically unusual renal masses. The CT density of all masses was measured and the masses categorized as simple cysts, complex cysts, angiomyolipomas or indeterminate solid masses. Subjects were maintained on regular follow-up with repeat CT or MRI and interval renal US. Indeterminate masses that showed rapid growth were considered suspicious for renal cell carcinoma and biopsy or nephrectomy followed. RESULTS: Comparative data were available for a median of 4 years. In each case the renal masses were multiple and bilateral; mean mass diameter was 3.6 cm. Among a total of 206 masses, 18 were simple cysts and 3 were complex cysts. Of the complex cysts, 1 proved to be an angiomyolipoma on histology and the other 2 showed no growth. Of the solid masses, 133 were typical angiomyolipomas (AMLs) and 52 were indeterminate. On follow-up, only 3 indeterminate masses showed rapid growth (>0.5 cm/year), of which only 1 proved to be an RCC on biopsy. The other 2 were minimal-fat AMLs, and the remainder of the masses showed no or slow growth. CONCLUSION: Many renal masses associated with TSC are radiologically indeterminate. A growth threshold of >0.5 cm/year identified the only RCC in this study (0.5% of all masses). Yearly radiological follow-up of indeterminate renal masses is recommended for individuals with TSC.

  5. Tuberose sclerosis complex: analysis of growth rates aids differentiation of renal cell carcinoma from atypical or minimal-fat-containing angiomyolipoma

    International Nuclear Information System (INIS)

    AIM: To study the radiological characteristics of renal masses in individuals with tuberous sclerosis complex (TSC) using serial CT, and to examine how renal cell carcinoma (RCC) may be differentiated from indeterminate cysts or masses. METHODS: This was a retrospective study of 12 cases of TSC in which dedicated renal CT followed after US had demonstrated cystic or sonographically unusual renal masses. The CT density of all masses was measured and the masses categorized as simple cysts, complex cysts, angiomyolipomas or indeterminate solid masses. Subjects were maintained on regular follow-up with repeat CT or MRI and interval renal US. Indeterminate masses that showed rapid growth were considered suspicious for renal cell carcinoma and biopsy or nephrectomy followed. RESULTS: Comparative data were available for a median of 4 years. In each case the renal masses were multiple and bilateral; mean mass diameter was 3.6 cm. Among a total of 206 masses, 18 were simple cysts and 3 were complex cysts. Of the complex cysts, 1 proved to be an angiomyolipoma on histology and the other 2 showed no growth. Of the solid masses, 133 were typical angiomyolipomas (AMLs) and 52 were indeterminate. On follow-up, only 3 indeterminate masses showed rapid growth (>0.5 cm/year), of which only 1 proved to be an RCC on biopsy. The other 2 were minimal-fat AMLs, and the remainder of the masses showed no or slow growth. CONCLUSION: Many renal masses associated with TSC are radiologically indeterminate. A growth threshold of >0.5 cm/year identified the only RCC in this study (0.5% of all masses). Yearly radiological follow-up of indeterminate renal masses is recommended for individuals with TSC

  6. Mycobacterium avium complex (MAC isolated from AIDS patients and the criteria required for its implication in disease Complexo Mycobacterium avium (MAC isolado de pacientes com AIDS e os critérios exigidos para sua implicação em doença

    Directory of Open Access Journals (Sweden)

    David Jamil Hadad

    1995-10-01

    Full Text Available Before the AIDS pandemia, the Mycobacterium avium complex (MAC was responsible in most cases for the pneumopathies that attack patients with basic chronic pulmonary diseases such as emphysema and chronic bronchitis36. In 1981, with the advent of the acquired immunodeficiency syndrome (AIDS, MAC started to represent one of the most frequent bacterial diseases among AIDS patients, with the disseminated form of the disease being the major clinical manifestation of the infection8. Between January 1989 and February 1991, the Section of Mycobacteria of the Adolfo Lutz Institute, São Paulo, isolated MAC from 103 patients by culturing different sterile and no-sterile processed specimens collected from 2304 patients seen at the AIDS Reference and Training Center and/or Emilio Ribas Infectology Institute. Disseminated disease was diagnosed in 29 of those patients on the basis of MAC isolation from blood and/or bone marrow aspirate. The other 74 patients were divided into categories highly (5, moderately (26 and little suggestive of disease (43 according to the criteria of DAVIDSON (198910. The various criteria for MAC isolation from sterile and non-sterile specimens are discussed.Anterior a pandemia de AIDS, o Complexo Mycobacterium avium (MAC era responsável pela maioria das vezes, por pneumopatias acometendo pacientes com doença pulmonar crônica de base como enfisema e bronquite crônica36. Em 1981, com o advento da síndrome de imunodeficiência adquirida (SIDA, o MAC passou a representar uma das doenças bacterianas mais frequentes em pacientes com esta síndrome, sendo a doença disseminada a principal forma de manifestação clínica da infecção8. Entre Janeiro de 1989 e Fevereiro de 1991, no Setor de Micobactérias do Instituto Adolfo Lutz em São Paulo, o MAC foi isolado de 103 pacientes a partir do cultivo de diferentes espécimes estéreis e não estéreis processados, coletados de 2.304 pacientes atendidos no Centro de Referência e

  7. Creating space for citizenship: The impact of group structure on validating the voices of people with dementia.

    Science.gov (United States)

    Wiersma, Elaine C; O'Connor, Deborah L; Loiselle, Lisa; Hickman, Kathy; Heibein, Bill; Hounam, Brenda; Mann, Jim

    2016-05-01

    Recently, there has been increasing attention given to finding ways to help people diagnosed with dementia 'live well' with their condition. Frequently however, the attention has been placed on the family care partner as the foundation for creating a context that supports the person with dementia to live well. A recent participatory action research (PAR) study highlighted the importance of beginning to challenge some of the assumptions around how best to include family, especially within a context of supporting citizenship. Three advisory groups consisting of 20 people with dementia, 13 care partners, and three service providers, were set up in three locations across Canada to help develop a self-management program for people with dementia. The hubs met monthly for up to two years. One of the topics that emerged as extremely important to consider in the structuring of the program revolved around whether or not these groups should be segregated to include only people with dementia. A thematic analysis of these ongoing discussions coalesced around four inter-related themes: creating safe spaces; maintaining voice and being heard; managing the balancing act; and the importance of solidarity Underpinning these discussions was the fifth theme, recognition that 'one size doesn't fit all'. Overall an important finding was that the presence of family care-partners could have unintended consequences in relation to creating the space for active citizenship to occur in small groups of people with dementia although it could also offer some opportunities. The involvement of care partners in groups with people with dementia is clearly one that is complex without an obvious answer and dependent on a variety of factors to inform a solution, which can and should be questioned and revisited. PMID:27170590

  8. Exploring the views of GPs, people with dementia and their carers on assistive technology: a qualitative study

    Science.gov (United States)

    Newton, Lisa; Dickinson, Claire; Gibson, Grant; Brittain, Katie; Robinson, Louise

    2016-01-01

    Objectives To explore the views and experiences of people with dementia, their family carers and general practitioners (GPs) on their knowledge and experience of accessing information about, and use of, assistive technology (AT) in dementia care. Design Qualitative methods with semistructured interviews and thematic analysis. Participants 56 participants comprising 17 GPs, 13 people with dementia and 26 family carers. Setting Community care settings in the North East of England. Results 4 main themes emerged: awareness and experience of AT; accessing information on AT; roles and responsibilities in the current care system and the future commissioning of AT services. All participants had practical experience of witnessing AT being used in practice. For people with dementia and their families, knowledge was usually gained from personal experience rather than from health and social care professionals. For GPs, knowledge was largely gained through experiential, patient-led learning. All groups acknowledged the important role of the voluntary sector but agreed a need for clear information pathways for AT; such pathways were perceived to be essential to both service providers and service commissioners. Conclusions People with dementia and their family carers appear to be mainly responsible for driving a gradual increase in both awareness and the use of AT in dementia care. GPs should be equipped with the relevant knowledge to ensure families living with dementia receive appropriate information and support to enable them to live independently for as long as possible. There is an urgent need to simplify current complex community care pathways; as demonstrated in other chronic health conditions, a single point of access and a named lead professional may improve future care. PMID:27178978

  9. Evaluating the Association between Diabetes, Cognitive Decline and Dementia

    Directory of Open Access Journals (Sweden)

    Omorogieva Ojo

    2015-07-01

    Full Text Available The aim of this article is to review the association between diabetes mellitus, cognitive decline and dementia, including the effects of cognitive decline and dementia on self management of diabetes. This is a literature review of primary research articles. A number of contemporary research articles that met the inclusion criteria were selected for this review paper. These articles were selected using a number of search strategies and electronic databases, such as EBSCOhost Research and SwetsWise databases. The duration of diabetes, glycated haemoglobin levels and glycaemic fluctuations were associated with cognitive decline and dementia. Similarly, hypoglycaemia was significantly related to increased risk of developing cognitive decline and dementia. Furthermore, cognitive decline and dementia were associated with poorer diabetes management. There is evidence of the association between diabetes, cognitive decline and dementia including the shared pathogenesis between diabetes and Alzheimer’s disease. In addition, the self management of diabetes is affected by dementia and cognitive decline. It could be suggested that the association between diabetes and dementia is bidirectional with the potential to proceed to a vicious cycle. Further studies are needed in order to fully establish the relationship between diabetes, cognitive decline and dementia. Patients who have diabetes and dementia could benefit from structured education strategies, which should involve empowerment programmes and lifestyle changes. The detection of cognitive decline should highlight the need for education strategies.

  10. The Association between Hypertension and Dementia in the Elderly

    Directory of Open Access Journals (Sweden)

    Michiya Igase

    2012-01-01

    Full Text Available Hypertension (HT and dementia are common disorders in the elderly. HT in the elderly is associated with increased occurrence rates of dementia including Alzheimer's disease (AD and vascular dementia (VaD. In connection to this, some studies have suggested that HT in old age correlates with the pathogenesis of dementia. Since HT is potentially reversible, a number of randomized trials have examined whether antihypertensive treatment may help in preventing dementia occurrence. We review five studies, all using subjects 60 years or older, which investigated different antihypertensive pharmacological treatments. Data from two trials (Syst-Eur, PROGRESS open the way toward the prevention of dementia (AD or VaD by antihypertensive treatments. In the Syst-Eur study, with the dihydropyridine calcium antagonists, a reduction in both types of dementia was demonstrated (risk reduction 55%. The PROGRESS study showed that the use of angiotensin-converting enzyme inhibitors (ACEIs, with or without diuretics, resulted in decrease incidence of stroke-related dementia (risk reduction 19%, but dementia without stroke was not reduced. In contrast, the SHEP trial, treatment with a chlorthalidone-based antihypertensive regimen, did not significantly reduced the incidence of dementia. The SCOPE study (candesartan or hydrochlorothiazide versus placebo and the HYVET-COG study (indapamide or perindopril versus placebo found no significant difference between the active treatment and placebo group on the incidence of dementia. We found conflicting results regarding treatment benefits in dementia prevention. Recent clinical trials and studies on animal models suggest that blockades of RAS system could have reduced cognitive decline seen in Alzheimer's disease and vascular dementia. Future trials primarily designed to investigate the effects of antihypertensive agents on impaired cognition are needed.

  11. Enhanced uptake and translocation of arsenic in Cretan brake fern (Pteris cretica L.) through siderophorearsenic complex formation with an aid of rhizospheric bacterial activity.

    Science.gov (United States)

    Jeong, Seulki; Moon, Hee Sun; Nam, Kyoungphile

    2014-09-15

    Siderophores, produced by Pseudomonas aeruginosa, released slightly more Fe (53.6 μmol) than that chelated by ethylenediaminetetraacetic acid (EDTA; i.e. 43.7 μmol) in batch experiment using As-adsorbed ferrihydrite. More importantly, about 1.79 μmol of As was found to be associated with siderophores in the aqueous phase due to siderophore-As complex formation when siderophores were used to release As from ferrihydrite. In contrast, As was not detected in the aqueous phase when EDTA was used, probably due to the readsorption of released As to ferrihydrite. A series of pot experiment was conducted to investigate the effect of siderophores as a microbial iron-chelator on As uptake by Cretan brake fern (Pteris cretica L.) during phtoextraction. Results revealed that P. cretica, a known As hyperaccumulator, grown in the siderophore-amended soil showed about 3.7 times higher As uptake (5.62 mg-Asg(-1)-plant) than the plant grown in the EDTA-treated soil (1.51 mg-Asg(-1)-plant). In addition, As taken up by roots of P. cretica in the presence of siderophores seemed to be favorably translocated to shoots (i.e. stems and leaves). About 79% of the accumulated As was detected in the shoots in the presence of siderophores after ten weeks. Fluorescence microscopic analysis confirmed that As in the roots was delivered to the leaves of P. cretica as a siderophore-As complex. PMID:25215655

  12. Motor neuron disease and frontotemporal dementia: One, two, or three diseases?

    Directory of Open Access Journals (Sweden)

    Bak Thomas

    2010-10-01

    Full Text Available The relationship between motor neurone disease (MND and frontotemporal dementia (FTD has been a topic of scientific exploration for over hundred years. A connection between both diseases was first postulated in 1932 and has been strengthened by a steady stream of case reports since then. By the late 20th century, the link between both diseases was firmly established, with the resulting condition often referred to as MND/FTD. Several strands of evidence support the notion of an MND/FTD overlap. First, a small but well-documented group of patients present with a full-blown FTD, associated with MND. Second, subtle but characteristic changes in frontal-executive functions and social cognition have been described in non-demented MND patients, often in association with frontal atrophy/hypoactivity on neuroimaging. Third, amyotrophic features have been documented in patients primarily diagnosed with FTD. Moreover, the same genetic defect can lead to FTD and MND phenotypes in different members of the same family. However, as the current research is moving toward a more fine-grained evaluation, an increasingly complex picture begins to emerge. Some features, such as psychotic symptoms or severe language deficits (particularly in comprehension and verb processing, seem to occur more often in MND/dementia than in the classical FTD. On the basis of the review of 100 years of literature as well as 10 years of clinical experience of longitudinal follow-up of MND/dementia patients, this review argues in favor of MND/dementia (or, more precisely, MND/dementia/aphasia as a separate clinical entity, not sufficiently explained by a combination of MND and FTD.

  13. Comparison study of positron emission tomography, X-ray CT and MRI in Parkinsonism with dementia

    International Nuclear Information System (INIS)

    Brain atrophy and local cerebral metabolic rate of glucose (LCMR-glc) in Parkinson's disease with dementia and Parkinsonism-dementia complex (PDC) were studied using positron emission tomography (PET) with F-18-2-deoxy-2-fluoro-D-glucose, X-ray CT and magnetic resonance imaging (MRI). The group of Parkinson's disease with dementia (n=7) had a significantly decreased LCMR-glc in all regions when compared with the age-matched normal group. In the group of Parkinson's disease without dementia (n=6), LCMR-glc was also significantly lower than the control group, although it was higher than the group with associated dementia. Some of the normal aged persons had cortical atrophy. There was no correlation between LCMR-glc and cortical atrophy. Six Guamnian patients had PDC associated with amyotrophic lateral sclerosis (ALS), and four patients had it without ALS. LCMR-glc did not differ in the two groups. It was, however, significantly lower than that in 5 Guamanian and 10 Caucasian normal persons. The group of PDC had a noticeable cortical atrophy and ventricular dilatation, regardless of the presence or absence of ALS. There was correlation between decrease of LCMR-glc and cortical atrophy of the frontal, parietal and temporal lobes. Parkinson's disease and PDC were different from Alzheimer's disease in which a decreased LCMR-glc has been reported to be usually confined to the cerebral cortex. Cortical atrophy and ventricular dilatation were depicted on MRI and CT in the PDC group, but did not in the group of Parkinson's disease. PET was useful in the functional examination and both MRI and CT were useful in the anatomical examination of these diseases. (Namekawa, K)

  14. Participatory Research to Design a Novel Telehealth System to Support the Night-Time Needs of People with Dementia: NOCTURNAL

    Directory of Open Access Journals (Sweden)

    Suzanne Martin

    2013-12-01

    Full Text Available Strategies to support people living with dementia are broad in scope, proposing both pharmacological and non-pharmacological interventions as part of the care pathway. Assistive technologies form part of this offering as both stand-alone devices to support particular tasks and the more complex offering of the “smart home” to underpin ambient assisted living. This paper presents a technology-based system, which expands on the smart home architecture, orientated to support people with daily living. The system, NOCTURNAL, was developed by working directly with people who had dementia, and their carers using qualitative research methods. The research focused primarily on the nighttime needs of people living with dementia in real home settings. Eight people with dementia had the final prototype system installed for a three month evaluation at home. Disturbed sleep patterns, night-time wandering were a focus of this research not only in terms of detection by commercially available technology but also exploring if automated music, light and visual personalized photographs would be soothing to participants during the hours of darkness. The NOCTURNAL platform and associated services was informed by strong user engagement of people with dementia and the service providers who care for them. NOCTURNAL emerged as a holistic service offering a personalised therapeutic aspect with interactive capabilities.

  15. [Measurement of activities of daily living in patients with dementia living at home: development of a questionnaire].

    Science.gov (United States)

    Teunisse, S; Derix, M M

    1991-04-01

    In clinical practice and for scientific research a method is needed for the assessment of changes in functioning in daily life of dementia patients living at home. As existing methods have their limitations, a questionnaire was developed (the Interview for Deterioration in Daily life in Dementia: IDDD), to be answered by caregivers. The questionnaire concerns self-care and complex activities, that are usually performed by men as well as women. Attention is paid to the difference between lack of initiative and impaired performance itself. Caregivers are interviewed in a structured interview. A study among 30 caregivers of dementia patients living at home, showed the relevance and usefulness of the questions. The questionnaire shows high internal consistency, which may be the result of our structured interview technique. PMID:2042235

  16. Advance Care Planning in Dementia: Do Family Carers Know the Treatment Preferences of People with Early Dementia?

    Science.gov (United States)

    King, Michael; Jones, Louise; Vickestaff, Victoria; Sampson, Elizabeth L.

    2016-01-01

    = -0.52; CPR, k = -0.07; PABAK = -0.45; tube feeding; k = 0.20; PABAK = -0.22). However, both PWD and carers showed marked uncertainty about their preferences for end of life treatment choices. Relationship quality, carer distress and burden had no influence on agreement. Conclusions This study is the first to have used the LSPQ with PWD in the UK to consider treatment options in hypothetical illness scenarios. Key finding are that family carers had a low to moderate agreement with PWD on preferences for end of life treatment. This underscores how planning for care at the end of life is beset with uncertainty, even when the carer and PWD perceive the care-giving/receiving relationship is good. Families affected by dementia may benefit from early and ongoing practical and emotional support to prepare for potential changes and aid decision making in the context of the realities of care towards the end of life. PMID:27410259

  17. Difference in MRI findings and risk factors between multiple infarction without dementia and multi-infarct dementia

    International Nuclear Information System (INIS)

    MRI findings and risk factors for vascular dementia were evaluated with multi-variate analysis in 96 multi-infarct patients without dementia and 40 multi-infarct patients with dementia (MID). Only subjects with small infarcts in the territory of the perforator artery or deep white matter were studied. The diagnosis of MID was diagnosed according to DMS-III criteria and Hachinski's ischemia score. Location and area of patchy high-intensity areas including small infarcts, the degree of periventricular high intensity (PVH), and the degree of brain atrophy were examined with MR images. Independent variables were: history of hypertension, diabetes mellitus, other complications; systolic and diastolic blood pressure, atherosclerotic index, hematocrit, history of smoking, level of education, and activities of daily life (ADL). Hayashi's quantification method II was used to analyze the data. The most significant correlation was found between history of hypertension and dementia (partial correlation coefficient: 0.39). Significant correlations were also found between ADL and dementia (0.32), between thalamic infarction and dementia (0.31), and between PVH and dementia (0.27). Age, brain atrophy index, and history of diabetes mellitus contributed little to dementia. The contribution to dementia did not differ significantly between right and left patchy high-intensity areas on MR images. Location of infarcts, except for bilateral thalamic infarcts and large PVH, contributed little to dementia. Thus it would be difficult to base a prediction of the prevalence of vascular dementia on MRI findings. However, both hypertention and ADL contribute to vascular dementia and both are treatable, which may be significant for the prevention of dementia. (author)

  18. Types of Foreign Aid

    DEFF Research Database (Denmark)

    Bjørnskov, Christian

    Foreign aid is given for many purposes and different intentions, yet most studies treat aid flows as a unitary concept. This paper uses factor analysis to separate aid flows into different types. The main types can be interpreted as aid for economic purposes, social purposes, and reconstruction; a...... residual category captures remaining purposes. Estimating the growth effects of separable types of aid suggests that most aid has no effects while reconstruction aid has direct positive effects. Although this type only applies in special circumstances, it has become more prevalent in more recent years....

  19. [Regional network for patients with dementia--carrying out Kumamoto model for dementia].

    Science.gov (United States)

    Ikeda, Manabu

    2014-01-01

    The Japanese government has tried to establish 150 Medical Centers for Dementia (MCDs) since 2008 to overcome the dementia medical service shortage. MCDs are required to provide special medical services for dementia and connect with other community resources in order to contribute to building a comprehensive support network for demented patients. The main specific needs are as follows: 1) special medical consultation; 2) differential diagnosis and early intervention; 3) medical treatment for the acute stage of BPSD; 4) corresponding to serious physical complications of dementia; 5) education for general physicians (GPs) and other community professionals. According to the population rate, two dementia medical centers were planned in Kumamoto Prefecture. However, it seemed to be too few to cover the vast Kumamoto area. Therefore, the local government and I proposed to the Japanese government that we build up networks that consist of one core MCD in our university hospital and several regional MCDs in local mental hospitals. The local government selected seven (nine at present) centers according to the area balance and condition of equipment. The Japanese government has recommended and funded such networks between core and regional centers since 2010. The main roles of the core centers are as follows: 1) early diagnosis such as Mild cognitive impairment, very mild Alzheimer's disease, Dementia with Lewy bodies, and Frontotemporal lobar degeneration using comprehensive neuropsychological batteries and neuroimagings, such as MRI and SPECT scans; 2) education for GPs; 3) training for young consultants. The core center opens case conferences at least every one or two months for all staff of regional centers to maintain the quality of all centers and give training opportunities for standardized international assessment scales. While the main roles of the regional centers are differential diagnosis, intervention for BPSD, and management of general medical problems using

  20. The use of socially assistive robots for dementia care.

    Science.gov (United States)

    Huschilt, Julie; Clune, Laurie

    2012-10-01

    Innovative solutions for dementia care are required to address the steady rise in adults living with dementia, lack of adequate staffing to provide high-quality dementia care, and the need for family caregivers to provide care for their loved ones in the home. This article provides an overview of the use of socially assistive robots (SARs) to offer support as therapists, companions, and educators for people living with dementia. Social, ethical, and legal challenges associated with the use of robotic technology in patient care and implications for the use of SARs by nurses are discussed. These items considered, the authors conclude that SARs should be considered as a viable way to assist people living with dementia to maintain their highest possible level of independence, enhance their quality of life, and provide support to overburdened family caregivers. Further research is needed to evaluate the merits of this technological approach in the care of adults with dementia. PMID:22998095

  1. Pregnancy and AIDS.

    Science.gov (United States)

    Henrion, R

    1988-02-01

    Since the first cases of a new acquired immunodeficiency syndrome (AIDS) described by Oleske et al. and Rubinstein et al. in children in 1983, we have witnessed an ever-increasing number of such observations. As serology is not being performed on all pregnant women in many European countries, obstetricians must try to identify those belonging to risk groups: intravenous drug abusers, natives of affected regions or women having travelled to these areas, women having numerous sexual partners, presenting with other sexually transmitted diseases or living with infected individuals, prostitutes, transfused women. If the woman belongs to risk groups, HIV antibody testing is to be done at the beginning of pregnancy. The risks for the mother remain ill-defined, due in part to the difficulties inherent in keeping track of heroin abusers. Aggravation is certain if the mother is affected with AIDS or an associated syndrome called ARC (AIDS-related complex). It is debatable and at least rarer if the mother presents no clinical symptoms. Infant risks are becoming better known. The existence of materno-fetal contamination by transplacental route is undebatable. However, contamination during delivery or during the passage through the maternal genital tract cannot be excluded. The proportion of contaminated infants is approximately 40%. The disease in the infant is highly dangerous. According to these data, the procedure adopted by most obstetricians is the following: abortion is recommended at the first trimester of the pregnancy, a free choice is left open for the woman at the second trimester and at the third trimester delivery is carried out naturally. Caesarean sections are only done when there are obstetrical indications.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3281969

  2. Liver transplantion in a patient with rapid onset parkinsonism-dementia complex induced by manganism secondary to liver failure Transplante hepático em um paciente com complexo parkinsonismo-demência rapidamente progressivo induzido por manganismo devido a insuficiência hepática

    Directory of Open Access Journals (Sweden)

    Giorgio Fabiani

    2007-09-01

    Full Text Available Bilateral and symmetric globus-pallidus hyperintensities are observed on T1-weighted MRI in most of the patients with chronic liver failure, due to manganese accumulation. We report a 53-year-old man, with rapid onset parkinsonism-dementia complex associated with accumulation of manganese in the brain, secondary to liver failure. A brain MRI was performed and a high signal on T1-weighted images was seen on globus-pallidus, as well as on T2-weighted images on the hemispheric white-matter. He was referred to a liver-transplantation. The patient passed away on the seventh postoperative day. Our findings support the concept of the toxic effects of manganese on the globus-pallidus. The treatment of this form of parkinsonism is controversial and liver-transplantation should not be considered as first line treatment but as an alternative one.Hiperintesidades simétricas e bilaterais dos gânglios da base são observadas em imagens de ressonância magnética encefálica (RM ponderadas em T1 na maioria dos pacientes com insuficiência hepática crônica devidas ao acúmulo de manganês. Nós relatamos o caso de um homem, com 53 anos de idade, com um complexo parkinsonismo-demência rapidamente progressivo associado com o acúmulo de manganês no cérebro, secundariamente a insuficiência hepática. Uma RM encefálica foi realizada e foram observadas imagens hiperintensas/hipersinal nas imagens ponderadas em T1 no globo pálido e, também, na substância branca dos hemisférios cerebrais ponderadas em T2. Devido à falta de resposta ao tratamento clinico optamos pelo transplante hepático. O paciente faleceu no 7º dia de PO. Nossos achados corroboram o conceito dos efeitos tóxicos do manganês nos gânglios da base/globo pálido. O tratamento desta forma de parkinsonismo é controverso e o transplante hepático não deverá ser considerada uma opção terapêutica de primeira linha, porém como um tratamento alternativo considerando-se os riscos

  3. How to Get Hearing Aids

    Science.gov (United States)

    ... Consumer Products Hearing Aids How to get Hearing Aids Share Tweet Linkedin Pin it More sharing options ... my hearing aids? How do I get hearing aids? To get hearing aids, you should first have ...

  4. Copper(II)-Complex Directed Regioselective Mono-p-Toluenesulfonylation of Cyclomaltoheptaose at a Primary Hydroxyl Group Position: An NMR and Molecular Dynamics-Aided Design

    International Nuclear Information System (INIS)

    Interactions between cyclomaltoheptaose (β-cyclodextrin, βCD) and p-toluenesulfonyl chloride (TsCl) were investigated using MD simulations, both in vacuum, approximating the hydrophobic environment of the CD cavity, and with water as a solvent. In both cases, the minimum energy adiabatic paths, and the mean force potentials (MFP) for the insertion of TsCl along a reaction coordinate perpendicular to the CD plane, were calculated for the two possible orientations of TsCl. The results show a preferred entry of TsCl in the CD cavity with the sulfonyl chloride group pointing to the primary hydroxyls rim. In each orientation, two energy minima for the complex are detected in vacuum that reflect the HH contacts between host and guest observed by NMR spectroscopy (ROESY, NOESY). These separate minima collapsed into a single broader minimum, when the solvent was introduced in the simulations. The resulting association constant between TsCl and βCD (Ka ≅ 100 M-1) is in good agreement with the NMR results (Ka = 102 ± 12 M-1) in deuterated water solution at 298 K. Advantage has been taken of the dynamics of the reagent inclusion to set up a one step process involving a transient Cu2+ chelate at the secondary hydroxyls rim position for the electrophilic mono-activation of βCD at the primary hydroxyls rim using water as solvent. (authors)

  5. Vitamins, trace elements, and antioxidant status in dementia disorders

    OpenAIRE

    Tabet, N.; Mantle, D; WALKER, Z.; Orrell, M.

    2001-01-01

    Antioxidants, such as vitamins C and E, have been proposed for the treatment of dementia disorders. Although other vitamins and trace elements may also have antioxidant-enhancing activities, it is not known whether the overall antioxidant status in dementia patients is associated with the intake level of these vitamins and trace elements. In this study, we assessed the levels of vitamins and trace elements in the diet of patients with Alzheimer's disease (AD), vascular dementia (VaD), and dem...

  6. A Genetic Epidemiological Study of Dementia and Cognitive Function

    OpenAIRE

    Ibrahim-Verbaas, Carla

    2014-01-01

    markdownabstract__Abstract__ The epidemic of dementia is one of the greatest challenges for health care systems in the Western world. Dementia is a chronic and progressive syndrome of deterioration of cognitive ability, beyond what might be expected from normal ageing,1 and is seen in different underlying neurodegenerative diseases. The most common type of dementia among the aging population is Alzheimer’s Disease (AD), characterized by an insidious but progressive impairment, often most of s...

  7. Molecular Characterization of Novel Progranulin (GRN) Mutations in Frontotemporal Dementia

    OpenAIRE

    Mukherjee, Odity; Wang, Jun; Gitcho, Michael; Chakraverty, Sumi; Taylor-Reinwald, Lisa; Shears, Shantia; Kauwe, John S. K.; Norton, Joanne; Levitch, Denise; Bigio, Eileen H.; Hatanpaa, Kimmo J.; White, Charles L.; Morris, John C.; Cairns, Nigel J.; Goate, Alison

    2008-01-01

    Frontotemporal dementia (FTD) is a clinical term encompassing dementia characterized by the presence of two major phenotypes: 1) behavioral and personality disorder, and 2) language disorder, which includes primary progressive aphasia and semantic dementia. Recently, the gene for familial frontotemporal lobar degeneration (FTLD) with ubiquitin-positive, tau-negative inclusions (FTLD-U) linked to chromosome 17 was cloned. In the present study, 62 unrelated patients from the Washington Universi...

  8. Comorbidity and dementia: a scoping review of the literature

    OpenAIRE

    Bunn, F; Burn, A-M; Goodman, C; Rait, G.; Norton, S.; Robinson, L.; J Schoeman; Brayne, C

    2014-01-01

    Background Evidence suggests that amongst people with dementia there is a high prevalence of comorbid medical conditions and related complaints. The presence of dementia may complicate clinical care for other conditions and undermine a patient’s ability to manage a chronic condition. The aim of this study was to scope the extent, range and nature of research activity around dementia and comorbidity. Methods We undertook a scoping review including all types of research relating to the prevalen...

  9. Progress in Research on Acupuncture Treatment of Senile Dementia

    Institute of Scientific and Technical Information of China (English)

    CHENG Hai-ying; CHENG Dong-qi

    2009-01-01

    @@ Senile dementia is a chronic retrograde encephalopathy seriously jeopardizing the health of elderly people. It is clinically manifested by progressive remote and recent dysmnesia, declined ability in analysis and judgment, emotional changes,abnormal behaviors, and even disturbances of consciousness.In recent years, acupuncture has been used to treat dementia with satisfactory therapeutic effects.The following is a survey for the progress in research on acupuncture treatment of senile dementia in the past 10 years.

  10. EFFECT OF ACUPUNCTURE ON THE INTELLIGENCE OF CEREBROVASCULAR DEMENTIA PATIENT

    Institute of Scientific and Technical Information of China (English)

    陈邦国

    2000-01-01

    Cerebrovascular dementia is a common disese in the old and medium-aged people. Its morbidity constitutes about 10-20% of all the dementia patients and results mainly from all-round decline of the brain function due to cerebral atheroscleorsis and cerebral infarction. The author of the present paper adopted acupuncture therapy to; treat this kind of disease and observed its effect on dementia patient's intelligence. Here is the report.

  11. A Bayesian Approach to Identifying New Risk Factors for Dementia

    OpenAIRE

    Wen, Yen-Hsia; Wu, Shihn-Sheng; Lin, Chun-Hung Richard; Tsai, Jui-Hsiu; Yang, Pinchen; Chang, Yang-Pei; Tseng, Kuan-Hua

    2016-01-01

    Abstract Dementia is one of the most disabling and burdensome health conditions worldwide. In this study, we identified new potential risk factors for dementia from nationwide longitudinal population-based data by using Bayesian statistics. We first tested the consistency of the results obtained using Bayesian statistics with those obtained using classical frequentist probability for 4 recognized risk factors for dementia, namely severe head injury, depression, diabetes mellitus, and vascular...

  12. Feasibility of central meditation and imagery therapy for dementia caregivers

    OpenAIRE

    Jain, FA; Nazarian, N.; Lavretsky, H.

    2014-01-01

    Objectives: Family dementia caregivers are at high risk of depression and burnout. We assessed the feasibility of Central Meditation and Imagery Therapy for Caregivers (CMIT-C), a novel 8-week group meditation and guided imagery group therapy program, for dementia caregivers reporting stress because of caregiving responsibilities. Methods: Twelve family dementia caregivers enrolled in CMIT-C. Primary outcomes included depression and anxiety, and secondary outcomes included insomnia, quality o...

  13. "Depressive pseudodementia" or "Melancholic dementia": a 19th century view.

    OpenAIRE

    Berrios, G E

    1985-01-01

    Nineteenth century views on the interaction between dementia, depressive illness, general paralysis and brain localisation are discussed in the context of a book by A Mairet entitled: Melancholic Dementia. It is shown that by 1883 there was already awareness of the fact that severe affective disorder could lead to cognitive impairment. General paralysis was the commonest diagnosis put forward to account for patients with depression who went on to develop dementia. Patients so diagnosed, howev...

  14. Vascular risk factors and dementia: How to move forward?

    OpenAIRE

    Viswanathan, Anand; Rocca, Walter A.; Tzourio, Christophe

    2009-01-01

    In recent years, accumulating evidence has suggested that vascular risk factors contribute to Alzheimer disease (AD). Vascular dementia had been traditionally considered secondary to stroke and vascular disease. It has been traditionally distinguished from AD, considered to be a purely neurodegenerative form of dementia. However, in light of this more recent literature, it appears that there is a spectrum: ranging from patients with pure vascular dementia to patients with pure AD and includin...

  15. Global Epidemiology of Dementia: Alzheimer’s and Vascular Types

    OpenAIRE

    Liara Rizzi; Idiane Rosset; Matheus Roriz-Cruz

    2014-01-01

    The prevalence of dementia varies substantially worldwide. This is partially attributed to the lack of methodological uniformity among studies, including diagnostic criteria and different mean population ages. However, even after considering these potential sources of bias, differences in age-adjusted dementia prevalence still exist among regions of the world. In Latin America, the prevalence of dementia is higher than expected for its level of population aging. This phenomenon occurs due to ...

  16. Beyond mild cognitive impairment: vascular cognitive impairment, no dementia (VCIND)

    OpenAIRE

    Stephan, Blossom CM; Matthews, Fiona E; Khaw, Kay-Tee; Dufouil, Carole; Brayne, Carol

    2009-01-01

    Identifying the causes of dementia is important in the search for effective preventative and treatment strategies. The concept of mild cognitive impairment (MCI), as prodromal dementia, has been useful but remains controversial since in population-based studies it appears to be a limited predictor of progression to dementia. Recognising the relative contribution of neurodegenerative and vascular causes, as well as their interrelationship, may enhance predictive accuracy. The concept of vascul...

  17. Dementia prevention: current epidemiological evidence and future perspective

    OpenAIRE

    Mangialasche, Francesca; Kivipelto, Miia; Solomon, Alina; Fratiglioni, Laura

    2012-01-01

    Dementia, a major cause of disability and institutionalization in older people, poses a serious threat to public health and to the social and economic development of modern society. Alzheimer's disease (AD) and cerebrovascular diseases are the main causes of dementia; most dementia cases are attributable to both vascular and neurodegenerative brain damage. No curative treatment is available, but epidemiological research provides a substantial amount of evidence of modifiable risk and protecti...

  18. Reviewing the definition of crisis in dementia care

    OpenAIRE

    Vroomen Janet MacNeil; Bosmans Judith E; van Hout Hein PJ; de Rooij Sophia E

    2013-01-01

    Abstract Background Crisis is a term frequently used in dementia care lacking a standardized definition. This article systematically reviews existing definitions of crisis in dementia care literature to create a standardized definition that can be utilized for research, policy and clinical practice. Methods We systematically searched for articles containing definitions of crisis in the context of dementia care. We created an operational framework of crisis based on retrieved definitions. Reco...

  19. Dementia Care: Intersecting Informal Family Care and Formal Care Systems

    OpenAIRE

    Prabhjot Singh; Rafat Hussain; Adeel Khan; Lyn Irwin; Roslyn Foskey

    2014-01-01

    Dementia is one of the major causes of disability and dependence amongst older people and previous research has highlighted how the well-being of people with dementia is inherently connected to the quality of their relationships with their informal carers. In turn, these carers can experience significant levels of emotional stress and physical burden from the demands of caring for a family member with dementia, yet their uptake of formal services tends to be lower than in other conditions rel...

  20. Forgetting in Dementia With and Without Subcortical Lacunes

    OpenAIRE

    Kramer, Joel H.; Mungas, Dan; Reed, Bruce R.; Schuff, Norbert; Weiner, Michael W.; Miller, Bruce L.; Chui, Helena C.

    2004-01-01

    Alzheimer’s disease (AD) and subcortical ischemic vascular disease (SIVD) are common causes of dementia, often co-occur, and can present quite similarly, making differential diagnosis clinically challenging. This study tested the hypothesis that patients with SIVD retain information better than AD patients. Participants were 35 dementia patients with subcortical lacunes (SIVD group), 27 dementia patients without lacunar infarction (AD group), and 56 normal controls. Results indicated that des...