WorldWideScience

Sample records for dementia rating cdr

  1. Hippocampal volume and CDR-SB can predict conversion to dementia in MCI patients

    Directory of Open Access Journals (Sweden)

    João Guilherme Fiorani Borgio

    2012-11-01

    Full Text Available OBJECTIVE: To evaluate the combination of two factors: clinical dementia rating sum of boxes scores (CDR-SB and hippocampal volume (HV as predictors of conversion from mild cognitive impairment (MCI to dementia. METHODS: Twenty-eight individuals (9 normal and 19 with MCI were classified according to their CDR sum of boxes scores into 3 groups. RESULTS: The hippocampal volume was significantly lower in the high-risk group and in those who developed dementia after two years. The rate of conversion was crescent among the three groups. CONCLUSION: We were proposed an additional measurement of the hippocampal volume which may be helpful in the prognosis. However, we noted that the CDR-SB is a method as efficient as neuroimaging to predict dementia with the advantage of being a procedure for low cost and easy implementation, more consistent with public policy.

  2. Detecting Treatment Group Differences in Alzheimer's Disease Clinical Trials: A Comparison of Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-Cog) and the Clinical Dementia Rating - Sum of Boxes (CDR-SB).

    Science.gov (United States)

    Wessels, A M; Dowsett, S A; Sims, J R

    2018-01-01

    The Alzheimer's Disease Assessment Scale's cognitive subscale (ADAS-Cog) has been widely used as an outcome measure in Alzheimer's Disease (AD) clinical trials. In its original form (ADAS-Cog11), the scale has been used successfully in mild-to-moderate AD dementia populations, but its use is more limited in the study of earlier disease (mild cognitive impairment [MCI] or mild dementia due to AD) owing to lack of appropriate sensitivity of some items. With recent focus on earlier treatment, efforts have focused on the development of more sensitive tools, including the Clinical Dementia Rating-Sum of Boxes (CDR-SB), a global assessment tool to evaluate both cognition and function. The ability of the ADAS-Cog and CDR-SB to detect treatment group differences in the clinical trial environment has not been systematically studied. The aim of this analysis was to compare the utility of these tools in detecting treatment group differences, by reviewing study findings identified through advanced searches of clinicaltrials.gov and Ovid, and press releases and scientific presentations. Findings from placebo-controlled studies of ≥ 6m duration and enrolling >100 participants were included; reporting of both the ADAS-Cog and CDR-SB at endpoint was also a requirement. Of the >300 records identified, 34 studies fulfilled the criteria. There were significant placebo versus active drug group differences based on findings from at least one measure for 14 studies. The ADAS-Cog detected treatment differences more frequently than the CDR-SB. Based on these and previously published findings, the ADAS-Cog appears more useful than the CDR-SB in detecting treatment group differences.

  3. Aplicação da versão brasileira da escala de avaliação clínica da demência (Clinical Dementia Rating - CDR em amostras de pacientes com demência Application of the Brazilian version of the CDR scale in samples of dementia patients

    Directory of Open Access Journals (Sweden)

    Alberto Luiz Grigoli Maia

    2006-06-01

    Full Text Available OBJETIVO: Avaliar a concordância da escala CDR com critérios diagnósticos e mini exame do estado mental (MEEM, e correlação com escala de Blessed, numa amostra de pacientes do sul do Brasil. MÉTODO: A escala foi avaliada em 269 pacientes com doença de Alzheimer (DA, demência vascular e demência questionável num desenho transversal. Os critérios do NINCDS-ADRDA para provável DA e NINDS-AIREN para provável demência vascular foram os padrões-ouro. O MEEM, a escala Blessed para gravidade da demência, o escore isquêmico de Hachinski, e uma bateria de testes cognitivos também foram aplicados. RESULTADOS: A concordância com o padrão-ouro foi boa (kappa=0,73, e com o MEEM em categorias foi moderada (kappa= 0,53. Observou-se correlação significativa da escala CDR com Blessed (r=0,96; p=0,001. Não se observou diferença de escolaridade ou de idade entre as categorias da escala CDR. CONCLUSÃO: A concordância da CDR foi boa para os critérios diagnósticos e moderada para o MEEM. A escala mostrou validade de construto para gravidade de demência. Não se observou impacto da escolaridade sobre este instrumento.OBJECTIVE: The objective of the study was the analysis of agreement between the CDR scale with diagnostic criteria and mini mental state examination (MMSE, as well as correlation with Blessed scale, in a sample of Southern Brazilian patients. METHOD: The CDR scale was cross-sectionaly evaluated in 269 dementia patients Alzheimer’s disease (AD vascular dementia, and questionable. The NINCDS-ADRDA criteria for probable AD and the NINDS-AIREN for probable vascular dementia were the gold standard. The MMSE, the Blessed scale, the Hachinski ischemic score, and a battery of cognitive tests were also applied. RESULTS: The agreement to gold standard was good (kappa=0.73, while to MMSE categorized was moderate (kappa=0.53. A significant correlation with the Blessed scale (r=0.96; p=0.001 was observed. Education and age were similar

  4. Awareness of disease in dementia: Development of a multidimensional rating scale

    Directory of Open Access Journals (Sweden)

    Marcia Dourado

    Full Text Available Abstract Objective: To describe the development of the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia (ASPIDD, a multidimensional scale to evaluate awareness of disease in dementia. Method: The development of this scale was conducted in four steps. In step one, questions were drawn up after a review of the literature. The second step involved the suggestions offered by a neurologist regarding the skills considered important for the scale. The third step involved the re-writing and review of the domains and questions in the scale followed by a semantic evaluation performed by two independent psychiatrists. Step four consisted of the preliminary study aimed at evaluating the applicability of the ASPIDD. Results: In the semantic evaluation only minor changes were proposed. The preliminary sample had 52 patients, comprising 23 CDR 1 (male=9; female=14 and 29 CDR2 (male=13; female=16. Mean age of patients was 69.7±5.51 (CDR1 and 73.6±9.4 (CDR2, and age at onset was 66.4±5.7 years (CDR1 and 68.3±9.3 year (CDR2. Mean schooling was 9.0±4.3 years (CDR1 and 8.8±4.4 years (CDR2. Mean MMSE was 21.0±3.3 (CDR1 and 17.6±3.5 (CDR2. Mean Cornell was 4.8±2.3 (CDR1 and 4.2±1.9 (CDR2. The patient and caregiver dyads were aware of problems, mainly of those related to social, family and affective relations. The higher rates of discrepant responses were found on the awareness of cognitive deficits and changes in ADL. Conclusion: The ASPIDD is a multidimensional instrument to assess awareness of disease among AD patients.

  5. Reliability and Validity of the Clinical Dementia Rating for Community-Living Elderly Subjects without an Informant

    Directory of Open Access Journals (Sweden)

    Ma Shwe Zin Nyunt

    2013-10-01

    Full Text Available Background: The Clinical Dementia Rating (CDR scale is widely used to assess cognitive impairment in Alzheimer's disease. It requires collateral information from a reliable informant who is not available in many instances. We adapted the original CDR scale for use with elderly subjects without an informant (CDR-NI and evaluated its reliability and validity for assessing mild cognitive impairment (MCI and dementia among community-dwelling elderly subjects. Method: At two consecutive visits 1 week apart, nurses trained in CDR assessment interviewed, observed and rated cognitive and functional performance according to a protocol in 90 elderly subjects with suboptimal cognitive performance [Mini-Mental State Examination (MMSE Results: The CDR-NI scores (0, 0.5, 1 showed good internal consistency (Crohnbach's a 0.83-0.84, inter-rater reliability (κ 0.77-1.00 for six domains and 0.95 for global rating and test-retest reliability (κ 0.75-1.00 for six domains and 0.80 for global rating, good agreement (κ 0.79 with the clinical assessment status of MCI (n = 37 and dementia (n = 4 and significant differences in the mean scores for MMSE, MOCA and Instrumental Activities of Daily Living (ANOVA global p Conclusion: Owing to the protocol of the interviews, assessments and structured observations gathered during the two visits, CDR-NI provides valid and reliable assessment of MCI and dementia in community-living elderly subjects without an informant.

  6. Validity and Reliability of Clinical Dementia Rating Scale among the Elderly in Iran

    Directory of Open Access Journals (Sweden)

    Nahid Sadeghi

    2012-10-01

    Full Text Available Background: The most common cause of dementia among the elderly is Alzheimer’s disease. Given the increasing population of the elderly, achieving a screening tool with high reliability and validity is an essential need for all communities. The main objective of the project was to determine the Persian version of Clinical Dementia Rating Scale (P-CDR1. Materials and Methods: Twenty subjects were randomly selected from among 150, 50-70 year old people, who were illiterate and not mentally retarded, residing in the nursing home; and they were given the Persian version of CDR scale (test. After three months, the group was given the test again. Results: The findings showed that from the specialists’ standpoint CDR scale had acceptable validity, and the test validity was achieved 0.05 at the significant level with Cronbach’s alpha and reliability coefficients 73% and 89%, respectively. Conclusion: CDR scale is a reliable instrument for evaluation of clinical dementia rating among the elderly in Iran. It can be used in screening dementia, Alzheimer, and diagnosis of the severity and stages of Alzheimer.

  7. Translation, cross-cultural adaptation and applicability of the Brazilian version of the Frontotemporal Dementia Rating Scale (FTD-FRS

    Directory of Open Access Journals (Sweden)

    Thais Bento Lima-Silva

    Full Text Available ABSTRACT Background: Staging scales for dementia have been devised for grading Alzheimer's disease (AD but do not include the specific symptoms of frontotemporal lobar degeneration (FTLD. Objective: To translate and adapt the Frontotemporal Dementia Rating Scale (FTD-FRS to Brazilian Portuguese. Methods: The cross-cultural adaptation process consisted of the following steps: translation, back-translation (prepared by independent translators, discussion with specialists, and development of a final version after minor adjustments. A pilot application was carried out with 12 patients diagnosed with bvFTD and 11 with AD, matched for disease severity (CDR=1.0. The evaluation protocol included: Addenbrooke's Cognitive Examination-Revised (ACE-R, Mini-Mental State Examination (MMSE, Executive Interview (EXIT-25, Neuropsychiatric Inventory (NPI, Frontotemporal Dementia Rating Scale (FTD-FRS and Clinical Dementia Rating scale (CDR. Results: The Brazilian version of the FTD-FRS seemed appropriate for use in this country. Preliminary results revealed greater levels of disability in bvFTD than in AD patients (bvFTD: 25% mild, 50% moderate and 25% severe; AD: 36.36% mild, 63.64% moderate. It appears that the CDR underrates disease severity in bvFTD since a relevant proportion of patients rated as having mild dementia (CDR=1.0 in fact had moderate or severe levels of disability according to the FTD-FRS. Conclusion: The Brazilian version of the FTD-FRS seems suitable to aid staging and determining disease progression.

  8. Reliability and Validity of the Clinical Dementia Rating for Community-Living Elderly Subjects without an Informant.

    Science.gov (United States)

    Nyunt, Ma Shwe Zin; Chong, Mei Sian; Lim, Wee Shiong; Lee, Tih Shih; Yap, Philip; Ng, Tze Pin

    2013-01-01

    The Clinical Dementia Rating (CDR) scale is widely used to assess cognitive impairment in Alzheimer's disease. It requires collateral information from a reliable informant who is not available in many instances. We adapted the original CDR scale for use with elderly subjects without an informant (CDR-NI) and evaluated its reliability and validity for assessing mild cognitive impairment (MCI) and dementia among community-dwelling elderly subjects. At two consecutive visits 1 week apart, nurses trained in CDR assessment interviewed, observed and rated cognitive and functional performance according to a protocol in 90 elderly subjects with suboptimal cognitive performance [Mini-Mental State Examination (MMSE) reliability (κ 0.77-1.00 for six domains and 0.95 for global rating) and test-retest reliability (κ 0.75-1.00 for six domains and 0.80 for global rating), good agreement (κ 0.79) with the clinical assessment status of MCI (n = 37) and dementia (n = 4) and significant differences in the mean scores for MMSE, MOCA and Instrumental Activities of Daily Living (ANOVA global p reliable assessment of MCI and dementia in community-living elderly subjects without an informant.

  9. Association between late-onset depression and incident dementia in Chinese older persons.

    Science.gov (United States)

    Tam, C W C; Lam, L C W

    2013-12-01

    OBJECTIVE. Previous studies have shown that depression is a precursor / prodrome or susceptible state for the development of dementia. This study aimed to examine the relationship between late-onset depression and subsequent cognitive and functional decline in a cohort of non-demented older Chinese persons at their 2-year follow-up and investigate for possible predictors of cognitive decline. METHODS. A total of 81 depressed subjects and 468 non-depressed community controls were recruited. RESULTS. Subjects with late-onset depression showed significantly more incident Clinical Dementia Rating (CDR) scale decline (odds ratio = 3.87, 95% confidence interval = 2.23-6.70) and dementia (odds ratio = 3.44, 95% confidence interval = 1.75-6.77) than those without depression. A higher proportion of depressed CDR 0 subjects had CDR and functional decline than their non-depressed counterparts. Depressed CDR 0.5 subjects had significantly higher rates of functional decline and lower rates of improvement in CDR than their non-depressed counterparts. CONCLUSION. Diagnosis of depression was a robust predictor of incident very mild dementia (i.e. CDR of 0.5) and depression severity was a predictor of progression to dementia from CDR of 0.5. The association between depression and the risk of CDR decline and dementia was observed in non-demented Chinese subjects. Depression was also associated with persistent mild cognitive deficits in CDR 0.5 subjects.

  10. The Structured Interview & Scoring Tool-Massachusetts Alzheimer's Disease Research Center (SIST-M): development, reliability, and cross-sectional validation of a brief structured clinical dementia rating interview.

    Science.gov (United States)

    Okereke, Olivia I; Copeland, Maura; Hyman, Bradley T; Wanggaard, Taylor; Albert, Marilyn S; Blacker, Deborah

    2011-03-01

    The Clinical Dementia Rating (CDR) and CDR Sum-of-Boxes can be used to grade mild but clinically important cognitive symptoms of Alzheimer disease. However, sensitive clinical interview formats are lengthy. To develop a brief instrument for obtaining CDR scores and to assess its reliability and cross-sectional validity. Using legacy data from expanded interviews conducted among 347 community-dwelling older adults in a longitudinal study, we identified 60 questions (from a possible 131) about cognitive functioning in daily life using clinical judgment, inter-item correlations, and principal components analysis. Items were selected in 1 cohort (n=147), and a computer algorithm for generating CDR scores was developed in this same cohort and re-run in a replication cohort (n=200) to evaluate how well the 60 items retained information from the original 131 items. Short interviews based on the 60 items were then administered to 50 consecutively recruited older individuals, with no symptoms or mild cognitive symptoms, at an Alzheimer's Disease Research Center. Clinical Dementia Rating scores based on short interviews were compared with those from independent long interviews. In the replication cohort, agreement between short and long CDR interviews ranged from κ=0.65 to 0.79, with κ=0.76 for Memory, κ=0.77 for global CDR, and intraclass correlation coefficient for CDR Sum-of-Boxes=0.89. In the cross-sectional validation, short interview scores were slightly lower than those from long interviews, but good agreement was observed for global CDR and Memory (κ≥0.70) as well as for CDR Sum-of-Boxes (intraclass correlation coefficient=0.73). The Structured Interview & Scoring Tool-Massachusetts Alzheimer's Disease Research Center is a brief, reliable, and sensitive instrument for obtaining CDR scores in persons with symptoms along the spectrum of mild cognitive change.

  11. Rate of Forgetting in Dementia and Depression.

    Science.gov (United States)

    Hart, Robert P.; And Others

    1987-01-01

    Examined patients (N=14) with mild Alzheimer's dementia (DAT), patients with major depression (N=10), and normal control subjects (N=14), for rate of forgetting. Suggests that some form of deficient consolidation contributes to memory loss in DAT but not in depression. Implicates the disruption of different psychobiological mechanisms in these…

  12. Incidence of dementia and cause of death in elderly Japanese emigrants to Brazil before World War II.

    Science.gov (United States)

    Meguro, Kenichi; Chubaci, Rosa Y S; Meguro, Mitsue; Kawamorida, Kazumi; Goto, Nobuko; Caramelli, Paulo

    2011-01-01

    In 1997 we examined the prevalence of dementia among the Japanese elderly immigrants living in the São Paulo metropolitan area (n=166). Herein, we followed up on these subjects for causes of death and dementia incidence. We were able to contact 108 subjects: 54 were already dead. The most common cause of death was cardiac disease. For dementia, 31.6% of the dead subjects were found to have developed dementia before they died, and 20.8 % of the living subjects were demented. As for the baseline the clinical dementia rating (CDR), 20.8 % of CDR 0 and 50.0 % of CDR 0.5 subjects developed dementia in the dead group; whereas in the living group, 23.9 % of CDR 0 and 52.6 % of CDR 0.5 developed dementia. As a whole, the incidence was 34.2 ‰ per 1000 person-years. Cardiac disease as the most common cause of death was probably due to the higher prevalence of diabetes mellitus. Compared with the previous study, the lower incidence of dementia from the CDR 0.5 group may have been due to a higher mortality rate. This is the first study on the incidence of dementia in elderly Japanese immigrants in Brazil. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  13. Dementia and Hospital Readmission Rates: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Sabrina Pickens

    2017-10-01

    Full Text Available Background: Although community-dwelling persons with dementia have an increased risk of hospital readmission, no systematic review has examined the contribution of dementia to readmissions. Summary: We examined articles in English, with no restrictions on publication dates, from Medline, PubMed, PsycINFO, CINAHL, and EMBASE. Keywords used were dementia, Alzheimer disease, frontotemporal lobar degeneration, elderly, frontotemporal dementia, executive function, brain atrophy, frontal lobe atrophy, cognitive impairment, readmission, readmit, rehospitalization, patient discharge, and return visit. Of 404 abstracts identified, 77 articles were retrieved; 12 were included. Four of 5 cohort studies showed significantly increased readmission rates in patients with dementia. On average the absolute increase above the comparison groups was from 3 to 13%. Dementia was not associated with readmission in 7 included case-control studies. Key Message: Findings suggest a small increased risk of hospital readmission in individuals with dementia. More study is needed.

  14. Evaluation of Anosognosia in Alzheimer's Disease Using the Symptoms of Early Dementia-11 Questionnaire (SED-11Q

    Directory of Open Access Journals (Sweden)

    Yohko Maki

    2013-10-01

    Full Text Available Aims: The objective is to propose a brief method to evaluate anosognosia in Alzheimer's disease (AD using the Symptoms of Early Dementia-11 Questionnaire (SED-11Q, a short informant-based screening questionnaire for identifying dementia. Methods: The participants were 107 elderly individuals: 13 with a Clinical Dementia Rating (CDR of 0.5, 73 with mild AD of CDR 1, and 21 with moderate AD of CDR 2. The patients and caregivers answered the SED-11Q independently, and the degree of discrepancy indicated the severity of anosognosia. Results: The scores were as follows: caregiver scores were 2.46 ± 1.85 (mean ± SD in CDR 0.5, 6.36 ± 3.02 in CDR 1, and 9.00 ± 1.14 in CDR 2; patient scores were 2.00 ± 1.78, 2.55 ± 2.33, and 1.33 ± 2.46, respectively. Discrepancy was 0.46 ± 1.61, 3.81 ± 3.95, and 7.67 ± 2.87, respectively, and the caregiver assessments were significantly higher than the patient assessments in CDR 1 and CDR 2 (p Conclusion: The SED-11Q serves a dual purpose: caregiver assessment is useful for the screening of dementia, and any discrepancy between the patient and the caregiver assessment is considered as an indication of the severity of anosognosia; this can be informative for caregivers and essential for successful care.

  15. A new self-rating questionnaire for dementia screening

    Directory of Open Access Journals (Sweden)

    Jin WANG

    2015-07-01

    Full Text Available Background The AD8 plays an important role in the early diagnosis of dementia. However, because of cultural and language difference, it is difficult for Chinese subjects to understand and answer questions in AD8. This paper aims to make a new dementia self-rating questionnaire for Chinese people based on the AD8, and to determine its value for dementia screening.  Methods According to early symptoms of dementia and life style of old Chinese people, a dementia self-rating questionnaire was made based on the AD8. The new questionnaire includes 10 questions, and can be finished in 3 min. The reliability and validity was validated by a questionnaire survey in senior citizens older than 50 years in urban Xi'an. All patients were screened by Mini-Mental State Examination (MMSE and dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders Forth Edition (DSM-Ⅳ criteria.  Results A total of 620 patients finished the new questionnaire, and among them 17 patients (2.74% were diagnosed as dementia. The score of each question in the questionnaire was positively correlated with the total score (rs = 0.300-0.709; P = 0.000, for all. The Cronbach α was 0.795, indicating that the questionnaire got good internal consistency reliability. Two principal components were extracted, and the cumulative variance contribution ratio was 49.771%. Factor loading of each subitem was > 0.500, indicating a good construct validity. According to receiver operating characteristic (ROC curve, the critical value was 2, with the sensitivity 94.10% and specificity 82.10%. Youden index was 0.762.  Conclusions The new dementia self-rating questionnaire can detect dementia patients sensitively and correctly, and is very useful for early screening of dementia. DOI: 10.3969/j.issn.1672-6731.2015.07.009

  16. Hypertension is associated with cognitive decline in elderly people at high risk for dementia.

    Science.gov (United States)

    Wysocki, Michael; Luo, Xiaodong; Schmeidler, James; Dahlman, Karen; Lesser, Gerson T; Grossman, Hillel; Haroutunian, Vahram; Beeri, Michal Schnaider

    2012-02-01

    Cardiovascular risk factors including hypertension (HTN) have been shown to increase the risk of Alzheimer disease. The current study investigated whether individuals with HTN are more susceptible to increased cognitive decline and whether the influence of HTN on cognitive decline varied as a function of dementia severity. A total of 224 nursing home and assisted living residents, with a mean age of 84.9 (±7.6) years, were assessed longitudinally with Mini Mental State Exams (MMSEs) and Clinical Dementia Ratings (CDR). Baseline dementia status was defined by the CDR score. As described in , MMSE scores in persons with HTN and questionable dementia (CDR = 0.5) declined significantly faster than nonhypertensive questionably demented persons. Hypertensive participants did not decline significantly faster than nonhypertensive participants in persons with intact cognition (CDR = 0) or frank dementia (CDR ≥ 1). These results suggest an increased risk of subsequent cognitive decline in hypertensive individuals who are especially vulnerable to developing dementia and raises the possibility that avoiding or controlling HTN might reduce the rate of cognitive decline in cognitively vulnerable individuals, potentially delaying their conversion to full-fledged dementia.

  17. Executive function impairment in community elderly subjects with questionable dementia.

    Science.gov (United States)

    Lam, Linda C W; Lui, Victor W C; Chiu, Helen F K; Chan, Sandra S M; Tam, Cindy W C

    2005-01-01

    The neurocognitive profile of community-dwelling Chinese subjects with 'questionable' dementia was studied. One hundred and fifty-four ambulatory Chinese subjects were recruited from local social centers for the elderly. Each subject was examined using the Clinical Dementia Rating (CDR), the Cantonese version of the Mini-Mental State Examination (CMMSE), the Chinese version of the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), the Category Verbal Fluency Test (CVFT), digit and visual span tests, and the Cambridge Neurological Inventory. The neurocognitive profile of nondemented subjects (CDR 0) was compared with that of subjects with 'questionable' dementia (CDR 0.5). Subjects with 'questionable' dementia were older, and had lower educational levels and global cognitive assessment scores than the controls (CMMSE and ADAS-Cog; t tests, p < 0.001). In addition, they also had significantly lower scores in delayed recall, reverse span, verbal fluency tests and worse performance in complex motor tasks related to executive function (Mann-Whitney tests, p < 0.001). Logistic regression analysis revealed that ADAS-Cog, CVFT, and reverse visual span were significant predictors for the CDR of 'questionable' dementia. Aside from memory impairment, executive function deficits were also present in subjects with 'questionable' dementia. To identify groups cognitively at risk for dementia, concomitant assessments of memory and executive function are suggested.

  18. Adaptation and validation of a Spanish-language version of the Frontotemporal Dementia Rating Scale (FTD-FRS).

    Science.gov (United States)

    Turró-Garriga, O; Hermoso Contreras, C; Olives Cladera, J; Mioshi, E; Pelegrín Valero, C; Olivera Pueyo, J; Garre-Olmo, J; Sánchez-Valle, R

    2017-06-01

    The Frontotemporal Dementia Rating Scale (FTD-FRS) is a tool designed to aid with clinical staging and assessment of the progression of frontotemporal dementia (FTD-FRS). Present a multicentre adaptation and validation study of a Spanish version of the FRS. The adapted version was created using 2 translation-back translation processes (English to Spanish, Spanish to English) and verified by the scale's original authors. We validated the adapted version in a sample of consecutive patients diagnosed with FTD. The procedure included evaluating internal consistency, testing unidimensionality with the Rasch model, analysing construct validity and discriminant validity, and calculating the degree of agreement between the Clinical Dementia Rating scale (CDR) and FTD-FRS for FTD cases. The study included 60 patients with DFT. The mean score on the FRS was 12.1 points (SD=6.5; range, 2-25) with inter-group differences (F=120.3; df=3; Pde Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Clinical diagnosis by computed tomography on Alzheimer type dementia

    Energy Technology Data Exchange (ETDEWEB)

    Imai, Yukimichi

    1983-09-01

    The relationships of CT findings, intellectual impairment by psychological assessment and severity of dementia by clinical evaluation were studied on 109 patients with clinical diagnosis of Alzheimer type dementia (AD) and 43 controls. CT examinations were carried out on three tomographic sections, that is, a section through anterior and posterior horns of lateral ventricles, a section through cellae mediae of lateral ventricles and a section through cortex with intracranial space of 60-80 cm/sup 2/. In the three tomographic sections, CSF space percent and half width full max (HWFM) in the histogram corresponding to brain tissue were employed as indexes of brain atrophy by CT. Psychological evaluation of dementia was made by using Hasegawa's dementia scale (HDS). The present study revealed the following findings. though CSF% in the sections through lateral ventricles significantly correlated with age, it was more significantly correlated with HDS and CDR(clinical dementia rating) scores, respectively. This finding seems to mean that the effect of dementia is so great as to override the effect of dementia. In the cortex slice, the correlations between CSF% and HDS and CDR scores were very low, though they were significant. HWFM in the same slice, showed the moderate and significant correlations with HDS and CDR scores, respectively, comparing with no relationship between HWFM and age. Concerning mean CSF% and HWFM of each group according to CDR staging, they increased with advancement of dementia. The significant differences between the groups by CDR, however, were not always obtained. According to CT indexes as independent variable, the normal subject were discriminated from the demented subjects in 82.6% of the total by discriminat analysis. (J.P.N.).

  20. Clinical diagnosis by computed tomography on Alzheimer type dementia

    International Nuclear Information System (INIS)

    Imai, Yukimichi

    1983-01-01

    The relationships of CT findings, intellectual impairment by psychological assessment and severity of dementia by clinical evaluation were studied on 109 patients with clinical diagnosis of Alzheimer type dementia (AD) and 43 controls. CT examinations were carried out on three tomographic sections, that is, a section through anterior and posterior horns of lateral ventricles, a section through cellae mediae of lateral ventricles and a section through cortex with intracranial space of 60-80 cm 2 . In the three tomographic sections, CSF space percent and half width full max (HWFM) in the histogram corresponding to brain tissue were employed as indexes of brain atrophy by CT. Psychological evaluation of dementia was made by using Hasegawa's dementia scale (HDS). The present study revealed the following findings. though CSF% in the sections through lateral ventricles significantly correlated with age, it was more significantly correlated with HDS and CDR(clinical dementia rating) scores, respectively. This finding seems to mean that the effect of dementia is so great as to override the effect of dementia. In the cortex slice, the correlations between CSF% and HDS and CDR scores were very low, though they were significant. HWFM in the same slice, showed the moderate and significant correlations with HDS and CDR scores, respectively, comparing with no relationship between HWFM and age. Concerning mean CSF% and HWFM of each group according to CDR staging, they increased with advancement of dementia. The significant differences between the groups by CDR, however, were not always obtained. According to CT indexes as independent variable, the normal subject were discriminated from the demented subjects in 82.6% of the total by discriminat analysis. (J.P.N.)

  1. A Cluster Randomized Controlled Trial of Nonpharmacological Interventions for Old-Old Subjects with a Clinical Dementia Rating of 0.5: The Kurihara Project

    Directory of Open Access Journals (Sweden)

    Masahiro Nakatsuka

    2015-05-01

    Full Text Available Background: Evidence as to the benefits of nonpharmacological interventions for the boundary state between normal aging and dementia [mild cognitive impairment or a Clinical Dementia Rating (CDR of 0.5] remains weak due to a lack of positive controls. Aims: To directly compare the effects of cognitive interventions (CI, physical activities (PA and a group reminiscence approach (GRA, we conducted a pilot study on the basis of a cluster randomized controlled trial design. Method: A total of 127 participants aged >74 years with a CDR of 0.5 were cluster randomized into three groups for CI, PA and GRA. The intervention lasted 12 weeks and consisted of weekly group sessions and home assignments. Mini-Mental State Examination (MMSE, Trail Making Test part A (TMT-A, word fluency (WF, 6-meter walk time and Quality of Life (QOL Face Scale scores were evaluated as primary outcomes. Results: Methodology-related benefits of CI and PA were found for MMSE scores and walk time, respectively. TMT-A, WF and QOL Face Scale scores improved irrespective of the methodologies used. Conclusions: Our findings suggest that CI and PA may be beneficial to cognitive and physical abilities, respectively. Executive functions and QOL may improve irrespective of the intervention methodologies used.

  2. Are we comparing frontotemporal dementia and Alzheimer disease patients with the right measures?

    Science.gov (United States)

    Deutsch, Mariel B; Liang, Li-Jung; Jimenez, Elvira E; Mather, Michelle J; Mendez, Mario F

    2016-09-01

    Clinical research studies of behavioral variant frontotemporal dementia (bvFTD) often use Alzheimer disease (AD) as a comparison group for control of dementia variables, using tests of cognitive function to match the groups. These two dementia syndromes, however, are very different in clinical manifestations, and the comparable severity of these dementias may not be reflected by commonly used cognitive scales such as the Mini-Mental State Examination (MMSE). We evaluated different measures of dementia severity and symptoms among 20 people with bvFTD compared to 24 with early-onset AD. Despite similar ages, disease-duration, education, and cognitive performance on two tests of cognitive function, the MMSE and the Montreal Cognitive Assessment (MoCA), the bvFTD participants, compared to the AD participants, were significantly more impaired on other measures of disease severity, including function (Functional Assessment Questionnaire (FAQ)), neuropsychiatric symptoms (Neuropsychiatric Inventory (NPI)), and global dementia stage (Clinical Dementia Rating Scales (CDRs)). However, when we adjusted for the frontotemporal lobar degeneration-CDR (FTLD-CDR) in the analyses, the two dementia groups were comparable across all measures despite significant differences on the cognitive scales. We found tests of cognitive functions (MMSE and MoCA) to be insufficient measures for ensuring comparability between bvFTD and AD groups. In clinical studies, the FTLD-CDR, which includes additional language and behavior items, may be a better overall way to match bvFTD and AD groups on dementia severity.

  3. Computerized visuo-spatial memory test as a supplementary screening test for dementia.

    Science.gov (United States)

    Maki, Yohko; Yoshida, Hiroshi; Yamaguchi, Haruyasu

    2010-06-01

    To prepare for a super-aging society, effective dementia screening tests are required. The most salient deficit appearing from the early stages of dementia/Alzheimer's disease (AD) is a deterioration in memory. The Hasegawa Dementia Scale-revised (HDS-R) and the Mini-Mental State Examination (MMSE) are widely used in Japan to screen for dementia. Both place an emphasis on memory function, but neither examines visuo-spatial memory (VSM) function, even though VSM deficits are a sensitive marker for the detection of conversion to dementia. Furthermore, brief tests of VSM that are appropriate for screening have not been standardized. Thus, in the present study, we devised a brief, computer-aided short-term VSM test. Sixty-six aged people were evaluated. Using the Clinical Dementia Rating (CDR), it was found that 29 could be considered normal controls (NC; CDR 0), 10 had mild cognitive impairment (MCI; CDR 0.5), 15 had mild dementia (CDR 1), and 12 had moderate to severe dementia (CDR 2-3). The VSM test estimated how many locations each subject could memorize. Several numbered circles were shown on a monitor and subjects were required to memorize the location of these circles sequentially. After the numbers on the circles on the screen had disappeared, the subjects were required to indicate the circles in ascending order. A touch panel screen was used for this test to make it easier. The HDS-R was applied to subjects with MCI and dementia. The mean (+/-SD) VSM score in subjects with MCI (5.70 +/- 0.96) was significantly lower than that in NC subjects (6.69 +/- 0.82), but significantly higher than that in subjects classified as CDR 1 (4.67 +/- 0.87). There was no significant difference in VSM scores between subjects classified as CDR 1 and CDR 2-3 (3.80 +/- 0.80). There was a moderate significant correlation between VSM and HDS-R scores. In the present study, the VSM test detected differences in VSM function among NC subjects and subjects with MCI and mild dementia. The

  4. Dementia

    Science.gov (United States)

    ... aging. Many different diseases can cause dementia, including Alzheimer's disease and stroke. Drugs are available to treat some of these diseases. While these drugs cannot cure dementia or repair brain damage, they may improve ...

  5. Dementia

    Science.gov (United States)

    ... continue to look for new genes that may be responsible for the development of Alzheimer’s disease and other forms of dementia. Several research projects hope to identify dementia biomarkers (measurable biological signs ...

  6. SU-E-P-55: The Reaserch of Cervical Cancer Delivered with Constant Dose Rate and Gantry Speed Arc Therapy(CDR-CAS-IMAT) On Conventional Linac

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, R; Bai, W; Chi, Z; Gao, C; Xiaomei, F [The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei (China); Gao, Y [Hebei General Hospital, Shijiazhuang, Hebei (China)

    2015-06-15

    Purpose: Postoperative cervical cancer patients with large target volume and the target shape is concave, treatmented with static intensity-modulated radiotherapy (IMRT) is time consuming. The purpose of this study is to investigate using constant dose rate and gantry speed arc therapy(CDR-CAS-IMAT) on conventional linear accelrator, by comparing with the IMRT technology to evaluate the performance of CDR-CAS-IMAT on postoperative cervical cancer patients. Methods: 18 cervical cancer patients treated with IMRT on Varian 23IX were replanted using CDR-CAS-IMAT. The plans were generated on Oncentra v4.1 planning system, PTV was prescribed to 50.4 Gy in 28 fractions. Plans were evaluated based on the ability to meet the dose volume histogram. The homogeneity index (HI), conformity index (CI) of target volume, the dose of organs at risk, radiation delivery time and monitor units were also compared. SPSS 19.0 software paired T-test analysis was carried out on the two sets of data. Results: Compared with the IMRT plans PTV’s CI (t= 3.85, P =0.001), CTV’s CI, HI, D90, D95, D98, V95, V98, V100 (t=4.21, −3.18, 2.13, 4.65, 7.79, 2.29, 6.00, 2.13, p=0.001, 0.005, 0.049, 0.000, 0.000, 0.035, 0.000, 0.049), and cord D2 and rectum V40 (t=−2.65, −2.47, p= P =0.017, 0.025), and treatment time and MU (t=−36.0, −6.26, P =0.000, 0.000) were better than that of IMRT group. But the IMRT plans in terms of decreasing bladder V50, bowel V30 (t=2.14, 3.00, P =0.048, 0.008) and low dose irradiation volume were superior to that of CDR-CAS-IMAT plans. There were no significant differences in other statistical index. Conclusion: Cervical cancer patients with CDR-CAS-IMAT on Varian Clinical 23IX can get equivalent or superior dose distribution compared with the IMRT technology. IMAT have much less treatment time and MU can reduce the uncertainty factor and patient discomfort in treatment. This work was supported by the Medical Science Foundation of the health department of Hebei

  7. The Development of the circadian heart rate rhytm (CDR) in Asian infants

    OpenAIRE

    Stanislaus Sandarupa, Drs., M.A., Ph.D.

    2011-01-01

    Although the human fetus can follow the maternal circadian thythm, the enterained expression of the circadian clock, based in the suprachiasmatic nucleus (SCN) of the hypothalamus awaits postnatal maturation of the retinal hypothalamic tract, and melatonin neurotransmission. Objective: To test the hypothesis that term-born Asian Infants, at reduced risk to die of Sudden Infant Death Syndrome (SIDS) exhibit a circadian heat rate thythm (CHR) at a later age than non-Asian term infants.

  8. Association between dentures and the rate of falls in dementia

    Directory of Open Access Journals (Sweden)

    Eshkoor SA

    2014-06-01

    Full Text Available Sima Ataollahi Eshkoor,1 Tengku Aizan Hamid,1 Siti Sa'adiah Hassan Nudin,2 Chan Yoke Mun11Institute of Gerontology, Universiti Putra Malaysia, Serdang, 2Institute for Behavioral Research, Kuala Lumpur, MalaysiaBackground: Poor oral health, chronic diseases, functional decline, and low cognitive ability can increase the risk of falls in the elderly.Objectives: The current study aimed to show the effects of oral health, diabetes mellitus (DM, hypertension (HT, heart disease, functional status, and sociodemographic factors on the risk of falls in elderly with dementia.Materials and methods: The sample comprised 1,210 Malaysian elderly who were demented and noninstitutionalized. This study was a national cross-sectional survey entitled “Determinants of Health Status among Older Malaysians”. The effects of age, ethnicity, sex differences, marital status, educational level, oral health, DM, HT, heart disease, and functional status on the risk of falls were evaluated. The multiple logistic regression model was used to estimate the effects of contributing variables on the risk of falls in samples.Results: The prevalence of falls was approximately 17% in subjects. It was found that age (odds ratio [OR] 1.02, non-Malay ethnicity (OR 1.66, heart disease (OR 1.92, and functional decline (OR 1.58 significantly increased the risk of falls in respondents (P<0.05. Furthermore, having teeth (OR 0.59 and dentures (OR 0.66 significantly decreased the rate of falls (P<0.05.Conclusion: It was concluded that age, non-Malay ethnicity, functional decline, heart disease, and oral health significantly affected falls in dementia.Keywords: chronic diseases, dementia, fall, functional decline, oral health

  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. Patients With Very Mild Dementia May Confuse Objective Cognitive Impairments With Subjective Physical Health of Quality of Life: The Tome City Project in Japan.

    Science.gov (United States)

    Kasai, Mari; Meguro, Kenichi

    2018-01-01

    Many elderly people with cognitive dysfunction may observe a decrease in their health levels and quality of life (QOL). The basic concept of QOL consists of several categories including physical functions and mental health. The QOL domain that is most important for elderly people is physical health and, to a lesser extent, psychological health, social relationships, and/ or the environment. Our aim was to explore the relationships between the subjective measure of QOL, an abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF) scale, and the objective measure of impairment, Clinical Dementia Rating (CDR), among elderly people in a community. Totally, 178 community dwellers aged 75 years and above agreed to participate and completed the WHOQOL-BREF; 66 (32 males, 34 females) scored a CDR of 0 (healthy), 86 (33, 53) scored a CDR of 0.5 (questionable dementia or very mild dementia), and 26 (12, 14) scored a CDR of 1 and above (dementia). According to Pearson's correlation coefficient analysis (significance level, p < 0.05), the physical domain of the WHOQOL-BREF had significant statistical negative correlations with all CDR subscales. The CDR subscale of memory impairment had a significant statistical negative correlation with the WHOQOL-BREF subscales of the physical ( r = -0.151, p = 0.044) and psychological ( r = -0.232, p < 0.002) domains. The CDR subscale of home and hobbies impairment had significant statistical negative correlations with all WHOQOL-BREF subscales including the physical ( r = -0.226, p = 0.002), psychological ( r = -0.226, p = 0.002), social ( r = -0.167, p = 0.026), and environmental ( r = -0.204, p = 0.006) domains. Patients with very mild dementia may confuse cognitive impairment and physical disabilities. In the future, we need to systematically combine memory clinics and all departments related to the elderly for the successful early detection and rehabilitation of, and long-term care for, dementia.

  11. How Do Scores on the ADAS-Cog, MMSE, and CDR-SOB Correspond?

    Science.gov (United States)

    Balsis, Steve; Benge, Jared F; Lowe, Deborah A; Geraci, Lisa; Doody, Rachelle S

    2015-01-01

    Clinicians and researchers who measure cognitive dysfunction often use the Alzheimer's Disease Assessment Scale--Cognitive Subscale (ADAS-Cog), the Mini-Mental State Examination (MMSE), or the Clinical Dementia Rating scale (CDR-SOB). But, the use of different measures can make it difficult to compare data across patients or studies. What is needed is a simple chart that shows how scores on these three important measures correspond to each other. Using data from 1709 participants from the Alzheimer's Disease Neuroimaging Initiative and item response theory-based statistics, we analyzed how scores on each measure, the ADAS-Cog, the MMSE, and the CDR-SOB, correspond. Results indicated multiple inflections in CDR-SOB and ADAS-Cog scores within a given MMSE score, suggesting that the CDR-SOB and ADAS-Cog are more precise in measuring the severity of cognitive dysfunction than the MMSE. This study shows how scores on these three popular measures of cognitive dysfunction correspond to each other, which is very useful information for both researchers and clinicians.

  12. Dementia

    Science.gov (United States)

    ... Poor judgment and loss of ability to recognize danger Using the wrong word, not pronouncing words correctly, ... disease and other dementias. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: ...

  13. Dementia.

    Science.gov (United States)

    Nardone, Raffaele; Golaszewski, Stefan; Trinka, Eugen

    2013-01-01

    Transcranial magnetic stimulation (TMS) has been used extensively to characterize motor system pathophysiology in Alzheimer's disease (AD) and other forms of dementia, as well to monitor the effects of certain pharmacological agents. Among the studies focusing on motor cortical excitability measures, the most consistent finding is a significant reduction of short-latency afferent inhibition (SAI) in AD and other forms of dementia in which the cholinergic system is affected, such as dementia with Lewy bodies. SAI evaluation may thus provide a reliable biomarker of cortical cholinergic dysfunction in dementias. Moreover, most TMS studies have demonstrated cortical hyperexcitability and asymptomatic motor cortex functional reorganization in the early stages of the disease. Integrated approaches utilizing TMS together with high-density EEG have indicated impaired cortical plasticity and functional connectivity across different neural networks in AD. Paired associative stimulation-induced plasticity has also been found to be abnormal in patients with AD. The development of novel noninvasive methods of brain stimulation, in particular repetitive TMS (rTMS) and transcranial direct current stimulation (tDCS), has increased the interest in neuromodulatory techniques as potential therapeutic tools for cognitive rehabilitation in AD. Preliminary studies have revealed that rTMS and tDCS can induce beneficial effects on specific cognitive functions in AD. Future studies are warranted to replicate and extend the initial findings. © 2013 Elsevier B.V. All rights reserved.

  14. Dementia.

    Science.gov (United States)

    Butler, Rob; Radhakrishnan, Raghavakurup

    2012-09-10

    Dementia is characterised by chronic, global, non-reversible deterioration in memory, executive function, and personality. Speech and motor function may also be impaired. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments on cognitive symptoms of dementia (Alzheimer's, Lewy body, or vascular)? What are the effects of treatments on behavioural and psychological symptoms of dementia (Alzheimer's, Lewy body, or vascular)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 49 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review, we present information relating to the effectiveness and safety of the following interventions: acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine), antidepressants (clomipramine, fluoxetine, imipramine, sertraline), antipsychotics (haloperidol, olanzapine, quetiapine, risperidone), aromatherapy, benzodiazepines (diazepam, lorazepam), cognitive behavioural therapy (CBT), cognitive stimulation, exercise, ginkgo biloba, memantine, mood stabilisers (carbamazepine, sodium valproate/valproic acid), music therapy, non-steroidal anti-inflammatory drugs (NSAIDs), omega 3 (fish oil), reminiscence therapy, and statins.

  15. Dementia Rating Scale psychometric study and its applicability in long term care institutions in Brazil

    OpenAIRE

    Alessandro Ferrari Jacinto; Ana Cristina Procópio de Oliveira Aguiar; Fabio Gazelato de Melo Franco; Miriam Ikeda Ribeiro; Vanessa de Albuquerque Citero

    2012-01-01

    Objective: To evaluate the diagnostic sensitivity, specificity, andagreement of the Dementia Rating Scale with clinical diagnosis ofcognitive impairment and to compare its psychometric measureswith those from Mini Mental State Examination. Methods: Eighty-sixelders from a long-term care institution were invited to participatein a study, and fifty-eight agreed to participate. The global healthassessment protocol applied to these elders contained Mini MentalState Examination and Dementia Rating...

  16. Validity, reliability, and feasibility of clinical staging scales in dementia: a systematic review

    DEFF Research Database (Denmark)

    Rikkert, Marcel G M Olde; Tona, Klodiana Daphne; Janssen, Lieneke

    2011-01-01

    New staging systems of dementia require adaptation of disease management programs and adequate staging instruments. Therefore, we systematically reviewed the literature on validity and reliability of clinically applicable, multidomain, and dementia staging instruments. A total of 23 articles...... describing 12 staging instruments were identified (N = 6109 participants, age 65-87). Reliability was studied in most (91%) of the articles and was judged moderate to good. Approximately 78% of the articles evaluated concurrent validity, which was good to very good, while discriminant validity was assessed...... in only 25%. The scales can be applied in ±15 minutes. Clinical Dementia Rating (CDR), Global Deterioration scale (GDS), and Functional Assessment Staging (FAST) have been monitored on reliability and validity, and the CDR currently is the best-evidenced scale, also studied in international perspective...

  17. Comparative validation of proxy-based montgomery-asberg depression rating scale and cornell scale for depression in dementia in nursing home residents with dementia

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Vernooij-Dassen, M.F.J.; Smalbrugge, M.; Koopmans, R.T.C.M.

    2012-01-01

    Objective: To 1) compare the accuracy of the Montgomery-̊Asberg Depression Rating Scale (MADRS) and the Cornell Scale for Depression in Dementia (CSDD) in nursing home residents with dementia when professional caregivers are the only available source of information and 2) explore different methods

  18. Self-rated versus Caregiver-rated Health for Patients with Mild Dementia as Predictors of Patient Mortality

    DEFF Research Database (Denmark)

    Phung, Thien Kieu Thi; Siersma, Volkert; Vogel, Asmus

    2018-01-01

    OBJECTIVE: Self-assessment of health is a strong and independent predictor of mortality for cognitively intact people. Because the ability of patients with dementia to rate their own health is questionable, caregiver-rated health for patients may serve as a proxy. The authors aimed to validate...... and compare self- and caregiver-rated health for patients with dementia as independent predictors of patient mortality. METHODS: This was a post-hoc analysis of data from The Danish Alzheimer's Disease Intervention Study, a randomized controlled trial of psychosocial intervention for 330 patients with mild...... dementia and their caregivers with a 36-month follow-up. Patients and caregivers rated patients' health on the Euro Quality of Life Visual Analog Scale (EQ-VAS) from 0 (worst) to 100 (best). The ability of self- and caregiver-rated health for the patient to predict patient mortality was analyzed as hazard...

  19. Trajectories of depressive symptoms and their relationship to the progression of dementia.

    Science.gov (United States)

    Barca, Maria Lage; Persson, Karin; Eldholm, Rannveig; Benth, Jūratė Šaltytė; Kersten, Hege; Knapskog, Anne-Brita; Saltvedt, Ingvild; Selbaek, Geir; Engedal, Knut

    2017-11-01

    The relationship between progression of Alzheimer's disease and depression and its underlying mechanisms has scarcely been studied. A sample of 282 outpatients with Alzheimer's disease (AD; 105 with amnestic AD and 177 with Alzheimer's dementia) from Norway were followed up for an average of two years. Assessment included Cornell Scale for Depression in Dementia and Clinical Dementia Rating Scale (CDR) at baseline and follow-up to examine the relationship between AD and depression. Additionally, MRI of the brain, CSF dementia biomarkers and APOE status were assessed at baseline. Progression of dementia was defined as the difference between CDR sum of boxes at follow-up and baseline (CDR-SB change). Trajectories of depressive symptoms on the Cornell Scale were identified using growth mixture modeling. Differences between the trajectories in regard to patients' characteristics were investigated. Three distinct trajectories of depressive symptoms were identified: 231 (82.8%) of the patients had stable low-average scores on the Cornell Scale (Class 1); 11 (3.9%) had high and decreasing scores (Class 2); and 37 (13.3%) had moderate and increasing scores (Class 3). All classes had average probabilities over 80%, and confidence intervals were non-overlapping. The only significant characteristic associated with membership in class 3 was CDR-SB change. Not all patients screened for participation were included in the study, but the included and non-included patients did not differ significantly. Some patients with amnestic MCI might have been misdiagnosed. A more rapid progression of dementia was found in a group of patients with increasing depressive symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Analysis of brief language tests in the detection of cognitive decline and dementia

    Directory of Open Access Journals (Sweden)

    Marcia Radanovic

    Full Text Available Abstract Lexical access difficulties are frequent in normal aging and initial stages of dementia. Verbal fluency tests are valuable to detect cognitive decline, evidencing lexico-semantic and executive dysfunction. Objectives: To establish which language tests can contribute in detecting dementia and to verify schooling influence on subject performance. Method: 74 subjects: 33 controls, 17 Clinical Dementia Rating (CDR 0.5 and 24 (Brief Cognitive Battery - BCB e Boston Naming Test - BNT 1 were compared in tests of semantic verbal fluency (animal and fruit, picture naming (BCB and BNT and the language items of Mini Mental State Examination (MMSE. Results: There were significant differences between the control group and both CDR 0.5 and CDR 1 in all tests. Cut-off scores were: 11 and 10 for animal fluency, 8 for fruit fluency (in both, 8 and 9 for BCB naming. The CDR 0.5 group performed better than the CDR 1 group only in animal fluency. Stepwise multiple regression revealed fruit fluency, animal fluency and BCB naming as the best discriminators between patients and controls (specificity: 93.8%; sensitivity: 91.3%. In controls, comparison between illiterates and literates evidenced schooling influence in all tests, except for fruit fluency and BCB naming. In patients with dementia, only fruit fluency was uninfluenced by schooling. Conclusion: The combination of verbal fluency tests in two semantic categories along with a simple picture naming test is highly sensitive in detecting cognitive decline. Comparison between literate and illiterate subjects shows a lesser degree of influence of schooling on the selected tests, thus improving discrimination between low performance and incipient cognitive decline.

  1. Dementia correlates with anticoagulation underuse in older patients with atrial fibrillation.

    Science.gov (United States)

    Viscogliosi, Giovanni; Ettorre, Evaristo; Chiriac, Iulia Maria

    2017-09-01

    Stroke prevention in older atrial fibrillation (AF) patients remains a challenge. This study aimed to investigate whether a dementia diagnosis is an independent correlate of lower prescription rate of oral anticoagulant treatment (OAT) in a sample of older AF patients. Cross-sectional retrospective study. Consecutive older community-dwelling AF patients referred for a comprehensive geriatric assessment, were considered. Evaluation of physical, social and mental health, and administration of the Cumulative Illness Rating Scale (CIRS) and Barthel Index were performed. Dementia cases were ascertained by consensus of 2 experienced geriatricians. Dementia severity was assessed using the Clinical Dementia Rating scale (CDR). 316 AF patients (ages 74.7±7.0years, 55.7% women) with high stroke risk (77.5% had a CHA 2 DS 2 VASC score ≥3), low bleeding and falling risk, and no neuropsychiatric/behavioral symptoms, were included. 60.1% were prescribed with OAT. Among patients with dementia (n=86, 27.2%), 22.0% received inadequate antithrombotic prophylaxis (i.e. antiplatelet) and 38.5% no treatment. Proportion of those receiving inadequate or no prophylaxis increased at increasing CDR score. By multiple regression models, either dementia (yes vs no), OR=1.33, 95%CI=1.11-1.46, pdementia severity (CDR>1), OR=2.38, 95%CI=2.19-2.60, pDementia might be associated with underuse of OAT in older AF patients even in the absence of established contraindications. Future studies are needed to assess the real dimension of the problem and clinician's barriers to prescribing OAT in demented patients. Copyright © 2017. Published by Elsevier B.V.

  2. Kanji and Kana agraphia in mild cognitive impairment and dementia: A trans-cultural comparison of elderly Japanese subjects living in Japan and Brazil

    Directory of Open Access Journals (Sweden)

    Kyoko Akanuma

    Full Text Available Abstract This study verifies the environmental effects on agraphia in mild cognitive impairment and dementia. We compared elderly Japanese subjects living in Japan and Brazil. Methods: We retrospectively analyzed the database of the Prevalence Study 1998 in Tajiri (n=497, Miyagi, Japan and the Prevalence Study 1997 of elderly Japanese immigrants living in Brazil (n=166, migrated from Japan and living in the São Paulo Metropolitan Area. In three Clinical Dementia Rating (CDR groups, i.e., CDR 0 (healthy, CDR 0.5 (questionable dementia, and CDR 1+ (dementia , the Mini-Mental State Examination (MMSE item of spontaneous writing and the Cognitive Abilities Screening Instrument (CASI domain of dictation were analyzed with regard to the number of Kanji and Kana characters. Formal errors in characters and pragmatic errors were also analyzed. Results: The immigrants in Brazil wrote similar numbers of Kanji or Kana characters compared to the residents of Japan. In spontaneous writing, the formal Kanji errors were greater in the CDR 1+ group of immigrants. In writing from dictation, all the immigrant CDR groups made more formal errors in Kana than the Japan residents. No significant differences in pragmatic errors were detected between the two groups. Conclusions: Subjects living in Japan use Kanji frequently, and thus the form of written characters was simplified, which might be assessed as mild formal errors. In immigrants, the deterioration in Kanji and Kana writing was partly due to decreased daily usage of the characters. Lower levels of education of immigrants might also be related to the number of Kanji errors.

  3. Antipsychotic drug prescription rates among Dutch nursing homes : the influence of patient characteristics and the dementia special care unit

    NARCIS (Netherlands)

    van der Putten, M. J. G.; Wetzels, R. B.; Bor, H.; Zuidema, S. U.; Koopmans, R. T. C. M.

    2014-01-01

    Objectives: To assess the differences in antipsychotic drug prescription rates in residents with dementia in dementia special care units (SCUs) of Dutch nursing homes, considering the differences in patient characteristics. Method: As part of the Waalbed-II study, the data on antipsychotic drug use

  4. Patients With Very Mild Dementia May Confuse Objective Cognitive Impairments With Subjective Physical Health of Quality of Life: The Tome City Project in Japan

    Directory of Open Access Journals (Sweden)

    Mari Kasai

    2018-04-01

    Full Text Available Many elderly people with cognitive dysfunction may observe a decrease in their health levels and quality of life (QOL. The basic concept of QOL consists of several categories including physical functions and mental health. The QOL domain that is most important for elderly people is physical health and, to a lesser extent, psychological health, social relationships, and/ or the environment. Our aim was to explore the relationships between the subjective measure of QOL, an abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF scale, and the objective measure of impairment, Clinical Dementia Rating (CDR, among elderly people in a community. Totally, 178 community dwellers aged 75 years and above agreed to participate and completed the WHOQOL-BREF; 66 (32 males, 34 females scored a CDR of 0 (healthy, 86 (33, 53 scored a CDR of 0.5 (questionable dementia or very mild dementia, and 26 (12, 14 scored a CDR of 1 and above (dementia. According to Pearson’s correlation coefficient analysis (significance level, p < 0.05, the physical domain of the WHOQOL-BREF had significant statistical negative correlations with all CDR subscales. The CDR subscale of memory impairment had a significant statistical negative correlation with the WHOQOL-BREF subscales of the physical (r = -0.151, p = 0.044 and psychological (r = -0.232, p < 0.002 domains. The CDR subscale of home and hobbies impairment had significant statistical negative correlations with all WHOQOL-BREF subscales including the physical (r = -0.226, p = 0.002, psychological (r = -0.226, p = 0.002, social (r = -0.167, p = 0.026, and environmental (r = -0.204, p = 0.006 domains. Patients with very mild dementia may confuse cognitive impairment and physical disabilities. In the future, we need to systematically combine memory clinics and all departments related to the elderly for the successful early detection and rehabilitation of, and long-term care for, dementia.

  5. Patients With Very Mild Dementia May Confuse Objective Cognitive Impairments With Subjective Physical Health of Quality of Life: The Tome City Project in Japan

    Science.gov (United States)

    Kasai, Mari; Meguro, Kenichi

    2018-01-01

    Many elderly people with cognitive dysfunction may observe a decrease in their health levels and quality of life (QOL). The basic concept of QOL consists of several categories including physical functions and mental health. The QOL domain that is most important for elderly people is physical health and, to a lesser extent, psychological health, social relationships, and/ or the environment. Our aim was to explore the relationships between the subjective measure of QOL, an abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF) scale, and the objective measure of impairment, Clinical Dementia Rating (CDR), among elderly people in a community. Totally, 178 community dwellers aged 75 years and above agreed to participate and completed the WHOQOL-BREF; 66 (32 males, 34 females) scored a CDR of 0 (healthy), 86 (33, 53) scored a CDR of 0.5 (questionable dementia or very mild dementia), and 26 (12, 14) scored a CDR of 1 and above (dementia). According to Pearson’s correlation coefficient analysis (significance level, p hobbies impairment had significant statistical negative correlations with all WHOQOL-BREF subscales including the physical (r = -0.226, p = 0.002), psychological (r = -0.226, p = 0.002), social (r = -0.167, p = 0.026), and environmental (r = -0.204, p = 0.006) domains. Patients with very mild dementia may confuse cognitive impairment and physical disabilities. In the future, we need to systematically combine memory clinics and all departments related to the elderly for the successful early detection and rehabilitation of, and long-term care for, dementia. PMID:29706921

  6. Reliability and validity of the international dementia alliance schedule for the assessment and staging of care in China.

    Science.gov (United States)

    Wang, Xiao; Sun, Zhenghai; Xiong, Lingchuan; Semrau, Maya; He, Jianhua; Li, Yang; Zhu, Jianzhong; Zhang, Nan; Wang, Aimin; Jiang, Qinpu; Mu, Nan; Zhao, Yuping; Chen, Wei; Wu, Donghui; Zheng, Zhanjie; Sun, Yongan; Zhang, Jing; Xu, Jun; Meng, Xue; Zhao, Mei; Zhang, Haifeng; Lv, Xiaozhen; Sartorius, Norman; Li, Tao; Yu, Xin; Wang, Huali

    2017-11-21

    Clinical and social services both are important for dementia care. The International Dementia Alliance (IDEAL) Schedule for the Assessment and Staging of Care was developed to guide clinical and social care for dementia. Our study aimed to assess the validity and reliability of the IDEAL schedule in China. Two hundred eighty-two dementia patients and their caregivers were recruited from 15 hospitals in China. Each patient-caregiver dyad was assessed with the IDEAL schedule by a rater and an observer simultaneously. The Clinical Dementia Rating (CDR), Mini-Mental Status Examination (MMSE), and Caregiver Burden Inventory (CBI) were assessed for criterion validity. IDEAL repeated assessment was conducted 7-10 days after the initial interview for 62 dyads. Two hundred seventy-seven patient-caregiver dyads completed the IDEAL assessment. Inter-rater reliability for the total score of the IDEAL schedule was 0.93 (95%CI = 0.92-0.95). The inter-class coefficient for the total score of IDEAL was 0.95 for the interviewers and 0.93 for the silent raters. The IDEAL total score correlated with the global CDR score (ρ = 0.72, p valid and reliable tool for the staging of care for dementia in the Chinese population.

  7. Semantic Verbal Fluency test in dementia: Preliminary retrospective analysis

    Directory of Open Access Journals (Sweden)

    Marcos Lopes

    Full Text Available Abstract The Semantic Verbal Fluency (SVF test entails the generation of words from a given category within a pre-set time of 60 seconds. Objectives: To verify whether socio-demographic and clinical data of individuals with dementia correlate with the performance on the SVF test and to ascertain whether differences among the criteria of number of answers, clusters and data spread over the intervals, predict clinical results. Methods: This was a retrospective study of 49 charts of demented patients classified according to the Clinical Dementia Rating (CDR scale. We correlated education, age and gender, as well as CDR and Mini-Mental State Exam (MMSE scores with the number of answers, clustering and switching distributed over four 15-second intervals on the SVF test. Results: The correlation between number of answers and quartiles was weak (r=0.407, p=0.004; r=0.484, p<0.001 but correlation between the number of clusters and responses was strong (r=0.883, p<0.001. The number of items on the SVF was statistically significant with MMSE score (p=0.01 and there was a tendency for significance on the CDR (p=0.06. The results indicated little activity regarding what we propose to call cluster recalling in the two groups. Discussion: The SVF test, using number of items generated, was found to be more effective than classic screening tests in terms of speed and ease of application in patients with CDR 2 and 3.

  8. Dissociation in Rating Negative Facial Emotions between Behavioral Variant Frontotemporal Dementia and Major Depressive Disorder.

    Science.gov (United States)

    Chiu, Isabelle; Piguet, Olivier; Diehl-Schmid, Janine; Riedl, Lina; Beck, Johannes; Leyhe, Thomas; Holsboer-Trachsler, Edith; Berres, Manfred; Monsch, Andreas U; Sollberger, Marc

    2016-11-01

    Features of behavioral variant frontotemporal dementia (bvFTD) such as executive dysfunction, apathy, and impaired empathic abilities are also observed in major depressive disorder (MDD). This may contribute to the reason why early stage bvFTD is often misdiagnosed as MDD. New assessment tools are thus needed to improve early diagnosis of bvFTD. Although emotion processing is affected in bvFTD and MDD, growing evidence indicates that the pattern of emotion processing deficits varies between the two disorders. As such, emotion processing paradigms have substantial potentials to distinguish bvFTD from MDD. The current study compared 25 patients with bvFTD, 21 patients with MDD, 21 patients with Alzheimer disease (AD) dementia, and 31 healthy participants on a novel facial emotion intensity rating task. Stimuli comprised morphed faces from the Ekman and Friesen stimulus set containing faces of each sex with two different degrees of emotion intensity for each of the six basic emotions. Analyses of covariance uncovered a significant dissociation between bvFTD and MDD patients in rating the intensity of negative emotions overall (i.e., bvFTD patients underrated negative emotions overall, whereas MDD patients overrated negative emotions overall compared with healthy participants). In contrast, AD dementia patients rated negative emotions similarly to healthy participants, suggesting no impact of cognitive deficits on rating facial emotions. By strongly differentiating bvFTD and MDDpatients through negative facial emotions, this sensitive and short rating task might help improve the early diagnosis of bvFTD. Copyright © 2016 American Association for Geriatric Psychiatry. All rights reserved.

  9. Development and validation of the Pictorial Cognitive Screening Inventory for illiterate people with dementia

    Directory of Open Access Journals (Sweden)

    Park S

    2014-09-01

    Full Text Available Soowon Park,1,* Se-Eun Park,1,* Min-Ji Kim,2 Hee-Yeon Jung,1,2 Jung-Seok Choi,1,2 Kee-Hwan Park,3 Inhye Kim,1 Jun-Young Lee1,2 1Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea; 2Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea; 3Department of Psychology, The Catholic University of Korea, Bucheon, Republic of Korea *These authors contributed equally to this work Purpose: The purpose of this study was to develop and validate a tool called the Pictorial Cognitive Screening Inventory (PCSI, which consists of pictorial memory and attention tests that are not influenced by literacy level.Patients and methods: PCSI, Mini Mental State Examination (MMSE, and Clinical Dementia Rating (CDR questionnaires were administered to 80 elderly participants (20 illiterate normal, 20 illiterate with dementia, 20 literate normal, and 20 literate with dementia.Results: PCSI scores were highly correlated with those of the MMSE (r 0.51 and the CDR (r -0.71. In addition, the PCSI scores differed significantly between the normal group and the dementia group (mean difference 1.71, standard error [SE] 0.14, P<0.001, while no such difference was observed between the illiterate group and the literate group (mean difference 0.00, SE 0.24, P=0.997. Diagnostic validity of the PCSI is excellent, with a sensitivity of 90% and a specificity of 98% for screening dementia, whereas the MMSE has a sensitivity of 85% and a specificity of 60%.Conclusion: These results indicate that the PCSI is a sensitive and reliable test for screening dementia, regardless of an individual’s literacy skills. The PCSI meets the increasing needs for screening of dementia in illiterate elderly populations in developing countries. Keywords: screening, dementia, literacy, cognition 

  10. Principal component analysis of the Norwegian version of the quality of life in late-stage dementia scale.

    Science.gov (United States)

    Mjørud, Marit; Kirkevold, Marit; Røsvik, Janne; Engedal, Knut

    2014-01-01

    To investigate which factors the Quality of Life in Late-Stage Dementia (QUALID) scale holds when used among people with dementia (pwd) in nursing homes and to find out how the symptom load varies across the different severity levels of dementia. We included 661 pwd [mean age ± SD, 85.3 ± 8.6 years; 71.4% women]. The QUALID and the Clinical Dementia Rating (CDR) scale were applied. A principal component analysis (PCA) with varimax rotation and Kaiser normalization was applied to test the factor structure. Nonparametric analyses were applied to examine differences of symptom load across the three CDR groups. The mean QUALID score was 21.5 (±7.1), and the CDR scores of the three groups were 1 in 22.5%, 2 in 33.6% and 3 in 43.9%. The results of the statistical measures employed were the following: Crohnbach's α of QUALID, 0.74; Bartlett's test of sphericity, p Kaiser-Meyer-Olkin measure, 0.77. The PCA analysis resulted in three components accounting for 53% of the variance. The first component was 'tension' ('facial expression of discomfort', 'appears physically uncomfortable', 'verbalization suggests discomfort', 'being irritable and aggressive', 'appears calm', Crohnbach's α = 0.69), the second was 'well-being' ('smiles', 'enjoys eating', 'enjoys touching/being touched', 'enjoys social interaction', Crohnbach's α = 0.62) and the third was 'sadness' ('appears sad', 'cries', 'facial expression of discomfort', Crohnbach's α 0.65). The mean score on the components 'tension' and 'well-being' increased significantly with increasing severity levels of dementia. Three components of quality of life (qol) were identified. Qol decreased with increasing severity of dementia. © 2013 S. Karger AG, Basel.

  11. Putative Dementia Cases Fluctuate as a Function of Mini-Mental State Examination Cut-Off Points.

    Science.gov (United States)

    Rosa, Ilka M; Henriques, Ana G; Wiltfang, Jens; da Cruz E Silva, Odete A B

    2018-01-01

    As the population ages, there is a growing need to quickly and accurately identify putative dementia cases. Many cognitive tests are available; among those commonly used are the Cognitive Dementia Rating (CDR) and the Mini-Mental Status Examination (MMSE). The aim of this work was to compare the validity and reliability of these cognitive tests in a primary care based cohort (pcb-Cohort). The MMSE and the CDR were applied to 568 volunteers in the pcb-Cohort. Distinct cut-off points for the MMSE were considered, namely MMSE 27, MMSE 24, and MMSE PT (adapted for the Portuguese population). The MMSE 27 identified the greatest number of putative dementia cases, and, as determined by the ROC curve, it was the most sensitive and specific of the MMSE cut-offs considered. Putative predictive or risk factors identified included age, literacy, depression, and diabetes mellitus (DM). DM has previously been indicated as a risk factor for dementia and Alzheimer's disease. Comparatively, the MMSE 27 cut-off has the greatest sensibility (94.9%) and specificity (66.3%) when compared to MMSE PT and MMSE 24. Upon comparing MMSE and CDR scores, the latter identified a further 146 putative dementia cases, thus permitting one to propose that in an ideal situation, both tests should be employed. This increases the likelihood of identifying putative dementia cases for subsequent follow up work, thus these cognitive tests represent important tools in patient care. Further, this is a significant study for Portuguese populations, where few of these studies have been carried out.

  12. The development of a self-administered dementia checklist: the examination of concurrent validity and discriminant validity.

    Science.gov (United States)

    Miyamae, Fumiko; Ura, Chiaki; Sakuma, Naoko; Niikawa, Hirotoshi; Inagaki, Hiroki; Ijuin, Mutsuo; Okamura, Tsuyoshi; Sugiyama, Mika; Awata, Shuichi

    2016-01-01

    The present study aims to develop a self-administered dementia checklist to enable community-residing older adults to realize their declining functions and start using necessary services. A previous study confirmed the factorial validity and internal reliability of the checklist. The present study examined its concurrent validity and discriminant validity. The authors conducted a 3-step study (a self-administered survey including the checklist, interviews by nurses, and interviews by doctors and psychologists) of 7,682 community-residing individuals who were over 65 years of age. The authors calculated Spearman's correlation coefficients between the scores of the checklist and the results of a psychological test to examine the concurrent validity. They also compared the average total scores of the checklist between groups with different Clinical Dementia Rating (CDR) scores to examine discriminant validity and conducted a receiver operating characteristic analysis to examine the discriminative power for dementia. The authors analyzed the data of 131 respondents who completed all 3 steps. The checklist scores were significantly correlated with the respondents' Mini-Mental State Examination and Frontal Assessment Battery scores. The checklist also significantly discriminated the patients with dementia (CDR = 1+) from those without dementia (CDR = 0 or 0.5). The optimal cut-off point for the two groups was 17/18 (sensitivity, 72.0%; specificity, 69.2%; positive predictive value, 69.2%; negative predictive value, 72.0%). This study confirmed the concurrent validity and discriminant validity of the self-administered dementia checklist. However, due to its insufficient discriminative power as a screening tool for older people with declining cognitive functions, the checklist is only recommended as an educational and public awareness tool.

  13. The impact of MRI combined with visual rating scales on the clinical diagnosis of dementia: a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Verhagen, Martijn V.; Guit, Gerard L. [Spaarne Gasthuis, Department of Radiology, Haarlem (Netherlands); Hafkamp, Gerrit Jan; Kalisvaart, Kees [Spaarne Gasthuis, Department of Geriatrics, Haarlem (Netherlands)

    2016-06-15

    Dementia is foremost a clinical diagnosis. However, in diagnosing dementia, it is advocated to perform at least one neuroimaging study. This has two purposes: to rule out potential reversible dementia (PRD), and to help determine the dementia subtype. Our first goal was to establish if MRI combined with visual rating scales changes the clinical diagnosis. The second goal was to demonstrate if MRI contributes to a geriatrician's confidence in the diagnosis. The dementia subtype was determined prior to and after MRI. Scoring scales used were: global cortical atrophy (GCA), medial temporal atrophy (MTA), and white matter hyperintensity measured according to the Fazekas scale. The confidence level of the geriatrician was determined using a visual analogue scale. One hundred and thirty-five patients were included. After MRI, the diagnosis changed in 23.7 % (CI 17.0 %-31.1 %) of patients. Change was due to vascular aetiology in 13.3 % of patients. PRD was found in 2.2 % of all patients. The confidence level in the diagnosis increased significantly after MRI (p = 0.001). MRI, combined with visual rating scales, has a significant impact on dementia subtype diagnosis and on a geriatrician's confidence in the final diagnosis. (orig.)

  14. The impact of MRI combined with visual rating scales on the clinical diagnosis of dementia: a prospective study

    International Nuclear Information System (INIS)

    Verhagen, Martijn V.; Guit, Gerard L.; Hafkamp, Gerrit Jan; Kalisvaart, Kees

    2016-01-01

    Dementia is foremost a clinical diagnosis. However, in diagnosing dementia, it is advocated to perform at least one neuroimaging study. This has two purposes: to rule out potential reversible dementia (PRD), and to help determine the dementia subtype. Our first goal was to establish if MRI combined with visual rating scales changes the clinical diagnosis. The second goal was to demonstrate if MRI contributes to a geriatrician's confidence in the diagnosis. The dementia subtype was determined prior to and after MRI. Scoring scales used were: global cortical atrophy (GCA), medial temporal atrophy (MTA), and white matter hyperintensity measured according to the Fazekas scale. The confidence level of the geriatrician was determined using a visual analogue scale. One hundred and thirty-five patients were included. After MRI, the diagnosis changed in 23.7 % (CI 17.0 %-31.1 %) of patients. Change was due to vascular aetiology in 13.3 % of patients. PRD was found in 2.2 % of all patients. The confidence level in the diagnosis increased significantly after MRI (p = 0.001). MRI, combined with visual rating scales, has a significant impact on dementia subtype diagnosis and on a geriatrician's confidence in the final diagnosis. (orig.)

  15. Delaying cognitive and physical decline through multidomain interventions for residents with mild-to-moderate dementia in dementia care units in Taiwan: A prospective cohort study.

    Science.gov (United States)

    Liang, Chih-Kuang; Chou, Ming-Yueh; Chen, Liang-Yu; Wang, Kuei-Yu; Lin, Shih-Yi; Chen, Liang-Kung; Lin, Yu-Te; Liu, Tsung-Yun; Loh, Ching-Hui

    2017-04-01

    To develop experimental multi-domain interventions for older people with mild-to-moderate dementia, and to evaluate the effect of delaying cognitive and physical decline, and improvement or prevention of geriatric syndromes during 1-year follow up. Participants aged 65 years and older with mild-to-moderate dementia (clinical dementia rating [CDR] 1 or 2) were grouped as intervention in Jia-Li Veterans Home and usual care model in the community (Memory clinic). All residents in Jia-Li Veterans Home received comprehensive intervention, including Multi-disciplinary team consultation and intervention, Multi-component non-pharmacological management, geriatric syndromes survey and intervention by CGA, and a dementia friendly medical Green channel Approach (2MCGA). The decline of cognitive and physical function are determined by the change of Mini-Mental State Examination score, CDR and the sum of CDR box, as well as activities of daily living based on the Barthel Index. We also screened geriatric syndromes at baseline and 1 year later. Participants in the intervention group were older and had a lower educational level, lower body mass index, poor baseline activities of daily living function, lower visual impairment, and higher rates of hearing impairment, polypharmacy and risk of malnutrition. The residents receiving 2MCGA had lower baseline Mini-Mental State Examination scores, and higher CDR. For residents in Jia-Li Veterans Home, all cognitive measurements except Mini-Mental State Examination were significantly associated with delaying the decline of cognition after analyzing by multiple linear regression, and multivariate logistic regression also showed that patients living in the community was independently associated with a higher odds ratio for activities of daily living decline (3.180, 95% CI 1.384-7.308, P = 0.006). There are also more improvement in their baseline geriatric syndromes and suffered less from new geriatric syndromes, including falls, urinary

  16. Quantification of microangiopathic lesions in brain parenchyma and age-adjusted mean scores for the diagnostic separation of normal from pathological values in senile dementia

    International Nuclear Information System (INIS)

    Hentschel, F.; Kreis, M.; Damian, M.; Krumm, B.; Froelich, F.

    2005-01-01

    Purpose: to quantify microangiopathic lesions in the cerebral white matter and to develop age-corrected cut-off values for separating normal from dementia-related pathological lesions. Materials and methods: in a memory clinic, 338 patients were investigated neuropsychiatrically by a psychological test battery and by MRI. Using a FLAIR sequence and a newly developed rating scale, white matter lesions (WMLs) were quantified with respect to localization, number and intensity, and these ratings were condensed into a score. The WML scores were correlated with the mini-mental state examination (MMSE) and clinical dementia rating (CDR) score in dementia patients. A non-linear smoothing procedure was used to calculate age-related mean values and confidence intervals, separate for cognitively intact subjects and dementia patients. Results: the WML scores correlated highly significantly with age in cognitively intact subjects and with psychometric scores in dementia patients. Age-adjusted WML scores of cognitively intact subjects were significantly different from those of dementia patients with respect to the whole brain as well as to the frontal lobe. Mean value and confidence intervals adjusted for age significantly separated dementia patients from cognitively intact subjects over an age range of 54 through 84 years. Conclusion: a rating scale for the quantification of WML was validated and age-adjusted mean values with their confidence intervals for a diagnostically relevant age range were developed. This allows an easy to handle, fast and reliable diagnosis of the vascular component in senile dementia. (orig.)

  17. Driving Cessation and Dementia: Results of the Prospective Registry on Dementia in Austria (PRODEM)

    Science.gov (United States)

    Seiler, Stephan; Schmidt, Helena; Lechner, Anita; Benke, Thomas; Sanin, Guenter; Ransmayr, Gerhard; Lehner, Riccarda; Dal-Bianco, Peter; Santer, Peter; Linortner, Patricia; Eggers, Christian; Haider, Bernhard; Uranues, Margarete; Marksteiner, Josef; Leblhuber, Friedrich; Kapeller, Peter; Bancher, Christian; Schmidt, Reinhold

    2012-01-01

    Objective To assess the influence of cognitive, functional and behavioral factors, co-morbidities as well as caregiver characteristics on driving cessation in dementia patients. Methods The study cohort consists of those 240 dementia cases of the ongoing prospective registry on dementia in Austria (PRODEM) who were former or current car-drivers (mean age 74.2 (±8.8) years, 39.6% females, 80.8% Alzheimer’s disease). Reasons for driving cessation were assessed with the patients’ caregivers. Standardized questionnaires were used to evaluate patient- and caregiver characteristics. Cognitive functioning was determined by Mini-Mental State Examination (MMSE), the CERAD neuropsychological test battery and Clinical Dementia Rating (CDR), activities of daily living (ADL) by the Disability Assessment for Dementia, behavior by the Neuropsychiatric Inventory (NPI) and caregiver burden by the Zarit burden scale. Results Among subjects who had ceased driving, 136 (93.8%) did so because of “Unacceptable risk” according to caregiver’s judgment. Car accidents and revocation of the driving license were responsible in 8 (5.5%) and 1(0.7%) participant, respectively. Female gender (OR 5.057; 95%CI 1.803–14.180; p = 0.002), constructional abilities (OR 0.611; 95%CI 0.445–0.839; p = 0.002) and impairment in Activities of Daily Living (OR 0.941; 95%CI 0.911–0.973; p<0.001) were the only significant and independent associates of driving cessation. In multivariate analysis none of the currently proposed screening tools for assessment of fitness to drive in elderly subjects including the MMSE and CDR were significantly associated with driving cessation. Conclusion The risk-estimate of caregivers, but not car accidents or revocation of the driving license determines if dementia patients cease driving. Female gender and increasing impairment in constructional abilities and ADL raise the probability for driving cessation. If any of these factors also relates to

  18. Driving cessation and dementia: results of the prospective registry on dementia in Austria (PRODEM.

    Directory of Open Access Journals (Sweden)

    Stephan Seiler

    Full Text Available OBJECTIVE: To assess the influence of cognitive, functional and behavioral factors, co-morbidities as well as caregiver characteristics on driving cessation in dementia patients. METHODS: The study cohort consists of those 240 dementia cases of the ongoing prospective registry on dementia in Austria (PRODEM who were former or current car-drivers (mean age 74.2 (±8.8 years, 39.6% females, 80.8% Alzheimer's disease. Reasons for driving cessation were assessed with the patients' caregivers. Standardized questionnaires were used to evaluate patient- and caregiver characteristics. Cognitive functioning was determined by Mini-Mental State Examination (MMSE, the CERAD neuropsychological test battery and Clinical Dementia Rating (CDR, activities of daily living (ADL by the Disability Assessment for Dementia, behavior by the Neuropsychiatric Inventory (NPI and caregiver burden by the Zarit burden scale. RESULTS: Among subjects who had ceased driving, 136 (93.8% did so because of "Unacceptable risk" according to caregiver's judgment. Car accidents and revocation of the driving license were responsible in 8 (5.5% and 1(0.7% participant, respectively. Female gender (OR 5.057; 95%CI 1.803-14.180; p = 0.002, constructional abilities (OR 0.611; 95%CI 0.445-0.839; p = 0.002 and impairment in Activities of Daily Living (OR 0.941; 95%CI 0.911-0.973; p<0.001 were the only significant and independent associates of driving cessation. In multivariate analysis none of the currently proposed screening tools for assessment of fitness to drive in elderly subjects including the MMSE and CDR were significantly associated with driving cessation. CONCLUSION: The risk-estimate of caregivers, but not car accidents or revocation of the driving license determines if dementia patients cease driving. Female gender and increasing impairment in constructional abilities and ADL raise the probability for driving cessation. If any of these factors also relates to undesired

  19. Reduction in Fall Rate in Dementia Managed Care Through Video Incident Review: Pilot Study.

    Science.gov (United States)

    Bayen, Eleonore; Jacquemot, Julien; Netscher, George; Agrawal, Pulkit; Tabb Noyce, Lynn; Bayen, Alexandre

    2017-10-17

    Falls of individuals with dementia are frequent, dangerous, and costly. Early detection and access to the history of a fall is crucial for efficient care and secondary prevention in cognitively impaired individuals. However, most falls remain unwitnessed events. Furthermore, understanding why and how a fall occurred is a challenge. Video capture and secure transmission of real-world falls thus stands as a promising assistive tool. The objective of this study was to analyze how continuous video monitoring and review of falls of individuals with dementia can support better quality of care. A pilot observational study (July-September 2016) was carried out in a Californian memory care facility. Falls were video-captured (24×7), thanks to 43 wall-mounted cameras (deployed in all common areas and in 10 out of 40 private bedrooms of consenting residents and families). Video review was provided to facility staff, thanks to a customized mobile device app. The outcome measures were the count of residents' falls happening in the video-covered areas, the acceptability of video recording, the analysis of video review, and video replay possibilities for care practice. Over 3 months, 16 falls were video-captured. A drop in fall rate was observed in the last month of the study. Acceptability was good. Video review enabled screening for the severity of falls and fall-related injuries. Video replay enabled identifying cognitive-behavioral deficiencies and environmental circumstances contributing to the fall. This allowed for secondary prevention in high-risk multi-faller individuals and for updated facility care policies regarding a safer living environment for all residents. Video monitoring offers high potential to support conventional care in memory care facilities. ©Eleonore Bayen, Julien Jacquemot, George Netscher, Pulkit Agrawal, Lynn Tabb Noyce, Alexandre Bayen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 17.10.2017.

  20. Geographic distribution of dementia mortality: elevated mortality rates for black and white Americans by place of birth.

    Science.gov (United States)

    Glymour, M Maria; Kosheleva, Anna; Wadley, Virginia G; Weiss, Christopher; Manly, Jennifer J

    2011-01-01

    We hypothesized that patterns of elevated stroke mortality among those born in the United States Stroke Belt (SB) states also prevailed for mortality related to all-cause dementia or Alzheimer Disease. Cause-specific mortality (contributing cause of death, including underlying cause cases) rates in 2000 for United States-born African Americans and whites aged 65 to 89 years were calculated by linking national mortality records with population data based on race, sex, age, and birth state or state of residence in 2000. Birth in a SB state (NC, SC, GA, TN, AR, MS, or AL) was cross-classified against SB residence at the 2000 Census. Compared with those who were not born in the SB, odds of all-cause dementia mortality were significantly elevated by 29% for African Americans and 19% for whites born in the SB. These patterns prevailed among individuals who no longer lived in the SB at death. Patterns were similar for Alzheimer Disease-related mortality. Some non-SB states were also associated with significant elevations in dementia-related mortality. Dementia mortality rates follow geographic patterns similar to stroke mortality, with elevated rates among those born in the SB. This suggests important roles for geographically patterned childhood exposures in establishing cognitive reserve.

  1. Depressive symptomatology in severe dementia in a European sample: prevalence, associated factors and prescription rate of antidepressants.

    Science.gov (United States)

    Giebel, Clarissa M; Sutcliffe, Caroline; Renom-Guiteras, Anna; Arve, Seija; Hallberg, Ingalill Rahm; Soto, Maria; Zabalegui, Adelaida; Hamers, Jan; Saks, Kai; Challis, David

    2015-04-01

    Depression is a common comorbid disorder of dementia. This study explores the prevalence of and factors associated with depressive symptomatology, and antidepressant prescription rates in severe dementia across eight European countries. In total, 414 people with severe dementia completed measures of cognition and quality of life (QoL), whilst carers completed proxy measures of activities of daily living (ADLs), depression, neuropsychiatric symptoms, QoL and comorbidity. Findings indicated that 30% of the sample had depression, whilst the highest and lowest prevalence of depression was reported in Germany and Finland, respectively. Lower QoL, the presence of pain and more frequent neuropsychiatric symptoms were associated with depressive symptomatology, whilst no significant relationship between impairment of ADLs, comorbidity, and depression emerged. Spain and Estonia had the highest and lowest rates of antidepressant prescribing, respectively, whilst Germany had the highest discrepancy between depressive symptomatology and prescription. The study highlights variations across countries in the prevalence of depressive symptomatology in severe dementia and prescription of antidepressants. Information about factors associated with depressive symptomatology may help to better identify and manage depression.

  2. Major depressive symptoms increase 3-year mortality rate in patients with mild dementia

    DEFF Research Database (Denmark)

    Petersen, Jindong Ding; Waldorff, Frans Boch; Siersma, Volkert Dirk

    2017-01-01

    Depression and dementia are commonly concurrent and are both associated with increased mortality among older people. However, little is known about whether home-dwelling patients newly diagnosed with mild dementia coexisting with depressive symptoms have excess mortality. We conducted a post hoc...... analysis based on data from the Danish Alzheimer's Intervention Study of 330 individuals who were diagnosed with mild dementia within the past 12 months. Thirty-four patients were identified with major depressive symptoms (MD-S) at baseline. During the 3-year follow-up period, 56 patients died, and, among...... mortality as compared to the patients without or with only few depressive symptoms. Our result revealed that depression is possibly associated with increased mortality in patients with mild dementia. Given that depression is treatable, screening for depression and treatment of depression can be important...

  3. Sensitivity and specificity of Addenbrooke's Cognitive Examination, Mattis Dementia Rating Scale, Frontal Assessment Battery and Mini Mental State Examination for diagnosing dementia in Parkinson's disease.

    Science.gov (United States)

    Kaszás, B; Kovács, N; Balás, I; Kállai, J; Aschermann, Z; Kerekes, Z; Komoly, S; Nagy, F; Janszky, J; Lucza, T; Karádi, K

    2012-06-01

    Among the non-motor features of Parkinson's disease (PD), cognitive impairment is one of the most troublesome problems. Highly sensitive and specific screening instruments for detecting dementia in PD (PDD) are required in the clinical practice. In our study we evaluated the sensitivity and specificity of different neuropsychological tests (Addenbrooke's Cognitive Examination, ACE; Frontal Assessment Battery, FAB and Mattis Dementia Rating Scale, MDRS) in 73 Parkinson's disease patients without depression. By receiver operating characteristic curve analysis, these screening instruments were tested against the recently established clinical diagnostic criteria of PDD. Best cut-off score for ACE to identify PDD was 80 points (sensitivity = 74.0%, specificity = 78.1%). For FAB the most optimal cut-off value was 12 points (sensitivity = 66.3%, specificity = 72.2%); whereas for MDRS it was 125 points (sensitivity = 89.8%, specificity = 98.3%). Among the examined test batteries, MDRS had the best clinicometric profile for detecting PDD. Although the types of applied screening instruments might differ from movement disorder clinic to clinic within a country, determination of the most specific and sensitive test for the given population remains to be an important task. Our results demonstrated that the specificity and sensitivity of MDRS was better than those of ACE, FAB and MMSE in Hungary. However, further studies with larger sample size and more uniform criteria for participation are required to determine the most suitable screening instrument for cognitive impairment. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Korean version of mini mental status examination for dementia screening and its' short form.

    Science.gov (United States)

    Kim, Tae Hui; Jhoo, Jin Hyeong; Park, Joon Hyuk; Kim, Jeong Lan; Ryu, Seung Ho; Moon, Seok Woo; Choo, Il Han; Lee, Dong Woo; Yoon, Jong Chul; Do, Yeon Ja; Lee, Seok Bum; Kim, Moon Doo; Kim, Ki Woong

    2010-06-01

    We developed a Korean version of Mini-Mental Status Examination (MMSE) optimized for screening dementia (MMSE-DS) and its' short form (SMMSE-DS). We constructed the MMSE-DS using the items of the two current Korean versions of MMSE and then construct the SMMSE-DS consisted of 13 items from the MMSE-DS based on the diagnostic accuracy of individual items for dementia. We investigated reliability and validity of MMSE-DS and SMMSE-DS on 1,555 subjects (1,222 nondemented controls, 333 dementia patients). We compared the diagnostic accuracy of the SMMSE-DS with that of the three full Korean versions of MMSE, and examined its' age- and education-specific optimal cutoff scores for dementia. The internal consistency obtained by Cronbach's coefficient alpha was 0.826. The inter-rater reliability and test-retest reliability were 0.968 (p<0.001) and 0.825 (p<0.001), respectively. It showed significant correlation with the Clinical Dementia Rating (CDR) (r=-0.698, p<0.05) and the three full Korean versions of MMSE (r=0.839-0.938, p<0.001). The area under the receiver operator curve for dementia of the SMMSE-DS was larger than those of the three full Korean versions of MMSE (p<0.001). Age, education and gender explained 19.4% of the total variance of SMMSE-DS scores. The optimal cutoff scores for dementia of the SMMSE-DS were estimated differently by age and educational attainment of the subjects. The SMMSE-DS was found to be accurate, brief and portable instrument for screening dementia in Korean elders, and may be particularly useful for screening dementia in elderly populations with wide variation in educational levels.

  5. The Gesture Imitation in Alzheimer's Disease Dementia and Amnestic Mild Cognitive Impairment.

    Science.gov (United States)

    Li, Xudong; Jia, Shuhong; Zhou, Zhi; Hou, Chunlei; Zheng, Wenjing; Rong, Pei; Jiao, Jinsong

    2016-07-14

    Alzheimer's disease dementia (ADD) has become an important health problem in the world. Visuospatial deficits are considered to be an early symptom besides memory disorder. The gesture imitation test was devised to detect ADD and amnestic mild cognitive impairment (aMCI). A total of 117 patients with ADD, 118 with aMCI, and 95 normal controls were included in this study. All participants were administered our gesture imitation test, the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), the Clock Drawing Test (CDT), and the Clinical Dementia Rating Scale (CDR). Patients with ADD performed worse than normal controls on global scores and had a lower success rate on every item (p imitation test scores were positively correlated with the MMSE (r = 0.637, p imitation test is an easy, rapid tool for detecting ADD, and is suitable for the patients suspected of mild ADD and aMCI in outpatient clinics.

  6. Validation of Montgomery-Åsberg Rating Scale and Cornell Scale for Depression in Dementia in Brazilian elderly patients.

    Science.gov (United States)

    Portugal, Maria da Glória; Coutinho, Evandro Silva Freire; Almeida, Cloyra; Barca, Maria Lage; Knapskog, Anne-Brita; Engedal, Knut; Laks, Jerson

    2012-08-01

    There are few studies on validation of depression scales in the elderly in Latin America. This study aimed to assess the validity of Montgomery-Åsberg. Depression Rating Scale (MADRS) and Cornell Scale for Depression in Dementia (CSDD) in Brazilian elderly outpatients. A convenience sample of 95 outpatients was diagnosed for dementia and depression according to DSM-IV-TR, ICD-10, and PDC-dAD criteria. Receiver Operating Curves (ROC) were used to calculate the area under the curve (AUC) and to assess MADRS and CSDD cut-offs for each diagnostic criterion. Dementia was diagnosed in 71 of 95 patients. Depression was diagnosed in 35, 30, and 51 patients by ICD-10, DSM-IV, and PDC-dAD, respectively. MADRS cut-off score of 10 correctly diagnosed 67.4% and 66.3% patients as depressed according to DSM-IV and ICD-10. A cut-off of 9 correctly identified 74.7% by PDC-dAD criteria; a CSDD cut-off score of 13 best recognized depression according to DSM-IV and ICD-10. A score of 11 diagnosed depression according to PDC-dAD, while MADRS = 9 recognized depression in dementia. CSDD was more efficient in showing depression in mild than in moderate/severe dementia according to DSM-IV/ICD-10. PDC-dAD behaved nicely for any severity stage. MADRS and CSDD cut-offs of 10 and 13 were the optimal ones to diagnose depression in elderly, respectively. CSDD cut-offs are higher than those found in other countries. Other Latin American studies are needed to compare results with our study.

  7. A Longitudinal Study of Neurocognition in Dementia with Lewy Bodies Compared to Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Monica H. Breitve

    2018-03-01

    Full Text Available IntroductionThere are relatively few longitudinal studies on the differences in cognitive decline between Alzheimer’s disease (AD and dementia with Lewy bodies (DLB, and the majority of existing studies have suboptimal designs.AimWe investigated the differences in cognitive decline in AD compared to DLB over 4 years and cognitive domain predictors of progression.MethodsIn a longitudinal study, 266 patients with first-time diagnosis of mild dementia were included and followed annually. The patients were tested annually with neuropsychological tests and screening instruments [MMSE (Mini-Mental Status Examination, Clinical Dementia Rating (CDR, the second edition of California Verbal Learning Test (CVLT-II, Trail Making Test A & B (TMT A & B, Stroop test, Controlled Oral Word Associations Test (COWAT animal naming, Boston Naming Test, Visual Object and Space Perception Battery (VOSP Cubes and Silhouettes]. Longitudinal analyses were performed with linear mixed effects (LME models and Cox regression. Both specific neuropsychological tests and cognitive domains were analyzed.ResultsThis study sample comprised 119 AD and 67 DLB patients. In TMT A, the DLB patients had a faster decline over 4 years than patients with AD (p = 0.013. No other longitudinal differences in specific neuropsychological tests were found. Higher executive domain scores at baseline were associated with a longer time to reach severe dementia (CDR = 3 or death for the total sample (p = 0.032. High or low visuospatial function at baseline was not found to be associated with cognitive decline (MMSE or progression of dementia severity (CDR over time.ConclusionOver 4 years, patients with DLB had a faster decline in TMT A than patients with AD, but this should be interpreted cautiously. Beyond this, there was little support for faster decline in DLB patients neuropsychologically than in AD patients.

  8. Neuropsychiatric profiles in patients with Alzheimer′s disease and vascular dementia

    Directory of Open Access Journals (Sweden)

    Tushar Kanti Bandyopadhyay

    2014-01-01

    Full Text Available Background/Aims: The aim of the following study is to compare the behavioral and psychological symptoms of dementia (BPSD in patients of Alzheimer disease (AD and vascular dementia (VaD. Materials and Methods: We used National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer′s Disease and Related Disorders Association criteria for diagnosing AD and National Institute of Neurological Disorders and Stroke-Association International pour la Recherche et l′Enseignement en Neurosciences Criteria for diagnosing VaD. VaD cohort was further subcategorized into small vessel and large vessel disease. The severity of cognitive impairment and the BPSD were studied by means of the Clinical Dementia Rating Scale (CDR and the Neuropsychiatric Inventory respectively. Results: We studied 50 AD and 50 VaD patients of whom 38 were small vessels and 12 were large vessels VaD. The severity of dementia was comparable in both groups. The agitation/aggression, depression/dysphoria, anxiety, apathy/indifference, irritability, aberrant motor behavior, appetite and eating behavior and night-time behaviors occurred significantly more frequently in patients with VaD than AD. We found a weak positive correlation between the CDR score and the number of neuropsychiatric symptoms per patient in both cohorts. Elation/euphoria, agitation/aggression was significantly more frequent in patients with large vessel in comparison to small vessel VaD. Conclusions: BPSD are common in both types of dementia and they are more severe in VaD than AD when the groups have similar levels of cognitive impairment.

  9. Cumulative dosages of antipsychotic drugs are associated with increased mortality rate in patients with Alzheimer's dementia

    DEFF Research Database (Denmark)

    Nielsen, R E; Lolk, A; Valentin, J B

    2016-01-01

    OBJECTIVE: We wished to investigate the effects of cumulative dosages of antipsychotic drug in Alzheimer's dementia, when controlling for known risk factors, including current antipsychotic exposure, on all-cause mortality. METHOD: We utilized a nationwide, population-based, retrospective cohort...... study design with mortality as outcome in individual patients diagnosed with Alzheimer's dementia. RESULTS: We included a total of 45 894 patients and followed them for 3 803 996 person-years in total, presenting 27 894 deaths in the study population. Cumulative antipsychotic exposure increased...... or equal to 730 DDDs: HR 1.06, 95% CI (0.95-1.18), P = 0.322, when controlling for proxy markers of severity, somatic and mental comorbid disorders. CONCLUSION: In this nationwide cohort study of 45 894 patients diagnosed with Alzheimer's dementia, we found that cumulative dosages of antipsychotic drugs...

  10. Measurement of mean cerebral blood flow using SPECT and dementia rating scales in the memory clinic

    International Nuclear Information System (INIS)

    Kawahata, Nobuya; Daitoh, Nobuyuki; Shirai, Fumie; Yoshikawa, Ayumi; Gotoh, Chiharu

    1997-01-01

    We investigated the association between mean cerebral blood flow (mCBF) values using single photon emission computed tomography (SPECT) and cognitive performance scores of three dementia rating scales (ADAS, MMSE, HDS-R). Mean CBF was measured by the 123 I-IMP-ARG method in a selected group of 51 out-patients aged 41 to 90 years and by the 99m Tc-ECD method in the other group of 57 out-patients aged 51 to 91 years. Simple regressions were calculated for each of the neuropsychological clusters and mCBF values. In 123 I-IMP-ARG-SPECT study, there was a significant correlation between the mCBF values and HDS-R scores (R=0.37, p=0.01). 99m Tc-ECD-SPECT study revealed statistically significant correlations between the mCBF values and ADAS scores (R=-0.48, p 123 I-IMP-ARG-SPECT study and 99m Tc-ECD-SPECT study showed the progressive declines of mCBF with advancing cognitive dysfunctions. Using the cut-off point study (23/24 scores in MMSE and 20/21 scores in HDS-R), we have found that the patients with cognitive dysfunctions had lower mCBF values than the patients with those in each group of aged 60-69 years, 70-79 years, and 80-89 years. However, the difference of mCBF values between the groups with cognitive dysfunctions and without those had decreased gradually with advancing age. The present study suggests that SPECT can provide important functional informations to assess the cognitive impairment in patients with the memory disturbance. (author)

  11. Evolution of short cognitive test performance in stroke patients with vascular cognitive impairment and vascular dementia: Baseline evaluation and follow-up

    Science.gov (United States)

    Custodio, Nilton; Montesinos, Rosa; Lira, David; Herrera-Perez, Eder; Bardales, Yadira; Valeriano-Lorenzo, Lucia

    2017-01-01

    ABSTRACT. There is limited evidence about the progression of cognitive performance during the post-stroke stage. Objective: To assess the evolution of cognitive performance in stroke patients without vascular cognitive impairment (VCI), patients with vascular mild cognitive impairment (MCI), and patients with vascular dementia (VD). Methods: A prospective cohort of stroke outpatients from two secondary medical centers in Lima, Peru was studied. We performed standardized evaluations at definitive diagnosis (baseline evaluation), and control follow-ups at 6 and 12 months, including a battery of short cognitive tests: Clinical Dementia Rating (CDR), Addenbrooke's Cognitive Examination (ACE), and INECO Frontal Screening (IFS). Results: 152 outpatients completed the follow-up, showing progressive increase in mean score on the CDR(0.34 to 0.46), contrary to the pattern observed on the ACE and IFS (78.18 to 76.48 and 23.63 to 22.24). The box plot for the CDR test showed that VCI patients had progressive worsening (0.79 to 0.16). Conversely, this trend was not observed in subjects without VCI. The box plot for the ACE and IFS showed that, for the majority of the differentiated stroke types, both non-VCI and VCI patients had progressive worsening. Conclusion: According to both ACE and IFS results during a 1-year follow-up, the cognitive performance of stroke patients worsened, a trend which was particularly consistent in infarction-type stroke patients. PMID:29354218

  12. Evolution of short cognitive test performance in stroke patients with vascular cognitive impairment and vascular dementia: Baseline evaluation and follow-up

    Directory of Open Access Journals (Sweden)

    Nilton Custodio

    Full Text Available ABSTRACT. There is limited evidence about the progression of cognitive performance during the post-stroke stage. Objective: To assess the evolution of cognitive performance in stroke patients without vascular cognitive impairment (VCI, patients with vascular mild cognitive impairment (MCI, and patients with vascular dementia (VD. Methods: A prospective cohort of stroke outpatients from two secondary medical centers in Lima, Peru was studied. We performed standardized evaluations at definitive diagnosis (baseline evaluation, and control follow-ups at 6 and 12 months, including a battery of short cognitive tests: Clinical Dementia Rating (CDR, Addenbrooke's Cognitive Examination (ACE, and INECO Frontal Screening (IFS. Results: 152 outpatients completed the follow-up, showing progressive increase in mean score on the CDR(0.34 to 0.46, contrary to the pattern observed on the ACE and IFS (78.18 to 76.48 and 23.63 to 22.24. The box plot for the CDR test showed that VCI patients had progressive worsening (0.79 to 0.16. Conversely, this trend was not observed in subjects without VCI. The box plot for the ACE and IFS showed that, for the majority of the differentiated stroke types, both non-VCI and VCI patients had progressive worsening. Conclusion: According to both ACE and IFS results during a 1-year follow-up, the cognitive performance of stroke patients worsened, a trend which was particularly consistent in infarction-type stroke patients.

  13. Factors related to the high fall rate in long-term care residents with dementia

    NARCIS (Netherlands)

    Kosse, Nienke M.; de Groot, Maartje H.; Vuillerme, Nicolas; Hortobagyi, Tibor; Lamoth, Claudine J. C.

    Background: Falls in long-term care residents with dementia represent a costly but unresolved safety issue. The aim of the present study was to (1) determine the incidence of falls, fall-related injuries and fall circumstances, and (2) identify the relationship between patient characteristics and

  14. Vascular Risk as a Predictor of Cognitive Decline in a Cohort of Elderly Patients with Mild to Moderate Dementia

    Directory of Open Access Journals (Sweden)

    Pedro K. Curiati

    2014-10-01

    Full Text Available Background/Aims: The purpose of our study was to evaluate vascular risk factors and other clinical variables as predictors of cognitive and functional decline in elderly patients with mild to moderate dementia. Methods: The clinical characteristics of 82 elderly patients (mean age 79.0 ± 5.9 years; 67.1% females with mild to moderate dementia were obtained at baseline, including years of education, Framingham Coronary Heart Disease Risk score, Hachinski Ischemic Score (HIS, Clinical Dementia Rating (CDR, Mini-Mental State Examination (MMSE score, Functional Activities Questionnaire (FAQ score, Burden Interview Scale score, and Neuropsychiatric Inventory (NPI score. Changes in MMSE and FAQ scores over time were assessed annually. The association between baseline clinical variables and cognitive and functional decline was investigated during 3 years of follow-up through the use of generalized linear mixed effects models. Results: A trend was found towards steeper cognitive decline in patients with less vascular burden according to the HIS (β = 0.056, p = 0.09, better cognitive performance according to the CDR score (β = 0.313, p = 0.06 and worse caregiver burden according to the Burden Interview Scale score (β = -0.012, p = 0.07 at baseline. Conclusion: Further studies with larger samples are necessary to confirm and expand our findings.

  15. New DSM-V neurocognitive disorders criteria and their impact on diagnostic classifications of mild cognitive impairment and dementia in a memory clinic setting.

    Science.gov (United States)

    Tay, Laura; Lim, Wee Shiong; Chan, Mark; Ali, Noorhazlina; Mahanum, Shariffah; Chew, Pamela; Lim, June; Chong, Mei Sian

    2015-08-01

    To examine diagnostic agreement between Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) Neurocognitive Disorders (NCDs) criteria and DSM, Fourth Edition (DSM-IV) criteria for dementia and International Working Group (IWG) criteria for mild cognitive impairment (MCI) and DSM-V's impact on diagnostic classifications of NCDs. The authors further examined clinical factors for discrepancy in diagnostic classifications between the different operational definitions. Using a cross-sectional study in tertiary memory clinic, the authors studied consecutive new patients aged 55 years or older who presented with cognitive symptoms. Dementia severity was scored based on the Clinical Dementia Rating scale (CDR). All patients completed neuropsychological evaluation. Agreement in diagnostic classifications between DSM-IV/IWG and DSM-V was examined using the kappa test and AC1 statistic, with multinomial logistic regression for factors contributing to MCI reclassification as major NCDs as opposed to diagnostically concordant MCI and dementia groups. Of 234 patients studied, 166 patients achieved concordant diagnostic classifications, with overall kappa of 0.41. Eighty-six patients (36.7%) were diagnosed with MCI and 131 (56.0%) with DSM-IV-defined dementia. With DSM-V, 40 patients (17.1%) were classified as mild NCDs and 183 (78.2%) as major NCDs, representing a 39.7% increase in frequency of dementia diagnoses. CDR sum-of-boxes score contributed independently to differentiation of MCI patients reclassified as mild versus major NCDs (OR: 0.01; 95% CI: 0-0.09). CDR sum-of-boxes score (OR: 5.18; 95% CI: 2.04-13.15), performance in amnestic (OR: 0.14; 95% CI: 0.06-0.34) and language (Boston naming: OR: 0.52; 95% CI: 0.29-0.94) tests, were independent determinants of diagnostically concordant dementia diagnosis. The authors observed moderate agreement between the different operational definitions and a 40% increase in dementia diagnoses with

  16. Adult-onset phenylketonuria with rapidly progressive dementia and parkinsonism.

    Science.gov (United States)

    Tufekcioglu, Zeynep; Cakar, Arman; Bilgic, Basar; Hanagasi, Hasmet; Gurvit, Hakan; Emre, Murat

    2016-06-01

    Phenylketonuria (PKU) is an autosomal recessive metabolic disorder due to mutations in the phenylalanine hydroxylase (PAH) gene, which converts phenylalanine (PHE) to tyrosine. Although it is principally a childhood disorder, in rare cases, the first signs of PKU may develop in late adulthood resembling common neurological diseases. Here we report a 59-year-old, previously normal functioning man who was admitted with blurred vision, cognitive problems, and gait difficulty that began 8 months before. He had brisk reflexes and left side dominant parkinsonism. His Mini-Mental State Examination (MMSE) score was 25/30, and neuropsychological evaluation revealed a dysexecutive syndrome with simultanagnosia and constructional apraxia. His Clinical Dementia Rating score (CDR) was 1. Cranial MRI revealed bilateral diffuse hyperintense lesions in parietal and occipital white matter in T2, fluid-attenuated inversion recovery, and diffusion weighted images. Diagnostic workup for rapidly progressive dementias was all normal except PHE level which was found to be highly elevated (1075 μmol/L, normal 39-240 μmol/L) with normal tyrosine level (61.20 μmol/L, normal 35-100 μmol/L). Three months after PHE-restricted diet, his cognitive impairment and signs of parkinsonism significantly improved, with MRI scan unchanged. This case demonstrates that late-onset PKU is a rare, treatable cause of rapidly progressive dementia and parkinsonism with certain constellations such as consanguinity and white matter abnormalities (WMAs) in imaging.

  17. Neuropsychiatric symptoms and CT findings in Alzheimer type dementia clinicoradiological correlation

    International Nuclear Information System (INIS)

    Imai, Yukimichi; Honma, Akira; Hasegawa, Kazuo; Inada, Yoichi

    1984-01-01

    The purpose of the present study is to clarify the relationship among clinical severity of dementia, associated clinical symptoms and degree of brain atrophy. The subjects of this study were 109 demented patients with clinical diagnosis of Alzheimer type dementia. The age of them ranged from 51 years to 87 years with mean age of 71.8 +- 8.8 years. Clinical severity of dementia was evaluated by using Clinical Dementia Rating (CDR) by Hughes et al. Intellectual impairment was assessed psychologically by Hasagawa's dementia scale which was one of the standadized psychometric tests for the elderly with dementia in Japan. Brain atrophy was estimated in the three computed tomographic sections. They were the section through anterior and posterior horns of lateral ventricles, the section through cellae mediae of lateral ventricles and the section through cortex. Degree of brain atrophy was evaluated by two indexes, that is, CSF% and half width full max (HWFM) obtained from the pixel number and CT number histogram in each section, which were considered to correspond to the enlargement of the free space and mainly to the cortical atrophy, respectively. The analysis of the relationship between clinical symptoms and HWFM showed that the HWFM in the section through lateral ventricles was more increased in the patients with incontinence and personality change, compared with the patients without those symptoms. Also, the HWFM in the cortex slice was more increased in the patients with perseveration, compared with the patients without perseveration. The above mentioned results seem to indicate the relationship between the degree of brain atrophy by CT and characteristic symptoms which are likely to be specific to each stage of dementia. The clinical implications of these results were discussed. (J.P.N.)

  18. Neuropsychiatric symptoms and CT findings in Alzheimer type dementia clinicoradiological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Imai, Yukimichi; Honma, Akira; Hasegawa, Kazuo; Inada, Yoichi [St. Marianna Univ. School of Medicine, Kanagawa (Japan)

    1984-03-01

    The purpose of the present study is to clarify the relationship among clinical severity of dementia, associated clinical symptoms and degree of brain atrophy. The subjects of this study were 109 demented patients with clinical diagnosis of Alzheimer type dementia. The age of them ranged from 51 years to 87 years with mean age of 71.8 +- 8.8 years. Clinical severity of dementia was evaluated by using Clinical Dementia Rating (CDR) by Hughes et al. Intellectual impairment was assessed psychologically by Hasagawa's dementia scale which was one of the standardized psychometric tests for the elderly with dementia in Japan. Brain atrophy was estimated in the three computed tomographic sections. They were the section through anterior and posterior horns of lateral ventricles, the section through cellae mediae of lateral ventricles and the section through cortex. Degree of brain atrophy was evaluated by two indexes, that is, CSF% and half width full max (HWFM) obtained from the pixel number and CT number histogram in each section, which were considered to correspond to the enlargement of the free space and mainly to the cortical atrophy, respectively. The analysis of the relationship between clinical symptoms and HWFM showed that the HWFM in the section through lateral ventricles was more increased in the patients with incontinence and personality change, compared with the patients without those symptoms. Also, the HWFM in the cortex slice was more increased in the patients with perseveration, compared with the patients without perseveration. The above mentioned results seem to indicate the relationship between the degree of brain atrophy by CT and characteristic symptoms which are likely to be specific to each stage of dementia. The clinical implications of these results were discussed.

  19. Chronic Depressive Symptomatology in Mild Cognitive Impairment Is Associated with Frontal Atrophy Rate which Hastens Conversion to Alzheimer Dementia.

    Science.gov (United States)

    Sacuiu, Simona; Insel, Philip S; Mueller, Susanne; Tosun, Duygu; Mattsson, Niklas; Jack, Clifford R; DeCarli, Charles; Petersen, Ronald; Aisen, Paul S; Weiner, Michael W; Mackin, R Scott

    2016-02-01

    Investigate the association of chronic depressive symptomatology (chrDS) with cortical atrophy rates and conversion to Alzheimer dementia (AD) over 3 years in mild cognitive impairment (MCI). In a multicenter, clinic-based study, MCI elderly participants were selected from the Alzheimer's Disease Neuroimaging Initiative repository, based on availability of both serial structural magnetic resonance imaging and chrDS endorsed on three depression-related items from the Neuropsychiatric Inventory Questionnaire (chrDS N = 32 or no depressive symptoms N = 62) throughout follow-up. Clinical and laboratory investigations were performed every 6 months during the first 2 years and yearly thereafter (median follow-up: 3 years; interquartile range: 1.5-4.0 years). Cortical atrophy rates in 16 predefined frontotemporoparietal regions affected in major depression and AD and the rate of incident AD at follow-up. ChrDS in a single domain amnestic MCI sample were associated with accelerated cortical atrophy in the frontal lobe and anterior cingulate but not with atrophy rates in temporomedial or other AD-affected regions. During follow-up, 38 participants (42.7%) developed AD. Participants with chrDS had 60% shorter conversion time to AD than those without depressive symptoms. This association remained significant in survival models adjusted for temporomedial atrophy rates and showed the same trend in models adjusted for frontal cortical atrophy rate, which all increased the risk of AD. Our results suggest that chrDS associated with progressive atrophy of frontal regions may represent an additional risk factor for conversion to dementia in MCI as opposite to representing typical prodromal AD symptomatology. Published by Elsevier Inc.

  20. Efficacy and safety of galantamine in the treatment of Alzheimer’s Disease and Alzheimer’s Disease with cerebrovascular (Mixed Dementia (GAL-DEM-402

    Directory of Open Access Journals (Sweden)

    S. F. Lumempouw

    2007-06-01

    Full Text Available This study was aimed to evaluate the efficacy and safety of Acetylcholinesterase Inhibitor Galantamine (Reminyl® for patients with Alzheimer’s Disease (AD and Alzheimer’s Disease with cerebrovascular Disease (AD+CVD or mixed Dementia. A 6-month open label observational study of Galantamine has been conducted on 28 patients with AD and AD+CVD patients. Primary endpoints were cognitive performance as assessed using the Mini Mental Scale Examination (MMSE, the Restricted Reminding Test, the Neuropsychology Assessment, the Clinical Dementia Rating (CDR to assess global function and the Neuropsychiatric Inventory (NPI to assess behavioral symptoms. Patients were also monitored for safety evaluation. Six month Galantamine group had a significant better outcome of cognitive performance, global function and behavioral symptoms compared with the baseline data as were assessed using the MMSE (p<0.05, the Restricted Reminding (p<0.05, the Neuropsychology Assessment (p<0.05, the CDR (p<0.05 and the NPI (p<0.05. Minimal adverse events (32% were anorexia and nausea. It is concluded that Galantamine has a significant benefit to improve cognitive, global function, behavioral symptoms and only caused minimal adverse events. (Med J Indones 2007; 16:94-100Keywords: Galantamine, alzheimer, cerebrovascular disease, dementia, AD, AD+CVD

  1. Antidepressants and dementia

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Søndergård, Lars; Forman, Julie Lyng

    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...

  2. A Wide Lock-Range Referenceless CDR with Automatic Frequency Acquisition

    OpenAIRE

    Seon-Kyoo Lee; Young-Sang Kim; Hong-June Park; Jae-Yoon Sim

    2011-01-01

    A wide lock-range referenceless CDR circuit is proposed with an automatic tracking of data rate. For efficient frequency acquisition, a DLL-based loop is used with a simple phase/frequency detector to extract 1-bit period of input data stream. The CDR, implemented in a 65 nm CMOS, shows a lock range of 650 Mb/s-to-8 Gb/s and BER of less than 10-12 at 8 Gb/s with low power consumption.

  3. A Wide Lock-Range Referenceless CDR with Automatic Frequency Acquisition

    Directory of Open Access Journals (Sweden)

    Seon-Kyoo Lee

    2011-01-01

    Full Text Available A wide lock-range referenceless CDR circuit is proposed with an automatic tracking of data rate. For efficient frequency acquisition, a DLL-based loop is used with a simple phase/frequency detector to extract 1-bit period of input data stream. The CDR, implemented in a 65 nm CMOS, shows a lock range of 650 Mb/s-to-8 Gb/s and BER of less than 10-12 at 8 Gb/s with low power consumption.

  4. Self-rated driving habits among older adults with clinically-defined mild cognitive impairment, clinically-defined dementia, and normal cognition.

    Science.gov (United States)

    O'Connor, Melissa L; Edwards, Jerri D; Bannon, Yvonne

    2013-12-01

    Older adults with clinically-defined dementia may report reducing their driving more than cognitively normal controls. However, it is unclear how these groups compare to individuals with clinically-defined mild cognitive impairment (MCI) in terms of driving behaviors. The current study investigated self-reported driving habits among adults age 60 and older with clinical MCI (n=41), clinical mild dementia (n=40), and normal cognition (n=43). Participants reported their driving status, driving frequency (days per week), and how often they avoided accessing the community, making left turns, driving at night, driving in unfamiliar areas, driving on high-traffic roads, and driving in bad weather. After adjusting for education, a MANCOVA revealed that participants with MCI and dementia avoided unfamiliar areas and high-traffic roads significantly more than normal participants. Participants with dementia also avoided left turns and accessing the community more than those with normal cognition and MCI (pdriving variables did not significantly differ between groups. Thus, older adults with clinically-defined MCI, as well as those with dementia, avoided some complex driving situations more than cognitively intact adults. However, all diagnostic groups had similar rates of driving cessation and frequency. Future research should examine the safety implications of such findings. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Lower mortality rate in people with dementia is associated with better cognitive and functional performance in an outpatient cohort

    Directory of Open Access Journals (Sweden)

    Carolina Verdan

    2014-04-01

    Full Text Available We describe a three-year experience with patients with dementia. Method: clinical, cognitive and functional evaluation was performed by a multidisciplinary team for persons above 60 years. Mortality was assessed after three years. Results: Mini-Mental State Examination (MMSE (n=2,074 was 15.7 (8.4. Male patients MMSE (n=758 was 15.6 (8.3 and female's (n=1315 was 15.8 (8.3. Instrumental Activities of Daily Living Scale (n=2023 was 16.5 (7.6; females (n=1277 was 16.9 (7.2 and males (n=745 was 15.7(8.2. From these patients, 12.6% (n=209 died within three years. Baseline cognition of patients still alive was higher (p<0.001 than MMSE of those who died [MMSE=16.3 (8.1 vs. 10.6 (7.6]. Mortality rate decreased 6% (IR=0.94 for each additional point on MMSE. Higher functional status decreases the mortality rate approximately 11% (IR=0.89 independently of age, gender, and education. Conclusion: Three-year mortality rates are dependent on baseline functional and cognitive status

  6. Assessment of Depression in Dementia Patients: Association of Caregiver Mood with Depression Ratings.

    Science.gov (United States)

    Teri, Linda; Truax, Paula

    1994-01-01

    Primary caregivers (n=41) of memory-impaired patients rated a standardized stimulus of depression and their actual patient. They were able to correctly identify depression in both. Further, their mood was unassociated with video ratings and only moderately associated with patient ratings. The findings support reliance on caregiver input.…

  7. Atrophy in distinct corticolimbic networks in frontotemporal dementia relates to social impairments measured using the Social Impairment Rating Scale

    Science.gov (United States)

    Bickart, Kevin C; Brickhouse, Michael; Negreira, Alyson; Sapolsky, Daisy

    2015-01-01

    Patients with frontotemporal dementia (FTD) often exhibit prominent, early and progressive impairments in social behaviour. We developed the Social Impairment Rating Scale (SIRS), rated by a clinician after a structured interview, which grades the types and severity of social behavioural symptoms in seven domains. In 20 FTD patients, we used the SIRS to study the anatomic basis of social impairments. In support of hypotheses generated from a prior study of healthy adults, we found that the relative magnitude of brain atrophy in three partially dissociable corticolimbic networks anchored in the amygdala predicted the severity of distinct social impairments measured using the SIRS. Patients with the greatest atrophy in a mesolimbic, reward-related (affiliation) network exhibited the most severe socioemotional detachment, whereas patients with the greatest atrophy in an interoceptive, pain-related (aversion) network exhibited the most severe lack of social apprehension. Patients with the greatest atrophy in a perceptual network exhibited the most severe lack of awareness or understanding of others’ social and emotional behaviour. Our findings underscore observations that FTD is associated with heterogeneous social symptoms that can be understood in a refined manner by measuring impairments in component processes subserved by dissociable neural networks. Furthermore, these findings support the validity of the SIRS as an instrument to measure the social symptoms of patients with FTD. Ultimately, we hope it will be useful as a longitudinal outcome measure in natural history studies and in clinical trials of putative interventions to improve social functioning. PMID:24133285

  8. Conversion between mini-mental state examination, montreal cognitive assessment, and dementia rating scale-2 scores in Parkinson's disease.

    Science.gov (United States)

    van Steenoven, Inger; Aarsland, Dag; Hurtig, Howard; Chen-Plotkin, Alice; Duda, John E; Rick, Jacqueline; Chahine, Lama M; Dahodwala, Nabila; Trojanowski, John Q; Roalf, David R; Moberg, Paul J; Weintraub, Daniel

    2014-12-01

    Cognitive impairment is one of the earliest, most common, and most disabling non-motor symptoms in Parkinson's disease (PD). Thus, routine screening of global cognitive abilities is important for the optimal management of PD patients. Few global cognitive screening instruments have been developed for or validated in PD patients. The Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Dementia Rating Scale-2 (DRS-2) have been used extensively for cognitive screening in both clinical and research settings. Determining how to convert the scores between instruments would facilitate the longitudinal assessment of cognition in clinical settings and the comparison and synthesis of cognitive data in multicenter and longitudinal cohort studies. The primary aim of this study was to apply a simple and reliable algorithm for the conversion of MoCA to MMSE scores in PD patients. A secondary aim was to apply this algorithm for the conversion of DRS-2 to both MMSE and MoCA scores. The cognitive performance of a convenience sample of 360 patients with idiopathic PD was assessed by at least two of these cognitive screening instruments. We then developed conversion scores between the MMSE, MoCA, and DRS-2 using equipercentile equating and log-linear smoothing. The conversion score tables reported here enable direct and easy comparison of three routinely used cognitive screening assessments in PD patients. © 2014 International Parkinson and Movement Disorder Society.

  9. Experiment Simulation Configurations Used in DUNE CDR

    Energy Technology Data Exchange (ETDEWEB)

    Alion, T. [Univ. of South Carolina, Columbia, SC (United States); Black, J. J. [Univ. of Warwick, Coventry (United Kingdom); Bashyal, A. [Oregon State Univ., Corvallis, OR (United States); Bass, M. [Univ. of Oxford (United Kingdom); Bishai, M. [Brookhaven National Lab. (BNL), Upton, NY (United States); Cherdack, D. [Colorado State Univ., Fort Collins, CO (United States); Diwan, M. [Brookhaven National Lab. (BNL), Upton, NY (United States); Djurcic, Z. [Argonne National Lab. (ANL), Argonne, IL (United States); Evans, J. [Univ. of Manchester (United Kingdom); Fernandez-Martinez, E. [Madrid Autonama Univ. (Spain); Fields, L. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Fleming, B. [Yale Univ., New Haven, CT (United States); Gran, R. [Univ. of Minnesota, Duluth, MN (United States); Guenette, R. [Univ. of Oxford (United Kingdom); Hewes, J. [Univ. of Manchester (United Kingdom); Hogan, M. [Colorado State Univ., Fort Collins, CO (United States); Hylen, J. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Junk, T. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Kohn, S. [Univ. of California, Berkeley, CA (United States); LeBrun, P. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Lundberg, B. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Marchionni, A. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Morris, C. [Univ. of California, Berkeley, CA (United States); Papadimitriou, V. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Rameika, R. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Rucinski, R. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Soldner-Rembold, S. [Univ. of Manchester (United Kingdom); Sorel, M. [Spanish National Research Council (CSIC), Valencia (Spain). Univ. of Valencia (UV), Inst. de Fisica Corpuscular; Urheim, J. [Indiana Univ., Bloomington, IN (United States); Viren, B. [Brookhaven National Lab. (BNL), Upton, NY (United States); Whitehead, L. [Univ. of Houston, TX (United States); Wilson, R. [Colorado State Univ., Fort Collins, CO (United States); Worcester, E. [Brookhaven National Lab. (BNL), Upton, NY (United States); Zeller, G. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States)

    2016-06-30

    The LBNF/DUNE CDR describes the proposed physics program and experimental design at the conceptual design phase. Volume 2, entitled The Physics Program for DUNE at LBNF, outlines the scientific objectives and describes the physics studies that the DUNE collaboration will perform to address these objectives. The long-baseline physics sensitivity calculations presented in the DUNE CDR rely upon simulation of the neutrino beam line, simulation of neutrino interactions in the far detector, and a parameterized analysis of detector performance and systematic uncertainty. The purpose of this posting is to provide the results of these simulations to the community to facilitate phenomenological studies of long-baseline oscillation at LBNF/DUNE. Additionally, this posting includes GDML of the DUNE single-phase far detector for use in simulations. DUNE welcomes those interested in performing this work as members of the collaboration, but also recognizes the benefit of making these configurations readily available to the wider community.

  10. Apraxia for differentiating Alzheimer’s disease from subcortical vascular dementia and mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Ozkan S

    2013-07-01

    Full Text Available Serhat Ozkan,1 Demet Ozbabalik Adapinar,1 Nese Tuncer Elmaci,2 Didem Arslantas31Department of Neurology, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey; 2Department of Neurology, Marmara University Medical Faculty, Istanbul, Turkey; 3Department of Public Health, Eskisehir Osmangazi University Medical Faculty, Eskisehir, TurkeyAbstract: Although ideomotor limb apraxia is considered to be a typical sign of cortical pathologies such as Alzheimer’s disease (AD, it has been also reported in subcortical neurodegenerative diseases and vascular lesions. We aimed to investigate the difference between AD, subcortical vascular dementia (SVaD and mild cognitive impairment (MCI patients by means of ideomotor limb apraxia frequency and severity. Ninety-six AD, 72 SVaD, and 84 MCI patients were assessed with the mini-mental status examination (MMSE, clinical dementia rating (CDR and the apraxia screening test of TULIA (AST. Apraxia was significantly more frequent in the AD patients (32.3% than in both of the SVaD (16.7% and MCI (4.8% patients. The frequency of apraxia was also significantly higher in SVaD patients than in MCI patients. AD patients had significantly lower apraxia scores than both SVaD and MCI patients. In addition, a significant difference was found between SVaD and MCI patients in terms of apraxia scores. These results suggest that the widespread belief of the association between apraxia and cortical dementias is not exactly correct. The significant difference between both of the dementia groups and the MCI patients suggests that the absence of apraxia can be an indicator for MCI diagnosis.Keywords: apraxia, Alzheimer’s disease, subcortical vascular dementia, mild cognitive impairment

  11. XML Schema Guide for Primary CDR Submissions

    Science.gov (United States)

    This document presents the extensible markup language (XML) schema guide for the Office of Pollution Prevention and Toxics’ (OPPT) e-CDRweb tool. E-CDRweb is the electronic, web-based tool provided by Environmental Protection Agency (EPA) for the submission of Chemical Data Reporting (CDR) information. This document provides the user with tips and guidance on correctly using the version 1.7 XML schema. Please note that the order of the elements must match the schema.

  12. Tracking Cognitive Decline in Amnestic Mild Cognitive Impairment and Early-Stage Alzheimer Dementia: Mini-Mental State Examination versus Neuropsychological Battery.

    Science.gov (United States)

    Kim, Joonho; Na, Han Kyu; Byun, Justin; Shin, Jiwon; Kim, Sungsoo; Lee, Byung Hwa; Na, Duk L

    2017-01-01

    Although the Mini-Mental State Examination (MMSE), Clinical Dementia Rating-Sum of Boxes (CDR-SOB), and neuropsychological batteries are widely used for evaluating cognitive function, it remains elusive which instrument best reflects the longitudinal disease progression in amnestic mild cognitive impairment (aMCI) and probable Alzheimer disease (AD). We investigated whether changes in these three instruments over time correlate with loss of cortical gray matter volume (cGMV). We retrospectively investigated 204 patients (aMCI, n = 114; AD, n = 90) who had undergone MMSE, CDR-SOB, the dementia version of the Seoul Neuropsychological Screening Battery (SNSB-D), and 3-dimensional T1-weighted magnetic resonance images at least twice. We investigated the partial correlation between annual decline in test scores and percent change of cGMV. In aMCI patients, changes in the SNSB-D total score (r = 0.340, p < 0.001) and CDR-SOB (r = 0.222, p = 0.020), but not MMSE, showed a correlation with cGMV loss, with the SNSB-D total score showing the strongest correlation. In AD patients, decline in all three test scores correlated significantly with cGMV loss, with MMSE exhibiting the strongest correlation (r = 0.464, p < 0.001). In aMCI patients, neuropsychological battery, though time-consuming, was the most adequate tool in tracking disease progression. In AD patients, however, MMSE may be the most effective longitudinal monitoring tool when considering cost-effectiveness. © 2017 S. Karger AG, Basel.

  13. Real-Time Observation of Apathy in Long-Term Care Residents With Dementia: Reliability of the Person-Environment Apathy Rating Scale.

    Science.gov (United States)

    Jao, Ying-Ling; Mogle, Jacqueline; Williams, Kristine; McDermott, Caroline; Behrens, Liza

    2018-04-01

    Apathy is prevalent in individuals with dementia. Lack of responsiveness to environmental stimulation is a key characteristic of apathy. The Person-Environment Apathy Rating (PEAR) scale consists of environment and apathy subscales, which allow for examination of environmental impact on apathy. The interrater reliability of the PEAR scale was examined via real-time observation. The current study included 45 observations of 15 long-term care residents with dementia. Each participant was observed at three time points for 10 minutes each. Two raters observed the participant and surrounding environment and independently rated the participant's apathy and environmental stimulation using the PEAR scale. Weighted Kappa was 0.5 to 0.82 for the PEAR-Environment subscale and 0.5 to 0.8 for the PEAR-Apathy subscale. Overall, with the exception of three items with relatively weak reliability (0.50 to 0.56), the PEAR scale showed moderate to strong interrater reliability (0.63 to 0.82). The results support the use of the PEAR scale to measure environmental stimulation and apathy via real-time observation in long-term care residents with dementia. [Journal of Gerontological Nursing, 44(4), 23-28.]. Copyright 2018, SLACK Incorporated.

  14. NJS July 2011 for Ogidi.cdr final.cdr

    African Journals Online (AJOL)

    Trauma continues to be a major cause of morbidity and mortality world over. ... rib fracture(s) (23.8%), hemopneumothorax (14.3%), hemothorax (7.1%), ... The mortality rate was 2.4%. Only 7(16.7%) patients were seen beyond the first outpatient clinic appointment. Conclusion. Most patients arriving at the hospital survived, ...

  15. RJHS 5(4).cdr

    African Journals Online (AJOL)

    USER

    breast cancer is associated with high rate of mortality and morbidity. The aim of this study ... Results: During the period of study, 166 females with symptomatic breast lesions had diagnostic .... case use of ultrasonography as an adjunct would.

  16. The CLIC ILD CDR Geometry for the CDR Monte Carlo Mass Production

    CERN Document Server

    Muennich, A

    2012-01-01

    The CLIC ILD CDR detector for the Monte Carlo event simulation is described in a GEANT4 application, with some parameters available in a database and XML files. This makes it difficult to quickly “look up” interesting parameters of the detector geometry used for the simulation. This note summarises the important geometrical parameters and some details of the implemented detector components.

  17. Association between diabetes and causes of dementia: Evidence from a clinicopathological study

    Directory of Open Access Journals (Sweden)

    Maria Niures Pimentel dos Santos Matioli

    Full Text Available ABSTRACT. Background: Diabetes mellitus is a risk factor for dementia, especially for vascular dementia (VaD, but there is no consensus on diabetes as a risk factor for Alzheimer's disease (AD and other causes of dementia. Objective: To explore the association between diabetes and the neuropathological etiology of dementia in a large autopsy study. Methods: Data were collected from the participants of the Brain Bank of the Brazilian Aging Brain Study Group between 2004 and 2015. Diagnosis of diabetes was reported by the deceased's next-of-kin. Clinical dementia was established when CDR ≥ 1 and IQCODE > 3.41. Dementia etiology was determined by neuropathological examination using immunohistochemistry. The association of diabetes with odds of dementia was investigated using multivariate logistic regression. Results: We included 1,037 subjects and diabetes was present in 279 participants (27%. The prevalence of dementia diagnosis was similar in diabetics (29% and non-diabetics (27%. We found no association between diabetes and dementia (OR = 1.22; 95%CI = 0.81-1.82; p = 0.34 on the multivariate analysis. AD was the main cause of dementia in both groups, while VaD was the second-most-frequent cause in diabetics. Other mixed dementia was the second-most-common cause of dementia and more frequent among non-diabetics (p = 0.03. Conclusion: Diabetes was not associated with dementia in this large clinicopathological study.

  18. Lewy Body Dementia

    Science.gov (United States)

    Lewy body dementia Overview Lewy body dementia, also known as dementia with Lewy bodies, is the second most common type of progressive dementia after Alzheimer's disease dementia. Protein deposits, ...

  19. Expression of cold and drought regulatory protein (CcCDR) of pigeonpea imparts enhanced tolerance to major abiotic stresses in transgenic rice plants.

    Science.gov (United States)

    Sunitha, Mellacheruvu; Srinath, Tamirisa; Reddy, Vudem Dashavantha; Rao, Khareedu Venkateswara

    2017-06-01

    Transgenic rice expressing pigeonpea Cc CDR conferred high-level tolerance to different abiotic stresses. The multiple stress tolerance observed in CcCDR -transgenic lines is attributed to the modulation of ABA-dependent and-independent signalling-pathway genes. Stable transgenic plants expressing Cajanus cajan cold and drought regulatory protein encoding gene (CcCDR), under the control of CaMV35S and rd29A promoters, have been generated in indica rice. Different transgenic lines of CcCDR, when subjected to drought, salt, and cold stresses, exhibited higher seed germination, seedling survival rates, shoot length, root length, and enhanced plant biomass when compared with the untransformed control plants. Furthermore, transgenic plants disclosed higher leaf chlorophyll content, proline, reducing sugars, SOD, and catalase activities, besides lower levels of MDA. Localization studies revealed that the CcCDR-GFP fusion protein was mainly present in the nucleus of transformed cells of rice. The CcCDR transgenics were found hypersensitive to abscisic acid (ABA) and showed reduced seed germination rates as compared to that of control plants. When the transgenic plants were exposed to drought and salt stresses at vegetative and reproductive stages, they revealed larger panicles and higher number of filled grains compared to the untransformed control plants. Under similar stress conditions, the expression levels of P5CS, bZIP, DREB, OsLEA3, and CIPK genes, involved in ABA-dependent and-independent signal transduction pathways, were found higher in the transgenic plants than the control plants. The overall results amply demonstrate that the transgenic rice expressing CcCDR bestows high-level tolerance to drought, salt, and cold stress conditions. Accordingly, the CcCDR might be deployed as a promising candidate gene for improving the multiple stress tolerance of diverse crop plants.

  20. NESG EPR Journal.cdr

    African Journals Online (AJOL)

    Tosin Bashir

    This paper examines the impact of in ation on economic growth in Sub-Saharan Africa in ... because of the importance of in ation rate in ... ongoing slowdown in private sector credit ..... Optimal in ation for the U.S. economy. ... United States.

  1. RJHS 5(4).cdr

    African Journals Online (AJOL)

    USER

    Background:Caecal intubation is an important measure of the quality of colonoscopy. Information on the effect of the time of colonoscopy on caecal intubation rate (CIR) is scarce. This study aimed to compare .... CIR had been studied, but information on the .... interval between the start of bowel preparation and the timing of ...

  2. African Journal June 2011.cdr

    African Journals Online (AJOL)

    SEGUN ADENIJI

    Pregnancy rates were higher in day 3 group (55/131, 42%) when compared to ... insemination or ICSI) of pronuclear morphology as a predictor of ... until the time of the transfer. Embryos were ..... A (2001) The effect of pronuclear morphology ...

  3. XML Schema Guide for Secondary CDR Submissions

    Science.gov (United States)

    This document presents the extensible markup language (XML) schema guide for the Office of Pollution Prevention and Toxics’ (OPPT) e-CDRweb tool. E-CDRweb is the electronic, web-based tool provided by Environmental Protection Agency (EPA) for the submission of Chemical Data Reporting (CDR) information. This document provides the user with tips and guidance on correctly using the version 1.1 XML schema for the Joint Submission Form. Please note that the order of the elements must match the schema.

  4. Dementia in affective disorder

    DEFF Research Database (Denmark)

    Kessing, L V; Olsen, E W; Mortensen, P B

    1999-01-01

    OBJECTIVE: The aim of the study was to investigate whether patients with affective disorder have increased risk of developing dementia compared to other groups of psychiatric patients and compared to the general population. METHOD: In the Danish psychiatric central register, 3363 patients...... with unipolar affective disorder, 518 patients with bipolar affective disorder, 1025 schizophrenic and 8946 neurotic patients were identified according to the diagnosis at the first ever discharge from psychiatric hospital during the period from 1970 to 1974. The rate of discharge diagnosis of dementia...... on readmission was estimated during 21 years of follow-up. In addition, the rates were compared with the rates for admission to psychiatric hospitals with a discharge diagnosis of dementia for the total Danish population. RESULTS: Patients with unipolar and with bipolar affective disorder had a greater risk...

  5. Beyond CDR-grafting: Structure-guided humanization of framework and CDR regions of an anti-myostatin antibody.

    Science.gov (United States)

    Apgar, James R; Mader, Michelle; Agostinelli, Rita; Benard, Susan; Bialek, Peter; Johnson, Mark; Gao, Yijie; Krebs, Mark; Owens, Jane; Parris, Kevin; St Andre, Michael; Svenson, Kris; Morris, Carl; Tchistiakova, Lioudmila

    2016-10-01

    Antibodies are an important class of biotherapeutics that offer specificity to their antigen, long half-life, effector function interaction and good manufacturability. The immunogenicity of non-human-derived antibodies, which can be a major limitation to development, has been partially overcome by humanization through complementarity-determining region (CDR) grafting onto human acceptor frameworks. The retention of foreign content in the CDR regions, however, is still a potential immunogenic liability. Here, we describe the humanization of an anti-myostatin antibody utilizing a 2-step process of traditional CDR-grafting onto a human acceptor framework, followed by a structure-guided approach to further reduce the murine content of CDR-grafted antibodies. To accomplish this, we solved the co-crystal structures of myostatin with the chimeric (Protein Databank (PDB) id 5F3B) and CDR-grafted anti-myostatin antibody (PDB id 5F3H), allowing us to computationally predict the structurally important CDR residues as well as those making significant contacts with the antigen. Structure-based rational design enabled further germlining of the CDR-grafted antibody, reducing the murine content of the antibody without affecting antigen binding. The overall "humanness" was increased for both the light and heavy chain variable regions.

  6. 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 accordin...... with dementia and the matched controls and amounts on average to DKK 77,000 per person per year. However, priority setting cannot be based on the cost of dementia per se, but only on the cost of a specific dementia intervention compared to its health benefit.......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...

  7. Optical System Critical Design Review (CDR) Flight Software Summary

    Science.gov (United States)

    Khorrami, Mori

    2006-01-01

    The Mid Infrared Instrument (MIRI FSW presentation covers: (1) Optical System FSW only and Cooling System FSW is covered at its CDR (2) Requirements & Interfaces (3) Relationship with the ISIM FSW (4) FSW Design Drivers & Solutions.

  8. Pharmacotherapy of dementia

    Directory of Open Access Journals (Sweden)

    Ajit Avasthi

    2016-01-01

    variability in assessment instruments used for rating various symptoms encountered in patients of dementia. However, it can be concluded that in recent times, quality of studies has improved and many studies have included adequate sample sizes.

  9. Spent nuclear fuel Canister Storage Building CDR Review Committee report

    International Nuclear Information System (INIS)

    Dana, W.P.

    1995-12-01

    The Canister Storage Building (CSB) is a subproject under the Spent Nuclear Fuels Major System Acquisition. This subproject is necessary to design and construct a facility capable of providing dry storage of repackaged spent fuels received from K Basins. The CSB project completed a Conceptual Design Report (CDR) implementing current project requirements. A Design Review Committee was established to review the CDR. This document is the final report summarizing that review

  10. Prevalence and etiology of dementia in a Japanese community.

    Science.gov (United States)

    Ueda, K; Kawano, H; Hasuo, Y; Fujishima, M

    1992-06-01

    We sought to determine the type-specific prevalence of dementia and its risk factors in elderly persons from the Japanese community of Hisayama. We studied the prevalence of dementia in 887 Hisayama residents (353 men and 534 women) aged 65 years or older (screening rate, 94.6%) using various items of clinical information, neurological examination, and dementia scales. We also studied brain morphology in 50 of 59 determined to have dementia by computed tomography or autopsy during the subsequent 54-month period. Factors relevant to dementia were compared between 27 patients with vascular dementia and 789 control subjects without dementia in a retrospective fashion. The prevalence rate of dementia among Hisayama residents aged 65 or older was estimated at 6.7%, with a females to males ratio of 1:2. Among 50 cases of dementia in which brain morphology was examined, the frequency of vascular dementia was 56%; this rate was 2.2 times higher than that for senile dementia of the Alzheimer type. Aging, hypertension, electrocardiographic abnormalities, and high hematocrit were significantly (p less than 0.05) and independently associated with the occurrence of vascular dementia. Prevalence of dementia among the Hisayama residents was relatively identical to that previously reported, but vascular dementia was more predominant. Risk factors for vascular dementia were similar to those for lacunar infarcts. Control of hypertension may be a key to reducing dementia among the Japanese population.

  11. Types of Dementia

    Science.gov (United States)

    ... Kids For Teens For Parents & Teachers Resolving Family Conflicts The Holidays and Alzheimer's Glossary Virtual Library Online ... Use Map Selector Search Alzheimer’s Association Alzheimer's & Dementia Types of Dementia Types of Dementia Types of Dementia ...

  12. Imaging dementias

    Energy Technology Data Exchange (ETDEWEB)

    Savoiardo, M.; Grisoli, M. [Dept. of Neuroradiology, Istituto Nazionale Neurologico, Milan (Italy)

    2001-03-01

    Dementia is the progressive loss of intellectual functions due to involvement of cortical or subcortical areas. Specific involvement of certain brain areas in the different diseases leads to impairment of different functions, e. g., memory, language, visuospatial abilities, and behavior. Magnetic resonance imaging and other neuroradiological studies may indicate which structures are mainly or selectively involved in a demented patient, thus allowing clinical-radiological correlations. Clinical presentation and evolution of the disease, supported by imaging studies, may lead to a highly probable diagnosis. The most common disorders, or the most relevant from the neuroradiological point of view, such as Alzheimer's disease, frontotemporal dementia, vascular dementias, dementia associated with parkinsonism, Huntington's disease, Creutzfeldt-Jakob disease, and normal-pressure hydrocephalus, are briefly discussed. (orig.)

  13. Vascular dementia

    Science.gov (United States)

    ... poor judgment and loss of ability to recognize danger Using the wrong word, not pronouncing words correctly, ... disease and other dementias. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: ...

  14. Neurodegenerative Dementia

    International Nuclear Information System (INIS)

    Allard, Michelle

    2006-01-01

    Full text: With increasing life expectancy across the world, the number of elderly people at risk of developing dementia is growing rapidly. Thus, progressive neurodegenerative disorders such as dementia represent a growing public health concern. These diseases are characterized by a progressive loss in most of the cognitive functions. The promise, possibly in a near future, of disease-modifying therapies has made the characterization of the early stages of dementia a topic of major interest. The assessment of these early stages is a challenge for neuroimaging studies. In order to conceive prevention trials; it is of major outcome to fully understand the mechanisms of the cognitive system impairment and its evolution, with a particular reference to the symptomatic pre-dementia stage, when subjects just begin to depart from normality. In this article we review recent progress in neuroimaging, and their potentiality for increasing a diagnostic accuracy. (author)

  15. Imaging dementias

    International Nuclear Information System (INIS)

    Savoiardo, M.; Grisoli, M.

    2001-01-01

    Dementia is the progressive loss of intellectual functions due to involvement of cortical or subcortical areas. Specific involvement of certain brain areas in the different diseases leads to impairment of different functions, e. g., memory, language, visuospatial abilities, and behavior. Magnetic resonance imaging and other neuroradiological studies may indicate which structures are mainly or selectively involved in a demented patient, thus allowing clinical-radiological correlations. Clinical presentation and evolution of the disease, supported by imaging studies, may lead to a highly probable diagnosis. The most common disorders, or the most relevant from the neuroradiological point of view, such as Alzheimer's disease, frontotemporal dementia, vascular dementias, dementia associated with parkinsonism, Huntington's disease, Creutzfeldt-Jakob disease, and normal-pressure hydrocephalus, are briefly discussed. (orig.)

  16. [{sup 123}]FP-CIT SPECT scans initially rated as normal became abnormal over time in patients with probable dementia with Lewy bodies

    Energy Technology Data Exchange (ETDEWEB)

    Zande, J.J. van der; Scheltens, P.; Lemstra, A.W. [VU Medical Center Alzheimer Center, Amsterdam (Netherlands); Booij, J. [Academic Medical Center, Department of Nuclear Medicine, Amsterdam (Netherlands); Raijmakers, P.G.H.M. [VU Medical Center, Department of Nuclear Medicine, Amsterdam (Netherlands)

    2016-06-15

    Decreased striatal dopamine transporter (DAT) binding on SPECT imaging is a strong biomarker for the diagnosis of dementia with Lewy bodies (DLB). There is still a lot of uncertainty about patients meeting the clinical criteria for probable DLB who have a normal DAT SPECT scan (DLB/S-). The aim of this study was to describe the clinical and imaging follow-up in these patients, and compare them to DLB patients with abnormal baseline scans (DLB/S+). DLB patients who underwent DAT imaging ([{sup 123}I]FP-CIT SPECT) were selected from the Amsterdam Dementia Cohort. All [{sup 123}I]FP-CIT SPECT scans were evaluated independently by two nuclear medicine physicians and in patients with normal scans follow-up imaging was obtained. We matched DLB/S- patients for age and disease duration to DLB/S+ patients and compared their clinical characteristics. Of 67 [{sup 123}I]FP-CIT SPECT scans, 7 (10.4 %) were rated as normal. In five DLB/S- patients, a second [{sup 123}I]FP-CIT SPECT was performed (after on average 1.5 years) and these scans were all abnormal. No significant differences in clinical characteristics were found at baseline. DLB/S- patients could be expected to have a better MMSE score after 1 year. This study was the first to investigate DLB patients with the initial [{sup 123}I]FP-CIT SPECT scan rated as normal and subsequent scans during disease progression rated as abnormal. We hypothesize that DLB/S- scans could represent a relatively rare DLB subtype with possibly a different severity or spread of alpha-synuclein pathology (''neocortical predominant subtype''). In clinical practice, if an alternative diagnosis is not imminent in a DLB/S- patient, repeating [{sup 123}I]FP-CIT SPECT should be considered. (orig.)

  17. High rate of hypoglycemia in 6770 type 2 diabetes patients with comorbid dementia: A multicenter cohort study on 215,932 patients from the German/Austrian diabetes registry.

    Science.gov (United States)

    Prinz, Nicole; Stingl, Julia; Dapp, Albrecht; Denkinger, Michael D; Fasching, Peter; Jehle, Peter M; Merger, Sigrun; Mühldorfer, Steffen; Pieper, Urte; Schuler, Andreas; Zeyfang, Andrej; Holl, Reinhard W

    2016-02-01

    Dementia and type 2 diabetes (T2D) are two major phenomena in older people. To compare anti-hyperglycemic therapy and diabetes-related comorbidities between elderly T2D patients with or without comorbid dementia. 215,932 type 2 diabetes patients aged ≥ 40 years (median [Q1;Q3]: 70.4 [61.2;77.7] years) from the standardized, multicenter German/Austrian diabetes patient registry, DPV, were studied. To identify patients with comorbid dementia, the registry was searched by ICD-10 codes, DSM-IV/-5 codes, respective search terms and/or disease-specific medication. For group comparisons, multiple hierarchic regression modeling with adjustments for age, sex, and duration of diabetes was applied. 3.1% (n=6770; 57% females) of the eligible T2D patients had clinically recognized comorbid dementia. After adjustment for demographics, severe hypoglycemia (insulin group: 14.8 ± 0.6 vs. 10.4 ± 0.2 events per 100 patient-years, p<0.001), hypoglycemia with coma (insulin group: 7.6 ± 0.4 vs. 3.9 ± 0.1 events per 100 patient-years, p<0.001), depression (9.9 vs. 4.7%, p<0.001), hypertension (74.7 vs. 72.2%, p<0.001), stroke (25.3 vs. 6.5%, p<0.001), diabetic foot syndrome (6.0 vs. 5.2%, p=0.004), and microalbuminuria (34.7 vs. 32.2%, p<0.001) were more common in dementia patients compared to T2D without dementia. Moreover, patients with dementia received insulin therapy more frequently (59.3 vs. 54.7%, p<0.001), but metabolic control (7.7 ± 0.1 vs. 7.7 ± 0.1%) was comparable to T2D without dementia. In T2D with dementia, higher rates of hypoglycemia and other diabetes-related comorbidities were observed. Hence, the risks of a glucocentric and intense diabetes management with insulin and a focus on tight glycemic control without considering other factors may outweigh the benefits in elderly T2D patients with comorbid dementia. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Memantine improves attention and episodic memory in Parkinson's disease dementia and dementia with Lewy bodies.

    Science.gov (United States)

    Wesnes, Keith A; Aarsland, Dag; Ballard, Clive; Londos, Elisabet

    2015-01-01

    In both dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), attentional dysfunction is a core clinical feature together with disrupted episodic memory. This study evaluated the cognitive effects of memantine in DLB and PDD using automated tests of attention and episodic memory. A randomised double-blind, placebo-controlled, 24-week three centre trial of memantine (20 mg/day) was conducted in which tests of attention (simple and choice reaction time) and word recognition (immediate and delayed) from the CDR System were administered prior to dosing and again at 12 and 24 weeks. Although other results from this study have been published, the data from the CDR System tests were not included and are presented here for the first time. Data were available for 51 patients (21 DLB and 30 PDD). In both populations, memantine produced statistically significant medium to large effect sized improvements to choice reaction time, immediate and delayed word recognition. These are the first substantial improvements on cognitive tests of attention and episodic recognition memory identified with memantine in either DLB or PDD. Copyright © 2014 John Wiley & Sons, Ltd.

  19. NOAA Climate Data Record (CDR) of AVHRR Polar Pathfinder (APP) Cryosphere

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This NOAA Climate Data Record (CDR) contains the AVHRR Polar Pathfinder (APP) product. APP is a fundamental CDR comprised of calibrated and navigated AVHRR channel...

  20. 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...... exposed to lithium (50.4%), 1,781 to anticonvulsants (36.7%), 4,280 to antidepressants (88.1%), and 3,901 to antipsychotics (80.3%) during the study period. A total of 216 patients received a diagnosis of dementia during follow-up (103.6/10,000 person-years). During the period following the second...... prescription of lithium, the rate of dementia was decreased compared to the period following the first prescription. In contrast, the rates of dementia during multiple prescription periods with anticonvulsants, antidepressants, or antipsychotics, respectively, were not significantly decreased compared...

  1. Addressing the bias problem in the assessment of the quality of life of patients with dementia: determinants of the accuracy and precision of the proxy ratings.

    Science.gov (United States)

    Gomez-Gallego, M; Gomez-Garcia, J; Ato-Lozano, E

    2015-03-01

    We aimed to examine the discrepancy between patients and caregivers' ratings of quality of life in terms of accuracy and precision, and identify factors associated with it, in order to facilitate the use of this scale as dementia progresses. Cross-sectional analytic study. Day care centres. Community-living patients with Alzheimer's disease in early or moderate stage and their principal caregivers. PARTICIPANTS rated patients' quality of life using DEMQOL. The discrepancy was assessed using the individual difference score and the residuals for each domain of DEMQOL. The scores on Mini-Mental State Examination, Geriatric Depression Scale, Neuropsychiatric Inventory, Clinical Insight Rating Scale, Cumulative Illness Rating Scale, Health Utilities Index Mark 3 and Zarit Burden Interview were considered as possible predictors of the discrepancy. A total of 276 subjects participated in the study (138 patients with Alzheimer's disease and their caregivers). Discrepancy measured by individual difference score was lower than that measured by the residuals. Burden and mood-related symptoms explained the positive differences and residuals, while pain, self-perceived depression and cognition determined the negative ones. Differences exist between patients and caregivers' perceptions about subjective states. The evaluations of each informant seem to be influenced by their own emotional state and the inner experience of the effects of the disease. Caregivers' ratings on DEMQOL could be useful to monitor the efficacy of any treatment whenever burden is low and patients have no great physical or emotional suffering.

  2. Força de preensão palmar em idosos com demência: estudo da confiabilidade Handgrip strength in elderly with dementia: study of reliability

    Directory of Open Access Journals (Sweden)

    Mariana A. Alencar

    2012-01-01

    Full Text Available CONTEXTUALIZAÇÃO: Instrumentos de medida devem ser analisados quanto a sua utilidade clínica e científica em diferentes populações. Apesar de o teste da força de preensão palmar (FPP ser amplamente utilizado, pouco foi investigado quanto a sua confiabilidade ao ser utilizado em idosos com demência e em qual grau de demência seria inviabilizado o seu uso. OBJETIVO: Avaliar a confiabilidade teste-reteste da FPP em idosos com diferentes graus de demência. MÉTODO: Realizou-se uma avaliação dos aspectos cognitivos de 76 idosos com demência e uma entrevista com o cuidador, permitindo a classificação do idoso segundo os critérios da Escala Clínica de Demência (Clinical dementia rating - CDR. Para essas avaliações, foram utilizados o Miniexame do Estado Mental e os questionários Pfeffer, Lawton e Katz. Vinte idosos foram classificados como grau questionável (83,4±5,8 anos; 19, como leve (82,4±6,8 anos; 19, como moderado (85,8±5,6 anos e 18, como grave (84,0±5,1 anos. Os idosos tiveram a FPP avaliada por meio de um dinamômetro hidráulico JAMAR e, após uma semana, foram reavaliados. A confiabilidade foi estimada pelo Coeficiente de Correlação Intraclasse (ICC. O nível de significância foi α=0,05. RESULTADOS: A confiabilidade teste-reteste foi excelente para os grupos que apresentaram o CDR questionável (ICC=0,975; p=0,001, leve (ICC=0,968; p=0,002 e moderado (ICC=0,964; p=0,001. A análise do grupo com CDR grave mostrou não haver uma significância estatística e um ICC baixo (ICC=0,415; p=0,376. CONCLUSÃO: O teste de FPP apresenta excelente confiabilidade ao ser utilizado em idosos com demências questionável, leve e moderada, viabilizando seu uso em pesquisas. Já em idosos classificados como graves, seu uso não é recomendado visto que a confiabilidade da medida é baixa e, portanto, sem relevância clínica para uso na prática.BACKGROUND: Measuring instruments should have their scientific and clinical value

  3. Força de preensão palmar em idosos com demência: estudo da confiabilidade Handgrip strength in elderly with dementia: study of reliability

    Directory of Open Access Journals (Sweden)

    Mariana A. Alencar

    2012-12-01

    Full Text Available CONTEXTUALIZAÇÃO: Instrumentos de medida devem ser analisados quanto a sua utilidade clínica e científica em diferentes populações. Apesar de o teste da força de preensão palmar (FPP ser amplamente utilizado, pouco foi investigado quanto a sua confiabilidade ao ser utilizado em idosos com demência e em qual grau de demência seria inviabilizado o seu uso. OBJETIVO: Avaliar a confiabilidade teste-reteste da FPP em idosos com diferentes graus de demência. MÉTODO: Realizou-se uma avaliação dos aspectos cognitivos de 76 idosos com demência e uma entrevista com o cuidador, permitindo a classificação do idoso segundo os critérios da Escala Clínica de Demência (Clinical dementia rating - CDR. Para essas avaliações, foram utilizados o Miniexame do Estado Mental e os questionários Pfeffer, Lawton e Katz. Vinte idosos foram classificados como grau questionável (83,4±5,8 anos; 19, como leve (82,4±6,8 anos; 19, como moderado (85,8±5,6 anos e 18, como grave (84,0±5,1 anos. Os idosos tiveram a FPP avaliada por meio de um dinamômetro hidráulico JAMAR e, após uma semana, foram reavaliados. A confiabilidade foi estimada pelo Coeficiente de Correlação Intraclasse (ICC. O nível de significância foi α=0,05. RESULTADOS: A confiabilidade teste-reteste foi excelente para os grupos que apresentaram o CDR questionável (ICC=0,975; p=0,001, leve (ICC=0,968; p=0,002 e moderado (ICC=0,964; p=0,001. A análise do grupo com CDR grave mostrou não haver uma significância estatística e um ICC baixo (ICC=0,415; p=0,376. CONCLUSÃO: O teste de FPP apresenta excelente confiabilidade ao ser utilizado em idosos com demências questionável, leve e moderada, viabilizando seu uso em pesquisas. Já em idosos classificados como graves, seu uso não é recomendado visto que a confiabilidade da medida é baixa e, portanto, sem relevância clínica para uso na prática.BACKGROUND: Measuring instruments should have their scientific and clinical value

  4. MR spectroscopy in dementia

    International Nuclear Information System (INIS)

    Hauser, T.; Gerigk, L.; Giesel, F.; Schuster, L.; Essig, M.

    2010-01-01

    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.) [de

  5. Recognizing Dementia

    DEFF Research Database (Denmark)

    Gjødsbøl, Iben Mundbjerg; Svendsen, Mette Nordahl

    2018-01-01

    narratives; yet during memory testing, patients are not allowed any substitution to clearly expose cognitive shortcomings. In combining works of theorists Ian Hacking and Paul Ricoeur, we argue that the clinical identification of dementia unmakes the knowing subject, a deconstruction that threatens...

  6. Lewy body dementias

    DEFF Research Database (Denmark)

    Løkkegaard, Annemette; Korbo, Lise

    2017-01-01

    Dementia with Lewy bodies and Parkinson disease dementia share the same pathophysiology. Together they are called Lewy body dementias and are the second most common type of dementia. Lewy body dementias receive little attention, and patients are often misdiagnosed, leading to less than ideal...

  7. Parkinson's Disease Dementia

    Science.gov (United States)

    ... Find your local chapter Join our online community Parkinson's Disease Dementia Parkinson's disease dementia is an impairment ... disease. About Symptoms Diagnosis Causes & risks Treatments About Parkinson's disease dementia The brain changes caused by Parkinson's ...

  8. Lewy Body Dementia Diagnosis

    Science.gov (United States)

    ... provide an experienced diagnostic team skilled in Lewy body dementia. A thorough dementia diagnostic evaluation includes physical ... a good way to benefit others with Lewy body dementia. Medications Medications are one of the most ...

  9. Frontotemporal Dementias: A Review

    Directory of Open Access Journals (Sweden)

    Wilkins Kirsten

    2007-06-01

    Full Text Available Abstract Dementia is a clinical state characterized by loss of function in multiple cognitive domains. It is a costly disease in terms of both personal suffering and economic loss. Frontotemporal dementia (FTD is the term now preferred over Picks disease to describe the spectrum of non-Alzheimers dementias characterized by focal atrophy of the frontal and anterior temporal regions of the brain. The prevalence of FTD is considerable, though specific figures vary among different studies. It occurs usually in an age range of 35–75 and it is more common in individuals with a positive family history of dementia. The risk factors associated with this disorder include head injury and family history of FTD. Although there is some controversy regarding the further syndromatic subdivision of the different types of FTD, the three major clinical presentations of FTD include: 1 a frontal or behavioral variant (FvFTD, 2 a temporal, aphasic variant, also called Semantic dementia (SD, and 3 a progressive aphasia (PA. These different variants differ in their clinical presentation, cognitive deficits, and affected brain regions. Patients with FTD should have a neuropsychiatric assessment, neuropsychological testing and neuroimaging studies to confirm and clarify the diagnosis. Treatment for this entity consists of behavioral and pharmacological approaches. Medications such as serotonin reuptake inhibitors, antipsychotics, mood stabilizer and other novel treatments have been used in FTD with different rates of success. Further research should be directed at understanding and developing new diagnostic and therapeutic modalities to improve the patients' prognosis and quality of life.

  10. Associations between physical function and depression in nursing home residents with mild and moderate dementia: a cross-sectional study.

    Science.gov (United States)

    Kvæl, Linda Aimée Hartford; Bergland, Astrid; Telenius, Elisabeth Wiken

    2017-07-20

    The primary aim of this study is to describe depression and physical function in nursing home residents with dementia, as well as to examine the associations between depression and balance function, lower limb muscle strength, mobility and activities of daily living. The secondary aim is to examine the differences in physical function between the groups classified as depressed and not depressed. The study has a cross-sectional design. A convenience sample of 18 nursing homes in, and around, Oslo, Norway, participated. We included 170 nursing home residents aged 60-100 years with mild or moderate degree of dementia defined by a score of 1 or 2 on the Clinical Dementia Rating Scale (CDR). Assessments used were Cornell Scale for Depression in Dementia (CSDD), Berg Balance Scale (BBS), 'the 6-metre walking test' (walking speed), 30 s Chair Stand Test (CST) and the Barthel Index (BI). Nursing home residents with dementia are a heterogeneous group in terms of physical function and depression. By applying the recommended cut-off of ≥8 on CSDD, 23.5% of the participants were classified as being depressed. The results revealed significant associations between higher scores on CSDD (indicating more symptoms of depression) and lower scores on BBS (95% CI -0.12 to -0.02, p=0.006), 30 s CST (95% CI -0.54 to -0.07, p=0.001) as well as maximum walking speed (95% CI -4.56 to -0.20, p=0.003) (indicating lower level of physical function). Better muscle strength, balance and higher walking speed were significantly associated with less depressive symptoms. The potential interaction of dementia with poor physical function and depression indicates an area to explore in future epidemiological studies with a prospective design. NCT02262104. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Conversion Between Mini-Mental State Examination, Montreal Cognitive Assessment, and Dementia Rating Scale-2 Scores in Parkinson’s Disease

    Science.gov (United States)

    van Steenoven, Inger; Aarsland, Dag; Hurtig, Howard; Chen-Plotkin, Alice; Duda, John E.; Rick, Jacqueline; Chahine, Lama M.; Dahodwala, Nabila; Trojanowski, John Q.; Roalf, David R.; Moberg, Paul J.; Weintraub, Daniel

    2015-01-01

    Cognitive impairment is one of the earliest, most common, and most disabling non-motor symptoms in Parkinson’s disease (PD). Thus, routine screening of global cognitive abilities is important for the optimal management of PD patients. Few global cognitive screening instruments have been developed for or validated in PD patients. The Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Dementia Rating Scale-2 (DRS-2) have been used extensively for cognitive screening in both clinical and research settings. Determining how to convert the scores between instruments would facilitate the longitudinal assessment of cognition in clinical settings and the comparison and synthesis of cognitive data in multicenter and longitudinal cohort studies. The primary aim of this study was to apply a simple and reliable algorithm for the conversion of MoCA to MMSE scores in PD patients. A secondary aim was to apply this algorithm for the conversion of DRS-2 to both MMSE and MoCA scores. The cognitive performance of a convenience sample of 360 patients with idiopathic PD was assessed by at least two of these cognitive screening instruments. We then developed conversion scores between the MMSE, MoCA, and DRS-2 using equipercentile equating and log-linear smoothing. The conversion score tables reported here enable direct and easy comparison of three routinely used cognitive screening assessments in PD patients. PMID:25381961

  12. 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

  13. Characteristics of Cerebral Blood Flow in Vascular Dementia using SPM Analysis Compared to Normal Control and Alzheimer's Dementia

    International Nuclear Information System (INIS)

    Kang, Do Young; Park, Kyung Won; Kim, Jae Woo

    2003-01-01

    Cerebral perfusion pattern of vascular dementia (VD) was not well established and overlap of cerebral perfusion pattern was reported between VD and Alzheimer's dementia (AD). The aim of this study is to assess the specific patterns of SPECT finding in VD compared with normal control subjects and to disclose differences of cerebral blood flow between subjects with VD and AD were investigated using statistic parametric mapping analysis. Thirty-two VD (mean age ; 67.86.4 years, mean CDR ; 0.980.27), 51 AD (mean age ; 71.47.2 years, CDR ; 1.160.47), which were matched for age and severity of dementia, and 30 normal control subjects (mean age ; 60.17.7 years) participated in this study. The Tc-99m HMPAO brain perfusion SPECT data were analyzed by SPM99. The SPECT data of the patients with VD were compared to those of the control subjects and then compared to the patients with AD. SPM analysis of the SPECT image showed significant perfusion deficits in the both frontal (both cingulate gyrus, both inferior frontal gyrus, B no.47, right frontal rectal gyrus, left frontal subcallosal gyrus, B no.25), both temporal (right insula, B no.13, left superior temporal gyrus, left parahippocampal gyrus, B no.35), occipital (occipital lingual gyrus), right corpus callosum and right cerebellar tonsil regions in subjects with VD compared with normal control subjects (uncorrected p<0.01). Comparison of the two dementia groups (uncorrected p<0.01) revealed significant hypoperfusion in both parietal posterior central gyrus, right inferior frontal gyrus (B no.47), left insula, right thalamus (ventral lateral nucleus), right claustrum and right occipital cuneus regions in VD group compared with AD. There were no typical confined regional hypoperfusion areas but scattered multiple perfusion deficits in VD compared AD. These findings may be helpful to reflect the pathophysiological mechanisms of VD and to disclose differences of cerebral blood flow between subjects with VD and AD

  14. Different cerebral metabolic features in dementia with lewy bodies with/without visual hallucination

    International Nuclear Information System (INIS)

    Kim, Bom Sahn; Kim, Yu Kyeong; Yang, Young Soon; Park, Eun Kyung; Cho, Sang Soo; Kim, Sang Yun; Kim, Sang Eun

    2007-01-01

    Reduction of glucose metabolism in the occipital cortex is well known in dementia with Lewy Bodies (DLB). The aim of this study was to evaluate the different nature of FDG PET in DLB patients who had visual hallucination or not. Thirteen patients (729 yrs, m:f=6:7) with DLB participated. DLB patient were classified into two groups according to the presence of visual hallucination; seven DLB patients with visual hallucination and 6 patients without visual hallucination. No differences between patient with and without visual hallucination was found in their cognitive function measured by mini mental status exam (MMSE) and clinical dementia rating (CDR) scale. Age and gender matched 30 healthy subjects (age; 715 yrs, m: f = 13:17) served as controls for comparison purpose. Regional metabolic differences on FDG PET among the groups were tested using SPM. In DLB patients groups regardless of visual hallucination, significant regional hypometabolism were observed in the bilateral occipital cortices as well as bilateral parietotemporal and frontal association cortices when compared with healthy controls, as expected. In DLB patients with visual hallucination compared to patients without hallucination, regional hypometabolism over primary and secondary visual cortex (BA17, BA18) was more significant. Moreover, lower regional metabolism in the paracentral area (BA 6) and cerebellar vermis was also observed in DLB with visual hallucination than without hallucination. Profound hypometabolism in the visual cortex may be a feature in DLB patients with visual hallucination. Also, relative hypometabolism in the paracentral area and cerebellum could be neurobiological characteristics related with abnormal cognitive and motor process response to hallucination

  15. CLICdet: The post-CDR CLIC detector model

    CERN Document Server

    Alipour Tehrani, Niloufar; Cure, Benoit; Dannheim, Dominik; Duarte Ramos, Fernando; Elsener, Konrad; Gaddi, Andrea; Gerwig, Hubert; Green, Steven; Grefe, Christian; Hynds, Daniel; Klempt, Wolfgang; Linssen, Lucie; Nikiforou, Nikiforos; Nurnberg, Andreas Matthias; Marshall, John Stuart; Petric, Marko; Redford, Sophie; Roloff, Philipp Gerhard; Sailer, Andre; Sefkow, Felix; Sicking, Eva; Siegrist, Nicolas; Simon, Frank Richard; Simoniello, Rosa; Spannagel, Simon; Sroka, Szymon Krzysztof; Strom, Lars Rickard; Weber, Matthias Artur

    2017-01-01

    A new model for the CLIC detector has been defined based on lessons learnt while working with the CDR detector models and after a series of simulation studies. The new model, dubbed "CLICdet", also incorporates the experience from various R&D activities linked to a future experiment at CLIC. This note describes the studies and thoughts leading to the new detector model, and gives details on all of its sub-detector systems.

  16. Application of false discovery rate control in the assessment of decrease of FDG uptake in early Alzheimer dementia

    International Nuclear Information System (INIS)

    Lee, Dong Soo; Kang, Hye Jin; Jang, Myung Jin; Kang, Won Jun; Lee, Jae Sung; Kang, Eun Joo; Lee, Kang Uk; Woo, Jong In; Lee, Myung Chul; Cho, Sang Soo

    2003-01-01

    Determining an appropriate thresholding is crucial for PDG PET analysis since strong control of Type I error could fail to find pathological differences between early Alzheimer' disease (AD) patients and healthy normal controls. We compared the SPM results on FDG PET imaging of early AD using uncorrected p-value, random-field based corrected p-value and false discovery rate (FDR) control. Twenty-eight patients (66±7 years old) with early AD and 18 age-matched normal controls (68±6 years old) underwent FDG brain PET. To identify brain regions with hypo-metabolism in group or individual patient compared to normal controls, group images or each patient's image was compared with normal controls using the same fixed p-value of 0.001 on uncorrected thresholding, random-field based corrected thresholding and FDR control. The number of hypo-metabolic voxels was smallest in corrected p-value method, largest in uncorrected p-value method and intermediate in FDG thresholding in group analysis. Three types of result pattern were found. The first was that corrected p-value did yield any voxel positive but FDR gave a few significantly hypometabolic voxels (8/28, 29%). The second was that both corrected p-value and FDR did not yield any positive region but numerous positive voxels were found with the threshold of uncorrected p-values (6/28, 21%). The last was that FDR was detected as many positive voxels as uncorrected p-value method (14/28, 50%). Conclusions FDR control could identify hypo-metabolic areas in group or individual patients with early AD. We recommend FDR control instead of uncorrected or random-field corrected thresholding method to find the areas showing hypometabolism especially in small group or individual analysis of FDG PET

  17. A follow-up study of mortality of dementia patients in Guangzhou%广州市城乡老年期痴呆死亡率的随访研究

    Institute of Scientific and Technical Information of China (English)

    黄若燕; 唐牟尼; 林康广; 郁俊昌; 陈映梅; 郭伟坚; 肖頔; 王怀坤; 佘生林

    2014-01-01

    .The severity of dementia was assessed with the Clinical Scale for the Staging of Dementia Rate.Results (1) After 7 years the mortality of dementia was 18.55/100 person-years.The mortality rates of patients with Alzheimer's disease (AD),vascular dementia (VD) and other types of dementia (OD) were 17.69/100,19.05/100 and 32.93/100 person-years respectively.The mortality rate of female dementia aged 60-69,70-79,and 80 years or over were 17.14/100,13.67/100 and 19.87/100 person-years respectively.Logistic regression analysis showed that age(OR =1.05,95% confidence interval (CI):1.03-1.08) and CDR (OR =2.56,95% CI:1.50-4.37) increased the risk of death.Conclusion The mortality of patients with OD is possibly highest among all the cases and the lowest in patients with AD.Age and the severity of dementia is likely to increase the mortality.The mortality on lower-age patients is higher than that in middle-age patients.

  18. Effect of the herbal formulation Jianpijiedu on the TCRVβCDR3 repertoire in rats with hepatocellular carcinoma and subjected to food restriction combined with laxative.

    Science.gov (United States)

    Sun, Baoguo; Meng, Jun; Xiang, Ting; Zhang, Lei; Deng, Liuxiang; Chen, Yan; Luo, Haoxuan; Yang, Zhangbin; Chen, Zexiong; Zhang, Shijun

    2016-03-01

    The aim of this study was to investigate the effects of the Chinese herbal formulation Jianpijiedu (JPJD) in a rat model of orthotopic hepatocellular carcinoma (OHC). The tumor-bearing rats underwent food restriction combined with laxative (FRL) treatment in order to model the nutritional and digestive symptoms of patients with hepatocellular carcinoma. In addition, the study aimed to elucidate the effect of JPJD on the T cell receptor Vβ-chain complementarity-determining region 3 (TCRVβCDR3) repertoire and the underlying mechanism. The FRL rat model was established by alternate-day food restriction and the oral administration of Glauber's salt (sodium sulfate), based on which the OHC model was then established. Subsequently, the FRL-OHC induced animals received JPJD or thymopentin-5 (TP5) for 17 days. Differences in the TCRVβCDR3 repertoire in the rat thymus, liver and hepatocellular carcinoma tissues were analyzed by polymerase chain reaction. Compared with the FRL-OHC model animals without any treatment, those treated with JPJD exhibited significantly inhibited hepatocellular carcinoma growth (PSimpsons diversity index (Ds) values and the quasi-Gaussian distribution rate of the TCRVβCDR3 repertoire in the thymus, liver and hepatocellular carcinoma tissues. However, no anti-hepatoma effects were evident in the rats treated with TP5. In addition, TP5 increased the Ds values and the quasi-Gaussian distribution rate of the TCRVβCDR3 repertoire in hepatocellular carcinoma tissues compared with those in the JPJD-treated group. The anti-hepatoma effects of JPJD in FRL-OHC-induced animals may be due to the promotion of the Ds values of the TCRVβCDR3 repertoire.

  19. TJOG Vol 26 No 1.cdr

    African Journals Online (AJOL)

    Perinatal Outcomes of Rural Population of South Africa. 1. 2. 3. 4. Monjurul ..... population such as poverty and high rate of HIV. 25 infection. ... Low birth weight delivery rates though remained antenatal ... World Health Organization. Health and ...

  20. 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.

  1. FDG PET imaging dementia

    International Nuclear Information System (INIS)

    Ahn, Byeong Cheol

    2007-01-01

    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

  2. Quantitative Proteomics Reveals the Regulatory Networks of Circular RNA CDR1as in Hepatocellular Carcinoma Cells.

    Science.gov (United States)

    Yang, Xue; Xiong, Qian; Wu, Ying; Li, Siting; Ge, Feng

    2017-10-06

    Circular RNAs (circRNAs), a class of widespread endogenous RNAs, play crucial roles in diverse biological processes and are potential biomarkers in diverse human diseases and cancers. Cerebellar-degeneration-related protein 1 antisense RNA (CDR1as), an oncogenic circRNA, is involved in human tumorigenesis and is dysregulated in hepatocellular carcinoma (HCC). However, the molecular mechanisms underlying CDR1as functions in HCC remain unclear. Here we explored the functions of CDR1as and searched for CDR1as-regulated proteins in HCC cells. A quantitative proteomics strategy was employed to globally identify CDR1as-regulated proteins in HCC cells. In total, we identified 330 differentially expressed proteins (DEPs) upon enhanced CDR1as expression in HepG2 cells, indicating that they could be proteins regulated by CDR1as. Bioinformatic analysis revealed that many DEPs were involved in cell proliferation and the cell cycle. Further functional studies of epidermal growth factor receptor (EGFR) found that CDR1as exerts its effects on cell proliferation at least in part through the regulation of EGFR expression. We further confirmed that CDR1as could inhibit the expression of microRNA-7 (miR-7). EGFR is a validated target of miR-7; therefore, CDR1as may exert its function by regulating EGFR expression via targeting miR-7 in HCC cells. Taken together, we revealed novel functions and underlying mechanisms of CDR1as in HCC cells. This study serves as the first proteome-wide analysis of a circRNA-regulated protein in cells and provides a reliable and highly efficient method for globally identifying circRNA-regulated proteins.

  3. Insights on dying, dementia and death certificates.

    Science.gov (United States)

    Vandormael, Sofie; Meirschaert, Alexander; Steyaert, Jan; De Lepeleire, Jan

    2018-01-01

    For our master thesis in medicine, we aimed to determine how many deaths were caused by and with dementia in 2014 and we compared our results with figures from abroad. The mortality rates of 2014 in Flanders were used to determine the amount of deaths related to dementia. These figures are collected by Vlaams Agentschap Zorg & Gezondheid (VAZG) and coded per ICD-10 classification. Of all deaths in Flanders in 2014, 6.60% were caused by dementia and 4.29% were caused by another condition, while also suffering from dementia. Data from abroad are ambiguous. While working on our thesis about "death & dementia", we questioned the reliability of mortality statistics. Possible explanations could be; the complexity of completing death certificates correctly and the challenges involved in properly constructing a chain of causes of death. The accuracy of mortality data can be improved by training and redrafting death certificates.

  4. Variables associated with change in quality of life among persons with dementia in nursing homes: a 10 months follow-up study.

    Directory of Open Access Journals (Sweden)

    Marit Mjørud

    Full Text Available To investigate variables associated with change in quality of life (QOL, measured by QUALID scale and three subscales; tension, sadness and wellbeing, among dementia patients in nursing homes.A 10 months follow-up study including 198 (female 156, 79% nursing home patients, mean age 87 (s.d 7.7 years. Scales applied; quality of life in late stage dementia (QUALID scale and three subscales (wellbeing, sadness and tension, neuropsychiatric inventory questionnaire 10 items (NPI-10-Q, clinical dementia rating (CDR scale, physical self-maintenance (PSMS scale and a scale of general medical health. Use of psychotropic medication, gender and age was collected from the patient's records.Mean baseline QUALID score: 20.6 (s.d.7.0, follow-up score: 22.9 (s.d.7.4, mean change 2.8 (s.d.7.4. QOL improved in 30.8%, were unchanged in 14.7%, deteriorated in 54.6% of patients. A regression analysis revealed that change in QUALID score was significantly associated with: QUALID baseline score (beta -.381, p-value.000, change in NPI score (beta.421, p-value.000, explained variance 38.1%. Change in score on wellbeing subscale associated with: change in PSMS score (beta.185, p-value.019, wellbeing baseline score (beta -.370, p-value.000, change in NPI score (beta.186, p-value.017, explained variance 25.3%. Change in score on tension subscale associated with: change in CDR sum-of-boxes (beta.214, p-value.003, change in NPI score (beta.270, p-value.000, tension baseline score (beta -.423, p-value.000, explained variance 34.6%. Change in score on sadness subscale associated with: change in NPI score (beta.404, p-value.000, sadness baseline score (beta -.438, p-value.000, explained variance 38.8%.The results imply that a lower baseline score (better QOL results in a larger change in QOL (towards worse QOL. Change in QOL is mostly associated with change in neuropsychiatric symptoms. In almost 50% of patients QOL did not deteriorate.

  5. The cost of dementia in Denmark: the Odense Study.

    Science.gov (United States)

    Kronborg Andersen, C; Søgaard, J; Hansen, E; Kragh-Sørensen, A; Hastrup, L; Andersen, J; Andersen, K; Lolk, A; Nielsen, H; Kragh-Sørensen, P

    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 those with dementia and the matched controls and amounts on average to DKK 77,000 per person per year. However, priority setting cannot be based on the cost of dementia per se, but only on the cost of a specific dementia intervention compared to its health benefit.

  6. 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 ...

  7. Longitudinal Association of Dementia and Depression.

    Science.gov (United States)

    Snowden, Mark B; Atkins, David C; Steinman, Lesley E; Bell, Janice F; Bryant, Lucinda L; Copeland, Catherine; Fitzpatrick, Annette L

    2015-09-01

    Depression is an important precursor to dementia, but less is known about the role dementia plays in altering the course of depression. We examined whether depression prevalence, incidence, and severity are higher in those with dementia versus those with mild cognitive impairment (MCI), or normal cognition. Prospective cohort study using the longitudinal Uniform Data Set of the National Alzheimer's Coordinating Center (2005-2013). 34 Alzheimer Disease research centers. 27,776 subjects with dementia, MCI, or normal cognition. Depression status was determined by a clinical diagnosis of depression within the prior 2 years and by a Geriatric Depression Scale-Short Form score >5. Rates of depression were significantly higher in subjects with MCI and dementia compared with those with normal cognition at index visit. Controlling for demographics and common chronic conditions, logistic regression analysis revealed elevated depression in those with MCI (OR: 2.40 [95% CI: 2.25, 2.56]) or dementia (OR: 2.64 [95% CI: 2.43, 2.86]) relative to those with normal cognition. In the subjects without depression at the index visit (N = 18,842), those with MCI and dementia had higher probabilities of depression diagnosis 2 years post index visit than those with normal cognition: MCI = 21.7%, dementia = 24.7%, normal cognition = 10.5%. MCI and dementia were associated with significantly higher rates of depression in concurrent as well as prospective analyses. These findings suggest that efforts to effectively engage and treat older adults with dementia will need also to address co-occurring depression. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  8. 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 ...

  9. 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 ...

  10. Association between recognizing dementia as a mental illness and dementia knowledge among elderly Chinese Americans.

    Science.gov (United States)

    Zheng, Xin; Woo, Benjamin K P

    2016-06-22

    To investigate whether older Chinese Americans perceive dementia as a mental illness and the relationship between such perception and their general understanding of dementia remains unclear. Our study aims to understand this relationship and its future implication on improving dementia literacy among ethnic minorities. Elderly Chinese American participants from the Greater Los Angeles were asked to complete an 11-item dementia questionnaire, following a community health seminar. Cross-sectional survey data was analyzed using standard statistical methods. The questionnaire received an 88.3% response rate. Among 316 responders, only 28.8% (n = 91) of elderly Chinese Americans identified dementia as a mental illness, and 71.2% (n = 225) did not recognize its mental disease origin. Furthermore, in comparison between these two groups, the first group demonstrated significantly higher level of baseline knowledge of the disease. This study reveals that only approximately 1 out of 4 older Chinese Americans recognized dementia as a mental illness, consistent with previous studies on Asian Americans. Our study however showed that when dementia was being perceived as a mental illness, such perception was associated with a higher level of baseline dementia understanding. The current study suggested the potential of improving older Chinese Americans dementia literacy by increasing awareness of its mental illness origin.

  11. TJOG Vol 26 No 1.cdr

    African Journals Online (AJOL)

    Objectives: To determine pregnancy outcomes and microbial organisms in .... urinary tract infection giving an asymptomatic abdominal/uterine tenderness and foul smelling bacteriuria rate of 42.3%. lochia. .... expect of expectant management.

  12. TJOG Vol 26 No 1.cdr

    African Journals Online (AJOL)

    to reduce the rising trend especially in developing countries where the figures are competing seriously with those ... Objective: The study assesses the current caesarean section rate in the hospital, ... birth to women aged 30-50 years despite a.

  13. 37(4) All.cdr

    African Journals Online (AJOL)

    HP

    The aim of this research was to determine the prevalence rate of BVDV antibodies in cattle, sheep and goats in Maiduguri, northeastern Nigeria. Sera from 333 ... Key words: Bovine Viral Diarrhoea Virus, Infertility, Ruminants, Seroprevalence.

  14. Cognitive impairment of dementias

    OpenAIRE

    Medina, L. D.; Rodríguez-Agudelo, Yaneth

    2012-01-01

    Dementia is a clinical syndrome characterized by a loss of cognitive and emotional abilities of sufficient severity to infer with social or occupational functioning, or both. Although the causes of dementia and characteristics are not always fully understood, it is understood that it is not a natural part of aging. Definitive diagnosis of dementia is made only through the autopsy and although the diagnosis of probable or possible dementia is complex is achieved by the intervention of several ...

  15. NOAA Climate Data Record (CDR) of Precipitation Estimation from Remotely Sensed Information using Artificial Neural Networks (PERSIANN-CDR), Version 1 Revision 1

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — PERSIANN Precipitation Climate Data Record (PERSIANN-CDR) is a daily quasi-global precipitation product for the period of 1982 to 2011. The data covers from 60...

  16. The roles of CDR1, CDR2, and MDR1 in kaempferol-induced suppression with fluconazole-resistant Candida albicans.

    Science.gov (United States)

    Shao, Jing; Zhang, MengXiang; Wang, TianMing; Li, Yue; Wang, ChangZhong

    2016-01-01

    Fungal infections caused by fluconazole-resistant Candida albicans are an intractable clinical problem, calling for new efficient antifungal drugs. Kaempferol, an active flavonoid, has been considered a potential candidate against Candida species. This work investigates the resistance reversion of kaempferol in fluconazole-resistant C. albicans and the underlying mechanism. The antifungal activities of fluconazole and/or kaempferol were assessed by a series of standard procedures including broth microdilution method, checkerboard assay and time-kill (T-K) test in nine clinical strains as well as a standard reference isolate of C. albicans. Subsequently, the morphological changes, the efflux of rhodamine 6G, and the expressions of CDR 1, CDR 2, and MDR 1 were analysed by scanning electron microscope (SEM), inverted fluorescence microscope and quantitative reverse transcription polymerase chain reaction (qRT-PCR) in C. albicans z2003. For all the tested C. albicans strains, the minimum inhibitory concentrations (MICs) of fluconazole and kaempferol ranged 0.25-32 and 128-256 μg/mL with a range of fractional inhibitory concentration index of 0.257-0.531. In C. albicans z2003, the expression of both CDR 1 and CDR 2 were decreased after exposure to kaempferol alone with negligible rhodamine 6G accumulation, while the expression of CDR 1, CDR 2 and MDR 1 were all decreased when fluconazole and kaempferol were used concomitantly with notable fluorescence of rhodamine 6G observed. Kaempferol-induced reversion in fluconazole-resistant C. albicans might be likely due to the suppression of the expression of CDR1, CDR2 and MDR1.

  17. The sensitivity and specificity of subjective memory complaints and the subjective memory rating scale, deterioration cognitive observee, mini-mental state examination, six-item screener and clock drawing test in dementia screening.

    Science.gov (United States)

    Ramlall, S; Chipps, J; Bhigjee, A I; Pillay, B J

    2013-01-01

    The effectiveness of dementia screening depends on the availability of suitable screening tools with good sensitivity and specificity to confidently distinguish normal age-related cognitive decline from dementia. The aim of this study was to evaluate the discriminant validity of 7 screening measures for dementia. A sample of 140 participants aged ≥60 years living in a residential facility for the aged were assessed clinically and assigned caseness for dementia using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revised diagnostic criteria. Sensitivity and specificity of a selection of the following screening measures were tested using receiver operating characteristic (ROC) analysis for individual and combined tests: the Mini-Mental State Examination (MMSE), Six-Item Screener (SIS), Subjective Memory Complaint, Subjective Memory Complaint Clinical (SMCC), Subjective Memory Rating Scale (SMRS), Deterioration Cognitive Observee (DECO) and the Clock Drawing Test (CDT). Using ROC analyses, the SMCC, MMSE and CDT were found to be 'moderately accurate' in screening for dementia with an area under the curve (AUC) >0.70. The AUCs for the SIS (0.526), SMRS (0.661) and DECO (0.687) classified these measures as being 'less accurate'. At recommended cutoff scores, the SMCC had a sensitivity of 90.9% and specificity of 45.7%; the MMSE had a sensitivity of 63.6% and a specificity of 76.0%, and the CDT had a sensitivity of 44.4% and a specificity of 88.9%. Combining the SMCC and MMSE did not improve their predictive power except for a modest increase when using the sequential rule. The SMCC is composed of valid screening questions that have high sensitivity, are simple to administer and ideal for administration at the community or primary health care level as a first level of 'rule-out' screening. The MMSE can be included at a second stage of screening at the general hospital level and the CDT in specialist clinical settings. Sequential use of the

  18. Evaluative Conditioning with Facial Stimuli in Dementia Patients

    OpenAIRE

    Blessing, Andreas; Zöllig, Jacqueline; Weierstall, Roland; Dammann, Gerhard; Martin, Mike

    2013-01-01

    We present results of a study investigating evaluative learning in dementia patients with a classic evaluative conditioning paradigm. Picture pairs of three unfamiliar faces with liked, disliked, or neutral faces, that were rated prior to the presentation, were presented 10 times each to a group of dementia patients (N = 15) and healthy controls (N = 14) in random order. Valence ratings of all faces were assessed before and after presentation. In contrast to controls, dementia patients chan...

  19. RJHS V2(2).cdr

    African Journals Online (AJOL)

    Abe Olugbenga

    projected to increase to 552million by 2030), and is undoubtedly one of the ... Diabetes exerts a significant burden in sub-Saharan Africa, ... highest mortality rates due to diabetes. The first step ..... Singapore Med J. 2002;43:128–34. 16. Cullen KW ...

  20. JUNE ISSUE 2008 FINAL.cdr

    African Journals Online (AJOL)

    birth and 40 weeks post conception, growth rates for different gestational age groups were 129 to 207g/week. (weight) ... half of intra-uterine life, there is a rapid weight gain especially in ... increase is accounted for by an increase in size and.

  1. nvj 36 2 new.cdr

    African Journals Online (AJOL)

    GRAPHICS DEPT

    normal physiological behavior of the animals and reduced feed intake and nitrogen retention leading to decreased efficiency of utilization of feed which causes decreased performance in terms of reduced growth rates by up to 30 % or more (Lewis, 1975; Adu and Buvanendra,. 1982; Provost, 1989). Other effects include low.

  2. MJZ VOL 37 NO 2.CDR

    African Journals Online (AJOL)

    MJZ

    Peltier et al evaluated the algorithm in Rwanda and documented. 10. 77% sensitivity but only 63% specificity. Both of these studies had higher detection rates for stage 4 conditions. In Rwanda, 52% of all patients had severe malnutrition, a stage 4 diagnosis that was relatively uncommon in our study population. A.

  3. RJHS Vol 4(1).cdr

    African Journals Online (AJOL)

    ABEOLUGBENGAS

    Knowledge and practice of sewage disposal in Abattoir community of Jos. South LGA ... A mean age of 31± 2 years was found with a .... urban populations had no toilet facilities of any ... management and form a basis for further studies. ... response rate of 10% was taken into ... based on responses to a total of ten questions.

  4. Personal Subscription 2018 revised.cdr

    Indian Academy of Sciences (India)

    user

    Resonance - Journal of Science Education. 0250-6335. 0250-5991. 0253-4142. 0022-1333. 0250-4707. 0253-4126. 0256-2499. 0253- ... Rates are inclusive of postage (ordinary post) and handling charges but with additional charges, journals can also be mailed by Registered post. 4. All correspondence regarding journal ...

  5. Ujah (Vol. 8 No. 1).cdr

    African Journals Online (AJOL)

    MASTERPLUS

    contributed to high mortality rates among women and children in Nigeria in recent .... di njo” (we are Christians but we will not leave our traditions and customs of our ... Some others are just reluctant to let go of age-long chauvinistic attitudes that ... community, warning that “very soon a maternity will be opened in his (the ...

  6. JUNE 2010.for Ogidi (final).cdr

    African Journals Online (AJOL)

    User

    Prolonged pressure from the hernia contents may lead to skin problems like attenuated skin, ulceration and infection,. 2, 3 .... dressing. The high rate of failed repairs in larger hernias and complex hernias may also be related to the high incidence of associated co morbid conditions in such hernias. These not only contribute.

  7. JUNE ISSUE 2008 FINAL.cdr

    African Journals Online (AJOL)

    port wound infection rate, abdominal discomfort (feeling of retained gas in the abdomen) and shoulder pain with resultant ... eliminated the abdominal discomfort and shoulder pain associated with Room Air pneumoperitoneum. This was followed by .... could be harmful to the bacteria in the air and the heat also contributes ...

  8. RJHS Vol 4(3).cdr

    African Journals Online (AJOL)

    ABEOLUGBENGAS

    Objective: Immunization is one of the most cost-effective public health ... policy to ensure nursing mothers are permitted to take their children for immunization during working hours would go a long way to improve rate of immunization uptake of ...

  9. Lewy body dementias

    DEFF Research Database (Denmark)

    Løkkegaard, Annemette; Korbo, Lise

    2017-01-01

    Dementia with Lewy bodies and Parkinson disease dementia share the same pathophysiology. Together they are called Lewy body dementias and are the second most common type of dementia. Lewy body dementias receive little attention, and patients are often misdiagnosed, leading to less than ideal...... management. In this article, diagnostic criteria combined with imaging and other biomarkers as well as current treatment recommendations are summarized, and some of the challenges for the future are outlined. Refinement of diagnosis and clarification of the pathogenesis are required in search for disease...

  10. Health Policy and Dementia.

    Science.gov (United States)

    Powell, Tia

    2018-02-01

    The anticipated number of persons with dementia continues to grow, and the US has insufficiently planned to provide and pay for care for this large population. A number of significant clinical trials aiming to prevent or cure dementia, including Alzheimer's disease, have not demonstrated success. Because of the lack of efficacious treatments, and the fact that brain changes associated with dementia may begin decades before symptoms, we can predict that efforts to cure or prevent dementia will not succeed in time for millions of people in the baby boomer generation. Because of the anticipated increase in people suffering with dementia in the coming years, US health policy must address major gaps in how to provide and pay for dementia care. Reliance on Medicaid and Medicare as currently structured will not sustain the necessary care, nor can families alone provide all necessary dementia care. Innovative forms of providing long-term care and paying for it are crucially needed.

  11. Caring for people with dementia in hospital: findings from a survey to identify barriers and facilitators to implementing best practice dementia care.

    Science.gov (United States)

    Tropea, Joanne; LoGiudice, Dina; Liew, Danny; Roberts, Carol; Brand, Caroline

    2017-03-01

    Best practice dementia care is not always provided in the hospital setting. Knowledge, attitudes and motivation, practitioner behavior, and external factors can influence uptake of best practice and quality care. The aim of this study was to determine hospital staff perceived barriers and enablers to implementing best practice dementia care. A 17-item survey was administered at two Australian hospitals between July and September 2014. Multidisciplinary staff working in the emergency departments and general medical wards were invited to participate in the survey. The survey collected data about the respondents' current role, work area, and years of experience, their perceived level of confidence and knowledge in dementia care and common symptoms of dementia, barriers and enablers to implementing best practice dementia care, job satisfaction in caring for people with dementia, and to rate the hospital's capacity and available resources to support best practice dementia care. A total of 112 survey responses were received. The environment, inadequate staffing levels and workload, time, and staff knowledge and skills were identified as barriers to implementing best practice dementia care. Most respondents rated their knowledge of dementia care and common symptoms of dementia, and confidence in recognizing whether a person has dementia, as moderate or high dementia. Approximately, half the respondents rated access to training and equipment as low or very low. The survey findings highlighted hospital staff perceived barriers to implementing best practice dementia care that can be used to inform locally tailored improvement interventions.

  12. Neurocognitive differential diagnosis of dementing diseases: Alzheimer's Dementia, Vascular Dementia, Frontotemporal Dementia, and Major Depressive Disorder.

    Science.gov (United States)

    Braaten, Alyssa J; Parsons, Thomas D; McCue, Robert; Sellers, Alfred; Burns, William J

    2006-11-01

    Similarities in presentation of Dementia of Alzheimer's Type, Vascular Dementia, Frontotemporal Dementia, and Major Depressive Disorder, pose differential diagnosis challenges. The current study identifies specific neuropsychological patterns of scores for Dementia of Alzheimer's Type, Vascular Dementia, Frontotemporal Dementia, and Major Depressive Disorder. Neuropsychological domains directly assessed in the study included: immediate memory, delayed memory, confrontational naming, verbal fluency, attention, concentration, and executive functioning. The results reveal specific neuropsychological comparative profiles for Dementia of Alzheimer's Type, Vascular Dementia, Frontotemporal Dementia, and Major Depressive Disorder. The identification of these profiles will assist in the differential diagnosis of these disorders and aid in patient treatment.

  13. Dementia: role of MRI

    International Nuclear Information System (INIS)

    Georgieva-Kozarova, G.

    2012-01-01

    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)

  14. Analysis on early clinical features of behavioral variant frontotemporal dementia

    Directory of Open Access Journals (Sweden)

    Guan-jun LI

    2017-11-01

    Full Text Available Background Although the early behavioral symptoms of behavioral variant frontotemporal dementia (bvFTD are prominent, early diagnosis for bvFTD is difficult due to confusion with other mental disorders, and lack of sensitivity and specificity of diagnostic criteria, etc. In this paper, we summarized the important reviews in recent years and analyzed the clinical characteristics of bvFTD patients to improve the detection of early symptoms in bvFTD. Methods Twenty-three possible or probable bvFTD patients were diagnosed according to International Behavioral Variant Frontotemporal Dementia Criteria Consortium (FTDC. Self-designed questionnaires designed by Shanghai Mental Health Center were used to collect sociodemographic data and general information of patients. Their clinical characteristics were summarized, including abnormal behaviors, cognitive impairment, psychotic symptoms and other symptoms. Mini-Mental State Examination (MMSE, Activities of Daily Living (ADL and Clinical Dementia Rating Scale (CDR were used to make neuropsychological tests and compare with similar overseas studies (control group, N = 66. Results Eleven male patients and 12 female patients were included in our study. Compared with control group, the average age of onset [(50.83 ± 11.55 years vs. (57.00 ± 10.00 years; t = 3.863, P = 0.000] and average age of diagnosis [(53.22 ± 11.55 years vs. (61.00 ± 9.00 years; t = 13.423, P = 0.000] of bvFTD patients were smaller. The study showed that bvFTD patients had more apathy or indolence [95.65% (22/23 vs. 65.15% (43/66; χ2 = 8.057, P = 0.005], loss of sympathy or empathy [95.65% (22/23 vs. 33.33% (22/66; χ2 = 26.499, P = 0.000], while patients in control group showed more derepression behavior [98.48% (65/66 vs. 52.17% (12/23; χ2 = 27.514, P = 0.000] and continuous, stiff, obsessive and/or ritualized behavior [95.45% (63/66 vs. 30.43% (7/23; adjusted χ2 = 39.159, P = 0.000]. For cognitive impairment, bvFTD patients

  15. Assessment of volumetric-modulated arc therapy for constant and variable dose rates

    Directory of Open Access Journals (Sweden)

    Mariluz De Ornelas-Couto

    2017-01-01

    Full Text Available Purpose: The aim of this study is to compare the effects of dose rate on volumetric-modulated arc therapy plans to determine optimal dose rates for prostate and head and neck (HN cases. Materials and Methods: Ten prostate and ten HN cases were retrospectively studied. For each case, seven plans were generated: one variable dose rate (VDR and six constant dose rate (CDR (100–600 monitor units [MUs]/min plans. Prescription doses were: 80 Gy to planning target volume (PTV for the prostate cases, and 70, 60, and 54 Gy to PTV1, PTV2, and PTV3, respectively, for HN cases. Plans were normalized to 95% of the PTV and PTV1, respectively, with the prescription dose. Plans were assessed using Dose-Volume-Histogram metrics, homogeneity index, conformity index, MUs, and delivery time. Results: For the prostate cases, significant differences were found for rectum D35 between VDR and all CDR plans, except CDR500. Furthermore, VDR was significantly different than CDR100 and 200 for bladder D50. Delivery time for all CDR plans and MUs for CDR400–600 were significantly higher when compared to VDR. HN cases showed significant differences between VDR and CDR100, 500 and 600 for D2 to the cord and brainstem. Significant differences were found for delivery time and MUs for all CDR plans, except CDR100 for number of MUs. Conclusion: The most significant differences were observed in delivery time and number of MUs. All-in-all, the best CDR for prostate cases was found to be 300 MUs/min and 200 or 300 MUs/min for HN cases. However, VDR plans are still the choice in terms of MU efficiency and plan quality.

  16. Characteristics of Cerebral Blood Flow in Vascular Dementia using SPM Analysis Compared to Normal Control and Alzheimer's Dementia

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Do Young; Park, Kyung Won; Kim, Jae Woo [College of Medicine, Univ. of Donga, Busan (Korea, Republic of)

    2003-07-01

    Cerebral perfusion pattern of vascular dementia (VD) was not well established and overlap of cerebral perfusion pattern was reported between VD and Alzheimer's dementia (AD). The aim of this study is to assess the specific patterns of SPECT finding in VD compared with normal control subjects and to disclose differences of cerebral blood flow between subjects with VD and AD were investigated using statistic parametric mapping analysis. Thirty-two VD (mean age ; 67.86.4 years, mean CDR ; 0.980.27), 51 AD (mean age ; 71.47.2 years, CDR ; 1.160.47), which were matched for age and severity of dementia, and 30 normal control subjects (mean age ; 60.17.7 years) participated in this study. The Tc-99m HMPAO brain perfusion SPECT data were analyzed by SPM99. The SPECT data of the patients with VD were compared to those of the control subjects and then compared to the patients with AD. SPM analysis of the SPECT image showed significant perfusion deficits in the both frontal (both cingulate gyrus, both inferior frontal gyrus, B no.47, right frontal rectal gyrus, left frontal subcallosal gyrus, B no.25), both temporal (right insula, B no.13, left superior temporal gyrus, left parahippocampal gyrus, B no.35), occipital (occipital lingual gyrus), right corpus callosum and right cerebellar tonsil regions in subjects with VD compared with normal control subjects (uncorrected p<0.01). Comparison of the two dementia groups (uncorrected p<0.01) revealed significant hypoperfusion in both parietal posterior central gyrus, right inferior frontal gyrus (B no.47), left insula, right thalamus (ventral lateral nucleus), right claustrum and right occipital cuneus regions in VD group compared with AD. There were no typical confined regional hypoperfusion areas but scattered multiple perfusion deficits in VD compared AD. These findings may be helpful to reflect the pathophysiological mechanisms of VD and to disclose differences of cerebral blood flow between subjects with VD and AD.

  17. Depression associated with dementia.

    Science.gov (United States)

    Gutzmann, H; Qazi, A

    2015-06-01

    Depression and cognitive disorders, including dementia and mild cognitive impairment, are common disorders in old age. Depression is frequent in dementia, causing distress, reducing the quality of life, exacerbating cognitive and functional impairment and increasing caregiver stress. Even mild levels of depression can significantly add to the functional impairment of dementia patients and the severity of psychopathological and neurological impairments increases with increasing severity of depression. Depressive symptoms may be both a risk factor for, as well as a prodrome of dementia. Major depressive syndrome of Alzheimer's disease may be among the most common mood disorders of older adults. Treating depression is therefore a key clinical priority to improve the quality of life both of people with dementia as well as their carergivers. Nonpharmacological approaches and watchful waiting should be attempted first in patients who present with mild to moderate depression and dementia. In cases of severe depression or depression not able to be managed through nonpharmacological means, antidepressant therapy should be considered.

  18. Physiological phenotyping of dementias using emotional sounds.

    Science.gov (United States)

    Fletcher, Phillip D; Nicholas, Jennifer M; Shakespeare, Timothy J; Downey, Laura E; Golden, Hannah L; Agustus, Jennifer L; Clark, Camilla N; Mummery, Catherine J; Schott, Jonathan M; Crutch, Sebastian J; Warren, Jason D

    2015-06-01

    Emotional behavioral disturbances are hallmarks of many dementias but their pathophysiology is poorly understood. Here we addressed this issue using the paradigm of emotionally salient sounds. Pupil responses and affective valence ratings for nonverbal sounds of varying emotional salience were assessed in patients with behavioral variant frontotemporal dementia (bvFTD) (n = 14), semantic dementia (SD) (n = 10), progressive nonfluent aphasia (PNFA) (n = 12), and AD (n = 10) versus healthy age-matched individuals (n = 26). Referenced to healthy individuals, overall autonomic reactivity to sound was normal in Alzheimer's disease (AD) but reduced in other syndromes. Patients with bvFTD, SD, and AD showed altered coupling between pupillary and affective behavioral responses to emotionally salient sounds. Emotional sounds are a useful model system for analyzing how dementias affect the processing of salient environmental signals, with implications for defining pathophysiological mechanisms and novel biomarker development.

  19. Dementia in Qatar

    International Nuclear Information System (INIS)

    Hamad, Ahmad I.; Ibrahim, Mohammed A.; Sulaiti, Essa M.

    2004-01-01

    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)

  20. Dementia in middle-aged patients with schizophrenia.

    Science.gov (United States)

    Nicolas, Gaël; Beherec, Laurène; Hannequin, Didier; Opolczynski, Gaëlle; Rothärmel, Maud; Wallon, David; Véra, Pierre; Martinaud, Olivier; Guillin, Olivier; Campion, Dominique

    2014-01-01

    Although numerous studies have assessed cognitive dysfunction in patients with schizophrenia, very few have focused on the diagnosis of dementia. Our objectives were to accurately diagnose dementia in a cohort of middle-aged patients with schizophrenia and to assess the type of dementia. 96 patients with schizophrenia (46 inpatients and 50 outpatients), aged 50 to 70 years, underwent a psychiatric, neurological, and neuropsychological evaluation at baseline and after a 20-month follow-up. We established a 3-step procedure: 1) diagnose dementia according to the DSM-IV criteria, using the Mattis Dementia Rating and Activities of Daily Living scales; 2) characterize dementia using brain imaging, perfusion by 99mTc-ECD-SPECT and laboratory tests including Alzheimer's disease cerebrospinal fluid biomarkers; and 3) search for genetic determinants. Fourteen patients fulfilled the diagnostic criteria of dementia. Four were diagnosed with possible or probable behavioral-variant frontotemporal dementia (bvFTD), two with probable Alzheimer's disease, two with probable vascular dementia (including one due to CADASIL), one with CNS inflammatory disease, and six could not be fully characterized. The diagnosis of dementia in middle-aged patients with schizophrenia is challenging but possible, using a multistep procedure. The most frequent condition, bvFTD, could reflect the presence of an evolutive neurodegenerative process in some patients.

  1. Cerebral imaging and dementia

    International Nuclear Information System (INIS)

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

    1989-01-01

    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 [fr

  2. 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.

  3. NOAA Climate Data Record (CDR) of Ocean Near Surface Atmospheric Properties, Version 2

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Ocean Surface Bundle (OSB) Climate Data Record (CDR) consist of three parts: sea surface temperature; near-surface wind speed, air temperature, and specific...

  4. NOAA Climate Data Record (CDR) of Ocean Heat Fluxes, Version 2

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Ocean Surface Bundle (OSB) Climate Data Record (CDR) consist of three parts: sea surface temperature; near-surface wind speed, air temperature, and specific...

  5. NOAA Climate Data Record (CDR) of Sea Surface Temperature - WHOI, Version 2

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Ocean Surface Bundle (OSB) Climate Data Record (CDR) consist of three parts: sea surface temperature, near-surface atmospheric properties, and heat fluxes....

  6. NOAA Climate Data Record (CDR) of Total Solar Irradiance (TSI), NRLTSI Version 2

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This Climate Data Record (CDR) contains total solar irradiance (TSI) as a function of time created with the Naval Research Laboratory model for spectral and total...

  7. NOAA Climate Data Record (CDR) of Solar Spectral Irradiance (SSI), NRLSSI Version 2

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This Climate Data Record (CDR) contains solar spectral irradiance (SSI) as a function of time and wavelength created with the Naval Research Laboratory model for...

  8. NOAA Climate Data Record (CDR) of Atmospheric Layer Temperatures, Version 3.3

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Atmospheric Layer Temperature Climate Data Record (CDR) dataset is a monthly analysis of the tropospheric and stratospheric data using temperature sounding...

  9. NOAA Climate Data Record (CDR) of Passive Microwave Sea Ice Concentration, Version 2

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Passive Microwave Sea Ice Concentration Climate Data Record (CDR) dataset is generated using daily gridded brightness temperatures from the Defense...

  10. NOAA Climate Data Record (CDR) of AVHRR Polar Pathfinder Extended (APP-X) Cryosphere

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Climate Data Record (CDR) of the extended AVHRR Polar Pathfinder (APP-x) cryosphere contains 19 geophysical variables over the Arctic and Antarctic for the...

  11. NOAA Climate Data Record (CDR) of Monthly Outgoing Longwave Radiation (OLR), Version 2.2-1

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This Climate Data Record (CDR) of monthly mean High Resolution Infrared Radiation Sounder (HIRS) Outgoing Longwave Radiation (OLR) flux at the top of the atmosphere...

  12. NOAA Climate Data Record (CDR) of Daily Outgoing Longwave Radiation (OLR), Version 1.2

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This Climate Data Record (CDR) contains the daily mean Outgoing Longwave Radiation (OLR) time series in global 1 degree x 1 degree equal-angle gridded maps spanning...

  13. NOAA Climate Data Record (CDR) of Normalized Difference Vegetation Index (NDVI), Version 4

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset contains gridded daily Normalized Difference Vegetation Index (NDVI) derived from the NOAA Climate Data Record (CDR) of Advanced Very High Resolution...

  14. NOAA Climate Data Record (CDR) of Northern Hemisphere (NH) Snow Cover Extent (SCE), Version 1

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This NOAA Climate Data Record (CDR) is a record for the Northern Hemisphere (NH) Snow Cover Extent (SCE) spanning from October 4, 1966 to present, updated monthly...

  15. NOAA Fundamental Climate Data Record (CDR) of AMSU-B and MHS Brightness Temperature, Version 1

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Climate Data Record (CDR) of Advanced Microwave Sounding Unit-B (AMSU-B) and Microwave Humidity Sounder (MHS) brightness temperature (Tb) in "window...

  16. NOAA Climate Data Record (CDR) of Passive Microwave Sea Ice Concentration, Version 1.0

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset version has been superseded by version 2. This data set provides a Climate Data Record (CDR) of passive microwave sea ice concentration based on the...

  17. 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.

  18. Electroencephalography Is a Good Complement to Currently Established Dementia Biomarkers

    DEFF Research Database (Denmark)

    Ferreira, Daniel; Jelic, Vesna; Cavallin, Lena

    2016-01-01

    , 135 Alzheimer's disease (AD), 15 dementia with Lewy bodies/Parkinson's disease with dementia (DLB/PDD), 32 other dementias]. The EEG data were recorded in a standardized way. Structural imaging data were visually rated using scales of atrophy in the medial temporal, frontal, and posterior cortex......BACKGROUND/AIMS: Dementia biomarkers that are accessible and easily applicable in nonspecialized clinical settings are urgently needed. Quantitative electroencephalography (qEEG) is a good candidate, and the statistical pattern recognition (SPR) method has recently provided promising results. We......EEG to the diagnostic workup substantially increases the detection of AD pathology even in pre-dementia stages and improves differential diagnosis. EEG could serve as a good complement to currently established dementia biomarkers since it is cheap, noninvasive, and extensively applied outside academic centers....

  19. Dementias show differential physiological responses to salient sounds.

    Science.gov (United States)

    Fletcher, Phillip D; Nicholas, Jennifer M; Shakespeare, Timothy J; Downey, Laura E; Golden, Hannah L; Agustus, Jennifer L; Clark, Camilla N; Mummery, Catherine J; Schott, Jonathan M; Crutch, Sebastian J; Warren, Jason D

    2015-01-01

    Abnormal responsiveness to salient sensory signals is often a prominent feature of dementia diseases, particularly the frontotemporal lobar degenerations, but has been little studied. Here we assessed processing of one important class of salient signals, looming sounds, in canonical dementia syndromes. We manipulated tones using intensity cues to create percepts of salient approaching ("looming") or less salient withdrawing sounds. Pupil dilatation responses and behavioral rating responses to these stimuli were compared in patients fulfilling consensus criteria for dementia syndromes (semantic dementia, n = 10; behavioral variant frontotemporal dementia, n = 16, progressive nonfluent aphasia, n = 12; amnestic Alzheimer's disease, n = 10) and a cohort of 26 healthy age-matched individuals. Approaching sounds were rated as more salient than withdrawing sounds by healthy older individuals but this behavioral response to salience did not differentiate healthy individuals from patients with dementia syndromes. Pupil responses to approaching sounds were greater than responses to withdrawing sounds in healthy older individuals and in patients with semantic dementia: this differential pupil response was reduced in patients with progressive nonfluent aphasia and Alzheimer's disease relative both to the healthy control and semantic dementia groups, and did not correlate with nonverbal auditory semantic function. Autonomic responses to auditory salience are differentially affected by dementias and may constitute a novel biomarker of these diseases.

  20. Dementias show differential physiological responses to salient sounds

    Directory of Open Access Journals (Sweden)

    Phillip David Fletcher

    2015-03-01

    Full Text Available Abnormal responsiveness to salient sensory signals is often a prominent feature of dementia diseases, particularly the frontotemporal lobar degenerations, but has been little studied. Here we assessed processing of one important class of salient signals, looming sounds, in canonical dementia syndromes. We manipulated tones using intensity cues to create percepts of salient approaching (‘looming’ or less salient withdrawing sounds. Pupil dilatation responses and behavioural rating responses to these stimuli were compared in patients fulfilling consensus criteria for dementia syndromes (semantic dementia, n=10; behavioural variant frontotemporal dementia, n=16, progressive non-fluent aphasia, n=12; amnestic Alzheimer’s disease, n=10 and a cohort of 26 healthy age-matched individuals. Approaching sounds were rated as more salient than withdrawing sounds by healthy older individuals but this behavioural response to salience did not differentiate healthy individuals from patients with dementia syndromes. Pupil responses to approaching sounds were greater than responses to withdrawing sounds in healthy older individuals and in patients with semantic dementia: this differential pupil response was reduced in patients with progressive nonfluent aphasia and Alzheimer’s disease relative both to the healthy control and semantic dementia groups, and did not correlate with nonverbal auditory semantic function. Autonomic responses to auditory salience are differentially affected by dementias and may constitute a novel biomarker of these diseases.

  1. Dementias show differential physiological responses to salient sounds

    Science.gov (United States)

    Fletcher, Phillip D.; Nicholas, Jennifer M.; Shakespeare, Timothy J.; Downey, Laura E.; Golden, Hannah L.; Agustus, Jennifer L.; Clark, Camilla N.; Mummery, Catherine J.; Schott, Jonathan M.; Crutch, Sebastian J.; Warren, Jason D.

    2015-01-01

    Abnormal responsiveness to salient sensory signals is often a prominent feature of dementia diseases, particularly the frontotemporal lobar degenerations, but has been little studied. Here we assessed processing of one important class of salient signals, looming sounds, in canonical dementia syndromes. We manipulated tones using intensity cues to create percepts of salient approaching (“looming”) or less salient withdrawing sounds. Pupil dilatation responses and behavioral rating responses to these stimuli were compared in patients fulfilling consensus criteria for dementia syndromes (semantic dementia, n = 10; behavioral variant frontotemporal dementia, n = 16, progressive nonfluent aphasia, n = 12; amnestic Alzheimer's disease, n = 10) and a cohort of 26 healthy age-matched individuals. Approaching sounds were rated as more salient than withdrawing sounds by healthy older individuals but this behavioral response to salience did not differentiate healthy individuals from patients with dementia syndromes. Pupil responses to approaching sounds were greater than responses to withdrawing sounds in healthy older individuals and in patients with semantic dementia: this differential pupil response was reduced in patients with progressive nonfluent aphasia and Alzheimer's disease relative both to the healthy control and semantic dementia groups, and did not correlate with nonverbal auditory semantic function. Autonomic responses to auditory salience are differentially affected by dementias and may constitute a novel biomarker of these diseases. PMID:25859194

  2. Disulfiram is a potent modulator of multidrug transporter Cdr1p of Candida albicans

    International Nuclear Information System (INIS)

    Shukla, Suneet; Sauna, Zuben E.; Prasad, Rajendra; Ambudkar, Suresh V.

    2004-01-01

    To find novel drugs for effective antifungal therapy in candidiasis, we examined disulfiram, a drug used for the treatment of alcoholism, for its role as a potential modulator of Candida multidrug transporter Cdr1p. We show that disulfiram inhibits the oligomycin-sensitive ATPase activity of Cdr1p and 2.5 mM dithiothreitol reverses this inhibition. Disulfiram inhibited the binding of photoaffinity analogs of both ATP ([α- 32 P]8-azidoATP; IC 50 = 0.76 μM) and drug-substrates ([ 3 H]azidopine and [ 125 I]iodoarylazidoprazosin; IC 50 ∼ 12 μM) to Cdr1p in a concentration-dependent manner, suggesting that it can interact with both ATP and substrate-binding site(s) of Cdr1p. Furthermore, a non-toxic concentration of disulfiram (1 μM) increased the sensitivity of Cdr1p expressing Saccharomyces cerevisiae cells to antifungal agents (fluconazole, miconazole, nystatin, and cycloheximide). Collectively these results demonstrate that disulfiram reverses Cdr1p-mediated drug resistance by interaction with both ATP and substrate-binding sites of the transporter and may be useful for antifungal therapy

  3. Depression in dementia: epidemiology, mechanisms, and treatment.

    Science.gov (United States)

    Enache, Daniela; Winblad, Bengt; Aarsland, Dag

    2011-11-01

    Depression in people with dementia has important implications, such as reduced quality of life of patients and carers, and is associated with increased costs and reduced cognition. Here, we review recent studies of the epidemiology, course, mechanisms and treatment of depression in people with dementia. Depression is both a risk factor and a prodrome of Alzheimer's disease. Depression is a common occurrence in all types of dementias and at all disease stages, including in mild cognitive impairment (MCI). Many studies have explored whether depression in MCI increased the conversion rate to dementia, but findings are inconsistent. Studies of the mechanisms are relatively few and findings inconsistent, but inflammatory, trophic and cerebrovascular factors may contribute, in addition to monoamine deficiency and severity of plaques and tangle pathology. Studies of antidepressants for depression in dementia are inconclusive, with several negative findings reported in recent large studies, suggesting that antidepressant may not confer benefit over placebo. Depression is a common risk factor, prodrome, and accompanying symptom of people with Alzheimer's dementia. The mechanisms are unknown, and there is little evidence of effective therapies.

  4. Trajectories of Behavioural Disturbances Across Dementia Types.

    Science.gov (United States)

    Linds, Alexandra B; Kirstein, Alana B; Freedman, Morris; Verhoeff, Nicolaas P L G; Wolf, Uri; Chow, Tiffany W

    2015-11-01

    To replicate a previous finding that the trajectory of the Neuropsychiatric Inventory (NPI) shifts in the sixth year of behavioural variant frontotemporal dementia (bvFTD). We evaluated longitudinal tracking with both the Frontal Behavioural Inventory (FBI) and NPI, comparing bvFTD against other dementias. Chart reviews over two to five years for patients with bvFTD (n=30), primary progressive aphasia (PPA, n=13) and Alzheimer's disease (AD, n=118) at an urban Canadian tertiary clinic specializing in dementia. Linear regressions of the longitudinal data tested predictors of annualized rates of change (ROC) in NPI and FBI total and subscales for apathy and disinhibition among dementia groups. The mode of the overall sample for the most advanced duration of illness observed was 5 years, with the median at 7 years. We did not find a crescendo-decrescendo pattern in scores although, for bvFTD and AD, high initial scores correlated with ensuing downward ROCs on the NPI and FBI. Educational level showed an influence on disinhibition ROCs. The FBI was no more revealing than the NPI for apathy and disinhibition scores in these dementias. A cognitive reserve effect on behavioural disturbance was supported but it may take longer than our 4 years of observing the clinical sample to record inflection points in the behavioural and psychiatric symptoms seen in bvFTD. The current data only imply that both apathy and disinhibition will diminish over the course of dementia.

  5. Stereotypic behaviors in degenerative dementias.

    Science.gov (United States)

    Prioni, S; Fetoni, V; Barocco, F; Redaelli, V; Falcone, C; Soliveri, P; Tagliavini, F; Scaglioni, A; Caffarra, P; Concari, L; Gardini, S; Girotti, F

    2012-11-01

    Stereotypies are simple or complex involuntary/unvoluntary behaviors, common in fronto-temporal dementia (FTD), but not studied in other types of degenerative dementias. The aim was to investigate stereotypy frequency and type in patients with FTD, Alzheimer's disease (AD), progressive supranuclear palsy (PSP) and Parkinson's disease with dementia (PDD) in a multicenter observational study; and to investigate the relation of stereotypies to cognitive, behavioral and motor impairment. One hundred fifty-five consecutive outpatients (45 AD, 40 FTD, 35 PSP and 35 PDD) were studied in four hospitals in northern Italy. Stereotypies were examined by the five-domain Stereotypy Rating Inventory. Cognition was examined by the Mini Mental State and Frontal Assessment Battery, neuropsychiatric symptoms by the Neuropsychiatric Inventory, and motor impairment and invalidity by the Unified Parkinson's Disease Rating Scale part III, and activities of daily living. Stereotypies were present in all groups. FTD and PDD had the greatest frequency of one-domain stereotypies; FTD also had the greatest frequency of two-or-more domain stereotypies; movement stereotypies were the most common stereotypies in all groups. AD patients had fewer stereotypies than the other groups. Stereotypies are not exclusive to FTD, but are also fairly common in PSP and PDD, though less so in AD. Stereotypies may be underpinned by dysfunctional striato-frontal circuits, known to be damaged in PSP and PDD, as well as FTD.

  6. Prognosis of dementia

    NARCIS (Netherlands)

    van de Vorst, IE

    2016-01-01

    Background: In this thesis, we focused on the prognosis of patients with dementia who visited a hospital (inpatient or day clinic care) in the Netherlands. So far, absolute mortality risks for dementia were lacking in the Netherlands, whereas these risks have been available for years for cancer or

  7. Barriers, motivators, and facilitators of physical activity in dementia patients : A systematic review

    NARCIS (Netherlands)

    van Alphen, Helena J. M.; Hortobagyi, Tibor; van Heuvelen, Marieke J. G.

    2016-01-01

    Purpose: Physical activity (PA) has the potential to slow the progression of dementia patients' cognitive and physical decline. A better understanding of the factors that facilitate or hamper dementia patients' PA participation will increase the success rate of implementing PA in dementia patients'

  8. Incidence of dementia and major subtypes in Europe

    DEFF Research Database (Denmark)

    Fratiglioni, L; Launer, L J; Andersen, K

    2000-01-01

    The authors examined the association of incident dementia and subtypes with age, sex, and geographic area in Europe. Incidence data from eight population-based studies carried out in seven European countries were compared and pooled. The pooled data included 835 mild to severe dementia cases and 42......,996 person-years of follow-up. In all studies a higher proportion of cases were diagnosed with AD (60 to 70% of all demented cases) than vascular dementia (VaD). The incidence of dementia and AD continued to increase with age up to age 85 years, after which rates increased in women but not men....... There was a large variation in VaD incidence across studies. In the pooled analysis, the incidence rates increased with age without any substantial difference between men and women. Surprisingly, higher incidence rates of dementia and AD were found in the very old in northwest countries than in southern countries...

  9. Incidence of Dementia in Older Adults with Intellectual Disabilities

    Science.gov (United States)

    Strydom, Andre; Chan, Trevor; King, Michael; Hassiotis, Angela; Livingston, Gill

    2013-01-01

    Dementia may be more common in older adults with intellectual disability (ID) than in the general population. The increased risk for Alzheimer's disease in people with Down syndrome (DS) is well established, but much less is known about dementia in adults with ID who do not have DS. We estimated incidence rates from a longitudinal study of…

  10. Early-Onset Dementia

    DEFF Research Database (Denmark)

    Konijnenberg, Elles; Fereshtehnejad, Seyed-Mohammad; Kate, Mara Ten

    2017-01-01

    BACKGROUND: Early-onset dementia (EOD) is a rare condition, with an often atypical clinical presentation, and it may therefore be challenging to diagnose. Specialized memory clinics vary in the type of patients seen, diagnostic procedures applied, and the pharmacological treatment given. The aim...... of this study was to investigate quality-of-care indicators in subjects with EOD from 3 tertiary memory clinics in 3 European countries. METHODS: We included 1325 newly diagnosed EOD patients, ages 65 years or younger, between January 1, 2007 and December 31, 2013, from the Danish Dementia Registry...... (Rigshospitalet, Copenhagen), the Swedish Dementia Registry ("SveDem", Karolinska University Hospital, Stockholm), and the Amsterdam Dementia Cohort (VU University Medical Center). RESULTS: The frequency of EOD among all dementia patients was significantly lower in Copenhagen (410, 20%) and Stockholm (284, 21...

  11. Leisure activities and the risk of dementia in the elderly.

    Science.gov (United States)

    Verghese, Joe; Lipton, Richard B; Katz, Mindy J; Hall, Charles B; Derby, Carol A; Kuslansky, Gail; Ambrose, Anne F; Sliwinski, Martin; Buschke, Herman

    2003-06-19

    Participation in leisure activities has been associated with a lower risk of dementia. It is unclear whether increased participation in leisure activities lowers the risk of dementia or participation in leisure activities declines during the preclinical phase of dementia. We examined the relation between leisure activities and the risk of dementia in a prospective cohort of 469 subjects older than 75 years of age who resided in the community and did not have dementia at base line. We examined the frequency of participation in leisure activities at enrollment and derived cognitive-activity and physical-activity scales in which the units of measure were activity-days per week. Cox proportional-hazards analysis was used to evaluate the risk of dementia according to the base-line level of participation in leisure activities, with adjustment for age, sex, educational level, presence or absence of chronic medical illnesses, and base-line cognitive status. Over a median follow-up period of 5.1 years, dementia developed in 124 subjects (Alzheimer's disease in 61 subjects, vascular dementia in 30, mixed dementia in 25, and other types of dementia in 8). Among leisure activities, reading, playing board games, playing musical instruments, and dancing were associated with a reduced risk of dementia. A one-point increment in the cognitive-activity score was significantly associated with a reduced risk of dementia (hazard ratio, 0.93 [95 percent confidence interval, 0.90 to 0.97]), but a one-point increment in the physical-activity score was not (hazard ratio, 1.00). The association with the cognitive-activity score persisted after the exclusion of the subjects with possible preclinical dementia at base line. Results were similar for Alzheimer's disease and vascular dementia. In linear mixed models, increased participation in cognitive activities at base line was associated with reduced rates of decline in memory. Participation in leisure activities is associated with a reduced

  12. 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. © 2015 Elsevier B.V. All rights reserved.

  13. Depression, Dementia, and Social Supports.

    Science.gov (United States)

    Esser, Sally R.; Vitaliano, Peter P.

    1988-01-01

    Reviews recent literature on the relationships among dementia, depression, and social support, emphasizing the diagnostic differentiation of dementia and depression, and the role of these three entities in elderly with cognitive impairment. Discusses dementia-like symptoms arising in depression and the coexistence of dementia and depression.…

  14. Predictors of dementia caregiver depressive symptoms in a population: the Cache County dementia progression study.

    Science.gov (United States)

    Piercy, Kathleen W; Fauth, Elizabeth B; Norton, Maria C; Pfister, Roxane; Corcoran, Chris D; Rabins, Peter V; Lyketsos, Constantine; Tschanz, JoAnn T

    2013-11-01

    Previous research has consistently reported elevated rates of depressive symptoms in dementia caregivers, but mostly with convenience samples. This study examined rates and correlates of depression at the baseline visit of a population sample of dementia caregivers (N = 256). Using a modified version of Williams (Williams, I. C. [2005]. Emotional health of black and white dementia caregivers: A contextual examination. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 60, P287-P295) ecological contextual model, we examined 5 contexts that have contributed to dementia caregiver depression. A series of linear regressions were performed to determine correlates of depression. Rates of depressive symptoms were lower than those reported in most convenience studies. We found fewer depressive symptoms in caregivers with higher levels of education and larger social support networks, fewer health problems, greater likelihood of using problem-focused coping, and less likelihood of wishful thinking and with fewer behavioral disturbances in the persons with dementia. These results suggest that depression may be less prevalent in populations of dementia caregivers than in clinic-based samples, but that the correlates of depression are similar for both population and convenience samples. Interventions targeting individuals with small support networks, emotion-focused coping styles, poorer health, low quality of life, and those caring for persons with higher numbers of behavioral problems need development and testing.

  15. Expression of the CDR1 efflux pump in clinical Candida albicans isolates is controlled by a negative regulatory element

    International Nuclear Information System (INIS)

    Gaur, Naseem Akhtar; Manoharlal, Raman; Saini, Preeti; Prasad, Tulika; Mukhopadhyay, Gauranga; Hoefer, Milan; Morschhaeuser, Joachim; Prasad, Rajendra

    2005-01-01

    Resistance to azole antifungal drugs in clinical isolates of the human fungal pathogen Candida albicans is often caused by constitutive overexpression of the CDR1 gene, which encodes a multidrug efflux pump of the ABC transporter superfamily. To understand the relevance of a recently identified negative regulatory element (NRE) in the CDR1 promoter for the control of CDR1 expression in the clinical scenario, we investigated the effect of mutation or deletion of the NRE on CDR1 expression in two matched pairs of azole-sensitive and resistant clinical isolates of C. albicans. Expression of GFP or lacZ reporter genes from the wild type CDR1 promoter was much higher in the azole-resistant C. albicans isolates than in the azole-susceptible isolates, reflecting the known differences in CDR1 expression in these strains. Deletion or mutation of the NRE resulted in enhanced reporter gene expression in azole-sensitive strains, but did not further increase the already high CDR1 promoter activity in the azole-resistant strains. In agreement with these findings, electrophoretic mobility shift assays showed a reduced binding to the NRE of nuclear extracts from the resistant C. albicans isolates as compared with extracts from the sensitive isolates. These results demonstrate that the NRE is involved in maintaining CDR1 expression at basal levels and that this repression is overcome in azole-resistant clinical C. albicans isolates, resulting in constitutive CDR1 overexpression and concomitant drug resistance

  16. Awareness of Mild Cognitive Impairment and Mild Alzheimer's Disease Dementia Diagnoses Associated With Lower Self-Ratings of Quality of Life in Older Adults.

    Science.gov (United States)

    Stites, Shana D; Karlawish, Jason; Harkins, Kristin; Rubright, Jonathan D; Wolk, David

    2017-10-01

    This study examined how awareness of diagnostic label impacted self-reported quality of life (QOL) in persons with varying degrees of cognitive impairment. Older adults (n = 259) with normal cognition, Mild Cognitive Impairment (MCI), or mild Alzheimer's disease dementia (AD) completed tests of cognition and self-report questionnaires that assessed diagnosis awareness and multiple domains of QOL: cognitive problems, activities of daily living, physical functioning, mental wellbeing, and perceptions of one's daily life. We compared measures of QOL by cognitive performance, diagnosis awareness, and diagnostic group. Persons with MCI or AD who were aware of their diagnosis reported lower average satisfaction with daily life (QOL-AD), basic functioning (BADL Scale), and physical wellbeing (SF-12 PCS), and more difficulties in daily life (DEM-QOL) than those who were unaware (all p ≤ .007). Controlling for gender, those expecting their condition to worsen over time reported greater depression (GDS), higher stress (PSS), lower quality of daily life (QOL-AD, DEM-QOL), and more cognitive difficulties (CDS) compared to others (all p cognitive impairment. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Alzheimer disease brain atrophy subtypes are associated with cognition and rate of decline.

    Science.gov (United States)

    Risacher, Shannon L; Anderson, Wesley H; Charil, Arnaud; Castelluccio, Peter F; Shcherbinin, Sergey; Saykin, Andrew J; Schwarz, Adam J

    2017-11-21

    To test the hypothesis that cortical and hippocampal volumes, measured in vivo from volumetric MRI (vMRI) scans, could be used to identify variant subtypes of Alzheimer disease (AD) and to prospectively predict the rate of clinical decline. Amyloid-positive participants with AD from the Alzheimer's Disease Neuroimaging Initiative (ADNI) 1 and ADNI2 with baseline MRI scans (n = 229) and 2-year clinical follow-up (n = 100) were included. AD subtypes (hippocampal sparing [HpSp MRI ], limbic predominant [LP MRI ], typical AD [tAD MRI ]) were defined according to an algorithm analogous to one recently proposed for tau neuropathology. Relationships between baseline hippocampal volume to cortical volume ratio (HV:CTV) and clinical variables were examined by both continuous regression and categorical models. When participants were divided categorically, the HpSp MRI group showed significantly more AD-like hypometabolism on 18 F-fluorodeoxyglucose-PET ( p Alzheimer's Disease Assessment Scale, 13-Item Subscale (ADAS-Cog 13 ), Mini-Mental State Examination (MMSE), and Functional Assessment Questionnaire (all p < 0.05) and tAD MRI on the MMSE and Clinical Dementia Rating Sum of Boxes (CDR-SB) (both p < 0.05). Finally, a larger HV:CTV was associated with poorer baseline executive function and a faster slope of decline in CDR-SB, MMSE, and ADAS-Cog 13 score ( p < 0.05). These associations were driven mostly by the amount of cortical rather than hippocampal atrophy. AD subtypes with phenotypes consistent with those observed with tau neuropathology can be identified in vivo with vMRI. An increased HV:CTV ratio was predictive of faster clinical decline in participants with AD who were clinically indistinguishable at baseline except for a greater dysexecutive presentation. © 2017 American Academy of Neurology.

  18. Significant differences in physicochemical properties of human immunoglobulin kappa and lambda CDR3 regions

    Directory of Open Access Journals (Sweden)

    Catherine L Townsend

    2016-09-01

    Full Text Available Antibody variable regions are composed of a heavy and a light chain and in humans there are two light chain isotypes: kappa and lambda. Despite their importance in receptor editing, the light chain is often overlooked in the antibody literature, with the focus being on the heavy chain CDR-H3 region. In this paper, we set out to investigate the physicochemical and structural differences between human kappa and lambda light chain CDR regions. We constructed a dataset containing over 29,000 - light chain variable region sequences from IgM-transcribing, newly formed B cells isolated from human bone marrow and peripheral blood. We also used a published human naïve dataset to investigate the CDR-H3 properties of heavy chains paired with kappa and lambda light chains, and probed the Protein Data Bank (PDB to investigate the structural differences between kappa and lambda antibody CDR regions. We found that kappa and lambda light chains have very different CDR physicochemical and structural properties, whereas the heavy chains with which they are paired do not differ significantly. We also observed that the mean CDR3 N nucleotide addition in the kappa, lambda and heavy chain gene rearrangements are correlated within donors, but can differ between donors. This indicates that TdT may work with differing efficiencies between different people, but the same efficiency in the different classes of immunoglobulin chain within one person. We have observed large differences in the physicochemical and structural properties of kappa and lambda light chain CDR regions. This may reflect different roles in the humoral immune response.

  19. Significant Differences in Physicochemical Properties of Human Immunoglobulin Kappa and Lambda CDR3 Regions.

    Science.gov (United States)

    Townsend, Catherine L; Laffy, Julie M J; Wu, Yu-Chang Bryan; Silva O'Hare, Joselli; Martin, Victoria; Kipling, David; Fraternali, Franca; Dunn-Walters, Deborah K

    2016-01-01

    Antibody variable regions are composed of a heavy and a light chain, and in humans, there are two light chain isotypes: kappa and lambda. Despite their importance in receptor editing, the light chain is often overlooked in the antibody literature, with the focus being on the heavy chain complementarity-determining region (CDR)-H3 region. In this paper, we set out to investigate the physicochemical and structural differences between human kappa and lambda light chain CDR regions. We constructed a dataset containing over 29,000 light chain variable region sequences from IgM-transcribing, newly formed B cells isolated from human bone marrow and peripheral blood. We also used a published human naïve dataset to investigate the CDR-H3 properties of heavy chains paired with kappa and lambda light chains and probed the Protein Data Bank to investigate the structural differences between kappa and lambda antibody CDR regions. We found that kappa and lambda light chains have very different CDR physicochemical and structural properties, whereas the heavy chains with which they are paired do not differ significantly. We also observed that the mean CDR3 N nucleotide addition in the kappa, lambda, and heavy chain gene rearrangements are correlated within donors but can differ between donors. This indicates that terminal deoxynucleotidyl transferase may work with differing efficiencies between different people but the same efficiency in the different classes of immunoglobulin chain within one person. We have observed large differences in the physicochemical and structural properties of kappa and lambda light chain CDR regions. This may reflect different roles in the humoral immune response.

  20. CLIC CDR - physics and detectors: CLIC conceptual design report.

    Energy Technology Data Exchange (ETDEWEB)

    Berger, E.; Demarteau, M.; Repond, J.; Xia, L.; Weerts, H. (High Energy Physics); (Many)

    2012-02-10

    This report forms part of the Conceptual Design Report (CDR) of the Compact LInear Collider (CLIC). The CLIC accelerator complex is described in a separate CDR volume. A third document, to appear later, will assess strategic scenarios for building and operating CLIC in successive center-of-mass energy stages. It is anticipated that CLIC will commence with operation at a few hundred GeV, giving access to precision standard-model physics like Higgs and top-quark physics. Then, depending on the physics landscape, CLIC operation would be staged in a few steps ultimately reaching the maximum 3 TeV center-of-mass energy. Such a scenario would maximize the physics potential of CLIC providing new physics discovery potential over a wide range of energies and the ability to make precision measurements of possible new states previously discovered at the Large Hadron Collider (LHC). The main purpose of this document is to address the physics potential of a future multi-TeV e{sup +}e{sup -} collider based on CLIC technology and to describe the essential features of a detector that are required to deliver the full physics potential of this machine. The experimental conditions at CLIC are significantly more challenging than those at previous electron-positron colliders due to the much higher levels of beam-induced backgrounds and the 0.5 ns bunch-spacing. Consequently, a large part of this report is devoted to understanding the impact of the machine environment on the detector with the aim of demonstrating, with the example of realistic detector concepts, that high precision physics measurements can be made at CLIC. Since the impact of background increases with energy, this document concentrates on the detector requirements and physics measurements at the highest CLIC center-of-mass energy of 3 TeV. One essential output of this report is the clear demonstration that a wide range of high precision physics measurements can be made at CLIC with detectors which are challenging, but

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

    Science.gov (United States)

    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; King, Jenifer; Koch, Tamar; Kumar, Sanjoy; Lees, Stavroula; Mir, Sinan; Naidoo, Dominic; Nyame, Sylvia; Sasae, Ryuichiro; Sharma, Tushar; Thormod, Clare; Vedavanam, Krish; Wilton, Anja; Flaherty, Breda

    2013-12-23

    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 up' dementia coding and records at a practice level. The guidance had five elements: (1) identify Read Codes for dementia; (2) access QOF dementia register; (3) generate lists of patients who may have dementia; (4) compare search with QOF data and (5) review cases. In each practice, one general practitioner conducted the exercise. The number of dementia QOF registers before and after the exercise was recorded with the hours taken to complete the exercise. London primary care. 23 (85%) of 27 practices participated, covering 79 312 (19 562 over 65 s) participants. The number on dementia QOF registers; time taken. The number of people with dementia on QOF registers increased from 1007 to 1139 (χ(2)=8.17, p=0.004), raising identification rates by 8.8%. It took 4.7 h per practice, on an average. These data demonstrate the potential of a simple primary care coding exercise, requiring no specific training, to increase the dementia identification rate. An improvement of 8.8% between 2011 and 2012 is equivalent to that of the fourth most improved primary care trust in the UK. In absolute terms, if this effects were mirrored across the UK primary care, the number of cases with dementia identified would rise by over 70 000 from 364 329 to 434 488 raising the recognition rate from 46% to 54.8%. Implementing this exercise appears to be a simple and effective way to improve recognition rates in primary care.

  2. Cdr2p contributes to fluconazole resistance in Candida dubliniensis clinical isolates.

    LENUS (Irish Health Repository)

    2011-05-01

    The development of resistance to azole antifungals used in the treatment of fungal infections can be a serious medical problem. Here, we investigate the molecular mechanisms associated with reduced susceptibility to fluconazole in clinical isolates of Candida dubliniensis , showing evidence of the trailing growth phenomenon. The changes in membrane sterol composition were studied in the presence of subinhibitory fluconazole concentrations. Despite lanosterol and eburicol accumulating as the most prevalent sterols after fluconazole treatment, these ergosterol precursors still support growth of Candida isolates. The overexpression of ABC transporters was demonstrated by immunoblotting employing specific antibodies against Cdr1p and Cdr2p. The presence of a full-length 170 kDa protein Cdr1p was detected in two isolates, while a truncated form of Cdr1p with the molecular mass of 85 kDa was observed in isolate 966\\/3(2). Notably, Cdr2p was detected in this isolate, and the expression of this transporter was modulated by subinhibitory concentrations of fluconazole. These results suggest that C. dubliniensis can display the trailing growth phenomenon, and such isolates express similar molecular mechanisms like that of fluconazole-resistant isolates and can therefore be associated with recurrent infections.

  3. Lewy Body Dementia Research

    Science.gov (United States)

    ... notices changes in at least one area of cognition, such as memory or language. Daytime Sleepiness is ... the field of Lewy body dementias. Memantine Improves Attention and Episodic Memory in Mild to Moderate Lewy ...

  4. Lewy Body Dementia Association

    Science.gov (United States)

    ... Now events There are no upcoming events. Lewy Body Digest September 2017 Lewy Digest Caregiving as a ... and research, we support those affected by Lewy body dementias, their families and caregivers. We are dedicated ...

  5. Dementia - home care

    Science.gov (United States)

    ... help improve communication skills and prevent wandering. Calming music may reduce wandering and restlessness, ease anxiety, and ... Budson AE, Solomon PR. Why diagnose and treat memory loss, Alzheimer's disease, and dementia? In: Budson AE, ...

  6. Differential Classification of Dementia

    Directory of Open Access Journals (Sweden)

    E. Mohr

    1995-01-01

    Full Text Available In the absence of biological markers, dementia classification remains complex both in terms of characterization as well as early detection of the presence or absence of dementing symptoms, particularly in diseases with possible secondary dementia. An empirical, statistical approach using neuropsychological measures was therefore developed to distinguish demented from non-demented patients and to identify differential patterns of cognitive dysfunction in neurodegenerative disease. Age-scaled neurobehavioral test results (Wechsler Adult Intelligence Scale—Revised and Wechsler Memory Scale from Alzheimer's (AD and Huntington's (HD patients, matched for intellectual disability, as well as normal controls were used to derive a classification formula. Stepwise discriminant analysis accurately (99% correct distinguished controls from demented patients, and separated the two patient groups (79% correct. Variables discriminating between HD and AD patient groups consisted of complex psychomotor tasks, visuospatial function, attention and memory. The reliability of the classification formula was demonstrated with a new, independent sample of AD and HD patients which yielded virtually identical results (classification accuracy for dementia: 96%; AD versus HD: 78%. To validate the formula, the discriminant function was applied to Parkinson's (PD patients, 38% of whom were classified as demented. The validity of the classification was demonstrated by significant PD subgroup differences on measures of dementia not included in the discriminant function. Moreover, a majority of demented PD patients (65% were classified as having an HD-like pattern of cognitive deficits, in line with previous reports of the subcortical nature of PD dementia. This approach may thus be useful in classifying presence or absence of dementia and in discriminating between dementia subtypes in cases of secondary or coincidental dementia.

  7. 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.

  8. Phytosterols and Dementia.

    Science.gov (United States)

    Shuang, Rong; Rui, Xu; Wenfang, Li

    2016-12-01

    As the aging of the world's population is becoming increasingly serious, dementia-related diseases have become a hot topic in public health research. In recent years, human epidemiological studies have focused on lipid metabolism disorders and dementia. The efficacy of phytosterol intake as a cholesterol-lowering agent has been demonstrated. Phytosterols directly serve as ligands of the nuclear receptors, peroxisome proliferator-activated receptors (PPARs), activating Sirtuin 1 (SIRT-1), which are involved in the regulation of lipid metabolism and the pathogenesis of dementia. Moreover, phytosterols mediate cell and membrane cholesterol efflux or beta amyloid (Aβ) metabolism, which have preventative and therapeutic effects on dementia. Additionally, incorporation of plant sterols in lipid rafts can effectively reduce dietary fat and alter the dietary composition of fiber, fat and cholesterol to regulate appetite and calories. Overall, the objectives of this review are to explore whether phytosterols are a potentially effective target for the prevention of dementia and to discuss a possible molecular mechanism by which phytosterols play a role in the pathogenesis of dementia via the PPARs-SIRT-1 pathway.

  9. Sexuality, aging, and dementia.

    Science.gov (United States)

    Benbow, Susan Mary; Beeston, Derek

    2012-07-01

    Sexuality in later life and its relationship to dementia is a neglected topic: greater understanding of the area has the potential to contribute to the quality of life of people with dementia, their family members, and formal carers. We review current knowledge about sexuality, aging, and dementia. We undertook a review of the recent literature to examine of the following areas: what is known about sexuality and aging, and about attitudes to sexuality and aging; what is known about the relevance of sexuality and aging to people living with dementia and their care; and the management of sexual behaviors causing concern to others. Sexual activity decreases in frequency with increasing age but many older people remain sexually active; there is no age limit to sexual responsiveness; and sexuality is becoming more important to successive cohorts of older people, including people living with dementia and gay, lesbian, bisexual, and transgendered elderly people. Attitudes and beliefs toward sexuality and aging are strongly influenced by stereotypes and myths, not only among the general public but also among those working in health and social care. Professional bodies should include sexuality, aging, and dementia in their training curricula. More work is needed on the impact of environmental issues, particularly in group living situations, on older adults' sexuality, and on consent issues. Ethical decision-making frameworks can be useful in practice. Organizations should investigate how to support staff in avoiding a problem-orientated approach and focus on providing holistic person-centered care.

  10. Computertomographic studies of dementia

    International Nuclear Information System (INIS)

    Kohlmeyer, K.

    1983-01-01

    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.) [de

  11. Diabetes and dementia links

    Directory of Open Access Journals (Sweden)

    Paula Jankowska

    2018-06-01

    Full Text Available Introduction The number of patients suffering from diabetes mellitus is growing globally. It is expected to observe 253.4 million sufferers in geriatric population in 2045. In this time, also 131.5 million of people is going to have dementia and other cognitive problems. In people aged over 65 these two diseases are concomitant quite often. What are the connections in the area of etiology and treatment? Aim The purpose of this study is to present links between dementia and diabetes are depicted in professional literature. Results Diabetes and dementia are associated on many levels. These conditions have common risk factors. Diabetes may contribute to cognitive impairment in many ways, promoting development of atherosclerosis, brain vessel damage and vascular dementia. Alzheimer disease may be promoted by hyperglycemia and hyperinsulinemia. On contrary also hypoglycaemia, often met in elderly diabetic patients has negative impact on cognitive function. Dementia seriously affects treatment of diabetes. The main problems are not satisfying adherence and diabetes self-management. Conclusions Prevention of diabetes and dementia risk factors can be performed simultaneously as the are common for both diseases. Enhancing physical activity, reducing saturated fats consumption, levels of cholesterol and body mass are considered to be beneficial in the context of described conditions. Furthermore, treatment of diabetes is strongly affected by cognitive dysfunction. Management of dementive diabetics requires individualization and using long-acting drugs. It is crucial to reduce risk of life-threatening hypoglycaemias and to create wide team to take care of these patients.

  12. [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.

  13. Evaluative Conditioning with Facial Stimuli in Dementia Patients.

    Science.gov (United States)

    Blessing, Andreas; Zöllig, Jacqueline; Weierstall, Roland; Dammann, Gerhard; Martin, Mike

    2013-01-01

    We present results of a study investigating evaluative learning in dementia patients with a classic evaluative conditioning paradigm. Picture pairs of three unfamiliar faces with liked, disliked, or neutral faces, that were rated prior to the presentation, were presented 10 times each to a group of dementia patients (N = 15) and healthy controls (N = 14) in random order. Valence ratings of all faces were assessed before and after presentation. In contrast to controls, dementia patients changed their valence ratings of unfamiliar faces according to their pairing with either a liked or disliked face, although they were not able to explicitly assign the picture pairs after the presentation. Our finding suggests preserved evaluative conditioning in dementia patients. However, the result has to be considered preliminary, as it is unclear which factors prevented the predicted rating changes in the expected direction in the control group.

  14. Prevalence of dementia in urban and regional Aboriginal Australians.

    Science.gov (United States)

    Radford, Kylie; Mack, Holly A; Draper, Brian; Chalkley, Simon; Daylight, Gail; Cumming, Robert; Bennett, Hayley; Delbaere, Kim; Broe, Gerald A

    2015-03-01

    This study aimed to determine the prevalence of dementia in collaboration with urban/regional Aboriginal communities. A census of Aboriginal and Torres Strait Islander men and women aged 60 years and above in the target communities identified 546 potential participants, with 336 (61.5%) participating in this cross-sectional study. Participants completed a structured interview and cognitive screening tests. One hundred fifty-three participants also completed a detailed medical assessment. Assessment data were reviewed by a panel of clinicians who determined a diagnosis of dementia or mild cognitive impairment (MCI) according to standard criteria. Crude prevalence of dementia was 13.4%, and age-standardized prevalence was 21.0%. The most common types of dementia were Alzheimer's dementia (44%) and mixed dementia diagnoses (29%). Estimated prevalence of MCI was 17.7%. Consistent with previous findings in a remote population, urban and regional Aboriginal Australians face high rates of dementia at younger ages, most commonly Alzheimer's dementia. Copyright © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  15. Qualitative aspects of learning, recall, and recognition in dementia

    Directory of Open Access Journals (Sweden)

    Ranjith Neelima

    2010-01-01

    Full Text Available Objective: To determine whether learning and serial position effect (SPE differs qualitatively and quantitatively among different types of dementia and between dementia patients and controls; we also wished to find out whether interference affects it. Materials and Methods: We administered the Malayalam version of the Rey Auditory Verbal Learning Test (RAVLT to 30 cognitively unimpaired controls and 80 dementia patients [30 with Alzheimer′s disease (AD, 30 with vascular dementia (VaD, and 20 with frontotemporal dementia (FTD] with mild severity on the Clinical Dementia Rating Scale. Results: All groups were comparable on education and age, except the FTD group, who were younger. Qualitatively, the learning pattern and SPE (with primacy and recency being superior to intermediate was retained in the AD, VaD, and control groups. On SPE in free recall, recency was superior to intermediate in the FTD group (P < 0.01 using Bonferroni correction. On recognition, the AD and VaD groups had more misses (P < 0.01, while the FTD group had more false positives (P < 0.01. Conclusion: Quantitative learning is affected by dementia. The pattern of qualitative learning remains unaltered in dementia in the early stages.

  16. Symptoms of Lewy Body Dementia

    Science.gov (United States)

    ... the fight against LBD! Donate Symptoms Lewy body dementia (LBD) has variable presentations that include cognitive difficulties ... wake cycle alterations. Cognitive impairment in Lewy body dementia (LBD) is often misdiagnosed as Alzheimer’s disease (AD). ...

  17. 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 ...

  18. Variations in dementia diagnosis in England and association with general practice characteristics.

    Science.gov (United States)

    Walker, Ian F; Lord, Paul A; Farragher, Tracey M

    2017-05-01

    Improving dementia diagnosis rates in England has been a key strategic aim of the UK Government but the variation and low diagnosis rates are poorly understood. The aim of this study was to explore the variation in actual versus expected diagnosis of dementia across England, and how these variations were associated with general practice characteristics. A cross-sectional, ecological study design using secondary data sources and median regression modelling was used. Data from the year 2011 for 7711 of the GP practices in England (92.7%). Associations of dementia diagnosis rates (%) per practice, calculated using National Health Service England's 'Dementia Prevalence Calculator' and various practice characteristics were explored using a regression model. The median dementia diagnosis rate was 41.6% and the interquartile range was 31.2-53.9%. Multivariable regression analysis demonstrated positive associations between dementia diagnosis rates and deprivation of the population, overall Quality and Outcomes Framework performance, type of primary care contract and size of practice list. Negative associations were found between dementia diagnosis rates and average experience of GPs in the practice and the proportion of the practice caseload over 65 years old. Dementia diagnosis rates vary greatly across GP practices in England. This study has found independent associations between dementia diagnosis rates and a number of patient and practice characteristics. Consideration of these factors locally may provide targets for case-finding interventions and so facilitate timely diagnosis.

  19. Influence of dementia on pain

    NARCIS (Netherlands)

    Scherder, E

    2006-01-01

    In the next decades the number of older persons with dementia and with a painful condition will increase. This is an important conclusion since at this moment older persons with dementia and a painful condition receive less analgesic medication than older persons without dementia. One explanation

  20. Diagnostic criteria for vascular dementia

    NARCIS (Netherlands)

    Scheltens, P.; Hijdra, A. H.

    1998-01-01

    The term vascular dementia implies the presence of a clinical syndrome (dementia) caused by, or at least assumed to be caused by, a specific disorder (cerebrovascular disease). In this review, the various sets of criteria used to define vascular dementia are outlined. The various sets of criteria

  1. Language and Dementia: Neuropsychological Aspects

    OpenAIRE

    Kempler, Daniel; Goral, Mira

    2008-01-01

    This article reviews recent evidence for the relationship between extralinguistic cognitive and language abilities in dementia. A survey of data from investigations of three dementia syndromes (Alzheimer's disease, semantic dementia and progressive nonfluent aphasia) reveals that, more often than not, deterioration of conceptual organization appears associated with lexical impairments, whereas impairments in executive function are associated with sentence- and discourse-level deficits. These ...

  2. Admission of people with dementia to psychiatric hospitals in Japan: factors that can shorten their hospitalizations.

    Science.gov (United States)

    Morikawa, Takako; Maeda, Kiyoshi; Osaki, Tohmi; Kajita, Hiroyuki; Yotsumoto, Kayano; Kawamata, Toshio

    2017-11-01

    People exhibiting serious behavioural and psychological symptoms of dementia are usually voluntarily or involuntarily committed to psychiatric hospitals for treatment. In Japan, the average hospital stay for individuals with dementia is about 2 years. Ideally, individuals should be discharged once their symptoms have subsided. However, we see cases in Japan where individuals remain institutionalized long after behavioural and psychological symptoms of dementia are no longer apparent. This study will attempt to identify factors contributing to shorter stays in psychiatric hospitals for dementia patients. Questionnaires consisting of 17 items were mailed to 121 psychiatric hospitals with dementia treatment wards in western Japan. Out of 121 hospitals that received the questionnaires, 45 hospitals returned them. The total number of new patient admissions at all 45 hospitals during the month of August 2014 was 1428, including 384 dementia patients (26.9%). The average length of stay in the dementia wards in August 2014 was 482.7 days. Our findings revealed that the rate of discharge after 2 months was 35.4% for the dementia wards. In addition, we found that the average stay in hospitals charging or planning to charge the rehabilitation fee to dementia patients was significantly shorter than in hospitals not charging the rehabilitation fee. In Japan, dementia patients account for over 25% of new admissions to psychiatric hospitals with dementia wards. The average length of stay in a psychiatric hospital dementia ward is more than 1 year. A discharge after fewer than 2 months is exceedingly rare for those in a dementia ward compared with dementia patients in other wards. If institutions focus on rehabilitation, it may be possible to shorten the stay of dementia patients in psychiatric hospitals. © 2017 Japanese Psychogeriatric Society.

  3. General Practitioner's Attitudes and Confidence in Managing Patients with Dementia in Singapore.

    Science.gov (United States)

    Subramaniam, Mythily; Ong, Hui Lin; Abdin, Edimansyah; Chua, Boon Yiang; Shafie, Saleha; Siva Kumar, Fiona Devi; Foo, Sophia; Ng, Li Ling; Lum, Alvin; Vaingankar, Janhavi A; Chong, Siow Ann

    2018-03-01

    The number of people living with dementia is increasing globally as a result of an ageing population. General practitioners (GPs), as the front-line care providers in communities, are important stakeholders in the system of care for people with dementia. This commentary describes a study conducted to understand GPs' attitudes and self-perceived competencies when dealing with patients with dementia and their caregivers in Singapore. A set of study information sheet and survey questionnaires were mailed to selected GP clinics in Singapore. The survey, comprising the "GP Attitudes and Competencies Towards Dementia" questionnaire, was administered. A total of 400 GPs returned the survey, giving the study a response rate of 52.3%. About 74% of the GPs (n=296) were seeing dementia patients in their clinics. Almost all the GPs strongly agreed that early recognition of dementia served the welfare of the patients (n=385; 96%) and their relatives (n=387; 97%). About half (51.5%) of the respondents strongly agreed or agreed that they felt confident carrying out an early diagnosis of dementia. Factor analysis of questionnaire revealed 4 factors representing "benefits of early diagnosis and treatment of patients with dementia", "confidence in dealing with patients and caregiver of dementia", "negative perceptions towards dementia care" and "training needs". GPs in Singapore held a generally positive attitude towards the need for early dementia diagnosis but were not equally confident or comfortable about making the diagnosis themselves and communicating with and managing patients with dementia in the primary care setting. Dementia education and training should therefore be a critical step in equipping GPs for dementia care in Singapore. Shared care teams could further help build up GPs' knowledge, confidence and comfort in managing patients with dementia.

  4. Vascular dementia: Facts and controversies

    Directory of Open Access Journals (Sweden)

    Pavlović Aleksandra

    2013-01-01

    Full Text Available Vascular dementia (VaD is the second most frequent dementia after Alzheimer’s disease, and is diagnosed during lifetime in 20% of demented patients. Five­year survival rate in VaD is 39%, while it is estimated to be 75% in healthy persons of the same age. It is therefore important to make correct diagnosis of VaD early in the course of the disease. Risk factors for VaD are identical to stroke risk factors, and there are significant possibilities for the prevention of vascular cognitive decline. Cognitive decline develops acutely or step­by­step within three months after stroke, but more gradual progression of intellectual decline is also possible. Neurological examination can reveal pyramidal and extrapyramidal signs, pseudobulbar palsy, gait disturbance and urinary incontinence. Neuropsychological profile comprises the loss of cognitive set shifting, decline in word fluency, verbal learning difficulties, perseverations, difficulties in complex figure copying, and in patients with cortically located lesions also problems with speech and praxia. The basis of the diagnosis is, besides history, neurological examination and neuropsychological assessment, computed tomography and/ or magnetic resonance brain imaging. Vascular risk factors control is the most important measure in VaD prevention. Modern guidelines for the treatment of cognitive decline in VaD emphasize that donepezil can be useful in the improvement of cognitive status at the level of Class IIa recommendation at the level of evidence A, while memantine may be useful in patients with mixed VaD and Alzheimer’s disease dementia. [Projekat Ministarstva nauke Republike Srbije, br. 175022 i br. 175033

  5. [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.

  6. Subsyndromal delirium compared with delirium, dementia, and subjects without delirium or dementia in elderly general hospital admissions and nursing home residents

    OpenAIRE

    Sepulveda, Esteban; Leonard, Maeve; Franco, Jose G.; Adamis, Dimitrios; McCarthy, Geraldine; Dunne, Colum; Trzepacz, Paula T.; Gaviria, Ana M.; de Pablo, Joan; Vilella, Elisabet; Meagher, David J.

    2016-01-01

    Introduction Subsyndromal delirium (SSD) complicates diagnosis of delirium and dementia, although there is little research comparing their symptom profiles. Methods Cross-sectional study of 400 elderly patients' admission to a general hospital or nursing home diagnosed with delirium, SSD, dementia, or no-delirium/no-dementia (NDND). Symptom profiles were assessed using the Delirium Rating Scale-Revised-98 (DRS-R98). Results Twenty percent patients had delirium, 19.3% had SSD, 29.8% had dement...

  7. Comparison of cognitive and neuropsychiatric profiles in hospitalised elderly medical patients with delirium, dementia and comorbid delirium-dementia.

    Science.gov (United States)

    Leonard, Maeve; McInerney, Shane; McFarland, John; Condon, Candice; Awan, Fahad; O'Connor, Margaret; Reynolds, Paul; Meaney, Anna Maria; Adamis, Dimitrios; Dunne, Colum; Cullen, Walter; Trzepacz, Paula T; Meagher, David J

    2016-03-08

    Differentiation of delirium and dementia is a key diagnostic challenge but there has been limited study of features that distinguish these conditions. We examined neuropsychiatric and neuropsychological symptoms in elderly medical inpatients to identify features that distinguish major neurocognitive disorders. University teaching hospital in Ireland. 176 consecutive elderly medical inpatients (mean age 80.6 ± 7.0 years (range 60-96); 85 males (48%)) referred to a psychiatry for later life consultation-liaison service with Diagnostic and Statistical Manual of Mental Disorders (DSM) IV delirium, dementia, comorbid delirium-dementia and cognitively intact controls. Participants were assessed cross-sectionally with comparison of scores (including individual items) for the Revised Delirium Rating Scale (DRS-R98), Cognitive Test for Delirium (CTD) and Neuropsychiatric Inventory (NPI-Q). The frequency of neurocognitive diagnoses was delirium (n=50), dementia (n=32), comorbid delirium-dementia (n=62) and cognitively intact patients (n=32). Both delirium and comorbid delirium-dementia groups scored higher than the dementia group for DRS-R98 and CTD total scores, but all three neurocognitively impaired groups scored similarly in respect of total NPI-Q scores. For individual DRS-R98 items, delirium groups were distinguished from dementia groups by a range of non-cognitive symptoms, but only for impaired attention of the cognitive items. For the CTD, attention (p=0.002) and vigilance (p=0.01) distinguished between delirium and dementia. No individual CTD item distinguished between comorbid delirium-dementia and delirium. For the NPI-Q, there were no differences between the three neurocognitively impaired groups for any individual item severity. The neurocognitive profile of delirium is similar with or without comorbid dementia and differs from dementia without delirium. Simple tests of attention and vigilance can help to distinguish between delirium and other presentations

  8. Comparison of cognitive and neuropsychiatric profiles in hospitalised elderly medical patients with delirium, dementia and comorbid delirium–dementia

    Science.gov (United States)

    Leonard, Maeve; McInerney, Shane; McFarland, John; Condon, Candice; Awan, Fahad; O'Connor, Margaret; Reynolds, Paul; Meaney, Anna Maria; Adamis, Dimitrios; Dunne, Colum; Cullen, Walter; Trzepacz, Paula T; Meagher, David J

    2016-01-01

    Objectives Differentiation of delirium and dementia is a key diagnostic challenge but there has been limited study of features that distinguish these conditions. We examined neuropsychiatric and neuropsychological symptoms in elderly medical inpatients to identify features that distinguish major neurocognitive disorders. Setting University teaching hospital in Ireland. Participants and measures 176 consecutive elderly medical inpatients (mean age 80.6±7.0 years (range 60–96); 85 males (48%)) referred to a psychiatry for later life consultation-liaison service with Diagnostic and Statistical Manual of Mental Disorders (DSM) IV delirium, dementia, comorbid delirium–dementia and cognitively intact controls. Participants were assessed cross-sectionally with comparison of scores (including individual items) for the Revised Delirium Rating Scale (DRS-R98), Cognitive Test for Delirium (CTD) and Neuropsychiatric Inventory (NPI-Q). Results The frequency of neurocognitive diagnoses was delirium (n=50), dementia (n=32), comorbid delirium–dementia (n=62) and cognitively intact patients (n=32). Both delirium and comorbid delirium–dementia groups scored higher than the dementia group for DRS-R98 and CTD total scores, but all three neurocognitively impaired groups scored similarly in respect of total NPI-Q scores. For individual DRS-R98 items, delirium groups were distinguished from dementia groups by a range of non-cognitive symptoms, but only for impaired attention of the cognitive items. For the CTD, attention (p=0.002) and vigilance (p=0.01) distinguished between delirium and dementia. No individual CTD item distinguished between comorbid delirium–dementia and delirium. For the NPI-Q, there were no differences between the three neurocognitively impaired groups for any individual item severity. Conclusions The neurocognitive profile of delirium is similar with or without comorbid dementia and differs from dementia without delirium. Simple tests of attention and

  9. Between Scylla and Charybdis: Delayed mitigation narrows the passage between large-scale CDR and high costs

    Science.gov (United States)

    Strefler, Jessica; Bauer, Nico; Kriegler, Elmar; Popp, Alexander; Giannousakis, Anastasis; Edenhofer, Ottmar

    2018-04-01

    There are major concerns about the sustainability of large-scale deployment of carbon dioxide removal (CDR) technologies. It is therefore an urgent question to what extent CDR will be needed to implement the long term ambition of the Paris Agreement. Here we show that ambitious near term mitigation significantly decreases CDR requirements to keep the Paris climate targets within reach. Following the nationally determined contributions (NDCs) until 2030 makes 2 °C unachievable without CDR. Reducing 2030 emissions by 20% below NDC levels alleviates the trade-off between high transitional challenges and high CDR deployment. Nevertheless, transitional challenges increase significantly if CDR is constrained to less than 5 Gt CO2 a‑1 in any year. At least 8 Gt CO2 a‑1 CDR are necessary in the long term to achieve 1.5 °C and more than 15 Gt CO2 a‑1 to keep transitional challenges in bounds.

  10. Detection of inhibitors of Candida albicans Cdr transporters using a diS-C3(3 fluorescence

    Directory of Open Access Journals (Sweden)

    Joanna eSzczepaniak

    2015-03-01

    Full Text Available Candida albicans is a major cause of opportunistic and life-threatening, systemic fungal infections. Hence new antifungal agents, as well as new methods to treat fungal infections, are still needed. The application of inhibitors of drug-efflux pumps may increase the susceptibility of C. albicans to drugs. We developed a new fluorescence method that allows the in vivo activity evaluation of compounds inhibiting of C. albicans transporters. We show that the potentiometric dye 3,3′-dipropylthiacarbocyanine iodide diS-C3(3 is pumped out by both Cdr1 and Cdr2 transporters. The fluorescence labeling with diS-C3(3 enables a real-time observation of the activity of C. albicans Cdr1 and Cdr2 transporters. We demonstrate that enniatin A and beauvericin show different specificities toward these transporters. Enniatin A inhibits diS-C3(3 efflux by Cdr1 while beauvericin inhibits both Cdr1p and Cdr2p.

  11. 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. © The Author(s) 2016.

  12. [Preventive strategies for dementia].

    Science.gov (United States)

    Müller, Patrick; Schmicker, Marlen; Müller, Notger G

    2017-05-01

    In the context of the demographically induced increase in the prevalence of dementia and the simultaneous lack of causal pharmacological therapies, preventive approaches are gaining in importance. By reducing risk factors and with measures which induce neuroplasticity successful aging can be supported. This article summarizes the current developments in preventing dementia by modification of life style factors. The main focus lies on the impact of cognitive and physical activity on neuroprotection. A promising approach combines both activities within a dance training program. Further studies that meet the demanding criteria of a randomized clinical trial are urgently needed.

  13. Memantine for dementia?

    Science.gov (United States)

    2003-10-01

    Memantine (Ebixa--Lundbeck Ltd), an oral medicine, is available in the UK for treating "patients with moderately severe to severe Alzheimer's disease". It differs from other licensed dementia medicines in that it is an N-methyl-D-aspartate (NMDA) receptor antagonist. The company has claimed that, with memantine therapy, "improvements in activities of daily living help patients to maintain a degree of independence and be easier to care for, potentially avoiding the need for nursing home care". We assess the efficacy of memantine for dementia and discuss its place in the management of patients with Alzheimer's disease.

  14. 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.

  15. Functional human antibody CDR fusions as long-acting therapeutic endocrine agonists.

    Science.gov (United States)

    Liu, Tao; Zhang, Yong; Liu, Yan; Wang, Ying; Jia, Haiqun; Kang, Mingchao; Luo, Xiaozhou; Caballero, Dawna; Gonzalez, Jose; Sherwood, Lance; Nunez, Vanessa; Wang, Danling; Woods, Ashley; Schultz, Peter G; Wang, Feng

    2015-02-03

    On the basis of the 3D structure of a bovine antibody with a well-folded, ultralong complementarity-determining region (CDR), we have developed a versatile approach for generating human or humanized antibody agonists with excellent pharmacological properties. Using human growth hormone (hGH) and human leptin (hLeptin) as model proteins, we have demonstrated that functional human antibody CDR fusions can be efficiently engineered by grafting the native hormones into different CDRs of the humanized antibody Herceptin. The resulting Herceptin CDR fusion proteins were expressed in good yields in mammalian cells and retain comparable in vitro biological activity to the native hormones. Pharmacological studies in rodents indicated a 20- to 100-fold increase in plasma circulating half-life for these antibody agonists and significantly extended in vivo activities in the GH-deficient rat model and leptin-deficient obese mouse model for the hGH and hLeptin antibody fusions, respectively. These results illustrate the utility of antibody CDR fusions as a general and versatile strategy for generating long-acting protein therapeutics.

  16. CLIC Detector Concepts as described in the CDR: Differences between the GEANT4 and Engineering Models

    CERN Document Server

    Elsener, K; Schlatter, D; Siegrist, N

    2011-01-01

    The CLIC_ILD and CLIC_SiD detector concepts as used for the CDR Vol. 2 in 2011 exist both in GEANT4 simulation models and in engineering layout drawings. At this early stage of a conceptual design, there are inevitably differences between these models, which are described in this note.

  17. Identifying risk for dementia across populations: A study on the prevalence of dementia in tribal elderly population of Himalayan region in Northern India

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Raina

    2013-01-01

    Full Text Available Introduction: Studies have suggested that dementia is differentially distributed across populations with a lower prevalence in developing regions than the developed ones. A comparison in the prevalence of dementia across populations may provide an insight into its risk factors. Keeping this in view, a study was planned to evaluate the prevalence of dementia in tribal elderly population. Materials and Methods: A cross-sectional comprehensive two-phase survey of all residents aged 60 years and older was conducted. Phase one involved screening of all individuals aged 60 and above with the help of a cognitive screen specifically developed for the tribal population. Phase two involved clinical examination of individuals who were suspected of dementia as per the developed cognitive screening test. Results: The results revealed that no individual above 60 years of age in the studied population was diagnosed as a case of dementia. Thereby, pointing out at some unknown factors, which are responsible for prevention of dementia. Discussion: The differences between the prevalence rate in this study and other studies in India appear to be a function of a valid regional difference. Environmental, phenotypic and genetic factors may contribute to regional and racial variations in dementia. Societies living in isolated hilly and tribal areas seem less predisposed to dementia, particularly age related neurodegenerative and vascular dementia, which are the most common causes for dementia in elderly. This may be because some environmental risk factors are much less prevalent in these settings.

  18. Aromatherapy for dementia.

    Science.gov (United States)

    Forrester, Lene Thorgrimsen; Maayan, Nicola; Orrell, Martin; Spector, Aimee E; Buchan, Louise D; Soares-Weiser, Karla

    2014-02-25

    Complementary therapy has received great interest within the field of dementia treatment and the use of aromatherapy and essential oils is increasing. In a growing population where the majority of patients are treated by US Food and Drug Administration (FDA)-approved drugs, the efficacy of treatment is short term and accompanied by negative side effects. Utilisation of complimentary therapies in dementia care settings presents as one of few options that are attractive to practitioners and families as patients often have reduced insight and ability to verbally communicate adverse reactions. Amongst the most distressing features of dementia are the behavioural and psychological symptoms. Addressing this facet has received particular interest in aromatherapy trials, with a shift in focus from reducing cognitive dysfunction to the reduction of behavioural and psychological symptoms in dementia. To assess the efficacy of aromatherapy as an intervention for people with dementia. ALOIS, the Cochrane Dementia and Cognitive Improvement Group Specialized Register, was searched on 26 November 2012 and 20 January 2013 using the terms: aromatherapy, lemon, lavender, rose, aroma, alternative therapies, complementary therapies, essential oils. All relevant randomised controlled trials were considered. A minimum length of a trial and requirements for follow-up were not included, and participants in included studies had a diagnosis of dementia of any type and severity. The review considered all trials using fragrance from plants defined as aromatherapy as an intervention with people with dementia and all relevant outcomes were considered. Titles and abstracts extracted by the searches were screened for their eligibility for potential inclusion in the review. For Burns 2011, continuous outcomes were estimated as the mean difference between groups and its 95% confidence interval using a fixed-effect model. For Ballard 2002, analysis of co-variance was used for all outcomes, with the

  19. Theoretical Modeling and Simulation of Phase-Locked Loop (PLL for Clock Data Recovery (CDR

    Directory of Open Access Journals (Sweden)

    Zainab Mohamad Ashari

    2012-01-01

    Full Text Available Modern communication and computer systems require rapid (Gbps, efficient  and large bandwidth data transfers. Agressive scaling of digital integrated systems  allow buses and communication controller circuits to be integrated with the microprocessor on the same chip. The  Peripheral Component Interconnect Express (PCIe protocol handles all communcation between the central processing unit (CPU and hardware devices. PCIe buses require efficient clock data recovery circuits (CDR to recover clock signals embedded in data during transmission. This paper describes the theoretical modeling and simulation of a phase-locked loop (PLL used in a CDR circuit. A simple PLL architecture for a 5 GHz CDR circuit is proposed  and elaborated in this work. Simulations were carried out using a Hardware Description Language, Verilog-AMS. The effect of jitter on the proposed design is also simulated and evaluated in this work. It was found that the proposed design is robust against both input and VCO jitter.ABSTRAK: Sistem komunikasi dan komputer moden memerlukan pemindahan data yang cekap (Gbps, dan bandwidth yang besar. Pengecilan agresif menggunakan teknik sistem digital bersepadu membenarkan bas dan litar pengawal komunikasi disatukan dengan  mikroprocessor dalam cip yang sama. Protokol persisian komponen sambung tara ekspres (PCIe mengendalikan semua komunikasi antara unit pemprosesan pusat (CPU dan peranti perkakasan. Bas PCIe memerlukan litar jam pemulihan data (CDR yang cekap untuk mendapatkan kembali isyarat jam yang tertanam dalam data semasa transmisi. Karya ini menerangkan teori pemodelan dan simulasi gelung fasa terkunci (PLL untuk CDR. Rekabentuk 5 GHz PLL yang mudah telah dicadangkan dalm kertas kerja ini. Simulasi telah dijalankan menggunakan perisian verilog-AMS. Simulasi mengunnakan kesan ketar dalam reka bentuk yang dicadangkan telah dinilai. Reka bentuk yang dicadangkan terbukti teguh mengatasi ganguan ketar di input dan VCO.KEY WORDS

  20. 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.)

  1. Radiologic diagnostics of dementia

    International Nuclear Information System (INIS)

    Essig, M.; Schoenberg, S.O.

    2003-01-01

    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.) [de

  2. Dementia and driving.

    Science.gov (United States)

    O'Neill, D; Neubauer, K; Boyle, M; Gerrard, J; Surmon, D; Wilcock, G K

    1992-04-01

    Many European countries test cars, but not their drivers, as they age. There is evidence to suggest that human factors are more important than vehicular factors as causes of motor crashes. The elderly also are involved in more accidents per distance travelled than middle-aged drivers. As the UK relies on self-certification of health by drivers over the age of 70 years, we examined the driving practices of patients with dementia attending a Memory Clinic. Nearly one-fifth of 329 patients with documented dementia continued to drive after the onset of dementia, and impaired driving ability was noted in two-thirds of these. Their families experienced great difficulty in persuading patients to stop driving, and had to invoke outside help in many cases. Neuropsychological tests did not help to identify those who drove badly while activity of daily living scores were related to driving ability. These findings suggest that many patients with dementia drive in an unsafe fashion after the onset of the illness. The present system of self-certification of health by the elderly for driver-licensing purposes needs to be reassessed.

  3. A Review of Behavioural Gerontology and Dementia Related Interventions

    Directory of Open Access Journals (Sweden)

    Josling, Megan

    2015-12-01

    Full Text Available Behavioural Gerontology is concerned with the interaction of the aging individual and their environment. One aspect of behavioural gerontology has focussed on the use of behaviourist methods to improve the functioning and quality of life of individuals with dementia. Positive reinforcement techniques have shown to have an effect on dementia related behavioural excesses (wandering, disruptive vocalisations, behavioural deficits (incontinence, self feeding and mood changes (depression. One of the major concerns of using reinforcement techniques in the case of dementia is maintenance of the behavioural changes with the continual implementation of the intervention. Research has indicated that individuals with dementia meet behavioural extinction criteria at an advanced rate in comparison with individuals without dementia. Thus for a behavioural change to be successfully maintained it requires diligence on the part of the caregiver and/or nursing home staff. In the case of dementia care centres and nursing homes, when using behavioural interventions to modify the behavioural symptoms of dementia, there needs to be a considerable overlap between Behavioural Gerontology and Organisational Behavioural Management to ensure the successful maintenance of behavioural change.

  4. PET studies in dementia

    International Nuclear Information System (INIS)

    Herholz, K.

    2003-01-01

    Measurement of local cerebral glucose metabolism (lCMRGlc) by positron emission tomography (PET) and 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 ( 18 F-F-DOPA) and for ( 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

  5. Music perception in dementia

    Science.gov (United States)

    Nicholas, Jennifer M; Cohen, Miriam H; Slattery, Catherine F; Paterson, Ross W; Foulkes, Alexander J M; Schott, Jonathan M; Mummery, Catherine J; Crutch, Sebastian J; Warren, Jason D

    2017-01-01

    Despite much recent interest in music and dementia, music perception has not been widely studied across dementia syndromes using an information processing approach. Here we addressed this issue in a cohort of 30 patients representing major dementia syndromes of typical Alzheimer’s disease (AD, n=16), logopenic aphasia (LPA, an Alzheimer variant syndrome; n=5) and progressive nonfluent aphasia (PNFA; n=9) in relation to 19 healthy age-matched individuals. We designed a novel neuropsychological battery to assess perception of musical patterns in the dimensions of pitch and temporal information (requiring detection of notes that deviated from the established pattern based on local or global sequence features) and musical scene analysis (requiring detection of a familiar tune within polyphonic harmony). Performance on these tests was referenced to generic auditory (timbral) deviance detection and recognition of familiar tunes and adjusted for general auditory working memory performance. Relative to healthy controls, patients with AD and LPA had group-level deficits of global pitch (melody contour) processing while patients with PNFA as a group had deficits of local (interval) as well as global pitch processing. There was substantial individual variation within syndromic groups. No specific deficits of musical temporal processing, timbre processing, musical scene analysis or tune recognition were identified. The findings suggest that particular aspects of music perception such as pitch pattern analysis may open a window on the processing of information streams in major dementia syndromes. The potential selectivity of musical deficits for particular dementia syndromes and particular dimensions of processing warrants further systematic investigation. PMID:27802226

  6. 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.

  7. Music Perception in Dementia.

    Science.gov (United States)

    Golden, Hannah L; Clark, Camilla N; Nicholas, Jennifer M; Cohen, Miriam H; Slattery, Catherine F; Paterson, Ross W; Foulkes, Alexander J M; Schott, Jonathan M; Mummery, Catherine J; Crutch, Sebastian J; Warren, Jason D

    2017-01-01

    Despite much recent interest in music and dementia, music perception has not been widely studied across dementia syndromes using an information processing approach. Here we addressed this issue in a cohort of 30 patients representing major dementia syndromes of typical Alzheimer's disease (AD, n = 16), logopenic aphasia (LPA, an Alzheimer variant syndrome; n = 5), and progressive nonfluent aphasia (PNFA; n = 9) in relation to 19 healthy age-matched individuals. We designed a novel neuropsychological battery to assess perception of musical patterns in the dimensions of pitch and temporal information (requiring detection of notes that deviated from the established pattern based on local or global sequence features) and musical scene analysis (requiring detection of a familiar tune within polyphonic harmony). Performance on these tests was referenced to generic auditory (timbral) deviance detection and recognition of familiar tunes and adjusted for general auditory working memory performance. Relative to healthy controls, patients with AD and LPA had group-level deficits of global pitch (melody contour) processing while patients with PNFA as a group had deficits of local (interval) as well as global pitch processing. There was substantial individual variation within syndromic groups. Taking working memory performance into account, no specific deficits of musical temporal processing, timbre processing, musical scene analysis, or tune recognition were identified. The findings suggest that particular aspects of music perception such as pitch pattern analysis may open a window on the processing of information streams in major dementia syndromes. The potential selectivity of musical deficits for particular dementia syndromes and particular dimensions of processing warrants further systematic investigation.

  8. NOAA Climate Data Record (CDR) of Advanced Microwave Sounding Unit (AMSU)-A Brightness Temperature, Version 1

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Climate Data Record (CDR) for Advanced Microwave Sounding Unit-A (AMSU-A) brightness temperature in "window channels". The data cover a time period from...

  9. NOAA Climate Data Record (CDR) of SSM/I and SSMIS Microwave Brightness Temperatures, CSU Version 1

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This NOAA Climate Data Record (CDR) from Colorado State University (CSU) contains brightness temperatures that have been improved and quality-controlled over the...

  10. NOAA Climate Data Record (CDR) of MSU and AMSU-A Mean Layer Temperatures, UAH Version 5.4 (Superseded)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Please note: this dataset has been superseded by a newer version (see below). This version is archived offline by NOAA NCEI. This Climate Data Record (CDR) includes...

  11. NOAA Climate Data Record (CDR) of Cloud Properties from AVHRR Pathfinder Atmospheres - Extended (PATMOS-x), Version 5.3

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This NOAA Climate Data Record (CDR) of cloud products was produced by the University of Wisconsin using the AVHRR Pathfinder Atmospheres - Extended (PATMOS-X)...

  12. MESSENGER E/V/H MLA 3/4 CDR/RDR DATA V1.0

    Data.gov (United States)

    National Aeronautics and Space Administration — Abstract ======== This data set consists of the MESSENGER Mercury Laser Altimeter (MLA) Calibrated Data Record (CDR) and Reduced Data Record (RDR) products. The MLA...

  13. NOAA Climate Data Record (CDR) of Zonal Mean Ozone Binary Database of Profiles (BDBP), version 1.0

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This NOAA Climate Data Record (CDR) of Zonal Mean Ozone Binary Database of Profiles (BDBP) dataset is a vertically resolved, global, gap-free and zonal mean dataset...

  14. NOAA Climate Data Record (CDR) of SSM/I and SSMIS Microwave Brightness Temperatures, RSS Version 7

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This Version 7 NOAA Fundamental Climate Data Record (CDR) from Remote Sensing Systems (RSS) contains brightness temperatures that have been inter-calibrated and...

  15. The diagnosis of depression and use of antidepressants in nursing home residents with and without dementia.

    Science.gov (United States)

    van Asch, Iris F M; Nuyen, Jasper; Veerbeek, Marjolein A; Frijters, Dinnus H M; Achterberg, Wilco P; Pot, Anne Margriet

    2013-03-01

    To compare the prevalence of diagnosed depressive disorders, depressive symptoms and use of antidepressant medication between nursing home residents with and without dementia. This cross-sectional study used Minimal Data Set of the Resident Assessment Instrument 2.1 data collected in seven nursing homes located in an urbanized region in the Netherlands. Trained nurse assistants recorded all medical diagnoses made by a medical specialist, including dementia and depressive disorder, and medication use. Depressive symptoms were measured with the Depression Rating Scale. Multivariate logistic regression analysis was used to compare data between residents with and without dementia. Included in the study were 1885 nursing home residents (aged 65 years or older), of which 837 had dementia. There was no significant difference in the prevalence of diagnosed depressive disorder between residents with (9.6%) and without dementia (9.8%). Residents with dementia (46.4%) had more depressive symptoms than residents without dementia (22.6%). Among those with depressive symptoms, residents with dementia had the same likelihood of being diagnosed with a depressive disorder as residents without dementia. Among residents with a diagnosed depressive disorder, antidepressant use did not differ significantly between residents with dementia (58.8%) and without dementia (57.3%). The same holds true for residents with depressive symptoms, where antidepressant use was 25.3% in residents with dementia and 24.6% in residents without dementia. Regarding the prevalence rates of diagnosed depressive disorder and antidepressant use found in this study, our findings demonstrate that there is room for improvement not only for the detection of depression but also with regard to its treatment. Copyright © 2012 John Wiley & Sons, Ltd.

  16. Consensus Statement of the International Summit on Intellectual Disability and Dementia Related to End-of-Life Care in Advanced Dementia

    Science.gov (United States)

    McCallion, Philip; Hogan, Mary; Santos, Flavia H.; McCarron, Mary; Service, Kathryn; Stemp, Sandy; Keller, Seth; Fortea, Juan; Bishop, Kathleen; Watchman, Karen; Janicki, Matthew P.

    2017-01-01

    Background: Adults with intellectual disability are affected by dementia at equivalent and elevated rates, many surviving into advanced age. End of life care and support considerations come into play among these individuals when most are in the advanced stage of dementia. Methods: A preliminary report summarizing available literature and making…

  17. Dementia and legal competency.

    Science.gov (United States)

    Filaković, Pavo; Erić, Anamarija Petek; Mihanović, Mate; Glavina, Trpimir; Molnar, Sven

    2011-06-01

    The legal competency or capability to exercise rights is level of judgment and decision-making ability needed to manage one's own affairs and to sign official documents. With some exceptions, the person entitles this right in age of majority. It is acquired without legal procedures, however the annulment of legal capacity requires a juristic process. This resolution may not be final and could be revoked thorough the procedure of reverting legal capacity - fully or partially. Given the increasing number of persons with dementia, they are often subjects of legal expertise concerning their legal capacity. On the other part, emphasis on the civil rights of mentally ill also demands their maximal protection. Therefore such distinctive issue is approached with particular attention. The approach in determination of legal competency is more focused on gradation of it's particular aspects instead of existing dual concept: legally capable - legally incapable. The main assumption represents how person with dementia is legally capable and should enjoy all the rights, privileges and obligations as other citizens do. The aspects of legal competency for which person with dementia is going to be deprived, due to protection of one's rights and interests, are determined in legal procedure and then passed over to the guardian decided by court. Partial annulment of legal competency is measure applied when there is even one existing aspect of preserved legal capability (pension disposition, salary or pension disposition, ability of concluding contract, making testament, concluding marriage, divorce, choosing whereabouts, independent living, right to vote, right to decide course of treatment ect.). This measure is most often in favour of the patient and rarely for protection of other persons and their interests. Physicians are expected to precisely describe early dementia symptoms which may influence assessment of specific aspects involved in legal capacity (memory loss, impaired task

  18. Complement activation in chromosome 13 dementias

    DEFF Research Database (Denmark)

    Rostagno, A.; Revesz, T.; Lashley, T.

    2002-01-01

    Chromosome 13 dementias, familial British dementia (FBD) and familial Danish dementia (FDD), are associated with neurodegeneration and cerebrovascular amyloidosis, with striking neuropathological similarities to Alzheimer's disease (AD). Despite the structural differences among the amyloid subunits...

  19. Snoezelen for dementia.

    Science.gov (United States)

    Chung, J C; Lai, C K; Chung, P M; French, H P

    2002-01-01

    Snoezelen, multi-sensory stimulation, provides sensory stimuli to stimulate the primary senses of sight, hearing, touch, taste and smell, through the use of lighting effects, tactile surfaces, meditative music and the odour of relaxing essential oils (Pinkney 1997). The clinical application of snoezelen has been extended from the field of learning disability to dementia care over the past decade. The rationale for its use lies in providing a sensory environment that places fewer demands on intellectual abilities but capitalizes on the residual sensorimotor abilities of people with dementia (e.g. Buettner 1999, Hope 1998). Practitioners are keen to use snoezelen in dementia care, and some encouraging results have been documented in the area of promoting adaptive behaviours (e.g. Baker, Long 1992, Spaull 1998). However, the clinical application of snoezelen often varies in form, nature, principles and procedures. Such variations not only make examination of the therapeutic values of Snoezelen difficult, but also impede the clinical development of snoezelen in dementia care. A systematic review of evidence for the efficacy of snoezelen in the care of people with dementia is therefore needed to inform future clinical applications and research directions. This review aims to examine the clinical efficacy of snoezelen for older people with dementia. "Snoezelen", "multi-sensory", "dement*", "Alzheimer*", "randomized control/single control/double control" were used as keywords to search seven electronic databases (e.g. MEDLINE, PsyLIT). The list of trials was compared with those identified from a search of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group. All RCTs in which Snoezelen or multi-sensory programmes were used as an intervention for people with dementia were included in the review. Trial data included in the review were restricted to those involving people aged over 60 years suffering from any type of dementia, except one subject

  20. PHENIX CDR update: An experiment to be performed at the Brookhaven National Laboratory relativistic heavy ion collider. Revision

    International Nuclear Information System (INIS)

    1994-11-01

    The PHENIX Conceptual Design Report Update (CDR Update) is intended for use together with the Conceptual Design Report (CDR). The CDR Update is a companion document to the CDR, and it describes the collaboration's progress since the CDR was submitted in January 1993. Therefore, this document concentrates on changes, refinements, and decisions that have been made over the past year. These documents together define the baseline PHENIX detector that the collaboration intends to build for operation at RHIC startup. In this chapter the current status of the detector and its motivation are briefly described. In Chapters 2 and 3 the detector and the physics performance are more fully developed. In Chapters 4 through 13 the details of the present design status, the technology choices, and the construction costs and schedules are presented. The physics goals of PHENIX collaboration have remained exactly as they were described in the CDR. Primary among these is the detection of a new phase of matter, the quark-gluon plasma (QGP), and the measurement of its properties. The PHENIX experiment will measure many of the best potential QGP signatures to see if any or all of these physics variables show anomalies simultaneously due to the formation of the QGP

  1. Smart Homes Design for People with Dementia

    OpenAIRE

    Amiribesheli, Mohsen; Bouchachia, Abdelhamid

    2015-01-01

    In this paper, we present a user-centred approach for designing and developing smart homes for people with dementia. In contrast to most of the existing literature related to dementia, the present approach aims at tailoring the system to the specific needs of dementia using a scenario-based methodology. Scenarios are based on typical dementia symptoms which are collected from research literatures and validated by dementia caregivers. They portray the common behaviour of people with dementia. ...

  2. Frontotemporal dementia: An updated overview

    OpenAIRE

    Mohandas, E.; Rajmohan, V.

    2009-01-01

    Frontotemporal dementia (FTD) is a progressive neurodegenerative syndrome occurring between 45 and 65 years. The syndrome is also called frontotemporal lobar degeneration (FTLD). However, FTLD refers to a larger group of disorders FTD being one of its subgroups. The other subgroups of FTLD are progressive nonfluent aphasia (PFNA), and semantic dementia (SD). FTLD is characterized by atrophy of prefrontal and anterior temporal cortices. FTD occurs in 5-15% of patients with dementia and it is t...

  3. Dementia communication using empathic curiosity.

    Science.gov (United States)

    McEvoy, Phil; Eden, John; Plant, Rachel

    Communication skills training materials in dementia care usually focus on reminiscence. This is important because talking about past events can help people with dementia to retain their sense of self. This article examines the use of an alternative set of communication skills known as empathic curiosity, which may help to promote meaningful communication in the here and now with people who are living with dementia.

  4. Predictors of institutionalization in patients with dementia in Korea.

    Science.gov (United States)

    Kim, Jae-Min; Shin, Il-Seon; Jeong, Seong-Joo; Gormley, Niall; Yoon, Jin-Sang

    2002-02-01

    Many studies have sought to determine the predictors of institutionalization of patients with dementia. Such studies, performed in developed western societies, have come to various conclusions which may not be supported in an East Asian culture such as that found in Korea. This study aimed to determine the factors that predict institutionalization of patients in Korea diagnosed with dementia. Seventy-nine cases (37 institutionalized, 42 community-dwelling) in the Kwangju area were evaluated for patient characteristics, severity of dementia symptoms, caregiver characteristics, burden and distress. Logistic regression was performed to determine predictors of actual institutionalization. Six predictors of institutionalization were identified. Of these, three were patient-related factors: higher score on the Clinical Dementia Rating, higher score on the Brief Psychiatric Rating Scale, and shorter duration of dementia. The other three were caregiver-related factors: younger age, higher education (formal schooling), and higher cost of home care. As seen in previous western studies, institutionalization of dementia sufferers was influenced by both patient and caregiver factors. But, the specific predictors and their relative influences might be explained best by the particular social, cultural and economic situation in Korea. This study was the first of its kind in Korea and, as such, could serve as a reference for future intra-cultural and cross-cultural comparisons. Copyright 2002 John Wiley & Sons, Ltd.

  5. Early AIDS dementia complex

    International Nuclear Information System (INIS)

    Mountz, J.M.; Speed, N.M.; Adams, K.; Schwartz, J.A.; Gross, M.D.; Ostrow, D.G.

    1988-01-01

    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

  6. Dementia, Clinical Aspects

    Directory of Open Access Journals (Sweden)

    Docu Any Axelerad

    2017-12-01

    Full Text Available Disordered arousal leads to a confusional state with an incoherent line of thought, temporal disorientation, poor recall, visual illusions, hallucinations and disordered behavior. With the exception of dementia with Lewy bodies, which is characterized by fluctuating confusion, other disorders causing dementia persist and deteriorate over months or years, and are not characterized by fluctuations or confusional episodes, except when other medical or environmental perturbations disrupt the arousal systems of the brain (e.g. intercurrent infection, anoxia. Sometimes, their hallucinations are different, with a religious tendency, and maybe we must insist with anamnesis related to previous religious beliefs, to see if it is possible to correlate some damaged area than cause hallucinations, are reliable with our faith.

  7. Association between Frailty and Dementia

    DEFF Research Database (Denmark)

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

    2014-01-01

    dementia with Lewy bodies and 8 persons (1%) had some other type of dementia. Multivariate logistic regression models showed that frail persons were almost 8 times more likely to have cognitive impairment (OR 7.8, 95% CI 4.0-15.0), 8 times more likely to have some kind of dementia (OR 8.0, 95% CI 4.0...... 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...

  8. Language and Dementia: Neuropsychological Aspects.

    Science.gov (United States)

    Kempler, Daniel; Goral, Mira

    2008-01-01

    This article reviews recent evidence for the relationship between extralinguistic cognitive and language abilities in dementia. A survey of data from investigations of three dementia syndromes (Alzheimer's disease, semantic dementia and progressive nonfluent aphasia) reveals that, more often than not, deterioration of conceptual organization appears associated with lexical impairments, whereas impairments in executive function are associated with sentence- and discourse-level deficits. These connections between extralinguistic functions and language ability also emerge from the literature on cognitive reserve and bilingualism that investigates factors that delay the onset and possibly the progression of neuropsychological manifestation of dementia.

  9. A survey of senile dementia in the high background radiation areas in Yangjiang, China

    International Nuclear Information System (INIS)

    Li Jia; Su Gasaki, H.; Yang Yuhua

    1997-01-01

    Objective: To evaluate the effects of long-term low dose and low dose-rate ionizing radiation exposure on the prevalence rate of senile dementia, further assess the effects of low-dose radiation exposure on central nervous system and study the pathogen of senile dementia, and provide direct observational data of human beings. Methods: A cross-sectional study of the prevalence of senile dementia was carried out in high background radiation areas in Yangjiang, Guangdong Province, China. The survey was conducted in two stages. For the initial screening, Hasegawa Dementia Scale (HDS) was used for all subjects. In the second stage, the stage of diagnosis, special questionnaires of healthy state of old people were sued. The final diagnoses were made according to the third revised edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM III-R) of American Psychiatric Association. Results: 1018 inhabitants aged 65 years and over, including 513 persons in HBRA and 505 in CA were observed. According to DSM III-R, 61 cases (31 cases in HBRA and 30 cases in CA) of senile dementia were diagnosed. The prevalence rates of senile dementia are 6.04% in HBRA and 5.94% in CA, the total prevalence rate being 5.99%. Conclusion: No significant statistical difference in the prevalence rate of senile dementia between the two areas was found, suggesting that the prevalence rate of senile dementia in these areas is not associated with the high background radiation exposure

  10. Insulin, cognition, and dementia

    Science.gov (United States)

    Cholerton, Brenna; Baker, Laura D.; Craft, Suzanne

    2015-01-01

    Cognitive disorders of aging represent a serious threat to the social and economic welfare of current society. It is now widely recognized that pathology related to such conditions, particularly Alzheimer’s disease, likely begins years or decades prior to the onset of clinical dementia symptoms. This revelation has led researchers to consider candidate mechanisms precipitating the cascade of neuropathological events that eventually lead to clinical Alzheimer’s disease. Insulin, a hormone with potent effects in the brain, has recently received a great deal of attention for its potential beneficial and protective role in cognitive function. Insulin resistance, which refers to the reduced sensitivity of target tissues to the favorable effects of insulin, is related to multiple chronic conditions known to impact cognition and increase dementia risk. With insulin resistance-associated conditions reaching epidemic proportions, the prevalence of Alzheimer’s disease and other cognitive disorders will continue to rise exponentially. Fortunately, these chronic insulin-related conditions are amenable to pharmacological intervention. As a result, novel therapeutic strategies that focus on increasing insulin sensitivity in the brain may be an important target for protecting or treating cognitive decline. The following review will highlight our current understanding of the role of insulin in brain, potential mechanisms underlying the link between insulin resistance and dementia, and current experimental therapeutic strategies aimed at improving cognitive function via modifying the brain’s insulin sensitivity. PMID:24070815

  11. Does wine prevent dementia?

    Directory of Open Access Journals (Sweden)

    Roger M Pinder

    2009-02-01

    Full Text Available Roger M PinderPharma Consultant, York, UKAbstract: There is substantial evidence that moderate consumption of alcohol reduces significantly the risks of coronary heart disease, stroke and type 2 diabetes. Furthermore, the incidence of dementia, both of the Alzheimer’s type (AD and the vascular variety (VaD, is lower in societies which consume a Mediterranean diet of mainly fish, fruit, vegetables, olive oil, and wine. In particular, extensive evidence from both population-based cohort and case control studies in different areas of the world and across genders and racial groups suggests that regular consumption of moderate amounts of alcohol, especially in the form of wine, is associated with a lower risk of developing AD and VaD compared with abstention and heavy drinking. Carriers of the APOE ε4 allele seem to gain less benefit. Age-related cognitive decline, particularly in women, is lower in regular drinkers, while older drinkers with Mild Cognitive Impairment (MCI progress less frequently to AD than their abstaining counterparts. Plausible biological mechanisms for the neuroprotective effects of wine include its glucose-modifying, antioxidant and inflammatory properties, but it additionally seems to modify the neuropathology of AD, particularly the deposition of amyloid plaque. Indeed, some of these mechanisms are already targets for the development of new therapeutic agents for the treatment of dementia.Keywords: alcohol, Alzheimer’s disease, dementia, epidemiology, polyphenols, wine

  12. Energy expenditure in frontotemporal dementia: a behavioural and imaging study

    Science.gov (United States)

    Ahmed, Rebekah M; Landin-Romero, Ramon; Collet, Tinh-Hai; van der Klaauw, Agatha A; Devenney, Emma; Henning, Elana; Kiernan, Matthew C; Piguet, Olivier; Farooqi, I Sadaf; Hodges, John R

    2017-01-01

    Abstract See Finger (doi:10.1093/aww312) for a scientific commentary on this article. Abnormal eating behaviour and metabolic parameters including insulin resistance, dyslipidaemia and body mass index are increasingly recognized as important components of neurodegenerative disease and may contribute to survival. It has previously been established that behavioural variant frontotemporal dementia is associated with abnormal eating behaviour characterized by increased sweet preference. In this study, it was hypothesized that behavioural variant frontotemporal dementia might also be associated with altered energy expenditure. A cohort of 19 patients with behavioural variant frontotemporal dementia, 13 with Alzheimer’s disease and 16 (age- and sex-matched) healthy control subjects were studied using Actiheart devices (CamNtech) to assess resting and stressed heart rate. Actiheart devices were fitted for 7 days to measure sleeping heart rate, activity levels, and resting, active and total energy expenditure. Using high resolution structural magnetic resonance imaging the neural correlates of increased resting heart rate were investigated including cortical thickness and region of interest analyses. In behavioural variant frontotemporal dementia, resting (P = 0.001), stressed (P = 0.037) and sleeping heart rate (P = 0.038) were increased compared to control subjects, and resting heart rate (P = 0.020) compared to Alzheimer disease patients. Behavioural variant frontotemporal dementia was associated with decreased activity levels compared to controls (P = 0.002) and increased resting energy expenditure (P = 0.045) and total energy expenditure (P = 0.035). Increased resting heart rate correlated with behavioural (Cambridge Behavioural Inventory) and cognitive measures (Addenbrooke’s Cognitive Examination). Increased resting heart rate in behavioural variant frontotemporal dementia correlated with atrophy involving the mesial temporal cortex, insula, and amygdala

  13. Comparison of dementia recorded in routinely collected hospital admission data in England with dementia recorded in primary care.

    Science.gov (United States)

    Brown, Anna; Kirichek, Oksana; Balkwill, Angela; Reeves, Gillian; Beral, Valerie; Sudlow, Cathie; Gallacher, John; Green, Jane

    2016-01-01

    Electronic linkage of UK cohorts to routinely collected National Health Service (NHS) records provides virtually complete follow-up for cause-specific hospital admissions and deaths. The reliability of dementia diagnoses recorded in NHS hospital data is not well documented. For a sample of Million Women Study participants in England we compared dementia recorded in routinely collected NHS hospital data (Hospital Episode Statistics: HES) with dementia recorded in two separate sources of primary care information: a primary care database [Clinical Practice Research Datalink (CPRD), n = 340] and a survey of study participants' General Practitioners (GPs, n = 244). Dementia recorded in HES fully agreed both with CPRD and with GP survey data for 85% of women; it did not agree for 1 and 4%, respectively. Agreement was uncertain for the remaining 14 and 11%, respectively; and among those classified as having uncertain agreement in CPRD, non-specific terms compatible with dementia, such as 'memory loss', were recorded in the CPRD database for 79% of the women. Agreement was significantly better (p primary care (CPRD) than in hospital (HES) data. Age-specific rates for dementia based on the hospital admission data were lower than the rates based on the primary care data, but were similar if the delay in recording in HES was taken into account. Dementia recorded in routinely collected NHS hospital admission data for women in England agrees well with primary care records of dementia assessed separately from two different sources, and is sufficiently reliable for epidemiological research.

  14. 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

  15. T cells to a dominant epitope of GAD65 express a public CDR3 motif.

    Science.gov (United States)

    Quinn, Anthony; McInerney, Marcia; Huffman, Donald; McInerney, Brigid; Mayo, Stella; Haskins, Kathryn; Sercarz, Eli

    2006-06-01

    Non-obese diabetic (NOD) mice spontaneously develop autoimmune diabetes, and serve as a model for type 1 diabetes (T1D) and natural autoimmunity. T cell responses to the pancreatic islet antigen glutamic acid decarboxylase 65 (GAD65) can be detected in the spleens of young prediabetic NOD mice, which display a unique MHC class II molecule. Here, we report that a distinct TcR beta chain and CDR3 motif are utilized by all NOD mice in response to a dominant determinant on GAD65, establishing a public repertoire in the spontaneous autoimmunity to an important islet cell antigen. GAD65 530-543 (p530)-reactive T cells preferentially utilize the Vbeta4, Dbeta2.1 and Jbeta2.7 gene segments, with a CDR3 that is characterized by a triad of amino acids, DWG, preceded by a polar residue. In addition, we used CDR3 length spectratyping, CDR3-specific reverse transcriptase-PCR and direct TcR sequencing to show that the TcR beta chain structural patterns associated with p530-specific T cells consistently appeared in the islets of young NOD mice with insulitis, but not in the inflamed islets of streptozotocin-treated C57BL/6 mice, or in inflamed NOD salivary glands. To our knowledge, this is the first report to demonstrate that a public T cell repertoire is used in spontaneous autoimmunity to a dominant self-determinant. These findings suggest that defined clonotypes and repertoires may be preferentially selected in haplotypes predisposed to spontaneous autoimmunity.

  16. The physics benchmark processes for the detector performance studies used in CLIC CDR Volume 3

    CERN Document Server

    Allanach, B.J.; Desch, K.; Ellis, J.; Giudice, G.; Grefe, C.; Kraml, S.; Lastovicka, T.; Linssen, L.; Marschall, J.; Martin, S.P.; Muennich, A.; Poss, S.; Roloff, P.; Simon, F.; Strube, J.; Thomson, M.; Wells, J.D.

    2012-01-01

    This note describes the detector benchmark processes used in volume 3 of the CLIC conceptual design report (CDR), which explores a staged construction and operation of the CLIC accelerator. The goal of the detector benchmark studies is to assess the performance of the CLIC ILD and CLIC SiD detector concepts for different physics processes and at a few CLIC centre-of-mass energies.

  17. Cardiovascular risk factors and dementia.

    Science.gov (United States)

    Fillit, Howard; Nash, David T; Rundek, Tatjana; Zuckerman, Andrea

    2008-06-01

    Dementias, such as Alzheimer's disease (AD) and vascular dementia, are disorders of aging populations and represent a significant economic burden. Evidence is accumulating to suggest that cardiovascular disease (CVD) risk factors may be instrumental in the development of dementia. The goal of this review was to discuss the relationship between specific CVD risk factors and dementia and how current treatment strategies for dementia should focus on reducing CVD risks. We conducted a review of the literature for the simultaneous presence of 2 major topics, cardiovascular risk factors and dementia (eg, AD). Special emphasis was placed on clinical outcome studies examining the effects of treatments of pharmacologically modifiable CVD risk factors on dementia and cognitive impairment. Lifestyle risk factors for CVD, such as obesity, lack of exercise, smoking, and certain psychosocial factors, have been associated with an increased risk of cognitive decline and dementia. Some evidence suggests that effectively managing these factors may prevent cognitive decline/dementia. Randomized, placebo-controlled trials of antihypertensive medications have found that such therapy may reduce the risk of cognitive decline, and limited data suggest a benefit for patients with AD. Some small open-label and randomized clinical trials of statins have observed positive effects on cognitive function; larger studies of statins in patients with AD are ongoing. Although more research is needed, current evidence indicates an association between CVD risk factors--such as hypertension, dyslipidemia, and diabetes mellitus--and cognitive decline/dementia. From a clinical perspective, these data further support the rationale for physicians to provide effective management of CVD risk factors and for patients to be compliant with such recommendations to possibly prevent cognitive decline/dementia.

  18. Office-Based Screening for Dementia in Parkinson Disease: The Montreal Parkinson Risk of Dementia Scale in 4 Longitudinal Cohorts.

    Science.gov (United States)

    Dawson, Benjamin K; Fereshtehnejad, Seyed-Mohammad; Anang, Julius B M; Nomura, Takashi; Rios-Romenets, Silvia; Nakashima, Kenji; Gagnon, Jean-François; Postuma, Ronald B

    2018-06-01

    Parkinson disease dementia dramatically increases mortality rates, patient expenditures, hospitalization risk, and caregiver burden. Currently, predicting Parkinson disease dementia risk is difficult, particularly in an office-based setting, without extensive biomarker testing. To appraise the predictive validity of the Montreal Parkinson Risk of Dementia Scale, an office-based screening tool consisting of 8 items that are simply assessed. This multicenter study (Montreal, Canada; Tottori, Japan; and Parkinson Progression Markers Initiative sites) used 4 diverse Parkinson disease cohorts with a prospective 4.4-year follow-up. A total of 717 patients with Parkinson disease were recruited between May 2005 and June 2016. Of these, 607 were dementia-free at baseline and followed-up for 1 year or more and so were included. The association of individual baseline scale variables with eventual dementia risk was calculated. Participants were then randomly split into cohorts to investigate weighting and determine the scale's optimal cutoff point. Receiver operating characteristic curves were calculated and correlations with selected biomarkers were investigated. Dementia, as defined by Movement Disorder Society level I criteria. Of the 607 patients (mean [SD] age, 63.4 [10.1]; 376 men [62%]), 70 (11.5%) converted to dementia. All 8 items of the Montreal Parkinson Risk of Dementia Scale independently predicted dementia development at the 5% significance level. The annual conversion rate to dementia in the high-risk group (score, >5) was 14.9% compared with 5.8% in the intermediate group (score, 4-5) and 0.6% in the low-risk group (score, 0-3). The weighting procedure conferred no significant advantage. Overall predictive validity by the area under the receiver operating characteristic curve was 0.877 (95% CI, 0.829-0.924) across all cohorts. A cutoff of 4 or greater yielded a sensitivity of 77.1% (95% CI, 65.6-86.3) and a specificity of 87.2% (95% CI, 84.1-89.9), with a

  19. Does Schizophrenia in Offspring Increase the Risk of Developing Alzheimer's Dementia

    Directory of Open Access Journals (Sweden)

    Christopher Rohde

    2016-08-01

    Full Text Available Background/Aims: Prior studies have consistently found a higher risk of dementia in individuals with schizophrenia, but whether this is due to a common etiology between the disorders remains obscure. We wanted to elucidate this association by investigating whether schizophrenia in offspring increases the risk of Alzheimer's dementia. Methods: All individuals born between 1930 and 1953 were identified through national registers and followed from their 50th birthday until the date of Alzheimer's dementia, death or end of the study. Regressions were performed to evaluate the association between offspring with schizophrenia and Alzheimer's dementia. Results: Individuals with offspring with schizophrenia did not have an increased risk of Alzheimer's dementia [incidence rate ratio (IRR, 0.97; 95% CI, 0.88-1.07] compared to individuals with offspring without psychiatric contact. This finding remained stable when evaluating early-onset (IRR, 1.10; 95% CI, 0.91-1.31 and late-onset Alzheimer's dementia (IRR, 0.92; 95% CI, 0.88-1.07. Similar findings were made for vascular and unspecified dementia. Conclusion: The finding of no familial coaggregation between schizophrenia and Alzheimer's dementia may suggest that no common etiology between the disorders exists. This may indicate that the excess risk of dementia in individuals with schizophrenia is a by-product of the higher rates of somatic comorbidity and adverse health risk factors among these individuals.

  20. Evaluation of PERSIANN-CDR for Meteorological Drought Monitoring over China

    Directory of Open Access Journals (Sweden)

    Hao Guo

    2016-05-01

    Full Text Available In this paper, Precipitation Estimation from Remotely Sensed Information using Artificial Neural Networks–Climate Data Record (PERSIANN-CDR is analyzed for the assessment of meteorological drought. The evaluation is conducted over China at 0.5° spatial resolution against a ground-based gridded China monthly Precipitation Analysis Product (CPAP from 1983 to 2014 (32 years. The Standardized Precipitation Index (SPI at various time scales (1 month to 12 months is calculated for detecting drought events. The results show that PERSIANN-CDR depicts similar drought behavior as the ground-based CPAP in terms of capturing the spatial and temporal patterns of drought events over eastern China, where the intensity of gauge networks and the frequency of droughts are high. 6-month SPI shows the best agreement with CPAP in identifying drought months. However, large differences between PERSIANN-CDR and CPAP in depicting drought patterns and identifying specific drought events are found over northwestern China, particularly in Xinjiang and Qinghai-Tibet Plateau region. Factors behind this may be due to the relatively sparse gauge networks, the complicated terrain and the performance of PERSIANN algorithm.

  1. Prevalence of dementia-associated disability among Chinese older adults: results from a national sample survey.

    Science.gov (United States)

    Li, Ning; Zhang, Lei; Du, Wei; Pang, Lihua; Guo, Chao; Chen, Gong; Zheng, Xiaoying

    2015-03-01

    Due to rapid population aging and a tidal wave of dementia, dementia has become an urgent public health issue in China. Few large-scale surveys on dementia have been conducted in China and little was known about the magnitude of dysfunction and disability caused by dementia. In this study, using national sample survey data, we aimed to describe the prevalence rate of dementia-associated disability, its associated factors, and daily activities and social functions of people with dementia-associated disability in Chinese older adults. We used the second China National Sample Survey on Disability, comprising 2,526,145 persons from 771,797 households. Identification for dementia was based on consensus manuals. Standard weighting procedures were used to construct sample weights considering the multistage stratified cluster sampling survey scheme. Population weighted numbers, weighted prevalence, and the odd ratios (ORs) were calculated. The prevalence rate of dementia-associated disability was 4.64% (95% CI: 4.26-5.01) and it accounted for 41.03% of mental disability among Chinese older adults. Urban residence (OR: 1.33 [1.12-1.57]), older age (80+ years) (OR: 4.12 [3.38-.03]), illiteracy (OR: 1.79 [1.27-2.53]), and currently not married (OR: 1.15 [1.00-1.32]) were associated with increased risk of dementia-associated disability. Compared with those with mental disability of other causes and those with other types of disabilities, older adults with dementia-asscoiated disability were more likely to have severe or extreme difficulty in daily activities and social functions. Countermeasures are warranted to obtain a more precise overview of dementia in China, and strategies on enhancing early identification, treatment, and rehabilitation should be developed for people with dementia. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  2. BMI and risk of dementia in two million people over two decades: a retrospective cohort study.

    Science.gov (United States)

    Qizilbash, Nawab; Gregson, John; Johnson, Michelle E; Pearce, Neil; Douglas, Ian; Wing, Kevin; Evans, Stephen J W; Pocock, Stuart J

    2015-06-01

    Dementia and obesity are increasingly important public health issues. Obesity in middle age has been proposed to lead to dementia in old age. We investigated the association between BMI and risk of dementia. For this retrospective cohort study, we used a cohort of 1,958,191 individuals derived from the United Kingdom Clinical Practice Research Datalink (CPRD) which included people aged 40 years or older in whom BMI was recorded between 1992 and 2007. Follow-up was until the practice's final data collection date, patient death or transfer out of practice, or first record of dementia (whichever occurred first). People with a previous record of dementia were excluded. We used Poisson regression to calculate incidence rates of dementia for each BMI category. Our cohort of 1,958,191 people from UK general practices had a median age at baseline of 55 years (IQR 45-66) and a median follow-up of 9·1 years (IQR 6·3-12·6). Dementia occurred in 45,507 people, at a rate of 2·4 cases per 1000 person-years. Compared with people of a healthy weight, underweight people (BMI risk of dementia. Furthermore, the incidence of dementia continued to fall for every increasing BMI category, with very obese people (BMI >40 kg/m(2)) having a 29% lower (95% CI 22-36) dementia risk than people of a healthy weight. These patterns persisted throughout two decades of follow-up, after adjustment for potential confounders and allowance for the J-shape association of BMI with mortality. Being underweight in middle age and old age carries an increased risk of dementia over two decades. Our results contradict the hypothesis that obesity in middle age could increase the risk of dementia in old age. The reasons for and public health consequences of these findings need further investigation. None. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Alzheimer's disease neuroimaging initiative: a one-year follow up study using tensor-based morphometry correlating degenerative rates, biomarkers and cognition.

    Science.gov (United States)

    Leow, Alex D; Yanovsky, Igor; Parikshak, Neelroop; Hua, Xue; Lee, Suh; Toga, Arthur W; Jack, Clifford R; Bernstein, Matt A; Britson, Paula J; Gunter, Jeffrey L; Ward, Chadwick P; Borowski, Bret; Shaw, Leslie M; Trojanowski, John Q; Fleisher, Adam S; Harvey, Danielle; Kornak, John; Schuff, Norbert; Alexander, Gene E; Weiner, Michael W; Thompson, Paul M

    2009-04-15

    Tensor-based morphometry can recover three-dimensional longitudinal brain changes over time by nonlinearly registering baseline to follow-up MRI scans of the same subject. Here, we compared the anatomical distribution of longitudinal brain structural changes, over 12 months, using a subset of the ADNI dataset consisting of 20 patients with Alzheimer's disease (AD), 40 healthy elderly controls, and 40 individuals with mild cognitive impairment (MCI). Each individual longitudinal change map (Jacobian map) was created using an unbiased registration technique, and spatially normalized to a geometrically-centered average image based on healthy controls. Voxelwise statistical analyses revealed regional differences in atrophy rates, and these differences were correlated with clinical measures and biomarkers. Consistent with prior studies, we detected widespread cerebral atrophy in AD, and a more restricted atrophic pattern in MCI. In MCI, temporal lobe atrophy rates were correlated with changes in mini-mental state exam (MMSE) scores, clinical dementia rating (CDR), and logical/verbal learning memory scores. In AD, temporal atrophy rates were correlated with several biomarker indices, including a higher CSF level of p-tau protein, and a greater CSF tau/beta amyloid 1-42 (ABeta42) ratio. Temporal lobe atrophy was significantly faster in MCI subjects who converted to AD than in non-converters. Serial MRI scans can therefore be analyzed with nonlinear image registration to relate ongoing neurodegeneration to a variety of pathological biomarkers, cognitive changes, and conversion from MCI to AD, tracking disease progression in 3-dimensional detail.

  4. Family caregivers of patients with frontotemporal dementia: An integrative review.

    Science.gov (United States)

    Caceres, Billy A; Frank, Mayu O; Jun, Jin; Martelly, Melissa T; Sadarangani, Tina; de Sales, Paloma Cesar

    2016-03-01

    The purpose of this integrative review is to: (1) identify the characteristics of family caregivers of patients with frontotemporal dementia, (2) explore the impact of providing care on family caregivers' health and well-being, and (3) identify coping strategies used by family caregivers. Frontotemporal dementia is thought to be the second most common form of dementia after Alzheimer's disease. Family caregivers of patients with frontotemporal dementia face unique challenges due to its early onset, behavioral symptoms, and slow progression of decline. However, there is a dearth of research evaluating the health and wellbeing of family caregivers of patients with frontotemporal dementia. An integrative review was conducted using the Whittemore and Knafl methodology. An electronic search of the literature was conducted using four electronic databases: PubMed, Embase, CINAHL, and Web of Science. The Crowe Critical Appraisal tool was used to evaluate the quality of the selected articles. Findings of 11 articles informed this integrative review. Family caregivers of patients with frontotemporal dementia identify behavioral disturbances as most troubling. Spouses and female caregivers experience greater caregiver burden, distress, increased rates of depression, as well as decreased sleep related to behavior disturbances. Though less explored, providing care to those with behavioral disturbances may also impact caregiver physical health. Additionally, female caregivers are most likely to employ coping strategies, most commonly, adaptation and reframing. Effective interventions to reduce family caregiver burden are poorly understood but family caregivers suggest education and internet-based support groups are most helpful. Family caregivers of patients with frontotemporal dementia experience significant distress, which impacts their health and wellbeing. It is important for healthcare providers who care for patients with frontotemporal dementia to recognize the unique

  5. Health, social and economic consequences of dementias

    DEFF Research Database (Denmark)

    Frahm-Falkenberg, S.; Ibsen, Rikke; Kjellberg, J.

    2016-01-01

    Background and purpose: Dementia causes morbidity, disability and mortality, and as the population ages the societal burden will grow. The direct health costs and indirect costs of lost productivity and social welfare of dementia were estimated compared with matched controls in a national register......, gender, geographical area and civil status. Direct health costs included primary and secondary sector contacts, medical procedures and medication. Indirect costs included the effect on labor supply. All cost data were extracted from national databases. The entire cohort was followed for the entire period...... – before and after diagnosis. Results: In all, 78 715 patients were identified and compared with 312 813 matched controls. Patients' partners were also identified and matched with a control group. Patients had lower income and higher mortality and morbidity rates and greater use of medication. Social...

  6. Age-specific incidence rates for dementia and Alzheimer disease in NIA-LOAD/NCRAD and EFIGA families: National Institute on Aging Genetics Initiative for Late-Onset Alzheimer Disease/National Cell Repository for Alzheimer Disease (NIA-LOAD/NCRAD) and Estudio Familiar de Influencia Genetica en Alzheimer (EFIGA).

    Science.gov (United States)

    Vardarajan, Badri N; Faber, Kelley M; Bird, Thomas D; Bennett, David A; Rosenberg, Roger; Boeve, Bradley F; Graff-Radford, Neill R; Goate, Alison M; Farlow, Martin; Sweet, Robert A; Lantigua, Rafael; Medrano, Martin Z; Ottman, Ruth; Schaid, Daniel J; Foroud, Tatiana M; Mayeux, Richard

    2014-03-01

    Late-onset Alzheimer disease (LOAD), defined as onset of symptoms after age 65 years, is the most common form of dementia. Few reports investigate incidence rates in large family-based studies in which the participants were selected for family history of LOAD. To determine the incidence rates of dementia and LOAD in unaffected members in the National Institute on Aging Genetics Initiative for Late-Onset Alzheimer Disease/National Cell Repository for Alzheimer Disease (NIA-LOAD/NCRAD) and Estudio Familiar de Influencia Genetica en Alzheimer (EFIGA) family studies. Families with 2 or more affected siblings who had a clinical or pathological diagnosis of LOAD were recruited as a part of the NIA-LOAD/NCRAD Family Study. A cohort of Caribbean Hispanics with familial LOAD was recruited in a different study at the Taub Institute for Research on Alzheimer's Disease and the Aging Brain in New York and from clinics in the Dominican Republic as part of the EFIGA study. Age-specific incidence rates of LOAD were estimated in the unaffected family members in the NIA-LOAD/NCRAD and EFIGA data sets. We restricted analyses to families with follow-up and complete phenotype information, including 396 NIA-LOAD/NCRAD and 242 EFIGA families. Among the 943 at-risk family members in the NIA-LOAD/NCRAD families, 126 (13.4%) developed dementia, of whom 109 (86.5%) met criteria for LOAD. Among 683 at-risk family members in the EFIGA families, 174 (25.5%) developed dementia during the study period, of whom 145 (83.3%) had LOAD. The annual incidence rates of dementia and LOAD in the NIA-LOAD/NCRAD families per person-year were 0.03 and 0.03, respectively, in participants aged 65 to 74 years; 0.07 and 0.06, respectively, in those aged 75 to 84 years; and 0.08 and 0.07, respectively, in those 85 years or older. Incidence rates in the EFIGA families were slightly higher, at 0.03 and 0.02, 0.06 and 0.05, 0.10 and 0.08, and 0.10 and 0.07, respectively, in the same age groups. Contrasting these

  7. Impact of Dementia-Derived Nonpharmacological Intervention Procedures on Cognition and Behavior in Older Adults with Intellectual Disabilities: A 3-Year Follow-Up Study

    Science.gov (United States)

    De Vreese, Luc P.; Mantesso, Ulrico; De Bastiani, Elisa; Weger, Elisabeth; Marangoni, Annachiara C.; Gomiero, Tiziano

    2012-01-01

    Dementia appears at a higher rate among some adults with intellectual disabilities (ID) and this potentially poses a greater risk of nursing home admission. Yet, to date, there is no evidence on the efficacy of general dementia-derived environment-, personnel-, and patient-oriented intervention strategies in delaying onset of dementia or in…

  8. Improving Services for People with Learning Disabilities and Dementia: Findings from a Service Evaluation Exploring the Perspectives of Health and Social Care Professionals

    Science.gov (United States)

    Chapman, Melanie; Lacey, Huma; Jervis, Nicola

    2018-01-01

    Background: Dementia prevalence rates are higher amongst people with learning disabilities than the general population. People with Down's syndrome are at even greater risk of developing dementia and of developing dementia at an earlier age. This study, conducted as part of a wider service evaluation, explored community learning disability team…

  9. The prevalence of pain in nursing home residents with dementia measured using an observational pain scale.

    NARCIS (Netherlands)

    Zwakhalen, S.M.G.; Koopmans, R.T.C.M.; Geels, P.J.; Berger, M.P.; Hamers, J.P.H.

    2009-01-01

    BACKGROUND: Studies on pain and pain prevalence in older people with dementia are limited compared to those on cognitively intact older people. Pain prevalence rates in older people with dementia are estimated to be between 28% and 83%. AIMS: This study aimed to explore pain prevalence in nursing

  10. [Dementia due to Endocrine Diseases].

    Science.gov (United States)

    Matsunaga, Akiko; Yoneda, Makoto

    2016-04-01

    Endocrine diseases affecting various organs, such as the pituitary gland, the thyroid, the parathyroid, the adrenal glands and the pancreas, occasionally cause dementia. While Alzheimer's disease (AD) is the main cause of dementia in the elderly and is untreatable, dementia caused by endocrine diseases is treatable in most cases. However, patients with dementia associated with endocrine diseases show memory impairments similar to those found in AD, often leading to misdiagnoses. Patients with endocrine diseases often present with other characteristic systemic and neuropsychiatric symptoms caused by altered hormone levels. Such neuropsychiatric symptoms include involuntary movements, depression, seizures, and muscle weakness. In these cases, abnormalities in imaging and blood or urine tests are helpful in making a differential diagnosis. As delays in the diagnosis and treatment of these patients may cause irreversible brain damage, it is imperative for clinicians to carefully exclude the possibility of latent endocrine diseases when treating patients with dementia.

  11. 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…

  12. Beyond competence: advance directives in dementia research

    NARCIS (Netherlands)

    K.R. Jongsma (Karin); S. van de Vathorst (Suzanne)

    2015-01-01

    textabstractDementia 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

  13. Animal models of dementia

    DEFF Research Database (Denmark)

    Olsson, I. Anna S.; Sandøe, Peter

    2011-01-01

    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...... 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...... bears responsibility for the use of animals in disease models?...

  14. 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......-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...

  15. Artistic creativity and dementia.

    Science.gov (United States)

    Miller, Zachary A; Miller, Bruce L

    2013-01-01

    Artistic ability and creativity are defining characteristics of human behavior. Behavioral neurology, as a specialty, believes that even the most complex behaviors can be modeled and understood as the summation of smaller cognitive functions. Literature from individuals with specific brain lesions has helped to map out these smaller regions of cognitive abilities. More recently, models based on neurodegenerative conditions, especially from the frontotemporal dementias, have allowed for greater nuanced investigations into the various functional anatomies necessary for artistic behavior and possibly the underlying networks that promote creativity. © 2013 Elsevier B.V. All rights reserved.

  16. Attitudes to diagnosis and management in dementia care: views of future general practitioners.

    Science.gov (United States)

    Tang, Eugene Yee Hing; Birdi, Ratika; Robinson, Louise

    2018-03-01

    ABSTRACTConsiderable international governmental support is focused on the timely diagnosis of dementia and post-diagnostic care of people with dementia. Identifying those at high risk of dementia is one approach to timely diagnosis. General practitioners (GPs) are well-placed clinicians in the community to provide both pre- and post-diagnostic dementia care. However, GPs have in the past consistently demonstrated low confidence in both diagnosing dementia and providing care for these complex patients particularly for patients in the post-diagnostic phase. It is currently unclear how future GPs view dementia care. We aimed to evaluate the current attitudes and experiences of future GPs in dementia care and their views on targeting high risk groups. All (n = 513) GP trainees were approached by email to participate in a cross-sectional web and paper-based survey in the North of England. A further reminder was sent out two months after the initial invitation. We received 153 responses (29.8% response rate, 66.7% female, average age 31 (range 25-55 years old). The main difficulties encountered included coordinating supporting services for carers and the person with dementia and responding to co-existing behavioral and psychiatric symptoms. Further education in dementia management was considered to be important by respondents. GP trainees were generally very positive about their future role in caring for people with dementia, particularly in the area of earlier diagnosis via identification of high-risk individuals. Future GPs in one area of England are very positive about their key role in dementia care. In order to facilitate the delivery of high quality, community-based care, work is required to establish core post-diagnostic dementia support services. Further research is needed to identify effective systems to enable accurate assessment and to ensure earlier diagnosis in high-risk groups.

  17. Interrogating personhood and dementia

    Science.gov (United States)

    Higgs, Paul; Gilleard, Chris

    2016-01-01

    ABSTRACT Objectives: To interrogate the concept of personhood and its application to care practices for people with dementia. Method: We outline the work of Tom Kitwood on personhood and relate this to conceptualisations of personhood in metaphysics and in moral philosophy. Results: The philosophical concept of personhood has a long history. The metaphysical tradition examines the necessary and sufficient qualities that make up personhood such as agency, consciousness, identity, rationality and second-order reflexivity. Alternative viewpoints treat personhood as a matter of degree rather than as a superordinate category. Within moral philosophy personhood is treated as a moral status applicable to some or to all human beings. Conclusion: In the light of the multiple meanings attached to the term in both metaphysics and moral philosophy, personhood is a relatively unhelpful concept to act as the foundation for developing models and standards of care for people with dementia. Care, we suggest, should concentrate less on ambiguous and somewhat abstract terms such as personhood and focus instead on supporting people's existing capabilities, while minimising the harmful consequences of their incapacities. PMID:26708149

  18. Dementia and the Power of Music Therapy.

    Science.gov (United States)

    Matthews, Steve

    2015-10-01

    Dementia is now a leading cause of both mortality and morbidity, particularly in western nations, and current projections for rates of dementia suggest this will worsen. More than ever, cost effective and creative non-pharmacological therapies are needed to ensure we have an adequate system of care and supervision. Music therapy is one such measure, yet to date statements of what music therapy is supposed to bring about in ethical terms have been limited to fairly vague and under-developed claims about an improvement in well-being. This article identifies the relevant sense of wellbeing at stake in the question of dementia therapies of this type. In broad terms the idea is that this kind of therapy has a restorative effect on social agency. To the extent that music arouses a person through its rhythms and memory-inducing effects, particularly in communal settings, it may give rise to the recovery of one's narrative agency, and in turn allow for both carer and patient to participate in a more meaningful and mutually engaging social connection. © 2015 John Wiley & Sons Ltd.

  19. Early diagnosis of dementia and protection

    International Nuclear Information System (INIS)

    Mizuno, Toshiki

    2010-01-01

    Mild cognitive impairment (MCI) refers to the transitional state between the normal elderly and dementia. This concept accelerated many clinical, epidemiological and neuroimaging research in recent 10 years about an early stage of dementia. These studies have approved a significance of this concept and MCI have been classified into subtypes, including prodromal forms of a variety of dementias. An algorithm is proposed to assist the clinician in subclassifying subjects into the various types of MCI, but new several concepts, such as vascular cognitive impairment, still confused clinicians. Therefore, definition and diagnostic procedure for MCI were discussed in this review. Several population-based studies as well as Alzheimer's Disease Neuroimaging Initiative (ADNI) study have documented a higher rate of progression to Alzheimer's disease in individuals diagnosed with MCI. Progression factors, including neuroimaging and vascular risk factors are also discussed. Vascular risk factors, such as hypertension, hyperlipemia and diabetes mellitus can be modulated by food, life style and treatment. The recent clinical trials for protective cognition using anti- hypertensive medication as well as statin is discussed. (author)

  20. Multi-Infarct Dementia: A Historical Perspective

    Directory of Open Access Journals (Sweden)

    Erin McKay

    2017-05-01

    Full Text Available Background: Multi-infarct dementia (MID, a prominent subtype of vascular dementia (VaD, has only achieved recognition in the last 4 decades. Since its original description, the characterization, etiological understanding, and therapeutic direction of MID and other VaD subtypes has progressed at an astounding rate. Summary: This paper divides the landmark discoveries and emergence of new research strategies for MID into decade-defining patterns so that a condensed picture of the total history of MID and its eventual inclusion as a VaD subtype emerges. This paper follows the first descriptive decade, a shift to a preventative focus, a renewed interest coinciding with timely advances in research technology, and a hopeful return to treatment possibilities for VaD. Key Message: Concisely tracing the historical lineage of the modern understanding of MID, both as a singular entity and as part of the VaD con­stellation of disorders, provides a novel perspective on the foundation upon which future advances in combating vascular contributions to dementia will be based.

  1. Reminiscence therapy for dementia.

    Science.gov (United States)

    Woods, Bob; O'Philbin, Laura; Farrell, Emma M; Spector, Aimee E; Orrell, Martin

    2018-03-01

    This updated Cochrane Review of reminiscence therapy (RT) for dementia was first published in 1998, and last updated in 2005. RT involves the discussion of memories and past experiences with other people using tangible prompts such as photographs or music to evoke memories and stimulate conversation. RT is implemented widely in a range of settings using a variety of formats. To assess the effects of RT on people living with dementia and their carers, taking into account differences in its implementation, including setting (care home, community) and modality (group, individual). We searched ALOIS (the Cochrane Dementia and Cognitive Improvement Group's Specialized Register) on 6 April 2017 using the search term 'reminiscence.' We included all randomised controlled trials of RT for dementia in which the duration of the intervention was at least four weeks (or six sessions) and that had a 'no treatment' or passive control group. Outcomes of interest were quality of life (QoL), cognition, communication, behaviour, mood and carer outcomes. Two authors (LOP and EF) independently extracted data and assessed risk of bias. Where necessary, we contacted study authors for additional information. We pooled data from all sufficiently similar studies reporting on each outcome. We undertook subgroup analysis by setting (community versus care home) and by modality (individual versus group). We used GRADE methods to assess the overall quality of evidence for each outcome. We included 22 studies involving 1972 people with dementia. Meta-analyses included data from 16 studies (1749 participants). Apart from six studies with risk of selection bias, the overall risk of bias in the studies was low.Overall, moderate quality evidence indicated RT did not have an important effect on QoL immediately after the intervention period compared with no treatment (standardised mean difference (SMD) 0.11, 95% confidence interval (CI) -0.12 to 0.33; I 2 = 59%; 8 studies; 1060 participants

  2. Dementia incidence trend over 1992-2014 in the Netherlands: Analysis of primary care data

    Science.gov (United States)

    van Bussel, Emma F.; Richard, Edo; Coloma, Preciosa M.; de Waal, Margot W. M.; van den Akker, Marjan; Nielen, Markus M. J.; van Boven, Kees; Busschers, Wim B.; van Gool, Willem A.

    2017-01-01

    Background Recent reports have suggested declining age-specific incidence rates of dementia in high-income countries over time. Improved education and cardiovascular health in early age have been suggested to be bringing about this effect. The aim of this study was to estimate the age-specific dementia incidence trend in primary care records from a large population in the Netherlands. Methods and findings A dynamic cohort representative of the Dutch population was composed using primary care records from general practice registration networks (GPRNs) across the country. Data regarding dementia incidence were obtained using general-practitioner-recorded diagnosis of dementia within the electronic health records. Age-specific dementia incidence rates were calculated for all persons aged 60 y and over; negative binomial regression analysis was used to estimate the time trend. Nine out of eleven GPRNs provided data on more than 800,000 older people for the years 1992 to 2014, corresponding to over 4 million person-years and 23,186 incident dementia cases. The annual growth in dementia incidence rate was estimated to be 2.1% (95% CI 0.5% to 3.8%), and incidence rates were 1.08 (95% CI 1.04 to 1.13) times higher for women compared to men. Despite their relatively low numbers of person-years, the highest age groups contributed most to the increasing trend. There was no significant overall change in incidence rates since the start of a national dementia program in 2003 (−0.025; 95% CI −0.062 to 0.011). Increased awareness of dementia by patients and doctors in more recent years may have influenced dementia diagnosis by general practitioners in electronic health records, and needs to be taken into account when interpreting the data. Conclusions Within the clinical records of a large, representative sample of the Dutch population, we found no evidence for a declining incidence trend of dementia in the Netherlands. This could indicate true stability in incidence rates, or

  3. Dementia incidence trend over 1992-2014 in the Netherlands: Analysis of primary care data.

    Directory of Open Access Journals (Sweden)

    Emma F van Bussel

    2017-03-01

    Full Text Available Recent reports have suggested declining age-specific incidence rates of dementia in high-income countries over time. Improved education and cardiovascular health in early age have been suggested to be bringing about this effect. The aim of this study was to estimate the age-specific dementia incidence trend in primary care records from a large population in the Netherlands.A dynamic cohort representative of the Dutch population was composed using primary care records from general practice registration networks (GPRNs across the country. Data regarding dementia incidence were obtained using general-practitioner-recorded diagnosis of dementia within the electronic health records. Age-specific dementia incidence rates were calculated for all persons aged 60 y and over; negative binomial regression analysis was used to estimate the time trend. Nine out of eleven GPRNs provided data on more than 800,000 older people for the years 1992 to 2014, corresponding to over 4 million person-years and 23,186 incident dementia cases. The annual growth in dementia incidence rate was estimated to be 2.1% (95% CI 0.5% to 3.8%, and incidence rates were 1.08 (95% CI 1.04 to 1.13 times higher for women compared to men. Despite their relatively low numbers of person-years, the highest age groups contributed most to the increasing trend. There was no significant overall change in incidence rates since the start of a national dementia program in 2003 (-0.025; 95% CI -0.062 to 0.011. Increased awareness of dementia by patients and doctors in more recent years may have influenced dementia diagnosis by general practitioners in electronic health records, and needs to be taken into account when interpreting the data.Within the clinical records of a large, representative sample of the Dutch population, we found no evidence for a declining incidence trend of dementia in the Netherlands. This could indicate true stability in incidence rates, or a balance between increased

  4. Similarities of cerebral glucose metabolism in Alzheimer's and Parkinsonian dementia

    International Nuclear Information System (INIS)

    Kuhl, D.E.; Metter, E.J.; Benson, D.F.; Ashford, J.W.; Riege, W.H.; Fujikawa, D.G.; Markham, C.H.; Maltese, A.

    1985-01-01

    In the dementia of probable Alzheimer's Disease (AD), there is a decrease in the metabolic ratio of parietal cortex/caudate-thalamus which relates measures in the most and in the least severely affected locations. Since some demented patients with Parkinson's Disease (PDD) are known to share pathological and neurochemical features with AD patients, the authors evaluated if the distribution of cerebral hypometabolism in PDD and AD were the same. Local cerebral metabolic rates were determined using the FDG method and positron tomography in subjects with AD (N=23), and PDD (N=7), multiple infarct dementia (MID)(N=6), and controls (N=10). In MID, the mean par/caudthal ratio was normal (0.79 +- 0.9, N=6). In AD and PDD patients, this ratio correlated negatively with both the severity (r=-0.624, rho=0.001) and duration (r=-0.657, rho=0.001) of dementia. The ratio was markedly decreased in subjects with mild to severe dementia (0.46 +- 0.09, N=21) and with dementia duration greater than two years (0.44 +- 0.08, N=18), but the ratio was also significantly decreased in patients with less advanced disease, i.e., when dementia was only questionable (0.64 +- 0.14, N=9) (t=2.27, rho<0.037) and when duration was two years or less (0.62 +- 0.13, N=12)(t=2.88, rho<0.009). This similarity of hypometabolism in AD and PDD is additional evidence that a common mechanism may operate in both disorders. The par/caud-thal metabolic ratio may be an index useful in the differential diagnosis of early dementia

  5. Diagnosis and management of dementia

    African Journals Online (AJOL)

    2007-09-19

    Sep 19, 2007 ... Dementia is an acquired syndrome of memory decline with at least one other cognitive .... functions and memory retrieval are the .... behavioural problems.5 Cost-effectiveness of ... (For words not recalled, prompt with a cue.).

  6. 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.

  7. Dementia due to metabolic causes

    Science.gov (United States)

    ... Poor judgment and losing the ability to recognize danger Using the wrong word, not pronouncing words correctly, ... disease and other dementias. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: ...

  8. Dementia, Caregiving, and Controlling Frustration

    Science.gov (United States)

    ... to be calm can help you to gain cooperation. See FCA ʼ s fact sheet Caregiver’s Guide to ... cuidador para entender la conducta de los pacientes con demencia (Caregiver’s Guide to Understanding Dementia Behaviors) We ...

  9. NJP VOlume 38 Number 4 PDF.cdr

    African Journals Online (AJOL)

    Prof Ezechukwu

    It is inherited as an X linked recessive disorder. It affects about 400 million people worldwide. The highest prevalence rates occur in persons of African, Asian, ... Type of Delivery. Singleton. 903 (96.8). Twins. 15 (3.2). Gestational age (GA). Preterm. 187 (20.1%). Term. 764 (79.9%). Gender. Male. 514 (55.1). Female.

  10. NJP Volume 38 Number 3 PDF.cdr

    African Journals Online (AJOL)

    Prof Ezechukwu

    community, thus placing newborn babies at risk of morbidity and mortality. In spite of this, there is paucity of data on cord care practices in developing countries. 6. Introduction. Infections account for an estimated 1·44 million. (36%) deaths, and about half of deaths in regions with high neonatal mortality rates. A substantial.

  11. NJP Volume 38 Number 2 PDF.cdr

    African Journals Online (AJOL)

    Prof Ezechukwu

    maternal age, high birth order and assisted delivery. Perinatal asphyxia, hypoglycaemia, hyperbilirubinaemia, sepsis and trauma were the common perinatal conditions in high birthweight babies. Perinatal mortality rate for high birthweight babies was 3.9 per. 1000 total births and 71.9 per 1000 high birthweight deliveries.

  12. 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 application's impact on the patient's 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.

  13. 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.

  14. 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...

  15. A review of ethical issues in dementia.

    Science.gov (United States)

    Johnson, Rebecca A; Karlawish, Jason

    2015-10-01

    Dementia raises many ethical issues. The present review, taking note of the fact that the stages of dementia raise distinct ethical issues, focuses on three issues associated with stages of dementia's progression: (1) how the emergence of preclinical and asymptomatic but at-risk categories for dementia creates complex questions about preventive measures, risk disclosure, and protection from stigma and discrimination; (2) how despite efforts at dementia prevention, important research continues to investigate ways to alleviate clinical dementia's symptoms, and requires additional human subjects protections to ethically enroll persons with dementia; and (3) how in spite of research and prevention efforts, persons continue to need to live with dementia. This review highlights two major themes. First is how expanding the boundaries of dementias such as Alzheimer's to include asymptomatic but at-risk persons generate new ethical questions. One promising way to address these questions is to take an integrated approach to dementia ethics, which can include incorporating ethics-related data collection into the design of a dementia research study itself. Second is the interdisciplinary nature of ethical questions related to dementia, from health policy questions about insurance coverage for long-term care to political questions about voting, driving, and other civic rights and privileges to economic questions about balancing an employer's right to a safe and productive workforce with an employee's rights to avoid discrimination on the basis of their dementia risk. The review highlights these themes and emerging ethical issues in dementia.

  16. Anosognosia and depression in patients with Alzheimer's dementia.

    Science.gov (United States)

    Verhülsdonk, Sandra; Quack, Robin; Höft, Barbara; Lange-Asschenfeldt, Christian; Supprian, Tillmann

    2013-01-01

    Anosognosia refers to impaired awareness of patients to realize deficits related to a disorder and is a common symptom of dementia. Anosognosia has far-reaching consequences for diagnosis and treatment and is probably associated with unfavorable prognosis. This study examined the relationship between anosognosia and depression in patients with Alzheimer's dementia (AD). Assessment included interviews of patients and their caregivers. Depressive symptoms were evaluated with observer and self-rating instruments: the Geriatric Depression Scale (GDS), and the "mood" subscale of the Nurses Observation Scale for geriatric patients (NOSGER). Anosognosia was evaluated with the Anosognosia Questionnaire for Dementia (AQ-D). For the evaluation of behavioral and neuropsychological symptoms in dementia and the caregiver burden, the neuropsychiatric inventory (NPI) and the Cares of older People in Europe (COPE) Index were administered. A total of 47 patients were enrolled in the study at the department's geriatric psychiatry outpatient clinic. A considerable discrepancy was found between observer- and self-ratings of depressive symptoms. In 74.5% of the participants, caregiver ratings indicated secondary symptoms of depression as opposed to patient ratings. Thus, in AD, anosognosia may affect not only deficits in cognition and everyday functioning but also affective symptoms ("affective anosognosia"). Caregiver rating therefore is particularly important when assessing mood changes in AD patients. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Turkish Cloud-Radiation Database (CRD) and Its Application with CDR Bayesian Probability Algorithm

    Science.gov (United States)

    Oztopal, A.; Mugnai, A.; Casella, D.; Formenton, M.; Sano, P.; Sonmez, I.; Sen, Z.; Hsaf Team

    2010-12-01

    ABSTRACT It is rather a very difficult task to determine ground rainfall amounts from few Special Sensor Microwave Imager/Sounder (SSMI/S) channels. Although ground rainfall cannot be observed from the space directly, but knowledge about the cloud physics helps to estimate the amound of ground rainfall. SSMI/S includes so much information about the atmospheric structure, however it cannot provide cloud micro-physical structural information. In such a situation, in the rainfall algorithm, besides the SSMI/S data, it is necessary to incorporate cloud micro-physical properties from an external data source. These properties can be obtained quite simply by the help of Cloud Resolving Model (CRM). Later, in addition to all available data, also micro-physical properties obtained from Radiative Transfer Model (RTM) help to determine the SSMI/S brightness temperatures (Brightness temperatures - TBs), which can then be correlated with Cloud-Radiation Database (CRD) data generation. SSMI/S satellite data and CDR provide a common basis for rainfall prediction procedure through CDR Bayesian probability algorithm, which combines the two sets of data in a scientific manner. The first applications of this algorithm, which is being used up today, is due to various researchers. In this work, in order to establish a reflection of available data processing CDR CRM University of Wisconsin - Non-hydrostatic Modeling System (UW-NMS) model is employed, which is first developed by Prof. Gregory J. Tripoli. It is also used by Turkish Meteorological Service by benefiting from radar network data, and finally 14 simulations are realized in this study. Moreover, one case study is fulfilled by using a 3X3 spatial filtering, and then radar data and result of CDR Bayesian probability algorithm are compared with each other. On 9 September 2009 at 03:40 GMT rainfall event on comparatively flat area matches far better with the retrieval values and hence the spatial rainfall occurrence extent and

  18. Trichotillomania in a dementia case

    Directory of Open Access Journals (Sweden)

    Leonardo Caixeta

    Full Text Available Abstract We report an 87-year-old male case of hair pulling associated with a white-matter vascular dementia (Binswanger's disease. Trichotillomania in our case did not resolve using mirtazapine or anticholinesterasic medication. Trichotillomania seems to be related to a form of perseveration associated with dementia. The findings in this case suggest the abnormality involving white matter in the pathogenesis of trichotillomania, may constitute a defect in connectivity in the right frontal-subcortical circuit.

  19. Trichotillomania in a dementia case

    OpenAIRE

    Caixeta, Leonardo; Lopes, Danielly Bandeira

    2011-01-01

    Abstract We report an 87-year-old male case of hair pulling associated with a white-matter vascular dementia (Binswanger's disease). Trichotillomania in our case did not resolve using mirtazapine or anticholinesterasic medication. Trichotillomania seems to be related to a form of perseveration associated with dementia. The findings in this case suggest the abnormality involving white matter in the pathogenesis of trichotillomania, may constitute a defect in connectivity in the right frontal-s...

  20. Advance directives for future dementia can be modified by a brief video presentation on dementia care: An experimental study.

    Directory of Open Access Journals (Sweden)

    Theresia Volhard

    Full Text Available To investigate whether life-sustaining measures in medical emergency situations are less accepted for an anticipated own future of living with dementia, and to test whether a resource-oriented, in contrast to a deficit-oriented video about the same demented person, would increase the acceptance of such life-saving measures.Experimental study conducted between September 2012 and February 2013.Community dwelling female volunteers living in the region of Bonn, Germany.278 women aged 19 to 89 (mean age 53.4 years.Presentation of a video on dementia care focusing either on the deficits of a demented woman (negative framing, or focusing on the remaining resources (positive framing of the same patient.Approval of life-sustaining treatments in five critical medical scenarios under the assumption of having comorbid dementia, before and after the presentation of the brief videos on care.At baseline, the acceptance of life-sustaining measures in critical medical situations was significantly lower in subjects anticipating their own future life with dementia. Participants watching the resource-oriented film on living with dementia had significantly higher post-film acceptance rates compared to those watching the deficit-oriented negatively framed film. This effect particularly emerges if brief and efficient life-saving interventions with a high likelihood of physical recovery are available (eg, antibiotic treatment for pneumonia.Anticipated decisions regarding life-sustaining measures are negatively influenced by the subjective imagination of living with dementia, which might be shaped by common, unquestioned stereotypes. This bias can be reduced by providing audio-visual information on living with dementia which is not only centred around cognitive and functional losses but also focuses on remaining resources and the apparent quality of life. This is particularly true if the medical threat can be treated efficiently. These findings have implications for the

  1. The VOICE study - A before and after study of a dementia communication skills training course.

    Science.gov (United States)

    O'Brien, Rebecca; Goldberg, Sarah E; Pilnick, Alison; Beeke, Suzanne; Schneider, Justine; Sartain, Kate; Thomson, Louise; Murray, Megan; Baxendale, Bryn; Harwood, Rowan H

    2018-01-01

    A quarter of acute hospital beds are occupied by persons living with dementia, many of whom have communication problems. Healthcare professionals lack confidence in dementia communication skills, but there are no evidence-based communication skills training approaches appropriate for professionals working in this context. We aimed to develop and pilot a dementia communication skills training course that was acceptable and useful to healthcare professionals, hospital patients and their relatives. The course was developed using conversation analytic findings from video recordings of healthcare professionals talking to patients living with dementia in the acute hospital, together with systematic review evidence of dementia communication skills training and taking account of expert and service-user opinion. The two-day course was based on experiential learning theory, and included simulation and video workshops, reflective diaries and didactic teaching. Actors were trained to portray patients living with dementia for the simulation exercises. Six courses were run between January and May 2017. 44/45 healthcare professionals attended both days of the course. Evaluation entailed: questionnaires on confidence in dementia communication; a dementia communication knowledge test; and participants' satisfaction. Video-recorded, simulated assessments were used to measure changes in communication behaviour. Healthcare professionals increased their knowledge of dementia communication (mean improvement 1.5/10; 95% confidence interval 1.0-2.0; pskills learned in clinical practice. Blind-ratings of simulated patient encounters demonstrated behaviour change in taught communication behaviours to close an encounter, consistent with the training, but not in requesting behaviours. We have developed an innovative, evidence-based dementia communication skills training course which healthcare professionals found useful and after which they demonstrated improved dementia communication

  2. Neuropsychiatric Inventory data in a Belgian sample of elderly persons with and without dementia

    Directory of Open Access Journals (Sweden)

    Squelard GP

    2012-10-01

    Full Text Available Gilles P Squelard,1 Pierre A Missotten,1 Louis Paquay,2 Jan A De Lepeleire,2 Frank JVM Buntinx,2 Ovide Fontaine,1 Stephane R Adam,1 Michel JD Ylieff11Clinical Psychology of Ageing, Qualidem Research Project, University of Liège (ULg, Liège, Belgium; 2KU Leuven, Department of Public Health and Primary Care, Leuven, BelgiumBackground/aims: This study assesses and compares prevalence of psychological and behavioral symptoms in a Belgian sample of people with and without dementia.Methods: A total of 228 persons older than 65 years with dementia and a group of 64 non-demented persons were assessed using the Neuropsychiatric Inventory (NPI in 2004.Results: Within the group without dementia, the most frequent symptoms were depression, agitation, and irritability. Within the group with dementia, the most common symptoms were depression, irritability, apathy, and agitation. Prevalence of delusions (P < 0.05, hallucinations (P < 0.05, anxiety (P < 0.05, agitation (P < 0.05, apathy (P < 0.01, aberrant motor behavior (P < 0.01, and eating disorders (P < 0.05 were significantly higher in the group with dementia.Conclusion: Depression, elation, irritability, disinhibition, and sleeping disorders are not specific to dementia. Agitation, apathy, anxiety, and delusions are more frequent in dementia but were not specific to the dementia group because their prevalence rates were close to 10% in the group without dementia. Hallucinations, aberrant motor behavior, and eating disorders are specific to dementia. The distinction between specific and nonspecific symptoms may be useful for etiological research on biological, psychological, and environmental factors.Keywords: behavior, behavior disorders, epidemiology, dementia, psychiatric symptoms, neuropsychiatry

  3. Dementia: sociological and philosophical constructions.

    Science.gov (United States)

    Davis, Daniel H J

    2004-01-01

    This analysis presents a challenge to the biomedical view of dementia as a disease. This view is critiqued from two perspectives: those of sociology and philosophy. Because these domains inform the creation of the medical discourse, their analysis provides an important refinement to the apprehension of the phenomenon of dementia. From the work of Foucault, and in particular his analysis of the historical origins of modern medicine, the sociological construction of dementia is considered. Following this, the philosophical question of Being is discussed, considering particularly the positions of Heidegger and Merleau-Ponty. Lastly aspects of dementia nursing that are damaging to those relatives forced to take on the role of primary carer are isolated, in the context of Kitwood's view that it is possible to maintain personhood at the extremes of this condition. It is suggested that this critique of sociological and philosophical foundations of dementia might offer a way of approaching the dismantling of the self and revise current conceptions of dementia care for the better.

  4. Profile of clinically-diagnosed dementias in a neuropsychiatric ...

    African Journals Online (AJOL)

    Alzheimer's disease (AD) and Vascular dementia (VaD) were the predominant phenotypes seen in 62 (57.4%) and 18 (16.7%) subjects respectively. Others include mixed dementia (4 cases), frontotemporal dementia (4 cases), Lewy body dementia (3 cases), alcohol-related dementia (3 cases), PD dementia (1 case) and ...

  5. Identification and diagnostic evaluation of possible dementia in general practice. A prospective study

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Rishøj, Susanne; Waldemar, Gunhild

    2005-01-01

    , and 4 (3%) were treated for depression or referred for another condition. A total of 6 patients were lost to follow-up. In the remaining 102 undiagnosed patients the main reasons for not performing a diagnostic evaluation of dementia were patient/relative hesitation (34%), the GP thought that it would......OBJECTIVE: To investigate the rate of diagnostic evaluation of dementia for patients in whom a suspicion of dementia was raised, and to investigate reasons why a diagnostic evaluation was not always being performed. DESIGN: A prospective study among elderly patients aged 65+, and a follow-up study...... of dementia, laboratory-screening tests prescribed by the GPs and referral status after 6 months, and follow-up questionnaire. RESULTS: Of 793 patients a total of 138 patients were identified with possible dementia. Among the identified patients 26 (20%) were referred for further evaluation within 6 months...

  6. The role of traditional and faith healers in the treatment of dementia in Tanzania and the potential for collaboration with allopathic healthcare services.

    Science.gov (United States)

    Hindley, Guy; Kissima, John; L Oates, Lloyd; Paddick, Stella-Maria; Kisoli, Aloyce; Brandsma, Christine; K Gray, William; Walker, Richard W; Mushi, Declare; Dotchin, Catherine L

    2017-01-04

    Low diagnostic rates are a barrier to improving care for the growing number of people with dementia in sub-Saharan Africa. Many people with dementia are thought to visit traditional healers (THs) and Christian faith healers (FHs) and these groups may have a role in identifying people with dementia. We aimed to explore the practice and attitudes of these healers regarding dementia in rural Tanzania and investigate attitudes of their patients and their patients’ carers. This was a qualitative study conducted in Hai district, Tanzania. Semi-structured interviews were conducted with a convenience sample of THs and FHs and a purposive-stratified sample of people with dementia and their carers. Interview guides were devised which included case vignettes. Transcripts of interviews were subject to thematic analysis. Eleven THs, 10 FHs, 18 people with dementia and 17 carers were recruited. Three themes emerged: (i) conceptualisation of dementia by healers as a normal part of the ageing process and no recognition of dementia as a specific condition; (ii) people with dementia and carer reasons for seeking help and experiences of treatment and the role of prayers, plants and witchcraft in diagnosis and treatment; (iii) willingness to collaborate with allopathic healthcare services. FHs and people with dementia expressed concerns about any collaboration with THs. Although THs and FHs do not appear to view dementia as a specific disease, they may provide a means of identifying people with dementia in this setting.

  7. Prevalence of dementia in Al Kharga District, New Valley Governorate, Egypt.

    Science.gov (United States)

    El Tallawy, Hamdy N; Farghly, Wafaa M A; Shehata, Ghaydaa A; Rageh, Tarek A; Hakeem, Nabil Abdel; Abo-Elfetoh, Noha; Hegazy, Ahmed M; Rayan, Ibraheem; El-Moselhy, Essam A

    2012-01-01

    With aging, there is a parallel increase in the prevalence of dementia worldwide. The aim of this work is to determine the prevalence of dementia among the population of Al Kharga District, New Valley, Egypt. Screening of all subjects aged ≥50 years (n = 8,173 out of 62,583 inhabitants) was done through a door-to-door survey by 3 neurologists, using a short standardized Arabic screening test and a modified Mini-Mental State Examination. Suspected cases were subjected to full clinical examination, psychometric assessment using the Cognitive Abilities Screening Instrument, Instrumental Activities of Daily Living Scale, Geriatric Depression Scale, Hachinski Ischemic Score, DSM-IV-TR diagnostic criteria, neuroimaging, and laboratory investigations, when indicated. The prevalence rate of dementia was 2.26% for the population aged ≥50 years. It increased steeply with age to a maximum of 18.48% for those aged ≥80 years. Alzheimer's disease (51.2%) was the most common subtype, followed by vascular dementia (28.7%), dementia due to general medical conditions (12.8%), and lastly dementia due to multiple etiologies (7.3%). Mild dementia was the commonest (53.7%). Dementia is prevalent in Egypt as elsewhere. Detection through a door-to-door survey is the best method in developing countries for early detection of mild cases. Copyright © 2012 S. Karger AG, Basel.

  8. "We're certainly not in our comfort zone": a qualitative study of GPs' dementia-care educational needs.

    Science.gov (United States)

    Foley, Tony; Boyle, Siobhán; Jennings, Aisling; Smithson, W Henry

    2017-05-22

    Rising dementia prevalence rates rise combined with the policy objective of enabling people with dementia to remain living at home, means that there will be a growing demand for dementia care in the community setting. However, GPs are challenged by dementia care and have identified it as an area in which further training is needed. Previous studies of GPs dementia care educational needs have explored the views of GPs alone, without taking the perspectives of people with dementia and family carers into account. The aim of the study was to explore GPs' dementia care educational needs, as viewed from multiple perspectives, in order to inform the design and delivery of an educational programme for GPs. A qualitative study of GPs, people with dementia and family carers in a community setting was undertaken. Face-to-face interviews were performed with GPs, people with dementia and with family carers. Interviews were audio-recorded, transcribed verbatim and thematically analysed. Thirty-one people were interviewed, consisting of fourteen GPs, twelve family carers and five people with dementia. GPs expressed a wish for further education, preferentially through small group workshops. Five distinct educational needs emerged from the interviews, namely, diagnosis, disclosure, signposting of local services, counselling and the management of behavioural and psychological symptoms (BPSD). While GPs focused on diagnosis, disclosure and BPSD in particular, people with dementia and family carers emphasised the need for GPs to engage in counselling and signposting of local services. The triangulation of data from multiple relevant sources revealed a broader range of GPs' educational needs, incorporating both medical and social aspects of dementia care. The findings of this study will inform the content and delivery of a dementia educational programme for GPs that is practice-relevant, by ensuring that the curriculum meets the needs of GPs, patients and their families.

  9. [The prevalence of Parkinson's disease, associated dementia, and depression in Dresden].

    Science.gov (United States)

    Riedel, O; Schneider, C; Klotsche, J; Reichmann, H; Storch, A; Wittchen, H-U

    2013-02-01

    Parkinson's disease (PD) is frequently compounded by dementia and depression. Yet local total estimates on the prevalence of PD with dementia/depression are still lacking. These are socioeconomically important, especially for the eastern federal states in Germany due to the demographic structures. We conducted a two-staged total estimation in the area of Dresden. First, all local office-based neurologists, hospitals and retirement homes were asked to list their patients/residents with PD on a single study day. Then a random sample of patients/home residents was neuropsycholoigcally examined, including the Mini-mental-state exam and the Montgomery-Asberg Depression rating scale. Dementia was diagnosed according to DSM-IV criteria. Overall, 886 PD cases (95 % CI: 809 - 926) were estimated, of which 252 (95 % CI: 226 - 279) suffered from dementia and 216 (95 % CI: 191 - 242) from depression. Dementia rates increased by age with 13.8 % (≤ 65 years) to 40.2 % (≥ 76 years). Depression rates ranged from 23.3 % to 28.0 %. Overall, 20.6 % of all ambulatory treated PD patients and 85.7 % of all home residents with PD had dementia. The prevalence of PD in Dresden dovetails with previous reported estimates. Dementia and depression are frequent complications in outpatients as well as home residents with PD. © Georg Thieme Verlag KG Stuttgart · New York.

  10. 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

    the possible causal relations between the rate of success of the intervention components and the outcomes. Discussion We developed multifaceted dementia training programme. Novelties in this programme are the training in fixed collaborative duos and the inclusion of an individual coaching program. The intervention is designed according to international guidelines and educational standards. Exploratory analysis will reveal its successful elements. Selection bias and contamination may be threats to the reliability of future results of this trial. Nevertheless, the results of this trial may provide useful information for policy makers and developers of continuing medical education. Trial registration ClinicalTrials.gov ID NCT00459784

  11. BCR CDR3 length distributions differ between blood and spleen and between old and young patients, and TCR distributions can be used to detect myelodysplastic syndrome

    International Nuclear Information System (INIS)

    Pickman, Yishai; Mehr, Ramit; Dunn-Walters, Deborah

    2013-01-01

    Complementarity-determining region 3 (CDR3) is the most hyper-variable region in B cell receptor (BCR) and T cell receptor (TCR) genes, and the most critical structure in antigen recognition and thereby in determining the fates of developing and responding lymphocytes. There are millions of different TCR Vβ chain or BCR heavy chain CDR3 sequences in human blood. Even now, when high-throughput sequencing becomes widely used, CDR3 length distributions (also called spectratypes) are still a much quicker and cheaper method of assessing repertoire diversity. However, distribution complexity and the large amount of information per sample (e.g. 32 distributions of the TCRα chain, and 24 of TCRβ) calls for the use of machine learning tools for full exploration. We have examined the ability of supervised machine learning, which uses computational models to find hidden patterns in predefined biological groups, to analyze CDR3 length distributions from various sources, and distinguish between experimental groups. We found that (a) splenic BCR CDR3 length distributions are characterized by low standard deviations and few local maxima, compared to peripheral blood distributions; (b) healthy elderly people's BCR CDR3 length distributions can be distinguished from those of the young; and (c) a machine learning model based on TCR CDR3 distribution features can detect myelodysplastic syndrome with approximately 93% accuracy. Overall, we demonstrate that using supervised machine learning methods can contribute to our understanding of lymphocyte repertoire diversity. (paper)

  12. CDR3 analysis of TCR Vβ repertoire of CD8⁺ T cells from chickens infected with Eimeria maxima.

    Science.gov (United States)

    Ren, Chao; Yin, Guangwen; Qin, Mei; Suo, Jingxia; Lv, Qiyao; Xie, Li; Wang, Yunzhou; Huang, Xiaoxi; Chen, Yuchen; Liu, Xianyong; Suo, Xun

    2014-08-01

    CD8(+) T cells play a major role in the immune protection of host against the reinfection of Eimeria maxima, the most immunogenic species of eimerian parasites in chickens. To explore the dominant complementarity-determining regions 3 (CDR3) of CD8(+) T cell populations induced by the infection of this parasite, sequence analysis was performed in this study for CDR3 of CD8(+) T cells from E. maxima infected chickens. After 5 days post the third or forth infection, intraepithelial lymphocytes were isolated from the jejunum of bird. CD3(+)CD8(+) T cells were sorted and subjected to total RNA isolation and cDNA preparation. PCR amplification and cloning of the loci between Vβ1 and Cβ was conducted for the subsequent sequencing of CDR3 of T cell receptor (TCR). After the forth infection, 2 birds exhibited two same frequent TCR CDR3 sequences, i.e., AKQDWGTGGYSNMI and AGRVLNIQY; while the third bird showed two different frequent TCR CDR3 sequences, AKQGARGHTPLN and AKQDIEVRGPNTPLN. No frequent CDR3 sequence was detected from uninfected birds, though AGRVLNIQY was also found in two uninfected birds. Our result preliminarily demonstrates that frequent CDR3 sequences may exist in E. maxima immunized chickens, encouraging the mining of the immunodominant CD8(+) T cells against E. maxima infection. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. BCR CDR3 length distributions differ between blood and spleen and between old and young patients, and TCR distributions can be used to detect myelodysplastic syndrome

    Science.gov (United States)

    Pickman, Yishai; Dunn-Walters, Deborah; Mehr, Ramit

    2013-10-01

    Complementarity-determining region 3 (CDR3) is the most hyper-variable region in B cell receptor (BCR) and T cell receptor (TCR) genes, and the most critical structure in antigen recognition and thereby in determining the fates of developing and responding lymphocytes. There are millions of different TCR Vβ chain or BCR heavy chain CDR3 sequences in human blood. Even now, when high-throughput sequencing becomes widely used, CDR3 length distributions (also called spectratypes) are still a much quicker and cheaper method of assessing repertoire diversity. However, distribution complexity and the large amount of information per sample (e.g. 32 distributions of the TCRα chain, and 24 of TCRβ) calls for the use of machine learning tools for full exploration. We have examined the ability of supervised machine learning, which uses computational models to find hidden patterns in predefined biological groups, to analyze CDR3 length distributions from various sources, and distinguish between experimental groups. We found that (a) splenic BCR CDR3 length distributions are characterized by low standard deviations and few local maxima, compared to peripheral blood distributions; (b) healthy elderly people's BCR CDR3 length distributions can be distinguished from those of the young; and (c) a machine learning model based on TCR CDR3 distribution features can detect myelodysplastic syndrome with approximately 93% accuracy. Overall, we demonstrate that using supervised machine learning methods can contribute to our understanding of lymphocyte repertoire diversity.

  14. Giving dementia a face? The portrayal of older people with dementia in German weekly news magazines between the years 2000 and 2009.

    Science.gov (United States)

    Kessler, Eva-Marie; Schwender, Clemens

    2012-03-01

    We investigated photographic depictions of older people with dementia in news magazines according to their frequency as well as observable characteristics of the characters. We examined all 2,604 photos appearing in articles identified using the key words "dementia" and "Alzheimer's" published in the 4 major German weekly news magazines between 2000 and 2009. According to the body text and/or the legend, 154 characters with dementia were identified. Trained judges rated the age and gender of each character as well as the emotional expression, physical functioning, physical surroundings, and social context of the characters. Visual representations of characters with dementia linearly increased across time (both in terms of absolute and relative figures). Women were shown more often than men. Young-old and old-old characters were depicted equally often. Characters were mostly depicted as having positive emotions and good functional health. A large majority of characters were shown in individualized contexts and together with social partners. Only 2 social partners displayed negative emotions, and he/she was a "helper" in less than one third of cases. Despite the overall low frequency of photos of older people with dementia, dementia seems to have "acquired a face" across the past decade. Although our analysis revealed a heterogeneous portrayal of older people with dementia, "positive" representations clearly prevailed.

  15. 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....

  16. 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 ...

  17. Do continued antidepressants protect against dementia in patients with severe depressive disorder?

    Science.gov (United States)

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

    2011-11-01

    Studies on humans show that depressive disorder is associated with an increased risk of developing cognitive dysfunction, and animal studies suggest that antidepressants may have neuroprotective abilities. On the basis of these observations, it was hypothesized that treatment with antidepressants may decrease the risk of developing dementia in patients with depression. We investigated whether continued treatment with antidepressants is associated with a decreased rate of dementia in a population of patients discharged from psychiatric healthcare service with a diagnosis of depression. We used register data on all prescribed antidepressants in all patients discharged from psychiatric healthcare service with a diagnosis of depression and with subsequent diagnoses of dementia in Denmark from 1995 to 2005. A total of 37 658 patients with a diagnosis of depression at their first psychiatric contact and who were exposed to antidepressants after discharge were included in the study. A total of 2007 patients (5.3%) were subsequently diagnosed with dementia of any kind. The rate of dementia decreased during periods of two or more prescriptions of older antidepressants compared with the period of only one prescription of older antidepressants [relative risk (RR)=0.83 (95% confidence interval (CI)=0.70-0.98)]. This finding was replicated with Alzheimer's disease as the outcome [RR=0.66 (95% CI=0.47-0.94)] but not with dementia of other kinds as the outcome [RR=0.88 (95% CI=0.73-1.06)]. In contrast, during periods of continued use of selective serotonin reuptake inhibitors or newer nonselective serotonin reuptake inhibitors, the rate of dementia was not decreased, regardless of the subtype of dementia. It was concluded that continued long-term treatment with older antidepressants is associated with a reduced rate of dementia in patients treated in psychiatric healthcare settings, whereas continued treatment with other kinds of antidepressants is not. Methodological reasons for

  18. The association of dementia with upper arm and waist circumference in seven low- and middle-income countries: the 10/66 cross-sectional surveys.

    Science.gov (United States)

    Taylor, Clare L; Albanese, Emiliano; Stewart, Robert

    2012-08-01

    Weight loss in dementia contributes to morbidity and mortality but the distribution of anthropometric change and its consistency between populations are less clear. Our aim was to investigate and compare the associations of dementia with waist and upper arm circumference in elders from seven low- and middle-income nations. Cross-sectional surveys were conducted of 15,022 residents aged 65 years and older in Cuba, Mexico, Venezuela, Peru, Dominican Republic, China, and India. Dementia was assessed using a cross-culturally validated algorithm, and anthropometric measurements were taken. Associations with dementia and dementia severity (clinical dementia rating scale) were investigated in linear regression models, with fixed-effects meta-analyses used to investigate between-country heterogeneity. Dementia and increased dementia severity were both associated with smaller arm and waist circumferences with little evidence of confounding by sociodemographic and health status. Associations between dementia/clinical dementia rating and arm circumference were homogeneous between countries (Higgins I(2) 0% and 7%, respectively), whereas those with waist circumference were more heterogeneous (Higgins I(2) 67% and 62%, respectively). Although cross-sectional, our findings are consistent with prospective observations of weight loss in dementia and suggest loss of both muscle and fat-the former being consistent across different settings and the latter being more context dependent.

  19. Teaching Mands to Older Adults with Dementia

    OpenAIRE

    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 Alzheimer’s Association 8:131–168 2012; American Psychiatric Association, 2000; Engelman et al., Journal of Applied Behavior Analysis 32:107–110, 1999; Engelman ...

  20. Recognition of dementia in hospitalized older adults.

    Science.gov (United States)

    Maslow, Katie; Mezey, Mathy

    2008-01-01

    Many hospital patients with dementia have no documented dementia diagnosis. In some cases, this is because they have never been diagnosed. Recognition of Dementia in Hospitalized Older Adults proposes several approaches that hospital nurses can use to increase recognition of dementia. This article describes the Try This approaches, how to implement them, and how to incorporate them into a hospital's current admission procedures. For a free online video demonstrating the use of these approaches, go to http://links.lww.com/A216.

  1. 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...

  2. 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....

  3. Brain perfusion SPECT in dementia syndromes

    International Nuclear Information System (INIS)

    Libus, P.; Stupalova, J.; Kuzelka, I.; Konrad, J.

    2002-01-01

    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. Innate-like control of human iNKT cell autoreactivity via the hypervariable CDR3beta loop.

    Directory of Open Access Journals (Sweden)

    Gediminas Matulis

    2010-06-01

    Full Text Available Invariant Natural Killer T cells (iNKT are a versatile lymphocyte subset with important roles in both host defense and immunological tolerance. They express a highly conserved TCR which mediates recognition of the non-polymorphic, lipid-binding molecule CD1d. The structure of human iNKT TCRs is unique in that only one of the six complementarity determining region (CDR loops, CDR3beta, is hypervariable. The role of this loop for iNKT biology has been controversial, and it is unresolved whether it contributes to iNKT TCR:CD1d binding or antigen selectivity. On the one hand, the CDR3beta loop is dispensable for iNKT TCR binding to CD1d molecules presenting the xenobiotic alpha-galactosylceramide ligand KRN7000, which elicits a strong functional response from mouse and human iNKT cells. However, a role for CDR3beta in the recognition of CD1d molecules presenting less potent ligands, such as self-lipids, is suggested by the clonal distribution of iNKT autoreactivity. We demonstrate that the human iNKT repertoire comprises subsets of greatly differing TCR affinity to CD1d, and that these differences relate to their autoreactive functions. These functionally different iNKT subsets segregate in their ability to bind CD1d-tetramers loaded with the partial agonist alpha-linked glycolipid antigen OCH and structurally different endogenous beta-glycosylceramides. Using surface plasmon resonance with recombinant iNKT TCRs and different ligand-CD1d complexes, we demonstrate that the CDR3beta sequence strongly impacts on the iNKT TCR affinity to CD1d, independent of the loaded CD1d ligand. Collectively our data reveal a crucial role for CDR3beta for the function of human iNKT cells by tuning the overall affinity of the iNKT TCR to CD1d. This mechanism is relatively independent of the bound CD1d ligand and thus forms the basis of an inherent, CDR3beta dependent functional hierarchy of human iNKT cells.

  5. Dementia literacy in older adults.

    Science.gov (United States)

    Loi, Samantha M; Lautenschlager, Nicola T

    2015-09-01

    With the increasing aging population, it is predicted that there will also be a rise in the number of people with dementia. Although there is no definitive cure, early detection and access to treatment and services remains the cornerstone of management. Misinformation and poor knowledge about dementia may lead to delayed diagnosis. A study of dementia literacy was undertaken to explore current knowledge in a metropolitan city in Australia. A vignette describing an older person with symptoms of cognitive impairment was posted out to volunteers at the local hospital. The majority of participants surveyed correctly identified that the person in the vignette was suffering from symptoms of dementia or cognitive impairment. However, there was more variation with regard to types of treatment available and appropriate help-seeking behavior. Although people are able to identify symptoms of dementia when they are presented in a scenario, the reality is often not as clear. More education to improve knowledge with regard to this increasingly common disorder is required so that appropriate interventions can be made available. © 2014 Wiley Publishing Asia Pty Ltd.

  6. Dementia and rural nuclear medicine

    International Nuclear Information System (INIS)

    Cowell, S.F.; Davison, A.; Logan-Sinclair, P.; Sturt University, Dubbo, NSW; Greenough, R.

    2003-01-01

    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

  7. First TV ad for dementia care.

    Science.gov (United States)

    2008-12-10

    Last month, viewers saw the first-ever TV advertisement about providing care for people with dementia. Screened as part of Bupa's initiative, bringing the issue of dementia care 'out of the shadows,' the ad features Ernie visiting his sister June, who has dementia, in a Bupa care home and shows the personalised care being delivered by specially trained staff.

  8. Revisiting Regression in Autism: Heller's "Dementia Infantilis"

    Science.gov (United States)

    Westphal, Alexander; Schelinski, Stefanie; Volkmar, Fred; Pelphrey, Kevin

    2013-01-01

    Theodor Heller first described a severe regression of adaptive function in normally developing children, something he termed dementia infantilis, over one 100 years ago. Dementia infantilis is most closely related to the modern diagnosis, childhood disintegrative disorder. We translate Heller's paper, Uber Dementia Infantilis, and discuss…

  9. A Climate-Data Record (CDR) of the "Clear-Sky" Surface Temperature of the Greenland Ice Sheet

    Science.gov (United States)

    Hall, Dorothy K.; Comiso, Josefino C.; DiGirolamo, Nocolo E.; Shuman, Christopher A.

    2011-01-01

    We have developed a climate-data record (CDR) of "clear-sky" ice-surface temperature (IST) of the Greenland Ice Sheet using Moderate-Resolution Imaging Spectroradiometer (MODIS) data. The CDR provides daily and monthly-mean IST from March 2000 through December 2010 on a polar stereographic projection at a resolution of 6.25 km. The CDR is amenable to extension into the future using Visible/Infrared Imager Radiometer Suite (VIIRS) data. Regional "clear-sky" surface temperature increases since the early 1980s in the Arctic, measured using Advanced Very High Resolution Radiometer (AVHRR) infrared data, range from 0.57 +/- 0.02 to 0.72 +/- 0.1 c per decade. Arctic warming has important implications for ice-sheet mass balance because much of the periphery of the Greenland Ice Sheet is already near O C during the melt season, and is thus vulnerable to rapid melting if temperatures continue to increase. An increase in melting of the ice sheet would accelerate sea-level rise, an issue affecting potentially billions of people worldwide. The IST CDR will provide a convenient data set for modelers and for climatologists to track changes of the surface temperature of the ice sheet as a whole and of the individual drainage basins on the ice sheet. The daily and monthly maps will provide information on surface melt as well as "clear-sky" temperature. The CDR will be further validated by comparing results with automatic-weather station data and with satellite-derived surface-temperature products.

  10. A ‘Social Form Of Knowledge’ in Practice: Unofficial Compiling of 1960s Pop Music on CD-R

    Directory of Open Access Journals (Sweden)

    Paul Martin

    2012-01-01

    Full Text Available In this article I explore the ‘unofficial’ (and technically illegal compiling of marginally known 1960s pop records on Compact Disc Recordable (CD-R. I do so by situating it within the proposition by the late Raphael Samuel, that history is ‘social knowledge’ and a practice rather than a profession. I propose that this compiling activity exemplifies this proposition. The core of the paper is centred on a 2007 survey which I conducted via three on-line 1960s music enthusiast discussion forums. I draw on the sixteen responses to demonstrate how the motivations, values and intentions of those respondents engaging in the practice of CD-R compiling are historically and socially centred. In doing so, I seek to problematise the music industry’s undifferentiated condemnation of all copying as theft. I do so by showing how, far from stealing, these CD-R compilers are adding to the musical social knowledge of 1960s pop and rock music. I further situate them within a longer lineage of ‘unofficial listening’ dating back to at least the 1930s. In using the term ‘unofficial’ in both a legal and public historical sense (eg to take issue with a received narrative, I point to wider definitions of what historically has or has not been musically ‘official’ to listen to. I seek also to point to the practice of CD-R compiling as a historical ‘moment’ in technological change, which might otherwise go unremarked upon as the CD-R itself heads towards utilitarian obsolescence. Although, the issues and concepts raised in the paper can be little more than pointed to, it is hoped it might act as one platform for the historical engagement with a subject more commonly discussed in sociological terms. As public historians we should be reflexive and inter-disciplinary and it is with this mind set that this article is written.

  11. Association of Hypoglycemia With Subsequent Dementia in Older Patients With Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Mehta, Hemalkumar B; Mehta, Vinay; Goodwin, James S

    2017-08-01

    Studies have found conflicting evidence regarding the association of hypoglycemia with dementia. We evaluated an association of hypoglycemia with subsequent dementia in patients with type 2 diabetes. This retrospective longitudinal cohort study used the Clinical Practice Research Datalink, an electronic medical records data from the United Kingdom, from 2003 to 2012. We included patients aged >65 years diagnosed with type 2 diabetes, with no prior diagnosis of dementia. Dementia was defined using diagnosis codes from medical records. All patients were followed from the date of initial diabetes diagnosis. To account for competing risk of death, we used Fine and Gray's competing risk model to determine the association of hypoglycemia with dementia while adjusting for potential confounders. Hypoglycemia was modeled as a time-dependent covariate. Of 53,055 patients, 5.7% (n = 3,018) had at least one hypoglycemia episodes. The overall incidence rate of dementia was 12.7 per 1,000 person-years. In the fully adjusted model that controlled for all confounders, the occurrence of at least one hypoglycemia episode was associated with 27% higher odds of subsequent dementia (hazard ratio = 1.27; 95% confidence interval = 1.06-1.51). The risk increased with the number of hypoglycemia episodes: one episode (hazard ratio = 1.26; 95% confidence interval = 1.03-1.54); two or more episodes (hazard ratio = 1.50; 95% confidence interval = 1.09-2.08). Hypoglycemia is associated with a higher risk of dementia and may be responsible in part for the higher risk of dementia in patients with diabetes. Alternatively, hypoglycemia may be a marker for undiagnosed cognitive impairment, and we cannot rule out the possibility of reverse causation between hypoglycemia and dementia. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Leisure activities, cognition and dementia.

    Science.gov (United States)

    Wang, Hui-Xin; Xu, Weili; Pei, Jin-Jing

    2012-03-01

    Accumulated evidence shows that leisure activities have a positive impact on cognitive function and dementia. This review aimed to systematically summarize the current evidence on this topic taking into account the limitations of the studies and biological plausibility for the underlying mechanisms linking cognition, dementia and leisure activities, with special attention on mental, physical and social activities. We included only longitudinal studies, with a follow-up time of at least 2 years, published in English from 1991 to March 2011 on leisure activities and cognition (n=29) or dementia (n=23) and provided some evidence from intervention studies on the topic. A protective effect of mental activity on cognitive function has been consistently reported in both observational and interventional studies. The association of mental activity with the risk of dementia was robust in observational studies but inconsistent in clinical trials. The protective effect of physical activity on the risk of cognitive decline and dementia has been reported in most observational studies, but has been less evident in interventional studies. Current evidence concerning the beneficial effect of other types of leisure activities on the risk of dementia is still limited and results are inconsistent. For future studies it is imperative that the assessment of leisure activities is standardized, for example, the frequency, intensity, duration and the type of activity; and also that the cognitive test batteries and the definition of cognitive decline are harmonized/standardized. Further, well designed studies with long follow-up times are necessary. This article is part of a Special Issue entitled: Imaging Brain Aging and Neurodegenerative disease. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. Mentalising music in frontotemporal dementia.

    Science.gov (United States)

    Downey, Laura E; Blezat, Alice; Nicholas, Jennifer; Omar, Rohani; Golden, Hannah L; Mahoney, Colin J; Crutch, Sebastian J; Warren, Jason D

    2013-01-01

    Despite considerable recent interest, the biological basis and clinical diagnosis of behavioural variant frontotemporal dementia (bvFTD) pose unresolved problems. Mentalising (the cognitive capacity to interpret the behaviour of oneself and others in terms of mental states) is impaired as a prominent feature of bvFTD, consistent with involvement of brain regions including ventro-medial prefrontal cortex (PFC), orbitofrontal cortex and anterior temporal lobes. Here, we investigated mentalising ability in a cohort of patients with bvFTD using a novel modality: music. We constructed a novel neuropsychological battery requiring attribution of affective mental or non-mental associations to musical stimuli. Mentalising performance of patients with bvFTD (n = 20) was assessed in relation to matched healthy control subjects (n = 20); patients also had a comprehensive assessment of behaviour and general neuropsychological functions. Neuroanatomical correlates of performance on the experimental tasks were investigated using voxel-based morphometry of patients' brain magnetic resonance imaging (MRI) scans. Compared to healthy control subjects, patients showed impaired ability to attribute mental states but not non-mental characteristics to music, and this deficit correlated with performance on a standard test of social inference and with carer ratings of patients' empathic capacity, but not with other potentially relevant measures of general neuropsychological function. Mentalising performance in the bvFTD group was associated with grey matter changes in anterior temporal lobe and ventro-medial PFC. These findings suggest that music can represent surrogate mental states and the ability to construct such mental representations is impaired in bvFTD, with potential implications for our understanding of the biology of bvFTD and human social cognition more broadly. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Dance movement therapy for dementia.

    Science.gov (United States)

    Karkou, Vicky; Meekums, Bonnie

    2017-02-03

    Dementia is a collective name for different degenerative brain syndromes which, according to Alzheimer's Disease International, affects approximately 35.6 million people worldwide. The latest NICE guideline for dementia highlights the value of diverse treatment options for the different stages and symptoms of dementia including non-pharmacological treatments. Relevant literature also argues for the value of interventions that acknowledge the complexity of the condition and address the person as a whole, including their physical, emotional, social and cognitive processes. At the same time, there is growing literature that highlights the capacity of the arts and embodied practices to address this complexity. Dance movement therapy is an embodied psychological intervention that can address complexity and thus, may be useful for people with dementia, but its effectiveness remains unclear. To assess the effects of dance movement therapy on behavioural, social, cognitive and emotional symptoms of people with dementia in comparison to no treatment, standard care or any other treatment. Also, to compare different forms of dance movement therapy (e.g. Laban-based dance movement therapy, Chacian dance movement therapy or Authentic Movement). Searches took place up to March 2016 through ALOIS, Cochrane Dementia and Cognitive Improvement's Specialized Register, which covers CENTRAL, a number of major healthcare databases and trial registers, and grey literature sources. We checked bibliographies of relevant studies and reviews, and contacted professional associations, educational programmes and experts from around the world. We considered randomised controlled trials (RCTs) in any language, including cross-over design and cluster-RCTs for inclusion. Studies considered had to include people with dementia, in any age group and in any setting, with interventions delivered by a dance movement therapy practitioner who (i) had received formal training (ii) was a dance movement

  15. Spouse with schizophrenia and risk of dementia.

    Science.gov (United States)

    Rohde, Christopher; Agerbo, Esben; Nielsen, Philip Rising

    2016-12-01

    Increased prevalence of lifestyle risk factors or shared etiology may underlie the association between schizophrenia and the subsequent risk of dementia. We explored the association between having a spouse with schizophrenia and the risk of dementia. We found a positive relationship between having a spouse with schizophrenia and vascular dementia in individuals without a mental disorder themselves but no association between having a spouse with schizophrenia and Alzheimer's dementia. As spouses share environmental risk factors and lifestyle, this might suggest that the excess risk of dementia in probands with schizophrenia could be ascribed to the unhealthy living environment among individuals with schizophrenia.

  16. 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

  17. Etiologies and risk factors for dementia

    Directory of Open Access Journals (Sweden)

    Sandeep Grover

    2016-01-01

    Full Text Available Dementia is understood as a clinical syndrome characterized by impairment in memory impairment along with cognitive deficits in other domains. Over the years, understanding about the causes of dementias has improved. Broadly, dementias can be classified as irreversible degenerative dementias and reversible dementias. Alzheimer′s disease is the prototype of degenerative dementias and is characterized by the accumulation of beta-amyloid protein (called as amyloid plaques outside the neurons and accumulation of tau protein (called tau tangles inside the neurons. Vascular dementias are characterized by cerebrovascular insults which lead to pathological brain changes that impair cognition. The pathological hallmark of Lewy body dementia is the presence of α-synuclein neuronal inclusions, also known as Lewy bodies, accompanied by neuronal loss. Frontotemporal dementias are characterized by abnormal deposits of the microtubule-associated protein tau, the trans-activation response TAR DNA-binding protein with molecular weight 43 kDa (TDP-43, and the fused in sarcoma protein. Reversible dementias are characterized by the primary illness and may not present with characteristic brain deposits as seen with many degenerative dementias.

  18. Cooperative Lamb shift and the cooperative decay rate for an initially detuned phased state

    International Nuclear Information System (INIS)

    Friedberg, Richard; Manassah, Jamal T.

    2010-01-01

    The cooperative Lamb shift (CLS) is hard to measure because in samples much larger than a resonant wavelength it is much smaller, for an initially prepared resonantly phased state, than the cooperative decay rate (CDR). We show, however, that if the phasing of the initial state is detuned so that the spatial wave vector is k 1 congruent with k 0 ±O((1/R)) (where k 0 =ω 0 /c is the resonant frequency), the CLS grows to 'giant' magnitudes making it comparable to the CDR. Moreover, for certain controlled values of detuning, the initial CDR becomes small so that the dynamical Lamb shift (DLS) can be measured over a considerable period of time.

  19. Comparison of Hippocampal Volume in Dementia Subtypes

    International Nuclear Information System (INIS)

    Vijayakumar, Avinash; Vijayakumar, Abhishek

    2012-01-01

    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

  20. Detailed analysis of the supermarket task included on the Japanese version of the Rapid Dementia Screening Test.

    Science.gov (United States)

    Moriyama, Yasushi; Yoshino, Aihide; Muramatsu, Taro; Mimura, Masaru

    2017-05-01

    The supermarket task, which is included in the Japanese version of the Rapid Dementia Screening Test, requires the quick (1 min) generation of words for things that can be bought in a supermarket. Cluster size and switches are investigated during this task. We investigated how the severity of dementia related to cluster size and switches on the supermarket task in patients with Alzheimer's disease. We administered the Japanese version of the Rapid Dementia Screening Test to 250 patients with very mild to severe Alzheimer's disease and to 49 healthy volunteers. Patients had Mini-Mental State Examination scores from 12 to 26 and Clinical Dementia Rating scale scores from 0.5 to 3. Patients were divided into four groups based on their Clinical Dementia Rating score (0.5, 1, 2, 3). We performed statistical analyses between the four groups and control subjects based on cluster size and switch scores on the supermarket task. The score for cluster size and switches deteriorated according to the severity of dementia. Moreover, for subjects with a Clinical Dementia Rating score of 0.5, cluster size was impaired, but switches were intact. Our findings indicate that the scores for cluster size and switches on the supermarket task may be useful for detecting the severity of symptoms of dementia in patients with Alzheimer's disease. © 2016 The Authors. Psychogeriatrics © 2016 Japanese Psychogeriatric Society.

  1. Ambiguity Function Analysis and Processing for Passive Radar Based on CDR Digital Audio Broadcasting

    Directory of Open Access Journals (Sweden)

    Zhang Qiang

    2015-01-01

    Full Text Available China Digital Radio (CDR broadcasting is a new standard of digital audio broadcasting of FM frequency (87–108 MHz based on our research and development efforts. It is compatible with the frequency spectrum in analog FM radio and satisfies the requirements for smooth transition from analog to digital signal in FM broadcasting in China. This paper focuses on the signal characteristics and processing methods of radio-based passive radar. The signal characteristics and ambiguity function of a passive radar illumination source are analyzed. The adverse effects on the target detection of the side peaks owing to cyclic prefix, the Doppler ambiguity strips because of signal synchronization, and the range of side peaks resulting from the signal discontinuous spectrum are then studied. Finally, methods for suppressing these side peaks are proposed and their effectiveness is verified by simulations.

  2. NOAA Climate Data Record (CDR) of Intersatellite Calibrated Clear-Sky HIRS Channel 12 Brightness Temperature, Version 2.6 (Superseded)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This NOAA Climate Data Record (CDR) of Inter-Satellite Calibrated Clear-Sky High Resolution Infrared Radiation Sounder (HIRS) Channel 12 brightness temperatures...

  3. NOAA Climate Data Record (CDR) of Reflectance and Brightness Temperatures from AVHRR Pathfinder Atmospheres - Extended (PATMOS-x), Version 5.3

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This NOAA Climate Data Record (CDR) of AVHRR reflectance and brightness temperatures was produced by the University of Wisconsin using the AVHRR Pathfinder...

  4. NOAA Climate Data Record (CDR) of AVHRR Daily and Monthly Aerosol Optical Thickness (AOT) over Global Oceans, Version 3.0

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The product is the aerosol optical thickness (AOT) at 0.63 micron, which is retrieved from NOAA PATMOS-x level-2B orbital radinace and cloud CDR products. The...

  5. NOAA Climate Data Record (CDR) of GPS RO-Calibrated AMSU Channel 7 (Temperatures of Troposphere / Stratosphere, TTS), Version 1.0 (Version Superseded)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Climate Data Records (CDR) for Channel 7 contains Radio Occulation (RO) calibrated brightness temperatures from AMSU-A channel 7 measurements at 54.9 GHz from...

  6. A Climate Data Record (CDR) for the global terrestrial water budget: 1984-2010

    Science.gov (United States)

    Zhang, Yu; Pan, Ming; Sheffield, Justin; Siemann, Amanda L.; Fisher, Colby K.; Liang, Miaoling; Beck, Hylke E.; Wanders, Niko; MacCracken, Rosalyn F.; Houser, Paul R.; Zhou, Tian; Lettenmaier, Dennis P.; Pinker, Rachel T.; Bytheway, Janice; Kummerow, Christian D.; Wood, Eric F.

    2018-01-01

    Closing the terrestrial water budget is necessary to provide consistent estimates of budget components for understanding water resources and changes over time. Given the lack of in situ observations of budget components at anything but local scale, merging information from multiple data sources (e.g., in situ observation, satellite remote sensing, land surface model, and reanalysis) through data assimilation techniques that optimize the estimation of fluxes is a promising approach. Conditioned on the current limited data availability, a systematic method is developed to optimally combine multiple available data sources for precipitation (P), evapotranspiration (ET), runoff (R), and the total water storage change (TWSC) at 0.5° spatial resolution globally and to obtain water budget closure (i.e., to enforce P - ET - R - TWSC = 0) through a constrained Kalman filter (CKF) data assimilation technique under the assumption that the deviation from the ensemble mean of all data sources for the same budget variable is used as a proxy of the uncertainty in individual water budget variables. The resulting long-term (1984-2010), monthly 0.5° resolution global terrestrial water cycle Climate Data Record (CDR) data set is developed under the auspices of the National Aeronautics and Space Administration (NASA) Earth System Data Records (ESDRs) program. This data set serves to bridge the gap between sparsely gauged regions and the regions with sufficient in situ observations in investigating the temporal and spatial variability in the terrestrial hydrology at multiple scales. The CDR created in this study is validated against in situ measurements like river discharge from the Global Runoff Data Centre (GRDC) and the United States Geological Survey (USGS), and ET from FLUXNET. The data set is shown to be reliable and can serve the scientific community in understanding historical climate variability in water cycle fluxes and stores, benchmarking the current climate, and

  7. Trends in Dementia Incidence in a Birth Cohort Analysis of the Einstein Aging Study.

    Science.gov (United States)

    Derby, Carol A; Katz, Mindy J; Lipton, Richard B; Hall, Charles B

    2017-11-01

    Trends in dementia incidence rates have important implications for planning and prevention. To better understand incidence trends over time requires separation of age and cohort effects, and few prior studies have used this approach. To examine trends in dementia incidence and concomitant trends in cardiovascular comorbidities among individuals aged 70 years or older who were enrolled in the Einstein Aging Study between 1993 and 2015. In this birth cohort analysis of all-cause dementia incidence in persons enrolled in the Einstein Aging Study from October 20, 1993, through November 17, 2015, a systematically recruited, population-based sample of 1348 participants from Bronx County, New York, who were 70 years or older without dementia at enrollment and at least one annual follow-up was studied. Poisson regression was used to model dementia incidence as a function of age, sex, educational level, race, and birth cohort, with profile likelihood used to identify the timing of significant increases or decreases in incidence. Birth year and age. Incident dementia defined by consensus case conference based on annual, standardized neuropsychological and neurologic examination findings, using criteria from the DSM-IV. Among 1348 individuals (mean [SD] baseline age, 78.5 [5.4] years; 830 [61.6%] female; 915 [67.9%] non-Hispanic white), 150 incident dementia cases developed during 5932 person-years (mean [SD] follow-up, 4.4 [3.4] years). Dementia incidence decreased in successive birth cohorts. Incidence per 100 person-years was 5.09 in birth cohorts before 1920, 3.11 in the 1920 through 1924 birth cohorts, 1.73 in the 1925 through 1929 birth cohorts, and 0.23 in cohorts born after 1929. Change point analyses identified a significant decrease in dementia incidence among those born after July 1929 (95% CI, June 1929 to January 1930). The relative rate for birth cohorts before July 1929 vs after was 0.13 (95% CI, 0.04-0.41). Prevalence of stroke and myocardial infarction

  8. Unprecedented rates of land-use transformation in modeled climate change mitigation pathways

    Science.gov (United States)

    Turner, P. A.; Field, C. B.; Lobell, D. B.; Sanchez, D.; Mach, K. J.

    2017-12-01

    Integrated assessment models (IAMs) generate climate change mitigation scenarios consistent with global temperature targets. To limit warming to 2°, stylized cost-effective mitigation pathways rely on extensive deployments of carbon dioxide (CO2) removal (CDR) technologies, including multi-gigatonne yearly carbon removal from the atmosphere through bioenergy with carbon capture and storage (BECCS) and afforestation/reforestation. These assumed CDR deployments keep ambitious temperature limits in reach, but associated rates of land-use transformation have not been evaluated. For IAM scenarios from the IPCC Fifth Assessment Report, we compare rates of modeled land-use conversion to recent observed commodity crop expansions. In scenarios with a likely chance of limiting warming to 2° in 2100, the rate of energy cropland expansion supporting BECCS exceeds past commodity crop rates by several fold. In some cases, mitigation scenarios include abrupt reversal of deforestation, paired with massive afforestation/reforestation. Specifically, energy cropland in crop. If energy cropland instead increases at rates equal to recent soybean and oil palm expansions, the scale of CO2 removal possible with BECCS is 2.6 to 10-times lower, respectively, than the deployments <2° IAM scenarios rely upon in 2100. IAM mitigation pathways may favor multi-gigatonne biomass-based CDR given undervalued sociopolitical and techno-economic deployment barriers. Heroic modeled rates for land-use transformation imply that large-scale biomass-based CDR is not an easy solution to the climate challenge.

  9. The prevalence of dementia in a Portuguese community sample: a 10/66 Dementia Research Group study.

    Science.gov (United States)

    Gonçalves-Pereira, Manuel; Cardoso, Ana; Verdelho, Ana; Alves da Silva, Joaquim; Caldas de Almeida, Manuel; Fernandes, Alexandra; Raminhos, Cátia; Ferri, Cleusa P; Prina, A Matthew; Prince, Martin; Xavier, Miguel

    2017-11-07

    Dementia imposes a high burden of disease worldwide. Recent epidemiological studies in European community samples are scarce. In Portugal, community prevalence data is very limited. The 10/66 Dementia Research Group (DRG) population-based research programmes are focused in low and middle income countries, where the assessments proved to be culture and education fair. We applied the 10/66 DRG prevalence survey methodology in Portugal, where levels of illiteracy in older populations are still high. A cross-sectional comprehensive one-phase survey was conducted of all residents aged 65 and over of two geographically defined catchment areas in Southern Portugal (one urban and one rural site). Nursing home residents were not included in the present study. Standardized 10/66 DRG assessments include a cognitive module, an informant interview and the Geriatric Mental State-AGECAT, providing data on dementia diagnosis and subtypes, mental disorders including depression, physical health, anthropometry, demographics, disability/functioning, health service utilization, care arrangements and caregiver strain. We interviewed 1405 old age participants (mean age 74.9, SD = 6.7 years; 55.5% women) after 313 (18.2%) refusals to participate. The prevalence rate for dementia in community-dwellers was 9.23% (95% CI 7.80-10.90) using the 10/66 DRG algorithm and 3.65% (95% CI 2.97-4.97) using DSM-IV criteria. Pure Alzheimer's disease was the most prevalent dementia subtype (41.9%). The prevalence of dementia was strongly age-dependent for both criteria, but there was no association with sex. Dementia prevalence was higher than previously reported in Portugal. The discrepancy between prevalence according to the 10/66 DRG algorithm and the DSM-IV criteria is consistent with that observed in less developed countries; this suggests potential underestimation using the latter approach, although relative validity of these two approaches remains to be confirmed in the European context. We

  10. The prevalence of dementia in a Portuguese community sample: a 10/66 Dementia Research Group study

    Directory of Open Access Journals (Sweden)

    Manuel Gonçalves-Pereira

    2017-11-01

    Full Text Available Abstract Background Dementia imposes a high burden of disease worldwide. Recent epidemiological studies in European community samples are scarce. In Portugal, community prevalence data is very limited. The 10/66 Dementia Research Group (DRG population-based research programmes are focused in low and middle income countries, where the assessments proved to be culture and education fair. We applied the 10/66 DRG prevalence survey methodology in Portugal, where levels of illiteracy in older populations are still high. Methods A cross-sectional comprehensive one-phase survey was conducted of all residents aged 65 and over of two geographically defined catchment areas in Southern Portugal (one urban and one rural site. Nursing home residents were not included in the present study. Standardized 10/66 DRG assessments include a cognitive module, an informant interview and the Geriatric Mental State-AGECAT, providing data on dementia diagnosis and subtypes, mental disorders including depression, physical health, anthropometry, demographics, disability/functioning, health service utilization, care arrangements and caregiver strain. Results We interviewed 1405 old age participants (mean age 74.9, SD = 6.7 years; 55.5% women after 313 (18.2% refusals to participate. The prevalence rate for dementia in community-dwellers was 9.23% (95% CI 7.80–10.90 using the 10/66 DRG algorithm and 3.65% (95% CI 2.97–4.97 using DSM-IV criteria. Pure Alzheimer’s disease was the most prevalent dementia subtype (41.9%. The prevalence of dementia was strongly age-dependent for both criteria, but there was no association with sex. Conclusions Dementia prevalence was higher than previously reported in Portugal. The discrepancy between prevalence according to the 10/66 DRG algorithm and the DSM-IV criteria is consistent with that observed in less developed countries; this suggests potential underestimation using the latter approach, although relative validity of these two

  11. COTARD SYNDROME IN SEMANTIC DEMENTIA

    Science.gov (United States)

    Mendez, Mario F.; Ramírez-Bermúdez, Jesús

    2011-01-01

    Background Semantic dementia is a neurodegenerative disorder characterized by the loss of meaning of words or concepts. semantic dementia can offer potential insights into the mechanisms of content-specific delusions. Objective The authors present a rare case of semantic dementia with Cotard syndrome, a delusion characterized by nihilism or self-negation. Method The semantic deficits and other features of semantic dementia were evaluated in relation to the patient's Cotard syndrome. Results Mrs. A developed the delusional belief that she was wasting and dying. This occurred after she lost knowledge for her somatic discomforts and sensations and for the organs that were the source of these sensations. Her nihilistic beliefs appeared to emerge from her misunderstanding of her somatic sensations. Conclusion This unique patient suggests that a mechanism for Cotard syndrome is difficulty interpreting the nature and source of internal pains and sensations. We propose that loss of semantic knowledge about one's own body may lead to the delusion of nihilism or death. PMID:22054629

  12. Advanced dementia pain management protocols.

    Science.gov (United States)

    Montoro-Lorite, Mercedes; Canalias-Reverter, Montserrat

    Pain management in advanced dementia is complex because of neurological deficits present in these patients, and nurses are directly responsible for providing interventions for the evaluation, management and relief of pain for people suffering from this health problem. In order to facilitate and help decision-makers, pain experts recommend the use of standardized protocols to guide pain management, but in Spain, comprehensive pain management protocols have not yet been developed for advanced dementia. This article reflects the need for an integrated management of pain in advanced dementia. From the review and analysis of the most current and relevant studies in the literature, we performed an approximation of the scales for the determination of pain in these patients, with the observational scale PAINAD being the most recommended for the hospital setting. In addition, we provide an overview for comprehensive management of pain in advanced dementia through the conceptual framework «a hierarchy of pain assessment techniques by McCaffery and Pasero» for the development and implementation of standardized protocols, including a four-phase cyclical process (evaluation, planning/performance, revaluation and recording), which can facilitate the correct management of pain in these patients. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  13. AIDS dementia complex: a review

    NARCIS (Netherlands)

    Portegies, P.

    1994-01-01

    AIDS dementia complex (ADC) is a constellation of cognitive, motor, and behavioral dysfunctions frequently observed in persons with AIDS. Estimates of its prevalence vary. ADC may occur at any stage of AIDS but is usually associated with later stages of disease. Its severity varies among patients

  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

  15. [Depression: A predictor of dementia].

    Science.gov (United States)

    Deví Bastida, Josep; Puig Pomés, Núria; Jofre Font, Susanna; Fetscher Eickhoff, Albert

    2016-01-01

    Many studies suggest that in 10-25% of cases of Alzheimer's, the most common dementia in our society, can be prevented with the elimination of some risk factors. Barnes and Yaffe found that one-third of Alzheimer's cases are attributable to depression, but in the scientific literature it is not clear if it has a real causal effect on the development of dementia. The purpose of this study is to analyse the scientific evidence on the hypothesis that depression increases the risk of developing dementia. A systematic review and a meta-analysis were performed on the scientific literature published up until the present day, searching articles that were published between 1990 and 2014. Ten of the studies found met the selection criteria -similar to a) size and characteristics of the sample (origin, age…), b) process of gathering data c) method of studying the relationship (within and/or between group comparison), and d) statistical analysis of the results- and the previously established quality. The value of odds ratio varied from 1.72 to 3.59, and the hazard ratio from 1,72 to 5.44. This indicates that the subjects with a history of depression have a higher risk of developing dementia than others who did not suffer depression. Copyright © 2015 SEGG. Published by Elsevier Espana. All rights reserved.

  16. Frontotemporal dementia and its subtypes

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: Frontotemporal dementia (FTD) is a complex disorder characterised by a broad range of clinical manifestations, differential pathological signatures, and genetic variability. Mutations in three genes-MAPT, GRN, and C9orf72-have been associated with FTD. We sought to identify novel gene...

  17. Neuroprotective effect of selective DPP-4 inhibitor in experimental vascular dementia.

    Science.gov (United States)

    Jain, Swati; Sharma, Bhupesh

    2015-12-01

    Vascular risk factors are associated with a higher incidence of dementia. Diabetes mellitus is considered as a main risk factor for Alzheimer's disease and vascular dementia. Both forms of dementia are posing greater risk to the world population and are increasing at a faster rate. In the past we have reported the induction of vascular dementia by experimental diabetes. This study investigates the role of vildagliptin, a dipeptidyl peptidase-4 inhibitor in the pharmacological interdiction of pancreatectomy diabetes induced vascular endothelial dysfunction and subsequent vascular dementia in rats. Attentional set shifting and Morris water-maze test were used for assessment of learning and memory. Vascular endothelial function, blood brain barrier permeability, serum glucose, serum nitrite/nitrate, oxidative stress (viz. aortic superoxide anion, brain thiobarbituric acid reactive species and brain glutathione), brain calcium and inflammation (myeloperoxidase) were also estimated. Pancreatectomy diabetes rats have shown impairment of endothelial function, blood brain barrier permeability, learning and memory along with increase in brain inflammation, oxidative stress and calcium. Administration of vildagliptin has significantly attenuated pancreatectomy induced impairment of learning, memory, endothelial function, blood brain barrier permeability and biochemical parameters. It may be concluded that vildagliptin, a dipeptidyl peptidase-4 inhibitor may be considered as potential pharmacological agents for the management of pancreatectomy induced endothelial dysfunction and subsequent vascular dementia. The selective modulators of dipeptidyl peptidase-4 may further be explored for their possible benefits in vascular dementia. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Barriers, motivators, and facilitators of physical activity in dementia patients: A systematic review.

    Science.gov (United States)

    van Alphen, Helena J M; Hortobágyi, Tibor; van Heuvelen, Marieke J G

    2016-01-01

    Physical activity (PA) has the potential to slow the progression of dementia patients' cognitive and physical decline. A better understanding of the factors that facilitate or hamper dementia patients' PA participation will increase the success rate of implementing PA in dementia patients' daily care. We systematically screened the barriers, motivators, and facilitators of PA participation in dementia patients, complementing previous analyses of quantitative correlates of PA in community-dwelling dementia patients. Systematic searches yielded 78 potential studies of which seven met the eligibility criteria including 39 dementia patients and 36 caregivers (33 spouses and three daughters). We identified 35 barriers, 26 motivators, and 21 facilitators related to PA. We reduced these factors to six themes within the social-ecological model. Prominent barriers to PA were physical and mental limitations and difficulties with guidance and organization of PA by caregivers. Motivators included the motivation to maintain physical and mental health and participate in preferred PA options. Facilitators included strategies to avoid health problems, providing support and guidance for PA, and access to convenient and personalized PA options. The emerging picture suggests that dementia patients' PA participation will increase if service providers become familiar with the health benefits of PA, the characteristics of PA programs, methods of delivery, and the concepts of how such programs can be personalized to and synchronized with patients' individual needs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Socioeconomic status and survival among older adults with dementia and depression.

    Science.gov (United States)

    Chen, Ruoling; Hu, Zhi; Wei, Li; Wilson, Kenneth

    2014-06-01

    People from lower socioeconomic groups have a higher risk of mortality. The impact of low socioeconomic status on survival among older adults with dementia and depression remains unclear. To investigate the association between socioeconomic status and mortality in people with dementia and late-life depression in China. Using Geriatric Mental Status - Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) we interviewed 2978 people aged ⩾60 years in Anhui, China. We characterised baseline socioeconomic status and risk factors and diagnosed 223 people with dementia and 128 with depression. All-cause mortality was followed up over 5.6 years. Individuals with dementia living in rural areas had a three times greater risk of mortality (multivariate adjusted hazard ratio (HR) = 2.96, 95% CI 1.45-6.04) than those in urban areas, and for those with depression the HR was 4.15 (95% CI 1.59-10.83). There were similar mortality rates when comparing people with dementia with low v. high levels of education, occupation and income, but individuals with depression with low v. high levels had non-significant increases in mortality of 11%, 50% and 55% respectively Older adults with dementia and depression living in rural China had a significantly higher risk of mortality than urban counterparts. Interventions should be implemented in rural areas to tackle survival inequality in dementia and depression. Royal College of Psychiatrists.

  20. Perceived Challenges in Dementia Care by Vietnamese Family Caregivers and Care Workers in South Australia.

    Science.gov (United States)

    Xiao, Lily Dongxia; Habel, Lesley; De Bellis, Anita

    2015-09-01

    The majority of Vietnamese Australians migrated to Australia as refugees to escape a war and this unique migration background may affect their ability to access and utilize healthcare services in Australia. Inability to utilize dementia services is associated with higher levels of caregiver burden, higher rates of morbidities and mortality and hospitalization. The aim of the study was to explore the perceived challenges of dementia care from Vietnamese family caregivers and Vietnamese care workers. Gadamer's philosophical hermeneutics was used to interpret and describe the experiences of the participants. Data were collected from in-depth interviews with six Vietnamese family caregivers and a focus group with Vietnamese care workers using purposive sampling. Participants were recruited from a Vietnamese community care organization in South Australia. Five themes were identified from the data analysis namely: (1) a need for culturally and linguistically appropriate dementia education programs; (2) a willingness and unwillingness to seek help; (3) poor knowledge of health care service availability related to dementia; (4) the effect of language barrier in accessing services; and (5) the main sources of services utilized. The study revealed that Vietnamese family caregivers and Vietnamese care workers held different views on the association of stigma with dementia. Findings also revealed factors that impacted accessing and utilizing dementia services. These findings facilitate a more comprehensive understanding of Vietnamese family caregivers' needs and have implications for developing individualized support for family caregivers and for consumer-directed dementia services in Australia.

  1. Does Magnetization Transfer Ratio (MTR) contribute to the diagnosis and differential diagnosis of the dementias?

    International Nuclear Information System (INIS)

    Hentschel, F.; Kreis, M.; Damian, M.; Krumm, B.

    2004-01-01

    Purpose: The magnetization transfer ratio (MTR) is a MR-based neuroimaging procedure aiming at the quantification of the structural integrity of brain tissue. Its contribution to the differential diagnosis of dementias was examined and discussed in relation to the pathogenesis of age-related dementias. Materials and Methods: Sixty-one patients from a memory clinic were diagnosed by general physical and neuropsychiatric examination, and underwent neuropsychologic testing and neuroimaging using MRI. Their clinical diagnoses were based on standard operational research criteria. Additionally, the MTR in 10 defined regions of interest (ROI) was determined. This investigation was performed using a T1-weighted SE sequence. Average MTR values were determined in the individual ROI and their combinations and correlated with the age gender, cognitive impairment and clinical diagnosis. Sensitivity, specificity, positive and negative predictive value were determined, as well as the rate of correct classifications. Results: For cognitive healthy subjects, the MRT values correlate only mildly, though significantly, with age in the hippocampus and with gender in the dorsal corpus callosum. In contrast, the MTR in the frontal white matter correlates strongly and highly significantly with cognitive impairment in patients with dementia. The differential diagnostic assignment of Alzheimer's disease versus vascular dementia by MTR provides a correct classification of approximately 50% to 70%. PPV for no dementia vs. vascular dementia or the NPV for vascular vs. Alzheimer's disease are considerably higher exceeding 80%. For no dementia vs. Alzheimer's disease, the NPV was over 90%. (orig.)

  2. Cohort differences in dementia recognition and treatment indicators among assisted living residents in Maryland: did a change in the resident assessment tool make a difference?

    Science.gov (United States)

    Samus, Quincy M; Vavilikolanu, Amrita; Mayer, Lawrence; McNabney, Matthew; Brandt, Jason; Lyketsos, Constantine G; Rosenblatt, Adam

    2013-12-01

    There is a lack of empirical evidence about the impact of regulations on dementia care quality in assisted living (AL). We examined cohort differences in dementia recognition and treatment indicators between two cohorts of AL residents with dementia, evaluated prior to and following a dementia-related policy modification to more adequately assess memory and behavioral problems. Cross-sectional comparison of two AL resident cohorts was done (Cohort 1 [evaluated 2001-2003] and Cohort 2 [evaluated 2004-2006]) from the Maryland Assisted Living studies. Initial in-person evaluations of residents with dementia (n = 248) were performed from a random sample of 28 AL facilities in Maryland (physician examination, clinical characteristics, and staff and family recognition of dementia included). Adequacy of dementia workup and treatment was rated by an expert consensus panel. Staff recognition of dementia was better in Cohort 1 than in Cohort 2 (77% vs. 63%, p = 0.011), with no significant differences in family recognition (86% vs. 85%, p = 0.680), or complete treatment ratings (52% vs. 64%, p = 0.060). In adjusted logistic regression, cognitive impairment and neuropsychiatric symptoms correlated with staff recognition; and cognitive impairment correlated with family recognition. Increased age and cognitive impairment reduced odds of having a complete dementia workup. Odds of having complete dementia treatment was reduced by age and having more depressive symptoms. Cohort was not predictive of dementia recognition or treatment indicators in adjusted models. We noted few cohort differences in dementia care indicators after accounting for covariates, and concluded that rates of dementia recognition and treatment did not appear to change much organically following the policy modifications.

  3. Parkinson's disease-cognitive rating scale: psychometrics for mild cognitive impairment.

    Science.gov (United States)

    Fernández de Bobadilla, Ramón; Pagonabarraga, Javier; Martínez-Horta, Saül; Pascual-Sedano, Berta; Campolongo, Antonia; Kulisevsky, Jaime

    2013-09-01

    Lack of validated data on cutoff scores for mild cognitive impairment (MCI) and sensitivity to change in predementia stages of Parkinson's disease (PD) limit the utility of instruments measuring global cognition as screening and outcome measures in therapeutic trials. Investigators who were blinded to PD-Cognitive Rating Scale (PD-CRS) scores classified a cohort of prospectively recruited, nondemented patients into a PD with normal cognition (PD-NC) group and a PD with MCI (PD-MCI) group using Clinical Dementia Rating (CDR) and the Mattis Dementia Rating Scale-2 (MDRS-2). The discriminative power of the PD-CRS for PD-MCI was examined in a representative sample of 234 patients (145 in the PD-NC group; 89 in the PD-MCI group) and in a control group of 98 healthy individuals. Sensitivity to change in the PD-CRS score (the minimal clinically important difference was examined with the Clinical Global Impression of Change scale and was calculated with a combination of distribution-based and anchor-based approaches) was explored in a 6-month observational multicenter trial involving a subset of 120 patients (PD-NC, 63; PD-MCI, 57). Regression analysis demonstrated that PD-CRS total scores (P < 0.001) and age (P = 0.01) independently differentiated PD-NC from PD-MCI. Area under the receiver operating characteristic curve (AUC) analysis (AUC, 0.85; 95% confidence interval, 0.80-0.90) indicated that a score ≤ 81 of 134 was the optimal cutoff point on the total score for the PD-CRS (sensitivity, 79%; specificity, 80%; positive predictive value, 59%; negative predictive value, 91%). A range of change from 10 to 13 points on the PD-CRS total score was indicative of clinically significant change. These findings suggest that the PD-CRS is a useful tool to identify PD-MCI and to track cognitive changes in nondemented patients with PD. © 2013 International Parkinson and Movement Disorder Society.

  4. JOPATW~1.cdr 08.cdr

    African Journals Online (AJOL)

    tablets, the mechanism and kinetics of drug delivery were studied. ... different pH environments with a characteristic swelling ratio of 12 and 5 in ... stored in an air tight container and placed in a desiccator until used. ... Tablet physical quality.

  5. JOPATW~1.cdr 08.cdr

    African Journals Online (AJOL)

    4HIV Vaccine Trial Unit, Asokoro District Hospital, Abuja, Nigeria. Abstract ... for patient management and prevention of new infections and a number of test kits by different ... arriving HIV antibody detection assays are dynamic process. ... personnel should not only pay attention to public awareness about HIV/AIDS but.

  6. Management of the behavioral and psychological symptoms of dementia

    Directory of Open Access Journals (Sweden)

    Elizabeth C Hersch

    2008-01-01

    Full Text Available Elizabeth C Hersch, Sharon FalzgrafVA Puget Sound Health Care System, Tacoma, Washington, USAAbstract: More than 50% of people with dementia experience behavioral and psychological symptoms of dementia (BPSD. BPSD are distressing for patients and their caregivers, and are often the reason for placement into residential care. The development of BPSD is associated with a more rapid rate of cognitive decline, greater impairment in activities of daily living, and diminished quality of life (QOL. Evaluation of BPSD includes a thorough diagnostic investigation, consideration of the etiology of the dementia, and the exclusion of other causes, such as drug-induced delirium, pain, or infection. Care of patients with BPSD involves psychosocial treatments for both the patient and family. BPSD may respond to those environmental and psychosocial interventions, however, drug therapy is often required for more severe presentations. There are multiple classes of drugs used for BPSD, including antipsychotics, anticonvulsants, antidepressants, anxiolytics, cholinesterase inhibitors and NMDA modulators, but the evidence base for pharmacological management is poor, there is no clear standard of care, and treatment is often based on local pharmacotherapy customs. Clinicians should discuss the potential risks and benefits of treatment with patients and their surrogate decision makers, and must ensure a balance between side effects and tolerability compared with clinical benefit and QOL.Keywords: dementia, management, behavioral symptoms, psychological symptoms

  7. Deep brain stimulation targeting the fornix for mild Alzheimer dementia: design of the ADvance randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Holroyd KB

    2015-07-01

    stimulation (DBS of memory circuits may improve symptoms and possibly slow disease progression. The ADvance trial was designed to examine DBS of the fornix as a treatment for mild AD. Methods: ADvance is a randomized, double-blind, placebo-controlled, delayed-start, multicenter clinical trial conducted at six sites in the US and one site in Canada. Eighty-five subjects initially consented to be screened for the trial. Of these, 42 subjects who met inclusion and exclusion criteria were implanted with DBS leads anterior to the columns of the fornix bilaterally. They were randomized 1:1 to DBS “off” or DBS “on” groups for the initial 12 months of follow-up. After 1 year, all subjects will have their devices turned “on” for the remainder of the study. Postimplantation, subjects will return for 13 follow-up visits over 48 months for cognitive and psychiatric assessments, brain imaging (up to 12 months, and safety monitoring. The primary outcome measures include Alzheimer's Disease Assessment Scale – cognitive component (ADAS-cog-13, Clinical Dementia Rating sum of boxes (CDR-SB, and cerebral glucose metabolism measured with positron emission tomography. This report details the study methods, baseline subject characteristics of screened and implanted participants, and screen-to-baseline test–retest reliability of the cognitive outcomes. Results: Implanted subjects had a mean age of 68.2 years, were mostly male (55%, and had baseline mean ADAS-cog-13 and CDR-SB scores of 28.9 (SD, 5.2 and 3.9 (SD, 1.6, respectively. There were no significant differences between screened and implanted or nonimplanted subjects on most demographic or clinical assessments. Implanted subjects had significantly lower (better ADAS-cog-11 (17.5 vs 21.1 scores, but did not differ on CDR-SB. Scores on the major outcome measures for the trial were consistent at screening and baseline. Conclusion: ADvance was successful in enrolling a substantial group of patients for this novel application of

  8. Dementia and the gender trouble?: Theorising dementia, gendered subjectivity and embodiment.

    Science.gov (United States)

    Sandberg, Linn J

    2018-06-01

    Despite person-centred approaches increasingly focusing on looking at the person in dementia instead of the pathology, the role of gender in dementia has been little explored. This article discusses how pervasive discourses on a loss of self and dementia as abject are interwoven with a de-gendering of persons with dementia. The cultural anxiety that dementia evokes in terms of loss of bodily and cognitive control could also be linked to a failure to normatively and intelligibly express gender when living with dementia. As a way to sustain personhood for people with dementia and challenge discourses on people with dementia as 'non-people', person-centred approaches have emphasised the collaborative work of carers, relatives and persons with dementia. Often implicitly, this also involves a 're-gendering' of persons with dementia where gendered biographies and pasts are upheld and gendered embodied selfhood is maintained through, for example, dress, hair and other aspects of appearance. This re-gendering could be of great significance for people with dementia to become intelligible as persons. Still, dementia studies must further consider non-normative expressions of gender and involve feminist theorising on gender as a power asymmetry since some embodiments and selves are more likely to be sustained in dementia than others. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Mental and physical performance of dementia patients in long-term residential care

    Directory of Open Access Journals (Sweden)

    Zbigniew Śliwiński

    2013-10-01

    Full Text Available Introduction: Dementia syndromes are an increasing medical and social problem in today’s world. Preservation of the best possible quality of life in dementia patients relies on prolonging their independence in daily life for as long as possible. Dementia patients require increasing support as the disease progresses and will ultimately become dependent on the help of others. Aim of the research: To assess the level of mental and physical performance and nutritional status in patients with dementia syndromes in long-term residential care. Material and methods : The study group comprised 62 patients with dementia syndromes resident in a Medical and Nursing Care Facility in Pustków. Selected aspects of quality of life were investigated with the Barthel scale, GDS scale according to Reissberg, Abbreviated Mental Test Score (AMTS and Mini-Nutritional Assessment (MNA scale. Results: In our study men performed better than women on the Barthel scale, 58% of all patients were rated moderately severe on that scale, 36% were severe and 7% were mild. Assessment of the current severity of dementia on the GDS scale showed that 28% of the patients had very severe dementia, 27% had mild deficits, 27% had moderate deficits, 11% had moderately severe dementia and 6% had borderline dementia. In a mental state assessment according to the AMTS scale, men scored higher than women. This difference indicates less memory deficit and better psychological and physical status among men. With regard to nutritional status, our study revealed a risk of malnutrition in 65% of the patient and actual malnutrition in 7%. Conclusions : The Barthel scale, rating the performance of dementia patients with regard to activities of daily life, classified more than half of the patients as „moderately severe”. Women had lower mean scores than men in the Barthel scale, AMTS scale and GDS scale, indicating that dementia is more prevalent among women than among men. The findings of the

  10. Communicative Coping Behavior Checklist: Observation of Persons With Dementia in the Home Environment.

    Science.gov (United States)

    Saunders, Pamela A; Ruth, Julia; Latella, Lauren; Talisman, Nicholas

    2016-08-01

    Communication contributes to increased stress, mortality, and decreased quality of life (QOL) for persons with dementia (PWD) and caregivers. PWD use communicative coping behaviors (CCBs) to manage the demands of the disease. However, most assessments neither look for nor give credit to communication behaviors. This is the first study to examine CCBs in the home environment as measured by the Communicative Coping Behavior Checklist (CCBC). This cross-sectional quantitative study included 26 dementia and 18 cognitively normal control dyads. Raters observed their partners' CCBs at home, over several weeks and completed the CCBC. We analyzed the endorsement rates (how often behaviors were observed by a rater) of emotion and activity-focused CCBs in dementia and control dyads. The primary outcome was rate of CCB endorsement. Secondary outcomes included dementia diagnosis, cognitive status, depressive mood, life satisfaction (SWL) and QOL. Dementia dyads endorsed 11 of 23 CCBs significantly more than control dyads. Action-focused CCBs (p endorsement rates of action-focused than emotion-focused CCBs were seen in dementia dyads. We conclude that attention to CCBs during treatment and care will improve QOL and SWL of PWD and caregivers. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Depression and the risk for dementia.

    Science.gov (United States)

    Kessing, Lars Vedel

    2012-11-01

    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. Findings from recent studies suggest that some forms of depressive illness, for example early-onset depression before age 65 years and recurrent depression, may constitute long-term risk factors for development of dementia, whereas the onset of more recent depressive symptoms may reflect a prodromal phase of dementia. It is not clear whether specific subtypes of depression correspond to specific types of dementia. Recent studies suggest that long-term treatment with antidepressants may decrease the risk of developing some types of dementia, depending on the type of depressive disorder. This review has shown that the type of depression and dementia, as well as the effect of drug treatment, has to be considered to improve knowledge on the association between depression and dementia.

  12. Intracranial stenosis in cognitive impairment and dementia.

    Science.gov (United States)

    Hilal, Saima; Xu, Xin; Ikram, M Kamran; Vrooman, Henri; Venketasubramanian, Narayanaswamy; Chen, Christopher

    2017-06-01

    Intracranial stenosis is a common vascular lesion observed in Asian and other non-Caucasian stroke populations. However, its role in cognitive impairment and dementia has been under-studied. We, therefore, examined the association of intracranial stenosis with cognitive impairment, dementia and their subtypes in a memory clinic case-control study, where all subjects underwent detailed neuropsychological assessment and 3 T neuroimaging including three-dimensional time-of-flight magnetic resonance angiography. Intracranial stenosis was defined as ≥50% narrowing in any of the intracranial arteries. A total of 424 subjects were recruited of whom 97 were classified as no cognitive impairment, 107 as cognitive impairment no dementia, 70 vascular cognitive impairment no dementia, 121 Alzheimer's Disease, and 30 vascular dementia. Intracranial stenosis was associated with dementia (age/gender/education - adjusted odds ratios (OR): 4.73, 95% confidence interval (CI): 1.93-11.60) and vascular cognitive impairment no dementia (OR: 3.98, 95% CI: 1.59-9.93). These associations were independent of cardiovascular risk factors and MRI markers. However, the association with Alzheimer's Disease and vascular dementia became attenuated in the presence of white matter hyperintensities. Intracranial stenosis is associated with vascular cognitive impairment no dementia independent of MRI markers. In Alzheimer's Disease and vascular dementia, this association is mediated by cerebrovascular disease. Future studies focusing on perfusion and functional markers are needed to determine the pathophysiological mechanism(s) linking intracranial stenosis and cognition so as to identify treatment strategies.

  13. Spontaneously Reported Symptoms by Informants Are Associated with Clinical Severity in Dementia Help-Seekers.

    Science.gov (United States)

    Xu, Jia-Qi; Choy, Jacky C P; Tang, Jennifer Y M; Liu, Tian-Yin; Luo, Hao; Lou, Vivian W Q; Lum, Terry Y S; Wong, Gloria H Y

    2017-09-01

    To investigate the predictive value of symptoms of dementia that the person or an informant noticed spontaneously in determining the clinical severity of dementia. Cross-sectional. Community-based open-referral dementia assessment service in Hong Kong between 2005 and 2013. Help-seekers for dementia assessment service and their informants (N = 965 dyads). Participants underwent a clinical dementia interview based on the Clinical Dementia Rating. Spontaneous complaints that the person and the informant made that had prompted their help-seeking of groups with interview results suggestive of no impairment, mild cognitive impairment, and dementia were compared. Logistic regression was used to evaluate the predictive value of spontaneous complaints for clinical severity. Independent raters blinded to clinical results coded spontaneously reported symptoms into theoretical themes: memory, executive function, language, time and place orientation, neuropsychiatric, mood, and avolition. Memory problems were the most frequently reported complaints for participants (87.7%) and their informants (95.5%), followed by self-reported language (33.0%) and informant-reported orientation (33.0%) difficulties. Informant-reported but not self-reported symptoms predicted clinical severity. Compared with the persons themselves, informants reported more pervasive symptoms corresponding to clinical severity. Persons with dementia self-reported fewer types of symptoms than their healthy or mildly impaired counterparts. Spontaneously reported language and orientation symptoms by the informant distinguished persons with mild or worse dementia (P < .001, Nagelkerke coefficient of determination = 29.7%, percentage correct 85.6%). The type and pervasiveness of symptoms spontaneously that informants reported predicted clinical severity. This may provide a quick reference for triage. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  14. ABO Blood Group and Dementia Risk--A Scandinavian Record-Linkage Study.

    Directory of Open Access Journals (Sweden)

    Senthil K Vasan

    Full Text Available Dementia includes a group of neuro-degenerative disorders characterized by varying degrees of cognitive impairment. Recent data indicates that blood group AB is associated with impaired cognition in elderly patients. To date there are no large-scale studies that have examined the relationship between ABO blood group and dementia-related disorders in detail.We used data from the SCANDAT2 database that contains information on over 1.6 million blood donors from 1968 in Sweden and 1981 from Denmark. The database was linked with health outcomes data from nationwide patient and cause of death registers to investigate the relationship between blood groups and risk of different types of dementia. The incident rate ratios were estimated using log-linear Poisson regression models.Among 1,598,294 donors followed over 24 million person-years of observation we ascertained 3,615 cases of Alzheimer's disease, 1,842 cases of vascular dementia, and 9,091 cases of unspecified dementia. Overall, our study showed no association between ABO blood group and risk of Alzheimer's disease, vascular dementia or unspecified dementia. This was also true when analyses were restricted to donors aged 70 years or older except for a slight, but significantly decreased risk of all dementia combined in subjects with blood group A (IRR, 0.93; 95% confidence interval [CI], 0.88-0.98, compared to those with blood group O.Our results provide no evidence that ABO blood group influences the risk of dementia.

  15. Behavioral symptoms in community-dwelling elderly Nigerians with dementia, mild cognitive impairment, and normal cognition.

    Science.gov (United States)

    Baiyewu, Olusegun; Unverzagt, Fred W; Ogunniyi, Adesola; Smith-Gamble, Valerie; Gureje, Oye; Lane, Kathleen A; Gao, Sujuan; Hall, Kathleen S; Hendrie, Hugh C

    2012-09-01

    Few studies have examined the neuropsychiatric status of patients with dementia and cognitive impairment in the developing world despite the fact that current demographic trends suggest an urgent need for such studies. To assess the level of neuropsychiatric symptoms in community-dwelling individuals with dementia, cognitive impairment no dementia and normal cognition. Subjects were from the Ibadan site of Indianapolis-Ibadan Dementia Project with stable diagnoses of normal cognition, cognitive impairment, no dementia/mild cognitive impairment (CIND/MCI), and dementia. Informants of subjects made ratings on the neuropsychiatric inventory and blessed dementia scale; subjects were tested with the mini mental state examination. One hundred and eight subjects were included in the analytic sample, 21 were cognitively normal, 34 were demented, and 53 were CIND/MCI. The diagnostic groups did not differ in age, per cent female, or per cent with any formal education. The most frequent symptoms among subjects with CIND/MCI were depression (45.3%), apathy (37.7%), night time behavior (28.3%), appetite change (24.5%), irritability (22.6%), delusions (22.6%), anxiety (18.9%), and agitation (17.0%). Depression was significantly more frequent among the CIND/MCI and dementia (44.1%) groups compared with the normal cognition group (9.5%). Distress scores were highest for the dementia group, lowest for the normal cognition group, and intermediate for the CIND/MCI group. Significant neuropsychiatric symptomatology and distress are present among cognitively impaired persons in this community-based study of older adults in this sub-Saharan African country. Programs to assist family members of cognitively impaired and demented persons should be created or adapted for use in developing countries. Copyright © 2012 John Wiley & Sons, Ltd.

  16. Characteristic pattern of cerebral perfusion in patients with the early stage of subcortical vascular dementia compared with Alzheimer's disease

    International Nuclear Information System (INIS)

    Jeong, Young Jin; Kang, Do Young; Park, Kyung Won; Cheon, Sang Myung; Kim, Jong Kuk; Kim, Jae Woo

    2004-01-01

    Brain perfusion SPECT has been commonly used to evaluate several different types of dementia. The aim of this study is to assess the specific patterns of regional cerebral blood flow (rCBF) in patients with the early stage of subcortical vascular dementia (SVD) and Alzheimer's disease (AD) using Tc-99m HMPAO SPECT, and to compare the differences between the two conditions. Sixteen SVD (mean age; 68.0±7.0 years, educational period; 6.3±5.6 years, CDR; 0.80±0.26). 46 AD (mean age; 69.9±7.4 years, educational period; 5.4±4.7 years, CDR; 0.86±0.23) and 12 normal control subjects (mean age; 67.1±7.7 years, educational period; 6.2±4.2 years) participated in this study. We included the patients with SVD and AD according to NINCDS-ADRDA criteria for probable AD and NINDS-AIREN criteria for probable or possible VD. They were all matched for age, education and clinical dementia scale scores. SPM analysis of the SPECT image showed significant perfusion deficits on the right temporal region and right thalamus, left insula and superior temporal gyrus, both cingulate gyri and frontal subgyral regions in patients with SVD and on the left supramarginal gyrus, superior temporal gyrus, postcentral gyrus and inferior parietal lobule, right fugiform gyrus and both cingulate gyri in patients with AD compared with control subjects (uncorrected p<0.01). SVD patients revealed significant hypoperfusion in the right parahippocampal gyrus, right cingulated gyrus, left insula, and both frontal subgyral regions compared with AD patients (uncorrected p<0.01). SVD patients revealed significant hyperperfusion in right superior frontal gyrus, left pre- and postcentral gyri, left paracentral lobule, left precuneus and both medial frontal gyri compared with AD patients (uncorrected p<0.01). Our study shows characteristic and different pattern of perfusion deficits in patients with SVD and AD, and these results may be helpful to discriminate the two conditions in the early stage of illness

  17. Dementia ascertainment using existing data in UK longitudinal and cohort studies: a systematic review of methodology.

    Science.gov (United States)

    Sibbett, Ruth A; Russ, Tom C; Deary, Ian J; Starr, John M

    2017-07-03

    Studies investigating the risk factors for or causation of dementia must consider subjects prior to disease onset. To overcome the limitations of prospective studies and self-reported recall of information, the use of existing data is key. This review provides a narrative account of dementia ascertainment methods using sources of existing data. The literature search was performed using: MEDLINE, EMBASE, PsychInfo and Web of Science. Included articles reported a UK-based study of dementia in which cases were ascertained using existing data. Existing data included that which was routinely collected and that which was collected for previous research. After removing duplicates, abstracts were screened and the remaining articles were included for full-text review. A quality tool was used to evaluate the description of the ascertainment methodology. Of the 3545 abstracts screened, 360 articles were selected for full-text review. 47 articles were included for final consideration. Data sources for ascertainment included: death records, national datasets, research databases and hospital records among others. 36 articles used existing data alone for ascertainment, of which 27 used only a single data source. The most frequently used source was a research database. Quality scores ranged from 7/16 to 16/16. Quality scores were better for articles with dementia ascertainment as an outcome. Some papers performed validation studies of dementia ascertainment and most indicated that observed rates of dementia were lower than expected. We identified a lack of consistency in dementia ascertainment methodology using existing data. With no data source identified as a "gold-standard", we suggest the use of multiple sources. Where possible, studies should access records with evidence to confirm the diagnosis. Studies should also calculate the dementia ascertainment rate for the population being studied to enable a comparison with an expected rate.

  18. Repertoire Analysis of Antibody CDR-H3 Loops Suggests Affinity Maturation Does Not Typically Result in Rigidification

    Directory of Open Access Journals (Sweden)

    Jeliazko R. Jeliazkov

    2018-03-01

    Full Text Available Antibodies can rapidly evolve in specific response to antigens. Affinity maturation drives this evolution through cycles of mutation and selection leading to enhanced antibody specificity and affinity. Elucidating the biophysical mechanisms that underlie affinity maturation is fundamental to understanding B-cell immunity. An emergent hypothesis is that affinity maturation reduces the conformational flexibility of the antibody’s antigen-binding paratope to minimize entropic losses incurred upon binding. In recent years, computational and experimental approaches have tested this hypothesis on a small number of antibodies, often observing a decrease in the flexibility of the complementarity determining region (CDR loops that typically comprise the paratope and in particular the CDR-H3 loop, which contributes a plurality of antigen contacts. However, there were a few exceptions and previous studies were limited to a small handful of cases. Here, we determined the structural flexibility of the CDR-H3 loop for thousands of recent homology models of the human peripheral blood cell antibody repertoire using rigidity theory. We found no clear delineation in the flexibility of naïve and antigen-experienced antibodies. To account for possible sources of error, we additionally analyzed hundreds of human and mouse antibodies in the Protein Data Bank through both rigidity theory and B-factor analysis. By both metrics, we observed only a slight decrease in the CDR-H3 loop flexibility when comparing affinity matured antibodies to naïve antibodies, and the decrease was not as drastic as previously reported. Further analysis, incorporating molecular dynamics simulations, revealed a spectrum of changes in flexibility. Our results suggest that rigidification may be just one of many biophysical mechanisms for increasing affinity.

  19. Mediator Tail Module Is Required for Tac1-Activated CDR1 Expression and Azole Resistance in Candida albicans.

    Science.gov (United States)

    Liu, Zhongle; Myers, Lawrence C

    2017-11-01

    The human fungal pathogen Candida albicans develops drug resistance after long-term exposure to azole drugs in the treatment of chronic candidiasis. Gain-of-function (GOF) mutations in the transcription factor Tac1 and the consequent expression of its targets, drug efflux pumps Cdr1 and Cdr2, are a common mechanism by which C. albicans acquires fluconazole resistance. The mechanism by which GOF mutations hyperactivate Tac1 is currently unknown. Here, we define a transcriptional activation domain (TAD) at the C terminus of Tac1. GOF mutations within the Tac1 TAD, outside the context of full-length Tac1, generally do not enhance its absolute potential as a transcriptional activator. Negative regulation of the Tac1 TAD by the Tac1 middle region is necessary for the activating effect of GOF mutations or fluphenazine to be realized. We have found that full-length Tac1, when hyperactivated by xenobiotics or GOF mutations, facilitates the recruitment of the Mediator coactivator complex to the CDR1 promoter. Azole resistance and the activation of Tac1 target genes, such as CDR1 , are dependent on the Tac1 TAD and subunits of the Mediator tail module. The dependence of different Tac1 target promoters on the Mediator tail module, however, varies widely. Lastly, we show that hyperactivation of Tac1 is correlated with its Mediator-dependent phosphorylation, a potentially useful biomarker for Tac1 hyperactivation. The role of Mediator in events downstream of Tac1 hyperactivation in fluconazole-resistant clinical isolates is complex and provides opportunities and challenges for therapeutic intervention. Copyright © 2017 American Society for Microbiology.

  20. Overcoming the heterologous bias: An in vivo functional analysis of multidrug efflux transporter, CgCdr1p in matched pair clinical isolates of Candida glabrata

    International Nuclear Information System (INIS)

    Puri, Nidhi; Manoharlal, Raman; Sharma, Monika; Sanglard, Dominique; Prasad, Rajendra

    2011-01-01

    Research highlights: → First report to demonstrate an in vivo expression system of an ABC multidrug transporter CgCdr1p of C. glabrata. → First report on the structure and functional characterization of CgCdr1p. → Functional conservation of divergent but typical residues of CgCdr1p. → CgCdr1p elicits promiscuity towards substrates and has a large drug binding pocket with overlapping specificities. -- Abstract: We have taken advantage of the natural milieu of matched pair of azole sensitive (AS) and azole resistant (AR) clinical isolates of Candida glabrata for expressing its major ABC multidrug transporter, CgCdr1p for structure and functional analysis. This was accomplished by tagging a green fluorescent protein (GFP) downstream of ORF of CgCDR1 and integrating the resultant fusion protein at its native chromosomal locus in AS and AR backgrounds. The characterization confirmed that in comparison to AS isolate, CgCdr1p-GFP was over-expressed in AR isolates due to its hyperactive native promoter and the GFP tag did not affect its functionality in either construct. We observed that in addition to Rhodamine 6 G (R6G) and Fluconazole (FLC), a recently identified fluorescent substrate of multidrug transporters Nile Red (NR) could also be expelled by CgCdr1p. Competition assays with these substrates revealed the presence of overlapping multiple drug binding sites in CgCdr1p. Point mutations employing site directed mutagenesis confirmed that the role played by unique amino acid residues critical to ATP catalysis and localization of ABC drug transporter proteins are well conserved in C. glabrata as in other yeasts. This study demonstrates a first in vivo novel system where over-expression of GFP tagged MDR transporter protein can be driven by its own hyperactive promoter of AR isolates. Taken together, this in vivo system can be exploited for the structure and functional analysis of CgCdr1p and similar proteins wherein the arte-factual concerns encountered in using

  1. Overcoming the heterologous bias: An in vivo functional analysis of multidrug efflux transporter, CgCdr1p in matched pair clinical isolates of Candida glabrata

    Energy Technology Data Exchange (ETDEWEB)

    Puri, Nidhi; Manoharlal, Raman; Sharma, Monika [Membrane Biology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi 110 067 (India); Sanglard, Dominique [Institut de Microbiologie, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne (Switzerland); Prasad, Rajendra, E-mail: rp47jnu@gmail.com [Membrane Biology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi 110 067 (India)

    2011-01-07

    Research highlights: {yields} First report to demonstrate an in vivo expression system of an ABC multidrug transporter CgCdr1p of C. glabrata. {yields} First report on the structure and functional characterization of CgCdr1p. {yields} Functional conservation of divergent but typical residues of CgCdr1p. {yields} CgCdr1p elicits promiscuity towards substrates and has a large drug binding pocket with overlapping specificities. -- Abstract: We have taken advantage of the natural milieu of matched pair of azole sensitive (AS) and azole resistant (AR) clinical isolates of Candida glabrata for expressing its major ABC multidrug transporter, CgCdr1p for structure and functional analysis. This was accomplished by tagging a green fluorescent protein (GFP) downstream of ORF of CgCDR1 and integrating the resultant fusion protein at its native chromosomal locus in AS and AR backgrounds. The characterization confirmed that in comparison to AS isolate, CgCdr1p-GFP was over-expressed in AR isolates due to its hyperactive native promoter and the GFP tag did not affect its functionality in either construct. We observed that in addition to Rhodamine 6 G (R6G) and Fluconazole (FLC), a recently identified fluorescent substrate of multidrug transporters Nile Red (NR) could also be expelled by CgCdr1p. Competition assays with these substrates revealed the presence of overlapping multiple drug binding sites in CgCdr1p. Point mutations employing site directed mutagenesis confirmed that the role played by unique amino acid residues critical to ATP catalysis and localization of ABC drug transporter proteins are well conserved in C. glabrata as in other yeasts. This study demonstrates a first in vivo novel system where over-expression of GFP tagged MDR transporter protein can be driven by its own hyperactive promoter of AR isolates. Taken together, this in vivo system can be exploited for the structure and functional analysis of CgCdr1p and similar proteins wherein the arte-factual concerns

  2. Regional cerebral glucose metabolism in patients with Parkinson's disease with or without dementia

    Energy Technology Data Exchange (ETDEWEB)

    Sasaki, Masayuki; Ichiya, Yuichi; Hosokawa, Shinichi; Otsuka, Makoto; Kuwabara, Yasuo; Fukumura, Toshimitsu; Kato, Motohiro; Goto, Ikuo; Masuda, Kouji [Kyushu Univ., Fukuoka (Japan). Faculty of Medicine

    1992-11-01

    By means of positron emission tomography, the cerebral glucose metabolism in 5 patients with Parkinson's disease with dementia was compared with that in 9 patients without dementia, and that in 5 normal volunteers. The metabolic rates for glucose were measured by placing one hundred regions of interest. In the demented patients, cerebral glucose metabolism was diffusely decreased compared with that of the non-demented patients and the normal controls. The most significant decrease in glucose metabolism was observed in the angular gyrus (49.7% of the normal controls). The glucose metabolism in the cingulate, pre- and postcentral, occipital and subcortical regions was relatively spared (62.1 to 85.5% of the normal controls). In the patients without dementia, the glucose metabolism in each region was not significantly different from that in the normal controls. These results suggest that diffuse glucose hypometabolism in the cerebral cortex may correlate with that of patients with Parkinson's disease with dementia. (author).

  3. Predictors of Desire to Institutionalization in Dementia Caregivers From a Developing Country.

    Science.gov (United States)

    Sinha, Preeti; Yohannan, Sherin; Thirumoorthy, A; Sivakumar, Palanimuthu Thangaraju

    2017-08-01

    Older adults with dementia have higher rates of institutionalization than those without dementia. Desire to institutionalization (DTI) is an important factor influencing the actual institutionalization but is less well studied. This cross-sectional study examines the DTI with the scale of same name developed by Morycz, in 1985, in a sample of 50 caregivers of patients with dementia in a tertiary clinical care setting in a developing country. Caregiver burden associated with personal strain (by factor analyzed Zarit Burden Interview scale), and stress perceived out of caregiving (by Perceived Stress Scale) predicted higher DTI. Besides, those who were married had lower DTI scores. The factors which didn't affect DTI were total caregiver burden, family and social support, age of patient and caregiver, education of caregiver, severity and duration of dementia, and treatment duration. These results were different from those of developed country-based DTI studies and may indicate sociocultural differences.

  4. Feasibility of central meditation and imagery therapy for dementia caregivers.

    Science.gov (United States)

    Jain, Felipe A; Nazarian, Nora; Lavretsky, Helen

    2014-08-01

    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. Twelve family dementia caregivers enrolled in CMIT-C. Primary outcomes included depression and anxiety, and secondary outcomes included insomnia, quality of life, and mindfulness. Changes over the study and 3 month follow-up were analyzed with non-parametric related samples tests. Correlations of feeling state changes from meditation diaries at 1 week were made with symptom changes post meditation training. Ten participants completed the study. Completers came to an average of 7 ± 1 sessions out of a possible 8 sessions, and turned in home practice logs of 90 ± 10% of the time. Anxiety, depression, and insomnia symptoms decreased, and mindfulness ratings improved with large effects (all p meditation practice was associated with subsequent home meditation practice, anxiety change at 8 weeks, and endpoint satisfaction with CMIT-C. Central Meditation and Imagery Therapy for Caregivers is a feasible intervention for dementia caregivers. Results suggest that this therapeutic technique can reduce symptoms of anxiety, depression, and insomnia, and increase levels of mindfulness. Early response to meditation practice predicted those with the greatest short-term benefits, and this may inform future studies of meditation. Larger controlled efficacy studies of CMIT-C for dementia caregivers are warranted. Copyright © 2014 John Wiley & Sons, Ltd.

  5. Geographical variation in dementia: systematic review with meta-analysis

    Science.gov (United States)

    Russ, Tom C; Batty, G David; Hearnshaw, Gena F; Fenton, Candida; Starr, John M

    2012-01-01

    Background Geographical variation in dementia prevalence and incidence may indicate important socio-environmental contributions to dementia aetiology. However, previous comparisons have been hampered by combining studies with different methodologies. This review systematically collates and synthesizes studies examining geographical variation in the prevalence and incidence of dementia based on comparisons of studies using identical methodologies. Methods Papers were identified by a comprehensive electronic search of relevant databases, scrutinising the reference sections of identified publications, contacting experts in the field and re-examining papers already known to us. Identified articles were independently reviewed against inclusion/exclusion criteria and considered according to geographical scale. Rural/urban comparisons were meta-analysed. Results Twelve thousand five hundred and eighty records were reviewed and 51 articles were included. Dementia prevalence and incidence varies at a number of scales from the national down to small areas, including some evidence of an effect of rural living [prevalence odds ratio (OR) = 1.11, 90% confidence interval (CI) 0.79–1.57; incidence OR = 1.20, 90% CI 0.84–1.71]. However, this association of rurality was stronger for Alzheimer disease, particularly when early life rural living was captured (prevalence OR = 2.22, 90% CI 1.19–4.16; incidence OR = 1.64, 90% CI 1.08–2.50). Conclusions There is evidence of geographical variation in rates of dementia in affluent countries at a variety of geographical scales. Rural living is associated with an increased risk of Alzheimer disease, and there is a suggestion that early life rural living further increases this risk. However, the fact that few studies have been conducted in resource-poor countries limits conclusions. PMID:22798662

  6. The accuracy of family physicians' dementia diagnoses at different stages of dementia: a systematic review

    NARCIS (Netherlands)

    van den Dungen, Pim; van Marwijk, Harm W. M.; van der Horst, Henriëtte E.; Moll van Charante, Eric P.; Macneil Vroomen, Janet; van de Ven, Peter M.; van Hout, Hein P. J.

    2012-01-01

    Objective: Optimising care for dementia patients and their informal carers is imperative in light of the impending dementia epidemic. An important aspect of care is accurate recognition and diagnosis of dementia. The aim of this review was to estimate family physicians' diagnostic accuracy at the

  7. The accuracy of family physicians' dementia diagnoses at different stages of dementia: a systematic review

    NARCIS (Netherlands)

    van den Dungen, P.; van Marwijk, H.W.J.; van der Horst, H.E.; van Charante, E.P.M.; Vroomen, J.M.; van de Ven, P.M.; van Hout, H.P.J.

    2012-01-01

    Objective Optimising care for dementia patients and their informal carers is imperative in light of the impending dementia epidemic. An important aspect of care is accurate recognition and diagnosis of dementia. The aim of this review was to estimate family physicians' diagnostic accuracy at the

  8. Dementia quality of life instrument - construct and concurrent validity in patients with mild to moderate dementia

    NARCIS (Netherlands)

    Voigt-Radloff, S.; Leonhart, R.; Schutzwohl, M.; Jurjanz, L.; Reuster, T.; Gerner, A.; Marschner, K.; van Nes, F.A.; Graff, M.; Vernooij-Dassen, M.; Olde Rikkert, M.G.M.; Holthoff, V.; Hull, M.

    2012-01-01

    Background and purpose: To translate the Dementia quality of life instrument (DQoL) into German and assess its construct and concurrent validity in community-dwelling people with mild to moderate dementia. Methods: Dementia quality of life instrument data of two pooled samples (n=287) were analysed

  9. 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

  10. 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 ...

  11. Does Bilingualism Delay the Development of Dementia?

    OpenAIRE

    Amy L Atkinson

    2016-01-01

    It has been suggested that bilingualism (where individuals speak two languages) may delay the development of dementia. However, much of the research is inconclusive. Some researchers have reported that bilingualism delays the onset and diagnosis of dementia, whilst other studies have found weak or even detrimental effects. This paper reviews a series of nine empirical studies, published up until March 2016, which investigated whether bilingualism significantly delays the onset of dementia. Th...

  12. Effectiveness of a Virtual Reality Forest on People With Dementia: A Mixed Methods Pilot Study.

    Science.gov (United States)

    Moyle, Wendy; Jones, Cindy; Dwan, Toni; Petrovich, Tanya

    2018-05-08

    To measure and describe the effectiveness of a Virtual Reality Forest (VRF) on engagement, apathy, and mood states of people with dementia, and explore the experiences of staff, people with dementia and their families. A mixed-methods study conducted between February and May 2016. Ten residents with dementia, 10 family members, and 9 care staff were recruited from 2 residential aged care facilities, operated by one care provider, located in Victoria, Australia. Residents participated in one facilitated VRF session. Residents' mood, apathy, and engagement were measured by the Observed Emotion Rating Scale, Person-Environment Apathy Rating Scale, and Types of Engagement. All participants were interviewed. Overall, the VRF was perceived by residents, family members, and staff to have a positive effect. During the VRF experience, residents experienced more pleasure (p = .008) and a greater level of alertness (p anxiety during the forest experience than the comparative normative sample (p = .016). This initial, small-scale study represents the first to introduce the VRF activity and describe the impact on people with dementia. The VRF was perceived to have a positive effect on people with dementia, although, compared to the normative sample, a greater level of fear/anxiety during the VRF was experienced. This study suggests virtual reality may have the potential to improve quality of life, and the outcomes can be used to inform the development of future Virtual Reality activities for people with dementia.

  13. The Koori Growing Old Well Study: investigating aging and dementia in urban Aboriginal Australians.

    Science.gov (United States)

    Radford, Kylie; Mack, Holly A; Robertson, Hamish; Draper, Brian; Chalkley, Simon; Daylight, Gail; Cumming, Robert; Bennett, Hayley; Jackson Pulver, Lisa; Broe, Gerald A

    2014-06-01

    Dementia is an emerging health priority in Australian Aboriginal communities, but substantial gaps remain in our understanding of this issue, particularly for the large urban section of the population. In remote Aboriginal communities, high prevalence rates of dementia at relatively young ages have been reported. The current study is investigating aging, cognitive decline, and dementia in older urban/regional Aboriginal Australians. We partnered with five Aboriginal communities across the eastern Australian state of New South Wales, to undertake a census of all Aboriginal men and women aged 60 years and over residing in these communities. This was followed by a survey of the health, well-being, and life history of all consenting participants. Participants were also screened using three cognitive instruments. Those scoring below designated cut-offs, and a 20% random sample of those scoring above (i.e. "normal" range), completed a contact person interview (with a nominated family member) and medical assessment (blind to initial screening results), which formed the basis of "gold standard" clinical consensus determinations of cognitive impairment and dementia. This paper details our protocol for a population-based study in collaboration with local Aboriginal community organizations. The study will provide the first available prevalence rates for dementia and cognitive impairment in a representative sample of urban Aboriginal people, across city and rural communities, where the majority of Aboriginal Australians live. It will also contribute to improved assessment of dementia and cognitive impairment and to the understanding of social determinants of successful aging, of international significance.

  14. Assessment of capabilities in persons with advanced stage of dementia: Validation of The Montessori Assessment System (MAS).

    Science.gov (United States)

    Erkes, Jérôme; Camp, Cameron J; Raffard, Stéphane; Gély-Nargeot And, Marie-Christine; Bayard, Sophie

    2017-01-01

    This study evaluated the validity and reliability of the Montessori Assessment System. The Montessori Assessment System assesses preserved abilities in persons with moderate to severe dementia. In this respect, this instrument provides crucial information for the development of effective person-centered care plans. A total of 196 persons with a diagnosis of dementia in the moderate to severe stages of dementia were recruited in 10 long-term care facilities in France. All participants completed the Montessori Assessment System, the Clinical Dementia Rating Scale and/or the Mini Mental State Examination and the Severe Impairment Battery-short form. The internal consistency and temporal stability of the Montessori Assessment System were high. Additionally, good construct and divergent validity were demonstrated. Factor analysis showed a one-factor structure. The Montessori Assessment System demonstrated satisfactory psychometric properties while being a useful instrument to assess capabilities in persons with advanced stages of dementia and hence to develop person-centered plans of care.

  15. Risk factors for dementia in the ninth decade of life and beyond: a study of the Lothian birth cohort 1921.

    Science.gov (United States)

    Sibbett, Ruth A; Russ, Tom C; Deary, Ian J; Starr, John M

    2017-06-02

    % CI: 0.32, 0.93). Dementia incidence was consistent with expected rates. The risk profile for dementia in this cohort of participants aged 79-95 confirmed previous findings that risk factors differ for those over 79 years. Further evidence is recommended in order that the risk profile for this age group can be accurately determined.

  16. Impact of diabetes mellitus and chronic liver disease on the incidence of dementia and all-cause mortality among patients with dementia.

    Science.gov (United States)

    Kim, Hyun Min; Lee, Yong-Ho; Han, Kyungdo; Lee, Byung-Wan; Kang, Eun Seok; Kim, Jaetaek; Cha, Bong-Soo

    2017-11-01

    This study investigated the effects of the presence of type 2 diabetes mellitus (T2D) and/or chronic liver disease (CLD) on the incidence and prognosis of dementia during a 10-year period in Korea using a nationwide population-based dataset from the Korea National Health Insurance Service.To assess the impact of T2D and CLD on the incidence of dementia, we included subjects aged ≥60 years without dementia, T2D, and CLD from 2003 to 2005. We created another cohort for evaluating the all-cause mortality in subjects with dementia between 2003 and 2005. The participants were categorized into 4 groups: control (neither CLD nor T2D), CLD-only, T2D-only, and T2D-and-CLD groups, and they were followed up until 2013.The incidence of dementia was higher in the T2D-only group than in the control and CLD-only groups (2.78 vs. 2.04 and 2.00 per 1000 person-years). After adjustment for age, gender, and comorbid conditions, both T2D and CLD increased the risk of any type of dementia; however, the impact of CLD alone was much lower [hazard ratio (HR) 1.07, 95% confidence interval (CI): 1.06-1.08] than that of T2D alone (HR 1.27, 95% CI: 1.27-1.28). The risk of dementia did not significantly change in patients with the co-occurrence of T2D and CLD compared to those with T2D alone. The all-cause mortality rate was the lowest in the control group (2.59 per 1000 person-years) and the highest in the T2D-and-CLD group (3.77 per 1000 person-years). Presence of T2D or CLD alone was associated with higher mortality (HR 1.46 and HR 1.21, respectively) compared with in the absence of both the diseases. Furthermore, the presence of both the diseases further significantly increased the mortality rate compared to the presence of each disease alone (HR 1.67, 95% CI: 1.65-1.69).In conclusion, this study found that the incidence of dementia was much higher in patients with T2D. CLD was associated with a modest increase in risk of dementia; however, there was no additive effect with T2D. In the

  17. 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. Copyright 2016, SLACK Incorporated.

  18. SU-E-T-421: Feasibility Study of Volumetric Modulated Arc Therapy with Constant Dose Rate for Endometrial Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yang, R; Wang, J [Peking University Third Hospital, Beijing, Beijing (China)

    2014-06-01

    Purpose: To investigate the feasibility, efficiency, and delivery accuracy of volumetric modulated arc therapy with constant dose rate (VMAT-CDR) for whole-pelvic radiotherapy (WPRT) of endometrial cancer. Methods: The nine-Field intensity-modulated radiotherapy (IMRT), VMAT with variable dose-rate (VMAT-VDR), and VMAT-CDR plans were created for 9 patients with endometrial cancer undergoing WPRT. The dose distribution of planning target volume (PTV), organs at risk (OARs), and normal tissue (NT) were compared. The monitor units (MUs) and treatment delivery time were also evaluated. For each VMAT-CDR plan, a dry Run was performed to assess the dosimetric accuracy with MatriXX from IBA. Results: Compared with IMRT, the VMAT-CDR plans delivered a slightly greater V20 of the bowel, bladder, pelvis bone, and NT, but significantly decreased the dose to the high-dose region of the rectum and pelvis bone. The MUs Decreased from 1105 with IMRT to 628 with VMAT-CDR. The delivery time also decreased from 9.5 to 3.2 minutes. The average gamma pass rate was 95.6% at the 3%/3 mm criteria with MatriXX pretreatment verification for 9 patients. Conclusion: VMAT-CDR can achieve comparable plan quality with significant shorter delivery time and smaller number of MUs compared with IMRT for patients with endometrial cancer undergoing WPRT. It can be accurately delivered and be an alternative to IMRT on the linear accelerator without VDR capability. This work is supported by the grant project, National Natural; Science Foundation of China (No. 81071237)

  19. Framing Confusion: Dementia, Society, and History.

    Science.gov (United States)

    Ballenger, Jesse F

    2017-07-01

    This essay will briefly sketch historical changes in the framing of dementia since the late nineteenth century. In broad terms, this period has seen a shift from viewing dementia as a pathological variant of normal aging to viewing it as a distinct disease. Although this broad reframing of dementia was clearly positive in raising awareness and funding for research, it had some negative aspects that should be considered. Caregiving came to seem less important than research aimed at a cure, and the stigma surrounding dementia has, if anything, increased. © 2017 American Medical Association. All Rights Reserved.

  20. Internet-based screening for dementia risk.

    Science.gov (United States)

    Brandt, Jason; Sullivan, Campbell; Burrell, Larry E; Rogerson, Mark; Anderson, Allan

    2013-01-01

    The Dementia Risk Assessment (DRA) is an online tool consisting of questions about known risk factors for dementia, a novel verbal memory test, and an informant report of cognitive decline. Its primary goal is to educate the public about dementia risk factors and encourage clinical evaluation where appropriate. In Study 1, more than 3,000 anonymous persons over age 50 completed the DRA about themselves; 1,000 people also completed proxy reports about another person. Advanced age, lower education, male sex, complaints of severe memory impairment, and histories of cerebrovascular disease, Parkinson's disease, and brain tumor all contributed significantly to poor memory performance. A high correlation was obtained between proxy-reported decline and actual memory test performance. In Study 2, 52 persons seeking first-time evaluation at dementia clinics completed the DRA prior to their visits. Their responses (and those of their proxy informants) were compared to the results of independent evaluation by geriatric neuropsychiatrists. The 30 patients found to meet criteria for probable Alzheimer's disease, vascular dementia, or frontotemporal dementia differed on the DRA from the 22 patients without dementia (most other neuropsychiatric conditions). Scoring below criterion on the DRA's memory test had moderately high predictive validity for clinically diagnosed dementia. Although additional studies of larger clinical samples are needed, the DRA holds promise for wide-scale screening for dementia risk.

  1. Adult dementia: history, biopsy, pathology.

    Science.gov (United States)

    Torack, R M

    1979-05-01

    The historical events in the evolution of Alzheimer's disease are reviewed, including the initial description by Alois Alzheimer and the subsequent controversy regarding the nosological specificity of this entity. The similarity of senile dementia and Alzheimer's disease is emphasized. The basis for the modern concept of Alzheimer's disease as premature or accelerated aging is included in the review. The pathological correlates of the major categories of adult dementia have been described. The traditional criteria of neurofibrillary tangles and senile plaques have been re-evaluated using the current insight into these changes afforded by electron microscopy and biochemistry. The significance of amyloid has been described because it occurs within the senile plaque and also as the essential component of congophilic angiopathy. The new information regarding neuronal cell counts and the loss of choline acetyltransferase has been evaluated in terms of an indication of a pathogenic mechanism of Alzheimer's disease. The current understanding of normal pressure hydrocephalus, Creutzfeldt-Jakob disease, and multi-infarct dementia has been described. Brain biopsy in dementia has been described as having diagnostic, research, pathogenic, and prognostic value. The precautions involving the performance and handling of the biopsy have been stressed, particularly because these procedures involve conditions of possible slow virus etiology. The polemic for Alzheimer's disease as aging or slow virus infection has been summarized. At this time a consideration seems justified that Alzheimer's disease is an age-related, slow virus disease due to a hitherto unknown immune defect. Aging as an etiological agent must be clarified before Alzheimer's disease, in any form, can be considered to be an inevitable consequence of longevity.

  2. 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

  3. Dementia pugilistica 1a. parte

    OpenAIRE

    OTERO SILICEO, ENRIQUE; PADILLA RUBIO, JOEL

    2004-01-01

    Sports is considered a synonym for body and mind health. However, the so called contaet sports, the main example being boxing, more or less go beyond this definition. Contemporary boxing is a spetacle, who is a continuation of historical fights of gladiators. For many years, several complications and head alterations have been related to boxing involving both the face and the skull. And, because of their outcome, some of the most important alterations are neuropsychiatric such as dementia pug...

  4. Rights in mind: Thinking differently about dementia and disability.

    Science.gov (United States)

    Shakespeare, Tom; Zeilig, Hannah; Mittler, Peter

    2017-01-01

    The aim of this paper is to argue for the utility of a relational model of disability, as a way of conceptualizing dementia. We explore whether dementia should be considered as a disability, and whether people with dementia might consider themselves as disabled people. We review examples of, and issues raised by, the political activism of people with dementia. We consider how language constructs dementia negatively. We discuss how the environment influences the experience of dementia. In conclusion, we show that a relational model of dementia lays the basis for a human rights approach to the condition, based on collaborative partnerships between people with dementia and people from other disability communities.

  5. Pharmaceutical consumption and cost in patients with dementia: A longitudinal study by the Registry of Dementias of Girona (ReDeGi) in Catalonia (Spain).

    Science.gov (United States)

    Turró-Garriga, O; Calvó-Perxas, L; Albaladejo, R; Alsina, E; Cuy, J M; Llinàs-Reglà, J; Roig, A M; Serena, J; Vallmajó, N; Viñas, M; López-Pousa, S; Vilalta-Franch, J; Garre-Olmo, J

    2015-01-01

    Drug spending increases exponentially from the age of 65-70 years, and dementia is one of the diseases significantly contributing to this increase. Our aim was to describe pharmaceutical consumption and cost in patients with dementia, using the Anatomical Therapeutic Chemical (ATC) classification system. We also assessed the evolution of costs and consumption, and the variables associated to this evolution during three years. Three years prospective cohort study using data from the ReDeGi and the Health Region of Girona (HRG) Pharmacy Unit database from the Public Catalan Healthcare Service (PCHS). Frequency of consumption and costs of ATC categories of drugs were calculated. Sample of 869 patients with dementia, most of them with a diagnosis of degenerative dementia (72.6%), and in a mild stage of the disease (68.2%). Central nervous system (CNS) drugs had the highest consumption rate (97.2%), followed by metabolic system drugs (80.1%), and cardiovascular system drugs (75.4%). Total pharmaceutical cost was of 2124.8 € per patient/year (standard deviation (SD)=1018.5 €), and spending on CNS drugs was 55.5% of the total cost. After 36 months, pharmaceutical cost increased in 694.9 € (SD=1741.9), which was associated with dementia severity and institutionalization at baseline. Pharmaceutical consumption and costs are high in patients with dementia, and they increase with time, showing an association with baseline dementia severity and institutionalization. CNS drugs are the pharmaceuticals with highest prescription rates and associated costs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Report by the Spanish Foundation of the Brain on the social impact of Alzheimer disease and other types of dementia.

    Science.gov (United States)

    Villarejo Galende, A; Eimil Ortiz, M; Llamas Velasco, S; Llanero Luque, M; López de Silanes de Miguel, C; Prieto Jurczynska, C

    2017-12-14

    Knowledge of the socioeconomic impact of dementia-related disorders is essential for appropriate management of healthcare resources and for raising social awareness. We performed a literature review of the published evidence on the epidemiology, morbidity, mortality, associated disability and dependence, and economic impact of dementia and Alzheimer disease (AD) in Spain. Most population studies of patients older than 65 report prevalence rates ranging from 4% to 9%. Prevalence of dementia and AD is higher in women for nearly every age group. AD is the most common cause of dementia (50%-70% of all cases). Dementia is associated with increased morbidity, mortality, disability, and dependence, and results in a considerable decrease in quality of life and survival. Around 80% of all patients with dementia are cared for by their families, which cover a mean of 87% of the total economic cost, resulting in considerable economic and health burden on caregivers and loss of quality of life. The economic impact of dementia is huge and difficult to evaluate due to the combination of direct and indirect costs. More comprehensive programmes should be developed and resources dedicated to research, prevention, early diagnosis, multidimensional treatment, and multidisciplinary management of these patients in order to reduce the health, social, and economic burden of dementia. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Public awareness of dementia: A study in Botucatu, a medium-sized city in the State of São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Arthur Oscar Schelp

    Full Text Available Abstract Dementia is a progressive and debilitating disease affecting an increasing number of people worldwide. Despite its importance, only a few studies have examined public awareness of dementia. We present a study of the public awareness of dementia in Botucatu, São Paulo, Brazil. Methods: A sample of 73 individuals answered a questionnaire approved by the Medical Ethics Research Committee inquiring about the characteristics of healthy old-aged and demented individuals. Results: Those interviewed believed that dementia is characterized by prevalent memory impairment (41% and behavioral changes (32.9% with onset in the 60's or older (42.5% and upon suspecting dementia, only a few would seek specialized medical help. Discussion: Better understanding of public awareness of dementia provides the clue to more effective health and social policies in order to achieve a higher rate of early diagnosis and thereby possibly decreasing patient, family and caregiver distress.

  8. Usefulness of medial temporal lobe atrophy visual rating scale in detecting Alzheimer′s disease: Preliminary study

    Directory of Open Access Journals (Sweden)

    Jae-Hyeok Heo

    2013-01-01

    Full Text Available Background: The Korean version of Mini-Mental Status Examination (K-MMSE and the Korean version of Addenbrooke Cognitive Examination (K-ACE have been validated as quick neuropsychological tests for screening dementia in various clinical settings. Medial temporal atrophy (MTA is an early pathological characteristic of Alzheimer′s disease (AD. We aimed to assess the diagnostic validity of the fusion of the neuropsychological test and visual rating scale (VRS of MTA in AD. Materials and Methods: A total of fifty subjects (25 AD, 25 controls were included. The neuropsychological tests used were the K-MMSE and the K-ACE. T1 axial imaging visual rating scale (VRS was applied for assessing the grade of MTA. We calculated the fusion score with the difference of neuropsychological test and VRS of MTA. The receiver operating characteristics (ROC curve was used to determine optimal cut-off score, sensitivity and specificity of the fusion scores in screening AD. Results: No significant differences in age, gender and education were found between AD and control group. The values of K-MMSE, K-ACE, CDR, VRS and cognitive function test minus VRS were significantly lower in the AD group than control group. The AUC (Area under the curve, sensitivity and specificity for K-MMSE minus VRS were 0.857, 84% and 80% and for K-ACE minus VRS were 0.884, 80% and 88%, respectively. Those for K-MMSE only were 0.842, 76% and 72% and for K-ACE only were 0.868, 80% and 88%, respectively. Conclusions: The fusion of the neuropsychological test and VRS suggested clinical usefulness in their easy and superiority over neuropsychological test only. However, this study failed to find any difference. This may be because of small numbers in the study or because there is no true difference.

  9. Prevalence and conversion to dementia of Mild Cognitive Impairment in an elderly Italian population.

    Science.gov (United States)

    Limongi, Federica; Siviero, Paola; Noale, Marianna; Gesmundo, Antonella; Crepaldi, Gaetano; Maggi, Stefania

    2017-06-01

    Mild Cognitive Impairment (MCI) represents a significant risk factor for dementia but there are only a few Italian population studies on its prevalence and its rate of conversion to dementia. Aim of this study was to assess the prevalence of MCI, its subtypes, and rates of conversion to dementia 1 year later in an elderly Italian population. The data are based on an Italian multicenter population-based cohort study with both cross-sectional and longitudinal components. Two thousand three hundred thirty-seven individuals over 65 underwent screening, clinical confirmation and 1-year follow-up. The prevalence of MCI was 21.6% and the amnestic multiple domain was the most frequent subtype (63.2%). The conversion rate to dementia was 4.1% and was found only in the amnestic multiple domain and in the unclassifiable subjects, persons with cognitive deficit but neither demented nor with MCI. The prevalence of MCI in this population sample was similar to that found in other population studies using Petersen's modified MCI criteria as well as his original criteria. With regard to conversion to dementia, our results emphasize the importance to better classify the unclassifiable subjects at high risk of progression to dementia and also at risk of being undiagnosed and untreated. MCI is characterized by extreme variability and instability. Data on the prevalence and the rate of conversion from MCI to dementia are difficult to compare given the important differences from study to study especially with regard to the diagnostic criteria utilized and their operationalization.

  10. The engineering design evolution of IFMIF: From CDR to EDA phase

    Energy Technology Data Exchange (ETDEWEB)

    Pérez, Mario, E-mail: mario.perez@ifmif.org

    2015-10-15

    Highlights: • Brief description of International Fusion Materials Irradiation Facility (IFMIF), its background and scope its Engineering Design and Validation Activities (EVEDA) phase. • Description and justification of the main design evolutions from previous phases; and in particular from the baseline described in the “Comprehensive Design Report” (CDR). - Abstract: The International Fusion Materials Irradiation Facility (IFMIF), presently in its Engineering Design and Engineering Validation Activities (EVEDA) phase, started in 2007 under the framework of the Broader Approach (BA) Agreement between Japanese Government and EURATOM. The mandate assigned was to develop an integrated engineering design of IFMIF together with accompanying sub-projects to validate the major technological challenges that included the construction of either full scale prototypes or cleverly devised scaled down facilities, which are essential to reliably face the construction of IFMIF on schedule and cost. The Engineering Design Activities were accomplished on-schedule with the release of its “Intermediate Engineering Design Report (IIEDR)” in June 2013 compliant with our mandate. This paper highlights the design improvements implemented from the previous Conceptual Design Phase.

  11. [Malnutrition and dementia in the elderly in German nursing homes. Results of a prevalence survey from the years 2008 and 2009].

    Science.gov (United States)

    Reuther, S; van Nie, N; Meijers, J; Halfens, R; Bartholomeyczik, S

    2013-04-01

    Dementia is one of most challenging problems for the care of older people in Germany. Although malnutrition in nursing homes is also associated with dementia, few systematic studies have described health care structures in German nursing homes for people with dementia and their individual nutritional status. Therefore, the aim of this study was to determine dementia-specific differences concerning the nutrition situation for the elderly in German nursing homes. A cross-sectional multicenter study was performed using a standardized multilevel instrument (observation, questionnaire) developed at the University of Maastricht. Variables are indicators for malnutrition and its risks, quality indicators, care dependency and types of interventions. In the 2008 and 2009 surveys, 53% of 4,777 participants (77.9% women, 22.1% men, mean age 82 years) were identified (based on care documentation) as having dementia. More than one third of this population (n = 759, 85.1% women, 14.1% men, mean age 85 years) was probably malnourished; thus, the prevalence rate in the group of people with dementia was 10% higher compared to the group without dementia. People with dementia showed a higher risk in all relevant risk indicators (weight history, body mass index, and food intake) for malnutrition compared to those without dementia. Furthermore, people with dementia had higher care dependency rates and required more assistance for eating and drinking. The study results confirm the relationship between malnutrition and dementia. The use of standardized nutrition screening tools is not common practice in German nursing homes yet. However, the results suggest that with an increasing risk for malnutrition combined with dementia the proportion of nursing interventions also increases, which means that nurses must react adequately. Nevertheless, the interventions concerning malnutrition should be improved especially with respect to preventive measurements.

  12. End-stage dementia spark of life: reliability and validity of the "GATOS" questionnaire.

    Science.gov (United States)

    Tsoucalas, Gregory; Bourelia, Stamati; Kalogirou, Vaso; Giatsiou, Styliani; Mavrogiannaki, Eirini; Gatos, Georgios; Galanos, Antonis; Repana, Olga; Iliadou, Eleni; Antoniou, Antonis; Sgantzos, Markos; Gatos, Konstantinos

    2015-01-01

    Fl oor effects are present in most dementia assessment tools as dementia progresses and the in-depth assessment of patients considered more or less on vegetative state is questionable. To develop a questionnaire (the "Gatos Clinical Test-GCT") for the assessment of end-stage demented patients. Five hundred patients with dementia of various causes and an MMSE score between 0 and 2 were enrolled in the study. The GCT consists of 14 closed type questions rated on a Likert scale. The total score is used to evaluate patient's dementia. Various aspects of validity and reliability (including face, content and structural validity as well as test-retest reliability) were examined. Three subscales "Autonomy/Alertness", "Gnosias" and "Somatokinetic function" were defined, with a Cronbach equal to 0.851, 0.756 and 0.598 respectively. The GCT subscales and total score were statistically significant higher in patients with MMSE score 1 or 2 compared with those with MMSE score 0 (pGATOS" questionnaire is a valid and reliable test for patients with severe dementia, aiming at identification of those patients who could sustain some quality of life. It is a relatively short and easy to administer tool. As dementia prevalence is expected to rise further worldwide we believe that GCT could offer valuable services to health professionals, caregivers and patients.

  13. Cerebral glucose metabolic patterns in Alzheimer's disease. Effect of gender and age at dementia onset

    International Nuclear Information System (INIS)

    Small, G.W.; Kuhl, D.E.; Riege, W.H.; Fujikawa, D.G.; Ashford, J.W.; Metter, E.J.; Mazziotta, J.C.

    1989-01-01

    No previous study of Alzheimer's disease has, to our knowledge, assessed the effect of both age at dementia onset and gender on cerebral glucose metabolic patterns. To this end, we used positron emission tomography (fludeoxyglucose F 18 method) to study 24 patients with clinical diagnoses of probable Alzheimer's disease. Comparisons of the 13 patients with early-onset dementia (less than 65 years of age) with the 11 patients with late-onset dementia (greater than 65 years of age) revealed significantly lower left parietal metabolic ratios (left posterior parietal region divided by the hemispheric average) in the early-onset group. The metabolic ratio of posterior parietal cortex divided by the relatively disease-stable average of caudate and thalamus also separated patients with early-onset dementia from those with late-onset dementia, but not men from women. Further comparisons between sexes showed that, in all brain regions studied, the 9 postmenopausal women had higher nonweighted mean metabolic rates than the 15 men from the same age group, with hemispheric sex differences of 9% on the right and 7% on the left. These results demonstrate decreased parietal ratios in early-onset dementia of Alzheimer's disease, independent of a gender effect

  14. Is watching television a realistic leisure option for people with dementia?

    Science.gov (United States)

    Gústafsdóttir, Margrét

    2015-01-01

    Watching television is a common leisure activity, not least among older people. However, watching television may become difficult when it is disturbed by symptoms of dementia. A total of 284 questionnaires were handed out to relatives of people with dementia in Iceland, in the Memory Clinic of the University Hospital and in specialized units for people with dementia (6 day-care units and 8 units within nursing homes). The response rate was just below 58%. Watching television was shown to play a less important role in the course of the daily life of people with dementia as soon as the symptoms of the disease became evident, and it increasingly became less relevant. So, this previous leisure activity left an ever-growing void of time to fill. However, watching television may provide an important social context for contact and togetherness during the progress of the disease, as watching television with someone close to them was important for the individuals with dementia. It is not a viable option for people with dementia to watch television on their own, but they may enjoy watching television while sharing this activity with a person close to them. This may even provide quality time.

  15. Is Watching Television a Realistic Leisure Option for People with Dementia

    Directory of Open Access Journals (Sweden)

    Margrét Gústafsdóttir

    2015-03-01

    Full Text Available Background: Watching television is a common leisure activity, not least among older people. However, watching television may become difficult when it is disturbed by symptoms of dementia. Method: A total of 284 questionnaires were handed out to relatives of people with dementia in Iceland, in the Memory Clinic of the University Hospital and in specialized units for people with dementia (6 day-care units and 8 units within nursing homes. The response rate was just below 58%. Results: Watching television was shown to play a less important role in the course of the daily life of people with dementia as soon as the symptoms of the disease became evident, and it increasingly became less relevant. So, this previous leisure activity left an ever-growing void of time to fill. However, watching television may provide an important social context for contact and togetherness during the progress of the disease, as watching television with someone close to them was important for the individuals with dementia. Conclusion: It is not a viable option for people with dementia to watch television on their own, but they may enjoy watching television while sharing this activity with a person close to them. This may even provide quality time.

  16. The association between dementia and epilepsy: A systematic review and meta-analysis.

    Science.gov (United States)

    Subota, Ann; Pham, Tram; Jetté, Nathalie; Sauro, Khara; Lorenzetti, Diane; Holroyd-Leduc, Jayna

    2017-06-01

    Dementia is among the top 15 conditions with the most substantial increase in burden of disease in the past decade, and along with epilepsy, among the top 25 causes of years lived with disability worldwide. The epidemiology of dementia in persons with epilepsy, and vice versa, is not well characterized. The purpose of this systematic review was to examine the prevalence, incidence, and reported risk factors for dementia in epilepsy and epilepsy in dementia. Embase, PsycINFO, MEDLINE, and the Cochrane databases were searched from inception. Papers were included if they reported the incidence and/or prevalence of dementia and epilepsy. Two individuals independently performed duplicate abstract and full-text review, data extraction, and quality assessment. Random-effects models were used to generate pooled estimates when feasible. Of the 3,043 citations identified, 64 were reviewed in full text and 19 articles were included. The period prevalence of dementia ranged from 8.1 to 17.5 per 100 persons among persons with epilepsy (insufficient data to pool). The pooled period prevalence of epilepsy among persons with dementia was 5 per 100 persons (95% confidence interval [CI] 1-9) in population-based settings and 4 per 100 persons (95% CI 1-6) in clinic settings. There were insufficient data to report a pooled overall incidence rate and only limited data on risk factors. There are significant gaps in knowledge regarding the epidemiology of epilepsy in dementia and vice versa. Accurate estimates are needed to inform public health policy and prevention, and to understand health resource needs for these populations. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  17. Associations between Race and Dementia Status and the Quality of End-of-Life Care.

    Science.gov (United States)

    Luth, Elizabeth A; Prigerson, Holly G

    2018-04-05

    Non-Hispanic black and dementia patients receive more invasive and futile treatment at end of life (EOL) relative to others. Little is known about the relationship between race/ethnicity, dementia, and EOL care quality. Identify the relationship between race/ethnicity, dementia, and proxy reporters' evaluation of EOL care quality in older adults. Latent class analysis (LCA) of national survey data. 1588 deceased Medicare beneficiaries age 65 and older from the National Health and Aging Trends Study (2011-2016). LCA identified three types of quality EOL care using nine measures of symptom management, quality of healthcare encounters, and dignified treatment. Race and dementia were primary predictors of EOL care quality type. Adjusted models controlled for decedent education, sex, marital status, age, number of illnesses, number of hospitalizations, self-rated health, place of death, hospice involvement, and proxy relationship to decedent and familiarity with care. Over 20% of proxies report that dying individuals experienced suboptimal EOL care quality, characterized by pain, sadness, poor communication, and inattention to personal care needs. In adjusted analyses, proxies for non-Hispanic black decedents were less likely to provide negative care assessments than proxies for non-Hispanic white decedents (adjusted odds ratio [AOR]: 0.58; 95% confidence interval [CI]: 0.40-0.86). Proxies for decedents with dementia were less likely to provide negative assessments than proxies for decedents without dementia (AOR: 0.70; 95% CI: 0.51-0.97). Efforts to improve EOL care quality are needed. More positive EOL care quality assessments for non-Hispanic Black and dementia decedents appear counterintuitive given research demonstrating that these groups of individuals are likely to have received suboptimal EOL care. Because caregiver expectations for care may differ by decedent race and dementia status, research is needed to explore the role of caregiver expectations for EOL care

  18. The Lay Public’s Understanding and Perception of Dementia in a Developed Asian Nation

    Directory of Open Access Journals (Sweden)

    Wai Jia Tan

    2012-10-01

    Full Text Available Background: Early detection of dementia aims to improve treatment outcomes. However, poor perception and understanding of dementia are significant barriers. We aim to investigate the public’s perception of dementia and identify variables associated with the different profiles of public perception. Methods: A custom-designed questionnaire was used to assess laypersons’ knowledge and perception of dementia during a health fair at a public hospital in Singapore, a developed Asian nation. Out of a sample of 370 subjects, 32 declined to participate (response rate = 91.4%. Latent class analysis (LCA was used to identify meaningful subgroups of subjects from significant associations with multiple indicators of dementia awareness. Multinomial logistic regression was performed exploring variables associated with each of the subgroups derived from LCA. Results: The majority of the study participants were female (66.9%, 65 years or older (71.1%, and ethnic Chinese (88.1%. LCA classified the study participants into 3 subgroups: Class 1 (good knowledge, good attitude, Class 2 (good knowledge, poor attitude, and Class 3 (poor knowledge, poor attitude, in proportions of 14.28, 63.83, and 21.88%, respectively. Compared to other classes, participants with good knowledge and good attitude towards dementia (Class 1 were more likely to know someone with dementia and understand the effects of the disease, be married, live in private housing, receive higher monthly income, and not profess belief in Buddhism, Taoism, or Hinduism. Conclusion: Our results show that the public in Singapore may not be ready for screening initiatives and early dementia diagnosis. Education efforts should be targeted at lower socioeconomic groups, singles, and those of certain oriental religions.

  19. The Lay Public's Understanding and Perception of Dementia in a Developed Asian Nation

    Science.gov (United States)

    Tan, Wai Jia; Hong, Song-Iee; Luo, Nan; Lo, Tong Jen; Yap, Philip

    2012-01-01

    Background Early detection of dementia aims to improve treatment outcomes. However, poor perception and understanding of dementia are significant barriers. We aim to investigate the public's perception of dementia and identify variables associated with the different profiles of public perception. Methods A custom-designed questionnaire was used to assess laypersons’ knowledge and perception of dementia during a health fair at a public hospital in Singapore, a developed Asian nation. Out of a sample of 370 subjects, 32 declined to participate (response rate = 91.4%). Latent class analysis (LCA) was used to identify meaningful subgroups of subjects from significant associations with multiple indicators of dementia awareness. Multinomial logistic regression was performed exploring variables associated with each of the subgroups derived from LCA. Results The majority of the study participants were female (66.9%), 65 years or older (71.1%), and ethnic Chinese (88.1%). LCA classified the study participants into 3 subgroups: Class 1 (good knowledge, good attitude), Class 2 (good knowledge, poor attitude), and Class 3 (poor knowledge, poor attitude), in proportions of 14.28, 63.83, and 21.88%, respectively. Compared to other classes, participants with good knowledge and good attitude towards dementia (Class 1) were more likely to know someone with dementia and understand the effects of the disease, be married, live in private housing, receive higher monthly income, and not profess belief in Buddhism, Taoism, or Hinduism. Conclusion Our results show that the public in Singapore may not be ready for screening initiatives and early dementia diagnosis. Education efforts should be targeted at lower socioeconomic groups, singles, and those of certain oriental religions. PMID:23139688

  20. [Identification, evaluation and treatment of dementia patients in society].

    Science.gov (United States)

    Capildeo, R; Wallace, M G; Clifford Rose, F

    1983-12-29

    Patients with "mild to moderate" dementia might improve with appropriate drug therapy whereas patients with "severe" dementia are generally considered to have an irreversible condition, providing acute metabolic disorders have been excluded and appropriate investigations have been performed to exclude neurological conditions that might be amenable to neurosurgery. Since it is unlikely that this type of patient will be referred to the hospital outpatient clinics, it is necessary to identify these patients in the community. For this purpose, authors have used the Abbreviated Mental Test. A comparison between two observers (nurse and doctor) has been made. Subsequently, a 6 symptoms check-list, as abbreviated form of the Crichton Royal Rating Scale for geriatric patients, was used in an open pilot study on 260 patients completing a 12 weeks treatment by dihydroergotoxine mesylate (codergocrine mesylate, Hydergine) 4.5 mg once a day. Although this was an open pilot study, it does show that it is possible to identify and treat patients with "mild to moderate" dementia in the community. A single dose formulation in the elderly has obvious advantages. In this study, compliance was excellent and 88% of the patients showed significant improvement using the suggested rating scales.

  1. Integrating medical humanities into a pharmaceutical care seminar on dementia.

    Science.gov (United States)

    Zimmermann, Martina

    2013-02-12

    Objective. To design, integrate, and assess the effectiveness of a medical humanities teaching module that focuses on pharmaceutical care for dementia patients.Design. Visual and textual dementia narratives were presented using a combination of teacher and learner-centered approaches with the aim being to highlight patients' and caregivers' needs for empathy and counselling.Assessment. As gauged from pre- and post-experience questionnaires, students highly rated this approach to teaching medical humanities. In-class presentations demonstrated students' increased sensitivity to patient and caregiver needs, while objective learning outcomes demonstrated students' increased knowledge and awareness.Conclusions. Pharmacy students were open to and successfully learned from reading and discussing patient and caregiver narratives, which furthers the discussion on the value of integrating the medical humanities into the curricula of pharmacy and other health sciences.

  2. Shift work, long working hours, and later risk of dementia

    DEFF Research Database (Denmark)

    Nabe-Nielsen, Kirsten; Garde, Anne Helene; Ahmed, Kazi Ishtiak

    2017-01-01

    Objectives: The aim of this study was to investigate the effect of shift work and long working hours in midlife on the risk of dementia in old age. Methods: The present study comprised 4766 participants from the Copenhagen Male Study. We used information on shift work (collected in 1970......–1971 and 1985–1986), long working hours defined as >45 hours per week (collected in 1970–1971), socioeconomic status, sleep, stress, and cardiovascular risk factors. Information about dementia diagnoses was obtained from registers. Participants were followed until 2014 (mean length of follow-up was 17.8 years......). We employed Poisson regression for the survival analyses and estimated incidence rate ratios (IRR) and their 95% confidence intervals (CI). Results: We found no statistically significant association between shift work (IRR 0.86, 95% CI 0.70–1.05) or long working hours (IRR 0.97, 95% CI 0...

  3. Vascular risk factors, cognitve decline, and dementia

    Directory of Open Access Journals (Sweden)

    E Duron

    2008-04-01

    Full Text Available 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 risk factors have been found to be associated with vascular dementia but also Alzheimer’s disease. Some longitudinal studies, have found significant associations between hypertension, diabetus mellitus, and metabolic syndrome, assessed at middle age, and dementia. Studies assessing the link between hypercholesterolemia, atrial fibrillation, smoking, and dementia have given more conflicting results. Furthermore, some studies have highlighted the possible protective effect of antihypertensive therapy on cognition and some trials are evaluating the effects of statins and treatments for insulin resistance. Vascular risk factors and their treatments are a promising avenue of research for prevention of dementia, and further long-term, placebo-controlled, randomized studies, need to be performed.Keywords: dementia, hypertension, diabetus mellitus, hypercholesterolemia, metabolic syndrome

  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. Opening up the DNA methylome of dementia.

    Science.gov (United States)

    Delgado-Morales, R; Esteller, M

    2017-04-01

    Dementia is a complex clinical condition characterized by several cognitive impairments that interfere with patient independence in executing everyday tasks. Various neurodegenerative disorders have dementia in common among their clinical manifestations. In addition, these diseases, such as Alzheimer's disease, Parkinson's disease, dementia with Lewy bodies and frontotemporal dementia, share molecular alterations at the neuropathological level. In recent years, the field of neuroepigenetics has expanded massively and it is now clear that epigenetic processes, such as DNA methylation, are mechanisms involved in both normal and pathological brain function. Despite the persistent methodological and conceptual caveats, it has been reported that several genes fundamental to the development of neurodegenerative disorders are deregulated by aberrant methylation patterns of their promoters, and even common epigenetic signatures for some dementia-associated pathologies have been identified. Therefore, understanding the epigenetic mechanisms that are altered in dementia, especially those associated with the initial phases, will allow us not only to understand the etiopathology of dementia and its progression but also to design effective therapies to reduce this global public health problem. This review provides an in-depth summary of our current knowledge about DNA methylation in dementia, focusing exclusively on the analyses performed in human brain.

  6. 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.

  7. Role of BRI2 in Dementia

    NARCIS (Netherlands)

    del Campo, M.; Teunissen, C.E.

    2014-01-01

    Alzheimer's disease (AD), the most common form of dementia, shares clinical and pathological similarities with familial British and Danish dementias (FBD and FDD). Whereas the etiology of sporadic AD remains unclear, familial AD is linked to mutations in amyloid-β protein precursor (AβPP),

  8. 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 ... in a Home Setting. Updated 2009. Alz.org. www.alz.org/national/ ...

  9. 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…

  10. Pharmacological management of Alzheimer's and related dementias ...

    African Journals Online (AJOL)

    Background: Current treatment approaches in dementia lie on the use of cholinergic transmission enhancers. In recent times, herbal products have become popular in dementia and other chronic diseases treatment. Objective and Design: To review currently available (locally and internationally) herbal preparation and their ...

  11. Depression and Risk of Developing Dementia

    Science.gov (United States)

    Byers, Amy L.; Yaffe, Kristine

    2012-01-01

    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 more conflicting but the majority support an association; yet, the nature of this association is unclear (e.g., if depression is a prodrome or consequence or risk factor for dementia). The likely biological mechanisms linking depression to dementia include vascular disease, alterations in glucocorticoid steroids and hippocampal atrophy, increased deposition of β-amyloid plaques, inflammatory changes, and deficits of nerve growth factors. Treatment strategies for depression might intervene on these pathways and in turn may alter risk for dementia. Given the projected increase of dementia in the coming decades, it is critically important that we understand whether treatment for depression alone or combined with other regimens improves cognition. In this review, we summarize and analyze current evidence for late-life and earlier-life depression and their relationship to dementia, discuss the primary underlying mechanisms and implications for treatment. PMID:21537355

  12. Genetic Characterization of Movement Disorders and Dementias

    Science.gov (United States)

    2018-04-27

    Ataxia; Dystonia; Parkinson's Disease; Amyotrophic Lateral Sclerosis; Corticobasal Degeneration; Multiple System Atrophy; Alzheimer's Disease; Lewy Body Dementia; Parkinson Disease-Dementia; Dentatorubral-pallidoluysian Atrophy; Creutzfeldt-Jakob Disease and Fatal Familial Insomnia; Fragile X-associated Tremor/Ataxia Syndrome; Krabbe's Disease; Niemann-Pick Disease, Type C; Neuronal Ceroid Lipofuscinosis

  13. Cerebral emboli and depressive symptoms in dementia.

    NARCIS (Netherlands)

    Purandare, N.; Oude Voshaar, R.C.; Hardicre, J.; Byrne, J.; McCollum, C.N.; Burns, A.

    2006-01-01

    BACKGROUND: The vascular depression hypothesis and our recent findings of increased frequency of spontaneous cerebral emboli in dementia suggest that such emboli may be involved in the causation of depressive symptoms in dementia. AIMS: To evaluate the association between spontaneous cerebral emboli

  14. Policies in Dementia, comparing Germany and Denmark

    DEFF Research Database (Denmark)

    Bjerregaard, Lene Berit Skov

    2017-01-01

    In Short Germany as well as Denmark are focusing on the same issues regarding Dementia, as other European Countries are, too. The key issues in the national strategies are: timely diagnosis, self-determination for the person with dementia, unbroken “care chain”, better possibilities for the relief...

  15. Vascular dementia | Connor | African Journal of Psychiatry

    African Journals Online (AJOL)

    Vascular dementia (VaD) is a common but heterogeneous condition in which there is a clear temporal relationship between the dementia and vascular disease. It may result from multiple large or small vessel strokes or a single strategic stroke. Subcortical ischaemic VaD includes multiple lacunes and subcortical ...

  16. Increased Risk of Dementia in Patients with Tension-Type Headache: A Nationwide Retrospective Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Fu-Chi Yang

    Full Text Available The association between primary headaches, including tension-type headache (TTH as one of the most common primary headache disorders, and dementia remains controversial. In this nationwide, population-based, retrospective, cohort study, we explored the potential association between TTH and dementia and examined sex, age, and comorbidities as risk factors for dementia.Using the Taiwan National Health Insurance Research Database (NHIRD claims data, the sample included 13908 subjects aged ≥20 years with newly-diagnosed TTH in 2000-2006. The non-TTH group included 55632 randomly selected sex- and age-matched TTH-free individuals. All subjects were followed until dementia diagnosis, death, or the end of 2011. Patients with dementia, including vascular and non-vascular (including Alzheimer's subtypes, were identified using International Classification of Diseases Ninth Revision, Clinical Modification codes. Multivariate Cox proportional hazards regression models were used to assess the risk of dementia and dementia-associated risk factors, such as migraine and other medical comorbidities.During the average follow-up of 8.14 years, the incidence density rates of dementia were 5.30 and 3.68/1,000 person-years in the TTH and non-TTH groups, respectively. Compared with the non-TTH group, the risks of dementia were 1.25 (95% confidence interval [CI], 1.11-1.42 and 1.13 (95% CI, 1.01-1.27 times higher in the women and >65-year-old TTH group, respectively. TTH patients with comorbidities had a higher risk of dementia. TTH patients had a greater risk of non-vascular dementia (hazard ratio, 1.21; 95% CI, 1.09-1.34 than the non-TTH group.TTH patients have a future risk of dementia, indicating a potentially linked disease pathophysiology that warrants further study. The association between TTH and dementia is greater in women, older adults, and with comorbidities. Clinicians should be aware of potential dementia comorbidity in TTH patients.

  17. What do children need to know about dementia? The perspectives of children and people with personal experience of dementia.

    Science.gov (United States)

    Baker, Jess R; Jeon, Yun-Hee; Goodenough, Belinda; Low, Lee-Fay; Bryden, Christine; Hutchinson, Karen; Richards, Laura

    2017-10-02

    The vision for dementia-friendly communities is challenged by limited public awareness and stigma about dementia. The study aim was to elicit stakeholder priorities for the message content of an education program to improve dementia awareness among youth; specifically, what do children need to know about dementia? A qualitative inquiry using interviews and focus groups was used. Purposive sampling achieved maximum variation in dementia experience and participant characteristics. Focus groups with Scouts in the community aged 9-12 years old (n = 22) used innovative techniques to explore children's attitudes towards people with dementia. Participants with personal experience of dementia were five people with early-stage dementia; 12 adult primary carers; four non-primary carers; and six grandchildren of a person with dementia. They were asked what is important for children to understand about dementia and what attitudes they may like an education program to confer. Content analysis was performed using NVivo10. Strong themes to emerge were that children need to know the whole truth about dementia; that individuals with dementia are "still people," that it is "not the fault" of the person with dementia; and that dementia is different and typically unpredictable for everyone. Discussions also indicated a need to educate children about ways to relate to a person with dementia, and to appreciate "positives" within a relationship. Children are our future citizens. Developing an education program for children with this message content may be fundamental to de-stigmatizing dementia and laying the foundation to dementia-friendly communities.

  18. Mortality and hospitalization at the end of life in newly admitted nursing home residents with and without dementia.

    Science.gov (United States)

    Allers, Katharina; Hoffmann, Falk

    2018-05-02

    The proportion of deaths occurring in nursing homes is increasing and end of life hospitalizations in residents are common. This study aimed to obtain the time from nursing home admission to death and the frequency of hospitalizations prior to death among residents with and without dementia. This retrospective cohort study analyzed claims data of 127,227 nursing home residents aged 65 years and older newly admitted to a nursing home between 2010 and 2014. We analyzed hospitalizations during the last year of life and assessed mortality rates per 100 person-years. Factors potentially associated with time to death were analyzed in Cox proportional hazard models. The median time from nursing home admission to death was 777 and 635 days in residents with and without dementia, respectively. Being male, older age and a higher level of care decreased the survival time. Sex and age had a higher influence on survival time in residents with dementia, whereas level of care was found to have a higher influence in residents without dementia. Half of the residents of both groups were hospitalized during the last month and about 37% during the last week before death. Leading causes of hospitalizations were infections (with dementia: 20.6% vs. without dementia: 17.2%) and cardiovascular diseases (with dementia: 16.6% vs. without dementia: 19.0%). A high proportion of residents with and without dementia are hospitalized shortly before death. There should be an open debate about the appropriateness of hospitalizing nursing home residents especially those with dementia near death.

  19. Improving person-centred care in nursing homes through dementia-care mapping: design of a cluster-randomised controlled trial.

    NARCIS (Netherlands)

    Ven, G. van de; Draskovic, I.; Adang, E.M.M.; Donders, R.; Post, A.; Zuidema, S.U.; Koopmans, R.T.C.M.; Vernooij-Dassen, M.J.F.J.

    2012-01-01

    BACKGROUND: The effectiveness and efficiency of nursing-home dementia care are suboptimal: there are high rates of neuropsychiatric symptoms among the residents and work-related stress among the staff. Dementia-care mapping is a person-centred care method that may alleviate both the resident and the

  20. 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. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Constant displacement rate testing at elevated temperatures

    International Nuclear Information System (INIS)

    Pepe, J.J.; Gonyea, D.C.

    1989-01-01

    A short time test has been developed which is capable of determining the long time notch sensitivity tendencies of CrMoV rotor forging materials. This test is based on Constant Displacement Rate (CDR) testing of a specific notch bar specimen at 1200 0 F at 2 mils/in/hour displacement rate. These data were correlated to conventional smooth and notch bar rupture behavior for a series of CrMoV materials with varying long time ductility tendencies. The purpose of this paper is to describe the details of this new test procedure and some of the relevant mechanics of material information generated during its development

  2. Association between delirium superimposed on dementia and mortality in hospitalized older adults: A prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Thiago J Avelino-Silva

    2017-03-01

    Full Text Available Hospitalized older adults with preexisting dementia have increased risk of having delirium, but little is known regarding the effect of delirium superimposed on dementia (DSD on the outcomes of these patients. Our aim was to investigate the association between DSD and hospital mortality and 12-mo mortality in hospitalized older adults.This was a prospective cohort study completed in the geriatric ward of a university hospital in São Paulo, Brazil. We included 1,409 hospitalizations of acutely ill patients aged 60 y and over from January 2009 to June 2015. Main variables and measures included dementia and dementia severity (Informant Questionnaire on Cognitive Decline in the Elderly, Clinical Dementia Rating and delirium (Confusion Assessment Method. Primary outcomes were time to death in the hospital and time to death in 12 mo (for the discharged sample. Comprehensive geriatric assessment was performed at admission, and additional clinical data were documented upon death or discharge. Cases were categorized into four groups (no delirium or dementia, dementia alone, delirium alone, and DSD. The no delirium/dementia group was defined as the referent category for comparisons, and multivariate analyses were performed using Cox proportional hazards models adjusted for possible confounders (sociodemographic information, medical history and physical examination data, functional and nutritional status, polypharmacy, and laboratory covariates. Overall, 61% were women and 39% had dementia, with a mean age of 80 y. Dementia alone was observed in 13% of the cases, with delirium alone in 21% and DSD in 26% of the cases. In-hospital mortality was 8% for patients without delirium or dementia, 12% for patients with dementia alone, 29% for patients with delirium alone, and 32% for DSD patients (Pearson Chi-square = 112, p < 0.001. DSD and delirium alone were independently associated with in-hospital mortality, with respective hazard ratios (HRs of 2.14 (95% CI

  3. Cumulative Effect of Depression on Dementia Risk

    Directory of Open Access Journals (Sweden)

    J. Olazarán

    2013-01-01

    Full Text Available 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 (nD, past depression (pD, present depression (prD, and present and past depression (prpD. Logistic regression was used. Results. Data of 1,807 subjects were investigated at baseline (mean age 74.3, 59.3% women, and 1,376 (81.6% subjects were evaluated after three years. The prevalence of dementia at baseline was 6.7%, and dementia incidence was 6.3%. An effect of depression was observed on dementia prevalence (OR [CI 95%] 1.84 [1.01–3.35] for prD and 2.73 [1.08–6.87] for prpD, and on dementia due to AD (OR 1.98 [0.98–3.99] for prD and OR 3.98 [1.48–10.71] for prpD (fully adjusted models, nD as reference. Depression did not influence dementia incidence. Conclusions. Present depression and, particularly, present and past depression are associated with dementia at old age. Multiple mechanisms, including toxic effect of depression on hippocampal neurons, plausibly explain these associations.

  4. [Visual art, creativity and dementia].

    Science.gov (United States)

    Serrano, C; Allegri, R F; Martelli, M; Taragano, F; Rinalli, P

    2005-01-01

    Visual art is an expression of neurological function and how it organizes and interprets perception. The art is predominantly in the right hemisphere, in contrast, the left side, have inhibitory effects on artistic expression. In normal subjects, inhibitory and excitatory mechanisms could interact in a complex harmony, reflecting a paradoxical functional facilitation. Brain diseases such as dementia could change this harmony and then, alter the artistic abilities. Evaluate the art expression in the degenerative diseases. Artistic abilities of 3 painters with degenerative diseases were assessment. Patient 1: A 83 - year old right handed female, diagnosis: Alzheimer's disease. Artistic description: low productivity, simplified versions of earlier and alteration of the visuospatial organization. Patient 2: A 78-year-old right handed female, diagnosis: Primary Progressive Aphasia (PPA); Artistic description: oversimplified drawings which maintaining overall spatial organization, without impair artistic skills. Patient 3: A 68 year-old right handed woman, diagnosis: Fronto-Temporal Dementia (FTD). Artistic description: Increased artistic activity, originality, freedom, utilization of intense colours with perseverative and repetitive copying of similar paintings of her own work. Visual art in Alzheimer's disease is a consequence of visuospatial and constructive disabilities. In contrast, the conservation of this cognitive functions and left asymmetrical involved, in FTD and PPA respectively, suggest artistic preservation, independently of the language injury. The disproportionate functional prevalence of the right over the left could lead to a release of novelty - seeking in art and can contribute to emergent creativity. These observations suggest an organization for art in the brain and proposed bases for further investigations in dementias.

  5. Follow-up of 53 Alzheimer patients with the MODA (Milan Overall Dementia Assessment).

    Science.gov (United States)

    Capitani, E; Manzoni, L; Spinnler, H

    1997-01-01

    Fifty-three patients affected by Alzheimer's disease entered a longitudinal survey aimed at studying which factors influence the rate of progression, assessed by means of the Milan Overall Dementia Assessment (MODA). The second examination was carried out, on average, after 16 months from the first assessment. Only age proved to influence the decline rate, which was faster in elders.

  6. 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....

  7. Ascertainment bias in dementias: a secondary to tertiary centre analysis in Central Italy and conceptual review.

    Science.gov (United States)

    Bonanni, L; Bontempo, G; Borrelli, I; Bifolchetti, S; Buongarzone, M P; Carlesi, N; Carolei, A; Ciccocioppo, F; Colangelo, U; Colonna, G; Desiderio, M; Ferretti, S; Fiorelli, L; D'Alessio, O; D'Amico, A; D'Amico, M C; De Lucia, R; Del Re, L; Di Blasio, F; Di Giacomo, R; Di Iorio, A; Di Santo, E; Di Giuseppe, M; Felice, N; Litterio, P; Gabriele, A; Mancino, E; Manzoli, L; Maruotti, V; Mearelli, S; Molino, G; Monaco, D; Nuccetelli, F; Onofrj, M; Perfetti, B; Sacchet, C; Sensi, F; Sensi, S; Sucapane, P; Taylor, J P; Thomas, A; Viola, P; Viola, S; Zito, M; Zhuzhuni, H

    2013-06-01

    Ascertainment bias (AB) indicates a bias of an evaluation centre in estimating the prevalence/incidence of a disease due to the specific expertise of the centre. The aim of our study was to evaluate classification of different types of dementia in new cases appearing in secondary and tertiary centres, in order to evidence possible occurrence of AB in the various (secondary to tertiary) dementia centres. To assess the mechanism of AB, the rates of new cases of the different forms of dementia reported by different centres were compared. The centres involved in the study were 11 hospital-based centres including a tertiary centre, located in the University Department of Clinical Neurology. The tertiary centre is endowed with state-of-the-art diagnostic facilities and its scientific production is prominently focused on dementia with Lewy bodies (DLB) thus suggesting the possible occurrence of a bias. Four main categories of dementia were identified: Alzheimer's disease (AD), DLB, fronto-temporal dementia (FTD), vascular dementia (VaD), with other forms in a category apart. The classification rate of new cases of dementia in the tertiary centre was compared with rates reported by secondary centres and rates of recoding were calculated during a follow-up of 2 years. The study classified 2,042 newly diagnosed cases of dementia in a population of 1,370,000 inhabitants of which 315,000 were older than 65. AD was categorized in 48-52 % of cases, DLB in 25-28 %, FTD in 2-4 % and VaD in 17-28 %. During the 2-year follow-up the diagnosis was re-classified in 40 patients (3 %). The rate of recoding was 5 % in the tertiary centre, 2-8 % in referrals from secondary to tertiary centre, 2-10 % in recodings performed in secondary centres and addressed to tertiary centre. Recoding or percentages of new cases of AD or DLB were not different in the comparison between secondary or between secondary and tertiary centres. FTD and VaD were instead significantly recoded. The results

  8. Reversible dementia: The imitation game

    Directory of Open Access Journals (Sweden)

    Venugopalan Y Vishnu

    2016-10-01

    Full Text Available Rapidly progressive dementia (RPD is an emergency in behavioural or cognitive neurology. Many rare neuroinfections like Neurosyphilis may be missed, if they are not thoroughly evaluated. We report a patient with subacute onset and progressive cognitive decline, extrapyramidal involvement and myoclonic jerks who was initially suspected as probable autoimmune encephalitis or Creutzfeldt-Jakob disease (CJD. Investigations revealed positive serum and cerebrospinal fluid (CSF Venereal Disease Research Laboratory test (VDRL. On treatment with penicillin, he developed Jarisch-Herxheimer reaction and was treated symptomatically. After two weeks of penicillin, he improved significantly and except for mild short term memory recall, he is asymptomatic for last two years.

  9. Communicating with people with dementia

    Directory of Open Access Journals (Sweden)

    James McKillop

    2011-12-01

    Full Text Available It can be very difficult to communicate with people with dementia. Each case requires its own unique handling. Not every scenario is covered, as many times your own judgment is what will work, best according to the circumstances. These can change from dawn to evening and from day to day. Never assume things will be the way they were the last time you communicated. Be on your guard. Be adaptable. The article will help get you started to think of your own ways to communicate.

  10. Incidence of early-onset dementia in Mar del Plata.

    Science.gov (United States)

    Sanchez Abraham, M; Scharovsky, D; Romano, L M; Ayala, M; Aleman, A; Sottano, E; Etchepareborda, I; Colla Machado, C; García, M I; Gonorazky, S E

    2015-03-01

    Early-onset dementia (EOD) is defined as dementia with onset before the age of 65 years. EOD is increasingly recognised as an important clinical and social problem with devastating consequences for patients and caregivers. Determine the annual crude incidence rate and the specific incidence rates by sex and age in patients with EOD, and the standardised rate using the last national census of the population of Argentina (NCPA), from 2010. Hospital Privado de Comunidad, Mar del Plata, Argentina, attends a closed population and is the sole healthcare provider for 17 614 people. Using the database pertaining to the Geriatric Care department, we identified all patients diagnosed with EOD between 1 January, 2005 and 31 December, 2011. EOD was defined as dementia diagnosed in patients younger than 65. The study period yielded 14 patients diagnosed with EOD out of a total of 287 patients evaluated for memory concerns. The crude annual incidence of EOD was 11 per 100 000/year (CI 95%: 6.25-19.1): 17 per 100 000 (CI 95%: 7.2-33.1) in men and 8 per 100 000 (CI 95%: 3.4-17.2) in women. We observed a statistically significant increase when comparing incidence rates between patients aged 21 to <55 years and ≥ 55 to <65 years (3 vs 22 per 100 000, P=.0014). The rate adjusted by NCPA census data was 5.8 cases of EOD habitants/year. This study, conducted in a closed population, yielded an EOD incidence rate of 11 per 100 000 inhabitants/year. To the best of our knowledge, this is the first prospective epidemiological study in Argentina and in Latin America. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  11. Dissociation between implicit and explicit manifestations of awareness in early stage dementia: evidence from the emotional Stroop effect for dementia-related words.

    Science.gov (United States)

    Martyr, Anthony; Clare, Linda; Nelis, Sharon M; Roberts, Judith L; Robinson, Julia U; Roth, Ilona; Markova, Ivana S; Woods, Robert T; Whitaker, Christopher J; Morris, Robin G

    2011-01-01

    To determine whether people with dementia (PwD), and carers of PwD, show a processing bias to dementia-related words in an emotional Stroop task, and if so, whether the presence of such a bias is related to level of explicit awareness of the condition. Seventy-nine people with early stage Alzheimer's disease (AD), vascular or mixed dementia, and their carers, completed an emotional Stroop task. Time taken to colour-name dementia-related and neutral words was compared within and between groups. Additionally, as a comparison, ratings of the awareness of the condition shown by PwD were made on the basis of a detailed interview with each PwD and his/her carer. PwD and carers showed the same level of increase in response times to salient compared to neutral words. In the PwD this effect was unrelated to the degree of awareness that they demonstrated regarding the condition. The emotional Stroop effect in response to dementia-related words in PwD indicates that preserved implicit awareness of the condition can be elicited even where there is reduced explicit awareness. Copyright © 2010 John Wiley & Sons, Ltd.

  12. Intercomparison of PERSIANN-CDR and TRMM-3B42V7 precipitation estimates at monthly and daily time scales

    Science.gov (United States)

    Katiraie-Boroujerdy, Pari-Sima; Akbari Asanjan, Ata; Hsu, Kuo-lin; Sorooshian, Soroosh

    2017-09-01

    In the first part of this paper, monthly precipitation data from Precipitation Estimation from Remotely Sensed Information using Artificial Neural Networks-Climate Data Record (PERSIANN-CDR) and Tropical Rainfall Measuring Mission 3B42 algorithm Version 7 (TRMM-3B42V7) are evaluated over Iran using the Generalized Three-Cornered Hat (GTCH) method which is self-sufficient of reference data as input. Climate Data Unit (CRU) is added to the GTCH evaluations as an independent gauge-based dataset thus, the minimum requirement of three datasets for the model is satisfied. To ensure consistency of all datasets, the two satellite products were aggregated to 0.5° spatial resolution, which is the minimum resolution of CRU. The results show that the PERSIANN-CDR has higher Signal to Noise Ratio (SNR) than TRMM-3B42V7 for the monthly rainfall estimation, especially in the northern half of the country. All datasets showed low SNR in the mountainous area of southwestern Iran, as well as the arid parts in the southeast region of the country. Additionally, in order to evaluate the efficacy of PERSIANN-CDR and TRMM-3B42V7 in capturing extreme daily-precipitation amounts, an in-situ rain-gauge dataset collected by the Islamic Republic of the Iran Meteorological Organization (IRIMO) was employed. Given the sparsity of the rain gauges, only 0.25° pixels containing three or more gauges were used for this evaluation. There were 228 such pixels where daily and extreme rainfall from PERSIANN-CDR and TRMM-3B42V7 could be compared. However, TRMM-3B42V7 overestimates most of the intensity indices (correlation coefficients; R between 0.7648-0.8311, Root Mean Square Error; RMSE between 3.29mm/day-21.2mm/5day); PERSIANN-CDR underestimates these extremes (R between 0.6349-0.7791 and RMSE between 3.59mm/day-30.56mm/5day). Both satellite products show higher correlation coefficients and lower RMSEs for the annual mean of consecutive dry spells than wet spells. The results show that TRMM-3B42V7

  13. 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.

  14. Lower risk of incident dementia among Chinese older adults having three servings of vegetables and two servings of fruits a day.

    Science.gov (United States)

    Lee, Allen T C; Richards, Marcus; Chan, Wai C; Chiu, Helen F K; Lee, Ruby S Y; Lam, Linda C W

    2017-09-01

    dietary modification can potentially reduce dementia risk, but the importance of fruits and the amount of vegetables and fruits required for cognitive maintenance are uncertain. We examined whether the minimal daily requirement of vegetables and fruits recommended by the World Health Organization (WHO) would independently lower dementia risk. in this population-based observational study, we examined the diet of 17,700 community-living dementia-free Chinese older adults who attended the Elderly Health Centres in Hong Kong at baseline and followed their cognitive status for 6 years. In line with the WHO recommendation, we defined the cutoff for minimal intake of vegetables and fruits as at least three and two servings per day, respectively. The study outcome was incident dementia in 6 years. Dementia was defined by presence of clinical dementia in accordance with the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) or Clinical Dementia Rating of 1-3. multivariable logistic regression analysis showed that the estimated odds ratios for incident dementia were 0.88 (95% confidence interval 0.73-1.06; P = 0.17) for those consuming at least three servings of vegetables per day, 0.86 (0.74-0.99; P dementia in older adults. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

  15. A Climate-Data Record (CDR) of the "Clear Sky" Surface Temperature of the Greenland Ice Sheet

    Science.gov (United States)

    Hall, Dorothy K.; Comiso, J. C.; DiGirolamo, N. E.; Shuman, C. A.

    2011-01-01

    To quantify the ice-surface temperature (IST) we are developing a climate-data record (CDR) of monthly IST of the Greenland ice sheet, from 1982 to the present using Advanced Very High Resolution Radiometer (AVHRR) and Moderate-Resolution Imaging Spectroradiometer (MODIS) data at 5-km resolution. "Clear-sky" surface temperature increases have been measured from the early 1980s to the early 2000s in the Arctic using AVHRR data, showing increases ranging from 0.57-0.02 (Wang and Key, 2005) to 0.72 0.10 deg C per decade (Comiso, 2006). Arctic warming has implications for ice-sheet mass balance because much of the periphery of the ice sheet is near 0 deg C in the melt season and is thus vulnerable to more extensive melting (Hanna et al., 2008). The algorithm used for this work has a long history of measuring IST in the Arctic with AVHRR (Key and Haefliger, 1992). The data are currently available from 1981 to 2004 in the AVHRR Polar Pathfinder (APP) dataset (Fowler et al., 2000). J. Key1NOAA modified the AVHRR algorithm for use with MODIS (Hall et al., 2004). The MODIS algorithm is now being processed over Greenland. Issues being addressed in the production of the CDR are: time-series bias caused by cloud cover, and cross-calibration between AVHRR and MODIS instruments. Because of uncertainties, time series of satellite ISTs do not necessarily correspond with actual surface temperatures. The CDR will be validated by comparing results with in-situ (see Koenig and Hall, in press) and automatic-weather station data (e.g., Shuman et al., 2001).

  16. Open dementia project: Empathic tools between magic and everyday life

    OpenAIRE

    Lee, Yanki; Hendriks, Niels; Tsang, Albert

    2017-01-01

    In Chinese society like in many cultures, persons with dementia suffer some level of stigmatisation. For this reason a dementia research/care centre in Hong Kong (China) initiated the design of the “dementia experience tool”. Its main goal is to create public understanding through inviting the general public to experience dementia. The dementia research/care centre commissioned a social design research lab team (two of the authors are part of this) to create the tool, sta...

  17. Use of Tablet Devices in the Management of Agitation Among Inpatients with Dementia: An Open-Label Study.

    Science.gov (United States)

    Vahia, Ipsit V; Kamat, Rujvi; Vang, Cheng; Posada, Carolina; Ross, Lisa; Oreck, Sarah; Bhatt, Alok; Depp, Colin; Jeste, Dilip V; Sewell, Daniel D

    2017-08-01

    To investigate the feasibility, safety, and utility of tablet devices as novel nonpharmacologic tools in managing older psychiatric inpatients with agitation and dementia. Thirty-six patients at a geriatric psychiatry inpatient unit were provided with tablets when agitated and used various apps on the tablet related to communication, games, music, web browser, and photography during their stay. Study staff documented the frequency, duration, and app usage history and rated the extent to which agitation improved after tablet use. All participants, regardless of dementia severity, were able to use apps and were rated by staff to have clinical benefit. Dementia severity was negatively associated with app complexity. Age was negatively associated with frequency and duration of tablet use. Tablet use as a nonpharmacologic intervention for agitation in older adults, including those with severe dementia, appears to be feasible, safe, and of potential utility. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  18. 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.)

  19. Dementia, Decision Making, and Capacity.

    Science.gov (United States)

    Darby, R Ryan; Dickerson, Bradford C

    After participating in this activity, learners should be better able to:• Assess the neuropsychological literature on decision making and the medical and legal assessment of capacity in patients with dementia• Identify the limitations of integrating findings from decision-making research into capacity assessments for patients with dementia ABSTRACT: Medical and legal professionals face the challenge of assessing capacity and competency to make medical, legal, and financial decisions in dementia patients with impaired decision making. While such assessments have classically focused on the capacity for complex reasoning and executive functions, research in decision making has revealed that motivational and metacognitive processes are also important. We first briefly review the neuropsychological literature on decision making and on the medical and legal assessment of capacity. Next, we discuss the limitations of integrating findings from decision-making research into capacity assessments, including the group-to-individual inference problem, the unclear role of neuroimaging in capacity assessments, and the lack of capacity measures that integrate important facets of decision making. Finally, we present several case examples where we attempt to demonstrate the potential benefits and important limitations of using decision-making research to aid in capacity determinations.

  20. Cushing's Syndrome and Steroid Dementia.

    Science.gov (United States)

    Bernini, Giampaolo; Tricò, Domenico

    2016-01-01

    Cushing's Syndrome (CS) is associated with a specific spectrum of dementia-like symptoms, including psychiatric disorders, such as major depression, anxiety and mania, and neurocognitive alterations, like impairment of memory and concentration. This pattern of clinical complications, which significantly impair the health-related quality of life of CS patients, is sometimes referred to as "steroid dementia syndrome" (SDS). The SDS is the result of anatomical and functional anomalies in brain areas involved in the processing of emotion and cognition, which are only partially restored after the biochemical remission of the disease. Therefore, periodical neuropsychiatric evaluations are recommended in all CS patients, and a long-term follow-up is required after normalization of hypercortisolism. Recent evidences demonstrate that three classes of drugs (glucocorticoid receptor antagonists, steroidogenesis inhibitors, and pituitary tumor-targeted drugs), which are used for medical treatment of CS, can rapidly relief neuropsychiatric symptoms of SDS. Furthermore, several psychoactive medications have demonstrated effectiveness in the treatment of symptoms induced by the acute or chronic glucocosteroid administration. In this paper, a review of the current and future patents for the treatment and prevention of CS and SDS will be presented.