Full text articles and books are available to members of Alzheimer’s Australia NSW by emailing NSW.Library@alzheimers.org.au
American Journal of
Alzheimer's Disease & Other Dementias
Current Issue : Volume
31, Issue 8, December 2016
Table of Contents
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Errorless learning (EL) is an instructional
procedure involving error reduction during learning. Errorless learning is mostly
examined by counting correctly executed task steps or by rating them using a
Task Performance Scale (TPS).
Here, we explore the validity and reliability of a
new assessment procedure, the core elements method (CEM), which rates
essential building blocks of activities rather than individual steps.
Task performance was assessed in 35 patients with
Alzheimer’s dementia recruited from the Relearning methods on Daily Living
task performance of persons with Dementia (REDALI-DEM) study using TPS and
CEM independently.
Results showed excellent interrater reliabilities
for both measure methods (CEM: intraclass coefficient [ICC] = .85; TPS: ICC =
.97). Also, both methods showed a high agreement (CEM: mean of measurement
difference [MD] = −3.44, standard deviation [SD] = 14.72; TPS: MD = −0.41, SD
= 7.89) and correlated highly (>.75). Based on these results, TPS and CEM
are both valid for assessing task performance. However, since TPS is more
complicated and time consuming, CEM may be the preferred method for future
research projects
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We aimed to confirm the effectiveness of brain-activating
rehabilitation (BAR) performed in the day care setting at an acute hospital.
Brain-activating rehabilitation is based on 5 principles: developing a
pleasant atmosphere, promoting communication, praising patients, giving
patients a social role, and providing supportive care. A total of 48 patients
with dementia or cognitive impairment were selected and randomly divided into
the intervention and control groups. The BAR-based intervention was conducted
for 1 hour, 3 times a week. The patients’ score of the Multidimensional
Observation Scale for Elderly Subjects (MOSES) were used as outcome measures.
Repeated-measures analysis of covariance detected a significant interaction
between the MOSES disorientation (F = 4.437, P = .041) and the withdrawal (F
= 5.052, P = .030) subscales. A BAR-based intervention performed at our acute
hospital was effective at maintaining and improving the cognitive and
psychosocial functioning of patients with dementia or cognitive impairment.
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2016; pp. 618–630
Spatial navigation is one of the cognitive functions known
to decline in both normal and pathological aging. In the present study, we
aimed to assess the neural correlates of the decline of topographical memory
in patients with amnestic mild cognitive impairment (aMCI). Patients with
aMCI and age-matched controls were engaged in an intensive learning paradigm,
lasting for 5 days, during which they had to encode 1 path from an egocentric
perspective and 1 path from an allocentric perspective. After the learning
period, they were asked to retrieve each of these paths using an allocentric
or egocentric frame of reference while undergoing a functional magnetic
resonance imaging scan. We found that patients with aMCI showed a specific
deficit in storing new topographical memories from an allocentric perspective
and retrieving stored information to perform the egocentric task. Imaging
data suggest that this general decline is correlated with hypoactivation of
the brain areas generally involved in spatial navigation.
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2016; pp. 631–642
This study tested the effect of written
emotional expression on the ability to find meaning in caregiving and the
effects of finding meaning on emotional state and psychological burden in 91
dementia family caregivers. In a pretest–posttest design, participants were
randomly assigned to either an experimental or a comparison group.
Experimental caregivers (n = 57) wrote about their deepest thoughts and
feelings about caring for a family member with dementia, whereas those in the
comparison group (n = 34) wrote about nonemotional topics. Results showed
enhanced meaning-making abilities in experimental participants relative to
comparison participants, particularly for those who used more positive
emotion words. Improved meaning-making ability was in turn associated with
psychological benefits at posttest, but experimental participants did not
show significantly more benefit than comparison participants. We explore the
mediating roles of the meaning-making process as well as some of the background
characteristics of the individual caregivers and their caregiving
environments.
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2016; pp. 643–649
To determine the predictors of cognitive decline in a
rural and remote population with Alzheimer’s disease (AD), we examined the
association between cognitive change and sociodemographic, clinical, and
functional data at the initial day of diagnosis. Simple linear regression
analysis and multiple regression analysis were used to determine the
predictors of cognitive decline as measured by the difference in the
Mini-Mental State Examination over 1 year. Our sample included 72 patients
with AD. Age at the clinic day appointment was 75.3 (standard deviation [SD]
= 7.44). History of hypertension and decreased ability to carry out
activities of daily living were statistically significant and predicted
greater cognitive decline at 1 year. Many previously suggested predictors of
cognitive decline were not evidenced in this study. This research helps
identify clinically useful predictors of decline in a rural and remote
population with AD.
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2016; pp. 650–657
To explore the optimal cutoff score for initial
detection of Alzheimer’s Disease (AD) through the Chinese version of
Mini-Mental State Examination (CMMSE) in rural areas in China, we conducted a
cross-sectional study within the Linxian General Population Nutritional
Follow-up study. 16,488 eligible cohort members participated in the survey
and 881 completed the CMMSE. Among 881 participants, the median age
(Interquartile range) was 69.00 (10.00), 634 (71.92%) were female, 657
(74.57%) were illiterate, 35 (3.97%) had 6 years of education or higher, and
295 (33.48%) were diagnosed with AD. By reducing the CMMSE criteria for
illiterate to 16 points, primary school to 19 points, and middle school or
higher to 23 points, the efficiency of Chinese version of Mini-Mental State
Examination can be significantly improved for initial detection of AD in
rural areas in China, especially in those nutrition deficient areas.
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2016; pp. 658–663
We sought to investigate whether the Montreal Cognitive
Assessment (MoCA) could provide a brief assessment of recall and recognition
using Huntington disease (HD) and Alzheimer disease (AD) as disorders
characterized by different memory deficits. This study included 80
participants with HD, 64 participants with AD, and 183 community-dwelling
control participants. Random-effects hierarchical logistic regressions were
performed to assess the relative performance of the normal control (NC),
participants with HD, and participants with AD on verbal free recall, cued
recall, and multiple-choice recognition on the MoCA. The NC participants
performed significantly better than participants with AD at all the 3 levels
of assessment. No difference existed between participants with HD and NC for
cued recall, but NC participants performed significantly better than
participants with HD on free recall and recognition. The participants with HD
performed significantly better than participants with AD at all the 3 levels
of assessment. The MoCA appears to be a valuable, brief cognitive assessment
capable of identifying specific memory deficits consistent with known
differences in memory profiles.
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Education is needed for enhanced capacity of acute
hospitals to provide dementia care. A nonrandomized controlled,
repeated-measures design was used to evaluate a dementia education program
delivered to an intervention group (IG, n = 468), compared to a wait-listed
group (n = 277), representing separate sites of a multisite hospital.
Participants completed self-efficacy for dementia and satisfaction measures and
provided written descriptions of dementia care collected at baseline,
postintervention (IG only), and at 8-week follow-up. Oral narratives were
gathered from IG participants 8 weeks postintervention. The IG demonstrated
significant improvement in self-efficacy scores from baseline to immediately
postintervention (P < .001), sustained at 8 weeks. There were no
changes from baseline to 8 weeks postintervention evident in the wait-listed
group (P = .21). Intervention group participants described positive
impacts including implementation of person-centered care approaches.
Implementation of dementia care education programs throughout hospital settings
is promising for the enhancement of dementia care.
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2016; pp. 678–686
Objective:
This
study evaluated the risk of cognitive decline associated with paroxetine use
in elderly nursing home patients with depression.
There
was no differential effect of paroxetine on cognition when compared to other
SSRIs.
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2016; pp. 687–692
The purpose of the project, Centers for Medicare
& Medicaid Services (CMS) Innovation study, was to evaluate the impact on
12 quality measures including 10 Minimum Data Set (MDS) publicly reported
measures and 2 nursing home process measures using habilitation therapy
techniques and a behavior team to manage dementia-related behaviors. A
prospective design was used to assess the changes in the measures. A total of
30 Massachusetts nursing homes participated in the project over a 12-month
period. Project participation required the creation of an interdisciplinary
behavior team, habilitation therapy training, facility visit by the program
coordinator, attendance at bimonthly support and sharing calls, and monthly
collection of process measure data. Participating facilities showed
improvement in 9 of the 12 reported measures. Findings indicate potential
quality improvement in having nursing homes learn habilitation therapy
techniques and know how to use the interdisciplinary team to manage problem
behaviors
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Janet
Sansoni (1Australian Health
Services Research Institute, University of Wollongong, Wollongong, New South
Wales, Australia)
Cathy Duncan (1Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia) Pamela Grootemaat (1Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia)
Jacquelin
Capell (1Australian Health Services Research Institute, University
of Wollongong, Wollongong, New South Wales, Australia)
Peter Samsa
(1Australian Health Services Research Institute, University of Wollongong,
Wollongong, New South Wales, Australia)
Anita
Westera ( 1Australian Health Services Research Institute,
University of Wollongong, Wollongong, New South Wales, Australia
2016; pp. 693–705
This literature review focused on the experience, care,
and service requirements of people with younger onset dementia. Systematic
searches of 10 relevant bibliographic databases and a rigorous examination of
the literature from nonacademic sources were undertaken. Searches identified
304 articles assessed for relevance and level of evidence, of which 74% were
academic literature. The review identified the need for (1) more timely and
accurate diagnosis and increased support immediately following diagnosis; (2)
more individually tailored services addressing life cycle issues; (3)
examination of the service needs of those living alone; (4) more systematic
evaluation of services and programs; (5) further examination of service
utilization, costs of illness, and cost effectiveness; and (6) current
Australian clinical surveys to estimate prevalence, incidence, and survival
rates. Although previous research has identified important service issues,
there is a need for further studies with stronger research designs and consideration
of the control of potentially confounding factors.
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2016; pp. 706–716
Background:
Eating
problems and dietary changes have been reported in patients with dementia.
Objectives:
The aim
of this article is to explore the generalized problems with nutrition, diet,
feeding, and eating reported among patients with dementia.
Methods:
Medline
and Google Scholar searches were conducted for relevant articles, chapters,
and books published before 2016. Search terms used included behavioral and
psychological symptoms of dementia, dementia, dietary changes, eating
behavior. Publications found through this indexed search were reviewed for
further relevant references.
Results:
Abnormal
eating behaviors, eating problems, and dietary changes are present in most
people with dementia, especially in the later stages of the condition.
Individuals
with dementia frequently develop serious feeding difficulties and changes in
eating and dietary habits. The changes may be secondary to cognitive
impairment or apraxia, or the result of insufficient caregiving, or the
consequence of metabolic or neurochemical abnormalities occurring as part of
the dementing process.
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