May 24, 2017

American Journal of Alzheimer's Disease & Other Dementias

Topics include:

  • Impact of Dysphagia on Hospital Outcomes Among Patients With Dementia

  • Help  for Care Providers Communicate More Effectively With Persons Having Dementia Living in Long-Term Care Homes

  • Living Alone With Cognitive Impairment -Findings From the National Health and Aging Trends Study

  • A Novel Audiovisual Care Consultation for Caregivers

  • Marital Status and Persons With Dementia in Assisted Living -An Exploration of Length of Stay

  • Relationship Between “What We Believe” and “How We Care” Among Daughters Caring for a Parent With Dementia .. daughters’ belief that their parent can control dementia-related symptoms was associated with more relationship conflict - Educating caregivers about parental behaviors and examining factors underlying caregiver interpretations of these behaviors hold promise for reducing caregiver stress.

  • Tool for Screening Visual Acuity in Older Individuals With Dementia

  • Roles of Communication Problems and Communication Strategies on Resident-Related Role Demand and Role Satisfaction


To receive the full text of this article please email nsw.library@alzheimers.org.au
Kind regards Michelle


Table of Contents
Volume 32, Issue 1,
Current Topics in Research

A Nationwide Study of the Impact of Dysphagia on Hospital Outcomes Among Patients With Dementia
Suchitra Paranji et al.
Objectives:
To assess the impact of dysphagia on clinical and operational outcomes in hospitalized patients with dementia.
Conclusion:
Dysphagia is a significant predictor of worse clinical and operational outcomes including a 38% longer LOS and a 30% increase in charge per case among hospitalized patients with dementia. Although these findings may not be surprising, this new evidence might bring heightened awareness for the need to more thoughtfully support patients with dementia and dysphagia who are hospitalized.
Keywords  dementia, dysphagia, resource utilization, NIS, cost
pp. 12–21


Precuneus Structure Changes in Amnestic Mild Cognitive Impairment
Robert Haussmann et al
The d-mannuronic acid (M2000) is a novel nonsteroidal anti-inflammatory drug that has immunosuppressive effects together with antioxidant property. M2000 has shown a notable efficacy in experimental models of multiple sclerosis, rheumatoid arthritis, and nephrotic syndrome. In this work, the effect of M2000 on the treatment of Alzheimer’s disease (AD) was performed by Morris water maze experiment, and the immunological assessments were carried out by Western blot, apoptosis (procaspase-3, Bax/Bcl2, P53), enzymatic (superoxide dismutase [SOD]), and nonenzymatic oxidative stress (malondialdehyde [MDA]) tests. We found that pretreatment of AD in the rat model by M2000 had a potent efficacy on rat behavior and also it led to a significant inhibition of amyloid plaque production. Moreover, our data showed that M2000 can reduce the amount of Bax/Bcl2, P53, MDA, and SOD, as well as it normalized the level of procaspase-3. Our results suggest M2000 is a potential therapeutic agent for the treatment of AD.
; pp. 22–26

Association of GWAS Top Genes With Late-Onset Alzheimer’s Disease in Colombian Population
Diana Jennifer Moreno et al.
Patients with amnestic mild cognitive impairment (aMCI) are at risk for developing Alzheimer’s disease. Due to their prominent memory impairment, structural magnetic resonance imaging (MRI) often focuses on the hippocampal region. However, recent positron-emission tomography data suggest that within a network of frontal and temporal changes, patients with aMCI show metabolic alterations in the precuneus, a key region for higher cognitive functions. Using high-resolution MRI and whole-brain cortical thickness analyses in 28 patients with aMCI and 25 healthy individuals, we wanted to investigate whether structural changes in the precuneus would be associated with cortical thickness reductions in frontal and temporal brain regions in patients with aMCI. In contrast to healthy people, patients with aMCI showed an association of cortical thinning in the precuneus with predominantly left-hemispheric thickness reductions in medial temporal and frontal cortices. Our data highlight structural neuronal network characteristics among patients with aMCI.
Keywords  mild cognitive impairment, structural MRI, precuneus, cortical thickness
; pp. 27–35

Validity of the Georgian Montreal Cognitive Assessment for the Screening of Mild Cognitive Impairment and Dementia
Marina Janelidze et al.
Montreal Cognitive Assessment (MoCA) test has been shown to be a reliable tool to detect mild cognitive impairment (MCI), however, no Georgian language version exists. The goal of this study is to determine the validity, reliability, and accuracy of Georgian version of MoCA in the evaluation of amnestic MCI (aMCI) and Alzheimer’s disease (AD). Montreal Cognitive Assessment was translated into Georgian language and was administered to healthy participants (HP) and patients with aMCI and AD. We studied 46 HS, 20 patients with aMCI, and 20 patients with AD. There was significant difference in MoCA scores between HP, patients with aMCI, and patients with AD (P = 0.04). The area under the receiver operating characteristic curve for the aMCI and AD groups by MoCA was 0.88 and 0.95, respectively, compared to 0.43 and 0.67 by Mini-Mental State Examination (MMSE). The Georgian version of MoCA is a valid, reliable, and sensitive screening tool to detect aMCI and AD in Georgian-speaking population and is superior to MMSE.
; pp. 36–40

Can We Help Care Providers Communicate More Effectively With Persons Having Dementia Living in Long-Term Care Homes?
Katherine S. McGilton et al.
Background:

Effective communication between residents with dementia and care providers in long-term care homes (LTCHs) is essential to resident-centered care.
Purpose:
To determine the effects of a communication intervention on residents’ quality of life (QOL) and care, as well as care providers’ perceived knowledge, mood, and burden.
Method:
The intervention included (1) individualized communication plans, (2) a dementia care workshop, and (3) a care provider support system. Pre- and postintervention scores were compared to evaluate the effects of the intervention. A total of 12 residents and 20 care providers in an LTCH participated in the feasibility study.
Results:
The rate of care providers’ adherence to the communication plans was 91%. Postintervention, residents experienced a significant increase in overall QOL. Care providers had significant improvement in mood and perceived reduced burden.
Conclusion:
The results suggest that the communication intervention demonstrates preliminary evidence of positive effects on residents’ QOL and care providers’ mood and burden.; pp. 41–50
Urinary Incontinence in Alzheimer’s Disease - A Population-Based Cohort Study in Taiwan
Hsiang-Ying Lee et al.
Objectives:
Urinary incontinence (UI) is more prevalent in the elderly populations with dementia than without dementia, and Alzheimer’s disease (AD) is the most common cause of dementia. Urinary incontinence may complicate AD morbidity and mortality. Therefore, this study aimed to evaluate the prevalence and annual incidence and determine the risk possibility of UI, which is the main type of incontinence in patients with AD in Taiwan.
Conclusion:
The present results suggest that the risk of UI is higher in patients with AD than in the general population.
pp. 51–55

Current Topics in Care

Living Alone With Cognitive Impairment -Findings From the National Health and Aging Trends Study
Allison K. Gibson et al.
Although most individuals experiencing cognitive impairment (CI) reside with a caregiver, an estimated 800,000 live alone. Such individuals may have an increased risk for injury to self or others through self-neglect as a result of the CI symptoms. While persons living alone with CI have been identified as an important area for needed research, few studies have been able to examine this population due to the challenges of identifying and recruiting study participants. By using the National Health & Aging Trends Study data set, the researchers explored the characteristics to describe this population. The results of this study indicated that the majority of persons living with CI were older, widowed females who were not diagnosed with Alzheimer’s or dementia but tested positive on cognitive screening measures. Further, the majority of persons living alone with CI relied on adult children and paid professionals as the primary care providers.
; pp. 56–62

A Novel Audiovisual Care Consultation for Caregivers
Babak Tousi et al.
Currently, there is not enough time or staff in the physician’s office to provide education about Alzheimer’s disease for newly diagnosed patients and their family members. The Alzheimer’s Association Cleveland Area Chapter has implemented a novel approach for individuals to connect to helpful information about Alzheimer’s disease and related dementias while at the physician’s office. This project is being piloted at two memory assessment clinics of The Cleveland Clinic as a way to give assessment center staff the opportunity to connect families right away with the free support services available at the Association.
; pp. 63–66

 
VOLUME 32, ISSUE 2,

 TABLE OF CONTENTS

Current Topics in Research

In Vivo Effect of a 5-HT7 Receptor Agonist on 5-HT Neurons and GABA Interneurons in the Dorsal Raphe Nuclei of Sham and PD Rats - An Electrophysiological Study
Shuang Wang et al.
The 5-hydroxytryptamine (5-HT; serotonin) neurotransmission is severely affected by the degeneration of nigrostriatal dopaminergic neurons. Here, we report the effects of the systemic administration of the 5-HT7 receptor agonist AS-19. In sham rats, the mean response of the 5-HT neurons in the dorsal raphe nucleus (DRN) to systemic AS-19 was excitatory and the mean response of the γ-aminobutyric acid (GABA) interneurons was inhibitory. In Parkinson disease (PD) rats, the same dose did not affect the 5-HT neurons and only high doses (640 μg/kg intravenous) were able to the increase GABA interneuron activity. These results indicate that DRN 5-HT neurons and GABA interneurons are regulated by the activation of 5-HT7 receptors and that the degeneration of the nigrostriatal pathway leads to decreased responses of these neurons to AS-19, which in turn suggests that the 5-HT7 receptors on 5-HT neurons and GABA interneurons in PD rats are dysfunctional and downregulated.
pp. 73–81

Marital Status and Persons With Dementia in Assisted Living -An Exploration of Length of Stay
Noelle L. Fields et al.
Despite the prevalence of dementia among residents in assisted living (AL), few researchers have focused on the length of stay (LOS) in AL among this population. Little is known about the factors that may contribute to LOS in these settings, particularly for residents with dementia. In the current study, a sub-set of AL residents with dementia (n = 112) was utilized to examine whether marital status was associated with LOS in AL as this has received sparse attention in previous research despite studies suggesting that marital status influences LOS in other health-care and long-term care settings.
The Andersen-Newman behavioral model was used as a conceptual framework for the basis of this study of LOS, marital status, and dementia in AL. We hypothesized that persons with dementia who were married would have longer LOS than unmarried persons with dementia in AL. Cox regression was used to examine the association between marital status and LOS in AL of residents with dementia and whether activities of daily living were related to discharge from AL settings among married and unmarried residents with dementia. Main effects for marital status and the interaction between marital status and mobility with LOS were examined. Study findings provide information related to the psychosocial needs of AL residents with dementia and offer implications for assessing the on-going needs of vulnerable AL residents.
; pp. 82–89

The Relationship Between “What We Believe” and “How We Care” Among Daughters Caring for a Parent With Dementia
Cory K. Chen et al.
This study attempted to better understand factors associated with relationship conflict between daughters and their parents with dementia. We examined data from 77 daughters self-identified as primary caregivers of a parent with dementia to test the hypothesis that daughters’ belief that a parent with dementia can control their symptoms is associated with more conflict, defined as high expressed emotion (EE). Participants completed self-report questionnaires assessing beliefs about parents’ ability to control symptoms, stress, relationship conflict, parent agitation, and cognitive status. Results indicated that greater intensity of daughters’ belief that their parent can control dementia-related symptoms was associated with more relationship conflict or “high EE” (β = 0.57, P < .001). Daughters’ beliefs about parental behavior may contribute to caregiver stress and exacerbate negative behaviors exhibited by individuals with dementia. Educating caregivers about parental behaviors and examining factors underlying caregiver interpretations of these behaviors hold promise for reducing caregiver stress.
; pp. 90–95

Tool for Screening Visual Acuity in Older Individuals With Dementia
Hélène Kergoat et al.
Rationale/Objective:
To develop a screening and referral algorithm tool to help identify which older institutionalized individuals with dementia need an eye examination.
Methods:
The visual acuity (VA) screening test was developed on an iPad retina display. Three optotypes were used (letters, numbers, and tumbling E’s) to determine whether one works best with dementia. The screening VA results and algorithm decision were validated against those obtained by an optometrist performing a complete eye examination.
Conclusion:
The results indicate that the tool was successful at identifying older individuals with dementia needing an eye examination.
; pp. 96–100

Diagnostic Validity Comparison Between Criteria Based on CSF Alzheimer’s Disease Biomarkers
Maria Empar Blanco-Cantó et al.
Aim:
To compare the diagnostic validity of NIA-AA criteria, for AD CSF biomarkers, with our own new criteria.
Conclusion:
The inclusion of the ratios in diagnostic criteria increases sensitivity and NPV for the diagnosis of MCI due to AD.
; pp. 101–107
A Path Analysis of Dependence and Quality of Life in Alzheimer’s Disease
Josep Garre-Olmo et al.
Objective:
To determine the direct and indirect relationships of cognitive, functional, and behavioral factors and other medical comorbidities with the quality of life (QoL) of patients with Alzheimer’s disease (AD) according to the theoretical model of dependence.
Conclusion:
Direct and indirect effects exist between clinical indicators, dependence, and QoL.
; pp. 108–115

Roles of Communication Problems and Communication Strategies on Resident-Related Role Demand and Role Satisfaction
Marie Y. Savundranayagam et al.
This study investigated the impact of dementia-related communication difficulties and communication strategies used by staff on resident-related indicators of role demand and role satisfaction. Formal/paid long-term care staff caregivers (N = 109) of residents with dementia completed questionnaires on dementia-related communication difficulties, communication strategies, role demand (ie, residents make unreasonable demands), and role satisfaction (measured by relationship closeness and influence over residents). Three types of communication strategies were included: (a) effective repair strategies, (b) completing actions by oneself, and (c) tuning out or ignoring the resident. Analyses using structural equation modeling revealed that communication problems were positively linked with role demand. Repair strategies were positively linked with relationship closeness and influence over residents. Completing actions by oneself was positively linked to role demand and influence over residents, whereas tuning out was negatively linked with influence over residents. The findings underscore that effective caregiver communication skills are essential in enhancing staff–resident relationships
pp. 116–122


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