August 25, 2017
American Journal of Alzheimer’s Disease & Other Dementias,
Volume 32, Issue 5, August 2017
Table of Contents
Current Topics in Care
Predictors of Desire to Institutionalization in Dementia Caregivers From a Developing Country
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.
; pp. 245–251
Current Topics in Research
Prevalence of Dementia, Depression, and Mild Cognitive Impairment in a Rural Area of the Island of Crete, Greece
The studies on the prevalence of dementia, depression, and mild cognitive impairment (MCI) in Greece are sparse and show major variations of prevalence depending on geographical areas, nutritional habits, and the way of living. The aim of this door-to-door study was to find the prevalence of dementia, depression, and MCI in a rural Greek population. Four hundred and forty-three individuals older than 61years following the application of specific criteria were diagnosed with: normal cognition, depression, MCI with and without depression, and dementia with and without depression. Four diagnostic methods were used, 2 of which included Mungas correction for age and education. After Mungas adjustment, the results were as follows—depression: 33.9%; MCI: 15.3%; MCI with depression: 8.6%; dementia: 2.0%; and dementia with depression: 7.2%. Dementia is less prevalent compared to global data and other Greek areas. Mild cognitive impairment is more prevalent than dementia. High percentages of depression may be related to low education.
; pp. 252–264
Rethinking Psychosis in Dementia: An Analysis of Antecedents and Explanations
An in-depth analysis of qualitative data regarding antecedents, consequences, and descriptions of delusions of persons with dementia (PwD) provided by family caregivers is presented. Three broad classifications of reasons given behind types of delusions are included, namely environmental factors, personal factors, and dementia, with dementia being the most prominent factor. We observed an overlap between known cognitive symptoms of dementia and the characteristics of the reported “delusions” in dementia. It therefore appears that what is often classified as a delusion of a seemingly psychotic nature is in fact the PwD’s disorientation combined with an attempt to fill in gaps caused by cognitive deficiencies.
; pp. 265–271
Indoor Air Temperature and Agitation of Nursing Home Residents With Dementia
This study aimed to determine the specific correlation between indoor air temperature and agitation of nursing home residents with dementia. Agitated behaviours of 21 residents, living in 1 nursing home, were assessed for a 10-month period using the Cohen-Mansfield Agitation Inventory (CMAI). The CMAI Total Frequency scores were found to increase significantly when indoor average temperatures deviated from 22.6°C. In addition, cumulative exposure to temperatures higher than 26°C and lower than 20°C was linearly correlated with CMAI Total Frequency scores. Results showed that agitated behaviours not only affected the person manifesting them but were found to be disruptive for other residents and the delivery of care. Agitation can, therefore, be potentially reduced by limiting the range of indoor air temperature variations, and aged care providers should ensure that a thermally comfortable environment is provided in nursing homes to enhance comfort and well-being of all occupants.
; pp. 272–281
Score Disparity Between the MMSE and the SLUMS
Ann B. Yoelin
Multiple brief cognitive instruments are available to assess cognitive impairment in older adults. However, not all instruments demonstrate the same effectiveness when utilized with higher educated adults. This study evaluates the score disparity between the Mini-Mental State Examination (MMSE) and the St. Louis University Mental Status (SLUMS) Examination across the education spectrum. It was hypothesized that individuals with more years of formal education would produce higher scores on both the MMSE and SLUMS. Previous research was conducted to create a conversion scale used to compare and convert the MMSE scores to SLUMS scores. This research study provides additional data to add to the body of knowledge regarding a conversion scale for the MMSE and SLUMS.
Other factors besides education may impact the performance of older adults on the MMSE and SLUMS, but it does appear that education level may moderate the score disparity between the 2 instruments. Additional studies are needed before using the MMSE to predict the score on the SLUMS and vice versa.
; pp. 282–288
The Influence of Psychosocial and Cognitive Factors on Perceived Threat of Alzheimer’s Disease
Jenny E. Ostergren
This study explored psychosocial and cognitive predictors of perceived threat of Alzheimer’s disease (AD). Respondents were 1641 adults (mean age: 64.4; 54% female; 82% white) who completed a module in the Health and Retirement Study, a nationally representative survey of adults aged ≥50. Findings show that perceived threat was significantly higher for those aged 50 to 64 (P < .001) and 65 to 74 (P < .05) than for those ≥75.
Respondents with a family history of AD had significantly greater perceived threat (P < .001) than those with no experience.
Stronger endorsement of the beliefs that stress (P < .01) or genetics (P < .01) are important AD risk factors was significantly associated with greater perceived threat, as was having more depressive symptoms (P < .01), poorer self-rated memory (P < .01), and lower cognitive function (P < .01). Personal experience moderated the relationship between perceived threat and 2 variables: age and self-rated memory. Understanding perceived AD threat may inform practice and policies centered on early and accurate diagnosis.
; pp. 289–299
Frontal Tasks and Behaviour in Rigid or Tremor-Dominant Parkinson Disease
Parkinson disease (PD) is not an unambiguous entity, and there is a general consensus for the statement that an akinetic-rigid dominant type of presentation has a worse prognosis, in the follow-up. The aim of our study was to examine the differences in frontal tasks and behavior, in 2 PD naive groups: the rigid and the tremor-dominant types of presentation, according to motor scores. Our study has showed some important differences in frontal tasks and in behavior, performing more apathy, aggressiveness, and irritability in the rigid type, and more depression and anxiety in the tremor-dominant type. The former group causes the caregiver more distress and has a very rapid disease progression. It can be argued that rigid type PD presentation needs specific dedicated cares and more strong clinical attention.
; pp. 300–306