Aspects Of Dementia Research Articles

To What Extent Does Computational Modeling Help Understanding Dementia?

Dementia refers to a set of neurodegenerative illnesses defined by a decline in cognitive functions, such as thinking, reasoning, memory recall, and the ability to carry out daily tasks. In recent years, there have been significant advancements in dementia research. However, many aspects of dementia, including its underlying etiology, remain unknown. Thus, it is critical to use new approaches and technologies to uncover unresolved issues about these diseases. Computational modeling is used in various scientific, engineering, and problem-solving disciplines to simulate and study complex systems or events using computer algorithms and mathematical equations. It entails developing a simplified model of a real-world system to acquire insights, make predictions, test hypotheses, and optimize operations. This paper discusses recent case studies and computational models to understand how computational modeling can aid in uncovering the characteristics of visual hallucinations related to Lewy body dementia and the etiology of Alzheimer’s disease.

Grey matter networks in women and men with dementia with Lewy bodies

Sex differences permeate many aspects of dementia with Lewy bodies (DLB), yet sex differences in patterns of neurodegeneration in DLB remain largely unexplored. Here, we test whether grey matter networks differ between sexes in DLB and compare these findings to sex differences in healthy controls. In this cross-sectional study, we analysed clinical and neuroimaging data of patients with DLB and cognitively healthy controls matched for age and sex. Grey matter networks were constructed by pairwise correlations between 58 regional volumes after correction for age, intracranial volume, and centre. Network properties were compared between sexes and diagnostic groups. Additional analyses were conducted on w-scored data to identify DLB-specific sex differences. Data from 119 (68.7 ± 8.4 years) men and 45 women (69.9 ± 9.1 years) with DLB, and 164 healthy controls were included in this study. Networks of men had a lower nodal strength compared to women. In comparison to healthy women, the grey matter networks of healthy men showed a higher global efficiency, modularity, and fewer modules. None of the network measures showed significant sex differences in DLB. Comparing DLB patients with healthy controls revealed global differences in women and more local differences in men. Modular analyses showed a more distinct demarcation between cortical and subcortical regions in men compared with women. While topologies of grey matter networks differed between sexes in healthy controls, those sex differences were diluted in DLB patients. These findings suggest a disease-driven convergence of neurodegenerative patterns in women and men with DLB, which may inform precision medicine in DLB.

Killer, Thief or Companion? A Corpus-Based Study of Dementia Metaphors in UK Tabloids

ABSTRACT This article examines the metaphors that are used to represent dementia in British tabloid newspapers over a ten-year period (2010–2019). The analysis takes a corpus-based approach to metaphor identification and analysis, utilizing in particular the corpus linguistic technique of collocation analysis. Metaphors are considered in terms of the ‘targets’ they frame, which include the following aspects of dementia: (i.) prevalence; (ii.) causes; (iii.) symptoms and prognosis; (iv.) lived experience; and (v.) responses. A range of metaphors are identified, with the tabloids exhibiting a particular preference for metaphors which construct dementia as an agentive and violent entity and people with dementia as passive victims, and which foreground preventative responses to dementia such as pharmacological intervention and individual behavior change. It is argued that such metaphors have the potential to contribute to dementia stigma and place focus on preventing or eliminating dementia while backgrounding responses which may help people to “live well” with the syndrome in the here-and-now. Metaphors which frame dementia as a companion or which the experience of dementia as a journey are put forward as potentially less stigmatizing alternatives which might better reflect the particularities of this complex public health issue.

Empathy training models and the effects on psychological concerns in paid and unpaid caregivers of older people: A systematic review

IntroductionEmpathy training directed at empathic abilities and/or aspects of providing care can be effective at increasing levels of this ability. Moreover, training in different care contexts can minimize the negative impacts of providing care.ObjectivesTo identify empathy training models and the effects on psychological concerns in paid and unpaid caregivers of older people.MethodsA systematic review was conducted. Searches for relevant articles were performed in the Embase, LILACS, PsycInfo, Pubmed, Scopus and Web of Science databases using the following search strategy: “Empathy AND (Education OR Training OR Intervention) AND Caregiver”. No restrictions were imposed regarding language or year of publication.ResultsEmpathy training for caregivers of older people were performed in six studies, three of which identified a significant increase in empathy levels and consequent reduction in psychological concerns. Empathy training focused on aspects of empathy and/or the caregiver had significant effects on the outcome variables. Moreover, training conducted online, by telephone and/or in person can generate satisfactory results. The other three studies that conducted training with a focus on aspects of dementia and/or old age did not present any effect on the outcome variables.ConclusionsEmpathy training for caregivers of older people can increase levels of this ability, especially in the cognitive domain, as well as diminish psychological concerns caused by the negative impact of providing care.Disclosure of InterestNone Declared

Knowledge and attitude of caregivers of people with dementia.

This study aimed to evaluate the knowledge and attitude of caregivers of people with dementia towards the disease (Alzheimer disease). The secondary objective of the study was to assess the association of attitude and knowledge towards dementia. In total, 50 patients with dementia and their caregivers were included in the present study. Caregivers were evaluated on the Dementia Attitude Scale and Alzheimer's Disease Knowledge Scale (ADKS) to assess the level of knowledge and attitude. The mean age of patients was 72.2 years, and the majority of them were men, married, from joint/extended family setup, urban background, and upper or upper-middle socioeconomic status. The mean age of the caregivers was 48.04 years, and the majority was educated more than the matric level. Nearly half of the caregivers were children, and about one-third were the spouse of the person with dementia. The mean duration of the caregiver role was 3.6 ± 3.0 years, while the average time spent in caregiving was 7.4 ± 2.9 h/day. Using the Alzheimer's Disease Knowledge Scale, the mean knowledge score for the caregivers was 16.9 ± 2.7. In terms of individual items on the knowledge scale, most of the caregivers were aware of most aspects of dementia. In terms of the mean weighted score, the maximum score was for the domains of course and symptoms and this was followed by the domain of "treatment and management." The lowest score was obtained for the domain of assessment and diagnosis on ADKS. On the Dementia Attitude Scale, the mean total score was 76.4 ± 18.4. The mean total score for the knowledge domain was higher than the support domain. The current study suggests that most caregivers with dementia have a reasonable level of knowledge about dementia. However, in terms of attitude, caregivers of people with dementia have a less positive attitude towards dementia. The study's finding suggests that there is a need to evaluate the knowledge and attitude of the caregivers of people with dementia and the gaps must be addressed to improve the outcome, both for the people with dementia and their caregivers. Geriatr Gerontol Int 2022; 22: 19-25.

The role of animal-assisted therapy in the management of people with dementia: a systematic literature review

AimsThe aim of this systematic literature review was to determine the evidence-based effectiveness of animal assisted interventions and to look at the factors that limit implementation of this intervention.BackgroundDementia is a major health issue worldwide impacting not only on the people diagnosed with dementia, but also on their families and caregivers, and the healthcare professionals. The symptoms of dementia include cognitive impairment that can range from mild to severe, and behavioural and psychological symptoms which have debilitating effects on functional capacity and quality of life. A number of non-pharmacological interventions are being developed to help people with dementia. Animal assisted therapy is one of those interventions that has demonstrated positive effects on various aspects of dementia (Filan and Llewellyn-Jones, 2006). However, there are limitations to its use and feasibility of animal assisted therapy programmes is unclear.MethodOnly randomised-controlled trials (RCTs) were to be included to evaluate high quality evidence. A systematic literature search was carried out to find using the PubMed and Cochrane databases and a search of the NICE website. Literature was screened according to inclusion and exclusion criteria. Eight randomised-controlled trials were selected to be used in this systematic review to assess the effectiveness of animal-assisted therapy.ResultThe results regarding the effectiveness of animal assisted therapy were variable. There was some improvement demonstrated in symptoms of depression, agitation, behaviour and cognitive impairment. Quality of life and activities of daily living also demonstrated positive outcomes. There was a reduction in the risk of falls in people with dementia. However, the studies conducted demonstrated limited methodologies. The factors limiting the use of animal assisted therapy were found to be concerns around adverse events to animals, issues of animal welfare and economic feasibility of animal assisted therapy programmes.ConclusionFurther research needs to be done using properly conducted randomised controlled trials with larger sample sizes to formally assess people's perceptions regarding therapy animals and develop clear guidelines and protocols for integrating these interventions in healthcare.

Developments of a population‐based prospective cohort study for dementia (the Nakajima study) and an educational program for dementia experts (the NINPRO)

AbstractAging of population is rapidly growing in Japan and all over the world. To overcome problem associated with an increase of older people with dementia, we have conducted a population‐based cohort study for dementia in Nakajima, Ishikawa, Japan (the Nakajima study) since 2006, and an educational program for development of dementia experts (the NINPRO) since 2014. The Nakajima study aimed to develop methods for early detection, prevention, and treatment of dementia; we developed a computerized assessment battery for cognition (C‐ABC) that can detect mild cognitive impairment (MCI) as well as dementia around 5 min and reported usefulness of magnetoencephalography as a tool of detection of early Alzheimer's disease (AD); we explored potentials of dietary polyphenols as preventive and therapeutic agents for AD/dementia leading to clinical trials. The NINPRO has provided activities for learning the basics, clinical practice, and care of dementia using e‐learning lectures and web‐based conferences, and has involved about 2,300 people of medical doctors, nurses, caregivers, and other professionals related to dementia. The Nakajima study and the NINPRO would contribute to improvement of prevention, early detection, medical practice, care, social welfare, and all other aspects of dementia in a super‐aged society in the middle of the 21st century.

Stigmatization and the Experience of Informal Dementia Caregivers in Nigeria

There is no formal word for dementia in Nigeria. Instead, some Nigerians, in their effort to make sense of dementia symptoms, use descriptions that may result in stigmatization of people living with dementia and their families. With Nigeria’s rapid aging, increased risk of dementia, and lack of formal long-term care, this study focused on the impact of stigma on the caregiving experiences of Nigerian women. This exploration is significant as adult females in Nigeria are the pillar of informal caregiving in the country. The study employed a qualitative descriptive method. Semi-structured interviews were conducted with a purposive sample of 12 adult informal female caregivers in Anambra, Nigeria. Data were then transcribed, coded and analyzed for themes. Afterwards, focus groups of 21 adult Nigerians residing in Ohio, US, were conducted to offer more contextual insight on the findings. The three major themes identified were: 1) negative views of dementia symptoms (e.g., witchcraft, madness), 2) caregiving protects against stigmatization (e.g., by keeping family members out of sight), and 3) stigma and caregiving support such as adult children abandoning parents with dementia because of the stigma associated with dementia. Given the overwhelming presence of stigma in all aspects of dementia to include dementia caregiving, results point to the critical need for better strategies to help strengthen informal caregiving in Nigeria. This includes culturally appropriate dementia education for families and caregivers, and formal long-term care policies that include care support in a rapidly aging Nigeria.

Policy, practice, and public awareness: A review of national and international approaches to improve diagnosis and post‐diagnostic support for people living with dementia

AbstractBackgroundInternational policy emphasises the importance of gaining a diagnosis and access to better support to for people living with dementia and those providing support. The COGNISANCE programme aligns with key policy objectives to advance dementia diagnosis and post‐diagnostic support across three continents.COGNISANCE comprises an international team from Australia, Canada, Netherlands, Poland and the UK. Researchers, people living with dementia, informal care partners, health and social care professionals and key national and international dementia organisations are working together to co‐design, deliver and evaluate toolkits and campaigns; to improve the dementia diagnostic process and post‐diagnostic support in partner countries. Our aim was to review existing evidence to inform the development of new international dementia toolkits and campaigns. The review included: national and international dementia plans/strategies; evidence‐based guidelines; and public awareness campaigns from our partner countries and international organisations.MethodUndertaking a qualitative approach, we applied scoping review framework methodology, conducted online searches for sources, and consulted with partner countries, national and international organisations. Where needed, documents were translated into English to ensure broad representation and facilitate analysis. Concepts relating to diagnosis, and post diagnostic support were extracted from each source and mapped. Thematic analysis of the evidence elicited core themes, components, and gaps in current approaches to improving diagnosis and post‐diagnostic support.ResultAnalysis of documents from five partner countries and four international organisations relating to diagnosis and post diagnostic support revealed 15 themes from 15 dementia strategies and 13 guidelines; and 13 themes from 13 national and international public awareness strategies. Core themes were awareness raising; information, care and support; diagnostic processes and community/social aspects of dementia. Analysis of national and international themes for diagnosis and post‐diagnostic support are indicative of central messages and target audiences; additionally, we have identified areas not yet prioritised.ConclusionDespite some cross‐country commonality in themes, considerable diversity and inconsistency remain in the key messages regarding dementia diagnosis and post diagnostic support. Awareness of current themes, emergent gaps, and alignment of key areas for different audiences will inform the co‐design of our new, international campaigns and toolkits.

Steven R Sabat, Alzheimer’s disease and dementia: What everyone needs to know

Steven R Sabat, <i>Alzheimer’s disease and dementia: What everyone needs to know</i>

Development of Pictograms for an Interactive Web Application to Help Hispanic Caregivers Learn About the Functional Stages of Dementia.

Caregivers of persons with dementia need anticipatory guidance about the stages of dementia in order to prepare for the caregiving situations they will face. The study objective was to develop a set of pictograms representing the functional stages of dementia for eventual inclusion in a tailored, educational web application. We used a hybrid iterative participatory design process. A graphic designer prepared prototypes in a flat, minimalistic style. These were then culled and refined based on feedback from 16 Hispanic caregivers in six design sessions in English and Spanish. The resulting 19 pictograms representing the functional stages and substages of dementia were acceptable to and easily comprehended by participants. Short, plain-language captions support comprehension and aid discrimination between similar scenarios. Our participants preferred candid depictions of all aspects of dementia, including bodily functions, but acceptability may vary by population so further testing is warranted prior to deployment with a new population.

A comprehensive study of mobile-health based assistive technology for the healthcare of dementia and Alzheimer's disease (AD).

Assistive technology (AT) involvement in therapeutic treatment has provided simple and efficient healthcare solutions to people. Within a short span of time, mobile health (mHealth) has grown rapidly for assisting people living with a chronic disorder. This research paper presents the comprehensive study to identify and review existing mHealth dementia applications (apps), and also synthesize the evidence of using these applications in assisting people with dementia including Alzheimer's disease (AD) and their caregivers. Six electronic databases searched with the purpose of finding literature-based evidence. The search yielded 2818 research articles, with 29 meeting quantified inclusion and exclusion criteria. Six groups and their associated sub-groups emerged from the literature. The main groups are (1) activities of daily living (ADL) based cognitive training, (2) monitoring, (3) dementia screening, (4) reminiscence and socialization, (5) tracking, and (6) caregiver support. Moreover, two commercial mobile application stores i.e., Apple App Store (iOS) and Google Play Store (Android) explored with the intention of identifying the advantages and disadvantages of existing commercially available dementia and AD healthcare apps. From 678 apps, a total of 38 mobile apps qualified as per defined exclusion and inclusion criteria. The shortlisted commercial apps generally targeted different aspects of dementia as identified in research articles. This comprehensive study determined the feasibility of using mobile Health based applications for dementia including AD individuals and their caregivers regardless of limited available research, and these apps have capability to incorporate a variety of strategies and resources to dementia community care.

Perceived Needs of The Family Caregivers of People with Dementia in a Mediterranean Setting: A Qualitative Study.

The purpose of this study was to identify, classify and analyze the perceived needs of caregivers of elderly people with dementia during the care process. A descriptive phenomenological qualitative study using seven focus groups was conducted in different primary health care centers in the province of Jaén (Spain) between July 2012 and February 2013. Eighty-two family caregivers who were caring for people with dementia in different stages of the disease were selected by purposeful maximum variation sampling. Data were analyzed and organized thematically, considering the semantic and pragmatic content and field notes. Two main categories of the perceived needs of caregivers were identified. The first was related to the management of caring for a relative with dementia, and the second was related to the management of the caregivers’ own care. Our findings support the provision of comprehensive interventions for the improvement of caregivers’ emotional health that encompass more than one care need. This is where psycho-educational interventions aimed at managing the various aspects of dementia and self-care in caregivers can be accommodated. In addition, proactive interventions to develop important skills to care for a relative with dementia, which are not perceived as needs by the caregivers, are needed. These include skills in family negotiation, planning and searching for resources outside the family.

Patient and Public Involvement in Identifying Dementia Research Priorities.

To engage persons with dementia, friends, family, caregivers, and health and social care providers to identify and prioritize their questions for research related to living with dementia and prevention, diagnosis, and treatment of dementia. The Canadian Dementia Priority Setting Partnership (PSP) followed James Lind Alliance PSP methods. Results were compared with the World Health Organization research prioritization exercise and the United Kingdom Dementia PSP. Canada. In the first survey, 1,217 individuals and groups from across Canada submitted their questions about dementia. 249 participated in the interim prioritization. For the final prioritization workshop, the 28 participants included persons with dementia, friends, family, caregivers, health and social care providers, Alzheimer Society representatives, and members of an organization representing long-term care home residents. The Canadian Dementia PSP top 10 priorities relate to health, quality of life, societal issues, and dementia care. Five priorities overlap with one or both of the other two prioritization initiatives. These results provide researchers and research funding agencies with topics that individuals with personal or professional experience of dementia prioritize, but they are not intended to preclude research into other aspects of dementia.

Cross-cultural adaptation to Brazilian Portuguese of the Dementia Knowledge Assessment Tool Version Two: DKAT2.

The Dementia Knowledge Assessment Tool Version Two (DKAT2) was developed to measure caregivers' knowledge about the trajectory of dementia and assess changes in the knowledge before and after educational programs. The DKAT2 is a 21-item tool with questions about several aspects of dementia. The possible answers for each question are "yes", "no" or "don't know". The maximum score is 21. The aim of the study was to cross-culturally adapt the DKAT2 to Brazilian Portuguese. The essential steps to cross-culturally adapt were conducted and the final version administered to 30 caregivers of older people with dementia, sampled by convenience. In the sample assessed, the mean age was 55.7 (± 12.5) years, 93.3% were female, 56.7% were sons/daughters and 23.3% were spouses of the older adults with dementia. The mean time caring for the elder was 4.7 (± 3.3) years and 70% of the caregivers had some level of burden. The mean age of the older people was 82.4 (± 6.7) years, 19 (63.3%) had a diagnosis of Alzheimer's disease, 100% were dependent for instrumental activities of daily living and 70% had some degree of dependence for basic activities of daily living. The mean score for the caregivers' knowledge level was 15.0 (± 2.5) correct answers. The Brazilian Portuguese version was developed and the final version is suitable for use in Brazil.

Forkhead Transcription Factors: Formulating a FOXO Target for Cognitive Loss.

With almost 47 million individuals worldwide suffering from some aspect of dementia, it is clear that cognitive loss impacts a significant proportion of the global population. Unfortunately, definitive treatments to resolve or prevent the onset of cognitive loss are limited. In most cases such care is currently non-existent prompting the need for novel treatment strategies. Mammalian forkhead transcription factors of the O class (FoxO) are one such avenue of investigation that offer an exciting potential to bring new treatments forward for disorders that involve cognitive loss. Here we examine the background, structure, expression, and function of FoxO transcription factors and their role in cognitive loss, programmed cell death in the nervous system with apoptosis and autophagy, and areas to target FoxOs for dementia and specific disorders such as Alzheimer's disease. FoxO proteins work in concert with a number of other cell survival pathways that involve growth factors, such as erythropoietin and neurotrophins, silent mating type information regulation 2 homolog 1 (Saccharomyces cerevisiae) (SIRT1), Wnt1 inducible signaling pathway protein 1 (WISP1), Wnt signaling, and cancer-related pathways. FoxO transcription factors oversee proinflammatory pathways, affect nervous system amyloid (Aβ) production and toxicity, lead to mitochondrial dysfunction, foster neuronal apoptotic cell death, and accelerate the progression of degenerative disease. However, under some scenarios such as those involving autophagy, FoxOs also can offer protection in the nervous system and reduce toxic intracellular protein accumulations and potentially limit Aβ toxicity. Given the ability of FoxOs to not only promote apoptotic cell death in the nervous system, but also through the induction of autophagy offer protection against degenerative disease that can lead to dementia, a fine balance in the activity of FoxOs may be required to target cognitive loss in individuals. Future work should yield exciting new prospects for FoxO proteins as new targets to treat the onset and progression of cognitive loss and dementia.

“Where is Dementia?” A Systematic Literature Review Exploring Neuroanatomical Aspects of Dementia

Dementia is a condition caused by and associated with separate physical changes in the brain. The signs and symptoms of dementia are very similar across the diverse types, and it is difficult to diagnose the category by behavioral symptoms alone. Diagnostic criteria have relied on a constellation of signs and symptoms, but it is critical to understand the neuroanatomical differences among the dementias for a more precise diagnosis and subsequent management. With this regard, this review aims to explore the neuroanatomical aspects of dementia to better understand the nature of distinctive subtypes, signs, and symptoms. This is a review of English language literature published from 1996 to the present day of peer-reviewed academic and medical journal articles that report on older people with dementia. This review examines typical neuroanatomical aspects of dementia and reinforces the importance of a thorough understanding of the neuroanatomical characteristics of the different types of dementia and the differential diagnosis of them.

Can commonly prescribed drugs be repurposed for the prevention or treatment of Alzheimer's and other neurodegenerative diseases? Protocol for an observational cohort study in the UK Clinical Practice Research Datalink

IntroductionCurrent treatments for Alzheimer's and other neurodegenerative diseases have only limited effectiveness meaning that there is an urgent need for new medications that could influence disease incidence and progression. We...

Dementia and financial incapacity: a caregiver study

Purpose – The purpose of this paper is to identify strategies that caregivers of people with dementia use for financial and estate planning and what advice they would give to others in their position. Design/methodology/approach – Data were gathered via in-depth in-person interviews with 34 caregivers of individuals with dementia. Participants were asked questions about: how they financed care; the resources and people they used to help manage care and finances; and advice they would give to other caregivers. Findings – Caregivers wished that they had done more in-depth planning regarding dementia care and financial arrangements. Participants also wished they had saved more money for care expenses or a “nest-egg.” Participants had mixed feelings about the usefulness and trustworthiness of financial advisors, but those who had elder care lawyers recommended them highly. Research limitations/implications – It would be beneficial to reproduce this study with a larger, gender-balanced sample with a wider variety of socio-economic backgrounds. Social implications – The advice and insight provided in this paper are useful both to dementia caregivers, who can learn from the experiences of those interviewed, and to industry professionals such as financial advisors and elder care lawyers, who may recognize from these interviews the areas in which caregivers need assistance and the services they can provide to help them navigate this disease. Originality/value – This paper provides insights from actual caregivers about their experiences dealing with the financial aspect of dementia, an aspect of the disease that is not widely discussed.

Psychiatric assessment of patients with dementia in the community.

Physical decline and behavioural disturbance in advancing dementia often precipitates hospital or nursing home admission.1 The coexistence of behavioural or psychological symptoms and physical illness requires timely input from a number of professionals in both the health and social services. Numerous rating scales are available to assess different aspects of dementia, including cognition, psychopathology, quality-of-life, and caregiver burden. The …