Dementia In Elderly Research Articles

Unveiling the Unspeakable: Integrating Video Elicitation Focus Group Interviews and Participatory Video in an Action Research Project on Dementia Care Development

With the intention to comprehensively reflect the reality, foster interactions between researchers and participants, and empower the marginalized groups to be heard, videos are increasingly used in health studies. The findings of an action research project that integrates video-based methods into the development of dementia care in an aged care home in Hong Kong are reported. A working alliance consisted of practitioners, community-dwelling volunteers, service managers, university educators, and researchers was formed to develop a sustainable, need-based play program for the institutionalized elderly with dementia (EWD). Two innovative methods, namely, video elicitation focus group interview (VEFI) and participatory video (PV), were applied. Data analyses were collaboratively conducted by all practitioner-researchers during eight reflexive sessions. Several short films were made through PV for institutional training and community education. VEFI effectively enhanced the practitioners’ understanding of the embodied expressions of the EWD and provided a reflexive, democratic environment to generate knowledge among practitioner-researchers. Counter-narratives of the EWD and educational materials on dementia care were generated through PV. The study demonstrates how innovative video-based methods may enable participatory health research to be more inclusive, engaging, and empowering, and how these methods may provide new perspectives on the ethics of researching vulnerable populations.

Integrative Literature Review on Resilience of Family with the Elderly Dementia

Integrative Literature Review on Resilience of Family with the Elderly Dementia

The Effect of Awareness Toward Dementia on Dementia Education Program of Adolescents

Background/Objectives: As the elderly population increases, dementia patients are rapidly increasing as well and dementia causes various social problems such as burden and cost of care. These social problems will be affected by the present adolescents who will become responsible for dementia patients and aged generation. The purpose of this study was to survey the effect of awareness toward dementia on Dementia Education Program(DEP) of adolescents. Throughout the program, 32 subjects were educated and received tasks related to dementia.Method/Statistical Analysis: Subjects were recruited online and DEP was processed for 2 days with 9 educational topics. By providing volunteer work hours accepted in high school when the tasks were completed, we increased the participation. To evaluation the awareness toward dementia, we used the dementia awareness questionnaire used on nationwide study on the prevalence of dementia in Korean elders by the Ministry of Health and Welfare. To analyze the subject’s general characteristics, descriptive analysis was used. Conducted paired T-test to analyze the change of awareness toward dementia before and after DEP in the group.Findings: Dementia awareness questionnaire’s perfect score is 15. Higher the score is, greater the awareness toward dementia. Before DEP, the score was. After DEP, the score was. Comparing the before and after scores, the score increased. The result showed statistical significant difference.Improvements/Applications: The study showed that the effect of awareness toward dementia on DEP of adolescents was positive. This result can be used as a background data announcing the need for early education through school health education, starting from the present adolescence that will directly support the elderly generation in future.

The Frequency of Antipsychotic Prescribing in Older People Mental Health Services: A Southern Health OPMH CRIS Audit

Background: Antipsychotic prescription in older people with mental health problems can have severe adverse effects such as an increased risk of falls and show higher mortality rates. Moreover, this risk is elevated for the elderly with dementia. Aims: to provide an estimate of the frequency of antipsychotic use for mental health problems in older people mental health (OPMH) services and collect evidence of adherence to NICE guidelines. Methods: A retrospective clinical audit of typical and atypical antipsychotic medication use in OPMH services. A clinical Research Interactive Search (CRIS: 2007) was conducted from 1st January 2016 until 31st December 2017. This focused on patients referred to OPMH services that were being prescribed Flupentixol, Haloperidol, Prochloperazine, Amisulpride, Olanzapine, Quetiapine or Risperidone. Results: There were 1,642 (22.75%) patients prescribed one or more of the seven selected antipsychotics within the OPMH services. Of these patients without comorbid psychotic illness 1390 (84.6%) were prescribed an antipsychotic; the most common indications for such medication were agitation, psychotic symptoms, distress or aggression. This is 22.75% of the total number of people currently under OPMH services and is not limited to those of a specific disorder. The most commonly prescribed were atypicals and specifically Risperidone. The most common diagnosis prescribed antipsychotic medication was dementia 40%. Conclusions: These prescribing behaviours reveal good practice, in line with current NICE guidelines of what would be expected for the OPMH services. However, a further investigation into the rationale for the prescribing behaviour evident and the quality of alternative pharmacological and non-pharmacological approaches available to this population is essential.

The role of caregiver burden in the familial functioning, social support, and quality of family life of family caregivers of elders with dementia.

Objective: The present study aimed to examine the role that caregiver burden plays in the familial functioning, social support, and quality of family life (QOFL) of caregivers of elderly family members with dementia. Methods: A survey was conducted with 200 primary caregivers of elderly dementia patients who resided in prefecture “S”. The questionnaire consisted of items that required demographic information, the Japanese versions of the Zarit Burden Inventory (ZBI) and the Family Adaptability and Cohesion Evaluation Scales (FACES II), and scales that measure quality of family life and social support. On the basis of the median ZBI score (i.e., 30.8), participants were divided into two groups: group A (i.e., ZBI score < 30) and group B (i.e., ZBI score > 30). Stepwise multiple regression analysis was conducted with QOFL as the dependent variable. Version 24 of the Statistical Package for the Social Sciences for Windows was used to conduct all the statistical analyses; the statistical significance level was specified as 0.05. Results: Group A and B obtained average ZBI scores of 18.5 and 43.8, respectively. The study targeted 81 patients from group A (average age = 61.0 years) and 77 patients from group B (average age = 61.7 years). Time that was spent on caregiving tasks was significantly higher for group B, when compared to group A. In addition, significant differences in cohesion and adaptability, which are two dimensions that are measured by the FACES II, and QOFL emerged between the two groups. The results of the multiple regression analysis showed that cohesion (β = 0.38), practical support (β = 0.32), adaptability (β = 0.30), and living arrangement (β = −0.12) significantly predicted QOFL. Conclusion: Family cohesion and adaptability are indicators of healthy familial functioning. In order to improve the QOFL of caregivers of elderly dementia patients, it is necessary to strengthen emotional ties, maintain emotional attachment, and flexibly respond to the burden of nursing care and changes in power structures and role relationships.

Animal-assisted therapies for the treatment of elderly dementia

Animal-assisted therapies for the treatment of elderly dementia

Experiences of Families Supporting Elderly Dementia Patients Undergoing Hemodialysis

Experiences of Families Supporting Elderly Dementia Patients Undergoing Hemodialysis

Verification of Validity and Reliability of Seamless Care for Elderly Dementia Patients in Community-based Integrated Care Scale: Nursing Staff in Hospital for Community-based Care

Verification of Validity and Reliability of Seamless Care for Elderly Dementia Patients in Community-based Integrated Care Scale: Nursing Staff in Hospital for Community-based Care

Family Needs in Special Nursing Home for the Dementia Elderly

Family Needs in Special Nursing Home for the Dementia Elderly

Structural Analysis of Prevention and Management of Dementia in Community Dementia Elderly: Focusing on the Third Dementia Management Plan

Structural Analysis of Prevention and Management of Dementia in Community Dementia Elderly: Focusing on the Third Dementia Management Plan

The Effects of Symptoms of the Dementia Elderly on the Primary Caregivers’ Care-Stress: The Expert Support and the Family Support as a Moderator

본 연구는 치매환자가 보여주는 다양한 증상의 정도가 주부양자의 케어스트레스에 미치는 영향을 살펴보고, 이에 대한 보호요인으로써 전문가지지 및 가족지지의 영향을 검증하는 것을 목적으로 한다. 이를 위해 서울, 경기, 부산 3개 지역의 주간보호센터 및 병원, 요양시설 10곳을 대상으로 한 설문조사를 활용하였다. 연구대상으로 치매 진단기간 5년 이내인 치매환자의 배우자 및 자녀부양자 191명을 선정하였고, 다중회귀분석을 통해 연구모형 검증에 대한 분석을 진행하였다. 연구결과 치매환자의 증상정도는 주부양자가 느끼는 정신적 고통인 케어스트레스에 정적인 영향을 나타냈다. 전문가지지와 가족지지의 보호효과를 검증한 결과, 전문가지지는 치매환자의 증상으로 인한 주부양자의 케어스트레스를 완화시켜주는 것으로 나타난 반면, 가족지지의 보호효과는 유의미한 영향을 나타내지 않았다. 본 연구결과는 의료진 및 사회복지사와 같은 전문가지지는 주부양자의 케어스트레스 완화에 효과적이지만 친척과 같은 가족들의 지지는 케어스트레스 완화에 효과적이지 않았음을 보여준다. 분석결과를 바탕으로 본 연구는 치매환자의 부양가족을 대상으로 한 정기적인 치매 증상에 관한 교육의 필요성, 주부양자의 케어스트레스 감소를 위한 지원 정책의 확대, 치매전문인력 구성의 확대 및 협업 시스템의 구축, 치매환자 부양가족구성원 간의 기능 증진을 위한 개입 필요성을 제언하였다.Care-stress among the dementia caregivers has been an important issue. The purpose of this study is to examine the effects of the dementia elderly’s symptoms on the primary caregivers’care-stress. In addition, the moderators, the expert support and the family support, were used to examine the moderating effects between the symptoms and the care-stress. The data was obtained at 10 day-care facilities and services in Seoul, Gyeonggi and Busan province in South Korea. A total of 191 participants were analyzed. They were the spouses or the adult children of the dementia elderly who were diagnosed with dementia within five years. This study was conducted in multiple regression analysis. The main findings are as follows. First of all, the symptoms that the dementia elderly show were significantly associated with the primary caregivers’ care-stress. Also, the interactive variable with the expert support was statistically significant. However, it was not significant with the family support. This means that only the expert support from doctors, nurses or social workers decreased the caregivers’ care-stress. The implications of this study are 1) the necessities of the education that covers the specific symptoms of the dementia patients’, 2) the extension of the supportive policies for caregivers’ care-stress, 3) the necessities of more allocation of the dementia specialists in the practical settings and cooperative systems among the dementia specialists in various fields, and 4) the enhancement of the family function among families who have a dementia elderly as a family member.

Perbedaan Tingkat Caregiver Burden Yang Merawat Lansia Demensia Di Panti Wreda

Background: The prediction of the number of elderly people in Indonesia will increase along with changes in Indonesia's demographic status. Elderly people who feel that at home less socialize with elderly people choose to live in a nursing home, this is an alternative for the elderly, elderly degenerative diseases are very diverse one of which is elderly dementia with dementia will require a level of dependence beyond the elderly who do not have dementia. Caregivers who treat the elderly with dementia will be very vulnerable to burden in treating elderly dementia.Purpose: The purpose of this study was to analyze the difference in the level of caregiver burden who care for elderly dementia at a nursing home.Method: This research method uses "Quasy experiment pre and posttest with control group". Number of samples 34 from each group. Data were analyzed using the Mann Whitney test with the help of SPSS 22.0 for Windows.Results: Research in the control group has a higher level of burden caregivers compared to intervention groups, this is because the control group respondents have lower wages than the city minimum wage, besides that the elderly characteristics carried out by nursing care have more severe dementia than the intervention group.Conclusion: The results of this study can be used as a reference in developing services for the elderly and elderly caregiver, especially the elderly who suffer from dementia.

Survey on management and service needs among elderly dementia patients in Beijing Yuetan community

Patients aged ≥65 years with dementia diagnosed by neurological specialists were selected in Yuetan community from March 2016 to December 2016. The basic information of patients was collected from the health and medical records; the needs for community care were obtained through a questionnaire survey. Total 91 elderly patients with dementia was included in the study, among whom 15 (16.5%) were found by community institutions, 18 (19.9%) patients got medication from the community health institutions. The survey showed that the numbers of participants who agreed that the community health service could provide treatment, drug prescription, referral service, condition assessment, regular follow-up, professional guidance for caregivers, door-to-door service and counseling services for patients and their relatives were 29 (31.8%), 18 (19.9%), 33 (36.3%), 19 (20.9%), 23 (25.3%), 24 (26.4%), 49 (53.8%) and 29 (31.9%), respectively. Results showed that 53.8% (49/91) dementia patients or their family members wanted to receive instruction of drug use in community health service, 17.6%(16/91) wanted to know about the professional care skill as caregivers. Currently the services for dementia patients in health service centers and stations of Yuetan community are less sufficient, which cannot meet the needs of dementia patients and their family members. Key words: Dementia; Disease management; Community health services

Hospital admission risk in community dwelling elderly dementia subjects

Hospital admission risk in community dwelling elderly dementia subjects

Clinical and medication use characteristics of national cohort of elderly dementia patients

Little is known about how Medicare Part D Comprehensive Medication Review (CMR) affects quality of medication use and management. In this study, changes of plan level CMR completion rates over time were examined and their associations with medication use and management related (MUMR) quality measures.Using Medicare Part D plan Star Rating and contract information data, a longitudinal data set was developed with CMR completion rate and 17 MUMR measures. T-tests and one-way Analysis of Variance were used to examine the variation of CMR rates between contracts and over time, respectively, as well as the regression adjusted associations using fixed-effects and ordinary least squares models, verified by Generalized Estimating Equations.CMR completion rates increased substantially from contract year 2013–2016, with a larger increase among Medicare Advantage Prescription Drug Plans than stand-alone Prescription Drug Plans. Prior year's CMR completion rates had marginally positive effects on 4 of the 17 MUMR measures: medication adherence with statin drugs, continuous beta blocker treatment, and pharmacotherapy management of chronic obstructive pulmonary disease exacerbation (systemic corticosteroid or bronchodilator). Increasing CMR completion also was associated with increased chronic use of atypical antipsychotics by elderly beneficiaries in nursing homes, an unintended outcome and a reflection of poor quality of care. CMR completion rates in the same year had even more limited associations with other MUMR measures.At plan level, CMR completion rates had limited and inconsistent association with other MUMR measures. Although our research used an observational study design, the associations observed have policy implications to the Center for Medicare & Medicaid (CMS) Star Ratings program and quality bonus payments, as well as implications for plans' quality improvement.

PERMAINAN TRADISIONAL DHAKONAN MENCEGAH PROGRESIFITAS TINGKAT DEMENSIA PADA LANSIA

One of the elderly problem is dementia, which can interfere daily activity. One of the safetreatment for elderly with dementia is reminiscence therapy with dhakonan traditional games. Thepurpose of this study is explain the effect of dhakonan traditional games on dementia level in theelderly.The design of this study was quasy-experiment design. The population was elderly withdementia in Desa Wedoro Kecamatan Waru Kabupaten Sidoarjo. The total sample were 20respondents who appropriate to inclusion criteria. The sampling was simple random sampling. Theindependent variable was dhakonan traditional games, the dependent variable were cognitivefunction, depression, and dementia level. Data were collected using quissionaires of Mini MentalState Examination (MMSE), Geriatric Depression Scale (GDS), dan Functional AssessmentStaging Tool (FAST). Data analysis were Wilcoxon Sign Rank Test and Mann Whitney Test withsignificance level of α&lt;0,05.Based on Wilcoxon Sign Rank Test found that p&lt;0,05 for cognitive function, depression level,and dementia level in treatment group (cognitive function, p= 0,005; depression level, p= 0,005;dementia level, p= 0,014), it means the dhakonan traditional games had an effect to the dementialevel in the elderly.The conclusions of this study was the dhakonan traditional games significantly increasedcognitive function, decreased depression level and prevent progressifity of dementia level. Thefuture studies can add the respondents and behavioral changes in elderly with dementia.

Abstract P007: Arterial Stiffness is Associated With Increased Risk of Incident Dementia in the Older Elderly: The Cardiovascular Health Study Cognition Study

Introduction: Arterial stiffness is related to aging, hypertension, and obesity, and higher carotid-femoral pulse wave velocity (PWV) is associated with brain amyloid deposition. We hypothesized that higher cfPWV was associated with incident dementia in older adults (mean age 78) of the Cardiovascular Health Study Cognition Study (CHS-CS). Methods: Pittsburgh CHS-CS participants (n=532) without dementia at baseline (1998-99) had annual cognitive exams through 2013. CfPWV (m/sec) was measured from pulse velocity waveforms on 356 participants between 1996-2000, who were slightly younger, more educated, with less mild cognitive impairment (MCI) than those not included. Associations of cfPWV [continuous (transformed: -1/cfPWV) and quartile] with time-to-event [cfPWV measurement to dementia or death (competing event), or end of follow-up] were assessed in Cox proportional hazards model with competing risk of death. Results: Over 15-year follow-up, 212 (59.6%) dementia cases (median onset time=4 years) and 87 (24.4%) deaths occurred prior to dementia diagnosis. Adjusted for age and sex, incident dementia was related to higher cfPWV [hazard ratio (HR)=1.52 per -1/cfPWV, 95%CI=1.04, 2.24] (Table). Results were similar when further adjusted for education, race, ApoE4 , hypertension, diabetes, MCI, and abnormal white matter (WMG) or ventricular grade (VG). Results persisted in separate models that excluded those with ApoE4 + (n=79), diabetes (n=40), MCI (n=65) or abnormal WMG or VG (n=136). In stratified models, results were stronger for age ≥80 vs. &lt;80 and for hypertension vs. no hypertension. Pulse pressure (PP), another index of arterial stiffness, was not associated with incident dementia (age- and sex-adjusted HR=1.01 per mmHg PP, 95%CI=0.99, 1.01). Conclusions: Higher cfPWV, but not higher PP, was significantly associated with incident dementia in the older adults. Interventions to slow arterial stiffness with aging may reduce the risk of dementia among older individuals.

The Disease-modifying Drug Candidate, SAK3 Improves Cognitive Impairment and Inhibits Amyloid beta Deposition in App Knock-in Mice

Alzheimer’s disease (AD) is a progressive neurodegenerative disease and the most common form of elderly dementia in the world. At present, acetylcholine inhibitors, such as donepezil, galantamine and rivastigmine, are used for AD therapy, but the therapeutic efficacy is limited. We recently proposed T-type voltage-gated Ca2+ channels’ (T-VGCCs) enhancer as a new therapeutic candidate for AD. In the current study, we confirmed the pharmacokinetics of SAK3 in the plasma and brain of mice using ultra performance liquid chromatography-tandem mass spectrometry. We also investigated the effects of SAK3 on the major symptoms of AD, such as cognitive dysfunction and amyloid beta (Aβ) accumulation, in AppNL-F knock-in (NL-F) mice, which have been established as an AD model. Chronic SAK3 (0.5 mg/kg/day) oral administration for 3 months from 9 months of age improved cognitive function and inhibited Aβ deposition in 12-month-old NL-F mice. Using microarray and real-time PCR analysis, we discovered serum- and glucocorticoid-induced protein kinase 1 (SGK1) as one of possible genes involved in the inhibition of Aβ deposition and improvement of cognitive function by SAK3. These results support the idea that T-VGCC enhancer, SAK3 could be a novel candidate for disease-modifying therapeutics for AD.

Møter gjennom mønster i filt. Narrativ og poetisk dokumentasjon som utgangspunkt for og pådriver i kunstdidaktisk praksis i en helsekontekst

I denne artikkelen søkes det, fra et kunstdidaktisk perspektiv, å belyse forbindelser mellom kunstpraksis og utvidet omsorgsarbeid i en helsekontekst. Hensikten er, gjennom å beskrive, analysere og konstruere kjennetegn ved praksis, å bidra med kunnskap om hvordan en relasjonell og sosialt orientert kunstpraksis konstitueres med demente beboere og helsepersonell over tid på to sykehjem. Forskningsspørsmålet tar for seg hvordan narrativ og poetisk dokumentasjon påvirker didaktiske valg og hvilken betydning det får i utviklingen av kunstnerens praksis. I artikkelen resonneres det med at en gjennomgående og systematisk bruk av narrativ og poetisk dokumentasjon fører til en refleksiv kunstdidaktisk praksis som åpner for affektive møter gjennom materialer, integrering av levd kropp og aktørenes mulighet til å være i det kommende sammen. Disse aspektene forståes som vitale kvaliteter som kan ha overføringsverdi til sansebaserte strategier i et utvidet omsorgsarbeid. Kunstnerens dokumentasjonspraksis løftes fram som en strategi for å lyssette den etiske dimensjonen når personer med redusert eller manglende samtykkekompetanse inkluderes i kunstpraksis. I en refleksiv forskningsprosess som har en kunstledet, narrativ og praksisledet tilnærming utforskes visuelle metoder. Resultatene av studien formidles både som teoretisering i artikkelform og gjennom utprøving av undervisningsopplegg for sykepleiere, helsefagarbeidere og studenter med fokus på samarbeid mellom aktører i helsefeltet, forskeren og kunstneren.

The Demographic Characteristics and the Risk Factors of Dementia in SAUDI Elderly

There is a little information about dementia in Saudis. This is a retrospective chart review study from1995 -2010. to describe the demographic characteristics and the risk factors of dementia, the prevalence of different types of dementia, and the current clinical practice of dementia in Saudi tertiary care hospital. A total of 418 demented patients (236 males, 182 females) their mean age was 78.8. Prevalence of diabetes 32%, hypertension 71.53%, dyslipidemia 30.05% and depression 24.41%. Clinically 64.37% of patients had memory impairment, 54.25% had confusion and 34.63% had personality changing. The commonest type of dementia was mixed dementia 18.37% followed by Alzheimer disease15.87%. 16.10% of patients had received cholinesterase inhibitor and 9.78% had received memantine. Infection was the commonest cause of frequent admission (40%) Mortality rate was 77.99%. The commonest cause of death was infection (38.34%) followed by cardiovascular causes like stroke (23.34%) and cardiac diseases (17.48%). Conclusion: (1) Mixed dementia is the commonest type of dementia in Saudis due to high prevalence of cardiovascular diseases risk factors. (2) High prevalence of depression among demented Saudi patients. It requires early recognition and treatment. (3) Demented patients have frequent admissions and long stay in hospital which makes the economic cost is very high. (4) Mortality rate among demented patients is high and the outcome of dementia is expected to be poor. The underlying message of this study is to increase awareness of the public and health system about the impact of dementia in Saudis and the need for prevention strategies, trained physicians and more research.