Dementia In Thailand Research Articles

Osteoporosis as a Potential Modifiable Risk Factor for Dementia in Thailand: A Cross-Sectional Analysis.

This study aims to explore the potential of osteoporosis as a modifiable risk factor for dementia and investigatewhether treatments like estrogen supplementation and bisphosphonates can reduce the risk of dementia in the Thai population. This study aimed to evaluate the risk of dementia in patients with osteoporosis. A cross-sectional analysis was conducted. Participants aged <50 years and those with a history of dementia at baseline were excluded. Clinical variables were analyzed using the chi-squared test. Logistic regression analysis was conducted to determine independent factors of dementia after adjusting for potential confounders. The cohort was conducted on 54,399 participants, of whom 9763 (17.9%) had osteoporosis. The results indicated that individuals with osteoporosis had an odds ratio (OR) of 1.62-fold higher risk of developing dementia compared to those without osteoporosis (95% confidence interval (CI) 1.37-1.92, p-value < 0.001). Furthermore, compared to patients with osteoporosis not undergoing any treatment, those receiving estrogen supplementation and bisphosphonate treatment showed reduced associations with dementia, with an OR of 0.84 (95% CI 0.73-0.98, p-value = 0.023) and 0.66 (95% CI 0.60-0.73, p-value < 0.001), respectively. The study findings suggest an elevated risk of dementia in patients with osteoporosis and contribute substantially to our understanding of the link between osteoporosis and dementia in the Thai population.

Effect of Comorbidities on Ten-Year Survival in Patients with Dementia.

There is a verified association between comorbidity and survival in patients with dementia. To describe the ten-year survival probability of patients with dementia and to identify the impact of comorbidity. The prognostic retrospective cohort study was conducted using data from adults with dementia who had visited the outpatient departments at Maharaj Nakorn Chiang Mai hospital between 2006 and 2012. Dementia was verified in accordance with standard practice guidelines. Secondary data detailing about patient age, gender, date of dementia diagnosis and death, types of dementia, and comorbidities at the time of dementia diagnosis was obtained from electronic medical records. The association between comorbidity, patients' underlying disease at dementia diagnosis, and overall survival were analyzed using a multivariable Cox proportional hazard model adjusted for age, gender, types of dementia, and other comorbidities. Of the 702 patients, 56.9% were female. Alzheimer's disease (39.6%) was the most prevalent type of dementia. Median overall survival was 6.0 years (95% CI 5.5- 6.7). The comorbidities associated with a high risk of mortality included liver disease (aHR 2.70, 95% CI 1.46- 5.00), atrial fibrillation (aHR 2.15, 95% CI 1.29- 3.58), myocardial infarction (aHR 1.55, 95% CI 1.07- 2.26), and type 2 diabetes mellitus (aHR 1.40, 95% CI 1.13- 1.74). Overall survival rate of patients with dementia in Thailand was comparable to previous studies. Several comorbidities were associated with a ten-year survival. The prognosis of patients with dementia may be improved by appropriate care of comorbidities.

Five year dementia registry in Thailand: Regional distribution, etiologies, and outcome of dementia

AbstractBackgroundThere is a lack of epidemiological knowledge about whether individuals with dementia receive the same quality of diagnostics and treatment.MethodWe explored the ICD10 National Health Security Office (NHSO) in‐patient record of dementia in Thailand. We analyzed the prevalence, etiologies, regional distribution, and outcome of dementia in Thailand during 2015‐2019.We reviewed a cross‐sectional cohort study based on data from the NHSO.ResultStudied in‐patients diagnosed with dementia between 2015 and 2019 (n = 29,895; 40,981 visits) 17,058(57.1%) were female. 3,665(12.3%); 11,638(38.9%); 8,845(29.6%); 1,814(6.1%); 1,418(4.7%); and 2,515(8.4%) were in the northern, central, northeast, eastern, western, and southern part of Thailand respectively. Among 29,895 dementia cases, 15.4%, 18.7%, 20.2%, 24.1%, and 21.6% were prevalence cases in 2015, 2016, 2017, 2018, and 2019 (registered up to 30th September where was the end of fiscal year) respectively. 16.1% were single, 68.5% were married, 6.6% were divorced, and 8.9% had other marital status. 85% aged 65 and over. Mean age of these cohort was 75.42(sd = 11.97) years old. The etiologies registered as dementia were as followed: 9.3% had AD, 0.2% had bvFTD, 9.3% ha VaD, 2.1% had other degenerative dementia, 77.4% ha unspecified dementia, and 1.8% had cognitive impairment due to metabolic and physiological condition. During these 5 years, 59.3% were dead. Mean duration of admission were 9.84(sd = 19.84) days. Mean cost of expense during admission were 31,521.79(sd = 80,647.68) Baht.ConclusionThe dementia registry offers the surrogate clinical best practice and patient outcomes. The importance and significance in having dementia data cannot be undervalued.

PSYCHOMETRIC PROPERTIES OF THE NEUROPSYCHIATRIC INVENTORY QUESTIONNAIRE FOR THAI OLDER ADULTS WITH DEMENTIA

Abstract Psychiatric and behavioral symptoms are highly prevalent among persons living with dementia. Clinical evaluation of those symptoms is critical for assessment of dementia progression and development of effective treatment. The Neuropsychiatric Inventory Questionnaire (NPI-Q) is a brief informant-based instrument to assess the severity of 12 types of neuropsychiatric symptoms among persons with dementia and associated caregiver distress. Although Thailand is experiencing a rapid increase in the prevalence with dementia, there is no validated instrument to assess neuropsychiatric symptoms in Thailand. This study aims to examine the psychometric properties of the NPI-Q instrument among older adults with dementia in Thailand. Data were collected from 353 participants aged 60 and over with probable dementia, at least one neuropsychiatric symptom, and an adult family caregiver willing to participate in the study. We examined the internal consistency, factorial validity, and criterion validity of the NPI-Q instrument. NPI-Q has acceptable internal consistency (Cronbach’s α=0.77). Principal component analysis yielded a five-factor solution, which accounted for 63% of the variance. The five factors included (1) agitation, anxiety, and irritability, (2) delusions, hallucinations, apathy, and disinhibition, (3) euphoria, motor disturbance, and night disturbance, (4) depression, and (5) abnormal appetite. We found that higher NPI-Q severity score was significantly associated with higher geriatric depression, associated caregiver distress, caregiver burden, and caregiver depression and lower quality of life among older adults and their caregivers, which confirmed the criterion validity of the instrument. Findings provide support for use of the NPI-Q among older adults with dementia in Thailand.

Relationships between caregiving stress and sleep quality among family caregivers of older adults with dementia in Thailand.

Providing care for older people with memory loss is a significantly stressful task. The caregiver experienced deterioration of the care recipients regarding their cognitive and functioning abilities, often resulting in the caregiver's feelings of distress, stress, and unsatisfactory sleep quality. This cross-sectional study aimed to examine the relationships between caregiving stress and sleep quality among family caregivers of older adults with dementia. A simple random sampling method was used to recruit participants of seventy-two family caregivers who received care from a community long-term care facility at two primary hospitals in Thailand. Research instruments included the Relative Stress Scale and the Pittsburgh Sleep Quality Index. The data were analyzed using descriptive statistics, means, standard deviation, and simple linear regression. The study revealed that caregivers had a high level of caregiving stress (M = 49.68, SD = 4.71), and poor sleep quality (M = 12.44, SD = 3.60). Caregiving stress was positively correlated with poor sleep quality (r = 0.54, p < 0.01) with a large relationship. Thai family caregivers of people with dementia reported high stress level and had poor sleep quality. The findings suggest that nurses in primary health care should focus on assessing stress levels and sleep quality as well as improving sleep quality for family caregivers by developing interventions.

Quality of Life of Older People with Dementia in Thailand

The quality of life (QOL) of older people with dementia may depend on their care environment. This cross-sectional descriptive study aims to investigate the QOL of Thai older people with dementia in homes for the aged and those living in their own homes in the community, as well as the discrepancy between the QOL rated by the older people and by caregivers. The samples included 342 participants who met the inclusion criteria. Data were collected using the Quality of Life-Alzheimer’s Disease Scale (QOL-AD) and the EuroQol 5 Dimensions (EQ-5D) Questionnaire Thai Version Scale. Data were analyzed using descriptive statistics, t test, and Pearson’s correlation. The findings revealed that the overall QOL scores of participants in both groups were at a moderate level. Compared with participants in homes for the aged, those living in the community showed higher scores in 7 aspects of QOL-AD, including physical health, energy, living situation, memory, self as a whole, ability to do chores, and ability to make life fun, but lower scores in the aspects of family/members and marriage/closed persons. Self-rated and caregiver-rated scores were significantly different in the aspects of living situation, memory, relationship with family, and marriage/closed persons. The findings imply that health care professionals can also assess the QOL of older people with dementia through self-rating. Further research to find the most effective method for enhancing older peoples’ QOL is needed.

Quality of life and the associated factors among family caregivers of older people with dementia in Thailand.

Long-term care for older people with dementia can adversely impact a family caregiver's life. A decrease in their quality of life may compromise the quality of care they provide to older people and their own quality of life. The samples include 76 family caregivers of older people with dementia in Thailand. Six questionnaires and the EuroQoL Five Dimensions Questionnaire were used in data collection. Descriptive and inferential statistics were used in data analysis. The findings revealed that quality of life of family caregivers was at a high level. Experiences of close relationships between care dyads and perceived social support were positively related to family caregiver's quality of life, whereas perceived stress and burden were negatively related. Perceived social support and experiences of close relationships might be predictors of family caregiver's quality of life. High quality of life levels among Thai family caregivers of older people with dementia were influenced by high perceived social support and high experiences of close relationships. An intervention focusing on modifying such predicting factors may effectively help maintain quality of life of these family caregivers.

Validity of mobile application for monitoring behavioral and psychological symptoms in moderate to severe dementia in Thailand

Many patients with moderate - severe dementia with behavioral and psychological symptoms of dementia (BPSD) were living at home in Thailand. A mobile application which allows caregivers to evaluate patients’ BPSD at home is needed. To develop an application that caregivers can monitor BPSD in patients with moderate-severe dementia. A mobile application was developed to measure 9 common BPSD domains in Thai language. The application was a touchscreen-based questionnaire using Likert scale for frequency of each behavioral domain (frequency score) and visual analogue scale for its impact on caregivers’ emotion (impact score). Concurrent validity was compared to a paper-based version of Neuropsychiatric Inventory (NPI). From a total of 50 caregivers’ responses, both total frequency score and total impact score from the application were significantly correlated with NPI total frequency x severity score (ρ = 0.62, p <0.001) and NPI total burden score (ρ = 0.68, p <0.001). Frequency score in each domain from application was significantly correlated with corresponding NPI subscale scores (ρ = 0.31 – 0.73, all p <0.05). Regarding impact scores, every domain was significantly correlated with NPI burden score on corresponding subscales (ρ = 0.38 – 0.66, all p <0.01). The mobile application demonstrated strong to very strong correlations with NPI scores in patients with moderate – severe dementia. This application may be useful for caregivers in monitoring BPSD. Further testing for usability in community-dwelling is needed before implication into clinical practice.

Understanding the Effect of Using Music Therapy Programme Without Music Therapists for Seniors with Early Stage of Dementia in Thailand: A Preliminary Study

This article is written by the authors after studying the National Bureau of Statistics’ data about the number of the elderly in Thailand. It indicated the fast growing number of the Thai seniors as seen from their proportion to the entire population. In 2014, the number of the old people increased to 10 million, representing 14.9%. Of them, 5-8% suffered dementia, and more number when age climbed up. Treatment of dementia is available in two forms. The first is by medication for relief but no cure and at high cost when compared with the population’s income base. The second requires no medicine such as by brain management and the correct and closely care. However, the authors found that music therapy, a non-drug treatment, was a more interesting alternative thanks to its positive results shown by research abroad. As the social context of Thailand where the poor patients live in remote areas and thus are distant from music therapists hence encouraged the authors to present the ready-touse musical therapeutic package as a means to slow down dementia. The package combines meditation, music and bodily movements into a series of activities for 10 weeks to complete.

Nurses' Experiences Providing Care for People with Dementia: An Integrative Literature Review

Aims and objective: This article seeks to review the experience of registered nurses providing care for dementia patients including theoretical perspectives that have been used to provide care for people with dementia. Background: Nurses have a vital role in providing special and personalized care for people with dementia and also their family members. However, there is little knowledge about the experiences of nurses providing care for people with dementia in Thailand. Design: An integrative literature review. Method: This literature review of 19 articles was undertaken to encapsulate what research has done in the experience of nurses providing care for people with dementia. Results: Four themes related to the nurses’ experiences of providing care for people with dementia included encountering with painful emotions, working under severe conditions, meeting holistic care needs, and experiencing inadequate knowledge. Factors contributing to appropriate care for people with dementia and barriers to meet the optimal care were identified in this article. Conclusion: Nurses experienced struggling with painful emotions and working under difficult circumstances and there was the need for meeting spiritual care needs of patients. Nurses identified that a lack of knowledge of dementia and the need for improved effective communication when they provided care for a group of these patients and their family members. Relevance to clinical practice: Nurses seek to understand nurses’ experiences of providing care for people with dementia may help them to utilize positive care experiences to practice. Those nurses should consider to some experiences that may be factors to achieve and hinder the optimal care.

Understanding the Effect of Using Music Therapy Programme without Music Therapists for Seniors with Early Stage of Dementia in Thailand: A Preliminary Study

This article is written by the authors after studying the National Bureau of Statistics’ data about the number of the elderly in Thailand. It indicated the fast growing number of the Thai seniors as seen from their proportion to the entire population. In 2014, the number of the old people increased to 10 million, representing 14.9%. Of them, 5-8% suffered dementia, and more number when age climbed up. Treatment of dementia is available in two forms. The first is by medication for relief but no cure and at high cost when compared with the population’s income base. The second requires no medicine such as by brain management and the correct and closely care. However, the authors found that music therapy, a non-drug treatment, was a more interesting alternative thanks to its positive results shown by research abroad. As the social context of Thailand where the poor patients live in remote areas and thus are distant from music therapists hence encouraged the authors to present the ready-touse musical therapeutic package as a means to slow down dementia. The package combines meditation, music and bodily movements into a series of activities for 10 weeks to complete.

FP46-TH-01 The evaluation of the first caregiver training program for patients with dementia in Thailand

FP46-TH-01 The evaluation of the first caregiver training program for patients with dementia in Thailand

PO22-TH-05 Evaluation of an innovative, comprehensive management for patients with dementia in Thailand

PO22-TH-05 Evaluation of an innovative, comprehensive management for patients with dementia in Thailand

A counseling intervention for caregivers: effect on neuropsychiatric symptoms.

In Thailand, family caregivers have an important role in delivering care to patients with dementia. Most patients with dementia in Thailand and also in Western societies live in the community. Training caregivers may improve care of dementia patients. We performed a treatment study of a six-month caregiver intervention with group counseling and support with provision of techniques to cope with non-cognitive symptoms of patients with dementia. We hypothesized that this caregiver intervention with group counseling and support would reduce behavioral and neuropsychiatric symptoms in the demented patients. We conducted a parallel group intervention study. A manual for group counseling and support was developed focusing on education regarding dementia, behavioral analysis and intervention, and environmental adaptation. Fifty nonprofessional caregivers-25 from the control group and 25 from the study group-of patients with dementia from the memory clinic at Siriraj Hospital were alternately assigned to each group as they presented to the clinic if they met the inclusion criteria and agreed to participate. The Thai Mental State Examination (TMSE) was used to assess dementia severity. Forty-five minute counseling sessions were conducted every 6-8 weeks for 6 months and assessments were conducted at 3 months and 6 months. The primary outcome measure was the Neuropsychiatric Inventory (NPI). A paired samples analysis of the NPI scores demonstrated a significant change of the total NPI scores at the end of six month from baseline in the intervention group (P = 0.045). Change from baseline of the comparison group was not significant. There was a trend towards improvement of the TMSE scores between the two groups at month six (p = 0.061). The result favored the treatment group. This study provided evidence of the utility of a non-pharmacologic intervention using group counseling in an out-patient setting for caregivers of patients with dementia.