Proportion Of Dementia Patients Research Articles

Aqueous Extract of Pinellia ternata Breitenbach Tuber Ameliorates Bilateral Common Carotid Artery Stenosis-Induced Cognitive Deficit in Mice by Suppressing the Activation of Astrocytes

Background: The proportion of dementia patients in Asian countries is rapidly increasing, and because vascular dementia is more common than in the West, it is recognized as important as Alzheimer’s disease. Purpose: The aim of this study was to verify the benefits of Pinellia ternata Breitenbach tuber aqueous extract (PTex) in improving cognitive function and reducing inflammation in brain damage resulting from bilateral common carotid artery stenosis (BCAS). Materials and methods: Four groups of five C57BL/6 male mice each were randomly assigned (a sham group, a BCAS surgery group, and two experimental groups that received PTex concentrations of 25 and 50 mL/kg, respectively). Measuring behavioral learning and memory, the two concentrations of the extract were given orally three times a week for six weeks following BCAS surgery. Furthermore, the inflammatory response in the cerebral cortex was observed, and RNA sequencing analysis was carried out. Results: The novel object recognition test revealed that the PTex-50-treated group had improved cognitive function, and the anti-inflammatory effect was confirmed by immunofluorescence staining of brain tissue. Proteins such as Apob, Shh, Dscc1, Cdc45, and Cdc6 were identified through protein-protein interaction network analysis as having a beneficial effect on BCAS-induced cognitive deficit. Conclusion: Results show that PTex-50 was found to have a beneficial effect on BCAS-induced cognitive deficit.

Five-Year Community Management Rate for Dementia Patients: A Proposed Indicator for Dementia Policies.

Background and PurposeThere is no specific indicator for monitoring dementia management. We propose an auxiliary indicator called the community management rate, defined as the proportion of dementia patients who receive informal care from close caregivers or themselves within their community population. The 5-year community management rate is the percentage of dementia patients who are receiving community management at 5 years after they were diagnosed. The aim of this study was to identify how the community management rate has changed over time and how the 5-year community management rate differs according to age, sex, income, residence area, and comorbidities.MethodsWe analyzed customized research database of the Korean National Health Insurance Services from 2003 to 2018. The 5-year community management rate was calculated annually with newly diagnosed dementia patients, and compared among subgroups according to age, sex, income, residence area, and comorbidities.ResultsThis study analyzed 549,297 patients. Among those newly diagnosed with dementia in 2003, the mean duration of community management during the 15-year follow-up was 5.98 years. The community management rate decreased rapidly from 2003 to 2006, after which it increased. A low 5-year community management rate was associated with older age, higher comorbidity burden, nonmetropolitan residence, and low income.ConclusionsThe community management rate seems to reflect diverse patient factors. Efforts are needed to reduce the comorbidity burden and differences in the 5-year community management rate according to residence area and income. This study indicates the need for further investigations into the use of this indicator to monitor the management of dementia patients.

Neuropsychiatric Symptoms and Antipsychotic Therapy in the Elderly Patients with Dementia

The objective of the study was to investigate syndromal-nosological specificities of neuropsychiatric symptoms (NPS) and the frequency of use of antipsychotics in patients with various types of dementias, institutionalized to geriatric units of mental hospitals.Patients and methods: a total of 106 in-patients of three psychogeriatric units were examined. The median age of patients is 75 years [69; 80].The diagnostic distribution of patients at the time of the examination was as follows: in 33 subjects (31.1%) Alzheimer’s disease (AD) was diagnosed, in 25 (23.6%) - mixed dementia (MD), in 32 (30.2%) - vascular dementia (VD) and in 16 (15.1%) patients had dementia of complex origin (DCO).Results: a high incidence (54.7%) of NPS was found in patients with dementia of various origins. The greatest number of patients with behavioral and psychotic symptoms was found in AD and MD. The proportion of dementia patients with such disorders in each of these types of dementia is about 70%, while in CGD and VD, the proportion of patients with NPS is noticeably smaller (30% and 40%, respectively). For the treatment of NPS, antipsychotics were most often prescribed, but their use caused adverse events (AEs) in 1/3 of cases. Patients with VD are most susceptible to the development of AE, and AD patients are the least susceptible.Conclusion: the study showed that NPS are one of the important components of dementia, regardless of the nosology and stage of the disease. The treatment of NPS in dementia is particularly challenging because, although the symptoms cause significant distress, there are currently no effective alternative therapies. The risk of AE can be minimized by carefully considering the indications for prescribing antipsychotics and their short-term use, regular monitoring of the patient’s condition, and educating caregivers.

A telemedicine system as a care modality for dementia patients in Korea.

Because dementia is a chronic debilitating disease, there are the issues of the difficulty in continuous long-term care and limited accessibility to medical service. We developed the telemedicine system for dementia patients and aimed to examine the acceptance, reliability, and clinical outcome of our telemedicine service. We established the Dementia Telemedicine Center in connection with two recipient sites in 1996. The reliability of the center, which provides telemedicine, tele-education, and telecounseling services, was tested by comparing assessment via our system with in-person assessment, and the clinical outcome was assessed by rating the changes of behavioral symptoms. There have been 140 registered patients for 2 years. The general acceptance of our system by the patients and caregivers was good, and the consistency rates between the assessment via our telemedicine system and in-person assessment ranged from 76% to 89%. A considerable proportion of dementia patients in nursing homes (46%) showed relative clinical improvements through our service. Our telemedicine system seems to be reliable and effective for the assessment and care of dementia patients. Our future direction is to promote our system as a core model of the home-based care system for dementia patients.

Workshop 5: Neuropathological Assessments

Within our workshop we discussed neuropathological assessments in different cultures and countries, evaluation of dementia type, and availability of autopsy. We agreed that evaluation of dementia cases should not be limited to the use of diagnostic criteria; but neuropathologic assessment should be utilized where appropriate. We agreed that it is vital to communicate this concept to general practitioners (GPs) and physicians working in nursing homes, where there is often a high proportion of dementia patients. When neuropathologic assessments are conducted correctly, they provide both quantitative and qualitative information about cell and tissue damage. The assessment should preferably be performed by a neuropathologist in order that a diagnosis plus an estimation of disease severity and extent can be made.