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Cognat E, Sabia S, Fayel A, Lilamand M, Handels R, Fascendini S, Bergh S, Frisoni GB, Fabbo A, Tsolaki M, Frölich L, Peters O, Merlo P, Ciccone A, Mecocci P, Dumurgier J, Defanti CA, Hugon J, Paquet C. BPSD Patterns in Patients With Severe Neuropsychiatric Disturbances: Insight From the RECAGE Study. Am J Geriatr Psychiatry 2023; 31:633-639. [PMID: 37183097 DOI: 10.1016/j.jagp.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVE Behavioral and psychological symptoms of dementia (BPSD) profiles vary depending on etiology in patients with mild-to-moderate BPSD. It is not known if similar differences exist in patients with severe BPSD. METHODS We analyzed data collected at baseline in 398 patients with severe BPSD (NPI ≥ 32) and defined diagnosis of dementia (Alzheimer's disease [AD] 297; frontotemporal dementia [FTD] 39; Lewy body disease/Parkinsonian dementia [LBD/PD] 31; and vascular dementia [VD] 31) included in the European multicenter cohort RECAGE. RESULTS Mean total NPI was 52.11 (18.55). LBD/PD patients demonstrated more hallucinations, more anxiety and more delusions than patients with other dementia. FTD patients had less delusions and more disinhibition than patients with other neurodegenerative disorders. These profiles overlapped partially with those reported in the literature in patients with less severe symptoms. CONCLUSION Patients with severe BPSD display different and specific profiles of neuropsychiatric symptoms depending on dementia etiology.
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Affiliation(s)
- Emmanuel Cognat
- Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Cognitive Neurology Center (EC, AF, ML, JD, JH, CP), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France.
| | - Séverine Sabia
- Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Université Paris Cité (SS, JD), Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
| | - Alexandra Fayel
- Université Paris Cité (SS, JD), Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
| | - Matthieu Lilamand
- Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Cognitive Neurology Center (EC, AF, ML, JD, JH, CP), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France; Department of Geriatry (ML), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France
| | - Ron Handels
- Alzheimer Centre Limburg (RH), School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Sara Fascendini
- Fondazione Europea di Ricerca Biomedica (FERB Onlus) (SF), Gazzaniga, Italy
| | - Sverre Bergh
- The Research Centre for Age-related Functional Decline and Disease (SB), Innlandet Hospital Trust, Ottestad, Norway; The Norwegian National Centre for Aging and Health (SB), Vestfold Hospital Trust, Tønsberg, Norway
| | - Giovanni B Frisoni
- Memory Clinic (GBF), Geneva University Hospitals, Geneva, Switzerland; Laboratory of Neuroimaging of Aging (LANVIE) (GBF), University of Geneva, Geneva, Switzerland
| | - Andrea Fabbo
- Geriatric Service-Cognitive Disorders and Dementia (AF), Department of Primary Care, Health Authority and Services of Modena, Modena, Italy
| | - Magdalina Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD) (MT), Thessaloniki, Hellas, Macedonia Greece; First Department of Neurology, School of Medicine (MT), Aristotle University of Thessaloniki (AUTh), Hellas, Macedonia Greece
| | - Lutz Frölich
- Department of Geriatric Psychiatry (LF), Central Institute of Mental Health; Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Oliver Peters
- Department of Psychiatry (OP), Charité Universitätsmedizin Berlin, Berlin, Germany; German Center for Neurodegenerative Diseases (DZNE) (OP), Berlin, Germany
| | - Paola Merlo
- Neurological Unit (PM), U.V.A. Centre, Humanitas Gavazzeni, Bergamo, Italy
| | - Alfonso Ciccone
- Department of Neurology with neurosurgical activity and stroke unit (AC), ASST di Mantova, Mantova, Italy
| | - Patrizia Mecocci
- Section of Gerontology and Geriatrics (PM), Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Clinical Geriatrics (PM), NVS Department, Karolinska Institutet, Stockholm, Sweden
| | - Julien Dumurgier
- Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Cognitive Neurology Center (EC, AF, ML, JD, JH, CP), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France; Université Paris Cité (SS, JD), Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
| | - Carlo A Defanti
- Fondazione Europea di Ricerca Biomedica (FERB Onlus) (SF), Gazzaniga, Italy
| | - Jacques Hugon
- Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Cognitive Neurology Center (EC, AF, ML, JD, JH, CP), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France
| | - Claire Paquet
- Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Cognitive Neurology Center (EC, AF, ML, JD, JH, CP), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France
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Ma D, Wang Y, Zhao Y, Meng X, Su J, Zhi S, Song D, Gao S, Sun J, Sun J. How to manage comorbidities in people with dementia: A scoping review. Ageing Res Rev 2023; 88:101937. [PMID: 37087058 DOI: 10.1016/j.arr.2023.101937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/17/2023] [Accepted: 04/17/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND People with dementia experience a high prevalence of comorbidities that seriously affect patient outcomes. The aim of this study was to map the evidence and components related to comorbidity management, including interventions to facilitate and support the practice of management. METHODS A scoping review was conducted. In June 2022, PubMed, Web of Science, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The National Institute of Health and Care Excellence (NICE), Open grey, and the Cochrane Library were searched to identify relevant literature. The inclusion criteria were outlined to identify studies on comorbidity management in people with dementia. RESULTS We found 43 items that met the inclusion criteria. The majority of the studies were published since 2010. Most research focused on medication management, health care service use and provision, and comorbidity-related monitoring and management; there were a small number of studies that involved decision-making. Only 6 studies developed interventions to support dementia care, which included comorbidity management. Studies involving the comorbidity management process were mainly based on qualitative methods, which make it difficult to quantify the impact of these processes on comorbidity management. CONCLUSIONS Given the serious impact of dementia on managing comorbidities, there is a need to develop systematic interventions targeting the management of comorbidities.
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Affiliation(s)
- Dongfei Ma
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Yonghong Wang
- Department of Neurology, The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Yanjie Zhao
- School of Nursing, Jilin University, Changchun, Jilin, China; School of Nursing, Xinjiang Medical University, Urumqi Municipality, Xinjiang, China
| | - Xiangfei Meng
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Jianping Su
- School of Nursing, Jilin University, Changchun, Jilin, China; School of Nursing, Xinjiang Medical University, Urumqi Municipality, Xinjiang, China
| | - Shengze Zhi
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Dongpo Song
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Shizheng Gao
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Juanjuan Sun
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Jiao Sun
- School of Nursing, Jilin University, Changchun, Jilin, China.
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Naharci MI, Kayahan Satis N, Ozsurekci C, Tasci I. Assessment of clinical features and coexisting geriatric syndromes in newly diagnosed dementia with Lewy bodies: a retrospective study in a tertiary geriatrics setting in Turkey. Eur Geriatr Med 2023; 14:19-27. [PMID: 36512254 DOI: 10.1007/s41999-022-00727-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Identifying the associated clinical conditions in patients with newly diagnosed dementia with Lewy bodies (DLB) may contribute to the disease management. This study aimed to examine the clinical features and coexisting geriatric syndromes of patients with newly diagnosed DLB. METHOD This cross-sectional study included newly diagnosed DLB participants who were admitted to a tertiary geriatric outpatient clinic. Of the 857 patients with dementia, 116 DLB diagnoses were eligible for analysis. The core and supportive clinical features of DLB were recorded. Geriatric syndromes including polypharmacy, depression, insomnia, dependency, a history of delirium, falls, malnutrition, urinary incontinence, functional impairment, and living alone, were assessed and recorded at baseline. RESULTS The mean age was 79.0 ± 6.9 years, and 50.9% of the participants were female. The majority (63.8%) had mild dementia, 31.9% had moderate, and 4.3% had severe disease. Cognitive fluctuations (78.4%), visual hallucinations (77.6%), and Parkinsonism (73.3%) were the most common clinical features. Functional impairment (59.5%) and urinary incontinence (59.5%) were the leading geriatric syndromes, followed by polypharmacy (56.9%), depressive symptoms (54.7%), falls (52.6%), insomnia (49.1%), malnutrition (24.3%), and delirium (6.0%). Women had more functional impairment and depressive symptoms than men. CONCLUSION Although most patients had mild dementia, three-quarters of the DLB cohort had hallucinations, and nearly two-thirds were functionally impaired. The proportion of other serious health conditions also increased, indicating a high comorbidity and geriatric syndrome burden. Comprehensive geriatric assessment is strongly recommended for DLB patients from the time of diagnosis until death to reduce disability and comorbidities. THE CLINICAL TRIAL REGISTRATION NUMBER NCT05052450.
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Affiliation(s)
- Mehmet Ilkin Naharci
- Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Division of Geriatrics, University of Health Sciences, 06010, Ankara, Turkey
| | - Neslihan Kayahan Satis
- Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Division of Geriatrics, University of Health Sciences, 06010, Ankara, Turkey
| | - Cemile Ozsurekci
- Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Division of Geriatrics, University of Health Sciences, 06010, Ankara, Turkey.
| | - Ilker Tasci
- Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, University of Health Sciences, 06010, Ankara, Turkey
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Soysal P, Koc Okudur S, Uslu F, Smith L. Functional loss and worsening geriatric assessment parameters are more common in dementia with Lewy bodies than Alzheimer's disease. Psychogeriatrics 2023; 23:77-85. [PMID: 36349708 DOI: 10.1111/psyg.12905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/08/2022] [Accepted: 10/20/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND The main aim of this study was to compare older patients with Alzheimer's disease (AD) to those with dementia with Lewy bodies (DLB) according to their dependency in daily living activities and comprehensive geriatric assessment parameters. METHOD A total of 227 AD and 123 DLB patients underwent a geriatric assessment that included comorbidities, number of drugs used, falls, urinary incontinence, hand grip strength, Mini-Nutritional Assessment (MNA), Tinetti Performance Oriented Mobility Assessment Scale, Insomnia Severity Index (ISI), and Epworth Sleepiness Scale. Basic and instrumental activities of daily living were assessed by the Barthel Index and the Lawton scale, respectively. RESULTS The mean age of the participants was 83.4 years, and 73% were female. There were no statistically significant differences between AD and DLB patients in age, gender, cognitive function, or comorbidities except for coronary artery disease (P < 0.05). The number of falls, drugs used, and ISI and Epworth scores were higher in patients with DLB than patients with AD (P < 0.05). DLB patients had lower MNA, Tinetti scale, and hand grip strength scores than AD patients. The ratio of patients highly dependent in basic daily activities as a whole was significantly greater in DLB than in AD (P < 0.05), but there was no significant difference in the overall levels of dependency in instrumental activities. CONCLUSION DLB patients are more dependent on their caregivers than AD patients. Nutritional deterioration, sleep disorders, falls, balance and gait problems, decreased muscle strength, and multiple drug use are more common in those with DLB compared to those with AD. The management of older patients with DLB may be more difficult than older patients with AD.
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Affiliation(s)
- Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkiye
| | - Saadet Koc Okudur
- Department of Geriatric Medicine, Manisa State Hospital, Manisa, Turkey
| | - Ferda Uslu
- Department of Neurology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkiye
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
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Liang CK, Chou MY, Hsu YH, Wang YC, Liao MC, Chen MT, Hsiao PY, Chen LK, Lin YT. The association of potentially inappropriate medications, polypharmacy and anticholinergic burden with readmission and emergency room revisit after discharge: A hospital-based retrospective cohort study. Br J Clin Pharmacol 2023; 89:187-200. [PMID: 35821614 DOI: 10.1111/bcp.15457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/05/2022] [Accepted: 06/30/2022] [Indexed: 11/30/2022] Open
Abstract
AIMS While certain drug-use indicators are known to be associated with clinical outcomes, the relationship is unclear for some highly prevalent conditions in in patients aged ≥65 years. We examine correlations between 3 drug-use indicators and postdischarge healthcare services use by older patients according to the presence of dementia, advanced age and frailty. METHODS This retrospective cohort study analysed data collected from hospital electronic health records between April and December 2017. Potentially inappropriate medications (PIMs) and anticholinergic burden were assessed using the 2015 Beers Criteria and anticholinergic cognitive burden scale (ACBS) score. Minor and major polypharmacy were defined as the use of 5-9 and ≥10 drugs, respectively. Outcomes were set as emergency room revisits and readmissions at 1, 3 and 6 months postdischarge. The correlation between drug-use indicators and outcomes was analysed by multivariable logistic regression. RESULTS The final cohort included 3061 patients for the analysis, and 2930, 2671 and 2560 patients were followed up to 1, 3 and 6 months after discharge. After controlling for confounders, all 3 drug-use indicators were significantly associated with readmission and emergency room revisits except for the relationship between PIMs and readmission within 6 months. These associations were significantly observed among patients without dementia, aged >80 years and with frailty. CONCLUSION PIMs, polypharmacy and anticholinergic burden are common at discharge and correlate with future use of healthcare services. In older patients, the absence of dementia, advanced age and frailty should be given extra consideration with regard to medication safety.
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Affiliation(s)
- Chih-Kuang Liang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan.,Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei City, Taiwan.,Department of Geriatric Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.,Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Ming-Yueh Chou
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan.,Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei City, Taiwan.,Department of Geriatric Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan
| | - Ying-Hsin Hsu
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan.,Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan.,Chia Nan University, Tainan City, Taiwan
| | - Yu-Chun Wang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Mei-Chen Liao
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Miao-Ting Chen
- Department of Pharmacy, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Pei-Yu Hsiao
- Department of Pharmacy, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei City, Taiwan.,Department of Geriatric Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.,Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei City, Taiwan
| | - Yu-Te Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan.,Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan.,Department of Pharmacy, Tajen University, Yanpu Township, Pingtung County, Taiwan
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Elder GJ, Lazar AS, Alfonso‐Miller P, Taylor J. Sleep disturbances in Lewy body dementia: A systematic review. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5814. [PMID: 36168299 PMCID: PMC9827922 DOI: 10.1002/gps.5814] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/13/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Lewy body dementia (LBD) refers to both dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD). Sleep disturbances are common in LBD, and can include poor sleep quality, excessive daytime sleepiness (EDS), and rapid eye movement behaviour disorder (RBD). Despite the high clinical prevalence of sleep disturbances in LBD, they are under-studied relative to other dementias. The aim of the present systematic review was to examine the nature of sleep disturbances in LBD, summarise the effect of treatment studies upon sleep, and highlight specific and necessary directions for future research. METHODS Published studies in English were located by searching PubMED and PSYCArticles databases (until 10 June 2022). The search protocol was pre-registered in PROSPERO (CRD42021293490) and performed in accordance with PRISMA guidelines. RESULTS Following full-text review, a final total of 70 articles were included. These included 20 studies focussing on subjective sleep, 14 on RBD, 8 on EDS, 7 on objective sleep, and 1 on circadian rhythms. The majority of the 18 treatment studies used pharmacological interventions (n = 12), had an open-label design (n = 8), and were of low-to-moderate quality. Most studies (n = 55) included only patients with DLB. Due to the heterogeneity of the studies, we reported a narrative synthesis without meta-analysis. CONCLUSIONS At least one form of sleep disturbance may be present in as many as 90% of people with LBD. Subjectively poor sleep quality, excessive daytime sleepiness, and RBD are more common and severe in LBD relative to other dementias.
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Affiliation(s)
- Greg J. Elder
- Northumbria Sleep ResearchDepartment of PsychologyFaculty of Health and Life SciencesNorthumbria UniversityNewcastle upon TyneUK
| | - Alpar S. Lazar
- Sleep and Brain Research UnitFaculty of Medicine and Health SciencesUniversity of East AngliaNorwichUK
| | - Pam Alfonso‐Miller
- Northumbria Sleep ResearchDepartment of PsychologyFaculty of Health and Life SciencesNorthumbria UniversityNewcastle upon TyneUK
| | - John‐Paul Taylor
- Translational and Clinical Research InstituteNewcastle UniversityCampus for Ageing and VitalityNewcastle Upon TyneUK
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Borda MG, Jaramillo‐Jimenez A, Giil LM, Tovar‐Rios DA, Soennesyn H, Aarsland D. Body mass index trajectories and associations with cognitive decline in people with Lewy body dementia and Alzheimer's disease. Health Sci Rep 2022; 5:e590. [PMID: 35509416 PMCID: PMC9060322 DOI: 10.1002/hsr2.590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 11/28/2022] Open
Abstract
Background and Aims In older adults with dementia, low body mass index (BMI) is associated with higher mortality and other adverse health outcomes. BMI or nutritional status trajectories from diagnosis have not yet been well described in dementia, especially in people with Lewy body dementia (LBD); a group that has a poorer prognosis. With this study, we aimed to evaluate the BMI trajectory in people diagnosed with mild LBD and Alzheimer's disease (AD). Methods The Dementia Study of Western Norway is a cohort study with annual assessments. Five-year measurements of BMI from 196 patients (LBD = 85 and AD = 111) diagnosed with mild dementia were analyzed using adjusted linear mixed-effects models. Results There were no differences between LBD and AD in baseline BMI, age, or mini-mental status examination (MMSE). During the follow-up, we observed a significant decrease in BMI in the LBD group across the study period (estimation [Est.]: -0.63, SE: 0.14; p < 0.001). By contrast, there was no significant change in BMI trajectory associated with AD diagnosis (Est.: 0.05, SE: 0.15; p = 0.730). Further, the introduction of an interaction term between diagnosis and time in the study showed that this difference (BMI trajectories) was significant (Est.: -0.63, SE: 0.14; p < 0.001). In addition, there was a significant interaction between MMSE total score and the follow-up time; the lower the MMSE, the lower the BMI (Est.: 0.01, SE: 0.01; p = 0.044). Conclusion In LBD, BMI significantly decreased with disease progression. In addition, low cognitive performance was associated with a reduction in BMI. These results highlight the importance of BMI evaluation in people with dementia, particularly patients diagnosed with LBD, and suggest that patients with LBD could be targeted for dietary intervention to maintain body weight.
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Affiliation(s)
- Miguel G. Borda
- Centre for Age‐Related Medicine (SESAM)Stavanger University HospitalStavangerNorway
- Semillero de Neurociencias y Envejecimiento, Medical School, Ageing InstitutePontificia Universidad JaverianaBogotáColombia
- Faculty of Health SciencesUniversity of StavangerStavangerNorway
| | - Alberto Jaramillo‐Jimenez
- Centre for Age‐Related Medicine (SESAM)Stavanger University HospitalStavangerNorway
- Faculty of Health SciencesUniversity of StavangerStavangerNorway
- Grupo de Neurociencias de Antioquia, School of MedicineUniversidad de AntioquiaMedellínColombia
- Grupo Neuropsicología y Conducta, School of MedicineUniversidad de AntioquiaMedellínColombia
| | - Lasse M. Giil
- Department of Internal MedicineHaraldsplass Deaconess HospitalBergenNorway
| | - Diego A. Tovar‐Rios
- Centre for Age‐Related Medicine (SESAM)Stavanger University HospitalStavangerNorway
- Faculty of Health SciencesUniversity of StavangerStavangerNorway
- Faculty of EngineeringUniversidad Del ValleValle Del CaucaColombia
| | - Hogne Soennesyn
- Centre for Age‐Related Medicine (SESAM)Stavanger University HospitalStavangerNorway
| | - Dag Aarsland
- Centre for Age‐Related Medicine (SESAM)Stavanger University HospitalStavangerNorway
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and NeuroscienceKing's College LondonLondonUK
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Yang SN, Chueh CH, Peng LN, Tsai YW. Impacts of Intervals Between Sequential Development of Depression and Dementia in Older Adults: A Nationwide Population-based Study. Arch Gerontol Geriatr 2022; 101:104693. [DOI: 10.1016/j.archger.2022.104693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/20/2022] [Accepted: 03/20/2022] [Indexed: 11/02/2022]
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9
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Borda MG, Aarsland D, Cano-Gutiérrez CA, Pérez-Zepeda MU. Actions to be taken for improving functional prognosis in dementia. J Neurol Sci 2022; 434:120156. [DOI: 10.1016/j.jns.2022.120156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/14/2021] [Accepted: 01/11/2022] [Indexed: 10/19/2022]
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Dunn R, Clayton E, Wolverson E, Hilton A. Conceptualising comorbidity and multimorbidity in dementia: A scoping review and syndemic framework. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2022; 12:26335565221128432. [PMID: 36187908 PMCID: PMC9520180 DOI: 10.1177/26335565221128432] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Older people and people with dementia experience a high prevalence of multiple health conditions. The terms ‘comorbidity’ and ‘multimorbidity’ are often used interchangeably to describe this, however there are key conceptual differences between these terms and their definitions. This has led to issues in the validity and comparability of research findings, potentially inappropriate intervention development and differences in quality of health care. Objective To review how the terms ‘comorbidity’ and ‘multimorbidity’ are defined within peer-reviewed dementia research and propose an operational framework. Design A scoping review of definitions within dementia research was carried out. Searches took place across five databases: Academic Search Premier, CINAHL Complete, MEDLINE, PsycARTICLES and PsycINFO. PRISMA-ScR guidelines were followed. Results Content analysis revealed five key themes, showing significant overlap and inconsistencies from both within, and between, the comorbidity and multimorbidity definitions; 1. Number of conditions; 2. Type of health conditions; 3. The co-occurrence of conditions; 4. The inclusion of an index disease (or not); 5. Use of medical language. The analysis also revealed gaps in how the underlying concepts of the definitions relate to people with dementia living with multiple health conditions. Conclusion This scoping review found that current definitions of comorbidity and multimorbidity are heterogeneous, reductionist and disease-focussed. Recommendations are made on the design of research studies including transparency and consistency of any terms and definitions used. A syndemic framework could be a useful tool for researchers, clinicians and policy makers to consider a more holistic picture of a person with dementia’s health and wellbeing.
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Meng LC, Hsiao FY, Huang ST, Lu WH, Peng LN, Chen LK. Intrinsic Capacity Impairment Patterns and their Associations with Unfavorable Medication Utilization: A Nationwide Population-Based Study of 37,993 Community-Dwelling Older Adults. J Nutr Health Aging 2022; 26:918-925. [PMID: 36259580 DOI: 10.1007/s12603-022-1847-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Abstract
OBJECTIVES Our aim was to explore the patterns of intrinsic capacity (IC) impairments among community-dwelling older adults and the associations of these different patterns with excessive polypharmacy, potentially inappropriate medications, and adverse drug reactions in a nationwide population-based study. DESIGN A cross-sectional study included older adults from the Taiwan Integrated Care for Older People (ICOPE) program in 2020. SETTING AND PARTICIPANTS The study subjects comprised 38,308 adults aged 65 years and older who participated in the ICOPE Step 1 screening and assessed six domains of IC following the World Health Organization (WHO) ICOPE approach. METHODS Latent class analysis was adopted to identify distinct subgroups with different IC impairments patterns. The associations between different IC impairments patterns and unfavorable medication utilization, including excess polypharmacy (EPP), potentially inappropriate medications (PIMs), and adverse drug reactions (ADRs), were assessed by multivariate logistic regression models. RESULTS Latent class analysis identified five distinct subgroups with different IC impairment patterns: robust (latent class prevalence: 59.4%), visual impairment (17.7%), physio-cognitive decline (PCD) with sensory impairment (12.3%), depression with cognitive impairment (7.7%), and impairments in all domains (2.9%). Compared to the robust group, all other groups were at higher odds for unfavorable medication utilization. The "depression with cognitive impairment" group (EPP: aOR=4.35, 95% CI 3.52-5.39, p<0.01; PIMs: aOR=2.73, 95% CI 2.46-3.02, p<0.01) and the "impairment in all domains" group (EPP: aOR=9.02, 95% CI 7.16-11.37, p<0.01; PIMs: aOR=3.75, 95% CI 3.24-4.34, p<0.01) remained at higher odds for EPP and PIMs after adjustment. CONCLUSIONS We identified five distinct impairment patterns of IC, and each impairment pattern, particularly the "depression with cognitive impairment" and "impairment in all domains", was associated with higher odds of EPP and PIMs. Further longitudinal and intervention studies are needed to explore long-term outcomes of different impairment pattern and their reversibility.
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Affiliation(s)
- L-C Meng
- Li-Ning Peng, MD, PhD, Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec 2 Shih-Pai Road, Taipei, Taiwan, TEL: +886-2-28757830, FAX: +886-2-28757711,
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