Symptoms and Treatment Needs of People with Dementia-Related Psychosis: A Mixed-Methods Study of the Patient Experience

Undergraduate nursing students' knowledge of and attitudes toward people with alzheimer's disease

As the population ages, the number of people living with Alzheimer's disease is expected to grow; consequently, nursing students are expected to care for more people with Alzheimer's disease in their future careers. Exploring nursing students' level of knowledge and attitudes is essential here to fill any knowledge gap and enhance attitudes. For this reason, the current study aimed to measure the knowledge of and attitudes toward people living with Alzheimer's disease among undergraduate Jordanian nursing students. A descriptive cross-sectional design was utilized. Data were collected through an online questionnaire consisting of the Alzheimer's Disease Knowledge Scale (ADKS) and Dementia Attitudes Scale (DAS). A third part contained questions about previous formal education about Alzheimer's disease, reading Alzheimer's research, and the need for formal education about Alzheimer's disease. The study targeted all undergraduate Jordanian nursing students. A total of 275 students agreed to participate and completed the questionnaire. Jordanian nursing students had low knowledge regarding people living with Alzheimer's disease, with a mean ADKS score of 18.3 out of 30; however, their attitudes were positive, with a mean DAS score of 91 out of 140. There was no statistical difference in attitude or knowledge between different academic levels. The majority of students (90.5%) expressed their desire to have a formal education regarding Alzheimer's disease. Knowledge regarding people with Alzheimer's disease could be improved through training and education. Positive attitudes reported by students could augment the learning process.

Psychosis as a Treatment Target in Dementia: A Roadmap for Designing Interventions

Psychotic phenomena are among the most severe and disruptive symptoms of dementias and appear in 30% to 50% of patients. They are associated with a worse evolution and great suffering to patients and caregivers. Their current treatments obtain limited results and are not free of adverse effects, which are sometimes serious. It is therefore crucial to develop new treatments that can improve this situation. We review available data that could enlighten the future design of clinical trials with psychosis in dementia as main target. Along with an explanation of its prevalence in the common diseases that cause dementia, we present proposals aimed at improving the definition of symptoms and what should be included and excluded in clinical trials. A review of the available information regarding the neurobiological basis of symptoms, in terms of pathology, neuroimaging, and genomics, is provided as a guide towards new therapeutic targets. The correct evaluation of symptoms is transcendental in any therapeutic trial and these aspects are extensively addressed. Finally, a critical overview of existing pharmacological and non-pharmacological treatments is made, revealing the unmet needs, in terms of efficacy and safety. Our work emphasizes the need for better definition and measurement of psychotic symptoms in dementias in order to highlight their differences with symptoms that appear in non-dementing diseases such as schizophrenia. Advances in neurobiology should illuminate the development of new, more effective and safer molecules for which this review can serve as a roadmap in the design of future clinical trials.