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Abenza Abildua MJ, Lanz Santos E, Moreno Domínguez L, Mata Álvarez-Santullano M, Borrue Fernández C, Palmí Cortés I, Lobato Rodríguez R, Navacerrada Barrero FJ, Martínez Ubierna S, Gómez Aceña A Á, Suárez Gisbert E, Lores Gutiérrez V, Gómez de la Riva Á, Pérez López C, Novo Aparicio S. Early cortical atrophy in REM sleep behavior disorder. Med Clin (Barc) 2024:S0025-7753(24)00188-X. [PMID: 38679497 DOI: 10.1016/j.medcli.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION The presence of cortical atrophy (focal or diffuse) prior to the development of symptoms of cognitive impairment could predict the earliest cases of neurodegenerative disease in patients with REM sleep behavior disorder (RSBD). We reviewed the usefulness of cranial CT and MRI as early markers of cortical atrophy in patients with RSBD at our center. PATIENTS AND METHODS Retrospective observational descriptive analysis of patients diagnosed with RSBD from October 2012 to October 2022. All with cranial CT or MRI, evaluated by a neuroradiologist. RESULTS 54 patients were included, 21 women (38.88%), 33 men (61.12%), mean age at diagnosis of RSBD: 69.04±12.625 years. Of the 54 patients, 44 (81.48%) had imaging tests consistent with their age, and 10 had atrophy greater than expected for their age. Of the 54 patients, 21 (38.88%) with a diagnosis of neurodegenerative disease, 33 (61.12%) persist as idiopathic, almost all with more than 5years of evolution (range of 1 to 10years of evolution without diagnosis). Of the 10 (18.52%) patients with greater atrophy, all were diagnosed with neurodegenerative disease (8 in 1year, 2 in 8years). CONCLUSIONS Almost half of our series have developed a neurodegenerative disease in the first 10years of evolution. The majority of them presented global cortical atrophy measured by the GCA scale in the first year of diagnosis, without other neurological symptoms. Patients who did not show cortical atrophy at diagnosis have not yet developed the neurodegenerative disease in 10years of evolution. In our experience, the absence of cortical atrophy on cranial MRI or CT (measured by scales such as GCA) at the diagnosis of RSBD seems to predict slower progression cases. These data should be corroborated with larger series.
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Affiliation(s)
- María José Abenza Abildua
- Unidad del Sueño, Sección de Neurología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España.
| | - Elvira Lanz Santos
- Sección de Neurorradiología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España
| | - Luis Moreno Domínguez
- Sección de Neurorradiología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España
| | - Marina Mata Álvarez-Santullano
- Unidad del Sueño, Sección de Neurología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España
| | - Carmen Borrue Fernández
- Unidad del Sueño, Sección de Neurología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España
| | - Itziar Palmí Cortés
- Unidad del Sueño, Sección de Neurología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España
| | - Ricardo Lobato Rodríguez
- Unidad del Sueño, Sección de Neurología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España
| | | | - Sonia Martínez Ubierna
- Unidad del Sueño, Sección de Neurología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España
| | - Ángeles Gómez Aceña A
- Unidad del Sueño, Sección de Neumología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España
| | - Eugenio Suárez Gisbert
- Unidad del Sueño, Servicio de Psiquiatría, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España
| | - Vanesa Lores Gutiérrez
- Unidad del Sueño, Sección de Neumología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España
| | - Álvaro Gómez de la Riva
- Servicio de Neurocirugía, Complejo Hospital Universitario La Paz-Cantoblanco-CarlosIII, Madrid, España
| | - Carlos Pérez López
- Servicio de Neurocirugía, Complejo Hospital Universitario La Paz-Cantoblanco-CarlosIII, Madrid, España
| | - Susana Novo Aparicio
- Sección de Neurorradiología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España
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Fernández López M, Martín-Baranera M, Davins Riu M, Fontecha Gómez B. [Tecuide. Telemonitoring of patients with dementia and their caregivers]. Rev Esp Geriatr Gerontol 2024; 59:101492. [PMID: 38574566 DOI: 10.1016/j.regg.2024.101492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION Given the growing increase in dementia, the need to control these patients, together with the rise of new technologies, makes a change in the current control system imperative. MATERIAL AND METHOD We have carried out a single-center, clinical study with two groups, a control group of 72 patients/caregivers, who followed the usual controls in consultations, and another telematic group of 76 patients/caregivers, who followed the controls through of the Tecuide platform. The platform had a survey part to detect problems in patients and caregiver claudication, another training part and another chat for direct communication when the caregiver needed it and also served to respond when a problem was detected. RESULTS After a year of monitoring with the platform we have obtained: a)in patients, reduce behavioral disorders and use of drugs, increase physical exercise and delay institutionalization (DS not found); b)in caregivers there is an improvement in satisfaction with respect to the control of patients with cognitive impairment, and c)in terms of resources, visits to emergency services and dementia consultations have decreased, although admissions to the psychogeriatric unit have increased. CONCLUSIONS The use of Tecuide as a telematic tool in the control of patients with cognitive impairment does not seem to be inferior to the usual controls in consultations and improves caregiver satisfaction.
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Affiliation(s)
- Mercedes Fernández López
- Hospital Sociosanitari de l'Hospitalet - Consorci Sanitari Integral, Hospitalet de Llobregat, Barcelona, España.
| | - Montserrat Martín-Baranera
- Hospital Sociosanitari de l'Hospitalet - Consorci Sanitari Integral, Hospitalet de Llobregat, Barcelona, España
| | | | - Benito Fontecha Gómez
- Hospital Sociosanitari de l'Hospitalet - Consorci Sanitari Integral, Hospitalet de Llobregat, Barcelona, España
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Leira Y, Vivancos J, Diz P, Martín Á, Carasol M, Frank A. The association between periodontitis and cerebrovascular disease, and dementia. Scientific report of the working group of the Spanish Society of Periodontology and the Spanish Society of Neurology. Neurologia 2024; 39:302-311. [PMID: 38224833 DOI: 10.1016/j.nrleng.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/03/2023] [Indexed: 01/17/2024] Open
Abstract
OBJECTIVE This article reviews the scientific evidence on the relationship between periodontitis and neurological disease, and particularly cerebrovascular disease and dementia. We also issue a series of recommendations regarding the prevention and management of periodontitis and these neurological diseases at dental clinics and neurology units. DEVELOPMENT In response to a series of questions proposed by the SEPA-SEN working group, a literature search was performed, with no restrictions on study design, to identify the most relevant articles on the association between periodontitis and cerebrovascular disease and dementia from the perspectives of epidemiology, treatment, and the biological mechanisms involved in these associations. CONCLUSIONS Periodontitis increases the risk of ischaemic stroke and Alzheimer dementia. Recurrent bacterial infections and increased low-grade systemic inflammation seem to be possible biological mechanisms underlying this association. Limited evidence suggests that various oral health interventions can reduce the future risk of cerebrovascular disease and dementia.
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Affiliation(s)
- Y Leira
- Unidad de Periodoncia, Facultad de Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, Spain; Grupo de Investigación en Neuroenvejecimiento, Laboratorio de Investigación en Neurociencias Clínicas (LINC), Instituto de Investigación Sanitaria de Santiago (IDIS), Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Grupo de Trabajo de la Sociedad Española de Periodoncia (SEPA) y Sociedad Española de Neurología (SEN), Madrid, Spain.
| | - J Vivancos
- Grupo de Trabajo de la Sociedad Española de Periodoncia (SEPA) y Sociedad Española de Neurología (SEN), Madrid, Spain; Servicio de Neurología, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - P Diz
- Grupo de Trabajo de la Sociedad Española de Periodoncia (SEPA) y Sociedad Española de Neurología (SEN), Madrid, Spain; Unidad de Pacientes Especiales, Facultad de Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Á Martín
- Grupo de Trabajo de la Sociedad Española de Periodoncia (SEPA) y Sociedad Española de Neurología (SEN), Madrid, Spain; Servicio de Neurología, Hospital Universitario de La Paz, Universidad Autónoma de Madrid, Madrid, Spain
| | - M Carasol
- Grupo de Trabajo de la Sociedad Española de Periodoncia (SEPA) y Sociedad Española de Neurología (SEN), Madrid, Spain; Grupo de Investigación en Etiología y Terapéutica de Enfermedades Periodontales y Periimplantarias, Universidad Complutense de Madrid, Madrid, Spain
| | - A Frank
- Grupo de Trabajo de la Sociedad Española de Periodoncia (SEPA) y Sociedad Española de Neurología (SEN), Madrid, Spain; Servicio de Neurología, Hospital Universitario de La Paz, Universidad Autónoma de Madrid, Madrid, Spain
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Ruisch JE, Havermans DCD, Gielkens EMJ, Olff M, Daamen MAMJ, van Alphen SPJ, van Kordenoordt M, Schols JMGA, Schruers KRJ, Sobczak S. Posttraumatic stress disorder in people with dementia: study protocol. Eur J Psychotraumatol 2024; 15:2320040. [PMID: 38488137 PMCID: PMC10946268 DOI: 10.1080/20008066.2024.2320040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/31/2024] [Indexed: 03/19/2024] Open
Abstract
Background: Posttraumatic stress disorder (PTSD) is considered an independent risk factor for dementia. Despite the (clinical) evidence that PTSD is associated with neuropsychiatric symptoms in people with dementia, studies on its prevalence and clinical manifestation are limited, and their quality is affected by the lack of a structured method to diagnose PTSD in this population. The primary aim of the current study is to validate the 'TRAuma and DEmentia' interview as a diagnostic tool for PTSD in people with dementia and to test feasibility of EMDR treatment for people with PTSD and dementia.Methods: This prospective multi-centre study is divided into two parts. In study A, 90 participants with dementia will be included to test the criterion validity, inter-rater reliability and feasibility of the 'TRAuma and DEmentia' interview. In study B, 29 participants with dementia and PTSD will receive eye movement desensitisation and reprocessing therapy by a trained psychologist, and 29 participants with dementia and PTSD will be placed on the waiting list control group.Conclusion: This study aims to improve the diagnostic process of PTSD and to assess the effects of eye movement desensitisation and reprocessing treatment in people with dementia living in Dutch care facilities.Trial registration: NL70479.068.20 / METC 20-063 / OSF registration: https://doi.org/10.17605/OSF.IO/AKW4F.
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Affiliation(s)
- J. E. Ruisch
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht, the Netherlands
- Envida, Care for Older People, Department of Treatment and Support, Maastricht, the Netherlands
- Department of Family Medicine, Maastricht University, Maastricht, the Netherlands
| | - D. C. D. Havermans
- Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
- Faculty of Psychology and Neuroscience, Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands
- TanteLouise, Bergen op Zoom, the Netherlands
| | - E. M. J. Gielkens
- Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
- Vrije Universiteit Brussel (VUB), Department of Psychology, Personality and Psychopathology Research Group (PEPS), Brussels, Belgium
| | - M. Olff
- Department of Psychiatry, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health, Amsterdam, the Netherlands
- ARQ National Psychotrauma Centre, Diemen, the Netherlands
| | - M. A. M. J. Daamen
- Department of Family Medicine, Maastricht University, Maastricht, the Netherlands
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Cicero, Department of Treatment and Guidance, Brunssum, the Netherlands
| | - S. P. J. van Alphen
- Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
- Vrije Universiteit Brussel (VUB), Department of Psychology, Personality and Psychopathology Research Group (PEPS), Brussels, Belgium
| | - M. van Kordenoordt
- Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
- Zuyderland Care, Sittard, the Netherlands
| | - J. M. G. A. Schols
- Envida, Care for Older People, Department of Treatment and Support, Maastricht, the Netherlands
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - K. R. J. Schruers
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht, the Netherlands
- Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
| | - S. Sobczak
- Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
- Faculty of Psychology and Neuroscience, Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands
- Research Center Innovations in Care, Rotterdam University of Applied Science, Rotterdam, the Netherlands
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Rodríguez Espinosa N, Gonzalez-Colaço Harmand M, Moro Miguel MA. [Use of antipsychotics in patients with dementia in Spain: Comparison with prescription of acetylcholinesterase inhibitors and memantine and analysis of associations]. Rev Esp Geriatr Gerontol 2024; 59:101446. [PMID: 38029634 DOI: 10.1016/j.regg.2023.101446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 10/25/2023] [Accepted: 11/02/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE We have analyzed the prevalence of antipsychotics in patients with dementia in Spain, their age distribution and the influence of treatment with IACEs and memantine on their prescription. METHOD Descriptive, retrospective and cross-sectional study of the 2017 BIFAP database in over 65 years of age with dementia. Prescriptions of antipsychotics, IACEs and memantine were collected. For antipsychotics were also collected, the duration of treatment and time from dementia diagnosis to prescription. RESULTS A total of 1,327,792 subjects were retrieved, 89,464 (6.73%) with dementia. Antipsychotics were prescribed in 31.76%; by frequency: quetiapine (58.47%), risperidone (21%) and haloperidol (19.34%). Prescriptions of IACEs and memantine were clustered in those younger than 84 years and antipsychotics in those older than 85 (P<.001). Antipsychotics were maintained for a mean of 1174.5 days. In 26.4% of cases they were prescribed alone, OR 0.61 (95% CI: 0.59-0.62), in 35.85% associated with IACEs, OR 1.26 (95% CI: 1.22-1.30) and in 42.4% with memantine, OR 1.69 (95% CI: 1.62-1.78) (P<.000). From the diagnosis of dementia, 461 days (±1576.5) elapsed when isolated drugs were prescribed; 651 days (±1574.25) associated with IACEs and 1224 (±1779) with memantine. CONCLUSIONS One third of patients with dementia were prescribed antipsychotics, mostly atypical, more frequently in those older than 85 years and for prolonged periods. IACEs and memantine were associated with the risk of antipsychotic prescription, but paradoxically, with prolonged time to onset.
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Affiliation(s)
- Norberto Rodríguez Espinosa
- Unidad de Neurología de la Conducta y Memoria, Servicio de Neurología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Tenerife, España; Departamento de Medicina, Psiquiatría y Dermatología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna/Santa Cruz de Tenerife, Tenerife, España.
| | - Magali Gonzalez-Colaço Harmand
- Unidad de Investigación, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Tenerife, España; Universidad Europea de Canarias, La Orotava/Santa Cruz de Tenerife, Tenerife, España
| | - María Adoración Moro Miguel
- Unidad de Neurología de la Conducta y Memoria, Servicio de Neurología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Tenerife, España
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Yeverino Gutiérrez ML, González González MDR, González Santiago O. Trends in Parkinson's mortality in Mexico 2000-2020. Gac Sanit 2024; 38:102361. [PMID: 38422946 DOI: 10.1016/j.gaceta.2024.102361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/21/2023] [Accepted: 11/30/2023] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To describe the recent trends in Parkinson's disease mortality in Mexico during 2000-2020. METHOD The adjusted mortality rate per 100,000 inhabitants was calculated using the direct method and the world standard population. Trend analysis was performed with the Joinpoint software. RESULTS The average mortality rate was 1.26/100,000 inhabitants (SD: 0.09), and males showed higher mortality than females (M/F ratio=1.60). Older individuals ≥70 years old showed higher mortality rates than the rest of the age groups. During the period of study, a significant increase in mortality was observed from 2000 to 2005, while from 2005 to 2020 no significant trend was observed in all the studied groups. CONCLUSIONS In Mexico, males and older individuals showed the highest mortality rates. The socioeconomic regions with high levels of wellness showed the highest mortality rates levels. Parkinson's mortality rate has remained constant since 2005 in Mexico.
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Affiliation(s)
- Myrna L Yeverino Gutiérrez
- Laboratory of Pharmacology, Facultad de Ciencias Químicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
| | | | - Omar González Santiago
- Postgraduate Coordination in Pharmacy, Facultad de Ciencias Químicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México.
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Zhao J, Li T, Wang J. Association between psoriasis and dementia: A systematic review. Neurologia 2024; 39:55-62. [PMID: 38161072 DOI: 10.1016/j.nrleng.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/14/2020] [Indexed: 01/03/2024] Open
Abstract
INTRODUCTION Risk factors for dementia include genetic factors, aging, environmental factors, certain diseases, and unhealthy lifestyle; most types of dementia share a common chronic systemic inflammatory phenotype. Psoriasis is also considered to be a chronic systemic inflammatory disease. It has been suggested that psoriasis may also contribute to the risk of dementia. The aim of this study was to systematically review the literature on the association between psoriasis and dementia. DEVELOPMENT Articles were selected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the PubMed and Web of Science databases to identify articles published in peer-reviewed journals and studying the association between psoriasis and dementia. Studies meeting the inclusion criteria were reviewed. We used the Newcastle-Ottawa Scale to assess the quality of each study. After applying the inclusion and exclusion criteria, we included 8 studies for review, 3 of which were found to present a higher risk of bias. Six of the 8 studies supported the hypothesis that prior diagnosis of psoriasis increases the risk of dementia; one study including only a few cases reported that psoriasis decreased the risk of dementia, and one study including relatively young patients found no significant association between psoriasis and the risk of dementia. CONCLUSION Most studies included in this review supported the hypothesis that psoriasis constitutes a risk factor for dementia. However, well-designed stratified cohort studies assessing both psoriasis severity and treatment status are still required to determine the real effect of psoriasis on the risk of dementia and its subtypes.
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Affiliation(s)
- J Zhao
- Academy of Life Sciences, School of Medicine, Xi'an International University, Xi'an, China.
| | - T Li
- Disease Prevention and Control Section, Shangcai People's Hospital, Shangcai, China
| | - J Wang
- Academy of Life Sciences, School of Medicine, Xi'an International University, Xi'an, China
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Martínez-Contreras CA, Moreno-Fergusson ME. [Quality of life in institutionalized older adults with moderate to severe major neurocognitive disorder: Effect of Doll therapy]. Rev Esp Geriatr Gerontol 2023; 58:101410. [PMID: 37826931 DOI: 10.1016/j.regg.2023.101410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 07/22/2023] [Accepted: 09/14/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND AND OBJECTIVES Major neurocognitive disorder is characterized by progressive cognitive impairment, a decrease in the person's ability to perform activities of daily living and the appearance of psychological and behavioral symptoms that lead to a deterioration in the quality of life and progression towards institutionalization. The most common management of major neurocognitive disorder is pharmacological therapy that mitigates or slow progressive deterioration and symptom control. The objective of this study was to establish the effect of a nursing intervention based on Doll therapy, compared to conventional care on the quality of life of older adults with moderate to severe major neurocognitive disorder institutionalized in nursing homes in the city of Medellín, Colombia. METHODS Pilot experimental study with two groups and pretest post-test measurement. The sample consisted of 26 institutionalized elderly adults with advanced-stage major neurocognitive disorder, randomly assigned to each group. The experimental group received Doll therapy, based nursing therapy, while the comparison group continued to receive conventional therapy according to the institution's protocol. The QUALID instrument was used, which was evaluated by professionals external to the care centers. RESULTS The comparison of the groups, before and after the intervention, indicates that the experimental group showed a positive effect on quality of life, supported by the statistical significance of the data, with a moderate effect. CONCLUSIONS The Doll therapy as a non-pharmacological therapy has a positive effect on the quality of life of patients with moderate to severe major neurocognitive disorder, which constitutes a contribution to strengthen the knowledge associated with the effects or this intervention.
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Affiliation(s)
- Carmen Alicia Martínez-Contreras
- Enfermería, Universidad de La Sabana; Enfermería, Universidad de Sucre, Medellín, Antioquia, Colombia; Facultad de Enfermería y Rehabilitación, Universidad de La Sabana, Chía, Cundinamarca, Colombia.
| | - María Elisa Moreno-Fergusson
- Facultad de Enfermería y Rehabilitación, Universidad de La Sabana, Chía, Cundinamarca, Colombia; Enfermería, Universidad de la Sabana; Facultad de Enfermería y Rehabilitación, Universidad de La Sabana, Chía, Cundinamarca, Colombia
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López-Muñoz C, Aranda-Gallardo M, Rivas-Ruiz F, Moya-Suárez AB, Morales-Asencio JM, Canca-Sanchez JC. Clinical and functional assessment in patients admitted with pluripathological dysphagia according to the mode of feeding: Through a gastrostomy tube or oral. Enferm Clin (Engl Ed) 2023; 33:251-260. [PMID: 37394139 DOI: 10.1016/j.enfcle.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 05/28/2023] [Indexed: 07/04/2023]
Abstract
INTRODUCTION Multipathological patients are a vulnerable population with high comorbidity, functional impairment, and nutritional risk. Almost 50% of these hospitalized patients have dysphagia. There is no consensus on whether placement of a percutaneous endoscopic gastrostomy (PEG) tube provides greater clinical benefit. The purpose of this study was to know and compare 2 groups of multipathological patients with dysphagia according to the mode of feeding: PEG vs. oral. METHOD Retrospective descriptive study with hospitalized patients (2016-19), pluripathological, with dysphagia, nutritional risk, over 50 years with diagnoses of: dementia, cerebrovascular accident (CVA), neurological disease, or oropharyngeal neoplasia. Terminally ill patients with jejunostomy tube or parenteral nutrition were excluded. Sociodemographic variables, clinical situation, and comorbidities were evaluated. Bivariate analysis was performed to compare both groups according to their diet, establishing a significance level of p < .05. RESULTS 1928 multipathological patients. The PEG group consisted of 84 patients (n122). A total of 84 were randomly selected to form the non-PEG group (n434). This group had less history of bronchoaspiration/pneumonia (p = .008), its main diagnosis was stroke versus dementia in the PEG group (p < .001). Both groups had more than a 45% risk of comorbidity (p = .77). CONCLUSIONS multipathological patients with dysphagia with PEG usually have dementia as their main diagnosis, however, stroke is the most relevant pathology in those fed orally. Both groups have associated risk factors, high comorbidity, and dependence. This causes their vital prognosis to be limited regardless of the mode of feeding.
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Affiliation(s)
- Cristina López-Muñoz
- Unidad de Pruebas Funcionales Digestivas, Hospital Costa del Sol, Marbella, Málaga, Spain.
| | - Marta Aranda-Gallardo
- Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, Instituto de Investigación Biomédica de Málaga (IBIMA), Marbella, Málaga, Spain
| | - Francisco Rivas-Ruiz
- Área de Asesoramiento Metodológico, Documental y Ético, Unidad de Investigación e Innovación, Hospital Costa del Sol, Marbella, Málaga, Spain
| | - Ana Belén Moya-Suárez
- Unidad de Pruebas Funcionales Digestivas, Hospital Costa del Sol, Marbella, Málaga, Spain
| | - José Miguel Morales-Asencio
- Universidad de Málaga, Facultad Ciencias de la Salud, Instituto de Investigación Biomédica de Málaga (IBIMA), Marbella, Málaga, Spain
| | - José Carlos Canca-Sanchez
- Universidad de Málaga, Facultad Ciencias de la Salud, Instituto de Investigación Biomédica de Málaga (IBIMA), Marbella, Málaga, Spain
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Bermejo Gómez I, Gallego-Alberto L, Losada Baltar A, Mérida Herrera L, García Batalloso I, Márquez-González M. [Anticipatory grief in family caregivers of persons with dementia. Psychosocial correlates and impact on caregiver's health: A literature review]. Rev Esp Geriatr Gerontol 2023; 58:101374. [PMID: 37246011 DOI: 10.1016/j.regg.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/08/2023] [Accepted: 05/02/2023] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Taking care of a relative with dementia may be linked to negative consequences for the caregiver. One of the processes that can be experienced is anticipatory grief, that is defined as the feelings of pain and loss that appear in the caregiver before the death of the person cared for. OBJECTIVES The review aimed to conceptualize anticipatory grief in this population, to study the related psychosocial variables, and to know the repercussions for the health of the caregiver. METHOD A systematic search was made under the directives of PRISMA statement in the ProQuest, PubMed, Web of Science (WOS), and Scopus databases, including studies published in the last 10 years (2013-2023). RESULTS A total of 160 articles were obtained, 15 being finally selected. It is observed that anticipatory grief is defined as an ambiguous process since it appeared before the death of the sick family member. Being a female caregiver, spouse of a family member with dementia, having a closer relationship with him and/or having an important responsibility in care, are associated with a greater chance of experiencing anticipatory grief. In relation to the person cared for, if he or she is in a severe phase of the disease, is younger, and/or presents problematic behaviours, there is also greater anticipatory grief in the family caregiver. Anticipatory grief has a significant impact on caregivers' physical, psychological, and social health, being associated with greater burden, depressive symptomatology, and social isolation. CONCLUSIONS Anticipatory grief turns out to be a relevant concept in the context of dementia, being necessary to include it in intervention programs for this population.
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Affiliation(s)
- Isabel Bermejo Gómez
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, España.
| | - Laura Gallego-Alberto
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, España
| | - Andrés Losada Baltar
- Departamento de Psicología, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, España
| | - Laura Mérida Herrera
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, España
| | - Inés García Batalloso
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, España
| | - María Márquez-González
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, España
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Madruga Flores M, Corrales López M, Gómez-Pavón J. [The impact of the first pandemic waves of COVID-19 in older people with dementia]. Aten Primaria 2023; 55:102622. [PMID: 37058882 PMCID: PMC10040343 DOI: 10.1016/j.aprim.2023.102622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/05/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
Patients with dementia are in themselves more vulnerable, and have been especially affected by the effect of the COVID-19 pandemic, both directly due to the disease itself, and indirectly due to the deprivation of cognitive stimulation due to isolation social due to confinement. SARS-CoV-2 virus infection has given rise to a wide variety of symptoms, including neurological symptoms and especially delirium in the elderly with dementia. The virus has affected the central nervous system, both directly due to the neurotropism of the virus, and indirectly due to inflammation and tissue hypoxia of vascular origin. The different causes that have been able to lead, in the different waves prior to the omicron variant, to the significant increase in morbidity and mortality in patients with dementia, especially the elderly, are analyzed.
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Affiliation(s)
- María Madruga Flores
- Servicio de Geriatría, Hospital Universitario Central de la Cruz Roja San José y Santa Adela, Madrid, España.
| | | | - Javier Gómez-Pavón
- Servicio de Geriatría, Hospital Universitario Central de la Cruz Roja San José y Santa Adela, Madrid, España
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Doménech S, Rojano I Luque X, Sánchez-Martínez I, Fernández I, Solé M, Palacios F, Alsina M, Heras E. [Comparison of digital and conventional life story books on mood, communication, cognition and quality of life in people with dementia in nursing homes: A pilot study]. Rev Esp Geriatr Gerontol 2023; 58:141-147. [PMID: 37208276 DOI: 10.1016/j.regg.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 05/21/2023]
Abstract
INTRODUCTION Person-centered care (PCC) includes life story, a form of reminiscence therapy that can be useful in the treatment of dementia. We compared the efficacy of using a digital or conventional life story book (LSB) on depressive symptoms, communication, cognition, and quality of life. MATERIAL AND METHODS Thirty one persons with dementia living in 2 PCC nursing homes were randomly assigned to receive reminiscence therapy based on the Neural Actions digital LSB (n=16) or a conventional LSB (n=15). Both groups performed 2 weekly sessions of 45min for 5 weeks. Depressive symptoms were evaluated with the Cornell scale (CSDD); communication with the Holden scale (HCS), cognition with the Mini Mental State Examination (MMSE) and quality of life with the quality of life scale for Alzheimer's (QoL-AD). The results were analyzed using ANOVA of repeated measures with the jamovi 2.3 program. RESULTS Both LSB improved communication skills (η2=0.115; p<0.001), with no differences between groups. No effects on quality of life, cognition, or mood were found. CONCLUSIONS In PCC centres digital or conventional LSB can be useful in the treatment of people with dementia by facilitating communication. Its role on quality of life, cognition or mood is uncertain.
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Affiliation(s)
- Sara Doménech
- Fundació Salut i Envelliment, Universitat Autònoma de Barcelona, Barcelona, España.
| | | | - Iván Sánchez-Martínez
- Universidad de Vic - Universidad Central de Cataluña (UVic-UCC), Vic, Barcelona, España
| | | | | | | | | | - Eva Heras
- Servei Andorrà d'Atenció Sanitària, Andorra
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López-Cuevas R, Baquero-Toledo M, Cuevas-Jiménez A, Martín-Ibáñez N, Pascual-Costa R, Moreno-Monedero MJ, Cañada-Martínez A, Peña-Bautista C, Ferrer-Cairols I, Álvarez-Sánchez L, Cháfer-Pericás C. Prognostic value of cerebrospinal fluid biomarkers in mild cognitive impairment due to Alzheimer disease. Neurologia 2023; 38:262-269. [PMID: 37031800 DOI: 10.1016/j.nrleng.2020.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 07/29/2020] [Indexed: 04/11/2023] Open
Abstract
We performed a retrospective analysis of the patients assessed at our memory unit for whom Alzheimer disease (AD) cerebrospinal fluid biomarker results were available. We selected patients diagnosed with mild cognitive impairment due to AD (National Institute on Aging-Alzheimer's Association clinical criteria), confirmed neuropsychological deficit, a Global Deterioration Scale score of 3, and an abnormal profile of cerebrospinal fluid biomarkers. Of the 588 cases reviewed, 110 met the inclusion criteria. During follow-up, 50 cases (45.45%) progressed to dementia due to AD. Baseline levels of total and phosphorylated tau were higher in the group of patients that progressed to dementia than in those remaining with mild cognitive impairment. After adjusting for age, sex, history of hypertension, diabetes, and educational level, a 10% increase in total tau protein values was associated with a 7.60% increase in the risk of progression to dementia (hazard ratio: 2.22; 95% confidence interval, 1.28-3.84]; P = .004). Among patients with mild cognitive impairment due to AD and abnormal cerebrospinal fluid biomarker profiles, progressively higher concentrations of total or phosphorylated tau were associated with increased risk of progression to dementia.
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Affiliation(s)
- R López-Cuevas
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, Spain; Unidad de trastornos cognitivos. Servicio de Neurología. Hospital Universitario y Politécnico La Fe, Valencia, Spain.
| | - M Baquero-Toledo
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, Spain; Unidad de trastornos cognitivos. Servicio de Neurología. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - A Cuevas-Jiménez
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, Spain; Unidad de trastornos cognitivos. Servicio de Neurología. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - N Martín-Ibáñez
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, Spain; Unidad de trastornos cognitivos. Servicio de Neurología. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - R Pascual-Costa
- Servicio de análisis clínicos. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M J Moreno-Monedero
- Servicio de análisis clínicos. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - A Cañada-Martínez
- Departamento de bioestadística. Instituto de investigación sanitaria La Fe, Valencia, Spain
| | - C Peña-Bautista
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, Spain; Grupo de investigación en perinatología. Instituto de investigación sanitaria La Fe, Valencia, Spain
| | - I Ferrer-Cairols
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, Spain; Unidad de trastornos cognitivos. Servicio de Neurología. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - L Álvarez-Sánchez
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, Spain; Unidad de trastornos cognitivos. Servicio de Neurología. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - C Cháfer-Pericás
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, Spain; Grupo de investigación en perinatología. Instituto de investigación sanitaria La Fe, Valencia, Spain
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Aguilar-Navarro SG, Carbajal-Silva JC, Palacios-Hernández MGI, Gutiérrez-Gutierrez LA, Ávila-Funes JA, Mimenza-Alvarado AJ. Association between vitamin B 12 levels and cognitive impairment in older adults. GAC MED MEX 2023; 159:32-37. [PMID: 36930548 DOI: 10.24875/gmm.m22000733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
INTRODUCTION Whether vitamin B12 deficiency is associated with cognitive impairment remains controversial. OBJECTIVE To determine the association between vitamin B12 serum levels and cognitive performance. METHODS Two-hundred and forty-one adults aged ≥ 60 years who had serum vitamin B12 serum levels measurement were included. Physical and cognitive evaluation was carried out, and three groups were formed: normal cognition (NC), mild cognitive impairment (MCI) and dementia. Vitamin B12 levels were classified as sufficiency (> 400 pg/mL), subclinical deficiency (201-400 pg/mL), and absolute deficiency (≤ 200 pg/mL). Multivariate linear regression analysis was used to evaluate the association between cognitive function and vitamin B12 levels after controlling for confounding variables. RESULTS Mean age was 81.4 ± 8.0 years; 68% were females; 17.8 % and 39.8% had absolute and subclinical vitamin B12 deficiency, respectively; 80 individuals (33%) met the criteria for MCI, and 70 (29%), for dementia. Those with MCI and dementia had lower vitamin B12 levels in comparison with those with NC after adjusting for age, gender and educational level (p = 0.019). CONCLUSIONS A statistically significant association was observed between global cognitive performance and levels of vitamin B12.
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Affiliation(s)
| | | | | | - Lidia A Gutiérrez-Gutierrez
- Department of Neurology and Psychiatry. Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
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Duah-Owusu White M, Vassallo M, Kelly F, Nyman S. Two factors that can increase the length of hospital stay of patients with dementia. Rev Esp Geriatr Gerontol 2022; 57:298-302. [PMID: 36411104 DOI: 10.1016/j.regg.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 09/02/2022] [Accepted: 10/20/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Patients with dementia are at greater risk of a long hospital stay and this is associated with adverse outcomes. The aim of this service evaluation was to identify variables most predictive of increased length of hospital stay amongst patients with dementia. METHODS/DESIGN We conducted a retrospective analysis on a cross-sectional hospital dataset for the period January-December 2016. Excluding length of stay less than 24h and readmissions, the sample comprised of 1133 patients who had a dementia diagnosis on record. RESULTS The highest incidence rate ratio for length of stay in the dementia sample was: (a) discharge to a care home (IRR: 2.443, 95% CI 1.778-3.357), (b) falls without harm (IRR: 2.486, 95% CI 2.029-3.045). CONCLUSIONS Based on this dataset, we conclude that improvements made to falls prevention strategies in hospitals and discharge planning procedures can help to reduce the length of stay for patients with dementia.
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Affiliation(s)
| | - Michael Vassallo
- University Hospitals Dorset NHS Foundation Trust, United Kingdom
| | | | - Samuel Nyman
- Bournemouth University Clinical Research Unit, Bournemouth University, Bournemouth, Dorset, United Kingdom
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Robles Bayón A. Degenerative dementias: A question of syndrome or disease? Neurologia 2022; 37:480-491. [PMID: 31331676 DOI: 10.1016/j.nrl.2019.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 03/07/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Neurologists refer to numerous "syndromes,‿ consisting of specific combinations of clinical manifestations, following a specific progression pattern, and with the support of blood analysis (without genomic-proteomic parameters) and neuroimaging findings (MRI, CT, perfusion SPECT, or 18F-FDG-PET scans). Neurodegenerative "diseases,‿ on the other hand, are defined by specific combinations of clinical signs and histopathological findings; these must be confirmed by a clinical examination and a histology study or evidence of markers of a specific disorder for the diagnosis to be made. However, we currently know that most genetic and histopathological alterations can result in diverse syndromes. The genetic or histopathological aetiology of each syndrome is also heterogeneous, and we may encounter situations with pathophysiological alterations characterising more than one neurodegenerative disease. Sometimes, specific biomarkers are detected in the preclinical stage. DEVELOPMENT We performed a literature review to identify patients whose histopathological or genetic disorder was discordant with that expected for the clinical syndrome observed, as well as patients presenting multiple neurodegenerative diseases, confirming the heterogeneity and overlap between syndromes and diseases. We also observed that the treatments currently prescribed to patients with neurodegenerative diseases are symptomatic. CONCLUSIONS Our findings show that the search for disease biomarkers should be restricted to research centres, given the lack of disease-modifying drugs or treatments improving survival. Moreover, syndromes and specific molecular or histopathological alterations should be managed independently of one another, and new "diseases‿ should be defined and adapted to current knowledge and practice.
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Affiliation(s)
- A Robles Bayón
- Unidad de Neurología Cognitiva, Hospital HM Rosaleda, Santiago de Compostela, La Coruña, España.
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Mar J, Gorostiza A, Arrospide A, Larrañaga I, Alberdi A, Cernuda C, Iruin Á, Tainta M, Mar-Barrutia L, Ibarrondo O. Estimation of the epidemiology of dementia and associated neuropsychiatric symptoms by applying machine learning to real-world data. Rev Psiquiatr Salud Ment (Engl Ed) 2022; 15:167-175. [PMID: 36272739 DOI: 10.1016/j.rpsmen.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/14/2021] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Incidence rates of dementia-related neuropsychiatric symptoms (NPS) are not known and this hampers the assessment of their population burden. The objective of this study was to obtain an approximate estimate of the population incidence and prevalence of both dementia and NPS. METHODS Given the dynamic nature of the population with dementia, a retrospective study was conducted within the database of the Basque Health Service (real-world data) at the beginning and end of 2019. Validated random forest models were used to identify separately depressive and psychotic clusters according to their presence in the electronic health records of all patients diagnosed with dementia. RESULTS Among the 631,949 individuals over 60 years registered, 28,563 were diagnosed with dementia, of whom 15,828 (55.4%) showed psychotic symptoms and 19,461 (68.1%) depressive symptoms. The incidence of dementia in 2019 was 6.8/1000 person-years. Most incident cases of depressive (72.3%) and psychotic (51.9%) NPS occurred in cases of incident dementia. The risk of depressive-type NPS grows with years since dementia diagnosis, living in a nursing home, and female sex, but falls with older age. In the psychotic cluster model, the effects of male sex, and older age are inverted, both increasing the probability of this type of symptoms. CONCLUSIONS The stigmatization factor conditions the social and attitudinal environment, delaying the diagnosis of dementia, preventing patients from receiving adequate care and exacerbating families' suffering. This study evidences the synergy between big data and real-world data for psychiatric epidemiological research.
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Affiliation(s)
- Javier Mar
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Bizkaia, Spain.
| | - Ania Gorostiza
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain
| | - Arantzazu Arrospide
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Bizkaia, Spain
| | - Igor Larrañaga
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain
| | - Ane Alberdi
- Mondragon Unibertsitatea, Faculty of Engineering, Electronics and Computing Department, Arrasate-Mondragón, Gipuzkoa, Spain
| | - Carlos Cernuda
- Mondragon Unibertsitatea, Faculty of Engineering, Electronics and Computing Department, Arrasate-Mondragón, Gipuzkoa, Spain
| | - Álvaro Iruin
- Basque Health Service (Osakidetza), Gipuzkoa Mental Health Network, Donostia-San Sebastián, Gipuzkoa, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain
| | - Mikel Tainta
- Basque Health Service (Osakidetza), Goierri-Urola Garaia Integrated Healthcare Organisation, Department of Neurology, Zumarraga, Gipuzkoa, Spain; Fundación CITA-Alzheimer Fundazioa, Donostia-San Sebastián, Gipuzkoa, Spain
| | - Lorea Mar-Barrutia
- Psiquiatry Service, Hospital Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Oliver Ibarrondo
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain; RS-Statistics, Arrasate-Mondragón, Gipuzkoa, Spain
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Marsilli P, Funtowicz G, Epstein L, Giunta D, Peroni L, Vergara A. [Mortality in patients with dementia admitted in critical care units]. Rev Esp Geriatr Gerontol 2022; 57:150-155. [PMID: 35597699 DOI: 10.1016/j.regg.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 03/15/2022] [Accepted: 03/21/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the mortality and comorbidities associated of patients with dementia admitted to the Intensive Care Unit (ICU) on the hospitalization and at one year of follow-up. MATERIALS AND METHODS A retrospective observational cohort study was carried out between 2012 and 2017 at the Hospital Italiano de San Justo, of patients who were admitted to the ICU, these were observed up to hospitalary death, out hospital death one year of hospitalization, the disenrollment from the institution's health plan or the end of the follow-up. RESULTS A total of 163 patients were included for analysis. We recorded those 79 patients (48.47%) died one year after the hospitalization, of them 25 (15.34%) in ICU and 8 (4.91%) in general room. The most frequent causes of death were respiratory. The factors most associated with mortality were: orotracheal intubation (HR=2.01; 95% CI: 1.11-3.65; P=.02), history of leukemia (HR=8.55; 95% CI: 1.82-40.05; P≤.05), elevated Charlson (HR=1.16, 95% CI: 1.04-1.41; P=.05), and elevated APACHE II at admission (HR=1.07; 95% CI: 1.03-1.11; P≤.05). CONCLUSIONS The present study expresses the prognosis of patients with a diagnosis of dementia admitted to the ICU and that depends not only on their baseline neurological status but also on the severity at admission and comorbidities.
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Affiliation(s)
- Pablo Marsilli
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | | | - Lucas Epstein
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Diego Giunta
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Leticia Peroni
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Torres-Castro S, Mena-Montes B, González-Ambrosio G, Zubieta-Zavala A, Torres-Carrillo NM, Acosta-Castillo GI, Espinel-Bermúdez MC. Spanish-language screening scales: A critical review. Neurologia 2022; 37:53-60. [PMID: 29753565 DOI: 10.1016/j.nrl.2018.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 02/26/2018] [Accepted: 03/01/2018] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Dementia is a chronic, degenerative disease with a strong impact on families and health systems. The instruments currently in use for measuring cognitive impairment have different psychometric characteristics in terms of application time, cut-off point, reliability, and validity. The objective of this review is to describe the characteristics of the validated, Spanish-language versions of the Mini-Cog, Clock-Drawing Test, and Mini-Mental State Examination scales for cognitive impairment screening. DEVELOPMENT We performed a three-stage literature search of articles published on Medline since 1953. We selected articles on validated, Spanish-language versions of the scales that included data on reliability, validity, sensitivity, and specificity. CONCLUSIONS The 3 screening tools assessed in this article provide support for primary care professionals. Timely identification of mild cognitive impairment and dementia is crucial for the prognosis of these patients.
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Affiliation(s)
- S Torres-Castro
- Instituto Nacional de Geriatría, Institutos Nacionales de Salud de México, Secretaría de Salud, Ciudad de México, México.
| | - B Mena-Montes
- Instituto Nacional de Geriatría, Institutos Nacionales de Salud de México, Secretaría de Salud, Ciudad de México, México
| | - G González-Ambrosio
- Instituto Nacional de Geriatría, Institutos Nacionales de Salud de México, Secretaría de Salud, Ciudad de México, México
| | - A Zubieta-Zavala
- Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - N M Torres-Carrillo
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - G I Acosta-Castillo
- Instituto Nacional de Neurología y Neurocirugía, Institutos Nacionales de Salud de México, Secretaría de Salud, Ciudad de México, México
| | - M C Espinel-Bermúdez
- Unidad de Investigación Médica en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Guadalajara, México
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Abstract
INTRODUCTION Early diagnosis of Alzheimer disease (AD) through the use of biomarkers could assist in the implementation and monitoring of early therapeutic interventions, and has the potential to significantly modify the course of the disease. DEVELOPMENT The classic cerebrospinal fluid and approved structural and functional neuroimaging biomarkers are of limited clinical application given their invasive nature and/or high cost. The identification of more accessible and less costly biomarkers, such as blood biomarkers, would increase their use in clinical practice. We review the available published evidence on the main blood biochemical biomarkers potentially useful for diagnosing AD. CONCLUSIONS Blood biomarkers are more cost- and time-effective than CSF biomarkers. However, immediate applicability in clinical practice is relatively unlikely. The main limitations come from the difficulty of measuring and standardising thresholds between different laboratories and the failure to replicate results. Of all the molecules studied, apoptosis and neurodegeneration biomarkers and the biomarker panels obtained through "omics" approaches, such as isolated or combined metabolomics, offer the most promising results.
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Affiliation(s)
- M Altuna-Azkargorta
- Laboratorio de Neuroepigenética, Navarrabiomed, Complejo Hospitalario de Navarra, Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain.
| | - M Mendioroz-Iriarte
- Laboratorio de Neuroepigenética, Navarrabiomed, Complejo Hospitalario de Navarra, Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain; Servicio de Neurología, Complejo Hospitalario de Navarra, Pamplona, Spain
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Broche-Pérez Y, Fernández-Fleites Z, González B, Hernández Pérez MA, Salazar-Guerra YI. Knowledge and beliefs about dementia among the general public: A preliminary report on the Cuban population. Neurologia (Engl Ed) 2021; 36:361-368. [PMID: 34714234 DOI: 10.1016/j.nrleng.2018.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 03/01/2018] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND The number of people diagnosed with dementia globally has dramatically increased in recent years. The objective of this study was to explore beliefs and knowledge among the Cuban population with regard to the risk factors that may lead to dementia and the actions that may be taken to prevent it. METHOD In an exploratory cross-sectional study, we surveyed a total of 391 people aged between 18 and 96 years. The results were stratified by sex, age range, level of education, and contact with dementia. RESULTS Dementia was the fourth most worrying disease. A total of 64.5% of participants believed that the risk of dementia could be reduced, and 60% that the appropriate time to begin prevention measures is after the age of 40. Cognitive stimulation and healthy diet were more frequently cited as useful activities to reduce risk. Survey respondents reported little presence in their lifestyle of behaviours that are beneficial for reducing the risk of dementia. CONCLUSIONS Although dementia is an important health issue for respondents, their knowledge about disease prevention is still insufficient. The results obtained constitute a starting point for the design of policies aimed at increasing knowledge about the disease and improving prevention.
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Affiliation(s)
- Y Broche-Pérez
- Universidad Central «Marta Abreu» de Las Villas, Santa Clara, Cuba.
| | | | - B González
- Universidad de Ciencias Médicas «Serafín Ruiz de Zárate Ruiz», Santa Clara, Cuba
| | - M A Hernández Pérez
- Universidad de Ciencias Médicas «Serafín Ruiz de Zárate Ruiz», Santa Clara, Cuba
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Izquierdo Delgado E, Gutiérrez Ríos R, Andrés Calvo M, Repiso Gento I, Castrillo Sanz A, Rodríguez Herrero R, Rodríguez Sanz MF, Tola-Arribas MA. Nutritional status assessment in Alzheimer disease and its influence on disease progression. Neurologia (Engl Ed) 2021:S2173-5808(21)00167-X. [PMID: 34657824 DOI: 10.1016/j.nrleng.2019.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 11/04/2019] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Nutritional deficiencies are frequent in Alzheimer disease (AD), even in early stages. Nutritional impairment (NI) may be associated with faster disease progression. The objective of this study was to describe the frequency of NI and the associated risk factors at the time of diagnosis and to analyse its influence on subsequent progression. METHODS We performed a prospective, multicentre, observational study of patients recently diagnosed with prodromal AD (pAD) or dementia due to AD (ADd). Two clinical assessments were conducted over a period of 18 months. The Mini Nutritional Assessment test (MNA; score range, 0-30; cut-off point for NI, < 24) was used to estimate nutritional status. Progression was defined as an increase of ≥ 3 points on the Clinical Dementia Rating-sum of boxes test. RESULTS The sample included 50 patients with pAD (mean [standard deviation] age, 76.1 [5.3] years; 68% women), and 127 with ADd (80 [5.9] years; 72.4% women). A total of 141 (79.7%) completed both evaluations. The prevalence of NI was 28.2% (24% for pAD, 29.9% for ADd; P = .43), with the majority (92%) at risk of malnutrition. NI was associated with female sex (odds ratio [OR]: 4.2; 95% confidence interval [CI]: 1.7-10.5; P < .001) and greater behavioural involvement (OR: 5.8; 95% CI: 2.6-12.7; P < .001). A larger proportion of patients with progression was observed among those with NI than among those with normal nutritional status (50% vs 28.7%, P < .05; ADd: 53.6% vs 31.8%, P < .05; pAD: 41.7% vs 22.9%, P = .21). Greater cognitive impairment (OR: 2.1; 95% CI: 1.03-4.4; P < .05) and NI (OR: 2.4; 95% CI: 1.1-5.1; P < .05) were independent risk factors for disease progression. CONCLUSIONS NI is highly prevalent in patients with AD. Assessing nutritional status at the time of diagnosis may enable identification of patients at greater risk of disease progression.
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Sáinz Pelayo MDP, Pelayo Vergara R, Albu S, Figueira C. [Experience with 4 clinical cases. Traumatic encephalopathy may be associated with a single traumatic brain injury?]. Rehabilitacion (Madr) 2021:S0048-7120(21)00062-1. [PMID: 34538654 DOI: 10.1016/j.rh.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/21/2021] [Accepted: 04/24/2021] [Indexed: 11/20/2022]
Abstract
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease that affects people who had repetitive head trauma. Also, in single traumatic brain injury (TBI), changes may be found during the follow-up visits. We present four clinical cases of patients visited at the Institut Guttmann clinic between 2017 and 2019. They were affected by mild sequelae of severe and unique TBI who have subsequently developed a neurodegenerative disease without a specific diagnosis, and who could meet clinical criteria for chronic traumatic encephalopathy syndrome. Rehabilitation doctors are the professionals with the greatest possibility of identifying a suggestive clinic of this pathology, they can order the appropriate studies and indicate the new rehabilitation goals according to the new neurological situation.
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Bonilla-Santos J, Calceto-Garavito LN, Cala-Martínez DY, Gonzalez-Hernández A. [Influence of the caregiver on the cognitive and functional decline of people with dementia: A systematic review]. Semergen 2021; 47:488-94. [PMID: 34454828 DOI: 10.1016/j.semerg.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 06/24/2021] [Accepted: 07/12/2021] [Indexed: 11/19/2022]
Abstract
Dementia is a neurodegenerative disease that requires the accompaniment of a caregiver who is in charge of assisting and supervising basic and psychosocial needs. The objective of this article was to determine the influence of the caregiver on the cognitive and functional decline of patients with dementia. The method was a systematic review by searching the Scopus, Pubmed and Science Direct databases between the years 2010-2020. In conclusion, the informal caregiver condition was the most reported by the investigations, generally assumed by wives and children; Caregiver characteristics such as personality, subjective interpretations of the functional status of adults with dementia, and caregivers' coping strategies were associated with a decrease in the rate of cognitive and functional impairment of people with dementia.
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Zúñiga-Salazar GA, Hincapié-Arias SM, Salazar-Bolaños EE, Lara-Terán JJ, Cáceres-Vinueza SV, Duarte-Vera YC. Impact of arterial hypertension on the cognitive function of patients between 45 and 65 years. Luis Vernaza Hospital, Guayaquil, Ecuador. Arch Cardiol Mex 2021; 90:284-292. [PMID: 32952159 DOI: 10.24875/acm.20000350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introducción El deterioro cognitivo leve es una alteración de la función cognitiva que no afecta de manera negativa a las actividades diarias de la persona. Factores de riesgo modificables como la hipertensión arterial podrían intervenir en el aceleramiento de este proceso y afectar a personas menores de 65 años. Una detección temprana del deterioro cognitivo leve por medio del Montreal Cognitive Assesment (MoCA) en personas con hipertensión arterial ayudaría a idear medidas para su control eficaz. Materiales y métodos Se diseñó un estudio de tipo observacional transversal. La población se integra con pacientes hipertensos de 45 a 65 años de Guayaquil. De una base de datos de 570 pacientes, se realizó un llamado a sujetos que cumplieran los criterios de inclusión y exclusión, para la evaluación de la función cognitiva por medio del MoCA. Resultados El 93.3% de los participantes sometidos a la prueba MoCA presentó un puntaje menor de 26. El promedio del puntaje total fue de 18.9 y el 51.6% de los participantes reveló deterioro cognitivo leve. Se obtuvo una correlación negativa del 40% (-0.40) con una p = 0.0015 entre años con hipertensión arterial y el resultado total de la prueba MoCA. Conclusiones Por medio del MoCA se pudo cuantificar la magnitud del deterioro cognitivo en estos pacientes. Se identificó que la mayoría de los participantes examinados presentaba un puntaje promedio menor del intervalo normal. Las cifras obtenidas de los valores de correlación de Pearson muestran una actividad tendencial y relación de la hipertensión arterial con el deterioro de la función cognitiva. Introduction Mild cognitive impairment is an alteration of cognitive function that does not negatively affect the daily activities of the person. Modifiable risk factors such as hypertension could be involved in the acceleration of this process affecting people under 65 years of age. Early detection of mild cognitive impairment through the Montreal Cognitive Assessment (MoCA) in people with high blood pressure, would help to formulate strategies for its effective control. Materials and methods A cross-sectional observational study was designed. The population is hypertensive patients between 45 and 65 years old in Guayaquil. From a database of 570 patients, a call was made to patients who met the inclusion and exclusion criteria, for the evaluation of cognitive function through MoCA. Results 93.3% of the participants who underwent the MoCA test had a score lower than 26. The average of the total score was 18.9, with 51.6% of the participants suffering from mild cognitive impairment. A negative correlation of 40% (-0.40) was obtained with a p = 0.0015 between years with arterial hypertension and the total result of the MoCA test. Conclusions Through MoCA, the magnitude of cognitive deterioration in these patients could be quantified. It was detected that the majority of the examined participants had a lower average score of the normal range. The figures obtained from the Pearson correlation values show trend activity, relating arterial hypertension and deterioration of cognitive function.
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Affiliation(s)
| | | | | | - Joffre J Lara-Terán
- Servicio de Cardiología, Sociedad de Lucha Contra el Cáncer SOLCA. Guayaquil, Ecuador
| | | | - Yan C Duarte-Vera
- Facultad de Ciencias Médicas, Universidad de Guayaquil. Guayaquil, Ecuador.,Servicio de Cardiología, Hospital General Luis Vernaza. Guayaquil, Ecuador.,Departamento de Investigación de la, Sociedad Ecuatoriana de Cardiología. Guayaquil, Ecuador
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Cabrera-Martín MN, González-Pavón G, Sanchis-Hernández M, Morera-Ballester C, Matías-Guiu JA, Carreras Delgado JL. Validation technique and improvements introduced in a new dedicated brain positron emission tomograph (CareMiBrain). Rev Esp Med Nucl Imagen Mol 2021; 40:239-48. [PMID: 34059483 DOI: 10.1016/j.remn.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The goal of developing a PET dedicated to the brain (CareMiBrain) has evolved from its initial approach to diagnosis and monitoring of dementias, to the more ambitious of creating a revolutionary clinical pathway for the knowledge and personalized treatment of multiple neurological diseases. The main innovative feature of CareMiBrain is the use of detectors with continuous crystals, which allow a high resolution determination of the depth of annihilation photons interaction within the thickness of the scintillation crystal. The technical validation phase of the equipment consisted of a pilot, prospective and observational study whose objective was to obtain the first images (40 patients), analyze them and make adjustments in the acquisition, reconstruction and correction parameters, comparing the image quality of the CareMiBrain equipment with that of the whole-body PET-CT. Thanks to the team meetings and the joint analysis of the images, it was possible to detect its weak points and some of its causes. The calibration, acquisition and processing processes, as well as the reconstruction, were optimized, the number of iterations was set to achieve the best signal-to-noise ratio, the random correction was optimized and a post-processing algorithm was included in the reconstruction algorithm. The main technical improvements implemented in this phase of technical validation carried out through collaboration of the Services of Nuclear Medicine and Neurology of the Hospital Clínico San Carlos with the Spanish company Oncovision will be exposed in a project financed with funds from the European Union (Horizon 2020 innovation program, 713323).
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Cabrera-Martín MN, González-Pavón G, Sanchís Hernández M, Morera-Ballester C, Matías-Guiu JA, Carreras Delgado JL. Validation technique and improvements introduced in a new dedicated brain positron emission tomograph (CareMiBrain). Rev Esp Med Nucl Imagen Mol 2021; 40:239-248. [PMID: 34218886 DOI: 10.1016/j.remnie.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/08/2021] [Indexed: 11/30/2022]
Abstract
The goal of developing a PET dedicated to the brain (CareMiBrain) has evolved from its initial approach to diagnosis and monitoring of dementias, to the more ambitious of creating a revolutionary clinical pathway for the knowledge and personalized treatment of multiple neurological diseases. The main innovative feature of CareMiBrain is the use of detectors with continuous crystals, which allow a high resolution determination of the depth of annihilation photons interaction within the thickness of the scintillation crystal. The technical validation phase of the equipment consisted of a pilot, prospective and observational study whose objective was to obtain the first images (40 patients), analyze them and make adjustments in the acquisition, reconstruction and correction parameters, comparing the image quality of the CareMiBrain equipment with that of the whole-body PET/CT. Thanks to the team meetings and the joint analysis of the images, it was possible to detect its weak points and some of its causes. The calibration, acquisition and processing processes, as well as the reconstruction, were optimized, the number of iterations was set to achieve the best signal-to-noise ratio, the random correction was optimized and a post-processing algorithm was included in the reconstruction algorithm. The main technical improvements implemented in this phase of technical validation carried out through collaboration of the Services of Nuclear Medicine and Neurology of the Hospital Clínico San Carlos with the Spanish company Oncovision will be exposed in a project financed with funds from the European Union (Horizon 2020 innovation program, 713323).
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Affiliation(s)
- María Nieves Cabrera-Martín
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Universidad Complutense, Madrid, Spain.
| | | | | | | | - Jordi A Matías-Guiu
- Servicio de Neurología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Universidad Complutense, Madrid, Spain
| | - José Luis Carreras Delgado
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Universidad Complutense, Madrid, Spain
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Coelho-Guimarães N, Garcia-Casal JA, Díaz-Mosquera S, Álvarez-Ariza M, Martínez-Abad F, Mateos-Álvarez R. [Validation of RUDAS: A screening tool for dementia in Primary Health Care settings]. Aten Primaria 2021; 53:102024. [PMID: 33812318 PMCID: PMC8050365 DOI: 10.1016/j.aprim.2021.102024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/19/2020] [Accepted: 09/21/2020] [Indexed: 11/16/2022] Open
Abstract
Objetivo Validar la escala Rowland Dementia Assessment Scale (RUDAS) como instrumento de cribado de deterioro cognitivo y demencia en atención primaria (AP). Es un test breve, válido para población con bajo nivel educativo formal y fácilmente traducible en entornos multiculturales. Diseño Se realizó un estudio epidemiológico descriptivo, de corte transversal, con seguimiento a los 5 años. Emplazamiento Centro de salud de atención primaria de O Grove, que atiende a una población de 10.650 habitantes en Pontevedra. Participantes Ciento cincuenta personas aleatoriamente seleccionadas, con una edad media de 76,35 ± 7,12 años, bajo nivel educativo, origen predominantemente rural y semirrural y nivel socioeconómico bajo. Intervención Se analizó la viabilidad, la aceptabilidad, la validez y la fiabilidad de la escala. Mediciones principales RUDAS, Mini Mental State Examination, Clinical Dementia Rating, Índice de Katz, Índice de Barthel, Índice de Lawton y Escala de Depresión Geriátrica de Yesavage. Resultados El test fue bien acogido por los pacientes y rápido de aplicar (7,58 ± 2,10 min). El área bajo la curva COR para el diagnóstico de demencia fue 0,983 (IC 95%: 0,97-1,00). Para un punto de corte óptimo de 22,5 presentó una sensibilidad del 89,3% y una especificidad del 100%. El área bajo la curva COR para discriminar personas con DCL de personas con demencia fue 0,965 (IC 95%: 0,91-1,00). Conclusiones El RUDAS ha demostrado ser un instrumento viable y eficiente para cribar demencias en AP, libre de influencias educativas y socioculturales. Es especialmente sensible para discriminar población con deterioro cognitivo leve de población con demencia.
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Affiliation(s)
- Natacha Coelho-Guimarães
- Médicina de Familia y Comunitaria, Servicio Canario de Salud (SCS). Área de Tenerife, Santa Cruz de Tenerife, España
| | | | - Sofía Díaz-Mosquera
- Medicina Asistencial en ambulancia y helicóptero medicalizados, Fundación Pública de Urgencias Sanitarias de Galicia - 061, España
| | - María Álvarez-Ariza
- Servicio de Psiquiatría, Hospital Alvaro Cunqueiro, Área Sanitaria de Vigo. Instituto de Investigación Galicia Sur, Vigo, Pontevedra, España
| | - Fernando Martínez-Abad
- Instituto Universitario de Ciencias de la Educación, Universidad de Salamanca, Salamanca, España
| | - Raimundo Mateos-Álvarez
- Departamento de Psiquiatría, Universidad de Santiago de Compostela (USC) y Unidad de Psicogeriatría (CHUS), Santiago de Compostela, La Coruña, España.
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Mar J, Gorostiza A, Arrospide A, Larrañaga I, Alberdi A, Cernuda C, Iruin Á, Tainta M, Mar-Barrutia L, Ibarrondo O. Estimation of the epidemiology of dementia and associated neuropsychiatric symptoms by applying machine learning to real-world data. Rev Psiquiatr Salud Ment (Engl Ed) 2021; 15:S1888-9891(21)00032-X. [PMID: 33774222 DOI: 10.1016/j.rpsm.2021.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/14/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Incidence rates of dementia-related neuropsychiatric symptoms (NPS) are not known and this hampers the assessment of their population burden. The objective of this study was to obtain an approximate estimate of the population incidence and prevalence of both dementia and NPS. METHODS Given the dynamic nature of the population with dementia, a retrospective study was conducted within the database of the Basque Health Service (real-world data) at the beginning and end of 2019. Validated random forest models were used to identify separately depressive and psychotic clusters according to their presence in the electronic health records of all patients diagnosed with dementia. RESULTS Among the 631,949 individuals over 60 years registered, 28,563 were diagnosed with dementia, of whom 15,828 (55.4%) showed psychotic symptoms and 19,461 (68.1%) depressive symptoms. The incidence of dementia in 2019 was 6.8/1000 person-years. Most incident cases of depressive (72.3%) and psychotic (51.9%) NPS occurred in cases of incident dementia. The risk of depressive-type NPS grows with years since dementia diagnosis, living in a nursing home, and female sex, but falls with older age. In the psychotic cluster model, the effects of male sex, and older age are inverted, both increasing the probability of this type of symptoms. CONCLUSIONS The stigmatization factor conditions the social and attitudinal environment, delaying the diagnosis of dementia, preventing patients from receiving adequate care and exacerbating families' suffering. This study evidences the synergy between big data and real-world data for psychiatric epidemiological research.
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Affiliation(s)
- Javier Mar
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Bizkaia, Spain.
| | - Ania Gorostiza
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain
| | - Arantzazu Arrospide
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Bizkaia, Spain
| | - Igor Larrañaga
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain
| | - Ane Alberdi
- Mondragon Unibertsitatea, Faculty of Engineering, Electronics and Computing Department, Arrasate-Mondragón, Gipuzkoa, Spain
| | - Carlos Cernuda
- Mondragon Unibertsitatea, Faculty of Engineering, Electronics and Computing Department, Arrasate-Mondragón, Gipuzkoa, Spain
| | - Álvaro Iruin
- Basque Health Service (Osakidetza), Gipuzkoa Mental Health Network, Donostia-San Sebastián, Gipuzkoa, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain
| | - Mikel Tainta
- Basque Health Service (Osakidetza), Goierri-Urola Garaia Integrated Healthcare Organisation, Department of Neurology, Zumarraga, Gipuzkoa, Spain; Fundación CITA-Alzheimer Fundazioa, Donostia-San Sebastián, Gipuzkoa, Spain
| | - Lorea Mar-Barrutia
- Psiquiatry Service, Hospital Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Oliver Ibarrondo
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain; RS-Statistics, Arrasate-Mondragón, Gipuzkoa, Spain
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Zhao J, Li T, Wang J. Association between psoriasis and dementia: A systematic review. Neurologia 2021; 39:S0213-4853(21)00027-X. [PMID: 33771384 DOI: 10.1016/j.nrl.2020.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/13/2020] [Accepted: 12/14/2020] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Risk factors for dementia include genetic factors, aging, environmental factors, certain diseases, and unhealthy lifestyle; most types of dementia share a common chronic systemic inflammatory phenotype. Psoriasis is also considered to be a chronic systemic inflammatory disease. It has been suggested that psoriasis may also contribute to the risk of dementia. The aim of this study was to systematically review the literature on the association between psoriasis and dementia. DEVELOPMENT Articles were selected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the PubMed and Web of Science databases to identify articles published in peer-reviewed journals and studying the association between psoriasis and dementia. Studies meeting the inclusion criteria were reviewed. We used the Newcastle-Ottawa Scale to assess the quality of each study. After applying the inclusion and exclusion criteria, we included 8 studies for review, 3 of which were found to present a higher risk of bias. Six of the 8 studies supported the hypothesis that prior diagnosis of psoriasis increases the risk of dementia; one study including only a few cases reported that psoriasis decreased the risk of dementia, and one study including relatively young patients found no significant association between psoriasis and the risk of dementia. CONCLUSION Most studies included in this review supported the hypothesis that psoriasis constitutes a risk factor for dementia. However, well-designed stratified cohort studies assessing both psoriasis severity and treatment status are still required to determine the real effect of psoriasis on the risk of dementia and its subtypes.
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Affiliation(s)
- J Zhao
- Academy of Life Sciences, School of Medicine, Xi'an International University, Xi'an, China.
| | - T Li
- Disease Prevention and Control Section, Shangcai People's Hospital, Shangcai, China
| | - J Wang
- Academy of Life Sciences, School of Medicine, Xi'an International University, Xi'an, China
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Herrera Gómez PM, Ochoa-Orozco SA, Jaramillo Toro C. Cannabinoids for major neurocognitive disorder: case report and literature review. ACTA ACUST UNITED AC 2021; 50:47-51. [PMID: 33648697 DOI: 10.1016/j.rcp.2019.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/09/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Major neurocognitive disorder (MNCD) affects millions of people worldwide. However, the pharmacological options for its management are limited, ineffective and frequently associated with severe adverse reactions. CASE REPORT An 85-year-old man with history of multiple chronic brain injuries (alcohol-use disorder, haemorrhagic stroke, brain trauma, chronic use of benzodiazepines) developed an MNCD, reaching 7 points on the Reisberg Global Deterioration Scale. He had minimal response to antidepressants, antipsychotics and anticholinergic medications. After the use of mother tincture of Indian hemp (cannabis), a significant improvement was found in his cognitive function, ability to carry out activities of daily living and independence. DISCUSSION The endocannabinoid system seems to be implicated in age-related cognitive decline. In addition, the evidence derived from in-vitro and animal models suggest that this system could play an important role in the management of MNCD of different causes. CONCLUSIONS Cannabinoid treatment for MNCD emerges as a promising therapeutic approach that may benefit a growing number of patients who do not have other treatment options. It is therefore necessary to encourage more research efforts that will help to remove political and scientific barriers to its clinical use.
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Affiliation(s)
- Paula M Herrera Gómez
- Grupo de Investigación en Psiquiatría, Neurociencia y Comunidad, Universidad Tecnológica de Pereira, Pereira, Colombia; Grupo de Investigación en Inmunología y Biología Molecular, Universidad Tecnológica de Pereira, Pereira, Colombia; Grupo de Investigación en Neurociencia NeURos, Universidad del Rosario, Bogotá, Colombia; Cambridge Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom.
| | - Sergio A Ochoa-Orozco
- Grupo de Investigación en Psiquiatría, Neurociencia y Comunidad, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Carolina Jaramillo Toro
- Grupo de Investigación en Psiquiatría, Neurociencia y Comunidad, Universidad Tecnológica de Pereira, Pereira, Colombia
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Montaner X, Tárrega S, Moix J. [Psychological flexibility, burnout and job satisfaction in dementia care workers]. Rev Esp Geriatr Gerontol 2021; 56:144-151. [PMID: 33608164 DOI: 10.1016/j.regg.2020.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/23/2020] [Accepted: 10/28/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION The clinical complexity of dementia, its physical burden, and the potential assaults associated with psychological and behavioral symptoms, could put healthcare workers working with dementia at high risk of burnout. Certain attitudes toward dementia and certain coping styles may be a protective factor against the stress experienced by these workers. On the other hand, it has been shown that a coping style based on psychological flexibility can prevent the development of burnout in the workplace. The present study analyzes the relationship between levels of burnout, psychological flexibility, attitudes towards dementia and life satisfaction in a sample of healthcare workers who work with people affected by dementia. METHODS A sample of 105 healthcare workers from the Ricard Fortuny Social Hospital was recruited (day hospital, hospitalization unit, and nursing home), and psychological flexibility (AAQII), burnout levels (MBI), life satisfaction (SWL), anxiety (STAI-R), and attitudes towards dementia (EAD) were assessed. RESULTS Psychological inflexiblility showed a positive relationship with 2 dimensions of burnout (emotional exhaustion [r=.342, P<.01]; depersonalization [r=.328, P<.01]), and with anxiety (r=.723, P<.01), and also showed a negative relation with life satisfaction (r=-.485, P<.01) and affect attitude (r=-.209); p<.05). It was also found a negative relation between rejection attitude with emotional exhaustion (r=-.328, P<.01) and with depersonalization (r=-.328; P<.01). CONCLUSIONS Those participants with greater psychological flexibility, in addition to feel more satisfaction with life, were found to be less likely to feel emotionally exhausted, to depersonalize patients with dementia, and felt more affection for them. On the other hand, no relationship was found between Burnout levels and the cognitive dimension of Attitudes towards dementia (the worker's knowledge of dementia). The results have significant implications regarding the type of training that is given to healthcare workers who work with people affected by dementia. Psychoeducational interventions promoting the psychological flexibility could help to reduce the risk of burnout in healthcare workers who work with dementia.
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Affiliation(s)
- Xavier Montaner
- Departament de Psicologia Bàsica, Evolutiva i de l'Educació, Facultat de Psicologia, Universitat Autònoma de Barcelona, Campus de Bellaterra, Cerdanyola del Vallés, España; Consorci Sociosanitari Ricard Fortuny, Vilafranca del Penedès, España.
| | - Salomé Tárrega
- Facultat de ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya, Manresa. España; Estudis de Psicologia i Ciències de l'Educació, Universitat Oberta de Catalunya, Barcelona, España
| | - Jenny Moix
- Departament de Psicologia Bàsica, Evolutiva i de l'Educació, Facultat de Psicologia, Universitat Autònoma de Barcelona, Campus de Bellaterra, Cerdanyola del Vallés, España
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Martínez Arrechea S, Ferro Uriguen A, Beobide Telleria I, González Bueno J, Alaba Trueba J, Sevilla Sánchez D. [Prevalence of prescription of anticholinergic/sedative burden drugs among older people with dementia living in nursing homes]. Rev Esp Geriatr Gerontol 2020; 56:11-17. [PMID: 33309422 DOI: 10.1016/j.regg.2020.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/03/2020] [Accepted: 09/23/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Dementia is one of the most frequent diseases in the elderly, being its prevalence of up to 64% in institutionalized people. In this population, in addition to antidementia drugs, it is common to prescribe drugs with anticholinergic/sedative burden that, due to their adverse effects, could worsen their functionality and cognitive status. The objective is to estimate the prevalence of the use of drugs with anticholinergic/ sedative burden in institutionalized older adults with dementia and to assess the associated factors. MATERIALS AND METHODS A cross-sectional study developed in older with dementia living in nursing homes. The prevalence of prescription of anticholinergic/sedative drugs was estimated according to the Drug Burden Index (DBI). A comparative analysis of the DBI score was performed between different types of dementia as well as among various factors and according to the anticholinergic/sedative risk, establishing as a cut-off point of DBI≥1 (high anticholinergic/sedative risk). RESULTS 178 residents were included. 83.7% had some drug with anticholinergic/sedative burden according to DBI. 50% had a DBI≥1 score. Residents with vascular dementia had a mean DBI of 1.34 (SD 0.84), a significantly higher score than residents with Alzheimer's disease (0.41, 95% CI 0.04-0.78).). Likewise, a higher DBI was associated with more polypharmacy (3.36; 95% CI 2.64-4.08), more falls, hospital admissions and emergency room visits (P<.05). CONCLUSIONS Polypharmacy and prescription of anticholinergic/sedative drugs is frequent among institutionalized older adults with dementia, finding an association between DBI, falls and hospital admissions or emergency department visits. Therefore, it is necessary to propose interdisciplinary pharmacotherapeutic optimization strategies.
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Affiliation(s)
- Silvia Martínez Arrechea
- Servicio de Farmacia, Hospital Ricardo Bermingham (Matia Fundazioa), San Sebastián, Guipúzcoa, España.
| | - Alexander Ferro Uriguen
- Servicio de Farmacia, Hospital Ricardo Bermingham (Matia Fundazioa), San Sebastián, Guipúzcoa, España
| | - Idoia Beobide Telleria
- Servicio de Farmacia, Hospital Ricardo Bermingham (Matia Fundazioa), San Sebastián, Guipúzcoa, España
| | - Javier González Bueno
- Servicio de Farmacia, Hospital Universitari de Vic (Consorci Hospitalari de Vic), Vic, Barcelona, España; Sistema Integral de Salut d'Osona (SISO), Vic, Barcelona, España; Grupo de Investigación en Cronicidad de la Cataluña Central (C3RG)-Universitat de Vic/Universitat Central de Catalunya, Vic, Barcelona, España
| | - Javier Alaba Trueba
- Centro Residencial Fraisoro (Matia Fundazioa), San Sebastián, Guipúzcoa, España
| | - Daniel Sevilla Sánchez
- Servicio de Farmacia, Hospital Universitari de Vic (Consorci Hospitalari de Vic), Vic, Barcelona, España; Grupo de Investigación en Cronicidad de la Cataluña Central (C3RG)-Universitat de Vic/Universitat Central de Catalunya, Vic, Barcelona, España; Servicio de Farmacia, Hospital Universitari de la Santa Creu de Vic, Vic, Barcelona, España
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López-Cuevas R, Baquero-Toledo M, Cuevas-Jiménez A, Martín-Ibáñez N, Pascual-Costa R, Moreno-Monedero MJ, Cañada-Martínez A, Peña-Bautista C, Ferrer-Cairols I, Álvarez-Sánchez L, Cháfer-Pericás C. Prognostic value of cerebrospinal fluid biomarkers in mild cognitive impairment due to Alzheimer disease. Neurologia 2020; 38:S0213-4853(20)30292-9. [PMID: 33143865 DOI: 10.1016/j.nrl.2020.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/22/2020] [Accepted: 07/29/2020] [Indexed: 11/17/2022] Open
Abstract
We performed a retrospective analysis of the patients assessed at our memory unit for whom Alzheimer disease (AD) cerebrospinal fluid biomarker results were available. We selected patients diagnosed with mild cognitive impairment due to AD (National Institute on Aging-Alzheimer's Association clinical criteria), confirmed neuropsychological deficit, a Global Deterioration Scale score of 3, and an abnormal profile of cerebrospinal fluid biomarkers. Of the 588 cases reviewed, 110 met the inclusion criteria. During follow-up, 50 cases (45.45%) progressed to dementia due to AD. Baseline levels of total and phosphorylated tau were higher in the group of patients that progressed to dementia than in those remaining with mild cognitive impairment. After adjusting for age, sex, history of hypertension, diabetes, and educational level, a 10% increase in total tau protein values was associated with a 7.60% increase in the risk of progression to dementia (hazard ratio: 2.22; 95% confidence interval, 1.28-3.84]; P = .004). Among patients with mild cognitive impairment due to AD and abnormal cerebrospinal fluid biomarker profiles, progressively higher concentrations of total or phosphorylated tau were associated with increased risk of progression to dementia.
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Affiliation(s)
- R López-Cuevas
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, España; Unidad de trastornos cognitivos. Servicio de Neurología. Hospital Universitario y Politécnico La Fe, Valencia, España.
| | - M Baquero-Toledo
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, España; Unidad de trastornos cognitivos. Servicio de Neurología. Hospital Universitario y Politécnico La Fe, Valencia, España
| | - A Cuevas-Jiménez
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, España; Unidad de trastornos cognitivos. Servicio de Neurología. Hospital Universitario y Politécnico La Fe, Valencia, España
| | - N Martín-Ibáñez
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, España; Unidad de trastornos cognitivos. Servicio de Neurología. Hospital Universitario y Politécnico La Fe, Valencia, España
| | - R Pascual-Costa
- Servicio de análisis clínicos. Hospital Universitario y Politécnico La Fe, Valencia, España
| | - M J Moreno-Monedero
- Servicio de análisis clínicos. Hospital Universitario y Politécnico La Fe, Valencia, España
| | - A Cañada-Martínez
- Departamento de bioestadística. Instituto de investigación sanitaria La Fe, Valencia, España
| | - C Peña-Bautista
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, España; Grupo de investigación en perinatología. Instituto de investigación sanitaria La Fe, Valencia, España
| | - I Ferrer-Cairols
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, España; Unidad de trastornos cognitivos. Servicio de Neurología. Hospital Universitario y Politécnico La Fe, Valencia, España
| | - L Álvarez-Sánchez
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, España; Unidad de trastornos cognitivos. Servicio de Neurología. Hospital Universitario y Politécnico La Fe, Valencia, España
| | - C Cháfer-Pericás
- Grupo de Investigación en Neurodegeneración y Biomarcadores de Daño Neurológico, Instituto de investigación sanitaria La Fe, Valencia, España; Grupo de investigación en perinatología. Instituto de investigación sanitaria La Fe, Valencia, España
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Del Barrio Truchado E, Pinzón Pulido S, Sancho M, Garrido Peña F. [Being an active citizen and the elderly: Old concepts, new approaches. A systematic review and qualitative meta-synthesis]. Rev Esp Geriatr Gerontol 2020; 55:289-299. [PMID: 32278536 DOI: 10.1016/j.regg.2020.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/23/2019] [Accepted: 01/14/2020] [Indexed: 06/11/2023]
Abstract
The politics of active ageing present active citizenship of the elderly as a key challenge for the coming years. Active citizenship has been defined in different ways (as complimentary in most cases), outlining an eclecticism of participatory activities that includes political engagement in a participatory and deliberative manner, as well as community and voluntary action. This term is found in different contexts such as formal politics, work, civil society, and the home. This paper, based on a systematic review, identifies the context in which this concept emerges in relation to older people and people with dementia. It also analyses the different expressions of active citizenship used, and provides key elements to be taken into account in the formulation of policies in a context of accelerated demographic ageing and where dementia is a public health priority. The notion of active citizenship in old age is a step forward from active ageing to a broader concept that integrates the principle of equality between people irrespective of gender, age and the need for support.
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Affiliation(s)
| | | | - Mayte Sancho
- Instituto Matia, San Sebastián, Guipúzcoa, España
| | - Francisco Garrido Peña
- Departamento de Derecho Penal, Filosofía del Derecho, Filosofía Moral y Filosofía, Universidad de Jaén, Jaén, España
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Jiménez-Gonzalo L, Pedroso-Chaparro MDS, Barrera-Caballero S, Losada Baltar A. [Feasibility of an individualised psychological intervention for older adults with dementia and visual impairment]. Rev Esp Geriatr Gerontol 2020; 55:279-285. [PMID: 32278537 DOI: 10.1016/j.regg.2020.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 02/07/2020] [Accepted: 02/11/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION The ageing of the population has led to a progressive increase in age-related diseases, such as dementia or visual impairment, due to chronic diseases. This work describes and analyses the efficacy and feasibility of an individualised intervention carried out with two male users of a day-care centre with a diagnosis of dementia and a severe visual impairment, which made it difficult for them to take part in the regular activities of the centre. MATERIAL AND METHOD The intervention process had a time frame of three months, and had an assessment phase before and after the intervention. For the assessment, use was made of the Mini-Mental State Examination, Geriatric Depression Scale, and an observational tool based on the Dementia Categorization Recording Observational System. The intervention lasted for eight weeks, and consisted of different dynamics adjusted to the preferences of the participants. RESULTS AND CONCLUSIONS After the intervention, a clinically significant reduction in the depressive symptomatology was observed for both participants, along with a reduction in the frequency of apathetic behaviour during the time they spent in the centre. Furthermore, an increase was observed in the prosocial behaviour and on the engagement with the task. The results show that the personalisation of the activities for particular users increases the stimulation of the participants, improving their well-being through small and inexpensive adaptations to the interventions that are carried out in the centres.
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Sorbara M, Graviotto HG, Lage-Ruiz GM, Turizo-Rodriguez CM, Sotelo-López LA, Serra A, Gagliardi C, Heinemann G, Martinez P, Ces-Magliano F, Serrano CM. COVID-19 and the forgotten pandemic: follow-up of neurocognitive disorders during lockdown in Argentina. Neurologia 2021; 36:9-15. [PMID: 32921515 DOI: 10.1016/j.nrl.2020.07.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 07/29/2020] [Indexed: 12/18/2022] Open
Abstract
Introducción Varios países del mundo padecen una grave carga en sus sistemas de salud como consecuencia de la pandemia por COVID-19. Esta realidad pone en riesgo el seguimiento de patologías crónicas como las demencias. Asimismo, la atención de las posibles complicaciones neuropsiquiátricas relacionadas con el aislamiento preventivo de la población (cuarentena), que en el caso de Argentina se considera la más prolongada de Latinoamérica. El objetivo del presente trabajo es determinar la frecuencia de las distintas modalidades de consulta médica en relación con la patología neurocognitiva del paciente y las variables predictoras de consulta desde el inicio de la cuarentena. Métodos Estudio descriptivo observacional y transversal basado en la recolección de datos a través de una encuesta. Resultados Hubo 324 participantes, 165 (50,9%) de los cuales realizaron al menos una consulta médica. Frecuencia de modalidades de consulta: teléfono, 109 (33,6%); correo electrónico, 62 (19,1%); videoconsulta, 30 (9,3%); servicio de emergencias, 23 (7,1%). Predictores de consulta: Clinical Dementia Rating ≥ 1 (p < 0,001); diagnóstico: Alzheimer (p = 0,017). Se encontraron puntajes más altos del Inventario Neuropsiquiátrico (NPI) en el grupo que ha realizado consultas médicas (p < 0,001). Dicha diferencia no fue observada en el puntaje de la escala de carga del cuidador (Zarit). Conclusión Evidenciamos alta prevalencia de trastornos conductuales en pacientes y de sobrecarga en cuidadores durante la cuarentena. Solamente el 50% accedió a una consulta médica (52,7% por modalidad telefónica y correo electrónico). Es necesario extremar los cuidados en personas con demencia, garantizando el seguimiento de su patología.
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Chimbí-Arias C, Santacruz-Escudero JM, Chavarro-Carvajal DA, Samper-Ternent R, Santamaría-García H. Behavioural Disturbances in Patients with Diagnosis of Neurocognitive Disorder in Bogotá (Colombia). Rev Colomb Psiquiatr (Engl Ed) 2020; 49:136-141. [PMID: 32888656 DOI: 10.1016/j.rcp.2018.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/28/2018] [Accepted: 10/16/2018] [Indexed: 06/11/2023]
Abstract
INTRODUCTION The main aim of this study is to determine the prevalence of behavioural disturbances (BD) in a group of patients with diagnosis of neurocognitive disorders assessed by a memory clinic in a referral assessment centre in Bogotá, Colombia, in 2015. MATERIAL AND METHODS This is an observational, retrospective descriptive study of 507 patients with a diagnosis of neurocognitive disorder (according to DSM-5 criteria) evaluated in a referral centre in Bogotá, Colombia, in 2015. RESULTS Among the group of patients assessed, analyses reveal mean age for minor neurocognitive disorders of 71.04 years, and 75.32 years for major neurocognitive disorder (P <0.001). A total of 62.72% of the sample were female. The most prevalent aetiology of the neurocognitive disorders was Alzheimer's disease, followed by behavioural variant frontotemporal dementia and neurocognitive disorders due to multiple aetiologies. BD occur more frequently in neurocognitive disorder due to behavioural variant frontotemporal dementia (100%), Alzheimer's disease (77.29%) and vascular disease (76.19%). The most prevalent BD in the group assessed were apathy (50.75%), irritability (48.45%), aggression (16.6%), and emotional lability (14.76%). CONCLUSIONS BD are highly prevalent in patients with diagnosis of major neurocognitive disorder. BD are more prevalent in behavioural variant frontotemporal dementia than any other group. Apathy, irritability, emotional lability and aggression are the BD that occur with greater prevalence in our sample. We discuss the importance of BD in the clinical progression of neurocognitive disorders.
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Affiliation(s)
- Claudia Chimbí-Arias
- Unidad de Geriatría, Hospital Universitario San Ignacio, Bogotá, Colombia; Centro de Memoria y cognición Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - José Manuel Santacruz-Escudero
- Centro de Memoria y cognición Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia; Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, España; Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia.
| | - Diego Andrés Chavarro-Carvajal
- Unidad de Geriatría, Hospital Universitario San Ignacio, Bogotá, Colombia; Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Rafael Samper-Ternent
- Departamento de Medicina Interna, División de Geriatría, Sealy Center on Aging, University of Texas Medical Branch, Houston, Texas, Estados Unidos
| | - Hernando Santamaría-García
- Centro de Memoria y cognición Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia; Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia; Departamento de Fisiología, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
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Cassiani-Miranda CA, Chen X. Neurocognitive disorder due to neurosyphilis: a case report. Rev Colomb Psiquiatr (Engl Ed) 2020; 49:202-207. [PMID: 32888665 DOI: 10.1016/j.rcp.2018.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 05/17/2018] [Accepted: 10/16/2018] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Neurosyphilis is a chronic infectious disease caused by Treponema pallidum that can cause a great variety of neuropsychiatric signs and symptoms, which complicates its diagnosis. CASE DESCRIPTION This case occurred in a 40-year-old man who consulted the Emergency Department because of a convulsion (de novo) which was related to a chronic condition of cognitive impairment and psychosis. The appropriate studies were performed for the diagnosis of neurosyphilis and the recommended treatment was initiated. The patient presented clinical improvement and was discharged. DISCUSSION Positive VDRL serology results and imaging findings of marked cortical atrophy conducted to consider a late-stage parenchymatous neurosyphilis with serious cognitive impairment and associated psychosis. Treatment with crystalline penicillin was formulated, which reduced the intensity of the patient's symptoms; however, the patient's lack of interest to attend the check-ups significantly reduces his chances of an adequate recovery. CONCLUSIONS Neurosyphilis must be suspected in patients with clinically evident neurological or psychiatric symptoms. Analysis of VDRL serology and neuroimaging studies are important as an initial evaluation of the patient and must be complemented with cognitive tests or mental examination to determine the state of cognitive impairment.
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Affiliation(s)
| | - Xueyi Chen
- Semillero de Investigación en Psiquiatría de Enlace-Grupo de Investigación en Neuropsiquiatría, Universidad Autónoma de Bucaramanga (UNAB), Bucaramanga, Colombia
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Álvarez Muñoz FJ, Rubio-Aparicio M, Gurillo Muñoz P, García Herrero AM, Sánchez-Meca J, Navarro-Mateu F. Suicide and dementia: Systematic review and meta-analysis. Rev Psiquiatr Salud Ment (Engl Ed) 2020; 13:213-227. [PMID: 32507727 DOI: 10.1016/j.rpsm.2020.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/18/2020] [Accepted: 04/28/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION To analyse the possible relationship between dementia in the elderly and the subsequent development of suicide ideation, attempts and / or completed suicides. METHODS Systematic review and meta-analysis. SELECTION CRITERIA studies that analysed the relationship between dementia and suicide. SEARCH STRATEGY i) in PubMed, EMBASE, CINAHL, IME and Lilacs until December 2018; ii) manual search of the bibliography of selected articles; iii) contact with leading authors. Article selection and data extraction according to a predefined protocol, including bias risk assessment, were performed by independent peer reviewers. The effect size index was calculated using Odds Ratio (OR) and its 95% confidence interval (random-effects model). Heterogeneity was evaluated with forest plots, Cochran's Q and I2 index. Assessment of publication bias using funnel plots ("trim-and-fill" method) and the Egger test. The analysis of moderating variables was performed using a multiple meta-regression under a mixed-effects model. RESULTS 37 studies and 47 basic units of study were identified. Effect size of the association of dementia with: Suicidal Ideation OR = 1.37 (95% CI: .78-2.39); Suicide Attempt: OR = 2.24 (95% CI: 1.01-4.97); and Completed Suicide: OR = 1.28 (95% CI: .77-2.14). Possible publication bias was ruled out. CONCLUSIONS A trend towards suicidal events is identified, especially suicide attempts in people with dementia. Greater attention and care are recommended after a recent diagnosis of dementia, especially with adequate assessment of comorbidities, which could influence the occurrence and outcome of suicidal events.
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Affiliation(s)
- Francisco Javier Álvarez Muñoz
- Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Gerencia Regional de Salud Mental, Servicio Murciano de Salud, Murcia, España
| | - María Rubio-Aparicio
- Departamento de Psicología de la Salud, Facultad de Ciencias de la Salud, Universidad de Alicante, Alicante, España.
| | | | | | - Julio Sánchez-Meca
- Departamento de Psicología Básica y Metodología, Facultad de Psicología, Universidad de Murcia, Murcia, España
| | - Fernando Navarro-Mateu
- Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Gerencia Regional de Salud Mental, Servicio Murciano de Salud, Murcia, España; Departamento de Psicología Básica y Metodología, Facultad de Psicología, Universidad de Murcia, Murcia, España; CIBER de Epidemiología y Salud Pública (CIBERESP) IMIB-Arrixaca, Murcia, España
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Godoy-Monzon D, Garcia-Mansilla A, Buljubasich M, Cid-Casteulani A, Valentini R. Dual mobility system. The French solution in elderly patients with intracapsular hip fracture and high risk of dislocation. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020; 64:335-341. [PMID: 32493649 DOI: 10.1016/j.recot.2020.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 03/11/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE Actually there is a controversy about the treatment of hip fractures on older patients with high risk of dislocation. Our study is focused on report clinico-functional and radiographic results in this population treated with total hip replacement using a dual mobility system after a minimum follow up of 2 years. MATERIALS AND METHODS In the period from January 2015 to January 2016 patients assisted at the Emergency Unit at the participant hospital were recluted for participation. A total of 137 patients were assisted and 41 fulfilled the inclusion criteria and accepted to participate. All patients received a total hip replacement with a dual mobility system (cemented or uncemented). The patients were evaluated with the Mini-Mental State Examination, walking distance test, preop and postop at 3 and 6 weeks, 3 months, 6 months, one year and subsequent years. Radiographic evaluation was scheduled with clinico-functional review. RESULTS Forty-one patients included, follow up average 2.4 years (range 2 to 3.2 years). Mean age 85.2 (range 80 to 96 years). Four patients died during follow up due to causes not related to the total hip replacement and the implant was functioning. One case have an infection and was revised in one stage procedure. One case have an infection at 8 months follow-up and was revised in one stage procedure. There were no dislocations. CONCLUSION The use of dual mobility system in this high dislocation risk population has shown good clinical and functional results, and support the sistematic indication in our services.
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Affiliation(s)
- D Godoy-Monzon
- Servicio de Ortopedia y Traumatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - A Garcia-Mansilla
- Servicio de Ortopedia y Traumatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - M Buljubasich
- Servicio de Ortopedia y Traumatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - A Cid-Casteulani
- Servicio de Ortopedia y Traumatología, Centro Médico Fitz Roy, Buenos Aires, Argentina
| | - R Valentini
- Servicio de Ortopedia y Traumatología, Centro de Educación Médica e Investigación Clínicas (CEMIC), Buenos Aires, Argentina
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Vicario A, Cerezo GH. [The cognitive-behavioural impact of hypertension]. Hipertens Riesgo Vasc 2020; 37:125-132. [PMID: 32434685 DOI: 10.1016/j.hipert.2020.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 04/06/2020] [Accepted: 04/13/2020] [Indexed: 11/25/2022]
Abstract
Arterial hypertension is considered the main modifiable vascular risk factor that causes silent damage to brain vessels. This vascular brain injury could be the common nucleus that justifies the cognitive (cognitive impairment, dementia and Alzheimer's disease) and behavioural symptoms (late-life depression) of target organ damage mediated-hypertension. Incomplete knowledge about the complex pathophysiology that links hypertension with cognitive-behavioural changes is overlooking brain involvement and underestimating cardio and cerebrovascular risk. The confluence of cognitive impairment, depression and arterial hypertension in elderly adults, warns of the need for a comprehensive evaluation to plan treatment, improve prognosis and contribute to reducing the risk of dementia and its incidence.
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Affiliation(s)
- A Vicario
- Unidad Corazón-Cerebro, Servicio de Prevención Cardiovascular, ICBA-Instituto Cardiovascular, Buenos Aires, Argentina.
| | - G H Cerezo
- Unidad Corazón-Cerebro, Servicio de Prevención Cardiovascular, ICBA-Instituto Cardiovascular, Buenos Aires, Argentina
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Aldaz P, Garjón J, Beitia G, Beltrán I, Librero J, Ibáñez B, Arroyo P, Ariz MJ. Association between benzodiazepine use and development of dementia. Med Clin (Barc) 2021; 156:107-11. [PMID: 32434656 DOI: 10.1016/j.medcli.2020.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/22/2020] [Accepted: 02/27/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate the association between use of benzodiazepines and incident dementia. METHODS Analytical prospective nested case-control study for which the Spanish database for pharmacoepidemiological research in primary care (BIFAP) of the Spanish Agency of Medicines and Medical Devices (AEMPS) was used. A total of 15,212 subjects diagnosed with dementia of the Alzheimer type and 62,397 controls were identified. Exposure was retrieved retrospectively with a 3-year lag time before the index date. Adjusted odd ratios (OR) were calculated. RESULTS Benzodiazepines use increased the risk of suffering Alzheimer's disease (OR=1.05, 95% CI, 1.01-1.10). No statistical differences were shown between short-acting and long-acting drugs. The risk is more evident with longer exposure times. CONCLUSIONS There seems to be a weak association between benzodiazepine use and the development of dementia, the risk increases with greater exposure.
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Buiza C, García-Soler Á, Díaz-Veiga P, Arriola E, Fernández E. [Development and validation of an observational tool for the assessment of well-being in people with dementia from the perspective of Person Centred Care: List of Well-being Indicators of Wellbeing]. Rev Esp Geriatr Gerontol 2020; 55:147-155. [PMID: 32111483 DOI: 10.1016/j.regg.2019.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 04/16/2019] [Accepted: 06/05/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Within the context of Person Centred Care, the present paper shows the creation and validation process of an observational tool for the assessment of the wellbeing of people with dementia, from a perspective that seeks to highlight the effects that the physical and social environment have on the person, and how these are reflected in the well-being. METHODS The List of Wellbeing Indicators (LIBE) was created following an inductive iterative process with professionals from different disciplines, until the validated version was reached. It was then validated in two successive studies with a sample of 79 people with dementia. Discrimination capacity of the scale indicators, internal consistency, inter-rater reliability, and convergent and divergent validity were determined. RESULTS An internal consistency of Cronbach́s alpha 0.81 was obtained. The inter-rater reliability, analysing intraclass correlation coefficient (ICC) within the 3 raters, was significant for all the indicators in the tool, with scores between 0.59-1.00. Convergent validity was studied comparing scores in each LIBE indicator with scores in each QUALID indicator, and some significant associations were found between response categories in both tools. For the discriminant validity, the scores obtained in each LIBE indicator were compared with the scores in each PAINAD-Sp item, and no significant associations were found. CONCLUSION LIBE offers an observational measure of behaviours that can be considered well-being indicators in people with dementia living in residential care. LIBE is a valid and reliable tool that offers a different perspective of measuring a construct that has been infrequently explored in dementia population. Is also an easy to apply tool, with different uses (clinical, intervention, research), and applicable for professionals of several disciplines.
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Affiliation(s)
| | | | | | - Enrique Arriola
- Unidad de Memoria-Consultas externas, Matia Fundazioa, San Sebastián, España
| | - Elena Fernández
- UPSI Hospital R. Berminghan, Matia Fundazioa, San Sebastián, España
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Niñerola-Baizán A, Aguiar P, Cabrera-Martín MN, Vigil C, Gómez-Grande A, Lorenzo C, Rubí S, Sopena P, Camacho V. Relevance of quantification in brain PET studies with 18F-FDG. Rev Esp Med Nucl Imagen Mol 2020; 39:184-192. [PMID: 32345572 DOI: 10.1016/j.remn.2020.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 03/01/2020] [Accepted: 03/03/2020] [Indexed: 12/14/2022]
Abstract
The inclusion of 18F-FDG PET as a biomarker in the diagnostic criteria of neurodegenerative diseases and its indication in the presurgical assessment for drug-resistant epilepsies allow to improve specificity of these diagnosis. The traditional interpretation of neurological PET studies has been performed qualitatively, although in the last decade, several quantitative evaluation methods have emerged. This technical development has become relevant in clinical practice, improving specificity, reproducibility and reducing the interrater reliability derived from visual analysis. In this article we update/review the main imaging processing techniques currently used. This may allow the Nuclear Medicine physician to know their advantages and disadvantages when including these procedures in daily clinical practice.
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Affiliation(s)
- A Niñerola-Baizán
- Servicio de Medicina Nuclear, Hospital Clínic, Barcelona, España; Grupo de Imagen Biomédica, Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, España
| | - P Aguiar
- Grupo de Imaxe Molecular e Física Médica, Departamento de Radioloxía, Facultade de Medicina, Universidade de Santiago de Compostela, Santiago de Compostela, España; Servicio de Medicina Nuclear, Hospital Clínico de Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, España
| | - M N Cabrera-Martín
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Madrid, España
| | - C Vigil
- Servicio Medicina Nuclear, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, España.
| | - A Gómez-Grande
- Servicio de Medicina Nuclear, Hospital Universitario 12 de Octubre, Madrid, España
| | - C Lorenzo
- Servicio de Medicina Nuclear, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España
| | - S Rubí
- Servicio de Medicina Nuclear, Hospital Universitari Son Espases, Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, España
| | - P Sopena
- Servicio de Medicina Nuclear, Hospital Vithas-Nisa 9 de Octubre, Valencia, España; Servicio de Medicina Nuclear, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - V Camacho
- Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
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Zelada Rodríguez MA, Cerdà Mas G, García Ortiz de Uriarte L, Martí Company FX, Ronquillo Moreno N, Rodríguez González D. Arterial hypertension treatment in octogenarians with dementia according to ESC/ESH-2018: Three-year follow-up. Med Clin (Barc) 2020; 154:301-4. [PMID: 31558281 DOI: 10.1016/j.medcli.2019.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/19/2019] [Accepted: 06/27/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine the control of systolic blood pressure (SBP) retrospectively according to the recommendations of the ESC/ESH-2018 guideline and its relationship with mortality in octogenarian patients with dementia. PATIENTS AND METHODS Preliminary, longitudinal, observational, retrospective study, including 65 patients ≥80 years with diagnosis of dementia and arterial hypertension admitted to a psychogeriatric unit during 2015. The main variables were SBP control according to the recommendations of the ESC/ESH-2018 guideline, considering desirable SBP (130-139mmHg), undesirable SBP (suboptimal <130mmHg and elevated SBP ≥140mmHg) and mortality at 3 years in patients with antihypertensive treatment at discharge (n = 53). RESULTS Mean age, 86.7±4.31 years (63% women); severe functional dependence (Barthel index <40): 67.7%; severe cognitive impairment (GDS-Riesberg ≥6): 86.3%; high comorbidity: 49%; mortality at 3 years: 41 (63.1%). Patients with arterial hypertension and cardiovascular comorbidity had a higher prescription of antihypertensive drugs (2.07 vs. 1.18, p=.002). Three years mortality was lower in patients with desirable SBP (44.4%) versus undesirable SBP (72.7%) groups, although it was not statistically significant. CONCLUSIONS The percentage of patients in treatment with suboptimal SBP was elevated especially in hypertensive patients without cardiovascular comorbidity. We found a trend for higher mortality in undesirable SBP groups compared to desirable SBP.
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Jorge C, Cetó M, Arias A, Blasco E, Gil MP, López R, Dakterzada F, Purroy F, Piñol-Ripoll G. Level of understanding of Alzheimer disease among caregivers and the general population. Neurologia (Engl Ed) 2020; 36:426-432. [PMID: 34238525 DOI: 10.1016/j.nrleng.2018.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 03/01/2018] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Understanding of Alzheimer disease (AD) is fundamental for early diagnosis and to reduce caregiver burden. The objective of this study is to evaluate the degree of understanding of AD among informal caregivers and different segments of the general population through the Alzheimer's Disease Knowledge Scale (ADKS). PATIENTS AND METHODS We assessed the knowledge of caregivers in different follow-up periods (less than one year, between 1 and 5 years, and over 5 years since diagnosis) and individuals from the general population. ADKS scores were grouped into different items: life impact, risk factors, symptoms, diagnosis, treatment, disease progression, and caregiving. RESULTS A total of 419 people (215 caregivers and 204 individuals from the general population) were included in the study. No significant differences were found between groups for overall ADKS score (19.1 vs 18.8, P = .9). There is a scarce knowledge of disease risk factors (49.3%) or the care needed (51.2%), while symptoms (78.6%) and course of the disease (77.2%) were the best understood aspects. Older caregiver age was correlated with worse ADKS scores overall and for life impact, symptoms, treatment, and disease progression (P < .05). Time since diagnosis improved caregivers' knowledge of AD symptoms (P = .00) and diagnosis (P = .05). CONCLUSION Assessing the degree of understanding of AD is essential to the development of health education strategies both in the general population and among caregivers.
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Affiliation(s)
- C Jorge
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, IRBLleida-Hospital Universitari Santa Maria Lleida, Lleida, Spain
| | - M Cetó
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, IRBLleida-Hospital Universitari Santa Maria Lleida, Lleida, Spain
| | - A Arias
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, IRBLleida-Hospital Universitari Santa Maria Lleida, Lleida, Spain
| | - E Blasco
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, IRBLleida-Hospital Universitari Santa Maria Lleida, Lleida, Spain
| | - M P Gil
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, IRBLleida-Hospital Universitari Santa Maria Lleida, Lleida, Spain
| | - R López
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, IRBLleida-Hospital Universitari Santa Maria Lleida, Lleida, Spain
| | - F Dakterzada
- Department of Experimental Medicine, Clinical Neuroscience Research, IRBLleida, Lleida, Spain
| | - F Purroy
- Servicio Neurología, Clinical Neuroscience Research, IRBLleida-Hospital Universitari Arnau Vilanova Lleida, Lleida, Spain
| | - G Piñol-Ripoll
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, IRBLleida-Hospital Universitari Santa Maria Lleida, Lleida, Spain.
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Cobas Paz R, Raposeiras Roubín S, Abu Assi E, Barreiro Pardal C, García Comesaña J, González-Carrero López A, Caneiro Queija B, Cespón Fernández M, Muñoz Pousa I, Domínguez Erquicia P, Domínguez Rodríguez LM, Carpintero Vara A, García Campo E, Rodríguez Pascual C, Íñiguez Romo A. Impact of anticoagulation in patients with dementia and atrial fibrillation. Results of the CardioCHUVI-FA registry. ACTA ACUST UNITED AC 2020; 73:877-884. [PMID: 32081625 DOI: 10.1016/j.rec.2019.10.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 10/31/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION AND OBJECTIVES Population aging is associated with an increased prevalence of atrial fibrillation (AF) and dementia. This study aimed to analyze the impact of oral anticoagulation in elderly patients with AF and moderate-severe dementia. METHODS We conducted a single-center retrospective study analyzing patients aged ≥ 85 years with a diagnosis of AF between 2013 and 2018. The impact of anticoagulation on mortality, embolisms, and bleeding events was assessed by multivariate Cox analysis. In patients with dementia, this analysis was complemented by propensity score matching, depending on whether the patients were prescribed anticoagulant treatment or not. RESULTS Of the 3549 patients aged ≥ 85 years with AF, 221 had moderate-severe dementia (6.1%), of whom 88 (60.2%) were anticoagulated. During a follow-up of 2.8 ±1.7 years, anticoagulation was associated with lower embolic risk and higher bleeding risk both in patients with dementia (hazard ratio [HR]embolisms, 0.36; 95%CI, 0.15-0.84; HRbleeding, 2.44; 95%CI, 1.04-5.71) and in those without dementia (HRembolisms, 0.58; 95%CI, 0.45-0.74; HRbleeding, 1.55, 95%CI, 1.21-1.98). However, anticoagulation was associated with lower mortality only in patients without dementia (HR, 0.63; 95%CI, 0.53-0.75) and not in those with dementia (adjusted HR, 1.04; 95%CI, 0.63-1.72; P=.541; HR after propensity score matching 0.91, 95%CI, 0.45-1.83; P=.785). CONCLUSIONS In patients aged ≥ 85 years with moderate-severe dementia and AF, oral anticoagulation was significantly associated with a lower embolic risk and a higher bleeding risk, with no differences in total mortality.
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Affiliation(s)
- Rafael Cobas Paz
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
| | | | - Emad Abu Assi
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | | | | | | | | | - María Cespón Fernández
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | - Isabel Muñoz Pousa
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | | | | | | | - Enrique García Campo
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | | | - Andrés Íñiguez Romo
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain
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Mar J, Arrospide A, Soto-Gordoa M, Machón M, Iruin Á, Martinez-Lage P, Gabilondo A, Moreno-Izco F, Gabilondo A, Arriola L. Validity of a computerised population registry of dementia based on clinical databases. Neurologia (Engl Ed) 2020; 36:418-425. [PMID: 34238524 DOI: 10.1016/j.nrleng.2018.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/01/2018] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The handling of information through digital media allows innovative approaches for identifying cases of dementia through computerised searches within the clinical databases that include systems for coding diagnoses. The aim of this study was to analyse the validity of a dementia registry in Gipuzkoa based on the administrative and clinical databases existing in the Basque Health Service. METHODS This is a descriptive study based on the evaluation of available data sources. First, through review of medical records, the diagnostic validity was evaluated in two samples of cases identified and not identified as dementia. The sensitivity, specificity and positive and negative predictive value of the diagnosis of dementia were measured. Subsequently, the cases of living dementia in December 31, 2016 were searched in the entire Gipuzkoa population to collect sociodemographic and clinical variables. RESULTS The validation samples included 986 cases and 327 no cases. The calculated sensitivity was 80.2% and the specificity was 99.9%. The negative predictive value was 99.4% and positive value was 95.1%. The cases in Gipuzkoa were 10 551, representing 65% of the cases predicted according to the literature. Antipsychotic medication were taken by a 40% and a 25% of the cases were institutionalised. CONCLUSIONS A registry of dementias based on clinical and administrative databases is valid and feasible. Its main contribution is to show the dimension of dementia in the health system.
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Affiliation(s)
- J Mar
- Unidad de Gestión Sanitaria, Hospital Alto Deba, Arrasate-Mondragón, Spain; Unidad de Investigación AP-OSIs Gipuzkoa, Organización Sanitaria Integrada Alto Deba, Arrasate-Mondragón, Spain; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC), Spain; Instituto Biodonostia, Donostia-San Sebastián, Spain.
| | - A Arrospide
- Unidad de Investigación AP-OSIs Gipuzkoa, Organización Sanitaria Integrada Alto Deba, Arrasate-Mondragón, Spain; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC), Spain; Instituto Biodonostia, Donostia-San Sebastián, Spain
| | - M Soto-Gordoa
- Unidad de Investigación AP-OSIs Gipuzkoa, Organización Sanitaria Integrada Alto Deba, Arrasate-Mondragón, Spain; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC), Spain; Instituto Biodonostia, Donostia-San Sebastián, Spain
| | - M Machón
- Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC), Spain; Instituto Biodonostia, Donostia-San Sebastián, Spain; Unidad de Investigación AP-OSIs Gipuzkoa, Donostia-San Sebastián, Spain
| | - Á Iruin
- Instituto Biodonostia, Donostia-San Sebastián, Spain; Red de Salud Mental Extrahospitalaria de Gipuzkoa, Donostia-San Sebastián, Spain
| | | | - A Gabilondo
- Servicio de Neurología, Organización Sanitaria Integrada Bidasoa, Irún, Spain
| | - F Moreno-Izco
- Instituto Biodonostia, Donostia-San Sebastián, Spain; Servicio de Neurología, Hospital Donostia, Donostia-San Sebastián, Spain
| | - A Gabilondo
- Instituto Biodonostia, Donostia-San Sebastián, Spain; Red de Salud Mental Extrahospitalaria de Gipuzkoa, Donostia-San Sebastián, Spain
| | - L Arriola
- Instituto Biodonostia, Donostia-San Sebastián, Spain; Subdirección de Salud Pública de Gipuzkoa, Gobierno Vasco, Donostia-San Sebastián, Spain; CIBERESP CIBER Epidemiología y Salud Pública, Donostia-San Sebastián, Spain
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Izquierdo Delgado E, Gutiérrez Ríos R, Andrés Calvo M, Repiso Gento I, Castrillo Sanz A, Rodríguez Herrero R, Rodríguez Sanz MF, Tola-Arribas MA. Nutritional status assessment in Alzheimer disease and its influence on disease progression. Neurologia 2020; 37:S0213-4853(19)30148-3. [PMID: 31980283 DOI: 10.1016/j.nrl.2019.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 08/20/2019] [Accepted: 11/04/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Nutritional deficiencies are frequent in Alzheimer disease (AD), even in early stages. Nutritional impairment (NI) may be associated with faster disease progression. The objective of this study was to describe the frequency of NI and the associated risk factors at the time of diagnosis and to analyse its influence on subsequent progression. METHODS We performed a prospective, multicentre, observational study of patients recently diagnosed with prodromal AD (pAD) or dementia due to AD (ADd). Two clinical assessments were conducted over a period of 18months. The Mini Nutritional Assessment test (MNA; score range, 0-30; cut-off point for NI, <24) was used to estimate nutritional status. Progression was defined as an increase of ≥3points on the Clinical Dementia Rating-sum of boxes test. RESULTS The sample included 50 patients with pAD (mean [standard deviation] age, 76.1 [5.3] years; 68% women), and 127 with ADd (80 [5.9] years; 72.4% women). A total of 141 (79.7%) completed both evaluations. The prevalence of NI was 28.2% (24% for pAD, 29.9% for ADd; P=.43), with the majority (92%) at risk of malnutrition. NI was associated with female sex (odds ratio [OR]: 4.2; 95% confidence interval [CI]: 1.7-10.5; P<.001) and greater behavioural involvement (OR: 5.8; 95%CI: 2.6-12.7; P<.001). A larger proportion of patients with progression was observed among those with NI than among those with normal nutritional status (50% vs 28.7%, P<.05; ADd: 53.6% vs 31.8%, P<.05; pAD: 41.7% vs 22.9%, P=.21). Greater cognitive impairment (OR: 2.1; 95%CI: 1.03-4.4; P<.05) and NI (OR: 2.4; 95%CI: 1.1-5.1; P<.05) were independent risk factors for disease progression. CONCLUSIONS NI is highly prevalent in patients with AD. Assessing nutritional status at the time of diagnosis may enable identification of patients at greater risk of disease progression.
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Affiliation(s)
- E Izquierdo Delgado
- Servicio de Medicina Interna, Hospital Universitario Río Hortega, Valladolid, España
| | - R Gutiérrez Ríos
- Sección de Neurología, Complejo Asistencial de Segovia, Segovia, España
| | - M Andrés Calvo
- Servicio de Medicina Interna, Hospital Universitario Río Hortega, Valladolid, España
| | - I Repiso Gento
- Medicina de Familia, Área Sanitaria Valladolid Oeste, Valladolid, España
| | - A Castrillo Sanz
- Sección de Neurología, Complejo Asistencial de Segovia, Segovia, España
| | | | | | - M A Tola-Arribas
- Sección de Neurología, Hospital Universitario Río Hortega, Valladolid, España.
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