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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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Ruiz-García RG, Chacón-González J, Bayliss L, Ramírez-Bermúdez J. Neuropsychiatry of Susac syndrome: A case report. Rev Colomb Psiquiatr (Engl Ed) 2021; 50:146-151. [PMID: 34099251 DOI: 10.1016/j.rcpeng.2019.10.005] [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: 01/16/2019] [Accepted: 10/01/2019] [Indexed: 06/12/2023]
Abstract
Susac syndrome is a rare clinical condition, possibly mediated by an autoimmune process; the classic triad is composed of retinopathy, decreased hearing acuity and neuropsychiatric symptoms (encephalopathy). There are few cases reported with neuropsychiatric symptoms as the main manifestation. We present a case of Susac syndrome in a 34-year-old female with a predominance of neuropsychiatric symptoms, characterised by partial Klüver-Bucy syndrome, apathy syndrome, pathological laughter and crying, and cognitive dysfunction predominantly affecting attention, which showed a qualitative improvement with the use of immunological therapy. This case report highlights the importance of neuropsychiatric manifestations as clinical presentation in patients with neurological conditions.
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Affiliation(s)
- Ramiro Gilberto Ruiz-García
- Unidad de Neuropsiquiatría, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Ciudad de México, Mexico.
| | - Jacobo Chacón-González
- Unidad de Neuropsiquiatría, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Ciudad de México, Mexico
| | - Leo Bayliss
- Servicio de Neurología, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Ciudad de México, Mexico
| | - Jesús Ramírez-Bermúdez
- Unidad de Neuropsiquiatría, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Ciudad de México, Mexico
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Ruiz-García RG, Chacón-González J, Bayliss L, Ramírez-Bermúdez J. Neuropsychiatry of Susac Syndrome: a Case Report. Rev Colomb Psiquiatr (Engl Ed) 2021; 50:146-151. [PMID: 33735032 DOI: 10.1016/j.rcp.2019.10.007] [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: 01/16/2019] [Revised: 08/28/2019] [Accepted: 10/01/2019] [Indexed: 06/12/2023]
Abstract
Susac syndrome is a rare clinical condition, possibly mediated by an autoimmune process; the classic triad is composed of retinopathy, decreased hearing acuity and neuropsychiatric symptoms (encephalopathy). There are few cases reported with neuropsychiatric symptoms as the main manifestation. We present a case of Susac syndrome in a 34-year-old female with a predominance of neuropsychiatric symptoms, characterised by partial Klüver-Bucy syndrome, apathy syndrome, pathological laughter and crying, and cognitive dysfunction predominantly affecting attention, which showed a qualitative improvement with the use of immunological therapy. This case report highlights the importance of neuropsychiatric manifestations as clinical presentation in patients with neurological conditions.
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Affiliation(s)
- Ramiro Gilberto Ruiz-García
- Unidad de Neuropsiquiatría, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Ciudad de México, México.
| | - Jacobo Chacón-González
- Unidad de Neuropsiquiatría, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Ciudad de México, México
| | - Leo Bayliss
- Servicio de Neurología, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Ciudad de México, México
| | - Jesús Ramírez-Bermúdez
- Unidad de Neuropsiquiatría, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Ciudad de México, México
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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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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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Abstract
Neuropsychiatric symptoms (NPS) are frequent in dementia. These symptoms are also present in patients with mild cognitive impairment (MCI) and can even constitute the first manifestations of a neurodegenerative process, preceding the development of cognitive symptoms. The presence of NPS is associated with higher rates of conversion to dementia in healthy persons and patients with MCI. Recognizing the importance of NPS, the Alzheimer Association created a working group that has designed the ISTAART criteria for mild behavioral impairment (MBI), including the following areas of assessment: motivation, affect, impulse control, social appropriateness and thoughts/perception. The ISTAART criteria allow identification of NPS to prospectively assess the risk of a person developing dementia. The Mild Behavioral Impairment-Checklist (MBI-C) has subsequently been developed, which allows the MBI construct to be specifically assessed by quantifying the distinct symptoms, thus enhancing the clinical utility of this construct in clinical practice and research.
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Affiliation(s)
- Luis Agüera Ortiz
- Servicio de Psiquiatría, Hospital Universitario 12 de Octubre, Madrid, España.
| | - Jorge López Álvarez
- Servicio de Psiquiatría, Hospital Universitario 12 de Octubre, Madrid, España
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Ahunca Velásquez LF. [Beyond Cognitive Impairment: Neuropsychiatric Symptoms in Neurodegenerative Dementias]. Rev Colomb Psiquiatr 2017; 46 Suppl 1:51-58. [PMID: 29037339 DOI: 10.1016/j.rcp.2017.05.006] [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] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 05/06/2017] [Indexed: 06/07/2023]
Abstract
As life expectancy increases, the number of people diagnosed with neurodegenerative dementia also increases. Although cognitive impairment is central in dementia, neuropsychiatric symptoms (NPS) are very important because they increase both direct and indirect costs by generating greater morbidity, caregiver distress, use of medication and institutionalisation. Furthermore, it is important to understand the nature of NPS, since they can vary across the different types of dementia and may provide useful clinical information regarding the aetiology of cognitive impairment. The first-line management of NPS in dementia is non-pharmacological; internal and external causes should first be identified and strategies developed to modify the behavioural patterns of the patient and their caregiver. In addition, changes in the patient's surroundings that may improve patient performance and behaviour should be encouraged. If these practices are not satisfactory, a pharmacological treatment approach is adopted that includes anti-dementia drugs, antipsychotics, antidepressants, mood stabilisers and benzodiazepines. However, psychoactive drugs do not offer sufficient efficacy and most of them have significant adverse effects, so each patient should be individually assessed, together with the implementation of non-pharmacological strategies, before deciding on pharmacological treatment for the management of NPS in dementia.
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Córcoles D, Malagón A, Bellsolà M, Gonzalez A, Cortizo R, Leon J, Bulbena A, Pérez V, Martín LM. Síntomas neuropsiquiátricos como factor de confusión en la detección de la demencia. Aten Primaria 2017. [PMID: 28623009 PMCID: PMC6836988 DOI: 10.1016/j.aprim.2017.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aim of the study was to evaluate whether the neuropsychiatric symptoms interfere with cognitive impairment detection in primary care and to describe which of them generate more confusion. DESIGN Descriptive and observational study. LOCATION Mobile psychiatric unit in collaboration with primary healthcare centers in Barcelona. PARTICIPANTS A total of 104 patients over 65years referred to mobile psychiatric unit from primary healthcare clinicians suspecting mental disease. MAIN MEASUREMENTS All patients received a DSM-IV-TR diagnosis. We included in the study the Mini Mental State Examination (MMSE), Neuropsichiatric Inventory, Severe Psychiatric Illness scale, Global Assessment of Functioning, Clinical Global Impression and Word Health Organisation Dissability Assessment Schedule. RESULTS 55.8% of patients referred from primary care had altered MMSE score. Neuropsychiatric symptoms more frequently associated with suspected cognitive impairment were delusions, hallucinations, agitation, disinhibition, irritability and purposeless motor behavior. CONCLUSIONS When psychiatric symptoms of Severe Mental Disorder (SMD) are detected in elderly individuals with no history of SMD, cognitive impairment should be suspected and a screening test be done.
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Affiliation(s)
- David Córcoles
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España.
| | - Angeles Malagón
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, España
| | - Magdalena Bellsolà
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, España
| | - Ana Gonzalez
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, España
| | - Romina Cortizo
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, España
| | - Jordi Leon
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, España
| | - Antoni Bulbena
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, España; Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Barcelona, España
| | - Victor Pérez
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España
| | - Luis M Martín
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España
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Gómez Gallego M, Gómez García J. Music therapy and Alzheimer's disease: Cognitive, psychological, and behavioural effects. Neurologia 2017; 32:300-8. [PMID: 26896913 DOI: 10.1016/j.nrl.2015.12.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 09/10/2015] [Accepted: 12/06/2015] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Music therapy is one of the types of active ageing programmes which are offered to elderly people. The usefulness of this programme in the field of dementia is beginning to be recognised by the scientific community, since studies have reported physical, cognitive, and psychological benefits. Further studies detailing the changes resulting from the use of music therapy with Alzheimer patients are needed. OBJECTIVES Determine the clinical improvement profile of Alzheimer patients who have undergone music therapy. PATIENTS AND METHODS Forty-two patients with mild to moderate Alzheimer disease underwent music therapy for 6 weeks. The changes in results on the Mini-mental State Examination, Neuropsychiatric Inventory, Hospital Anxiety and Depression Scale and Barthel Index scores were studied. We also analysed whether or not these changes were influenced by the degree of dementia severity. RESULTS Significant improvement was observed in memory, orientation, depression and anxiety (HAD scale) in both mild and moderate cases; in anxiety (NPI scale) in mild cases; and in delirium, hallucinations, agitation, irritability, and language disorders in the group with moderate Alzheimer disease. The effect on cognitive measures was appreciable after only 4 music therapy sessions. CONCLUSIONS In the sample studied, music therapy improved some cognitive, psychological, and behavioural alterations in patients with Alzheimer disease. Combining music therapy with dance therapy to improve motor and functional impairment would be an interesting line of research.
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