Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “DEMENTIA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources
PubMed1988

Purine metabolites in the CSF in presenile and senile dementia of Alzheimer type, and in multi infarct dementia.

Concentrations of hypoxanthine, xanthine, uric acid and creatinine were measured in CSF of patients suffering form presenile and senile dementia of Alzheimer type (PDAT, SDAT) and multi infarct dementia (MID) and in a reference group of young neurotic patients. There was no difference in hypoxanthine concentration, but there was a marked elevation of xanthine concentration in each dementia group, independent of the type of dementia. There was a significant elevation of uric acid in SDAT and MID but not in PDAT. The concentration of uric acid was higher in MID than in SDAT. There was a higher level of creatinine in the dementia groups, but no difference was seen among the dementia groups. These results are discussed in order to better interpret the etiology and the differentiated diagnosis of the types of dementia.

Adolescent↗
PubMed2004

Progress in clinical neurosciences: Parkinson's disease with dementia and dementia with Lewy bodies.

Dementia occurs in up to 30% of people with Parkinson's disease and is a major cause of disability. Pathologically, Parkinson's dementia, where dementia follows the onset of parkinsonism by at least one year, overlaps with dementia with Lewy bodies. We review the functional impact, definitions, neuropsychology, epidemiology and pathophysiology of Parkinson's dementia, dementia with Lewy bodies and their overlap. Associated psychiatric and imaging findings are also considered. Lastly, current and emerging approaches to assessment and treatment in patients with these Lewy body associated dementias are presented.

Dementia↗
PubMed1999

[Epidemiology of dementia and regional health care concepts for dementia patients and relatives].

The prevalence of dementia varies according to the definitions used but shows always an exponential increase with age, a doubling by every five years increase from 60-95 years. Due to the aging of the baby boom generation a doubling of dementia prevalence in the next 50 years is to be expected. Alzheimer's disease is the most frequent cause of dementia. Combinations with vascular, Lewybody, frontotemporal and other causes of dementia are much more frequent than first considered. They all give rise to severe dementia despite only mild Alzheimer changes in the brain. However, a therapeutic response may be expected from cholinergic therapy. Since this pharmacotherapy of dementia only leads to a limited delay of 6-10 months in the progression of dementia, combinations with psychosocial measures such as caregiver-education and care-planning are necessary. We therefore need centers of excellence, such as memory clinics or psychogeriatric counselling centers throughout Switzerland.

Aged↗
PubMedDate not supplied

Quality of life (QoL) in dementia: a comparison of the perceptions of people with dementia and care staff in residential homes.

Evaluating quality of life (QoL) in people with dementia has become increasingly valued, for example in assessing the effectiveness of interventions or making treatment decisions. This study compared the QoL of people with dementia as assessed by the individuals and their care staff, and possible factors associated with the discrepancy between ratings. Seventy-six dyads of people with dementia and care staff in 9 residential homes were recruited. People with dementia were interviewed, using the "quality of life-Alzheimer disease" (QoL-AD) and assessed for severity of cognitive impairment. Staff completed the QoL-AD with respect to the person with dementia, and measures assessing their job satisfaction, level of hope, and person-centeredness. Results showed that people with dementia and care staff rated QoL differently. Some items on the QoL-AD ("physical health," "family," and "friends") were rated similarly between the 2 groups and others differently ("ability to do chores," "marriage/closest relationship," "memory," and "life as a whole"). Neither staff factors (hope, person-centeredness, or job satisfaction) nor the severity of cognitive impairment in the people with dementia explained the discrepancy between ratings. However, when data were aggregated within residential settings, a correlation between increased hope in staff and better resident assessed QoL emerged. Care homes should be aware that low staff hope may be linked to lower resident QoL. Effective training and support for care staff may impact on residents' QoL.

Adolescent↗
PubMed2004

'How can they tell?' A qualitative study of the views of younger people about their dementia and dementia care services.

There is growing interest in eliciting the views of younger people with dementia (i.e. those under 65 years of age) within health and social care research. The often erroneous view that these individuals are not capable of expressing their views and experiences has now been seriously challenged. The present paper draws on the findings from 14 qualitative in-depth interviews with younger people with dementia conducted in the South-west of England, and considers some of the issues involved in interviewing people with dementia. Purposive and snowballing techniques were used to recruit participants. Data were transcribed and subjected to comparative textual analysis to index, code and analyse the data for emergent themes. Four major themes emerged: (1) the general experience of having dementia; (2) dementia diagnosis; (3) the importance of age; and (4) risk and danger issues. The results indicate that the majority of participants were articulate and insightful about their experiences and needs. The present paper concludes by arguing that the challenge for health and social care professionals is to engage with and consult such individuals about their experiences and what they want from dementia care services, and the authors consider some of the issues involved in interviewing people with dementia.

Adult↗
PubMed1995

Patterns of neuropsychological impairment in mild dementia: a comparison between Alzheimer's disease and multi-infarct dementia.

The objective was to investigate the clinical and psychometric differences between patients with dementia of Alzheimer type (DAT) and patients with multi-infarct dementia (MID), matched for age, sex, education, and severity. Sixteen patients with DAT, 16 patients with MID, and 30 healthy individuals, were drawn from a longitudinal study on aging and dementia. Subjects with medical or previous mental disorders were excluded. DAT and controls with focal brain abnormalities on magnetic resonance imaging (MRI) were excluded. Diagnosis of dementia was carried out according to DSM-III-R criteria. Dementia severity was staged using the Clinical Dementia Rating (CDR) scale, and only patients with a score of 0.5-1 on CDR were studied. The main outcome measures were quantitative clinical scales of the assessment of global mental status, depression and anxiety, as well as a wide battery of neuropsychological tests for the evaluation of executive/conceptual functions and memory, as well as attention verbal ability, and visuospatial skill functions. The performance of demented patients compared to normal controls was affected on all measurements except for depression and anxiety. DAT patients showed compared to MID patients a greater extent of impairment on tasks assessing verbal comprehension and memory while MID patients were more significantly impaired on measures of frontal lobe functioning. Clinically matched DAT and MID patients show a differential pattern of neuropsychological impairment when studied in an early stage of dementia and with a mild degree of severity. Such patterns might be of value for the development of clinical diagnostic criteria.

Aged↗
PubMed2006

Quality of life in dementia: more than just cognition. An analysis of associations with quality of life in dementia.

OBJECTIVES: To explore the extent to which commonly used measures of specific outcomes in dementia are an appropriate proxy for quality of life in dementia. METHODS: This was a cross sectional study set in communities in London and Nottingham, comprising 101 people with dementia and their 99 main family caregivers. The main outcome measures were health related quality of life in dementia (measured by the DEMQOL-Proxy), cognition (Mini Mental State Examination), functional impairment (Barthel Index), behavioural and psychological symptoms in dementia (Neuropsychiatric Inventory; NPI), and carer mental health (General Health Questionnaire). RESULTS: On univariate analysis, decreased quality of life was statistically significantly correlated with higher levels of behavioural and psychological disturbance (NPI total score and its agitation, depression, anxiety, disinhibition, and irritability subscales); younger age of the person with dementia; and poorer mental health of the carer. Quality of life was not statistically significantly associated with cognition or carer age. In a multivariate model, psychological and behavioural disturbance and patient age remained statistically significantly associated with quality of life. Carer mental health was no longer statistically significantly associated, and cognition and functional limitation remained statistically insignificant. CONCLUSIONS: These data suggest that quality of life in dementia is complex, and that simple proxy substitutions of discrete measures such as cognition or function are likely to miss important factors.

Activities of Daily Living↗
PubMed2003

Neuropsychological prediction of conversion to dementia from questionable dementia: statistically significant but not yet clinically useful.

BACKGROUND: Verbal memory impairment, one of the earliest signs of Alzheimer's disease (AD), may help identify people with cognitive impairment, insufficient for a diagnosis of dementia (questionable dementia: QD), at risk of developing AD. Other cognitive parameters have been found that may indicate which people with QD will go on to develop dementia. Nevertheless, some researchers have reported only partial success in differentiating between mild AD and age related cognitive impairment. OBJECTIVES: To discover if there are early, pre-clinical cognitive markers that could help identify patients attending our memory clinic who were at risk of developing dementia. METHODS: Multidisciplinary assessment of a consecutive sample of 195 patients with QD seen in a National Health Service hospital outpatient clinic; 135 seen for a mean follow up of 24.5 months. RESULTS: Conversion rate to dementia was 27.4% (37 of 135). A diagnosis of probable or possible AD was made in 15.6% (21 of 135) of cases. Despite statistically significant differences in some cognitive tasks between those who did and those who did not go on to dement, Cox regression analyses failed to improve prediction rates markedly above base rates and were unstable. CONCLUSION: A large number of studies claim good prediction of conversion to dementia using cognitive test scores. Although this study produced similarly good sensitivity and specificity values, proper consideration of the statistical analyses and their clinical significance suggested that these prediction methods are currently too imprecise for clinical use. Use of cognitive indicators combined with neuroradiological, neuropathological, and genetic factors for predicting conversion to dementia might prove more reliable but may be beyond the scope of many geriatric services.

Aged↗
PubMedDate not supplied

Medial temporal lobe width on CT scanning in Alzheimer's disease: comparison with vascular dementia, depression and dementia with Lewy bodies.

A simple linear measurement of the minimum width of the medial temporal lobe (MTL) on angled CT scans has been suggested as an accurate ante-mortem marker for Alzheimer's disease (AD). To determine the clinical utility and specificity of this finding, we performed angled CT scans with 5-mm slices in 116 subjects referred to a geographically based Old Age Psychiatry service in Newcastle. Diagnoses were of NINCDS/ADRDA AD (n = 69, 36 probable and 33 possible). NINDS/AIREN vascular dementia (VaD, n = 25), consensus criteria for dementia with Lewy bodies (DLB, n = 9) and DSM-IV criteria for major depression (n = 13). Subjects were well matched for age. Minimum MTL width was significantly greater in depressed subjects (13.7 mm) compared to those with dementia, though no differences were seen within the dementia groups (AD 10.8, VaD 10.4, and DLB 10.9 mm). An MTL width below 11.5 mm had a sensitivity of 54% (56/103) and a specificity of 77% (10/13) for distinguishing dementia from depression. We conclude that a single cross-sectional measurement of MTL width on CT does not help differentiate between different types of dementia, though it may provide some supportive evidence when distinguishing depression from dementia.

Aged↗
PubMed2002

Neuropsychological predictors of incident dementia in patients with vascular cognitive impairment, without dementia.

BACKGROUND: Vascular cognitive impairment that does not fulfill dementia criteria (ie, vascular cognitive impairment, no dementia [CIND]) is common. Although progression to dementia is frequent, little is known about factors that predict progression. We examined whether performance on neuropsychological tests administered at baseline could predict incident cases of dementia in patients with vascular CIND after 5 years. Summary of Report- The Canadian Study of Health and Aging is a prospective, cohort study of 10 263 randomly selected persons aged > or =65 years. Of 149 people diagnosed with vascular CIND, 125 completed a battery of neuropsychological tests at baseline. Follow-up cognitive diagnoses were available for 102 individuals. After 5 years, 45 patients (44%) developed dementia. Low baseline scores on tests of memory and category fluency were associated with incident dementia. CONCLUSIONS: Neuropsychological measures can indicate risk of dementia in patients with vascular CIND. This study did not suggest a prediction-to-progression profile distinct from that seen in Alzheimer disease.

Aged↗
PubMed1983

Reversible dementia and the misdiagnosis of dementia: a review.

Ten to 33 percent of the patients who present for evaluation of dementia are found to have a potentially reversible cause of dementia such as metabolic, structural, or psychiatric condition. Another group of patients who present with symptoms or complaints of impaired thinking are erroneously diagnosed as suffering from dementia. The author reviews the criteria for diagnosis of dementia, the laboratory and other tests advisable for use in evaluating the presence of dementia or guiding the treatment of irreversible dementia, and some factors that may lead to the misdiagnosis of dementia. He emphasizes that a thorough medical, psychiatric, and psychosocial evaluation of all patients presenting with cognitive impairments is essential.

Cognition Disorders↗
PubMed2002

Is dementia with Lewy bodies the second most common cause of dementia?

Lewy bodies were originally described in isolated brainstem nuclei in persons with Parkinson's disease. They have since been recognized as a widespread and common neuropathologic finding in individuals with dementia. Dementia with Lewy bodies (DLB) is the preferred term for the dementia syndrome associated with Lewy bodies. Although DLB is acknowledged as the second most common degenerative dementia, trailing only Alzheimer's disease, its ranking with respect to vascular dementia remains controversial. Large, community-based studies of DLB with postmortem confirmation are lacking. Available data suggest that DLB is more common than pure vascular dementia but not more common than any vascular contribution to dementia.

Aged↗
PubMed1998

Hereditary dysphasic disinhibition dementia: a frontotemporal dementia linked to 17q21-22.

OBJECTIVE: The clinical and pathologic features of hereditary dysphasic disinhibition dementia (HDDD) are described to determine whether it is a variant of known dementias. BACKGROUND: Several dementing disorders have clinical and pathologic similarities with AD, Pick's disease, and the "nonspecific" dementias. A detailed description of clinical and pathologic presentation will aid classification, but ultimately the discovery of causative gene(s) will define these disorders. METHODS: The authors performed a clinical assessment: gross and microscopic pathologic evaluation of brain tissue, genetic linkage studies, and sequence analyses. RESULTS: HDDD is an autosomal-dominant frontotemporal dementia with many similarities to Pick's disease. Salient clinical features are global dementia with disproportionate dysphasia and "frontotemporal" symptoms. A linkage between HDDD and 17q21-22 was shown, with a maximum lod score of 3.68 at zero recombination. CONCLUSIONS: Several dementias have been linked to the same region and have been termed frontotemporal dementia with parkinsonism linked to chromosome 17. These disorders may represent phenotypic variants arising from mutations within a common gene.

Adult↗
PubMed2002

Chinese Dementia Specialist Education Program: training Chinese American health care professionals as dementia experts.

A Chinese Dementia Specialist Education Program (CDSEP) was launched in the Greater Boston Area to educate Chinese American health care providers who lacked adequate dementia education and services. This program trained bilingual health care providers to identify, assess and serve people with dementia and their families, and raised dementia awareness in Chinese American communities. The ten-month follow-up survey documented that the sixteen graduates helped over 70 families and held 76 workshops and formal and informal discussions, reaching over 400 people. The CDSEP demonstrates that a "Train the Trainer" model is an effective approach for building dementia care capacity in community-based agencies, increasing outreach to people with dementia and their families, and for raising dementia awareness in bilingual and minority communities.

Adult↗
PubMed2001

Dementia policy revisited: an analysis of the state laws targeted towards individuals with Alzheimer's disease and other forms of dementia.

Even though state governments assume public responsibility for persons with dementia, formal analysis of state laws concerning individuals with Alzhemier's disease and other forms of dementia has been rare. We responded to this by collecting and evaluating state legislation targeted towards individuals with dementia. These laws were collected by searching online statutory archives and were defined by the type of action, year of passage, and legislative purpose. Our research revealed that the legislatures have targeted an average of slightly more than five action towards persons with dementia. We also discovered that the earliest legislative act targeting individuals with dementia was passed by South Dakota in 1939, and by the end of the 1997 sessions, 49 state legislatures had enacted at least one targeted law. We sorted the variety of legislative actions into eight categories and illuminated how the purposes of these laws differed from one state legislature to the next. This research expands knowledge concerning state policies targeting people with dementia, imtroduces a reliable method of collecting state laws, and contributes to the advocacy effort made on behalf of persons with dementia.

Alzheimer Disease↗
PubMed1999

[A follow-up study on the outcome and relevant factors in senile dementia of Alzheimer type and vascular dementia].

We followed 126 patients with senile dementia of Alzheimer type (SDAT), and 129 over age 65 with vascular dementia (VD) who were diagnosed at the Center for Elderly Dementia in our institution between February 1990 and February 1993. At 5-year follow-up, 62 patients with SDAT and 71 patients with VD had died. These patients were assessed prospectively to investigate the neuropsychiatric and somatic factors related to the prognosis of SDAT and VD. There were no significant differences in the average age at onset and time of diagnosis of dementia between the SDAT and VD groups. Mean age at death, mean duration of dementia and 75% survival duration from dementia onset were shorter in patients with VD than in those with SDAT. Pneumonia was the most common cause of death in patients with either SDAT or VD, followed by geromarasmus in the SDAT group, and cerebrovascular and cardiovascular diseases in the VD group. In patients with SDAT, a poor prognosis was correlated with severe dementia, impaired intellectual function and degree of cortical atrophy. In patients with VD, physical complications, impaired motor function and hypoproteinemia enhanced the probability of death. This study confirmed that a progressive neurodegenerative course and physical conditions such as motor dysfunction or malnutrition are closely associated with the prognosis of patients with SDAT and VD, respectively.

Age of Onset↗
PubMed2001

[Consensus on the concepts of cortical, subcortical and frontal dementia. Research by national and international dementia experts].

The level of agreement concerning the concepts cortical, subcortical and frontal dementia. The level of agreement between experts in the field of dementia concerning cortical, subcortical and frontal dementia was established. Nowadays these syndromes are implemented in clinical practice; the discussion about the validity and reliability of these concepts however has diminished. Forty-one national and international dementia experts of four disciplines completed a questionnaire, based on the cognitive section of the CAMDEXR. For each syndrome they marked whether the cognitive function mentioned was impaired or unimpaired in cortical, subcortical and frontal dementia. The level of agreement between experts was determined by use of a derivative of the kappa-coefficient. Cortical dementia was characterised by high levels of agreement between the experts. With an observed level of agreement of 0.76, experts reached the highest consensus about this syndrome. Less agreement was observed in the judgements of subcortical and frontal dementia, with observed levels of agreement of 0.64 and 0.67 respectively. No differences were found in the assessments of national and international experts, as well as between the participating disciplines. Apparently, the application of these syndromes in clinical practice is difficult. Because of this confusion the practical meaning is limited, and one may wonder wether these concepts must still be used in clinical practice.

Brain↗
PubMed2004

[Neuropsychiatric symptoms in dementia and elderly people in the community: results from the Beijing Dementia Cooperative Study].

OBJECTIVE: To determine the prevalence of neuropsychiatric symptoms in dementia and normal elderly people living in the Chinese community of Beijing. METHODS: A cross-sectional study derived from the Beijing Dementia Cooperative Study was carried out a population survey was carried out on a total of 1540 participants aged 65 years and older living in Beijing city and rural areas. All the individuals and 373 demented elderly people completed a series of neuropsychological examination and the Neuropsychiatric Inventory (NPI). RESULTS: Among the dementia participants, 49.33% had exhibited neuropsychiatric symptoms (35.66% rated as clinically significant), in which 80.4% reported 2 or more disturbances, with depression (23.86%), apathy (21.72%) and anxiety (20.38%) being most common. Of the 1540 normal individuals, 18.25% of them exhibited neuropsychiatric symptoms (6.49% rated as clinically significant), in which 53% reported 2 or more disturbances, with sleepless (10%), depression (8.9%) and anxiety (6.97%) being the most common. CONCLUSION: To our knowledge, this was the first multi-center study on neuropsychiatric disturbances in dementia and cognitive normal elderly people. Neuropsychiatric symptoms occurred mainly in persons with dementia and of clinical severity. Though the neuropsychiatric disturbances reported in cognitive normal individuals were lower and less serious compared to dementia, they should not be neglected. These finding suggested that a screening programme focusing on identifying these symptoms should be included in the physician's diagnostic tools for dementia.

Aged↗