Disease Staging and Milestones

This new section to the guidelines was added due to the recognition that clinical milestones are useful indices of the progression of dementia in patients with Alzheimer's disease and could help in the development of stage-specific targeted therapy. This review specifically looks at clinical milestones that could be used in clinical trials, such as global function, function, behaviour, caregiver burden, and quality of life milestones. It also addresses the possible use of biological and surrogate markers for use as milestones - which may eventually replace clinical milestones. It concludes that current definitions of dementia must be broadened beyond cognition alone to include some of the domains listed.

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What Does Imaging Add to the Management of Alzheimer's Disease?

CNS Spectrums ◽

10.1017/s1092852900024779 ◽

2004 ◽

Vol 9 (S5) ◽

pp. 20-23 ◽

Cited By ~ 4

Author(s):

Gary W. Small

Keyword(s):

Quality Of Life ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Imaging Techniques ◽

Screening Tools ◽

Surrogate Markers ◽

Genetic Disposition ◽

Number Of Patients

AbstractThe prevalence of Alzheimer's disease (AD) and dementia continues to rise. However, a significant number of patients are undiagnosed or untreated. Given the complexities of detecting cognitive impairment and the early signs of AD, this review discusses how advances in brain imaging can help assist in improving overall management. Imaging techniques and surrogate markers may provide unique opportunities to diagnose accurately AD in presymptomatic stages with practical consequences for patients, caregivers, and physicians. The possible outcomes for using imaging and surrogate markers as adjuncts to clinical examination and as screening tools for AD, as well as tangible and intangible advantages to early diagnosis and treatment, will be discussed. The specific value of using advanced serial imaging in patients with a genetic disposition to AD will be evaluated. If neurons can be protected from neurodegenerative damage in early stages, this may preserve patient cognition, function, and quality of life, and may confer considerable societal healthcare benefits.

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Dance for People with Alzheimer’s Disease: A Systematic Review

Current Alzheimer Research ◽

10.2174/1567205016666190725151614 ◽

2019 ◽

Vol 16 (10) ◽

pp. 919-933 ◽

Cited By ~ 1

Author(s):

Alicia Ruiz-Muelle ◽

María Mar López-Rodríguez

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Clinical Trials ◽

Cognitive Function ◽

Dance Therapy ◽

Randomized Clinical Trials ◽

Future Research

Background: In recent years, several reviews have addressed the effectiveness of dance therapy in dementia, healthy older adults, or the elderly in general. However, reviews regarding the effect of this therapy exclusively on patients diagnosed with Alzheimer’s disease have not been found. Objective: The purpose of this study is to review the available literature describing clinical trials which explore the effects of dancing on psychological and physical outcomes, functionality, cognitive function, and quality of life in patients diagnosed with Alzheimer’s disease. In addition, this review aims to assess the quality of studies that perform dance therapy interventions in these patients. Methods: This study is a systematic review of randomized and non-randomized clinical trials regarding the effect of intervention including a dancing activity in people diagnosed with Alzheimer's disease. Results: In total, the evidence for this review rests on 12 studies with a total of 349 participants. The findings of this mini-review confirm the positive effect of dance therapy on physical and cognitive function, functionality, psychological outcomes, and quality of life in people with Alzheimer's disease. Conclusion: Most of the studies implementing dance as part of the therapeutic treatment has shown to improve or slow the worsening in the quality of life of patients with Alzheimer's disease and their caregivers. Future research focused on these patients should use a more exhaustive methodology and make a more detailed description of these kind of interventions.

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Impact of Donepezil on Caregiving Burden for Patients With Alzheimer's Disease

International Psychogeriatrics ◽

10.1017/s1041610200006499 ◽

2000 ◽

Vol 12 (3) ◽

pp. 389-401 ◽

Cited By ~ 34

Author(s):

Howard M. Fillit ◽

Elane M. Gutterman ◽

Rachelle L. Brooks

Keyword(s):

Quality Of Life ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Caregiver Burden ◽

Nationwide Survey ◽

Well Being ◽

Measured Time ◽

Burden Scale ◽

Selection Factors

Comprehensive Alzheimer's disease (AD) treatment should address caregiver well-being. We predicted that caregiver burden would be lower among caregivers of AD patients who received donepezil relative to caregivers of patients not treated with donepezil. A self-administered, nationwide survey of AD caregivers was used to match caregivers of patients treated with donepezil (n = 274) to caregivers of patients not treated with donepezil (n = 274). The Caregiver Burden Scale measured time demands and distress linked to commonly performed caregiving tasks. Respondents were three-quarters female, with an average age of 60 years. Results demonstrated that donepezil caregivers reported significantly lower scores on difficulty of caregiving. This difference remained when statistical controls for multiple patient and caregiver variables were imposed. However, selection factors must be recognized as a possible explanation for differences. The groups reported no difference on the time-demand subscale. In conclusion, better management of AD symptoms through donepezil treatment may reduce the burden of caregiving, providing physicians with a pharmacologic approach to improving quality of life for AD patients and their families.

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Caregiver rating bias in mild cognitive impairment and mild Alzheimer's disease: impact of caregiver burden and depression on dyadic rating discrepancy across domains

International Psychogeriatrics ◽

10.1017/s1041610213000562 ◽

2013 ◽

Vol 25 (8) ◽

pp. 1345-1355 ◽

Cited By ~ 34

Author(s):

Livia Pfeifer ◽

Reinhard Drobetz ◽

Sonja Fankhauser ◽

Moyra E. Mortby ◽

Andreas Maercker ◽

...

Keyword(s):

Quality Of Life ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Caregiver Burden ◽

Depression Scale ◽

Caregiver Rating ◽

Rating Bias

ABSTRACTBackground: Caregivers of individuals with dementia are biased in their rating of mental health measures of the care receiver. This study examines caregiver burden and depression as predictors of this bias for mild cognitive impairment and mild Alzheimer's disease in different domains.Methods: The sample consisted of 202 persons: 60 with mild cognitive impairment, 41 with mild Alzheimer's disease, and 101 caregivers. Discrepancy scores were calculated by subtracting the mean caregiver score from the respective mean patient score on the following assessment instruments: the Geriatric Depression Scale, Apathy Evaluation Scale, Bayer-Activities of Daily Living Scale, and Quality of Life-AD scale. Caregiver burden and depression were assessed by the Zarit Burden Interview and the Center for Epidemiologic Studies Depression Scale.Results: Intraclass correlation coefficients were low for apathy (0.38), daily functioning (0.38), and quality of life (0.30) and moderate for depression (0.49). These domains showed negative rating discrepancies, which indicates caregiver rating bias for all four domains. Regression analyses revealed that caregiver burden significantly contributed to explaining these discrepancies in the domains apathy, daily functioning, and quality of life.Conclusion: Caregiver rating bias can be attributed to caregiver burden. When caregiver burden is present, data based on caregiver ratings should therefore be interpreted with caution.

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Assessing quality of life in Alzheimer's disease: Implications for clinical trials

Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring ◽

10.1016/j.dadm.2016.11.004 ◽

2016 ◽

Vol 6 (1) ◽

pp. 82-90 ◽

Cited By ~ 9

Author(s):

Kristin Kahle‐Wrobleski ◽

Wenyu Ye ◽

David Henley ◽

Ann Marie Hake ◽

Eric Siemers ◽

...

Keyword(s):

Quality Of Life ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Clinical Trials

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Quality of Life and Caregiver Burden of Alzheimer’s Disease Among Community Dwelling Patients in Europe: Variation by Disease Severity and Progression

Journal of Alzheimer s Disease Reports ◽

10.3233/adr-210025 ◽

2021 ◽

pp. 1-14

Author(s):

Lutz Froelich ◽

Albert Lladó ◽

Rezaul K. Khandker ◽

Montse Pedrós ◽

Christopher M. Black ◽

...

Keyword(s):

Quality Of Life ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Disease Progression ◽

Caregiver Burden ◽

Resource Use ◽

Independent Predictor ◽

Community Dwelling ◽

Over Time

Background: Alzheimer’s disease (AD) is a significant burden on patients and caregivers. How this burden increases as disease progresses has not been well researched. Objective: To assess the association of caregiver burden and quality of life with Alzheimer’s disease severity and disease progression in community-dwelling patients in Germany, Spain, and the UK. Methods: This was a prospective observational longitudinal study of mild-to-moderate AD patients (assessed by Mini-Mental State Examination, MMSE), and their caregivers. The humanistic burden was assessed using these instruments: [Rapid Assessment of Physical Activity (RAPA), EuroQoL-5-Dimension Level (EQ-5D-5L)] and caregiver-reported [Dependence Scale (DS), EQ-5D-5L, Zarit Burden Interview (ZBI)]. Caregiver-reported healthcare resource use was assessed using the Resource Use in Dementia (RUD) and ad-hoc questions. Results: Of 616 patients recruited, 338 and 99 were followed-up at 12 and 18 months, respectively. The caregiver-reported EQ-5D-5L scores of patients’ health-related quality of life (HRQoL) showed a negative trend over time (baseline: 0.76; 18 months: 0.67) while patient-reported HRQoL remained at 0.85. DS scores tended to worsen. Disease progression was an independent predictor of HRQoL and increased dependence. Mean ZBI score increased over time reflecting an increase in caregiver burden; MMSE being an independent predictor for caregiver burden. Patient resource utilization and caregiver time for caregiving tended to increase over time. Conclusion: We found significant association between disease progression and caregiver and patient burden. Independently, both disease-specific outcomes and disease burden measures increased over time, but as disease progresses, we also found incremental burden associated with it.

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New Ways to Approach Manifestations of Alzheimer's Disease and to Reduce Caregiver Burden

International Psychogeriatrics ◽

10.1017/s1041610296003158 ◽

1996 ◽

Vol 8 (S1) ◽

pp. 91-94 ◽

Cited By ~ 2

Author(s):

Jiska Cohen-Mansfield

Keyword(s):

Quality Of Life ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Decline ◽

Caregiver Burden ◽

Routine Activities ◽

Affected Person ◽

And Behavior ◽

Financial Liability

Alzheimer's disease (AD) results in severe cognitive decline, deterioration in the ability to perform routine activities such as bathing or walking, and changes in affect and behavior. It severely diminishes the quality of life of the affected person and presents a colossal burden to caregivers and a tremendous financial liability to society. The impetus for research relates specifically to these burdens by testing new ways to approach the manifestations of the disease and effectively communicating these ways to caregivers.

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