Rate of dementia diagnoses according to the degree of aging of the population

2014 ◽  
Vol 27 (3) ◽  
pp. 419-427 ◽  
Author(s):  
Laia Calvó-Perxas ◽  
María Aguirregomozcorta ◽  
Isabel Casas ◽  
Margarita Flaqué ◽  
Marta Hernàndez ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Psychological Symptoms ◽  
Clinical Manifestations ◽  
Incidence Rates ◽  
Population Ageing ◽  
Dementia Diagnosis ◽  
Geographical Differences ◽  
Lack Of Information ◽  
Memory Clinics ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground:There is a lack of information regarding geographical differences in the incidence and prevalence of dementia diagnosis according to the degree of aging of the population. The objectives of this study were to analyze the rate of dementia diagnoses, and to compare the dementia subtypes and the clinical characteristics of the patients depending on the degree of aging of their municipalities.Methods:We used data from the Registry of Dementias of Girona (ReDeGi), containing the cases of dementia diagnosed in the memory clinics of the Health Region of Girona, in Catalonia (Spain), during 2007–2012. The municipalities were classified by a cluster analysis as aged or young municipalities according to their proportion of older people using population ageing indicators. The incidence rates of dementia diagnosis in each type of municipality were compared.Results:The ReDeGi registered 4,314 cases in the municipalities under surveillance. The clinical incidence of dementia was lower in aged municipalities (4.5 vs. 6.1 cases per 1,000 person-years aged 65 and over). Patients from young municipalities had an increased frequency of behavioral and psychological symptoms of dementia.Conclusions:The environment may influence the clinical manifestations of dementia that predispose people to visit health specialists and obtain a diagnosis.

scholarly journals Behavioral and psychological symptoms of dementia in different dementia disorders: A large-scale study of 12 000 individuals.

2021 ◽  
Author(s):  
Emilia Schwertner ◽  
Joana Braga Pereira ◽  
Hong Xu ◽  
Juraj Secnik ◽  
Bengt Winblad ◽  
...  
Keyword(s):  
Large Scale ◽  
Motor Behavior ◽  
Psychological Symptoms ◽  
Lewy Bodies ◽  
Time Behavior ◽  
Dementia Diagnosis ◽  
Night Time ◽  
Logistic Regression Models ◽  
National Quality ◽  
Behavioral And Psychological Symptoms

Objective: To characterize behavioral and psychological symptoms of dementia (BPSD) in different dementia diagnoses: Alzheimer's disease (AD), dementia with Lewy bodies (DLB), Parkinson's disease dementia (PDD), vascular dementia (VaD), frontotemporal dementia (FTD), mixed (Mixed) and unspecified dementia. Design: Registry-based cohort study. Setting and participants: 12,137 individuals with dementia registered in two national quality registries, the Swedish registry for cognitive/dementia disorders (SveDem) and the Swedish BPSD registry, during 2010 - 2016. Methods: BPSD was assessed with the Neuropsychiatric Inventory - Nursing Home Version (NPI-NH). Multivariate logistic regression models were used to evaluate the associations between dementia diagnoses and different BPSDs in reference to a) the AD group and b) each of the other diagnostic groups. All models were adjusted for age, gender, the severity of cognitive impairment at the time of dementia diagnosis, and time between dementia diagnosis and BPSD assessment. Results: In all individuals, the three most common symptoms were aberrant motor behaviour (35,1%), agitation (32,3%), and irritability (28,7%), while euphoria (5,9%) was the least frequent. Compared to AD, we found a lower risk of delusions (in VaD, FTD, unspecified dementia), hallucinations (in VaD and FTD), agitation (in PDD, unspecified dementia), elation/euphoria (in DLB), anxiety (in PDD, unspecified dementia), disinhibition (in PDD); irritability (in DLB, PDD, unspecified dementia), aberrant motor behavior (in Mixed, VaD, unspecified dementia) and sleep and night-time behavior changes (in unspecified dementia). Higher risks of delusions (in DLB), hallucinations (in DLB, PDD), apathy (VaD, FTD), disinhibition (in FTD) and appetite and eating abnormalities (in FTD) were found compared to AD. Conclusions and Implications: In this large contemporary cohort, BPSD was common in all types of dementia, with the most common symptoms being aberrant motor behavior, agitation, and irritability. Additionally, BPSD differed depending on the dementia type.

scholarly journals TREATMENT WITH ANTIPSYCHOTICS AND RISK OF DEATH IN 58,000 PATIENTS FROM SWEDISH DEMENTIA REGISTRY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S421-S421
Author(s):  
Dorota Religa ◽  
Emilia Schwertner ◽  
sara Garcia-ptacek ◽  
Bjorn Johansson ◽  
Katarina Nägga ◽  
...  
Keyword(s):  
Antipsychotic Drugs ◽  
Psychological Symptoms ◽  
Dementia Diagnosis ◽  
Educational Effort ◽  
Risk Of Death ◽  
Total Cohort ◽  
Dementia Patients ◽  
All Cause Mortality ◽  
Dementia Registry ◽  
Behavioral And Psychological Symptoms

Abstract Background: Behavioral and Psychological symptoms of Dementia (BPSD) are a heterogeneous group of clinical phenomena that is subjectively experienced by the patient and/or observable by an examiner (e.g., caregiver, physician) consisting in disturbed emotions, perception, thought, motor activity, and altered personality. There are recommendations to limit antipsychotic use in patients with dementia, and the big educational effort is made to follow them. In Sweden antipsychotics use changed from 10.1% in 2007-2008 to 5.2% in 2014-2015. Aims: The aim of the study is to analyze the actors associated with treatment and mortality of dementia patients, particularly those suffering from BPSD. Particularly we focus on assessing all-cause mortality patients with dementia treated with antipsychotic drugs (APDs). Methods: We have analyzed 58,412 patients newly diagnosed with dementia. We have found that 2526 of the patients were prescribed APDs (602 typical APDs and 1833 atypical APDs)- Results In the adjusted models, use of APDs at the time of dementia diagnosis was associated with increased mortality risk in the total cohort (hazard ratio = 1.4; 95% confidence interval 1.3-1.5). We have also stratified the results. Conclusions: The risk of death in patients with dementia was increased in group that used atypical and typical APDs. Our study gives more evidence to advice caution in APD prescription for patients with dementia.

scholarly journals 301 - The diagnostic and treatment challenges of behavioral and psychological symptoms in Alzheimer’s disease; a qualitative study in memory clinic practice

2020 ◽  
Vol 32 (S1) ◽  
pp. 57-57
Author(s):  
Willem S. Eikelboom ◽  
Michiel Coesmans ◽  
Rik Ossenkoppele ◽  
Esther van den Berg ◽  
Janne M. Papma
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Qualitative Study ◽  
The Netherlands ◽  
Psychological Symptoms ◽  
Memory Clinic ◽  
Early Stages ◽  
Treatment Type ◽  
Memory Clinics ◽  
Behavioral And Psychological Symptoms

Introduction:Behavioral and psychological symptoms in dementia (BPSD) have great impact on the daily lives of Alzheimer’s disease (AD) patients and their caregivers. Timely recognition and treatment of these symptoms may benefit quality of life, caregiver burden, and delay disease progression. In this qualitative study we examine the experiences of memory clinic physicians with the recognition and management of BPSD in early stages of AD.Methods:Semi-structured interviews were held with 8 physicians (5 neurologists, 3 geriatricians) employed at memory clinics of academic or general hospitals in the Netherlands. Two independent researchers coded verbatim transcripts of the interviews, followed by a consensus meeting on preliminary themes. In the upcoming months, additional interviews will be conducted until data saturation is reached.Results:Preliminary results indicate substantial variability in how memory clinic physicians recognize and diagnose BPSD in AD. Themes are: 1. Prevalence of BPSD in early stages of AD; e.g. ‘BPSD is more often present in late stages of AD […]’ vs. ‘I see this often, very often, I think these are the main problems people with AD face’). 2. Systematic assessment; some physicians consider it part of their clinical work-up to assess behavioral changes while other physicians do not touch upon BPSD. 3. Barriers for assessment; e.g. a lack of time, and not being able to observe BPSD occurring at home in a memory clinic setting. Treatment and management of BPSD in AD also differed greatly. Themes are 1. Treatment type; Two physicians discussed using a person-centered non-pharmacological approach, others refer patients with BPSD to daycare, a case manager or psychiatrist, or treat ‘problematic’ behaviors with psychotropic drugs. 2. Capabilities; some physicians experience managing BPSD in AD as very difficult, while others are confident about their capabilities. The majority suggests that collaboration with GPs or case managers may benefit treating these complex symptoms.Conclusion:There are remarkable differences in the recognition and management of BPSD in patients with AD visiting memory clinics in the Netherlands. Considering the potential benefit of early recognition and treatment, a first crucial step is discussing standardization of recognition and management of BPSD in memory clinics.

Anxiety in the Behavioral and Psychological Symptoms of Dementia

2000 ◽  
Vol 12 (S1) ◽  
pp. 139-142 ◽  
Author(s):  
Jacobo E. Mintzer ◽  
Olga Brawman-Mintzer ◽  
Dario F. Mirski ◽  
Karin Barkin
Keyword(s):  
Cognitive Decline ◽  
Psychological Symptoms ◽  
Clinical Manifestations ◽  
Anxiety Symptoms ◽  
Behavioral And Psychological Symptoms

Anxiety symptoms in dementia can be seen as an expression of stress in predisposed patients who become aware of their cognitive decline. In later stages of the disease, when awareness is lost, the presence of anxiety symptoms cannot be explained as a reaction to this type of stress. The presence of anxiety symptoms in the more impaired patients becomes similar and probably as complex in its etiology and clinical manifestations as other behavioral and psychological symptoms of dementia (BPSD). In this review, we will discuss anxiety symptoms in BPSD.

scholarly journals Are there sensitive time periods for dementia caregivers? The occurrence of behavioral and psychological symptoms in the early stages of dementia

2013 ◽  
Vol 25 (9) ◽  
pp. 1453-1462 ◽  
Author(s):  
K. A. Ornstein ◽  
J. E. Gaugler ◽  
D. P. Devanand ◽  
N. Scarmeas ◽  
C. W. Zhu ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Psychological Symptoms ◽  
Negative Impact ◽  
Early Stage ◽  
First Year ◽  
Dementia Patient ◽  
Dementia Diagnosis ◽  
Early Stages ◽  
Early Dementia ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground:The behavioral and psychological symptoms associated with dementia (BPSD) can be burdensome to informal/family caregivers, negatively affecting mental health and expediting the institutionalization of patients. Because the dementia patient–caregiver relationship extends over long periods of time, it is useful to examine how BPSD impact caregiver depressive symptoms at varied stages of illness. The goal of this study was to assess the association of BPSD that occur during early stage dementia with subsequent caregiver depressive symptoms.Methods:Patients were followed from the early stages of dementia every six months for up to 12 years or until death (n = 160). Caregiver symptoms were assessed on average 4.5 years following patient's early dementia behaviors. A generalized estimating equation (GEE) extension of the logistic regression model was used to determine the association between informal caregiver depressive symptoms and BPSD symptoms that occurred at the earliest stages dementia, including those persistent during the first year of dementia diagnosis.Results:BPSD were common in early dementia. None of the individual symptoms observed during the first year of early stage dementia significantly impacted subsequent caregiver depressive symptoms. Only patient agitation/aggression was associated with subsequent caregiver depressive symptoms (OR = 1.76; 95% CI = 1.04–2.97) after controlling for concurrent BPSD, although not in fully adjusted models.Conclusions:Persistent agitation/aggression early in dementia diagnosis may be associated with subsequent depressive symptoms in caregivers. Future longitudinal analyses of the dementia caregiving relationship should continue to examine the negative impact of persistent agitation/aggression in the diagnosis of early stage dementia on caregivers.

Postoperative cognitive dysfunction: progress mechanisms and clinical characteristics

2019 ◽  
Vol 2 (19) ◽  
pp. 29-33
Author(s):  
K. B. Manysheva ◽  
M. A. Akhmedov ◽  
A. A. Rakhmanova ◽  
S. M. Khutalieva
Keyword(s):  
Cognitive Dysfunction ◽  
Clinical Characteristics ◽  
Cognitive Deficit ◽  
Neuropsychological Testing ◽  
Postoperative Cognitive Dysfunction ◽  
Clinical Manifestations ◽  
Postoperative Recovery ◽  
Neuropsychological Rehabilitation ◽  
Brain Barrier Permeability ◽  
The Central Nervous System

The article is devoted to the study of postoperative cognitive dysfunction — a syndrome that is often found in the postoperative period and does not depend on the volume of surgeon. Based on the analysis of the results of modern studies, the authors cite the most likely etiological causes of the syndrome, grouped according to different categories of risk factors. The pathogenetic algorithm for cognitive dysfunction includes the appearance of systemic inflammation, improving blood-brain barrier permeability with the endothelial dysfunction, the migration of inflammatory agents into the central nervous system, and the formation of oxidative stress. The clinical manifestations of cognitive deficit in the outcome of surgeon performed under general anesthesia, the authors illustrate with their own observations of patients with a neurosurgical profile with spinal pathology operated on with the use of propofol anesthesia, comparing the results of neuropsychological testing with an assessment of the level of anxiety. In conclusion, the authors outline a strategy for the prevention of postoperative cognitive dysfunction and recommend conducting neuropsychological rehabilitation as an important component of postoperative recovery for all patients with a diagnosed cognitive deficit that occurred after surgery.

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