Neuropsychiatric Assessment and Intervention in Alzheimer's Disease

1996 ◽  
Vol 8 (S1) ◽  
pp. 25-30 ◽  
Author(s):  
Jeffrey L. Cummings
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Public Health Problem ◽  
The Elderly ◽  
The United States ◽  
Major Public Health Problem ◽  
Dementia Patients ◽  
Intellectual Abilities ◽  
The World ◽  
Eventual Death

Dementia is a major public health problem in the United States and the world, requiring the expenditure of enormous economic and human resources. Dementia is common in the elderly, and, as the size of the aged population increases, the number of dementia victims will rise. Many dementias are fatal, producing the gradual erosion of intellectual abilities and eventual death of the patient. Demands made on family members and caregivers of dementia patients are extraordinary and often result in their emotional and financial exhaustion. Although basic science efforts are devoted to finding a cure for Alzheimer's disease (AD) and other dementing illnesses, there is an urgent need for research that has immediate applicability to the 4 million current dementia patients.

Current and Future Treatments for Alzheimer's Disease

CNS Spectrums ◽  
2009 ◽  
Vol 14 (S7) ◽  
pp. 4-7 ◽  
Author(s):  
Stephen Salloway
Keyword(s):  
Public Health ◽  
United States ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Health Problem ◽  
Public Health Problem ◽  
The United States ◽  
The World ◽  
Future Treatments ◽  
New Treatments

There are currently >5 million people in the United States who have been diagnosed with Alzheimer's disease. That prevalence rate is expected to triple as the population ages. The health and economic burden due to Alzheimer's disease is a worldwide problem, with some of the greatest burden coming from the developing world as people live longer in those societies. Throughout the world, the projected growth of Alzheimer's disease is dramatic. This is a worldwide public health problem of the highest order, and there is a compelling need to develop new treatments and methods of earlier diagnosis need to slow the progression of the disease and lessen its impact.

scholarly journals Anhedonia as a Potential Risk Factor of Alzheimer’s Disease in a Community-Dwelling Elderly Sample: Results from the ZARADEMP Project

2021 ◽  
Vol 18 (4) ◽  
pp. 1370
Author(s):  
David Vaquero-Puyuelo ◽  
Concepción De-la-Cámara ◽  
Beatriz Olaya ◽  
Patricia Gracia-García ◽  
Antonio Lobo ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Potential Risk ◽  
Proportional Hazards ◽  
Univariate Analysis ◽  
Population Sample ◽  
Public Health Problem ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Major Public Health Problem

(1) Introduction: Dementia is a major public health problem, and Alzheimer’s disease (AD) is the most frequent subtype. Clarifying the potential risk factors is necessary in order to improve dementia-prevention strategies and quality of life. Here, our purpose was to investigate the role of the absence of hedonic tone; anhedonia, understood as the reduction on previous enjoyable daily activities, which occasionally is underdetected and underdiagnosed; and the risk of developing AD in a cognitively unimpaired and non-depressed population sample. (2) Method: We used data from the Zaragoza Dementia and Depression (ZARADEMP) project, a longitudinal epidemiological study on dementia and depression. After excluding subjects with dementia, a sample of 2830 dwellers aged ≥65 years was followed for 4.5 years. The geriatric mental state examination was used to identify cases of anhedonia. AD was diagnosed by a panel of research psychiatrists according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. A multivariate survival analysis and Cox proportional hazards regression model were performed, and the analysis was controlled by an analysis for the presence of clinically significant depression. (3) Results: We found a significant association between anhedonia cases and AD risk in the univariate analysis (hazard ratio (HR): 2.37; 95% CI: 1.04–5.40). This association persisted more strongly in the fully adjusted model. (4) Conclusions: Identifying cognitively intact individuals with anhedonia is a priority to implement preventive strategies that could delay the progression of cognitive and functional impairment in subjects at risk of AD.

scholarly journals Terapia Ocupacional no cuidado ao idoso com demência: uma revisão integrativa/Occupational therapy in the care of the elderly with dementia: integrative review

2019 ◽  
Vol 3 (1) ◽  
pp. 117-132
Author(s):  
Vanessa Silva Lins ◽  
Marcia Queiroz de Carvalho Gomes
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Occupational Therapy ◽  
Public Health Problem ◽  
Well Being ◽  
The Elderly ◽  
Occupational Performance ◽  
Number Of Publications

A demência é uma das principais causas de incapacidade entre a população idosa, sua prevalência vem crescendo com o aumento da longevidade e vem se tornando um problema de saúde pública. O idoso acometido por demência tem as ocupações e o desempenho ocupacional bastante comprometido, necessitando da assistência do terapeuta ocupacional. O objetivo do presente estudo é analisar as contribuições da Terapia Ocupacional na atenção ao idoso com demência, descritas nas produções científicas publicadas em periódicos na área de saúde. Trata-se de uma revisão sistemática, do tipo integrativa, realizada na plataforma BIREME, nas bases de dados da LILACS, SciELO e MEDLINE, usando os descritores “Demência AND Terapia Ocupacional” e “Doença de Alzheimer AND Terapia Ocupacional”, nos idiomas português e espanhol. Foram encontrados 33 artigos, desse total foram selecionados para análise 07 artigos, que estavam dentro dos critérios de inclusão. Esta revisão permitiu constatar que, apesar da tímida produção de publicações de terapeutas ocupacionais acerca da demência, nos dois idiomas pesquisados, a Terapia Ocupacional vem ampliando seu escopo de ação, para além das tradicionais abordagens cognitivas e centradas apenas no idoso, avançou na promoção de práticas preventivas e no manejo de sintomas psicológicos e comportamentais, que envolvem tanto o ambiente físico quanto o ambiente social do idoso. A Terapia Ocupacional tem desenvolvido e utilizado instrumentos próprios da profissão, tais como a DADL-Br e a COPM, fortalecendo sua identidade e especificidade. Vem contribuindo para a qualidade de vida e bem-estar do idoso com Demência e seus cuidadores/familiares, promovendo uma atenção integral e contextualizada. Abstract Dementia is one of the leading causes of disability among the elderly population. Its prevalence has increased with longevity growth and it has become a public health problem. The older adults person affected by dementia has his/her occupations and occupational performance quite compromised, requiring Occupational Therapy assistance. The objective of the present study is to analyze Occupational Therapy assistance contributions to the elderly with dementia, described in the scientific productions published in health journals. It is a review of the integrative type, performed in BIREME platform, in the databases of LILACS, SciELO and MEDLINE, using the descriptors "Dementia AND Occupational Therapy" and "Alzheimer's Disease AND Occupational Therapy", in Portuguese and Spanish.We have found 33 articles, from which 7 articles were selected for analysis, according to the inclusion criteria.This review showed that, in spite of the small number of publications about the performance of dementia in both languages, Occupational Therapy has expanded its scope of action. Beyond cognitive approaches focused on the older adults, it has been making progress on preventing and managing psychological and behavioral symptoms, involving both the physical and social environment of the older adults. Occupational Therapy has developed and used its own tests and evaluations, such as DADL-Br and COPM, strengthening its identity and specificity. It contributes to the quality of life and well-being of the elderly with Dementia and their caregivers / family, promoting integrated and contextualized care.Keywords: Dementia, Alzheimer's Disease, Elderly; Occupational Therapy.

scholarly journals Nutrition and cognitive impairment in the elderly

2001 ◽  
Vol 86 (3) ◽  
pp. 313-321 ◽  
Author(s):  
M. González-Gross ◽  
Ascensión Marcos ◽  
Klaus Pietrzik
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Large Scale ◽  
Public Health Problem ◽  
The Elderly ◽  
Vitamin B ◽  
Clinical Onset ◽  
Related Risk

As the number of older people is growing rapidly worldwide and the fact that elderly people are also apparently living longer, dementia, the most common cause of cognitive impairment is getting to be a greater public health problem. Nutrition plays a role in the ageing process, but there is still a lack of knowledge about nutrition-related risk factors in cognitive impairment. Research in this area has been intensive during the last decade, and results indicate that subclinical deficiency in essential nutrients (antioxidants such as vitamins C, E and β-carotene, vitamin B12, vitamin B6, folate) and nutrition-related disorders, as hypercholesterolaemia, hypertriacylglycerolaemia, hypertension, and diabetes could be some of the nutrition-related risk factors, which can be present for a long time before cognitive impairment becomes evident. Large-scale clinical trials in high-risk populations are needed to determine whether lowering blood homocysteine levels reduces the risk of cognitive impairment and may delay the clinical onset of dementia and perhaps of Alzheimer's disease. A curative treatment of cognitive impairment, especially Alzheimer's disease, is currently impossible. Actual drug therapy, if started early enough, may slow down the progression of the disease. Longitudinal studies are required in order to establish the possible link of nutrient intake – nutritional status with cognitive impairment, and if it is possible, in fact, to inhibit or delay the onset of dementia.

scholarly journals THE TRIAL-READY COHORT FOR PRECLINICAL/PRODROMAL ALZHEIMER’S DISEASE (TRC-PAD) – A FUNDAMENTAL ALLY IN AD PREVENTION RESEARCH

2020 ◽  
pp. 1-2
Author(s):  
A.P. Porsteinsson ◽  
E.D. Clark
Keyword(s):  
Public Health ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Financial Burden ◽  
Public Health Problem ◽  
Symptomatic Treatment ◽  
Health Impact ◽  
Major Public Health Problem ◽  
Medical Needs ◽  
Clinical Benefits

Alzheimer’s disease (AD) remains one of our greatest unmet medical needs, without any approved disease-modifying therapies. The emotional and financial burden of AD is enormous and predicted to grow exponentially with increasing median population age, posing a major public health problem. The potential to prevent or improve cognitive decline due to AD has important implications. There are medications currently approved for symptomatic treatment of AD, but they have limited clinical benefits and do not change the ultimate trajectory of the disease. The need to find effective treatments for AD that can prevent, slow, arrest, or even reverse the disease is ever more urgent and interventions that delay the symptomatic onset of AD would have a major public health impact (1).

Flavonoids with Potential Anti-Amyloidogenic Effects as Therapeutic Drugs for Treating Alzheimer’s Disease

2021 ◽  
pp. 1-29
Author(s):  
Qixin Wang ◽  
Xiaofang Dong ◽  
Ran Zhang ◽  
Changqi Zhao
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Brain Aging ◽  
Positive Impact ◽  
Amyloid Β ◽  
The Elderly ◽  
Favorable Effect ◽  
Amyloid Β Protein ◽  
Physical And Mental Health ◽  
Dementia Patients

Alzheimer’s disease (AD) is a central neurodegenerative disease generally among the elderly; it accounts for approximately 50–75%of total cases of dementia patients and poses a serious threat to physical and mental health. Currently available treatments for AD mainly relieves its symptoms, and effective therapy is urgently needed. Deposition of amyloid-β protein in the brain is an early and invariant neuropathological feature of AD. Currently the main efforts in developing anti-AD drugs focus on anti-amyloidogenic therapeutics that prevent amyloid-β production or aggregation and decrease the occurrence of neurotoxic events. The results of an increasing number of studies suggest that natural extracts and phytochemicals have a positive impact on brain aging. Flavonoids belong to the broad group of polyphenols and recent data indicate a favorable effect of flavonoids on brain aging. In this review, we collect relevant discoveries from 1999 to 2021, discuss 75 flavonoids that effectively influence AD pathogenesis, and summarize their functional mechanisms in detail. The data we have reviewed show that, these flavonoids belong to various subclasses, including flavone, flavanone, biflavone, etc. Our results provide a reference for further study of the effects of flavonoids on AD and the progress of anti-AD therapy.

Alzheimer’s Disease

2008 ◽  
Author(s):  
Martin Steinberg
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Depressive Disorders ◽  
Short Term Memory ◽  
Signs And Symptoms ◽  
The Elderly ◽  
Dementia Patients ◽  
Physical Burden ◽  
Degenerative Dementia ◽  
Proper Diagnosis

Alzheimer’s disease (AD), a progressive degenerative dementia, causes suffering for millions of patients as well as their caregivers. Among the elderly, the prevalence of AD increases dramatically with age: it is about 5% to 7% in people 65 years of age and older and rises to 40% to 50% in those older than 90 years of age (Rabins, Lyketsos, and Steele, 1999). AD typically affects short-term memory first; over time, impairment in language, praxis, recognition, and executive function occur. In the late stages, patients become completely dependent on others. In addition to this cognitive and physical burden, psychiatric signs and symptoms are nearly universal. These psychiatric phenomena, which include depression, delusions, hallucinations, apathy, and aggression, affect as many as 90% of patients with dementia over the course of their illness (Steinberg et al., 2003). Psychiatric phenomena often present differently in patients with AD than in the population without dementia. Uncertainty remains regarding how to best classify many of these phenomena. For example, delusions can be described as occurring in isolation, or as part of a psychotic syndrome, with associated features such as irritability and agitation. Delusions can also occur as part of a depressive syndrome or delirium. Little research is currently available to guide treatment. Nevertheless, many syndromes can be accurately diagnosed and can respond to a variety of pharmacologic and nonpharmacologic treatments. Depressive phenomena are common in AD. Estimates for the prevalence of major depression in patients with AD are 20% to 25%, (Lyketsos et al., 2003). Due to their dementia, patients with AD are often poor historians. They may not be aware of Depressive phenomena or able to recall them, and their aphasia may make describing symptoms difficult. Therefore, information from a reliable caregiver is crucial for making a proper diagnosis. Depressive disorders in AD are often somewhat different from those occurring in the absence of dementia. In particular, patients with AD may not endorse hopelessness, suicidal thoughts, or worthlessness (Zubenko et al., 2003). Patients with AD, however, express symptoms such as anxiety, anhedonia, irritability, lack of motivation, and agitation (Rosenberg et al., 2005).

Human Rights and the Elderly

2017 ◽  
Author(s):  
Robert Kohn
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Human Rights ◽  
Action Plan ◽  
The Elderly ◽  
The United States ◽  
Legal Analysis ◽  
Physical And Mental Health ◽  
Term Care ◽  
International Agencies

Attention to the human rights of the elderly has gained increased international attention. This chapter provides an overview of some international agencies’ efforts to address human rights of elders, as well as related efforts in different regions of the world. The UN does not have a specific treaty or convention regarding human rights of the elderly; only in 1995 was comprehensive legal analysis of the rights of the elderly addressed. The 2002 Madrid International Action Plan on Aging was a non-legally binding declaration by participating governments. Article 14 addresses equal access to healthcare and services, including physical and mental health services. The Commission on Human Rights 2011 Special Rapporteur emphasized human rights issues in primary healthcare and chronic illness; long-term care; palliative care; and informed consent as related to older persons. The Alzheimer’s Disease International Kyoto Declaration provides countries with a framework of action to address the needs and quality of life of those with dementia and their caregivers. Similarly, the United States has developed a national plan to address Alzheimer’s disease.

Alzheimer’s Disease: Causes, Mechanisms, and Steps Toward Prevention

2020 ◽  
Author(s):  
Se Hoon Choi ◽  
Rudolph E. Tanzi
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Molecular Mechanisms ◽  
Memory Loss ◽  
The Elderly ◽  
The United States ◽  
Fatal Disease ◽  
Comprehensive Overview ◽  
Total Incidence ◽  
Symptomatic Diagnosis

Alzheimer’s disease (AD) is the most common form of dementia in the elderly; it is clinically characterized by progressive memory loss and catastrophic cognitive dysfunction. Neuropathologically, the brains of AD patients are characterized by abundant beta-amyloid plaques, neurofibrillary tangles, and neuroinflammation. To date, this fatal disease ranks as the sixth leading cause of death; 5.8 million people in the United States are estimated to have the disease, and the total incidence of AD-related dementia is projected to grow to 16 million by 2050. Currently, there is no cure or any reliable means for pre-symptomatic diagnosis of AD. AD is a genetically heterogenous and multifactorial disease, and a variety of molecular mechanisms have been suggested to underlie its etiology and pathogenesis. A better understanding of pathogenic mechanisms underlying the development of AD pathology and symptoms would accelerate the development of effective therapeutic strategies for preventing and treating AD. Here, we present a comprehensive overview of the pathogenetic and molecular mechanisms underlying AD along with current therapeutic and lifestyles interventions being investigated for the prevention and treatment of this devastating neurological disorder.

scholarly journals Alzheimer's disease

2000 ◽  
Vol 2 (2) ◽  
pp. 91-100 ◽  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Behavioral Problems ◽  
Imaging Techniques ◽  
Public Health Problem ◽  
Functional Brain Imaging ◽  
Mood Stabilizers ◽  
Major Public Health Problem ◽  
Double Blind ◽  
Cognitive Disturbance

Alzheimer's disease is one of the most devastating brain disorders of elderly humans. It is an undertreated and under-recognized disease that is becoming a major public health problem. The last decade has witnessed a steadily increasing effort directed at discovering the etiology of the disease and developing pharmacological treatment. Recent developments include improved clinical diagnostic guidelines and improved treatment of both cognitive disturbance and behavioral problems. Symptomatic treatment mainly focusing on cholinergic therapy has been clinically evaluated by randomized, double-blind, placebo-controlled, parallel-group studies measuring performance-based tests of cognitive function, activities of daily living, and behavior. Cholinesterase inhibitors, including donepezil, tacrine, rivastigmine, and galantamine are the recommended treatment of cognitive disturbance in patients with Alzheimer's disease. The role of estrogen replacement, anti-inflammatory agents, and antioxidants is controversial and needs further study. Antidepressants, antipsychotics, mood stabilizers, anxiolytics, and hypnotics are used for the treatment of behavioral disturbance. Future directions in the research and treatment of patients with Alzheimer's disease include: applying functional brain imaging techniques in early diagnosis and evaluation of treatment efficacy; development of new classes of medications working on different neurotransmitter systems (cholinergic, glutamatergic, etc), both for the treatment of the cognitive deficit and the treatment of the behavioral disturbances; and developing preventive methods (amyloid p-peptide immunizations and inhibitors of β-secretase and γ-secretase).

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