Case Studies in Dementia-Related Anxiety

GeroPsych ◽  
2020 ◽  
pp. 1-6
Author(s):  
Molly Maxfield ◽  
Jennifer R. Roberts ◽  
JoAnna Dieker

Abstract. Two clients seeking neuropsychological assessment reported anxiety about their cognitive status. We review the cases to increase our understanding of factors contributing to dementia-related anxiety. Case 1 met the criteria for mild neurocognitive disorder; the client’s memory was impaired, and she had a high genetic risk for Alzheimer’s disease. The client reported anxiety about negative perceptions of quality of life among individuals diagnosed with Alzheimer’s disease. Case 2 did not meet the criteria for a neurocognitive disorder. Anxiety about this client’s cognitive status appeared attributable to generalized anxiety disorder, given his anxiety about diverse topics. Both clients reported embarrassment about forgetfulness and social withdrawal. Dementia-related anxiety is believed to be relatively common, to exist on a continuum, to have unique social implications, and to stem from various sources, necessitating differing interventions.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maja Zakošek Pipan ◽  
Sonja Prpar Mihevc ◽  
Malan Štrbenc ◽  
Urban Košak ◽  
Ilija German Ilić ◽  
...  

AbstractCanine cognitive dysfunction (CCD) is common in aged dogs and has many similarities with Alzheimer’s disease. Unfortunately, like Alzheimer’s disease, CCD cannot be cured. In the present study, we treated dogs with CCD with our newly developed and characterized butyrylcholinesterase inhibitor (BChEi). Seventeen dogs were randomized into two groups (treated with BChEi and untreated) and followed for 6 months at regular check-ups. The dogs’ cognitive status was determined by a Canine Dementia Scale (CADES) questionnaire and two cognitive tests. In dogs with moderate cognitive impairment, treatment caused significant improvement in the clinical rating of cognitive abilities and the performance-based tests of cognitive functioning when compared to the untreated group (p < 0.001). Dogs treated with BChEi showed markedly improved cognitive function with enhanced quality of life. No side effects were observed in the treated dogs with moderate cognitive impairment. According to the results of this preliminary study, there is an indication that novel BChEi may be a promising drug for the treatment of CCD in dogs and may be an interesting candidate for the treatment of Alzheimer's disease in humans. However, further clinical studies are needed to confirm this.


2012 ◽  
Vol 6 (4) ◽  
pp. 253-259 ◽  
Author(s):  
Thays Martins Vital ◽  
Salma S. Soleman Hernández ◽  
Renata Valle Pedroso ◽  
Camila Vieira Ligo Teixeira ◽  
Marcelo Garuffi ◽  
...  

ABSTRACT Deterioration in cognitive functions is characteristic in Alzheimer's disease (AD) and may be associated with decline in daily living activities with consequent reduced quality of life. Objective: To analyze weight training effects on cognitive functions in elderly with AD. Subjects: 34 elderly with AD were allocated into two groups: Training Group (TG) and Social Gathering Group (SGG). Methods: Global cognitive status was determined using the Mini-Mental State Exam. Specific cognitive functions were measured using the Brief Cognitive Battery, Clock Drawing Test and Verbal Fluency Test. The protocols were performed three times a week, one hour per session. The weight training protocol consisted of three sets of 20 repetitions, with two minutes of rest between sets and exercises. The activities proposed for the SGG were not systematized and aimed at promoting social interaction among patients. The statistical analyses were performed with the U Mann Whitney and Wilcoxon tests for group comparisons. All analyses were considered statistically significant at a p-value of 0.05. Results: There were no significant differences associated to the effects of the practice of weight training on cognition in AD patients. Conclusion: In this study, no improvement in cognitive functions was evident in elderly with AD who followed a low intensity resistance exercise protocol. Thus, future studies could evaluate the effect of more intense exercise programs.


Salud Mental ◽  
2019 ◽  
Vol 42 (6) ◽  
pp. 281-287
Author(s):  
Sara Gloria Aguilar-Navarro ◽  
Alberto José Mimenza-Alvarado ◽  
Rafael Martínez-Sánchez ◽  
Silvia Mejía-Arango ◽  
Lidia Gutiérrez-Gutiérrez ◽  
...  

Introduction. “Episodic” memory problems are common in people with cognitive impairment due to Alzheimer’s disease and related disorders. Dubois et al. developed the Five-Word Test (5WT) to evaluate episodic memory, which has proved to be an easy and valid test for identifying cognitive disorders. However, its validation and cultural adaptation from French to Spanish has not been undertaken and its usefulness in Mexican population is unknown. Objective. Validation and cultural adaptation of the 5WT for screening minor and major neurocognitive disorder (ND) in Mexican older adults with probable Alzheimer’s disease. Method. Two hundred and fifteen participants (70 cognitively healthy subjects, 73 with minor ND and 72 with major ND were included). The cognitive status (gold standard) was determined using current clinical criteria and neuropsychological evaluation. The Spearman coefficient, ROC curve, and multinomial logistic regression models were used to determine the concurrent validity of the 5WT. Results. The correlation between the 5WT and the Mini-Mental State Exam (MMSE) was .58, whereas for the clock face test it was -.37 (p < .001). The area under the 5WT curve was .97 (95% CI [.94, .99]), with a cut-off point of ≤ 16/20 for the diagnosis of major ND (89% sensitivity, 98% specificity) and .77 (95% CI [.70, .85]) for minor ND with a cut-off point of ≤ 18/20 (66% sensitivity, 77% specificity). Discussion and conclusion. Since the 5WT is a simple, valid instrument for the identification of neurocognitive disorders like Alzheimer’s disease, it could be a practical screening test.


2019 ◽  
Vol 18 (4) ◽  
pp. 27-37
Author(s):  
Angie L. Sardina, PhD ◽  
Suzanne Fitzsimmons, MSN, ARNP, GNP ◽  
Catherine M. Hoyt, BA ◽  
Linda L. Buettner, PhD

This study evaluated whether a mentally stimulating activities (MSA) program reduced neuropsychiatric symptoms and improved cognitive status and quality of life, as compared to a support group for persons in the early stage of Alzheimer’s disease (AD). This randomized controlled trial included 81 adults (aged 55+), who were randomly assigned to the MSA group (treatment) or a social support group (control). A repeated measures multivariate analysis of variance (MANOVA) identified that MSA participants significantly reduced apathy (p 0.001) and depressive symptoms (p 0.001), as well as improved cognitive status (p 0.001) and quality of life (p 0.001) as compared to the control group. A structured classroom-style MSA program may be a viable and therapeutic intervention to alleviate neuropsychiatric symptoms, and improve cognitive status and quality of life in early-stage AD.


2020 ◽  
Author(s):  
Maja Zakošek Pipan ◽  
Sonja Prpar Mihevc ◽  
Malan Štrbenc ◽  
Urban Košak ◽  
Ilija German Ilić ◽  
...  

Abstract Background: Canine cognitive dysfunction (CCD) is common in aged dogs and has many similarities with Alzheimer’s disease. Unfortunately, like Alzheimer’s disease, CCD cannot be cured. Methods: In the present study, we treated dogs with CCD with our newly developed and characterized butyrylcholinesterase inhibitor (BChEi). Seventeen dogs were randomized into two groups (treated with BChEi and untreated) and followed for 6 months at regular check-ups. The dogs’ cognitive status was determined by a CADES questionnaire and two cognitive tests. Results: In dogs with moderate cognitive impairment, treatment caused significant improvement in the clinical rating of cognitive abilities and the performance-based tests of cognitive functioning when compared to the untreated group (p < 0.001). Dogs treated with BChEi showed markedly improved cognitive function with enhanced quality of life. No side effects were observed in the treated dogs with moderate cognitive impairment. Conclusions: Novel BChE inhibitor is a promising candidate for treating CCD, and might be an interesting canidate drug for the treatment of Alzheimer disease in humans.


2010 ◽  
Vol 51 (02) ◽  
pp. 72 ◽  
Author(s):  
Oscar Rosas Carrasco ◽  
Laura del Pilar Torres Arreola ◽  
María de Guadalupe Guerra Silla ◽  
Sara Torres Castro ◽  
Luis Miguel Gutiérrez Robledo

2017 ◽  
Vol 14 (4) ◽  
pp. 441-452 ◽  
Author(s):  
Sofia Wenzler ◽  
Christian Knochel ◽  
Ceylan Balaban ◽  
Dominik Kraft ◽  
Juliane Kopf ◽  
...  

Depression is a common neuropsychiatric manifestation among Alzheimer’s disease (AD) patients. It may compromise everyday activities and lead to a faster cognitive decline as well as worse quality of life. The identification of promising biomarkers may therefore help to timely initiate and improve the treatment of preclinical and clinical states of AD, and to improve the long-term functional outcome. In this narrative review, we report studies that investigated biomarkers for AD-related depression. Genetic findings state AD-related depression as a rather complex, multifactorial trait with relevant environmental and inherited contributors. However, one specific set of genes, the brain derived neurotrophic factor (BDNF), specifically the Val66Met polymorphism, may play a crucial role in AD-related depression. Regarding neuroimaging markers, the most promising findings reveal structural impairments in the cortico-subcortical networks that are related to affect regulation and reward / aversion control. Functional imaging studies reveal abnormalities in predominantly frontal and temporal regions. Furthermore, CSF based biomarkers are seen as potentially promising for the diagnostic process showing abnormalities in metabolic pathways that contribute to AD-related depression. However, there is a need for standardization of methodological issues and for replication of current evidence with larger cohorts and prospective studies.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S641-S641
Author(s):  
Shanna L Burke

Abstract Little is known about how resting heart rate moderates the relationship between neuropsychiatric symptoms and cognitive status. This study examined the relative risk of NPS on increasingly severe cognitive statuses and examined the extent to which resting heart rate moderates this relationship. A secondary analysis of the National Alzheimer’s Coordinating Center Uniform Data Set was undertaken, using observations from participants with normal cognition at baseline (13,470). The relative risk of diagnosis with a more severe cognitive status at a future visit was examined using log-binomial regression for each neuropsychiatric symptom. The moderating effect of resting heart rate among those who are later diagnosed with mild cognitive impairment (MCI) or Alzheimer’s disease (AD) was assessed. Delusions, hallucinations, agitation, depression, anxiety, elation, apathy, disinhibition, irritability, motor disturbance, nighttime behaviors, and appetite disturbance were all significantly associated (p&lt;.001) with an increased risk of AD, and a reduced risk of MCI. Resting heart rate increased the risk of AD but reduced the relative risk of MCI. Depression significantly interacted with resting heart rate to increase the relative risk of MCI (RR: 1.07 (95% CI: 1.00-1.01), p&lt;.001), but not AD. Neuropsychiatric symptoms increase the relative risk of AD but not MCI, which may mean that the deleterious effect of NPS is delayed until later and more severe stages of the disease course. Resting heart rate increases the relative risk of MCI among those with depression. Practitioners considering early intervention in neuropsychiatric symptomology may consider the downstream benefits of treatment considering the long-term effects of NPS.


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