Alzheimer's Disease: Responsive Care Plans

2013 ◽  
BMJ ◽  
2010 ◽  
Vol 340 (jun03 1) ◽  
pp. c2626-c2626 ◽  
Author(s):  
L. S. Schneider

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S509-S509 ◽  
Author(s):  
Tadeja Gracner ◽  
Mark Sorbero ◽  
Patricia W Stone ◽  
Mansi Agarwal ◽  
Andrew W Dick

Abstract Alzheimer’s disease and related dementia (AD/ADRD) are leading causes of mortality in the United States. Identifying advanced illness (AI) in NH residents is key for developing therapeutic and palliative care plans for end of life. We refined and extended existing measures of AI in NH residents with AD/ADRD and described patterns of survival for each measure. Using the Minimum Data Set (MDS; 2011 to 2013) linked to vital status (through 2016), we defined categories of AD/ADRD residents at AI onset: (1) those with ADRD, (2) and those with both, AD and ADRD. We estimated survival functions and multivariable duration models to describe patterns of survival from AI onset until death, stratified by AD/ADRD classifications, sex and functional status at AI onset, conditional on socio-demographics and co-morbidities. We limited our sample to adults ages >64 for whom we observed the incident AI assessment in the MDS. Median survival was 229 days for all classifications of AI, but higher for those with only ADRD (300 days). Survival declined substantially for residents with eating difficulties; to 122 days for residents with AD and ADRD. A stark survival decline (40 days) occurred among residents with shortness of breath. Across all AI classifications, survival was negatively associated with male sex, age, diabetes, substantial weight-loss and events such as heart failure. Depression, hypertension, and UTI were associated with small or insignificant increases in mortality risk. AI can be defined using MDS data, allowing for examination of policies designed to improve end of life care.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 762-762
Author(s):  
Nasreen Sadeq ◽  
Brianne Stanback

Abstract Environmental scanning is a process that provides organizations with information about their internal and external strengths, challenges, and opportunities. Although traditionally used in business and strategic planning, environmental scanning is now being utilized in health care to evaluate currently available programs and services, identify gaps in patient care or research, and make educational, organizational, and policy recommendations. The current study explores adapting the environmental scan for students enrolled in a gerontology graduate program as a tool to facilitate career exploration. Students learned about environmental scanning and were instructed to perform an environmental scan on an important issue, program, or service relevant to their overall career goals. Because students completed their environmental scan while enrolled in an Alzheimer’s Disease Management course, they were encouraged to factor in the increasing prevalence of Alzheimer’s disease into their project. Students’ environmental scan projects spanned several timely topics, including an evaluation of the services currently offered in assisted living facilities from the perspective of a geriatric social worker, a review of memory training interventions and a proposal for a new research study, and preliminary plans for opening an assisted living facility catering to older adults in the LGBTQ community that outlined financial considerations, staff training goals, and patient care plans. Completing the environmental scan project gave students an opportunity to investigate the current state of the career field they are planning to enter, and provided them with a product that they can build upon as they complete the graduate program and begin their careers.


2019 ◽  
Vol 42 ◽  
Author(s):  
Colleen M. Kelley ◽  
Larry L. Jacoby

Abstract Cognitive control constrains retrieval processing and so restricts what comes to mind as input to the attribution system. We review evidence that older adults, patients with Alzheimer's disease, and people with traumatic brain injury exert less cognitive control during retrieval, and so are susceptible to memory misattributions in the form of dramatic levels of false remembering.


Author(s):  
J. Metuzals ◽  
D. F. Clapin ◽  
V. Montpetit

Information on the conformation of paired helical filaments (PHF) and the neurofilamentous (NF) network is essential for an understanding of the mechanisms involved in the formation of the primary lesions of Alzheimer's disease (AD): tangles and plaques. The structural and chemical relationships between the NF and the PHF have to be clarified in order to discover the etiological factors of this disease. We are investigating by stereo electron microscopic and biochemical techniques frontal lobe biopsies from patients with AD and squid giant axon preparations. The helical nature of the lesion in AD is related to pathological alterations of basic properties of the nervous system due to the helical symmetry that exists at all hierarchic structural levels in the normal brain. Because of this helical symmetry of NF protein assemblies and PHF, the employment of structure reconstruction techniques to determine the conformation, particularly the handedness of these structures, is most promising. Figs. 1-3 are frontal lobe biopsies.


Author(s):  
Mark Ellisman ◽  
Maryann Martone ◽  
Gabriel Soto ◽  
Eleizer Masliah ◽  
David Hessler ◽  
...  

Structurally-oriented biologists examine cells, tissues, organelles and macromolecules in order to gain insight into cellular and molecular physiology by relating structure to function. The understanding of these structures can be greatly enhanced by the use of techniques for the visualization and quantitative analysis of three-dimensional structure. Three projects from current research activities will be presented in order to illustrate both the present capabilities of computer aided techniques as well as their limitations and future possibilities.The first project concerns the three-dimensional reconstruction of the neuritic plaques found in the brains of patients with Alzheimer's disease. We have developed a software package “Synu” for investigation of 3D data sets which has been used in conjunction with laser confocal light microscopy to study the structure of the neuritic plaque. Tissue sections of autopsy samples from patients with Alzheimer's disease were double-labeled for tau, a cytoskeletal marker for abnormal neurites, and synaptophysin, a marker of presynaptic terminals.


Author(s):  
D.F. Clapin ◽  
V.J.A. Montpetit

Alzheimer's disease is characterized by the accumulation of abnormal filamentous proteins. The most important of these are amyloid fibrils and paired helical filaments (PHF). PHF are located intraneuronally forming bundles called neurofibrillary tangles. The designation of these structures as "tangles" is appropriate at the light microscopic level. However, localized domains within individual tangles appear to demonstrate a regular spacing which may indicate a liquid crystalline phase. The purpose of this paper is to present a statistical geometric analysis of PHF packing.


Author(s):  
V.J.A. Montpetit ◽  
S. Dancea ◽  
S.W. French ◽  
D.F. Clapin

A continuing problem in Alzheimer research is the lack of a suitable animal model for the disease. The absence of neurofibrillary tangles of paired helical filaments is the most critical difference in the processes by which the central nervous system ages in most species other than man. However, restricting consideration to single phenomena, one may identify animal models for specific aspects of Alzheimer's disease. Abnormal fibers resembling PHF have been observed in dorsal root ganglia (DRG) neurons of rats in a study of chronic ethanol intoxication and spontaneously in aged rats. We present in this report evidence that PHF-like filaments occur in ethanol-treated rats of young age. In control animals lesions similar in some respects to our observations of cytoskeletal pathology in pyridoxine induced neurotoxicity were observed.Male Wistar BR rats (Charles River Labs) weighing 350 to 400 g, were implanted with a single gastrostomy cannula and infused with a liquid diet containing 30% of total calories as fat plus ethanol or isocaloric dextrose.


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