scholarly journals SERUM 25(OH)D SIGNIFICANTLY IMPACTS ALZHEIMER’S DISEASE IN OLDER ADULTS LIVING IN LONG-TERM CARE COMMUNITIES.

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S863-S863
Author(s):  
Robert A Churchill ◽  
Ronna Robbins ◽  
Nalini Ranjit ◽  
Sara Sweitzer ◽  
Margaret Briley
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Vitamin D Supplementation ◽  
Cross Sectional ◽  
Term Care ◽  
Logistic Regression Models ◽  
Hydroxyvitamin D

Abstract 6.08 million Americans suffer from Alzheimer’s Disease (AD), with some estimating diagnoses will reach 15.0 million by 2060. Age is the strongest risk factor for AD, and the prevalence of AD among older adults necessitates investigation into preventable risk factors. 25-hydroxyvitamin D [25(OH)D] deficiency is more prevalent in older adults than other age demographics. Research shows a strong correlation between deficient 25(OH)D serum levels (≤20ng/ml) and AD diagnosis. The association with insufficient (≤30 ng/ml) levels remains unclear. Older adults (age > 65 yo) of five LTC communities in Texas participated in the cross-sectional study. One-year medical history and demographics were abstracted from medical records using double-blinded data abstraction and entry. Blood draws measured 25(OH)D serum levels. Adjusted logistic regression models examined if insufficient 25(OH)D serum levels (≤30 ng/ml) are associated with AD diagnosis. Confounders were total daily vitamin D supplementation, BMI, race, gender, age, years in community, and diagnosis of liver and renal disease. Participants (n=174, mean age: 83 yo) consisted of 63% female and 89% Caucasian. Fifty five percent had insufficient serum 25(OH)D levels (mean level: 32.6 ng/ml; mean supplementation rate: 1,138 IU per/d), and 20% had diagnosis of AD. 25% had both insufficient serum levels and AD, while 12.6% had adequate serum levels and AD. Those with insufficient 25(OH)D serum levels had elevated odds (OR=2.8; CL: 1.14, 7.02; p=0.024) of having AD after adjusting for confounders. Insufficient serum 25(OH)D levels (≤30 ng/ml) are associated with increased diagnoses of AD, indicating the importance of adequate levels among LTC residents.

scholarly journals SERUM 25-HYDROXYVITAMIN D LEVELS IMPACT RISK OF EXTENSIVE ASSISTANCE NEEDED BY OLDER ADULTS TO WALK

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S470-S470
Author(s):  
Krista N Jenney ◽  
Ronna Robbins ◽  
Sara Sweitzer ◽  
Nalini Ranjit ◽  
Margaret Briley
Keyword(s):  
Older Adults ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
Data Set ◽  
Study Objective ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Double Blinded

Abstract Study objective is to determine the association between deficient 25-hydroxyvitamin D [25(OH)D] serum levels and the amount of assistance needed to walk in a room by older adults living in long-term care (LTC) communities. Participants (age ≥ 65) from five LTC communities in Central Texas were recruited for a multi-site, cross-sectional study (n=169). Double-blinded data abstraction protocols were used to collect a one-year medical history. Laboratory blood draws measured serum 25(OH)D levels. Level of assistance was measured by the activities of daily living score for walking in room from section G of the Minimum Data Set (MDS). To determine the association between deficient 25(OH)D serum levels (≤20 ng/ml) and assistance with walking, adjusted logistic regression was used. Total vitamin D per day (supplementation and meals), therapy and/or restorative programs, body mass index, race, gender, age, and years living in the community were used as confounders. Of the 169 participants (mean age=83) 27.17% had deficient serum 25(OH)D and 9.25% required extensive assistance to walk in a room. The mean serum level and supplementation rate of participants was 32.61 ng/ml and 1,160.64 IU per/d, respectively. Participants with deficient 25(OH)D serum levels had significantly elevated odds (OR=8.73; CL: 1.28, 8.54; p=0.027) of requiring extensive assistance to walk in a room compared to those with adequate serum levels (>20 ng/ml). Deficient 25(OH)D serum levels are associated with increased assistance to walk in a room indicating that adequate serum levels in LTC residents could potentially decrease burden on staff.

scholarly journals Vitamin D Supplementation in Tuberculosis Patients: A Cross Sectional Study

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Dina Keumala Sari ◽  
Nurfida Khairina Arrasyid ◽  
Y. S. Harahap
Keyword(s):  
Vitamin D ◽  
Serum Level ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Vitamin D Supplementation ◽  
Sectional Study ◽  
Cross Sectional ◽  
Tuberculosis Patients ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

Previous studies have not been able to show with certainty the effect of vitamin D supplementation in tuberculosis patients. The objective of this study is to determine whether vitamin D supplementation to patients with tuberculosis could influence 25-hydroxyvitamin D (25(OH)D) and calcium serum levels. The results, after 28 days, the vitamin D supplementation showed significant increase of 25(OH)D serum level at the end point (p=0.001), but not for the calcium serum level (p=0.3). The Conclusions is supplementation with 1,000 IU vitamin D per day increased the 25(OH)D serum level but there was no association with the calcium serum level.

scholarly journals Enablers And Barriers To Utilisation Of Available Formal Support By Institutionalised Individuals With Alzheimer’s Disease And Related Dementias In Rural South Western Uganda: A Qualitative Descriptive Study

2019 ◽  
Author(s):  
VALLENCE NIYONZIMA ◽  
Samuel Maling ◽  
Zeina Chemali
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Rural Communities ◽  
Support Services ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
Formal Support ◽  
Western Uganda

Abstract Background: The world’s population is ageing resulting in a larger number of people living with dementia. Prevalence of dementia for persons aged above 60 years is expected to increase . There is paucity of information regarding formal support available for institutionalised individuals with AD/ADRD, enablers and barriers to its utilisation particularly South Western Uganda. Therefore this study, filling this knowledge gap, sought to assess formal support available for individuals with AD/ADRD, enablers and barriers to its utilisation in rural communities in South Western Uganda Methods: This study was conducted in two nongovernmental community based facilities for the elderly in South Western Uganda employing a qualitative cross sectional study design. Purposive sampling was used to recruit caretakers of individuals with Alzheimer’s disease and related dementias. A total of 28 in depth interviews and 6 key informant interviews were conducted. Results: Three arching themes emerged: 1) Formal support services available, 2) Enablers and 3) Barriers to the utilisation of the formal support services in institutionalised patients with AD/ADRD in rural communities in South Western Uganda. Conclusions: These findings highlight the importance of formal care in the long-term care of individuals with AD/ADRD. There is a dire need to equip caretakers involved in the care of patients with AD/ADRD with the required skill set and include formal support services in the mainstream primary health care to make the services accessible.

scholarly journals Baseline Prevalence of Polypharmacy in Older Hypertensive Study Subjects with Elevated Dementia Risk: Findings from the Risk Reduction for Alzheimer’s Disease Study (rrAD)

2020 ◽  
Vol 77 (1) ◽  
pp. 175-182
Author(s):  
Eric D. Vidoni ◽  
Ashwini Kamat ◽  
William P. Gahan ◽  
Victoria Ourso ◽  
Kaylee Woodard ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Risk Reduction ◽  
Structured Interview ◽  
Median Number ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Dementia Risk

Background: Little is known about the prevalence of polypharmacy, the taking of five or more medications a day, in older adults with specific dementia risk factors. Objective: To examine the prevalence of polypharmacy in participants at baseline in a vascular risk reduction focused Alzheimer’s disease (rrAD) trial targeting older patients with hypertension and elevated dementia risk. Methods: We conducted a detailed review of medications in a cross-sectional study of community-dwelling older adults with hypertension and elevated dementia risk. Medications were identified in a structured interview process with an onsite pharmacist or qualified designee. Polypharmacy was defined as use of five or more medications on a regular basis. Descriptive analyses were conducted on the sample as well as direct comparisons of subgroups of individuals with hypertension, diabetes, and hyperlipidemia. Results: The 514 rrAD participants, mean age 68.8 (standard deviation [sd] 6), reported taking different combinations of 472 unique medications at their baseline visit. The median number of medications taken by participants was eight [Range 0–21], with 79.2% exhibiting polypharmacy (n = 407). Sites differed in their prevalence of polypharmacy, χ2(3) = 56.0, p < 0.001. A nearly identical percentage of the 2,077 prescribed (51.8%) and over the counter (48.2%) medications were present in the overall medication profile. The presence of diabetes (87.5%), hyperlipidemia (88.2%), or both (97.7%) was associated with a higher prevalence of polypharmacy than participants who exhibited hypertension in the absence of either of these conditions (63.2%), χ2(3) = 35.8, p < 0.001. Conclusion: Participants in a dementia risk study had high levels of polypharmacy, with the co-existence of diabetes or hyperlipidemia associated with a greater prevalence of polypharmacy as compared to having hypertension alone.

scholarly journals Efficacy of various prescribed vitamin D supplementation regimens on 25-hydroxyvitamin D serum levels in long-term care

2021 ◽  
pp. 1-24
Author(s):  
Ronna N Robbins ◽  
Monica Serra ◽  
Nalini Ranjit ◽  
Deanna M Hoelscher ◽  
Sara J Sweitzer ◽  
...  
Keyword(s):  
Older Adults ◽  
Vitamin D ◽  
Long Term Care ◽  
Serum Levels ◽  
Vitamin D Supplementation ◽  
Serum Concentrations ◽  
Blood Draw ◽  
Term Care ◽  
Hydroxyvitamin D

ABSTRACT Objective: The aims of this study were to examine the efficacy among various vitamin D supplementation regimens on serum 25(OH)D concentrations and determine the minimal dose rate required to achieve sufficient serum concentrations (≥75 nmol/L) among older adults in long-term care (LTC). Design: A one-year medical history was abstracted from medical records, and a one-time blood draw to measure serum 25(OH)D concentrations was obtained. Individuals were stratified into vitamin D supplemented and non-supplemented groups. The supplemented group was further categorized into four treatment forms: single ingredient vitamin D2or3, multivitamin, calcium with vitamin D, or combination of the three, and by daily prescribed doses: 0-399, 400-799, 800-1999, 2000-3999, and >4000 IU/day. Setting: Five LTC communities in Austin, Texas. Participants: 173 older (≥65 years) adults. Results: Of the participants, 62% received a vitamin D supplement and 55% had insufficient (≤75 nmol/L) 25(OH)D serum concentrations. Individuals receiving single ingredient vitamin D2or3 supplementation received the highest daily vitamin D mean dose (2900 IU/d), while combination of forms was the most frequent treatment (44%) with the highest mean serum concentration (108 nmol/L). All supplementation doses were successful at reaching sufficient serum concentrations, except those <800 IU/d. Using a prediction model, it was observed that one IU/d of vitamin D supplementation resulted in a 0.008 nmol/L increase in serum 25(OH)D concentrations. Conclusion: Based on the predictive equation, results suggest that supplementation of 1500 IU/d of vitamin D2or3 or combination of vitamin D is most likely to achieve sufficient serum 25(OH)D concentrations in older adults in LTC.

scholarly journals Vitamin D and Hospital Admission in Older Adults: A Prospective Association

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 616
Author(s):  
Avril Beirne ◽  
Kevin McCarroll ◽  
James Bernard Walsh ◽  
Miriam Casey ◽  
Eamon Laird ◽  
...  
Keyword(s):  
Older Adults ◽  
Vitamin D ◽  
Hospital Admission ◽  
Cross Sectional Study ◽  
Vitamin D Supplementation ◽  
Inverse Association ◽  
Cross Sectional ◽  
Prospective Association ◽  
Randomised Controlled

The health effects of vitamin D are well documented, with increasing evidence of its roles beyond bone. There is, however, little evidence of the effects of vitamin D on hospitalisation among older adults. This study aimed to prospectively determine the relationship of vitamin D status in older adults with hospital admission and emergency department (ED) attendance. Trinity University of Ulster Department of Agriculture (TUDA) is a large cross-sectional study of older adults with a community population from three disease-defined cohorts (cognitive dysfunction, hypertension, and osteoporosis). Participants included in this analysis were recruited between 2008 and 2012. ED and hospital admission data were gathered from the date of TUDA participation until June 2013, with a mean follow up of 3.6 years. Of the 3093 participants, 1577 (50.9%) attended the ED during the period of follow-up. Attendees had lower mean serum 25(OH)D concentrations than non-attendees (59.1 vs. 70.6 nmol/L). Fully adjusted models showed an inverse association between vitamin D and ED attendance (Hazard Ratio (HR) 0.996; 95% Confidence Interval (CI) 0.995–0.998; p < 0.001). A total of 1269 participants (41%) were admitted to hospital during the follow-up. Those admitted had lower mean vitamin D concentrations (58.4 vs. 69.3 nmol/L, p < 0.001). In fully adjusted models, higher vitamin D was inversely associated with hospital admission (HR 0.996; 95% CI 0.994–0.998; p < 0.001) and length of stay (LOS) (β = −0.95, p = 0.006). This study showed independent prospective associations between vitamin D deficiency and increased hospitalisation by older adults. The need for further evaluation of current recommendations in relation to vitamin D supplementation, with consideration beyond bone health, is warranted and should focus on randomised controlled trials.

scholarly journals Perceived stress and depressive symptoms not neuropsychiatric symptoms predict caregiver burden in Alzheimer’s disease: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Manee Pinyopornpanish ◽  
Kanokporn Pinyopornpanish ◽  
Atiwat Soontornpun ◽  
Surat Tanprawate ◽  
Angkana Nadsasarn ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Depressive Symptoms ◽  
Caregiver Burden ◽  
Perceived Stress ◽  
Neuropsychiatric Symptoms ◽  
Cross Sectional Study ◽  
Assessment Tools ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background Caregiver burden affects the caregiver’s health and is related to the quality of care received by patients. This study aimed to determine the extent to which caregivers feel burdened when caring for patients with Alzheimer’s Disease (AD) and to investigate the predictors for caregiving burden. Methods A cross-sectional study was conducted. One hundred two caregivers of patients with AD at Maharaj Nakorn Chiang Mai Hospital, a tertiary care hospital, were recruited. Assessment tools included the perceived stress scale (stress), PHQ-9 (depressive symptoms), Zarit Burden Interview-12 (burden), Clinical Dementia Rating (disease severity), Neuropsychiatric Inventory Questionnaires (neuropsychiatric symptoms), and Barthel Activities Daily Living Index (dependency). The mediation analysis model was used to determine any associations. Results A higher level of severity of neuropsychiatric symptoms (r = 0.37, p < 0.01), higher level of perceived stress (r = 0.57, p < 0.01), and higher level of depressive symptoms (r = 0.54, p < 0.01) were related to a higher level of caregiver burden. The direct effect of neuropsychiatric symptoms on caregiver burden was fully mediated by perceived stress and depressive symptoms (r = 0.13, p = 0.177), rendering an increase of 46% of variance in caregiver burden by this parallel mediation model. The significant indirect effect of neuropsychiatric symptoms by these two mediators was (r = 0.21, p = 0.001). Conclusion Caregiver burden is associated with patients’ neuropsychiatric symptoms indirectly through the caregiver’s depressive symptoms and perception of stress. Early detection and provision of appropriate interventions and skills to manage stress and depression could be useful in reducing and preventing caregiver burden.

Evaluation of macrolinguistic aspects of the oral discourse in patients with Alzheimer’s disease

2018 ◽  
Vol 31 (9) ◽  
pp. 1343-1353 ◽  
Author(s):  
Juliana Onofre de Lira ◽  
Thaís Soares Cianciarullo Minett ◽  
Paulo Henrique Ferreira Bertolucci ◽  
Karin Zazo Ortiz
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Language Processing ◽  
Cross Sectional Study ◽  
Oral Discourse ◽  
Cross Sectional ◽  
Cohesive Devices ◽  
Global Coherence ◽  
Comparison Groups ◽  
Study Setting

ABSTRACTIntroduction:Alzheimer’s disease (AD) is a degenerative syndrome that impairs cognitive functioning, including speech and language. Discourse can be used to analyze language processing, which is organized into microlinguistic and macrolinguistic dimensions.Objectives:To identify the occurrence of changes in the macrolinguistic dimension of oral discourse in AD patients. Design: This was developed as a cross-sectional study. Setting: Outpatient clinic of the Behavioural Neurology Division of São Paulo Federal University.Participants:121 elderly patients, with ≥ 4 years of education, divided into AD and comparison groups.Measurements:The subjects were asked to create a narrative based on seven figures that made up a story. The macrolinguistic aspects of the narratives were analyzed.Results:The performance of the AD group was inferior to that of the comparison group on content-related, no-content-related complete and incomplete propositions as well as macropropositions, main information units, appropriated local and global coherence, cohesive devices and all subtypes, cohesive errors and some of their subtypes. Global coherence, macropropositions and ellipsis subtype of cohesive devices were the variables that best differentiated the groups.Conclusions:Changes were observed in most aspects of the macrolinguistic dimension of oral discourse in patients with AD.

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