Neuropsychiatry services in Japan

2020 ◽  
pp. 537-544
Author(s):  
Koho Miyoshi
Keyword(s):  
Psychiatric Symptoms ◽  
Oldest Old ◽  
Neuropsychiatric Symptoms ◽  
Psychiatric Hospitals ◽  
The Elderly ◽  
Training System ◽  
Elderly Persons ◽  
Career Opportunities ◽  
Number Of Patients ◽  
Set Up

This chapter deals with the neuropsychiatric service provision, training, career opportunities, particular issues in aged society, and scientific activities for understanding the situation of neuropsychiatry in Japan. The proportion of people aged 65 years and older in Japan reached the world’s highest at 21.0% in 2006. The elderly population has since increased persistently and is estimated at 27.1% of the total population. In addition to this, the ratios of people aged 75 years and over and those aged 85 years and over are estimated at 13.2% and 4.1%, respectively. The ‘oldest old ’ group has contributed to the increasing prevalence of dementia. According to the governmental survey, the estimated number of elderly persons with dementia was 2.80 million in 2010 and 3.45 million in 2015. It is predicted to increase to 4.1 million by 2020 and 4.7 million by 2035. The number of patients with major neuropsychiatric disorders, especially Alzheimer’s disease, vascular dementia, and Parkinson’s disease, has been increasing for the last two decades, and the needs for neuropsychiatric services are also rapidly increasing. Neuropsychiatric services consist mainly of provision of clinical diagnosis, based on clinical examination, and medical treatment for neuropsychiatric symptoms, i.e. psychiatric symptoms of neurological disorders. Neuropsychiatric services should be provided by neuropsychiatry specialists. There are approximately 13,000 psychiatrists and 8000 neurologists working in psychiatric hospitals, general hospitals, medical schools, and private clinics. However, the number of neuropsychiatry specialists is quite limited. Therefore, there is urgency for the Japanese Neuropsychiatric Association (JNA) to set up an appropriate training system for clinicians in order to remediate the shortage of neuropsychiatrists.

Neuropsychiatric Symptoms and Antipsychotic Therapy in the Elderly Patients with Dementia

Psychiatry ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 6-15
Author(s):  
I. V. Kolykhalov
Keyword(s):  
Neuropsychiatric Symptoms ◽  
The Elderly ◽  
Psychotic Symptoms ◽  
Mixed Dementia ◽  
Short Term ◽  
Antipsychotic Therapy ◽  
Dementia Patients ◽  
Frequency Of Use ◽  
Number Of Patients ◽  
High Incidence

The objective of the study was to investigate syndromal-nosological specificities of neuropsychiatric symptoms (NPS) and the frequency of use of antipsychotics in patients with various types of dementias, institutionalized to geriatric units of mental hospitals.Patients and methods: a total of 106 in-patients of three psychogeriatric units were examined. The median age of patients is 75 years [69; 80].The diagnostic distribution of patients at the time of the examination was as follows: in 33 subjects (31.1%) Alzheimer’s disease (AD) was diagnosed, in 25 (23.6%) - mixed dementia (MD), in 32 (30.2%) - vascular dementia (VD) and in 16 (15.1%) patients had dementia of complex origin (DCO).Results: a high incidence (54.7%) of NPS was found in patients with dementia of various origins. The greatest number of patients with behavioral and psychotic symptoms was found in AD and MD. The proportion of dementia patients with such disorders in each of these types of dementia is about 70%, while in CGD and VD, the proportion of patients with NPS is noticeably smaller (30% and 40%, respectively). For the treatment of NPS, antipsychotics were most often prescribed, but their use caused adverse events (AEs) in 1/3 of cases. Patients with VD are most susceptible to the development of AE, and AD patients are the least susceptible.Conclusion: the study showed that NPS are one of the important components of dementia, regardless of the nosology and stage of the disease. The treatment of NPS in dementia is particularly challenging because, although the symptoms cause significant distress, there are currently no effective alternative therapies. The risk of AE can be minimized by carefully considering the indications for prescribing antipsychotics and their short-term use, regular monitoring of the patient’s condition, and educating caregivers.

Treating chronically psychotic patients in nursing homes

2016 ◽  
Vol 33 (S1) ◽  
pp. S37-S37 ◽  
Author(s):  
J. Gauillard
Keyword(s):  
Nursing Home ◽  
Psychotic Disorders ◽  
Psychiatric Symptoms ◽  
Psychiatric Hospitals ◽  
The Elderly ◽  
Sheltered Housing ◽  
Psychiatric Disease ◽  
Public Health Issue ◽  
Old Patients ◽  
Alzheimer Dementia

The increase of aging patients with schizophrenia becomes a public health issue. The exponential demography of the elderly, the improvement of cares associated with better physical follow-up directly impact the number of old patients with chronic psychiatric disease. Deinstitutionalization associated with a dramatic enhancement of ambulatory and community cares has led to a reduction of beds in psychiatric hospitals. When dependency occurs, due to physical comorbid illness or a worsening of the negative symptoms, psychiatric teams should find appropriate housing and no longer the psychiatric hospital. Nursing home and sheltered housing for the elderly dependent persons become a solution, but geriatric staffs are not always prepared to receive resident with schizophrenia and other psychotic disorders. They often are at a loss when faced with the expression of psychiatric symptoms or with the specificity of caring for often-younger patients whose behavior is different from older people with neurodegenerative disorders.How psychiatric teams could long-term assist the sheltered housing and nursing home and bring a psychiatric know-how within staffs often reluctant to deal with psychotic patients who could burden caregivers. How could they be trained to cope with complex cognitive functions impairments of schizophrenia, far from cognitive impairments of Alzheimer dementia? How to change the representation of psychiatric illness, which often leads to a double stigmatization (old age and madness)? Improving the quality of life of aging patients with severe chronic mental illness in homes for seniors is a great challenge for psychiatric teams in collaboration with geriatric caregivers.Disclosure of interestThe author has not supplied his declaration of competing interest.

Long-term care for elderly people in the UK

1999 ◽  
Vol 9 (4) ◽  
pp. 383-393 ◽  
Author(s):  
Norman J Vetter
Keyword(s):  
Elderly People ◽  
Long Term Care ◽  
Elderly Person ◽  
The Elderly ◽  
Royal Commission ◽  
Elderly Persons ◽  
Term Care ◽  
Set Up ◽  
The Uk

The recent Royal Commission report on funding long-term care was produced following more than 100 visits and evidence from 400 organizations. It was set up following concern at the costs of long-term care for elderly people and what was seen to be the anomalous position of elderly people cared for by the NHS in long-term beds, where all costs were found by the state, albeit that elderly persons themselves lost most of their benefits. This contrasted with those in the social or independent sector, where payment has to be made unless the elderly person is poor.

scholarly journals Factors associated with mobility of the oldest old

2017 ◽  
Vol 30 (1) ◽  
pp. 69-76 ◽  
Author(s):  
Vanessa Ribeiro dos Santos ◽  
Diego Giulliano Destro Christofaro ◽  
Igor Conterato Gomes ◽  
Ismael Forte Freitas Júnior ◽  
Luís Alberto Gobbo
Keyword(s):  
Logistic Regression ◽  
Oldest Old ◽  
Multiple Logistic Regression Analysis ◽  
Binary Logistic Regression ◽  
The Elderly ◽  
Sociodemographic Factors ◽  
Elderly Persons ◽  
Functional Dependencies ◽  
Significance Level ◽  
Limited Mobility

Abstract Introduction: Several factors can be associated to the reduction of mobility among the elderly. Early identification of these factors is crucial, since it may lead to prevention of functional dependencies. Objective: To analyze the association between mobility, sociodemographic factors and the prevalence of noncommunicable chronic diseases (NCDs) in oldest old. Methods: The sample consisted of 120 elderly persons aged (80 and 95 years), with 76 of them being women (83 ± 3 years) and 44 of them men (83 ± 3 years). Sociodemographic factors and NCDs which we studied were: age, gender, marital status, education, nutritional status, ethnicity, hypertension, diabetes and osteoarticular diseases. Mobility was analyzed using a battery of Physical Performance Tests. For statistical analysis we used the chi-square test and binary logistic regression to examine the relationship between sociodemographic factors, NCDs and mobility. SPSS (17.0) software was used for this and the significance level was set at 5%. Results: Level of education (p ≤ 0.001) and age (p = 0.034) are the two factors related to low mobility. However, the model built by multiple logistic regression analysis revealed that age is independently related to limited mobility in oldest old people (OR 3.29; 95% CI 1.09 to 9.87). Conclusion: Thus, oldest old >85 years are at a greater risk of decreased mobility independent of their education, marital and nutritional statuses and gender. We encourage further studies in this area. Studies which will not only address those facts considered in this study but that also examine family-related aspects, especially using longitudinal studies.

Characteristics and health conditions of a group of nursing home patients with mental–physical multimorbidity – the MAPPING study

2017 ◽  
Vol 29 (6) ◽  
pp. 1037-1047 ◽  
Author(s):  
Anne M.A. van den Brink ◽  
Debby L. Gerritsen ◽  
Miranda M.H. de Valk ◽  
Richard C. Oude Voshaar ◽  
Raymond T.C.M. Koopmans
Keyword(s):  
Nursing Home ◽  
Neuropsychiatric Symptoms ◽  
Psychiatric Hospitals ◽  
Healthcare Services ◽  
Self Report ◽  
Care Needs ◽  
Term Care ◽  
Knowledge And Skills ◽  
Care Dependency ◽  
Number Of Patients

ABSTRACTBackground:Long-term care facilities have partly taken over the traditional asylum function of psychiatric hospitals and house an increasing group of patients with mental–physical multimorbidity (MPM). Little is known about the characteristics, behavior, and care dependency of these patients. This paper aims to describe these aspects.Methods:Explorative, descriptive study among patients with MPM without dementia (n = 142), living in 17 geronto-psychiatric nursing home (NH) units across the Netherlands, stratified by those referred from mental healthcare services (MHS) and other healthcare services (OHS). Data collection consisted of chart review, semi-structured interviews, (brief) neuropsychological testing, and self-report questionnaires. Patients referred from MHS (n = 58) and from OHS (n = 84) were compared by descriptive statistics.Results:Despite exclusion of patients with dementia, the majority of participants had cognitive impairment. Prevalence and severity of frontal impairment were high, as well as the number of patients with clinically relevant neuropsychiatric symptoms. MHS patients were younger, had more chronic psychiatric disorders, and more often used antipsychotics. Neuropsychiatric symptoms, domains of care dependency, physical conditions and concomitant medication use differed not significantly between the subgroups.Conclusions:Both groups of patients with MPM showed heterogeneity in various aspects but differed not significantly regarding the consequences of their multimorbidity. In a variety of characteristics, this group seems to be different from other NH patient groups, which requires extra knowledge and skills of the staff. To uncover which knowledge and skills are necessary, the next step should be to investigate the specific care needs of NH patients with MPM without dementia.

scholarly journals Introduction: Assessing Current Practice in Alzheimer's Disease

CNS Spectrums ◽  
2004 ◽  
Vol 9 (S5) ◽  
pp. 5-5
Author(s):  
Jacobo E. Mintzer
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Psychiatric Symptoms ◽  
Psychological Symptoms ◽  
Functional Decline ◽  
The Elderly ◽  
The United States ◽  
Scientific Basis ◽  
Baby Boomer Generation ◽  
Number Of Patients

Alzheimer's disease (AD) is a debilitating condition currently affecting 4.5 million elderly citizens in the United States alone. It is the most common form of dementia and is associated with significant disability. For many years the prognosis of the disease has remained largely unchanged. Those patients who develop AD face progressive cognitive and functional decline that ultimately shortens their life expectancy and destroys their quality of life. At the same time, the disease has a significant adverse impact on the lives of those family members who serve as caregivers. With the aging of the baby-boomer generation and the expected associated increase in the number of patients with AD, clinicians who treat the elderly will clearly be in need of some new answers. Recent advances in assessment, diagnosis, and treatment offer some hope for relief from this bleak prognosis.Advances in AD include the establishment of clear diagnostic criteria, the validation of disease-specific assessment instruments, and pharmacologic and behavioral therapies for management of symptoms. A handful of medications that enhance cognition have obtained the approval of the Food and Drug Administration, and more are currently in development. Trials of existing medications have demonstrated benefit in the management of the psychiatric symptoms (eg, psychosis and agitation) typically associated with the disease. But much still remains to be done.In the first article in this supplement, Michael A. Rogawski, MD, PhD, explains what is known about the pathogenesis and the behavioral and psychological symptoms of AD. He discusses the scientific basis for empirical therapies currently being used to relieve the symptoms of this disease, focusing on drug therapies approved by the FDA, including the newest AD medication to market memantine.

Validity of the Elderly Behavior Assessment for Relatives (EBAR)

2000 ◽  
Vol 16 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Lina Pezzuti ◽  
Caterina Laicardi ◽  
Marco Lauriola
Keyword(s):  
Cognitive Functioning ◽  
Mini Mental State Examination ◽  
Rating Scale ◽  
Good Health ◽  
The Elderly ◽  
Behavior Assessment ◽  
Elderly Persons ◽  
Behavior Rating Scale ◽  
Components Analysis ◽  
State Examination

Summary: An Elderly Behavior Assessment for Relatives (EBAR), updating the GERRI ( Schwartz, 1983 ), was administered to relatives (or significant others) of 349 elderly persons, from 60 to over 80 years of age, living at home, in good health and without cognitive impairment. A trained psychologist administered subjects the Life Satisfaction for Elderly Scale (LSES), the Instrumental Activity of Daily Living (IADL), the Mini Mental State Examination (MMSE), and personally answered to an overall elderly behavior rating scale (RA). EBAR items were first examined. The more attractive and less discriminative statements were excluded. A principal components analysis was carried out on the remaining EBAR items. Three factors were extracted. After varimax rotation they were tentatively labeled: Everyday Cognitive Functioning, Depression, and Hostility. Factor-driven EBAR subscales were designed, taking into account simpler items in the factor matrix. Results provide evidence for EBAR construct validity. Everyday Cognitive Functioning is connected to the IADL and the RA scores; Depression is very highly related to the LSES; Hostility is weakly related to RA, IADL, and MMSE, indicating that the scale needs further investigation.

Senior Living - Lighting, Circadian Rhythm and Dementia I

2019 ◽  
pp. 4-8
Author(s):  
Tadej Glažar ◽  
Marjeta Zupancic ◽  
Samo Kralj ◽  
Robert Peternelj
Keyword(s):  
The Elderly ◽  
Living Environment ◽  
Elderly Persons ◽  
Light Spectrum ◽  
Average Life Expectancy ◽  
The Real Estate ◽  
Lighting Conditions ◽  
Light Levels ◽  
Joint Fracture ◽  
Lease Contracts

The Real Estate Fund of Pension and Disability Insurance (Nepremicninski Sklad) in Slovenia, founded in1997 is the owner of 3255 properties in 116 locations throughout the country and is intended for solving housing issues of pensioners of 65 years or older and other elderly persons who are allowed independently to live. The lease contracts are concluded for an indefinite period of time. The aim and vision of the Fund is to improve the quality of life for the elderly tenants by adapting the living environment, the flats and surroundings according to the physical needs of aging tenants. Homes for seniors often have low light levels and poor light spectrum caused by fluorescent or incandescent lighting. Demographic changes in most European countries show rising average life expectancy which means that the number of people with weak visual capacity or visual impairment is increasing. Equally the risks of injuries due to poor lighting conditions are increasing, e.g. missing a step resulting in a hip joint fracture. Better lighting conditions are of critical importance for aging population, as stated also in the recently published CIE227:2017. To facilitate safe environment for the elderly, the Fund in 2013 initiated a lighting research study that should provide facts and evidence for a lighting standard for their own premises.

Formation and Development of the Pre-Professional Training System of Foreign Medical Applicants in Ukraine (Historical and Educational Aspect)

2014 ◽  
Vol 4 (3) ◽  
pp. 95-98
Author(s):  
Iana Proskurkina
Keyword(s):  
Foreign Students ◽  
Professional Training ◽  
Training System ◽  
Further Education ◽  
Effective System ◽  
History Of ◽  
Set Up ◽  
The University ◽  
History Of Formation ◽  
Educational Aspect

Abstract The growing number of foreign applicants looking forward to getting education in Ukrainian medical universities makes us find the ways how to improve and make effective the pre-professional training system of foreign medical applicants for further education. The article deals with the issues of the history of formation and development of the preprofessional training system of foreign medical applicants in Ukraine. On the ground of the electronic databases of the official websites of higher educational establishments, the data on years of opening first offices of the dean, departments and preparatory faculties for foreign medical applicants in Ukrainian medical universities are analyzed and systematized. Also the data on the setting up preparatory faculties at other universities who carry out licensed training of foreign students of the medical profile are presented. The data on the operating and management of such institutions in the system of the University administration are generalized. It’s revealed that during the years of its functioning the pre-professional training has changed, in particular the system was commercialized and the institutions involved in training foreign applicants have been reorganized. The modern trends in teaching foreign medical students at the preparatory faculties of the Ukrainian medical universities are displayed. Based on the analysis of the data it is concluded that the system of the pre-professional training of foreign medical applicants was set up in the 50s-60s years of the twentieth century. During this time, some positive experience in the preparation of future international medical specialists has been gained. The system of the pre-professional training of foreign medical applicants has been comprehensively improved and an effective system of managing foreign medical applicants has been created.

Identify Compounds' Target Against Alzheimer's Disease Based on In-Silico Approach

2019 ◽  
Vol 16 (3) ◽  
pp. 193-208 ◽  
Author(s):  
Yan Hu ◽  
Guangya Zhou ◽  
Chi Zhang ◽  
Mengying Zhang ◽  
Qin Chen ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Small Molecule ◽  
Characteristic Curve ◽  
Machine Learning Algorithms ◽  
Learner Model ◽  
Mao B ◽  
Number Of Patients ◽  
Sar Model ◽  
Set Up

Background: Alzheimer's disease swept every corner of the globe and the number of patients worldwide has been rising. At present, there are as many as 30 million people with Alzheimer's disease in the world, and it is expected to exceed 80 million people by 2050. Consequently, the study of Alzheimer’s drugs has become one of the most popular medical topics. Methods: In this study, in order to build a predicting model for Alzheimer’s drugs and targets, the attribute discriminators CfsSubsetEval, ConsistencySubsetEval and FilteredSubsetEval are combined with search methods such as BestFirst, GeneticSearch and Greedystepwise to filter the molecular descriptors. Then the machine learning algorithms such as BayesNet, SVM, KNN and C4.5 are used to construct the 2D-Structure Activity Relationship(2D-SAR) model. Its modeling results are utilized for Receiver Operating Characteristic curve(ROC) analysis. Results: The prediction rates of correctness using Randomforest for AChE, BChE, MAO-B, BACE1, Tau protein and Non-inhibitor are 77.0%, 79.1%, 100.0%, 94.2%, 93.2% and 94.9%, respectively, which are overwhelming as compared to those of BayesNet, BP, SVM, KNN, AdaBoost and C4.5. Conclusion: In this paper, we conclude that Random Forest is the best learner model for the prediction of Alzheimer’s drugs and targets. Besides, we set up an online server to predict whether a small molecule is the inhibitor of Alzheimer's target at http://47.106.158.30:8080/AD/. Furthermore, it can distinguish the target protein of a small molecule.

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