A Review of Pain Prevalence in Alzheimer's, Vascular, Frontotemporal and Lewy Body Dementias

Background: Numerous studies have reported on pain in dementia. It has been hypothesized that pain perception differs between dementia subtypes, and therefore, the prevalence of pain differs between dementia subtypes. However, there remains a paucity of evidence on the differences in the prevalence of pain in different dementia subtypes. This review aimed to determine the prevalence of pain for the major dementia subtypes: Alzheimer's disease (AD), vascular dementia (VaD), frontotemporal dementia (FTD) and dementia with Lewy bodies (DLB). Summary: We found 10 studies that met our inclusion criteria. Most of these studies reported on AD; studies reporting the prevalence of pain in people with DLB were scarce, and for FTD, we found no studies. The sample-weighted prevalence of pain could only be calculated for AD, VaD and mixed dementia: AD 45.8% (95% confidence interval, CI: 33.4-58.5%), VaD 56.2% (95% CI: 47.7-64.4%) and mixed dementia 53.9% (95% CI: 37.4-70.1%). Key Messages: Studies investigating the prevalence of pain in dementia subtypes were scarce; however, we found a high prevalence of pain in dementia without significant differences between the dementia subtypes. More studies are required to draw firm conclusions on the differences in the prevalence of pain between dementia subtypes.

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Pain in German physiotherapists: an analysis of pain prevalence and analgesics intake

physioscience ◽

10.1055/a-1397-6166 ◽

2021 ◽

Author(s):

Sarah Steiner ◽

Luis Möckel

Keyword(s):

Chronic Pain ◽

Back Pain ◽

Online Survey ◽

Recurrent Pain ◽

Pain Location ◽

High Prevalence ◽

Pain Prevalence ◽

Prevalence Of Pain ◽

Pain Analgesics ◽

Study Participants

Abstract Background Healthcare professionals of different occupations report pain, in particular back pain. It is known that the handling of patients and standing for long periods of time – like physiotherapists do, as well as working in bent posture – are causes of back pain. A high prevalence of low back pain (LBP) in German physiotherapists is to be expected. Objective To determine pain point prevalence, severity of pain, type of pain (acute, chronic, recurrent), most affected body locations and extent of analgesics intake in German physiotherapists. Method This was a nationwide online survey with German physiotherapists. Univariable and multivariable methods were applied to identify associations between sociodemographic variables and pain, type of pain and pain location as well as analgesic intake by type of pain. In addition, severity of pain by type was examined using the Kruska-Wallis Test. Results A total of 550 physiotherapists were included in the analysis. Prevalence of pain was 63.09 % (acute: 4.18 %, chronic: 15.27 %, recurrent: 43.64 %). Most frequently mentioned pain locations were lumbar spine (49.27 %), cervical spine (48.39 %) and head (40.47 %). Participants with chronic pain reported a higher pain severity than physiotherapists with recurrent pain. Analgesics were used by 35.29 % of study participants with pain. Participants with chronic pain indicated a significantly higher probability of using analgesics compared to physiotherapists with recurrent pain. Conclusion This study indicates a high prevalence of pain and analgesics intake in participating physiotherapists. Therefore, measures are needed to reduce pain in German physiotherapists.

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Adequacy of Using Consensus Guidelines for Diagnosis of Dementia with Lewy Bodies in Clinical Trials for Drug Development

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000441443 ◽

2015 ◽

Vol 41 (1-2) ◽

pp. 55-67 ◽

Cited By ~ 2

Author(s):

Manabu Ikeda ◽

Etsuro Mori ◽

Eizo Iseki ◽

Sadao Katayama ◽

Yasuto Higashi ◽

...

Keyword(s):

Clinical Trials ◽

Dementia With Lewy Bodies ◽

Lewy Bodies ◽

Phase Iii ◽

Rapid Eye Movement Sleep ◽

Yahr Stage ◽

Sleep Behaviour ◽

High Prevalence ◽

Diagnosis Of Dementia ◽

Using Data

Background/Aims: To evaluate the adequacy of using the consensus diagnostic criteria for dementia with Lewy bodies (DLB) to recruit patients with homogeneous characteristics in future clinical trials, where multiple departments of multinational centres are expected to participate with a long enrolment period, and additionally, to contribute to the possible future criteria revision. Methods: Using data from 2 trials of donepezil for DLB, conducted 3 years apart, characteristics in patients with probable DLB were analysed and compared between studies and between psychiatric and neurological centres. Results: In 273 patients (phase II: 135, phase III: 138; psychiatric: 73, neurological: 184), clinical characteristics overall were very similar between studies, and between specialty centres, excluding distinctive parkinsonism in the neurological versus psychiatric centres: incidence of parkinsonism (91.8 vs. 71.2%, p < 0.001), Hoehn and Yahr stage (III: 55.0 vs. 21.2%, p < 0.001), and concomitant anti-Parkinson medication (24.5 vs. 11.0%, p = 0.017). Rapid eye movement sleep behaviour disorder, depression, and delusion, suggestive or supportive features, were observed in 35-40%. Additionally, a high prevalence (55.3%) of anxiety was observed. Conclusion: Employing the consensus criteria is adequate to enrol homogeneous DLB patients into future clinical trials regardless of the specialty of centres and time. Further discussion could involve adding anxiety to future criteria.

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P.5.049 The influence of memantine on cognitionin Alzheimer's disease, mixed dementia and dementia with Lewy bodies

European Neuropsychopharmacology ◽

10.1016/s0924-977x(05)80451-1 ◽

2005 ◽

Vol 15 ◽

pp. S228

Author(s):

N.N. Yachno ◽

I.S. Preobrazhenskaya ◽

E.A. Mkhitaryan

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Dementia With Lewy Bodies ◽

Lewy Bodies ◽

Mixed Dementia

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Alpha-synuclein seeds in olfactory mucosa and cerebrospinal fluid of patients with dementia with Lewy bodies

Brain Communications ◽

10.1093/braincomms/fcab045 ◽

2021 ◽

Vol 3 (2) ◽

Author(s):

Daniela Perra ◽

Matilde Bongianni ◽

Giovanni Novi ◽

Francesco Janes ◽

Valentina Bessi ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Real Time ◽

Clinical Diagnosis ◽

Dementia With Lewy Bodies ◽

Lewy Bodies ◽

Alpha Synuclein ◽

Olfactory Mucosa ◽

Confirmatory Test ◽

Mixed Dementia

Abstract In patients with suspected dementia with Lewy bodies, the detection of the disease-associated α-synuclein in easily accessible tissues amenable to be collected using minimally invasive procedures remains a major diagnostic challenge. This approach has the potential to take advantage of modern molecular assays for the diagnosis of α–synucleinopathy and, in turn, to optimize the recruitment and selection of patients in clinical trials, using drugs directed at counteracting α-synuclein aggregation. In this study, we explored the diagnostic accuracy of α-synuclein real-time quaking-induced conversion assay by testing olfactory mucosa and CSF in patients with a clinical diagnosis of probable (n = 32) or prodromal (n = 5) dementia with Lewy bodies or mixed degenerative dementia (dementia with Lewy bodies/Alzheimer’s disease) (n = 6). Thirty-eight patients with non-α-synuclein-related neurodegenerative and non-neurodegenerative disorders, including Alzheimer’s disease (n = 10), sporadic Creutzfeldt–Jakob disease (n = 10), progressive supranuclear palsy (n = 8), corticobasal syndrome (n = 1), fronto-temporal dementia (n = 3) and other neurological conditions (n = 6) were also included, as controls. All 81 patients underwent olfactory swabbing while CSF was obtained in 48 participants. At the initial blinded screening of olfactory mucosa samples, 38 out of 81 resulted positive while CSF was positive in 19 samples out of 48 analysed. After unblinding of the results, 27 positive olfactory mucosa were assigned to patients with probable dementia with Lewy bodies, five with prodromal dementia with Lewy bodies and three to patients with mixed dementia, as opposed to three out 38 controls. Corresponding results of CSF testing disclosed 10 out 10 positive samples in patients with probable dementia with Lewy bodies and six out of six with mixed dementia, in addition to three out of 32 for controls. The accuracy among results of real-time quaking-induced conversion assays and clinical diagnoses was 86.4% in the case of olfactory mucosa and 93.8% for CSF. For the first time, we showed that α-synuclein real-time quaking-induced conversion assay detects α-synuclein aggregates in olfactory mucosa of patients with dementia with Lewy bodies and with mixed dementia. Additionally, we provided preliminary evidence that the combined testing of olfactory mucosa and CSF raised the concordance with clinical diagnosis potentially to 100%. Our results suggest that nasal swabbing might be considered as a first-line screening procedure in patients with a diagnosis of suspected dementia with Lewy bodies followed by CSF analysis, as a confirmatory test, when the result in the olfactory mucosa is incongruent with the initial clinical diagnosis.

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Severe, Persistent and Fatal Delirium in Psychogeriatric Patients Admitted to a Psychiatric Hospital

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000381847 ◽

2015 ◽

Vol 5 (2) ◽

pp. 253-264 ◽

Cited By ~ 4

Author(s):

Ingrid S. Jans ◽

Letty Oudewortel ◽

Paulien M. Brandt ◽

Willem A. van Gool

Keyword(s):

Cognitive Impairment ◽

Medical Records ◽

Dementia With Lewy Bodies ◽

Fatal Outcome ◽

Case Series ◽

Lewy Bodies ◽

Inclusion Criteria ◽

Disease Trajectory ◽

History Of ◽

Jakob Disease

Background/Aims: Although delirium is generally regarded as a transient syndrome, persistence of delirium in patients with cognitive impairment - even with fatal outcome - has been reported as well. This study aims to describe the clinical features and neuropathological correlates of this type of delirium. Methods: Inclusion criteria for this case series were: (1) severe persistent delirium until death, (2) history of cognitive decline and (3) consent for brain autopsy. Medical records were examined in combination with collected clinical data and neuropathological findings. Result: In 15 patients, all living at home before admission, episodes with delirium lasted for 4.2 months on average. No distinct medical causes of persistent delirium could be identified. Pathological diagnoses included Alzheimer's disease and dementia with Lewy bodies as well as single cases of Creutzfeldt-Jakob disease and progressive supranuclear palsy. Conclusion: Severe, persistent and fatal delirium in patients with cognitive impairment can occur relatively early in the disease trajectory and is associated with diverse neuropathologies.

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First delirium episode in Parkinson’s disease and parkinsonism: incidence, predictors, and outcomes

npj Parkinson s Disease ◽

10.1038/s41531-021-00234-2 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Samantha Green ◽

Sarah L. Perrott ◽

Andrew McCleary ◽

Isobel Sleeman ◽

Jodi Maple-Grødem ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Confidence Interval ◽

Early Identification ◽

Dementia With Lewy Bodies ◽

Lewy Bodies ◽

Atypical Parkinsonism ◽

Vascular Parkinsonism ◽

Community Based ◽

North East

AbstractTo define the incidence, predictors and prognosis of the first hospital delirium episode in Parkinson’s disease (PD) and atypical parkinsonism (AP), we identified the first hospital episode of delirium after diagnosis in the Parkinsonism Incidence in North-East Scotland (PINE) study, a prospective community-based incidence cohort of parkinsonism, using chart-based criteria to define delirium. Of 296 patients (189=PD, 107=AP [dementia with Lewy bodies, progressive supranuclear palsy, multiple system atrophy, vascular parkinsonism]), 152 developed delirium (PD = 98, AP = 54). Incidence of first hospital delirium episode per 100 person years was 8.1 (95% confidence interval [CI] 6.6–9.9) in PD and 18.5 (95% CI 13.9–24.7) in AP. Independent predictors of delirium were atypical parkinsonism (Hazard ratio [HR] vs PD = 2.83 [95% CI 1.60–5.03], age in PD but not in AP (HR for 10-year increase 2.29 [95% CI 1.74–3.02]), baseline MMSE (HR = 0.94 [95% CI 0.89–0.99]), APOE ε4 in PD (HR 2.16 [95% CI 1.15–4.08]), and MAPT H1/H1 in PD (HR 2.08 [95% CI 1.08–4.00]). Hazards of dementia and death after delirium vs before delirium were increased (dementia: HR = 6.93 [95% CI 4.18–11.48] in parkinsonism; death: HR = 3.76 [95% CI 2.65–5.35] in PD, 1.59 [95% CI 1.04–2.42] in AP). Delirium is a common non-motor feature of PD and AP and is associated with increased hazards of dementia and mortality. Whether interventions for early identification and treatment improve outcomes requires investigation.

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Dementia

10.1093/med/9780199664368.003.0011 ◽

2016 ◽

Author(s):

Sathiji Nageshwaran ◽

Heather C Wilson ◽

Anthony Dickenson ◽

David Ledingham

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Vascular Dementia ◽

Frontotemporal Dementia ◽

Clinical Features ◽

Dementia With Lewy Bodies ◽

Lewy Bodies ◽

Evidence Based ◽

Mixed Dementia ◽

Pharmacological Management

This chapter discusses the clinical features and evidence-based pharmacological management of dementia disorders (Alzheimer’s disease (AD), vascular dementia, dementia with Lewy bodies (DLB), Parkinson’s disease dementia (PDD), frontotemporal dementia (FTD), mixed dementia, and mild cognitive impairment (MCI)).

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The Diagnostic and Differential Diagnosis Utility of Cerebrospinal Fluidα-Synuclein Levels in Parkinson’s Disease: A Meta-Analysis

Parkinson s Disease ◽

10.1155/2015/567386 ◽

2015 ◽

Vol 2015 ◽

pp. 1-11 ◽

Cited By ~ 9

Author(s):

Bo Zhou ◽

Min Wen ◽

Wen-Feng Yu ◽

Chun-Lin Zhang ◽

Ling Jiao

Keyword(s):

Cerebrospinal Fluid ◽

Differential Diagnosis ◽

Dementia With Lewy Bodies ◽

Meta Analysis ◽

Lewy Bodies ◽

Diagnostic Biomarker ◽

Inclusion Criteria ◽

Human Cerebrospinal Fluid ◽

Significant Difference ◽

Mean Concentration

Several recent studies showed thatα-syn might be a potential diagnostic biomarker for PD in human cerebrospinal fluid (CSF), but the results were inconsistent. The purpose of this meta-analysis was to investigate the diagnostic and differential diagnosis efficacy of CSFα-syn in PD. Studies which measured CSFα-syn orα-syn oligomers in patients with PD and met the inclusion criteria were included in the analysis. Results of the meta-analysis indicated that mean concentration of CSFα-syn was significantly lower in PD compared to controls and significantly higher in PD compared to multiple system atrophy (MSA). No significant difference in mean concentration of CSFα-syn was found between PD and dementia with Lewy bodies (DLB). Mean concentration of CSFα-syn was slightly decreased in PD compared to progressive supranuclear palsy (PSP). Mean concentration of CSFα-syn oligomers was significantly higher in PD than control. These results support the findings that CSFα-syn may be a potential diagnostic and differential diagnosis biomarker in PD compared to control and MSA but not DLB. Furthermore,α-syn oligomer may represent a better biomarker for diagnosis of PD.

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