scholarly journals Concurrent Validity of the ABC Dementia Scale with Other Standard Scales: A New Comprehensive Instrument for Assessing Dementia in Japan

2021 ◽  
pp. 1-11
Author(s):  
Wataru Shimoda ◽  
Jun Murata ◽  
Akira Nakatani ◽  
Katsuya Satoh
Keyword(s):  
Concurrent Validity ◽  
Psychological Symptoms ◽  
Lewy Bodies ◽  
Clinical Dementia Rating ◽  
Severe Dementia ◽  
Standard Scale ◽  
Argyrophilic Grain ◽  
Severity Of Dementia ◽  
Standard Validity ◽  
Changes Over Time

<b><i>Background/Aims:</i></b> The ABC Dementia Scale (ABC-DS), a new tool for evaluating dementia, was developed in Japan. The ABC-DS is a comprehensive instrument that can simultaneously evaluate activities of daily living (ADLs), behavioral and psychological symptoms of dementia (BPSD), and cognitive function. The ABC-DS can be administered easily and quickly and can clarify the severity of dementia and its changes over time. While the ABC-DS has been reported to be useful in Alzheimer disease (AD)-type dementia, it has not yet been studied in other types of dementia. The purpose of this study was to reevaluate the standard validity of ABC-DS separately for various dementia types and severities. <b><i>Methods:</i></b> We evaluated the ABC-DS in outpatients at 1 hospital in Nagasaki Prefecture and patients who use the facility. Domain A, corresponding to ADLs, correlated with Disability Assessment for Dementia (DAD); domain B, corresponding to BPSD, correlated with the Neuropsychiatric Inventory (NPI); domain C, corresponding to cognitive functions, correlated with Mini-Mental State Examination (MMSE); and the total score of the ABC-DS correlated with the Clinical Dementia Rating (CDR). <b><i>Results:</i></b> 102 patients, comprising 38 males and 64 females with an average age of 80.7 ± 8.6 years, were enrolled. AD-type dementia was present in 38 cases, vascular dementia (VaD) in 23, mixed dementia in 23, dementia with Lewy bodies in 6, argyrophilic grain dementia in 9, and mild cognitive impairment in 3. A strong correlation was found between ABC-DS domain scores and their respective reference neuropsychological instruments (domain A and the DAD, domain B and the NPI, domain C and the MMSE, and total score and CDR). The correlation of each ABC-DS domain score with the corresponding standard scale depended on the type and severity of dementia, and we observed moderate or high correlations in AD and VaD patients with moderate and severe dementia. <b><i>Discussion:</i></b> Although the ABC-DS targets AD, it can be used in VaD based on the results of this study. In other types of dementia, the results differed depending on the domain; in some conditions, the ABC-DS may not show sufficient concurrent validity with other standard scales. Also, the ABC-DS is more beneficial for moderate-to-severe dementia, as reported in previous studies. It is highly useful in clinical practice in Japan since there more than half of all patients have moderate-to-severe dementia.

Effectiveness of treatment in wards for patients with dementia and issues associated with this treatment: A prospective analysis

Dementia ◽  
2017 ◽  
Vol 18 (5) ◽  
pp. 1751-1763 ◽  
Author(s):  
Shogo Taniguchi ◽  
Teruyuki Matsuoka ◽  
Takeshi Hikawa ◽  
Atsushi Machihara ◽  
Keisuke Shibata ◽  
...  
Keyword(s):  
Nursing Home ◽  
Length Of Stay ◽  
Scale Score ◽  
Psychological Symptoms ◽  
Prospective Analysis ◽  
Neuropsychiatric Inventory ◽  
Clinical Dementia Rating ◽  
Severity Of Dementia ◽  
Distress Scale ◽  
Behavioral And Psychological Symptoms

In order to optimize the treatment in wards for patients with dementia, we investigated predictors of the length of stay in the ward for patients with dementia. A prospective analysis of 72 patients with dementia was conducted in two wards for patients with dementia. Severity of dementia was assessed by the Clinical Dementia Rating, basic activities of daily living were evaluated using the Physical Self-Maintenance Scale, and severity of behavioral and psychological symptoms of dementia and caregiver distress were determined with the Nursing Home version of the Neuropsychiatric Inventory. Stepwise regression analysis was used to identify predictors of the length of stay. Fewer patients were discharged to home compared to those discharged to institutions or transferred to a different hospital or ward. The mean length of stay was 92.0 days. Clinical Dementia Rating and total distress scale score on the Nursing Home version of the Neuropsychiatric Inventory were significant independent predictors of the length of stay. The total Nursing Home version of the Neuropsychiatric Inventory score and total distress scale score on the Nursing Home version of the Neuropsychiatric Inventory were significantly improved through treatment. Our results suggest that treatment in the wards for patients with dementia is effective for improvement of behavioral and psychological symptoms of dementia. However, some patients could not be discharged to their home despite improvement of behavioral and psychological symptoms of dementia, and this may be related to caregiver burden at admission.

scholarly journals Classification of Dementia Severity in Taiwan Based on History-Based Clinical Diagnosis System

2020 ◽  
Vol 35 ◽  
pp. 153331752097078
Author(s):  
Yun Fah Chang ◽  
Woan Yee Loi ◽  
Pai-Yi Chiu ◽  
Huang-Nan Huang
Keyword(s):  
Rating Scale ◽  
Clinical Dementia Rating ◽  
Severe Dementia ◽  
Dementia Patients ◽  
Moderate Dementia ◽  
Solid Foundation ◽  
Severity Levels ◽  
Diagnosis Tool ◽  
Severity Of Dementia

Background/Aims: This study used HAICDDS screening questionnaire to classify the severity of dementia in Taiwan based on the clinical dementia rating scale. Methods: LDA was applied to 6,328 Taiwanese clinical patients for classification purposes. Clustering method was used to identify the associated influential symptoms for each severity level. Result: LDA shows only 36 HAICDDS questions are significant to distinguish the 5 severity levels with 80% overall accuracy and it increased to 85.83% when combining normal and MCI groups. Severe dementia patients have the most serious declination in most cognitive and functionality domains, follows by moderate dementia, mild dementia, MCI and normal patients. Conclusion: HAICDDS is a reliable and time-saved diagnosis tool in classifying the severity of dementia before undergoing a more in-depth clinical examination. The modified CDR may be indicated for epidemiological study and provide a solid foundation to develop a machine-learning derived screening instrument to detect dementia symptoms.

Profile and variables related to antipsychotic consumption according to dementia subtypes

2012 ◽  
Vol 24 (6) ◽  
pp. 940-947 ◽  
Author(s):  
Laia Calvó-Perxas ◽  
Rosa María de Eugenio ◽  
Fabian Marquez-Daniel ◽  
Raül Martínez ◽  
Joaquín Serena ◽  
...  
Keyword(s):  
Psychological Symptoms ◽  
Anatomical Therapeutic Chemical ◽  
Lewy Bodies ◽  
Binary Logistic Regression ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Passive Surveillance System ◽  
Poor Outcomes ◽  
Severity Of Dementia

ABSTRACTBackground: Antipsychotics (APs) are usually prescribed to deal with behavioral and psychological symptoms of dementia (BPSD), but poor outcomes, important side effects, and high mortality risk should be addressed. The aim of this study was to estimate the prevalence of AP consumption in patients with dementia, and to describe and compare the sociodemographic and clinical characteristics of patients consuming APs.Methods: This was a cross-sectional study using 1,894 cases of dementia registered from 2007 to 2009 by the Registry of Dementias of Girona (ReDeGi), which is a population-based passive surveillance system of dementia diagnoses. APs were categorized according to the anatomical therapeutic chemical (ATC) classification, and grouped as typical antipsychotics (TAPs) or atypical antipsychotics (AAPs). Binary logistic regression analyses were used to detect the predictors of AP use as well as the variables associated with TAP or AAP prescription.Results: APs were used in 29.6% of the cases, with Parkinsonian syndromes (PSd) being the subtype of dementia with the highest AP prescription (50.6% of the patients with PSd). AAPs were mainly prescribed in all subtypes of dementia, except in vascular dementia (VaD) and PSd, where no preference in TAP or AAP use was found. Psychotic antecedents, dementia with Lewy bodies (DLB) diagnoses, cognitive impairment, and BPSD were AP use predictors. AAP use was related to higher severity of dementia.Conclusions: Despite their disputed benefit–risk ratios, APs are extensively used, off-label, to treat BPSD, and AAPs are more commonly prescribed than TAPs. AP consumption was frequent in DLB, and was related to dementia severity indicators.

Prevalence and Severity of Dementia in Nursing Home Residents

2015 ◽  
Vol 40 (3-4) ◽  
pp. 166-177 ◽  
Author(s):  
Anne-Sofie Helvik ◽  
Knut Engedal ◽  
Jūratė Šaltytė Benth ◽  
Geir Selbæk
Keyword(s):  
Nursing Home ◽  
Rating Scale ◽  
Unit Length ◽  
Nursing Home Residents ◽  
Linear Regression Models ◽  
Clinical Dementia Rating ◽  
Severe Dementia ◽  
People With Dementia ◽  
Severity Of Dementia ◽  
Single Men

Background/Aims: The aim of this study was to compare the presence and severity of dementia in two large cross-sectional samples of nursing home residents from 2004/2005 and 2010/2011. Methods: Demographic information as well as data on the type of nursing home unit, length of stay before assessment, physical health, regularly used prescribed drugs and Clinical Dementia Rating scale scores were used in the analyses. Logistic and linear regression models for hierarchical data were estimated. Results: The odds of the occurrence and of a greater severity of dementia were higher in 2010/2011 than in 2004/2005. Independent of the time of study, married men had more severe dementia than single men, and single women had more severe dementia than single men. Conclusion: The findings may reflect the increase in the need for more nursing home beds designed for people with dementia between 2004/2005 and 2010/2011.

scholarly journals Behavioural and Psychological Symptoms of Dementia: Correlates and Impact on Caregiver Distress

2017 ◽  
Vol 7 (3) ◽  
pp. 354-365 ◽  
Author(s):  
Adreesh Mukherjee ◽  
Atanu Biswas ◽  
Arijit Roy ◽  
Samar Biswas ◽  
Goutam Gangopadhyay ◽  
...  
Keyword(s):  
Psychological Symptoms ◽  
Lewy Bodies ◽  
Cross Sectional Study ◽  
Caregiver Distress ◽  
Cross Sectional ◽  
Dementia Patients ◽  
Behavioural And Psychological Symptoms ◽  
Severity Of Dementia ◽  
Distress Scale ◽  
The Impact

Aims: To evaluate the behavioural and psychological symptoms of dementia (BPSD), to determine their correlation with types and stages of dementia and patient demographics, and to assess the impact on caregiver distress. Methods: This cross-sectional study recruited consecutive dementia patients and caregivers who attended our cognitive clinic. Standard criteria were used to classify types of dementia. BPSD were assessed with the Neuropsychiatric Inventory, and its distress scale was used for caregiver distress. Results: Of a total 107 patients, nearly all (99.1%) had at least one BPSD; 71% had ≥4 symptoms. Most frequent were apathy and agitation, followed by irritability, sleep and appetite disorders, and mood disorders; disinhibition and euphoria were least frequent. BPSD were less prominent with increasing age; males showed more agitation. Apathy and eating disorders were more prevalent in the rural community. BPSD were highest in frontotemporal dementia (FTD), followed by dementia with Lewy bodies (DLB), and least in vascular dementia. Hallucinations were more common in DLB, aberrant motor behaviour in FTD. All domains of BPSD, except for anxiety and euphoria, were more prominent with increasing severity of dementia. Increasing BPSD (except for euphoria) caused higher caregiver distress. Conclusion: BPSD are universally present, bear correlates with dementia type and severity, and cause significant caregiver distress.

scholarly journals Relationship between Dementia Severity and Behavioral and Psychological Symptoms of Dementia in Dementia with Lewy Bodies and Alzheimer's Disease Patients

2015 ◽  
Vol 5 (2) ◽  
pp. 244-252 ◽  
Author(s):  
Mamoru Hashimoto ◽  
Yusuke Yatabe ◽  
Tomohisa Ishikawa ◽  
Ryuji Fukuhara ◽  
Keiichiro Kaneda ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Dementia With Lewy Bodies ◽  
Psychiatric Symptoms ◽  
Psychological Symptoms ◽  
Lewy Bodies ◽  
Clinical Dementia Rating ◽  
Significant Difference ◽  
The Impact ◽  
Behavioral And Psychological Symptoms

Background/Aims: Behavioral and psychological symptoms of dementia (BPSD) are common in the clinical manifestation of dementia. Although most patients with dementia exhibit some BPSD during the course of the illness, the association of BPSD with the stage of dementia remains unclear. It was the aim of this study to evaluate the impact of severity of dementia on the expression of BPSD in patients with dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). Methods: Ninety-seven patients with DLB and 393 patients with AD were recruited from 8 dementia clinics across Japan. BPSD were assessed by the Neuropsychiatric Inventory (NPI). A relationship between BPSD and dementia stage classified by the Clinical Dementia Rating (CDR) in each type of dementia was assessed. Results: No significant difference was seen in NPI total score across CDR staging in the DLB group. On the other hand, the NPI total score significantly increased with dementia stage in the AD group. Conclusion: The relationship of dementia stage with the expression of BPSD was different according to the type of dementia. BPSD and dementia stage were correlated in AD subjects, in whom psychiatric symptoms increase as the disease progresses, but not in DLB subjects.

scholarly journals Impact of Social Isolation on People with Dementia and Their Family Caregivers

2021 ◽  
pp. 1-11
Author(s):  
Lílian Viana dos Santos Azevedo ◽  
Ismael Luis Calandri ◽  
Andrea Slachevsky ◽  
Héctor Gastón Graviotto ◽  
Maria Carolina Santos Vieira ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Social Isolation ◽  
Clinical Symptoms ◽  
Memory Function ◽  
South American ◽  
Severe Dementia ◽  
Dementia Caregivers ◽  
People With Dementia ◽  
Moderate Dementia ◽  
Severity Of Dementia

Background: People with dementia and their family caregivers may face a great burden through social isolation due to the COVID-19 pandemic, which can be manifested as various behavioral and clinical symptoms. Objective: To investigate the impacts of social isolation due to the COVID-19 pandemic on individuals with dementia and their family caregivers. Methods: Two semi-structured questionnaires were applied via telephone to family caregivers of people diagnosed with dementia in three cities in Argentina, Brazil, and Chile, in order to assess clinical and behavioral changes in people with dementia and in their caregivers. Results: In general, 321 interviews were conducted. A significant decline in memory function has been reported among 53.0%of people with dementia. In addition, 31.2%of individuals with dementia felt sadder and 37.4%had increased anxiety symptoms. These symptoms of anxiety were greater in individuals with mild to moderate dementia, while symptoms of agitation were greater in individuals with severe dementia. Moreover, compulsive-obsessive behavior, hallucinations, increased forgetfulness, altered appetite, and increased difficulty in activities of daily living were reported more frequently among individuals with moderate to severe dementia. Caregivers reported feeling more tired and overwhelmed during this period and these symptoms were also influenced by the severity of dementia. Conclusion: Social isolation during the COVID-19 pandemic triggered a series of negative behavioral repercussions, both for people with dementia and for their family caregivers in these three South American countries.

scholarly journals The Relationship between Clinic Visit Accompanied by Family and Dementia Severity in Taiwan

2021 ◽  
Vol 18 (4) ◽  
pp. 1792
Author(s):  
Chih-Yen Chang ◽  
Shou-Jen Lan ◽  
Chiao-Lee Chu ◽  
Ching-Sung Ho
Keyword(s):  
Educational Level ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Clinic Visit ◽  
Clinical Dementia Rating ◽  
Score Distribution ◽  
Chi Square ◽  
Cross Sectional ◽  
Central Taiwan ◽  
Severity Of Dementia

Introduction: This study analyzes the severity of dementia status with clinical dementia rating (CDR) score distribution among patients according to various family functional and sociodemographic issues. Methods: A cross-sectional study was performed in a regional hospital in Central Taiwan. The sample consisted of 318 patients who came to the clinic from May 2018 to April 2019, and who were diagnosed by the physicians with CDR scores ≧ 0.5. The Chi-Square test and binary logistic regression analyses were performed for inferential statistical analysis. Results: The mean age of the sample was 78.7 ± 8.51 years, and 61.6% of the samples’ CDR scores were equal or less than 1.0. Patients visiting the clinic were accompanied by spouses (21.7%), sons or daughters-in-law (40.6%), daughters (23.6%). Of the sample, 142 (44.3%) patients live with sons. Patients with a lower educational level had higher CDR scores. Compared to the patients who went to the clinic by themselves, the higher OR values of CDR scores ≧ 2 are found in patients who were accompanied by other relatives (OR = 18.871, 95% C.I. = 3.117–114.237, p = 0.001), or spouse (OR = 10.783, 95% C.I. = 1.996–58.245, p = 0.006). Conclusion: The family member who accompanied the patient to a clinic visit and the patient’s educational level are both significant issues relating to the severity of dementia.

Can Medial Temporal Impairment Be an Imaging Red Flag for Neurodegeneration in Disproportionately Enlarged Subarachnoid Space Hydrocephalus?

2021 ◽  
pp. 1-11
Author(s):  
Keita Sakurai ◽  
Daita Kaneda ◽  
Yuto Uchida ◽  
Shohei Inui ◽  
Masahiko Bundo ◽  
...  
Keyword(s):  
Neurodegenerative Diseases ◽  
Subarachnoid Space ◽  
Lewy Bodies ◽  
Normal Pressure ◽  
Temporal Horn ◽  
Red Flag ◽  
Argyrophilic Grain ◽  
Magnetic Resonance Imaging Mri ◽  
Specific Symptoms ◽  
Multiple Cerebral Infarctions

Background: The differentiation of idiopathic normal pressure hydrocephalus (iNPH) from neurodegenerative diseases such as Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB) is often challenging because of their non-specific symptoms. Therefore, various neuroradiological markers other than ventriculomegaly have been proposed. Despite the utility of disproportionately enlarged subarachnoid-space hydrocephalus (DESH) for the appropriate selection of shunt surgery candidates, the specificity and neuropathology of this finding have not been sufficiently evaluated. Objective: Investigation of the clinicopathological features and comparison of the neuroradiological findings between DESH with postmortem neuropathological diagnoses (pDESH) and clinically-diagnosed iNPH (ciNPH) patients are the main purposes of this study. Method: In addition to the retrospective evaluation of clinicopathological information, quantitative, semiquantitative, and qualitative magnetic resonance imaging (MRI) indices were compared between pathologically-investigated 10 patients with pDESH and 10 patients with ciNPH Results: Excluding one patient with multiple cerebral infarctions, the postmortem neuropathological diagnoses of the pathologically-investigated patients were mainly neurodegenerative diseases (five AD, one DLB with AD pathologies, one DLB, one argyrophilic grain disease, and one Huntington’s disease). In addition to the common neuroradiological features Conclusion: Hippocampal atrophy and deformation with temporal horn enlargement seem to be characteristic neuroradiological findings of long-standing severely demented patients with DESH and neurodegenerative diseases, mainly advanced-stage AD.

scholarly journals Educational bias in the assessment of severe dementia: Brazilian cutoffs for severe Mini-Mental State Examination

2014 ◽  
Vol 72 (4) ◽  
pp. 273-277 ◽  
Author(s):  
José Roberto Wajman ◽  
Fabricio Ferreira de Oliveira ◽  
Rodrigo Rizek Schultz ◽  
Sheilla de Medeiros Correia Marin ◽  
Paulo Henrique Ferreira Bertolucci
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Cognitive Responses ◽  
Clinical Dementia Rating ◽  
Severe Dementia ◽  
Advanced Stages ◽  
State Examination

Cognitive assessment in advanced stages of Alzheimer’s disease (AD) is limited by the imprecision of most instruments. Objective: To determine objective cognitive responses in moderate and severe AD patients by way of the Severe Mini-Mental State Examination (SMMSE), and to correlate performances with Mini-Mental State Examination (MMSE) scores. Method: Consecutive outpatients in moderate and severe stages of AD (Clinical Dementia Rating 2.0 or 3.0) were evaluated and compared according to MMSE and SMMSE scores. Results: Overall 400 patients were included, 67.5% females, mean age 76.6±6.7 years-old. There was no significant impact of age or gender over MMSE or SMMSE scores. Mean schooling was 4.4±2.5 years, impacting SMMSE scores (p=0.008). Scores on MMSE and SMMSE were significantly correlated (F-ratio=690.6325, p<0.0001). Conclusion: The SMMSE is influenced by schooling, but not by age or gender, and is an accurate test for assessment of moderate and severe AD.

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