The dignity of older individuals with Alzheimer’s disease and related dementias: A scoping review

Dementia ◽  
2021 ◽  
pp. 147130122110217
Author(s):  
Maral R Torossian
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Scoping Review ◽  
Web Of Science ◽  
Sense Of Self ◽  
Older Individuals ◽  
Delivery Of Care ◽  
The Individual ◽  
Narrative Description ◽  
State Of Art

Background Supporting human dignity is the essence of delivery of care. Dignity is one’s sense of self-value that is influenced by the perceived value attributed to the individual from others. Individuals with Alzheimer’s disease and related dementias (ADRD) are at risk of violations of their dignity, due to their diminished autonomy, the alteration in their sense of self, the loss of meaningful social roles, and their limited interactions with peers and confirmation of identity. Objectives A scoping review was conducted to explore the state of art regarding the dignity of individuals with ADRD. Methods: A search was conducted using CINAHL, PubMed, Web of Science, and PsycINFO. Relevant articles were analyzed and organized based on the themes they addressed, and a narrative description of findings was presented. Results Twenty-six articles were included in the review. Findings highlighted characteristics of care that affected the dignity of these individuals. Researchers found that care was task-centered, depersonalized, and lacked a genuine connection. Individuals with ADRD experienced embarrassment, lack of freedom, and powerlessness, which contributed to feelings of being devalued, and threatened their dignity. Studies testing interventions to enhance dignity were either inconclusive, lacked rigor, or had no lasting effect. Conclusion: The dignity of individuals with ADRD may be violated during healthcare interactions. More research is needed to objectively measure the dignity of these individuals and examine the effectiveness of interventions aimed at promoting dignity.

scholarly journals Brain-Derived Exosomal Proteins as Effective Biomarkers for Alzheimer’s Disease: A Systematic Review and Meta-Analysis

Biomolecules ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 980
Author(s):  
Ka-Young Kim ◽  
Ki-Young Shin ◽  
Keun-A. Chang
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Web Of Science ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Blood Biomarkers ◽  
Cell Lineages ◽  
The Central Nervous System ◽  
New Biomarkers ◽  
T Tau

Alzheimer’s disease (AD), a progressive neurodegenerative disease, affects approximately 50 million people worldwide, which warrants the search for reliable new biomarkers for early diagnosis of AD. Brain-derived exosomal (BDE) proteins, which are extracellular nanovesicles released by all cell lineages of the central nervous system, have been focused as biomarkers for diagnosis, screening, prognosis prediction, and monitoring in AD. This review focused on the possibility of BDE proteins as AD biomarkers. The articles published prior to 26 January 2021 were searched in PubMed, EMBASE, Web of Science, and Cochrane Library to identify all relevant studies that reported exosome biomarkers in blood samples of patients with AD. From 342 articles, 20 studies were selected for analysis. We conducted a meta-analysis of six BDE proteins and found that levels of amyloid-β42 (standardized mean difference (SMD) = 1.534, 95% confidence interval [CI]: 0.595–2.474), total-tau (SMD = 1.224, 95% CI: 0.534–1.915), tau phosphorylated at threonine 181 (SMD = 4.038, 95% CI: 2.312-5.764), and tau phosphorylated at serine 396 (SMD = 2.511, 95% CI: 0.795–4.227) were significantly different in patients with AD compared to those in control. Whereas, those of p-tyrosine-insulin receptor substrate-1 and heat shock protein 70 did not show significant differences. This review suggested that Aβ42, t-tau, p-T181-tau, and p-S396-tau could be effective in diagnosing AD as blood biomarkers, despite the limitation in the meta-analysis based on the availability of data. Therefore, certain BDE proteins could be used as effective biomarkers for AD.

scholarly journals The individual course of neuropsychiatric symptoms in people with Alzheimer's and Lewy body dementia: 12-year longitudinal cohort study

2019 ◽  
Vol 216 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Audun Osland Vik-Mo ◽  
Lasse Melvaer Giil ◽  
Miguel Germán Borda ◽  
Clive Ballard ◽  
Dag Aarsland
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Neuropsychiatric Symptoms ◽  
Personalised Medicine ◽  
Lewy Bodies ◽  
Lewy Body Dementia ◽  
Psychotic Symptoms ◽  
Primary Inclusion ◽  
The Individual

IntroductionUnderstanding the natural course of neuropsychiatric symptoms (NPS) in dementia is important for planning patient care and trial design, but few studies have described the long-term course of NPS in individuals.MethodPrimary inclusion of 223 patients with suspected mild dementia from general practice were followed by annual assessment, including the Neuropsychiatric Inventory (NPI), for up to 12 years. Total and item NPI scores were classified as stable, relapsing, single episodic or not present based on 4.96 (s.d. 2.3) observations (98% completeness of longitudinal data) for 113 patients with Alzheimer's disease and 84 patients with LBD (68 dementia with Lewy bodies and 16 Parkinson's disease dementia).ResultsWe found that 80% had stable NPI total ≥1, 50% had stable modest NPI total ≥12 and 25% had stable NPI total ≥24 scores. Very severe NPS (≥48) were mostly single episodes, but 8% of patients with Alzheimer's disease had stable severe NPS. Patients with Alzheimer's disease and the highest 20% NPI total scores had a more stable or relapsing course of four key symptoms: aberrant motor behaviour, aggression/agitation, delusions and irritability (odds ratio 55, P < 0.001). This was not seen in LBD. Finally, 57% of patients with Alzheimer's disease and 84% of patients with LBD had reoccurring psychotic symptoms.ConclusionsWe observed a highly individual course of NPS, with most presenting as a single episode or relapsing; a stable course was less common, especially in LBD. These findings demonstrate the importance of an individualised approach (i.e. personalised medicine) in dementia care.

[P4-279]: THE MEDIAL PREFRONTAL CORTEX SUPPORTS OF THE SENSE OF SELF IN ALZHEIMER's DISEASE

2017 ◽  
Vol 13 (7S_Part_29) ◽  
pp. P1392-P1392
Author(s):  
Nathalie Philippi ◽  
Vincent Noblet ◽  
Anne Botzung ◽  
Hedi Ben Malek ◽  
Benjamin Cretin ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Prefrontal Cortex ◽  
Medial Prefrontal Cortex ◽  
Sense Of Self

scholarly journals Environmental Substances Associated with Alzheimer’s Disease—A Scoping Review

2021 ◽  
Vol 18 (22) ◽  
pp. 11839
Author(s):  
Hanna Maria Elonheimo ◽  
Helle Raun Andersen ◽  
Andromachi Katsonouri ◽  
Hanna Tolonen
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Scoping Review ◽  
Cognitive Abilities ◽  
Human Biomonitoring ◽  
Chemical Exposure ◽  
Priority Substances ◽  
Environmental Chemical ◽  
Other Substances ◽  
Neurological Effects

Alzheimer’s disease (AD) is the most common form of dementia, prevalent in approximately 50–70% of the dementia cases. AD affects memory, and it is a progressive disease interfering with cognitive abilities, behaviour and functioning of the person affected. In 2015, there were 47 million people affected by dementia worldwide, and the figure was estimated to increase to 75 million in 2030 and to 132 million by 2050. In the framework of European Human Biomonitoring Initiative (HBM4EU), 18 substances or substance groups were prioritized for investigation. For each of the priority substances, a scoping document was prepared. Based on these scoping documents and complementary review of the recent literature, a scoping review of HBM4EU-priority substances which might be associated with AD was conducted. A possible association between risk of AD and pesticides was detected. For mercury (Hg), association is possible but inconsistent. Regarding cadmium (Cd) and arsenic (As), the results are inconsistent but inclined towards possible associations between the substances and the risk of disease. The evidence regarding lead (Pb) was weaker than for the other substances; however, possible associations exist. Although there is evidence of adverse neurological effects of environmental substances, more research is needed. Environmental chemical exposure and the related hazards are essential concerns for public health, and they could be preventable.

scholarly journals Spatial inhibition of return is impaired in mild cognitive impairment and mild Alzheimer’s disease

2020 ◽  
Author(s):  
Xiong Jiang ◽  
James H. Howard ◽  
G. Wiliam Rebeck ◽  
R. Scott Turner
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Medial Temporal Lobe ◽  
Inhibition Of Return ◽  
Memory Performance ◽  
Brain Regions ◽  
List Type ◽  
Older Individuals

ABSTRACTSpatial inhibition of return (IOR) refers to the phenomenon by which individuals are slower to respond to stimuli appearing at a previously cued location compared to un-cued locations. Here we provide evidence supporting that spatial IOR is mildly impaired in individuals with mild cognitive impairment (MCI) or mild Alzheimer’s disease (AD), and the impairment is readily detectable using a novel double cue paradigm. Furthermore, reduced spatial IOR in high-risk healthy older individuals is associated with reduced memory and other neurocognitive task performance, suggesting that the novel double cue spatial IOR paradigm may be useful in detecting MCI and early AD.SIGNIFICANCE STATEMENTNovel double cue spatial inhibition of return (IOR) paradigm revealed a robust effect IOR deficits in individuals with mild cognitive impairment (MCI) or mild Alzheimer’s disease (AD)Spatial IOR effect correlates with memory performance in healthy older adults at a elevated risk of Alzheimer’s disease (with a family history or APOE e4 allele)The data suggests that double cue spatial IOR may be sensitive to detect early AD pathological changes, which may be linked to disease progress at the posterior brain regions (rather than the medial temporal lobe)

scholarly journals Short-Term Response to Cholinesterase Inhibitors in Alzheimer’s Disease Delays Time to Nursing Home Placement

2018 ◽  
Vol 15 (10) ◽  
pp. 905-916 ◽  
Author(s):  
Carina Wattmo ◽  
Elisabet Londos ◽  
Lennart Minthon
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Nursing Home Placement ◽  
Specific Response ◽  
Short Term ◽  
Chei Treatment ◽  
The Individual ◽  
Home Placement ◽  
Term Response

Background: A varying response to cholinesterase inhibitor (ChEI) treatment has been reported among patients with Alzheimer’s disease (AD). Whether the individual-specific response directly affects time to nursing home placement (NHP) was not investigated. Objective: We examined the relationship between the 6-month response to ChEI and institutionalization. Methods: In a prospective, observational, multicenter study, 881 outpatients with a clinical AD diagnosis and a Mini-Mental State Examination score of 10-26 at the start of ChEI therapy (baseline) were included. The participants were evaluated using cognitive, global, and activities of daily living (ADL) scales at baseline and semiannually over 3 years. The date of NHP was recorded. Results: During the study, 213 patients (24%) were admitted to nursing homes. The mean ± standard deviation time from baseline (AD diagnosis) to NHP was 20.8 ± 9.3 months. After 6 months of ChEI treatment, the improved/unchanged individuals had longer time to NHP than those who worsened. The prolonged time to NHP was 3 months for cognitive response (P=0.022), 4 months for global response (P=0.004), 6 months for basic ADL response (P<0.001), and 8 months for response in all three scales (P<0.001). No differences were detected between the improved and unchanged groups in any scales. Conclusion: Patients who exhibit a positive short-term response to ChEI can expect to stay in their own home for 3-8 months longer. These findings underline the importance of a comprehensive clinical examination including various assessment scales to evaluate treatment response and provide a more accurate prognosis.

Effects of Exercise in the Treatment of Alzheimer’s Disease: An Umbrella Review of Systematic Reviews and Meta-Analyses

2021 ◽  
pp. 1-17
Author(s):  
Alexandro Andrade ◽  
Thais Cristina Siqueira ◽  
Anderson D’Oliveira ◽  
Fábio Hech Dominski
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Systematic Reviews ◽  
Web Of Science ◽  
Cochrane Library ◽  
Umbrella Review ◽  
Disease Symptoms ◽  
Moderate Quality ◽  
Low Incidence ◽  
Meta Analyses

The authors aimed to provide an overview of the evidence on the effects of exercise in people with Alzheimer’s disease through a comprehensive review of the existing systematic reviews and meta-analyses. A literature search was performed in CINAHL, Cochrane Library, EMBASE, PubMed, SPORTDiscus, Scopus, and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The AMSTAR-2-Tool was used for the quality assessment. Twenty-three reviews fulfilled the criteria. Most of the reviews investigated the effects of aerobic exercise on Alzheimer’s disease symptoms. The largest effects of exercise were seen in terms of improved cognition by multiple exercises. The majority of the reviews were rated as being of moderate quality and none were classified as having high quality. Exercise is an effective way to treat Alzheimer’s disease symptoms and has a low incidence of related adverse events. As most reviews were evaluated as low-moderate quality, caution is needed in the interpretation of the results.

scholarly journals Study of Biomolecular Interactions of Mitochondrial Proteins Related to Alzheimer’s Disease: Toward Multi-Interaction Biomolecular Processes

Biomolecules ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 1214 ◽  
Author(s):  
Erika Hemmerová ◽  
Tomáš Špringer ◽  
Zdeňka Krištofiková ◽  
Jiří Homola
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cyclophilin D ◽  
Ongoing Research ◽  
Binding Partners ◽  
Mitochondrial Functions ◽  
Key Characteristics ◽  
New Perspective ◽  
The Individual

Progressive mitochondrial dysfunction due to the accumulation of amyloid beta (Aβ) peptide within the mitochondrial matrix represents one of the key characteristics of Alzheimer’s disease (AD) and appears already in its early stages. Inside the mitochondria, Aβ interacts with a number of biomolecules, including cyclophilin D (cypD) and 17β-hydroxysteroid dehydrogenase type 10 (17β-HSD10), and affects their physiological functions. However, despite intensive ongoing research, the exact mechanisms through which Aβ impairs mitochondrial functions remain to be explained. In this work, we studied the interactions of Aβ with cypD and 17β-HSD10 in vitro using the surface plasmon resonance (SPR) method and determined the kinetic parameters (association and dissociation rates) of these interactions. This is the first work which determines all these parameters under the same conditions, thus, enabling direct comparison of relative affinities of Aβ to its mitochondrial binding partners. Moreover, we used the determined characteristics of the individual interactions to simulate the concurrent interactions of Aβ with cypD and 17β-HSD10 in different model situations associated with the progression of AD. This study not only advances the understanding of Aβ-induced processes in mitochondria during AD, but it also provides a new perspective on research into complex multi-interaction biomolecular processes in general.

scholarly journals Tratamentos não farmacológicos que melhoram a qualidade de vida de idosos com doença de Alzheimer: uma revisão sistemática

2016 ◽  
Vol 65 (4) ◽  
pp. 334-339 ◽  
Author(s):  
Paula Danielle Palheta Carvalho ◽  
◽  
Celina Maria Colino Magalhães ◽  
Janari da Silva Pedroso
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Pharmacological Treatment ◽  
Web Of Science

RESUMO Objetivo Realizar uma revisão sistemática sobre quais são os tratamentos não farmacológicos que ajudam a melhorar a qualidade de vida (QV) de idosos com doença de Alzheimer (DA) mais descritos na literatura nos últimos dez anos (2006-2016). Métodos Revisão sistemática da literatura realizada nas três primeiras semanas de janeiro de 2016, nas bases: Capes, SciELO, Web of Science, PubMed, Lilacs e Scopus. Foram utilizadas duas combinações de termos: (1) predictors AND quality of life AND elderly AND Alzheimer’s disease e (2) non-pharmacological treatment AND quality of life AND Alzheimer’s disease. Foram encontrados 240 artigos e analisados o título e o resumo dos artigos e, quando necessário, o próprio texto. Do total de 240 artigos, apenas quatro trabalhos preencheram os critérios de inclusão e foram selecionados. Resultados Os resultados mostraram que os tratamentos não farmacológicos mais descritos, no referido período, visando melhorar a QV de idosos com DA, foi a reabilitação, tanto cognitiva quanto multidisciplinar. Conclusão As técnicas de reabilitação mostraram-se capazes de melhorar a QV de idosos com doença de Alzheimer leve.

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