scholarly journals Clinical and demographic characteristics of elderly patients with dementia assisted at an outpatient clinic in Southern Brazil

2010 ◽  
Vol 4 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Cláudia Godinho ◽  
Iulek Gorczevski ◽  
Andréa Heisler ◽  
Maria Otília Cerveira ◽  
Márcia Lorena Chaves

Abstract The aging of the population is a worldwide phenomenon, where 60% of elders live in developing areas of the world such as Brazil, regions in which few studies have been carried out. Objectives: The goal of this study was to evaluate the clinical and demographic profile of patients with dementing disorders seen at a specialized outpatient clinic in South Brazil. Methods: A sample of 105 demented patients seen at the Dementia Outpatient Clinic from Hospital de Clínicas de Porto Alegre (HCPA), Brazil between June 2004 and June 2008. Evaluation of patients consisted of medical history, cognitive testing, assessment of functional status (Activities of Daily Living Scale - ADL; Instrumental Activities Daily Living - IADL) and application of the Neuropsychiatry Inventory (NPI) for behavioral symptoms. Severity of dementia was evaluated based on the CDR scale. All patients underwent laboratory screening tests and brain imaging exams to define etiology of dementia. Results: Of the whole sample, 71% were female. Age was 79±8 years (mean±SD). Educational level was 4±3 years (mean±SD). Sixty-four patients (60%) presented the diagnosis of Alzheimer's disease. Of the whole sample, 26.7% were classified as CDR=1, 44% as CDR=2 and 29. 3% as CDR=3. A significant difference on the Mini Mental State Examination (MMSE) and functional status scores was observed among the CDR categories (severity). No significant association was found between severity and impairment on memory tests and behavioral symptoms. Conclusions: Alzheimer's disease was the most common etiology, followed by vascular dementia. At diagnosis, most patients presented mild to moderate severity of dementia, independent of cause.

2021 ◽  
Vol 80 (2) ◽  
pp. 673-681
Author(s):  
Jin Wang ◽  
Xiaojuan Guo ◽  
Wenhui Lu ◽  
Jie Liu ◽  
Hong Zhang ◽  
...  

Background: Vascular factors and mitochondria dysfunction contribute to the pathogenesis of Alzheimer’s disease (AD). DL-3-n-butylphthalide (NBP) has an effect in protecting mitochondria and improving microcirculation. Objective: The aim was to investigate the effect of donepezil combined NBP therapy in patients with mild-moderate AD. Methods: It was a prospective cohort study. 92 mild-moderate AD patients were classified into the donepezil alone group (n = 43) or the donepezil combined NBP group (n = 49) for 48 weeks. All patients were evaluated with Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-cog), Clinician’s Interview-Based Impression of Change plus caregiver input (CIBIC-plus), Alzheimer’s Disease Cooperative Study-Activities of Daily Living (ADCS-ADL), and Neuropsychiatric Inventory (NPI) every 12 weeks. All patients were monitored for adverse events (AEs). The efficacy was analyzed using multivariate logistic regression analysis. Results: The multivariate logistic regression analysis showed that the changes of ADAS-cog score (OR = 2.778, 95% CI: [1.087, 7. 100], p = 0.033) and ADCS-ADL score (OR = 2.733, 95% CI: [1.002, 7.459], p = 0.049) had significant difference between donepezil alone group and donepezil combined NBP group, while the changes of NPI (OR = 1.145, 95% CI: [0.463, 2.829], p = 0.769), MMSE (OR = 1.563, 95% CI: [0.615, 3.971], p = 0.348) and CIBIC-plus (OR = 2.593, 95% CI: [0.696, 9.685], p = 0.156) had no significant difference. The occurrence of AEs was similar in the two groups. Conclusion: Over the 48-week treatment period, donepezil combined NBP group had slower cognitive decline and better activities of daily living in patients with mild to moderate AD. These indicated that the multi-target therapeutic effect of NBP may be a new choice for AD treatment.


Author(s):  
Zahra Ayati ◽  
Guoyan Yang ◽  
Mohammad Hossein Ayati ◽  
Seyed Ahmad Emami ◽  
Dennis Chang

Abstract Background Saffron (stigma of Crocus sativus L.) from Iridaceae family is a well-known traditional herbal medicine that has been used for hundreds of years to treat several diseases such as depressive mood, cancer and cardiovascular disorders. Recently, anti-dementia property of saffron has been indicated. However, the effects of saffron for the management of dementia remain controversial. The aim of the present study is to explore the effectiveness and safety of saffron in treating mild cognitive impairment and dementia. Methods An electronic database search of some major English and Chinese databases was conducted until 31st May 2019 to identify relevant randomised clinical trials (RCT). The primary outcome was cognitive function and the secondary outcomes included daily living function, global clinical assessment, quality of life (QoL), psychiatric assessment and safety. Rev-Man 5.3 software was applied to perform the meta-analyses. Results A total of four RCTs were included in this review. The analysis revealed that saffron significantly improves cognitive function measured by the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) and Clinical Dementia Rating Scale-Sums of Boxes (CDR-SB), compared to placebo groups. In addition, there was no significant difference between saffron and conventional medicine, as measured by cognitive scales such as ADAS-cog and CDR-SB. Saffron improved daily living function, but the changes were not statistically significant. No serious adverse events were reported in the included studies. Conclusions Saffron may have the potential to improve cognitive function and activities of daily living in patients with Alzheimer’s disease and mild cognitive impairment (MCI). However, due to limited high-quality studies there is insufficient evidence to make any recommendations for clinical use. Further clinical trials on larger sample sizes are warranted to shed more light on its efficacy and safety.


2011 ◽  
Vol 26 (S2) ◽  
pp. 498-498
Author(s):  
M.T. Santos ◽  
G.C. Couto ◽  
J.C. Achieri ◽  
C.A. Júnior

Dementia are increasingly prevalent in population. The most common causes of dementia is Alzheimer's disease (AD). Screening tests have been used for the premature diagnosis of Alzheimer Disease (AD), specifically in the executive functions and language, which are compromised at an initial stage. However, the necessity standardized means and validated for our middle, to show oneself a pressing subject.ObjectiveTo analyze the impact of the length of sentences in the abstraction of proverbs in the Screening Test for Alzheimer's disease with Proverbs (TRDAP), healthy elderly and with Alzheimer's disease at early stage.MethodSurvey document in the database, analyzing the responses of the elderly (abstract or concrete interpretation of proverbs), relating the length of sentences (sayings) of stage B of TRDAP with the diagnosis of Alzheimer's disease and the interference of age and schooling.ResultsHealthy older people showed greater capacity for abstraction than those with AD. There was Significant differences, in the sayings 1 (p = 0.033) and 2 (p = 0.001), corresponding to lower sentences, which did not occur with the proverb 3. As for age no verified significant difference among the healthy and only saying 3 in AD patients, however schooling differenced the healthy.ConclusionElderly with Alzheimer's disease at an initial stage have lower performance in the comprehension of ambiguous sentences, interpretation and abstraction of proverbs, corroborating with the data of the literature. The size of these sentences appears to be inversely proportional to the correctness of interpretation in elderly patients with and without AD.


1997 ◽  
Vol 9 (2) ◽  
pp. 197-206 ◽  
Author(s):  
Frances Oakley ◽  
Trey Sunderland

The purpose of this pilot study was to evaluate the usefulness of the Assessment of Motor and Process Skills (AMPS) as an outcome measure of instrumental activities of daily living (IADL) in pharmacologic studies of people with Alzheimer's disease. The AMPS simultaneously measures motor and process skills and their effect on the ability of the person to perform familiar IADL tasks. We administered the AMPS to 11 Alzheimer inpatients in a 31/2-month, double-blind, placebo-controlled, crossover study of fluoxetine and selegiline administered as single agents and in combination with physostigmine. Results indicated that there was a significant difference in IADL ability among study conditions for process skills, but not for motor skills, thereby suggesting that the AMPS is useful as a sensitive outcome measure of IADL ability in drug trials with this population.


CNS Spectrums ◽  
2005 ◽  
Vol 10 (S18) ◽  
pp. 10-12
Author(s):  
Warachal Eileen Faison

AbstractAlzheimer's disease is a devastating neurological disorder characterized by cognitive deficits, functional impairment, and often troublesome behavioral symptoms. Unfortunately, Alzheimer's disease can be difficult to diagnose at early and even moderate stages of the disease. This article outlines simple, efficient strategies for identifying patients with potential dementia. The discussion focuses on the key components of a comprehensive assessment plan, which typically involves taking the patient's history, as well as conducting cognitive testing, laboratory testing, neurologic examination, and neuroimaging to evaluate patients for Alzheimer's disease. Finally, opportunities for the improvement of care are discussed, with an emphasis on overcoming barriers to diagnosis such as time limitations and reimbursement issues.


2008 ◽  
Vol 2 (4) ◽  
pp. 284-288 ◽  
Author(s):  
Renata Teles Vieira ◽  
Leonardo Caixeta

Abstract Cerebral subcortical atrophy occurs in both Alzheimer's disease (AD) and frontotemporal dementia (FTD) but its significance for clinical manifestations and differential diagnosis between these common types of dementia has not been extensively investigated. Objectives: To compare the severity of cerebral subcortical atrophy in FTD and AD and to analyze the correlations between cerebral subcortical atrophy and demographics and clinical characteristics. Methods: Twenty three patients with FTD and 21 with AD formed the sample, which comprised 22 men and 22 women, aged 33 to 89, with mean age (±SD) of 68.52±12.08 years, with schooling ranging from 1 to 20 years, with a mean (±SD) of 7.35±5.54 years, and disease duration with a mean (±SD) of 3.66±3.44 years. The degree of cerebral subcortical atrophy was measured indirectly with a linear measurement of subcortical atrophy, the Bifrontal Index (BFI), using magnetic resonance imaging. We evaluated cognition, activities of daily living and dementia severity with the Mini-Mental State Examination, Functional Activities Questionnaire and the Clinical Dementia Rating, respectively. Results: There was no significant difference (p>0.05) in BFI between FTD and AD. The severity of cognitive deficits (for both FTD and AD groups) and level of daily living activities (only for AD group) were correlated with BFI. Conclusions: A linear measurement of cerebral subcortical atrophy did not differentiate AD from FTD in this sample. Cognitive function (in both FTD and AD groups) and capacity for independent living (only in AD group) were inversely correlated with cerebral subcortical atrophy.


2017 ◽  
Vol 29 (9) ◽  
pp. 1543-1550 ◽  
Author(s):  
Mehmet Yuruyen ◽  
Gozde Gultekin ◽  
Gizem Cetiner Batun ◽  
Hakan Yavuzer ◽  
Fundan Engin Akcan ◽  
...  

ABSTRACTBackground:Alteration in energy expenditure or metabolism is the most accused risk issue for the onset and for the course of neurodegenerative cognitive disorders. Neuropeptides are suggested to be related with learning and memory. Phoenixin (PNX) is the most recently reported neuropeptide and we aimed to compare the plasma level in people with subjective memory complaints, patients with mild cognitive impairment, and mild Alzheimer's disease (AD).Methods:Ninety two participants enrolled in the study. After screening tests, all participants were assessed with a neuropsychological battery for further cognitive evaluations. We used ELISA kit to assay the level of Human PNX.Results:Patients with AD were significantly older than people in subjective memory complaint group (p = 0.02). There was no significant difference between groups according to gender (p = 0.435). Mean plasma PNX level was not significantly different between groups (p = 0.279). Mean plasma PNX level in MCI group was positively correlated with BMI (r = 0.402 and p = 0.028), serum HDL level (r = 0.454 and p = 0.012), blood systolic pressure (r = 0.428 and p = 0.018) and negatively correlated with logical memory (r=−0.335 and p=0.031). The mean plasma PNX level was positively correlated with immediate recall in subjective memory complaint group (r = 0.417 and p = 0.034).Conclusion:This study is the first studying the association of plasma PNX level and cognitive complaints or decline. The knowledge about the role, interaction, and physiological functions of PNX is lacking. Lower plasma PNX level might be important in prodromal stages as MCI and the predictive role of PNX should be investigated in further studies.


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