Effectiveness of the On-the-Spot-EMDR Method for the Treatment of Behavioral Symptoms in Patients With Severe Dementia

2014 ◽  
Vol 8 (2) ◽  
pp. 50-65 ◽  
Author(s):  
Tamaki Amano ◽  
Motomi Toichi
Keyword(s):  
Psychological Symptoms ◽  
Behavioral Symptoms ◽  
Future Research ◽  
Long Term Memory ◽  
Therapeutic Effects ◽  
Severe Dementia ◽  
Traumatic Symptoms ◽  
Behavioral And Psychological Symptoms

Although the main symptoms of dementia consist of neuropsychological impairment, particularly long-term memory, dementia often involves severe behavioral and psychological symptoms of dementia (BPSD). There are quite a few patients whose BPSD are untreatable with medication. Such BPSD often have some characteristics similar to traumatic symptoms and appear related to the recollection of disturbing past traumatic events. Because the standard protocol of eye movement desensitization and reprocessing (EMDR) is not directly applicable to patients with dementia, we developed a modified protocol, the on-the-spot-EMDR method. This study describes the protocol and evaluates its application to three patients with moderate to severe dementia. Clear therapeutic effects were evident, and all three individuals showed pronounced improvement in BPSD, with results maintained at 6-month follow-up. The relevance of these findings is discussed and suggestions made for future research.

scholarly journals Rationale, Design, and Methodology of a Prospective Cohort Study for Coping with Behavioral and Psychological Symptoms of Dementia: The RECage Project

2021 ◽  
Vol 80 (4) ◽  
pp. 1613-1627
Author(s):  
Eleni Poptsi ◽  
Magda Tsolaki ◽  
Sverre Bergh ◽  
Bruno Mario Cesana ◽  
Alfonso Ciccone ◽  
...  
Keyword(s):  
Cohort Study ◽  
Psychotropic Drug ◽  
Psychological Symptoms ◽  
Cost Of Care ◽  
Community Dwelling ◽  
Drug Consumption ◽  
Study Results ◽  
Short And Long Term ◽  
Behavioral And Psychological Symptoms

Background: Behavioral and psychological symptoms of dementia (BPSD) are quite challenging problems during the dementia course. Special Care Units for people with dementia (PwD) and BPSD (SCU-B) are residential medical structures, where BPSD patients are temporarily admitted, in case of unmanageable behavioral disturbances at home. Objective: RECage (REspectful Caring for AGitated Elderly) aspires to assess the short and long-term effectiveness of SCU-Bs toward alleviating BPSD and improving the quality of life (QoL) of PwD and their caregivers. Methods: RECage is a three-year, prospective study enrolling 500 PwD. Particularly, 250 community-dwelling PwDs presenting with severe BPSD will be recruited by five clinical centers across Europe, endowed with a SCU-B, for a short period of time; a second similar group of 250 PwD will be followed by six other no-SCU-B centers solely via outpatient visits. RECage’s endpoints include short and long-term SCU-B clinical efficacy, QoL of patients and caregivers, cost-effectiveness of the SCU-B, psychotropic drug consumption, caregivers’ attitude toward dementia, and time to nursing home placement. Results: PwD admitted in SCU-Bs are expected to have diminished rates of BPSD and better QoL and their caregivers are also expected to have better QoL and improved attitude towards dementia, compared to those followed in no-SCU-Bs. Also, the cost of care and the psychotropic drug consumption are expected to be lower. Finally, PwD followed in no-SCU-Bs are expected to have earlier admission to nursing homes. Conclusion: The cohort study results will refine the SCU-B model, issuing recommendations for implementation of SCU-Bs in the countries where they are scarce or non-existent.

scholarly journals The impact of lockdown during SARS-CoV-2 outbreak on behavioral and psychological symptoms of dementia

2021 ◽  
Vol 42 (3) ◽  
pp. 825-833
Author(s):  
Arianna Manini ◽  
Michela Brambilla ◽  
Laura Maggiore ◽  
Simone Pomati ◽  
Leonardo Pantoni
Keyword(s):  
Logistic Regression ◽  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Community Dwelling ◽  
Caregiver Distress ◽  
Neuropsychiatric Inventory ◽  
Logistic Regression Models ◽  
The Impact ◽  
Behavioral And Psychological Symptoms

Abstract Background During Covid-19 pandemic, the Italian government adopted restrictive limitations and declared a national lockdown on March 9, which lasted until May 4 and produced dramatic consequences on people’s lives. The aim of our study was to assess the impact of prolonged lockdown on behavioral and psychological symptoms of dementia (BPSD). Methods Between April 30 and June 8, 2020, we interviewed with a telephone-based questionnaire the caregivers of the community-dwelling patients with dementia who had their follow-up visit scheduled from March 9 to May 15 and canceled due to lockdown. Among the information collected, patients’ BPSDs were assessed by the Neuropsychiatric Inventory (NPI). Non-parametric tests to compare differences between NPI scores over time and logistic regression models to explore the impact of different factors on BPSD worsening were performed. Results A total of 109 visits were canceled and 94/109 caregivers completed the interview. Apathy, irritability, agitation and aggression, and depression were the most common neuropsychiatric symptoms experienced by patients both at baseline and during Covid-19 pandemic. Changes in total NPI and caregiver distress scores between baseline and during lockdown, although statistically significant, were overall modest. The logistic regression model failed to determine predictors of BPSD worsening during lockdown. Conclusion This is one of the first studies to investigate the presence of BPSD during SARS-CoV-2 outbreak and related nationwide lockdown, showing only slight, likely not clinically relevant, differences in BPSD burden, concerning mostly agitation and aggression, anxiety, apathy and indifference, and irritability.

scholarly journals Factors related to sense of competence in family caregivers of people living with dementia in the community: a narrative synthesis

2018 ◽  
Vol 31 (06) ◽  
pp. 799-813 ◽  
Author(s):  
Jacki Stansfeld ◽  
Nadia Crellin ◽  
Martin Orrell ◽  
Jennifer Wenborn ◽  
Georgina Charlesworth ◽  
...  
Keyword(s):  
Psychological Symptoms ◽  
Future Research ◽  
Narrative Synthesis ◽  
Review Of The Literature ◽  
Factors Associated ◽  
Sense Of Competence ◽  
Proposed Model ◽  
Quality Rating ◽  
Clinical Concept ◽  
Behavioral And Psychological Symptoms

ABSTRACTObjectives:Sense of competence defines a caregiver’s feeling of being capable to manage the caregiving task and is an important clinical concept in the caregiving literature. The aim of this review was to identify the factors, both positive and negative, associated with a caregiver’s perception of their sense of competence.Design:A systematic review of the literature was conducted, retrieving both quantitative and qualitative papers from databases PsycINFO, CINAHL, EMBASE, and Medline. A quality assessment was conducted using the STROBE and CASP checklists, and the quality rating informed the inclusion of papers ensuring the evidence was robust. Narrative synthesis was employed to synthesize the findings and to generate an updated conceptual model of sense of competence.Results:Seventeen papers were included in the review, all of which were moderate to high quality. These included 13 quantitative, three mixed-methods and one qualitative study. Factors associated with sense of competence included: behavioral and psychological symptoms of dementia (BPSD), caregiver depression, gratitude, and the ability to find meaning in caregiving.Conclusions:The results of this review demonstrate that both positive and negative aspects of caring are associated with caregiver sense of competence. Positive and negative aspects of caregiving act in tandem to influence caregiver perception of their competence. The proposed model of sense of competence aims to guide future research and clinical interventions aimed at improving this domain but requires further testing, as due to the observational nature of the include papers, the direction of causality could not be inferred.

scholarly journals Age differences in the precision of memory at short and long delays

2019 ◽  
Author(s):  
Stephen Rhodes ◽  
Emily E Abenne ◽  
Ashley M Meierhofer ◽  
Moshe Naveh-Benjamin
Keyword(s):  
Older Adults ◽  
Age Differences ◽  
Long Term Memory ◽  
Age Difference ◽  
Younger Adults ◽  
Recall Error ◽  
Successful Recall ◽  
Error Distance

Age differences are well established for many memory tasks assessing both short-term and long-term memory. However, how age differences in performance vary with increasing delay between study and test is less clear. Here we report two experiments in which participants studied a continuous sequence of object-location pairings. Test events were intermixed such that participants were asked to recall the precise location of an object following a variable delay. Older adults exhibit a greater degree of error (distance between studied and recalled locations) relative to younger adults at short (0-2 intervening events) and longer delays (10-25 intervening events). Mixture modeling of the distribution of recall error suggests that older adults do not fail to recall information at a significantly higher rate than younger adults. Instead, what they do recall appears to be less precise. Follow up analyses demonstrate that this age difference emerges following only one or two intervening events between study and test. These findings are consistent with the suggestion that aging does not greatly impair recall from the focus of attention but age differences emerge once information is displaced from this highly accessible state. Further, we suggest that age differences in the precision of memory, but not the probability of successful recall, may be due to the use of more gist-like representations in this task.

scholarly journals Response to BNT162b2 mRNA COVID-19 vaccine among healthcare workers in Italy: a 3-month follow-up

2021 ◽  
Author(s):  
Domenico Ponticelli ◽  
Fabiana Madotto ◽  
Sara Conti ◽  
Ippazio C. Antonazzo ◽  
Andrea Vitale ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Future Research ◽  
Nasopharyngeal Swab ◽  
Special Focus ◽  
Rt Pcr ◽  
Vaccine Response ◽  
Serology Testing ◽  
Effectiveness Data

AbstractThis study investigated the response to BNT162b2 mRNA COVID-19 vaccine among healthcare workers (HCWs) in an Italian teaching hospital. 444 participants were surveyed with either multiple RT-PCR assays for detection of SARS-CoV-2 nucleic acid in nasopharyngeal swabs or serology testing for the research of virus-specific immunoglobulins. Adverse events following immunization (AEFI) were reported. Two weeks after the first dose anti-SARS-CoV-2 antibodies exceeded reactivity cut-off in 82.5% the participants. Four HCWs tested positive at nasopharyngeal swab after 3 months. More than three-quarters reported AEFIs. Our findings offer an insight regarding the vaccine response after 3 months from its administration, with a special focus on effectiveness data, as well as the type and number of AEFIs complained by HCW recipients. The presented study may serve as reference for future research which will be necessary to explore the long-term safety of this vaccine, especially in population at high risk for infection, such as HCWs.

Abstract 11503: Mindfulness is Inversely Associated with Psychological Symptoms in Long-Term Cardiac Arrest Survivors

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Alex Presciutti ◽  
Jonathan Greenberg ◽  
Ethan Lester ◽  
Mary M Newman ◽  
Jonathan Elmer ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Protective Factor ◽  
Psychological Symptoms ◽  
Sudden Cardiac Arrest ◽  
Survey Study ◽  
Present Moment ◽  
Cross Sectional ◽  
Patient Health

Introduction: We sought to identify correlates with psychological symptoms in long-term cardiac arrest (CA) survivors. Mindfulness, or nonjudgmental awareness of the present moment, is a modifiable protective factor against psychological symptoms in various clinical populations and could be a potential treatment target for CA survivors. Methods: We conducted a longitudinal survey study between 10-11/2019 (baseline) and 10-11/2020 (1-year follow-up) with long-term CA survivor members of the Sudden Cardiac Arrest Foundation. We collected demographic and CA characteristics at baseline. At both timepoints, we assessed posttraumatic stress symptoms (PTS) through the PTSD Checklist-5 (PCL-5) and depression and anxiety symptoms through the Patient Health Questionnaire-4 (PHQ-4). At follow-up, we assessed mindfulness through the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R). We used adjusted linear regression to predict 1-year PCL-5 and PHQ-4 scores, with particular consideration of the CAMS-R as a cross-sectional correlate of outcome. Results: We included 129 CA survivors (mean age: 52 years, 52% male, 98% white). At 1-year follow-up, in adjusted models, CAMS-R (β: -0.35, p <0.001) and baseline PCL-5 scores (β: 0.56, p <0.001) were associated with 1-year PCL-5 scores. CAMS-R (β: -0.34, p <0.001) and baseline PHQ-4 scores were associated with 1-year PHQ-4 scores (β: 0.37, p<0.001). Conclusion: Mindfulness was inversely associated with psychological symptoms in long-term CA survivors. Future studies should examine the longitudinal relationship of mindfulness and psychological symptoms after CA.

scholarly journals THALIDOMIDE FOR PATIENTS WITH THALASSEMIA INTERMEDIA: A RETROSPECTIVE MULTICENTER CLINICAL STUDY

2020 ◽  
Vol 12 (1) ◽  
pp. e2020021
Author(s):  
Kun Yang ◽  
Yi Wu ◽  
Yali Zhou ◽  
Tianhong Zhou ◽  
Li Wang ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Laboratory Data ◽  
Drug Discontinuation ◽  
Therapeutic Effects ◽  
Efficacy And Safety ◽  
Thalassemia Intermedia ◽  
Short Term ◽  
Long Term Follow Up

Objective: This study focused on the efficacy and safety of thalidomide for patients with thalassemia intermedia (TI) in a multicenter trial. Methods：Clinical and laboratory data of 62 patients subjected to thalidomide therapy in four centers were retrospectively analyzed. We evaluated the efficacy and safety of thalidomide in the short-term (three months) and long-term follow-up (12 and 24 months). Response to thalidomide was defined as follows: Main Responder (MaR) showing an increase in Hb level of >2.0 g/dl or removal from blood transfusion and Minor Responder (MiR) achieving elevated hemoglobin (Hb) level of 1.0-2.0 g/dl or ≥50% reduction in blood transfusion frequency. Results：The overall response rate (ORR) of 62 patients with TI was 93.5% (58/62), with MaR and MiR rates accounting for 62.9% (39/62) and 30.6% (19/62) in short-term follow-up and 66.1% (41/62) and 27.4% (17/62) in long-term follow-up, respectively. The clinical response during long-term follow-up was maintained and the Hb level remained stable during the observation period. The response was still observed in patients with dose reduction despite a slight decrease in Hb level. However, Hb decreased rapidly to the baseline level after drug discontinuation. No effect of thalidomide on spleen size in nonsplenectomized patients was evident. Minimal side-effects were documented throughout, except peripheral neurotoxicity in one patient. Nevertheless, the mean serum ferritin (SF) level was significantly increased after treatment. Conclusion: Thalidomide had significant therapeutic effects on patients with TI, and the response was sustained with acceptable short-term and long-term adverse reactions. While these preliminary results support the potential long-term efficacy and safety of thalidomide as a therapeutic agent for TI, several issues need to be addressed before its application in the clinic.

scholarly journals Shen-Zhi-Ling Oral Liquid Improves Behavioral and Psychological Symptoms of Dementia in Alzheimer’s Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Weidong Pan ◽  
Qiudong Wang ◽  
Shin Kwak ◽  
Yu Song ◽  
Baofeng Qin ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Rating Scale ◽  
Psychological Symptoms ◽  
Fluctuation Analysis ◽  
Double Blind ◽  
Oral Liquid ◽  
Detrended Fluctuation ◽  
Behavioral And Psychological Symptoms

We evaluated the effects of the traditional Chinese medicine (TCM) Shen-Zhi-Ling oral liquid (SZL) on the behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer’s disease (AD). Among 98 patients with AD and BPSD enrolled (mean age, 57.2 ± 8.9 years old), 91 (M = 55,F = 36; mean age, 57.2 ± 9.7 years old) completed the study. Patients took either SZL (n=45) or placebo granules (n=46) in a double-blind manner for 20 weeks while maintaining other anticognitive medications unchanged. Changes in BPSD between week 0, week 10, week 20, and week 25 were assessed using the behavioral pathology in Alzheimer’s disease (BEHAVE-AD) rating scale and the neuropsychiatric inventory (NPI), detrended fluctuation analysis (DFA) represented by diurnal activity (DA), evening activity (EA), and nocturnal activity (NA) according to actigraphic recordings. SZL but not placebo oral liquid delayed the development of BPSD significantly according to the changes in some of the clinical scores and the EA and NA parameters of DFA at week 20 compared with week 0. No side effects were observed in laboratory tests. The results indicate that SZL might delay the development of BPSD in AD patients and thus is a potentially suitable drug for long-term use.

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