Domains of Awareness in Young and Late Onset Dementia

2021 ◽  
pp. 1-10
Author(s):  
Maria Alice Tourinho Baptista ◽  
Nathália Kimura ◽  
Isabel Barbeito Lacerda ◽  
Felipe de Oliveira Silva ◽  
Marcia Cristina Nascimento Dourado
Keyword(s):  
Cognitive Functioning ◽  
Functional Activity ◽  
Late Onset ◽  
Emotional Functioning ◽  
Neuropsychiatric Symptoms ◽  
Age At Onset ◽  
Health Condition ◽  
Social And Emotional ◽  
People With Dementia ◽  
Late Onset Dementia

Background: There is a lack of research investigating whether there are differences in the domains of awareness according to the age at onset of dementia. Objective: This study is designed to investigate differences in awareness of cognitive functioning and health condition, functional activity impairments, emotional state, and social functioning and relationships among people with young onset (YOD) and late onset dementia (LOD); and examine associations between awareness and its domains with cognition, functionality, neuropsychiatric symptoms, social and emotional functioning, and quality of life (QoL) in both groups. Methods: A group of 136 people with dementia and their respective caregivers (YOD = 50 and LOD = 86) were consecutively selected. We assessed awareness of disease, dementia severity, cognition, functionality, neuropsychiatric symptoms, social and emotional functioning, and QoL. Results: People with YOD had more neuropsychiatric symptoms than people with LOD. People with YOD were more aware of disease (total score), of their cognitive functioning and health condition and of their functional activity impairments, even if this group was more severely cognitive impaired and had a worse level of functionality than LOD group. Multivariate linear regressions showed that functionality has a wide relationship to awareness for people with YOD. While neuropsychiatric symptoms and QoL has a greater relation to awareness for people with LOD. Conclusion: Different clinical variables are associated to different domains in YOD and LOD groups, reinforcing the heterogeneity of awareness in dementia.

scholarly journals YOUNG AND LATE ONSET DEMENTIA: HOW DO THEY DIFFER IN TERMS OF DOMAINS OF AWARENESS?

2021 ◽  
Author(s):  
Maria Alice Baptista ◽  
Nathália Kimura ◽  
Isabel Lacerda ◽  
Felipe Silva ◽  
Marcia Cristina Dourado
Keyword(s):  
Quality Of Life ◽  
Cognitive Functioning ◽  
Functional Activity ◽  
Late Onset ◽  
Emotional Functioning ◽  
Neuropsychiatric Symptoms ◽  
Health Condition ◽  
Social And Emotional ◽  
Late Onset Dementia

Background: Young onset dementia (YOD) is a diagnosis given when the neurocognitive process sets in before 65 years age. The YOD dementia process poses specific challenges related to financial issues, work and social demands, marriage, and parenthood, including losses and shifting roles, care responsibilities, as well as prospects for the future. Those challenges might account for the difference in awareness between YOD and late onset dementia (LOD). Awareness can be defined as the recognition of changes caused by deficits related to the disease process, which may include the ability to recognize a specific deficit, the emotional response to the difficulties presented and the ability to understand the impact of the disease in activities of daily living Objectives: This study is designed to investigate differences in awareness of cognitive functioning and health condition, functional activity impairments, emotional state, and social functioning and relationships among people with young onset (YOD) and late onset dementia (LOD); and examine associations between awareness and its domains with cognition, functionality, neuropsychiatric symptoms, social and emotional functioning and quality of life (QoL) in both groups. Methods: This is a cross-sectional design study. A group of 136 people with dementia and their respective caregivers (YOD = 50 and LOD = 86) were consecutively selected from an Alzheimer’s disease outpatient unit in Rio de Janeiro, Brazil. We assessed awareness of disease, dementia severity, cognition, functionality, neuropsychiatric symptoms, social and emotional functioning, and quality of life. Results: People with YOD were more aware of disease (total score), more aware of their cognitive functioning and health condition and of their functional activity impairments than people with LOD, even if this group was more severely cognitive impaired and had a worse level of functionality than LOD group. Besides, people with YOD had more neuropsychiatric symptoms than people with LOD. Multivariate linear regressions showed that functionality has a wide relationship to awareness for people with YOD. While neuropsychiatric symptoms and quality of life has a greater relation to awareness for people with LOD. Conclusions Different clinical variables are associated to different domains in YOD and LOD groups, reinforcing the heterogeneity of awareness in dementia.

scholarly journals Quality of Life in People with Young-Onset Alzheimer’s Dementia and Frontotemporal Dementia

2018 ◽  
Vol 45 (1-2) ◽  
pp. 91-104 ◽  
Author(s):  
Lara Hvidsten ◽  
Knut Engedal ◽  
Geir Selbæk ◽  
Torgeir Bruun Wyller ◽  
Frøydis Bruvik ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Late Onset ◽  
Neuropsychiatric Symptoms ◽  
The Elderly ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Young Onset ◽  
Proxy Version ◽  
Late Onset Dementia

Aims: The aims of this study were to compare quality of life (QOL) in people with young-onset Alzheimer’s (AD) and frontotemporal (FTD) dementia, explore variables associated with QOL, and compare QOL in young-onset dementia (YOD) and late-onset dementia (LOD). Methods: Cross-sectional data from a Nordic multicenter study of 50 community-dwelling participants with AD and 38 with FTD were included. A comparison group consisted of 100 people with LOD. QOL was measured using self-reported Euro-QOL 5-Dimension and the proxy version of Quality of Life in Alzheimer’s Disease (QOL-AD) questionnaire. Neuropsychiatric symptoms and needs were assessed using the Cornell Scale for Depression in Dementia (CSDD), Neuropsychiatric Inventory (NPI), and Camberwell Assessment of Needs in the Elderly. Multiple linear regression and multilevel modeling was used to determine variables associated with QOL. Results: We found no differences between the two YOD groups in QOL. The variables associated with QOL were scores on the CSDD, NPI, and unmet needs. The proxy QOL-AD score in YOD was significantly higher compared to LOD (median 36.0 [IQR 10.0] vs. 33.0 [IQR 9.0]). Conclusion: The QOL in Nordic people with YOD was better compared to people with LOD. Our results show depressive symptoms to be associated with QOL irrespective of age and diagnosis.

scholarly journals Differences in neuropsychiatric symptoms between nursing home residents with young-onset dementia and late-onset dementia

2018 ◽  
Vol 23 (5) ◽  
pp. 581-586 ◽  
Author(s):  
Britt Appelhof ◽  
Christian Bakker ◽  
Jeannette C. L. Van Duinen-van Den IJssel ◽  
Sandra A. Zwijsen ◽  
Martin Smalbrugge ◽  
...  
Keyword(s):  
Nursing Home ◽  
Late Onset ◽  
Neuropsychiatric Symptoms ◽  
Nursing Home Residents ◽  
Young Onset ◽  
Young Onset Dementia ◽  
Late Onset Dementia

scholarly journals Anosognosia in Early- and Late-Onset Dementia and Its Association With Neuropsychiatric Symptoms

2021 ◽  
Vol 12 ◽  
Author(s):  
Manuela Tondelli ◽  
Chiara Galli ◽  
Giulia Vinceti ◽  
Luigi Fiondella ◽  
Simone Salemme ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Disease Progression ◽  
Frontotemporal Dementia ◽  
Late Onset ◽  
Neuropsychiatric Symptoms ◽  
Diagnostic Delay ◽  
Early Onset Dementia ◽  
Dementia Patients ◽  
Clinical Variants ◽  
Late Onset Dementia

Background: The symptom anosognosia or unawareness of disease in dementia has mainly been studied in patients with late-onset dementia (LOD, ≥65 years), whereas little is known on whether it is also present in patients with early-onset dementia (EOD, <65 years). We aimed at investigating differences in anosognosia between LOD and EOD, by also studying its association with different clinical variants of EOD and the presence of neuropsychiatric symptoms.Methods: A total of 148 patients, 91 EOD and 57 LOD, were recruited and underwent extended clinical assessment and caregiver interview that included questionnaires aimed at measuring anosognosia and neuropsychiatric symptoms. Differences in anosognosia between EOD and LOD and between subgroups with different clinical variants were investigated, as well as correlation between anosognosia and neuropsychiatric symptoms. A regression analysis was applied to explore the association between anosognosia and development of neuropsychiatric symptoms during disease progression.Results: Median levels of anosognosia were not significantly different between EOD and LOD. Anosognosia increased overtime with disease progression and was higher in frontotemporal dementia patients or, more precisely, in frontotemporal dementia and Alzheimer's disease variants associated with involvement of the frontal lobes. Higher levels of early anosognosia were associated with higher frequency and severity of subsequent neuropsychiatric symptoms, in particular apathy, later in the course of the disease.Conclusion: Anosognosia is a frequent symptom of EOD, occurring in 94.5% of all-cause EOD, and it is associated with higher risk of developing neuropsychiatric symptoms during disease progression. Recognising anosognosia may be helpful for clinicians and families to reduce diagnostic delay and improve disease managment.

Time to diagnosis in young-onset dementia as compared with late-onset dementia

2012 ◽  
Vol 43 (2) ◽  
pp. 423-432 ◽  
Author(s):  
D. van Vliet ◽  
M. E. de Vugt ◽  
C. Bakker ◽  
Y. A. L. Pijnenburg ◽  
M. J. F. J. Vernooij-Dassen ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Late Onset ◽  
Linear Regression Analysis ◽  
Age At Onset ◽  
Multiple Linear Regression Analysis ◽  
Living Situation ◽  
Young Onset ◽  
Time To Diagnosis ◽  
Young Onset Dementia ◽  
Late Onset Dementia

BackgroundThe extent to which specific factors influence diagnostic delays in dementia is unclear. Therefore, the aim of the present study was to compare duration from symptom onset to diagnosis for young-onset dementia (YOD) and late-onset dementia (LOD) and to assess the effect of age at onset, type of dementia, gender, living situation, education and family history of dementia on this duration.MethodData on 235 YOD and 167 LOD patients collected from caregivers from two prospective cohort studies were used. Multiple linear regression analysis was performed.ResultsThe duration between symptom onset and the diagnosis of YOD exceeded that of LOD by an average of 1.6 years (2.8 v. 4.4 years). Young age and being diagnosed with frontotemporal dementia were related to increases in the time to diagnosis. Subjects with vascular dementia experienced shorter time to diagnosis.ConclusionsThere is a need to raise special awareness of YOD to facilitate a timely diagnosis.

scholarly journals Efficacy of music therapy in the neuropsychiatric symptoms of dementia: systematic review

2017 ◽  
Vol 66 (1) ◽  
pp. 52-61 ◽  
Author(s):  
Mariângela Aparecida Rezende Aleixo ◽  
Raquel Luiza Santos ◽  
Marcia Cristina do Nascimento Dourado
Keyword(s):  
Systematic Review ◽  
Music Therapy ◽  
Late Onset ◽  
Neuropsychiatric Symptoms ◽  
Psychosocial Interventions ◽  
Well Being ◽  
Cochrane Library ◽  
Group Setting ◽  
People With Dementia ◽  
Therapy Interventions

ABSTRACT Objective A large number of psychosocial interventions in dementia are based on music activities and music therapy interventions. We aim at assessing the efficacy of music therapy in the neuropsychiatric symptoms of people with dementia. Methods This systematic review is according to the methodology suggested by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched for articles in PubMed, Web of Knowledge Cross Search, Cochrane Library, Scopus and Lilacs/Bireme databases published from 2005 to 2016. The search keywords included “early onset” and “late onset” combined with “dementia”, “Alzheimer”, “vascular dementia”, “mixed dementia”, “frontotemporal dementia”, “neuropsychiatric symptoms”, “behavioral disturbances”, “behavioral and psychological symptoms of dementia” and “music therapy”. The studies were categorized according to its efficacy on the decline of neuropsychiatric symptoms and improvement of cognitive function, quality of life and well-being. Results We selected 12 out of 257 papers. Music therapy interventions were applied individually or in group setting, using active or receptive technique. In general, studies indicated the efficacy of music therapy on the decline of depression, agitation and anxiety. There were heterogeneity of interventions, methodological design and instruments of evaluation among the studies. Conclusions Although there are reports of the efficacy of music therapy on the decline of neuropsychiatric symptoms of dementia, the area still needs randomized studies aimed at the solution of important methodological problems like the lack of standardized approaches.

scholarly journals Nursing Staff Distress Associated With Neuropsychiatric Symptoms in Young-Onset Dementia and Late-Onset Dementia

2018 ◽  
Vol 19 (7) ◽  
pp. 627-632 ◽  
Author(s):  
Jeannette C.L. van Duinen-van den IJssel ◽  
Ans J.M.J. Mulders ◽  
Martin Smalbrugge ◽  
Sandra A. Zwijsen ◽  
Britt Appelhof ◽  
...  
Keyword(s):  
Nursing Staff ◽  
Late Onset ◽  
Neuropsychiatric Symptoms ◽  
Young Onset ◽  
Young Onset Dementia ◽  
Late Onset Dementia

scholarly journals Ethnic disparities in the uptake of anti-dementia medication in young and late-onset dementia

2020 ◽  
pp. 1-10
Author(s):  
Clarissa Giebel ◽  
Monica Cations ◽  
Brian Draper ◽  
Aravind Komuravelli
Keyword(s):  
Logistic Regression ◽  
Cholinesterase Inhibitors ◽  
Late Onset ◽  
Ethnic Disparities ◽  
Significant Determinant ◽  
Cross Sectional ◽  
Living Situation ◽  
People With Dementia ◽  
The Impact ◽  
Late Onset Dementia

ABSTRACT Objectives: People with dementia can face barriers when trying to access care after a diagnosis, particularly in young-onset dementia (YOD). Little is known about the effects of ethnicity on the use of anti-dementia medication and variations between age groups. The aim of this study was to analyze national data on variations in the uptake of anti-dementia medication between people with YOD and late-onset dementia (LOD). Design: Cross-sectional longitudinal cohort study. Setting: Data from the U.S. National Alzheimer’s Coordinating Centre were obtained from September 2005 to March 2019. Participants: First visits of people with a diagnosis of Alzheimer’s disease (AD) dementia, Lewy body dementia (LBD), and Parkinson’s disease dementia (PDD) were included. Measurements: Logistic regression was used to analyze the effects of education and ethnicity on use of cholinesterase inhibitors and memantine, accounting for YOD/LOD, gender, living situation, severity stage, and comorbidities. Results: In total, 15,742 people with AD dementia and LBD/PDD were included, with 11,019 PwD having completed a first follow-up visit. Significantly more people with YOD used memantine than those with LOD, while fewer used cholinesterase inhibitors. PwD from minority ethnic backgrounds used memantine and cholinesterase inhibitors less often than those from a White ethnic background. Logistic regression analysis showed that ethnicity was a significant determinant of both memantine and cholinesterase inhibitors usage, while education was only a significant determinant for memantine usage. Conclusions: Findings highlight the impact of social factors on current usage of anti-dementia medication and the need for more resources to enable equitable use of anti-dementia medication.

scholarly journals Network Approaches to Understand Individual Differences in Brain Connectivity: Opportunities for Personality Neuroscience

2018 ◽  
Vol 1 ◽  
Author(s):  
Steven H. Tompson ◽  
Emily B. Falk ◽  
Jean M. Vettel ◽  
Danielle S. Bassett
Keyword(s):  
Individual Differences ◽  
Cognitive Functioning ◽  
Network Science ◽  
Emotional Functioning ◽  
Brain Networks ◽  
Dynamic Network ◽  
Current Evidence ◽  
Experimental Session ◽  
Intrinsic Structure ◽  
Social And Emotional

AbstractOver the past decade, advances in the interdisciplinary field of network science have provided a framework for understanding the intrinsic structure and function of human brain networks. A particularly fruitful area of this work has focused on patterns of functional connectivity derived from noninvasive neuroimaging techniques such as functional magnetic resonance imaging. An important subset of these efforts has bridged the computational approaches of network science with the rich empirical data and biological hypotheses of neuroscience, and this research has begun to identify features of brain networks that explain individual differences in social, emotional, and cognitive functioning. The most common approach estimates connections assuming a single configuration of edges that is stable across the experimental session. In the literature, this is referred to as a static network approach, and researchers measure static brain networks while a subject is either at rest or performing a cognitively demanding task. Research on social and emotional functioning has primarily focused on linking static brain networks with individual differences, but recent advances have extended this work to examine temporal fluctuations in dynamic brain networks. Mounting evidence suggests that both the strength and flexibility of time-evolving brain networks influence individual differences in executive function, attention, working memory, and learning. In this review, we first examine the current evidence for brain networks involved in cognitive functioning. Then we review some preliminary evidence linking static network properties to individual differences in social and emotional functioning. We then discuss the applicability of emerging dynamic network methods for examining individual differences in social and emotional functioning. We close with an outline of important frontiers at the intersection between network science and neuroscience that will enhance our understanding of the neurobiological underpinnings of social behavior.

scholarly journals Clinical Phenotypes of Behavioral Variant Frontotemporal Dementia by Age at Onset

2021 ◽  
pp. 1-10
Author(s):  
Jay L.P. Fieldhouse ◽  
Flora T. Gossink ◽  
Thomas C. Feenstra ◽  
Sterre C.M. de Boer ◽  
Afina W. Lemstra ◽  
...  
Keyword(s):  
Frontotemporal Dementia ◽  
Mortality Risk ◽  
Late Onset ◽  
Neuropsychiatric Symptoms ◽  
Age At Onset ◽  
Depression Scale ◽  
Age At Diagnosis ◽  
Behavioral Variant Frontotemporal Dementia ◽  
Clinical Criteria ◽  
Symptom Profile

Background: Behavioral variant frontotemporal dementia (bvFTD) is generally considered a young-onset dementia, although age at onset is highly variable. While several studies indicate clinical differences regarding age at onset, no biomarker validated cohort studies with updated clinical criteria have been performed. Objective: We aimed to examine behavior, cognition, and mortality over the full age spectrum in a cohort of bvFTD patients with neuroimaging, genetic, or histopathological confirmation and exclusion of positive Alzheimer’s disease biomarkers or severe cerebrovascular damage. Methods: In total, 315 patients with a clinical diagnosis of probable or definite bvFTD were included from the Amsterdam Dementia Cohort and grouped into quartiles by age-at-diagnosis. Neuropsychiatric symptoms and cognitive functioning were assessed with the neuropsychiatric inventory, the geriatric depression scale and a neuropsychological test battery. Data on mortality was obtained from the Dutch municipal register. Associations between age-at-diagnosis and clinical features and mortality risk were examined. Results: Age-at-diagnosis ranged from 26 to 85 years and established quartiles with mean ages of 52±6, 61±2, 66±2, and 74±3 years. In the total sample, 44.4%exceeded an age of 65 years at time of diagnosis. Earlier age-at-diagnosis was associated with more severe behavioral symptoms, while later age-at-diagnosis was associated with more severe memory impairment. Unexpectedly, mortality risk was not associated with age-at-diagnosis. Conclusion: In bvFTD, symptom profile is associated with age-at-diagnosis. This should be taken into account with regard to diagnostics, patient management, and trial design. Additionally, based on our sample, the prevalence of late-onset bvFTD is higher than generally thought.

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