scholarly journals Clinical and functional impact of cognitive fluctuations in dementia

2021 ◽  
Author(s):  
Brian Mainland
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Cognitive Performance ◽  
Caregiver Burden ◽  
Daily Living ◽  
Term Care ◽  
Primary Nursing ◽  
Objective Evidence ◽  
Cognitive Fluctuations

Cognitive fluctuations (CFs) are defined as spontaneous alterations in cognition, attention, and arousal, and are highly prevalent and disabling among people with dementia. CFs occur with a frequency of 80-90% in dementia with Lewy bodies (DLB), 40% in vascular dementia (VaD), and 20% in Alzheimer’s disease (AD). While CFs have been recognized as an important component of dementia, the majority of studies examining them have lacked objective methods of assessing their presence and severity, making it difficult to determine the degree of interference with other clinical features that can be attributable to fluctuations. The present study examined the nature and frequency of CFs in 55 individuals with dementia living in a long-term care facility. Participants underwent neuropsychological assessment to profile their current cognitive functioning. The Dementia Cognitive Fluctuation Scale (DCFS) was used to characterize CFs in this sample. Patients also completed brief cognitive measures on three separate occasions during a one-week period to obtain objective evidence of variability in cognitive performance. This study also assessed the association between CFs and informant based measures of patients’ quality of life, activities of daily living, and formal caregiver burden. Longitudinal cognitive data was analyzed retrospectively to determine patients’ rate of cognitive decline over the past six months. Consistent with the limited research already completed in this area, this study found that increasing severity of CFs predicts lower cognitive performance and reduced ability to complete activities of daily living. Also, this is the first study to demonstrate that CFs predict patients’ overall quality of life and the degree of caregiver burden in primary nursing staff. Results of the current study suggest that CFs exert a broad range of influence over patients’ functional abilities and well being. Identifying which patients experience CFs could play an important role in developing individualized treatment plans best suited for patients specific care needs.

scholarly journals Clinical and functional impact of cognitive fluctuations in dementia

2021 ◽  
Author(s):  
Brian Mainland
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Cognitive Performance ◽  
Caregiver Burden ◽  
Daily Living ◽  
Term Care ◽  
Primary Nursing ◽  
Objective Evidence ◽  
Cognitive Fluctuations

Cognitive fluctuations (CFs) are defined as spontaneous alterations in cognition, attention, and arousal, and are highly prevalent and disabling among people with dementia. CFs occur with a frequency of 80-90% in dementia with Lewy bodies (DLB), 40% in vascular dementia (VaD), and 20% in Alzheimer’s disease (AD). While CFs have been recognized as an important component of dementia, the majority of studies examining them have lacked objective methods of assessing their presence and severity, making it difficult to determine the degree of interference with other clinical features that can be attributable to fluctuations. The present study examined the nature and frequency of CFs in 55 individuals with dementia living in a long-term care facility. Participants underwent neuropsychological assessment to profile their current cognitive functioning. The Dementia Cognitive Fluctuation Scale (DCFS) was used to characterize CFs in this sample. Patients also completed brief cognitive measures on three separate occasions during a one-week period to obtain objective evidence of variability in cognitive performance. This study also assessed the association between CFs and informant based measures of patients’ quality of life, activities of daily living, and formal caregiver burden. Longitudinal cognitive data was analyzed retrospectively to determine patients’ rate of cognitive decline over the past six months. Consistent with the limited research already completed in this area, this study found that increasing severity of CFs predicts lower cognitive performance and reduced ability to complete activities of daily living. Also, this is the first study to demonstrate that CFs predict patients’ overall quality of life and the degree of caregiver burden in primary nursing staff. Results of the current study suggest that CFs exert a broad range of influence over patients’ functional abilities and well being. Identifying which patients experience CFs could play an important role in developing individualized treatment plans best suited for patients specific care needs.

The association between cognitive fluctuations and activities of daily living and quality of life among institutionalized patients with dementia

2017 ◽  
Vol 33 (2) ◽  
pp. e280-e285 ◽  
Author(s):  
Meng Sun ◽  
Brian J. Mainland ◽  
Tisha J. Ornstein ◽  
Sasha Mallya ◽  
Alexandra J. Fiocco ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Institutionalized Patients ◽  
Cognitive Fluctuations

scholarly journals Burden and Quality of Life of Dependent Elderly Caregivers in Pakuncen Village Yogyakarta

2020 ◽  
Author(s):  
Herose Cendrasilvinia ◽  
◽  
The Maria Meiwati Widagdo ◽  
Widya Christine Manus ◽  
◽  
...  
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Caregiver Burden ◽  
Daily Living ◽  
Rank Correlation ◽  
Cross Sectional ◽  
Quality Life ◽  
Elderly Caregivers ◽  
Dependent Elderly

Background: Elderly people face health problems associated with reduced health and increased disability. Dependent elderly on caregivers who cause a burden affecting the quality of life of caregivers. The aim of this study was to analyze the correlation between the burden and quality of life among dependent elderly caregivers. Subjects and Method: A cross-sectional study was carried out in Pakuncen Village, Yogyakarta. The study subjects were 30 informal caregivers who cared for their family member aged ≥ 60 years with moderate dependence. Instruments used to screen dependent elderly included Activities of Daily Living (ADL) and Instrument Activities of Daily Living (IADL) to measure level of independence, MMSE and AD-8 to assess cognitive function of elderly. Caregivers aged ≥ 60 years underwent MMSE and those with scores <24 was excluded. Caregivers’ burden ware measured using The Zarit Burden Interview (ZBI) and Caregiver Reaction Assessment (CRA). Measurements of quality of life among caregivers was conducted by WHOQOL-BREF. Data were analyzed using Spearman-rank correlation. Results: Out of 30 caregivers, 24 were female and 6 were male with an average age of 49 years. Most respondents had light to moderate burden (Mean= 34.27; SD=18.94). Caregivers’ quality of life were low (<60) in psychological (Mean= 58.17; SD= 12.31), social relation (Mean= 59.77; SD= 9.04), and the environment domains (Mean= 51.90; SD= 10.00). Caregivers’ quality of life was high (≥60) in physical health domain (Mean= 63.30; SD=12.83). There were negative correlations between caregiver burden (ZBI and CRA) and the quality life of caregivers (WHOQOL-BREF). Conclusion: In Yogyakarta, the burden of caregivers (ZBI and CRA) and the quality of caregivers’ lives (WHOQOL-BREF) are negatively correlated. Keywords: caregiver, burden, quality of life, dependent, elderly Correspondence: Herose Cendrasilvinia. Faculty of Medicine, Universitas Duta Wacana Christian, Yogyakarta. Jl. Dr. Wahidin Sudirohusodo 5-25 Yogyakarta, 55224. Email: [email protected]. Mobile: 081226466770. DOI: https://doi.org/10.26911/the7thicph.01.08

scholarly journals Enabling meaningful activities and quality of life in long-term care facilities: The stepwise development of a participatory client-centred approach in Flanders

2018 ◽  
Vol 82 (1) ◽  
pp. 15-26 ◽  
Author(s):  
Patricia De Vriendt ◽  
Elise Cornelis ◽  
Ruben Vanbosseghem ◽  
Valerie Desmet ◽  
Dominique Van de Velde
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Social Life ◽  
Daily Living ◽  
Long Term Care ◽  
Term Care ◽  
Positive Effects ◽  
Care Facilities

Introduction Meaningful activities of daily living promote the quality of life of residents of long-term care facilities. This project aimed to develop an approach to enable meaningful activities of daily living and to guide long-term care facilities in a creative and innovative attitude towards residents' meaningful activities of daily living. Method The approach was developed in six steps: (1) in-depth-interviews with 14 residents; (2) a survey with 171 residents; (3) a systematic map and synthesis review on interventions enriching meaningful activities of daily living; (4) qualitative analysis of 24 ‘good examples’ and, to support future implementation, (5) focus groups with staff ( n = 69). Results determined the components of the new approach which was (6) pilot-tested in one long-term care facility. Quantitative and qualitative data were gathered concerning benefits for the residents and feasibility for the staff. Results A client- and activity-oriented approach was developed, characterised by an active participatory attitude of residents and staff and a systematic iterative process. Significant positive effects were found for the number of activities, the satisfaction with the leisure offered, the social network, medication use, but not for quality of life. The approach appeared to be feasible. Conclusion This approach stimulates residents' meaningful activities of daily living and social life. Further investigation is needed to evaluate its outcome and implementation potentials.

scholarly journals Analysis of Medication Adherence and Its Influencing Factors in Patients with Schizophrenia in the Chinese Institutional Environment

2021 ◽  
Vol 18 (9) ◽  
pp. 4746
Author(s):  
Wei Yu ◽  
Jie Tong ◽  
Xirong Sun ◽  
Fazhan Chen ◽  
Jie Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medication Adherence ◽  
Activities Of Daily Living ◽  
Influencing Factors ◽  
Self Efficacy ◽  
Daily Living ◽  
Institutional Environment ◽  
Factors Influencing ◽  
Quality Of Life Scale

Background: Factors related to medication adherence in patients with schizophrenia have always been key to the treatment and rehabilitation of these patients. However, the treatment modes in different countries are not the same, and there is no research on the factors influencing medication adherence under different mental health service modes. Objectives: The purpose of this study was to explore medication adherence and its influencing factors in patients with schizophrenia in the Chinese institutional environment. Methods: We conducted a cross-sectional study of hospitalized persons living with schizophrenia from November 2018 to January 2019. A systematic sampling method was used to select 217 hospitalized persons living with schizophrenia. The Medication Adherence Rating Scale (MARS), Positive and Negative Syndrome Scale (PANSS), General Self-Efficacy Scale (GSES), Schizophrenia Quality of Life Scale (SQLS), and Scale of Social Skills for Psychiatric Inpatients (SSPI) were used to explore medication compliance and its influencing factors in the Chinese institutional environment. Results: The descriptive analysis and ANOVA showed that there were no significant differences in medication adherence when assessed by demographic characteristics such as sex, marital status, and education level (p > 0.05). A correlation analysis showed that there was no significant correlation between medication adherence and mental symptoms (p > 0.05) but that there was a positive correlation with self-efficacy, quality of life, and activities of daily living (p < 0.01). The linear regression analysis showed that self-efficacy, psychosocial factors, symptoms/side effects, and activities of daily living had significant effects on medication adherence (F = 30.210, p < 0.001). Conclusions: Our findings show that the self-efficacy, quality of life, and social function of patients with schizophrenia are important self-factors influencing medication adherence in the Chinese institutional environment.

Rehabilitation training based on virtual reality for patients with Parkinson’s disease in improving balance, quality of life, activities of daily living, and depressive symptoms: A systematic review and meta-regression analysis

2021 ◽  
pp. 026921552199517
Author(s):  
Runze Li ◽  
Yanran Zhang ◽  
Yunxia Jiang ◽  
Mengyao Wang ◽  
Wei How Darryl Ang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Virtual Reality ◽  
Depressive Symptoms ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Meta Analysis ◽  
Rehabilitation Training

Objective: To examine the effectiveness of rehabilitation training based on virtual reality in improving balance, quality of life, activities of daily living, and depressive symptoms of patients with Parkinson’s disease. Data sources: PubMed, EMBASE, CINAHL, Scopus, Cochrane Library, PsycINFO, ProQuest, Physiotherapy Evidence Database, IEEE Xplore, China National Knowledge Infrastructure, Wanfang, and VIP Information databases were searched from their inception to October 15, 2020. Trial registries, gray literature, and target journals were also searched. Methods: Eligible randomized controlled trials included studies with patients with Parkinson’s disease in rehabilitation training based on virtual reality. Comprehensive Meta-Analysis 3.0 software was used. Physiotherapy Evidence Database Scale and the Grading of Recommendation, Assessment, Development, and Evaluation system were used to assess the methodological quality of individual trials and the overall quality of the evidence, respectively. Results: A total of 22 randomized controlled trials with 836 patients were included. Meta-analysis revealed that training significantly improved balance ( g = 0.66, P < 0.001), quality of life ( g = 0.28, P = 0.015), activities of daily living ( g = 0.62, P < 0.001), and depressive symptoms ( g = 0.67, P = 0.021) compared to the control group. Subgroup analysis indicated that training should utilize video game consoles. Meta-regression analyses showed that age, sessions, and frequency of training had statistically significant impacts on balance scores. Quality of individual trials was high and overall evidence ranged from very low to low. Conclusion: Virtual rehabilitation training could be adopted in healthcare institutions as supplementary training for patients with Parkinson’s disease.

scholarly journals FUNCTIONAL ASSESSMENT OF OLDER OBESE PATIENTS CANDIDATES FOR BARIATRIC SURGERY

2014 ◽  
Vol 51 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Denis PAJECKI ◽  
Marco Aurélio SANTO ◽  
Ana Lumi KANAGI ◽  
Daniel RICCIOPPO ◽  
Roberto de CLEVA ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bariatric Surgery ◽  
Activities Of Daily Living ◽  
Functional Assessment ◽  
Daily Living ◽  
Functional Decline ◽  
The Elderly ◽  
Obese Patients ◽  
Instrumental Activities

Context Obesity in the elderly is associated with exacerbation of functional decline (dependency), that occurs with aging, because of decreased muscle mass and strength, and increased joint dysfunction. Consequently, there is progressive loss of independence, autonomy, chronic pain and impaired quality of life. The weight loss can bring benefits in all these aspects, especially when accompanied by exercises. Elderly patients with morbid obesity may be submitted to surgical treatment, taking into account that the massive weight loss, eventually caused by bariatric surgery, may exacerbate the loss of muscle mass and nutritional complications that may bring harm to the overall health and quality of life of these patients. The functional assessment of elderly patients, candidates for bariatric surgery and the extent to which surgery can bring benefits to the patients, in the field of functionality, has still to be determined. Objective To describe profile functionality in obese elderly referred to a bariatric surgery program. Methods Patients with age ≥60 and BMI ≥35 underwent comprehensive geriatric assessment that evaluates co morbidities, medication use, ability to perform basic activities of daily living and instrumental activities of daily living, and the “Timedupandgo” test to evaluate mobility, whose cut-off point was ≤10 seconds. Statistical analysis was performed in order to see if there is a positive correlation of dependency with BMI and age (over or under 65 years). Results Forty subjects have completed evaluation. The mean age was 64.1 years (60-72) and 75% were women. They had an average weight of 121.1 kg (72.7-204) and a mean BMI of 47.2 kg/m2 (35.8-68.9). 16 patients (40%) have shown dependency for activities of daily living, 19 (47,5%) for instrumental activities of daily living and 20 patients (50%) had a “Timedupandgo” test over 10 seconds. Statistical analysis (t-Student, Mann-Whitney, Binary Logistic Regression) has shown positive correlation of dependency in activities of daily living for BMI >49 kg/m2, dependency in instrumental activities of daily living for BMI >46,5 kg/m2, and “Timedupandgo” test greater than 10 seconds for BMI >51 kg/m2 (P<0,05). No dependency difference was observed for patients over or under 65 years age. Conclusions Functional decline is observed in almost half of the morbid obese patients over 60 years old. It is related to increasing BMI (BMI >46,5 kg/m2) but not related to age (60 to 65 years or over 65 years). Functional decline should be considered a co-morbidity in the elderly obese patients and should be assessed before bariatric surgery in this population.

Deterioration of basic activities of daily living and their impact on quality of life across different cognitive stages of dementia: a European study

2014 ◽  
Vol 26 (8) ◽  
pp. 1283-1293 ◽  
Author(s):  
Clarissa M. Giebel ◽  
Caroline Sutcliffe ◽  
Minna Stolt ◽  
Staffan Karlsson ◽  
Anna Renom-Guiteras ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Large Scale ◽  
Depressive Symptomatology ◽  
European Study ◽  
Severe Dementia ◽  
People With Dementia ◽  
Adl Performance

ABSTRACTBackground:Performing basic activities of daily living (ADLs) is one of the major difficulties encountered in dementia, which can have considerable negative impacts on the quality of life (QoL) of people with dementia (PwD). However, the extent to which basic ADL performance deteriorates across mild, moderate, and severe dementia is little examined and its impact, together with depression and neuropsychiatric behavior, upon QoL, is of considerable relevance across European countries.Methods:Data were drawn from people living in the community who were participants in a large-scale European study on transition from community living to care homes of PwD. PwD completed measures on cognitive functioning and QoL, and informal carers reported upon QoL, depressive symptomatology, psychopathology, and functional ability of the PwD.Results:ADL performance deteriorated differently for each activity. In particular, toileting, transfer, and feeding remained relatively intact throughout, whereas performance on bathing and dressing deteriorated to a greater extent from mild to severe dementia. It appears that continence was not affected by the stage of dementia with similar levels of impairment. Basic ADL performance impacted to different degrees on QoL across dementia stages and countries.Conclusions:Interventions aimed at maintaining independence or QoL need to target different ADLs across different dementia stages and perhaps also tailor interventions to the context of different countries. Findings contribute to the development of non-pharmaceutical interventions and governmental pledges to promote independence in dementia.

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