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.

scholarly journals Very late-onset behavioral variant frontotemporal dementia

2013 ◽  
Vol 7 (1) ◽  
pp. 136-139
Author(s):  
Henrique Cerqueira Guimarães ◽  
Tatiana de Carvalho Espindola
Keyword(s):  
Case Report ◽  
Frontotemporal Dementia ◽  
Frontotemporal Lobar Degeneration ◽  
Clinical Presentation ◽  
Late Onset ◽  
Ground Level ◽  
Dementia Diagnosis ◽  
Behavioral Variant Frontotemporal Dementia ◽  
Genetically Determined ◽  
Late Onset Dementia

ABSTRACT Current concepts regarding frontotemporal lobar degeneration (FTLD) have evolved rapidly in recent years. Genetically determined FTLD cohorts have broadened our knowledge pertaining to its clinical presentation, neuroimaging findings and demographics. In this study we present a case report of a patient diagnosed with behavioral variant frontotemporal dementia diagnosis in her nineties during hospital admission for a ground-level fall. We believe this case reinforces the pervasive nature of this clinical entity, and may contribute to an increased awareness of this diagnostic possibility in late-onset 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 Characteristics of Young-Onset and Late-Onset Dementia Patients at a Remote Memory Clinic

2020 ◽  
Vol 47 (3) ◽  
pp. 320-327
Author(s):  
Jennifer F. W. Wong ◽  
Andrew Kirk ◽  
Landon Perlett ◽  
Chandima Karunanayake ◽  
Debra Morgan ◽  
...  
Keyword(s):  
Late Onset ◽  
Remote Memory ◽  
Memory Clinic ◽  
Rural And Remote ◽  
Caregiver Support ◽  
Young Onset ◽  
Highly Educated ◽  
Dementia Patients ◽  
Patient Groups ◽  
Late Onset Dementia

ABSTRACT:Background:Young-onset dementia (YOD) is defined as the onset of dementia symptoms before the age of 65 years and accounts for 2–8% of dementia. YOD patients and their caregivers face unique challenges in diagnosis and management. We aimed to compare the characteristics of rural YOD and late-onset dementia (LOD) patients at a rural and remote memory clinic in Western Canada.Methods:A total of 333 consecutive patients (YOD = 61, LOD = 272) at a rural and remote memory clinic between March 2004 and July 2016 were included in this study. Each patient had neuropsychological assessment. Health, mood, function, behaviour and social factors were also measured. Both groups were compared using χ2 tests and independent sample tests.Results:YOD patients were more likely to be married, employed, current smokers and highly educated. They reported fewer cognitive symptoms, but had more depressive symptoms. YOD patients were less likely to live alone and use homecare services. YOD caregivers were also more likely to be a spouse and had higher levels of distress than LOD caregivers. Both YOD and LOD patient groups were equally likely to have a driver’s licence.Conclusions:Our findings indicate YOD and LOD patients have distinct characteristics and services must be modified to better meet YOD patient needs. In particular, the use of homecare services and caregiver support may alleviate the higher levels of distress found in YOD patients and their caregivers. Additional research should be directed to addressing YOD patient depression, caregiver distress and barriers to services.

scholarly journals Atrial Fibrillation Increases the Risk of Early-Onset Dementia in the General Population: Data from a Population-Based Cohort

2020 ◽  
Vol 9 (11) ◽  
pp. 3665
Author(s):  
Dongmin Kim ◽  
Pil-Sung Yang ◽  
Gregory Y.H. Lip ◽  
Boyoung Joung
Keyword(s):  
Atrial Fibrillation ◽  
Early Onset ◽  
Late Onset ◽  
Population Data ◽  
The Elderly ◽  
Population Based ◽  
Early Onset Dementia ◽  
Increased Risk ◽  
Late Onset Dementia

Atrial fibrillation (AF) is considered a risk factor for dementia, especially in the elderly. However, the association between the two diseases is not well identified in different age subgroups. The association of incident AF with the development of dementia was assessed from 1 January 2005, to 31 December 2013, in 428,262 participants from a longitudinal cohort (the Korea National Health Insurance Service-Health Screening cohort). In total, 10,983 participants were diagnosed with incident AF during the follow-up period. The incidence of dementia was 11.3 and 3.0 per 1000 person-years in the incident-AF and without-AF groups, respectively. After adjustment for clinical variables, the risk of dementia was significantly elevated by incident AF, with a hazard ratio (HR) of 1.98 (95% confidence interval [CI]: 1.80–2.17, p < 0.001), even after censoring for stroke (HR: 1.74, 95% CI: 1.55–1.94, p < 0.001). The HRs of incident AF for dementia onset before the age of 65 (early-onset dementia) and for onset after the age of 65 (late-onset dementia) were 2.91 (95% CI: 1.93–4.41) and 1.67 (95% CI: 1.49–1.87), respectively. Younger participants with AF were more prone to dementia development than older participants with AF (p for trend < 0.001). AF was associated with an increased risk of both early- and late-onset dementia, independent of clinical stroke.

scholarly journals Identity work of children with a parent with early-onset dementia in the Netherlands: Giving meaning through narrative construction

Dementia ◽  
2021 ◽  
pp. 147130122110334
Author(s):  
Silke Hoppe
Keyword(s):  
The Netherlands ◽  
Adult Children ◽  
Early Onset ◽  
Cultural Context ◽  
Late Onset ◽  
Making Meaning ◽  
Early Onset Dementia ◽  
The Impact ◽  
Depth Interviews ◽  
Late Onset Dementia

Background In the past years an increasing amount of research has been done on the experiences of adult children of a parent with early-onset dementia. However, little is still known about how the socio-cultural context influences the narratives of these children. Aim This study aimed to provide insights into the far-reaching consequences of parental early-onset dementia for adult children in the Netherlands. It illustrates how the experiences of these adult children are shaped by the context they live in. Method 16 in-depth interviews were conducted with adult children of a parent with early-onset dementia in the Netherlands. The interviews offered the children space to reflect on the impact the illness of their parent had on them and their lives. The data were analysed using thematic analysis. Findings This article illustrates that the comparative processes of relating to others' experiences help the children to reflect on the impact that their parent's illness has on their own lives, which in turn aids them in contextualising and making meaning out of their changing lives and relationships. This contextualization and recovery of meaning is shaped by three processes. The first concerns the ways these adult children draw comparisons between their own lives and experiences and those of their peers of the same age group. The second process entails comparative understandings of having a parent with early-onset dementia versus having a parent with late-onset dementia. The third process explores how having a parent with early-onset dementia compares to having a parent with other diseases. The processes of contextualisation which the adult children engage in are shaped by what the children perceive to be normal and thus also by their socio-cultural contexts. Conclusions This article reveals how meaning is created in a constant interplay between the primary experiences of having an ill parent and the socio-cultural context in which the experiences take place. It illustrates how this context provides for particular narratives, which in turn shape how the children are able to give meaning to their experiences.

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 Patients with young-onset dementia in an older people's mental health service

2020 ◽  
pp. 1-5
Author(s):  
Michael Yeung ◽  
Katherine MacFarland ◽  
Vincent Mlilo ◽  
Nathan Dean ◽  
Benjamin R. Underwood
Keyword(s):  
Late Onset ◽  
Rare Condition ◽  
Service Level ◽  
Case Review ◽  
Young Onset ◽  
Dementia Patients ◽  
Level Data ◽  
Diagnosis Of Dementia ◽  
Young Onset Dementia ◽  
Late Onset Dementia

Aims and method Currently, no separate service exists for patients with young-onset dementia in Cambridgeshire. These patients are managed together with late-onset dementia patients within old age psychiatry services. To inform service design, we sought to characterise young-onset dementia patients in our population. We first analysed service-level data and supplemented this with a detailed case review of 90 patients. Results Young-onset dementia remains a relatively rare condition. Only a small proportion of those referred for assessment receive a diagnosis of dementia. Data collected on presenting complaints, comorbidities, medication and Health of the Nation Outcome Scales scores associated young-onset dementia with a greater incidence of depression than late-onset dementia. Outcomes in the two groups did not appear to differ. Clinical implications The data presented here do not suggest a need to create a separate service. Practitioners should be aware of the increased incidence of depression observed in this group.

Is there a familial overlap between dementia and other psychiatric disorders?

2010 ◽  
Vol 23 (5) ◽  
pp. 749-755 ◽  
Author(s):  
Janardhanan C. Narayanaswamy ◽  
Mathew Varghese ◽  
Sanjeev Jain ◽  
Palani Thangaraju Sivakumar ◽  
Om Prakash ◽  
...  
Keyword(s):  
Early Onset ◽  
Psychiatric Symptoms ◽  
Late Onset ◽  
Cumulative Risk ◽  
Behavioral Disturbances ◽  
Early Onset Dementia ◽  
Psychiatric Illnesses ◽  
Kaplan Meier ◽  
Genetic Overlap ◽  
Late Onset Dementia

ABSTRACTBackground:Cognitive and psychiatric features are important components of dementia. Early onset dementia (EOD) has been found to be associated with a greater genetic basis. If this is the case, EOD could have genetic association with psychiatric illnesses, given the presence of more behavioral disturbances in this condition. There is a definite need to explore the presence of psychiatric symptoms and disorders in families of patients with dementia.Methods:The authors compared 52 proband families of dementia and 45 control families in order to assess the familial co-aggregation of major psychiatric illnesses. The cumulative risk in first degree relatives in the two groups for major psychiatric illnesses was calculated using Kaplan Meier Survival analysis. Early onset and late onset dementia proband families were compared separately with control families for the same.Results:There was a significantly higher morbid risk for psychosis in dementia proband families (generalized Wilcoxon, Breslow −4.165, p = 0.041). Also, the morbid risk was higher in early onset dementia proband families (generalized Wilcoxon, Breslow −6.16, p = 0.013) while it was not so in late onset dementia proband families (generalized Wilcoxon, Breslow −2.99, p = 0.084)Conclusion:There is a possible genetic overlap between dementia and psychosis. This appears to be more pronounced with early onset dementia than with late onset dementia.

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