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 Impact of the Severity of Alzheimer’s Disease on the Quality of Life, Activities of Daily Living, and Caregiving Costs for Institutionalized Patients on Anti-Alzheimer Medications in Japan

2021 ◽  
pp. 1-8
Author(s):  
Takumi Ashizawa ◽  
Ataru Igarashi ◽  
Yukinori Sakata ◽  
Mie Azuma ◽  
Kenichi Fujimoto ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
The Elderly ◽  
The Mean ◽  
Institutionalized Patients ◽  
The Impact

Background: Alzheimer’s disease (AD) increases societal costs and decreases the activities of daily living (ADL) and quality of life (QoL) of the affected individuals. Objective: We assess the impact of AD severity on ADL, QoL, and caregiving costs in Japanese facilities for the elderly. Methods: Patients with AD in facilities for the elderly were included (47 facilities, N = 3,461). The QoL, ADL, and disease severity of patients were assessed using Barthel Index (BI), EuroQoL-5D-5L (EQ-5D-5L), and Mini-Mental State Examination (MMSE), respectively. Annual caregiving costs were estimated using patients’ claims data. The patients were subcategorized into the following three groups according to the MMSE score: mild (21≤MMSE≤30), moderate (11≤MMSE≤20), and severe (0≤MMSE≤10). Changes among the three groups were evaluated using the Jonckheere-Terpstra test. Results: Four hundred and one participants were on anti-AD medicines, of whom 287 (age: 86.1±6.4 years, 76.7% women) in the mild (n = 53, 84.0±6.9 years, 71.7%), moderate (n = 118, 86.6±5.9 years, 76.3%), and severe (n = 116, 86.6±6.5 years, 79.3%) groups completed the study questionnaires. The mean BI and EQ-5D-5L scores for each group were 83.6, 65.1, and 32.8 and 0.801, 0.662, and 0.436, respectively. The mean annual caregiving costs were 2.111, 2.470, and 2.809 million JPY, respectively. As AD worsened, the BI and EQ-5D-5L scores decreased and annual caregiving costs increased significantly. Conclusion: AD severity has an impact on QoL, ADL, and caregiving costs.

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.

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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