Impact of loss of independence in basic activities of daily living on caregiver burden in patients with Alzheimer's disease: A retrospective cohort study

2019 ◽  
Vol 19 (12) ◽  
pp. 1243-1247 ◽  
Author(s):  
Rika Kawaharada ◽  
Taiki Sugimoto ◽  
Naoka Matsuda ◽  
Yamato Tsuboi ◽  
Takashi Sakurai ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cohort Study ◽  
Activities Of Daily Living ◽  
Caregiver Burden ◽  
Retrospective Cohort Study ◽  
Daily Living ◽  
Retrospective Cohort

scholarly journals Alzheimer's disease medication and risk of all‐cause mortality and all‐cause hospitalization: A retrospective cohort study

2019 ◽  
Vol 5 (1) ◽  
pp. 294-302 ◽  
Author(s):  
Sandipan Bhattacharjee ◽  
Asad E. Patanwala ◽  
Wei‐Hsuan Lo‐Ciganic ◽  
Daniel C. Malone ◽  
Jeannie K. Lee ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
All Cause Mortality

scholarly journals DL-3-n-butylphthalide Delays Cognitive Decline in Patients With Mild to Moderate Alzheimer's Disease Already Receiving Donepezil: A Multicenter, Prospective Cohort Study

2020 ◽  
Author(s):  
Jin Wang ◽  
Xiaojuan Guo ◽  
Wenhui Lu ◽  
Jie Liu ◽  
Hong Zhang ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Daily Living

Abstract Background：Vascular factors and mitochondria dysfunction contributeto thepathogenesis of Alzheimer’s Disease (AD).DL-3-n-butylphthalide (NBP)has an effect in protecting mitochondria and improving microcirculation. We investigated the effect of NBP in patients with mild-moderate AD already receiving donepezil.Methods: It was a prospective cohort study. 92 mild-moderate AD patients were classified into the donepezil alone group (n=43) or the donepezil combined NBP group (n=49) for 48 weeks. The primary outcome was change of Alzheimer’s disease assessment scale-cognitive subscale (ADAS-cog) from baseline after treatment 48 weeks. All patients were also evaluated with clinician’s interview-based impression of change plus caregiver input (CIBIC-plus), Alzheimer's disease cooperative study-activities of daily living (ADCS-ADL) and neuropsychiatric inventory (NPI) every 12 weeks. All patients were monitored for adverse events (AEs). The efficacy was analyzed using logistic regression analysis.Results:The univariate analysis showed that age wasolder in donepezil alone group(P=0.005), prevalence of hypertension was higher in donepezil alone group(P=0.026).The ADAS-cog score change from baseline in thedonepezil alone group was significant than that in the donepezil combined NBP group at 48 weeks(1.82±5.20 vs -0.38±4.46, P=0.048). The multivariate logistic regression analysis showed that between the 2 groups, there were significant differencesin changes on the ADAS-cog(OR=0.879,95% CI:[0.785,0.984],P=0.026),MMSE(OR=1.270,95% CI:[1.036,1.557],P=0.021), and ADCS-ADL(OR=1.067,95% CI:[1.002,1.136],P=0.042) but no significant differences for changes on the NPI(OR=0.955,95% CI:[0.901，1.013],P=0.125)and CIBIC-plus (OR=0.356,95% CI:[0.093,1.364],P=0.132). The occurrence of AEs was similar in the 2 groups.Conclusions:Over the 48-week treatment period, donepezil combined NBP group had slower cognitive decline and better activities of daily living in patients with mild to moderate AD. These indicated that the multi-target therapeutic effect of NBP may be a new choice for AD treatment.Trial registration:Clinical trial registration URL:https://clinicaltrials.gov/ct2/show/NCT02711683?term=NCT02711683&draw=2&rank=1ClinicalTrials.gov Identifier: NCT02711683. Date of registration: March 14,2016.

scholarly journals Do premorbid characteristics of home care clients predict delayed discharges in acute care hospitals: a retrospective cohort study in Ontario and British Columbia, Canada

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e038484
Author(s):  
Stella A Arthur ◽  
John P Hirdes ◽  
George Heckman ◽  
Anne Morinville ◽  
Andrew P Costa ◽  
...  
Keyword(s):  
Cohort Study ◽  
Home Care ◽  
Activities Of Daily Living ◽  
Retrospective Cohort Study ◽  
Daily Living ◽  
Retrospective Cohort ◽  
Term Care ◽  
Delayed Discharge ◽  
Hospitalised Patients ◽  
Care Assessment

BackgroundImproved identification of patients with complex needs early during hospitalisation may help target individuals at risk of delayed discharge with interventions to prevent iatrogenic complications, reduce length of stay and increase the likelihood of a successful discharge home.MethodsIn this retrospective cohort study, we linked home care assessment records based on the Resident Assessment Instrument for Home Care (RAI-HC) of 210 931 hospitalised patients with their Discharge Abstract Database records. We then undertook multivariable logistic regression analyses to identify preadmission predictive factors for delayed discharge from hospital.ResultsCharacteristics that predicted delayed discharge included advanced age (OR: 2.72, 95% CI 2.55 to 2.90), social vulnerability (OR: 1.27, 95% CI 1.08 to 1.49), Parkinsonism (OR: 1.34, 95% CI 1.28 to 1.41) Alzheimer’s disease and related dementias (OR: 1.27, 95% CI 1.23 to 1.31), need for long-term care facility services (OR: 2.08, 95% CI 1.96 to 2.21), difficulty in performing activities of daily living and instrumental activities of daily living, falls (OR: 1.16, 95% CI 1.12 to 1.19) and problematic behaviours such as wandering (OR: 1.29, 95% CI 1.22 to 1.38).ConclusionPredicting delayed discharge prior to or on admission is possible. Characteristics associated with delayed discharge and inability to return home are easily identified using existing interRAI home care assessments, which can then facilitate the targeting of pre-emptive interventions immediately on hospital admission.

Variables Associated with High Caregiver Stress in Patients with Mild Cognitive Impairment or Alzheimer's Disease: Implications for Providers in a Co-Located Memory Assessment Clinic

2014 ◽  
Vol 36 (2) ◽  
pp. 145-159 ◽  
Author(s):  
Daniel Hall ◽  
Joseph Wilkerson ◽  
James Lovato ◽  
Kaycee Sink ◽  
Dana Chamberlain ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Caregiver Burden ◽  
Daily Living ◽  
Functional Independence ◽  
Assessment Clinic ◽  
Behavioral Disturbances ◽  
Memory Assessment

Caregiver burden—the stress associated with caring for a loved one with chronic illness—is rated as high or very high by about two-thirds of Alzheimer's caregivers. At Wake Forest School of Medicine, both patients with memory loss or cognitive impairment and caregivers are evaluated at a geriatrician-led co-located Memory Assessment Clinic (MAC). In a sample of 100 MAC-evaluated patient-caregiver dyads this study assessed both patient severity of Alzheimer's disease or other dementia, self-reported behavioral disturbances, degree of functional independence in general activities of daily living and instrumental activities of daily living (IADLs), and caregiver stress as measured by the Caregiver Burden Scale (CBS). Several patient factors were found to be related to high caregiver stress (CBS score > 25), in particular moderate-severe dementia; inability to perform most IADLs, especially managing medications; and most behavioral disturbances, especially agitation/aggression and appetite/eating problems. The article also suggests ways medical and mental health providers and researchers can help reduce caregiver stress.

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