The role of carers in the information process in dementia

1997 ◽  
Vol 21 (5) ◽  
pp. 264-266 ◽  
Author(s):  
Rahul Rao
Keyword(s):  
Cognitive Function ◽  
Early Detection ◽  
Cognitive Decline ◽  
Health Professionals ◽  
Information Process ◽  
Early Referral ◽  
Comprehensive Information ◽  
Specialist Services ◽  
Diagnosis Of Dementia

The role of carers is explored in the process beginning with the early detection of changes in cognitive function through to the diagnosis of dementia. Carers were not always aware of early cognitive decline before other family and friends. Forty-five per cent of initial diagnoses were made by GPs. In over 50% of cases, the sufferer had not been told their diagnosis by health professionals or carers. A quarter of carers wanted more information about dementia even after referral to specialist services. The importance of early referral and provision of sufficient comprehensive information about dementia are discussed.

The Validity of the Norwegian Version of the Cognitive Function Instrument

2018 ◽  
Vol 46 (3-4) ◽  
pp. 217-228 ◽  
Author(s):  
Mona Michelet ◽  
Knut Engedal ◽  
Geir Selbæk ◽  
Anne Lund ◽  
Guro Hanevold Bjørkløf ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Reference Group ◽  
Area Under The Curve ◽  
The Self ◽  
Norwegian Version ◽  
People With Dementia ◽  
Diagnosis Of Dementia ◽  
Proxy Version

Background/Aims: A timely diagnosis of dementia is important, and the Cognitive Function Instrument (CFI) is a newly developed instrument to screen for cognitive decline. The aim of this study was to evaluate the validity and internal consistency of the Norwegian version of the CFI. Methods: We included 265 participants with dementia, mild cognitive impairment (MCI), subjective cognitive impairment (SCI), and a reference group without subjective or assessed cognitive decline. The participants and their relatives answered the self- and proxy-rated versions of the CFI. Results: The Norwegian CFI had power to discriminate between people with dementia and with MCI, SCI, and the reference group. The proxy version had better power than the self-rated version in our participants (area under the curve [AUC] proxy-rated varying from 0.79 to 0.99, AUC self-rated varying from 0.56 to 0.85). Conclusion: The Norwegian CFI was found to be a useful, valid, and robust instrument.

scholarly journals The association between injurious falls and older adults’ cognitive function: the role of depressive mood and physical performance

2021 ◽  
Author(s):  
Caterina Trevisan ◽  
Enrico Ripamonti ◽  
Giulia Grande ◽  
Federico Triolo ◽  
Stina Ek ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Physical Performance ◽  
Walking Speed ◽  
Depressive Mood ◽  
Time Interval ◽  
Injurious Falls

Abstract Background The impact of falls on cognitive function is unclear. We explored whether injurious falls are associated with cognitive decline in older adults, and evaluated the role of changes in psychological and physical health as mediators of such association. Methods This prospective study involved 2,267 community-dwelling participants in the Swedish National study on Aging and Care in Kungsholmen (≥60 years). Data on injurious falls (i.e., falls requiring medical attention) during each 3-year time interval of follow-up were obtained from national registers. Assessment of cognitive function (Mini-Mental State Examination[MMSE]), depressive mood (Montgomery-Åsberg Depression Rating Scale), and physical performance (walking speed) were carried out every 3 or 6 years over a 12-year follow-up. The association between falls and cognition was estimated through linear mixed effects models, and the mediating role of changes in depressive mood and physical performance was tested using mediation analysis. Results After adjusting for potential confounders, individuals who experienced injurious falls had a greater annual decline in MMSE in the subsequent time interval (β=-1.49, 95%CI:-1.84;-1.13), than those who did not. The association increased with the occurrence of ≥2 falls (β=-2.13, 95%CI:-2.70;-1.56). Worsening of walking speed and depressive mood explained around 26% and 8%, respectively, of the association between falls and cognitive decline. Conclusions Injurious falls are associated with greater cognitive decline, and this association is partly mediated by worsening of physical performance and, in a lesser extent, of depressive mood. These findings suggest that physical deficits and low mood are potential therapeutic targets for mitigating the association between falls and cognitive decline.

scholarly journals New Therapeutic Approaches to Mild Cognitive Impairment and Mild Dementia: The Role of Ginkgo Biloba (EGb 761®)

2021 ◽  
Author(s):  
Carlo Tomino ◽  
Sara Ilari ◽  
Vincenzo Solfrizzi ◽  
Valentina Malafoglia ◽  
Guglielmo Zilio ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Combination Therapy ◽  
Cognitive Decline ◽  
Ginkgo Biloba ◽  
Neurodegenerative Disorder ◽  
Mild Dementia ◽  
Dementia Syndrome

Mild cognitive impairment (MCI) and mild dementia are a clinically relevant health problem in the elderly and Alzheimer's disease being the most common neurodegenerative disorder. Furthermore, MCI and mild dementia are characterized by a deterioration of cognitive function and their diagnosis is mainly based on cognitive examination and, the prognosis of the disease seems to be an essential reason for the diagnosis, because there is a high risk of cognitive decline in the two syndromes. This review describes the effectiveness of Ginkgo biloba (EGb761®) leaf extract for the treatment of dementia syndrome and EGb761® combination therapy with other medications for symptomatic dementia. Tebonin® is a drug of plant origin based on the active ingredient “Ginkgo biloba”. This drug has shown encouraging results, improving cognitive function, neuropsychiatric disorders and consequent reduction of caregiver stress and maintenance of autonomy in patients with age-related cognitive decline, MCI and mild dementia. Nowadays, there is little evidence to support the efficacy of EGb761® combination therapy with anti-dementia drugs and, therefore, more evidence is needed to evaluate the role of EGb761® in mixed therapy.

scholarly journals Peroxisomal Proliferator-Activated Receptor β/δ Deficiency Induces Cognitive Alterations

2021 ◽  
Author(s):  
Triana Espinosa-Jimenez ◽  
Oriol Busquets ◽  
Amanda Cano ◽  
Ester Verdaguer ◽  
Jordi Olloquequi ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Dendritic Spine ◽  
Coconut Oil ◽  
Spine Density ◽  
Synaptic Structure ◽  
Synaptic Markers ◽  
The Central Nervous System

Abstract BackgroundPPARβ/δ, the most PPAR abundant isotype in the central nervous system is involved in the modulation of microglial homeostasis and metabolism. Several studies have demonstrated that people suffering from type 2 diabetes mellitus develop cognitive decline turning insulin resistance one of the best predictors of this disturbance. Although numerous investigations have studied the role of PPARb/d in metabolism, its role in neuronal and cognitive function has been underexplored. Therefore, the aim of the study is to determine the role of PPARb/d in the neuropathological pathways involved in the development of cognitive decline and as to whether a risk factor involved in cognitive loss such as obesity modulates neuropathological markers.6-month-old male PPARβ/δ-null (PPARβ/δ-/-) and wildtype (WT) littermates with the same genetic background (C57BL/6X129/SV) and exceptionally, C57BL/6 were used. After the weaning, animals were fed either with conventional chow (CT) or with a palmitic acid-enriched diet containing 45% of fat mainly from hydrogenated coconut oil (HFD). Thus, four groups were defined: WT CT, WT HFD, PPARβ/δ-/- CT and PPARβ/δ-/- HFD and several pathological mechanisms involved in cognitive decline were analyzed.ResultsOur results confirmed that C57BL/6X129/SV showed significantly increased levels of anxiety compared to C57BL/6. Therefore, to evaluate cognitive decline, behavioral tests were dismissed, and dendritic spine quantification and other biochemical biomarkers were performed.PPARβ/δ-/- mice exhibited a decrease in dendritic spine density and synaptic markers, suggesting an alteration in cognitive function and synaptic plasticity. Likewise, our study demonstrated that the lack of PPARβ/δ receptor enhances gliosis in the hippocampus, contributing to astrocyte and microglial activation and also induced an increase in neuroinflammatory biomarkers. Additionally, alterations in the hippocampal insulin receptor pathway were found. Interestingly, while some of the disturbances caused by the lack of PPARβ/δ were not affected by feeding the HFD, others were exacerbated or required the combination of both factors.ConclusionsTaken together, these findings suggest that the loss of PPARβ/δ-/- affects neuronal and synaptic structure, contributing to cognitive dysfunction and, they also present this receptor as a possible new target for the treatment of cognitive decline.

scholarly journals Role of cholesterol in cognitive function in the elderly

2021 ◽  
Vol 8 (2) ◽  
pp. 56-59
Author(s):  
V K Deshpande ◽  
Vishwin Doda
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Blood Cholesterol ◽  
Elderly Subjects ◽  
Blood Concentrations ◽  
Cholesterol Levels ◽  
State Examination

The role of cholesterol in Cognitive Decline is less known as compared to other pathologies linked with dyslipidaemia. However, Cholesterol is well-known to have multiple functions in normal functioning of the brain and the aging process. This study therefore aimed at finding a co-relation, if any, between Cholesterol and age-related cognitive decline.To assess Cognitive Function of subjects and compare it with respective blood cholesterol levels. The study included 50 elderly subjects from Maharashtra (females: 12%) assessed using Marathi version of Mini Mental State Examination (MMSE) and their cholesterol blood concentrations obtained using a Lipid Profile investigation. Cholesterol levels and cognitive function was then co-related using statistical analysis.The subjects with a higher Total Cholesterol & LDL Cholesterol had slightly less scores on the Mini Mental State Examination (MMSE) Test. However, the difference was found to be significant.Based on the results obtained, no relevant co-relation could be found between Blood Cholesterol Levels and Cognitive Function

Role of Auditory Training in Intervention of Individuals With Cognitive Decline and Hearing Impairment

2015 ◽  
Vol 20 (2) ◽  
pp. 58-64 ◽  
Author(s):  
Sridhar Krishnamurti ◽  
Dianna Tingle ◽  
Hannah Bannon ◽  
Molly Armstrong
Keyword(s):  
Hearing Loss ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Hearing Impairment ◽  
Auditory Training

The role of auditory training in enhancement of auditory and cognitive function in aging individuals with hearing loss and cognitive decline is discussed in this article. Results of previous controlled studies and the current pilot (Angel Sound) support value for auditory training for these individuals.

When to suspect dementia

2018 ◽  
Vol 11 (5) ◽  
pp. 241-248
Author(s):  
Emily Foggin
Keyword(s):  
Early Detection ◽  
Advance Care Planning ◽  
Care Planning ◽  
Common Cause ◽  
Everyday Activities ◽  
Specialist Services ◽  
Diagnosis Of Dementia ◽  
Advance Care ◽  
The Common ◽  
Proactive Support

Dementia is a syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities. An accurate and timely diagnosis of dementia provides opportunity for early treatment, proactive support and advance care planning. However, there is evidence that GPs lack confidence in diagnosing dementia, in part because patients with dementia present in many different ways. Researchers believe that early detection of Alzheimer’s disease, the most common cause of dementia, is necessary if ways to prevent, slow and stop the disease are to be found. This article highlights the common presenting complaints in dementia and offers how GPs can work towards a diagnosis and refer to specialist services appropriately.

scholarly journals The Association between Neighborhood Amenities and Cognitive Function: Role of Lifestyle Activities

2020 ◽  
Vol 9 (7) ◽  
pp. 2109
Author(s):  
Osamu Katayama ◽  
Sangyoon Lee ◽  
Keitaro Makino ◽  
Ippei Chiba ◽  
Seongryu Bae ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Rural Areas ◽  
Urban Areas ◽  
Cognitive Disorders ◽  
Word List ◽  
Mini Mental Status Exam ◽  
List Memory ◽  
Lifestyle Activities

Many of the modifiable risk factors for dementia are lifestyle-related, and multidomain interventions tailored to individual lifestyles are recommended to prevent cognitive decline and dementia. However, studies of the relationship between the environment and cognitive function have shown that cognitive disorders and dementia are more prevalent in rural areas than in urban areas. The purpose of this study was to clarify the role of lifestyle activities on the association between neighborhood amenities and cognitive function. Our data were measured between August 2011 and February 2012. Participants comprised 3786 older adults (mean age: 71.5 years, standard deviation (SD) = ±5.2). We categorized neighborhood amenities as institutional resources that promote cognitively beneficial activities such as physical activity. We calculated the Walk Score® for all participants using their home address and divided them into three groups. We assessed their 12 lifestyle activities performed outdoors. Cognitive function was measured via Mini-Mental Status Exam, word list memory, attention, executive function, and processing speed. We found that participants who were more likely to report many lifestyle activities were more likely to have normal cognition, even in areas where neighborhood amenities were scarce. The clinical significance of this study is that increased lifestyle activity contributes to the prevention of cognitive decline.

scholarly journals Epigenetic Age Acceleration and Cognitive Decline: A Twin Study

2021 ◽  
Author(s):  
Viola Vaccarino ◽  
Minxuan Huang ◽  
Zeyuan Wang ◽  
Qin Hui ◽  
Amit J Shah ◽  
...  
Keyword(s):  
Executive Function ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Twin Study ◽  
Memory Function ◽  
Function Score ◽  
Epigenetic Age ◽  
Epigenetic Age Acceleration

Abstract Background Little is known about the role of DNA methylation (DNAm) epigenetic age acceleration in cognitive decline. Using a twin study design, we examined whether DNAm age acceleration is related to cognitive decline measured longitudinally in persons without a clinical diagnosis of dementia. Methods We studied 266 paired male twins (133 pairs) with a mean age of 56 years at baseline. Of these, 114 paired twins returned for a follow-up after an average of 11.5 years. We obtained six indices of DNAm age acceleration based on epigenome-wide data from peripheral blood lymphocytes. At both baseline and follow-up, we administered a battery of cognitive measures and constructed two composite scores, one for executive function and one for memory function. We fitted multivariable mixed regression models to examine the association of DNAm age acceleration markers with cognitive function within pairs. Results In cross sectional analyses at baseline, there was no association between DNAm age acceleration and cognitive function scores. In longitudinal analyses, however, comparing twins within pairs, each additional year of age acceleration using the Horvath’s method was associated with a 3% decline (95% CI, 1% to 5%) in the composite executive function score and a 2.5% decline (95% CI, 0.01% to 4.9%) in the memory function score. These results did not attenuate after adjusting for education and other risk factors. Conclusions Middle-aged men who had older DNAm age relative to their brothers of the same demographic age, showed a faster rate of cognitive decline in the subsequent 11.5 years. These results point to the role of epigenetic modifications in cognitive aging.

scholarly journals Affective problems and decline in cognitive state in older adults: a systematic review and meta-analysis

2018 ◽  
Vol 49 (3) ◽  
pp. 353-365 ◽  
Author(s):  
A. John ◽  
U. Patel ◽  
J. Rusted ◽  
M. Richards ◽  
D. Gaysina
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cognitive State ◽  
Depression And Anxiety ◽  
Eligibility Criteria ◽  
Diagnosis Of Dementia ◽  
Prospective Longitudinal

AbstractEvidence suggests that affective problems, such as depression and anxiety, increase risk for late-life dementia. However, the extent to which affective problems influence cognitive decline, even many years prior to clinical diagnosis of dementia, is not clear. The present study systematically reviews and synthesises the evidence for the association between affective problems and decline in cognitive state (i.e., decline in non-specific cognitive function) in older adults. An electronic search of PubMed, PsycInfo, Cochrane, and ScienceDirect was conducted to identify studies of the association between depression and anxiety separately and decline in cognitive state. Key inclusion criteria were prospective, longitudinal designs with a minimum follow-up period of 1 year. Data extraction and methodological quality assessment using the STROBE checklist were conducted independently by two raters. A total of 34 studies (n= 71 244) met eligibility criteria, with 32 studies measuring depression (n= 68 793), and five measuring anxiety (n= 4698). A multi-level meta-analysis revealed that depression assessed as a binary predictor (OR 1.36, 95% CI 1.05–1.76,p= 0.02) or a continuous predictor (B= −0.008, 95% CI −0.015 to −0.002,p= 0.012; OR 0.992, 95% CI 0.985–0.998) was significantly associated with decline in cognitive state. The number of anxiety studies was insufficient for meta-analysis, and they are described in a narrative review. Results of the present study improve current understanding of the temporal nature of the association between affective problems and decline in cognitive state. They also suggest that cognitive function may need to be monitored closely in individuals with affective disorders, as these individuals may be at particular risk of greater cognitive decline.

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