scholarly journals Rationale, Design, and Methodology of a Prospective Cohort Study for Coping with Behavioral and Psychological Symptoms of Dementia: The RECage Project

2021 ◽  
Vol 80 (4) ◽  
pp. 1613-1627
Author(s):  
Eleni Poptsi ◽  
Magda Tsolaki ◽  
Sverre Bergh ◽  
Bruno Mario Cesana ◽  
Alfonso Ciccone ◽  
...  
Keyword(s):  
Cohort Study ◽  
Psychotropic Drug ◽  
Psychological Symptoms ◽  
Cost Of Care ◽  
Community Dwelling ◽  
Drug Consumption ◽  
Study Results ◽  
Short And Long Term ◽  
Behavioral And Psychological Symptoms

Background: Behavioral and psychological symptoms of dementia (BPSD) are quite challenging problems during the dementia course. Special Care Units for people with dementia (PwD) and BPSD (SCU-B) are residential medical structures, where BPSD patients are temporarily admitted, in case of unmanageable behavioral disturbances at home. Objective: RECage (REspectful Caring for AGitated Elderly) aspires to assess the short and long-term effectiveness of SCU-Bs toward alleviating BPSD and improving the quality of life (QoL) of PwD and their caregivers. Methods: RECage is a three-year, prospective study enrolling 500 PwD. Particularly, 250 community-dwelling PwDs presenting with severe BPSD will be recruited by five clinical centers across Europe, endowed with a SCU-B, for a short period of time; a second similar group of 250 PwD will be followed by six other no-SCU-B centers solely via outpatient visits. RECage’s endpoints include short and long-term SCU-B clinical efficacy, QoL of patients and caregivers, cost-effectiveness of the SCU-B, psychotropic drug consumption, caregivers’ attitude toward dementia, and time to nursing home placement. Results: PwD admitted in SCU-Bs are expected to have diminished rates of BPSD and better QoL and their caregivers are also expected to have better QoL and improved attitude towards dementia, compared to those followed in no-SCU-Bs. Also, the cost of care and the psychotropic drug consumption are expected to be lower. Finally, PwD followed in no-SCU-Bs are expected to have earlier admission to nursing homes. Conclusion: The cohort study results will refine the SCU-B model, issuing recommendations for implementation of SCU-Bs in the countries where they are scarce or non-existent.

scholarly journals The Holistic Impact of Using Arts-Based Intervention for Elderly With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 567-567
Author(s):  
Rainbow Tin Hun Ho
Keyword(s):  
Motor Behavior ◽  
Psychological Symptoms ◽  
Controlled Trial ◽  
Negative Mood ◽  
Community Dwelling ◽  
Creative Arts ◽  
Dance Movement ◽  
Moderate Dementia ◽  
Practical Experiences ◽  
Behavioral And Psychological Symptoms

Abstract The use of creative arts on supporting elderly with dementia has been becoming popular due to its safe and engaging process. This non-pharmacological approach can complement with other treatment methods to support elderly with dementia on various aspects, including physical, cognitive and social functioning. In our randomized controlled trial on dance movement therapy (DMT) for 204 community dwelling elders with mild dementia, we found DMT could significantly reduce the level of depression, loneliness and negative mood (β=0.33-0.42, p<.01), and also the diurnal cortisol slope (β =0.30, p<.01); while in another trial on 73 elderly with moderate dementia, we found music and movement could help reduce the behavioral and psychological symptoms such as agitation (β = -0.41, p<.01), aberrant motor behavior (β=-1.02, p<.01), and dysphonia (β=-0.61, p<.05). The present presentation aims to share with the audience our practical experiences, the research procedures as well as the findings of the projects.

scholarly journals The impact of lockdown during SARS-CoV-2 outbreak on behavioral and psychological symptoms of dementia

2021 ◽  
Vol 42 (3) ◽  
pp. 825-833
Author(s):  
Arianna Manini ◽  
Michela Brambilla ◽  
Laura Maggiore ◽  
Simone Pomati ◽  
Leonardo Pantoni
Keyword(s):  
Logistic Regression ◽  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Community Dwelling ◽  
Caregiver Distress ◽  
Neuropsychiatric Inventory ◽  
Logistic Regression Models ◽  
The Impact ◽  
Behavioral And Psychological Symptoms

Abstract Background During Covid-19 pandemic, the Italian government adopted restrictive limitations and declared a national lockdown on March 9, which lasted until May 4 and produced dramatic consequences on people’s lives. The aim of our study was to assess the impact of prolonged lockdown on behavioral and psychological symptoms of dementia (BPSD). Methods Between April 30 and June 8, 2020, we interviewed with a telephone-based questionnaire the caregivers of the community-dwelling patients with dementia who had their follow-up visit scheduled from March 9 to May 15 and canceled due to lockdown. Among the information collected, patients’ BPSDs were assessed by the Neuropsychiatric Inventory (NPI). Non-parametric tests to compare differences between NPI scores over time and logistic regression models to explore the impact of different factors on BPSD worsening were performed. Results A total of 109 visits were canceled and 94/109 caregivers completed the interview. Apathy, irritability, agitation and aggression, and depression were the most common neuropsychiatric symptoms experienced by patients both at baseline and during Covid-19 pandemic. Changes in total NPI and caregiver distress scores between baseline and during lockdown, although statistically significant, were overall modest. The logistic regression model failed to determine predictors of BPSD worsening during lockdown. Conclusion This is one of the first studies to investigate the presence of BPSD during SARS-CoV-2 outbreak and related nationwide lockdown, showing only slight, likely not clinically relevant, differences in BPSD burden, concerning mostly agitation and aggression, anxiety, apathy and indifference, and irritability.

scholarly journals Biological and Functional Changes in Healthy Adult Smokers Who Are Continuously Abstinent From Smoking for One Year: Protocol for a Prospective, Observational, Multicenter Cohort Study (Preprint)

2018 ◽  
Author(s):  
Cam Tuan Tran ◽  
Loyse Felber Medlin ◽  
Nicola Lama ◽  
Brindusa Taranu ◽  
Weeteck Ng ◽  
...  
Keyword(s):  
Cohort Study ◽  
Adverse Events ◽  
Clinical Chemistry ◽  
Risk Level ◽  
Functional Changes ◽  
Biomarkers Of Exposure ◽  
Quit Smoking ◽  
Study Results ◽  
Biomarkers Of Effect

BACKGROUND The harm of smoking results mainly from long-term exposure to harmful and potentially harmful constituents (HPHCs) generated by tobacco combustion. Smoking cessation (SC) engenders favorable changes of clinical signs, pathomechanisms, and metabolic processes that together could reduce the harm of smoking-related diseases to a relative risk level approximating that of never-smokers over time. In most SC studies, the main focus is on the quitting rate of the SC program being tested. As there is limited information in the literature on short to multiple long-term functional or biological changes following SC, more data on short to mid-term favorable impacts of SC are needed. OBJECTIVE The overall aim of the study was to assess the reversibility of the harm related to smoking over 1 year of continuous smoking abstinence (SA). This has been verified by assessing a set of biomarkers of exposure to HPHCs and a set of biomarkers of effect indicative of multiple pathophysiological pathways underlying the development of smoking-related diseases. METHODS This multiregional (United States, Japan, and Europe), multicenter (42 sites) cohort study consisting of a 1-year SA period in an ambulatory setting was conducted from May 2015 to May 2017. A total of 1184 male and female adult healthy smokers, willing to quit smoking, were enrolled in the study. Nicotine replacement therapy (NRT) was provided for up to 3 months upon the subject’s request. SC counseling and behavioral support were continuously provided. Biomarkers of exposure to HPHCs and biomarkers of effect were assessed in urine and blood at baseline, Month 3, Month 6, and Month 12. Cardiovascular biomarkers of effect included parameters reflecting inflammation (white blood cell), lipid metabolism (high-density lipoprotein cholesterol), endothelial function (soluble intercellular adhesion molecule-1), platelet function (11-dehydrothromboxane B2), oxidative stress (8-epi-prostaglandin F2 alpha), and carbon monoxide exposure (carboxyhemoglobin). Respiratory biomarkers of effect included lung function parameters and cough symptoms. The biomarkers of effect to evaluate genotoxicity (total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol) and xenobiotic metabolism (cytochrome P450 2A6 activity) were also assessed. Continuous SA was verified at each visit following the actual quit date using self-reporting and chemical verification. Safety assessments included adverse events and serious adverse events, body weight, vital signs, spirometry, electrocardiogram, clinical chemistry, hematology and urine analysis safety panel, physical examination, and concomitant medications. RESULTS In total, 1184 subjects (50.1% male) were enrolled; 30% of them quit smoking successfully for 1 year. Data analyses of the study results are ongoing and will be published after study completion. CONCLUSIONS This study provides insights into biological and functional changes and health effects, after continuous SA over 1 year. Study results will be instrumental in assessing novel alternative products to cigarettes considered for tobacco harm reduction strategies. CLINICALTRIAL ClinicalTrials.gov NCT02432729; http://clinicaltrials.gov/ct2/show/NCT02432729 (Archived by WebCite at http://www.webcitation.org/78QxovZrr) INTERNATIONAL REGISTERED REPOR DERR1-10.2196/12138

Long-Term Exposure to Air Pollutants and Cognitive Function in Taiwanese Community-Dwelling Older Adults: A Four-Year Cohort Study

2021 ◽  
Author(s):  
Jen-Hau Chen ◽  
Tsung-Yu Kuo ◽  
Hwa-Lung Yu ◽  
Charlene Wu ◽  
Su-Ling Yeh ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Executive Function ◽  
Verbal Fluency ◽  
Air Pollutants ◽  
Community Dwelling ◽  
High Concentrations ◽  
High Level ◽  
Community Dwelling Older Adults

Background: Previous studies have assessed limited cognitive domains with relatively short exposure to air pollutants, and studies in Asia are limited. Objective: This study aims to explore the association between long-term exposure to air pollutants and cognition in community-dwelling older adults. Methods: This four-year prospective cohort study recruited 605 older adults at baseline (2011–2013) and 360 participants remained at four-year follow-up. Global and domain-specific cognition were assessed biennially. Data on PM2.5 (particulate matter ≤ 2.5 μm diameter, 2005–2015), PM10 (1993–2015), and nitrogen dioxide (NO2, 1993–2015) were obtained from Taiwan Environmental Protection Administration (TEPA). Bayesian Maximum Entropy was utilized to estimate the spatiotemporal distribution of levels of these pollutants. Results: Exposure to high-level PM2.5 (>29.98 μg/m3) was associated with an increased risk of global cognitive impairment (adjusted odds ratio = 4.56; β = −0.60). High-level PMcoarse exposure (>26.50 μg/m3) was associated with poor verbal fluency (β = −0.19). High-level PM10 exposure (>51.20 μg/m3) was associated with poor executive function (β = −0.24). Medium-level NO2 exposure (>28.62 ppb) was associated with better verbal fluency (β = 0.12). Co-exposure to high concentrations of PM2.5, PMcoarse or PM10 and high concentration of NO2 were associated with poor verbal fluency (PM2.5 and NO2: β = −0.17; PMcoarse and NO2: β = −0.23; PM10 and NO2: β = −0.21) and poor executive function (PM10 and NO2: β = −0.16). These associations became more evident in women, apolipoprotein ε4 non-carriers, and those with education > 12 years. Conclusion: Long-term exposure to PM2.5 (higher than TEPA guidelines), PM10 (lower than TEPA guidelines) or co-exposure to PMx and NO2 were associated with poor global, verbal fluency, and executive function over 4 years.

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