scholarly journals 549 - Psychosocial factors in the formation of non-cognitive symptoms of dementia

2021 ◽  
Vol 33 (S1) ◽  
pp. 91-91
Author(s):  
Alena Sidenkova
Keyword(s):  
Cognitive Impairment ◽  
Sleep Disturbances ◽  
Care Process ◽  
Functional Disorders ◽  
Family Role ◽  
Statistical Research ◽  
Number Of Patients ◽  
Psychosocial Conditions ◽  
High Level ◽  
Severity Of Dementia

Background:The growing prevalence of severe cognitive impairment in populations, the involvement of a significant number of people of working age in the medical, economic, psychological and social problems associated with late dementia, the insufficiency and inconsistency of information about the mechanisms of formation of these disorders actualize a comprehensive medical and social study of dementia.The goal is to study the psychosocial mechanisms of the formation of clinical, functional disorders in dementia, to develop comprehensive medical and psychosocial programs to help patients with dementia and those involved in caring for them, based on the proposals of the psychosocial model of dementia.Methods:A selective observational comparative dynamic study of 315 people with Alzheimer’s dementia and 214 people who care for the patients was carried out. The study used clinical, clinical, psychopathological, neuropsychological, psychometric, sociometric, and statistical research methods.Results:An increase in the severity of dementia contributes to a significant (p <0.05) increase in the number of patients in a dependent position in the family. The appearance of psychotic (painful ideas [r = 0.589]), behavioral (agitation/aggression [r = 0.654]), affective (anxiety [r = 0.536], unstable mood/irritability [r = 0.581]) symptoms of dementia contribute to family role changes structure and increase interpersonal distance in the dyad “caretaker - patient.” Decreased functional activity of the patient (r = 0.758), development of behavioral disorders (aberrant behavior [r = 0.675], agitation/aggression [r = 0.713], impaired night behavior [r = 0.597]), affective symptoms (anxiety [r = 0.685]) contribute to aggravation of the distress of the caregiver. Those who provide unprofessional care for dementia patients in a statistically significant (p <0.05) majority of cases have a high level of emotional involvement in the care process. Changes in family-role and social parameters, a high level of “expressed” emotions of caregivers have an adverse effect on the development of psychotic (r = 0.618), affective (r = 0.701), behavioral (r = 0.837) dementia disorders. The degree of adherence to anti- dementia therapy by the caregiver is one of the important factors determining the amount of care received by the patient (r = 0.698). Agitation/aggression (r = 0.761), anxiety (r = 0.562), sleep disturbances (r = 0.521) contribute to increased compliance. The low satisfaction of the caregiver with premorbid (r = 0.698) and current (r = 0.653) relationships with the patient leads to a decrease in the compliance of the caregiver.Conclusion:It was revealed that the formation of cognitive impairment is caused by biological factors, their severity depends on the severity of dementia. The mechanism of psychopathological symptoms, functional disorders is heterogeneous, depending on the biological causes and psychosocial conditions of functioning of patients.

scholarly journals Sleep Disturbances and Cognitive Impairment in the Course of Type 2 Diabetes-A Possible Link

2020 ◽  
Vol 19 (1) ◽  
pp. 78-91 ◽  
Author(s):  
Anna Brzecka ◽  
Natalia Madetko ◽  
Vladimir N. Nikolenko ◽  
Ghulam M. Ashraf ◽  
Maria Ejma ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Sleep Quality ◽  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Amyloid Β ◽  
Diabetic Patients ◽  
Poor Sleep ◽  
Toxic Substances ◽  
Poor Sleep Quality ◽  
Number Of Patients

: There is an increasing number of patients worldwide with sleep disturbances and diabetes. Various sleep disorders, including long or short sleep duration and poor sleep quality of numerous causes, may increase the risk of diabetes. Some symptoms of diabetes, such as painful peripheral neuropathy and nocturia, or associated other sleep disorders, such as sleep breathing disorders or sleep movement disorders, may influence sleep quality and quantity. Both sleep disorders and diabetes may lead to cognitive impairment. The risk of development of cognitive impairment in diabetic patients may be related to vascular and non-vascular and other factors, such as hypoglycemia, hyperglycemia, central insulin resistance, amyloid and tau deposits and other causes. Numerous sleep disorders, e.g., sleep apnea, restless legs syndrome, insomnia, and poor sleep quality are most likely are also associated with cognitive impairment. Adequate functioning of the system of clearance of the brain from toxic substances, such as amyloid β, i.e. glymphatic system, is related to undisturbed sleep and prevents cognitive impairment. In the case of coexistence, sleep disturbances and diabetes either independently lead to and/or mutually aggravate cognitive impairment.

scholarly journals Impact of Shift Work and Long Working Hours on Worker Cognitive Functions: Current Evidence and Future Research Needs

2021 ◽  
Vol 18 (12) ◽  
pp. 6540
Author(s):  
Veruscka Leso ◽  
Luca Fontana ◽  
Angela Caturano ◽  
Ilaria Vetrani ◽  
Mauro Fedele ◽  
...  
Keyword(s):  
Circadian Rhythm ◽  
Cognitive Impairment ◽  
Sleep Disturbances ◽  
Working Hours ◽  
Night Work ◽  
Current Evidence ◽  
Future Research ◽  
Negative Effects ◽  
Long Working Hours ◽  
Main Determinants

Particular working conditions and/or organization of working time may cause important sleep disturbances that have been proposed to be predictive of cognitive decline. In this regard, circadian rhythm misalignment induced by exposure to night work or long working hours would be responsible for cognitive impairment. Nevertheless, evidence supporting this correlation is limited and several issues still need to be elucidated. In this regard, we conducted a systematic review to evaluate the association between shift/night work and cognitive impairment and address its main determinants. Information provided by the reviewed studies suggested that night work might have serious immediate negative effects especially on cognitive domains related to attention, memory and response inhibition. Furthermore, cognitive performance would progressively worsen over consecutive night shifts or following exposure to very long work shifts. Otherwise, conflicting results emerged regarding the possible etiological role that night work chronic exposure would have on cognitive impairment. Therefore, circadian rhythm desynchronization, lack of sleep and fatigue resulting from night work may negatively impact worker’s cognitive efficiency. However, in light of the considerable methodological variability of the reviewed studies, we proposed to develop a standardized research and evaluation strategy in order to obtain a better and comprehensive understanding of this topic.

scholarly journals Assessment of Lacrimal Duct Patency in Patients Undergoing Endoscopic Medial Maxillectomy

2021 ◽  
Vol 10 (2) ◽  
pp. 245
Author(s):  
Andrzej Sieśkiewicz ◽  
Tomasz Łysoń ◽  
Marek Rogowski ◽  
Marek Bielecki ◽  
Ewa Gindzienska-Sieskiewicz ◽  
...  
Keyword(s):  
Assessment Method ◽  
Test Results ◽  
Functional Disorders ◽  
Lacrimal Duct ◽  
Assessment Tests ◽  
Number Of Patients ◽  
Study Results ◽  
Assessment Techniques ◽  
Medial Maxillectomy ◽  
Comparison Of The Results

Purpose: The risk of epiphora after medial maxillectomy with lacrimal duct transection is difficult to assess. The data available in the literature are inconclusive due to various operating techniques used by the authors of medical publications, different additional procedures aimed at improving tear drainage after maxillectomy, and a variety of lacrimal duct patency assessment techniques. The aim of our work was to assess the anatomical and functional patency of lacrimal ducts after medial maxillectomy without performing additional procedures to improve tear drainage as well as comparison of the results obtained with different assessment tests. Materials and methods: 21 patients who underwent medial maxillectomy in the years 2016–2019 were assessed for discomfort and epiphora based on patients’ own reports and basic clinical examination, lacrimal duct rinse test, the Munk score, and a modified endoscopic Jones I test. Results: Gradually increasing the sensitivity of the assessment method resulted in an increase in the number of patients with potential tear drainage disorders, starting from 0% in the rinsing test, 4.8% self-reported tearing complaints, 14.3% Munk score, and 19% modified endoscopic Jones I test. Conclusions: The study results revealed that a small fraction of patients tend to report epiphora as a consequence of medial maxillectomy themselves. Subtle functional disorders, which are not particularly bothersome to patients, are more common. More sensitive lacrimal duct patency tests reveal more cases of tear drainage disorders. The results of studies assessing the incidence of epiphora after medial maxillectomy appear to depend on the type of test used.

scholarly journals 598 Patients’ Knowledge and Compliance with Government Guidelines for COVID 19

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
J Eskander ◽  
A Khallaf ◽  
S Zaki ◽  
M Elkawafi ◽  
R Makar
Keyword(s):  
Cognitive Impairment ◽  
Hospital Stay ◽  
Safe Distance ◽  
Essential Information ◽  
Social Distancing ◽  
Viral Spread ◽  
Information Leaflets ◽  
Number Of Patients ◽  
Male Patients ◽  
The Government

Abstract Background Since the outbreak of COVID-19; social distancing and recognized effective precautions were recommended by various governments to fight the viral spread. Our aim was to assess the inpatient knowledge and compliance with the government guidelines during their hospital stay and at their discharge in two different NHS hospitals. Method The study took place in two hospitals: Berrywood hospital, UK and Countess of Chester hospital, UK. We invited inpatients to answer an anonymized questionnaire which was designed to include the contemporary government guidelines. We excluded patients with cognitive impairment and those who were not expected to be discharged within days. Results Out of 209 patients, 50% were male. Patients showed good awareness of the main symptoms of the virus (90%). However, A significant number of patients were not fully aware of the recommended precautions to minimize viral spread (28%) and the method of spread (43%). About 41% did not know the recommended safe distance. Conclusions Despite being aware of the main symptoms of COVID-19, a significant number of patients lack essential information needed to minimize the spread of the virus in the society and hospital. We recommend providing patients with information leaflets and direct advice on admission and discharge.

Workshop 1: Differential Diagnosis

1997 ◽  
Vol 9 (S1) ◽  
pp. 85-86
Author(s):  
Martin Rossor
Keyword(s):  
Differential Diagnosis ◽  
Cognitive Impairment ◽  
Memory Impairment ◽  
The Other ◽  
Neuropsychological Measures ◽  
Clinical Criteria ◽  
Dementia Syndrome ◽  
Number Of Patients ◽  
Diagnostic Modalities ◽  
Made In

We were asked to consider differential diagnosis. We decided that it really is different from the other diagnostic modalities and cannot be treated in the same way as, for example, global or neuropsychological measures. In the context of this meeting, we believed it would be appropriate to consider clinical criteria. Thus, clinical criteria for the dementia syndrome as well as for specific diseases were discussed. We recognized that in the future, an increasing number of patients will present with cognitive impairment who do not fulfill the clinical criteria for dementia. These patients may alternatively have an isolated memory impairment syndrome. Nevertheless, a diagnosis will still need to be made in these patients, at least in terms of the underlying molecular pathology, in order to implement potential treatments.

Consensus document on radiotherapy in patients with implantable pacemakers and cardioverter – defibrilators

2018 ◽  
Vol 2 (47) ◽  
pp. 27-31
Author(s):  
Lidia Chmielewska-Michalak ◽  
Ewelina Konstanty ◽  
Przemysław Mitkowski
Keyword(s):  
Current Knowledge ◽  
Clinical Status ◽  
Electronic Devices ◽  
Heart Rhythm ◽  
Complex Care ◽  
Consensus Document ◽  
Cardiac Implantable Electronic Devices ◽  
Number Of Patients ◽  
High Level ◽  
Emergency Mode

The number of patients with cardiac implantable electronic devices (CIED), who require oncological management including radiotherapy (RT) is still increasing. According to current knowledge the most frequent device dysfunction related to exposition to ionizing radiation is reprogramming to emergency mode (soft reset). There are uncommon cases of complete, irreversible device damage. CIED dysfunction during RT can be observed in approximately 3% of patients. In majority of cases they are asymptomatic, although in literature there are descriptions of deterioration of clinical status due to bradycardia or exacerbation of heart failure. The most important factor of device malfunction is radiotherapy with photons of energy >10 MV or protons despite energy used. So far there were no cases published with inadequate ICD therapies due to the presence of electromagnetic field interference during RT. Because patients with CIED undergoing RT need complex care to achieve high level of safety, experts of Heart Rhythm Society establish document, published in 2017 which summarized current knowledge about this group of patients. The document contains guidelines on peri-radiotherapy care of patients with CIED.

What Does Imaging Add to the Management of Alzheimer's Disease?

CNS Spectrums ◽  
2004 ◽  
Vol 9 (S5) ◽  
pp. 20-23 ◽  
Author(s):  
Gary W. Small
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Imaging Techniques ◽  
Screening Tools ◽  
Surrogate Markers ◽  
Genetic Disposition ◽  
Number Of Patients

AbstractThe prevalence of Alzheimer's disease (AD) and dementia continues to rise. However, a significant number of patients are undiagnosed or untreated. Given the complexities of detecting cognitive impairment and the early signs of AD, this review discusses how advances in brain imaging can help assist in improving overall management. Imaging techniques and surrogate markers may provide unique opportunities to diagnose accurately AD in presymptomatic stages with practical consequences for patients, caregivers, and physicians. The possible outcomes for using imaging and surrogate markers as adjuncts to clinical examination and as screening tools for AD, as well as tangible and intangible advantages to early diagnosis and treatment, will be discussed. The specific value of using advanced serial imaging in patients with a genetic disposition to AD will be evaluated. If neurons can be protected from neurodegenerative damage in early stages, this may preserve patient cognition, function, and quality of life, and may confer considerable societal healthcare benefits.

scholarly journals Social Cognition in Rehabilitation Context: Different Evolution of Affective and Cognitive Theory of Mind in Mild Cognitive Impairment

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Federica Rossetto ◽  
Francesca Baglio ◽  
Davide Massaro ◽  
Margherita Alberoni ◽  
Raffaello Nemni ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Social Skills ◽  
Mild Cognitive Impairment ◽  
Theory Of Mind ◽  
Cognitive Theory ◽  
Term Effect ◽  
Home Based ◽  
Long Term Effect ◽  
High Level

Maintaining social skills such as Theory of Mind (ToM) competences is important to counteract the conversion into dementia in Mild Cognitive Impairment (MCI). Multidimensional nonpharmacological interventions demonstrated their potential in improving cognitive and behavioral abilities; however, little is known about the long-term effect of such interventions on social skills in people with MCI. The aim of this longitudinal study was to monitor ToM competences considering both cognitive and affective domains in an amnestic MCI (aMCI) sample involved in a home-based multistimulation treatment (MST@H). 30 aMCI subjects (M:F=15:15; mean age±SD=77.00±4.60) were enrolled, and three steps of evaluation with neuropsychological tests and ToM tasks have been implemented. 21 healthy controls (HC) were also included (M:F=9:12; mean age±SD=74.95±3.88) to characterize the aMCI sample regarding differences in ToM performance compared to HC at the baseline evaluation. Our results show that the aMCI group statistically significantly underperformed the HC group only in the advanced ToM tasks, confirming an initial decline of high-level ToM competences in this population. The longitudinal evaluation revealed time changes not only in some subcognitive domains of MoCA (memory and executive functions) but also in cognitive and affective ToM dimensions in aMCI subjects. Our findings suggest that cognitive and affective ToM can be considered useful outcome measures to test the long-term effect of treatment over time.

scholarly journals Impact of a dementia-friendly program on detection and management of patients with cognitive impairment and delirium in acute-care hospital units: a non-equivalent control group design

2021 ◽  
Author(s):  
Nina Weldingh ◽  
Marte Mellingsæter ◽  
Bendik Hegna ◽  
Jūratė Šaltytė Benth ◽  
Gunnar Einvik ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Control Group ◽  
Care Hospital ◽  
Control Group Design ◽  
Group Design ◽  
Hospitalised Patients ◽  
Number Of Patients ◽  
Equivalent Control

Abstract Background Frail older persons with cognitive impairment (CI) are at special risk of experiencing delirium during acute hospitalisation. The purpose of this study was to investigate whether a dementia-friendly hospital program contributes to improved detection and management of patients with CI and risk of delirium at an acute-care hospital in Norway. Furthermore, we aimed to explore whether the program affected the prevalence of delirium, pharmacological treatment, 30-day re-hospitalisation, 30-day mortality and institutionalisation afterwards. Methods This study had a non-equivalent control group design and a historical control group. It was conducted at two different medical wards at a large acute-care hospital in Norway from September 2018 to December 2019. A total of 423 acute hospitalised patients 75 years of age or older were included in the study. Delirium screening and cognitive tests were recorded by research staff with the Four Assessment Test (4AT) and the Confusion Assessment Measure (CAM), while demographic and medical information was recorded from patient journals. Results Implementation of the dementia-friendly hospital program did not show any significant effect on the identification of patients with CI. However, the proportion of the patients with CI who received preventive measures increased by 32.2% (P < .001), compared to the control group. The share of patients screened with 4AT within 24 hours increased from 0–35.5% (P < .001). Furthermore, the number of patients with CI who were prescribed antipsychotic/hypnotic medications was reduced by 24.5% (P < .001). There were no differences in delirium, 30-day readmission or 30-day mortality. Conclusions Implementation of a model for early screening and multifactorial nonpharmacological interventions for patients with CI and delirium using quality improvement methodology may improve management of this patient group, increase staff awareness of family involvement, and reduce prescriptions of antipsychotics, hypnotics and sedatives. Trial registration: The protocol of this study was retrospectively registered in the ClinicalTrials.gov Protocol Registration and Results System with the registration number: NCT04737733 and date of registration: 03/02/2021.

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