Adverse Drug Reactions in Older Subjects
DementiaObjective: To identify risk factors for the occurrence of adverse drug reactions (ADRs) based on geriatric evaluation. Design: Longitudinal prospective study from May 2010 to November 2011. Setting: Dedicated acute geriatric care unit specializing in the management of patients with dementia at the University Hospital of Reims, France. Measurements: Sociodemographic variables and comprehensive geriatric assessment were recorded. Occurrence of ADRs was noted. Risk factors for ADR were identified by multivariate logistic regression.
Cardiovascular Risk Factors, Aging and Dementia
DementiaThe global challenges caused by dementia affect society from both the public health and economic perspective, and are exacerbated by the rapid growth of the population in the oldest age groups. Reducing the risk of developing dementia and improving the overall health status, psychosocial wellbeing, and the quality of life of the oldest old would bear individual and public health benefits, as well as social and economic advantages. Data from long-term longitudinal cohort studies can provide invaluable information about the factors that play a key role in healthy ageing and in the development of dementia. The aim of CAIDE 85+ is to better understand the factors that, from mid- to late-life, determine the development of cognitive disorders such as dementia, as well as the overall health status, psychosocial wellbeing and quality of life in the oldest old segment of the population. CAIDE85+ is the third follow-up of the main Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study conducted in the Kuopio and Joensuu areas in Eastern Finland. During midlife, participants were initially part of two population-based health surveys (North Karelia project and FINMONICA study) carried out between 1972 and 1987. In 1998, a random sample of 2000 individuals (aged 64-79) from these cohorts were invited to participate in a first re-examination as part of the CAIDE study. A second re-examination of this population was carried out between 2005 and 2008. Individuals who are still alive and living in the Kuopio and Joensuu areas will now be invited for a third re-examination. Participants' cognitive functioning and physical fitness will be assessed, and they will be asked questions about their health status, psychosocial wellbeing, and lifestyle. Blood samples will be also collected to investigate biomarkers that may be relevant for dementia-related diseases.
Factors Associated With Mortality, Morbidity and Prognosis in Dementia Patients
DementiaDementia6 moreDementia; It is a chronic syndrome characterized by a general and progressive deterioration in cognition, including memory, orientation, language, and comprehension. The prognosis of this progressive and neurodegenerative disease after diagnosis may differ between individuals. In its broadest sense, the prognosis after a diagnosis of dementia; can be defined by shortening of life span, high level of cognitive and functional loss, decrease in quality of life and increased need for care. However, the prognosis of different types of dementia is highly variable. Because it is the most common type of dementia, studies are usually on Alzheimer's disease. It constitutes 50-75% of total dementia cases. Vascular dementia is the second most common cause of dementia and accounts for approximately 15% of dementia cases. Dementia with Lewy bodies constitutes 10-20% of the total dementia patients and ranks second among degenerative dementia types. Frontotemporal dementia, which mimics psychiatric disorders and has prominent behavioural problems, and Parkinson's disease-associated dementia, which is characterized by cognitive impairment that can be added to the existing picture in Parkinson's patients, are also counted among other types of dementia. Prognosis-related data on dementia types other than Alzheimer's disease are limited in the literature. Determining the prognosis is important to support patients, anticipate long-term health problems, plan physician and healthcare provision, and support patients with dementia.In view of the lack of sufficient data on dementia types other than Alzheimer's disease, it is aimed to contribute to the literature on this subject and to determine the factors that may affect prognosis, morbidity and mortality in patients belonging to all dementia types.
Pathway to Detection & Differentiation of Delirium & Dementia in the Emergency Department
Cognitive ImpairmentEmergency Care2 moreThis is an observational study of the pragmatic implementation of an ED screening, outpatient referral, and care coordination process for older ED patients who may have UCID.
Young Onset Dementia - the Difficult Diagnosis and the Stressful Life for the Whole Family
Frontotemporal DementiaAlzheimer DiseasePeople diagnosed with young onset dementia are today mostly assigned to the same healthcare services as people developing dementia at an older age. They and their families are however in a quite different life situation, which is likely to generate different challenges and specific needs for tailored healthcare services, of importance in maintaining their perceived quality of life. The investigators of this study wish to assess the factors influencing these families' quality of life, their specific needs and their use of healthcare services by the use a combination of quantitative and qualitative methods. The main aim of this study is to provide better future healthcare services to these families, and to develop a programme for optimal collaboration between specialist healthcare services and the local dementia teams.
Dementia Registry for Parkinson's Disease
DementiaParkinson's DiseaseBackground Cognitive impairment in Parkinson's disease (PD) is common, even in the early stage of this disease.The cumulative prevalence of dementia associated with Parkinson's disease (PDD) is as high as 80% in a recent 8-year prospective study. However, some kinds of cognitive impairment are not apparent and the value of self-report cognitive decline became limited. In other words, some cognitive impairment may be detected by cognitive tests rather than self-report of the symptoms.The early intervention of the cognitive impairment may be helpful for these patients. Neuropsychiatric symptoms(NPSs) are also common in PD and PDD patients. The severity of NPSs contributes to reduced quality of life and distress for caregivers. Previous studies showed some different clinical phenotypes of NPSs in PD or PDD patients. Among the NPSs, hallucination was considered a critical factor of cognitive dysfunction in PD and PDD patients. The co-occurrence of NPSs in PD and PDD patients has limited evidence now. Purpose To establish the screening tools for early detecting the PD patient with cognitive impairment; exam the diagnostic value of MoCA and other cognitive tests in PD with mild cognitive impairment, possible PDD, and probable PDD; understand neuropsychiatric symptoms (NPSs) in these different patient groups; exam the relationship between each NPS and each domain of cognitive dysfunction. Methods In order to exam the cognitive dysfunction in PDD (attention, executive function, visuo-spatial function, and memory), several tests are performed. A 32-item cognitive decline questionnaire will be used to screen the cognitive impairment in subjects. Mini-Mental state examination (MMSE) and Montreal cognitive assessment (MoCA)are used for cognitive evaluation. The detail evaluation of each domain is specified asfollowing: (1) Attention (WAIS-R digit span), (2) Memory (12-item word recall test),(3) Executive function (category verbal fluency), (4) Visuospatial function (cube copying and clock drawing). The motor symptoms severity of the PD will be evaluated by the Hoehn & Yahr stage and motor portion of the Unified Parkinson's Disease Rating Scale (UPDRS). The neuropsychiatric symptoms will be recorded by Neuropsychiatric Inventory Questionnaire (NPI-Q). The daily living activity will beevaluated by modified Lawton's instrumental activities of daily living scale (IADL)and pill questionnaire. Subjects also receive 15-item Geriatric Depression Scale(GDS-S) to evaluate the mood status. The clinician's diagnosis of dementia will be based on the diagnostic criteria of DSM-IV, which will be compared with the PDDdiagnostic criteria proposed by MDS in 2007. The investigators will also try to develop a PDDscreening questionnaire. Expected results Cognitive impairment and dementia of PD patients will be ascertained by the cognitive test battery. The screening questionnaire will be established. The heterogeneity of NPSs in PD and PDD will be evaluated. The PDD screening questionnaire will help the clinician to diagnose the patients.
Delirium in Persons With Dementia
Delirium Superimposed on DementiaThe aims of this study were to identify risk factors associated with delirium in hospitalized persons with dementia, and to describe immediate and post-hospital (1&3 months) trajectory of cognitive decline and associated outcomes in persons with dementia who develop delirium. It was hypothesized that factors such as CNS-active medications, urinary tract infection, stage of dementia, pain, activity level, and dehydration would be associated with an increased risk of delirium and delirium severity in patients with dementia compared to dementia patients without delirium. It was also hypothesized that persons with DSD will have worse outcomes (longer hospital length of stays, decreased functional status, a steeper negative slope of cognitive decline) than dementia patients without delirium. Lastly, it was hypothesized that higher delirium severity would be associated with poorer outcomes in persons with dementia. The long-term objectives were to use the results from this study to design and test an intervention strategy to improve early recognition, management, prevention, and outcomes in persons with DSD.
Apolipoprotein E Gene and Functional MRI
DementiaApolipoprotein E gene (ApoE) is the most important genetic factor for Alzheimer disease (AD) and an important genetic factor for outcome of brain injury situations. Function magnetic resonance imaging (fMRI) is a powerful tool for study of both brain regional functions and brain network. Study about genetic contribution on fMRI is an emerging concept, which will help on understanding about how the genetics affecting the brain function.
An Observational Study of the Safety and Effectiveness of Galantamine in the Treatment of Patients...
Alzheimer DiseaseDementia1 moreThe purpose of this observational study is to investigate the changes in cognitive functioning, behavior, and functional improvement in Alzheimer's disease patients treated with Galantamine who are living at home (i.e. not in permanent residential care), and to obtain information regarding usual clinical practice that can be used for communicating treatment expectations to patients and supporters.
Performance of AclarusDx™, a Blood-Based Transcriptomic Test for AD, in US Patients Newly Referred...
Alzheimer's DiseaseMild Cognitive Impairment5 moreThe purpose of this study is to assess the performance of AclarusDx™, an investigational blood test detecting gene expression information, and intended to help physicians in making an Alzheimer's Disease diagnosis in patients having memory impairments.