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Journal of General Internal Medicine Aug 2022The emotional stress of caring for someone with Alzheimer's disease and related dementias is high and results in adverse effects on caregivers and the persons living...
BACKGROUND
The emotional stress of caring for someone with Alzheimer's disease and related dementias is high and results in adverse effects on caregivers and the persons living with disease. In preliminary work, caregiver reports of regularly feeling "completely overwhelmed" were associated with lack of measurable clinical benefit from a comprehensive dementia care program.
OBJECTIVE
To examine the sociodemographic and clinical characteristics of all caregivers who felt overwhelmed at entry into a comprehensive dementia care program, the trajectory of this symptom over 1 year, and its predictive value for 1-year caregiver outcomes.
DESIGN
Longitudinal cohort study SETTING: Academic health center PARTICIPANTS: Caregivers of patients enrolled in a comprehensive dementia care program EXPOSURES: Caregiver report of feeling "completely overwhelmed" at baseline MAIN MEASURES: Caregiver report of feeling "completely overwhelmed" at baseline and 1 year, and validated scales of caregiver strain, distress, depressive symptoms, burden, mortality, and long-term nursing home placement KEY RESULTS: Compared to caregivers who were not overwhelmed, overwhelmed caregivers had more distress from behavioral symptoms of the person living with dementia, worse depression scores, and higher composite dementia burden scores at baseline. They also had worse depressive symptoms, strain, and composite burden scores at 1 year, after adjustment for baseline scores. Having an overwhelmed caregiver did not predict long-term nursing home placement or mortality among persons with dementia.
CONCLUSIONS
A single question about whether a caregiver is overwhelmed might indicate caregivers who have considerable current and future symptom burden and who may benefit from increased support and resources.
Topics: Alzheimer Disease; Caregivers; Dementia; Humans; Nursing Homes; Vital Signs
PubMed: 34389938
DOI: 10.1007/s11606-021-07054-3 -
Journal of Integrative Neuroscience Apr 2022Worldwide, more than 50 million people live with dementia, and due to the rapidly aging population, dementia cases are expected to increase at least five times in 2050.... (Review)
Review
Worldwide, more than 50 million people live with dementia, and due to the rapidly aging population, dementia cases are expected to increase at least five times in 2050. 30%-40% of dementia cases are diagnosed as non-Alzheimer's dementia. Common subtypes of non-Alzheimer's dementia are known as vascular, Lewy body, and frontotemporal dementia. Despite advances in modern medicine, the mechanism of dementia is still not fully understood. The term "omics" is a general term and is used to comprehensively characterize molecules by functional and biological similarities, focusing on the basic biological processes of a living organism and these techniques have enabled us to examine the unknown areas of biology, such as the genome, transcriptome, proteome, microbiome, and metabolome. This review highlights the progress that has been made in omics research while noting the gaps in our knowledge.
Topics: Aged; Aging; Alzheimer Disease; Dementia; Humans; Learning
PubMed: 35633157
DOI: 10.31083/j.jin2103076 -
Neurobiology of Disease Nov 2023Dementia with Lewy bodies and Parkinson's disease dementia are common neurodegenerative diseases that share similar neuropathological profiles and spectra of clinical... (Review)
Review
Dementia with Lewy bodies and Parkinson's disease dementia are common neurodegenerative diseases that share similar neuropathological profiles and spectra of clinical symptoms but are primarily differentiated by the order in which symptoms manifest. The question of whether a distinct molecular pathological profile could distinguish these disorders is yet to be answered. However, in recent years, studies have begun to investigate genomic, epigenomic, transcriptomic and proteomic differences that may differentiate these disorders, providing novel insights in to disease etiology. In this review, we present an overview of the clinical and pathological hallmarks of Lewy body dementias before summarizing relevant research into genetic, epigenetic, transcriptional and protein signatures in these diseases, with a particular interest in those resolving "omic" level changes. We conclude by suggesting future research directions to address current gaps and questions present within the field.
Topics: Humans; Lewy Body Disease; Dementia; Parkinson Disease; Proteomics; Lewy Bodies
PubMed: 37918758
DOI: 10.1016/j.nbd.2023.106337 -
International Journal of Geriatric... Aug 2021When a genetic cause is suspected in a person with dementia, it creates unique diagnostic and management challenges to the treating clinician. Many clinicians may be... (Review)
Review
OBJECTIVE
When a genetic cause is suspected in a person with dementia, it creates unique diagnostic and management challenges to the treating clinician. Many clinicians may be unaware of the practicalities surrounding genetic testing for their patients, such as when to test and what tests to use and how to counsel patients and their families. This review was conducted to provide guidance to clinicians caring for patients with dementia regarding clinically relevant genetics.
METHODS
We searched PubMed for studies that involved genetics of dementia up to March 2020. Patient file reviews were also conducted to create composite cases.
RESULTS
In addition to families where a strong Mendelian pattern of family history is seen, people with younger age of onset, especially before the age of 65 years were found to be at an increased risk of harbouring a genetic cause for their dementia. This review discusses some of the most common genetic syndromes, including Alzheimer disease, frontotemporal dementia, vascular dementia, Parkinson disease dementia/dementia with Lewy bodies and some rarer types of genetic dementias, along with illustrative clinical case studies. This is followed by a brief review of the current genetic technologies and a discussion on the unique genetic counselling issues in dementia.
CONCLUSIONS
Inclusion of genetic testing in the diagnostic pathway in some patients with dementia could potentially reduce the time taken to diagnose the cause of their dementia. Although a definite advantage as an addition to the diagnostic repository, genetic testing has many pros and cons which need to be carefully considered first.
Topics: Aged; Alzheimer Disease; Dementia, Vascular; Frontotemporal Dementia; Genetic Testing; Genetics, Medical; Humans
PubMed: 33779003
DOI: 10.1002/gps.5535 -
BMJ (Clinical Research Ed.) Oct 2023
Topics: Humans; Charities; Dementia
PubMed: 37821121
DOI: 10.1136/bmj.p2356 -
Advances in Experimental Medicine and... 2021Filamentous inclusions of tau protein are found in cases of inherited and sporadic frontotemporal dementias (FTDs). Mutations in MAPT, the tau gene, cause approximately...
Filamentous inclusions of tau protein are found in cases of inherited and sporadic frontotemporal dementias (FTDs). Mutations in MAPT, the tau gene, cause approximately 5% of cases of FTD. They proved that dysfunction of tau protein is sufficient to cause neurodegeneration and dementia. Clinically and pathologically, cases with MAPT mutations can resemble sporadic diseases, such as Pick's disease, globular glial tauopathy, progressive supranuclear palsy and corticobasal degeneration. The structures of tau filaments from Pick's disease and corticobasal degeneration, determined by electron cryo-microscopy, revealed the presence of specific tau folds in each disease, with no inter-individual variation. The same was true of chronic traumatic encephalopathy.
Topics: Alzheimer Disease; Frontotemporal Dementia; Humans; Pick Disease of the Brain; Tauopathies; tau Proteins
PubMed: 33433876
DOI: 10.1007/978-3-030-51140-1_12 -
Aging Jan 2023
Topics: Humans; Alzheimer Disease; Dementia
PubMed: 36602534
DOI: 10.18632/aging.204478 -
Neurotherapeutics : the Journal of the... Jan 2022Lewy body dementia (LBD) is one of the most common neurodegenerative dementias. Clinical trials for symptomatic and disease-modifying therapies in LBD remain a national... (Review)
Review
Lewy body dementia (LBD) is one of the most common neurodegenerative dementias. Clinical trials for symptomatic and disease-modifying therapies in LBD remain a national research priority, but there are many challenges in both past and active drug developments in LBD. This review highlights the controversies in picking the appropriate populations, interventions, target selections, and outcome measures, which are all critical components of clinical trial implementation in LBD. The heterogeneity of LBD neuropathology and clinical presentations, limited understanding of core features such as cognitive fluctuations, and lack of validated LBD-specific outcome measures and biomarkers represent some of the major challenges in LBD trials.
Topics: Alzheimer Disease; Biomarkers; Clinical Trials as Topic; Drug Development; Humans; Lewy Body Disease
PubMed: 34859379
DOI: 10.1007/s13311-021-01161-z -
Acta Neurologica Belgica Dec 2019It is well established that the clinical picture of dementias is not clinically homogeneous. For example, non-amnestic presentations of Alzheimer's disease have been... (Review)
Review
It is well established that the clinical picture of dementias is not clinically homogeneous. For example, non-amnestic presentations of Alzheimer's disease have been referred to as a typical variant. Careful examination of clinical characteristics contributes to understanding the neurobiology of Alzheimer's disease and other dementias and may in turn enhance knowledge of the potential risk factors involved. This study aimed at describing uncommon or bizarre symptoms/syndromes observed in patients suffering from dementia. Medline and Google scholar searches were conducted for relevant articles, chapters, and books published before 2019. Search terms used included dementia, déjà vu, zoophilia, pathological lying, and somatic symptom disorder. Publications found through this indexed search were reviewed for further relevant references. Uncommon/bizarre features of dementia were described as case reports and there were no systematic investigations.
Topics: Dementia; Humans
PubMed: 31552557
DOI: 10.1007/s13760-019-01208-1 -
Biomedicine & Pharmacotherapy =... Aug 2022Dementia is defined as a gradual cognitive impairment that interferes with everyday tasks, and is a leading cause of dependency, disability, and mortality. According to... (Review)
Review
Dementia is defined as a gradual cognitive impairment that interferes with everyday tasks, and is a leading cause of dependency, disability, and mortality. According to the current scenario, millions of individuals worldwide have dementia. This review provides with an overview of dementia before moving on to its subtypes (neurodegenerative and non-neurodegenerative) and pathophysiology. It also discusses the incidence and severity of dementia, focusing on Alzheimer's disease with its different hypotheses such as Aβ cascade hypothesis, Tau hypothesis, inflammatory hypothesis, cholinergic and oxidative stress hypothesis. Alzheimer's disease is the most common type and a progressive neurodegenerative illness distinct by neuronal loss and resulting cognitive impairment, leading to dementia. Alzheimer's disease (AD) is considered the most familiar neurodegenerative dementias that affect mostly older population. There are still no disease-modifying therapies available for any dementias at this time, but there are various methods for lowering the risk to dementia patients by using suitable diagnostic and evaluation methods. Thereafter, the management and treatment of primary risk elements of dementia are reviewed. Finally, the future perspectives of dementia (AD) focusing on the impact of the new treatment are discussed.
Topics: Alzheimer Disease; Cognitive Dysfunction; Humans
PubMed: 35701303
DOI: 10.1016/j.biopha.2022.113168