37 results on '"Late-onset dementia"'
Search Results
2. Experiences with and perspectives on advance care planning in young- and lateonset dementia: A focus group study with physicians from various disciplines.
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Van Rickstal, Romy, De Vleminck, Aline, Engelborghs, Sebastiaan, and Van den Block, Lieve
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FOCUS groups ,TERMINAL care ,CAREGIVERS ,WORK ,AGE distribution ,PHYSICIANS' attitudes ,SOCIAL stigma ,DEMENTIA patients ,ADVANCE directives (Medical care) ,QUALITATIVE research ,RESPONSIBILITY ,AGE factors in disease ,EXPERIENTIAL learning ,HEALTH ,INFORMATION resources ,MEDICAL specialties & specialists - Abstract
Introduction: Despite the relevance of advance care planning (ACP) for people with dementia, its uptake in this population is particularly low. Several challenges for ACP in dementia have been identified from physicians' perspectives. However, the literature available mainly includes general practitioners and focuses exclusively on the context of late-onset dementia. This is the first study to inquire physicians from four highly relevant specialisms in dementia care, with a focus toward potential specificities based on patients' age. The research question of this study is: "What are physicians' experiences with and perspectives on discussing ACP with people with young- and/or late-onset dementia?". Methods: Five online focus groups were conducted with 21 physicians (general practitioners, psychiatrists, neurologists and geriatricians) in Flanders, Belgium. Verbatim transcripts were analyzed through the qualitative method of constant comparative analysis. Results: Physicians believed that the societal stigma related to dementia influences people's reaction to their diagnosis, at times characterized by catastrophic expectations for the future. In this regard, they explained that the topic of euthanasia is sometimes addressed by patients very early in the disease trajectory. Respondents paid ample attention to actual end-of-life decisions, including DNR directives, when discussing ACP in dementia. Physicians felt responsible for providing accurate information on both dementia as a condition, and the legal framework of end-of-life decisions. Most participants felt that patients' and caregivers' wish for ACP was more driven by who their personality than by their age. Nonetheless, physicians identified specificities for a younger dementia population in terms of ACP: they believed that ACP covered more domains of life than for older persons. A high consistency regarding the viewpoints of physicians from differing specialisms was noted. Discussion: Physicians acknowledge the added value of ACP for people with dementia and especially their caregivers. However, they face several challenges for engaging in the process. Attending to specific needs in young-onset, in comparison to late-onset dementia, requires ACP to entail more than solely medical domains. However, a medicalized view on ACP still appears to be dominant in practice as opposed to its broader conceptualization in academia. [ABSTRACT FROM AUTHOR]
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- 2023
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3. Outdoor artificial light at night and risk of early-onset dementia: A case-control study in the Modena population, Northern Italy
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Elena Mazzoleni, Marco Vinceti, Sofia Costanzini, Caterina Garuti, Giorgia Adani, Giulia Vinceti, Giovanna Zamboni, Manuela Tondelli, Chiara Galli, Simone Salemme, Sergio Teggi, Annalisa Chiari, and Tommaso Filippini
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Case-control study ,Early-onset dementia ,Late-onset dementia ,Light at night ,Light pollution ,Risk ,Science (General) ,Q1-390 ,Social sciences (General) ,H1-99 - Abstract
Background: Dementia is a neurological syndrome characterized by severe cognitive impairment with functional impact on everyday life. It can be classified as young onset dementia (EOD) in case of symptom onset before 65, and late onset dementia (LOD). The purpose of this study is to assess the risk of dementia due to light pollution, and specifically outdoor artificial light at night (LAN). Methods: Using a case-control design, we enrolled dementia patients newly-diagnosed in the province of Modena in the period 2017–2019 and a referent population from their caregivers. We geo-referenced the address of residence on the date of recruitment, provided it was stable for the previous five years. We assessed LAN exposure through 2015 nighttime luminance satellite images from the Visible Infrared Imaging Radiometer Suite (VIIRS). Using a logistic regression model adjusted for age, sex, and education, we calculated the risk of dementia associated with increasing LAN exposure, namely using
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- 2023
- Full Text
- View/download PDF
4. Experiences with and perspectives on advance care planning in young- and late- onset dementia: A focus group study with physicians from various disciplines
- Author
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Romy Van Rickstal, Aline De Vleminck, Sebastiaan Engelborghs, and Lieve Van den Block
- Subjects
advance care planning (ACP) ,young-onset dementia (YOD) ,focus group (FG) ,physicians ,late-onset dementia ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
IntroductionDespite the relevance of advance care planning (ACP) for people with dementia, its uptake in this population is particularly low. Several challenges for ACP in dementia have been identified from physicians’ perspectives. However, the literature available mainly includes general practitioners and focuses exclusively on the context of late-onset dementia. This is the first study to inquire physicians from four highly relevant specialisms in dementia care, with a focus toward potential specificities based on patients’ age. The research question of this study is: “What are physicians’ experiences with and perspectives on discussing ACP with people with young- and/or late-onset dementia?”.MethodsFive online focus groups were conducted with 21 physicians (general practitioners, psychiatrists, neurologists and geriatricians) in Flanders, Belgium. Verbatim transcripts were analyzed through the qualitative method of constant comparative analysis.ResultsPhysicians believed that the societal stigma related to dementia influences people’s reaction to their diagnosis, at times characterized by catastrophic expectations for the future. In this regard, they explained that the topic of euthanasia is sometimes addressed by patients very early in the disease trajectory. Respondents paid ample attention to actual end-of-life decisions, including DNR directives, when discussing ACP in dementia. Physicians felt responsible for providing accurate information on both dementia as a condition, and the legal framework of end-of-life decisions. Most participants felt that patients’ and caregivers’ wish for ACP was more driven by who their personality than by their age. Nonetheless, physicians identified specificities for a younger dementia population in terms of ACP: they believed that ACP covered more domains of life than for older persons. A high consistency regarding the viewpoints of physicians from differing specialisms was noted.DiscussionPhysicians acknowledge the added value of ACP for people with dementia and especially their caregivers. However, they face several challenges for engaging in the process. Attending to specific needs in young-onset, in comparison to late-onset dementia, requires ACP to entail more than solely medical domains. However, a medicalized view on ACP still appears to be dominant in practice as opposed to its broader conceptualization in academia.
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- 2023
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- View/download PDF
5. A Systematic Review of Palliative Care Needs in Young-Onset Dementia.
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Dang, Jiaojiao, Yong, Alisa Cui Wen, Fong, Zhi Hui, Ang, Kexin, and Ng, Adeline Su Lyn
- Abstract
The distinctive differences in clinical needs and disease trajectory between people with young-onset (YOD) and late-onset dementia (LOD) make dementia palliative care unique. Limited studies have reported on the differences in palliative care needs between YOD and LOD, and the optimal time point to introduce palliative care in YOD remains controversial. We performed a systematic review to summarize key issues surrounding palliative care in YOD and highlight unmet needs in this pertinent area. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the PubMed database for all studies published between January 2000 and July 2022 that reported on palliative care in YOD. Of 32 records identified, 8 articles were eligible for inclusion. The top 3 themes extracted centered around (1) clinical differences between YOD and LOD, (2) symptoms and causes of death in end-stage YOD, and (3) the importance of early advanced care planning (ACP). YOD diagnosis is often delayed and people with YOD have fewer somatic comorbidities but more neuropsychiatric symptoms, longer survival times, and a more malignant disease course. People with YOD and their families face unique psychosocial challenges when symptoms start at a younger age. End-stage YOD is not dissimilar to LOD where patients suffer from a broad spectrum of physical and psychological symptoms requiring palliation. Early initiation of ACP discussion is crucial in YOD given the more rapid progression of disease affecting cognition and decision-making capacity; however, rates of ACP completion in YOD remain low. Given the complex care needs and more rapid disease trajectory in YOD, palliative care in YOD should be considered from the time of diagnosis, and to be incorporated into routine dementia care. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Association of a wide range of chronic diseases and apolipoprotein E4 genotype with subsequent risk of dementia in community-dwelling adults: A retrospective cohort study
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Xianwen Shang, Zhuoting Zhu, Xueli Zhang, Yu Huang, Xiayin Zhang, Jiahao Liu, Wei Wang, Shulin Tang, Honghua Yu, Zongyuan Ge, Xiaohong Yang, and Mingguang He
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Dementia ,Young-onset dementia ,Late-onset dementia ,Major chronic diseases ,Multimorbidity ,Apolipoprotein E4 ,Medicine (General) ,R5-920 - Abstract
Summary: Background: Identifying independent and interactive associations of a wide range of diseases and multimorbidity and apolipoprotein E4 (APOE4) with dementia may help promote cognitive health. The main aim of the present study was to investigate associations of such diseases and their multimorbidity with incident dementia. Methods: In this retrospective cohort study, we included 471,485 individuals of European ancestry from the UK Biobank, aged 38–73 years at baseline (2006–10). Dementia was identified using inpatient records and death registers. The follow-up period was between March 16, 2006, and Jan 31, 2021. Findings: During a median follow-up of 11·9 years, 6189 cases of incident all-cause dementia (503 young-onset cases, 5686 late-onset cases) were documented. In multivariable-adjusted analysis, 33 out of 63 major diseases were associated with an increased risk of dementia. The hazard ratio (HR [95% CI]) ranged from 1·12 (1·06–1·19) for obesity to 14·22 (12·33–16·18) for Parkinson's disease. In addition to conventional diseases, respiratory disorders, musculoskeletal disorders, digestive disorders, painful conditions, and chronic kidney disease were associated with increased dementia risk. A larger HR for dementia was observed for a larger number of diseases (3·97 [3·51–4·48] for ≥6 diseases versus no disease). These individual diseases and multimorbidity were more predictive of young-onset dementia than of late-onset dementia. Dementia risk score incorporating multimorbidity, age, and APOE4 status had strong prediction performance (area under the curve [95% CI]: 82·2% [81·7–82·7%]). APOE4 was more predictive of late-onset dementia (HR [95% CI]: 2·90 [2·75–3·06]) than of young-onset dementia (1·26 [1·03–1·54]). Associations of painful conditions, depression, obesity, diabetes, stroke, Parkinson's disease, high cholesterol, and their multimorbidity with incident dementia were stronger among non-APOE4 carriers. Interpretation: Besides conventional diseases, numerous diseases are associated with an increased risk of dementia. These individual diseases and multimorbidity are more predictive of young-onset dementia, whereas APOE4 is more predictive of late-onset dementia. Individual diseases and multimorbidity are stronger predictors of dementia in non-APOE4 carriers. Although multiple risk factors have been adjusted for in the analysis, potential confounding from unknown factors may have biased the associations. Funding: The Fundamental Research Funds of the State Key Laboratory of Ophthalmology, Project of Investigation on Health Status of Employees in Financial Industry in Guangzhou, China (Z012014075), Science and Technology Program of Guangzhou, China (202,002,020,049).
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- 2022
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7. The influence of the age of dementia onset on college students’ stigmatic attributions towards a person with dementia
- Author
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Perla Werner, Lilach Raviv-Turgeman, and Patrick W. Corrigan
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Attributional model ,Dementia ,Young-onset dementia ,Late-onset dementia ,Public stigma ,Geriatrics ,RC952-954.6 - Abstract
Abstract Background Research in the area of public stigma and Alzheimer’s disease (AD) is limited to examining stigmatic beliefs towards persons aged 65 and over (i.e., persons with late-onset dementia). The aim of the present study was to compare college students’ stigmatic attributions towards an older and a younger person with AD, using an attributional model of stigma. Method A cross-sectional study was conducted with 375 college students (mean age = 25.5, 58.9% female, 64.3% Jewish) who answered a computerized, self-administered, structured questionnaire after being presented with one of two randomly distributed vignettes varying in the age of the person with AD – 80 or 50 years of age. Cognitive, emotional and behavioral attributions of stigma were assessed using an adapted version of the Attribution Questionnaire. Other variables examined included background information, experiences and concerns about developing AD. T-tests and Ordinary Least Square (OLS) hierarchical regressions were used to analyze results. Results Similar to previous studies, students’ levels of dementia stigma were low to moderate. Negative attributions were consistently and significantly higher (β = .17 to .33, p
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- 2020
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8. Atrial Fibrillation and Other Cardiovascular Factors and the Risk of Dementia: An Italian Case-Control Study.
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Mazzoli R, Chiari A, Vitolo M, Garuti C, Adani G, Vinceti G, Zamboni G, Tondelli M, Galli C, Costa M, Salemme S, Boriani G, Vinceti M, and Filippini T
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- Humans, Case-Control Studies, Italy epidemiology, Male, Female, Aged, Risk Factors, Middle Aged, Aged, 80 and over, Cardiovascular Diseases epidemiology, Cardiovascular Diseases etiology, Atrial Fibrillation epidemiology, Atrial Fibrillation etiology, Dementia epidemiology, Dementia etiology
- Abstract
Dementia is a major neurologic syndrome characterized by severe cognitive decline, and it has a detrimental impact on overall physical health, leading to conditions such as frailty, changes in gait, and fall risk. Depending on whether symptoms occur before or after the age of 65, it can be classified as early-onset (EOD) or late-onset (LOD) dementia. The present study is aimed at investigating the role of cardiovascular factors on EOD and LOD risk in an Italian population. Using a case-control study design, EOD and LOD cases were recruited at the Modena Cognitive Neurology Centers in 2016-2019. Controls were recruited among caregivers of all the dementia cases. Information about their demographics, lifestyles, and medical history were collected through a tailored questionnaire. We used the odds ratio (OR) and 95% confidence interval (CI) to estimate the EOD and LOD risk associated with the investigated factors after adjusting for potential confounders. Of the final 146 participants, 58 were diagnosed with EOD, 34 with LOD, and 54 were controls. According to their medical history, atrial fibrillation was associated with increased disease risk (ORs 1.90; 95% CI 0.32-11.28, and 3.64; 95% CI 0.32-41.39 for EOD and LOD, respectively). Dyslipidemia and diabetes showed a positive association with EOD, while the association was negative for LOD. We could not evaluate the association between myocardial infarction and EOD, while increased risk was observed for LOD. No clear association emerged for carotid artery stenosis or valvular heart disease. In this study, despite the limited number of exposed subjects and the high imprecision of the estimates, we found positive associations between cardiovascular disease, particularly dyslipidemia, diabetes, and atrial fibrillation, and EOD., Competing Interests: G.B. reported speaker’s fees of small amounts from Bayer, Boston, BMS, Daiichi-Sankyo, Janssen, and Sanofi outside of the present work. The other authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of the data; in the writing of the manuscript; or in the decision to publish the results.
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- 2024
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9. Young- and Late-Onset Dementia: A Comparative Study of Quality of Life, Burden, and Depressive Symptoms in Caregivers.
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Kimura, Nathália R. S., Simões, José Pedro, Santos, Raquel Luiza, Baptista, Maria Alice Tourinho, Portugal, Maria da Glória, Johannessen, Aud, Barca, Maria Lage, Engedal, Knut, Laks, Jerson, Rodrigues, Valeska Marinho, and Dourado, Marcia C. N.
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CAREGIVER attitudes , *MENTAL depression , *BURDEN of care , *QUALITY of life , *SERVICES for caregivers , *CAREGIVERS - Abstract
Objective: To compare the quality of life, burden, and depressive symptoms of caregivers of individuals with young-onset dementia (YOD) and late-onset dementia (LOD). Methods: Using a cross-sectional design, a convenience sample of 110 dyads of individuals with dementia and their caregivers, all living in the community, was included. The care recipients completed assessments about cognition, quality of life, and awareness of disease. Caregivers' quality of life, resilience, depressive and anxiety symptoms, hopelessness, and burden of care were assessed. Results: A significant difference was found in caregivers' burden and depressive symptoms according to the age of onset. However, there was no difference in caregivers' quality of life between YOD and LOD groups. In both groups, a linear regression analysis indicated that caregivers' perspective of quality of life of care recipient and caregivers' hopelessness were associated with their quality of life. In addition, in the LOD group, caregivers' burden was associated with their perspective of the quality of life of care recipient, type of kinship, and presence of emotional problems. In the YOD group, caregivers' burden was associated with duration of caregiving role, cohabitating with care recipient, and their anxiety symptoms. Caregivers' depressive symptoms were associated with anxiety symptoms in the YOD group, whereas hopelessness was associated with caregivers' depressive symptoms in both the groups. Conclusion: Our findings suggest that the factors that affect quality of life, burden, and depressive symptoms of caregivers of individuals with LOD differ from those that affect the caregivers of individuals with YOD. [ABSTRACT FROM AUTHOR]
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- 2021
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10. The Dementias
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Nagaratnam, Nages, Nagaratnam, Kujan, Cheuk, Gary, Nagaratnam, Nages, Nagaratnam, Kujan, and Cheuk, Gary
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- 2018
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11. Epidemiology of Dementia in Japan
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Asada, Takashi, Matsuda, Hiroshi, editor, Asada, Takashi, editor, and Tokumaru, Aya Midori, editor
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- 2017
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12. Quality of life of family carers of persons with young-onset compared to late-onset dementia.
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Hvidsten, Lara, Engedal, Knut, Selbaek, Geir, Wyller, Torgeir Bruun, Šaltytė Benth, Jūratė, Bruvik, Frøydis, and Kersten, Hege
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AGE factors in disease ,CAREGIVERS ,CONFIDENCE intervals ,DEMENTIA ,DEMENTIA patients ,MENTAL depression ,FAMILIES ,PSYCHOLOGICAL tests ,QUALITY of life ,QUESTIONNAIRES ,REGRESSION analysis ,BURDEN of care ,CROSS-sectional method ,GERIATRIC Depression Scale ,DELAYED onset of disease - Abstract
Objectives: To compare quality of life (QOL) of family carers of persons with young- (YOD) to late-onset dementia (LOD). Methods: This was a cross-sectional comparison of 88 carers of persons with YOD and 100 carers of persons with LOD. The Quality of Life – Alzheimer's Disease questionnaire (QOL–AD) was used to measure QOL of both carers and persons with dementia. Depressive symptoms were measured by the Geriatric Depression Scale (GDS) for carers and the Cornell Scale for Depression in Dementia for persons with dementia. Care burden was measured by the Relatives' Stress Scale. Activities of Daily Living (ADL) of the persons with dementia were assessed using the total score from the Lawton & Brody Instrumental-ADL scale and the Physical Self-Maintenance Scale. Multiple linear regression models with interactions between covariates and group (YOD versus LOD) were estimated. Results: The QOL–AD scores of YOD-carers were significantly poorer compared to LOD-carers (mean difference 2.5 (95% CI 0.7; 4.3), p = 0.006). Poorer QOL of carers was associated with more depressive symptoms (mean QOL-AD change −0.5 (−0.6; −0.3), p < 0.001), but with no difference between the two groups. In contrast to LOD, QOL of carers of people with YOD was also significantly associated with symptom duration (p = 0.002), depressive symptoms of the persons with dementia (p = 0.030), ADL (p = 0.001), and carer burden (p = 0.002). Conclusion: YOD-carers reported significantly poorer QOL compared to LOD-carers. QOL was significantly associated with depressive symptoms in carers of both groups. [ABSTRACT FROM AUTHOR]
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- 2020
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13. The influence of the age of dementia onset on college students' stigmatic attributions towards a person with dementia.
- Author
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Werner, Perla, Raviv-Turgeman, Lilach, and Corrigan, Patrick W.
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AGE of onset ,COLLEGE students ,DEMENTIA ,OLDER people ,APOLIPOPROTEIN E4 ,SENILE dementia ,DIAGNOSIS of dementia ,ALZHEIMER'S disease ,CROSS-sectional method ,SENSORY perception ,SOCIAL stigma ,PREJUDICES ,STUDENTS ,AGE factors in disease ,HEALTH attitudes - Abstract
Background: Research in the area of public stigma and Alzheimer's disease (AD) is limited to examining stigmatic beliefs towards persons aged 65 and over (i.e., persons with late-onset dementia). The aim of the present study was to compare college students' stigmatic attributions towards an older and a younger person with AD, using an attributional model of stigma.Method: A cross-sectional study was conducted with 375 college students (mean age = 25.5, 58.9% female, 64.3% Jewish) who answered a computerized, self-administered, structured questionnaire after being presented with one of two randomly distributed vignettes varying in the age of the person with AD - 80 or 50 years of age. Cognitive, emotional and behavioral attributions of stigma were assessed using an adapted version of the Attribution Questionnaire. Other variables examined included background information, experiences and concerns about developing AD. T-tests and Ordinary Least Square (OLS) hierarchical regressions were used to analyze results.Results: Similar to previous studies, students' levels of dementia stigma were low to moderate. Negative attributions were consistently and significantly higher (β = .17 to .33, p < .01), and positive attributions were significantly lower (β = -.26, p < .01) when the target person was younger rather than older.Conclusion: The differences in stigmatic beliefs towards a younger and older person with AD point to the theoretical and practical importance of clearly stating the age of the target person in stigma studies as well as in programs aimed at reducing public stigma towards persons with AD. [ABSTRACT FROM AUTHOR]- Published
- 2020
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14. Experiences with and perspectives on advance care planning in young- and late- onset dementia
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Romy Van Rickstal, Aline De Vleminck, Sebastiaan Engelborghs, Lieve Van den Block, Brussels Heritage Lab, Family Medicine and Chronic Care, Faculty of Medicine and Pharmacy, End-of-life Care Research Group, Clinical sciences, Neuroprotection & Neuromodulation, Neurology, and Brussels Interdisciplinary Research centre on Migration and Minorities
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Aging ,late-onset dementia ,Cognitive Neuroscience ,Physicians ,Neuroscience(all) ,neurology ,advance care planning (ACP) ,Public Health, Environmental and Occupational Health ,young-onset dementia (YOD) ,focus group (FG) - Abstract
IntroductionDespite the relevance of advance care planning (ACP) for people with dementia, its uptake in this population is particularly low. Several challenges for ACP in dementia have been identified from physicians’ perspectives. However, the literature available mainly includes general practitioners and focuses exclusively on the context of late-onset dementia. This is the first study to inquire physicians from four highly relevant specialisms in dementia care, with a focus toward potential specificities based on patients’ age. The research question of this study is: “What are physicians’ experiences with and perspectives on discussing ACP with people with young- and/or late-onset dementia?”.MethodsFive online focus groups were conducted with 21 physicians (general practitioners, psychiatrists, neurologists and geriatricians) in Flanders, Belgium. Verbatim transcripts were analyzed through the qualitative method of constant comparative analysis.ResultsPhysicians believed that the societal stigma related to dementia influences people’s reaction to their diagnosis, at times characterized by catastrophic expectations for the future. In this regard, they explained that the topic of euthanasia is sometimes addressed by patients very early in the disease trajectory. Respondents paid ample attention to actual end-of-life decisions, including DNR directives, when discussing ACP in dementia. Physicians felt responsible for providing accurate information on both dementia as a condition, and the legal framework of end-of-life decisions. Most participants felt that patients’ and caregivers’ wish for ACP was more driven by who their personality than by their age. Nonetheless, physicians identified specificities for a younger dementia population in terms of ACP: they believed that ACP covered more domains of life than for older persons. A high consistency regarding the viewpoints of physicians from differing specialisms was noted.DiscussionPhysicians acknowledge the added value of ACP for people with dementia and especially their caregivers. However, they face several challenges for engaging in the process. Attending to specific needs in young-onset, in comparison to late-onset dementia, requires ACP to entail more than solely medical domains. However, a medicalized view on ACP still appears to be dominant in practice as opposed to its broader conceptualization in academia.
- Published
- 2023
15. Chlamydia pneumoniae: An Etiologic Agent for Late-Onset Dementia
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Brian J. Balin, Christine J. Hammond, Christopher Scott Little, Susan T. Hingley, Zein Al-Atrache, Denah M. Appelt, Judith A. Whittum-Hudson, and Alan P. Hudson
- Subjects
late-onset dementia ,Alzheimer’s disease ,amyloid ,APOE ,Chlamydia pneumoniae ,etiology ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
The disease known as late-onset Alzheimer’s disease is a neurodegenerative condition recognized as the single most commonform of senile dementia. The condition is sporadic and has been attributed to neuronal damage and loss, both of which have been linked to the accumulation of protein deposits in the brain. Significant progress has been made over the past two decades regarding our overall understanding of the apparently pathogenic entities that arise in the affected brain, both for early-onset disease, which constitutes approximately 5% of all cases, as well as late-onset disease, which constitutes the remainder of cases. Observable neuropathology includes: neurofibrillary tangles, neuropil threads, neuritic senile plaques and often deposits of amyloid around the cerebrovasculature. Although many studies have provided a relatively detailed knowledge of these putatively pathogenic entities, understanding of the events that initiate and support the biological processes generating them and the subsequent observable neuropathology and neurodegeneration remain limited. This is especially true in the case of late-onset disease. Although early-onset Alzheimer’s disease has been shown conclusively to have genetic roots, the detailed etiologic initiation of late-onset disease without such genetic origins has remained elusive. Over the last 15 years, current and ongoing work has implicated infection in the etiology and pathogenesis of late-onset dementia. Infectious agents reported to be associated with disease initiation are various, including several viruses and pathogenic bacterial species. We have reported extensively regarding an association between late-onset disease and infection with the intracellular bacterial pathogen Chlamydiapneumoniae. In this article, we review previously published data and recent results that support involvement of this unusual respiratory pathogen in disease induction and development. We further suggest several areas for future research that should elucidate details relating to those processes, and we argue for a change in the designation of the disease based on increased understanding of its clinical attributes.
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- 2018
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16. Chlamydia pneumoniae : An Etiologic Agent for Late-Onset Dementia.
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Balin, Brian J., Hammond, Christine J., Little, Christopher Scott, Hingley, Susan T., Al-Atrache, Zein, Appelt, Denah M., Whittum-Hudson, Judith A., and Hudson, Alan P.
- Abstract
The disease known as late-onset Alzheimer's disease is a neurodegenerative condition recognized as the single most commonform of senile dementia. The condition is sporadic and has been attributed to neuronal damage and loss, both of which have been linked to the accumulation of protein deposits in the brain. Significant progress has been made over the past two decades regarding our overall understanding of the apparently pathogenic entities that arise in the affected brain, both for early-onset disease, which constitutes approximately 5% of all cases, as well as late-onset disease, which constitutes the remainder of cases. Observable neuropathology includes: neurofibrillary tangles, neuropil threads, neuritic senile plaques and often deposits of amyloid around the cerebrovasculature. Although many studies have provided a relatively detailed knowledge of these putatively pathogenic entities, understanding of the events that initiate and support the biological processes generating them and the subsequent observable neuropathology and neurodegeneration remain limited. This is especially true in the case of late-onset disease. Although early-onset Alzheimer's disease has been shown conclusively to have genetic roots, the detailed etiologic initiation of late-onset disease without such genetic origins has remained elusive. Over the last 15 years, current and ongoing work has implicated infection in the etiology and pathogenesis of late-onset dementia. Infectious agents reported to be associated with disease initiation are various, including several viruses and pathogenic bacterial species. We have reported extensively regarding an association between late-onset disease and infection with the intracellular bacterial pathogen Chlamydia pneumoniae. In this article, we review previously published data and recent results that support involvement of this unusual respiratory pathogen in disease induction and development. We further suggest several areas for future research that should elucidate details relating to those processes, and we argue for a change in the designation of the disease based on increased understanding of its clinical attributes. [ABSTRACT FROM AUTHOR]
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- 2018
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17. Perspectives on the Intracellular Bacterium Chlamydia pneumoniae in Late-Onset Dementia
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Balin, Brian J. and Hudson, Alan P.
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- 2020
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18. Do spouse caregivers of young and older persons with dementia have different needs? A comparative study.
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Wawrziczny, Emilie, Pasquier, Florence, Ducharme, Francine, Kergoat, Marie‐Jeanne, and Antoine, Pascal
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PSYCHOLOGY of caregivers , *COMPARATIVE studies , *DEMENTIA , *SERVICES for caregivers , *BURDEN of care , *DESCRIPTIVE statistics - Abstract
Aim The aim of this study was to explore the needs of spouse caregivers of persons with dementia (PWD) and then to compare them based on the PWD's age at disease onset. This data could be used to adapt support programmes to address differences between the two groups. Method Thirty-eight spouse caregivers of persons with late-onset dementia and 40 spouse caregivers of persons with early-onset dementia (PEOD) agreed to participate in the study. The mean ± SD age of the PEOD was 57.6 ± 4.0 years, whereas it was 80.9 ± 5.3 years for the persons with late-onset dementia. Interviews were conducted in the spouse caregivers' homes with only the spouse caregiver. The semi-structured interviews were based on the French version of the Carers Outcome Agreement Tool. The interviews were analyzed in two steps. The first step was qualitative to identify needs. The data were thematically analyzed using QSR NVivo 10. The second step was quantitative to compare the needs depending on the PWD's age at onset. The comparison between the two groups was performed using the χ2 test. Results The results demonstrated that the majority of needs are the same for the two groups of spouse caregivers. All caregivers need to unwind, to stimulate and pay attention to the PWD, to break the isolation, and to be more prepared and confident. However, some differences emerge, with the spouse caregivers of PEOD expressing a greater number of needs. The caregivers of PEOD seem to have a greater need to interact and maintain contacts with other people ( P = 0.001), have more general care-related needs ( P = 0.005), require more appropriate care structures ( P = 0.037), and need greater assistance with administrative procedures ( P = 0.004). Conclusion To improve spouse caregivers' well-being and sense of efficiency, it would be interesting to develop a support programme with a common framework and specific modules depending on the PWD's age at disease onset. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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19. Do spouse caregivers of persons with early- and late-onset dementia cope differently? A comparative study.
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Wawrziczny, Emilie, Pasquier, Florence, Ducharme, Francine, Kergoat, Marie-Jeanne, and Antoine, Pascal
- Subjects
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ADAPTABILITY (Personality) , *PSYCHOLOGICAL adaptation , *AGE factors in disease , *ELDER care , *CAREGIVERS , *COMPARATIVE studies , *DEMENTIA , *INTERVIEWING , *INVENTORIES , *SPOUSES , *STRATEGIC planning , *QUALITATIVE research , *QUANTITATIVE research - Abstract
Objectives To explore spouse caregivers’ means of coping with the disease and compare them based on the age of onset of the disease in order to adapt support programs. Methods Interviews were conducted with 38 spouse caregivers of persons with late-onset dementia (PLOD) and 40 spouse caregivers of persons with early onset dementia (PEOD). The first step in the analysis was qualitative, using QSR N’Vivo 10 to identify the coping strategies. The second step was quantitative, comparing the coping strategies based on the age of onset of the disease with a χ2 test. Results An inventory of 26 strategies used by all caregivers was established and consolidated into two groups: acceptance strategies and avoidance strategies. The statistical results show that some strategies were used by the two groups of caregivers. However, when differences emerged, the “Planning” strategy was used by spouse caregivers of PEOD, whereas the “Re-arranging”, “Humor” and “Getting away from the entourage” strategies were used by spouse caregivers of PLOD. Conclusion It would be interesting to develop a support program with a common framework and specific modules depending on the age of onset of the disease. Common modules would permit developing and strengthening acceptance strategies. Specific modules for caregivers of PEOD would guide them in the acquisition of more adaptability and flexibility in the assistance provided to the PWD, which can sometimes be too rigid and controlled. Specific modules for caregivers of PLOD would help them to develop the ability to request help and identify the intervention limits of the entourage. [ABSTRACT FROM AUTHOR]
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- 2017
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20. Outdoor artificial light at night and risk of early-onset dementia: A case-control study in the Modena population, Northern Italy.
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Mazzoleni E, Vinceti M, Costanzini S, Garuti C, Adani G, Vinceti G, Zamboni G, Tondelli M, Galli C, Salemme S, Teggi S, Chiari A, and Filippini T
- Abstract
Background: Dementia is a neurological syndrome characterized by severe cognitive impairment with functional impact on everyday life. It can be classified as young onset dementia (EOD) in case of symptom onset before 65, and late onset dementia (LOD). The purpose of this study is to assess the risk of dementia due to light pollution, and specifically outdoor artificial light at night (LAN)., Methods: Using a case-control design, we enrolled dementia patients newly-diagnosed in the province of Modena in the period 2017-2019 and a referent population from their caregivers. We geo-referenced the address of residence on the date of recruitment, provided it was stable for the previous five years. We assessed LAN exposure through 2015 nighttime luminance satellite images from the Visible Infrared Imaging Radiometer Suite (VIIRS). Using a logistic regression model adjusted for age, sex, and education, we calculated the risk of dementia associated with increasing LAN exposure, namely using <10 nW/cm
2 /sr as reference and considering ≥10-<40 nW/cm2 /sr intermediate and ≥40 nW/cm2 /sr high exposure, respectively We also implemented non-linear assessment using a spline regression model., Results: We recruited 58 EOD cases, 34 LOD cases and 54 controls. Average LAN exposure levels overlapped for EOD cases and controls, while LOD cases showed higher levels. Compared with the lowest exposure, the risk of EOD associated with LAN was higher in the intermediate exposure (OR = 1.36, 95% CI 0.54-3.39), but not in the high exposure category (OR = 1.04, 95% CI 0.32-3.34). In contrast, the risk of LOD was positively associated with LAN exposure, with ORs of 2.58 (95% CI 0.26-25.97) and 3.50 (95% CI 0.32-38.87) in the intermediate and high exposure categories, respectively. The spline regression analysis showed substantial lack of association between LAN and EOD, while almost linear although highly imprecise association emerged for LOD., Conclusions: Although the precision of the estimates was affected by the limited sample size and the study design did not allow us to exclude the presence of residual confounding, these results suggest a possible role of LAN in the etiology of dementia, particularly of its late-onset form., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)- Published
- 2023
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21. Functional Status Predicts Awareness in Late-Onset but not in Early-Onset Alzheimer Disease.
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Dourado, Marcia C. N., Laks, Jerson, and Mograbi, Daniel
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ALZHEIMER'S disease , *CAREGIVERS , *DISABILITIES , *QUALITY of life , *OUTPATIENT medical care - Abstract
This study aims to assess whether there are differences between the level of awareness in early-onset Alzheimer disease (EOAD) and late-onset Alzheimer disease (LOAD) and to test its association with quality of life (QOL). A consecutive series of 207 people with Alzheimer disease and their caregivers were selected from an outpatient unit. There were no significant differences in awareness. In LOAD, impairment on awareness was predicted by functional level (β = .37, P < .001), self ( P = .006), and informant report of QOL ( P = .010). The predictors of unawareness in EOAD were self ( P = .002) and informant report of QOL ( P < .001). There is a specific profile of functional deficits underlying awareness in people with LOAD. Additionally, reports of EOAD QOL were more strongly related to awareness than in people with LOAD. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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22. Precise or imprecise probabilities? Evidence from survey response related to late-onset dementia
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Pamela Giustinelli, Francesca Molinari, and Charles F. Manski
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Pediatrics ,medicine.medical_specialty ,LATE-ONSET DEMENTIA ,SUBJECTIVE EXPECTATIONS ,IMPRECISE PROBABILITIES ,medicine ,Late onset dementia ,ROUNDING ,IMPRECISE PROBABILITIES, SUBJECTIVE EXPECTATIONS, ROUNDING, LATE-ONSET DEMENTIA ,Psychology ,General Economics, Econometrics and Finance ,Article - Abstract
We elicit numerical expectations for late-onset dementia and long-term-care (LTC) outcomes in the US Health and Retirement Study. We provide the first empirical evidence on dementia-risk perceptions among dementia-free older Americans and establish important patterns regarding imprecision of subjective probabilities. Our elicitation distinguishes between precise and imprecise probabilities, while accounting for rounding of reports. Imprecise-probability respondents quantify imprecision using probability intervals. Nearly half of respondents hold imprecise dementia and LTC probabilities, while almost a third of precise-probability respondents round their reports. These proportions decrease substantially when LTC expectations are conditioned on hypothetical knowledge of the dementia state. Among rounding and imprecise-probability respondents, our elicitation yields two measures: an initial rounded or approximated response and a post-probe response, which we interpret as the respondent's true point or interval probability. We study the mapping between the two measures and find that respondents initially tend to over-report small probabilities and under-report large probabilities. Using a specific framework for study of LTC insurance choice with uncertain dementia state, we illustrate the dangers of ignoring imprecise or rounded probabilities for modeling and prediction of insurance demand.
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- 2022
23. Experiences with and perspectives on advance care planning in young- and late- onset dementia: A focus group study with physicians from various disciplines.
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Van Rickstal R, De Vleminck A, Engelborghs S, and Van den Block L
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Introduction: Despite the relevance of advance care planning (ACP) for people with dementia, its uptake in this population is particularly low. Several challenges for ACP in dementia have been identified from physicians' perspectives. However, the literature available mainly includes general practitioners and focuses exclusively on the context of late-onset dementia. This is the first study to inquire physicians from four highly relevant specialisms in dementia care, with a focus toward potential specificities based on patients' age. The research question of this study is: "What are physicians' experiences with and perspectives on discussing ACP with people with young- and/or late-onset dementia?"., Methods: Five online focus groups were conducted with 21 physicians (general practitioners, psychiatrists, neurologists and geriatricians) in Flanders, Belgium. Verbatim transcripts were analyzed through the qualitative method of constant comparative analysis., Results: Physicians believed that the societal stigma related to dementia influences people's reaction to their diagnosis, at times characterized by catastrophic expectations for the future. In this regard, they explained that the topic of euthanasia is sometimes addressed by patients very early in the disease trajectory. Respondents paid ample attention to actual end-of-life decisions, including DNR directives, when discussing ACP in dementia. Physicians felt responsible for providing accurate information on both dementia as a condition, and the legal framework of end-of-life decisions. Most participants felt that patients' and caregivers' wish for ACP was more driven by who their personality than by their age. Nonetheless, physicians identified specificities for a younger dementia population in terms of ACP: they believed that ACP covered more domains of life than for older persons. A high consistency regarding the viewpoints of physicians from differing specialisms was noted., Discussion: Physicians acknowledge the added value of ACP for people with dementia and especially their caregivers. However, they face several challenges for engaging in the process. Attending to specific needs in young-onset, in comparison to late-onset dementia, requires ACP to entail more than solely medical domains. However, a medicalized view on ACP still appears to be dominant in practice as opposed to its broader conceptualization in academia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Van Rickstal, De Vleminck, Engelborghs and Van den Block.)
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- 2023
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24. A Comparative Descriptive Study of Characteristics of Early- and Late-Onset Dementia Family Caregivers.
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Ducharme, Francine, Lachance, Lise, Kergoat, Marie-Jeanne, Coulombe, Renée, Antoine, Pascal, and Pasquier, Florence
- Abstract
Characteristics of early- and late-onset dementia family caregivers were described and compared. Based on a theoretical model of role transition, data were collected through structured interviews from 48 caregivers of adults with Alzheimer’s disease or a related dementia older than the age of 70 and 48 caregivers of similarly diagnosed adults younger than the age of 60. A significantly higher proportion of caregivers of younger adults were spouses and gainfully employed compared with those of older adults; they had more years of schooling, took care of a person with more severe impairments, received more help, perceived themselves as better prepared to deal with future needs, and better informed about services. They did not differ from caregivers of older adults in terms of psychological distress, role confidence, self-efficacy, and social support. This study highlights differences and similarities to be considered in the development of services tailored to the specific needs of each group. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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25. Early-onset Alzheimer's disease: a global cross-sectional analysis.
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Panegyres, P. K. and Chen, H. Y.
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ALZHEIMER'S disease , *DEMENTIA , *HYPERTENSION , *ATRIAL fibrillation , *STROKE , *ANXIETY - Abstract
Background and purpose Little is known about factors associated with early-onset Alzheimer's disease ( EOAD), which occurs before 65 years of age. The identification of factors of EOAD might provide insights into Alzheimer's disease ( AD) pathogenesis. Methods Data from over 3000 subjects with AD from C- Path Online Data Repository were used to compare demographics, comorbidities and prescribed medications between EOAD and late-onset Alzheimer's disease ( LOAD). The generalized estimating equations binomial model was used to identify factors associated with EOAD, allowing for within-trials correlation (multiple patients from one single trial). Results Despite the similar proportions in White, Asian and Black between EOAD and LOAD, a significantly higher proportion of EOAD population was from other races: Native American Indian, Alaskan and Hawaiian and other minorities (including Hispanics) ( P < 0.0001); and were more likely to have anxiety or depression ( P < 0.0001). A high proportion of the LOAD population reported a history of AD from any relative (70% vs. 58%); atrial fibrillation, hypertension, heart disease, stroke, hypercholesterolaemia and hypothyroidism were over-represented in LOAD ( P < 0.01). LOAD patients used more risperidone and donepezil ( P < 0.01). The multivariable model results showed that, compared with LOAD, EOAD patients were more frequently from other races and were more likely to have anxiety or depression, with less hypertension, stroke and atrial fibrillation. Conclusion Early-onset Alzheimer's disease is found more frequently in Native American Indians, Alaskans, Hawaiians and other minorities, including Hispanics; patients with EOAD have more anxiety or depression. EOAD occurs independently of hypertension, stroke and atrial fibrillation. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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26. Diagnostic profiles of patients with late-onset Creutzfeldt-Jakob disease differ from those of younger Creutzfeldt-Jakob patients: a historical cohort study using data from the German National Reference Center.
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Karch, André, Raddatz, Lena, Ponto, Claudia, Hermann, Peter, Summers, David, and Zerr, Inga
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NEURODEGENERATION , *CREUTZFELDT-Jakob disease , *OLDER patients , *CEREBROSPINAL fluid , *MAGNETIC resonance imaging , *BASAL ganglia diseases - Abstract
In contrast to other neurodegenerative diseases, sporadic Creutzfeldt-Jakob disease (sCJD) is rarely diagnosed in patients older than 75 years. Data describing the characteristics of sCJD in the very old are rare and inconclusive. Therefore, a historical cohort study was designed to evaluate clinical, cerebrospinal fluid (CSF), electroencephalography (EEG), and magnetic resonance imaging (MRI) features of this group. Patients older than 75 years identified via the German surveillance program from 2001 to 2012 ( n = 73) were compared to a random subsample of sCJD patients younger than 75 ( n = 73) from the same time period using an historical cohort design. Older patients showed a faster disease progression represented by an earlier point of diagnosis and a shorter survival time ( p < 0.001). In the early stages of disease, older patients presented slightly more often with dementia ( p = 0.127) or dysarthria ( p = 0.238), whereas disorders of the extrapyramidal ( p = 0.056) and visual system ( p = 0.015) were more common in the younger group. Atypical MRI profiles such as MRI lesions restricted to one hemisphere ( p < 0.001) or cortical lesions only ( p = 0.258) were found more frequently in patients older than 75 years, whereas typical cortical and basal ganglia hyperintensities were more common in the younger group ( p = 0.001). We demonstrated for the first time that patients with late-onset sCJD differ from younger sCJD patients with respect to MRI profiles and initial clinical presentation, but not among CSF markers. Misclassification of Creutzfeldt-Jakob disease cases in patients older than 75 years seems likely due to atypical clinical and radiological presentation. This might contribute to lower sCJD incidence rates in this age group. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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27. The influence of the age of dementia onset on college students’ stigmatic attributions towards a person with dementia
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Lilach Raviv-Turgeman, Perla Werner, and Patrick W. Corrigan
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Male ,Background information ,Health Knowledge, Attitudes, Practice ,medicine.medical_treatment ,Social Stigma ,Public stigma ,Stigma (botany) ,Disease ,lcsh:Geriatrics ,03 medical and health sciences ,0302 clinical medicine ,Alzheimer Disease ,Humans ,Medicine ,Dementia ,Age of Onset ,Students ,Aged ,Young-onset dementia ,Aged, 80 and over ,Older person ,Rehabilitation ,030214 geriatrics ,business.industry ,Late-onset dementia ,Cognition ,Attributional model ,medicine.disease ,lcsh:RC952-954.6 ,Cross-Sectional Studies ,Social Perception ,Female ,Geriatrics and Gerontology ,business ,Attribution ,Prejudice ,030217 neurology & neurosurgery ,Research Article ,Clinical psychology - Abstract
Background Research in the area of public stigma and Alzheimer’s disease (AD) is limited to examining stigmatic beliefs towards persons aged 65 and over (i.e., persons with late-onset dementia). The aim of the present study was to compare college students’ stigmatic attributions towards an older and a younger person with AD, using an attributional model of stigma. Method A cross-sectional study was conducted with 375 college students (mean age = 25.5, 58.9% female, 64.3% Jewish) who answered a computerized, self-administered, structured questionnaire after being presented with one of two randomly distributed vignettes varying in the age of the person with AD – 80 or 50 years of age. Cognitive, emotional and behavioral attributions of stigma were assessed using an adapted version of the Attribution Questionnaire. Other variables examined included background information, experiences and concerns about developing AD. T-tests and Ordinary Least Square (OLS) hierarchical regressions were used to analyze results. Results Similar to previous studies, students’ levels of dementia stigma were low to moderate. Negative attributions were consistently and significantly higher (β = .17 to .33, p Conclusion The differences in stigmatic beliefs towards a younger and older person with AD point to the theoretical and practical importance of clearly stating the age of the target person in stigma studies as well as in programs aimed at reducing public stigma towards persons with AD.
- Published
- 2020
28. Early-Onset Dementia Is Associated with Higher Mortality.
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Koedam, Esther L. G. E., Pijnenburg, Yolande A. L., Deeg, Dorly J. H., Baak, Merel M. E., Van der Vlies, Annelies E., Scheltens, Philip, and Van der Flier, Wiesje M.
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- *
DEMENTIA , *MORTALITY , *PSYCHOSES , *NEUROBEHAVIORAL disorders , *DISEASE risk factors - Abstract
Background/Aims: Our objective was to compare the mortality risks of patients with early- and late-onset dementia with non-demented controls of the same age range and to analyse the mortality risks in subtypes of dementia. Methods: We included 1,203 subjects from our memory clinic. Patients with dementia were subdivided into 2 groups, with early- (<65 years) or late-onset dementia (≥65 years), and compared with non-demented controls of the same age range. We used Cox proportional hazard models to estimate mortality risks. Results: When compared to non-demented controls of the same age range, the patients with early-onset dementia had a strongly elevated mortality risk [hazard ratio (95% confidence interval) = 43.3 (3.1–600.4)], while those with late-onset dementia had a moderately increased mortality risk compared to older controls [hazard ratio (95% confidence interval) = 3.4 (1.8–6.2)]. An additional analysis showed that, adjusted for age, Alzheimer’s disease seemed to have the most benign course, with a fourfold increased mortality risk. Dementia with Lewy bodies and vascular dementia (frequently seen at older age) and frontotemporal lobar degeneration and ‘other dementias’ (often found at younger age) had a six- to eightfold increased mortality risk. Conclusion: Dementia is a risk factor for death. Especially in young patients the impact of dementia on mortality is high. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
- Published
- 2008
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29. Atherosclerosis and cognitive impairment are linked in the elderly. The Leiden 85-plus Study
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van Exel, E., Gussekloo, J., Houx, P., de Craen, A.J.M., Macfarlane, P.W., Bootsma-van der Wiel, A., Blauw, G.J., and Westendorp, R.G.J.
- Subjects
- *
ATHEROSCLEROSIS , *COGNITION , *ISCHEMIA - Abstract
Post-mortem analyses suggest that atherosclerosis more often contributes to late-onset dementia than hitherto expected. We set out to further unravel the relation between atherosclerosis and cognitive impairment. We therefore tested the hypothesis that the number of cardiovascular pathologies is positively associated with cognitive impairment in elderly subjects, and that the smaller number of cardiovascular pathologies in women explains the better cognitive function of elderly women. Within the Leiden 85-plus Study, we assessed the atherosclerotic burden by counting the number of cardiovascular pathologies in the medical histories of a population-based sample of 599 subjects aged 85 years (response 87%). Significantly more men than women had a history of cardiovascular pathologies (67% compared to 59%, P<0.001). In addition, cognitive function was assessed. All subjects completed the Mini-Mental State Examination (MMSE). Cognitive speed and memory were determined with specific neuro-psychological tests in those with a MMSE-score above 18 points. There was a highly significant dose-response relationship between the number of cardiovascular pathologies and cognitive impairment for both men and women. The median MMSE-score was 26 points in subjects without cardiovascular disease and decreased to 25 points for subjects who had two or more cardiovascular pathologies (P for trend =0.003). Similar associations were found for cognitive speed but not for memory. Our data confirm that in old age atherosclerosis significantly contributes to cognitive impairment. Since treatments for atherosclerosis appear to be particularly effective in elderly people, we consider our finding of utmost clinical importance in possibly preventing cognitive impairment and late-onset dementia. [Copyright &y& Elsevier]
- Published
- 2002
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30. Quality of life of family carers of persons with young-onset compared to late-onset dementia
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Hege Kersten, Geir Selbæk, Knut Engedal, Jurate Saltyte Benth, Lara H. Thomasgaard Hvidsten, Frøydis Kristine Bruvik, and Torgeir Bruun Wyller
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Gerontology ,Yod ,health care facilities, manpower, and services ,Young onset ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Activities of Daily Living ,medicine ,Humans ,Dementia ,Age of Onset ,health care economics and organizations ,Aged ,030214 geriatrics ,business.industry ,carer ,family ,late-onset dementia ,young-onset dementia ,social sciences ,medicine.disease ,humanities ,Psychiatry and Mental health ,Cross-Sectional Studies ,Caregivers ,Young onset dementia ,Quality of Life ,Late onset dementia ,Geriatrics and Gerontology ,Pshychiatric Mental Health ,business ,human activities ,030217 neurology & neurosurgery - Abstract
OBJECTIVES: To compare quality of life (QOL) of family carers of persons with young- (YOD) to late-onset dementia (LOD). METHODS: This was a cross-sectional comparison of 88 carers of persons with YOD and 100 carers of persons with LOD. The Quality of Life - Alzheimer's Disease questionnaire (QOL-AD) was used to measure QOL of both carers and persons with dementia. Depressive symptoms were measured by the Geriatric Depression Scale (GDS) for carers and the Cornell Scale for Depression in Dementia for persons with dementia. Care burden was measured by the Relatives' Stress Scale. Activities of Daily Living (ADL) of the persons with dementia were assessed using the total score from the Lawton & Brody Instrumental-ADL scale and the Physical Self-Maintenance Scale. Multiple linear regression models with interactions between covariates and group (YOD versus LOD) were estimated. RESULTS: The QOL-AD scores of YOD-carers were significantly poorer compared to LOD-carers (mean difference 2.5 (95% CI 0.7; 4.3), p = 0.006). Poorer QOL of carers was associated with more depressive symptoms (mean QOL-AD change -0.5 (-0.6; -0.3), p
- Published
- 2019
31. Association of a wide range of chronic diseases and apolipoprotein E4 genotype with subsequent risk of dementia in community-dwelling adults: A retrospective cohort study.
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Shang X, Zhu Z, Zhang X, Huang Y, Zhang X, Liu J, Wang W, Tang S, Yu H, Ge Z, Yang X, and He M
- Abstract
Background: Identifying independent and interactive associations of a wide range of diseases and multimorbidity and apolipoprotein E4 (APOE4) with dementia may help promote cognitive health. The main aim of the present study was to investigate associations of such diseases and their multimorbidity with incident dementia., Methods: In this retrospective cohort study, we included 471,485 individuals of European ancestry from the UK Biobank, aged 38-73 years at baseline (2006-10). Dementia was identified using inpatient records and death registers. The follow-up period was between March 16, 2006, and Jan 31, 2021., Findings: During a median follow-up of 11·9 years, 6189 cases of incident all-cause dementia (503 young-onset cases, 5686 late-onset cases) were documented. In multivariable-adjusted analysis, 33 out of 63 major diseases were associated with an increased risk of dementia. The hazard ratio (HR [95% CI]) ranged from 1·12 (1·06-1·19) for obesity to 14·22 (12·33-16·18) for Parkinson's disease. In addition to conventional diseases, respiratory disorders, musculoskeletal disorders, digestive disorders, painful conditions, and chronic kidney disease were associated with increased dementia risk. A larger HR for dementia was observed for a larger number of diseases (3·97 [3·51-4·48] for ≥6 diseases versus no disease). These individual diseases and multimorbidity were more predictive of young-onset dementia than of late-onset dementia. Dementia risk score incorporating multimorbidity, age, and APOE4 status had strong prediction performance (area under the curve [95% CI]: 82·2% [81·7-82·7%]). APOE4 was more predictive of late-onset dementia (HR [95% CI]: 2·90 [2·75-3·06]) than of young-onset dementia (1·26 [1·03-1·54]). Associations of painful conditions, depression, obesity, diabetes, stroke, Parkinson's disease, high cholesterol, and their multimorbidity with incident dementia were stronger among non-APOE4 carriers., Interpretation: Besides conventional diseases, numerous diseases are associated with an increased risk of dementia. These individual diseases and multimorbidity are more predictive of young-onset dementia, whereas APOE4 is more predictive of late-onset dementia. Individual diseases and multimorbidity are stronger predictors of dementia in non-APOE4 carriers. Although multiple risk factors have been adjusted for in the analysis, potential confounding from unknown factors may have biased the associations., Funding: The Fundamental Research Funds of the State Key Laboratory of Ophthalmology, Project of Investigation on Health Status of Employees in Financial Industry in Guangzhou, China (Z012014075), Science and Technology Program of Guangzhou, China (202,002,020,049)., Competing Interests: The authors have no conflicts of interest to declare that are relevant to the content of this article., (© 2022 The Author(s).)
- Published
- 2022
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32. Chlamydia pneumoniae: An Etiologic Agent for Late-Onset Dementia
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Susan T. Hingley, Christine J. Hammond, Christopher S. Little, Alan P. Hudson, Judith A. Whittum-Hudson, Brian J. Balin, Zein Al-Atrache, and Denah M. Appelt
- Subjects
0301 basic medicine ,Aging ,Cognitive Neuroscience ,etiology ,Review ,Neuropathology ,Disease ,neuroinflammation ,lcsh:RC321-571 ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Chlamydia pneumoniae ,medicine ,Dementia ,Senile plaques ,Pathogen ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Chlamydia ,business.industry ,Neurodegeneration ,amyloid ,medicine.disease ,infection ,3. Good health ,030104 developmental biology ,late-onset dementia ,Immunology ,business ,Alzheimer’s disease ,030217 neurology & neurosurgery ,APOE ,Neuroscience - Abstract
Late-onset Alzheimer’s disease is a progressive neurodegenerative condition now recognized as the single most common, severe form of dementia in the elderly. The condition is sporadic and has been attributed to neuronal damage and loss, both of which have been linked to the accumulation of protein deposits in the brain. Significant progress has been made over the past two decades regarding our overall understanding of the apparently pathogenic entities that arise in the affected brain, both for early-onset disease, which constitutes approximately 5% of all cases, as well as late-onset disease, which constitutes the remainder of cases. Observable neuropathology includes: neurofibrillary tangles, neuropil threads, neuritic senile plaques, and often deposits of amyloid around the cerebrovasculature. Although many studies have provided a relatively detailed knowledge of these putatively pathogenic entities, understanding of the events that initiate and support the biological processes generating them and the subsequent observable neuropathology and neurodegeneration remain limited. This is especially true in the case of late-onset disease. Although early-onset Alzheimer’s disease has been shown conclusively to have genetic roots, the detailed etiologic initiation of late-onset disease without such genetic origins has remained elusive. Several studies over the last 15 years, including both current and ongoing work, have implicated infection in the etiology and pathogenesis of late-onset dementia. Infectious agents reported to be associated with disease initiation are various, including several viruses and pathogenic bacterial species. We have reported extensively regarding an association between late-onset disease and infection with the obligate intracellular bacterial pathogen Chlamydia pneumoniae. In this article, we review previously published data and recent results that support involvement of this unusual respiratory pathogen in disease induction and development. We further suggest several areas for future research that should elucidate details relating to those processes, and we argue for a change in the designation of the disease based on increased understanding of its clinical attributes.
- Published
- 2018
33. A Comparative Descriptive Study of Characteristics of Early- and Late-Onset Dementia Family Caregivers
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Francine M. Ducharme, Renée Coulombe, Marie-Jeanne Kergoat, Pascal Antoine, Lise Lachance, Florence Pasquier, Sciences Cognitives et Sciences Affectives (SCALab) - UMR 9193 (SCALab), Université de Lille-Centre National de la Recherche Scientifique (CNRS), Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire Sciences Cognitives et Sciences Affectives - UMR 9193 (SCALab), Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 (TCDV), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)
- Subjects
Male ,Gerontology ,characteristics ,[SDV]Life Sciences [q-bio] ,Disease ,Mesh:Adult ,Mesh:Employment ,Mesh:Caregivers/psychology ,[SCCO]Cognitive science ,0302 clinical medicine ,Surveys and Questionnaires ,Mesh:Alzheimer Disease/nursing ,Mesh:Aged ,comparative study ,Aged, 80 and over ,Family caregivers ,General Neuroscience ,Mesh:Canada ,Middle Aged ,Self Efficacy ,Mesh:Self Efficacy ,Psychiatry and Mental health ,Clinical Psychology ,late-onset dementia ,Caregivers ,Female ,Late onset dementia ,family caregivers ,Descriptive research ,Psychology ,Mesh:Surveys and Questionnaires ,Adult ,Employment ,Mesh:Female ,Mesh:Spouses/psychology ,Canada ,Mesh:Psychological/psychology ,Mesh:Male ,early-onset dementia ,03 medical and health sciences ,Social support ,Alzheimer Disease ,Mesh:Middle Aged ,Mesh:80 and over ,medicine ,Humans ,Dementia ,Spouses ,Aged ,030214 geriatrics ,Social Support ,medicine.disease ,Mesh:Stress ,Mesh:Social Support ,Mesh:Humans ,Younger adults ,Mesh:Alzheimer Disease/psychology ,Structured interview ,Geriatrics and Gerontology ,Stress, Psychological ,030217 neurology & neurosurgery - Abstract
International audience; Characteristics of early- and late-onset dementia family caregivers were described and compared. Based on a theoretical model of role transition, data were collected through structured interviews from 48 caregivers of adults with Alzheimer's disease or a related dementia older than the age of 70 and 48 caregivers of similarly diagnosed adults younger than the age of 60. A significantly higher proportion of caregivers of younger adults were spouses and gainfully employed compared with those of older adults; they had more years of schooling, took care of a person with more severe impairments, received more help, perceived themselves as better prepared to deal with future needs, and better informed about services. They did not differ from caregivers of older adults in terms of psychological distress, role confidence, self-efficacy, and social support. This study highlights differences and similarities to be considered in the development of services tailored to the specific needs of each group.
- Published
- 2015
34. Analysis of the needs and accompaniment of spouse caregivers of persons with early-onset dementia
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Wawrziczny, Emilie, Sciences Cognitives et Sciences Affectives (SCALab) - UMR 9193 (SCALab), Université de Lille-Centre National de la Recherche Scientifique (CNRS), Université Charles de Gaulle - Lille III, Pascal Antoine, and Laboratoire Sciences Cognitives et Sciences Affectives - UMR 9193 (SCALab)
- Subjects
Modèle structural ,Late-onset dementia ,[SHS.PHIL]Humanities and Social Sciences/Philosophy ,Besoins ,Démence à début tardif ,Spouse caregivers ,Couple ,Early-onset dementia ,Démence à début précoce ,Strategies ,Stratégies ,Needs ,Structural model ,Conjoints aidants - Abstract
This thesis aims to identify needs and difficulties of the spouse caregivers of persons with dementia. We also investigate similarities and specificities related to the caregiving situation regarding the age atonset of the disease.The first axis examines the experience of couples in which one member received a diagnosis of earlyon setdementia. The results show an evolution in the relation to knowledge of the caregivers and the persons with dementia. They oscillate between the need to understand the changes caused by the disease and a distancing after the diagnosis. Moreover, with the progression of the disease, the caregivers are not able to adapt their level of assistance, which increases tensions between the two partners. The two studies of the second axis aim to compare needs and coping strategies of spouse caregivers of persons with early and late onset dementia. The majority of needs and strategies are the same for all spouse caregivers. However, the spouse caregivers of persons with early-onset dementia express the greatest number of needs related to maintaining contacts, more need of adapted care structures and more need to be assisted in administrative procedures. The spouse caregivers of persons with late-onset dementia use more humor, re-arranging, and getting away from the entourage. The third axis investigates the influence of the characteristics of the caregiving context on spousal caregiver distress with a structural modelisation. The sittings of this general model were compared regarding the age at onset of the disease and the gender of caregiver. This study demonstrated that 4 factors contribute to spousal caregiver distress: preparedness, family support, self-rated health and the quality of the couple relationship. Dyadic determinants were more important for caregivers of PEOD. The analysis of these results permits to specify the content of support for a common core and specific modules depending on the age at onset of the disease.; La thèse a pour objectifs d'identifier les besoins et les difficultés des conjoints aidants de personnesprésentant une maladie d'Alzheimer. Elle vise également à mettre en évidence les points communs etles spécificités de la situation d’aide en fonction de l’âge d’apparition de la maladie. L’axe 1 porte sur l’analyse du vécu de couples dont l'un des partenaires présente une démence précoce. Les résultats mettent en évidence une évolution dans le rapport au savoir des aidants et des personnes malades. Ils passent d'un besoin de comprendre les changements occasionnés par l’arrivée de la maladie à une mise à distance après l'annonce du diagnostic. De plus, avec l'avancée des troubles, les aidants éprouvent des difficultés à ajuster leur niveau d’aide, ce qui est source de conflits entre les deux partenaires. Les deux études de l'axe 2 ont pour objectif d’établir une comparaison entre les aidants de personnes malades jeunes et de personnes malades âgées à la fois sur leurs besoins et sur leurs modes d’ajustement. La majorité des besoins et des stratégies est commune à tous les aidants. Néanmoins, les aidants de personnes malades jeunes expriment plus de besoins en termes de maintien de contact, d'adaptation des structures de soins et d'accompagnement dans les démarches administratives. Les aidants de personnes malades âgées utilisent plus l'humour, l'aménagement et la mise à distance de l'entourage comme stratégies d'ajustement. L’axe 3 vise à investiguer l'influence des caractéristiques de la situation d'aide sur la détresse du conjoint aidant à l’aide d’une modélisation structurale. Les paramètres de ce modèle général ont été comparés en fonction de l'âge de début de la maladie et du genre de l'aidant. Cette étude met en évidence 4 facteurs influençant le sentiment de détresse des conjoints aidants : le sentiment d'être préparé, la qualité du support familial, l’évaluation de sa santé et la qualité d’ajustement du couple. Ce dernier facteur est plus important pour les conjoints aidants de personnes malades jeunes. L’analyse de ces résultats permet de spécifier le contenu de programmes d’accompagnement en faveur de modules communs à tous les aidants et de modules spécifiques en fonction de l'âge d'apparition de la maladie.
- Published
- 2016
35. Neuropsychiatric Characteristics of Alzheimer’s Disease and the Behavioral Variant of Frontotemporal Dementia
- Author
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Carlos Muñoz-Neira, Andrea Slachevsky, and Lopez, Oscar L.
- Subjects
mental disorders ,Behavioral variant of frontotemporal dementia ,Late-onset dementia ,Early-onset dementia ,Alzheimer’s disease ,Neuropsychiatric symptoms - Abstract
Neurodegenerative dementias that occur in adults can present with significant behavioral symptoms in addition to the cognitive syndrome. These can be disruptive for the families who take care for these patients and cause a significant burden on the medical system. The incidence of Alzheimer’s disease (AD) is frequently greater in patients over 65 years of age, whereas the behavioral variant of frontotemporal dementia (bvFTD) is more common in subjects younger than 65. All the same, AD can have an early onset and present with behavioral symptoms that resemble bvFTD. Similarly, bvFTD can begin after age 65, thereby mimicking an AD syndrome. Whereas an amnesic syndrome along with deterioration in other cognitive domains, mood-related symptoms, psychosis and functional disabilities are the main elements characterizing AD, a dysexecutive syndrome accompanied by other neuropsychological detriments, a profound lack of social cognition and functional deterioration are the most prominent signs suggesting the presence of bvFTD. It should be noted, however, that in some cases, especially those in which AD begins before age 65, clinical differentiation of the two disease processes can be difficult. In this manuscript, the most salient aspects of AD and bvFTD and the key signs that might contribute to differential diagnosisof the two disorders are highlighted. Proper diagnosis of AD and bvFTD has important implications for treatment because there are symptomatic therapies for these two types of dementia. Additionally, their appropriate identification may contribute to long-term planning of the care of these patients.
- Published
- 2016
36. Case Studies Illustrating Focal Alzheimer's, Fluent Aphasia, Late-Onset Memory Loss, and Rapid Dementia.
- Author
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Camsari GB, Murray ME, and Graff-Radford NR
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- Aged, Aged, 80 and over, Alzheimer Disease diagnosis, Aphasia, Wernicke etiology, Dementia etiology, Female, Humans, Male, Middle Aged, Time Factors, Aphasia, Wernicke diagnosis, Dementia diagnosis, Memory Disorders etiology
- Abstract
Many dementia subtypes have more shared signs and symptoms than defining ones. We review 8 cases with 4 overlapping syndromes and demonstrate how to distinguish the cases. These include focal cortical presentations of Alzheimer's disease (AD; posterior cortical atrophy and corticobasal syndrome [CBS]), fluent aphasia (semantic dementia and logopenic aphasia), late-onset slowly progressive dementia (hippocampal sclerosis and limbic predominant AD) and rapidly progressive dementia (Creutzfeldt-Jakob disease and limbic encephalitis). Recognizing the different syndromes can help the clinician to improve their diagnostic skills, leading to improved patient outcomes by early and accurate diagnosis, prompt treatment, and appropriate counseling and guidance., (Copyright © 2016 Elsevier Inc. All rights reserved.)
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- 2016
- Full Text
- View/download PDF
37. Differences between early and late onset Alzheimer's disease.
- Author
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Panegyres PK and Chen HY
- Abstract
Previous studies comparing early-onset Alzheimer's disease (EOAD) and late-onset AD (LOAD) have been limited by cross-sectional design and a focus on isolated clinical variables. This study aims to explore differentials in clinical features between EOAD and LOAD and to examine longitudinally trends in cognitive function. Data from 3,747 subjects with AD from C-Path Online Data Repository was used to compare demographics, body mass index (BMI), mean arterial pressure (MAP), biochemistry and cognitive assessments, including mini-mental state examination (MMSE) and Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog), between EOAD and LOAD. The baseline differences were examined by binominal proportion test and t-test. The trends of cognitive functions, evaluating by MMSE and ADAS-Cog, were examined by the mixed model, controlling for the effect of repeated measures of the same person. No significant difference was found in BMI and MAP. C-reactive protein, creatinine and blood urea nitrogen (BUN) (p<0.05) were significantly higher in LOAD. The APOE ε4 alleles was more likely to be found among LOAD compared to APOE ε2 or APOE ε3. EOAD had significantly lower MMSE at baseline and this difference significantly increased over time. Despite an insignificant differential in ADAS-Cog between EOAD and LOAD at baseline, the differential was enlarged gradually and became more significant with time. Our findings suggest that elevated inflammatory markers, impaired renal function and APOE ε4 alleles are overrepresented in LOAD, possibly indicating that different factors determine the development of EOAD and its more rapid cognitive deterioration.
- Published
- 2013
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