Influence of socio-demographic, clinical and functional factors on the severity of dementia (original) (raw)
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Acta Fisiátrica, 2022
To evaluate dementia staging, physical-functional performance, and their possible correlations of elderlies with Alzheimer's Disease, assisted by a referral center. Method: Quantitative cross-sectional study of elderlies of both sexes, aged 60 years or older, with a clinical diagnosis of Alzheimer's Disease. The participants were evaluated with the Timed Up and Go Test (TUG), Rikli & Jones Sit and stand Test, Berg Balance Scale, and the Clinical Dementia Rating Score (CDR). Statistical analysis classified and compared groups of frail and non-frail participants with unpaired tests. The significance level was 0.05. Results: 46 participants of both sexes with a mean age of 78.72±7.37 years. Subjects were divided into frail and non-frail elderly. Older people were classified into questionable to mild dementia and moderate to severe dementia and matched. There was a significant correlation between age and TUG (r= 0.532; p= 0.041), age and Berg (r=-0.343; p= 0.040), TUG and Berg (r=-0.562; p= 0.029), and sit-stand test and Berg (r= 0.706; p= 0.003). Conclusion: Lower performance compared to the specialized literature for the assessment instruments proposed in this research was found, indicating that AD progression was directly related to their performance in physical-functional tests.
Advanced dementia in a sample of Brazilian elderly: Sociodemographic and morbidity analysis
Revista da Associacao Medica Brasileira (1992), 2016
To investigate the sociodemographic and morbidity profile of advanced dementia patients and sociodemographic data of their primary caregivers. Data was obtained from 67 elderly recruited for an observational prospective study, through interviews performed with primary caregivers. For statistical analysis, the Statistical Package for the Social Sciences (SPSS(r)) for Windowsr, version 19.0. was employed. Advanced dementia patients were mostly women, widows, and non-institutionalized, with low-income. An elevated rate of stroke, sarcopenia, and pressure ulcers in this population is noted. Caregivers were mostly women, married, children of the studied patients, and unemployed. Only one third of caregivers were hired for the task. Patients with advanced dementia present a high morbidity profile, low income, and depend on the care given by family members, mostly unemployed daughters.
Epidemiology of dementia – A current overview
Public Health Forum, 2012
SummaryDementia is common and one of the most burdensome diseases for sufferers and their relatives; it is also one of the biggest challenges for the healthcare systems of aging societies. Professional nursing care and informal care by family or friends constitute the most significant cost components of dementia. In the absence of effective therapeutic options, a healthy lifestyle might be the best option to reduce the individual risk of developing dementia.
Rev. psiquiatr. clín., 2014
Background: Proper control of cerebrovascular risk is essential to prevent cognitive change in dementia due to Alzheimer's disease (AD). Objective: To investigate whether caregiver awareness to control cerebrovascular risk impacts the lifestyles of patients with AD. Methods: Consecutive outpatients with AD were assessed for demographic features, Clinical Dementia Rating scores, cerebrovascular risk, pharmacotherapy, dietary therapy and practice of physical activities. Patients and caregivers were inquired on awareness of the importance of measures to control cerebrovascular risk. Chi-square test was employed for statistics, significance at ρ < 0.05. Results: A total of 217 patients were included; whereas 149 caregivers (68.7%) were aware of the need to control cerebrovascular risk, only 11 patients (5.1%) simultaneously practiced physical activities and received pharmacological treatment and dietary therapy. Patients with hypertension and diabetes mellitus were more likely to receive dietary therapy (ρ = 0.007). Male patients were more engaged in physical activities (ρ = 0.018). Patients in earlier AD stages exercised (ρ = 0.0003) and received pharmacological treatment more often (ρ = 0.0072). Caregiver awareness of the need to control cerebrovascular risk was higher when patients had hypertension (ρ = 0.024) and/or hypercholesterolemia (ρ = 0.006), and influenced adherence to dietary therapy (ρ = 0.002) and to pharmacological treatment (ρ = 0.001). Discussion: Caregiver awareness of the need to control cerebrovascular risk has positive impacts for patients with AD.
Doença de Alzheimer: declínio funcional e estágio da demência
Acta Paulista de Enfermagem, 2013
Objective: To determine how Alzheimer's disease stage is correlated with the functional ability of elderly people, according to the Functional Independence Measure. Methods: This observational and cross-sectional study involved elderly people diagnosed with Alzheimer's disease and their caregivers. For data collection, the Functional Independence Measure and the Clinical Dementia Rating scale were used. Results: The sample consisted of 67 elderly people (mean age, 79 years). Severe dementia was found in 46.3%, moderate dementia in 22.4%, and mild dementia in 31.3%. The mean scores on the Functional Independence Measure were 107.9, 84.5, and 39.7 for participants with mild, moderate, and severe dementia, respectively. A correlation was found between the Functional Independence Measure and dementia stage (p<0.001). Conclusion: The stage of dementia is an important predictive factor for functional performance problems in elderly people with Alzheimer's disease.
Dementia & Neuropsychologia, 2022
Alzheimer's disease (AD) and other neurodegenerative dementias have a progressive course, impairing cognition, functional capacity, and behavior. Most studies have focused on AD. Severe dementia is associated with increased age, higher morbidity-mortality, and rising costs of care. It is fundamental to recognize that severe dementia is the longest period of progression, with patients living for many years in this stage. It is the most heterogeneous phase in the process, with different abilities and life expectancies. This practice guideline focuses on severe dementia to improve management and care in this stage of dementia. As it is a long period in the continuum of dementia, clinical practice should consider non-pharmacological and pharmacological approaches. Multidisciplinary interventions (physical therapy, speech therapy, nutrition, nursing, and others) are essential, besides educational and support to caregivers.
International reflections on caring for people with advanced dementia
Public Health Nursing
Almost 50 million people around the world are living with a dementia diagnosis and the number of new cases is increasing by about 7.7 million per year (World Health Organization, 2012). The condition affects mostly older people and has a long trajectory (Li et al., 2017; Verlinden et al., 2016). It starts off with the characteristic symptom of memory loss and ends with an inability to live daily life independently. Dementia has a huge impact on social, economic, and medical systems worldwide (World Health Organization, 2012). Many countries are attempting to address the challenge of dementia in their national strategies and action plans (Nakanishi et al., 2015; World Health Organization, 2012). Although the approaches within these national plans and strategies vary from country to country, reflecting different social structures and policy situations, the worldwide priority actions are agreed to be awareness raising and prevention; early diagnosis; commitment to good quality continuing care and services; caregiver support; workforce planning and effective training; research to better understand the disease and inform evidence-based care (World Health Organization, 2012). Dementia is recognized as a long-term life-limiting illness: as yet there is no cure or effective treatment (Koller et al., 2012; Lee & Chodosh, 2009). With such a lengthy deterioration, patients often develop comorbidities and at the same time, lose the