Cognitive ageing and dementia

إِنَّمَا مَثَلُ ٱلۡحَيَوٰةِ ٱلدُّنۡيَا كَمَآءٍ أَنزَلۡنَٰهُ مِنَ ٱلسَّمَآءِ فَٱخۡتَلَطَ بِهِۦ نَبَاتُ ٱلۡأَرۡضِ مِمَّا يَأۡكُلُ ٱلنَّاسُ وَٱلۡأَنۡعَٰمُ حَتَّىٰٓ إِذَآ أَخَذَتِ ٱلۡأَرۡضُ زُخۡرُفَهَا وَٱزَّيَّنَتۡ وَظَنَّ أَهۡلُهَآ أَنَّهُمۡ قَٰدِرُونَ عَلَيۡهَآ أَتَىٰهَآ أَمۡرُنَا لَيۡلًا أَوۡ نَهَارࣰ ا فَجَعَلۡنَٰهَا حَصِيدࣰ ا كَأَن لَّمۡ تَغۡنَ بِٱلۡأَمۡسِۚ كَذَٰلِكَ نُفَصِّلُ ٱلۡأٓيَٰتِ لِقَوۡمࣲ يَتَفَكَّرُونَ

The life of this world is like this: rain that We send down from the sky is absorbed by the plants of the earth, from which humans and animals eat. But when the earth has taken on its finest appearance, and adorns itself, and its people think they have power over it, then the fate We commanded comes to it, by night or by day, and We reduce it to stubble, as if it had not flourished just the day before. This is the way We explain the revelations for those who reflect

أَوۡ يَكُونَ لَكَ بَيۡتࣱ مِّن زُخۡرُفٍ أَوۡ تَرۡقَىٰ فِي ٱلسَّمَآءِ وَلَن نُّؤۡمِنَ لِرُقِيِّكَ حَتَّىٰ تُنَزِّلَ عَلَيۡنَا كِتَٰبࣰ ا نَّقۡرَؤُهُۥۗ قُلۡ سُبۡحَانَ رَبِّي هَلۡ كُنتُ إِلَّا بَشَرࣰ ا رَّسُولࣰ ا

or have a house made of gold; or ascend into the sky- even then, we will not believe in your ascension until you send a real book down for us to read.’ Say, ‘Glory be to my Lord! Am I anything but a mortal, a messenger?’

وَزُخۡرُفࣰ اۚ وَإِن كُلُّ ذَٰلِكَ لَمَّا مَتَٰعُ ٱلۡحَيَوٰةِ ٱلدُّنۡيَاۚ وَٱلۡأٓخِرَةُ عِندَ رَبِّكَ لِلۡمُتَّقِينَ

and golden ornaments. All of these are mere enjoyments of this life; your Lord reserves the next life for those who take heed of Him

وَكَذَٰلِكَ جَعَلۡنَا لِكُلِّ نَبِيٍّ عَدُوࣰّ ا شَيَٰطِينَ ٱلۡإِنسِ وَٱلۡجِنِّ يُوحِي بَعۡضُهُمۡ إِلَىٰ بَعۡضࣲ زُخۡرُفَ ٱلۡقَوۡلِ غُرُورࣰ اۚ وَلَوۡ شَآءَ رَبُّكَ مَا فَعَلُوهُۖ فَذَرۡهُمۡ وَمَا يَفۡتَرُونَ

In the same way We assigned to each prophet an enemy, evil humans and evil jinn. They suggest alluring words to one another in order to deceive- if it had been your Lord’s will, [Prophet], they would not have done this: leave them to their inventions

Thus have We made for every prophet an enemy, satans of jinn and men. When someone's rank is higher, his trial will be more complete. When someone is nearer to the Real and his heart more limpid, his soul will be more captured by the hand of the enemy. Yes, without the grief of tribulation, the story of love cannot be told. Without the venom of trial, the honey of friendship cannot be found. Look at what Adam the Chosen, that sapling honored by the Real and nurtured by hallowing, saw from his enemy Iblis. God says, “Then Satan made them slip therefrom and brought them out from what they were in” [2:36]. And that other elder of the prophets and father of the world's folk, Noah-look at what he saw from his own people. For nine hundred and some years he invited them, and every day they beat him so much that he became unconscious, and they advised his own children to be his enemies. That par

The likeness the description of the life of this world is only as water rain which We send down from the heaven then the plants of the earth mingle with it they mingle because of it attaching themselves one to another whereof mankind eat plants such as wheat and barley and so on and cattle eat of pasture until when the earth has taken on its ornaments its splendour of plants and has adorned itself with flowers izzayyanat ‘adorned itself’ is originally tazayyanat but the tā’ has been substituted with the zāy and assimilated with it and its inhabitants think that they are masters of it fully capable of harvesting its fruits Our command Our decree or Our chastisement comes upon it by night or day and We make it that is its crops as reaped corn like that which has been reaped with sickles as though ka-an is softened in other words read it as ka-annahā the previous day it had not flourished a

or until you come to have a house adorned with gold or ascend into the heaven upon a ladder and even then we will not believe your ascension if you were to ascend into it until you bring down for us therefrom a book in which is confirmed your truthfulness that we may read’. Say to them ‘Glory be to my Lord — this is a statement of amazement — Am I anything but a human a messenger from God?’ in other words I am like all other messengers for they never brought any signs except by God’s leave.

And so We have appointed to every Prophet an enemy just as We have appointed these your enemies and this ‘adūwwan ‘an enemy’ is substituted by the following shayātīn ‘devils’ devils the rebels of mankind and jinn who inspire whisper fine speech to each other the falsehood that is disguised as such fine speech in delusion that is in order to delude them; yet had your Lord willed they would never have done it that mutual inspiration. So leave them let the disbelievers be with what they fabricate of disbelief and otherwise of what has been adorned for them — this was revealed before the command to fight them.

Verily, the parable of the life of the world is as the water which We send down from the sky; so by it arises the intermingled produce of the earth of which men and cattle eat: until when the earth is clad in its adornments and is beautified, and its people think that they have all the powers of disposal over it, Our command reaches it by night or by day and We make it like a clean-mown harvest, as if it had not flourished yesterday! Thus do We explain the Ayat in detail for the people who reflect (24)Allah calls to the Abode of Peace (Paradise) and guides whom He wills to the straight path (25) The Parable of this Life Allah the Almighty has set an example of the similitude of the life of this world, its glitter and the swiftness of its passage, likening it to the plant and vegetation that Allah brings out from the earth. This plant grows from the water that comes down from the sky. T

And they say: "We shall not believe in you, until you cause a spring to gush forth from the earth for us; (90)"Or you have a garden of date palms and grapes, and cause rivers to gush forth in their midst abundantly; (91)"Or you cause the heaven to fall upon us in pieces, as you have pretended, or you bring Allah and the angels before (us) face to face; (92)"Or you have a house of Zukhruf, or you ascend up into the sky, and even then we will put no faith in your ascension until you bring down for us a Book that we would read." Say: "Glorified be my Lord! Am I anything but a man, sent as a Messenger? (93) The Demand of Quraysh for a specific Sign, and the Rejection of that Ibn Jarir recorded from Muhammad bin Ishaq, "An old man from among the people of Egypt who came to us forty-odd years ago told me, from 'Ikrimah, from Ibn 'Abbas, that 'Utbah and Shaybah – the two sons of Rabi'ah, Abu

حَدَّثَنَا عَبْدُ اللَّهِ بْنُ يُوسُفَ، أَخْبَرَنَا مَالِكٌ، عَنْ يَحْيَى بْنِ سَعِيدٍ، عَنْ عَبْدِ الرَّحْمَنِ الأَعْرَجِ، عَنْ عَبْدِ اللَّهِ ابْنِ بُحَيْنَةَ ـ رضى الله عنه ـ أَنَّهُ قَالَ إِنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم قَامَ مِنِ اثْنَتَيْنِ مِنَ الظُّهْرِ لَمْ يَجْلِسْ بَيْنَهُمَا، فَلَمَّا قَضَى صَلاَتَهُ سَجَدَ سَجْدَتَيْنِ ثُمَّ سَلَّمَ بَعْدَ ذَلِكَ‏.‏

Narrated `Abdullah bin Buhaina:Allah's Messenger (ﷺ) got up after the second rak`a of the Zuhr prayer without sitting in between (the second and the third rak`at). When he finished the prayer he performed two prostrations (of Sahu) and then finished the prayer with Taslim

حَدَّثَنَا أَبُو الْوَلِيدِ، حَدَّثَنَا شُعْبَةُ، عَنِ الْحَكَمِ، عَنْ إِبْرَاهِيمَ، عَنْ عَلْقَمَةَ، عَنْ عَبْدِ اللَّهِ ـ رضى الله عنه ـ أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم صَلَّى الظُّهْرَ خَمْسًا فَقِيلَ لَهُ أَزِيدَ فِي الصَّلاَةِ فَقَالَ ‏ "‏ وَمَا ذَاكَ ‏"‏‏.‏ قَالَ صَلَّيْتَ خَمْسًا‏.‏ فَسَجَدَ سَجْدَتَيْنِ بَعْدَ مَا سَلَّمَ‏.‏

Narrated' `Abdullah:Once Allah's Messenger (ﷺ) offered five rak`at in the Zuhr prayer, and somebody asked him whether there was some increase in the prayer. Allah's Messenger (ﷺ) said, "What is that?" He said, "You have offered five rak`at." So Allah's Messenger (ﷺ) performed two prostrations of Sahu after Taslim

أَخْبَرَنَا عَمْرُو بْنُ عَلِيٍّ، قَالَ حَدَّثَنَا يَحْيَى بْنُ سَعِيدٍ، قَالَ حَدَّثَنَا حَمَّادُ بْنُ زَيْدٍ، قَالَ حَدَّثَنَا غَيْلاَنُ بْنُ جَرِيرٍ، عَنْ مُطَرِّفِ بْنِ عَبْدِ اللَّهِ، قَالَ صَلَّى عَلِيُّ بْنُ أَبِي طَالِبٍ فَكَانَ يُكَبِّرُ فِي كُلِّ خَفْضٍ وَرَفْعٍ يُتِمُّ التَّكْبِيرَ ‏.‏ فَقَالَ عِمْرَانُ بْنُ حُصَيْنٍ لَقَدْ ذَكَّرَنِي هَذَا صَلاَةَ رَسُولِ اللَّهِ صلى الله عليه وسلم ‏.‏

It was narrated that Mutarrif bin 'Abdullah said:"Ali bin Abi Talib prayed, and he said the takbir every time he went down and came up, in all movements of the prayer. 'Imran bin Husain said: 'This reminds me of the prayer of the Messenger of Allah (ﷺ)

أَخْبَرَنَا يَعْقُوبُ بْنُ إِبْرَاهِيمَ الدَّوْرَقِيُّ، وَمُحَمَّدُ بْنُ بَشَّارٍ، - وَاللَّفْظُ لَهُ - قَالاَ حَدَّثَنَا يَحْيَى بْنُ سَعِيدٍ، قَالَ حَدَّثَنَا عَبْدُ الْحَمِيدِ بْنُ جَعْفَرٍ، قَالَ حَدَّثَنِي مُحَمَّدُ بْنُ عَمْرِو بْنِ عَطَاءٍ، عَنْ أَبِي حُمَيْدٍ السَّاعِدِيِّ، قَالَ سَمِعْتُهُ يُحَدِّثُ، قَالَ كَانَ النَّبِيُّ صلى الله عليه وسلم إِذَا قَامَ مِنَ السَّجْدَتَيْنِ كَبَّرَ وَرَفَعَ يَدَيْهِ حَتَّى يُحَاذِيَ بِهِمَا مَنْكِبَيْهِ كَمَا صَنَعَ حِينَ افْتَتَحَ الصَّلاَةَ ‏.‏

It was narrated from Abu Humaid As-Sa'idi that:When the Prophet (ﷺ) stood up following two prostrations, he would say the takbir and raise his hands until they were level with his shoulders, as he had done at the beginning of the prayer

وبيان درجاته وبيان أقسام المخاوف وبيان فضيلة الخوف وبيان الأفضل من الخرف والرجاء وبيان دواء الخوف وبيان معنى سوء الخاتمة وبيان أحوال الخائفين من الأنبياء صلوات الله عليهم والصالحين رحمة الله عليهم ونسأل الله حسن التوفيق بيان حقيقة الخوف

فلا أحسن من هذه النصيحة وهذا الإرشاد والتعليم الذي لو أخذ به الناس لم يضع في الأكثر حق أحد ولم يتمكن المبطل من الجحود والنسيان

قالوا وكيف يظن بالشرع أنه يخفف عن هذا المتعمد المفرط العاصي لله ورسوله بترك الوجوب ويوجبه على المعذور بالنوم أو النسيان

| فصل قال : والذكر : هو التلخص من الغفلة والنسيان والفرق بين الغفلة

وصرح هؤلاء : أن التوكل والدعاء عبودية محضة لا فائدة لهما إلا ذلك ولو ترك العبد التوكل والدعاء ما فاته شيء مما قدر له ومن غلاتهم من يجعل الدعاء بعدم المؤاخذة على الخطإ والنسيان عديم الفائدة إذ هو مضمون الحصول

وأنشدني المنتصر بن بلال الأنصاري % الرفق ممن سيلقى اليمن صاحبه % والخرف منه يكون العنف والزلل % % والحزم أن يتأنى المرء فرصته % والكف عنها إذا ما أمكنت فشل % % والبر لله خير الأمر عاقبة % والله للبر عون ماله مثل % % خير البريه قولا خيرهم عملا % لا يصلح القول حتى يصلح العمل % $

The role of the Mediterranean diet in reducing the risk of cognitive impairement, dementia, and Alzheimer's disease: a meta-analysis.: Age-related cognitive impairment and dementia pose a significant global health, social, and economic challenge. While Alzheimer's disease (AD) has historically been viewed as the leading cause of dementia, recent evidence reveals the considerable impact of vascular cognitive impairment and dementia (VCID), which now accounts for nearly half of all dementia cases. The Mediterranean diet-characterized by high consumption of fruits, vegetables, whole grains, fish, and olive oil-has been widely reco

Sleep disorders increase the risk of dementia, Alzheimer's disease, and cognitive decline: a meta-analysis.: Sleep disorders, particularly insomnia and obstructive sleep apnea, are increasingly implicated as significant contributors to cognitive decline, dementia, and neurodegenerative diseases such as Alzheimer's disease (AD) and vascular cognitive impairment and dementia (VCID). However, the extent and specificity of these associations remain uncertain. This meta-analysis evaluates the impact of common sleep disorders on the risk of developing dementia and cognitive decline. A comprehensive search of

Modifiable predictors of dementia in mild cognitive impairment: a systematic review and meta-analysis.: Objective: Public health campaigns encouraging early help seeking have increased rates of mild cognitive impairment (MCI) diagnosis in Western countries, but we know little about how to treat or predict dementia outcomes in persons with the condition. Method: The authors searched electronic databases and references for longitudinal studies reporting potentially modifiable risk factors for incident dementia after MCI. Two authors independently evaluated study quality using a checklist. Meta-analy

Dietary Intake, Mediterranean and Nordic Diet Adherence in Alzheimer's Disease and Dementia: A Systematic Review.: Background/objectives: Dementia is not a single disease but an umbrella term that encompasses a range of symptoms, such as memory loss and cognitive impairments, which are severe enough to disrupt daily life. One of the most common forms of dementia is Alzheimer's Disease (AD), a complex neurodegenerative condition influenced by both genetic and environmental factors. Recent research has highlighted diet as a potential modifiable risk factor for AD. Decades of research have explored the role of

Technology-enhanced multi-domain at home continuum of care program with respect to usual care for people with cognitive impairment: the Ability-TelerehABILITation study protocol for a randomized controlled trial.: Background: According to the World Alzheimer Report (Prince, The Global Impact of Dementia: an Analysis of Prevalence, Incidence, Cost and Trends, 2015), 46.8 million people worldwide are nowadays living with dementia. And this number is estimated to approximate 131.5 million by 2050, with an increasing burden on society and families. The lack of medical treatments able to stop or slow down the course of the disease has moved the focus of interest toward the nonpharmacological approach and psych

Physical exercise attenuates cognitive decline and reduces behavioural problems in people with mild cognitive impairment and dementia: a systematic review.: Questions: What is the effect of physical exercise on cognitive decline and behavioural problems in people with mild cognitive impairment (MCI) or dementia? What is the effect of physical exercise on particular domains of cognitive function? How do training protocols and patients' characteristics influence the outcomes? Design: Systematic review and meta-analysis of randomised trials. Participants: People with MCI or dementia as their primary diagnosis. Intervention: Physical exercise. Outcome m

Death, Depression, Disability, and Dementia Associated With Self-reported Hearing Problems: A 25-Year Study.

Background: Hearing loss in older adults is suspected to play a role in social isolation, depression, disability, lower quality of life, and risk of dementia. Such suspected associations still need to be consolidated with additional research. With a particularly long follow-up, this study assessed the relationship between hearing status and four major adverse health events: death, dementia, depression, and disability. Methods: Prospective community-based study of 3,777 participants aged ≥65 followed up for 25 years. At baseline, 1,289 reported hearing problems and 2,290 reported no trouble. The risk of occurrence of the negative outcomes, including death, dementia, depressive symptoms, disability in activities of daily living (ADL), and instrumental ADL (IADL), was assessed with Cox proportional hazards models. Results: Adjusting for numerous confounders, an increased risk of disability …

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Multidimensional approach usefulness in early Alzheimer's disease: Advances in clinical practice.

Background and aim: Improving quality of life of patients with early Alzheimer's Disease (AD) is a primary concern of health professionals involved in dementia treatment. The aim of this study is to reveal associations among psychiatric symptoms and wellbeing aspects, dysfunctional lifestyles and stress-related behaviors, illness perception, personality traits, and life quality satisfaction, in order to offer a comprehensive evaluation of psychological and behavioral aspects characterizing patients with early AD. Methods: This is a cross-sectional study in which all the outpatients included were evaluated at the Dementia Clinic in Parma (Italy). 21 patients with probable AD were assessed by an overall cognitive screening (Milan Overall Dementia Assessment), the evaluation of personal and instrumental autonomy (Activities of Daily Living and Instrumental Activities of Daily Living), and o…

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SLAB51 Probiotic Formulation Activates SIRT1 Pathway Promoting Antioxidant and Neuroprotective Effects in an AD Mouse Model.

The gut-brain axis is a bidirectional communication network functionally linking the gut and the central nervous system (CNS). Based on this, the rational manipulation of intestinal microbiota represents a novel attractive therapeutic strategy for the treatment of CNS-associated disorders. In this study, we explored the properties of a probiotic formulation (namely SLAB51) in counteracting brain oxidative damages associated with Alzheimer's disease (AD). Specifically, transgenic AD mice (3xTg-AD) were treated with SLAB51 and the effects on protein oxidation, neuronal antioxidant defence and repair systems were monitored, with the particular focus on the role of SIRT1-related pathways. We demonstrated that SLAB51 markedly reduced oxidative stress in AD mice brain by activating SIRT1-dependent mechanisms, thus representing a promising therapeutic adjuvant in AD treatment.

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"I just don't focus on my needs." The unmet health needs of partner and offspring caregivers of people with dementia: A qualitative study.

Background: Family caregivers of people with dementia have significant unmet health needs. There is a lack of research that differentiates between the needs that are specifically relevant to partner and offspring caregivers. Objective: The aim of this study was to examine the health needs of partner and offspring caregivers of older people with dementia, including the barriers they experience in meeting their needs. Method: Semi-structured interviews were conducted with 24 family caregivers of community-dwelling people with dementia. Of these, 12 were partner caregivers (4 men, 8 women) and 12 were offspring caregivers (2 men, 10 women). The interviews were transcribed and analysed using thematic analysis. Results: Five themes were identified within the data. The first theme represents caregivers' overall assessment and perception of their health needs. The remaining four themes represen…

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Social isolation, cognitive reserve, and cognition in healthy older people.

There is evidence to suggest that social isolation is associated with poor cognitive health, although findings are contradictory. One reason for inconsistency in reported findings may be a lack of consideration of underlying mechanisms that could influence this relationship. Cognitive reserve is a theoretical concept that may account for the role of social isolation and its association with cognitive outcomes in later life. Therefore, we aimed to examine the relationship between social isolation and cognition in later life, and to consider the role of cognitive reserve in this relationship. Baseline and two year follow-up data from the Cognitive Function and Ageing Study-Wales (CFAS-Wales) were analysed. Social isolation was assessed using the Lubben Social Network Scale-6 (LSNS-6), cognitive function was assessed using the Cambridge Cognitive Examination (CAMCOG), and cognitive reserve …

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Positive Aspects of Caregiving and Caregiver Burden: A Study of Caregivers of Patients With Dementia.

Background: Now positive aspect of caregiving (PAC) is well-defined as caregiver gains, satisfaction, meaningful life, and enhanced family relationship. The adjusted association of PAC and caregiver burden is not well acknowledged. This study investigated the association of caregiver burden and PAC adjusting for potential confounders. Methods: This was a cross-sectional study that recruited 132 caregivers. A linear regression model with PAC was used to estimate the adjusted associations. Results: The caregiver burden was negatively associated with PAC (mean difference in PAC per a 1-unit increase in caregiver burden = -0.12, 95% confidence interval: -0.18 to -0.056; P < .001). This association remained after adjustment for caregivers' age and marital status as well as patients' dependency level. Conclusion: The negative significant association of caregiver burden with PAC reinforces the …

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Nutritional Status is Associated With Severe Dementia and Mortality: The Cache County Dementia Progression Study.

Purpose: Studies have reported faster cognitive/functional decline in persons with dementia (PWD) with malnutrition. We investigated whether baseline nutritional status predicted severe dementia and mortality in a population-based sample. Patients: A maximum of 300 PWD were assessed annually for up to 8.6 years. Methods: Nutritional status was assessed using a modified Mini-Nutritional Assessment (mMNA). Severe dementia was defined as: "severe" rating on the Clinical Dementia Rating or Mini-Mental State Examination score ≤10. Using Cox proportional hazards models, we examined the association between baseline mMNA score (or its subcomponents) with each outcome. Covariates included demographics; dementia onset age, type, and duration; APOE genotype; and residency with caregiver. Results: Compared with "well-nourished," "malnourished" PWD had 3-4 times the hazard of severe dementia [hazard …

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Perspectives and Insights from Vietnamese American Mental Health Professionals on How to Culturally Tailor a Vietnamese Dementia Caregiving Program.

Objective: Little is known about dementia and caregiving among the rapidly growing Vietnamese American population. This qualitative study elicited insights on culturally tailoring an intervention to address mental health needs in Vietnamese American dementia caregivers from Vietnamese American mental health professionals. Methods: Eight Vietnamese American mental health professionals were interviewed to explore: experiences working with and needs of the community; Vietnamese attitudes toward treatment; and acculturation in Vietnamese caregiving. Participants provided recommendations on tailoring a program for Vietnamese dementia caregivers. Content analysis of their responses was conducted. Results: Themes included: a) caregivers' unique needs and experiences; b) different waves of immigration and acculturation levels affect views on mental health, treatment, and caregiving; c); traditio…

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Feasibility of a staff training and support programme to improve pain assessment and management in people with dementia living in care homes.

Objectives: The objective of this study was to establish the feasibility and initial effectiveness of training and support intervention for care staff to improve pain management in people with dementia living in care homes (PAIN-Dem). Methods: PAIN-Dem training was delivered to care staff from three care homes in South London, followed by intervention support and resources to encourage improved pain management by staff over 4 weeks. Feasibility was assessed through fidelity to intervention materials and qualitative approaches. Focus group discussions with staff explored the use of the PAIN-Dem intervention, and interviews were held with six residents and family carers. Pain was assessed in all residents at baseline, 3 and 4 weeks, and goal attainment scaling was assessed at 4 weeks. Results: Delivery of training was a key driver for success and feasibility of the PAIN-Dem intervention. I…

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Genetic Risks for Chronic Conditions: Implications for Long-term Wellbeing.

Background: Relationships between genetic risks for chronic diseases and long-run wellbeing are largely unexplored. We examined the associations between genetic predispositions to several chronic conditions and long-term functional health and socioeconomic status (SES). Methods: We used data on a nationally representative sample of 9,317 adults aged 65 years or older from the 1992 to 2012 Health and Retirement Survey (HRS) in the US. Survey data were linked to genetic data on nearly 2 million single-nucleotide polymorphisms (SNPs). We measured individual-level genetic predispositions for coronary-artery disease, type 2 diabetes (T2D), obesity, rheumatoid arthritis (RA), Alzheimer's disease, and major depressive disorder (MDD) by polygenic risk scores (PRS) derived from genome-wide association studies (GWAS). The outcomes were self-rated health, depressive symptoms, cognitive ability, act…

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Psychological well-being and risk of dementia.

Objective: Well-being is a psychological resource that buffers against age-related disease. We test whether this protective effect extends to dementia and whether it is independent of distress. Methods: Participants (N = 10,099) were from the Health and Retirement Study. Five aspects of positive psychological functioning (life satisfaction, optimism, mastery, purpose in life, and positive affect) were tested as predictors of incident dementia over 6 to 8 years. Results: Purpose in life was associated with a 30% decreased risk of dementia, independent of psychological distress, other clinical and behavioral risk factors, income/wealth, and genetic risk. After controlling for distress and other risk factors, the other aspects of well-being were not associated with dementia risk. Conclusions: After considering psychological distress, we found that measures of well-being were generally not p…

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Gender effects on components of burden and depression among dementia caregivers.

Objective: Previous literature has examined burden and depression predominately as unitary constructs in relation to dementia caregiving. No studies thus far have examined gender differences in the specific components of burden and depression in dementia caregivers. The current study examined whether empirically validated dimensions of caregiver burden differed by gender for dementia caregivers. Methods: The sample consisted of 211 dementia caregivers enrolled in a longitudinal intervention study. Only baseline functioning was evaluated in this study. Levels of burden were assessed using the Zarit Burden Interview (ZBI), and levels of depression were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Results: Factor analysis revealed three facets of burden: impact of caregiving on the caregivers' lives, guilt, and frustration/embarrassment, and four facets of d…

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Mind-wandering in healthy aging and early stage Alzheimer's disease.

Objective: The frequency of mind-wandering (MW) decreases as a function of age in healthy individuals. One possible explanation is that MW is a resource-dependent process, and cognitive resources decline with age. The present study provides the first investigation of MW in the earliest stages of Alzheimer's disease (AD) to further examine the resource model and discontinuities between healthy aging and AD. Method: Three large cohorts completed the Sustained Attention to Response Task (SART): a healthy middle-aged group (mean age = 61.79 ± 5.84 years; N = 270), a healthy older adult group (mean age = 76.58 ± 5.27 years; N = 282), and a group with early stage AD (mean age = 76.08 ± 7.17; N = 77), comparable in age to the second group. Results: Self-reports of MW during the SART decreased as a function of age, and there was a further decrease in the AD group. All 3 groups produced faster re…

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The Evaluation of a Compassion-Focused Therapy Group for Couples Experiencing a Dementia Diagnosis.

Objectives: This study evaluated the effectiveness of a Compassion-Focused Therapy (CFT) group on reducing anxiety, depression, and respiratory rate (RR) in people with dementia (PwD) and their spouses, and improving quality of life (QoL) of PwD. Method: Sixty-four participants completed six weekly CFT sessions. Baseline and post-intervention assessments were analyzed using t-tests and Reliability Change Index. Results: Mean baseline and post-assessment anxiety and depression scores fell in the 'normal range'; although a significant reduction in depression with moderate effect was observed for PwD. Fifty-seven percent of PwD with borderline to abnormal baseline scores showed clinically significant improvement in anxiety and depression. For spouses, 80% showed clinically significant improvement in depression and 50% in anxiety. RR reduced for PwD and spouses with large and medium effects …

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Chronic Stress, Social Isolation, and Perceived Loneliness in Dementia Caregivers.

Caregivers of individuals with dementia are at risk for chronic stress and social isolation. These exogenous factors may lead to perceived stress and perceived loneliness-psychosocial endogenous (subjective) elements of caregiving experience. Chronic stress and perceived loneliness may disrupt neuroendocrine and neuroimmunological regulation, creating low-grade systemic inflammation, promoting proinflammatory gene expression, and expediting cellular aging (endogenous physiological factors). These disturbances may enhance caregivers' risk for chronic conditions of inflammatory pathogenesis. Thus, caregivers' perceived stress and perceived loneliness may form a symptom cluster that can serve as a marker of risks for physical and mental illness. Due to the overwhelming reliance on family caregivers within the increasing population of individuals with dementia, it is essential that clinician…

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Personalized Goal Attainment in Dementia Care: Measuring What Persons with Dementia and Their Caregivers Want.

Objectives: To develop a process of goal-setting and measurement of goal attainment in a dementia care management program. Design: Observational. Setting: Dementia care management program in an urban academic medical center. Participants: Persons with dementia (N=101) and their caregivers; nurse practitioner dementia care managers (N=5). Intervention: Specification of a personalized health goal and action plan and measurement of goal attainment using goal attainment scaling in a clinical care visit. Measurements: Goal attainment at 6 and 12 months; focus groups of 5 dementia care managers. Results: Eighty-four percent of participant goals were nonmedical, 47% were related to quality of life, and 29% were caregiver support goals. Eighty-eight percent of participants felt that the goal they set was meaningful and 74% that the goal-setting process captured something different from usual car…

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Development and feasibility of Inlife: A pilot study of an online social support intervention for informal caregivers of people with dementia.

Background: Informal caregivers of individuals with dementia have an increased risk to face social isolation due to progression of the disease. Online social media interventions might offer a new opportunity to increase access to social support and enhance positive interactions and openness in dementia care networks. Objective: This explorative pilot study describes (1) the development of an online social support intervention Inlife, and (2) the evaluation of the feasibility of this intervention and the measurements to assess its effectiveness. Methods: The Medical Research Council (MRC) framework guided the development of the online social support intervention. This is a stepwise approach that integrates potential users' views with the development and validation of the program content. The program was developed by combining (1) individual caregiver interviews (n = 10), (2) focus group s…

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Family and Other Unpaid Caregivers and Older Adults with and without Dementia and Disability.

Objectives: To estimate the number of caregivers providing assistance to community-dwelling older persons with and without dementia and with or without substantial disability; to describe the characteristics of caregivers and care recipients in these groups; to characterize the health-related tasks that caregivers provide; and to estimate associations between the numbers of tasks and caregiver burden. Design: Nationally representative surveys of caregivers and older adults in the United States. Setting: 2011 National Health and Aging Trends Study and National Study of Caregiving. Participants: Community-dwelling older adults and their family caregivers, who were selected on the basis of having assisted with mobility, self-care, household activities, transportation, or medical tasks. Measurements: Caregiver burden (emotional, physical, financial difficulties) and restrictions on social pa…

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Stigma towards people with mental disorders and its components - a perspective from multi-ethnic Singapore.

Aims: The current study aimed to: (i) describe the extent of overall stigma as well as the differences in stigma towards people with alcohol abuse, dementia, depression, schizophrenia and obsessive compulsive disorder, as well as (ii) establish the dimensions of stigma and examine its correlates, in the general population of Singapore, using a vignette approach. Methods: Data for the current study came from a larger nation-wide cross-sectional study of mental health literacy conducted in Singapore. The study population comprised Singapore Residents (Singapore Citizens and Permanent Residents) aged 18-65 years who were living in Singapore at the time of the survey. All respondents were administered the Personal and Perceived scales of the Depression Stigma scale and the Social Distance scale to measure personal stigma and social distance, respectively. Weighted mean and standard error of …

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Chemogenetic locus coeruleus activation restores reversal learning in a rat model of Alzheimer's disease.

See Grinberg and Heinsen (doi:10.1093/brain/awx261) for a scientific commentary on this article. Clinical evidence suggests that aberrant tau accumulation in the locus coeruleus and noradrenergic dysfunction may be a critical early step in Alzheimer’s disease progression. Yet, an accurate preclinical model of these phenotypes that includes early pretangle tau accrual in the locus coeruleus, loss of locus coeruleus innervation and deficits locus coeruleus/norepinephrine modulated behaviours, does not exist, hampering the identification of underlying mechanisms and the development of locus coeruleus-based therapies. Here, a transgenic rat (TgF344-AD) expressing disease-causing mutant amyloid precursor protein (APPsw) and presenilin-1 (PS1ΔE9) was characterized for histological and behavioural signs of locus coeruleus dysfunction reminiscent of mild cognitive impairment/early Alzheimer’s d…

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'This is my story, how I remember it': In-depth analysis of Dignity Therapy documents from a study of Dignity Therapy for people with early stage dementia.

Dementia is a progressive condition that impacts on individuals, families and care professionals. Maintaining quality of life through engagement with the person with dementia is an important part of their care. Dignity Therapy is an interactive, psychotherapeutic intervention that uses a trained dignity therapist to guide the person with dementia through an interview that then creates a written legacy called a generativity document. This can provide knowledge to inform care, as the condition progresses. Generativity documents were analysed using framework analysis. Main themes from the analysis were origin of values, essence and affirmation of self, forgiveness and resolution and existentialism/ meaning of life. These themes provide evidence of the type, scope and contribution that information generated from Dignity Therapy can make to the care and support of people with dementia. They p…

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Hearing Care Intervention for Persons with Dementia: A Pilot Study.

Objective: Hearing loss is a commonly unmet need among adults with dementia that may exacerbate common dementia-related behavioral symptoms. Accessing traditional audiology services for hearing loss is a challenge because of high cost and time commitment. To improve accessibility and affordability of hearing treatment for persons with dementia, there is a need for unique service delivery models. The purpose of this study is to test a novel hearing intervention for persons with dementia and family caregivers delivered in outpatient settings. Methods: The Memory-HEARS pilot study delivered a 2-hour in-person intervention in an outpatient setting. A trained interventionist provided hearing screening, communication strategies, and provision of and instruction using a simple over-the-counter amplification device. Caregivers (N = 20) responded to questionnaires related to depression, neuropsyc…

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Social health and dementia: a European consensus on the operationalization of the concept and directions for research and practice.

Background: Because the pattern of illnesses changes in an aging population and many people manage to live well with chronic diseases, a group of health care professionals recently proposed reformulating the static WHO definition of health towards a dynamic one based on the ability to physically, mentally and socially adapt and self-manage. This paper is the result of a collaborative action of the INTERDEM Social Health Taskforce to operationalize this new health concept for people with dementia, more specifically the social domain, and to formulate directions for research and practice to promote social health in dementia. Method: Based on the expertise of the Social Health Taskforce members (N = 54) three groups were formed that worked on operationalizing the three social health dimensions described by Huber et al.: (1) capacity to fulfil potential and obligations; (2) ability to manage…

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Psychological status and quality of life among primary caregivers of individuals with mental illness: a hospital based study.

Background: This study aimed to explore the psychological status and quality of life among primary caregivers of individuals suffering from various mental illnesses including early psychosis, chronic schizophrenia, depressive disorders, anxiety disorders and dementia. Methods: A total of 350 primary caregivers with relatives seeking treatment at a tertiary psychiatric hospital were recruited for this study. Socio-demographic data was obtained and the brief version of the World Health Organisation Quality of Life instrument was used to assess caregiver's quality of life (QOL). Psychological status among primary caregivers was assessed using the General Anxiety Disorder - 7 item (GAD-7) and Patient Health Questionnaire - 9 item (PHQ-9) scales. Family Interview Schedule (FIS) was used to assess the impact of caregiving relating to social problems, interpersonal strain among family members, …

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Cognitive Stimulation Therapy for Dementia: Pilot Studies of Acceptability and Feasibility of Cultural Adaptation for India.

Objective: This study aims to culturally adapt, translate, and test the feasibility and acceptability of delivering cognitive stimulation therapy (CST) for persons with mild to moderate dementia in Chennai, India. Methods: The adaptation followed a five-stage process in accordance with the formative method for adapting psychotherapy. Focus-group discussions with experts and feedback from participants, carers, and facilitators after two consecutive pilot studies provided the basis for adaptation. Results: Substantial modifications were required. The adapted program was found to be an acceptable, enjoyable, and constructive by participants and carers alike. Conclusion: CST was successfully adapted for use in South India. Translations into other Indian languages using the adapted manual are required for nation-wide implementation. Large-scale clinical trials are required to replicate global…

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