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

What Latino Puerto Ricans and non-Latinos say when they talk about Alzheimer's disease.

Background: To discover whether Latino Puerto Rican and non-Latino communities differ in the words they use to talk about Alzheimer's disease (AD). Methods: Four groups of 30 persons per group defined by self-identified ethnicity and caregiver status: Latino Puerto Ricans and non-Latino Whites, who were either caregivers or non-caregivers completed free-listing exercises to identify the words they use when they describe AD causes, symptoms, caregiving, and research risks and benefits. Results: Both Latino Puerto Ricans and non-Latino Whites recognize AD as a disease of memory loss and other cognitive problems. Although both groups used the term "sadness" to describe AD, non-Latino Whites did not feature emotional, behavioral, or psychological problems as among the causes of AD. Although all the groups' descriptions of a person who lives with and cares for a person with AD shared the word…

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Effects of adult day care on daily stress of caregivers: a within-person approach.

Unlabelled: OBJECTIVES. This article examined exposure to and appraisal of care-related stressors associated with use of adult day services (ADS) by family caregivers of individuals with dementia. Methods: Using a within-person withdrawal design (A-B-A-B), we compared caregivers' exposure to and appraisal of behavior problems on days their relative attended and did not attend ADS. Participants were 121 family caregivers enrolling a relative with dementia in an ADS program. Daily assessments were obtained prior to the person's attending ADS for the first time and after 1 and 2 months of attendance on days the person attended and did not attend ADS. Results: Total exposure to stressors and stress appraisals decreased significantly over time on ADS days compared with non-ADS days. Most of this difference was accounted by the time the person with dementia was away from the caregiver, but the…

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Blocking IL-1 signaling rescues cognition, attenuates tau pathology, and restores neuronal β-catenin pathway function in an Alzheimer's disease model.

Inflammation is a key pathological hallmark of Alzheimer's disease (AD), although its impact on disease progression and neurodegeneration remains an area of active investigation. Among numerous inflammatory cytokines associated with AD, IL-1β in particular has been implicated in playing a pathogenic role. In this study, we sought to investigate whether inhibition of IL-1β signaling provides disease-modifying benefits in an AD mouse model and, if so, by what molecular mechanisms. We report that chronic dosing of 3xTg-AD mice with an IL-1R blocking Ab significantly alters brain inflammatory responses, alleviates cognitive deficits, markedly attenuates tau pathology, and partly reduces certain fibrillar and oligomeric forms of amyloid-β. Alterations in inflammatory responses correspond to reduced NF-κB activity. Furthermore, inhibition of IL-1 signaling reduces the activity of several tau k…

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Motives for caring: relationship to stress and coping dimensions.

Background: Although research has highlighted the importance of including cultural factors in the analysis of caregiver stress, little is known about the effects of motives for caregiving on the stress and coping process. This study is aimed at analyzing the dimensional structure of the Cultural Justifications for Caregiving Scale - Revised (CJCS-R), and the effects of motives for caregiving on stressors, caregiver resources and outcome variables. Methods: Dementia caregivers (N = 166) were interviewed and the following variables were assessed: motives for caregiving (CJCS-R), stressors (frequency of behavioral problems), resources (rumination, cognitive reappraisal), and outcomes (depression, anxiety and anger). Results: A bidimensional structure was obtained for the CJCS-R, and the two factors were labeled Intrinsic and Extrinsic motives for caregiving. Participants were divided into f…

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Effects of Alzheimer caregiving on allostatic load.

This study aimed to determine if Alzheimer caregivers have increased allostatic load compared to non-caregivers. Potential psychological moderators (mastery, depression, and role overload) of the relationship between caregiving status and allostatic load were also explored. Eighty-seven caregivers and 43 non-caregivers underwent biological assessment of allostatic load and psychological assessments. Caregivers had significantly higher allostatic load compared to non-caregivers ( p < .05). Mastery, but not depression or overload, moderated the relationship between caregiving status and allostatic load. In conclusion, allostatic load may represent a link explaining how stress translates to downstream pathology, but more work is necessary to understand the role of psychological factors.

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Couple meaning-making and dementia: challenges to the deficit model.

By combining a relationship- and strengths-based approach, the article suggests that, with the onset of progressive cognitive impairment, verbal, nonverbal, and embodied exchanges can function as meaning-making processes for life-partner co-carers. These exchanges can sustain a sense of relatedness, which has been shown to increase wellbeing. The article identifies gaps in knowledge and practice limitations that result from the deficit approach to dementia research and care that currently dominates the field. Suggestions for future research and the development of interventions are included. In addition, the article challenges theoretical assumptions about meaning-making, arguing for a reexamination of dementia-affected couplehood processes.

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Age-related changes in the default mode network are more advanced in Alzheimer disease.

Objective: To investigate age-related default mode network (DMN) connectivity in a large cognitively normal elderly cohort and in patients with Alzheimer disease (AD) compared with age-, gender-, and education-matched controls. Methods: We analyzed task-free-fMRI data with both independent component analysis and seed-based analysis to identify anterior and posterior DMNs. We investigated age-related changes in connectivity in a sample of 341 cognitively normal subjects. We then compared 28 patients with AD with 56 cognitively normal noncarriers of the APOE ε4 allele matched for age, education, and gender. Results: The anterior DMN shows age-associated increases and decreases in fontal lobe connectivity, whereas the posterior DMN shows mainly age-associated declines in connectivity throughout. Relative to matched cognitively normal controls, subjects with AD display an accelerated pattern…

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Awareness of social and emotional functioning in people with early-stage dementia and implications for carers.

Objectives: This study explores the extent to which awareness of social and emotional function is reduced in early-stage dementia and whether this relates to the quality of life of the person with dementia (PwD), the quality of the relationship between the PwD and carer and carer stress. Method: Ninety-seven participants with a diagnosis of Alzheimer's, vascular or mixed dementia rated their social functioning using the Socio-Emotional Questionnaire (SEQ). Carers provided parallel ratings, allowing calculation of discrepancy scores used to index awareness. Neuropsychiatric symptoms, PwD quality of life, the perceived quality of the relationship for both partners and carer stress were also measured. Results: Factor analysis of the SEQ indicated three domains of social functioning: emotional recognition and empathy (ERE), social relationships (SR) and prosocial behaviour (PB). For PwD unaw…

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Grief among family members of nursing home residents with advanced dementia.

Objectives: To describe preloss and postloss grief symptoms among family members of nursing home (NH) residents with advanced dementia, and to identify predictors of greater postloss grief symptoms. Design: Prospective cohort study. Setting: 22 NHs in the greater Boston area. Participants: 123 family members of NH residents who died with advanced dementia. Measurements: Preloss grief was measured at baseline, and postloss grief was measured 2 and 7 months postloss using the Prolonged Grief Disorder Scale. Independent variables included resident and family member sociodemographic characteristics, resident comfort, acute illness, acute care prior to death, family member depression, and family member understanding of dementia and of resident's prognosis. Results: Levels of preloss and postloss grief were relatively stable from baseline to 7 months postloss. Feelings of separation and yearni…

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Behavioral, neuropsychiatric and cognitive disorders in Parkinson's disease patients with and without motor complications.

Background: Parkinson's disease (PD), commonly defined as a hypokinetic movement disorder, is hampered by the appearance of motor complications (MC), including dyskinesias and motor fluctuations, and non-motor symptoms such as behavioral, neuropsychiatric and cognitive disorders, which, in the last years, are gaining increasing attention. The factors affecting MC and these non-motor symptoms are still largely unknown and their interactions are not yet fully evaluated. Objective: To identify the presence of behavioral, neuropsychiatric and cognitive disorders in PD patients with and without MC and to evaluate their association with MC. Methods: Consecutive PD patients received a comprehensive structured clinical evaluation including pharmacologic treatment, MC and non-motor symptoms such as reward-seeking behaviors, neuropsychiatric symptoms (depression, anxiety, psychoses and hallucinati…

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Marriage and mental health: when a spouse has Alzheimer's disease.

Unlabelled: When spouses suffer from memory disorders, caregivers are at high risk for negative mental health consequences. The purpose of this pilot study was to identify factors within marital relationships that increase risk for caregiver burden and depression. PARTICIPANTS/SAMPLING: Caregivers (5 men and 11 women) and their partners with Alzheimer's disease were English speaking, age 55 and older and living in the community. Caregivers were cognitively intact and spouses had moderate cognitive impairment. Methods: This was a descriptive correlational study. Martial quality was rated by caregivers (CG) using the Marital Quality Index. Caregiver burden was measured by the Zarit Burden Interview and depression was measured by the 20-item Center for Epidemiological Studies- Depression Scale (CES-D). Results: Spouses who rated their marriage as strong and satisfying experienced less burde…

matched on Alzheimer Disease (mesh)

Partners in dementia care: a care coordination intervention for individuals with dementia and their family caregivers.

Purpose: This article provides a detailed description of a telephone-based care coordination intervention, Partners in Dementia Care (PDC), for veterans with dementia and their family caregivers. Essential features of PDC included (a) formal partnerships between Veterans Affairs (VA) medical centers and Alzheimer's Association Chapters; (b) a multidimensional assessment and treatment approach, (c) ongoing monitoring and long-term relationships with families, and (d) a computerized information system to guide service delivery and fidelity monitoring. Design and methods: Data illustrating the use of the intervention were displayed for 93 veterans and their caregivers after 12 months in PDC. Descriptive data were provided for each major component of the intervention protocol, including: initial assessment, goals, action steps, and on-going monitoring. Care coordinators completed a 12-item q…

matched on Dementia (mesh)

Over- and under-diagnosis of dementia in ethnic minorities: a nationwide register-based study.

Objective: Among dementia professionals in several European countries, it is believed that dementia is under-diagnosed and under-treated to a greater extent among ethnic minorities than in the native population. It is unknown whether this belief holds true. The objective of this study was to compare the prevalence of register-based dementia diagnoses in the largest ethnic minority groups in Denmark with the prevalence of register-based dementia diagnoses in the general Danish population. Methods: By linking the Danish hospital registers with the Danish Civil Registration System, nationwide dementia cases for three main ethnic minorities were identified. Age- and gender-specific prevalence rates for dementia were calculated and compared to previously published data for the general population. Results: The study population consisted of 68 219 persons aged 20 and older. A total of 174 demen…

matched on Dementia (mesh)

Barriers and facilitators of African American participation in Alzheimer disease biomarker research.

African Americans experience a greater risk of Alzheimer disease (AD), but are underrepresented in AD research. Our study examined barriers and facilitators of AD research participation among African Americans. Investigators conducted 11 focus groups with African American participants (n=70) who discussed barriers and facilitators to AD research participation including lumbar puncture studies. The moderator and comoderator independently reviewed the transcripts, identified themes, and coded transcripts for analysis. Participants were predominately female (73%) with a mean age of 52 years (range 21 to 86 y). Concerns and attitudes were consistent across education, socioeconomic status, and sex. Mistrust was a fundamental reason for nonparticipation. Additional barriers included insufficient information dissemination in the African American community, inconvenience, and reputation of the r…

matched on Alzheimer Disease (mesh)

Dynamics of telomerase activity in response to acute psychological stress.

Telomerase activity plays an essential role in cell survival, by lengthening telomeres and promoting cell growth and longevity. It is now possible to quantify the low levels of telomerase activity in human leukocytes. Low basal telomerase activity has been related to chronic stress in people and to chronic glucocorticoid exposure in vitro. Here we test whether leukocyte telomerase activity changes under acute psychological stress. We exposed 44 elderly women, including 22 high stress dementia caregivers and 22 matched low stress controls, to a brief laboratory psychological stressor, while examining changes in telomerase activity of peripheral blood mononuclear cells (PBMCs). At baseline, caregivers had lower telomerase activity levels than controls, but during stress telomerase activity increased similarly in both groups. Across the entire sample, subsequent telomerase activity increase…

matched on Dementia (mesh)

The primary care physician and Alzheimer's disease: an international position paper.

This paper aims to define the role of the primary care physician (PCP) in the management of Alzheimer's disease (AD) and to propose a model for a work plan. The proposals in this position paper stem from a collaborative work of experts involved in the care of AD patients. It combines evidence from a literature review and expert's opinions who met in Paris, France, on July 2009 during the International Association of Geriatrics and Gerontology (IAGG) World Congress. The PCP's intervention appears essential at many levels: detection of the onset of dementia, diagnostic management, treatment and follow-up. The key role of the PCP in the management of AD, as care providers and care planners, is consolidated by the family caregiver's confidence in their skills. In primary care practice the first step is to identify dementia. The group proposes a "case finding" strategy, in target situations i…

matched on Alzheimer Disease (mesh)

The structure of risk factors and outcomes for family caregivers: implications for assessment and treatment.

Purpose: We examined the associations among risk factors (e.g., behavioral problems, family conflict) and outcomes (e.g., overload, depression) commonly used in the research literature in order to inform the design of caregiver assessment and interventions. Methods: A sample of 67 caregivers caring for a family member in the middle stages of dementia were assessed on 15 risk factors and six outcome measures. Results: Risk factors were at best only moderately correlated with one another, suggesting their relative independence. Outcome measures showed somewhat higher correlations with one another, but participants varied in terms of the number and type of outcomes that were elevated. Multivariate results showed that risk factors differed in their contribution to models, predicting various outcomes. Implications: Caregivers possess unique combinations of risk factors and outcomes that sugge…

matched on Dementia (mesh)

The Janus face of DNA methylation in aging.

Aging is arguably the most familiar yet least-well understood aspect of human biology. The role of epigenetics in aging and age-related diseases has gained interest given recent advances in the understanding of how epigenetic mechanisms mediate the interactions between the environment and the genetic blueprint. While current concepts generally view global deteriorations of epigenetic marks to insidiously impair cellular and molecular functions, an active role for epigenetic changes in aging has so far received little attention. In this regard, we have recently shown that early-life adversity induced specific changes in DNA methylation that were protected from an age-associated erasure and correlated with a phenotype well-known to increase the risk for age-related mental disorders. This finding strengthens the idea that DNA (de-)methylation is controlled by multiple mechanisms that might …

matched on Dementia (mesh)

Divergent network connectivity changes in behavioural variant frontotemporal dementia and Alzheimer's disease.

Resting-state or intrinsic connectivity network functional magnetic resonance imaging provides a new tool for mapping large-scale neural network function and dysfunction. Recently, we showed that behavioural variant frontotemporal dementia and Alzheimer's disease cause atrophy within two major networks, an anterior 'Salience Network' (atrophied in behavioural variant frontotemporal dementia) and a posterior 'Default Mode Network' (atrophied in Alzheimer's disease). These networks exhibit an anti-correlated relationship with each other in the healthy brain. The two diseases also feature divergent symptom-deficit profiles, with behavioural variant frontotemporal dementia undermining social-emotional function and preserving or enhancing visuospatial skills, and Alzheimer's disease showing the inverse pattern. We hypothesized that these disorders would exert opposing connectivity effects wit…

matched on Alzheimer Disease (mesh)

Posttraumatic stress disorder and risk of dementia among US veterans.

Context: Posttraumatic stress disorder (PTSD) is highly prevalent among US veterans because of combat and may impair cognition. Objective: To determine whether PTSD is associated with the risk of developing dementia among older US veterans receiving treatment in the Department of Veterans Affairs medical centers. Design: A stratified, retrospective cohort study conducted using the Department of Veterans Affairs National Patient Care Database. Setting: Department of Veterans Affairs medical centers in the United States. Participants: A total of 181 093 veterans 55 years or older without dementia from fiscal years 1997 through 2000 (53 155 veterans with and 127 938 veterans without PTSD). Main outcome measures: During the follow-up period between October 1, 2000, and December 31, 2007, 31 107 (17.2%) veterans were ascertained to have newly diagnosed dementia according to International Clas…

matched on Dementia (mesh)

Resting brain connectivity: changes during the progress of Alzheimer disease.

Purpose: To investigate alterations in functional connectivity in the resting brain networks in healthy elderly volunteers and patients with mild, moderate, or severe Alzheimer Disease (AD). Materials and methods: This study was approved by the institutional ethics committee, and informed consent was obtained. Forty-six patients with AD and 16 healthy elderly volunteers were prospectively examined. Resting-state functional magnetic resonance imaging was used to detect alterations in posterior cingulate cortex (PCC) functional connectivity through a comparison of the healthy control group with three separate AD groups-mild, moderate, and severe AD. A temporal correlation method was used to obtain PCC connectivity maps. Results: Dissociated functional connectivity between the PCC and a set of regions, including the visual cortices bilaterally, the inferior temporal cortex, the hippocampus,…

matched on Alzheimer Disease (mesh)

Depressive symptoms and health problems among Chinese immigrant elders in the US and Chinese elders in China.

Objectives: Researchers speculate that depression tends to be more prevalent among immigrant elders due to their lack of resources, acculturation stress, language problems, and social isolation. However, other characteristics of elderly immigrants, such as the healthy immigrant effect, may counteract these potential risk factors. This study examined whether depressive symptoms differed between Chinese immigrant elders and their counterparts in China and whether health conditions were similarly associated with depressive symptoms in these two samples. Methods: Depression and health information was collected from 177 Chinese immigrant elders in Boston, the US in 2000 and from 428 education and gender-matched elders in Shanghai, China in 2003. Results: Chinese immigrants had a significantly lower score on the modified Center for Epidemiologic Studies Depression Scale (CES-D) and its subscal…

matched on Alzheimer Disease (mesh)

Compliance assessment of ambulatory Alzheimer patients to aid therapeutic decisions by healthcare professionals.

Background: Compliance represents a major determinant for the effectiveness of pharmacotherapy. Compliance reports summarising electronically compiled compliance data qualify healthcare needs and can be utilised as part of a compliance enhancing intervention. Nevertheless, evidence-based information on a sufficient level of compliance is scarce complicating the interpretation of compliance reports. The purpose of our pilot study was to determine the compliance of ambulatory Alzheimer patients to antidementia drugs under routine therapeutic use using electronic monitoring. In addition, the forgiveness of donepezil (i.e. its ability to sustain adequate pharmacological response despite suboptimal compliance) was characterised and evidence-based guidance for the interpretation of compliance reports was intended to be developed. Methods: We determined the compliance of four different antideme…

matched on Alzheimer Disease (mesh)

Making decisions for people with dementia who lack capacity: qualitative study of family carers in UK.

Objective: To identify common difficult decisions made by family carers on behalf of people with dementia, and facilitators of and barriers to such decisions, in order to produce information for family carers about overcoming barriers. Design: Qualitative study to delineate decision areas through focus groups and complexity of decision making in individual interviews. Setting: Community settings in London. Participants: 43 family carers of people with dementia in focus groups and 46 carers who had already made such decisions in individual interviews. Results: Family carers identified five core problematic areas of decision making: accessing dementia related health and social services; care homes; legal-financial matters; non-dementia related health care; and making plans for the person with dementia if the carer became too ill to care for them. They highlighted the difficulties in making…

matched on Dementia (mesh)

Influences of mutuality, preparedness, and balance on caregivers of patients with dementia.

Background: There is a lack of research exploring the influence of the role implementation process of family caregivers of older people with dementia in Taiwan. Purpose: The purpose of this study was to investigate the predictive ability on positive and negative caregiving outcomes of several role implementation variables, including mutuality, preparedness, and balance between competing needs. Methods: A cross-sectional, correlational study design was used. Data were collected from family caregivers of patients with dementia from neurological clinics at a medical center and at local hospitals through a take-home mail survey. One hundred seventy-six family caregivers of patients with dementia completed the Family Caregiving Inventory. Results: After controlling for age and gender of the family caregiver and the cognitive function of the elderly patients, mutuality was found to associate n…

matched on Dementia (mesh)