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

Caregiver burden in Alzheimer disease: cross-sectional and longitudinal patient correlates.

Objectives: Alzheimer disease (AD) imposes a severe burden on patients and their caregivers. Although there is substantial evidence of the adverse impact of burden, considerably less is known about its specific correlates and potential causes. Design: The authors use data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE)-AD study to examine the relationship of burden and depression among AD caregivers to patient and caregiver sociodemographic characteristics, patients' cognitive status, psychiatric and behavioral symptoms, functional abilities, quality of life, and intensity of care provided by caregivers. Setting: CATIE-AD included outpatients in usual care settings and assessed treatment outcomes during 9 months. Participants: Data were examined from 421 ambulatory outpatients with a diagnosis of dementia of the Alzheimer type or probable AD with agitation or…

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Spatial correlation between brain aerobic glycolysis and amyloid-β (Aβ ) deposition.

Amyloid-β (Aβ) plaque deposition can precede the clinical manifestations of dementia of the Alzheimer type (DAT) by many years and can be associated with changes in brain metabolism. Both the Aβ plaque deposition and the changes in metabolism appear to be concentrated in the brain's default-mode network. In contrast to prior studies of brain metabolism which viewed brain metabolism from a unitary perspective that equated glucose utilization with oxygen consumption, we here report on regional glucose use apart from that entering oxidative phosphorylation (so-called "aerobic glycolysis"). Using PET, we found that the spatial distribution of aerobic glycolysis in normal young adults correlates spatially with Aβ deposition in individuals with DAT and cognitively normal participants with elevated Aβ, suggesting a possible link between regional aerobic glycolysis in young adulthood and later d…

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Stages of use: consideration, initiation, utilization, and outcomes of an internet-mediated intervention.

Background: Attrition, or nonuse of the intervention, is a significant problem in e-health. However, the reasons for this phenomenon are poorly understood. Building on Eysenbach's "Law of Attrition", this study aimed to explore the usage behavior of users of e-health services. We used two theoretical models, Andersen's Behavioral Model of Health Service Utilization and Venkatesh's Unified Theory of Acceptance and Use of Technology, to explore the factors associated with uptake and use of an internet-mediated intervention for caregivers taking care of a family member with dementia. Methods: A multiphase, longitudinal design was used to follow a convenience sample of 46 family caregivers who received an e-health intervention. Applying the two theories, usage behavior was conceptualized to form four stages: consideration, initiation, utilization (attrition or continuation), and outcome. The…

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Seeking connection: family care experiences following long-term dementia care placement.

Aim: To outline the experiences of family caregivers in Brisbane, Australia who have placed a relative with dementia into long-term care. Background: Whilst the aged care literature in Australia highlights the rising numbers of people with dementia admitted to long-term care, empirical research exploring family and staff relationships and their influence on quality of care remains limited. International research demonstrates that the transition to long-term care is stressful for families and the person with dementia, often resulting in ongoing family and staff conflict. Design: The study utilised a descriptive qualitative design. Methods: A purposive sample of 10 participants from a large study that tested an education intervention took part in the qualitative phase of this mixed method, sequential design study. Semi-structured interviews and confirmatory thematic analysis were used to i…

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Physical activity, diet, and risk of Alzheimer disease.

Context: Both higher adherence to a Mediterranean-type diet and more physical activity have been independently associated with lower Alzheimer disease (AD) risk but their combined association has not been investigated. Objective: To investigate the combined association of diet and physical activity with AD risk. Design, setting, and patients: Prospective cohort study of 2 cohorts comprising 1880 community-dwelling elders without dementia living in New York, New York, with both diet and physical activity information available. Standardized neurological and neuropsychological measures were administered approximately every 1.5 years from 1992 through 2006. Adherence to a Mediterranean-type diet (scale of 0-9; trichotomized into low, middle, or high; and dichotomized into low or high) and physical activity (sum of weekly participation in various physical activities, weighted by the type of p…

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Granulocyte colony stimulating factor decreases brain amyloid burden and reverses cognitive impairment in Alzheimer's mice.

Granulocyte colony stimulating factor (G-CSF) is a multi-modal hematopoietic growth factor, which also has profound effects on the diseased CNS. G-CSF has been shown to enhance recovery from neurologic deficits in rodent models of ischemia. G-CSF appears to facilitate neuroplastic changes by both mobilization of bone marrow-derived cells and by its direct actions on CNS cells. The overall objective of the study was to determine if G-CSF administration in a mouse model of Alzheimer's disease (AD) (Tg APP/PS1) would impact hippocampal-dependent learning by modifying the underlying disease pathology. A course of s.c. administration of G-CSF for a period of less than three weeks significantly improved cognitive performance, decreased beta-amyloid deposition in hippocampus and entorhinal cortex and augmented total microglial activity. Additionally, G-CSF reduced systemic inflammation indicate…

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Older adults' attitudes toward enrollment of non-competent subjects participating in Alzheimer's research.

Objective: Research that seeks to enroll noncompetent patients with Alzheimer's disease without presenting any potential benefit to participants is the source of substantial ethical controversy. The authors used hypothetical Alzheimer's disease studies that included either a blood draw or a blood draw and lumbar puncture to explore older persons' attitudes on this question. Method: Face-to-face interviews were conducted with 538 persons age 65 and older. Questions explored participants' understanding of research concepts, their views on enrolling persons with Alzheimer's disease in research, and their preferences regarding having a proxy decision maker, granting advance consent, and granting their proxy leeway to override the participant's decision. Additional questions assessed altruism, trust, value for research, and perceptions of Alzheimer's disease. Results: The majority (83%) were …

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Healthcare proxies of nursing home residents with advanced dementia: decisions they confront and their satisfaction with decision-making.

Objectives: To describe the medical decisions confronting healthcare proxies (HCPs) of nursing home (NH) residents with advanced dementia and to identify factors associated with greater decision-making satisfaction. Design: Prospective cohort study. Setting: Twenty-two Boston-area NHs. Participants: Three hundred twenty-three NH residents with advanced dementia and their HCPs. Measurements: Decisions made by HCPs over 18 months were ascertained quarterly. After making a decision, HCPs completed the Decision Satisfaction Inventory (DSI) (range 0-100). Independent variables included HCP and resident sociodemographic characteristics, health status, and advance care planning. Multivariable linear regression identified factors associated with higher DSI scores (greater satisfaction). Results: Of 323 HCPs, 123 (38.1%) recalled making at least one medical decision; 232 decisions were made, conc…

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The impact of anticipatory grief on caregiver burden in dementia caregivers.

Purpose: Interest in anticipatory grief (AG) has typically focused on terminal diseases such as cancer. However, the issues involved in AG are unique in the context of dementia due to the progressive deterioration of both cognitive and physical abilities. The current study investigated the nature of AG in a sample of dementia caregivers and examined the relationship between AG and caregiver burden. Design and methods: A total of 80 informal caregivers of individuals with dementia completed interviews and questionnaires assessing their experience of grief, physical and mental health, aspects of the caregiving situation, and the level of patient impairment. Hierarchical linear regression models were used to examine whether AG is significantly associated with caregiver burden. Results: AG was shown to be significantly and independently associated with caregiver burden in this sample, beyond…

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Translating the REACH caregiver intervention for use by area agency on aging personnel: the REACH OUT program.

Purpose: The aim of this study was to translate the evidence-based Resources for Enhancing Alzheimer's Caregiver Health (REACH) II intervention for use in 4 Area Agencies on Aging (AAAs). A secondary aim was to examine possible moderators of treatment outcome. Design and methods: We used a quasi-experimental pre-post treatment design with no control group. A partnership was formed between the Alabama Department of Senior Services and the University of Alabama. The partnership trimmed the REACH II intervention used in the clinical trial for feasible use in a social service agency. The condensed REACH intervention, termed REACH OUT, was delivered to 272 dementia caregivers during 4 home visits and 3 phone calls for a period of 4 months. The assessment examined pre-post treatment effects on a number of outcomes, including care recipient risk, mood, memory, and behavior problems; caregiver s…

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Early identification and treatment of Alzheimer's disease: social and fiscal outcomes.

Background: Alzheimer's disease (AD) is a progressive neurodegenerative disease that places substantial burdens on those who provide support for family members with declining cognitive and functional abilities. Many AD patients eventually require formal long-term care services because of the absence, exhaustion, or inability of family members to provide care. The costs of long-term care, and especially nursing home care, often deplete private financial resources, placing a substantial burden on state Medicaid programs. Current evidence suggests that pharmacological treatments and caregiver interventions can delay entry into nursing homes and potentially reduce Medicaid costs. However, these cost savings are not being realized because many patients with AD are either not diagnosed or diagnosed at late stages of the disease, and have no access to Medicare-funded caregiver support programs.…

matched on Alzheimer Disease (mesh)

Emotional reactions of Arab lay persons to a person with Alzheimer's disease.

Aims: To assess emotional reactions of Israeli Arab people to persons with Alzheimer's Disease (AD) and assess the associations of perceptions of threat of AD, personal experience with AD and socio-demographic characteristics with emotional reactions to persons with AD. Method: A total of 170 Israeli Arab adults, aged 40-85, were interviewed in person by the vignette methodology for their emotional reactions to people with AD, an issue not yet studied in this population. Their perceptions of dangerousness of persons with AD to themselves and to others, familiarity with the disease and perceptions of personal threat were also probed. Results: Four dimensions of emotional reactions to a person with AD emerged: anxiety, aggressiveness, prosocial reactions and rejection. More positive than negative emotions were expressed. Levels of education and religiosity, and perceived dangerousness of t…

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'Knowing what makes them tick': motivating cognitively impaired older adults to participate in restorative care.

Nursing home residents with dementia represent a majority of the most functionally impaired individuals residing in nursing homes. Although many perceive this population as having little restorative potential, maintaining resident functional abilities for as long as possible helps to optimize quality of life and decrease caregiver burden. This study used a qualitative design with a focus group methodology to explore facilitators and barriers to engaging cognitively impaired residents in functional activities and exercise. A purposive sample of seven geriatric nursing assistants who were experts in dementia care participated in the study. Twenty-seven codes were reduced to three themes: (i) knowing what makes them tick and move; (ii) teamwork and utilizing resources; and (iii) barriers to restorative care. The study findings were used to revise the Restorative Care for the Cognitively Imp…

matched on Dementia (mesh)

Social conceptual impairments in frontotemporal lobar degeneration with right anterior temporal hypometabolism.

Inappropriate social behaviours are early and distinctive symptoms of the temporal and frontal variants of frontotemporal lobar degeneration (FTLD). Knowledge of social behaviour is essential for appropriate social conduct. It is unknown, however, in what way this knowledge is degraded in FTLD. In a recent functional MRI study, we have identified a right-lateralized superior anterior temporal lobe (aTL) region showing selective activation for 'social concepts' (i.e. concepts describing social behaviour: e.g. 'polite', 'stingy') as compared with concepts describing less socially relevant animal behaviour ('animal function concepts': e.g. 'trainable', 'nutritious'). In a further fMRI study, superior aTL activation was independent of the context of actions and feelings associated with these social concepts. Here, we investigated whether the right superior sector of the aTL is necessary for …

matched on Dementia (mesh)

Dementia literacy: recognition and beliefs on dementia of the Australian public.

Background: Dementia is a growing health problem worldwide and in Australia. Little research has been conducted on dementia literacy in the community. Methods: The aim of this study was to investigate the recognition of dementia and beliefs regarding prognosis, cause, and risk reduction in the Australian public. A cross-sectional telephone survey of 2,000 randomly selected community-dwelling adults (23.4% response rate) was conducted. Results: Eighty-two percent of the sample correctly identified "dementia" or "Alzheimer's" from a vignette. There were no differences in recognition rates between vignettes describing mild or moderate dementia symptoms. Almost half thought that at least partial recovery would occur, given appropriate treatment. More than 80% of the sample thought that genetics, old age, brain disease, and stroke or mini-stroke contributed to a person getting dementia. Seven…

matched on Dementia (mesh)

Caregiver depression is associated with a low sense of coherence and health-related quality of life.

Objectives: The main objective is to examine the sense of coherence (SOC) of spouse caregivers. The aim was further investigate the association of SOC, health-related quality of life (HRQoL), depressive symptoms, distress and how severity of Alzheimer's disease (AD) affects SOC. Method: 17O patient-spouse caregiver dyads in which the patient has recently diagnosed mild AD. Caregivers completed SOC scale (SOC-29), HRQoL (15D), Beck depression and general health questionnaire scale. The assessment of AD-related symptoms was made using mini mental state examination, clinical dementia rating, neuropsychiatric inventory and functional performance using activities of daily living (ADCS-ADL) scale. Results: Male caregivers' SOC was significantly higher than female caregivers. The main predictor for low SOC was depression, with 37% of spousal caregivers reporting depressive symptoms. Women repor…

matched on Alzheimer Disease (mesh)

Coping strategies, anxiety and depression in caregivers of people with Alzheimer's disease.

Objectives: There have been few longitudinal studies investigating the impact of coping on psychological morbidity in caregivers of people with dementia. Findings have been inconsistent and little attention has been paid to anxiety in caregivers. We explored the hypothesis that the relationship between caregiver burden and anxiety and depression is mediated by coping style. Methods: As part of the LASER-AD study, 93 (73.8%) people with Alzheimer's disease and their family caregivers recruited at baseline were re-interviewed 1 year later. Sampling aimed to ensure that the participants were representative of people living in the UK with Alzheimer's disease in terms of dementia severity, gender and care setting. We used the Hospital Anxiety and Depression Scale, the Zarit Burden scale and the Brief COPE to measure coping strategies. Results: Using fewer emotion-focused strategies and more p…

matched on Alzheimer Disease (mesh)

Improvement in behavioural symptoms in patients with moderate to severe Alzheimer's disease by memantine: a pooled data analysis.

Introduction: Behavioural disturbances are a common and distressing aspect of Alzheimer's disease (AD). This pooled analysis evaluated the specific benefits of memantine on behavioural disturbances in patients with moderate to severe AD. Methods: Data were pooled from six 24/28-week, randomised, placebo-controlled, double-blind studies. Of the 2,311 patients included in these studies, 1,826 patients with moderate to severe AD (MMSE <20) were included in this analysis, corresponding to the extended indication for memantine in Europe. In this subgroup, 959 patients received memantine 20 mg/day and 867 received placebo. Behavioural symptoms were rated using the Neuropsychiatric Inventory (NPI) total and single-item scores at weeks 12 and 24/28. Results: At weeks 12 and 24/28, ITT analysis demonstrated that memantine treatment produced statistically significant benefits over placebo treatmen…

matched on Alzheimer Disease (mesh)

Pain assessment as intervention: a study of older adults with severe dementia.

Objectives: The communication impairments that characterize severe dementia make pain assessment challenging. As such, pain problems often go undetected. Our goal was to determine whether systematic pain assessment leads to improved pain management practices and decreases nursing stress in comparison with a control condition. Methods: We adopted a 3-month comparative longitudinal design. Nursing staff regularly assessed dementia patients' pain through the use of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC). A second group of nurses completed an attention-control measure for a control group of patients. In addition, nursing staff regularly completed measures of work stress to investigate the effects of the workload associated with systematic pain assessment on nurse stress. Results: Regular use of the PACSLAC improved pain management practices ov…

matched on Dementia (mesh)

Dying with advanced dementia in long-term care geriatric institutions: a retrospective study.

Objective: The aim of this study is to describe the last month of life of severely demented elders in long-term care institutions, and the clinical decisions in the management of their end-of-life events. Design: Retrospective exploratory study. Setting: Seven Italian long-term care institutions with more than 200 beds. Participants: One hundred forty-one patients with advanced (FAST stage = 7c) dementia (Alzheimer disease, vascular, other kinds of dementia, severe cognitive impairment). Measurement: Diagnosis, Mini-Mental State Examination, cause of death. Data were collected from clinical and nursing records referring to the last 30 days of life: symptoms and signs, intensity and incidence, treatments (antibiotics, analgesics, anxiolytics, antidepressants, artificial nutrition/hydration, and use of restraints); the last 48 hours: cardiopulmonary resuscitation attempts and life-sustaini…

matched on Dementia (mesh)

Reexamining the relationships among dementia, stigma, and aging in immigrant Chinese and Vietnamese family caregivers.

Prior literature emphasizes that Asian Americans with dementia may be particularly vulnerable to the stigma of chronic and severe mental illness. However, there is a dearth of empirical research to support this claim. This study examines the relationship of stigma and dementia in 32 qualitative interviews with Chinese and Vietnamese family caregivers. Stigma was a common theme in the interviews (91%). Further analysis revealed two sources: the stigma of chronic and severe mental illness and a stigma reflecting negative stereotypes of aging or the aged. Chinese and Vietnamese cultural views of normal aging are not unitary but accommodate different trajectories of aging, some more and some less desired. When applied to persons with dementia, a "normalized" but negative trajectory of aging carried with it significant stigma that was distinct from but in addition to the stigma of chronic and…

matched on Dementia (mesh)

Determinants of burden in those who care for someone with dementia.

Objectives: Caregiver burden is a key measure in caregiver research and is frequently used as a baseline measure in intervention studies. Previous research has found numerous factors associated with caregiver burden such as the relationship quality between carer and patient, the patient's cognitive ability, behavioural and psychological symptoms displayed by the patient, caregiver gender, adverse life events to name a few. Many studies have investigated these factors singularly however current thought suggests a multi-factorial role and inter-dependence of these factors. Based on this it was decided to investigate factors associated with caregiver burden using a multiple regression analysis in order to ascertain the predictive quality of these factors of caregiver burden. Method: Cross-sectional study using validated measures of a patient's cognitive ability, ability to carry out day-to-…

matched on Dementia (mesh)

Is there a link between sleep changes and memory in Alzheimer's disease?

Aging and Alzheimer's disease (AD) are both characterized by memory impairments and sleep changes. We investigated the potential link between these disturbances, focusing on sleep spindles, involved in memory consolidation. Two episodic memory tasks were given to young and old healthy participants, as well as to AD patients. Postlearning sleep was recorded. Sleep spindles were globally reduced in aging and AD. AD patients also exhibited a further decrease in fast spindles. Besides, mean intensity of fast spindles was positively correlated, in AD patients, with immediate recall performance. Our results are the first report of a specific decrease in fast spindles in AD, associated with learning abilities. They also give further hints for a functional differentiation between slow and fast spindles.

matched on Alzheimer Disease (mesh)

Effects of environmental enrichment on exploration, anxiety, and memory in female TgCRND8 Alzheimer mice.

After we could recently demonstrate a beneficial effect of environmental enrichment on AD-like brain pathology in female TgCRND8 mice [Ambrée O, Leimer U, Herring A, Görtz N, Sachser N, Heneka MT, et al. Reduction of amyloid angiopathy and Abeta plaque burden after enriched housing in TgCRND8 mice: involvement of multiple pathways. Am J Pathol 2006;169:544-52] the present study focuses on the behavioural effects of environmental enrichment with special emphasis on learning and memory performance in this AD model. In the first experiment spontaneous exploration, locomotor activity and anxiety-related behaviour were assessed as the performance in learning tasks can be biased substantially by exploratory behavioural traits. In the second experiment spatial memory in the Barnes maze test and object recognition memory were examined. Regarding exploratory behaviour transgenic mice from standar…

matched on Alzheimer Disease (mesh)

Family caregivers' strains: comparative analysis of cancer caregiving with dementia, diabetes, and frail elderly caregiving.

Objective: This study aimed to investigate the impact of cancer from family caregivers' perspective, based on a comparative analysis of caregiving burden and distress, among four types of caregivers. Methods: The sample included caregivers of persons with cancer, dementia, diabetes, or frail elderly from a nationally representative sample of 606 caregivers. Results: Although the four different types of caregivers were comparable in most sociodemographic characteristics, caregiving involvement and caregiving outcomes differed among the caregiving groups. Both cancer and dementia caregivers reported greater levels of physical burden and psychological distress than other caregivers, after controlling for sociodemographic and caregiving involvement (i.e., level of burden and caregiving duration) factors. Discussion: The comparative analysis provided a systematic review of cancer caregiving i…

matched on Dementia (mesh)