98 research outputs found
Health promotion intervention for people with early-stage dementia: A quasi-experimental study
Introduction: With the limited advancements in medical treatment, there is a growing need for supporting people with earlyâstage dementia adjust to their diagnosis and improve their quality of life. This study aimed to investigate the effects of a 12âweek health promotion course for people with earlyâstage dementia.
Methods: Quasiâexperimental, single group, pretestâposttest design. A total of 108 persons with dementia participated in this study, and for each participant, a carer was interviewed. The 12âweek health promotion intervention consisted of 2âhr sessions at weekly intervals. Outcome measures were cognition, measured by MiniâMental State Examination, personal, and instrumental activities of daily living (PâADL and IâADL), measured by Lawton and Brody's Physical SelfâMaintenance Scale and Instrumental Activities of Daily Living Scale, selfârated health, measured by the European Quality of life Visual Analogue Scale, depressive symptoms, measured by the Cornell Scale for Depression in Dementia, and neuropsychiatric symptoms, measured by The Neuropsychiatric Inventory. Assessments were conducted at baseline and at followâup 1â2 months postintervention.
Results: The results demonstrate a small but statistically significant improvement in depressive symptoms (p = .015) and in selfârated health (p = .031). The results also demonstrated a small statistically significant decline in the participantsâ IâADL (p = .007). The participantsâ cognitive function, PâADL, and neuropsychiatric symptoms were stable during the 4âmonth followâup.
Conclusion: This study demonstrates promising results with regard to the benefit of attending a 12âweek health promotion intervention in promoting health and wellâbeing in people with earlyâstage dementia. With the majority of participants with earlyâstage dementia living at home without any healthcare services in a vulnerable stage of the condition, this study makes an important contribution to highlighting the need for, and benefit of, educational approaches for this population.publishedVersio
Correction: Clinical outcome measures in dementia with Lewy bodies trials: critique and recommendations.
The selection of appropriate outcome measures is fundamental to the design of any successful clinical trial. Although dementia with Lewy bodies (DLB) is one of the most common neurodegenerative conditions, assessment of therapeutic benefit in clinical trials often relies on tools developed for other conditions, such as Alzheimer's or Parkinson's disease. These may not be sufficiently valid or sensitive to treatment changes in DLB, decreasing their utility. In this review, we discuss the limitations and strengths of selected available tools used to measure DLB-associated outcomes in clinical trials and highlight the potential roles for more specific objective measures. We emphasize that the existing outcome measures require validation in the DLB population and that DLB-specific outcomes need to be developed. Finally, we highlight how the selection of outcome measures may vary between symptomatic and disease-modifying therapy trials
Clinical outcome measures in dementia with Lewy bodies trials: critique and recommendations.
The selection of appropriate outcome measures is fundamental to the design of any successful clinical trial. Although dementia with Lewy bodies (DLB) is one of the most common neurodegenerative conditions, assessment of therapeutic benefit in clinical trials often relies on tools developed for other conditions, such as Alzheimer's or Parkinson's disease. These may not be sufficiently valid or sensitive to treatment changes in DLB, decreasing their utility. In this review, we discuss the limitations and strengths of selected available tools used to measure DLB-associated outcomes in clinical trials and highlight the potential roles for more specific objective measures. We emphasize that the existing outcome measures require validation in the DLB population and that DLB-specific outcomes need to be developed. Finally, we highlight how the selection of outcome measures may vary between symptomatic and disease-modifying therapy trials
Clinical outcome measures in dementia with Lewy bodies trials: critique and recommendations
The selection of appropriate outcome measures is fundamental to the design of any successful clinical trial. Although dementia with Lewy bodies (DLB) is one of the most common neurodegenerative conditions, assessment of therapeutic benefit in clinical trials often relies on tools developed for other conditions, such as Alzheimer's or Parkinson's disease. These may not be sufficiently valid or sensitive to treatment changes in DLB, decreasing their utility. In this review, we discuss the limitations and strengths of selected available tools used to measure DLB-associated outcomes in clinical trials and highlight the potential roles for more specific objective measures. We emphasize that the existing outcome measures require validation in the DLB population and that DLB-specific outcomes need to be developed. Finally, we highlight how the selection of outcome measures may vary between symptomatic and disease-modifying therapy trials
GBA and APOE Δ4 associate with sporadic dementia with Lewy bodies in European genome wide association study
Dementia with Lewy Bodies (DLB) is a common neurodegenerative disorder with poor prognosis and mainly unknown pathophysiology. Heritability estimates exceed 30% but few genetic risk variants have been identified. Here we investigated common genetic variants associated with DLB in a large European multisite sample. We performed a genome wide association study in Norwegian and European cohorts of 720 DLB cases and 6490 controls and included 19 top-associated single-nucleotide polymorphisms in an additional cohort of 108 DLB cases and 75545 controls from Iceland. Overall the study included 828 DLB cases and 82035 controls. Variants in the ASH1L/GBA (Chr1q22) and APOE Δ4 (Chr19) loci were associated with DLB surpassing the genome-wide significance threshold (p < 5 à 10). One additional genetic locus previously linked to psychosis in Alzheimer's disease, ZFPM1 (Chr16q24.2), showed suggestive association with DLB at p-value < 1 à 10. We report two susceptibility loci for DLB at genome-wide significance, providing insight into etiological factors. These findings highlight the complex relationship between the genetic architecture of DLB and other neurodegenerative disorders
A genome-wide association study with 1,126,563 individuals identifies new risk loci for Alzheimer's disease
Late-onset Alzheimerâs disease is a prevalent age-related polygenic disease that accounts for 50â70% of dementia cases. Currently, only a fraction of the genetic variants underlying Alzheimerâs disease have been identified. Here we show that increased sample sizes allowed identification of seven previously unidentified genetic loci contributing to Alzheimerâs disease. This study highlights microglia, immune cells and protein catabolism as relevant to late-onset Alzheimerâs disease, while identifying and prioritizing previously unidentified genes of potential interest. We anticipate that these results can be included in larger meta-analyses of Alzheimerâs disease to identify further genetic variants that contribute to Alzheimerâs pathology
The association between benzodiazepine use and sleep quality in residential aged care facilities: a cross-sectional study
Polygenic overlap between C-reactive protein, plasma lipids, and Alzheimer disease
BackgroundâEpidemiological findings suggest a relationship between Alzheimer disease (AD), inflammation, and dyslipidemia, although the nature of this relationship is not well understood. We investigated whether this phenotypic association arises from a shared genetic basis. Methods and ResultsâUsing summary statistics (P values and odds ratios) from genome-wide association studies of >200 000 individuals, we investigated overlap in single-nucleotide polymorphisms associated with clinically diagnosed AD and C-reactive protein (CRP), triglycerides, and high- and low-density lipoprotein levels. We found up to 50-fold enrichment of AD single-nucleotide polymorphisms for different levels of association with C-reactive protein, low-density lipoprotein, high-density lipoprotein, and triglyceride single-nucleotide polymorphisms using a false discovery rate threshold <0.05. By conditioning on polymorphisms associated with the 4 phenotypes, we identified 55 loci associated with increased AD risk. We then conducted a meta-analysis of these 55 variants across 4 independent AD cohorts (total: n=29 054 AD cases and 114 824 healthy controls) and discovered 2 genome-wide significant variants on chromosome 4 (rs13113697; closest gene, HS3ST1; odds ratio=1.07; 95% confidence interval=1.05â1.11; P=2.86Ă10â8) and chromosome 10 (rs7920721; closest gene, ECHDC3; odds ratio=1.07; 95% confidence interval=1.04â1.11; P=3.38Ă10â8). We also found that gene expression of HS3ST1 and ECHDC3 was altered in AD brains compared with control brains. ConclusionsâWe demonstrate genetic overlap between AD, C-reactive protein, and plasma lipids. By conditioning on the genetic association with the cardiovascular phenotypes, we identify novel AD susceptibility loci, including 2 genome-wide significant variants conferring increased risk for AD.acceptedVersio
A longitudinal study of anxiety and cognitive decline in dementia with Lewy bodies and Alzheimerâs disease
Dementia with Lewy bodies: Impact of co-pathologies and implications for clinical trial design
Dementia with Lewy bodies (DLB) is clinically defined by the presence of visual hallucinations, fluctuations, rapid eye movement (REM) sleep behavioral disorder, and parkinsonism. Neuropathologically, it is characterized by the presence of Lewy pathology. However, neuropathological studies have demonstrated the high prevalence of coexistent Alzheimer's disease, TAR DNA-binding protein 43 (TDP-43), and cerebrovascular pathologic cases. Due to their high prevalence and clinical impact on DLB individuals, clinical trials should account for these co-pathologies in their design and selection and the interpretation of biomarkers values and outcomes. Here we discuss the frequency of the different co-pathologies in DLB and their cross-sectional and longitudinal clinical impact. We then evaluate the utility and possible applications of disease-specific and disease-nonspecific biomarkers and how co-pathologies can impact these biomarkers. We propose a framework for integrating multi-modal biomarker fingerprints and step-wise selection and assessment of DLB individuals for clinical trials, monitoring target engagement, and interpreting outcomes in the setting of co-pathologies.Wellcome Clinical Research Career Development Fellowship. Grant Number: 205167/Z/16/Z; National Institute for Health Research (NIHR); National Institute of Neurological Disorders and Stroke. Grant Number: 1ZIANS003154; NIH. Grant Numbers: P30 AG62677, U01 NS100620, U19 AG 071754, U54 NS110435
NINDS. Grant Number: U01NA100610; National Institute on Aging. Grant Number: P30AG072959Peer reviewe
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