Understanding and predicting the longitudinal course of dementia

PURPOSE OF REVIEW: To date, most research in dementia has focused either on the identification of dementia risk prediction or on understanding changes and predictors experienced by individuals before diagnosis. Despite little is known about how individuals change after dementia diagnosis, there is agreement that changes occur over different time scales and are multidomain. In this study, we present an overview of the literature regarding the longitudinal course of dementia. RECENT FINDINGS: Our review suggests the evidence is scarce and findings reported are often inconsistent. We identified large heterogeneity in dementia trajectories, risk factors considered and modelling approaches employed. The heterogeneity of dementia trajectories also varies across outcomes and domains investigated. SUMMARY: It became clear that dementia progresses very differently, both between and within individuals. This implies an average trajectory is not informative to individual persons and this needs to be taken into account when communicating prognosis in clinical care. As persons with dementia change in many more ways during their patient journey, heterogeneous disease progressions are the result of disease and patient characteristics. Prognostic models would benefit from including variables across a number of domains. International coordination of replication and standardization of the research approach is recommended

Physical, Chemical and Sensory Properties of Baked Products from Blends of Wheat and African Yam Bean (Sphenostylis stenocarpa) Water-Extractable Proteins

ABSTRACTBlends of wheat flour (WF) and African yam bean water-extractable proteins (AYBWEP) were processed into bread and cookies in the following ratios: 100: 0; 95: 5; 90: 10; 85: 15; 80: 20. The proximate composition, physical, chemical properties and sensory properties of bread and cookies samples from the blends were determined. Breads and cookies produced from the resultant blends were significantly higher (p<0.05) in protein (16.39% – 18.36%) than the control (11.80% – 12.58%). Carbohydrate content decreased from 60.74% with addition of AYBWEP to 52.81% following 20% substitution. The pH of bread samples prepared from whole wheat flour and blends of wheat flour and AYBWEP were significantly different (p<0.05) while bulk density and specific volume were not significantly different (p>0.05). The pH of bread samples and cookies decreased with increase in the proportion of the AYBWEP blend from 5% to 20%. The highest specific volume (3.70ml/g) was observed in bread samples prepared from the control 100: 0 blends while the 80:20 blends had the lowest specific volume (3.10ml/g). There was no significant difference (p>0.05) in the bulk density and thickness of the cookies. The cookies prepared using 80: 20 blends had the higher diameter (22.53cm) and spread factor (54.03cm) compared to the control. Generally, acceptability of the bread and cookies decreased with higher ratios of AYBWEP inclusion. The sensory acceptability scores showed the best AYBWEP substitution level for making bread and cookies was 5% and 10% of the AYBWEP respectively. The results are discussed in the context of the growing importance of promoting the processing and utilization of lesser known local crops in baked products.enrichment

Het filosofische systeem van Herman Dooyeweerd en de filosofie van de techniek

FDR De bescherming van fundamentele rechten in een integrerend Europa ou

Het toevoegen van perspulp aan droogvoer voor vleesvarkens

Dit rapport gaat in op de verstrekking van perspulp via het droogvoer. Naast de technische resultaten en de gezondheid van met perspulp gevoerde dieren is er ook aandacht voor de effecten op vleeskwaliteit, ammoniakemissie, mestproductie en -samenstelling, voertechniek en stof. Hiertoe zijn twee experimenten uitgevoer

Frailty as a predictor of mortality in older adults within 5 years of psychiatric admission

Objectives Older adults with psychiatric disorders have a substantially lower life expectancy than age-matched controls. Knowledge of risk factors may lead to targeting treatment and interventions to reduce this gap in life expectancy. In this study, we investigated whether frailty independently predicts mortality in older patients following an acute admission to a geriatric psychiatry hospital. Methods Clinical cohort study with a 5-year follow-up of 120 older patients admitted to a psychiatric hospital between February 2009 and September 2010. On admission, we assessed frailty with a frailty index (FI). We applied Cox regression analyses with time to death as the dependent variable, to examine whether the FI was a predictor for mortality, adjusted for age, sex, level of education, multimorbidity (Cumulative Illness Rating Scale for Geriatrics, CIRS-G scores), functional status (Barthel Index), neuropsychiatric symptoms (NPS), and severity of psychiatric symptoms at admission (Clinical Global Impressions Scale of Severity). Results Of the 120 patients, 63 (53%) patients were frail (FI >= 0.25), and 59 (49%) had died within 5 years. The FI predicted mortality with a hazard ratio (HR) of 1.78 (95% CI, 1.06-2.98) per 0.1 point increase, independent of the covariates. Co-morbidity measured by the CIRS-G and functional status measured by the Barthel Index were not significantly associated. Conclusions Frailty was a strong predictor of mortality, independent of age, gender, multimorbidity, and functional status. This implies that frailty may be helpful in targeting inpatient psychiatric treatment and aftercare according to patients' life expectancy