Positive and Negative Experiences of Social Support and Risk of Dementia in Later Life: An Investigation Using the English Longitudinal Study of Ageing.

BACKGROUND: Having a network of close relationships may reduce the risk of developing dementia. However, social exchange theory suggests that social interaction entails both rewards and costs. The effects of quality of close social relationships in later life on the risk of developing dementia are not well understood. OBJECTIVE: To investigate the effects of positive and negative experiences of social support within key relationships (spouse or partner, children, other immediate family, and friends) on the risk of developing dementia in later life. METHODS: We analyzed 10-year follow up data (2003/4 to 2012/13) in a cohort of 10,055 dementia free (at baseline) core participants aged 50 years and over from the English Longitudinal Study of Ageing (ELSA). Incidence of dementia was identified from participant or informant reported physician diagnosed dementia or overall score of informant-completed IQCODE questionnaire. Effects of positive and negative experiences of social support measured at baseline on risk of developing dementia were investigated using proportional hazards regression accommodating interval censoring of time-to-dementia. RESULTS: There were 340 (3.4%) incident dementia cases during the follow-up. Positive social support from children significantly reduced the risk of dementia (hazard ratio, HR = 0.83, p = 0.042, 95% CI: 0.69 to 0.99). Negative support from other immediate family (HR = 1.26, p = 0.011, CI: 1.05 to 1.50); combined negative scores from spouse and children (HR = 1.23, p = 0.046, CI: 1.004 to 1.51); spouse, children, and other family (HR = 1.27, p = 0.021, CI = 1.04 to 1.56); other family & friends (HR = 1.25, p = 0.033, CI: 1.02 to 1.55); and the overall negative scores (HR = 1.31, p = 0.019, CI: 1.05 to 1.64) all were significantly associated with increased risk of dementia. CONCLUSION: Positive social support from children is associated with reduced risk of developing dementia whereas experiences of negative social support from children and other immediate family increase the risk. Further research is needed to better understand the causal mechanisms that drive these associations

Distinguishing frontotemporal dementia from Alzheimer disease through everyday function profiles: Trajectories of change

Background: Different dementia syndromes display different patterns of everyday functioning. This article explored different patterns of functioning at baseline and trajectories of change in behavioral variant frontotemporal dementia (bvFTD) and Alzheimer disease (AD). Methods: Data from the Uniform Data Set of the National Alzheimer’s Coordinating Centre were employed. The Functional Assessment Questionnaire assessed functioning at up to 7 follow-up visits. Independent t tests assessed variations in functioning between syndromes at baseline. Linear mixed-effect modeling explored longitudinal functional trajectories between syndromes. Results: Data from 3351 patients (306 bvFTD and 3,045AD) were analyzed. At baseline, patients with bvFTD performed all daily activities poorer than AD dementia. Linear mixed models showed a significant effect of syndrome and time on functioning, and evidence of interaction between syndrome and time, with bvFTD showing a steeper decline for using the stove and travel. Conclusions: Findings can help in the effective care planning of everyday functioning for bvFTD and AD dementia

Effect of 6-benzyl aminopurine (BAP) on meristem culture for virus free seed production of some popular potato varieties in Bangladesh

The present study was undertaken to fix the suitable concentration of 6-benzyl aminopurine on shoot development from meristem for producing virus free potato plantlet. The experiment consisted of five potato cultivars namely Diamant, Heera, Dheera, Granula and Cardinal for meristem culture and four 6-benzyl aminopurine levels namely 0, 1.0, 1.5, 2.0 mg/l. As a whole, twenty treatments were allotted in complete randomized design with three replications. Resulted in vitro regenerated plantlets were used as treatment for double antibody sandwich (DAS-), enzyme linked immunosorbent assay (ELISA) test, while, the infected plant parts were used as positive control. In virus elimination through meristem culture, Cardinal with 1 mg l-1 6-benzyl aminopurine gave maximum number of shoots (2.43 cm) explant-1, whereas, Dheera with 1.5 mg l-1 6-benzyl aminopurine gave the tallest plantlet (5.23 cm). On the other hand, explants of Dheera and Cardinal with 1.5 mg l-1 6-benzyl aminopurine and explants of Diamant, Heera, Granula and Cardinal with 2.0 mg l-1 6-benzyl aminopurine produced no roots. Finally, after DAS-ELISA test, the infected field samples developed yellow color but in vitro regenerated plantlets of all the varieties under study showed 100% virus freeness.Keywords: Virus elimination, meristem culture, virus detection, seed potatoAfrican Journal of Biotechnology Vol. 12(18), pp. 2406-241

Contributions of Caregiver Management Styles to the Discrepancy Between Reported and Observed Task Performance in People with Dementia

Background: The identification and understanding of the discrepancy between caregivers’ reports of people with dementia’s (PwD) performance of activities of daily living (ADLs) and observed performance, could clarify what kind of support a PwD effectively needs when completing tasks. Strategies used by caregivers have not been included in the investigation of this discrepancy. Objectives: To (1) investigate if caregivers’ report of PwD’s ADL performance are consistent with PwD’s observed performance; (2) explore if caregiver management styles, depression, and anxiety, contribute to this discrepancy. Methods: PwD (n=64) were assessed with standardised performance-based (AMPS) and informant-based (DAD) ADL assessments. Caregivers completed depression (PHQ-9), anxiety (GAD-7), and dementia management style (DMSS: criticism, active-management, and encouragement) questionnaires. Cohen’s kappa determined agreement/disagreement in ADL performance. To investigate the potential discrepancy between the DAD and AMPS, a continuous variable was generated: comparative ADL score. Multiple linear regression analysis explored whether caregivers’ management styles, depression or anxiety could explain the ADL discrepancy. Results: Poor level of agreement between observed and reported ADL performance [k= -0.025 (95%CI -0.123 – 0.073)] was identified, with most caregivers underestimating ADL performance. The combined model explained 18% (R2=0.18, F(5, 55)=2.52,p=<0.05) of the variance of the comparative ADL score. Active-management (β=-0.037,t(60)=-3.363, p=0.001) and encouragement (β=0.025,t(60)=2.018, p=0.05) styles made the largest and statistically significant contribution to the model. Conclusions: Encouragement style could be advised for caregivers who underestimate ADL performance, while active management style for those who overestimate it. Findings have scope to increase caregivers’ abilities to support PwD activity engagement in daily life

A New and Tidier Setting How Does Environmental Clutter Affect People With Dementia’s Ability to Perform Activities of Daily Living?

Background: The relationship between the physical environment and the person with dementia’s (PwD) activities of daily living (ADLs) task performance is controversial. Although the general assumption is that this population benefits from their home environment when performing ADLs, very few experimental studies have been conducted to date. Objectives: The aim was to investigate the influence of the environment (home vs. Research-lab) and the role of clutter on ADL performance. Methods: Sixty-five PwD were evaluated with a performance-based ADL assessment (at home and clutter-free Research-lab). Paired t tests compared ADL performance and level of clutter in both environments. Multiple regression analysis investigated factors associated with better ADL performance. Results: Overall, PwD performed better at home even though clutter was significantly lower in the Research-lab. When stratified by dementia stage, PwD in the moderate stage of the disease performed better at home. Conclusion: Absence of clutter in the Research-Lab did not appear to play a beneficial role in ADLs. When stratified by dementia stage, only PwD in the moderate stage appeared to benefit from their home environment when performing ADL tasks. Future studies are required to elucidate the wider role of the environment in supporting engagement in daily activities in different dementia stages

How does carer management style influence the performance of activities of daily living in people with dementia?

INTRODUCTION: People with Dementia (PwD)’s performance of activities of daily living (ADLs) has been associated with apathy, cognitive deficits, carers’ depression and burden. However, it is not known if the carers’ management style affects ADL performance, particularly alongside PwD’s cognitive deficits and apathy. Thus, the aim of this study was to explore the contribution of intrinsic (cognition, apathy) and extrinsic (carer management styles) dementia factors to ADL performance. METHODS: PwD (n=143) were assessed on global cognition (ACE-III); apathy (CBI-R); ADLs (Disability Assessment for Dementia-DAD). Carers’ (n=143) criticism, encouragement and active-management styles were assessed with the Dementia Management Strategy Scale (DMSS). Multiple linear regression analysis investigated contributions of carer styles, cognition, apathy (independent variables) on ADLs (dependent variable). RESULTS: The best model explaining the variance of the DAD scores included cognition (β =0.413, t(142)=4.463, p=0.001), apathy (β =-0.365, t(142)=-5.556, p=0.001), carer criticism (β =-0.326, t(142)=-2.479, p=0.014) and carer encouragement styles (β =0.402, t(142)=2.941, p=0.004) accounting for 40% of the variance of the DAD scores. CONCLUSIONS: This novel study demonstrated that PwD’s level of apathy and the carer’s use of criticism negatively affected ADL performance while PwD’s cognitive abilities and carer encouragement style improved ADL performance. These findings have critical implications for the development of novel multi-component non-pharmacological interventions to maintain function and delay disease progression in dementia, as well as direct relevance to current carers and families

Binding of desloratadine and atenolol with bovine serum albumin and their in-vitro interactions

Objetivo: Unir atenolol, antagonista selectivo de los receptores β1, y desloratadina, antagonista de los receptores H1, a albúmina sérica bovina.Método: El análisis de la unión se analizó mediante diálisis de equilibrio utilizando ranitidina y diazepam como sondas específicas para el sitio I y sitio II respectivamenteResultados: Los resultados sugirieron dos conjuntos de constantes de asociación. Para el atenolol: constante de asociación con afinidad elevada (k1 = 5 x 10-5 M-1) con baja capacidad (n1 = 2) y constante de asociación con afinidad baja (k2 = 5 x 10-5 M-1) con alta capacidad (n2 = 5), mientras que para la desloratadina: constante de afinidad de asociación elevada (k1 = 45 x 10-5 M-1) con baja capacidad (n1 = 1,3) y constante de afinidad de asociación baja (k2= 5 x 10-5 M-1) con alta capacidad (n2 = 2,5), a un pH 7,4 y 27 °C. Tras la administración conjunta de atenolol y desloratadina en presencia o ausencia de ranitidina o diazepam, la desloratadina provocó la liberación del atenolol de su sitio de unión a la albúmina sérica bovina, provocando una disminución de la unión del atenolol a la albúmina sérica bovina. La fracción libre de atenolol incrementó del 84,1% al 99% y la concentración de la desloratadina de 0 x 10-5 M a 14 x 10-5 M. En presencia de diazepam como sonda específica para el sitio II, la desloratadina incrementó la fracción libre de atenolol del 0,45% to 14,3%.Conclusión: Los datos obtenidos indican la interacción de concentraciones elevadas de desloratadina a los sitios de unión de la albúmina sérica bovina modificando las propiedades farmacocinéticas del atenolol.Aims: The binding of atenolol a selective β1 receptor antagonist and desloratadine, an H1 receptor antagonist, to bovine serum albumin.Methods: The analysis of binding was studied by equilibrium dialysis method (ED) using ranitidine and diazepam as site-1 and site-2 specific probe, respectively.Results: The study suggested two sets of association constants, for atenolol: high affinity association constant (k1 = 5 x 10-5 M-1) with low capacity (n1 = 2) and low affinity association constant (k2 = 2.5 x 10-5 M-1) with high capacity (n2 = 5), while for desloratadine: high affinity association constant (k1 = 45 x 10-5 M-1) with low capacity (n1 = 1.3) and low affinity association constant (k2 = 5 x 10-5 M-1) with high capacity (n2 = 2.5) at pH 7.4 and 27 °C. During concurrent administration of atenolol and desloratadine in presence or absence of ranitidine or diazepam, desloratadine causes the release of atenolol from its binding site on BSA resulting reduced binding of atenolol to BSA. The increment in free fraction of atenolol was from 84.01% to 99 % upon the addition of increased concentration of only desloratadine at a concentration of 0 x 10-5 M to 14 x 10-5 M. In presence of diazepam as site-II specific probes, desloratadine further increases the free fraction of atenolol was from 0.45% to 14.3%.Conclusion: These data were indicative for the interaction of higher concentration of desloratadine at the binding sites on BSA changing the pharmacokinetics properties of atenolol

Binding of desloratadine and atenolol with bovine serum albumin and their in-vitro interactions

Objetivo: Unir atenolol, antagonista selectivo de los receptores β1, y desloratadina, antagonista de los receptores H1, a albúmina sérica bovina.Método: El análisis de la unión se analizó mediante diálisis de equilibrio utilizando ranitidina y diazepam como sondas específicas para el sitio I y sitio II respectivamenteResultados: Los resultados sugirieron dos conjuntos de constantes de asociación. Para el atenolol: constante de asociación con afinidad elevada (k1 = 5 x 10-5 M-1) con baja capacidad (n1 = 2) y constante de asociación con afinidad baja (k2 = 5 x 10-5 M-1) con alta capacidad (n2 = 5), mientras que para la desloratadina: constante de afinidad de asociación elevada (k1 = 45 x 10-5 M-1) con baja capacidad (n1 = 1,3) y constante de afinidad de asociación baja (k2= 5 x 10-5 M-1) con alta capacidad (n2 = 2,5), a un pH 7,4 y 27 °C. Tras la administración conjunta de atenolol y desloratadina en presencia o ausencia de ranitidina o diazepam, la desloratadina provocó la liberación del atenolol de su sitio de unión a la albúmina sérica bovina, provocando una disminución de la unión del atenolol a la albúmina sérica bovina. La fracción libre de atenolol incrementó del 84,1% al 99% y la concentración de la desloratadina de 0 x 10-5 M a 14 x 10-5 M. En presencia de diazepam como sonda específica para el sitio II, la desloratadina incrementó la fracción libre de atenolol del 0,45% to 14,3%.Conclusión: Los datos obtenidos indican la interacción de concentraciones elevadas de desloratadina a los sitios de unión de la albúmina sérica bovina modificando las propiedades farmacocinéticas del atenolol.Aims: The binding of atenolol a selective β1 receptor antagonist and desloratadine, an H1 receptor antagonist, to bovine serum albumin.Methods: The analysis of binding was studied by equilibrium dialysis method (ED) using ranitidine and diazepam as site-1 and site-2 specific probe, respectively.Results: The study suggested two sets of association constants, for atenolol: high affinity association constant (k1 = 5 x 10-5 M-1) with low capacity (n1 = 2) and low affinity association constant (k2 = 2.5 x 10-5 M-1) with high capacity (n2 = 5), while for desloratadine: high affinity association constant (k1 = 45 x 10-5 M-1) with low capacity (n1 = 1.3) and low affinity association constant (k2 = 5 x 10-5 M-1) with high capacity (n2 = 2.5) at pH 7.4 and 27 °C. During concurrent administration of atenolol and desloratadine in presence or absence of ranitidine or diazepam, desloratadine causes the release of atenolol from its binding site on BSA resulting reduced binding of atenolol to BSA. The increment in free fraction of atenolol was from 84.01% to 99 % upon the addition of increased concentration of only desloratadine at a concentration of 0 x 10-5 M to 14 x 10-5 M. In presence of diazepam as site-II specific probes, desloratadine further increases the free fraction of atenolol was from 0.45% to 14.3%.Conclusion: These data were indicative for the interaction of higher concentration of desloratadine at the binding sites on BSA changing the pharmacokinetics properties of atenolol

The impact of co-located welfare advice in healthcare settings: a prospective quasi-experimental controlled study

Evaluations of primary healthcare co-located welfare advice services have been methodologically limited. To examine the impact and cost-consequences of co-located benefits and debt advice on mental health and service use. Prospective, controlled quasi-experimental study in eight intervention and nine comparator sites across North Thames. Changes in the proportion meeting criteria for common mental disorder (CMD, 12-item General Health Questionnaire); well-being scores (Shortened Warwick and Edinburgh Mental Well-being Scale), 3-month GP consultation rate and financial strain were measured alongside funding costs and financial gains. Relative to controls, CMD reduced among women (ratio of odds ratios (rOR) = 0.37, 95% CI 0.20–0.70) and Black advice recipients (rOR=0.09, 95% CI 0.03–0.28). Individuals whose advice resulted in positive outcomes demonstrated improved well-being scores (β coefficient 1.29, 95% CI 0.25–2.32). Reductions in financial strain (rOR=042, 95% CI 0.23–0.77) but no changes in 3-month consultation rate were found. Per capita, advice recipients received £15 per £1 of funder investment. Co-located welfare advice improves short-term mental health and well-being, reduces financial strain and generates considerable financial returns

Social prescribing programmes to prevent or delay frailty in community-dwelling older adults

The increasing incidence of frailty is a health and social care challenge. Social prescription is advocated as an important approach to allow health professionals to link patients with sources of support in the community. This study aimed to determine the current evidence on the effectiveness of social prescribing programmes to delay or reduce frailty in frail older adults living in the community. A systematic literature review of published (DARE, Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, CINAHL, NICE and SCIE, NHS Economic Evaluation Database) and unpublished databases (OpenGrey; WHO Clinical Trial Registry; ClinicalTrials.gov) were searched to July 2019. Studies were eligible if they reported health, social or economic outcomes on social prescribing, community referral, referral schemes, wellbeing programmes or interventions when a non-health link worker was the intervention provider to people who are frail living in the community. 1079 unique studies were screened for eligibility. No papers were eligible. There is therefore a paucity of evidence reporting the effectiveness of social prescribing programmes for frail older adults living in the community. Given that frailty is a clinical priority and social prescribing is considered a key future direction in the provision of community care, this is a major limitation