The effect of perceived forgetfulness on quality of life in older adults: a qualitative review

Background Approximately 50% of older individuals perceive themselves as being forgetful. Objective The objective of this review is to get an overview of previous research on the relation between perceived forgetfulness (in the absence of objective memory deficit) and quality of life in older individuals. Findings in previous research might be a starting point for further research and possible future interventions. Methods Scientific papers that investigated the relation between subjective memory complaints and quality of life were searched. Two independent raters scored the articles on their methodology. The methodological quality was taken into account when conclusions were drawn. Results The literature search resulted in 682 articles, of which five studies met the inclusion criteria. Although the five studies differed in their methodology, the findings of the methodologically adequate studies show a relation between memory complaints and a diminished quality of life in the elderly. Conclusions The negative impact that subjective memory complaints can have on quality of life makes it important to acknowledge forgetfulness as a serious issue in the life of older individuals. However, more research is needed to explore the relationship between subjective memory complaints and quality of life, also with regard to the influence of depression and objective memory performance

Economic Issues in Funding and Supplying Public Sector Information

BACKGROUND: Cerebrospinal fluid (CSF) biomarkers are increasingly being used for diagnosis of Alzheimer's disease (AD). OBJECTIVE: We investigated the influence of CSF intralaboratory and interlaboratory variability on diagnostic CSF-based AD classification of subjects and identified causes of this variation. METHODS: We measured CSF amyloid-beta (Abeta) 1-42, total tau (t-tau), and phosphorylated tau (p-tau) by INNOTEST enzyme-linked-immunosorbent assays (ELISA) in a memory clinic population (n = 126). Samples were measured twice in a single or two laboratories that served as reference labs for CSF analyses in the Netherlands. Predefined cut-offs were used to classify CSF biomarkers as normal or abnormal/AD pattern. RESULTS: CSF intralaboratory variability was higher for Abeta1-42 than for t-tau and p-tau. Reanalysis led to a change in biomarker classification (normal vs. abnormal) of 26% of the subjects based on Abeta1-42, 10% based on t-tau, and 29% based on p-tau. The changes in absolute biomarker concentrations were paralleled by a similar change in levels of internal control samples between different assay lots. CSF interlaboratory variability was higher for p-tau than for Abeta1-42 and t-tau, and reanalysis led to a change in biomarker classification of 12% of the subjects based on Abeta1-42, 1% based on t-tau, and 22% based on p-tau. CONCLUSIONS: Intralaboratory and interlaboratory CSF variability frequently led to change in diagnostic CSF-based AD classification for Abeta1-42 and p-tau. Lot-to-lot variation was a major cause of intralaboratory variability. This will have implications for the use of these biomarkers in clinical practice

The Dutch Parelsnoer Institute - Neurodegenerative diseases; methods, design and baseline results

Background: The is a collaboration between 8 Dutch University Medical Centers in which clinical data and biomaterials from patients suffering from chronic diseases (so called "Pearls") are collected according to harmonized protocols. The Pearl Neurodegenerative Diseases focuses on the role of biomarkers in the early diagnosis, differential diagnosis and in monitoring the course of neurodegenerative diseases, in particular Alzheimer's disease. Methods: The Pearl Neurodegenerative Diseases is a 3-year follow-up study of patients referred to a memory clinic with cognitive complaints. At baseline, all patients are subjected to a standardized examination, including clinical data and biobank materials, e.g. blood samples, MRI and cerebrospinal fluid. At present, in total more than 1000 patients have been included, of which cerebrospinal fluid and DNA samples are available of 211 and 661 patients, respectively. First descriptives of a subsample of the data (n = 665) shows that patients are diagnosed with dementia (45%), mild cognitive impairment (31%), and subjective memory complaints (24%). Discussion: The Pearl Neurodegenerative Diseases is an ongoing large network collecting clinical data and biomaterials of more than 1000 patients with cognitive impairments. The project has started with data analyses of the baseline characteristics and biomarkers, which will be the starting point of future specific research questions that can be answered by this unique dataset

Cerebrovascular and amyloid pathology in predementia stages: the relationship with neurodegeneration and cognitive decline (vol 9, 101, 2017)

Pathophysiology, epidemiology and therapy of agein

Obtaining EQ-5D-5L utilities from the disease specific quality of life Alzheimer’s disease scale: development and results from a mapping study

Purpose The Quality of Life Alzheimer’s Disease Scale (QoL-AD) is commonly used to assess disease specific health-related quality of life (HRQoL) as rated by patients and their carers. For cost-effectiveness analyses, utilities based on the EQ-5D are often required. We report a new mapping algorithm to obtain EQ-5D indices when only QoL-AD data are available. Methods Different statistical models to estimate utility directly, or responses to individual EQ-5D questions (response mapping) from QoL-AD, were trialled for patient-rated and proxy-rated questionnaires. Model performance was assessed by root mean square error and mean absolute error. Results The response model using multinomial regression including age and sex, performed best in both the estimation dataset and an independent dataset. Conclusions The recommended mapping algorithm allows researchers for the first time to estimate EQ-5D values from QoL-AD data, enabling cost-utility analyses using datasets where the QoL-AD but no utility measures were collected

Affective symptoms as predictors of Alzheimer's disease in subjects with mild cognitive impairment: a 10-year follow-up study

Background Affective symptoms are common in subjects with mild cognitive impairment (MCI), but there is disagreement whether these symptoms are predictive for Alzheimer's disease (AD). We investigated the predictive accuracy of affective symptoms for AD during a follow-up study in subjects with MCI, and whether the predictive accuracy was modified by age, the presence of amnestic MCI or the length of follow-up.Method Newly referred subjects (n=263) with MCI older than 55 years were selected from a memory clinic and followed up after 2, 5 and 10 years. Predictors investigated were: symptoms of depression, anxiety, apathy and sleeping problems.Results Affective symptoms were present in 50-70% of the subjects. The average follow-up period was 5.4 years and 79 subjects (29%) developed AD. Sleeping problems were associated with a decreased risk for AD [odds ratio (OR) 0.35, p<0.001]. Symptoms of depression (OR 0.61, p=0.059) and anxiety (OR 0.58, p=0.051) showed a trend in the same direction. The OR of apathy for AD was 0.67 (p=0.14). Depression was associated with a decreased risk for AD only in subjects without amnestic MCI, but not in subjects with amnestic MCI. Moreover, anxiety was related to the risk for AD differently between subjects diagnosed with AD at the 5-year follow-up (OR 0.23) and subjects diagnosed with AD at the 10-year follow-up (OR 1.7).Conclusions Affective symptoms are associated with a decreased risk for AD. The risk may be dependent on MCI subtype or length of follow-up, but it does not depend on age. © Cambridge University Press 2009

Ervaringen van patiënten en naasten met het neuropsychologisch onderzoek en uitslaggesprek op de geheugenpoli

Om meer inzicht te krijgen in de ervaringen van patiënten en naasten met het neuropsychologisch onderzoek (NPO) en het medische uitslaggesprek op de geheugenpoli werden vier focusgroepen met veertien patiënten en dertien naasten georganiseerd. De gegevens werden zowel inductief als deductief geanalyseerd. Uit de groepsinterviews kwamen drie thema's naar voren: onzekerheid, vroege diagnostische paradox en informatieretentie. Tijdens het NPO en uitslaggesprek bestond er een hoge mate van onzekerheid. De vroege diagnostische paradox verwijst naar het tegelijk aanwezig zijn van negatieve (confrontatie met cognitieve klachten tijdens het NPO) en positieve ervaringen (opluchting of bevestiging door resultaten van het NPO en medische diagnose). Informatieretentie verwijst naar de geringe mate waarin medische informatie beklijft. In de klinische praktijk kunnen clinici onzekerheid verminderen door duidelijk te communiceren en onderbrekingen tijdens het NPO te voorkomen. Het onthouden van informatie kan worden verbeterd door een naaste erbij te betrekken of de informatie ook visueel of geschreven aan te bieden

Ervaringen van patiënten en naasten met het neuropsychologisch onderzoek en uitslaggesprek op de geheugenpoli

Item does not contain fulltextOm meer inzicht te krijgen in de ervaringen van patiënten en naasten met het neuropsychologisch onderzoek (NPO) en het medische uitslaggesprek op de geheugenpoli werden vier focusgroepen met veertien patiënten en dertien naasten georganiseerd. De gegevens werden zowel inductief als deductief geanalyseerd. Uit de groepsinterviews kwamen drie thema's naar voren: onzekerheid, vroege diagnostische paradox en informatieretentie. Tijdens het NPO en uitslaggesprek bestond er een hoge mate van onzekerheid. De vroege diagnostische paradox verwijst naar het tegelijk aanwezig zijn van negatieve (confrontatie met cognitieve klachten tijdens het NPO) en positieve ervaringen (opluchting of bevestiging door resultaten van het NPO en medische diagnose). Informatieretentie verwijst naar de geringe mate waarin medische informatie beklijft. In de klinische praktijk kunnen clinici onzekerheid verminderen door duidelijk te communiceren en onderbrekingen tijdens het NPO te voorkomen. Het onthouden van informatie kan worden verbeterd door een naaste erbij te betrekken of de informatie ook visueel of geschreven aan te bieden.16 p