Development of caregiver resilience scale (CRS) for Thai caregivers of older persons with dementia

Abstract: This research aim to develop the Caregiver Resilience Scale (CRS) and examine the validity and reliability. The process began with a review of the concept of resilience based on a synthesis of existing research together with an exploration of qualitative data derived from an interview of ten caregivers of older persons with dementia. The CRS was examined by a panel of three experts to confirm its content validity, with the content validity index equal to 0.84. It was also tried out with 30 caregivers to test its internal consistency, and the result showed that the internal consistency was at a high level (Cronbach's alpha 0.87). Furthermore, the Exploratory Factor Analysis was conducted with 150 caregivers to test construct validity of the scale, and it was found that all six domains of the CRS had construct validity. The final version of the CRS was composed of 30 items within six domains: physical competence; relationship competence; emotional competence; cognitive competence; moral competence; and spiritual competence. The 30-item CRS was considered appropriate as a newly developed instrument

Posttraumatic mental health establishment of the Tsunami survivors in Thailand

The natural disaster known as "the Tsunami" occurred in Andaman coast of Thailand in December 2004, and there had been questions whether it could cause PTSD amongst the population who lives in the affected area and how to avoid PTSD condition to occur

Cognitive impairments predict the behavioral and psychological symptoms of dementia

IntroductionThe purpose of this study was to (1) validate the Thai version of the Neuropsychiatric Inventory Questionnaire (NPI-Q) as a screening tool for behavioral and psychological symptoms of dementia (BPSD), and (2) examine the relationship between cognitive performance and BPSD in an elderly population with amnestic mild cognitive impairment (aMCI) and dementia of Alzheimer’s type (DAT).MethodsOne hundred and twenty participants, comprising 80 aMCI and 40 DAT patients, and their respective caregivers were included in the study. Participants completed the NPI-Q and the Neuropsychiatric Inventory (NPI) within 2 weeks of each other and cognitive performance was primarily assessed using the Montreal Cognitive Assessment (MoCA).ResultsThe Thai NPI-Q had good validity and reliability. Pure exploratory bifactor analysis revealed that a general factor and a single-group factor (with high loadings on delusions, hallucinations, apathy, and appetite) underpinned the NPI-Q domains. Significant negative correlations between the MoCA total score and the general and single-group NPI-Q scores were found in all subjects (aMCI + DAT combined) and DAT alone, but not in aMCI. Cluster analysis allocated subjects with BPSD (10% of aMCI and 50% of DAT participants) into a distinct “DAT + BPSD” class.ConclusionThe NPI-Q is an appropriate instrument for assessing BPSD and the total score is largely predicted by cognitive deficits. It is plausible that aMCI subjects with severe NPI-Q symptoms (10% of our sample) may have a poorer prognosis and constitute a subgroup of aMCI patients who will likely convert into probable dementia

Sequence variation and linkage disequilibrium in the GABA transporter-1 gene (SLC6A1) in five populations: implications for pharmacogenetic research

<p>Abstract</p> <p>Background</p> <p>GABA transporter-1 (GAT-1; genetic locus <it>SLC6A1</it>) is emerging as a novel target for treatment of neuropsychiatric disorders. To understand how population differences might influence strategies for pharmacogenetic studies, we identified patterns of genetic variation and linkage disequilibrium (LD) in <it>SLC6A1 </it>in five populations representing three continental groups.</p> <p>Results</p> <p>We resequenced 12.4 kb of <it>SLC6A1</it>, including the promoters, exons and flanking intronic regions in African-American, Thai, Hmong, Finnish, and European-American subjects (total n = 40). LD in <it>SLC6A1 </it>was examined by genotyping 16 SNPs in larger samples. Sixty-three variants were identified through resequencing. Common population-specific variants were found in African-Americans, including a novel 21-bp promoter region variable number tandem repeat (VNTR), but no such variants were found in any of the other populations studied. Low levels of LD and the absence of major LD blocks were characteristic of all five populations. African-Americans had the highest genetic diversity. European-Americans and Finns did not differ in genetic diversity or LD patterns. Although the Hmong had the highest level of LD, our results suggest that a strategy based on the use of tag SNPs would not translate to a major improvement in genotyping efficiency.</p> <p>Conclusion</p> <p>Owing to the low level of LD and presence of recombination hotspots, <it>SLC6A1 </it>may be an example of a problematic gene for association and haplotype tagging-based genetic studies. The 21-bp promoter region VNTR polymorphism is a putatively functional candidate allele for studies focusing on variation in GAT-1 function in the African-American population.</p

Mild cognitive impairment vs. mild cognitive dysfunctions: validation with a nomothetic network approach

Aim: No studies have examined whether interactions between the apolipoprotein E4 (ApoE4) allele and peripheral biomarkers, hypertension, and type 2 diabetes mellitus (T2DM) may impact the neurocognitive, behavioral, and social dysfunctions in amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease (AD). We aimed to clinically define and biologically validate a subgroup of aMCI subjects who take up an intermediate position between controls and AD patients.Methods: In 61 healthy controls, 60 subjects with aMCI, and 60 AD patients, we measured the features of aMCI/AD using the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD). A composite BIORISK score was computed using the ApoE4 allele, serum folate, albumin, white blood cells, fasting blood glucose, atherogenic index of plasma, T2DM, and hypertension.Results: Clustering and nearest neighbor analyses were unable to validate the aMCI subgroup. We constructed two z unit-based composite scores, the first indicating overall burden of cognitive, social, and behavioral deterioration (OBD) and the second reflecting the interactions among ApoE4, all other biomarkers, hypertension, and T2DM (BIORISK). We found that 40.2% of the variance in the OBD score was explained by BIORISK, ApoE4, age, and education. The OBD index was used to construct three subgroups (normal, medium, and high OBD) with the medium group (n = 45) showing mild cognitive dysfunctions (MCD) in memory, language, orientation, and ADL. People with MCD show OBD and BIORISK scores that are significantly different from controls and AD.Conclusion: Petersen’s aMCI criteria cannot be validated and should be replaced by the more restrictive, biologically validated MCD class

Development of caregiver resilience scale (CRS) for Thai caregivers of older persons with dementia

This research aim to develop the Caregiver Resilience Scale (CRS) and examine the validity and reliability. The process began with a review of the concept of resilience based on a synthesis of existing research together with an exploration of qualitative data derived from an interview of ten caregivers of older persons with dementia. The CRS was examined by a panel of three experts to confirm its content validity, with the content validity index equal to 0.84. It was also tried out with 30 caregivers to test its internal consistency, and the result showed that the internal consistency was at a high level (Cronbach’s alpha 0.87). Furthermore, the Exploratory Factor Analysis was conducted with 150 caregivers to test construct validity of the scale, and it was found that all six domains of the CRS had construct validity. The final version of the CRS was composed of 30 items within six domains: physical competence; relationship competence; emotional competence; cognitive competence; moral competence; and spiritual competence. The 30-item CRS was considered appropriate as a newly developed instrument

Qigong programme among community-dwelling older adults at risk of depression: A randomised controlled study

The objective of this study was to evaluate the effects of Qigong programme on depression of older adults with mild-moderate depression. The experimental study was conducted at the Public Health Service Centre (PHS) in two randomised districts of Bangkok, Thailand from October to December 2017. This parallel, randomised controlled trial compared the Qigong programme with the usual singing and praying activities among older adults at mild-to-moderate risk of depression. The Qigong programme was based on mind-body exercises incorporate mindful breathing. The intervention group underwent a 3 sessions/week 12-week course of Qigong exercises while the control group participated in singing and praying with the same duration and frequency. The outcome measure was the change in the TGDS from baseline to 12 weeks. Data analysis was conducted using STATA. The outcome data are available for all randomized subjects, all analyses were conducted as intention-to-treat. The Qigong programme was highly significant (−9.88 score points; 95% CI −11.62 to −8.13; p < 0.001) than the control group in reducing depression scores at 12 weeks. Depression score decreased (10.39 score points; 95% CI −11.77 to −9.02; p < 0.001) only in the Qigong group. These findings support the Qigong programme was effective in reducing depression score both in mild and moderate depression community-dwelling older adults. The Qigong programme appears to confer greater improvements than the usual program

Episodic memory and delayed recall are significantly more impaired in younger patients with deficit schizophrenia than in elderly patients with amnestic mild cognitive impairment

<div><p>Background</p><p>Both amnestic mild cognitive impairment (aMCI) and schizophrenia, in particular deficit schizophrenia, are accompanied by cognitive impairments. The aim of the present study was to examine the cognitive differences between aMCI and (non)deficit schizophrenia.</p><p>Methods</p><p>Towards this end we recruited 60 participants with aMCI, 40 with deficit and 40 with nondeficit schizophrenia and 103 normal volunteers. Cognitive measures were assessed with the Consortium to Establish a Registry for Alzheimer’s disease (CERAD) using the Verbal Fluency Test (VFT), Boston Naming Test (BNT), Mini-Mental State Examination (MMSE), Word list memory (WLM), Word list recall (WLRecall) and Word list recognition (WLRecognition). Data were analyzed using multivariate analyses and machine learning techniques.</p><p>Results</p><p>BNT scores were significantly lower in aMCI as compared with nondeficit schizophrenia. Patients with deficit schizophrenia had significantly lower MMSE, WLM, WL True Recall and WL Recognition than aMCI patients, while WL False Recall was significantly higher in deficit schizophrenia than in aMCI. Neural network importance charts show that deficit and nondeficit schizophrenia are best separated from aMCI using total BNT score, while WLM and WL false Recall follow at a distance.</p><p>Conclusions</p><p>Patients with schizophrenia and aMCI have a significantly different neurocognitive profile. Memory impairments, especially in episodic memory, are significantly worse in younger patients with deficit schizophrenia as compared with elderly patients with aMCI, while the latter show more dysnomia than patients with schizophrenia.</p></div

Results of binary logistic regression analyses with amnestic mild cognitive impairment (aMCI) versus deficit or non-deficit schizophrenia as classes and 7 Consortium to Establish a Registry for Alzheimer’s disease (CERAD) tests as explanatory variables.

<p>Results of binary logistic regression analyses with amnestic mild cognitive impairment (aMCI) versus deficit or non-deficit schizophrenia as classes and 7 Consortium to Establish a Registry for Alzheimer’s disease (CERAD) tests as explanatory variables.</p

Socio-demographic data in normal controls, schizophrenia patients with and without deficit schizophrenia and patients with amnestic mild cognitive impairment (aMCI).

<p>Socio-demographic data in normal controls, schizophrenia patients with and without deficit schizophrenia and patients with amnestic mild cognitive impairment (aMCI).</p