•42 trials including 8249 participants are enrolled in our meta-analysis.•A traditional and net meta-analysis was performed to test the diagnostic value of NfL.•NfL increases in all kinds of ...neurodegenerative disease compared to healthy controls.•NfL in CSF and blood differentiates neurodegenerative dementia from healthy controls.•NfL concentration is ranked among neurodegenerative dementia using cluster analysis.
The diagnostic value of neurofilament light chain protein in neurodegenerative dementia diseases is still controversial. A systematic literature search was performed to identify relevant case-control studies conducted through October 2018. Traditional and net meta-analyses were performed based on 42 studies that tested the diagnostic performance of neurofilament light chain protein (NfL) concentration in CSF and serum/plasma from patients with neurodegenerative dementia. CSF and serum/plasma NfL levels were significantly increased in patients with neurodegenerative dementia diseases. Network meta-analysis showed a significant reduction in CSF NfL levels during mild cognitive impairment, whereas an increase was observed in vascular dementia compared to Alzheimer’s disease. Surface under the cumulative ranking curve and cluster analysis showed that the NfL concentration in CSF (vascular dementia, frontotemporal dementia, and Alzheimer’s disease) and serum/plasma (frontotemporal dementia and Alzheimer’s disease) ranked first among neurodegenerative dementia diseases. NfL is an important biomarker that can help clinical neurologists make early diagnoses of neurodegenerative diseases, so patients can receive prompt treatment.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
12.
Dementia care Grealy, James; McMullen, Helen; Grealy, Julia
2005., 2005, 2008-04-15
eBook
Dementia care: a practical photographic guide is a unique illustrated guide to caring for people with dementia in care homes. It presents practical prevention and management techniques for resistance ...to care in common activities of daily living, explores cognitive loss, physical loss and sensory loss in dementia, and examines means of improving communication with those with dementia to enhance their understanding of their environment and improve their compliance in care.
Post-Stroke Cognitive Impairment and Dementia Rost, Natalia S; Brodtmann, Amy; Pase, Matthew P ...
Circulation research,
2022-Apr-15, 2022-04-15, 20220415, Volume:
130, Issue:
8
Journal Article
Peer reviewed
Open access
Poststroke cognitive impairment and dementia (PSCID) is a major source of morbidity and mortality after stroke worldwide. PSCID occurs as a consequence of ischemic stroke, intracerebral hemorrhage, ...or subarachnoid hemorrhage. Cognitive impairment and dementia manifesting after a clinical stroke is categorized as vascular even in people with comorbid neurodegenerative pathology, which is common in elderly individuals and can contribute to the clinical expression of PSCID. Manifestations of cerebral small vessel disease, such as covert brain infarcts, white matter lesions, microbleeds, and cortical microinfarcts, are also common in patients with stroke and likewise contribute to cognitive outcomes. Although studies of PSCID historically varied in the approach to timing and methods of diagnosis, most of them demonstrate that older age, lower educational status, socioeconomic disparities, premorbid cognitive or functional decline, life-course exposure to vascular risk factors, and a history of prior stroke increase risk of PSCID. Stroke characteristics, in particular stroke severity, lesion volume, lesion location, multiplicity and recurrence, also influence PSCID risk. Understanding the complex interaction between an acute stroke event and preexisting brain pathology remains a priority and will be critical for developing strategies for personalized prediction, prevention, targeted interventions, and rehabilitation. Current challenges in the field relate to a lack of harmonization of definition and classification of PSCID, timing of diagnosis, approaches to neurocognitive assessment, and duration of follow-up after stroke. However, evolving knowledge on pathophysiology, neuroimaging, and biomarkers offers potential for clinical applications and may inform clinical trials. Preventing stroke and PSCID remains a cornerstone of any strategy to achieve optimal brain health. We summarize recent developments in the field and discuss future directions closing with a call for action to systematically include cognitive outcome assessment into any clinical studies of poststroke outcome.
Background:
Best practice in dementia care is support in the home. Yet, crisis is common and can result in hospital admission. Home-treatment of crisis is an alternative to hospital admission that ...can have better outcomes and is the preference of people living with dementia.
Purpose:
To report an investigation of the management of crisis for people with dementia living at home and managed by a Home Treatment Crisis Team.
Objective:
To identify critical factors for successful resolution of crisis and avoidance of hospital admission
Methods:
The research was mixed-methods case study design. It was an in depth investigation of what happens during crisis in people with dementia and how it is managed by a home treatment crisis team to resolution and outcome at six weeks and six months. Methods were observation of the management of crisis in the home setting for 15 people with dementia (max 3 per person, total 41 observations), interviews with people with dementia (n=5), carers (n=13), and 14 professionals (range 1 to 6 per person, total 29), a focus group with professionals (n=9) and extraction from medical records of demographics and medical history.
The analysis focused on the identification of key treatments, behaviours, education and context important for home treatment to prevent hospital admission.
Findings:
The study recruited 15 of the 88 accepted referrals to the service for management of a crisis in a person with dementia.
Factors key for crisis resolution were
a systems approach with embedded respect for personhood,
attention to carer needs independently of the person with dementia,
review and monitoring of the effect of medications,
awareness and promotion of potential benefits with treatment at home,
education of the health and social care workforce in dementia care,
local availability of respite and other social care services.
The Home Treatment Crisis Team created a ‘Safe Dementia Space’ for the person with dementia in crisis. In the first instance, this was immediate but temporary with on-going assessment and intervention until negotiated permanent support was in place coproduced and agreed by stakeholders to be a sustainable dementia space with acceptable risk of harm to the person with dementia or others. The approach enabled avoidance of hospital admission in more than 80% of referrals.
Conclusion:
This is the first study to collect data during crisis at home for people with dementia and to investigate process and management. It reveals the Home Treatment Crisis Team created sustainable ‘Safe Dementia Space’ to enable the person with dementia to continue to live in the community during and after crisis, thus avoiding hospital admission. The identified key components of the management approach for crisis resolution are important considerations in the design and delivery of home treatment services for people with dementia in the UK and beyond.
Introduction:
Research into the experiences of those with a diagnosis of young onset dementia is extremely limited and the research that does exist tends to be loss orientated.
Aim:
This paper will ...focus on a doctoral study which aimed to explore the full spectrum of lived experience of those with young onset dementia, whilst considering the unique impact of diagnosis at a younger age and the possibility of personal growth.
Methods:
Five individuals took part in semi-structured interviews within which they were invited to bring along artefacts that helped them to share their experiences. Transcribed interviews were analysed using Interpretative Phenomenological Analysis and superordinate and subordinate themes were identified.
Findings:
Four superordinate themes emerged: ‘Fear’, ‘Anger’, ‘Sadness’, ‘Contentment’ with thirteen subordinate themes. The findings indicated that participants experienced feelings of fear and vulnerability in response to their diagnosis. Participants felt angry that they did not have a voice, not enough was being done for those with dementia and they were being stereotyped. Participants spoke of a depressive state of mind in which they grieved for their past self, experienced isolation and loneliness, and feelings of hopelessness and despair. Finally, participants spoke of a sense of contentment in relation to a preserved self, a sense of living alongside their dementia and a desire to live in the present; making the most of the here and now.
Conclusions:
The findings highlight the transitory nature of participants’ experiences as a result of multiple and repeated challenges to psychological equanimity. It suggested that these experiences could best be understood using lenses of lifespan development, bereavement and grief. The findings suggest that approaches to dementia care that focus on developing present-mindedness, acceptance and compassion may be particularly helpful.
Background:
Best practice in dementia care is support in the home. Yet, crisis is common and can result in hospital admission. Home-treatment of crisis is an alternative to hospital admission that ...can have better outcomes and is the preference of people living with dementia.
Purpose:
To report an investigation of the management of crisis for people with dementia living at home and managed by a Home Treatment Crisis Team.
Objective:
To identify critical factors for successful resolution of crisis and avoidance of hospital admission
Methods:
The research was mixed-methods case study design. It was an in depth investigation of what happens during crisis in people with dementia and how it is managed by a home treatment crisis team to resolution and outcome at six weeks and six months. Methods were observation of the management of crisis in the home setting for 15 people with dementia (max 3 per person, total 41 observations), interviews with people with dementia (n=5), carers (n=13), and 14 professionals (range 1 to 6 per person, total 29), a focus group with professionals (n=9) and extraction from medical records of demographics and medical history.
The analysis focused on the identification of key treatments, behaviours, education and context important for home treatment to prevent hospital admission.
Findings:
The study recruited 15 of the 88 accepted referrals to the service for management of a crisis in a person with dementia.
The seven key factors key for crisis resolution were
a systems approach with embedded respect for personhood,
attention to carer needs independently of the person with dementia,
review and monitoring of the effect of medications,
awareness and promotion of potential benefits with treatment at home,
education of the health and social care workforce in dementia care,
local availability of respite and other social care services.
a dynamic and flexible working ethos and meaningful MDT working with flattened hierarchy
The Home Treatment Crisis Team created a ‘Safe Dementia Space’ for the person with dementia in crisis. In the first instance, this was immediate but temporary with on-going assessment and intervention until negotiated permanent support was in place coproduced and agreed by stakeholders to be a sustainable dementia space with acceptable risk of harm to the person with dementia or others. The approach enabled avoidance of hospital admission in more than 80% of referrals.
Conclusion:
This is the first study to collect data during crisis at home for people with dementia and to investigate process and management. It reveals the Home Treatment Crisis Team created sustainable ‘Safe Dementia Space’ to enable the person with dementia to continue to live in the community during and after crisis, thus avoiding hospital admission. The identified key components of the management approach for crisis resolution are important considerations in the design and delivery of home treatment services for people with dementia in the UK and beyond.
General introduction
Dementia is a global health problem with increasing numbers of people with dementia, especially in low and middle-income countries. Over the past decade, research and policy have ...been gradually expanding their view on lowering the burden of dementia by exploring the possibilities for dementia risk reduction strategies targeting modifiable risk factors. In this symposium, four speakers will present on new insights in dementia prevention from epidemiological research, randomized controlled trials and innovative implementation projects in primary and secondary care.
Social and cognitive activity as resilience factors for dementia
Sebastian Köhler
1
(presenting author), Dorina Cadar
2
, Daisy Fancourt
2
, Kay Deckers
1
, Andrew Steptoe
2
1
Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
2
Department of Behavioural Science and Health, University College London, London, UK
As life expectancy increases in India, the number of people living with dementia will also rise. Yet little is known about how people in India cope with dementia, how relationships and identities ...change through illness and loss.
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