Search results for ‘Subject term:"alzheimers disease"’ Sort:
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Alzheimer's aggression: influences on caregiver coping and resilience
- Authors:
- WILKS Scott E., et al
- Journal article citation:
- Journal of Gerontological Social Work, 54(3), April 2011, pp.260-275.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The presence of aggression in Alzheimer’s patients is fairly common. Aggressive behaviour can be physical or verbal, and includes biting, spitting, destruction of property, threatening the caregiver or others verbally or physically, and being uncooperative. This study aimed to assess the impact of Alzheimer's aggression on caregiver coping strategies and caregiver resilience, and to investigate whether specific coping strategies moderate the relationship between aggression and caregiver resilience. A self-administered survey was completed by 700 informal caregivers of Alzheimer’s patients across Louisiana. Analysis was done of the 419 responses which reported some aggression. The findings showed that task-focused coping positively related to resilience. Aggression negatively predicted caregiver resilience. Emotion- and avoidance-focused coping strategies separately interacted with aggression and increased its negative relationship to caregiver resilience. Task-focused coping showed no moderation. The results suggest that task-focused skills training programmes may improve or protect caregiver mental health.
Relationship of psychosis to aggression, apathy and function in dementia
- Authors:
- RAPOPORT Mark J., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 16(2), February 2001, pp.123-130.
- Publisher:
- Wiley
Reports on a study to investigate the relationship between psychosis and aggression, apathy, and functional status in outpatients with dementia. The presence of psychosis was assessed by clinical interview and two different scales. Aggression, apathy, and functional status (activities of daily living) were measured using structured instruments. Relationships were found between psychotic symptoms in dementia and aggression as well as apathy and impaired functional status. These relationships suggest pathophysiologic mechanisms and have possible treatment implications.
Clinical predictors of aggressive behaviour in Alzheimer's Disease
- Authors:
- GORMLEY Niall, RIZWAN M.R., LOVESTONE Simon
- Journal article citation:
- International Journal of Geriatric Psychiatry, 13(2), February 1998, pp.109-115.
- Publisher:
- Wiley
Examines the level and clinical correlates of aggressive behaviour in Alzheimer's Disease. Seventy patients were rated using validated assessment instruments including the Rating Scale for Aggressive Behaviour in the Elderly (RAGE). Concludes that aggressive behaviour occurs frequently in patients with Alzheimer's Disease. Results confirm the findings of previous studies that the presence of delusions increase the risk of aggression in this population.
Agitation-associated behavioral symptoms in mild cognitive impairment and Alzheimer's dementia
- Authors:
- VAN DER MUSSELE Stefan, et al
- Journal article citation:
- Aging and Mental Health, 19(3), 2015, pp.247-257.
- Publisher:
- Taylor and Francis
Objectives: The aim of this study is to determine the prevalence of agitation in mild cognitive impairment (MCI, Petersen's criteria) and patients with Alzheimer's dementia (AD), and to characterise the associated behavioural symptoms. Method: A cross-sectional analysis of baseline data from a prospective, longitudinal study on behavioral symptoms was performed, including 268 MCI and 393 AD patients. Behavioural assessment was performed through Middelheim Frontality Score (MFS), Behavioural Pathology in Alzheimer's Disease Rating Scale (Behave-AD) and Cornell Scale for Depression in Dementia (CSDD). Agitated behaviour was considered to be clinically relevant when one or more items of the Cohen-Mansfield Agitation Inventory (CMAI) occurred at least once a week. Results: The prevalence of agitation in AD (76%) was higher than in MCI (60%). Patients with agitation showed more severe frontal lobe, behavioural and depressive symptoms (MFS, Behave-AD and CSDD total scores). In agitated AD patients, all behavioural symptoms and types of agitation were more severe compared to non-agitated AD patients, but in agitated MCI patients only for diurnal rhythm disturbances. This resulted in more severe Behave-AD global scores in patients with agitation as compared to patients without agitation. Comparing MCI and AD patients, MCI patients with agitation showed more severe behavioral and depressive symptoms than AD patients without agitation. The structure of agitation in AD consisted of more aggressive and physically non-aggressive behavior than in MCI. Conclusion: Frontal lobe, behavioural and depressive symptoms are more severe in MCI and AD patients with clinically relevant agitation as compared to patients without agitation. However, this association is less pronounced in MCI. (Edited publisher abstract)
An overview of the use of music therapy in the context of Alzheimer's disease: a report of a French expert group
- Authors:
- GUETIN Stéphane, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 12(5), 2013, pp.619-634.
- Publisher:
- Sage
This overview presents an international review of the literature on music therapy in the context of Alzheimer's disease. Experts in music therapy and psychosocial techniques then considered the different points highlighted in the review of literature. Clinical and neurophysiological studies have enlightened some positive benefits of music in providing support for people with Alzheimer's disease or related disorders. Music therapy acts mainly through emotional and psycho-physiological pathways. It includes a series of techniques that can respond to targeted therapeutic objectives. Some studies have shown that music therapy reduces anxiety, alleviates periods of depression and aggressive behaviour and thus significantly improves mood, communication, emotional and social skills and autonomy of patients. (Edited publisher abstract)
Understanding challenging behaviours in dementia
- Authors:
- MCEVOY Jonathan, (Director), MILLBROOK STUDIOS, (Producer)
- Publisher:
- Dementia Services Information and Development Centre
- Publication year:
- 2005
- Pagination:
- (26 mins), DVD
- Place of publication:
- Dublin
This video explores in different behaviours such as wandering, repetitive questioning and agitation/aggression - the type of behaviours we know can cause caregivers strain and which not infrequently result in people with a dementia being admitted to long term care. In this second video, a conceptual model is provided which may be useful to help practitioners and family caregivers better understand the root cause of these behaviours. Through the clever use of vignettes, different strategies to help address some of these challenging behaviours are demonstrated. The point is made that whilst the interventions covered in the programme may not work in every case, knowing the person and his or her life story is critical to best practice in dementia care and to combating challenging behaviours and that drugs should only ever be considered when all other interventions and options are exhausted.
Childhood conduct problems, stages of Alzheimer's disease, and physical aggression against caregivers
- Authors:
- O'LEARY Daniel, JYRINGI Darlene, SEDLER Mark
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(5), May 2005, pp.401-405.
- Publisher:
- Wiley
One hundred and ninety-eight individuals with dementia, primarily Alzheimer's disease (AD) were evaluated with the Cohen-Mansfield Agitation Inventory, the Mini Mental Status Examination, two measures of Activities of Daily Living, portions of the Conflict Tactics Scale to measure physical aggression against partner, questions about conduct problems during childhood/adolescence of the patients, and chart records of delusion and paranoia. 25% of the patients engaged in physical aggression against their caregivers in the past year, and 33% of the patients engaged in some act of physical aggression against any individual in the past two weeks. Physical aggression against a caregiver was more likely in the middle (34%) than the early stage of AD (4%). Physical aggression against a partner and agitation were more likely if the patient had a history of symptoms of conduct disorder. Delusions and paranoia were both associated with general physical aggression and general verbal aggression but not physical aggression against a caretaker. 25% of Alzheimer's disease and Multi-Infarct dementia patients engaged in acts of physical aggression against their caregivers. The rate of aggression seen in this clinical sample was much higher than the rate of physical aggression in a community sample of the elderly.
Effects of memantine on behavioural symptoms in Alzheimer's disease patients: an analysis of the Neuropsychiatric Inventory (NPI) data of two randomised, controlled studies
- Authors:
- GAUTHIER S., WIRTH Y., MOBIUS H. J.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(5), May 2005, pp.459-464.
- Publisher:
- Wiley
Behavioural symptoms are common in moderate to severe Alzheimer's disease (AD). We have analysed the databases of two randomised studies with regard to the effects of memantine treatment on behavioural symptoms, measured using the 12-item version of the Neuropsychiatric Inventory (NPI). The monotherapy study (memantine only) reported by Reisberg et al. (2003) involved 252 patients with baseline MMSE total score of between 3 and 14, whereas the combination study (memantine and donepezil) reported by Tariot et al. (2004) comprised 404 patients with MMSE scores of between 5 and 14. In both studies, patients received 10 mg memantine b.i.d. or matching placebo, and lived in the community. For both studies NPI total and individual domains scores were analysed in the ITT population. For the monotherapy study a dichotomised analysis was performed separately for patients who had behavioural symptoms at baseline and for those without pre-existing symptoms. Furthermore, a factor analysis was used to identify any behavioural clusters within the patient population. In both studies, the change in NPI total scores at endpoint was consistently in favour of memantine treatment, reaching statistical significance in the combination study (p = 0.002). Memantine treatment showed a significant beneficial effect in comparison to placebo treatment in the NPI agitation/aggression domain in both studies (p = 0.008; p = 0.001). The dichotomised analysis of the monotherapy study showed that there was significantly less agitation/aggression emerging in the memantine-treated group compared to placebo (p = 0.003). Factor analysis showed that hyperactivity accounted for 27% of the data variance. Memantine has a beneficial effect on the behavioural symptoms of patients with moderate to severe AD, with the most pronounced effect on agitation/aggression.
Fastest fight/flight reaction via amygdalar visual pathway implicates simple face drawing as its marker: neuroscientific data consistent with neuropsychological findings
- Author:
- PONTIUS Anneliese A.
- Journal article citation:
- Aggression and Violent Behavior, 10(3), March 2005, pp.363-373.
- Publisher:
- Elsevier
Prompt unthinking violence requires fast visual processing, apparently reflected in specifically coarse neuropsychological visuospatial test performances by fear-ridden, warring hunter–gatherer tribespeople. Given that such tribes' survival depended on immediate reaction to quickly, albeit crudely evaluated visual stimuli, amygdalar visual processing was implicated, by-passing detailed cortical parieto–occipital evaluation. Independently, such amygdalar shortcut processing is now also being proposed by new neuroscientific data (fMRI, ERPS) under the impact of fear and in parieto–occipital dysfunctions. These data include representation of crude "blurred faces" analogous to the coarse "Neolithic face" (NF) patterns delineated by neuropsychological tests. Moreover, based on such congruencies between neuropsychological and neuroscientific findings, a common denominator of subcortical (amygdalar) visual processing is implicated to underlie various dysfunctions of the parieto–occipital cortex, including subforms of visuospatial dyslexia or preliterates' lack of training or ecocultural underuse of refined visual cortical evaluation. Such kinds of low or absent literacy skills reportedly also have an enhanced rate of aggressive behavior. Furthermore, NF is suggested as a triage-like marker for subtle parieto–occipital dysfunction that may also occur in early stages of Alzheimer's disease (with some reported aggressivity), possibly also early in HIV infection.
Aggressive behaviors between residents with dementia in an assisted living residence
- Author:
- CASPI Eilon
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 14(4), 2015, pp.528-546.
- Publisher:
- Sage
This study examines the circumstances, sequence of events, and triggers that lead to aggressive behaviour between residents with dementia in long-term care residences. Data were collected during 10 months in two special care units of an assisted living residence. Participant observation was used as the primary data collection strategy, complemented by review of clinical records and semi-structured interviews with care staff and managers. Grounded Theory informed by Miles and Huberman’s approach was used as the analytic framework. In a substantial number of the reported 85 incidents, observable early warning signs were identified. In the majority of cases observable causes or triggers prior to the aggressive acts were identified. The majority of incidents were situational-reactive (circumstance-driven) and therefore potentially modifiable. Twelve effective staff prevention strategies were identified. It is suggested that the study findings could be incorporated into care staff training programs. (Edited publisher abstract)