Search results for ‘Subject term:"alzheimers disease"’ Sort:
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Change in direct measures of physical performance among persons with Alzheimer's disease
- Authors:
- HEBERT Liesi E., et al
- Journal article citation:
- Aging and Mental Health, 12(6), November 2008, pp.729-734.
- Publisher:
- Taylor and Francis
Measures of physical performance were used in intact and community populations. The authors examined upper and lower extremity physical performance tests among people with Alzheimer's disease. A total of 367 persons with probable Alzheimer's disease, recruited from an Alzheimer's disease diagnostic centre in the United States, were given three tests of lower extremity function and two tests of upper extremity function at 6 month intervals for up to 4 years. Gender, race, age and Mini-Mental State Examination (MMSE) score at baseline were used to predict subsequent decline in composite scores of lower and upper extremity function. At baseline, older age and lower MMSE scores were associated with lower scores on both lower and upper extremity function. Males performed better at baseline on lower extremity tests only. For each point higher on MMSE, a person declined 0.023 Standard Unit (SU) less per year (p = 0.0001) on lower extremity tests and declined 0.019 SU less per year (p < 0.0001) on upper extremity tests. Physical performance was measured across a range of disease severities and declined over time. Lower cognitive score at baseline predicted faster decline in both lower and upper extremity function. Demographic heterogeneity in decline suggests other predictors may identify factors protective against physical decline.
Utility of the Algase Wandering Scale in an outpatient Alzheimer's disease sample
- Authors:
- MARCUS Jacqueline F., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(8), August 2007, pp.801-805.
- Publisher:
- Wiley
Wandering represents a major problem in the management of patients with Alzheimer's disease (AD). This American study examined the utility of the Algase Wandering Scale (AWS), a newly developed psychometric instrument that asks caregivers to assess the likelihood of wandering behaviour. The AWS was administered to the caregivers of 40 AD patients and total and subscale scores were examined in relation to measures of mental and functional status, depressive symptoms and medication usage. AWS scores were comparable, though slightly lower, than those normative values previously published. Higher scores were associated with more severe dementia. The Negative Outcome subscale showed a significant increase in reported falls or injuries in association with anti-depressant use. These data provide some construct validation for the AWS as a potentially useful scale to assess wandering behaviours in AD.
Family physicians' perceptions and predictors regarding the competence of a person with Alzheimer's disease
- Author:
- WERNER Perla
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(4), April 2007, pp.320-326.
- Publisher:
- Wiley
The aim of the present study was to assess family physicians' perceptions about the competence of a person with AD. Telephone interviews were conducted with a representative sample of 395 family physicians who were members of the Israeli Medical Association using an experimental vignette methodology, varying in the severity of the disease. Participants were requested to rate the competence of the person described in the vignette in the areas of driving, health-decision making, financial decisions, and the performance of instrumental activities of daily living. Results of the study showed that family physicians perceived the person described in the vignette to be highly incompetent in items involving safety issues. Only a small variety of factors were associated with these perceptions. The main factors were the severity of the disease as reflected in the vignette, participants' perceptions regarding the dangerousness and responsibility of the person with AD, and the percentage of patients aged 65 and over with cognitive deterioration in the physician's practice. The assessment of competence in persons with AD is a subtle and complex process. Future research is urgently needed to further explore the factors affecting the process, such as stigmatic views.
Use of cognitive assessment with Alzheimer's disease
- Author:
- BUSH Tony
- Journal article citation:
- Nursing Times, 9.1.07, 2007, pp.31-32.
- Publisher:
- Nursing Times
This article discusses the rationale for cognitive assessment and the use of the most widely accepted rating scale with Alzheimer's disease. It assesses the process of administering cognitive assessment in a patient-focused way and summarises best practice in cognitive testing.
A prospective, longitudinal study of functional decline in individuals with Down's Syndrome
- Authors:
- McKENZIE K., et al
- Journal article citation:
- Journal of Learning Disabilities for Nursing Health and Social Care, 2(2), June 1998, pp.98-104.
This article used a standardised criteria for diagnosing Alzheimer's Disease in individuals with learning disabilities to undertake a prospective, longitudinal study of 22 individuals with Down's Syndrome. Results show that, after a period of up to 6 years, four individuals showed functional decline. A similar pattern of decline was found to that described in previous studies, although the mean age of onset was later. All four subjects met the criteria for probable Alzheimer's Disease.
Perceptions of depression among dementia caregivers: findings from the CATIE-AD trial
- Authors:
- WATSON Lea C., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 26(4), April 2011, pp.397-402.
- Publisher:
- Wiley
Estimates of the co-occurrence of Alzheimer's disease and depression range from 15-40%. This study assessed patient and caregiver accuracy in recognising patient depression in Alzheimer's disease complicated by behavioural disturbances using single questions. Three single-item yes/no questions were used. Patients were asked ‘Do you believe you are depressed?’ Caregivers were asked ‘Do you believe the patient is depressed?’ and ‘Do you believe you (caregiver) are depressed?’ Responses were compared to the patient's score on the Cornell Scale for Depression in Dementia (CSDD), and to the caregiver's score on the Beck Depression Inventory (BDI). A total of 257 American patient/caregiver pairs were evaluated (patients, mean age 78 years, mainly female, white, mean MMSE 15; caregivers average 63 years, mostly spouses or children). Overall 37% of patients had depression and they recognised their own depression with a sensitivity of 0.26 and specificity of 0.85. Caregivers' accuracy in recognising depression in the patient revealed a sensitivity of 0.65 and specificity of 0.58. Depression was present in 12% of caregivers and caregiver burden was associated with patient depression. The authors conclude that clinically significant depression was common and asking the patient a single question about depression failed to detect most cases. Caregivers identified two-thirds of patient depression when asked this one question.
The Alzheimer's Disease Knowledge Scale: development and psychometric properties
- Authors:
- CARPENTER Brian D., et al
- Journal article citation:
- Gerontologist, 49(2), April 2009, pp.236-247.
- Publisher:
- Oxford University Press
This study provides preliminary evidence for the acceptability, reliability, and validity of the new Alzheimer's Disease Knowledge Scale (ADKS), a content and psychometric update to the Alzheimer's Disease Knowledge Test. Traditional scale development methods were used to generate items and evaluate their psychometric properties in a variety of subsamples. The final 30-item, true/false scale takes approximately 5–10 min to complete and covers risk factors, assessment and diagnosis, symptoms, course, life impact, caregiving, and treatment and management. Preliminary results suggest that the ADKS has adequate reliability (test–retest and internal consistency) and validity (content, predictive, concurrent, and convergent). The ADKS is designed for use in both applied and research contexts, capable of assessing knowledge about Alzheimer's disease among laypeople, patients, caregivers, and professionals.
How can we best assess the quality of life of people with dementia? The Bath Assessment of Subjective Quality of Life in Dementia (BASQID)
- Authors:
- TRIGG Richard, SKEVINGTON Suzanne M., JONES Roy W.
- Journal article citation:
- Gerontologist, 47(6), December 2007, pp.789-797.
- Publisher:
- Oxford University Press
The study aim was to develop a measure of self-reported quality of life (QoL) for people with mild to moderate dementia based on their views - the Bath Assessment of Subjective Quality of Life in Dementia (BASQID). The measure was developed through multiple stages. Two field tests of the measure (ns = 60 and 150) enrolled people with dementia from a memory clinic, and the data was used to analyze the psychometric properties of the scale. Nested within this was a longitudinal investigation of 36 Alzheimer's disease patients prescribed with acetylcholinesterase inhibitors. The BASQID contains 14 items assessing a range of QoL issues. Results showed that the BASQID satisfies the criteria of a valid, reliable, and acceptable assessment of subjective QoL. Scores were responsive to changes in QoL over 3 months. Low association between the BASQID and the Mini-Mental State Examination indicates that cognitive function may influence QoL but is an indirect measure of the QoL experienced during dementia. The BASQID provides a means of better understanding the experiences, perceptions, and beliefs of people with dementia. It does this through acknowledgement of the many influences on QoL over and above health status. Practitioners and researchers can use the BASQID alongside objective assessments of dementia to obtain a complete appraisal of a person's QoL.
Differences in depression symptoms in patients with Alzheimer's and Parkinson's diseases: evidence from the 15-item Geriatric Depression Scale
- Authors:
- WEINTRAUB Daniel, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(10), October 2007, pp.1025-1030.
- Publisher:
- Wiley
Depression occurs frequently in patients with both Alzheimer's disease (AD) and Parkinson's disease (PD), but there has been little comparison of depression symptoms in the two populations. The 15-item Geriatric Depression Scale (GDS-15) was administered as a depression screening instrument to 232 AD patients and 266 PD specialty care patients with at most mild dementia. Logistic regression models were used to determine disease-specific associations with individual GDS-15 items, and factor analysis was used to assess GDS-15 factor structure in the two populations. Controlling for total GDS-15 score and other covariates, AD patients reported more dissatisfaction with life (p = 0.03) and memory problems (p < 0.001), while PD patients reported more fearfulness (p = 0.01), helplessness (p < 0.01), a preference to stay at home (p = 0.02), and diminished energy (p < 0.01). Three factors were generated in PD (explaining 55% of the total variance) and five in AD (explaining 59% of the total variance), and the two main factors generated in both populations related primarily to unhappiness and negative thoughts. The factor structure of the GDS-15 is similar in AD and PD patients with at most mild stage dementia, but between-group differences on 6 of the GDS-15 items suggests the non-specificity of certain items in the two populations.
Self- and proxy reports across three populations: older adults, persons with Alzheimer's Disease, and persons with intellectual disabilities
- Author:
- PERKINS Elizabeth A.
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 4(1), March 2007, pp.1-10.
- Publisher:
- Wiley
Self-reports are often used to determine general well-being in both research studies and practice settings. Proxy reports are also used to gain insight into the well-being of persons with physical ill-heath, cognitive impairments, or disabilities. The author reviews the utility and limitations of using self- and proxy reports across three populations: older adults, persons with Alzheimer's disease (AD), and persons with intellectual disabilities (ID). For differing reasons, the use of self- and proxy reports often results in inaccuracies. Among older adults, the level of subjectivity in questions, type of relationship, and levels of carer burden may influence the outcomes, while increasing severity of dementia and decreased deficit awareness may affect data from persons with AD, and question formats, acquiescence, and level of intellectual development may affect data from persons with ID. However, generally, proxy reports can be useful in determining aspects of well-being in people with ID, in people with AD, and in the general older population, as long as researchers keep in mind that factors that can enhance (e.g., experiences/abilities that are more objectively assessed, and attention to question format) or diminish (e.g., experiences/abilities that are more subjectively assessed, severity of dementia, and level of ID) the quality of information obtained. With respect to the use of these techniques with people with ID, the author concludes that careful attention to survey items, especially response format and wording, can greatly enhance self-report completion and proxy concordance.