Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 9 of 9
Personality changes in Alzheimer's disease: a systematic review
- Authors:
- WAHLIN Tarja-Brita Robins, BYRNE Gerald J.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 26(10), October 2011, pp.1019-1029.
- Publisher:
- Wiley
People with Alzheimer's disease (AD) commonly exhibit changes in personality that sometimes precedes other early clinical manifestations such as cognitive impairment and mood changes. Early identification of personality change might therefore assist with diagnosis of AD. The objective of this paper is to provide a systematic review of the literature to examine the nature and extent of change in personality in people with AD. Systematic searches of 5 databases to November 2009 were undertaken to identify studies of informant-rated personality traits in AD patients. Nine studies that mapped changes in traits from the 5-factor model of personality (neuroticism, extraversion, openness, agreeableness and conscientiousness) were selected for analysis. The change in each of these 5 traits was calculated as the mean difference in score before and after the diagnosis of AD. The findings showed a mean increase in neuroticism of 10–20 T scores, a decrease of the same magnitude in extraversion, consistently reduced openness and agreeableness, and a marked decrease in conscientiousness of about 20–30 T scores. These changes were systematic and consistent. The article concludes that conscientiousness and neuroticism are the personality traits that exhibit the most change in dementia, and that these traits might therefore be useful early markers of dementia.
Functional outcomes of drug treatment in Alzheimer’s disease: a systematic review and meta-analysis
- Authors:
- HANSEN Richard A., et al
- Journal article citation:
- Drugs and Aging, 24(2), 2007, pp.155-167.
- Publisher:
- Wolters Kulwer
Data from 14 randomised controlled trials comparing four drugs (donepezil, galantamine, rivastigmine and memantine) with placebo were meta-analysed to identify their impact on functional outcomes. The overall standardised effect size was small (d = 0.1-0.4) but consistently favoured drug treatment over placebo and was consistent in short (less than 24 weeks) and long (24 weeks or more) trials. Adverse side effects were generally limited to gastro-intestinal problems, weight loss and dizziness, all of which were reported in less than 20% of patients on average. Given the current lack of other effective treatments for Alzheimer’s disease, the authors conclude that their findings support the view that these drugs have clinical benefits with respect to functional outcomes.
Cognitive training in Alzheimer’s disease: a meta-analysis of the literature
- Authors:
- SITZER D.I., TWAMLEY E.W., JESTE C.V.
- Journal article citation:
- Acta Psychiatrica Scandinavica, 114(2), August 2006, pp.75-90.
- Publisher:
- Blackwell Publishing
Effect sizes (Cohen’s d) were calculated for 19 controlled studies, and an overall effect size of 0.47 was observed for all cognitive training (CT) strategies across all measured outcomes. Mean effect sizes were higher for restorative strategies (designed to return functioning in specific domains to pre-disease levels) than for compensatory strategies (to teach new ways of performing tasks by ‘working round’ the cognitive deficit). Primarily medium effect sizes were observed for learning, memory, executive functioning, activities of daily living, general cognitive problems and self-rated general functioning. Several limitations of the published literature are discussed, including small sample sizes and the fact that most studies combine multiple treatment strategies, making it difficult to evaluate the efficacy of individual components.
Support for family carers for an elderly person at home: a systematic literature review
- Authors:
- STOLTZ Peter, UDDEN Giggi, WILLMAN Ania
- Journal article citation:
- Scandinavian Journal of Caring Sciences, 18(2), June 2004, pp.111-119.
- Publisher:
- Blackwell Publishing
Sweden, like other countries, has an ageing population, and support for the carers of older people in their own homes is an important policy issue. Support may take a variety of forms, both formal and informal, and this review aims to identify and synthesise high quality evidence on family carers’ perspectives of their situations and needs. Twenty-six papers (primarily American and of carers of people with Alzheimer’s disease) are included in the review, showing that carers fear social isolation and want to network with their peers, either for social or learning purposes. They also want respite care. However, the evidence is not clear on whether they actually benefit from these forms of support, or how service provision should be attempted.
Family-centeredness in dementia care: what is the evidence?
- Authors:
- HAO Zhichao, RUGGIANO Nicole
- Journal article citation:
- Social Work in Health Care, 59(1), 2020, pp.1-19.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Over the last decade, person-centered practices in care for adults with Alzheimer’s disease and related dementias (AD/RD) has received significant attention from the health care and social service literature, though less attention has been paid to family-centered care (FCC). Initially conceptualized for application in pediatric care, FCC is an approach where clinicians develop partnerships with care recipients’ family members and views family members as having expertise to contribute to the clinical team. More recently, FCC has been extended to the literature on AD/RD care, though little is known about the extent to which family-centered interventions have been developed for use in AD/RD clinical practice, or the effectiveness of family-centered care for this population. To contribute to gaps in scholarship, this systematic review identified and evaluated intervention studies examining FCC in AD/RD clinical care. Implications for research and practice are discussed. (Edited publisher abstract)
Hospital readmission in persons with dementia: a systematic review
- Authors:
- MA Chenjuan, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 34(8), 2019, pp.1170-1184.
- Publisher:
- Wiley
Objective: Hospital readmission in persons with dementia is becoming a critical safety and cost issue. The purpose of this review is to systematically assess published evidence on hospital readmissions in persons with dementia, including rate, clinical reasons, risk factors, and prevention programs. Methods: A systematic review of relevant literature was conducted. Literature were searched in PubMed, CINAHL, PsycINFO, and Embase as well as hand searching. Quality of reviewed studies were assessed independently by reviewers using quality assessment checklists. Results: Nineteen studies met the inclusion criteria and were reviewed. In persons with dementia, all‐cause 30‐day readmission rate was most frequently reported and ranged from 7% to 35%. Compared with those without dementia, persons with dementia had significantly higher rate of readmission. Reported risk factors of readmission varied across studies from patient sociodemographic and clinical status, history of health care utilization, to family caregivers. Reasons for readmission were rarely documented. Programs of home‐based individualized care and interdisciplinary team care were used for preventing readmissions. Findings from some of the studies were limited by small sample sizes, single data source, and other methodologic flaws. Conclusions: Persons with dementia are at high risk for hospital readmission, but many of the readmissions are potentially preventable. Multiple strategies such like identifying high‐risk individuals and the clinical reasons for index admission and readmission and implementing home‐based individualized care by interdisciplinary team can reduce preventable hospital readmissions. Future studies should use multiple national data sources and advanced methodology to identify risk factors and clinical reasons of hospital readmissions. (Edited publisher abstract)
Acceptance and use of innovative assistive technologies among people with cognitive impairment and their caregivers: a systematic review
- Authors:
- THORDARDOTTIR Bjorg, et al
- Journal article citation:
- BioMed Research International, 2019, Online only
- Publisher:
- Hindawi Publishing Corporation
Cognitive impairments (CI), associated with the consequences of Alzheimer’s disease and other dementias, are increasingly prevalent among older adults, leading to deterioration in self-care, mobility, and interpersonal relationships among them. Innovative Assistive Technologies (IAT) such as electronic reminders and surveillance systems are considered as increasingly important tools to facilitate independence among this population and their caregivers. The aim of this study is to synthesise knowledge on facilitators and barriers related to acceptance of and use of IAT among people with CI and their caregivers. This systematic review includes original papers with quantitative, qualitative, or mixed methods design. Relevant peer-reviewed articles published in English between 2007 and 2017 were retrieved in the following databases: CINAHL; PubMed; Inspec; and PsycINFO. The Mixed Method Appraisal Tool (MMAT) was used for quality assessment. We retrieved thirty studies, including in total 1655 participants from Europe, USA/Canada, Australia, and Asia, enrolled in their homes, care-residences, day-care centres, or Living Labs. Two-thirds of the studies tested technologies integrating home sensors and wearable devices for care and monitoring CI symptoms. Main facilitators for acceptance and adherence to IAT were familiarity with and motivation to use technologies, immediate perception of effectiveness (e.g., increase in safety perceptions), and low technical demands. Barriers identified included older age, low maturity of the IAT, little experience with technologies in general, lack of personalization, and support. More than 2/3 of the studies met 80% of the quality criteria of the MMAT. Low acceptance and use of IAT both independently and with caregivers remains a significant concern. More knowledge on facilitators and barriers to use of IAT among clients of health care and social services is crucial for the successful implementation of innovative programmes aiming to leverage innovative technologies for the independence of older people with CI. (Edited publisher abstract)
Alzheimers’ disease and caregiving: a meta-analytic review comparing the mental health of primary carers to controls
- Authors:
- MA Mandy, et al
- Journal article citation:
- Aging and Mental Health, 22(11), 2018, pp.1395-1405.
- Publisher:
- Taylor and Francis
Objectives: To quantitatively review the literature comparing depressed mood, anxiety and psychological distress in caregivers (CGs) of older adults with Alzheimer's disease (AD) with non-caregivers (NCGs) Methods: Eighteen independent studies comparing AD CGs (N = 2378) with NCGs (N = 70,035) were evaluated in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Standardised mean differences (Hedges’ g) with associated 95% confidence intervals and p-values were calculated using a random-effects model. Results: Studies generally conformed to STROBE criteria in terms of their methodological and procedural detail, although data management issues that may contribute to methodological bias were identified. Pooled effect estimates revealed medium to large group differences in depression (gw = 1.01 [CI: 0.73, 1.29] p < 0.01) and anxiety (gw = 0.64 [CI: 0.39, 0.89] p < 0.01): AD caregivers reported higher symptom severity. Gender was a significant moderator: female caregivers experienced poor self-reported mood (gw = 1.58 [CI: 1.11, 2.05], p< 0.01), although this analysis was limited in power given the small number of contributing studies. Discussion: Caregivers of patients with AD experience poor mental health in comparison to the general population, with female caregivers being disproportionately affected. Further exploration of the psychosocial variables that contribute to these group differences is needed to inform effective support services and, in turn, help caregivers manage the emotional demands of AD. (Edited publisher abstract)
Reality orientation for dementia: a systematic review of the evidence of effectiveness from randomised controlled trials
- Authors:
- SPECTOR Aimee, et al
- Journal article citation:
- Gerontologist, 40(2), April 2000, pp.206-212.
- Publisher:
- Oxford University Press
The effectiveness of classroom reality orientation (RO) in dementia was evaluated by conducting a systematic literature review. The evidence indicates that RO has benefits on both cognition and behaviour for dementia sufferers. However, a continued programme may be needed to sustain potential benefits. Future research should evaluate RO in well-designed multicentre trials.