Abstract
In “Multisensory stimulation for people with dementia: a review of the literature,” Millán-Calenti et al note that multisensory stimulation in people with dementia is becoming increasingly popular. The aim of their review was to analyze the therapeutic effectiveness of multisensory stimulation in patients with dementia. They found the evidence that multisensory stimulation environments produce immediate positive effects on the behavior and mood in those with dementia. They believe it is a useful nonpharmacological intervention on neuropsychological symptoms. However, reliable protocols from the methodological point are needed to determine whether there are sustained effects.
In “Motor and multisensory care-based approach in dementia: long-term effects of a pilot study,” Marques et al examine the short-, mid-, and long-term effects of a motor and multisensory care-based approach on the behavior of institutionalized individuals with dementia and on care practices according to staff perspective. They used both motor and multisensory stimulation strategies during morning care. They found short-term improvement in communication and engagement in their patients. However, this was followed by a decline over time. They also noted difficulties related to their institutional organization. They conclude that multisensory care may be helpful; however, there is a need to implement long-term strategies and involve institutions at different organizational levels to sustain results.
Mowrey et al (Application of Behavior-Based Ergonomics Therapies to Improve Quality of Life and Reduce Medication Usage for Alzheimer’s/Dementia Residents) propose behavior-based ergonomics therapies as a viable nonpharmacological intervention to manage challenging behaviors and promote engagement among long-term care residents diagnosed with Alzheimer’s disease and other types of dementia. They evaluated the effect of behavior-based ergonomics therapies on quality of life and the need for behavioral medications in a dementia care unit at a not-for-profit continuing care retirement community. Comparing a target cohort during the 6-month pre-implementation period with the 6-month post-implementation period, their study indicates that behavior-based ergonomics therapies have a positive impact on quality of life and also correlate with behavioral medical reduction.
Wang et al review the aspects of frontotemporal dementia in progress in frontotemporal dementia research. They note that frontotemporal dementia is one of the most common subtypes of early onset dementia. Its typical symptoms include behavioral disorders, affective symptoms, and language disorders. Frontotemporal dementia is a genetically and pathologically heterogeneous degenerative disorder. Animal models have provided more insights into the pathogenic mechanisms. There are currently no medications that are specifically approved for the treatment of frontotemporal dementia by the Food and Drug Administration. In this article, we review the recent advances in the molecular pathogenesis, pathology, animal models, and therapy for frontotemporal dementia. Better understanding of the pathogenesis and the use of animal models will help develop novel therapeutic strategies and provide new targets for frontotemporal dementia treatment.
Armari et al (The needs of patients with early onset dementia) note that the burden of early onset dementia is often overshadowed by our large elderly population. They administered a questionnaire to assess needs. Early recognition and referral was the principle area of weakness noted by both patients and caregivers. Patients evaluated “diagnosis” as the area of most need compared to caregivers who rated “Treatment” as their principle concern. They concluded that the relative concerns of patients with early onset dementia differ from their caregivers.
Schoon et al (Hypotensive Syndromes Are Not Associated with Cognitive Impairment in Geriatric Patients.) investigate the association of orthostatic hypotension, postprandial hypotension, and carotid sinus hypersensitivity with cognitive impairment (mild cognitive impairment or dementia). In this retrospective cohort study, continuous measurements of blood pressure were performed while standing, meal testing, and during carotid sinus massage, among 184 older patients presenting with falls. Forty three percent of the patients were cognitively impaired (with either mild cognitive impairment or dementia). The prevalence of cognitive impairment was stable across the 3 hypotensive syndromes and was similar in patients with and without these hypotensive syndromes. They concluded that patients with one or more hypotensive syndromes were not more likely to have cognitive impairment than those without.
Alsadany et al (Histone deacetylases enzyme, copper, and IL-8 levels in Alzheimer’s disease patients) note that epigenetic modifications, oxidative stress, and inflammation play an important role in the pathogenesis of Alzheimer’s disease. They assessed peripheral biomarkers with a high degree of sensitivity and specificity in diagnosis and progression of Alzheimer’s disease including histone deacetylases, copper, and interleukin (IL)-8 levels. They found that histone deacetylases, copper, and IL-8 levels were higher in patients with Alzheimer’s disease than control cases, and they had a negative effect on all cognitive assessment tests. Histone deacetylases and copper levels had the highest sensitivity and specificity. They speculate that the latter 2 substances could potentially be useful as peripheral biomarkers in the diagnosis of Alzheimer’s disease, while IL-8 levels could be a useful biomarker in following disease progression.
Sevgi et al (Plasma viscosity: Is a biomarker for the differential diagnosis of Alzheimer’s disease and vascular dementia?) investigated the potential of plasma viscosity as a biomarker in differential diagnosis of dementia subtypes (Alzheimer’s disease and vascular dementia). The plasma viscosity level of the dementia group was higher than that of the control group. Patients with vascular dementia had higher plasma viscosity levels than patients with Alzheimer’s disease. Plasma viscosity may help in differentiating between Alzheimer’s disease and vascular dementia.
Yohko et al (Communicative competence in Alzheimer disease: metaphor and sarcasm comprehension) evaluate the deficits of metaphor and sarcasm comprehension in mild normal aging, cognitive impairment, and Alzheimer’s disease. Sarcasm comprehension, which requires second-order Theory of Mind, started to deteriorate in aged normal control cases, and metaphor comprehension, which requires first-order Theory of Mind, started to deteriorate in amnestic mild cognitive impairment. Both deteriorated as disease progressed. Literal interpretation of pragmatic language is characteristic of mild Alzheimer’s disease. These findings are important since misinterpretations could result in social miscommunication.
In “Potential Blood Biomarker for Disease Severity in the Taiwanese Population with Alzheimer’s Disease” Ching-Wen Huang et al compared serum/plasma levels of amyloid beta, tau, cytokines, and biometals between Alzheimer’s disease and non- Alzheimer’s disease groups. They found that serum zinc was lower in patients with Alzheimer’s disease. They found possible biomarkers for Alzheimer’s disease diagnosis and prognosis that adds to what is known in this population.
Gilligan et al (Health Disparities in Cost of Care in Patients with Alzheimer's Disease: An Analysis Across Four State Medicaid Populations) investigate health disparities with respect to cost across Medicaid populations with Alzheimer’s disease. Their primary outcome was cost. Decomposition of cost to calculate disparities was estimated using the Oaxaca-Blinder model. They found disparities between blacks and whites (with blacks having higher costs), whites and others (with whites having higher costs), blacks and Hispanics (with blacks having higher costs), blacks and others (with blacks having higher costs), and Hispanics and others (with Hispanics having higher costs). They conclude that the disparities in cost among minority-to-minority populations were just as prevalent, or greater, than minority-white disparities. Further research needs to be done to better understand the reasons for these trends.