Abstract
Godwin et al note that caregiving for a person with dementia can lead to physical and psychological morbidity. Technology-driven interventions hold the promise of convenient, low-cost methods of delivering psychosocial interventions. Their review examined the efficacy of technology-driven interventions for caregivers of persons with dementia. Almost all interventions had positive findings. However, there was variability in the content and delivery of interventions, inconsistency in measurement, and variability of outcomes. Future studies should employ randomized control trial methodology and measure outcomes with commonly used measures to ensure feasibility of comparisons across the studies.
In Learning to live with a loved one with Mild Cognitive Impairment: Effectiveness of a waiting-list controlled trial of a group intervention on significant others’ sense of competence and well-being, Joosten et al examine the efficacy of a comprehensive group program aimed at caregivers of patients with mild cognitive impairment. It includes psychoeducation, cognitive rehabilitation, and cognitive behavioral therapy. Quantitative analysis did not reveal differences between the control and the intervention condition, but qualitative results suggest that caregivers still reported gains in knowledge, insight, acceptance, and coping skills. Suggestions for program adjustments and alternative outcome measures are discussed.
Shanley et al (Qualitative research on dementia in ethnically diverse communities: fieldwork challenges and opportunities) note that Australia (like other ethnically diverse societies) needs to provide culturally appropriate health care. They wish to ensure that health services research adequately reflects the circumstances and needs for culturally and linguistically diverse communities within the populations. Their manuscript discusses the fieldwork phase of a qualitative research project on dementia caregiving in 4 culturally and linguistically diverse sites, with focus on some of the fieldwork issues that arose. They offered practical suggestions regarding the inclusion of culturally and linguistically diverse communities in research projects.
Hopkins and Kilik studied the Standardized Cognitive Assessment (a cognitive screening tool for health professionals who are not trained in cognitive assessment techniques). Specifically, they used the mini-Kingston Standardized Cognitive Assessment—Revised (a shortened version that can be given in less time and allows for quick follow-up or screening). They recommend it as a rapid in-office dementia screening for primary care physicians.
Spackman et al (The validity of dependence as a health outcome measure in Alzheimer disease) evaluated the association between dependence and functional impairment. Dependence was most strongly associated with physical functioning. A secondary analysis suggested a strong association of dependence with multiple impairments, as measured by the interaction terms, in more severe patients. Spackman et al concluded that dependence is associated with physical functioning, cognition, and behavior. Dependence might be a simple measure to explain the disease progression in Alzheimer’s disease.
In The Effects of Social Support and Having a Partner on Sleep Quality in Dementia, Ataollahi Eshkoor et al examined the effects of social support and having a partner on sleep quality in the elderly patient with dementia. They concluded that social isolation (and being single) increased sleep disruption among respondents. Having a partner decreased the rate of sleep problems.
In Cognitive Insight in Alzheimer’s disease, Degirmenci et al investigated the cognitive insight profile of patients with Alzheimer’s disease using the Beck Cognitive Insight Scale. Mean scores of the subscales were significantly different between Alzheimer’s disease and control groups. More studies on cognitive insight are needed to improve patient safety and quality of life.
Chin et al (Utility of the AD8 as a Self-Rating Tool for Cognitive Impairment in an Asian Population) describe the AD8 as a brief informant interview used to detect early cognitive change. They evaluated the diagnostic performance of the participant-administered AD8 in a Chinese population, consisting of noncognitively impaired, mildly impaired, and Alzheimer’s disease participant–informant dyads. They found AD8 scores to be associated with dementia severity. They concluded that within their transcultural setting, the p-AD8 demonstrated good discriminative validity. They believe that it could be used as a screen for cognitive status.
Cipriani et al (Repetitive, stereotypic phenomena and dementia) examined the repetitive phenomena in patients with demetia using the PubMed electronic database. Repetitive and stereotypic phenomena are a common problem in dementia, which may reflect a disruption of coordinated function within the basal ganglia or corticostriatal structures. They conclude that there is a need for studies concerning repetitive phenomena in dementia, with an eye toward interventions.
Gill et al (Apolipoprotein E levels in the cerebrospinal fluid of north Indian Alzheimer’s disease patients) remind us that apolipoprotein E genotype plays a pivotal role in risk and age of onset in Alzheimer’s disease. However, little is known about apolipoprotein E levels in cerebrospinal fluid and its relationship with Alzheimer’s disease. Gill et al found no difference in apolipoprotein E concentrations in their cerebrospinal fluid between patients with Alzheimer’s disease and controls.
Dong et al (Involvement of heat shock protein 70 in the DNA protective effect from estrogen) note that the functional interaction between estrogen and heat shock protein (Hsp70) on DNA damage repair is largely unknown. They found a reduction in cell survival and elevation in oxidative stress, while cells were exposed to amyloid β (Aβ) 25-35, but preincubation of the cells with 17β-estradiol ameliorated the trend. 17β-estradiol also alleviated oxidized DNA damage induced by Aβ and elevated the expression of Hsp70. However, these beneficial effects were reduced when the Hsp70 gene was silenced. Dong et al concluded that Hsp70 plays a role in DNA protection mediated by estrogen.