Abstract
Smith and Greenwood (The Impact of Volunteer Mentoring Schemes on Carers of People With Dementia and Volunteer Mentors: A Systematic Review) examined the differences and similarities between types of volunteer mentoring (befriending, mentoring, and peer support). They found a slight reduction in depression after 6 months of volunteer befriending of patients with dementia. They noted the value carers placed on the volunteer mentors’ experiential similarity. Matching was not essential. Smith and Greenwood believe that the lack of need for matching and the importance of experiential similarity deserve further investigation.
Wang et al (Registration of Alzheimer’s Disease in Taiwan: Patient and Informant) obtained updated data of patients with Alzheimer’s disease and their informants in Taiwan, with the aim of fostering and supporting collaborative research. The mean age of the patients was 79 years and it was 57.5 years for the informants. Sixty-nine percent of the informants lived with the patients. Seventy-seven percent of patients lived with a spouse/partner or with their children. Over 11% had at least 1 sibling with dementia. Wang et al believe that their updated information could be used to help direct the care of patients with Alzheimer’s disease in Taiwan.
Chappell et al (Change and Predictors of Change in Social Skills of Nursing Home Residents With Dementia) note that social skills are of primary importance for those with dementia (and their care providers), yet we know little about the extent to which basic social skills can be maintained over time in this context, and this study addressed that. The authors found that most residents maintained or improved their basic social skills. Decline was explained more by cognitive status (orientation, in particular) at admission. However, staff to resident communication became more important over time. Chappell et al concluded that social skills present an opportunity to maintain interaction with residents having dementia. They suggested that caregivers focus on orientation around the time of admission and on staff to resident communication as time goes on.
In A Pilot of an Intervention Delivered to Chinese and Spanish-Speaking Carers of People With Dementia in Australia, Leone et al note that there are limited language and culture-specific support programs for carers of people with dementia in Australia. A group intervention for use with Chinese and Spanish speakers in the United States was adapted to the Australian context and a pilot study was undertaken with these 2 communities. The intervention used a cognitive behavioral therapy approach and was delivered by bilingual health professionals. They found a decrease in depression, anxiety, and stress among Spanish speakers and a decrease in depression and anxiety was present among the Chinese speakers. They discussed implications of their findings in the context of Australia’s changing aged care service system.
Iansoori et al (Serum Folic Acid and RFC A80G Polymorphism in Alzheimer’s Disease and Vascular Dementia) believe that low vitamin B12 and folic acid levels may play a role in the pathogenesis of Alzheimer’s disease and vascular dementia. Serum folic acid and vitamin B12 were assayed in 80 patients with Alzheimer’s disease, 50 patients with vascular dementia, and in 120 healthy controls. Reduced folate carrier 1 (RFC-1) gene, rs1051266, which encodes the RFC-1 protein was analyzed for the polymorphism. It was observed that the patients having low folic acid had 2.4 times higher odds of having Alzheimer’s disease and over twice the odds of having vascular dementia than patients having high folic acid levels. Serum vitamin B12 levels did not show this effect. No genetic association was found with patients having Alzheimer’s disease or vascular dementia. These data add to what we know about nutritional factors and dementia.
Joshi et al remind us that hippocampal and mesial temporal sclerosis may occur with frontotemporal lobar degeneration and Alzheimer’s disease as well as with normal aging. Prior studies suggest they may be more closely associated with frontotemporal lobar degeneration but have not directly compared the prevalence and clinical characteristics of this using neuropathologically confirmed early-onset dementia cohorts. They used the National Alzheimer’s Center Consortium databases to compare neuropathological and clinical data between the 2 groups. The frontotemporal lobar degeneration group had a significantly higher prevalence of sclerosis than the Alzheimer’s disease group. However, hippocampal and mesial temporal sclerosis was associated with increasing age and memory impairment only in the Alzheimer’s disease group. They concluded that hippocampal and mesial temporal sclerosis in frontotemporal lobar degeneration is part of the primary pathological process, whereas in Alzheimer’s it may be a secondary, nonspecific effect of aging on memory and hippocampal function.
Hernández et al’s alterations in DNA methylation have implicated as an epigenetic event in the pathogenesis of late-onset Alzheimer’s disease. They evaluated global DNA methylation levels in Colombian patients with Alzheimer’s disease and controls. They did not find differences in LINE-1 methylation levels between patients and controls. Furthermore, stratified analyses did not show differences in methylation levels for male or female patients with Alzheimer’s disease versus controls nor for apolipoprotein E4 (APOE4) carriers and noncarriers.
In CSF Apolipoprotein E Concentration and Severity of Cognitive Impairment in Patients With Newly Diagnosed Alzheimer’s Disease, Schmidt et al hypothesized that cerebrospinal fluid (CSF) apoE levels of patients with newly diagnosed Alzeimer’s disease would be associated with cognitive performance. However, no association of CSF apoE levels and cognitive function could be demonstrated in the current study. They concluded that CSF apoE is not a biochemical correlate of the level of cognitive decline in Alzheimer’s disease.
Hamid et al (Importance of Hypertension (HT) and Social Isolation in Causing Sleep Disruption in Dementia) aimed to determine the effects of diabetes mellitus, hypertension, heart disease, social isolation, and sociodemographic factors on sleep in the elderly patients with dementia. Samples were 1210 noninstitutionalized, Malaysian elderly patients with dementia. Hamid et al found that 41% of patients with dementia experienced sleep problems. The results showed that age, social isolation, and hypertension increased sleep disruption in respondents. Furthermore, education and non-Malay ethnicity were associated with decreased sleep problems. Other factors were not significant predictors of sleep disturbances. They concluded that age, social isolation, and hypertension increased sleep disruption and a higher level of education and ethnic factors reduced the risk of sleep problems. Finally, high blood pressure was the most important variable to increase sleep disturbances in the elderly patient with dementia.
Sutter et al (Linking Family Dynamics and the Mental Health of Colombian Dementia Caregivers) conducted a cross-sectional, quantitative, self-report study to examine the relationship between family dynamics (cohesion, flexibility, pathology/functioning, communication, family satisfaction, and empathy) and mental health (depression, burden, stress, and satisfaction with life) in dementia caregivers. They determined that family dynamics were most strongly associated with caregiver depression, stress, and satisfaction. Empathy was uniquely associated with stress, flexibility with depression, and family communication marginally with burden and stress. Caregivers had stronger mental health when their family dynamics were healthy. Sutter et al concluded that family systems interventions may improve family empathy, flexibility, and communication, thereby producing better caregiver mental health and better informal care for people with dementia.
Park et al (Serum Trace Metal Levels in AD and Normal Control Groups) examined whether serum trace metals are related to abnormal cognition in Alzheimer’s disease by serum lead (Pb), cadmium (Cd), mercury (Hg), and arsenic (As) in 89 patients with Alzheimer’s disease and in 118 cognitively normal individuals. Park et al found that serum Pb levels correlated with word list recall and word list recognition. Without age adjustment, serum Cd levels were significantly higher in the group with Alzheimer’s disease. After stratified age adjustment, the levels of selected trace metals did not differ significantly between individuals with Alzheimer’s disease and normal individuals. Food intakes regarding selected trace metals were not significantly different between the 2 groups. Park et al concluded that serum Pb, Cd, Hg, and As levels were not related to abnormal cognition. However, serum Pb levels were significantly negatively correlated with verbal memory scores.
Galindo Garre et al, The Bedford Alzheimer Nursing-Severity Scale (BANS-S) Assesses Disease Severity in Patients With Advanced Alzheimer’s Disease, studied the hierarchy of the items in the scale as it related to the progression of the disease. They discuss pros and cons of various versions of this scale.
In Related Genes and Potential Biomarkers for Early Diagnosis of Alzheimer’s Disease: A Preliminary Study Based on DNA Microarray, Lin et al extend our understanding of the molecular mechanism of Alzheimer’s disease. They downloaded the gene expression profile GSE18309 from Gene Expression Omnibus database, which included gene expression profiles from patients with mild cognitive impairment, Alzheimer’s disease, and normal controls. They identified potential early diagnosis biomarkers and noted that active sites might be used to screen specific drug-binding molecules.