Abstract:
:Current symptomatic treatments for dementia have only modest efficacy. Assessing meaningful benefits in this variably progressive syndrome is complex and difficult. This consensus statement was generated by an international group representing caregivers, organizations and professionals with expertise in dementia. We recommend the statement of clear, pre-defined diagnostic and severity criteria and outcome measures, which include functional and executive capacity, in treatment trials. Outcomes can include effects on people with dementia (PWD) with regard to cognition, behavioral and psychological symptoms, quality of life, global assessments, and activities of daily living, and must be tailored to the education and culture of the participants. Outcomes can also appropriately encompass effects on caregivers. New instruments may be needed, as validation of many existing measures has been in relatively homogenous populations. Treatment goals can be to prevent dementia emerging, or in those with established dementia to slow deterioration, and to postpone, stabilize or improve symptoms. Comparisons between treatment groups should be on the basis of clinically relevant measures with both risk and benefit reported for all participants regardless of whether or not they continue to receive treatment throughout the trial. Characterization of any groups that respond well to treatment has been unsuccessful to date, but may be facilitated in the future by measurement of putative biomarkers. Despite considerable recent progress and several 'candidate' biomarkers, none is yet satisfactory for determining diagnosis, severity, progression or prediction of response. To provide meaningful data, economic analyses should use up-to-date, country-specific data. Health economic measures should be incorporated as secondary outcomes in all Phase 3 trials since health systems are concerned with cost-effectiveness as well as clinical outcome. Health utility measures are not, however, validated satisfactorily in dementia, thus calling into question previous health economic analyses. While current drugs appear to reduce the amount of family caregiver time required by PWD, these costs fall in the main on older individuals who often exert little political leverage, rather than on society at large. Traditionally, elderly people have been marginalized in the political process. The growth in the older population across the world, and their potential for increasing political empowerment may lead to a radical re-evaluation of the economics of treatment in dementia.
journal_name
Int Psychogeriatrjournal_title
International psychogeriatricsauthors
Katona C,Livingston G,Cooper C,Ames D,Brodaty H,Chiu Edoi
10.1017/S1041610207005145subject
Has Abstractpub_date
2007-06-01 00:00:00pages
345-54issue
3eissn
1041-6102issn
1741-203Xpii
S1041610207005145journal_volume
19pub_type
共识发展会议,杂志文章abstract:OBJECTIVES:Geriatric depression complicates cognitive health in older adults. This study aims to investigate the impact of depressive symptoms on cognitive impairment in community-dwelling older adults, depending on whether cognitive dysfunction accompanied. DESIGN:A community-based longitudinal cohort study. SETTING...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610220003622
更新日期:2020-11-16 00:00:00
abstract::Loss of brain tissue becomes notable to cerebral magnetic resonance imaging (MRI) at age 30 years, and progresses more rapidly from mid 60s. The incidence of dementia increases exponentially with age, and is all too frequent in the oldest old (≥ 90 years of age), the fastest growing age group in many countries. Howeve...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610216000673
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Delirium is frequently observed in clinical practice, particularly in medical and surgical wards and more so among patients at risk, especially elderly with preexisting central nervous system impairments. OBJECTIVE:Despite the severe consequences of delirium, epidemiological data relating to incidence of de...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/s1041610202008499
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Workforce shortages to meet the mental health needs of the world's aging population are well documented. Within the field of professional geropsychology in the U.S.A., a national conference was convened in 2006 to delineate competencies for psychological practice with older adults and a training model for th...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610209991736
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:The Charles Bonnet syndrome (CBS) is characterized by distinct visual hallucinations and ocularpathology causing visual impairment in patients with insight and the absence of psychiatric comorbidity. The number of reported cases of CBS is expanding as the population ages and the prevalence of vision disorder...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610213000719
更新日期:2013-09-01 00:00:00
abstract::The purpose of this study was to examine the relationship between age-associated changes in central serotonergic function and abnormalities associated with major depression. Under randomized double-blind conditions, prolactin and cortisol responses to the serotonin-releasing agent d,l-fenfluramine hydrochloride (60 mg...
journal_title:International psychogeriatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s1041610296002499
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:Emotional distress associated with Parkinson's disease (PD) increases disease burden and decreases functioning. The literature supports the benefits of psychological interventions for amelioration of emotional distress in persons with PD. The objective of this study is to apply the Contextual Adult Lifespan ...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610216000569
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Research with nondepressed adults suggests that social networks and social support are stable over the life course until very late age. This may not hold true for older adults with depression. We examined baseline status and trajectories of social networks and social support at the group and individual level...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610207005303
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:The Addenbrooke's Cognitive Examination (ACE) and its Revised version (ACE-R) are relatively new screening tools for cognitive impairment that may improve upon the well-known Mini-Mental State Examination (MMSE) and other brief batteries. We systematically reviewed diagnostic accuracy studies of ACE and ACE-...
journal_title:International psychogeriatrics
pub_type: 杂志文章,meta分析,评审
doi:10.1017/S1041610213002329
更新日期:2014-04-01 00:00:00
abstract::Epidemiologic survey data were used to examine relationships between alcohol use and abuse and the physical and mental health status of elderly public housing residents (weighted n = 865) and to determine the influence that drinking behavior had on mortality. Residents with a current alcohol disorder (4%) were more li...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/s1041610298005407
更新日期:1998-09-01 00:00:00
abstract::ABSTRACT Background: The consequences of co-occurring persistent loneliness and late life depression are yet unknown. The aim of this study was to get a deeper insight into the mental health consequences of loneliness in older persons with depressive symptoms and their perspectives of emotional distress by using a mix...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610214000581
更新日期:2014-04-09 00:00:00
abstract:BACKGROUND:The social and economic burden of Alzheimer's disease (AD) and its increasing prevalence has led to much work on new treatment strategies and clinical trials. The search for surrogate markers of disease progression continues but traditional parallel group trial designs that use well-established, but often in...
journal_title:International psychogeriatrics
pub_type: 杂志文章,评审
doi:10.1017/S1041610211001116
更新日期:2012-05-01 00:00:00
abstract::ABSTRACTBackground:US suicide rates among older women have substantially increased over the past decade. We examined potential differences in sociodemographic and risk/precipitating factors among older female suicide decedents who died by drug overdose versus firearms, hanging/suffocation, and other means, and postmor...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610218000212
更新日期:2018-10-01 00:00:00
abstract::One hundred and seven newly diagnosed, untreated patients with Parkinson's disease (PD) were divided into two groups according to their age at reported onset of symptoms. Of these, 79 patients were under age 70 (early-onset) and 28 patients were age 70 and over (late-onset). The group of 50 control subjects comprised ...
journal_title:International psychogeriatrics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Subjective memory complaints (SMC) have been suggested as an early marker of mild cognitive impairment and dementia. However, there is a paucity of evidence on the effects of early life conditions on the development of SMC in old age. This study is aimed at investigating the association between childhood soc...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610219000814
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Eating disorders in the elderly are often overlooked. When they occur, significant morbidity and mortality result. In this study we review all existing literature on eating disorders in the elderly and provide practical guidelines for clinicians in recognizing and managing eating disorders in the elderly. M...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610210000104
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:The length of stay and bed usage on acute psychogeriatric admission wards are influenced by several factors. The impact of a dedicated specialist social worker working exclusively with acutely ill psychogeriatric inpatients and with a dedicated budget for domiciliary care packages on the length of stay, bed ...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/s1041610201007724
更新日期:2001-09-01 00:00:00
abstract::The onset of obsessive-compulsive disorder (OCD) for the first time in old age is uncommon and has been mostly related to cerebral abnormalities. We report a case of late-onset OCD in a 77-year-old woman following stressful life events but with a normal cerebral structure. The contribution of life events and vulnerabi...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610205002735
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVES:Data on psychotropic medications of older patients with schizophrenia spectrum disorder are scarce. Specifically, information about the use of benzodiazepines among older patients with schizophrenia spectrum disorder is very limited. Because benzodiazepine use in older patients has been associated with many ...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610219000358
更新日期:2020-04-01 00:00:00
abstract::Many nursing home residents are candidates for antipsychotic pharmacotherapy for dementia-related behavioral disturbances that include physical agitation and aggression, verbal outbursts, anxiety, and depression. These patients are often resistant to or intolerant of standard neuroleptics and are usually receiving mul...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/s1041610297004213
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Most research on family members' experience of dementia has focused on the time after diagnosis. Yet, once people reach clinical attention, families have already been living with the changes for some time. These pre-diagnosis experiences can influence later caregiving. We aimed to synthesize qualitative rese...
journal_title:International psychogeriatrics
pub_type: 杂志文章,评审
doi:10.1017/S1041610217000862
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:A single-item depression measure may not be adequate in capturing the complex entity of mental health, despite wide use of this indicator in community studies. This study evaluated the accuracy of a single-question depression measure in comparison to two composite indices-the Center for Epidemiologic Studies...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610217001673
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The delirium index (DI) is a valid measure of delirium severity. We proposed to describe longitudinal patterns of severity scores in older long-term care (LTC) residents. METHODS:A prospective cohort study of 280 residents in seven LTC facilities in Montreal and Quebec City, Canada, was conducted. DI, Barth...
journal_title:International psychogeriatrics
pub_type: 杂志文章,多中心研究
doi:10.1017/S104161021600137X
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Australia has a growing aging migrant population and rates of dementia in residential care are high. The communication of persons with dementia and limited English language proficiency in residential care is an area that has received little attention in the research literature. METHOD:Thirty-nine Italian-ba...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610205002309
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Quality of Life-Alzheimer's Disease (QOL-AD) is a widely used scale for the study of quality of life in patients with dementia. The aim of this study is the transcultural adaptation and validation of the QOL-AD scale in Portugal. METHODS:Translation and transcultural adaptation was performed according to st...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610213000379
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:We assessed eight-year mortality rates and predictors in a rural cohort of elderly individuals with cognitive impairment. METHODS:A total of 1,035 individuals, including 155 (15.0%) individuals with cognitive impairment, no dementia (CIND), and 69 (6.7%) individuals with clinically diagnosed dementia were f...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610214000556
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Delirium is a risk factor for long-term cognitive impairment and dementia. Yet, the nature of these cognitive deficits is unknown as is the extent to which the persistence of delirium symptoms and presence of depression at follow-up may account for the association between delirium and cognitive impairment at...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610213000574
更新日期:2013-09-01 00:00:00
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journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/s1041610297004547
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:Religious and spiritual issues are clearly important to the older adult population and may play a positive role in maintaining health and recovering from illness. This study systematically reviewed the literature examining the effects of religion and spirituality on health outcomes such as cognitive function...
journal_title:International psychogeriatrics
pub_type: 杂志文章,评审
doi:10.1017/S1041610214001665
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Preventing and/or delaying cognitive impairment is a public health priority. To increase awareness of and participation in behaviors that may help maintain cognitive function or reduce risk of impairment, we need to understand public perceptions about risk and protective factors. METHODS:We conducted a scop...
journal_title:International psychogeriatrics
pub_type: 杂志文章,评审
doi:10.1017/S1041610214002877
更新日期:2015-08-01 00:00:00