Abstract:
OBJECTIVE:Nearly half of care home residents with advanced dementia have clinically significant agitation. Little is known about costs associated with these symptoms toward the end of life. We calculated monetary costs associated with agitation from UK National Health Service, personal social services, and societal perspectives. DESIGN:Prospective cohort study. SETTING:Thirteen nursing homes in London and the southeast of England. PARTICIPANTS:Seventy-nine people with advanced dementia (Functional Assessment Staging Tool grade 6e and above) residing in nursing homes, and thirty-five of their informal carers. MEASUREMENTS:Data collected at study entry and monthly for up to 9 months, extrapolated for expression per annum. Agitation was assessed using the Cohen-Mansfield Agitation Inventory (CMAI). Health and social care costs of residing in care homes, and costs of contacts with health and social care services were calculated from national unit costs; for a societal perspective, costs of providing informal care were estimated using the resource utilization in dementia (RUD)-Lite scale. RESULTS:After adjustment, health and social care costs, and costs of providing informal care varied significantly by level of agitation as death approached, from £23,000 over a 1-year period with no agitation symptoms (CMAI agitation score 0-10) to £45,000 at the most severe level (CMAI agitation score >100). On average, agitation accounted for 30% of health and social care costs. Informal care costs were substantial, constituting 29% of total costs. CONCLUSIONS:With the increasing prevalence of dementia, costs of care will impact on healthcare and social services systems, as well as informal carers. Agitation is a key driver of these costs in people with advanced dementia presenting complex challenges for symptom management, service planners, and providers.
journal_name
Int Psychogeriatrjournal_title
International psychogeriatricsauthors
Buylova Gola A,Morris S,Candy B,Davis S,King M,Kupeli N,Leavey G,Moore K,Nazareth I,Omar R,Vickerstaff V,Jones L,Sampson ELdoi
10.1017/S1041610219002059subject
Has Abstractpub_date
2020-03-01 00:00:00pages
359-370issue
3eissn
1041-6102issn
1741-203Xpii
S1041610219002059journal_volume
32pub_type
杂志文章abstract:BACKGROUND:The Cambridge Cognitive Examination (CAMCOG) is a useful test in screening for Alzheimer's disease (AD). However, the interpretation of CAMCOG cut-off scores is problematic and reference values are needed for different educational strata. Given the importance of earlier diagnoses of mild dementia, new cut-of...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S104161021000116X
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Mild cognitive impairment (MCI) is proposed to describe the transitional stage between normal cognitive aging and dementia. It has had significant impact in the field of dementia research, but it remains controversial whether or not it should be used as a diagnostic category in clinical practice. METHODS:Se...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610208007126
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:It is necessary to continue to explore the psychometric characteristics of key cognitive screening tests such as the Montreal Cognitive Assessment (MoCA) to diagnose cognitive decline as early as possible and to attend to the growing need of clinical trials involving mild cognitive impairment (MCI) participa...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610215001982
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:This study aimed to determine: (1) the prevalence of depression, anxiety, and depression associated with anxiety (DA); (2) the risk factor profile of depression, anxiety, and DA; (3) the course of depression, anxiety, and DA over 24 months. METHODS:Two-year longitudinal study of 20,036 adults aged 60+ years...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S104161021200107X
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Few studies have estimated care burden in large, representative, multi-ethnic Asian population-based informal caregivers of older adults with care needs. This study describes informal caregivers' care participation for a population-based sample of older adults with care needs in Singapore, investigates diffe...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S104161021500160X
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:The International Psychogeriatric Association (IPA) capacity taskforce was established to promote the autonomy, proper access to care, and dignity of persons with decision-making disabilities (DMDs) across nations. The Asia Consortium of the taskforce was established to pursue these goals in the Asia-Pacific...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S104161021400266X
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:We assessed the relationship between cognitive impairment (including mild cognitive impairment with no signs of dementia, and dementia) and risk for depression in old age (60 years and older). METHODS:MEDLINE, EMBASE and the Cochrane Library database were used to identify potential studies. All of the clini...
journal_title:International psychogeriatrics
pub_type: 杂志文章,meta分析,评审
doi:10.1017/S1041610210000049
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND AND AIM:Previous research suggested caregiver singing could influence persons with severe dementia to communicate with increased competence, to cease aggression, and to cease disruptive screaming, while at the same time they seemed to understand what was going on when being cared for during morning care sess...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:Little is known about the prevalence of, or associations with behavioral and psychological symptoms of dementia (BPSD) in developing countries. METHODS:Individuals diagnosed as having dementia according to DSM-IV criteria (mild and moderate cases as defined by the Clinical Dementia Rating scale only), toget...
journal_title:International psychogeriatrics
pub_type: 杂志文章,多中心研究
doi:10.1017/s1041610204000833
更新日期:2004-12-01 00:00:00
abstract::ABSTRACTBackground:The number of elderly individuals living in China is increasing rapidly. The aim of this study was to examine the potential risk factors of geriatric depression in rural areas. METHODS:A repeated cross-sectional study was conducted between January 2015 and October 2016 in rural China. Nine hundred ...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610218000030
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Verbal fluency (VF) tasks are simple and efficient clinical tools to detect executive dysfunction and lexico-semantic impairment. VF tasks are widely used in patients with suspected dementia, but their accuracy for detection of mild cognitive impairment (MCI) is still under investigation. Schooling in partic...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610209990639
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Previous studies have shown that the verbal fluency test (VFT) is a sensitive measure of cognitive dysfunction in Alzheimer's disease (AD). However, other studies have shown that the performances were significantly influenced by education in the normal elderly population. In order to examine the utility of t...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610210000839
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVES:To investigate the presence of neuropsychiatric symptoms (NPS) and sub-syndromes in elderly community-dwelling Asians with varying severity of cognitive impairment. METHODS:Chinese and Malay participants (n = 613) from the Epidemiology of Dementia in Singapore (EDIS) Study aged ≥ 60 years underwent clinical...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610215000976
更新日期:2015-11-01 00:00:00
abstract::ABSTRACTBackground:Little is known about the combined use of benzodiazepines and antidepressants in older psychiatric patients. This study examined the prescription pattern of concurrent benzodiazepines in older adults treated with antidepressants in Asia, and explored its demographic and clinical correlates. METHODS...
journal_title:International psychogeriatrics
pub_type: 杂志文章,多中心研究
doi:10.1017/S1041610217002563
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Dementia in the elderly is associated with a greater risk of being subjected to abuse. More than half of those in Japan who abuse elderly relatives with dementia do not realize that their behavior corresponds to abuse. OBJECTIVE:This study sought to examine the effect of the presence of dementia in the elde...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610206004789
更新日期:2007-10-01 00:00:00
abstract::Dementia is defined as global cognitive impairment that interferes with function; however, function has been less well measured than cognition in anti-dementia drug trials. In the modern era of anti-dementia clinical trials, measurement of function has improved by differentiating between the aspects of function that h...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610207004966
更新日期:2007-06-01 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:OBJECTIVES:The aim of this study was to investigate survival time and life-expectancy in people with young-onset dementia (YOD) and to examine the relationship with age, sex, dementia subtype and comorbidity. DESIGN, SETTING AND PARTICIPANTS:Survival was examined in 198 participants in the Needs in Young-onset Dementi...
journal_title:International psychogeriatrics
pub_type: 杂志文章,多中心研究
doi:10.1017/S1041610219000152
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:This article analyzes the natural history of wandering behavior throughout the course of dementia. DESIGN:Prospective, 10-year, longitudinal study of wandering behavior in dementia, with autopsy follow-up. SETTING:Participants with dementia, living at home with a carer. All lived in Oxfordshire, UK. PARTIC...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/s1041610201007542
更新日期:2001-06-01 00:00:00
abstract::ABSTRACTAssociations between high body mass index (BMI) and subsequent cognitive decline, reported in elderly averaging below age 75, become less consistent at older ages. We compared the associations of BMI with cognition in moderately old (ages 75-84, N = 154) and oldest-old (85+, N = 93) samples. BMI and cognition ...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610218001412
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To identify, in caregivers of patients with Alzheimer's disease (AD) dementia, factors associated with subjective (personal, physical, emotional, and social) and objective (informal caregiver time and costs) caregiver burden. DESIGN:Prospective longitudinal European observational study: post-hoc analysis. S...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610219000425
更新日期:2020-02-01 00:00:00
abstract::Psychotic symptoms in Alzheimer's disease (AD) have been associated with increased rates of cognitive impairment and functional decline. Prior studies have been conflicting with regard to whether AD patients with psychosis (AD+P) have evidence of more severe neuropathologic findings at postmortem exam. We examined the...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/s1041610200006657
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Hospital-treated deliberate self harm and suicide among older adults have rarely been examined at a national level. METHODS:The Irish Central Statistics Office provided suicide and undetermined death data for 1980-2006. The National Registry of Deliberate Self Harm collected data relating to deliberate self...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610210001377
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVE:To validate a shorter version of the Geriatric Depression Scale (GDS) for older, visually impaired patients. PARTICIPANTS:Subjects were 70 visually impaired adults over age 65 who were presenting for services at a low vision clinic. METHOD:Subjects were interviewed by a geriatric nurse practitioner. A struc...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/s1041610200006554
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Despite the increasing prevalence of Alzheimer's disease (AD), very few studies have examined advanced preparation for the possibility of becoming sick with AD, and these few studies indicate a general lack of preparation. This study aimed to expand knowledge regarding preparedness for AD among younger and o...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610211001803
更新日期:2012-02-01 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:Research on the behavioral correlates of anxiety in older adults is sparse. The aim of this study was to explore the association of anxiety with behavioral patterns defined by health, activity, emotional and social variables. METHODS:A convenience sample of 395 older adults completed measures of health, act...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610214001148
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Elder mistreatment, social ageism, and human rights are increasingly powerful discourses in positioning older people in society, yet the relationship between them has rarely been subjected to critical investigation. This perceived relationship will have implications for how mistreatment is understood and res...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610212002372
更新日期:2013-08-01 00:00:00
abstract::This issue of International Psychogeriatrics contains three papers from three continents that explore the use of sedatives-hypnotics and opioids in the treatment of older adults (Hamina et al., 2018; Machado-Duque et al., 2018; Tseng et al., 2018), and a fourth paper reporting on a qualitative study that addresses the...
journal_title:International psychogeriatrics
pub_type: 社论
doi:10.1017/S104161021800087X
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:A careful characterization of behavioral abnormalities in corticobasal degeneration syndrome (CBDS) and progressive supranuclear palsy (PSP) by reliable tools is still lacking. Literature data provided evidence of the usefulness of the Frontal Behavioral Inventory (FBI) to operationalize such disturbances, p...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610209008862
更新日期:2009-06-01 00:00:00