Neuropsychiatric Symptoms in Alzheimer’s Disease Are the Main Determinants of Functional Impairment in Advanced Everyday Activities

Delgado, Carolina; Vergara, Rodrigo C.; Martínez, Melissa; Musa, Gada; Henríquez, Fernando; Slachevsky, Andrea

doi:10.3233/jad-180771

Cited by 26 publications

(20 citation statements)

References 71 publications

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“…Carer's use of criticism style decreased ADL performance while encouragement style improved task performance, confirming the key role that carers have when supporting PwD in the performance of daily tasks. In addition, better global cognition increased ADL performance while apathy had the opposite effect, confirming previous studies 2,3,24‐26 …”

Section: Discussionsupporting

confidence: 89%

How does carer management style influence the performance of activities of daily living in people with dementia?

Camino

Kishita

Bregola

et al. 2021

Int J Geriat Psychiatry

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Introduction People with Dementia (PwD)'s performance of activities of daily living (ADLs) has been associated with apathy, cognitive deficits, carers' depression and burden. However, it is not known if the carers' management style affects ADL performance, particularly alongside PwD's cognitive deficits and apathy. Thus, the aim of this study was to explore the contribution of intrinsic (cognition, apathy) and extrinsic (carer management styles) dementia factors to ADL performance. Methods PwD (n = 143) were assessed on global cognition (ACE‐III); apathy (CBI‐R); ADLs (Disability Assessment for Dementia‐DAD). Carers' (n = 143) criticism, encouragement and active‐management styles were assessed with the Dementia Management Strategy Scale (DMSS). Multiple linear regression analysis investigated contributions of carer styles, cognition, apathy (independent variables) on ADLs (dependent variable). Results The best model explaining the variance of the DAD scores included cognition (β = 0.413, t(142) = 4.463, p = 0.001), apathy (β = –0.365, t(142) = –5.556, p = 0.001), carer criticism (β = –0.326, t(142) = –2.479, p = 0.014) and carer encouragement styles (β = 0.402, t(142) = 2.941, p = 0.004) accounting for 40% of the variance of the DAD scores. Conclusions This novel study demonstrated that PwD's level of apathy and the carer's use of criticism negatively affected ADL performance while PwD's cognitive abilities and carer encouragement style improved ADL performance. These findings have critical implications for the development of novel multi‐component non‐pharmacological interventions to maintain function and delay disease progression in dementia, as well as direct relevance to current carers and families.

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Section: Discussionsupporting

confidence: 89%

How does carer management style influence the performance of activities of daily living in people with dementia?

Camino

Kishita

Bregola

et al. 2021

Int J Geriat Psychiatry

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“…The most important determinants of functional impairment in presbycusis were the NPS, specifically apathy and irritability. Apathy is widely defined as a marked "loss of motivation" (Marin et al, 1991;Kaji and Hirata, 2011;Kirsch-Darrow et al, 2011), which has been related with functional impairment in demented (Freels et al, 1992;Lechowski et al, 2009;Clarke et al, 2011;Rog et al, 2014;You et al, 2015;Stanton and Carson, 2016;Farias et al, 2017;Lanctôt et al, 2017;Parrao et al, 2017) and non-demented elders (Freels et al, 1992;Rog et al, 2014;van Dalen et al, 2018;Delgado et al, 2019). Considering the high prevalence of presbycusis in the elderly, it is possible that hearing loss could mediate, at least partially, the association between apathy and functional impairment described in these studies.…”

Section: Hearing Loss and Functional Impairmentmentioning

confidence: 83%

Insula and Amygdala Atrophy Are Associated With Functional Impairment in Subjects With Presbycusis

Belkhiria

Vergara

Martin

et al. 2020

Front. Aging Neurosci.

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Belkhiria et al. Neurobehavioral Impairment in Presbycusis that (i) the neuropsychiatric symptoms had a major effect on functional loss in subjects with presbycusis, (ii) cochlear dysfunction is relevant for the association between hearing loss and behavioral impairment, and (iii) atrophy of the insula and amygdala among other temporal areas are related with hearing loss and behavioral impairment.

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“…People aged above 70 were categorised as high risk by the UK government and encouraged to maintain rigorous social distancing leading to risks of loneliness 1 , 2 which, in turn, can lead to depression and anxiety. 3 Additionally, functional and cognitive impairments experienced by older people with severe enduring mental illness or dementia 4 , 5 , 6 are likely to further exacerbate the impacts of COVID‐19 and social isolation.…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID‐19 pandemic on older adults mental health services: A mixed methods study

Bhome

Huntley

Dalton-Locke

et al. 2021

Int J Geriat Psychiatry

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Objectives The COVID‐19 pandemic has had a significant impact on older adults mental health care. Our study aimed to explore staff perspectives on key challenges and innovations in order to help inform the delivery of older adults mental health care in subsequent waves of the pandemic. Methods A mixed methods online questionnaire developed by National Institute for Health Research Mental Health Policy Research Unit was used to gather staff perspectives on their challenges at work, problems faced by service users and their carers, and sources of help and support. Descriptive statistics were used for quantitative analysis and descriptive content analysis for qualitative analysis. Results 158 participants, working in either community or inpatient settings, and from a range of professional disciplines, were included. For inpatient staff, a significant challenge was infection control. In the community, staff identified a lack of access to physical and social care as well as reduced contact with friends and families as being challenges for patients. Remote working was seen as a positive innovation along with COVID‐19 related guidance from various sources and peer support. Conclusion Our study, with a focus on staff and patient well‐being, helps to inform service development for future waves of the pandemic. We discuss measures to improve infection control in inpatient settings, the role of voluntary organisations in supporting socially isolated community patients, the need for better integration of physical and mental health services at an organisational level, and the importance of training staff to support patients and their families with end of life planning.

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Neuropsychiatric Symptoms in Alzheimer’s Disease Are the Main Determinants of Functional Impairment in Advanced Everyday Activities

Cited by 26 publications

References 71 publications

How does carer management style influence the performance of activities of daily living in people with dementia?

How does carer management style influence the performance of activities of daily living in people with dementia?

Insula and Amygdala Atrophy Are Associated With Functional Impairment in Subjects With Presbycusis

Impact of the COVID‐19 pandemic on older adults mental health services: A mixed methods study

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