Journal of Alzheimer's Disease - Volume 81, issue 2

Authors: Damron, Lisa | Litvan, Irene | Bayram, Ece | Berk, Sarah | Siddiqi, Bernadette | Shill, Holly

Article Type: Research Article

Abstract: Background: Hispanics are under-represented in Parkinson’s disease (PD) research despite the importance of diversity for results to apply to a wide range of patients. Objective: To investigate the perspective of Hispanic persons with Parkinson disease (PWP) regarding awareness, interest, and barriers to participation in research. Methods: We developed and administered a survey and qualitative interview in English and Spanish. For the survey, 62 Hispanic and 38 non-Hispanic PWP linked to a tertiary center were recruited in Arizona. For interviews, 20 Hispanic PWP, 20 caregivers, and six physicians providing service to Hispanic PWP in the community were …recruited in California. Survey responses of Hispanic and non-Hispanic PWP were compared. Major survey themes were identified by applying grounded theory and open coding. Results: The survey found roughly half (Q1 54%, Q2 55%) of Hispanic PWP linked to a tertiary center knew about research; there was unawareness among community Hispanic PWP. Most preferred having physician recommendations for research participation and were willing to participate. Hispanics preferred teams who speak their native language and include family. Research engagement, PD knowledge, role of family, living with PD, PD care, pre-diagnosis/diagnosis emerged as themes from the interview. Conclusion: Barriers exist for participation of Hispanic PWP in research, primarily lack of awareness of PD research opportunities. Educating physicians of the need to encourage research participation of Hispanic PWP can address this. Physicians need to be aware of ongoing research and should not assume PWP disinterest. Including family members and providing research opportunities in their native language can increase research recruitment. Show more

Keywords: Health services research, hispanic, minority health, Parkinson’s disease, research access, research barriers

DOI: 10.3233/JAD-210231

Citation: Journal of Alzheimer's Disease, vol. 81, no. 2, pp. 809-819, 2021

Authors: Suh, Seung Wan | Kim, You Joung | Kwak, Kyung Phil | Kim, Kiwon | Kim, Moon-Doo | Kim, Byung-Soo | Kim, Bong Jo | Kim, Shin Gyeom | Kim, Jeong Lan | Kim, Tae Hui | Moon, Seok Woo | Park, Kyung Won | Park, Jong-Il | Park, Joon Hyuk | Bae, Jae Nam | Seo, Jiyeong | Seong, Su Jeong | Son, Sang Joon | Shin, Il-Seon | Ryu, Seung-Ho | Lee, Kang Joon | Lee, Nam-Jin | Lee, Dong Young | Lee, Dong Woo | Lee, Seok Bum | Lee, Chang Uk | Chang, Sung Man | Jeong, Hyun-Ghang | Cho, Maeng Je | Cho, Seong-Jin | Jhoo, Jin Hyeong | Choe, Young Min | Han, Ji Won | Kim, Ki Woong

Article Type: Research Article

Abstract: Background: In many high-income Western countries, the prevalence of dementia had been reduced over the past decades. Objective: We investigated whether the prevalence of all-cause dementia, Alzheimer’s disease, vascular dementia, and mild cognitive impairment (MCI) had changed in Korea from 2008 to 2017. Methods: Nationwide Survey on Dementia Epidemiology of Korea (NaSDEK) in 2008 and 2017 was conducted on representative elderly populations that were randomly sampled across South Korea. Both surveys employed a two-stage design (screening and diagnostic phases) and diagnosed dementia and MCI according to the fourth edition of the Diagnostic and Statistical Manual of …Mental Disorders and the consensus criteria from the International Working Group, respectively. The numbers of participants aged 65 years or older in the screening and diagnostic phases were 6,141 and 1,673 in the NaSDEK 2008 and 2,972 and 474 in the NaSDEK 2017, respectively. Results: The age- and sex-standardized prevalence of all-cause dementia and Alzheimer’s disease showed nonsignificant decrease (12.3% to 9.8%, odds ratio [OR] = 0.89, 95% confidence interval [CI] = 0.54–1.48 for all-cause dementia; 7.6% to 6.8%, OR [95% CI] = 0.91 [0.58–1.42] for Alzheimer’s disease). Vascular dementia decreased in the young-old population aged less than 75 years (2.7% to 0.001%, OR [95% CI] = 0.04 [0.01–0.15]) and in women (1.9% to 0.5%, OR [95% CI] = 0.27 [0.10–0.72]) while MCI remained stable (25.3% to 26.2%, OR [95% CI] = 1.08 [0.67–1.73]). Conclusion: We found that the prevalence of dementia in Korea showed a nonsignificant decrease between 2008 and 2017. Show more

Keywords: Alzheimer’s disease, dementia, mild cognitive impairment, prevalence, vascular dementia

DOI: 10.3233/JAD-201588

Citation: Journal of Alzheimer's Disease, vol. 81, no. 2, pp. 821-831, 2021

Authors: Taylor, Morag E. | Toots, Annika | Lord, Stephen R. | Payne, Narelle | Close, Jacqueline C.T.

Article Type: Research Article

Abstract: Background: In older people with cognitive impairment (CI), executive function (EF) has been associated with motor performance including balance and gait. The literature examining and supporting a relationship between balance performance and other cognitive domains is limited. Objective: To investigate the relationship between global cognition and cognitive domain function and balance performance in older people with CI. Methods: The iFOCIS randomized controlled trial recruited 309 community-dwelling older people with CI. Baseline assessments completed before randomization were used for analyses including the Addenbrooke’s Cognitive Examination-III (ACE-III; global cognition) and its individual cognitive domains (attention; memory; verbal …fluency; language; visuospatial ability) and the Frontal Assessment Battery (FAB), a measure of EF. A composite balance score was derived from postural sway and leaning balance tests. Results: In linear regression analyses adjusted for covariates, global cognition and each cognitive domain were significantly associated with balance performance. EF (verbal fluency; β= –0.254, p  < 0.001, adjusted R2  = 0.387) and visuospatial ability (β= –0.258, p  < 0.001, adjusted R2  = 0.391) had the strongest associations with balance performance. In a comprehensively adjusted multivariable model including all of the ACE-III cognitive domains, visuospatial ability and EF (verbal fluency) were independently and significantly associated with balance performance. Conclusion: Poorer global cognition and cognitive domain function were associated with poorer balance performance in this sample of people with CI. Visuospatial ability and EF were independently associated with balance, highlighting potential shared neural networks and the role higher-level cognitive processes and spatial perception/processing play in postural control. Show more

Keywords: Aged, cognition, dementia, executive function, postural control, visuospatial

DOI: 10.3233/JAD-201325

Citation: Journal of Alzheimer's Disease, vol. 81, no. 2, pp. 833-841, 2021

Authors: Roβmeier, Carola | Hartmann, Julia | Riedl, Lina | Dorn, Bianca | Fischer, Julia | Hartmann, Florentine | Egert-Schwender, Silvia | Kehl, Victoria | Schneider-Schelte, Helga | Jox, Ralf J. | Dinkel, Andreas | Diehl-Schmid, Janine

Article Type: Research Article

Abstract: Background: End of life symptoms and symptom management as well as the quality of dying (QoD) of persons with advanced dementia (PWAD) have not yet been systematically studied in Germany. Objective: 1) To investigate symptoms, treatment and care at the end of life, advance care planning, and circumstances of death of recently deceased PWAD; 2) To determine whether there are differences between young and late onset dementia (YOD and LOD). Methods: The study was performed in the context of the project EPYLOGE (IssuE s in P alliative care for persons in advanced and terminal stages of …Y oung-onset and L ate-O nset dementia in Ge rmany). Closest relatives of recently deceased patients with advanced YOD (N = 46) and LOD (N = 54) living at home or in long term care were interviewed. Results: Circumstances of death, symptoms, and treatment appeared to be similar between YOD and LOD, except that persons with LOD had significantly more somatic comorbidities and were admitted to hospital in the last three months of life more often than persons with LOD. At end of life, 60% of PWAD appeared to be “at peace”. Difficulty swallowing, gurgling, shortness of breath, and discomfort were observed most frequently. Large interindividual differences in suffering and QoD were present. Determinants of QoD were not identified. Conclusion: Our findings suggest that low QoD was caused by inadequate recognition and/or insufficient treatment of burdensome physical and emotional symptoms. PWADs’ needs should be assessed regularly, and strategies focusing on treatment and implementing support for both the patient and caregiver must be established. Show more

Keywords: Dementia, end-of-life symptoms, home care, late onset dementia, long term care, palliative care, quality of dying, young onset dementia

DOI: 10.3233/JAD-210046

Citation: Journal of Alzheimer's Disease, vol. 81, no. 2, pp. 843-852, 2021

Article Type: Correction

DOI: 10.3233/JAD-219003

Citation: Journal of Alzheimer's Disease, vol. 81, no. 2, pp. 853-853, 2021