Examining spiritual support among African American and Caucasian Alzheimer's caregivers: A risk and resilience study

Research shows African Americans at greater risk of developing Alzheimer's disease (AD) compared to the Caucasian population, suggesting African American AD caregivers are rising in numbers at a greater rate than Caucasian counterparts. Over a decade ago, an article in Geriatric Nursing revealed spiritual well-being differences among these caregiver groups. The purpose of this study was a quasi-follow-up, utilizing a larger caregiver sample to test spiritual support as a moderator via a risk-and-resilience framework. Secondary data analysis from a sample of 691 AD caregivers examined data on demographics and standardized measures of spiritual support, caregiver burden, and psychological resilience. One-third of the sample reported as African American. Resilience negatively regressed, though not significantly, on caregiving burden among both groups. Spiritual support positively, significantly impacted resilience among both groups, slightly stronger among African Americans. Spiritual support did not significantly moderate risk with either group. Implications for professional healthcare practice are discussed.     

Experiences of caregivers by care recipient's health condition: A study of caregivers for Alzheimer's disease and related dementias versus other chronic conditions

This study described experiences of caregivers of persons with Alzheimer's disease and other dementias (ADRD) and caregivers of persons with other chronic conditions on self-reported health, type of assistance they provide, perceptions of how caregiving interferes with their lives, and perceived level of support. A secondary analysis was conducted of the 2013 Porter Novelli SummerStyles survey data. Of the 4033 respondents, 650 adults self-identified as caregivers with 11.6% caring for people with ADRD. Over half of all caregivers reported that caregiving interfered with their lives to some extent. The greater the perceived support caregivers reported, the less they thought that caregiving interfered with their lives (p?<?.001). No significant differences were found between ADRD and non-ADRD caregivers regarding general health, types of assistance they provided, and perceived level of support. These findings have the potential to inform future research and practice in the development of supportive services for caregivers.     

健康信念模式为框架的护理干预对老年痴呆患者认知功能障碍及生活质量的影响

目的探讨基于健康信念模式为框架的护理干预对老年痴呆患者认知功能障碍及生活质量的影响。方法选取71例老年痴呆患者,随机分为观察组36例和对照组35例,对照组予以常规护理干预,观察组在对照组基础上实施基于健康信念模式为框架的护理干预,观察并比较2组认知功能评分(MMSE)、生活质量各指标评分及语言能力评分、意外事件发生情况及护理满意度评分。结果干预后观察组MMSE评分高于对照组(P0.05);干预后观察组生活质量各指标评分均高于对照组(P0.05);观察组干预后阅读及听理解能力评分高于对照组(P0.05);观察组意外事件发生率为8.33%,低于对照组的28.57%(P0.05);观察组护理满意度为91.67%,高于对照组的71.43%(P0.05)。结论基于健康信念模式为框架的护理干预可改善老年痴呆患者认知功能、语言能力及生活质量,且意外事件发生率低,护理满意度高。     

New treatment modalities in Alzheimer's disease

Alzheimer’s disease (AD) is still a major public health challenge without an effective treatment to prevent or stop it. Routinely used acetylcholinesterase inhibitors and memantine seem to slow disease progression only to a limited extend. Therefore, many investigations on new drugs and other treatment modalities are ongoing in close association with increasing knowledge of the pathophysiology of the disease. Here, we review the studies about the new treatment modalities in AD with a classification based on their main targets, specifically pathologic structures of the disease, amyloid and tau, neural network dysfunction with special interest to the regulation of gamma oscillations, and attempts for the restoration of neural tissue via regenerative medicine. Additionally, we describe the evolving modalities related to gut microbiota, modulation, microglial function, and glucose metabolism.     

Preserving personhood of individuals with advanced dementia: Lessons from family caregivers

This article reports on a phenomenological study of 15 family caregivers who admitted their spouse or parent with probable Alzheimer's disease to long-term care. The caregivers were attuned to the needs, desires, moods and concerns of their family members with dementia; thus, they were attuned to personhood. Caregivers also reported observations of care by nurses and nursing staff. Observations were of individualized care and actions that promoted personhood and impoverished care delivered with minimal or no communication. These family caregivers' perspectives can inform the care of individuals with advanced dementia by nurses and nursing staff.     

血浆总tau蛋白和磷酸化tau蛋白在阿尔茨海默病中的诊断意义

目的探讨血浆总tau(T-tau)蛋白和磷酸化tau(P-tau)蛋白在阿尔茨海默病(AD)中的诊断意义。方法以天津市北辰区某社区服务中心≥60岁的22 352例体检者作为调查对象,运用随机整群抽样方法,先采用简易智力状态检查量表(MMSE)和日常生活能力评定表(ADL)进行认知功能和日常能力的评分,评分低于标准者再使用Hamilton抑郁量表和Hachinski缺血量表进行诊断性评分,相关的实验室检查排除其他中枢神经系统,以及其他系统和物质原因等所致的痴呆患者,最终由神经内科医师确诊AD患者105例,将无中枢神经系统疾病、无痴呆的非神经系统疾病患者作为健康对照组,共42例。采用ELISA方法检测两组受试者的血浆T-tau蛋白和P-tau蛋白水平。结果 AD组和健康对照组血浆T-tau和P-tau蛋白水平比较,AD组血浆T-tau水平(15.93±6.59)ng/L高于健康对照组(14.10±6.32)ng/L,但差异无统计学意义(P0.05);AD组血浆P-tau蛋白水平(1.26±0.75)ng/L高于健康对照组(0.69±0.24)ng/L,差异有统计学意义(P0.05)。结论血浆磷酸化tau蛋白水平可能对AD患者具有辅助诊断价值。     

Executive function: Responses to aerobic exercise in Alzheimer's disease

Executive dysfunction occurs early and is prevalent in Alzheimer's disease (AD). This study tested the ability of different measures for identifying changes in executive function and the effect of 6-months of aerobic exercise on executive function in older adults with mild to moderate AD, using a single-group, repeated-measures design (n = 28, age 78.1 ± 8.37). Factor analysis and linear mixed-effects model analyses showed that individually the Exit Interview-25 (EXIT-25), Behavioral Dyscontrol Scale (BDS), and Golden Stroop test were the preferred instruments for measuring changes in executive function in the sample. The COWAT and TMT had substantial floor effects limiting their ability to identify changes in executive function. A single latent factor was sufficient to describe the heterogeneity of executive function. Over 6 months, aerobic exercise maintained executive function (effect size = ?0.11, ?0.24, ?0.27, and ?0.21 for the EXIT-25, BDS, Stroop, and latent factor, respectively). Decline in the latent factor (effect size = ?0.21, p = 0.06) was minimal and comparable to that in global cognition (effect size = ?0.20, p = 0.34). Aerobic exercise may be effective on maintaining executive function in AD.     

Role of micronutrients in Alzheimer's disease: Review of available evidence

Alzheimer's disease (AD) is one of the most common age-related neurodegenerative disorders that have been studied for more than 100 years. Although an increased level of amyloid precursor protein is considered a key contributor to the development of AD, the exact pathogenic mechanism remains known. Multiple factors are related to AD, such as genetic factors, aging, lifestyle, and nutrients. Both epidemiological and clinical evidence has shown that the levels of micronutrients, such as copper, zinc, and iron, are closely related to the development of AD. In this review, we summarize the roles of eight micronutrients, including copper, zinc, iron, selenium, silicon, manganese, arsenic, and vitamin D in AD based on recently published studies.     

Evaluation of the poly(ADP‐ribose) polymerase‐1 gene variants in Alzheimer's disease

Amyloid peptide is thought to play a critical role in neuronal death in Alzheimer's disease (AD), most likely through oxidative stress. Free radical‐related injury leads to DNA breaks, which subsequently activates the repair enzyme poly(ADP‐ribose) polymerase‐1 (PARP‐1). In this study, the relationship between genetic variants situated at the PARP‐1 gene and AD development was investigated. We performed a case and control study from a Taiwanese population enrolled 120 AD patients and 111 healthy controls by using a polymerase chain reaction restriction fragment length polymorphism approach for two PARP‐1 exonic polymorphisms, 414C/T (rs1805404) and 2456T/C (rs1136410), corresponding to protein residues at positions 81Asp/Asp and762Val/Ala. There were no significant differences in allele or genotype frequencies for either PARP‐1 gene variant between the case and control groups; however, upon analysis of the haplotype distribution, four haplotypes (Hts) were identified. We found that the distributions of Ht3‐TT and Ht4‐CC were significantly associated with an increased risk of AD (P<0.0001), whereas the Ht1‐TC haplotype showed a protective effect for cases compared with the control group (P<0.05). These results reveal that the PARP‐1 gene is highly associated with AD susceptibility and might contribute to a critical mechanism that mediates cell survival or death as a response to cytotoxic stress. J. Clin. Lab. Anal. 24:182–186, 2010. © 2010 Wiley‐Liss, Inc.     

帕金森病抑郁患者双侧额叶的磁共振波谱改变及意义

目的研究帕金森病抑郁(DPD)患者额叶磁共振波谱(1H-MRS)的改变及其临床意义。方法对20例DPD患者、23例PD患者和20名正常对照者的双侧额叶进行~1H-MRS检测,分析3组双侧额叶的N-乙酰基天门冬氨酸(NAA)/肌酸复合物(Cr)和含胆碱化合物(Cho)/Cr值的变化。结果 DPD患者症状首发侧额叶的NAA/Cr值显著低于PD患者(P0.05),Cho/Cr值显著高于PD患者(P0.05)。DPD患者症状首发侧额叶的NAA/Cr和Cho/Cr值与PD患者比较无显著差异。结论~1H-MRS可以检测到DPD患者额叶的代谢改变,有助于DPD的病因诊断及风险预测。     

Predictive model for health-related quality of life in patients with Parkinson's disease

This study was conducted to develop and test a prediction model that explains health-related quality of life (HRQoL) of patients with Parkinson's disease (PD). Participants were 248 patients with PD enrolled in the neurology clinic of a university hospital in Seoul, Korea. The data were collected through structured questionnaires from March 1 to July 5, 2013. Motor fluctuations, depression, sleep disturbances, fatigue, and activities of daily living had significant direct effects on the quality of life of PD patients. Disease severity, social support, pain, sleep disturbances, fatigue, and activities of daily living had significant indirect effects on patients' quality of life. These predictive variables explained 77.4% of the total variance. The assessment of HRQoL in PD should be considered along with the variables affecting it, including social support. In addition, strategies to enhance social support may be useful for improving the quality of life for patients with PD.     

Kohler's disease presenting as acute foot injury

Kohler's disease is rare cause of foot pain and limping in the pediatric population. The exact etiology of Kohler's disease is unknown. It usually presents as sudden and unexplained foot pain and limping. We report a case of a 5-year-old male who presented to the Pediatric Emergency Department with foot pain and inability to bear weight for two days after overactivity and acute foot injury. The patient was eventually diagnosed with Kohler's disease (avascular necrosis of the navicular bone). Although Kohler's disease is not very common, it should be considered in the differential diagnosis of foot pain in the pediatric population, as it may prevent unnecessary tests and treatments.     

阿尔茨海默病的血管周围间隙影像特征分析

目的分析血管周围间隙(Virchow-Robin spaces,VRS)MRI影像表现与阿尔茨海默病(Alzheimer’s disease,AD)的相关性。材料与方法选取AD患者(阿尔茨海默病组)70例和健康体检者(对照组)62例,进行标准头颅MRI检查,计数中脑、基底节区、岛叶深部白质、半卵圆中心VRS的数目并测量其直径,对所得数据进行分析。结果 AD组颅脑MRI上可观察到VRS,以基底节区最为常见。AD组VRS检出率(49.1%,34/70)高于对照组(24.2%,15/62),差异具有统计学意义(P0.05)。AD组VRS的平均数目[(4.1±2.2)个/例]多于对照组[(2.4±1.9)个/例],差异具有统计学意义(P0.05)。AD组VRS的平均直径[(2.8±1.2)mm]大于对照组[(1.8±0.5)mm](P0.05),差异具有统计学意义。多元线性回归分析显示对照组中VRS的数目、直径均与年龄呈正相关(r1=0.802,r2=0.902,均P0.05)。结论 AD组VRS的MRI影像表现具有一定的特征性,应引起临床的重视。     

A possible significant role of zinc and GPR39 zinc sensing receptor in Alzheimer disease and epilepsy

Zinc the essential trace element, plays a significant role in the brain development and in the proper brain functions at every stage of life. Misbalance of zinc (Zn²⁺) ions in the central nervous system is involved in the pathogenesis of numerous neurodegenerative disorders such as Alzheimer's disease, Depression, and Epilepsy. In brain, Zn²⁺ has been identified as a ligand, capable of activating and inhibiting the receptors including the NMDA-type glutamate receptors (NMDARs), GABA_A receptors, nicotinic acetylcholine receptors (nAChRs), glycine receptors (glyR) and serotonin receptors (5-HT3). Recently GPR39 has been identified as a zinc-specific receptor, widely expressed in brain tissues including the frontal cortex, amygdala, and hippocampus. GPR39, when binding with Zn²⁺ has shown promising therapeutic potentials. This review presents current knowledge regarding the role of GPR39 zinc sensing receptor in brain, with a focus on Alzheimer’s disease and Epilepsy. Although the results are encouraging, further research is needed to clarify zinc and GPR39 role in the treatment of Alzheimer's disease and Epilepsy.