Dementia Dotaz Zobrazit nápovědu
INTRODUCTION: Dementia is a multifactorial disease with Alzheimer's disease (AD) and vascular dementia (VaD) pathologies making the largest contributions. Yet, most genome-wide association studies (GWAS) focus on AD. METHODS: We conducted a GWAS of all-cause dementia (ACD) and examined the genetic overlap with VaD. Our dataset includes 800,597 individuals, with 46,902 and 8702 cases of ACD and VaD, respectively. Known AD loci for ACD and VaD were replicated. Bioinformatic analyses prioritized genes that are likely functionally relevant and shared with closely related traits and risk factors. RESULTS: For ACD, novel loci identified were associated with energy transport (SEMA4D), neuronal excitability (ANO3), amyloid deposition in the brain (RBFOX1), and magnetic resonance imaging markers of small vessel disease (SVD; HBEGF). Novel VaD loci were associated with hypertension, diabetes, and neuron maintenance (SPRY2, FOXA2, AJAP1, and PSMA3). DISCUSSION: Our study identified genetic risks underlying ACD, demonstrating overlap with neurodegenerative processes, vascular risk factors, and cerebral SVD. HIGHLIGHTS: We conducted the largest genome-wide association study of all-cause dementia (ACD) and vascular dementia (VaD). Known genetic variants associated with AD were replicated for ACD and VaD. Functional analyses identified novel loci for ACD and VaD. Genetic risks of ACD overlapped with neurodegeneration, vascular risk factors, and cerebral small vessel disease.
- Klíčová slova
- Alzheimer's disease, GWAS meta‐analysis, all‐cause dementia, cross‐ancestry, genome‐wide association study (GWAS), vascular dementia,
- MeSH
- Alzheimerova nemoc genetika MeSH
- celogenomová asociační studie * MeSH
- demence genetika MeSH
- genetická predispozice k nemoci genetika MeSH
- lidé MeSH
- rizikové faktory MeSH
- vaskulární demence * genetika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
At present there are about 47.5 million people having different types of dementia and by 2030 this number would reach 75.6 million. This obviously brings about a serious social and economic burden for people who take care for those with any kind of dementia. The purpose of this article is to explore only semantic dementia (SD), more specifically called semantic variant of primary progressive aphasia, as one of the forms of frontotemporal dementia (FTD) and provide the latest information on its diagnosis and treatment which play a significant role in the maintenance of quality of life of both patients and their caregivers. Especially unimpaired communication is one of the key factors in the relationship between the patients and their caregivers. The methods used for this mini review include a literature review of available sources found in the world's acknowledged databases such as Web of Science, PubMed, Springer and Scopus from 2000 to 2015; and a comparison and evaluation of the selected studies. The findings of this mini review show that FTD, respectively SD, is a serious neurodegenerative disorder which has fatal consequences for the affected patients. In addition, the findings also indicate that there are not many possibilities of pharmacological treatment for semantic dementia and therefore more attention should be paid to alternative, non-pharmacological approaches. Although semantic dementia is a relatively rare neurodegenerative disorder if compared with other types of dementia, it has an irreversible impact on patient's and his/her caregiver's life in terms of quality.
- Klíčová slova
- Frontotemporal dementia, diagnosis, patient, quality of life, semantic dementia, treatment,
- MeSH
- frontotemporální demence * diagnóza farmakoterapie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
OBJECTIVES: This research explores how the representations and meanings of living with dementia are constructed by older adults. METHODS: Focus groups (N = 19) and in-depth interviews (N = 29) were conducted with older adults aged 65+ living in the Czech Republic, representing different levels of personal familiarity with care for an individual experiencing dementia. RESULTS: We identified 2 different discourses: (1) Tragedy discourse with two distinctive repertoires "dementia as a thief of personality" and "dementia as a thief of humanity." Within such discourse, dementia transcends mere medical terminology, serving as a symbolic representation of existential anxieties linked to aging and the perceived loss of control. (2) The discourse of Dementia as a specific way in which people approach the world was articulated mainly by caregivers, providing them with a coping mechanism and a means to reconstruct the agency of the person experiencing dementia. In older adults' representations, references to suffering among family members emerged as a primary association with dementia. Dementia was portrayed as "contagious" in its effect on the family members who were, in a sense, depicted as the primary sufferers of the disease. DISCUSSION: Dementia often serves as a symbolic tool for older adults to articulate concerns about advanced old age, extending beyond its clinical definition to convey deep-seated fears associated with aging. The experience of people surrounding those diagnosed with dementia and the permeability of the impacts of this disease between bodies represented crucial frameworks for conceptualizing dementia in the narratives of older adults.
- Klíčová slova
- Dementia worry, Discourse, Fourth age, Language,
- MeSH
- adaptace psychologická MeSH
- Alzheimerova nemoc * psychologie MeSH
- demence * psychologie MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- osoby pečující o pacienty psychologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- zjišťování skupinových postojů MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: Research studies show a positive impact of physical activities such as dancing on the improvement of cognitive reserves of people with dementia. OBJECTIVE: The purpose of this study is to explore dancing efficacy on people with dementia and list the key benefits and limitations of dancing therapy for these people. METHODS: The methods used in this study include a method of literature review of available Englishwritten sources with respect to the dancing therapy and dementia in the acknowledged databases Pub- Med, Web of Science, Springer, and Scopus, and a method of comparison and evaluation of their findings. RESULTS: The findings of this mini review confirm positive efficacy of dancing therapy on cognitive, physical, emotional and social performance of people with dementia. CONCLUSION: More randomized controlled clinical trials should be conducted in this field, as well as other non-pharmacological therapies should be employed in order to holistically contribute to the prevention and treatment of dementia.
- Klíčová slova
- Dementia, benefits, dancing, efficacy, findings, limitations, review.,
- MeSH
- cvičení * MeSH
- demence patofyziologie rehabilitace MeSH
- lidé MeSH
- terapie tancem metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
BACKGROUND: In light of the increasing trend in the global number of individuals affected by dementia and the lack of any available disease-modifying therapies, it is necessary to fully understand and quantify the global burden of dementia. This work aimed to estimate the proportion of dementia due to Down syndrome, Parkinson's disease, clinical stroke, and traumatic brain injury (TBI), globally and by world region, in order to better understand the contribution of clinical diseases to dementia prevalence. METHODS: Through literature review, we obtained data on the relative risk of dementia with each condition and estimated relative risks by age using a Bayesian meta-regression tool. We then calculated population attributable fractions (PAFs), or the proportion of dementia attributable to each condition, using the estimates of relative risk and prevalence estimates for each condition from the Global Burden of Disease Study 2019. Finally, we multiplied these estimates by dementia prevalence to calculate the number of dementia cases attributable to each condition. FINDINGS: For each clinical condition, the relative risk of dementia decreased with age. Relative risks were highest for Down syndrome, followed by Parkinson's disease, stroke, and TBI. However, due to the high prevalence of stroke, the PAF for dementia due to stroke was highest. Together, Down syndrome, Parkinson's disease, stroke, and TBI explained 10.0% (95% UI: 6.0-16.5) of the global prevalence of dementia. INTERPRETATION: Ten percent of dementia prevalence globally could be explained by Down syndrome, Parkinson's disease, stroke, and TBI. The quantification of the proportion of dementia attributable to these 4 conditions constitutes a small contribution to our overall understanding of what causes dementia. However, epidemiological research into modifiable risk factors as well as basic science research focused on elucidating intervention approaches to prevent or delay the neuropathological changes that commonly characterize dementia will be critically important in future efforts to prevent and treat disease.
- Klíčová slova
- Burden of disease, Dementia, Global health, Meta-analysis, Public health,
- MeSH
- Bayesova věta MeSH
- celosvětové zdraví MeSH
- cévní mozková příhoda * epidemiologie MeSH
- demence * epidemiologie MeSH
- Downův syndrom * epidemiologie MeSH
- globální zátěž nemocemi MeSH
- kvalitativně upravené roky života MeSH
- lidé MeSH
- Parkinsonova nemoc * epidemiologie MeSH
- prevalence MeSH
- rizikové faktory MeSH
- traumatické poranění mozku * epidemiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Research Support, N.I.H., Extramural MeSH
Cognitive impairment following SARS-CoV-2 infection is being increasingly recognized as an acute and possibly also long-term sequela of the disease. Direct viral entry as well as systemic mechanisms such as cytokine storm are thought to contribute to neuroinflammation in these patients. Biomarkers of COVID-19-induced cognitive impairment are currently lacking, but there is some limited evidence that SARS-CoV-2 could preferentially target the frontal lobes, as suggested by behavioral and dysexecutive symptoms, fronto-temporal hypoperfusion on MRI, EEG slowing in frontal regions, and frontal hypometabolism on 18F-FDG-PET. Possible confounders include cognitive impairment due to hypoxia and mechanical ventilation and post-traumatic stress disorder. Conversely, patients already suffering from dementia, as well as their caregivers, have been greatly impacted by the disruption of their care caused by COVID-19. Patients with dementia have experienced worsening of cognitive, behavioral, and psychological symptoms, and the rate of COVID-19-related deaths is disproportionately high among cognitively impaired people. Multiple factors, such as difficulties in remembering and executing safeguarding procedures, age, comorbidities, residing in care homes, and poorer access to hospital standard of care play a role in the increased morbidity and mortality. Non-pharmacological interventions and new technologies have shown a potential for the management of patients with dementia, and for the support of their caregivers.
- Klíčová slova
- Alzheimer’s disease, COVID-19, SARS-CoV-2, cognition, dementia,
- MeSH
- Alzheimerova nemoc * patofyziologie psychologie MeSH
- biologické markery analýza MeSH
- COVID-19 komplikace imunologie psychologie terapie MeSH
- kognitivní dysfunkce * imunologie patofyziologie virologie MeSH
- komorbidita MeSH
- lidé MeSH
- mozek * diagnostické zobrazování metabolismus patofyziologie virologie MeSH
- neuroimunomodulace imunologie MeSH
- neurozobrazování metody MeSH
- péče o pacienta MeSH
- postakutní syndrom COVID-19 MeSH
- SARS-CoV-2 MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- biologické markery MeSH
AIMS: Heart failure (HF) and dementia frequently coexist, but little is known about their types, relationships to each other and prognosis. The aims were to (i) describe patients with HF and dementia, assess (ii) the proportion of specific dementia disorders in types of HF based on ejection fraction and (iii) the prognostic role of types of HF and dementia disorders. METHODS AND RESULTS: The Swedish Heart Failure Registry (RiksSvikt) and The Swedish Dementia Registry (SveDem) were record-linked. Associations between dementia disorders and HF types were assessed with multinomial logistic regression and survival was investigated with Kaplan-Meier analysis and multivariable Cox regression. We studied 775 patients found in both registries (55% men, mean age 82 years). Ejection fraction was preserved in 38% of patients, reduced in 34%, and missing in 28%. The proportions of dementia disorders were similar across HF types. Vascular dementia was the most common dementia disorder (36%), followed by other dementias (28%), mixed dementia (20%), and Alzheimer disease (16%). Over a mean follow-up of 1.5 years, 76% of patients survived 1 year. We observed no significant differences in survival with regard to HF type (P = 0.2) or dementia disorder (P = 0.5). After adjustment for baseline covariates, neither HF types nor dementia disorders were independently associated with survival. CONCLUSIONS: Heart failure with preserved ejection fraction was the most common HF type and vascular dementia was the most common dementia disorder. The proportions of dementia disorders were similar across HF types. Neither HF types nor specific dementia disorders were associated with survival.
- Klíčová slova
- Alzheimer disease, Dementia, Heart failure, Preserved ejection fraction, Reduced ejection fraction, Registry, Survival, Vascular dementia,
- MeSH
- Alzheimerova nemoc epidemiologie MeSH
- lidé MeSH
- míra přežití MeSH
- registrace MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- srdeční selhání mortalita MeSH
- tepový objem fyziologie MeSH
- vaskulární demence mortalita MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: The association between mortality risk and use of antidepressants in people with dementia is unknown. OBJECTIVE: To describe the use of antidepressants in people with different dementia diagnoses and to explore mortality risk associated with use of antidepressants 3 years before a dementia diagnosis. METHODS: Study population included 20 050 memory clinic patients from the Swedish Dementia Registry (SveDem) diagnosed with incident dementia. Data on antidepressants dispensed at the time of dementia diagnosis and during 3-year period before dementia diagnosis were obtained from the Swedish Prescribed Drug Register. Cox regression models were used. RESULTS: During a median follow-up of 2 years from dementia diagnosis, 25.8% of dementia patients died. A quarter (25.0%) of patients were on antidepressants at the time of dementia diagnosis, while 21.6% used antidepressants at some point during a 3-year period before a dementia diagnosis. Use of antidepressant treatment for 3 consecutive years before a dementia diagnosis was associated with a lower mortality risk for all dementia disorders and in Alzheimer's disease. CONCLUSION: Antidepressant treatment is common among patients with dementia. Use of antidepressants during prodromal stages may reduce mortality in dementia and specifically in Alzheimer's disease.
- Klíčová slova
- Alzheimer's disease, antidepressant treatment, dementia, mortality risk,
- MeSH
- antidepresiva terapeutické užití MeSH
- demence diagnóza farmakoterapie mortalita MeSH
- lidé středního věku MeSH
- lidé MeSH
- prospektivní studie MeSH
- registrace MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Švédsko epidemiologie MeSH
- Názvy látek
- antidepresiva MeSH
BACKGROUND: Driving constitutes a very important aspect of daily life and is dependent on cognitive functions such as attention, visuo-spatial skills and memory, which are often compromised in dementia. Therefore, the driving fitness of patients with dementia needs to be addressed by physicians and those that are deemed unfit should not be allowed to continue driving. OBJECTIVE: We aimed at investigating to what extent physicians assess driving fitness in dementia patients and determinant factors for revoking of their licenses. METHODS: This study includes 15113 patients with newly diagnosed dementia and driver's license registered in the Swedish Dementia Registry (SveDem). The main outcomes were reporting to the licensing authority and making an agreement about driving eligibility with the patients. RESULTS: Physicians had not taken any action in 16% of dementia patients, whereas 9% were reported to the authority to have their licenses revoked. Males (OR = 3.04), those with an MMSE score between 20-24 (OR = 1.35) and 10-19 (OR = 1.50), patients with frontotemporal (OR = 3.09) and vascular dementia (OR = 1.26) were more likely to be reported to the authority. CONCLUSION: For the majority of patients with dementia, driving fitness was assessed. Nevertheless, physicians did not address the issue in a sizeable proportion of dementia patients. Type of dementia, cognitive status, age, sex and burden of comorbidities are independent factors associated with the assessment of driving fitness in patients with dementia. Increased knowledge on how these factors relate to road safety may pave the way for more specific guidelines addressing the issue of driving in patients with dementia.
- Klíčová slova
- Alzheimer’s disease, Dementia, agreement, cognitive status, driving license, frontotemporal dementia,
- MeSH
- demence komplikace MeSH
- lidé MeSH
- longitudinální studie MeSH
- průřezové studie MeSH
- psychomotorické poruchy diagnóza etiologie MeSH
- registrace * statistika a číselné údaje MeSH
- řízení motorových vozidel * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- testy pro posouzení mentálních funkcí a demence MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Švédsko epidemiologie MeSH
OBJECTIVES: The causes of death in dementia are not established, particularly in rarer dementias. The aim of this study is to calculate risk of death from specific causes for a broader spectrum of dementia diagnoses. DESIGN: Cohort study. SETTING: Swedish Dementia Registry (SveDem), 2007-2012. PARTICIPANTS: Individuals with incident dementia registered in SveDem (N = 28,609); median follow-up 741 days. Observed deaths were 5,368 (19%). MEASUREMENTS: Information on number of deaths and causes of mortality was obtained from death certificates. Odds ratios for the presence of dementia on death certificates were calculated. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox hazards regression for cause-specific mortality, using Alzheimer's dementia (AD) as reference. Hazard ratios for death for each specific cause of death were compared with hazard ratios of death from all causes (P-values from t-tests). RESULTS: The most frequent underlying cause of death in this cohort was cardiovascular (37%), followed by dementia (30%). Dementia and cardiovascular causes appeared as main or contributory causes on 63% of certificates, followed by respiratory (26%). Dementia was mentioned less in vascular dementia (VaD; 57%). Compared to AD, cardiovascular mortality was higher in individuals with VaD than in those with AD (HR = 1.82, 95% CI = 1.64-2.02). Respiratory death was higher in individuals with Lewy body dementia (LBD, including Parkinson's disease dementia and dementia with Lewy bodies, HR = 2.16, 95% CI = 1.71-2.71), and the risk of respiratory death was higher than expected from the risk for all-cause mortality. Participants with frontotemporal dementia were more likely to die from external causes of death than those with AD (HR = 2.86, 95% CI = 1.53-5.32). CONCLUSION: Dementia is underreported on death certificates as main and contributory causes. Individuals with LBD had a higher risk of respiratory death than those with AD.
- Klíčová slova
- Alzheimer's, Lewy body dementia, causes of death, death certificate, dementia, respiratory death, survival analyses,
- MeSH
- Alzheimerova nemoc mortalita MeSH
- demence s Lewyho tělísky mortalita MeSH
- kardiovaskulární nemoci mortalita MeSH
- kohortové studie MeSH
- lidé MeSH
- nemoci dýchací soustavy mortalita MeSH
- příčina smrti * MeSH
- registrace MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- úmrtní listy * MeSH
- vaskulární demence mortalita MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Švédsko epidemiologie MeSH