Heavy Drinking Is the Biggest Risk Factor for Dementia, Study Says
Hot on the heels of headlines linking alcohol consumption with longer life comes new research that casts a much more sobering light on drinking. According to an analysis of more than 1 million people—the largest study of its kind to date—scientists say that heavy alcohol use is the biggest modifiable risk factor for dementia, especially early-onset forms of the disease. The findings, which are published in The Lancet Public Health, came as a shock to the researchers involved. “We hypothesized that alcohol would play some role, but I don’t think anyone expected the size of the effect to be so large,” says lead author Dr. Jürgen Rehm, director of the University of Toronto’s Center for Addiction and Mental Health Institute for Mental Health Policy Research. There have been few studies examining the potential role of heavy alcohol consumption, Rehm says. Some research has suggested that a drink or two a day may have a protective effect on cognitive health—but other studies have linked drinking, even at moderate levels, to detrimental effects on brain structure. In a recent review by the Lancet Commission on Dementia Prevention, Intervention and Care, reducing alcohol consumption was not included as one of the nine lifestyle changes that may reduce the risk of dementia. To investigate the relationship further, Rehm and his colleagues analyzed hospital records of more than 1 million adults in France who were diagnosed with dementia b...
Atypical chest pain is of diverse origin. Typically, we initially consider cardiac etiology. When pain appears non-cardiac, there is a tendency to underestimate the illness, especially if the patient has neuropsychiatric illness. Our resident with dementia and anxiety disorder had chest pain; the diagnosis was unexpected.
West Nile Virus (WNV) infection is the most common mosquito-borne illness in the United States. Most cases are asymptomatic or with mild symptoms. Older adults are more likely to have central nervous system (CNS) involvement, and a higher risk for mortality.
Antipsychotic medications are a vital part of controlling psychosis in schizophrenic patients. However, when those patients live in nursing facilities, we are obligated by CMS to undertake gradual dose reductions of antipsychotic medication if possible. Sometimes, these efforts are successful and sometimes they fail. Antipsychotic medications have many side effects, including sedation, diabetes, hyperlipidemia, weight gain, motor rigidity, impaired gait, and falls. Monitoring of blood glucose, lipids, and extrapyramidal symptoms is mandatory.
Psychotropic medications are often prescribed to manage behavioral and psychological symptoms of dementia (BPSD) in nursing home (NH) residents, although these medications may lack efficacy for BPSD and can have adverse effects. NHs can receive a deficiency of care citation for inappropriate psychotropic medication use (F-758 tag). To promote more effective dementia care, some states specify dementia-specific training requirements for NH nursing staff. The occurrence of F-758 citations related to care of residents with dementia was examined in relation to the presence of state-level dementia-specific in-service training re...
Many older adults do not plan for their LTSS needs. When older adults experience a health crisis (e.g. hospitalization, worsening dementia), family members must often react to the crisis. With PCORI funding, we developed PlanYourLifespan.org (PYL.org) as a national, free, publicly available website that enables older adults and families to understand future needs and plan for what they will need as they age. Different than end-of-life planning, PYL.org focuses on what LTSS people will need when they are in their 80 ’s, 90’s, and 100’s.
Most behaviour assessment tools used in long-term care (LTC) involve retrospective reports. These assessments are prone to errors in recall and provide little opportunity to identify the context of behaviours. Furthermore, these assessments are often underused, prone to incomplete and inaccurate data collection, and the results can be difficult to analyze. To address these problems, we developed a Dementia Observations (DObs) mobile application for direct observation of behaviour symptoms. Direct observation of behaviour provides more detail about the frequency, duration, precipitants, and patterns.
Up to 38% of individuals with advanced dementia experience clinical depression. Although studies demonstrate lower rates of clinical depression as dementia advances, this may be attributed to the difficulty of assessment at this stage. Clinical interviews are thorough in assessing depression, though they are time- and resource-contingent. As such, healthcare providers often turn to screening tools or scales. However, conventional tools for assessing depression have problems with validity in this population.
This study leveraged data analytics to understand the similarities and differences between the urban and non-urban home health agencies in terms of their quality measures.
Symptoms of delirium are common in the post-acute care setting, particularly in patients who have dementia or are approaching the end of life. When behavioral measures fail to adequately manage symptoms, there are few alternative options. Antipsychotic medications have long been the mainstay of pharmacologic treatment for delirium, despite a paucity of evidence for efficacy and newer data suggestive of possible harms. Moreover, the use of a new antipsychotic medication in veterans admitted to a short-term rehabilitation center is seen as potentially inappropriate and negatively affects the CMS/Medicare Quality Indicator (QI) profile.
At San Francisco Veterans Affairs Health Care System (SFVA) Community Living Center (CLC), most veterans have dementia plus co-occurring mental illness. Many demonstrate distressed behavior that interferes with care. CLC restorative care and mental health staff identified the need to improve engagement of veterans with dementia or behavioral challenges, and improve care partner training. Along with researchers at SFVA, they implemented PLI É, a novel integrative group exercise program for people with dementia.
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