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ObjectiveTo investigate the characteristics of gender difference and the trend of the mortality rate of senile dementia in registered population in Shanghai from year 2002 to 2018， and to provide the basis for formulating relative intervention measures before and after senile dementia from an public-health view. MethodsBased on the collected data of death registration， focused on the senile dementia disease codes F03，G30.0，G30.1，G30.8，G30.9 according to The International Classification of Diseases 10th revision （ICD-10）. We analyzed the characteristics of gender difference in the mortality rate of senile dementia in registered population in Shanghai from year 2002 to 2018. According to ASR， we calculated the standardized mortality rate of senile dementia， and used the chi-square test to compare the difference between the gender mortality rates. The trend and the turning point of the mortality rate of senile dementia were determined by linear regression analysis by Join-point. ResultsThe crude mortality rate of senile dementia in the registered population in Shanghai from year 2002 to 2018 was 5.46/105， 3.50/105 in males and 7.43/105 in females. The standardized mortality rate of senile dementia was 2.61/105， 1.67/105 in males and 3.56/105 in females. The trend of the standardized mortality rate of senile dementia in 17 years decreased ［APC=-5.5（-6.5，-4.5）%，P<0.01］. The trend of the standardized mortality rate of senile dementia decreased in both males ［APC=-4.9（-6.2，-3.6）%，P<0.01］ and females ［APC=-5.9（-6.9，-4.9）%，P<0.01］. The trend of the gender difference decreased ［APC=-6.8（-8.2，-5.3）%，P<0.01］. The mortality rate of senile dementia was higher in females than in males ［（χ2=33.63，P<0.01）］. ConclusionThe mortality rate of senile dementia in females is higher than in males in Shanghai， though the trend of the gender difference decreased. This gender difference is worth of attention.
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Objective:To discuss the medication law in prescriptions of Professor Shao Nianfang in the treatment of kidney deficiency and bone marrow loss in senile dementia based on data mining.Methods:Medical cases of kidney deficiency and bone marrow loss in senile dementia in the Geriatric Hospital of Shandong University of Traditional Chinese Medicine from 1st Jan. 2014 to 31st Oct, 2019 were collected. Through hospital electronic medical records system prescription statistics, using ancient and modern medical case cloud platform (V1.2.4), medication frequency, property ans taste, efficacy analysis, correlation rule analysis, clustering analysis and complex network analysis were performed.Results:Totally 110 cases were included in medical cases, involving 238 kinds of Chinese materia medica. The top 10 Chinese materia medica with use frequency were Poria, Acori Tatarinowii Rhizoma, Corni Fructus, Dioscoreae Rhizoma, Rehmanniae Radix Praeparata, Alpiniae Oxyphyllae Fructus, Rehmanniae Radix, Astragali Radix, Chuanxiong Rhizoma, Atractylodis Macrocephalae Rhizoma; the properties were mainly mild, warm slight cold, and cold; the tastes were mainly sweet, bitter, pungent, and light; the meridians were mainly spleen, liver, lung and kidney meridians; the efficacy was clearing dampness and promoting diuresis, clearing heat and promoting blood circulation, calming mind, clearing heat and detoxification, reducing dampness and promote appetizing, tonifying spleen; the association analysis found 15 groups of drug combinations used more than 25 times, they were: Corni Fructus and Poria, Corni Fructus and Dioscoreae Rhizoma, Dioscoreae Rhizoma and Corni Fructus, Rehmanniae Radix Praeparata and Corni Fructus, Dioscoreae Rhizoma and Poria, Astragali Radix and Poria, Alismatis Rhizoma and Poria, Moutan Cortex and Poria, Rehmanniae Radix Praeparata and Poria, Rehmanniae Radix and Poria, Polygalae Radix and Acori Tatarinowii Rhizoma, Moutan Cortex and Corni Fructus, Moutan Cortex and Dioscoreae Rhizoma, Alismatis Rhizoma and Corni Fructus, Alismatis Rhizoma and Dioscoreae Rhizoma; clustering analysis identified four groups of new prescriptions, the first group: Poria, Rehmanniae Radix, Rehmanniae Radix Praeparata, Alismatis Rhizoma, Moutan Cortex, Corni Fructus, Dioscoreae Rhizoma; the second group: Acori Tatarinowii Rhizoma, Cistanches Herba, Morindae Officinalis Radix; the third group: Alpiniae Oxyphyllae Fructus, Chuanxiong Rhizoma, Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle; the fourth group: Atractylodis Macrocephalae Rhizoma, Codonopsis Radix, Astragali Radix, Angelicae Sinensis Radix; the results of complex network analysis showed that the core prescription was modified Liuwei Dihuang Pills. Conclusion:This study found that in view of kidney deficiency and bone marrow loss in senile dementia, Professor Shao pays attention to strengthening the healthy qi, and focuses on tonifying deficiency, taking into account the methods of clearing dampness, clearing heat, detoxification, removing blood stasis and restoring consciousness. The four new prescriptions found in the study can provide a reference for modified medication for syndrome differentiation.
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Objective:To clarify the influence and influence paths of stigma on the time of the healthcare-seeking decision in caregivers of elderly patients with dementia, and to provide a theoretical basis for the construction of corresponding humanistic care strategies.Methods:A total of 176 caregivers of elderly patients with dementia who visited the Affiliated Hospital of Xuzhou Medical University and Xuzhou Oriental People ′s Hospital from February 2021 to February 2022 were selected as the study subjects. The General Information Questionnaire, self-designed Scale of Stigma for Caregivers of Senile dementia patients, Multidimensional Scale of Perceived Social Support, self-designed Elderly Dementia Caregivers′ Perceived Barriers Scale for Healthcare-seeking Decision, and self-designed Scale of the Intention to Seek Healthcare for caregivers of senile dementia patients were used in the survey. AMOS 20.0 was used to establish a structural equation model for path analysis. Results:The higher the stigma of caregivers, the longer the time of the healthcare-seeking decision ( β=0.05, P<0.05). Social support, perceived barriers to the healthcare-seeking decision, and the intention to seek healthcare were the mediating variables of caregivers ′ stigma affecting the time of the healthcare-seeking decision, with a total effect of -0.04, 0.14, and 0.36, respectively, and all P<0.05. Conclusions:The stigma in caregivers of senile dementia patients is an important factor affecting the time of the healthcare-seeking decision. By improving mediating factors including social support, perceived barriers to the healthcare-seeking decision, and the intention to seek healthcare, the implementations of targeted humanistic care strategies are expected to help shorten the time of the healthcare-seeking decision.
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OBJECTIVE@#To explore the effects of cluster needling at the scalp points on the expression of choline acetyl transferase (ChAT) and choline cholinesterase (AchE).@*METHODS@#A total of 60 Wistar rats were randomized into a sham-operation group, a model group, a medication group and a cluster needling group, 15 rats in each one. In the model group, the medication group and the cluster needling group, the models of Alzheimer's disease (AD) were established by the orienteering injection with Aβ1-42 in the bilateral hippocampal CA1 in the rats. In the sham-operation group, the distilled water was injected in bilateral hippocampus of rats. In the medication group, the lavage with aricept was adopted for the basic treatment, once a day, for 4 weeks consecutively. In the cluster needling group, on the base of the treatment as the medication group, the cluster needling at the scalp points was adopted, once a day, 6 times a week, for 4 weeks totally. In the sham-operation group and the model group, the normal feeding was provided. After intervention, the learning and memory ability was measured with Morris water maze in the rats of each group. The changes in the hippocampal gross structure were observed with HE staining. The changes in the positive expressions of hippocampal ChAT and AchE were determined with the immunohistochemical method.@*RESULTS@#Compared with the sham-operation group, the escape latency was prolonged and the percentage of the second quadrant and the frequency of platform leaping were reduced in the rats of the model group (all 0.05) and the expression of AchE was reduced (<0.05) in the medication group; the expression of ChAT was increased (<0.05) and that of AchE decreased (<0.01) in the cluster needling group. Compared with the medication group, the expression of ChAT was increased and that of AchE decreased in the cluster needling group (both <0.05).@*CONCLUSION@#The effect mechanism of cluster needling at the scalp points on AD could be related to the up-regulation of ChAT expression and down-regulation of AchE expression in the hippocampus. The combined treatment with the cluster needling and aricept achieves the better therapeutic effect on AD.
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Animals , Rats , Alzheimer Disease , Choline O-Acetyltransferase , Hippocampus , Rats, Sprague-Dawley , Rats, Wistar , ScalpABSTRACT
The prevalence of elderly dementia patients in our country is high, the course is long and the cost is high, the visiting rate is low and it is difficult to cure. The implementation of humanistic care to them is the essen-tial demands of medical spirits, also is a necessary supplement to the poor medical treatment and can also give more psychological support to patients and their families. Therefore, it should establish a sound service system, strength-en health education and cultivate professional accompanying staff, in order to enhance the quality of life of elderly dementia patients and improve the living conditions.
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OBJECTIVE To explore the mechanisms of the volatiles of Wendan granule for the treatment of senile dementia,network pharmacology method integrating absorption,distribution,metab-olism, and excretion (ADME) screening, target fishing, network constructing, pathway analyzing, and correlated diseases prediction was applied. METHODS Twelve small molecular compounds of WDG were selected as the objects from 74 volatiles with the relative abundances above 2%,and their ADME parameters were collected from Traditional Chinese Medicine Systems Pharmacology platform (TCMSP), and then the corresponding targets, genes, pathways and diseases were predicted according to the data provided by TCMSP,DrugBank,Uniport and the Database for Annotation,Visualization and Integrated Discovery(DAVID).The related pathways and correlation analysis were explored by the Kyoto Encyclo-pedia and Genomes (KEGG) database. Finally, the networks of compound-target, target-pathway and pathway-disease of WDG were constructed by Cytoscape software. RESULTS Twelve compounds interacted with 49 targets, of which top three targets were Gamma-aminobutyric acid receptor subunit alpha-1 (GABRA1), Prostaglandin G/H synthase 2 (PGHS-2) and Sodium-dependent noradrenaline transporter.Interestingly,these targets were highly associated with depression,insomnia and Alzheimer′s disease that mainly corresponded to mental and emotional illnesses. CONCLUSION The integrated network pharmacology method provides precise probe to illuminate the molecular mechanisms of volatiles of WDG for relieving senile dementia related syndromes,which will also facilitate the application of traditional Chinese medicine in modern medicine,as well as follow-up studies such as upgrading the quality stan-dard of clinical medicine and novel drug development.
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Objective To investigate characteristics of abnormal eating behaviors in patients with Alzheimer's disease and explore the potential needs of the patients.Methods Based on the model of Need-driven Dementiacompromised Behavior (NDB),we used the list of eating behaviors in patients with Alzheimer's disease to observe and record the behaviors of 120 patients and extracted the characteristics of abnormal eating behaviors.Twelve caregivers were selected to participate in the individual in-depth interview using semi-structured interview method,and then 5 of them were involved in the focus group interview for richness and accuracy.Content analysis was used to analyze data.Results Abnormal eating behaviors were identified in 47.5％(57/120) of the patients with Alzheimer's disease.The most common abnormal eating behavior was verbal refusal to eat or stating "No more","Not hungry","I'm fu11"(64.9％),the second was spiting food out(63.2％),the simultaneous items were impatient behaviors prior to or during meal time(38.6％),being distracted from eating(38.6％),resisting help with meal(38.6％),refusal to open mouth (38.6％).Four potential needs were extracted,including desire for family,desire for companion,desire for eating dignity,and eagerness for a sense of inner security.Conclusion It is common for patients with Alzheimer's disease to show abnormal eating behaviors,which demonstrate their potential needs.Caregivers need to be trained to identify the abnormal behaviors of patients and reflected potential needs.Those needs should be met to improve patients' quality of care,and reduce burdens of caregivers.
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Objective · To explore family medical intervention model of senile dementia with behavioral and psychological symptoms. Methods · Four streets of Changning District in Shanghai were randomly selected and subjects were enrolled according to the inclusion criteria, who were randomly divided into the intervention group (n=71) and control group (n=70). The intervention group received door-to-door service from psychiatric doctors, given drug treatment and psychological intervention. Subjects were evaluated by several scales, including Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), Mini-Mental State of Examination (MMSE), Activity of Daily Living Scale (ADL), Quality of Life-Alzheimer's Disease (QOL-AD), and Generic Quality of Life Inventory-74 (GQOLI-74), at baseline and by the end of 6 months and 12 months. Results · ① There was no significant difference in the total scores and all factor scores of BEHAVE-AD between the two groups before intervention (P>0.05). Repeated measures analysis of variance revealed a significant main effect of time (P0.05). Repeated measures analysis of variance revealed a significant main effect of time (P<0.001). The between-group effect was significant in the scores of MMSE and QOL-AD (P<0.001). The interactive effect of time×group was significant in the scores of MMSE, ADL, QOL-AD, and GQOLI-74 (P<0.05). ④ Inter-group comparison of MMSE, ADL, QOL-AD, and GQOLI-74 scores indicated that by the end of 6 months, scores of MMSE of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.05). By the end of 12 months, scores of MMSE, ADL, QOL-AD, and GQOLI-74 of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.05). Conclusion · The family medical intervention model of door-to-door services from psychiatrists integrating multidisciplinary team is effective to attenuate the mental and behavioral symptoms of senile dementia patients, and can improve the quality of life of patients and caregivers. The effect of persistent implementation will be more remarkable.
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Objective To explore the effects of cluster nursing intervention on cognitive improvement in the caregivers of senile dementia.Methods Totally 95 caregivers of senile dementia selected from a grade 3 A hospital in Chongqing City were employed the cluster nursing intervention.The Alzheimer's disease knowledge assessment (ADKS) scale was used to conduct the assessment before and after intervention.Results The ADKS total score before intervention in the caregivers of senile dementia was (19.970±2.216) points,which after intervention was (23.400± 1.270) points,the difference was statistically significant (P=0.000).The ADKS scores at high,middle and low score segmentations after intervention were significantly higher than those before intervention(P＜0.05),in which the difference between the low score segmentation and middle score segmentation was more significant.Conclusion The cluster nursing intervention has obvious improvement effect on the cognitive situation in the caregivers of senile dementia,especially for the group of lower ADKS scores.
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Objective To explore the effects of cluster nursing intervention on cognitive improvement in the caregivers of senile dementia.Methods Totally 95 caregivers of senile dementia selected from a grade 3 A hospital in Chongqing City were employed the cluster nursing intervention.The Alzheimer's disease knowledge assessment (ADKS) scale was used to conduct the assessment before and after intervention.Results The ADKS total score before intervention in the caregivers of senile dementia was (19.970±2.216) points,which after intervention was (23.400± 1.270) points,the difference was statistically significant (P=0.000).The ADKS scores at high,middle and low score segmentations after intervention were significantly higher than those before intervention(P＜0.05),in which the difference between the low score segmentation and middle score segmentation was more significant.Conclusion The cluster nursing intervention has obvious improvement effect on the cognitive situation in the caregivers of senile dementia,especially for the group of lower ADKS scores.
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Objective To understand the prevalence of senile dementia in the elderly aged ≥ 60 years in China between 2000 and 2015.Methods Publications between 2000 and 2015 were retrieved from China National Knowledge Infrastructure (CNKI),Wanfang Databases,Chinese Science and Technology Journal Databases (VIP) and PubMed.Observational studies on prevalence of senile dementia were included.Meta-analysis was carried out by using R software.Results A total of 25 papers were included in this study.The total number of participants investigated was 76 980,with 4 295 dementia cases identified.The prevalence of senile dementia in the elderly was 5.15％ (95％CI:4.21％-6.09％);Subgroup analysis showed that the women had a higher prevalence (6.08％) than the men (4.10％);and the prevalence was significant increased with age (The senile dementia prevalence was 1.01％ in age groups 60-64 years,but 23.60％ in age group ≥85 years).The prevalence of Alzheimer's disease (3.56％) was higher than that of cerebral vascular dementia (1.11％).The senile dementia prevalence in the illiterate was 8.74％,higher than 3.17％ in the literate.The prevalence of senile dementia in the unmarried was 6.83％,higher than that in the married (3.95％).Conclusion The prevalence of senile dementia was high in the population aged ≥60 years in China.Age,sex,education level and marital status might influence the prevalence of senile dementia.
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Objective To understand the prevalence of senile dementia in the elderly aged ≥ 60 years in China between 2000 and 2015.Methods Publications between 2000 and 2015 were retrieved from China National Knowledge Infrastructure (CNKI),Wanfang Databases,Chinese Science and Technology Journal Databases (VIP) and PubMed.Observational studies on prevalence of senile dementia were included.Meta-analysis was carried out by using R software.Results A total of 25 papers were included in this study.The total number of participants investigated was 76 980,with 4 295 dementia cases identified.The prevalence of senile dementia in the elderly was 5.15％ (95％CI:4.21％-6.09％);Subgroup analysis showed that the women had a higher prevalence (6.08％) than the men (4.10％);and the prevalence was significant increased with age (The senile dementia prevalence was 1.01％ in age groups 60-64 years,but 23.60％ in age group ≥85 years).The prevalence of Alzheimer's disease (3.56％) was higher than that of cerebral vascular dementia (1.11％).The senile dementia prevalence in the illiterate was 8.74％,higher than 3.17％ in the literate.The prevalence of senile dementia in the unmarried was 6.83％,higher than that in the married (3.95％).Conclusion The prevalence of senile dementia was high in the population aged ≥60 years in China.Age,sex,education level and marital status might influence the prevalence of senile dementia.
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Alois Alzheimer is best known for his description of a novel disease, subsequently named after him. However, his wide range of interests also included vascular brain diseases. He described Senile dementia, a highly heterogeneous condition, and was able not only to distinguish it from syphilitic brain disease, but also to discriminate two clinicopathological subtypes, that may be labeled a "arteriosclerotic subtype", comparable to the present clinicopathological continuum of "Vascular cognitive impairment", and another as a "neurodegenerative subtype", characterized by primary [cortical] ganglion cell [nerve cells] degeneration, possibly foreshadowing a peculiar presenile disease that he was to describe some years later and would carry his name. He also considered the possibility of a senile presentation of this disease subtype, which was described by Oskar Fischer a short time later. Considering the clinicopathological overlapping features of the "arteriosclerotic subtype" of Senile dementia with Arteriosclerotic atrophy of the brain, it might be possible to consider that both represent a single condition.
Alois Alzheimer é conhecido principalmente por sua descrição de uma nova doença, logo designado com seu nome. Entretanto, sua ampla gama de interesses, compreendia também doenças vasculares cerebrais. Descreveu a Demência senil, uma condição muito heterogênea, e foi capaz, não somente distingui-la da doença cerebral sifilítica, como também separar dois subtipos clinicopatológicos que podem ser rotulados como um "subtipo arteriosclerótico", que pode ser relacionado ao atual continuum clinicopatológico do "Comprometimento cognitivo vascular", e um "subtipo neurodegenerativo", caracterizado por degeneração [cortical] primária de células ganglionares [células nervosas], possivelmente prenunciando uma doença peculiar pré-senil, que ele descreveu alguns anos depois e que portaria seu nome. Considerou a possibilidade de uma apresentação senil deste subtipo da doença, que seria descrita por Oskar Fischer pouco tempo depois. Levando em conta os aspectos de sobreposição clinicopatológica do "subtipo arteriosclerótico" da Demência senil com a Atrofia arteriosclerótica do cérebro, poderia ser possível considerar que ambas representariam uma só condição.
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Humans , Arteriosclerosis , Brain Diseases , Alzheimer DiseaseABSTRACT
Initially the trajectory of the historical forerunners and conceptions of senile dementia are briefly presented, being highlighted the name of Alois Alzheimer who provided clinical and neuropathological indicators to differentiate a group of patients with Senile dementia. Alzheimer's examination of Auguste D’s case, studied by him with Bielschowsky’s silver impregnation technique, permitted to identify a pathological marker, the intraneuronal neurofibrillary tangles, characterizing a new disease later named after him by Kraepelin – Alzheimer’s disease. Over the time this disorder became one of the most important degenerative dementing disease, reaching nowadays a status that may be considered as epidemic.
Incialmente é apresentada brevemente a trajetória histórica dos precursores e dos conceitos da demência senil, sendo destacado o nome de Alois Alzheimer que forneceu indicadores clínicos e neuropatológicos para diferenciar um grupo de pacientes com Demência senil. O exame de Alzheimer do caso de Auguste D, estudado por ele com a técnica de impregnação argêntica de Bielschowsky, permitiu identificar um marcador patológico, os emaranhados neurofibrilares intraneuronais, caracterizando uma nova doença, mais tarde denominada com seu nome por Kraepelin – doença de Alzheimer. Com o passar do tempo esta desordem tornou-se uma das mais importantes doenças demenciante degenerativa, alcançando, na atualidade, um status que pode ser considerado como epidêmico.
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Female , Humans , Pregnancy , Fetal Diseases/prevention & control , Glucocorticoids/administration & dosage , Glucocorticoids/pharmacology , Prenatal Care/methods , Drug Administration Schedule , Glucocorticoids/adverse effects , Lung/embryology , Pulmonary Surfactants/therapeutic useABSTRACT
Objective To analyze the relationship between hyperhomocystinemia (HHcy) and occurrence of Alzheimer disease (AD) .Methods A total of 100 cases of elderly patients with dementia were collected ,from April 2010 to May 2013 ,and divided in‐to AD group and vascular dementia (VD) group according to patients′condition .Other 50 cases of healthy elderly individuals were collected in the control group .Levels of homocysteine (Hcy) were detected ,and the relationship between level of Hcy and occur‐rence of AD was analysed .Results Levels of Hcy in the AD group and VD group were higher than that in the control group ,and were decreased after treatment ,there were statistically significant differences(P<0 .05) .After treatment ,the scores of mini‐mental state examination(MMSE) in the AD group and VD group both were increased ,and the score of activity of daily living scale(ADL) was decreased in the AD group ,there were statistically significant differences (P<0 .05) .The level of Hcy in mild AD patients was lower than that in severe AD patients ,the difference was statistically significant (P<0 .05) .The AD odds ratio(OR) was 4 .7 ,and 95% confidence interval(CI) was 1 .76 -7 .09 .The level of Hcy in patients with AD was significantly negatively correlated with score of MMSE ,the coefficient value(r) was -0 .32 ,-0 .40 and -0 .27 in mild ,moderate and severe AD(P<0 .05) .Conclusion HHcy is an independent risk factor for the onset of AD ,so attention should be paid on high Hcy level ,in order to prevent AD .
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Objective To study experienced doctors’ treatment of senile dementia based on association rule. Methods Databases, such as CNKI, CSCD, CBMdisc, CPD, and Wanfang Data were searched for articles about senile dementia. SPSS17.0 and Clementine12.0 software were used for frequency and correlation analysis of prescription. Results In total of 67 articles about TCM therapy for senile dementia were included, containing 112 prescriptions, 178 Chinese herbal medicines, 1589 frequency, and 14.2 entries for each prescription. The first three frequently used herbal medicines were Acori Tatarinowii Rhizoma, Polygala Radix, and Salviae Miltiorrhizae Radix et Rhizoma. Accoring to association rule, the first three medicine pairs were Citrus Reticulatae Pericarpium→Pinelliae Rhizoma, Dioscoreae Rhizoma→Rehmanniae Radix Praeparata, and Codonopsis Radix→Citrus Reticulatae Pericarpium. The first three thriple herbal medicines were Dioscoreae Rhizoma+Lycii Fructus→Corni Fructus, Acori Tatarinowii Rhizoma+Corni Fructus→Rehmanniae Radix Praeparata, and Carthami Flos + Hirudo→Bupleuri Radix. Conclusion The results based on association rule effectively summarized all the doctors’ treatment experience in senile dementia, and provided the beneficial reference for the clinical treatment of senile dementia.
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La Enfermedad de Alzheimer (EA) es una patología neurodegenerativa frecuente en la población senil. Clínicamente se caracteriza por la pérdida progresiva de la memoria y otras habilidades cognitivas. Se han propuesto diversas causas como desencadenantes de la EA, entre las cuales se encuentran factores ambientales como malnutrición, lesiones a nivel craneal y exposición al aluminio (Al), debido a que este metal es una sustancia neurotóxica. El objetivo del presente estudio fue evaluar los niveles de aluminio sérico en pacientes con enfermedad de Alzheimer, internados en un geriátrico en el municipio Veroes, Estado Yaracuy, durante el período mayo-junio de 2013. La muestra estuvo conformada por 22 pacientes con EA, y el grupo control estuvo representado por 12 pacientes sin EA. Las concentraciones de aluminio sérico fueron determinadas por Espectrofotometría de Absorción Atómica Electrotérmica (ETAAS) con horno de grafito. Se obtuvieron valores de la mediana de aluminio sérico de 2,15 mg/L, con un máximo de elevación de 3,0 mg/L para el grupo con EA, mientras que el control fue de 1,60 mg/L, con un máximo de 3,30 mg/L. Ninguno de los pacientes presentaron niveles de Al sérico por encima del límite permisible. Se observaron cifras superiores de este metal en los pacientes con EA en comparación con el grupo control, además de ser significativamente mayores en el género femenino y en aquellos que consumían antiácidos.
Alzheimer's disease (AD) is a common neurodegenerative disorder in the elderly population. It is clinically characterized by progressive loss of memory and other cognitive skills. There are several proposed AD causes as triggers, among which are environmental factors including malnutrition, cranial injuries and exposure level aluminum (Al), because this metal is a neurotoxic substance. The aim of this study was to evaluate serum aluminum levels in patients with Alzheimer's disease, institutionalized in Veroes town, Yaracuy state during May-June 2013 period. The sample consisted of 22 patients with AD and the control group was represented by 12 patients without AD. Serum aluminum concentrations were determined by Electrothermal Atomic Absorption Spectrophotometry (ETAAS) with graphite furnace. Median values of serum aluminum of 2.15 mg/L, with a maximum height of 3.0 mg/L for the AD group were obtained, while the control was 1.60 mg/L, with a maximum of 3.30 mg/L. None of the patients had serum Al levels above the allowable limit. Higher figures of this metal were observed in patients with AD compared with the control group, as well as being significantly higher in females and in those eating antacids.
A doença de Alzheimer (DA) é uma desordem neurodegenerativa frequente na população idosa. Clinicamente caracteriza-se pela perda progressiva da memória e outras habilidades cognitivas. Várias causas têm sido propostas como gatilhos para DA, incluindo fatores ambientais tais como a desnutrição, lesões cranianas e exposição de alumínio (Al), devido a que este metal é uma substância neurotóxica. O objetivo deste estudo foi avaliar os níveis de alumínio sérico em pacientes com doença de Alzheimer, hospitalizados na cidade Veroes, Estado Yaracuy, durante o período maio-junho de 2013. A mostra consistiu de 22 pacientes com DA e o grupo controle foi representado por 12 pacientes sem DA. Concentrações de alumínio sérico foram determinadas por Espectrofotometria de Absorção Atômica Eletrotérmica (ETAAS) com forno de grafite. Os valores da mediana de alumínio sérico de 2,15 mg/L, com uma altura máxima de 3,0 mg/L para o grupo DA foram obtidos, enquanto que para o grupo controle foi de 1,60 mg/L, com um máximo de 3,30 mg/L. Nenhum dos pacientes tinha níveis séricos de Al acima do limite permitido. Foram observados valores mais elevados deste metal nos pacientes com DA em comparação com o grupo controle, além de ser significativamente maior no sexo feminino e nas pessoas que consumiam antiácidos.
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Humans , Aluminum , Alzheimer Disease , Environment , Precipitating FactorsABSTRACT
El Alzheimer es una enfermedad neurodegenerativa que se manifiesta como deterioro cognitivo y trastornos conductuales. En Cuba, junto a la demencia, ocupa el lugar número 6 en el cuadro de principales causas de muerte. No hay tratamiento eficaz para detener la progresión del Alzheimer. Sin embargo, algunas terapias detienen o ralentizan temporalmente el deterioro cognitivo, funcional y conductual de la enfermedad. En el trabajo se presenta una revisión actualizada a partir de la base de datos MEDLINE (2008-2013) sobre los mecanismos patológicos y los medicamentos usados en el tratamiento de los pacientes con la referida afección(AU)
Alzheimer disease is a neurodegenerative illness that manifests as cognitive deterioration and behavioral disorders. It holds the 6th place, like dementia, in the list of main causes of death in Cuba. There is no effective treatment to stop progression of Alzheimer's disease. However, some therapies manage to halt or to slow at least temporarily the cognitive, functional and behavioral deterioration of the disease. This paper presented an updated review on the pathological mechanisms and the drugs used in the treatment of Alzheimer patients, using MEDLINE database(AU)
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Humans , Alzheimer Disease/drug therapy , Alzheimer Disease/therapyABSTRACT
Objective To evaluate the risk factors for healthcare-associated infection(HAI)in senile dementia pa-tients,so as to adopt effective nursing measures to reduce the incidence of HAI.Methods Clinical data of 82 senile dementia patients aged≥60 years and hospitalized between January 2011 and June 2013 were analyzed retrospective-ly.Results Of 82 patients,28 (34.15%)developed HAI.The main infection site was lower respiratory tract(n=15,53.57%),followed by urinary tract(n=6,21 .43%).Univariate analysis revealed that risk factors for HAI in senile dementia patients were bedridden,long length of hospital stay ,dysphagia,indwelling urinary catheter,irra-tional use of antimicrobial agents,combined with tumor,and hypoproteinemia (all P <0.05 ).The main isolated bacteria were gram-negative bacilli(n=40,62.50%),the top three pathogens were Klebsiella pneumoniae (n=12, 18.75%),Escherichia coli (n =10,15.63%),and Pseudomonas aeruginosa (n =8,12.50%).Conclusion Reali-zing the risk factors and common pathogens of HAI in senile dementia patients is helpful for taking effective meas-ures to prevent and control the incidence of HAI .
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Objective To explore the effect of rehabilitation training on self-care ability of patients with senile dementia. Methods One hundred and one senile dementia patients were divided into two groups with 53 cases in experimental group receiving targeted rehabilitation training besides routine nursing and 48 in control group only receiving routine nursing.Self-care ability of patients in the two groups was comparatively evaluated according to the activity of daily living scale (ADL).Result The ADL score and the total score of the experimental group were both higher than those of the control group (P<0.05).Conclusion Rehabilitation training according to the specific conditions of patients with senile dementia can improve their self-care ability in adapting to the society, delaying the progress of the disease and improving the quality of life.