Application and evaluation of multi-sensory stimulation therapy in agitation behavior of patients with Alzheimer′s disease / 中国实用护理杂志

Objective:To investigate the effect of multi-sensory stimulation therapy on agitation behavior in patients with Alzheimer's disease(AD).Methods:A total of 45 patients with AD hospitalized in the Department of Neurology of Xuanwu Hospital, Capital Medical University, from June 2021 to January 2022 were selected, including 23 cases in the control group and 22 cases in the experimental group. The control group was treated with routine nursing methods, and the experimental group was treated with multi-sensory stimulation. The scores of Cohen-Mansfield Agitation Inventory (CMAI) and Behavioral Pathology in Alzheimer′s Disease Rating Scale (BEHAVE-AD) were compared between the two groups before and after treatment.Results:CMAI comparison showed that after the intervention, the CMAI scores of the experimental group and the control group was 33.14 ± 3.72 and 37.13 ± 7.23 respectively. The difference was statistically significant ( t=-2.34, P<0.05). The total score of "physical non aggressive behavior" and "language non aggressive behavior" in the experimental group were (11.09±2.91), (5.73±2.16), which were lower than those in the control group (13.57±4.33), (8.22±2.71). The differences were statistically significant ( t=-2.26,-3.39, P<0.05). The BEHAVE-AD scores of the experimental group before and after the intervention were (13.14 ± 9.54), (9.50 ± 4.81), in the control group were (11.04 ± 8.34), (10.70 ± 9.81). There was significant difference in BEHAVE-AD score before and after the intervention in the experimental group ( t=2.21, P<0.05), but there was no significant difference compared with the control group ( t=-0.73, P>0.05). "Behavior disorder" of the experimental group improved significantly after the intervention, and the score was (2.41 ± 1.26) compared with the control group (4.48 ± 2.87), the difference was statistically significant ( t=-3.10, P<0.05). Conclusions:Compared with routine nursing, visual + auditory + tactile multi-sensory stimulation can improve the agitation behavior of AD patients, especially non aggressive agitation behavior, which has certain clinical significance and can provide reference for future related research.

Improvement of Screening Accuracy of Mini-Mental State Examination for Mild Cognitive Impairment and Non-Alzheimer's Disease Dementia by Supplementation of Verbal Fluency Performance

OBJECTIVE: This study aimed to investigate whether the supplementation of Verbal Fluency: Animal category test (VF) performance can improve the screening ability of Mini-Mental State Examination (MMSE) for mild cognitive impairment (MCI), dementia and their major subtypes. METHODS: Six hundred fifty-five cognitively normal (CN), 366 MCI [282 amnestic MCI (aMCI); 84 non-amnestic MCI (naMCI)] and 494 dementia [346 Alzheimer's disease (AD); and 148 non-Alzheimer's disease dementia (NAD)] individuals living in the community were included (all aged 50 years and older) in the study. RESULTS: The VF-supplemented MMSE (MMSE+VF) score had a significantly better screening ability for MCI, dementia and overall cognitive impairment (MCI plus dementia) than the MMSE raw score alone. MMSE+VF showed a significantly better ability than MMSE for both MCI subtypes, i.e., aMCI and naMCI. In the case of dementia subtypes, MMSE+VF was better than the MMSE alone for NAD screening, but not for AD screening. CONCLUSION: The results support the usefulness of VF-supplementation to improve the screening performance of MMSE for MCI and NAD.

Predictive Factors for Decline in Activities of Daily Living in Alzheimer's Disease Dementia with More than 2 Follow-up

BACKGROUND: Impairment in activities of daily living (ADL) is a major problem in Alzheimer's disease (AD), and is related to increased caregiver burden.The present study evaluated whether there are any components of initial dementia evaluation that could predict ADL decline in years follow-up. METHODS: The 32 subjects underwent more than two consecutive neuropsychological evaluation and maintained anti-dementia medication from the Ewha Dementia Cohort. The first clinical, neuropsychological test results, medial temporal atrophy rating and white matter ratings were correlated with the final ADL scores. The subjects were further divided into ADL-preserved and declined groups for the comparison depending on final ADL scores. RESULTS: The annual decline of the Korean Mini-mental status examination (K-MMSE) score was 1.5+/-1.2 and of the Seoul-instrumental ADL score was 6.1+/-4.6. The Factors correlated with the ADL at baseline were the clinical dementia rating, K-MMSE, memory function score and the total neuropsychological test score, left medial temporal lobe atrophy rating, and the neuropsychiatric total score. Only the neuropsychological component including total test, frontal and visuospatial function scores were statistically different between the two groups in the baseline evaluation. CONCLUSIONS: The result of our preliminary study emphasize the other study results that the initial cognitive and dementia status are the strong predictive factors not only for the initial ADL dysfunction but also for the ADL decline in years followed-up dementia cohort.

Family Burden from Behavioral and Psychological Symptoms in Patients with Alzheimer Disease Living at Home and in Nursing Home / 中国康复理论与实践

@#Objective To investigate the family burden from behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer disease (AD) living at home and in nursing home.Methods Neuropsychiatric Inventory/Neuropsychiatric Inventory-Nursing Home (NPI) and Family Burden Interview Scale (FBIS) were used to measure the occurrence of BPSD in 200 AD patients. The data were analyzed.Results In-home patients' total score and family daily activities, family entertainment, family relationships, family members' mental health and the body healthy dimension scores of FBIS were significantly higher （ P<0.05）, and the dimension scores of economic burden were significantly lower ( P<0.01) than those of patients in nursing home. Patients' total score of NPI was positively correlated with the economic burden, family entertainment, family relationships, family members' mental health and the body healthy dimension scores of FBIS （ P<0.01）. Every dimension score of NPI and total score of FBIS positively related ( P<0.05). Dimension score of family daily activities of FBIS was not related to all of the dimension scores and total score of NPI ( P>0.05).Conclusion The family burden from BPSD should not be ignored, especially the patients living at home, which suggests that AD patients should be sent to nursing home to spend their rest life.

Cerebrospinal Fluid Aspartate Aminotransferase in Alzheimer Disease and Vascular Dementia

BACKGROUND: To evaluate usefulness of cerebrospinal aspartate aminotransferase(AST) as a biologic marker for differentiation of Alzheimer's disease(AD) and Vascular dementia(VD) METHODS: A consecutive series of patients who met either the criteria of the National Institute of Neurological Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association(NINCDSADRDA) for probable AD or National Institute of Neurological Disorders and Stroke and the Association Internationale pour la Recherche et l'Enseignement en Neurosciences(NINDS-AIREN) criteria for porbable VD were included in the study. Enzymatic determinations in cere brospinal fluid of aspartate aminotransferase in cerebrospinal fluid of aspartate aminotransferase and serologic analysis of apolipoprotein E were performed in 17 patients with AD and in 15 patients with VD. And we compared CSF AST of AD with that of VD. RESULTS: We found no difference of CSF AST concentration between patients with Alzheimer's disease and vascular dementia. Cerebrospinal AST activity also did not correlate with K-MMSE score, serum AST activity, Functional inde-pence measure(FIM) as a ADL(Activity of daily living), and presence of Apolipoprotein E4 allele in AD. Only serum AST of VD shows correlation with CSF AST. CONCLUSION: These findings suggest that cerebrospinal AST concentration is not useful maker for differentiation between AD and VD.