Review of Risk Factors Associated With Biomarkers for Alzheimer Disease.

ABSTRACT: BACKGROUND: Alzheimer disease (AD) is a neurodegenerative disease with no cure. The number of individuals living with AD doubles every 5 years. The current clinical practice relies on clinical history, mental status tests, cerebrum imaging, and physical and neurological examinations; however, recent advances in the field of biomarkers have provided clues for the early detection of AD. High levels of tau and low levels of amyloid-ß (Aß) in cerebrospinal fluid are well-known biomarkers for AD. METHODS: A database search of PubMed, Ovid MEDLINE, and CINAHL was conducted to identify relevant articles published within the last 5 years. The search was limited to articles concerning adults 65 years or older and published in the English language. Twelve articles were included in the review. RESULTS: Risk factors of sleep disruption, depression, and motor function are implicated. Cerebrospinal fluid parameters for biomarkers of tau and Aß were universally lower among Blacks compared with Whites, raising concern that norm reference may not be accurate for all populations. Older adults are more at risk for AD. Results are inconclusive regarding whether depression is related to Aß and tau pathology. CONCLUSION: Nurses should screen for sleep architecture, depression, and motor function in their patients and educate them on good sleep hygiene. Sleep studies should be advocated for people with suspected sleep apnea to mitigate the risk factor related to abnormal Aß and tau pathology. Falls and decreased motor function require screening because they may be early indicators of abnormal biomarkers leading to AD.

CE: Managing Movement Disorders: A Clinical Review.

: Neuromuscular disorders are complex, difficult both to differentiate and to manage. Yet nurses, who encounter a symptomatically diverse neuromuscular patient population in various practice settings, are expected to be well versed in managing the variable associated symptoms of these disorders. Here the authors discuss how to assess such neuromuscular conditions as muscle tightness, spasticity, and clonus; the pathophysiology underlying each; and the available recommended treatments, an understanding of which is necessary for successful symptom management and clear provider-patient communication.

Lived Experiences of Muscle Tightness Symptoms From Patients' Perspectives.

The aims of this study were to understand symptoms of chronic muscle tightness from the patient's perspective and explore symptom management strategies used by them. Muscle tightness, a common symptom, is a challenge to manage in clinical practice because it is commingled with other orthopedic conditions. Nurses may not be aware of the negative impact of tight muscles because this symptom is presumed to be self-limiting; however, if not treated appropriately, muscle tightness can become chronic. The focus of this study is the lived experience of patients with chronic muscle tightness. The researchers used a qualitative descriptive design in which patients provided insights into the experiences and self-management of chronic muscle tightness. Sixteen adult subjects experiencing physical impairments who were managed by physical therapists in a specialty clinic participated in the study. The subjects participated in 45- to 60-minute semistructured interviews to provide understanding of chronic muscle tightness. The interviews were recorded and transcribed for content analysis. Results indicate that patients identify day-to-day experiences of chronic muscle tightness as unresolving; these patients experience myriads of sensations and live with life restrictions that negatively affect their quality of life. Uses of complementary therapies are commonplace in managing this symptom. The symptom of chronic muscle tightness may linger, and patients use workarounds to manage their lives. Nurses must understand patients' perspectives to assist them in achieving an acceptable quality of life.