Striatal Blood–Brain Barrier Opening in Parkinson's Disease Dementia: A Pilot Exploratory Study

Movement Disorders, Journal Year: 2022, Volume and Issue: 37(10), P. 2057 - 2065

Published: June 28, 2022

Abstract Background Parkinson's disease (PD) exhibits a high prevalence of dementia as severity and duration progress. Focused ultrasound (FUS) has been applied for transient blood–brain barrier (BBB) opening cortical regions in neurodegenerative disorders. The striatum is primary target delivery putative therapeutic agents PD. Objective Here, we report prospective, single‐arm, nonrandomized, proof‐of‐concept, phase I clinical trial (NCT03608553 amended) PD with to test the safety feasibility striatal BBB patients. Methods Seven patients cognitive impairment were treated posterior putamen. This was performed two sessions separated by 2 4 weeks, where second session included bilateral putamina 3 Primary outcome measures focal opening. Changes motor functions, magnetic resonance imaging (MRI), 18 F‐fluorodopa (FDOPA), β‐amyloid PET (positron emission tomography) images determined. Results procedure feasible well tolerated, no serious adverse events. No neurologically relevant change (battery neuropsychological tests) functions recognized at follow‐up. MRI revealed putamen closing shortly after treatment (24 hours 14 days) ruled out hemorrhagic ischemic lesions. There discrete but significant reduction uptake targeted region FDOPA PET. Conclusions These initial results indicate that FUS‐mediated safe therefore could become an effective tool facilitate neurorestorative molecules © 2022 International Parkinson Movement Disorder Society.

Language: Английский

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Remote neuropsychological evaluation of older adults

Applied Neuropsychology Adult, Journal Year: 2022, Volume and Issue: 31(5), P. 796 - 803

Published: May 20, 2022

The use of technological means in the process neuropsychological assessment has been proposed as a technique with promising results field detection neurocognitive disorders for community-dwelling older adults. Especially during pandemic period due to COVID-19, telemedicine assumed be vital early diagnosis cognitive and highlighted clinical utility remote methods assessmentby video-conference. This descriptive study presents development protocol by selecting appropriate validated tests part more comprehensive evaluation adults dwelling community. We recruited participants from Athens Alzheimer's Association center collaboration Hellenic Neuropsychological Society, Athens, Greece, regarding between April 2020 October 2021. 90 individuals, tested first time, were categorized into three groups according their which included: (a) Mild Cognitive Impairment (MCI), (b) disease, (c) cognitively healthy presented outlines main considerations framework about assessment, can maximize effectiveness interventions continuity care recommendations outlined highlight strengths limitations that should taken account control procedures. Although was created response restrictions, tele-neuropsychology shows promise way improve access opportunity neurodiagnostic services rural aging underserved populations, lack specialized healthcare services. Further application different populations will add validity protocol.

Language: Английский

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The early impacts of COVID-19 on people living with dementia: part I of a mixed-methods systematic review

Aging & Mental Health, Journal Year: 2022, Volume and Issue: 27(3), P. 533 - 546

Published: June 28, 2022

Objectives: The aim of this Part I systematic review was to understand the impact COVID-19 pandemic on lives people with dementia living in community or residential care. II focused unpaid carers.Methods: This registered PROSPERO [CRD42021248050]. Five data bases (PubMed, CINAHL, Embase, Scopus, Web Science) were searched July 2021. Studies included if they reported impacts dementia, either settings, and published English, German, Polish, Spanish. Risk bias assessed using Standard Quality Assessment QualSyst.Results: Forty papers from 33 studies effects dementia. Included conducted across 15 countries, focusing single-country evaluations except one study. Three care homes, whilst remainder community. categorised into five impacts: Cognition; Independence physical functioning; Behavioural symptoms; Well-being; Access All evidenced negative impacts, including faster cognitive, physical, behavioural deterioration, limited access care, poorer mental social health.Conclusions: Future restrictions need consider for stay cognitively, physically, socially stimulated live well, provides a call future strategy Longitudinal research is required long-term time home entry.

Language: Английский

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The early impacts of COVID-19 on unpaid carers of people living with dementia: part II of a mixed-methods systematic review

Aging & Mental Health, Journal Year: 2022, Volume and Issue: 27(3), P. 547 - 562

Published: July 12, 2022

Objectives With a lack of existing comprehensive reviews, the aim this mixed-method systematic review was to synthesise evidence on early impacts pandemic unpaid dementia carers across globe.Methods This registered PROSPERO [CDR42021248050]. PubMed, CINAHL, Embase, Scopus and Web Science were searched from 2020 July 2021. Studies included if they reported different aged 18+, with papers published in English, German, Polish, or Spanish. A number research team members involved selection studies following PRISMA guidance.Results Thirty-six (43 papers) 18 countries impact carers. Impacts noted accessing care support; carer burden; well-being. found that had limited access support services, increased workload, enhanced feelings social isolation, reduced wellbeing. Specifically, reductions carer's caring tasks, removing any opportunities for temporary respite, thus further increasing burden reducing mental well-being many.Conclusions The needs appear have during pandemic, without adequate provided. Policy initiatives need enable better health formal provision their relatives dementia, whilst future explore long-term implications light home restrictions delivery.

Language: Английский

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Padci pri starejših in vpliv pandemije covida-19

ZRC SAZU, Založba ZRC eBooks, Journal Year: 2022, Volume and Issue: unknown

Published: Dec. 20, 2022

JAVNOZDRAVSTVENI IZZIVI DEMENCE

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The Impact of Social Isolation Due to COVID-19 on Symptom Progression in People With Dementia: Findings of the SOLITUDE Study

Frontiers in Psychiatry, Journal Year: 2022, Volume and Issue: 13

Published: May 10, 2022

People with dementia (PWD) are vulnerable to abrupt changes daily routines. The lockdown enforced on the 23rd of March 2020 in UK contain expansion COVID-19 pandemic limited opportunities for PWD access healthcare services and socialise. SOLITUDE study explored potential long-term effects PWD's symptoms carers' burden.Forty-five carers 36 completed a telephone-based assessment at recruitment (T0) after 3 (T1) 6 months (T2). measures validated telephonic evaluations cognition depression. Carers questionnaires their burden health answered customised interview symptom observed initial lockdown. Longitudinal were investigated all outcome variables repeated-measures models. Additional post hoc multiple regression analyses carried out investigate whether several objective factors (i.e., demographics time under social restrictions) carer-reported following before T0 associated outcomes T0.No significant any over observations. However, showed that length isolation was negatively correlated episodic semantic memory performance T0. reporting worsening neuropsychiatric faster disease progression also reported higher burden. Moreover, cognitive poorer T0.PWD's remained stable observation. amount spent restrictions appears have had detrimental impact patients. In fact, decline during consistent finding memory, domain sensitive Alzheimer's disease. Therefore, stricter period greater patients carers, followed then by plateau. Future interventions may be designed maintain an optimal level engagement challenging times, prevent consequences patients' carers.

Language: Английский

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Cognitive, Functional, and Emotional Changes During the COVID-19 Pandemic in Greek Patients with Neurocognitive Disorders

Journal of Alzheimer s Disease, Journal Year: 2022, Volume and Issue: 88(2), P. 537 - 547

Published: May 17, 2022

Prolonged periods of social deprivation, such as COVID-19-related lockdowns, are associated with deleterious effects on cognitive functions.The aim this study was to gauge the effect prolonged isolation function older adults neurocognitive disorders.We recruited 125 minor or major disorders divided into two groups. The control group tested at first period (October 2018-May 2019), whereas experimental evaluated second chronological 2020-May 2021) during wave COVID-19. Neuropsychological tests were performed baseline and six months after baseline.In group, significant changes in scores from Montreal Cognitive Assessment (MoCA; p = 0.049) Functional Rating Scale for Symptoms Dementia (FRSSD; 0.005) found between follow-up assessments, no identified Mini-Mental State Examination (MMSE; 0.229) Geriatric Depression (GDS; 0.619) scores. In all neuropsychological (MoCA, MMSE, GDS, FRSSD; < 0.001 all) significantly different when compared those measurements. Moreover, deterioration specific functions assessed MMSE FRSSD detected, especially group.This highlights directly affected by deprivation individuals disorders. findings can be used rehabilitation confinement its negative consequences.

Language: Английский

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Translation, cultural adaptation and pilot testing of a questionnaire measuring the factors affecting the acceptance of telemedicine by Greek cancer patients

PLoS ONE, Journal Year: 2023, Volume and Issue: 18(2), P. e0278758 - e0278758

Published: Feb. 2, 2023

The emergency presented through the COVID-19 pandemic exposed need to adopt remote, technology-driven solutions and make healthcare services more resilient. To do so, we technological applications (i.e., telemedicine) that are designed tailored end-users chronic patients) needs type of service they get cancer care). requirements above especially relevant Greece, being a country with numerous sparsely populated regions (e.g., islands, at borders) deteriorating access for all citizens. Trying address such diverse problems needs, there have been multiple, different telemedicine telecare projects in Greece past years. support future design implementation endeavours, this study translated questionnaire measuring acceptance by patients adapted it Greek context. We continued running small-scale pilot 73 women breast assess instrument its reliability construct validity. created had good overall internal scores most sub-scales. Factor analysis did not identify same number latent dimensions as original theoretical model. Reverse wording items needing be recoded were identified, could omitted versions questionnaire. Increasing sample size purposes longitudinal study, construct, convergent, discriminant validity elements further examined studies. It is envisaged creation will adoption into routine areas patient care provision.

Language: Английский

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Low cognitive functioning and depressive symptoms in patients with rheumatoid arthritis and systemic sclerosis: a clinical study

BMC Psychiatry, Journal Year: 2023, Volume and Issue: 23(1)

Published: July 18, 2023

Recently, cognitive deficits occurring in rheumatic diseases have attracted scientific attention. Cognitive symptoms patients with Rheumatoid Arthritis (RA) and Systemic Sclerosis (SSc) not been thoroughly studied. This study aimed to assess function its relationship depressive RA SSc compare it mild neurocognitive disorder due Alzheimer's disease (MiND) individuals without impairment.Cognitive were tapped the Telephone Screening Instrument plus (COGTEL+), Serial Seven Test (SST), Mini-Mental State Examination (MMSE) Geriatric Depression scale-15 (GDS), respectively. Statistical analyses included between groups-, correlation- regression analyses. Demographic characteristics considered models.The 30 RA, 24 SSc, 26 adults impairment 33 MiND. Lower performance verbal short-term memory, concentration/attention, fluency MMSE compared was detected. Of note, on fluency, inductive reasoning lower Individuals performed worse comparison deficits. Verbal exceeded that Performance MMSE, COGTEL+, prospective working concentration/attention related GDS scores, which did vary across groups.Patients encountered dysfunction, partially pertains symptoms. severity of dysfunction many cases

Language: Английский

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Effect of the COVID-19 Pandemic on the Self-Perceived Change of Caregivers’ Burden in Providing Care for People With Dementia

Gerontology and Geriatric Medicine, Journal Year: 2023, Volume and Issue: 9

Published: Jan. 1, 2023

Objectives: To explore how the COVID-19 pandemic affects caregiver (CG) burden, quality of care provided to people with dementia (PwD) and their perceived changes between before during pandemic. Methods: A cross-sectional study surveyed primary CGs about burden self-perceived change in multidimensional domains compared these Results: About 135 PwD were enrolled at Siriraj Hospital's Geriatric Clinic Thailand assessed using various online platforms. 13.8% had a "mild moderate" burden. The NPI-Q score level functional capacity declined (p-value .001 .001, respectively). CG-associated factors that related higher CG younger age (mean 54.2 years old), female (76.3%), high educational (80.7%). Conflict was associated an increase .004; 95% CI [1.19, 6.12]). Regarding COVID-19-related factors, there no association PwD's characteristics or concerns. Conclusions: Identifying unusual situation may help reduce improve PwD.

Language: Английский

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