Articles: dementia.
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The relationship between apo E genotypes and risk of dementia in Down syndrome is not clear. Accordingly, we have analysed this locus in 20 demented and 25 nondemented individuals with Down syndrome and combined these data with other studies in a meta-analysis. ⋯ An additional parallel with late-onset Alzheimer's disease was shown by the apo epsilon2 allele, which was associated with decreased dementia risk in Down syndrome (odds ratio for apo epsilon2/epsilon2 + epsilon2/epsilon3 = 0.37 (95% CI 0.14-0. 96)). Thus, apo E genotypes are associated with similar risk effects in Down syndrome dementia and late-onset Alzheimer's disease.
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Randomized Controlled Trial Clinical Trial
Improving adherence to dementia guidelines through education and opinion leaders. A randomized, controlled trial.
Educational methods that encourage physicians to adopt practice guidelines are needed. ⋯ A multifaceted educational program can improve physician adoption of practice guidelines.
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Comparative Study
Is there a difference between family caregiving of institutionalized elders with or without dementia?
Based on the stress and coping model of Lazarus and Folkman, the aim of this comparative study was to determine whether the caregiving experience of the caregivers of an institutionalized demented relative is different from the one of the caregivers whose relative does not suffer from dementia. Five dimensions of the caregiving experience were considered: stressors, cognitive appraisal of the stressors, social support, coping strategies and well-being. The sample consisted of primary caregivers of a demented and a nondemented relative. ⋯ According to MANCOVA analysis, formal and informal social support seems to play a protective role in the psychological distress of the caregivers of a demented relative. There was no difference between the two groups with regard to their coping strategies. Overall, the caregivers of a demented relative seemed to experience some dimensions of caregiving in a different way compared with their counterparts, and the nature of dementia in itself helps to explain this difference.
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The aetiology of cognitive impairment is multifactorial; however, drugs are an important cause of delirium and dementia. Several factors may increase the risk of drug-induced cognition disorders in the elderly including imbalances in neurotransmitters (e.g. acetylcholine), age-related alterations in pharmacokinetics and pharmacodynamics, and high levels of medication use. Nearly any drug can cause cognitive impairment in susceptible individuals; however, certain classes are more commonly implicated. ⋯ Although some drugs have shown low risk for causing cognition disorders in research studies, risk may be increased in frail older adults taking several medications and each case should be reviewed carefully. Identification of drug-induced cognitive impairment is crucial to early detection and resolution of symptoms. Preventive strategies directed at avoiding high risk medications when possible, appropriately adjusting doses based on age-related changes and close follow-up may prevent these conditions.