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Background Small sample sizes have constrained the examination of dementia subtypes in Autism Spectrum Disorder (ASD) compared to other groups. Data from Medicaid and Medicare, which enroll tens of millions of Americans, can address this limitation and support identification of system‐level improvements to address needs of those with ASD and co‐occurring dementia. This study sought to examine dementia subtypes among autistic individuals compared to other groups. Method Individually‐linked national Medicare and Medicaid data from 2014–2016 included individuals age 30 and older with dementia from mutually exclusive groups with ASD (2,229 with no intellectual disability (ID), 4,263 with ID), 52,198 with ID, 1,199 with Down Syndrome (DS), and a random sample of 237,009 individuals without these diagnoses (RS). The validated Bynum algorithm was organized into the subtypes shown in Table 1. The last observed dementia diagnosis was used for dementia subtype. Following preliminary analyses showing similar data for those with ASD with and without ID, a single ASD category (ASD only and ASD+ID) was used. Result Unspecified dementia represented the largest proportion of cases for all groups (50.0% for ASD, 56.3% for ID, 42.1% for DS, and 54.3% for RS). The ASD group had the lowest proportion of Alzheimer's disease cases (11.7%), compared to ID (14.2%), DS (32.2%), and RS (22%). Senile dementia represented a larger proportion of ASD dementia cases (11.5%) than the other categories combined (ID=1.5%, DS=0%, RS=0.1%). The relative proportion of other dementia subtypes did not differ substantially between ASD versus ID. The proportion of all dementia subtypes among autistic females was an average of 25% lower than females in RS. A lower proportion of all dementia cases in non‐white adults was observed for ASD compared to RS. Conclusion Examination of dementia subtypes suggests a lower proportion of Alzheimer's disease and a higher proportion of Senile dementia in ASD compared to other populations under examination, whereas the proportion of other dementia subtypes was generally aligned with that of participants with ID. Non‐white adults might be misdiagnosed or underdiagnosed in the ASD population, pointing to the possibility of ASD‐specific service implications amid the backdrop of rising dementia cases nationally.

Introduction The perception of elderly people is complex, diverse, multidimensional, and determined by many factors. Old age is often seen through the prism of numerous myths and stereotypes that can be both positive and negative. Therefore, it is important to recognize the attitudes and factors that affect the perception of seniors by society. Objectives The aim of this study was to analyze the attitudes of society towards old age and elderly people with regard to socio-demographic factors. Material and methods The study involved 219 individuals living in Szczecin, Nowa Sól, and Zielona Góra, Poland. Mean age of the respondents – 42.35±14.05 years. For the purposes of statistical analysis, respondents’ ages were grouped according to the WHO classification. The participants were divided into three groups: young adulthood (34.2%), middle adulthood (38.4%), and old age (27.4%). The study was survey-based and performed using the standardized Kogan Questionnaire and an author-constructed questionnaire. Results Statistical analysis demonstrated a significant relationship between the attitude towards the elderly and gender. However, there was no relationship between the respondents› attitude and age, marital status, or education. Respondents, who claimed that seniors are not a problem for society were much more likely to achieve higher results in the Kogan test. Conclusions The majority of respondents perceived senility and elderly people positively. Gender occurred to be an important determinant of the perception of senility. Women perceived old age better.

Assisted living residences have become prominent sites of long-term residential care for older adults with dementia. Estimates derived from national data indicate that seven out of ten residents in these residences have some form of cognitive impairment, with 29 percent having mild impairment, 23 percent moderate impairment, and 19 percent severe impairment. More than one-third of residents display behavioral symptoms, and of these, 57 percent have a medication prescribed for their symptoms. Only a minority of cognitively impaired residents reside in a dementia special care unit, where admission and discharge policies are more supportive of their needs. Policy-relevant recommendations from our study include the need to examine the use of psychotropic medications and cultures related to prescribing, better train assisted living staff to handle medications and provide nonpharmacological treatments, use best practices in caring for people with dementia, and promote consumer education regarding policies and practices in assisted living. Adapted from the source document.

Background The advent of new diagnostic tools and the novel disease‐modifying treatment approval have started changing Alzheimer disease (AD) situation. However, because these drugs are approved in initial stage of the disease, it is crucial to diagnose in early stages to allow patients to be eligible to new treatments The objective of this study was to describe the time between the onset of symptoms, initial consultation, and diagnosis in patients with cognitive impairment. Method A cross‐sectional observational study was conducted. An anonymous survey was developed for patients who consulted to a memory clinic with cognitive complains. Questions were answered by patients’ partners. We include the onset time of cognitive symptoms, the time of first consultation with any health professional, as well as the time between first consultation and diagnosis. A descriptive statistical and frequency assessment were performed. Result To date, 104 patients have been included. Mean age was 76.6±6.2 years. A 31% experienced cognitive symptoms onset within of one to two years. 44% attended for first time to health care professional between one and two years after symptoms onset. Half of them had their first consultation at the time of completing the survey. Eighty percent reported that their initial evaluation for cognitive symptoms was performed by a neurologist. Only 13% had their first evaluation by a general practitioner. A 59% of patients had received a previous diagnosis, with a time delay from first consultation to diagnosis between six months to two years in 56% of the cases. Mild cognitive impairment was the most common diagnosis with 47%, followed by Alzheimer's disease (28.9%) and dementia (19.1%). Almost 27% of diagnoses were due conditions like arteriosclerosis, senile dementia, and age‐related cognitive impairment. Conclusion We noted a significant delay between cognitive symptoms onset and the initial consultation and also several incorrect diagnoses. The new disease‐modifying therapies has created an opportunity to improve AD subjects and family's life but it is imperative early and correct disease diagnosis. It is crucial to have population learning about the disease for early consultation and to improve medical knowledge for early diagnosis and treatment

In this article, we use clothes as a tool for exploring the life stories and narratives of people with dementia, eliciting memories through the sensory and material dimensions of dress. The article draws on an Economic and Social Research Council-funded study, ‘Dementia and Dress’, which explored everyday experiences of clothing for carers, care workers and people with dementia, using qualitative and ethnographic methods including: ‘wardrobe interviews’, observations, and visual and sensory approaches. In our analysis, we use three dimensions of dress as a device for exploring the experiences of people with dementia: kept clothes, as a way of retaining connections to memories and identity; discarded clothes, and their implications for understanding change and loss in relation to the ‘dementia journey’; and absent clothes, invoked through the sensory imagination, recalling images of former selves, and carrying identity forward into the context of care. The article contributes to understandings of narrative, identity and dementia, drawing attention to the potential of material objects for evoking narratives, and maintaining biographical continuity for both men and women. The paper has larger implications for understandings of ageing and care practice; as well as contributing to the wider Material Turn in gerontology, showing how cultural analyses can be applied even to frail older groups who are often excluded from such approaches.

Primary Sjögren’s syndrome (pSS) is a systemic autoimmune disease characterized by exocrine gland dysfunction and inflammation. Patients often have dry mouth and dry eye symptoms, which seriously affect their lives. Improving dry mouth and eye symptoms has become a common demand from patients. For this reason, researchers have conducted many studies on external secretory glands. In this paper, we summarize recent studies on the salivary glands of pSS patients from the perspective of the immune microenvironment. These studies showed that hypoxia, senescence, and chronic inflammation are the essential characteristics of the salivary gland immune microenvironment. In the SG of pSS, genes related to lymphocyte chemotaxis, antigen presentation, and lymphocyte activation are upregulated. Interferon (IFN)-related genes, DNA methylation, sRNA downregulation, and mitochondrial-related differentially expressed genes are also involved in forming the immune microenvironment of pSS, while multiple signaling pathways are involved in regulation. We further elucidated the regulation of the salivary gland immune microenvironment in pSS and relevant, targeted treatments.

As life expectancy increases in India, the number of people living with dementia will also rise. Yet little is known about how people in India cope with dementia, how relationships and identities change through illness and loss.

The well-being of informal carers of people with dementia is an important public health issue. Caring for an elderly relative with dementia may be burdensome and stressful, and can negatively affect the carer's social, family, and professional life. The combination of loss, the physical demands of caregiving, prolonged distress, and biological vulnerabilities of older carers may compromise their physical health, increase social isolation, and increase the risk of anxiety and depressive disorders. Caregiver stress is also linked to negative outcomes for the recipient of care and costs to society, including increased nursing home and hospital admissions. Consequently, carer support interventions are an important component of dementia care. Computer-mediated carer support offers a range of potential advantages compared to traditional face-to-face support groups, including accessibility and the possibility of tailoring to meet individual needs, but there has been little research on its effectiveness so far. This mixed-methods study examined the impact of a well-respected UK-based online support forum for carers of people with dementia. A total of 61 new forum users completed measures of anxiety (7-item Generalized Anxiety Disorder scale, GAD-7), depression (9-item Patient Health Questionnaire, PHQ-9), and quality of relationship with the person with dementia (Scale for the Quality of the Current Relationship in Caregiving, SQCRC), at baseline and again after 12 weeks of forum usage, within a pre-post design. In addition, 8 participants were interviewed about their experiences with using the forum. There was an improvement in the quality of the relationship with the person with dementia (SQCRC: P=.003). There was no change in users' depression (PHQ-9) or anxiety (GAD-7) over the 12-week study period. Interview participants reported a range of positive experiences and benefits from using the forum. Limited negative experiences were also reported. Many of the reported experiences and benefits are unique to online peer support. Further research into online peer support for carers of people with dementia is needed to clarify who benefits under what conditions.

The number of older adults with cognitive impairment is increasing, and such adults often require a surrogate to make decisions about health care. However, little is known about the aggressiveness of end-of-life care for these people, especially those who reside in the community. We found that cognitive impairment is common among older adults approaching the end of life, whether they live in the community or in a nursing home, and that nearly 30 percent of patients with severe dementia remained in the community until death. Among those patients, having an advance directive in the form of a living will was associated with significantly less aggressive care at the end of life, compared to similar patients without an advance directive-as measured by Medicare spending ($11,461 less per patient), likelihood of in-hospital death (17.9 percentage points lower), and use of the intensive care unit (9.4 percentage points lower). In contrast, advance directives were not associated with differences in care for people with normal cognition or mild dementia, whether they resided in the community or in a nursing home. Timely advance care planning after a diagnosis of cognitive impairment may be particularly important for older adults who reside in the community. Adapted from the source document.

Background: In this study, the geniatric status of OECD (Organisation for Economic Co-operation and Development) countries was measured, and the effects of aging status on disease patterns in each country were quantitatively assessed. A theoretical model explaining the effects was suggested, and the implications were discussed. Methods: Data used in this study were the OECD Health Statistics data and WHO Global Burden of Disease data. The values for each country were paired with disability-adjusted life years (DALYs) presented by the WHO and Institute for Health Metrics and Evaluation (IHME). A cross-country panel analysis was conducted to analyze the effects of senility on the burden of disease in OECD countries. Results: Geniatric status had effects on the burden of disease (P = .048). Total health expenditure significantly reduced the burden of disease (P = .001). In the panel model with YLL (Year of Life Lost) as the outcome variable, geniatric status had twice greater effects on the burden of disease than that in the model with DALY (P = .003). Conclusions: In medical insurance-related policies, the characteristics of the disease should be considered. In particular, chronic diseases have not received much attention compared to their risk. However, the disease that actually affects the burden of disease is a disease that becomes chronic and requires long-term treatment rather than a disease with a high fatality rate. And, as a result of this study, the higher the level of resource consumption for treatment in OECD countries, where aging is progressing, the burden of disease was rather reduced. Therefore, if there is institutional support to receive appropriate treatment, it will be possible to reduce the national burden of disease.