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Position statement of the American Association for Geriatric Psychiatry regarding principles of care for patients with dementia resulting from Alzheimer disease.

American Journal of Geriatric Psychiatry (Impact Factor: 3.52). 08/2006; 14(7):561-72. DOI: 10.1097/01.JGP.0000221334.65330.55
Source: PubMed

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    • "Examples include social contact, stimulating activity, and human touch (e.g., massage) for the relief of discomfort. Consensus statements on best practices for Alzheimer's disease indicate that behavioral and psychological symptoms of dementia (BPSD) are best treated initially with non-pharmacological therapies (American Geriatrics Society & American Association for Geriatric Psychiatry, 2003; Benoit et al., 2006; Lyketsos et al., 2006). The empirical evidence to support the efficacy of most nonpharmacological therapies is quite limited. "
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    ABSTRACT: The purpose of this study was to describe the nonpharmacological and pharmacological treatments stopped and started over 6 weeks among a sample of nursing home residents with moderate to severe dementia and to identify nurse and resident factors associated with starting new and stopping ineffective/unnecessary nonpharmacological and pharmacological treatments. One hundred thirty-four nursing home residents with dementia and 39 nurses from 12 nursing homes in the Midwest participated in this study. Resident and nursing process data were collected on daily tracking forms completed by the primary nurse over a 6-week period. Both assessment-driven intervention and evaluation-driven follow through significantly predicted treatments stopped and new treatments started. The findings demonstrate that nurses serve an essential role in maintaining resident physiological and psychological homeostasis by vigilantly responding to residents' physical problems and behaviors with assessment-driven intervention and evaluation-driven follow through.
    Research in Gerontological Nursing 09/2011; 5(2):130-7. DOI:10.3928/19404921-20110831-01 · 0.61 Impact Factor
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    • "This degree of cognitive impairment is not normal for age and, thus, constructs such as age-associated memory impairment and ageassociated cognitive decline do not apply. From this perspective , MCI due to AD can be considered as a subset of the many causes of cognitive impairment that are not dementia (CIND), including impairments resulting from head trauma, substance abuse, or metabolic disturbance [4]. Thus, the concept of " MCI due to AD " is used throughout this article to reflect the fact that the ultimate focus of these criteria is to identify those symptomatic but nondemented individuals whose primary underlying pathophysiology is AD. "
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    ABSTRACT: The National Institute on Aging and the Alzheimer's Association charged a workgroup with the task of developing criteria for the symptomatic predementia phase of Alzheimer's disease (AD), referred to in this article as mild cognitive impairment due to AD. The workgroup developed the following two sets of criteria: (1) core clinical criteria that could be used by healthcare providers without access to advanced imaging techniques or cerebrospinal fluid analysis, and (2) research criteria that could be used in clinical research settings, including clinical trials. The second set of criteria incorporate the use of biomarkers based on imaging and cerebrospinal fluid measures. The final set of criteria for mild cognitive impairment due to AD has four levels of certainty, depending on the presence and nature of the biomarker findings. Considerable work is needed to validate the criteria that use biomarkers and to standardize biomarker analysis for use in community settings.
    Alzheimer's & dementia: the journal of the Alzheimer's Association 05/2011; 7(3):270-9. DOI:10.1016/j.jalz.2011.03.008 · 17.47 Impact Factor
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    • "The literature on dementia supports the efficacy of nonpharmacological interventions for treating common neuropsychiatric symptoms (e.g., agitation, depression, passivity, aggression) and improving quality of life. Such approaches may offer PWD opportunities for social contact and engagement in meaningful activities, which are care goals endorsed by the American Geriatrics Society and the American Association for Geriatric Psychiatry (2003; Lyketsos et al., 2006). These interventions include behavior therapy, multisensory stimulation, cognitive stimulation, exercise therapy, and recreation therapy (Burgener et al., 2008; Fitzsimmons & Buettner, 2003; Livingston, Johnston, Katona, Paton, & Lyketsos, 2005; Verkaik, van Weert, & Francke, 2005). "
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    ABSTRACT: Effective nonpharmacological interventions are needed to treat neuropsychiatric symptoms and to improve quality of life for the 5.3 million Americans affected by dementia. The purpose of this study was to test the effect of a storytelling program, TimeSlips, on communication, neuropsychiatric symptoms, and quality of life in long-term care residents with dementia. A quasi-experimental, two-group, repeated measures design was used to compare persons with dementia who were assigned to the twice-weekly, 6-week TimeSlips intervention group (n = 28) or usual care group (n = 28) at baseline and postintervention at Weeks 7 and 10. Outcome measures included the Cornell Scale for Depression in Dementia, the Neuropsychiatric Inventory-Nursing Home Version, the Functional Assessment of Communication Skills, the Quality of Life-Alzheimer's Disease, and the Observed Emotion Rating Scale (this last measure was collected also at Weeks 3 and 6 during TimeSlips for the treatment group and during mealtime for the control group). Compared with the control group, the treatment group exhibited significantly higher pleasure at Week 3 (p < .001), Week 6 (p < .001), and Week 7 (p < .05). Small to moderate treatment effects were found for Week 7 social communication (d = .49) and basic needs communication (d = .43). A larger effect was found for pleasure at Week 7 (d = .58). As expected, given the engaging nature of the TimeSlips creative storytelling intervention, analyses revealed increased positive affect during and at 1 week postintervention. In addition, perhaps associated with the intervention's reliance on positive social interactions and verbal communication, participants evidenced improved communication skills. However, more frequent dosing and booster sessions of TimeSlips may be needed to show significant differences between treatment and control groups on long-term effects and other outcomes.
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