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Dementia Research: Epidemiology and Public Health

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Aging".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 34927

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Dr. Yasutake Tomata

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Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka 221-8686, Japan
Interests: epidemiology; public health; nutrition; healthy aging; dementia; frailty
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Koji Miura

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School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
Interests: public health; health policy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Dementia is becoming one of the biggest social health care challenges with the aging of the population worldwide. Because an effective curative care of dementia is not established, dementia prevention strategies or care strategies for dementia patients in circumstances surrounding aging societies are getting increasing attention. However, there is a lack of information about these issues.

This Special Issue will feature articles regarding epidemiological studies or the review of strategies for dementia.

You may choose our Joint Special Issue in Healthcare.

Prof. Dr. Yasutake Tomata
Prof. Dr. Koji Miura
Guest Editors

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Keywords

dementia
Alzheimer’s disease
cognitive function
intervention study
cohort study
risk factor
population attributable fraction
simulation study for public health action
systematic review
nursing care for people with dementia
nutrition care for people with dementia
dementia friendly community
social services for people with dementia
international comparative research

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Published Papers (10 papers)

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Research

Jump to: Review, Other

14 pages, 1426 KiB

Open AccessArticle

The Hong Kong Grocery Shopping Dialog Task (HK-GSDT): A Quick Screening Test for Neurocognitive Disorders

by Xianmin Gong, Patrick C. M. Wong, Helene H. Fung, Vincent C. T. Mok, Timothy C. Y. Kwok, Jean Woo, Ka Ho Wong and Helen Meng

Int. J. Environ. Res. Public Health 2022, 19(20), 13302; https://doi.org/10.3390/ijerph192013302 - 15 Oct 2022

Cited by 2 | Viewed by 2263

Abstract

The Hong Kong Grocery Shopping Dialog Task (HK-GSDT) is a short and easy-to-administer cognitive test developed for quickly screening neurocognitive disorders (NCDs). In the test, participants are instructed to do a hypothetical instrumental activity of daily living task of purchasing ingredients for a dish from a grocery store and verbally describe the specific shopping procedures. The current study aimed to validate the test with a sample of 545 Hong Kong older adults (58.8% female; aged 73.4 ± 8.37 years), including 464 adults with normal cognitive function, 39 with mild NCD, and 42 with major NCD. Demographic characteristics (i.e., sex, age, education) and clinical diagnosis of cognitive states (i.e., major NCD, mild NCD, and normal aging) were collected. Cognitive functioning was measured using the HK-GSDT and several standardized NCD-screening tests. The results showed good reliability (i.e., internal consistency) and structural validity in the HK-GSDT. It discriminated among different cognitive conditions, particularly between major NCDs and the other conditions, as effectively as did the existing standardized neurocognitive tests (e.g., Montreal Cognitive Assessment, Hong Kong List Learning Test). Moreover, the HK-GSDT explained additional variance of cognitive condition on top of those standardized neurocognitive tests. These results indicate that the HK-GSDT can be used alone, or in combination with other tests, to screen for NCDs. Full article

(This article belongs to the Special Issue Dementia Research: Epidemiology and Public Health)

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9 pages, 328 KiB

Open AccessArticle

How Are Sociodemographic, Health, Psychological, and Cognitive Factors Associated with Dementia Worry? An Online Survey Study among Israeli and Australian Laypeople

by Perla Werner and Sarang Kim

Int. J. Environ. Res. Public Health 2022, 19(18), 11313; https://doi.org/10.3390/ijerph191811313 - 8 Sep 2022

Cited by 4 | Viewed by 1557

Abstract

Background: Dementia worry is a widespread phenomenon and the most common emotional reaction elicited by the threat of developing dementia in the future. The cultural factors of dementia worry have not been examined widely, although dementia can be perceived differently between cultures and lead to varying levels of dementia worry. The purpose of this study was to examine the level of dementia worry and factors associated with it cross-nationally in Israel and Australia. Methods: A cross-sectional, online survey was conducted with two age-matched adult samples (447 participants in Israel and 290 in Australia). The primary outcome measure was the 12-item Dementia Worry Scale. Results: Israeli participants (mean age = 42.5 years; 50.1% female) reported statistically significantly (p < 0.05) higher levels of concern about developing dementia in comparison to Australian participants (mean age = 43.7 years; 49.8% female). Increased ageism and increased perceptions about the likelihood of developing dementia were the most important factors associated with increased worry. Conclusions: Our findings suggest that country may not be the best criterion to assess cultural differences and should be accompanied by the participants’ assessment of their cultural tendencies. Our study also stresses the importance of conceptualizing and assessing affective and cognitive aspects of dementia worry, as people from different cultures might perceive dementia worry cognitively differently but affectively similar and vice-versa. Full article

(This article belongs to the Special Issue Dementia Research: Epidemiology and Public Health)

13 pages, 519 KiB

Open AccessArticle

Confidence in Dementia Management and Its Associated Factors among Primary Care Doctors in Malaysia

by Nurul Izzah Sodri, Mohamed-Syarif Mohamed-Yassin, Mariam Mohamad and Noorhida Baharudin

Int. J. Environ. Res. Public Health 2022, 19(16), 9995; https://doi.org/10.3390/ijerph19169995 - 13 Aug 2022

Cited by 4 | Viewed by 2154

Abstract

Primary care doctors (PCDs) play an important role in the early diagnosis and management of dementia. This study aimed to determine the knowledge, attitude, and confidence in managing dementia among PCDs in Malaysia. It also aimed to determine the factors associated with higher confidence levels in dementia management. An online-based cross-sectional study using Google Forms^TM was performed. Sociodemographic and work-related data were collected, and Dementia Knowledge among General Practitioners & General Practitioners Attitude and Confidence Scale for Dementia questionnaires were utilized to assess the knowledge, attitude, and confidence scores. Multiple linear regression was conducted to determine the association between sociodemographic factors, knowledge, and attitude with the confidence in dementia management score. A total of 239 PCDs participated, with the majority being female (72.4%) and Malay (64.4%) and working in public primary care clinics (67.4%). The mean (±SD) score for confidence was 2.96 (±0.76). Among the factors associated with higher confidence levels in managing dementia were higher dementia knowledge scores, higher attitude towards dementia scores, prior dementia education, and the availability of nearby referral services for dementia. Malaysian PCDs’ confidence in dementia management was comparable to the PCDs of other countries. Strategies addressing these factors should be implemented to improve the confidence of PCDs in managing dementia. Full article

(This article belongs to the Special Issue Dementia Research: Epidemiology and Public Health)

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12 pages, 349 KiB

Open AccessArticle

Family Caregivers of People with Dementia Have Poor Sleep Quality: A Nationwide Population-Based Study

by Min Ji Song and Ji Hyun Kim

Int. J. Environ. Res. Public Health 2021, 18(24), 13079; https://doi.org/10.3390/ijerph182413079 - 11 Dec 2021

Cited by 15 | Viewed by 3328

Abstract

Previous studies have documented cognitive impairments, psychological stress, and depressive symptoms in family caregivers of people with dementia (PWD), which could be attributed to their sleep disturbances. Notwithstanding the increasing recognition of poor sleep quality and sleep disturbances in family caregivers of PWD, their association has not been tested yet using population-representative samples. We conducted a retrospective, cross-sectional study using population-based data from the 2018 Korean Community Health Survey. Sociodemographic, mental health-related, and physical health-related variables as well as sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI) were compared between 2537 cohabitating caregivers of PWD, 8864 noncohabitating caregivers of PWD, and 190,278 non-caregivers. Two sets of multivariable logistic regressions were conducted to examine the associations between dementia caregiving and poor sleep quality in cohabitating and noncohabitating caregivers versus noncaregivers. Both cohabitating and noncohabitating caregivers had higher global PSQI scores and higher prevalence of poor sleep quality (PSQI score > 5) than did noncaregivers. Multivariable logistic regressions adjusted for potential confounders revealed that cohabitating caregivers (odds ratio (OR) 1.26, 95% confidence interval (CI) 1.15–1.38) and noncohabitating caregivers (OR 1.15, CI 1.10–1.21) were significantly associated with poor sleep quality. Our results showed that both cohabitating and noncohabitating caregivers of PWD experienced overall poorer sleep quality compared to noncaregivers, indicating the deleterious effect of dementia caregiving on sleep quality, regardless of living arrangements. Given the high prevalence of poor sleep quality in family caregivers of PWD and the increasing awareness of the serious health consequences of poor-quality sleep, physicians should consider active sleep interventions to promote health and wellbeing not only for the dementia patients but also for family caregivers. Full article

(This article belongs to the Special Issue Dementia Research: Epidemiology and Public Health)

19 pages, 942 KiB

Open AccessArticle

Dementia in Media Coverage: A Comparative Analysis of Two Online Newspapers across Time

by Atiqur sm-Rahman, Chih Hung Lo and Yasmin Jahan

Int. J. Environ. Res. Public Health 2021, 18(19), 10539; https://doi.org/10.3390/ijerph181910539 - 8 Oct 2021

Cited by 5 | Viewed by 3333

Abstract

The news media, specifically online newspapers, is one of the powerful transmitters of discourse due to its rapid accessibility that contributes to social beliefs and attitudes that often shape our perceptions on dementia and Alzheimer’s disease. The media portrayal of dementia is largely heterogeneous, but there is certainly an association between the influence of online news coverage and the social perceptions of dementia that need to be understood more broadly. In this study, we examined the portrayal of dementia in two online newspapers (The New York Times and The Guardian) that might have an influence on dementia discourse by comparing the content and form of the news coverage on dementia across time. This study was guided by three interconnected theoretical understandings: cultivation theory, agenda-setting theory, and spiral of silence theory. A total of 291 published articles featuring dementia from 2014 to 2019 were included in this study and a content analysis of the articles provided insight into the dementia-related news coverage. Our results showed that both newspapers have a decreasing trend in publishing articles related to dementia over time. In addition, dementia-related (modifiable) risk factors as principal news content was significantly associated with the year of publication. Despite a weak association between story categories and newspapers, the majority of articles reported preventive measures as the main story category. Although both newspapers featured more articles with a less negative tone across time when reporting on dementia, derogative wording, as discourse, was commonly used to address the illness. We have provided some insight into understanding how online newspapers potentially affect subjective representations of dementia as well as perpetuate dementia discourse. Finally, we suggest that future study may benefit from establishing a linkage between the depiction of dementia in online newspapers and the contextualization of dementia within cultures. Full article

(This article belongs to the Special Issue Dementia Research: Epidemiology and Public Health)

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16 pages, 401 KiB

Open AccessArticle

The Apathy Evaluation Scale (AES-C): Psychometric Properties and Invariance of Italian Version in Mild Cognitive Impairment and Alzheimer’s Disease

by Giovanna Furneri, Silvia Platania, Alessandra Privitera, Federica Martelli, Rossana Smeriglio, Grazia Razza, Tiziana Maci, Sabrina Castellano, Filippo Drago, Mario Santagati, Pasquale Caponnetto, Filippo Caraci and Santo Di Nuovo

Int. J. Environ. Res. Public Health 2021, 18(18), 9597; https://doi.org/10.3390/ijerph18189597 - 12 Sep 2021

Cited by 8 | Viewed by 4604

Abstract

Apathy is a neuropsychiatric symptom observed in different neurological and psychiatric disorders. Although apathy is considered a symptom, it has been recently reconsidered as a syndrome characterised by three dimensions: cognitive symptoms, affective symptoms and behavioural symptoms. Recent studies have shown that apathy can be considered as a prodromal symptom of Alzheimer’s disease (AD), but also an indicator of the transition from mild cognitive impairment to AD. According to this scenario, an early detection of apathy in subjects with Mild Cognitive Impairment (MCI) and Mild AD can be a valid psychometric strategy to improve an early diagnosis and promote a prompt intervention. The Apathy Evaluation Scale is a validated tool composed of 18 items that assess and quantify emotional, behavioural and cognitive aspects of apathy. The aim of this study is to assess the specific reliability and validity of the Italian version of the Apathy Evaluation Scale—Clinician Version (AES-C) to detect apathy both in amnestic MCI and mild AD patients. In the present paper, we therefore examined the psychometric properties and the invariance of the Italian Version of the AES-C conducted on a sample composed of an experimental group of amnestic MCI and AD patients (N = 107) and a control group (N = 107) constituted by Age- and Sex-matched healthy controls. Results confirm the goodness of the scale. Confirmatory factory analysis confirmed that the AES-C Italian Version presents the same stability of one second-order factor and three first-order factors identified in the original version, and all items are predicted by a single general factor. Moreover, the scale was found to be invariant across both populations. Moreover, reliability and discriminant analysis showed good values. We found in the experimental group a negative correlation between the AES-C and Frontal Assessment Battery (FAB) (rs = −0.21, p < 0.001) and Mini Mental State Examination (MMSE) (rs = −0.04, p < 0.001), while a positive correlation was found between the AES-C and Hamilton psychiatric Rating scale for Depression (HAM-D) scores (rs = 0.58, p < 0.001) Overall, our data demonstrated the validity of the Italian version of the AES-C for the assessment of apathy both in MCI and in AD patients. Full article

(This article belongs to the Special Issue Dementia Research: Epidemiology and Public Health)

8 pages, 341 KiB

Open AccessArticle

The Persian Version of the Quick Mild Cognitive Impairment Screen (Qmci-Pr): Psychometric Properties among Middle-Aged and Older Iranian Adults

by Mohammad Rezaei, Behnam Shariati, David William Molloy, Rónán O’Caoimh and Vahid Rashedi

Int. J. Environ. Res. Public Health 2021, 18(16), 8582; https://doi.org/10.3390/ijerph18168582 - 14 Aug 2021

Cited by 3 | Viewed by 2448

Abstract

Brief cognitive screening instruments are used to identify patients presenting with cognitive symptoms that warrant further assessment. This study aimed to evaluate the reliability and validity of the Persian version of the Quick Mild Cognitive Impairment (Qmci-Pr) among middle-aged and older Iranian adults. Consecutive patients aged ≥55 years and caregivers attending with them as normal controls (NCs) were recruited from geriatric outpatient clinics and a hospital in Tehran, Iran. All patients completed the Qmci-Pr before completing an independent detailed neuropsychological assessment and staging using the Clinical Dementia Rating (CDR) Scale. NCs underwent the same assessment. In all, 92 participants with a median age of 70 years (±13) were available. Of these, 20 participants were NCs, 24 had subjective memory complaints (SMC), 24 had mild cognitive impairment (MCI), and 24 had Alzheimer’s disease (AD). The Qmci-Pr had good accuracy in differentiating SMC and NC from MCI (area under the curve (AUC): 0.80 (0.69–0.91)) and in identifying cognitive impairment (MCI and mild AD) (AUC: 0.87 (0.80–0.95)) with a sensitivity of 88% and specificity of 80%, at an optimal cut-off of <53/100. The Qmci-Pr is an accurate short cognitive screening impairment for separating NC and patients with SMC from MCI and identifying cognitive impairment. Further research with larger samples and comparison with other widely used instruments such as the Montreal Cognitive Assessment is needed. Given its established brevity, the Qmci-Pr is a useful screen for Iranian adults across the spectrum of cognitive decline. Full article

(This article belongs to the Special Issue Dementia Research: Epidemiology and Public Health)

12 pages, 644 KiB

Open AccessArticle

Association between Anti-Psychotic Drugs Use and Hip Fractures in Patients with Dementia: A Nationwide Population-Based Study

by Chia-Hung Tang, Yi-Chen Lai, Yi-Chen Chen, Shun-Min Chang, Yu-Han Chen, Jung-Yu Liao, Yi-Chi Wang, Chung-Han Ho and Ping-Jen Chen

Int. J. Environ. Res. Public Health 2021, 18(15), 8118; https://doi.org/10.3390/ijerph18158118 - 31 Jul 2021

Cited by 3 | Viewed by 2128

Abstract

Background: People with dementia are a high-risk group for hip fractures. Although the increased risk of hip fractures associated with antipsychotic drugs (APD) is found in older populations, little is known about the risk for people with dementia living in Asia. We aimed to investigate the association between hip fractures and the characteristics of APD use in patients with dementia. Methods: A nested case-control analysis was conducted on a nationwide cohort in Taiwan. People with diagnoses of dementia during 2003–2012 were identified. Conditional logistic regression analysis was performed, and adjusted odds ratios (aORs) were calculated with a 95% confidence interval (CI) to estimate the risk of hip fractures. Results: APD use was associated with an increased risk of hip fractures in patients with dementia; current use or combined use of first and second generations of APDs had even higher risks. Regarding the duration of APD use, a U-shape curve of hip fracture risk was noted, and the risk peaked during 0–15 days and >215 days of exposure (aOR = 1.46, 95% CI 1.37–1.57; aOR = 1.47, 95% CI 1.37–1.58; respectively). Considering the doses of APDs, the hip fracture risk was significantly increased with all four levels of the cumulative doses and average daily doses and peaked in the group with the highest average daily dose. Conclusions: The findings suggest that caution must be taken when initiating APD use in patients with dementia, even in a small dose, and mixed types of APD prescriptions should be administered with care. Furthermore, frequent evaluation of the possibility of tapering or withdrawal of the medication is necessary, as the risk does not attenuate after long-term use. Full article

(This article belongs to the Special Issue Dementia Research: Epidemiology and Public Health)

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Review

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16 pages, 2978 KiB

Open AccessReview

Physical Activity Improves Cognition and Activities of Daily Living in Adults with Alzheimer’s Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

by Shengwen Zhou, Sitong Chen, Xiaolei Liu, Yanjie Zhang, Mengxian Zhao and Wenjiao Li

Int. J. Environ. Res. Public Health 2022, 19(3), 1216; https://doi.org/10.3390/ijerph19031216 - 22 Jan 2022

Cited by 44 | Viewed by 7943

Abstract

Objective: The purpose of this meta-analysis was to examine the effects of physical activity (PA) on cognition and activities of daily living in adults with Alzheimer’s Disease (AD). Methods: Six electronic databases (MEDLINE, CINAHL, PsycArticles, SPORTDiscus, EMBASE and CNKI) were used to search for potential studies from inception until October 2021. Randomized controlled trials (RCTs) investigating the effect of physical activity (PA) on cognition and activities of daily living in AD patients compared to a control condition were included. The effect sizes were synthesized using a random effects model with a 95% confidence interval (CI). Results: Sixteen articles including 945 participants (aged 70 to 88 years, 34.6% male) met the inclusion criteria. The pooled effect sizes demonstrated that PA intervention was associated with significant improvements in global cognition (Standard Mean Difference (SMD) = 0.41, 95% CI [0.24, 0.58], p < 0.01) and activities of daily living (SMD = 0.56, 95% CI [0.32, 0.79], p < 0.01) in AD patients. Subgroup analyses suggested that PA for 3–4 times per week for 30–45 min for more than 12 weeks had a relatively strong effect on improving global cognition in AD patients. The sensitivity analysis showed robust results. Conclusions: The findings from the current meta-analysis suggested that AD patients can improve their global cognition and Activities of Daily Living (ADL) through engaging in aerobic and mixed exercise (aerobic and anaerobic exercise). Full article

(This article belongs to the Special Issue Dementia Research: Epidemiology and Public Health)

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Other

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22 pages, 1008 KiB

Open AccessSystematic Review

Nutritional Care for Institutionalized Persons with Dementia: An Integrative Review

by María Elisa Moreno-Fergusson, Gabriela Rabe Caez-Ramírez, Luz Indira Sotelo-Díaz and Beatriz Sánchez-Herrera

Int. J. Environ. Res. Public Health 2023, 20(18), 6763; https://doi.org/10.3390/ijerph20186763 - 15 Sep 2023

Cited by 3 | Viewed by 2727

Abstract

Background: Older people are at risk of malnutrition, especially when they suffer from cognitive impairment. Guidelines that orient nursing care in this regard need to be updated. The aim of this review is to address the best available evidence on interventions that can benefit nutritional nursing care for institutionalized older adults with dementia. Methods: Integrative review using the Dimensions and Eureka search engines, and the PubMed, Embase, Scielo, CINAHL, and ScienceDirect databases. We searched from the year 2015 through to 2021. We employed the MMAT guidelines for mixed, qualitative, and quantitative studies, and the PRISMA, CASP, and JBI guidelines to value the reviews. Results: A total of 55 studies met the inclusion criteria. The best available evidence to support nutritional nursing care for institutionalized older adults with dementia highlights several aspects related to the assessment and caring interventions that are focused on people with dementia, their caregivers, and their context. Conclusions: Both the assessment and nutritional care interventions for older people with dementia should consider the patient–caregiver dyad as the subject of care and understand the context as a fundamental part of it. The analysis of the context should look further than the immediate environment. Full article

(This article belongs to the Special Issue Dementia Research: Epidemiology and Public Health)

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