Displaying publications 21 - 40 of 129 in total

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  1. Quality of life in dementia patients: nursing home versus home care
    Nikmat AW, Hawthorne G, Al-Mashoor SH
    Int Psychogeriatr, 2011 Dec;23(10):1692-700.
    PMID: 21729416 DOI: 10.1017/S1041610211001050
    Care management providing a high quality of life (QoL) is a crucial issue in dealing with increasing numbers of dementia patients. Although the transition from informal (home-based) care to formal (institutional) care is often a function of dementia stage, for those with early dementia there is currently no definitive evidence showing that informal or formal care provides a higher QoL, particularly where informal care is favored for local cultural reasons. This paper outlines the research protocol for a study comparing formal and informal care in Malaysia. It seeks to provide evidence regarding which is more appropriate and results in higher QoL in early dementia.
    Matched MeSH terms: Dementia/nursing*; Dementia/psychology
  2. Schizophrenia or frontotemporal dementia in a young Chinese female: a purview of possible diagnoses
    Grewal GS, Kanagasundram S, Jambunathan S
    Turk Psikiyatri Derg, 2011;22(4):266-8.
    PMID: 22143952
    Frontotemporal dementia (FTD) is now increasingly being recognized as one of the causes of young onset dementia (YOD). The presentation of FTD can be subtle with a broad range of symptoms. This frequently causes misdiagnosis and a delay in initiating the correct treatment. While subtle personality changes, disinhibition and problems in executive functioning are frequently encountered in FTD, frank psychotic symptoms resembling schizophrenia are unusual. This is a case of a 38 year old Chinese female that highlights how obsessive compulsive symptoms which progressed to florid psychosis and disorganized speech and behavior can be a presenting picture in FTD. For seven years, this patient was treated as a case of schizophrenia and was thought to have poor response to electroconvulsive therapy (ECT) as well as antipsychotic medication. Her blood work and electroencephalogram (EEG) were normal. Magnetic resonance imaging (MRI) showed progressive cerebral atrophy. This case report suggests that psychosis should be investigated in detail especially when the clinical presentation is not typical of a functional disorder and more so when the patient is not responsive to conventional treatment. This report also highlights the importance of eliciting symptoms suggestive of an "organic" etiology, such as incontinence and disorientation. In addition, the usefulness of repeated imaging to show the rapidly progressive course of FTD has been illustrated. Other possible differential diagnoses of this patient are also discussed.
    Matched MeSH terms: Frontotemporal Dementia/diagnosis*; Frontotemporal Dementia/psychology
  3. Fulltext Diagnosis and management of mild cognitive impairment in the community: What is the role of primary care physician?
    Ambigga Devi SK, Suthahar A, Ramli AS, Ng KK, Radziah AR, Marymol K
    Malays Fam Physician, 2011;6(2-3):74-8.
    PMID: 25606229 MyJurnal
    Dementia is a large and growing problem in the ageing population but often not diagnosed in its earlier stages which is Mild Cognitive Impairment (MCI). MCI represents the phase between normal ageing and early dementia. About 12% of patients with MCI develop dementia per year, usually Alzheimer's disease. It is a diagnosis given to individuals who have cognitive impairments beyond that is expected for their age and education. However, this condition does not interfere significantly with daily activities as these individuals retain their critical thinking and reasoning skills. Nevertheless, due to its complexity and vague initial presentation, many cases of MCI can be missed. Therefore, it is imperative for primary care physicians to recognise these symptoms as opposed to normal ageing memory changes, and refer these patients to the memory clinic early to confirm the diagnosis. This paper illustrates a common primary care presentation of a patient with MCI. As there is no proven pharmacological treatment for MCI, the mainstay of management is to provide lifestyle intervention and long term support to these patients in the community. Primary care physicians should work as a team with the geriatrician, allied health personnel, support groups and caregivers in providing this care.
    Matched MeSH terms: Dementia
  4. Fulltext Dementia in Malaysia: issues and challenges
    Nikmat AW, Hawthorne G, Al-Mashoor SHA
    ASEAN Journal of Psychiatry, 2011;12(1):95-101.
    MyJurnal
    Objective: The number of people surviving until old age has been increasing worldwide. Reductions in both fertility and mortality rates, better living standards, nutrition and health care are claimed to be the key factors that increase the proportion of aged people within the population. Nevertheless, growing numbers of older adults also increases the susceptibility to diseases that commonly afflict the elderly, such as dementia. In this article, we discuss on the current issues of dementia in Malaysia and its challenge in providing a
    better management and services for this population. Methods and Results:Review of literature by searching the databases CINAHL, SCOPUS, MEDLINE and PsychINFO from June 2010 to November 2010 was done on the issues involving dementia patients in Malaysia such as ageing trend, awareness and availability of services. Conclusion: Despite a limited number of studies on dementia in Malaysia, literature revealed the importance of
    acknowledging the issues and improving the services for the patients. Efforts should be made by the government and private sectors to promote healthy ageing in Malaysia.
    Matched MeSH terms: Dementia
  5. Fulltext Lipid Peroxidation in Chronic Cerebral HypoperfusionInduced Neurodegeneration in Rats
    Anil Kumar, S., Saif, S.A., Oothuman, P., Mustafa, M.I.A.
    International Medical Journal Malaysia, 2011;10(2):3-6.
    MyJurnal
    Introduction: Reduced cerebral blood fl ow is associated with neurodegenerative disorders and dementia, in particular. Experimental evidence has demonstrated the initiating role of chronic cerebral hypoperfusion in neuronal damage to the hippocampus, the cerebral cortex, the white matter areas and the visual system. Permanent, bilateral occlusion of the common carotid arteries of rats (two vessel occlusion - 2VO) has been introduced for the reproduction of chronic cerebral hypoperfusion as it occurs in Alzheimer’s disease and human aging. Increased generation of free radicals through lipid peroxidation can damage neuronal cell membrane. Markers of lipid peroxidation have been found to be elevated in brain tissues and body fl uids in neurodegenerative diseases, including Alzheimer’s disease, Parkinson disease and amyotrophic lateral sclerosis. Materials and Methods: Malondialdehyde (MDA), fi nal product of lipid peroxidation, was estimated by thiobarbituric acid-reactive substances (TBARS) assay kit at eight weeks after induction of 2VO in the rats and control group. Results: Our study revealed a highly signifi cant (p
    Matched MeSH terms: Dementia
  6. Fulltext Sociodemographic profiles of caregivers and their association with burden of care in dementia
    Rosdinom, R., Norzarina, M.Z., Ruzanna, Z., Zanariah, M.S.
    Malaysian Journal of Psychiatry, 2011;20(1):1-10.
    MyJurnal
    Caring for a family member with dementia is associated with distress and several caregiver factors are known to be determinants of burden of care.
    Objective: To determine the relationship between the caregivers’ sociodemographic variables and their perceived burden of care. 
    Methods: Patients diagnosed as having dementia with their caregivers were selected through a non-randomised sampling method from the psychogeriatric and memory clinics in Universiti Kebangsaan Malaysia Medical Centre and Hospital Kuala Lumpur. Burden of care was assessed using the Zarit Burden Interview.
    Results: Age, gender, educational achievement, ethnicity and kinship of the 65 caregivers did not show any significant statistical difference in relation to their perceived burden. Conclusion: Burden in caring after patients with dementia was not significantly determined by the sociodemographic characteristics of their caregivers
    Study site: Psychogeriartic clinics and memory clinics of Pusat Perubatan University Kebangsaan Malaysia (PPUKM) and Hospital Kuala Lumpur (HKL), Kuala Lumpur, Malaysia
    Matched MeSH terms: Dementia
  7. Fulltext Digital elevation model (DEM) generation from stereo images
    Joanna Tan, C.E., Mat Jafri, M.Z., Lim, H.S., Abdullah, K.
    Pertanika Journal of Science & Technology, 2011;19(3):77-82.
    MyJurnal
    Digital elevation model (DEM) generation from stereo images is an effective and economical method in topography mapping. This paper used the stereo pair methodology to generate the digital elevation model (DEM) from PRISM (Panchromatic Remote-Sensing Instrument Satellite) sensor which is onboard of ALOS (Advanced Land Observing Satellite). The pair of forward-backward is used as stereoscopic imagery in this study. Ten ground control points (GCPs) are collected with residual error 0.49 pixels to generate an absolute DEM. This generated DEM with 2.5 m spatial resolution is then matched with the 90 m spatial resolution of
    SRTM (Space Shuttle Radar Topography Mission) DEM to compare the result. Although SRTM-DEM has a much coarser resolution, the positional accuracy of the matching is found. The difference of the height from the mean sea level (MSL) between the SRTM-DEM and the PRISM-DEM is analyzed and the correlation between the two DEMs is R²=0.8083. The accuracy of the DEM generated is given by the RMSE value of 0.8991 meter.
    Matched MeSH terms: Frontotemporal Dementia
  8. Fulltext Development and acceptance of a nutrition and lifestyle education booklet to improve mild cognitive impairment among elderly
    Sa’ida Munira Johari, Suzana Shahar, Roslee Rajikan, Safiyyah A. Aziz
    Jurnal Sains Kesihatan Malaysia, 2011;9(2):45-50.
    MyJurnal
    Mild cognitive impairment (MCI) is a common disorder among elderly and may worsen to dementia. The aim of this study is to develop a nutrition and lifestyle booklet to implement better lifestyle modification, as an effort to delay cognitive decline. A series of discussions with a research group comprising of dieticians, nutritionists, a geriatrician and a public health physician were conducted to ascertain the content of the booklet. There were seven guidelines in the booklet including; eat more fish, eat more foods rich in folic acid, eat more fruits and vegetables, exercise regularly, do activities to stimulate memory, stop smoking and alcohol drinking and stay cheerful and positive. Evaluation of acceptance for the booklet was carried out which comprised of assessment on content, graphic and design among elderly and health staff at health clinic in Cheras. The assessment involved 15 Malay elderly subjects aged 60 to 81 years (mean age 66.1 ±6.6 years), with 60.0% men and 40.0% women and 10 health staff aged 36.6 ± 12.0 years, with range of 27 to 58 years, consists of 20.0% men and 80.0% women also participated. Most of elderly subjects (80.0%, n = 12) indicated they understood information in the booklet. Meanwhile, 20.0% (n = 3) of elderly expressed they did not fully understand the content of the booklet in particular on sentence and terminology. All health staff (100.0%) understood the information in the booklet. This booklet was well accepted by elderly subjects and health staff, however adding more graphics, simplifying sentence structures and minimizing scientific terminologies to improve understanding were suggested. The booklet has the potential to increase the nutritional and health knowledge of elderly specifically with MCI. This would motivate them to adopt healthy eating and lifestyle, thus reducing cognitive decline and prevent dementia.
    Keywords: Cognitive, education, booklet, elderly, lifestyle
    Matched MeSH terms: Dementia
  9. Dementia, stroke, and vascular risk factors; a review
    Sahathevan R, Brodtmann A, Donnan GA
    Int J Stroke, 2012 Jan;7(1):61-73.
    PMID: 22188853 DOI: 10.1111/j.1747-4949.2011.00731.x
    Interest in dementia has increased over the past few decades. Stroke is an important cause of cognitive problems. The term vascular cognitive impairment is now used to describe dementia attributed to stroke or deep white matter lesions detected on imaging. Although vascular cognitive impairment is increasingly diagnosed, Alzheimer's disease remains the most common dementia worldwide. The relationship between Alzheimer's disease and vascular cognitive impairment is unclear, although there exists significant overlap, which prompts physicians to consider them opposite ends of a disease spectrum, rather than separate entities. There is also substantial evidence that stroke risk factors such as hypertension, diabetes; lipid disorders, etc. are independently associated with an increased risk of Alzheimer's disease and vascular cognitive impairment. Evidence suggests that these risk factors have a cumulative effect on Alzheimer's disease development but not on vascular cognitive impairment. This is more marked in Alzheimer's disease patients in the presence of the ε4 allelic variant of apolipoprotein E. How these risk factors increase the risk of dementia is largely unknown. Physicians must be aware that stroke causes dementia; that vascular risk factors appear to be independent risk factors in developing dementia, and that poststroke care must include cognitive assessment.
    Matched MeSH terms: Dementia, Vascular/etiology*; Dementia, Vascular/epidemiology; Dementia, Vascular/pathology
  10. Protective effects of total alkaloidal extract from Murraya koenigii leaves on experimentally induced dementia
    Mani V, Ramasamy K, Ahmad A, Parle M, Shah SA, Majeed AB
    Food Chem Toxicol, 2012 Mar;50(3-4):1036-44.
    PMID: 22142688 DOI: 10.1016/j.fct.2011.11.037
    Dementia is a syndrome of gradual onset and continuous decline of higher cognitive functioning. It is a common disorder in older persons and has become more prevalent today. The fresh leaves of Murraya koenigii are often added to various dishes in Asian countries due to the delicious taste and flavor that they impart. These leaves have also been proven to have health benefits. In the present study, the effect of total alkaloidal extract from M. koenigii leaves (MKA) on cognitive functions and brain cholinesterase activity in mice were determined. In vitro β-secretase 1 (BACE1) inhibitory activity was also evaluated. The total alkaloidal extract was administered orally in three doses (10, 20 and 30 mg/kg) for 15 days to different groups of young and aged mice. Elevated plus maze and passive avoidance apparatus served as the exteroceptive behavioral models for testing memory. Diazepam-, scopolamine-, and ageing-induced amnesia served as the interoceptive behavioral models. MKA (20 and 30 mg/kg, p.o.) showed significant improvement in memory scores of young and aged mice. Furthermore, the same doses of MKA reversed the amnesia induced by scopolamine (0.4 mg/kg, i.p.) and diazepam (1 mg/kg, i.p.). Interestingly, the brain cholinesterase activity was also reduced significantly by total alkaloidal extract of M. koenigii leaves. The IC50 value of MKA against BACE1 was 1.7 μg/mL. In conclusion, this study indicates MKA to be a useful remedy in the management of Alzheimer's disease and dementia.
    Matched MeSH terms: Dementia/drug therapy*; Dementia/enzymology
  11. Pisa syndrome secondary to rivastigmine: a case report
    Muthupalaniappen L, Rosdinom R, Suguna M
    Clin Ter, 2012;163(1):31-2.
    PMID: 22362231
    Pisa syndrome or pleurothotonus is the persistent flexion of the body and head to one side giving the appearance of the leaning tower of Pisa. It is most commonly caused by typical and atypical antipsychotic drugs. We report a case of Pisa Syndrome caused by prolonged use of high dose cholinesterase inhibitor, rivastigmine. Symptoms subsided when rivastigmine was withdrawn and did not reappear when a different cholinesterase inhibitor, donepezil was introduced. Physicians should be aware of Pisa syndrome and should alert patient of this possibility when starting and stepping up medications. The purpose of reporting this case is to create awareness among general practitioners as it is a reversible condition which responds to removal of the offending drug.
    Matched MeSH terms: Dementia/drug therapy
  12. Fulltext Prevalence of depression in stroke patients with vascular dementia in universiti kebangsaan malaysia medical center
    Khoo KF, Tan HJ, Rosdinom R, Raymond AA, Norlinah MI, Shamsul A, et al.
    Med J Malaysia, 2013 Apr;68(2):105-10.
    PMID: 23629553 MyJurnal
    Depression among patients with vascular dementia is frequently overlooked and potentially causes significant morbidity. There is limited data in Malaysia on the subject and this study was conducted to determine the prevalence of depression in vascular dementia (VaD) in UKMMC.
    Matched MeSH terms: Dementia, Vascular*
  13. Fulltext The effects of social support and having a partner on sleep quality in dementia
    Eshkoor SA, Hamid TA, Nudin SS, Mun CY
    Am J Alzheimers Dis Other Demen, 2013 May;28(3):253-7.
    PMID: 23612908 DOI: 10.1177/1533317513481098
    OBJECTIVES: This study aimed to determine the effects of social support and having a partner on sleep quality in the elderly patients with dementia.

    METHODOLOGY: This research was conducted on 1210 noninstitutionalized elderly Malaysian individuals with dementia. The effects of age, ethnicity, educational level, marital status, sex differences, social support, and having a partner on sleep quality were evaluated in the respondents. The multiple logistic regression analysis was used to predict the risk of sleep disturbances among the participants.

    RESULTS: Approximately, 41% of the participants experienced sleep disruption. Further findings showed that ethnicity (odds ratio [OR] = 0.62), social support (OR = 1.35), marital status (OR = 2.21), educational level (OR = 0.65), and having a partner (OR = 0.45) significantly affected sleep quality (P < .05). Sex differences and age were unrelated predictors of sleep disturbances (P > .05).

    CONCLUSION: It was concluded that social isolation and being single increased sleep disruption among respondents, but having a partner and ethnic non-Malay decreased the rate of sleep problems.

    Matched MeSH terms: Dementia/ethnology*; Dementia/psychology
  14. Fulltext CNS toxoplasmosis induced hydrocephalus revisited and a brief review of AIDS dementia complex
    Chow MB
    Med J Malaysia, 2013 Jun;68(3):278.
    PMID: 23749026
    Matched MeSH terms: AIDS Dementia Complex*
  15. Fulltext The effects of sleep quality, physical activity, and environmental quality on the risk of falls in dementia
    Eshkoor SA, Hamid TA, Nudin SS, Mun CY
    Am J Alzheimers Dis Other Demen, 2013 Jun;28(4):403-7.
    PMID: 23698600 DOI: 10.1177/1533317513488921
    OBJECTIVES: This study aimed to identify the effects of sleep quality, physical activity, environmental quality, age, ethnicity, sex differences, marital status, and educational level on the risk of falls in the elderly individuals with dementia.

    METHODOLOGY: Data were derived from a group of 1210 Malaysian elderly individuals who were noninstitutionalized and demented. The multiple logistic regression model was applied to estimate the risk of falls in respondents.

    RESULTS: Approximately the prevalence of falls was 17% among the individuals. The results of multiple logistic regression analysis revealed that age (odds ratio [OR] = 1.03), ethnicity (OR = 1.76), sleep quality (OR = 1.46), and environmental quality (OR = 0.62) significantly affected the risk of falls in individuals (P < .05). Furthermore, sex differences, marital status, educational level, and physical activity were not significant predictors of falls in samples (P > .05).

    CONCLUSION: It was found that age, ethnic non-Malay, and sleep disruption increased the risk of falls in respondents, but high environmental quality reduced the risk of falls.

    Matched MeSH terms: Dementia/epidemiology*
  16. Fulltext Cholinesterase inhibitors from botanicals
    Ahmed F, Ghalib RM, Sasikala P, Ahmed KK
    Pharmacogn Rev, 2013 Jul;7(14):121-30.
    PMID: 24347920 DOI: 10.4103/0973-7847.120511
    Alzheimer's disease (AD) is a progressive neurodegenerative disease, wherein a progressive loss of cholinergic synapses occurs in hippocampus and neocortex. Decreased concentration of the neurotransmitter, acetylcholine (ACh), appears to be critical element in the development of dementia, and the most appropriate therapeutic approach to treat AD and other form of dementia is to restore acetylcholine levels by inhibiting both major form of cholinesterase: Acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). Consequently, researches have focused their attention towards finding cholinesterase inhibitors from natural products. A large number of such inhibitors have been isolated from medicinal plants. This review presents a comprehensive account of the advances in field of cholinesterase inhibitor phytoconstituents. The structures of some important phytoconstituents (collected through www.Chemspider.com) are also presented and the scope for future research is discussed.
    Matched MeSH terms: Dementia
  17. Fulltext Initial evaluation of the training programme for health care professionals on the use of Malaysian clinical practice guidelines for management of dementia
    Yusoff S, Koh CT, Mohd Aminuddin MY, Krishnasamy M, Suhaila MZ
    East Asian Arch Psychiatry, 2013 Sep;23(3):91-101.
    PMID: 24088402
    The Malaysian Clinical Practice Guidelines (CPG) for Management of Dementia (second edition) was launched in April 2010 by the Ministry of Health Malaysia. A training programme for the management of dementia, involving all categories of staff working at primary and secondary centres, was implemented to ensure that care delivery for people with dementia was in accordance with the guidelines. The study aimed to look into improving knowledge and understanding of dementia following training, and to evaluate the effectiveness of the training programme using a clinical audit indicator recommended in the guidelines.
    Matched MeSH terms: Dementia/psychology; Dementia/therapy*
  18. Fulltext Is it toxoplasma encephalitis, HIV encephalopathy or brain tuberculoma?
    Nimir AR, Osman E, Ibrahim IA, Saliem AM
    BMJ Case Rep, 2013;2013.
    PMID: 23580678 DOI: 10.1136/bcr-2013-008803
    A 31-year-old Malaysian man was presented with an episode of seizures by the roadside, after having been recently diagnosed as HIV positive accompanied with miliary tuberculosis. On physical examination, he was oriented to person, but not to time or place. There was no neck stiffness or papilloedema. The other systemic examination was unremarkable. Chest examination revealed crepitations at the upper zone of the right lung. After diagnosis suspicion, the case was confirmed as toxoplasma encephalitis by MRI and serological tests. Patient was treated with trimethoprim/sulfamethoxazole 480-2400 mg/day with folinic acid supplement for 60 days. Two months later, a repeat brain MRI showed resolution of the cerebral lesions.
    Matched MeSH terms: AIDS Dementia Complex/diagnosis
  19. Fulltext Early Dementia Questionnaire (EDQ): a new screening instrument for early dementia in primary care practice
    Arabi Z, Aziz NA, Abdul Aziz AF, Razali R, Wan Puteh SE
    BMC Fam Pract, 2013;14:49.
    PMID: 23586732 DOI: 10.1186/1471-2296-14-49
    BACKGROUND: Worldwide, the population is ageing, resulting in an associated increase in dementia prevalence. Forgetfulness in elderly people is often perceived as normal in some local cultures and thus, the early detection of dementia in primary care requires detection of symptoms other than memory complaints.This study was conducted to screen elderly patients for early dementia in primary care using a newly developed Early Dementia Questionnaire (EDQ) and comparing it with a standard assessment tool, the Mini Mental State Examination (MMSE).
    METHODS: A cross-sectional study was conducted on a group of elderly patients using convenience sampling of consecutive patients. Elderly depression was excluded using the Geriatric Depression Scale (GDS). Exclusion criteria also included known cases of dementia. Inclusion criteria included a score of 5 or less in GDS and the presence of a reliable informant. A face-to-face interview was done using the EDQ with the patient and informant to elicit symptoms of early dementia. If the informant was not present, a telephone interview was used instead. The patient was then assessed with the Mini Mental State Examination (MMSE) using a cut-off point of 21.
    RESULTS: Prevalence of dementia among 155 subjects was 52.3% by EDQ and 15.5% by MMSE. The EDQ demonstrated a sensitivity of 79.2% with specificity of 52.7%. Positive predictive value (PPV) of EDQ was 23.5% with the negative predictive value (NPV) of 93.2%. The strongest predictor of possible early dementia was complaints of memory problems (OR 26.22; 95% CI 2.03-338.14) followed by complaints of concentration problems (OR 14.33; 95% CI 5.53-37.12), emotional problems (OR 4.75; 95% CI 1.64-13.81) and sleep disturbances (OR 3.14; 95% CI 1.15-8.56). Socio-demographic factors, medical problems and smoking status were not associated with possible dementia (p>0.05), despite that 60-70% of the elderly had chronic illnesses.
    CONCLUSION: The EDQ is a promising alternative to MMSE for screening of early dementia in primary care.
    Matched MeSH terms: Dementia/diagnosis*
  20. Do depression and educational attainment mediate the association between ethnicity and dementia?
    Momtaz YA, Hamid TA, Yusoff S, Ibrahim R
    Gerontology, 2013;59(3):206-12.
    PMID: 23147388 DOI: 10.1159/000342254
    Research shows marked differences in the prevalence of dementia among different ethnic groups. However, there is a relative dearth of studies focusing on how ethnicity may influence dementia. The main aim of the current study is to test potential mediating effects of depression and level of education on the association between ethnicity and dementia.
    Matched MeSH terms: Dementia/complications; Dementia/epidemiology*; Dementia/psychology
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