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Ethnic differences in Singapore's dementia prevalence: the stroke, Parkinson's disease, epilepsy, and dementia in Singapore study

Sahadevan S, Saw SM, Gao W, Tan LC, Chin JJ, Hong CY, et al.

J Am Geriatr Soc, 2008 Nov;56(11):2061-8.
PMID: 19016940 DOI: 10.1111/j.1532-5415.2008.01992.x

To study the prevalence of dementia in Singapore among Chinese, Malays, and Indians.

Matched MeSH terms: Dementia/ethnology*
Item response bias was present in instrumental activity of daily living scale in Asian older adults

Niti M, Ng TP, Chiam PC, Kua EH

J Clin Epidemiol, 2007 Apr;60(4):366-74.
PMID: 17346611

Item response bias (also called differential item functioning, DIF) in Instrumental Activities of Daily Living (IADL) occurs when members of different groups possessing the same disability level do not have the same probability of responding positively for a given item(s). This study aimed to identify the extent of DIF by gender, age, ethnicity, and dementia groups in IADL estimates in Asian (Chinese, Malays, and Indian) elderly subjects.

Matched MeSH terms: Dementia/epidemiology
Cultural considerations in forgoing enteral feeding: A comparison between the Hong Kong Chinese, North American, and Malaysian Islamic patients with advanced dementia at the end-of-life

Ngan OMY, Bergstresser SM, Sanip S, Emdadul Haque ATM, Chan HYL, Au DKS

Dev World Bioeth, 2020 06;20(2):105-114.
PMID: 31241234 DOI: 10.1111/dewb.12239

Cultural competence, a clinical skill to recognise patients' cultural and religious beliefs, is an integral element in patient-centred medical practice. In the area of death and dying, physicians' understanding of patients' and families' values is essential for the delivery of culturally appropriate care. Dementia is a neurodegenerative condition marked by the decline of cognitive functions. When the condition progresses and deteriorates, patients with advanced dementia often have eating and swallowing problems and are at high risk of developing malnutrition. Enteral tube feeding is a conventional means of providing artificial nutrition and hydration to meet nutritional needs, but its benefits to the frail population are limitedly shown in the clinical evidence. Forgoing tube feeding is ethically challenging when patients are mentally incompetent and in the absence of an advance directive. Unlike some developed countries, like the United States of America, death and dying is a sensitive issue or even a taboo in some cultures in developing countries that forgoing enteral tube feeding is clinically and ethically challenging, such as China and Malaysia. This article in three parts 1) discusses the clinical and ethical issues related to forgoing tube feeding among patients with advanced dementia, 2) describes how Hong Kong Chinese, North American, and Malaysian Islamic cultures respond differently in the decision-making patterns of forgoing tube feeding for patients with advanced dementia, and 3) reiterates the clinical implications of cultural competence in end-of-life care.

Matched MeSH terms: Dementia*
Fulltext Link Between Dietary Sodium Intake, Cognitive Function, and Dementia Risk in Middle-Aged and Older Adults: A Systematic Review

Mohan D, Yap KH, Reidpath D, Soh YC, McGrattan A, Stephan BCM, et al.

J Alzheimers Dis, 2020;76(4):1347-1373.
PMID: 32675410 DOI: 10.3233/JAD-191339

BACKGROUND: A key focus for dementia risk-reduction is the prevention of socio-demographic, lifestyle, and nutritional risk factors. High sodium intake is associated with hypertension and cardiovascular disease (both are linked to dementia), generating numerous recommendations for salt reduction to improve cardiovascular health.
OBJECTIVE: This systematic review aimed to assess, in middle- and older-aged people, the relationship between dietary sodium intake and cognitive outcomes including cognitive function, risk of cognitive decline, or dementia.
METHODS: Six databases (PubMed, EMBASE, CINAHL, Psych info, Web of Science, and Cochrane Library) were searched from inception to 1 March 2020. Data extraction included information on study design, population characteristics, sodium reduction strategy (trials) or assessment of dietary sodium intake (observational studies), measurement of cognitive function or dementia, and summary of main results. Risk-of-bias assessments were performed using the National Heart, Lung, and Blood Institute (NHLBI) assessment tool.
RESULTS: Fifteen studies met the inclusion criteria including one clinical trial, six cohorts, and eight cross-sectional studies. Studies reported mixed associations between sodium levels and cognition. Results from the only clinical trial showed that a lower sodium intake was associated with improved cognition over six months. In analysis restricted to only high-quality studies, three out of four studies found that higher sodium intake was associated with impaired cognitive function.
CONCLUSION: There is some evidence that high salt intake is associated with poor cognition. However, findings are mixed, likely due to poor methodological quality, and heterogeneous dietary, analytical, and cognitive assessment methods and design of the studies. Reduced sodium intake may be a potential target for intervention. High quality prospective studies and clinical trials are needed.

Matched MeSH terms: Dementia/prevention & control*
Application of the European quality indicators for psychosocial dementia care in long-term care facilities in the Asia-Pacific region: a pilot study

Jeon YH, Chien WT, Ha JY, Ibrahim R, Kirley B, Tan LL, et al.

Aging Ment Health, 2018 10;22(10):1279-1286.
PMID: 28714742 DOI: 10.1080/13607863.2017.1351521

OBJECTIVES: An Asia-Pacific regional collaboration group conducted its first multi-country research project to determine whether or not European quality indicators (QIs) for psychosocial care in dementia could be implemented as a valid tool in residential aged care across seven Asia-Pacific sites (Australia, Hong Kong Special Administrative Region, Mainland China, Malaysia, Singapore, South Korea, and Thailand).
METHOD: Following the European QI protocol, auditing and data extraction of medical records of consenting residents with dementia were conducted by trained auditors with relevant health care backgrounds. Detailed field notes by the auditors were also obtained to describe the characteristics of the participating care facilities, as well as key issues and challenges encountered, for each of the 12 QIs.
RESULTS: Sixteen residential care facilities in the seven Asia-Pacific sites participated in this study. Data from 275 residents' records revealed each of the 12 Qis' endorsement varied widely within and between the study sites (0%-100%). Quality of the medical records, family and cultural differences, definitions and scoring of certain indicators, and time-consuming nature of the QI administration were main concerns for implementation.
CONCLUSION: Several items in the European QIs in the current format were deemed problematic when used to measure the quality of psychosocial care in the residential aged care settings in participating Asia-Pacific countries. We propose refinements of the European QIs for the Asian-Pacific context, taking into account multiple factors identified in this study. Our findings provide crucial insights for future research and implementation of psychosocial dementia care QIs in this region.

Matched MeSH terms: Dementia/therapy*
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*
Fulltext Use of Potentially Inappropriate Medications in People With Dementia in Vietnam and Its Associated Factors

Nguyen TA, Pham T, Vu HTT, Nguyen TX, Vu TT, Nguyen BTT, et al.

Am J Alzheimers Dis Other Demen, 2018 Nov;33(7):423-432.
PMID: 29642720 DOI: 10.1177/1533317518768999

This study examined the use of potentially inappropriate medicines that may affect cognition (PIMcog) in people with dementia and its associated factors. Medical records of all outpatients with dementia attending a tertiary hospital in Vietnam between January 1, 2015, and December 31, 2016, were examined. Medicine use was assessed against a list of PIMcog. Variables associated with having a PIMcog were assessed using a multiple logistic regression. Of the 128 patients, 41% used a PIMcog, 39.1% used cholinesterase inhibitors (CEIs) concomitantly with anticholinergics, and 18% used antipsychotics. The number of hospital visits (adjusted odds ratio [OR]: 1.08; 95% confidence interval [CI]: 1.02-1.16) and number of treating specialists (adjusted OR: 0.61; 95% CI: 0.45-0.83) were associated with PIMcog use. This study highlights a high-level use of medicines that can further impair cognition or reduce the effectiveness of CEIs in people with dementia. Efforts to improve quality use of medicines for this population are warranted.

Matched MeSH terms: Dementia/epidemiology*
Fulltext Importance of hypertension and social isolation in causing sleep disruption in dementia

Eshkoor SA, Hamid TA, Nudin SS, Mun CY

Am J Alzheimers Dis Other Demen, 2014 Feb;29(1):61-6.
PMID: 24085252 DOI: 10.1177/1533317513505136

This study aimed to determine the effects of diabetes mellitus (DM), hypertension (HT), heart disease, social isolation, and sociodemographic factors on sleep in the elderly patients with dementia. Samples included 1210 noninstitutionalized, Malaysian elderly patients with dementia. The multiple logistic regression analysis was applied to estimate the risk of sleep disturbances among respondents. Approximately 41% of the patients experienced sleep problems. The results showed that age (odds ratio [OR] = 1.02), social isolation (OR = 1.33), and HT (OR = 1.53) significantly increased sleep disruption in respondents (P .05). It was concluded that age, social isolation, and HT increased sleep disruption but education and ethnic non-Malay reduced the risk of sleep problems. Moreover, HT was the most important variable to increase sleep disturbances in the elderly patients with dementia.

Matched MeSH terms: Dementia/epidemiology*
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
Ethnic variations in dementia: the contributions of cardiovascular, psychosocial and neuropsychological factors

Ng TP, Leong T, Chiam PC, Kua EH

Dement Geriatr Cogn Disord, 2010;29(2):131-8.
PMID: 20145399 DOI: 10.1159/000275668

Ethnic variations in dementia rate have been reported worldwide. Understanding these differences is vital for aetiological research, clinical care and health service planning. While age and gender have been consistently implicated, the reasons behind interethnic variation remain unclear.

Matched MeSH terms: Dementia/epidemiology*; Dementia/physiopathology; Dementia/psychology
Fulltext Identification of two novel mutations, PSEN1 E280K and PRNP G127S, in a Malaysian family

Ch'ng GS, An SS, Bae SO, Bagyinszky E, Kim S

Neuropsychiatr Dis Treat, 2015;11:2315-22.
PMID: 26396515 DOI: 10.2147/NDT.S86334

Alzheimer's disease (AD) is the most common form of dementia, which can be categorized into two main forms: early onset AD and late onset AD. The genetic background of early onset AD is well understood, and three genes, the APP, PSEN1, and PSEN2 have been identified as causative genes. In the current study, we tested three siblings from Malaysia who were diagnosed with early onset dementia, as well as their available family members. The family history was positive as their deceased father was similarly affected. Patients were tested for mutations in APP, PSEN1, PSEN2, and PRNP. A novel variant, E280K, was discovered in exon 8 of PSEN1 in the three siblings. In silico analyses with SIFT, SNAP, and PolyPhen2 prediction tools and three-dimensional modeling were performed, and the results suggested that the mutation is probably a pathogenic variant. Two additional pathogenic mutations were previously been described for codon 280, E280A, and E280G, which could support the importance of the E280 residue in the PS1 protein contributing to the pathogenic nature of E280K. Additional ten family members were screened for the E280K mutation, and all of them were negative. Six of them presented with a variety of neuropsychiatric symptoms, including learning disabilities, epilepsy, and schizophrenia, while four family members were asymptomatic. A novel PRNP G127S mutation was found in a step-niece of the three siblings harboring the PSEN1 E280K mutation. In silico predictions for PRNP G127S mutation suggested that this might be possibly a damaging variant. Additional studies to characterize PRNP G127S would be necessary to further understand the effects of this mutation.

Matched MeSH terms: Dementia
Fulltext The Association Between Bullous Pemphigoid and Neurological Disorders in A Selected Malaysian Population

Kwan Z, Lai YN, Ch'ng CC, Tan AH, Tan LL, Robinson S, et al.

Med J Malaysia, 2015 Apr;70(2):81-5.
PMID: 26162382 MyJurnal

BACKGROUND: An association of bullous pemphigoid with neurological disorders has been reported. The objectives of this study were to review the clinical characteristics of patients with bullous pemphigoid and compare the association between bullous pemphigoid and various neurological disorders and comorbidities.

METHODS: This was a retrospective case-control study involving 43 patients with bullous pemphigoid and 43 age-, sex- and ethnicity-matched controls.

RESULTS: There was a statistically significant association between bullous pemphigoid and neurological disorders [Odds Ratio (OR) = 3.5, 95% Confidence Interval (CI) 1.3 to 9.2, p=0.011 and adjusted OR=3.5, 95% CI 1.2-10.3, p=0.026], in particular for dementia (p=0.002). Although stroke was more common among patients with bullous pemphigoid, this association was not statistically significant with OR of 1.9 (95% CI 0.7 to 5.2) and adjusted OR of 2.1 (95% CI 0.6 to 7.2). Similarly both ischaemic stroke (OR 1.5, 95% CI 0.5 to 4.2) and haemorrhagic stroke (OR 1.5, 95% CI 0.2 to 9.7) were more common. Other neurological disorders more common among patients with bullous pemphigoid were Parkinson's disease and epilepsy. Dyslipidaemia was significantly less common among patients with bullous pemphigoid (OR 0.4, 95% CI 0.1 to 0.9, p=0.033).

CONCLUSION: A combination of an inflammatory process, prothrombotic state and endothelial activation leads to an increased frequency of neurological disorders among patients with bullous pemphigoid. Thus, a holistic approach to patient care, including screening for dementia and control of comorbidities, should be practised as bullous pemphigoid affects more than just the skin.

Matched MeSH terms: Dementia
Fulltext Prevention of brain hypoperfusion-induced neurodegeneration in rat’s hippocampus by black cumin fixed oil treatment

Marwan Saad Azzubaidi, Al-Ani, Imad Matloub, Anil Kumar Saxena, Ghasak Ghazi Faisal

International Medical Journal Malaysia, 2018;17(1):103-112.
MyJurnal

Introduction: The oil extract of black cumin seeds Nigella sativa (NSO) demonstrated considerable
preservation of spatial cognitive functions in rats subjected to chronic brain hypoperfusion (CBH). The hippocampal CA1 region pyramidal cells are the earliest neurons suffering neurodegeneration following CBH. Objective: The current study was devoted to assess the protective effects of Nigella sativa (NSO) treatment on CA1 hippocampal pyramidal cells of rats subjected to chronic brain hypoperfusion (CBH) that was achieved through permanent two vessel occlusion (2VO) procedure. Methods: Twenty four rats were equally divided into three groups; sham control, untreated 2VO and NSO treated group (2VO with daily oral NSO treatment. After the 10th postoperative week coronal sections of the hippocampus were collected for histopathological and electron microscopical examinations. Results: The number of viable pyramidal cells within CA1 hippocampal region in sham control and NSO treated groups was significantly higher than that of untreated 2VO group, while the difference was not significant when comparing the viable pyramidal cells number of sham control with NSO treated groups. Furthermore, 2VO group showed marked intracellular ultrastructural distortions that were less pronounced in NSO treated group. Conclusion: NSO displayed a robust potential to protect hippocampal pyramidal cells from CBH induced neurodegeneration putting forward its prospective neuroprotective activity against age related cognitive decline of Alzheimer’s disease and vascular dementia.

Matched MeSH terms: Dementia, Vascular
The Effect of Cyberspace-based Education on the Well-Being of Caregivers of Elderly People with Dementia

Momtaz YA, Mollaei P, Taheri-Tanjani P

Curr Aging Sci, 2021 Feb 08.
PMID: 33563165 DOI: 10.2174/1874609814666210208180051

INTRODUCTION: One of the consequences of aging is the prevalence of chronic and age-related diseases, such as dementia. Caring for patients with dementia has a negative impact on the caregiver's well-being. This study aimed to examine the impact of cyberspace-based education on the well-being of caregivers of demented elderly people.
METHODS: This experimental study was done on a sample of 86 caregivers of elderly with dementia in 2018. The study sample was selected from memory clinic of Taleghani Hospital and randomly assigned into groups (intervention n = 43, control n = 43 groups). The well-being was measured using the World Health Organization - Five Well-Being Index (WHO-5), before and two months after the intervention. Cyberspace-based educational intervention was conducted for one month. The SPSS software version 23 was employed in data analysis.
RESULTS: The mean age of the caregivers in the intervention and control groups were (M = 51.95, SD = 10.90) and (M = 51.36, SD = 15.12) respectively. No significant difference was found between two groups in terms of age, gender and level of education. The results of analysis showed that while the well-being of the intervention group was significantly increased (t (38) = -11.38, P<0.001) the well-being in the control group was significantly reduced ( t(36) =4.71 , P<0.001).
CONCLUSION: The findings showed that cyberspace-based education can improve the well-being of caregivers of the elderly with dementia.

Matched MeSH terms: Dementia
Fulltext Sesame Oil-Based Nanostructured Lipid Carriers of Nicergoline, Intranasal Delivery System for Brain Targeting of Synergistic Cerebrovascular Protection

Abourehab MAS, Khames A, Genedy S, Mostafa S, Khaleel MA, Omar MM, et al.

Pharmaceutics, 2021 Apr 19;13(4).
PMID: 33921796 DOI: 10.3390/pharmaceutics13040581

Nicergoline (NIC) is a semisynthetic ergot alkaloid derivative applied for treatment of dementia and other cerebrovascular disorders. The efficacy of sesame oil to slow and reverse the symptoms of neurodegenerative cognitive disorders has been proven. This work aimed to formulate and optimize sesame oil-based NIC-nanostructured lipid carriers (NIC-NLCs) for intranasal (IN) delivery with expected synergistic and augmented neuroprotective properties. The NIC-NLC were prepared using sesame oil as a liquid lipid. A three-level, three-factor Box-Behnken design was applied to statistically optimize the effect of sesame oil (%) of the total lipid, surfactant concentration, and sonication time on particle size, zeta potential, and entrapment efficacy as responses. Solid-state characterization, release profile, and ex vivo nasal permeation in comparison to NIC solution (NIC-SOL) was studied. In vivo bioavailability from optimized NIC-NLC and NIC-SOL following IN and IV administration was evaluated and compared. The optimized NIC-NLC formula showed an average particle size of 111.18 nm, zeta potential of -15.4 mV, 95.11% entrapment efficacy (%), and 4.6% loading capacity. The NIC-NLC formula showed a biphasic, extended-release profile (72% after 48 h). Permeation of the NIC-NLC formula showed a 2.3 enhancement ratio. Bioavailability studies showed a 1.67 and 4.57 fold increase in plasma and brain following IN administration. The results also indicated efficient direct nose-to-brain targeting properties with the brain-targeting efficiency (BTE%) and direct transport percentage (DTP%) of 187.3% and 56.6%, respectively, after IN administration. Thus, sesame oil-based NIC-NLC can be considered as a promising IN delivery system for direct and efficient brain targeting with improved bioavailability and expected augmented neuroprotective action for the treatment of dementia.

Matched MeSH terms: Dementia
Fulltext Association between caregiver burden with feeding problems and functional status of patients with dementia

Suzana, S., Lee, Y.H., Chong, H.Y., Nurfatina, M.D., Nurwhidayu, A.W., Siah, P.J., et al.

Malays J Nutr, 2014;20(1):27-37.
MyJurnal

Introduction: Feeding difficulty and functional disability are common problems among patients with dementia but their influence on caregivers' burden has not been addressed comprehensively. Thus, this study aimed to determine the association between feeding problems, functional status and caregiver burden among patients with dementia who receive outpatient treatment at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in Kuala Lumpur, Malaysia, as compared to their non-demented counterparts. Methods: A cross-sectional comparative study was conducted among 30 patients with dementia (12 men, 18 women, mean age 75 ± 7 years old) and 60 subjects without dementia (25 men, 35 women, mean age 69 ± 7 years), as well as their caregivers. Subjects' functional status, feeding problems and also caregiver burden were assessed using Activities of Daily Livings (ADLs) and Instrumental Activities of Daily Living (IADL) questionnaire, The Edinburgh Feeding Evaluation in Dementia Questionnaire (EdFED-Q) and Zarit Burden Interview (ZBI), respectively. Subjects were also measured for height and weight. Results: Patients with dementia needed supervision (50%) and physical help during mealtime (40%). The mean functional status score of these patients was higher than the patients without dementia (p<0.05). Caregiver burden score was positively correlated with the EdFED-Q score (r=0.405, p<0.05) but negatively correlated with functional status score (r=0.475, p<0.01). Further, multiple regression analysis showed that after adjustment for age, EdFED-Q score and functional status remained correlated with caregiver burden at R2 of 0.210. Conclusion: Caregiver burden is associated with feeding problems and functional disability among patients with dementia. There is a need to educate the caregivers in order to improve the quality of life of both carers and the demented patients.
Key words: Caregiver burden, dementia, feeding problems, functional status, outpatient
Study site: Psychiatric and medical clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

Matched MeSH terms: Dementia
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
Cognitive Profiles in Parkinson's Disease and their Correlation with Dementia, Anxiety and Depression: A Preliminary Study

Wan Mohamed WN, Che Din N, Ibrahim N

Malays J Med Sci, 2015 Dec;22(Spec Issue):29-35.
PMID: 27006635

A cross-sectional study was carried out at a medical centre to determine the cognitive profiles of 30 Parkinson's disease patients with age of 69.76 ± 7.39 years. Thirty-seven percent of the patients were found to be at risk for dementia. The scores on subscales of working memory and alternating verbal fluency were significantly lower in Parkinson's disease patients who were older than 77 years old. The scores on a subtest of working memory on the Parkinson's Disease Cognitive Rating Scale (PDCRS) were significantly lower in Parkinson's disease patients with a duration of illness of more than 10 years. In cognitive measurement, the subtests of verbal memory, delayed free recall and verbal fluency on the PD¬CRS were significantly lower in patients with less than six years of education. The patients who had difficulty with sustained attention, working memory and movement had significant anxiety and depression symptoms. In conclusion, multiple patterns in cognitive profiles influence the quality of life of patients with Parkinson's disease in multi-dimensional ways.

Matched MeSH terms: Dementia
Social support and burden among caregivers of patients with dementia in Malaysia

Choo WY, Low WY, Karina R, Poi PJ, Ebenezer E, Prince MJ

Asia Pac J Public Health, 2003;15(1):23-9.
PMID: 14620494 DOI: 10.1177/101053950301500105

This study aims to examine selected factors of dementia patients and their caregivers that were associated with the burden of family caregivers. This cross sectional study involves face-to-face interview with family caregivers of patients with dementia. Participants were recruited through convenient sampling from geriatric and psychiatry outpatient clinics from three government hospitals, one university hospital, one rural health centre and Alzheimer Disease caregivers' support groups. 70 caregivers took part in the study. Measures included patient and caregiver demographic variables and caregiver burden using the Zarit Burden Interview (ZBI). Caregiver burden was found to be significantly associated with both ethnicity and informal support. Chinese caregivers were found to have a higher level of burden compared to Indians and Malays. Informal support, in particular assistance from family members, was significantly associated with a lower burden perceived by the caregivers. However, the study shows that formal support such as assistance from maids and private nurses did not alleviate the burden of caregivers. Results highlighted the importance of improving the coping skills in burdened caregivers particularly among family members with dementia relatives. Interventions should be designed for specific needs of caregivers of different ethnicities.

Matched MeSH terms: Dementia/ethnology; Dementia/nursing*
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

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