Journal of Gerontological Nursing

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News

Abstract

A study published in Nature Genetics has identified two more genetic risk factors for Alzheimer’s disease, adding to the four that have already been identified, including APOE4, which has been linked to the late-onset form of the disease.

The investigation, the largest ever genome-wide association study involving patients with Alzheimer’s disease, pooled DNA samples from more than 19,000 European and U.S. residents. Seven thousand had Alzheimer’s disease, and the others had no clinical symptoms of the disorder.

By looking at more than 600,000 common DNA markers, researchers were able to identify two new genes that appeared to be involved in elevated risk for Alzheimer’s disease: APOJ, also called clustrin on chromosome 8, and PICALM on chromosome 11. Each gene was assessed to have less than 10% risk in the occurrence of Alzheimer’s disease, whereas APOE has been estimated to present a 20% risk.

Although it is not yet clear how these new genes influence Alzheimer’s disease risk, levels of clustrin tend to rise when brain tissue is injured or becomes inflamed, and some researchers have noted increased clustrin levels in the brain and cerebrospinal fluid of Alzheimer’s patients.

The other gene, PICALM, appears to be involved in the breakdown of synapses, and some scientists hypothesize that the gene may be involved in the development of amyloid deposits. In addition, the study identified 13 more gene variants worthy of further investigation.

Such genetic research may be valuable in a time where the prevalence of Alzheimer’s disease is rising. According to the 2009 World Alzheimer Report ( http://www.alz.co.uk/research/worldreport/) from Alzheimer’s Disease International, more than 35 million people worldwide will have dementia in 2010, a 10% increase over previous global dementia prevalence reported in 2005 in The Lancet. The new report predicts that dementia prevalence will nearly double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050.

According to researchers, these increases were driven primarily by new data from low- and middle-income countries. Estimates for three regions are higher—Western Europe (7.29% versus 5.92%), South Asia (5.65% versus 3.40%), and Latin America (8.50% versus 7.25%); East Asia is lower (4.98% versus 6.46%), and North America is effectively identical. In addition, the researchers found that 57.7% of people with dementia in 2010 live in low- and middle-income countries, rising to 70.5% by 2050.

The report also focuses on the impact of dementia on family and caregivers. For example, statistics cited in the new report suggest that 40% to 75% of caregivers have significant psychological illness as a result of their caregiving, and 15% to 32% have depression.

Sources.“More Than 35 Million People Have Alzheimer’s and Dementia Worldwide, According to New Report.” (2009, September 21). Retrieved November 4, 2009, from http://www.prnewswire.co.uk/cgi/news/release?id=266385.“Researchers Find Two More Genetic Risk Factors for Alzheimer’s Disease.” (2009, September 7). Retrieved November 4, 2009, from http://www.medicalnewstoday.com/articles/163152.php.

Cognitive testing by telephone, an option valued by older adults who live in rural areas or great distances from medical centers, is generally as effective as in-person testing, according to a study published in the International Journal of Geriatric Psychiatry. The study was the first to evaluate the effectiveness of telephone assessment in an elderly cohort using well-established neuropsychological tests.

Fifty-four healthy women with an average age of 79 were divided into two groups and asked to complete a series of standard neuropsychological tests, including mental status questions such as identifying the day and time, remembering a series of words or numbers, and naming tasks. Both groups received in-person assessment of cognition as well as assessment by telephone.

The results indicated that the telephone and in-person assessments were comparable, suggesting that telephone assessment…

Dementia Prevalence Increases; More Genetic Factors Identified

A study published in Nature Genetics has identified two more genetic risk factors for Alzheimer’s disease, adding to the four that have already been identified, including APOE4, which has been linked to the late-onset form of the disease.

The investigation, the largest ever genome-wide association study involving patients with Alzheimer’s disease, pooled DNA samples from more than 19,000 European and U.S. residents. Seven thousand had Alzheimer’s disease, and the others had no clinical symptoms of the disorder.

By looking at more than 600,000 common DNA markers, researchers were able to identify two new genes that appeared to be involved in elevated risk for Alzheimer’s disease: APOJ, also called clustrin on chromosome 8, and PICALM on chromosome 11. Each gene was assessed to have less than 10% risk in the occurrence of Alzheimer’s disease, whereas APOE has been estimated to present a 20% risk.

Although it is not yet clear how these new genes influence Alzheimer’s disease risk, levels of clustrin tend to rise when brain tissue is injured or becomes inflamed, and some researchers have noted increased clustrin levels in the brain and cerebrospinal fluid of Alzheimer’s patients.

The other gene, PICALM, appears to be involved in the breakdown of synapses, and some scientists hypothesize that the gene may be involved in the development of amyloid deposits. In addition, the study identified 13 more gene variants worthy of further investigation.

Such genetic research may be valuable in a time where the prevalence of Alzheimer’s disease is rising. According to the 2009 World Alzheimer Report ( http://www.alz.co.uk/research/worldreport/) from Alzheimer’s Disease International, more than 35 million people worldwide will have dementia in 2010, a 10% increase over previous global dementia prevalence reported in 2005 in The Lancet. The new report predicts that dementia prevalence will nearly double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050.

According to researchers, these increases were driven primarily by new data from low- and middle-income countries. Estimates for three regions are higher—Western Europe (7.29% versus 5.92%), South Asia (5.65% versus 3.40%), and Latin America (8.50% versus 7.25%); East Asia is lower (4.98% versus 6.46%), and North America is effectively identical. In addition, the researchers found that 57.7% of people with dementia in 2010 live in low- and middle-income countries, rising to 70.5% by 2050.

The report also focuses on the impact of dementia on family and caregivers. For example, statistics cited in the new report suggest that 40% to 75% of caregivers have significant psychological illness as a result of their caregiving, and 15% to 32% have depression.

Sources.“More Than 35 Million People Have Alzheimer’s and Dementia Worldwide, According to New Report.” (2009, September 21). Retrieved November 4, 2009, from http://www.prnewswire.co.uk/cgi/news/release?id=266385.“Researchers Find Two More Genetic Risk Factors for Alzheimer’s Disease.” (2009, September 7). Retrieved November 4, 2009, from http://www.medicalnewstoday.com/articles/163152.php.

Telephone Assessments OK to Evaluate Cognition

Cognitive testing by telephone, an option valued by older adults who live in rural areas or great distances from medical centers, is generally as effective as in-person testing, according to a study published in the International Journal of Geriatric Psychiatry. The study was the first to evaluate the effectiveness of telephone assessment in an elderly cohort using well-established neuropsychological tests.

Fifty-four healthy women with an average age of 79 were divided into two groups and asked to complete a series of standard neuropsychological tests, including mental status questions such as identifying the day and time, remembering a series of words or numbers, and naming tasks. Both groups received in-person assessment of cognition as well as assessment by telephone.

The results indicated that the telephone and in-person assessments were comparable, suggesting that telephone assessment may be a useful, cost-effective, and time-efficient alternative to in-person assessment of cognition in older adults, especially for participants of clinical trials who require frequent follow up.

Source.“Researchers Find Telephone Assessment to be Effective for Evaluating Cognition in the Elderly.” (2009, September 15). Retrieved November 4, 2009, from http://www.physorgcom/news172253085.html.

Endovascular Repair Recommended for Older Adults with Abdominal Aortic Aneurysm

A new study published in the Journal of Vascular Surgery reports that older adults have better operative outcomes when endovascular repair (EVAR), rather than open surgery (OAR), is used to treat an abdominal aortic aneurysm (AAA).

Researchers examined data from the Nationwide Inpatient Sample to focus on patients between the ages of 50 and 85 and older who had had EVAR or OAR to treat AAAs. They found that those between ages 50 and 64 had an in-hospital operative mortality of 1.2% for OAR and 0.3% for EVAR. In comparison, in-patient mortality rates for older patients (ages 75 to 85) were 9.5% for OAR and 3.2% for EVAR. Furthermore, patients older than age 85 who had EVAR were significantly more likely to be discharged to their home (85.6%) than those who had OAR (50.2%).

Source.“Abdominal Aortic Aneurysm Repair Outcomes for Seniors Reviewed.” (2009, September 29). Retrieved November 4, 2009, from http://www.medicalnewstoday.com/articles/165636.php.

Hospice in Nursing Homes Benefits Residents

A review article published in the Journal of Pain and Symptom Management has found a number of benefits indicating that greater availability of hospice holds promise in the nursing home setting. Despite being relatively underutilized among nursing home residents, hospice in nursing homes can provide high quality end-of-life care and offers benefits such as reduced hospitalizations and improved pain management. The provision of hospice care in nursing homes has been shown to also have positive effects on nonhospice residents, suggesting indirect benefits on nursing home clinical practices. In addition, the study’s authors found that nursing home hospice patients received the same high quality care as those hospice patients living in their own homes.

Compared with similar residents not enrolled in hospice, previous studies reviewed by the researchers found nursing home hospice patients were more likely to be assessed for pain, twice as likely to receive daily treatment for pain, and more likely to receive pain management in accordance with clinical guidelines. They were also less likely to require hospitalization in the final 30 days of life.

Source.“Hospice Care in the Nursing Home Offers Benefits to Residents at End of Life.” (2009, September 29). Retrieved November 4, 2009, from http://www.reuters.com/article/pressRelease/idUS126155+29-Sep-2009+PRN20090929.

Online Store Offers Senior-Friendly Decor

In an effort to help older adults age in place without making their homes look like an institution, home product distributor Dynamic Living Inc. has launched AdaptMy.com, an online store featuring safety elements and products that fit in with older adults’ home decor. The site offers selections that are “universally designed,” an industry term meaning that the products can be comfortably used by people with a wider range of abilities.

Grab bars, for example, are available in standard stainless steel, as well as other chic models that look like sculptures. Designer bathroom collections feature matching robe hooks, toothbrush holders, and towel bars. The kitchen improvement section contains sinks, faucets, accessible kitchen islands, and pull-out shelving that are compliant with the Americans with Disabilities Act. In addition to the unique set of products, the website itself is accessible and includes larger text and bigger pictures. AdaptMy.com is also screen reader-friendly for individuals with visual impairments.

Source.“Seniors Want to Age in Place Without Making Their Home Look Like an Institution.” (2009, September 29). Retrieved November 4, 2009, from http://www.prnewswire.com/news-releases/seniors-want-to-age-in-place-without-making-their-home-look-like-an-institution-62548302.html.

10.3928/00989134-20091113-01

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