BACKGROUND AND OBJECTIVES

The demographic background, level of knowledge, and attitude of caregivers are pillars of care in dementia. Family and non-family members take on this role. Studies have been done on their knowledge and attitude, but none have focused on them during hospitalization, wherein greater stress is imposed on both the caregiver and the patient. This study aims to determine the profiles, and its association with knowledge, and attitudes of caregivers of hospitalized patients with dementia in a tertiary hospital in Metro Manila.

A single-center descriptive cross-sectional design using Demographic profile Questionnaire, Alzheimer’s Disease Knowledge Scale (ADKS), and Dementia Attitude Scale (DAS) were used on Filipino caregivers of inpatients with dementia in Metro Manila. Simple and multivariable linear regression were used to assess demographic factors in relation to the attitude and knowledge of the caregivers.

Eighteen females with a mean age of 49 (SD=8) years old participated. Ten participants completed college. Six (33.3%) of the respondents were family members, five (27.8%) were occupational caregivers, four (22.2%) were house-helps, and two (11.1%) were nurses. Majority (66%) had 3-10-year duration of caregiving. Mean score of knowledge scale is 21.17 out of 30. Age, education, caregiver role, and attitude were positively associated with knowledge. The mean score for attitude level is 119.83 out of 140. Age, education, duration, caregiving role, patient’s age, and knowledge were positively associated with attitude; with education being statistically significant (p=0.046).

Caregivers exhibited reasonable knowledge for such caregivers to carry out their duties on inpatients with dementia at an adequate level, with several factors correlating positively, indicating areas for improvement. Their attitude scores revealed positive disposition; with education emerging as statistically significant. Continuing education and targeted interventions can further enhance quality of caregiving.

Autonomic nervous system dysfunction is one of the most common non-motor symptoms of Parkinson disease（PD）， and orthostatic hypotension（OH） is one of the common features of autonomic nervous system dysfunction. OH and cognitive impairment are the most common non-motor symptoms of PD and can run through the whole course of the disease， and it remains unclear whether there is an association between these two non-motor symptoms. At present， a large number of studies have been conducted on the association between PD-OH and cognitive impairment abroad， but there are few similar studies in China. Therefore， this article summarizes the association between cognitive impairment and OH in PD， in order to provide a reference for the pathogenesis， treatment， and prevention of cognitive impairment in PD and brings new ideas for the treatment of cognitive impairment in PD.
Parkinson disease ; Dementia

INTRODUCTION

Dementia has been a public health concern for several years. As the population continuously ages, the prevalence of dementia is projected to significantly rise, thus governments will face an increasing demand for support services. Unfortunately, dementia is not recognized as a major public health concern in the Philippines. As the extent of the dementia epidemic needs to be further delineated in the Philippines, and research on dementia is still limited, a larger study is needed to provide more information about the disease burden. This will raise awareness and inform policy makers about the necessity of social and health care reform in dementia care.

We aimed to collect uniform data from patients with cognitive impairment and determine the frequency of dementia and mild cognitive impairment in the study population. These data are crucial for providing information to policy makers in the country.

This is a multi-center, prospective, observational, non-interventional study and standing database of patients clinically diagnosed with Mild Cognitive Impairment (MCI) or dementia seen at the participating training institutions. Corresponding anonymized data on demographics, medical history, risk factors, level of functional impairment, diagnosis, baseline cognitive scores and management will be collected from each patient and entered into the database using a secure online data collection tool. Collective data will be extracted, summarized and analyzed every year with oversight provided by the Philippine Neurological Association (PNA).

Approval from the ethics committees or institutional review boards (EC/IRB) was obtained from the Single Joint Research Ethics Board and all participating institutions.

The PNA1DB-Dementia initiative will be crucial in providing information to policy makers, to further enhance the implementation of the Mental Health Act. The dissemination of results will be conducted through scientific or public conferences and scientific journal publication.

NCT05484960; ClinicalTrials.gov.

BACKGROUND

Type 2 Diabetes Mellitus (T2DM) patients are predisposed to cognitive decline and dementia. The cooccurrence of the two diseases translate to a higher medical cost. Identification of factors contributing to cognitive impairment is warranted.

To determine the predictors of cognitive impairment among Filipino patients with Type 2 Diabetes Mellitus.

This is a cross-sectional analytical study involving Filipino patients diagnosed with T2DM in the outpatient clinic. A total of 171 patients were included and were screened using AD8-P tool.

A total of 171 adult patients were included and screened for cognitive impairment.19.3% were cognitively impaired, with mean age of 59.6 years old (vs. 55.5 years old, p < 0.029), and two-thirds were female. The mean duration of the patient’s diabetes was 11.2 years. After adjusting for confounders and multi-collinearity, the duration of diabetes was significantly associated with cognitive impairment with odds of developing cognitive impairment increasing as the duration reach 10 years above. Those with T2DM for at least ten years were 2.5 times more likely to develop cognitive impairment, holding the age constant. (OR = 2.5, 95% CI – 1.0 to 5.8, p < 0.043).

19.3% of Filipino patients with Type 2 Diabetes Mellitus in a tertiary government hospital are cognitively impaired and this can occur even in less than 65 years old. The ten years or longer duration of T2DM increases the risk of developing cognitive impairment by 2.5%.

Background and Objectives: The demographic background, level of knowledge, and attitude of caregivers are pillars of care in dementia. Family and non-family members take on this role. Studies have been done on their knowledge and attitude, but none have focused on them during hospitalization, wherein greater stress is imposed on both the caregiver and the patient. This study aims to determine the profiles, and its association with knowledge, and attitudes of caregivers of hospitalized patients with dementia in a tertiary hospital in Metro Manila. Methods: A single-center descriptive cross-sectional design using Demographic profile Questionnaire, Alzheimer’s Disease Knowledge Scale (ADKS), and Dementia Attitude Scale (DAS) were used on Filipino caregivers of inpatients with dementia in Metro Manila. Simple and multivariable linear regression were used to assess demographic factors in relation to the attitude and knowledge of the caregivers. Results: Eighteen females with a mean age of 49 (SD=8) years old participated. Ten participants completed college. Six (33.3%) of the respondents were family members, five (27.8) % were occupational caregivers, four (22.2%) were house-helps, and two (11.1%) were nurses. Majority (66%) had 3-10-year duration of caregiving. Mean score of knowledge scale is 21.17 out of 30. Age, education, caregiver role, and attitude were positively associated with knowledge. The mean score for attitude level is 119.83 out of 140. Age, education, duration, caregiving role, patient’s age, and knowledge were positively associated with attitude; with education being statistically significant (p=0.046). Conclusion Caregivers exhibited reasonable knowledge for such caregivers to carry out their duties on inpatients with dementia at an adequate level, with several factors correlating positively, indicating areas for improvement. Their attitude scores revealed positive disposition; with education emerging as statistically significant. Continuing education and targeted interventions can further enhance quality of caregiving.
dementia ; caregiver burden ; attitude ; knowledge ; Philippines

BACKGROUND

E-learning has emerged as a crucial technique that educators embrace and apply. Two effective e-learning materials are video-based learning (VBL) and e-book-based remote learning (EBRL). While several studies have proven their effectiveness, none have compared these e-learning materials, especially regarding caregivers’ knowledge of delirium, dementia, and depression (3Ds). Based on the extant literature, many caregivers are untrained and often lack the knowledge and skills to lessen the burden on delirious, demented, and depressed older adults. Hence, there is a growing need to explore how e-learning materials will address caregivers’ lack of knowledge about the 3Ds of geriatric psychiatry.

This study ascertained the effects of e-learning materials on caregivers’ knowledge about the 3Ds of geriatric psychiatry and determined significant differences within and between groups.

A three-arm, quasi-experimental study, which included 63 informal caregivers in Baguio City who met the inclusion criteria and were chosen through purposive sampling, was conducted. Data were gathered using the Delirium-related knowledge tool, the Bangladesh version of the Depression Literacy Questionnaire, and the Dementia Knowledge Assessment Tool version 2. Data collection was done face-to-face and was conducted from March to April 2023. Data were treated with descriptive and inferential statistics using means, paired t-test, one-way omnibus ANOVA, and the post hoc Scheffé’s test. Ethics approval was provided by the Saint Louis University Research Ethics Committee (SLU-REC-UG 2023-004).

All the pretest mean scores of respondents in the VBL, EBRL, and control groups increased in the posttest. Additionally, the paired t-test revealed that the VBL and EBRL materials significantly affected the caregivers’ knowledge about the 3Ds of geriatric psychiatry, evidenced by a t-statistic of -5.80 (p=0.00001) and -4.48 (p= 0.00023), respectively. Lastly, one-way ANOVA revealed that there was a statistically significant difference in mean scores between at least two groups (F(2,60) = [7.060], p=0.002). Post hoc analysis using Scheffé’s test for multiple comparisons found that the mean values significantly differed between the VBL and the waitlist control group (Scheffé=10.589), and between the EBRL and the waitlist control group (Scheffé=10.589). There was no statistically significant difference between the VBL and the EBRL groups (Scheffé=0).

This study suggests that informal caregivers in Baguio City are moderately knowledgeable about the 3Ds of geriatric psychiatry. Moreover, both VBL and EBRL materials showed effectiveness in improving caregivers’ knowledge about the 3Ds of geriatric psychiatry, highlighting the substantial equivalence of both materials. Lastly, caregivers’ knowledge about the 3Ds of geriatric psychiatry increases as they engage in e-learning materials. Thus, it is acknowledged that VBL and EBRL materials are valuable, cost-effective, and practical interventions in improving caregivers’ knowledge about the 3Ds of geriatric psychiatry.

Background: Dementia is a chronic progressive disease that ultimately affects the patient’s quality of life. It is therefore important to manage and treat patients with the disease holistically, addressing other factors such as the patient’s lifestyle, family problems and even economic strains. Objective: This meta-analysis was conducted to determine the effectiveness of a patient-centered intervention among patients with dementia as the primary objective. Methods: A meta-analysis of studies was done on elderly patients diagnosed with dementia undergoing usual care or patientcentered care. Eligible studies for the meta-analysis were searched on electronic databases of Pubmed, Cochrane, Grey Literature and by cross referencing. Three review authors independently carried out all aspects of study selection, ‘risk of bias’ assessment and data extraction. RevMan 5 software was used in the analysis of gathered data. Results: Results in favor of patient centered care interventions were seen in the studies. In the analyses of 3 studies pertaining to the improvement of quality of life as measured by QUALID, QOD AD and EURO QL scale, the combined results were noted to favor the intervention over the control. Pooled results showed effectiveness favoring PCC intervention as compared to usual care (mean difference: 0.26, 95% CI: -1.31, 0.80), though not statistically significant. Conclusion Patient-centered care intervention is effective in improving the quality of life of patients with dementia. PCC should be initiated whenever possible from the time of dementia diagnosis and through the stages of the diseas
Patient-centered care ; dementia

Behavioral and psychological symptoms of dementia (BPSD) are common in the patients with dementia.Creative arts therapies (CAT) are one of the safe and effective non-pharmacological interventions for BPSD.This paper elaborates on the therapeutic effects of four common CAT,including art therapy,music therapy,dance therapy,and drama therapy,on BPSD.Despite the shortcomings,CAT offer a new gateway for the safe and noninvasive treatment of BPSD.
Humans ; Art Therapy ; Music Therapy ; Dementia/psychology*

Background: Breast cancer is the leading cause of cancer death among women worldwide. Studies showed conflicting results regarding presence of cancer, cancer treatment, and its association with dementia. Likewise, depression is often associated with cognitive problems. Objectives: This study aims to determine the prevalence and association of cognitive impairment and depression among breast cancer patients Methods: This is a prospective cross-sectional study utilizing Montreal Cognitive Assessment – Philippines (MOCA-P) and Patient Health Questionnaire (PHQ-9) Filipino version questionnaires through face-to-face interview. In analyzing the presence of cognitive impairment and depression, Chi-square was performed; all significant factors from this test underwent binary logistic regression to ascertain the statistical effect size for the presence of cognitive impairment and depression. Results: Results showed that 80.8% (97 out of 120 patients) have cognitive impairment while 27.5% of the patients have depression. Among the patients with cognitive impairment, 24.2% of them had depression. Results also showed significant association between the level of education and MOCA-P score suggesting that the higher the level of education, the better the MOCA-P score. This study showed no significant association between presence of cognitive impairment and depression. Conclusion In analyzing and managing patients with cognitive impairment, the level of educational attainment should be put into consideration since it is correlated significantly with MOCA-P results. As such, concomitant depression should be addressed accordingly since it may affect the patients’ overall health status.
Cognitive Dysfunction ; Depression ; Breast Neoplasms ; Mental Status and Dementia Tests

BACKGROUND: Sex- and age-specific impacts of cardiovascular risk factors on the development of dementia have not been well evaluated. We investigated these impacts of smoking, overweight/obesity, hypertension, and diabetes mellitus on the risk of disabling dementia. METHODS: The study participants were 25,029 (10,134 men and 14,895 women) Japanese aged 40-74 years without disabling dementia at baseline (2008-2013). They were assessed on smoking status (non-current or current), overweight/obesity (body mass index ≥25 kg/m² and ≥30 kg/m², respectively), hypertension (systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg or any antihypertensive medication use), and diabetes mellitus (a fasting serum glucose ≥126 mg/dL, non-fasting glucose ≥200 mg/dL, hemoglobin A1c ≥6.5% by the National Glycohemoglobin Standardization Program or glucose-lowering medication use) at baseline. Disabling dementia was identified as the level of care required ≥1 and cognitive disability grade ≥IIa according to the National Long-term Care Insurance Database. We used a Cox proportional regression model to estimate hazard ratios and 95% confidence intervals (95% CIs) of disabling dementia according to the cardiovascular risk factors and calculated the population attributable fractions (PAFs). RESULTS: During a median follow-up of 9.1 years, 1,322 (606 men and 716 women) developed disabling dementia. Current smoking and hypertension were associated with a higher risk of disabling dementia in both sexes, whereas overweight or obesity was not associated with the risk in either sex. Diabetes mellitus was associated with a higher risk only in women (p for sex interaction = 0.04). The significant PAFs were 13% for smoking and 14% for hypertension in men and 3% for smoking, 12% for hypertension, and 5% for diabetes mellitus in women. The total PAFs of the significant risk factors were 28% in men and 20% in women. When stratified by age, hypertension in midlife (40-64 years) was associated with the increased risk in men, while diabetes mellitus in later-life (65-74 years) was so in women. CONCLUSIONS A substantial burden of disabling dementia was attributable to smoking, and hypertension in both sexes and diabetes mellitus in women, which may require the management of these cardiovascular risk factors to prevent dementia.
Male ; Humans ; Female ; Adult ; Middle Aged ; Overweight/complications* ; East Asian People ; Cardiovascular Diseases/epidemiology* ; Hypertension/etiology* ; Diabetes Mellitus/etiology* ; Obesity/etiology* ; Smoking/epidemiology* ; Risk Factors ; Age Factors ; Dementia/etiology*