Expert Consensus on the Care and Management of Patients with Cognitive Impairment in China
- 31 Downloads
Abstract
The cognitive disease consensus was prepared by panels of health and public representatives based on actual clinical practice in Geriatric Departments in Chinese hospitals and a systematic literature review. This consensus reflects the medical knowledge accumulated by those experts and provides information about professional medical care and advice. A multidisciplinary panel of specialists (neurologists, psychiatrists, and nursing specialists) reports an expert consensus on the medical knowledge accumulated from those experts and provides information about professional medical care and advice. The recommendations focus on the care and management of older adults with mild cognitive impairment, the objectives and methods of maintaining cognition and training, the assessments and measures of daily care for patients at different stages of dementia, the assessments and coping strategies for the behavioral and psychological symptoms of dementia, principles and suggestions for an appropriate living environment, arrangements for recreational activities, the care and management of patients with end-stage dementia, and suggestions for addressing stress in caregivers.
Keywords
Consensus Healthcare Management Cognitive disordersSupplementary material
References
- 1.Behrman S, Valkanova V, Allan CL. Diagnosing and managing mild cognitive impairment. Practitioner 2017, 261: 17–20.PubMedGoogle Scholar
- 2.Langa KM, Levine DA. The diagnosis and management of mild cognitive impairment: a clinical review. JAMA 2014, 312: 2551–2561.PubMedPubMedCentralCrossRefGoogle Scholar
- 3.Sanford AM. Mild cognitive impairment. Clin Geriatr Med 2017, 33: 325–337.PubMedCrossRefGoogle Scholar
- 4.Petersen RC. Mild cognitive impairment. Continuum (Minneap Minn) 2016, 22: 404–418.Google Scholar
- 5.Manly JJ, Tang MX, Schupf N, Stern Y, Vonsattel JP, Mayeux R. Frequency and course of mild cognitive impairment in a multiethnic community. Ann Neurol 2008, 63: 494–506.PubMedPubMedCentralCrossRefGoogle Scholar
- 6.Alzheimer’s Association. 2018 Alzheimer’s disease facts and figures. Alzheimers Dement 2018, 14: 367–429.Google Scholar
- 7.Alzheimer’s Disease International (ADI). World Alzheimer Report, 2018.Google Scholar
- 8.Wang LN. Pay close attention to demetia patients health caregivers’ issue. Chin J Intern Med 2006, 45: 266.Google Scholar
- 9.Yang Z, Zhang DM, Chen R, Hu Z. A survey on care and caregiver of people with dementia in five provinces in China. Anhui Med J 2013, 34: 847–850.Google Scholar
- 10.van den Dungen P, van Kuijk L, van Marwijk H, van der Wouden J, Moll van Charante E, van der Horst H, et al. Preferences regarding disclosure of a diagnosis of dementia: a systematic review. Int Psychogeriatr 2014, 26: 1603–1618.Google Scholar
- 11.Zou Y, Song N, Hu YB, Gao Y, Zhang YQ, Zhao QH, et al. Caregivers’ attitude toward disclosure of Alzheimer’s disease diagnosis in Urban China. Int Psychogeriatr 2017, 29: 1849–1855.PubMedCrossRefPubMedCentralGoogle Scholar
- 12.Petersen RC, Lopez O, Armstrong MJ, Getchius TSD, Ganguli M, Gloss D, et al. Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2018, 90: 126–135.PubMedPubMedCentralCrossRefGoogle Scholar
- 13.Edmonds EC, Delano-Wood L, Jak AJ, Galasko DR, Salmon DP, Bondi MW, et al. “Missed” mild cognitive impairment: high false-negative error rate based on conventional diagnostic criteria. J Alzheimers Dis 2016, 52: 685–691.PubMedPubMedCentralCrossRefGoogle Scholar
- 14.Whitlatch CJ, Orsulic-Jeras S. Meeting the informational, educational, and psychosocial support needs of persons living with dementia and their family caregivers. Gerontologist 2018, 58: S58–S73.PubMedPubMedCentralGoogle Scholar
- 15.Zeng F, Xie WT, Wang YJ, Luo HB, Shi XQ, Zou HQ, et al. General public perceptions and attitudes toward Alzheimer’s disease from five cities in China. J Alzheimers Dis 2015, 43: 511–518.PubMedCrossRefGoogle Scholar
- 16.Xu L, Hsiao HY, Denq W, Chi I. Training needs for dementia care in China from the perspectives of mental health providers: who, what, and how. Int Psychogeriatr 2018, 30: 929–940.PubMedCrossRefGoogle Scholar
- 17.Woo BKP. An evaluation of YouTube in disseminating dementia knowledge to older Chinese in Britain. Int Psychogeriatr 2018, 30: 1575.PubMedCrossRefGoogle Scholar
- 18.Burla C, Rego G, Nunes R. Alzheimer, dementia and the living will: a proposal. Med Health Care Philos 2014, 17: 389–395.PubMedPubMedCentralCrossRefGoogle Scholar
- 19.Gates NJ, Sachdev P. Is cognitive training an effective treatment for preclinical and early Alzheimer’s disease? J Alzheimers Dis 2014, 42 Suppl 4: S551–559.PubMedCrossRefGoogle Scholar
- 20.Corbett A, Owen A, Hampshire A, Grahn J, Stenton R, Dajani S, et al. The effect of an online cognitive training package in healthy older adults: an online randomized controlled trial. J Am Med Dir Assoc 2015, 16: 990–997.PubMedCrossRefPubMedCentralGoogle Scholar
- 21.Liang JH, Xu Y, Lin L, Jia RX, Zhang HB, Hang L. Comparison of multiple interventions for older adults with Alzheimer disease or mild cognitive impairment: A PRISMA-compliant network meta-analysis. Medicine (Baltimore) 2018, 97: e10744.CrossRefGoogle Scholar
- 22.Hill NT, Mowszowski L, Naismith SL, Chadwick VL, Valenzuela M, Lampit A. Computerized cognitive training in older adults with mild cognitive impairment or dementia: a systematic review and meta-analysis. Am J Psychiatry 2017, 174: 329–340.PubMedCrossRefPubMedCentralGoogle Scholar
- 23.Kojima G. Quick and simple FRAIL scale predicts incident activities of daily living (ADL) and instrumental ADL (IADL) disabilities: A systematic review and meta-analysis. J Am Med Dir Assoc 2018, 19: 1063–1068.PubMedCrossRefPubMedCentralGoogle Scholar
- 24.Volkert D, Chourdakis M, Faxen-Irving G, Fruhwald T, Landi F, Suominen MH, et al. ESPEN guidelines on nutrition in dementia. Clin Nutr 2015, 34: 1052–1073.PubMedCrossRefPubMedCentralGoogle Scholar
- 25.Finucane T. Thinking about life-sustaining treatment late in the life of a demented person. Georgia Law Rev 2001, 35: 691–705.PubMedPubMedCentralGoogle Scholar
- 26.Bartley MM, Suarez L, Shafi RMA, Baruth JM, Benarroch AJM, Lapid MI. Dementia care at end of life: current approaches. Curr Psychiatry Rep 2018, 20: 50.PubMedCrossRefPubMedCentralGoogle Scholar
- 27.Goncalves AC, Cruz J, Marques A, Demain S, Samuel D. Evaluating physical activity in dementia: a systematic review of outcomes to inform the development of a core outcome set. Age Ageing 2018, 47: 34–41.PubMedCrossRefPubMedCentralGoogle Scholar
- 28.Iliffe S, Wilcock J, Drennan V, Goodman C, Griffin M, Knapp M, et al. Changing practice in dementia care in the community: developing and testing evidence-based interventions, from timely diagnosis to end of life (EVIDEM). Southampton (UK): NIHR Journals Library, 2015.Google Scholar
- 29.Bidzan L, Bidzan M, Pachalska M. The effects of intellectual, physical, and social activity on further prognosis in mild cognitive impairment. Med Sci Monit 2016, 22: 2551–2560.PubMedPubMedCentralCrossRefGoogle Scholar
- 30.Sinnott C, Foley T, Forsyth J, McLoughlin K, Horgan L, Bradley CP. Consultations on driving in people with cognitive impairment in primary care: A scoping review of the evidence. PLoS One 2018, 13: e0205580.PubMedPubMedCentralCrossRefGoogle Scholar
- 31.Frank CC, Lee L, Molnar F. Driving assessment for people with dementia. Can Fam Physician 2018, 64: 744.PubMedPubMedCentralGoogle Scholar
- 32.Hamdy RC, Kinser A, Kendall-Wilson T, Depelteau A, Whalen K, Culp J. Driving and patients with dementia. Gerontol Geriatr Med 2018, 4: 2333721418777085.PubMedPubMedCentralGoogle Scholar
- 33.Kales HC, Gitlin LN, Lyketsos CG. Assessment and management of behavioral and psychological symptoms of dementia. BMJ 2015, 350: h369.PubMedPubMedCentralCrossRefGoogle Scholar
- 34.Jecmenica-Lukic M, Pekmezovic T, Petrovic IN, Tomic A, Svetel M, Kostic VS. Use of the Neuropsychiatric inventory to characterize the course of neuropsychiatric symptoms in progressive supranuclear palsy. J Neuropsychiatry Clin Neurosci 2018, 30: 38–44.PubMedCrossRefGoogle Scholar
- 35.Lin X, Haralambous B, Pachana NA, Bryant C, LoGiudice D, Goh A, et al. Screening for depression and anxiety among older Chinese immigrants living in Western countries: The use of the Geriatric Depression Scale (GDS) and the Geriatric Anxiety Inventory (GAI). Asia Pac Psychiatry 2016, 8: 32–43.PubMedCrossRefGoogle Scholar
- 36.Wang G, Albayrak A, van der Cammen TJM. A systematic review of non-pharmacological interventions for BPSD in nursing home residents with dementia: from a perspective of ergonomics. Int Psychogeriatr 2018: 1–13.Google Scholar
- 37.Elliott M, Gardner P. The role of music in the lives of older adults with dementia ageing in place: A scoping review. Dementia (London) 2018, 17: 199–213.CrossRefGoogle Scholar
- 38.Woods DL, Dimond M. The effect of therapeutic touch on agitated behavior and cortisol in persons with Alzheimer’s disease. Biol Res Nurs 2002, 4: 104–114.PubMedCrossRefPubMedCentralGoogle Scholar
- 39.Yang MH, Lin LC, Wu SC, Chiu JH, Wang PN, Lin JG. Comparison of the efficacy of aroma-acupressure and aromatherapy for the treatment of dementia-associated agitation. BMC Complement Altern Med 2015, 15: 93.PubMedPubMedCentralCrossRefGoogle Scholar
- 40.Konis K, Mack WJ, Schneider EL. Pilot study to examine the effects of indoor daylight exposure on depression and other neuropsychiatric symptoms in people living with dementia in long-term care communities. Clin Interv Aging 2018, 13: 1071–1077.PubMedPubMedCentralCrossRefGoogle Scholar
- 41.Abraha I RJ, Trotta FM, Dell’Aquila G, Cruz-Jentoft A, Petrovic M, Gudmundsson A, et al. Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series. BMJ Open 2017, 16: e012759.CrossRefGoogle Scholar
- 42.Scales K, Zimmerman S, Miller SJ. Evidence-based nonpharmacological practices to address behavioral and psychological symptoms of dementia. Gerontologist 2018, 58: S88–S102.PubMedPubMedCentralCrossRefGoogle Scholar
- 43.Blake M. Group reminiscence therapy for adults with dementia: a review. Br J Community Nurs 2013, 18: 228–233.PubMedCrossRefGoogle Scholar
- 44.Theleritis C, Siarkos K, Politis AA, Katirtzoglou E, Politis A. A systematic review of non-pharmacological treatments for apathy in dementia. Int J Geriatr Psychiatry 2018, 33: e177–e192.PubMedCrossRefGoogle Scholar
- 45.Garriga M, Pacchiarotti I, Kasper S, Zeller SL, Allen MH, Vazquez G, et al. Assessment and management of agitation in psychiatry: Expert consensus. World J Biol Psychiatry 2016, 17: 86–128.CrossRefGoogle Scholar
- 46.Sarkamo T, Laitinen S, Numminen A, Kurki M, Johnson JK, Rantanen P. Pattern of emotional benefits induced by regular singing and music listening in dementia. J Am Geriatr Soc 2016, 64: 439–440.PubMedCrossRefGoogle Scholar
- 47.Guarnieri B, Musicco M, Caffarra P, Adorni F, Appollonio I, Arnaldi D, et al. Recommendations of the Sleep Study Group of the Italian Dementia Research Association (SINDem) on clinical assessment and management of sleep disorders in individuals with mild cognitive impairment and dementia: a clinical review. Neurol Sci 2014, 35: 1329–1348.PubMedCrossRefGoogle Scholar
- 48.Dowling GA, Graf CL, Hubbard EM, Luxenberg JS. Light treatment for neuropsychiatric behaviors in Alzheimer’s disease. West J Nurs Res 2007, 29: 961–975.PubMedPubMedCentralCrossRefGoogle Scholar
- 49.Burns A, Allen H, Tomenson B, Duignan D, Byrne J. Bright light therapy for agitation in dementia: a randomized controlled trial. Int Psychogeriatr 2009, 21: 711–721.PubMedCrossRefGoogle Scholar
- 50.Suzuki H, Inoue Y, Nishiyama A, Mikami K, Gen K. Clinical efficacy and changes in the dosages of concomitantly used psychotropic drugs in memantine therapy in Alzheimer’s disease with behavioral and psychological symptoms on dementia. Ther Adv Psychopharmacol 2013, 3: 123–128.PubMedPubMedCentralCrossRefGoogle Scholar
- 51.Soril LJ, Leggett LE, Lorenzetti DL, Silvius J, Robertson D, Mansell L, et al. Effective use of the built environment to manage behavioural and psychological symptoms of dementia: a systematic review. PLoS One 2014, 9: e115425.PubMedPubMedCentralCrossRefGoogle Scholar
- 52.Guideline Adaptation Committee. Clinical Practice Guidelines and Principles of Care for People with Dementia. Sydney: Guideline Adaptation Committee, 2016.Google Scholar
- 53.Konno R, Stern C, Gibb H. The best evidence for assisted bathing of older people with dementia: a comprehensive systematic review. JBI Database of Systematic Reviews and Implementation Reports 2013, 11: 123–212.CrossRefGoogle Scholar
- 54.Topfer LA. GPS locator devices for people with dementia. CADTH Issues in Emerging Health Technologies. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health, 2016: 147.Google Scholar
- 55.White EB, Montgomery P. Electronic tracking for people with dementia: an exploratory study of the ethical issues experienced by carers in making decisions about usage. Dementia (London) 2014, 13: 216–232.CrossRefGoogle Scholar
- 56.Guidelines and Protocols Advisory Committee. Cognitive Impairment: Recognition, Diagnosis and Management in Primary Care 2014.Google Scholar
- 57.Kok JS, van Heuvelen MJ, Berg IJ, Scherder EJ. Small scale homelike special care units and traditional special care units: effects on cognition in dementia; a longitudinal controlled intervention study. BMC Geriatr 2016, 16: 47.PubMedPubMedCentralCrossRefGoogle Scholar
- 58.The National Institute for Health and Care Excellence (NICE). Dementia: assessment, management and support for people living with dementia and their carers (NG97) 2018.Google Scholar
- 59.Andrews J. A guide to creating a dementia-friendly ward. Nurs Times 2013, 109: 20–21.PubMedPubMedCentralGoogle Scholar
- 60.Chiu HL, Chan PT, Chu H, Hsiao SS, Liu D, Lin CH, et al. Effectiveness of light therapy in cognitively impaired persons: a metaanalysis of randomized controlled trials. J Am Geriatr Soc 2017, 65: 2227–2234.PubMedCrossRefPubMedCentralGoogle Scholar
- 61.van der Steen JT, Smaling HJ, van der Wouden JC, Bruinsma MS, Scholten RJ, Vink AC. Music-based therapeutic interventions for people with dementia. Cochrane Database Syst Rev 2018, 7: CD003477.Google Scholar
- 62.Lin LW, Weng SC, Wu HS, Tsai LJ, Lin YL, Yeh SH. The effects of white noise on agitated behaviors, mental status, and activities of daily living in older adults with dementia. J Nurs Res 2018, 26: 2–9.PubMedPubMedCentralGoogle Scholar
- 63.Ng QX, Ho CY, Koh SS, Tan WC, Chan HW. Doll therapy for dementia sufferers: A systematic review. Complement Ther Clin Pract 2017, 26: 42–46.PubMedCrossRefPubMedCentralGoogle Scholar
- 64.Travers C, Brooks D, Hines S, O’Reilly M, McMaster M, He W, et al. Effectiveness of meaningful occupation interventions for people living with dementia in residential aged care: a systematic review. JBI Database System Rev Implement Rep 2016, 14: 163–225.PubMedCrossRefPubMedCentralGoogle Scholar
- 65.Lorusso LN, Bosch SJ. Impact of multisensory environments on behavior for people with dementia: a systematic literature review. Gerontologist 2018, 58: e168–e179.PubMedCrossRefPubMedCentralGoogle Scholar
- 66.International Psychogeriatric Association. IPA Complete Guides to Behavioral and Psychological Symptoms of Dementia (BPSD) 2015.Google Scholar
- 67.Garcia LJ, Hebert M, Kozak J, Senecal I, Slaughter SE, Aminzadeh F, et al. Perceptions of family and staff on the role of the environment in long-term care homes for people with dementia. Int Psychogeriatr 2012, 24: 753–765.PubMedCrossRefPubMedCentralGoogle Scholar
- 68.Lyketsos CG, Colenda CC, Beck C, Blank K, Doraiswamy MP, Kalunian DA, et al. Position statement of the American Association for Geriatric Psychiatry regarding principles of care for patients with dementia resulting from Alzheimer disease. Am J Geriatr Psychiatry 2006, 14: 561–572.CrossRefGoogle Scholar
- 69.Fleiner T, Leucht S, Forstl H, Zijlstra W, Haussermann P. Effects of short-term exercise interventions on behavioral and psychological symptoms in patients with dementia: a systematic review. J Alzheimers Dis 2017, 55: 1583–1594.PubMedCrossRefPubMedCentralGoogle Scholar
- 70.Barreto Pde S, Demougeot L, Pillard F, Lapeyre-Mestre M, Rolland Y. Exercise training for managing behavioral and psychological symptoms in people with dementia: A systematic review and meta-analysis. Ageing Res Rev 2015, 24: 274–285.PubMedCrossRefGoogle Scholar
- 71.Roland KP, Chappell NL. Meaningful activity for persons with dementia: family caregiver perspectives. Am J Alzheimers Dis Other Demen 2015, 30: 559–568.PubMedCrossRefGoogle Scholar
- 72.Castro-Monteiro E, Alhayek-Ai M, Diaz-Redondo A, Ayala A, Rodriguez-Blazquez C, Rojo-Perez F, et al. Quality of life of institutionalized older adults by dementia severity. Int Psychogeriatr 2016, 28: 83–92.PubMedCrossRefGoogle Scholar
- 73.Duru Asiret G, Kapucu S. The effect of reminiscence therapy on cognition, depression, and activities of daily living for patients With Alzheimer disease. J Geriatr Psychiatry Neurol 2016, 29: 31–37.PubMedCrossRefGoogle Scholar
- 74.Olley R, Morales A. Systematic review of evidence underpinning non-pharmacological therapies in dementia. Aust Health Rev 2018, 42: 361–369.PubMedCrossRefGoogle Scholar
- 75.Wu J, Wang Y, Wang Z. The effectiveness of massage and touch on behavioural and psychological symptoms of dementia: A quantitative systematic review and meta-analysis. J Adv Nurs 2017, 73: 2283–2295.PubMedCrossRefGoogle Scholar
- 76.Searson R, Hendry AM, Ramachandran R, Burns A, Purandare N. Activities enjoyed by patients with dementia together with their spouses and psychological morbidity in carers. Aging Ment Health 2008, 12: 276–282.PubMedCrossRefGoogle Scholar
- 77.Raposo VL. Lost in ‘Culturation’: medical informed consent in China (from a Western perspective). Med Health Care Philos 2019, 22: 17–30.PubMedCrossRefGoogle Scholar
- 78.Stewart JT, Schultz SK. Palliative care for dementia. Psychiatr Clin North Am 2018, 41: 141–151.PubMedCrossRefGoogle Scholar
- 79.Zarit SH, Todd PA, Zarit JM. Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist 1986, 26: 260–266.PubMedCrossRefGoogle Scholar
- 80.Mausbach BT, Chattillion EA, Roepke SK, Patterson TL, Grant I. A comparison of psychosocial outcomes in elderly Alzheimer caregivers and noncaregivers. Am J Geriatr Psychiatry 2013, 21: 5–13.PubMedCrossRefGoogle Scholar
- 81.Seeher K, Low LF, Reppermund S, Brodaty H. Predictors and outcomes for caregivers of people with mild cognitive impairment: a systematic literature review. Alzheimers Dement 2013, 9: 346–355.PubMedCrossRefGoogle Scholar
- 82.Fonareva I, Oken BS. Physiological and functional consequences of caregiving for relatives with dementia. Int Psychogeriatr 2014, 26: 725–747.PubMedPubMedCentralCrossRefGoogle Scholar
- 83.Shaw WS, Patterson TL, Ziegler MG, Dimsdale JE, Semple SJ, Grant I. Accelerated risk of hypertensive blood pressure recordings among Alzheimer caregivers. J Psychosom Res 1999, 46: 215–227.PubMedCrossRefGoogle Scholar
- 84.Vitaliano PP, Scanlan JM, Zhang J, Savage MV, Hirsch IB, Siegler IC. A path model of chronic stress, the metabolic syndrome, and coronary heart disease. Psychosom Med 2002, 64: 418–435.PubMedCrossRefGoogle Scholar
- 85.Wang G, Cheng Q, Zhang S, Bai L, Zeng J, Cui PJ, et al. Economic impact of dementia in developing countries: an evaluation of Alzheimer-type dementia in Shanghai, China. J Alzheimers Dis 2008, 15: 109–115.PubMedCrossRefGoogle Scholar
- 86.Tang SH, Chio OI, Chang LH, Mao HF, Chen LH, Yip PK, et al. Caregiver active participation in psychoeducational intervention improved caregiving skills and competency. Geriatr Gerontol Int 2018, 18: 750–757.PubMedCrossRefGoogle Scholar
- 87.Wang Z, Ma C, Han H, He R, Zhou L, Liang R, et al. Caregiver burden in Alzheimer’s disease: Moderation effects of social support and mediation effects of positive aspects of caregiving. Int J Geriatr Psychiatry 2018. https://doi.org/10.1002/gps.4910.CrossRefPubMedPubMedCentralGoogle Scholar
- 88.Forstmeier S, Maercker A, Savaskan E, Roth T. Cognitive behavioural treatment for mild Alzheimer’s patients and their caregivers (CBTAC): study protocol for a randomized controlled trial. Trials 2015, 16: 526.PubMedPubMedCentralCrossRefGoogle Scholar
- 89.Sepe-Monti M, Vanacore N, Bartorelli L, Tognetti A, Giubilei F, Caregiver Study Group Savvy. The Savvy Caregiver Program: a probe multicenter randomized controlled pilot trial in caregivers of patients affected by Alzheimer’s disease. J Alzheimers Dis 2016, 54: 1235–1246.Google Scholar
- 90.Pozet A, Lejeune C, Bonnet M, Dabakuyo S, Dion M, Fagnoni P, et al. Evaluation of efficacy and efficiency of a pragmatic intervention by a social worker to support informal caregivers of elderly patients (The ICE Study): study protocol for a randomized controlled trial. Trials 2016, 17: 531.PubMedPubMedCentralCrossRefGoogle Scholar
- 91.Nguyen TA, Nguyen H, Pham T, Nguyen TH, Hinton L. A cluster randomized controlled trial to test the feasibility and preliminary effectiveness of a family dementia caregiver intervention in Vietnam: The REACH VN study protocol. Medicine (Baltimore) 2018, 97: e12553.PubMedCentralCrossRefGoogle Scholar
- 92.Black CM, Lipton RB, Thiel E, Brouillette M, Khandker R. Relationship between treatment initiation and healthcare costs in Alzheimer’s disease. J Alzheimers Dis 2019, 68: 1575–1585.PubMedCrossRefPubMedCentralGoogle Scholar