Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society
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Comparative Study
Development of the Japanese DOLOPLUS-2: a pain assessment scale for the elderly with Alzheimer's disease.
Pain assessment in non-communicative patients relies primarily on observation scales. The DOLOPLUS-2 is a behavioral pain assessment scale for the elderly with impaired verbal communication. It rates five somatic items, two psychomotor items, and three psychosocial items as indicators of pain. The aims of the present study were to develop a Japanese version of the DOLOPLUS-2 and to apply it to elderly patients with Alzheimer's disease (AD). ⋯ The findings of the present study suggest that Version 2 of the Japanese DOLOPLUS-2 can be used reliably in clinical settings to measure the pain AD patients may be experiencing. However, the final version of the Japanese DOLOPLUS-2 needs to be validated in a larger patient cohort in future studies.
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Visual cognitive dysfunction is one of the most important signs indicating the early stage of dementia. Thus, visual testing could be used as an aid to the clinical diagnosis of dementia. In the present study, exploratory eye movement was measured to evaluate visual cognitive function in elderly subjects, including those with dementia. ⋯ These findings suggest that RSS using an eye mark recorder is a useful psychophysiological marker to evaluate the early stage of dementia as well as at-risk elderly people.
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Previous longitudinal studies have revealed that specific patterns on [(18) F]-fluoro-d-glucose (FDG) positron emission tomography (PET) scans in patients with amnesic mild cognitive impairment can predict Alzheimer's disease (AD). However, the significance of particular patterns on [(18) F]-FDG PET scans in prodromal patients with dementia with Lewy bodies (DLB) remains unclear. ⋯ These variations in [(18) F]-FDG PET scans raise the possibility that the specific pattern of CMRglc reduction may predict developing DLB in patients with idiopathic RBD. Further follow-up studies are needed, particularly on patients with diffuse occipital hypometabolism.
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The first part of the present review describes the current status of elderly people with behavioral and psychological symptoms of dementia (BPSD) in the community and basic viewpoints for differentiating between different forms of dementia. Specifically, it focuses on four points among the data and research related to determining the current status of elderly people with BPSD. We also propose basic concepts for differentiating between the core symptoms of dementia and BPSD, BPSD and delirium, and agitation and delirium. ⋯ When BPSD occurs in a person with dementia, the burden on caregivers increases. At such times, physicians tend to side with the family rather than with the patient. However, medical care is intended to be for the afflicted person, and physicians should base their plans for medical intervention on this principle.