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Aims: The aims of this study are to (1) explore the determinants of quality of life (QoL) in nursing home residents with young-onset dementia (YOD), (2) investigate whether there are differences between dementia subtypes (Alzheimer dementia, vascular/mixed dementia, frontotemporal dementia, other) regarding these determinants, and (3) compare QoL profiles of YOD nursing home residents across dementia subtypes. Methods: This cross-sectional study included 207 nursing home residents. Multilevel modeling was used to determine the relationships between QoL and neuropsychiatric symptoms (NPS), dementia severity, psychotropic drug use (PDU), dementia subtype, age, and gender. Additional multilevel models were used to compare aspects of QoL between dementia subtypes. Results: Residents' QoL was negatively associated with advanced dementia, PDU, and NPS. In general, the relationships between the determinants and QoL were similar across the dementia subtypes. Aspects of QoL differed by dementia subtype. Residents with frontotemporal dementia showed less negative emotions, accepted more help and experienced better quality of relationships with professional caregivers, had a more positive self-image, felt more comfortable in the nursing home environment, and experienced lower quality of social relationships. Conclusions: Considering the high rates of NPS and PDU in YOD residents and their negative associations with QoL, we recommend emphasizing services to manage and reduce NPS and PDU in nursing home residents with YOD. Furthermore, our findings suggest accounting for differences in aspects of QoL by dementia subtype to address specific needs and thereby improve QoL. [ABSTRACT FROM AUTHOR]

Background/Aims: Knowledge about neuropsychiatric symptoms in young-onset Alzheimer's disease (YO-AD) is scarce, but essential to establish a prognosis and plan care for YO-AD patients. The aim of this study is to assess frequency parameters of neuropsychiatric symptoms in YO-AD over 2 years and investigate whether there are differences compared with late-onset Alzheimer's disease (LO-AD). Methods: 98 YO-AD and 123 LO-AD patients and caregivers from two prospective cohort studies were included and assessed every 6 months for 2 years, using the Neuropsychiatric Inventory to evaluate neuropsychiatric symptoms. Results: Over the course of 2 years, the incidence, prevalence and persistence of neuropsychiatric symptoms were in general lower in YO-AD than in LO-AD, specifically for delusions, agitation, depression, anxiety, apathy, irritability and aberrant motor behavior. Frequency of individual symptoms showed large variability in both groups. Within the group of YO-AD patients, apathy was the most prevalent symptom. Conclusion: Neuropsychiatric symptoms, notably apathy, should be paid appropriate attention to in the diagnosis and treatment of YO-AD patients. Further research is needed to gain insight into the mechanisms underlying the differences in neuropsychiatric symptoms between YO-AD and LO-AD. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Although frailty is often conceptualized in terms of deficits, the level of frailty can be perceived as a complex interplay between deficits and resources. Objective: We studied whether resources such as educational level, financial situation, and living-alone status moderate the negative effects of deficits on two potentially adverse consequences of frailty: self-perceived health and receiving professional care. Methods: Logistic regression analysis was performed with data from a cross-sectional survey, designed by the public health service in the south of the Netherlands. The questionnaire was completed by a representative sample of people aged 70 and over (n = 5,559). Interaction effects between deficits (multimorbidity, difficulty performing ADLs, psychological distress, loneliness) and resources (educational level, financial situation, living-alone status) were studied in relation to self-perceived health and receiving professional care. Results: We found that in males the effect of difficulty in performing ADLs on self-perceived health was modified by educational level (p < 0.05, indicating that difficulty in performing ADLs is more strongly related to moderate/bad self-perceived health for those with higher education). In females, the effect of psychological distress on self-perceived health was modified by educational level (p < 0.05, indicating that suffering from psychological distress is more strongly related to moderate/bad self-perceived health for those with higher education) and the effect of difficulty in performing ADLs on receiving professional care was modified by living-alone status (p < 0.05, indicating that difficulty in performing ADLs was more strongly related to receiving professional care for those women who lived alone). Conclusions: Resources moderate the impact of personal deficits on self-perceived health and receiving professional care. Some frail people seem to be more vulnerable as they lack resources such as a high level of education. This should be taken into account in deciding when elderly people are at risk of negative outcomes of frailty and is therefore important for health professionals and policy-makers. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Behavioural changes are a key factor in distinguishing frontotemporal dementia (FTD) from Alzheimer’s disease (AD), however, little is known about the impact of these changes on caregivers. The aim of this study was to compare caregivers’ distress related to behavioural symptoms of AD and FTD. Methods: 47 spouse caregivers of consecutively referred patients with AD and 27 spouse caregivers of patients with FTD participated in this study. Behavioural disturbances in the patient and caregivers’ emotional reactions were measured with the Neuropsychiatric Inventory. Results: Patients with FTD had significantly higher levels of agitation, apathy, disinhibition and aberrant motor behaviour than did patients with AD. High distress scores were found for disinhibition, depression and apathy in caregivers of FTD patients whereas caregivers of AD patients reported patient apathy, depression and anxiety as being severely distressing. Higher mean distress scores were found for disinhibition in the FTD group. Furthermore, caregivers of FTD patients reported higher levels of general burden, and felt less competent than AD caregivers. Conclusions: Caregivers of FTD patients were overall more distressed by the behaviour of their partners than were the caregivers of AD patients.Findings from this study underscore the importance of differentiating between diagnostic groups and specific behavioural domains when focusing on caregiver reactions to problem behaviour. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]