9 results on '"Olde Rikkert, Marcel G.M."'
Search Results
2. Survival time tool to guide care planning in people with dementia
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Haaksma, Miriam L., Eriksdotter, Maria, Rizzuto, Debora, Leoutsakos, Jeannie-Marie S., Olde Rikkert, Marcel G.M., Melis, René J.F., and Garcia-Ptacek, Sara
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Aged, 80 and over ,Male ,Sweden ,Age Factors ,Comorbidity ,Prognosis ,Article ,Patient Care Planning ,Survival Rate ,Advance Care Planning ,Sex Factors ,Alzheimer Disease ,Residence Characteristics ,Humans ,Dementia ,Female ,Decision Making, Shared ,Aged ,Proportional Hazards Models - Abstract
Objective To develop survival prediction tables to inform physicians and patients about survival probabilities after the diagnosis of dementia and to determine whether survival after dementia diagnosis can be predicted with good accuracy. Methods We conducted a nationwide registry-linkage study including 829 health centers, i.e., all memory clinics and ≈75% of primary care facilities, across Sweden. Data including cognitive function from 50,076 people with incident dementia diagnoses ≥65 years of age and registered with the Swedish Dementia Register in 2007 to 2015 were used, with a maximum follow-up of 9.7 years for survival until 2016. Sociodemographic factors, comorbidity burden, medication use, and dates of death were obtained from nationwide registries. Cox proportional hazards regression models were used to create tables depicting 3-year survival probabilities for different risk factor profiles. Results By August 2016, 20,828 (41.6%) patients in our cohort had died. Median survival time from diagnosis of dementia was 5.1 (interquartile range 2.9–8.0) years for women and 4.3 (interquartile range 2.3–7.0) years for men. Predictors of mortality were higher age, male sex, increased comorbidity burden and lower cognitive function at diagnosis, a diagnosis of non-Alzheimer dementia, living alone, and using more medications. The developed prediction tables yielded c indexes of 0.70 (95% confidence interval [CI] 0.69–0.71) to 0.72 (95% CI 0.71–0.73) and showed good calibration. Conclusions Three-year survival after dementia diagnosis can be predicted with good accuracy. The survival prediction tables developed in this study may aid clinicians and patients in shared decision-making and advance care planning.
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- 2019
3. Cognitive and functional progression of dementia in two longitudinal studies.
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Wang, Yuwei, Haaksma, Miriam L., Ramakers, Inez H.G.B., Verhey, Frans R.J., Flier, Wiesje M., Scheltens, Philip, Maurik, Ingrid, Olde Rikkert, Marcel G.M., Leoutsakos, Jeannie‐Marie S., Melis, René J.F., van de Flier, Wiesje M, van Maurik, Ingrid, and Leoutsakos, Jeannie-Marie S
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DEMENTIA ,LONGITUDINAL method ,ACTIVITIES of daily living ,COMPARATIVE studies ,RESEARCH methodology ,MEDICAL cooperation ,RESEARCH ,RESEARCH funding ,COMORBIDITY ,EVALUATION research ,DISEASE progression - Abstract
Objectives: Previous studies have identified several subgroups (ie, latent trajectories) with distinct disease progression among people with dementia. However, the methods and results were not always consistent. This study aims to perform a coordinated analysis of latent trajectories of cognitive and functional progression in dementia across two datasets.Methods: Included and analyzed using the same statistical approach were 1628 participants with dementia from the US National Alzheimer's Coordinating Center (NACC) and 331 participants with dementia from the Dutch Clinical Course of Cognition and Comorbidity study (4C-Study). Trajectories of cognition and instrumental activities of daily living (IADL) were modeled jointly in a parallel-process growth mixture model.Results: Cognition and IADL tended to decline in unison across the two samples. Slow decline in both domains was observed in 26% of the US sample and 74% of the Dutch sample. Rapid decline in cognition and IADL was observed in 7% of the US sample and 26% of the Dutch sample. The majority (67%) of the US sample showed moderate cognitive decline and rapid IADL decline.Conclusions: Trajectories of slow and rapid dementia progression were identified in both samples. Despite using the same statistical methods, the number of latent trajectories was not replicated and the relative class sizes differed considerably across datasets. These results call for careful consideration when comparing progression estimates in the literature. In addition, the observed discrepancy between cognitive and functional decline stresses the need to monitor dementia progression across multiple domains. [ABSTRACT FROM AUTHOR]- Published
- 2019
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4. The Influence of Co-Morbidity and Frailty on the Clinical Manifestation of Patients with Alzheimer's Disease.
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Oosterveld, Saskia M., Kessels, Roy P.C., Hamel, Renske, Ramakers, Inez H.G.B., Aalten, Pauline, Verhey, Frans R.J., Sistermans, Nicole, Smits, Lieke L., Pijnenburg, Yolande A., van der Flier, Wiesje M., Olde Rikkert, Marcel G.M., and Melis, René J.F.
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ALZHEIMER'S disease ,COMORBIDITY ,FRAGILITY (Psychology) ,ACTIVITIES of daily living ,COGNITIVE ability ,PSYCHOLOGY - Abstract
Co-morbidity and frailty are common in Alzheimer's disease (AD) and may contribute to the heterogeneity in clinical manifestations of the disease. We cross-sectionally investigated whether co-morbidity and frailty were independently associated with the clinical manifestation of AD in the 4C-Dementia study; a multicenter, longitudinal study in newly diagnosed AD patients. Clinical manifestation was operationalized using a composite of cognitive performance (neuropsychological assessment), activities of daily living (Disability Assessment for Dementia; DAD) and neuropsychiatric symptoms (Neuropsychiatric Inventory). As predictors of prime interest, co-morbidity was determined using the Cumulative Illness Rating Scale (CIRS-G) and frailty by the Fried criteria. In total, 213 AD patients participated (mean age 75 ± 10 years; 58% females). In linear regression models adjusted for age, gender, education, and disease duration, CIRS-G (β = -0.21, p < 0.01) and frailty (β = -0.34, p < 0.001) were separately associated with clinical AD manifestation. However, CIRS-G (β = -0.12, p = 0.12) lost statistical significance when both were combined (frailty: β = -0.31, p < 0.001). Models with the individual components of clinical AD manifestation as dependent variables show significant associations between cognitive performance and CIRS-G (β = -0.22, p = 0.01), and between DAD and frailty (β = -0.37, p < 0.001). Our findings indicate that physical health and clinical AD manifestation are associated. This association may be responsible for part of the heterogeneity in the presentation of AD. This emphasizes the importance of adequate assessment of co-morbid medical conditions and frailty in patients with AD. [ABSTRACT FROM AUTHOR]
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- 2014
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5. Moving beyond multimorbidity as a simple count of diseases.
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Melis, René J.F., Gijzel, Sanne M.W., and Olde Rikkert, Marcel G.M.
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PSYCHOLOGICAL adaptation ,AGING ,CHRONIC diseases ,COMBINED modality therapy ,HEALTH care teams ,HEALTH status indicators ,HOLISTIC medicine ,MEDICAL care ,MEDICINE ,PSYCHOPHYSIOLOGY ,PHENOTYPES ,COMORBIDITY - Abstract
The author looks into the concept of multimorbidity of patients in relation to the improvement of healthcare worldwide. Topics include the importance of understanding the plurality of diseases and its reality, how the operationalization of multimorbidity should be about its causes and consequences, and multimorbidity operationalization as a complex adaptive system's phenomenon.
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- 2017
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6. Predicting Cognitive and Functional Trajectories in People With Late-Onset Dementia: 2 Population-Based Studies.
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Haaksma, Miriam L., Rizzuto, Debora, Leoutsakos, Jeannie-Marie S., Marengoni, Alessandra, Tan, Edwin C.K., Olde Rikkert, Marcel G.M., Fratiglioni, Laura, Melis, René J.F., and Calderón-Larrañaga, Amaia
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DIAGNOSIS of dementia , *DEMENTIA prevention , *DEMENTIA risk factors , *AGE distribution , *GERIATRIC assessment , *ALZHEIMER'S disease , *COGNITIVE testing , *CONFIDENCE intervals , *COUNSELING , *DEMENTIA , *LONGITUDINAL method , *QUESTIONNAIRES , *RISK assessment , *SOCIAL networks , *STATISTICS , *COMORBIDITY , *LOGISTIC regression analysis , *ACTIVITIES of daily living , *STRUCTURAL equation modeling , *DISEASE progression , *ODDS ratio , *DELAYED onset of disease , *OLD age ,PREVENTION of disease progression - Abstract
Previous studies have shown large heterogeneity in the progression of dementia, both within and between patients. This heterogeneity offers an opportunity to limit the global and individual burden of dementia through the identification of factors associated with slow disease progression in dementia. We explored the heterogeneity in dementia progression to detect disease, patient, and social context factors related to slow progression. Two longitudinal population-based cohort studies with follow-up across 12 years. 512 people with incident dementia from Stockholm (Sweden) contributed to the Kungsholmen Project and the Swedish National Study of Aging and Care in Kungsholmen. We measured cognition using the Mini-Mental State Examination and daily functioning using the Katz Activities of Daily Living Scale. Latent classes of trajectories were identified using a bivariate growth mixture model. We then used bias-corrected logistic regression to identify predictors of slower progression. Two distinct groups of progression were identified; 76% (n = 394) of the people with dementia exhibited relatively slow progression on both cognition and daily functioning, whereas 24% (n = 118) demonstrated more rapid worsening on both outcomes. Predictors of slower disease progression were Alzheimer's disease (AD) dementia type [odds ratio (OR) 2.07, 95% confidence interval (CI) 1.15-3.71], lower age (OR 0.88, 95% CI 0.83-0.94), fewer comorbidities (OR 0.77, 95% CI 0.66-0.90), and a stronger social network (OR 1.72, 95% CI 1.01-2.93). Lower age, AD dementia type, fewer comorbidities, and a good social network appear to be associated with slow cognitive and functional decline. These factors may help to improve the counseling of patients and caregivers and to optimize the planning of care in dementia. [ABSTRACT FROM AUTHOR]
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- 2019
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7. Measurement of Dynamical Resilience Indicators Improves the Prediction of Recovery Following Hospitalization in Older Adults.
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Gijzel, Sanne M.W., Rector, Jerrald, van Meulen, Fokke B., van der Loeff, Rolinka Schim, van de Leemput, Ingrid A., Scheffer, Marten, Olde Rikkert, Marcel G.M., and Melis, René J.F.
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ADAPTABILITY (Personality) , *ELDER care , *HOSPITAL care of older people , *ANXIETY , *CONVALESCENCE , *FRAIL elderly , *GERIATRICS , *HEALTH status indicators , *HEART beat , *LENGTH of stay in hospitals , *HOSPITAL wards , *LONGITUDINAL method , *MEDICAL practice , *PATIENT monitoring , *PHYSICAL diagnosis , *PSYCHOLOGICAL resilience , *SATISFACTION , *TIME , *TIME series analysis , *WEARABLE technology , *COMORBIDITY , *PSYCHOSOCIAL factors , *WELL-being , *DISCHARGE planning , *GERIATRIC rehabilitation , *RECEIVER operating characteristic curves , *ACUTE diseases , *PHYSICAL activity , *INDIVIDUALIZED medicine , *DESCRIPTIVE statistics , *ODDS ratio , *WALKING speed - Abstract
Acute illnesses and subsequent hospital admissions present large health stressors to older adults, after which their recovery is variable. The concept of physical resilience offers opportunities to develop dynamical tools to predict an individual's recovery potential. This study aimed to investigate if dynamical resilience indicators based on repeated physical and mental measurements in acutely hospitalized geriatric patients have added value over single baseline measurements in predicting favorable recovery. Intensive longitudinal study. 121 patients (aged 84.3 ± 6.2 years, 60% female) admitted to the geriatric ward for acute illness. In addition to preadmission characteristics (frailty, multimorbidity), in-hospital heart rate and physical activity were continuously monitored with a wearable sensor. Momentary well-being (life satisfaction, anxiety, discomfort) was measured by experience sampling 4 times per day. The added value of dynamical indicators of resilience was investigated for predicting recovery at hospital discharge and 3 months later. 31% of participants satisfied the criteria of good recovery at hospital discharge and 50% after 3 months. A combination of a frailty index, multimorbidity, Clinical Frailty Scale, and or gait speed predicted good recovery reasonably well on the short term [area under the receiver operating characteristic curve (AUC) = 0.79], but only moderately after 3 months (AUC = 0.70). On addition of dynamical resilience indicators, the AUC for predicting good 3-month recovery increased to 0.79 (P =.03). Variability in life satisfaction and anxiety during the hospital stay were independent predictors of good 3-month recovery [odds ratio (OR) = 0.24, P =.01, and OR = 0.54, P =.04, respectively]. These results highlight that measurements capturing the dynamic functioning of multiple physiological systems have added value in assessing physical resilience in clinical practice, especially those monitoring mental responses. Improved monitoring and prediction of physical resilience could help target intensive treatment options and subsequent geriatric rehabilitation to patients who will most likely benefit from them. [ABSTRACT FROM AUTHOR]
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- 2020
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8. The Impact of Frailty and Comorbidity on Institutionalization and Mortality in Persons With Dementia: A Prospective Cohort Study.
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Haaksma, Miriam L., Rizzuto, Debora, Ramakers, Inez H.G.B., Garcia-Ptacek, Sara, Marengoni, Alessandra, van der Flier, Wiesje M., Verhey, Frans R.J., Olde Rikkert, Marcel G.M., and Melis, René J.F.
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DIAGNOSIS of dementia , *DEMENTIA , *REPORTING of diseases , *FRAIL elderly , *INSTITUTIONAL care , *LONGITUDINAL method , *REGRESSION analysis , *COMORBIDITY , *PROGNOSIS - Abstract
Abstract Objectives The predictive value of frailty and comorbidity, in addition to more readily available information, is not widely studied. We determined the incremental predictive value of frailty and comorbidity for mortality and institutionalization across both short and long prediction periods in persons with dementia. Design Longitudinal clinical cohort study with a follow-up of institutionalization and mortality occurrence across 7 years after baseline. Setting and Participants 331 newly diagnosed dementia patients, originating from 3 Alzheimer centers (Amsterdam, Maastricht, and Nijmegen) in the Netherlands, contributed to the Clinical Course of Cognition and Comorbidity (4C) Study. Measures We measured comorbidity burden using the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) and constructed a Frailty Index (FI) based on 35 items. Time-to-death and time-to-institutionalization from dementia diagnosis onward were verified through linkage to the Dutch population registry. Results After 7 years, 131 patients were institutionalized and 160 patients had died. Compared with a previously developed prediction model for survival in dementia, our Cox regression model showed a significant improvement in model concordance (U) after the addition of baseline CIRS-G or FI when examining mortality across 3 years (FI: U = 0.178, P =.005, CIRS-G: U = 0.180, P =.012), but not for mortality across 6 years (FI: U = 0.068, P =.176, CIRS-G: U = 0.084, P =.119). In a competing risk regression model for time-to-institutionalization, baseline CIRS-G and FI did not improve the prediction across any of the periods. Conclusions Characteristics such as frailty and comorbidity change over time and therefore their predictive value is likely maximized in the short term. These results call for a shift in our approach to prognostic modeling for chronic diseases, focusing on yearly predictions rather than a single prediction across multiple years. Our findings underline the importance of considering possible fluctuations in predictors over time by performing regular longitudinal assessments in future studies as well as in clinical practice. [ABSTRACT FROM AUTHOR]
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- 2019
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9. Physical Functioning in Older Persons With Somatoform Disorders: A Pilot Study
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Benraad, Carolien E.M., Hilderink, Peter H., van Driel, Dorine T.J.W., Disselhorst, Luc G., Lubberink, Brechtje, van Wolferen, Loes, Olde Rikkert, Marcel G.M., and Oude Voshaar, Richard C.
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GERIATRIC assessment , *DIAGNOSIS , *GAIT in humans , *GRIP strength , *LIFE skills , *MENTAL health services , *PROBABILITY theory , *SCALES (Weighing instruments) , *SOMATOFORM disorders , *STATISTICS , *COMORBIDITY , *PILOT projects , *PSYCHIATRIC treatment , *INTER-observer reliability , *SEVERITY of illness index , *PHYSICAL activity , *SYMPTOMS , *OLD age - Abstract
Abstract: Objectives: The primary objective of this study was to systematically examine the physical functioning of older persons with somatoform disorders, as this has never been carried out before. Second, we wanted to test our hypothesis that higher somatic disease burden in patients with somatoform disorders is associated with a higher level of somatisation. Design and Setting: Observational study of patients referred for medically unexplained symptoms (MUS) to our outpatient mental health center for older adults. The patients were offered a standardized, multidisciplinary diagnostic procedure, including a comprehensive geriatric assessment. Inter-rater reliability between two geriatricians assessing the contribution of somatic pathology to the main somatic symptom was assessed. Participants: A total of 37 patients referred for MUS (mean age 75 ± 6 years). Measurements: Timed up and go test (TUG) and hand grip strength were used as measures for frailty; the Cumulative Index Rating Scale for Geriatrics (CIRS-G) sum score and severity index measured the burden of cumulative somatic morbidity. The Groningen Activity Rating Scale (GARS) measured functional status. The Whitely Index was used as measure for somatisation. Results: Patients’ main symptom could be completely explained by a somatic disease in 3/37 (8%) patients (kappa between geriatricians = 0.72). A total of 32 patients met the criterion for a Somatoform Disorder according to DSM-IV-TR criteria, but somatic comorbidity partially explained the main symptom in 15/32 patients. These patients were older (P = .049), had more somatic comorbidity (P = .049), a slower gait speed (TUG, P = .035), a lower hand grip strength (P = .050), and a lower functional status (P = .30) compared with the 17 patients without any explanation for their main somatic symptom. In contrast to our hypothesis, a higher level of somatisation was associated with less somatic disease burden. Conclusion: Geriatric assessment has an important added value in older patients referred with medically unexplained symptoms because in half of these patients, symptoms can be partially or fully explicable following careful assessment of comorbidity and frailty. [Copyright &y& Elsevier]
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- 2013
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