Dorota Szcześniak

Anserine and carnosine supplementation in the elderly: Effects on cognitive functioning and physical capacity

The aim of this study was to investigate the potential beneficial effects of dietary anserine and carnosine (CRC) supplementation on cognitive functioning and physical activity of the elderly. The fifty-six subjects (65+) were allocated to the CRC group or placebo group at a 1:1 ratio. The double-blind procedure was used. Data were collected at the baseline and after 13-weeks of supplementation. In the follow up procedure fifty one subjects took part. Chicken meat extract (CME) containing 40% of CRC components (2:1 ratio of anserine to carnosine) was administered 2.5 g per day which allowed to rich the level of 1g CRC in dipeptides supplement. The cognitive function, physical capacity, body measurements, blood pressure and heart rate (HR) were assessed. After supplementation Body Mass Index (BMI) decreased significantly (p<0.05) in the CRC group performance comparing the placebo group. In two of six Senior Fitness Test the scores increased significantly (p<0.05) in CRC group comparing to the placebo group. The perceived exertion differed significantly (p<0.05) at the baseline and after follow up at the CRC group. The mean values of the Short Test of Mental Status (STMS) scores showed the significant (p<0.04) increase only in CRC group, in the subscores of construction/copying, abstraction and recall. Conducted anserine and carnosine supplementation in the elderly brings promising effects on cognitive functioning and physical capacity of participants. However, further studies are needed.

Technologies to support community-dwelling persons with dementia: a position paper on issues regarding development, usability, effectiveness and cost-effectiveness, deployment, and ethics

Background With the expected increase in the numbers of persons with dementia, providing timely, adequate, and affordable care and support is challenging. Assistive and health technologies may be a valuable contribution in dementia care, but new challenges may emerge. Objective The aim of our study was to review the state of the art of technologies for persons with dementia regarding issues on development, usability, effectiveness and cost-effectiveness, deployment, and ethics in 3 fields of application of technologies: (1) support with managing everyday life, (2) support with participating in pleasurable and meaningful activities, and (3) support with dementia health and social care provision. The study also aimed to identify gaps in the evidence and challenges for future research. Methods Reviews of literature and expert opinions were used in our study. Literature searches were conducted on usability, effectiveness and cost-effectiveness, and ethics using PubMed, Embase, CINAHL, and PsycINFO databases with no time limit. Selection criteria in our selected technology fields were reviews in English for community-dwelling persons with dementia. Regarding deployment issues, searches were done in Health Technology Assessment databases. Results According to our results, persons with dementia want to be included in the development of technologies; there is little research on the usability of assistive technologies; various benefits are reported but are mainly based on low-quality studies; barriers to deployment of technologies in dementia care were identified, and ethical issues were raised by researchers but often not studied. Many challenges remain such as including the target group more often in development, performing more high-quality studies on usability and effectiveness and cost-effectiveness, creating and having access to high-quality datasets on existing technologies to enable adequate deployment of technologies in dementia care, and ensuring that ethical issues are considered an important topic for researchers to include in their evaluation of assistive technologies. Conclusions Based on these findings, various actions are recommended for development, usability, effectiveness and cost-effectiveness, deployment, and ethics of assistive and health technologies across Europe. These include avoiding replication of technology development that is unhelpful or ineffective and focusing on how technologies succeed in addressing individual needs of persons with dementia. Furthermore, it is suggested to include these recommendations in national and international calls for funding and assistive technology research programs. Finally, practitioners, policy makers, care insurers, and care providers should work together with technology enterprises and researchers to prepare strategies for the implementation of assistive technologies in different care settings. This may help future generations of persons with dementia to utilize available and affordable technologies and, ultimately, to benefit from them.

The Quality of Life and Psychological, Social and Cognitive Functioning of Patients with Acromegaly

Acromegaly is a rare and chronic disease, most often caused by a pituitary adenoma. Excessive secretion of the growth hormone (GH) leads to hepatic secretion of insulin-like growth factor-1 (IGF-1), which in turn causes characteristic changes in the patients appearance, many skeletal deformities and metabolic disorders. In addition to somatic symptoms, acromegalic patients demonstrate psychosocial and personality deficits, as well as common co-occurrence of mental disorders. There are few studies investigating acromegaly in Poland. In recent years, the concept of quality of life has become fundamental to understanding health problems. Studies dealing with acromegaly likewise tend to include assessments of quality of life of patients suffering from this endocrinopathy.

Not re-inventing the wheel: the adaptive implementation of the meeting centres support programme in four European countries.

ABSTRACT Objectives: The implementation of new health services is a complex process. This study investigated the first phase of the adaptive implementation of the Dutch Meeting Centres Support Programme (MCSP) for people with dementia and their carers in three European countries (Italy, Poland, the UK) within the JPND-MEETINGDEM project. Anticipated and experienced factors influencing the implementation, and the efficacy of the implementation process, were investigated. Findings were compared with previous research in the Netherlands. Method: A qualitative multiple case study design was applied. Checklist on anticipated facilitators and barriers to the implementation and semi-structured interview were completed by stakeholders, respectively at the end and at the beginning of the preparation phase. Results: Overall, few differences between countries were founded. Facilitators for all countries were: added value of MCSP matching needs of the target group, evidence of effectiveness of MCSP, enthusiasm of stakeholders. General barriers were: competition with existing care and welfare organizations and scarce funding. Some countries experienced improved collaborations, others had difficulties finding a socially integrated location for MCSP. The step-by-step implementation method proved efficacious. Conclusion: These insights into factors influencing the implementation of MCSP in three European countries and the efficacy of the step-by-step preparation may aid further implementation of MCSP in Europe.

DemTect®– effective to asses MCI and dementia – validation study of the Polish language version

Objectives: To validate DemTect®, a highly sensitive psychometric screening tool – designed to identify patients with mild cognitive impairment (MCI) and patients with dementia (AD). Method: A prospective cohort/cross-sectional study was designed. The data were collected from a group of 224 subjects, including 85 patients with MCI, 109 with Alzheimers disease (AD) and 30 healthy control (HC) subjects. All subjects underwent a detailed neuropsychological assessment including CT, the assessment of biological parameters and a psychometric examination using DemTect®, MMSE, TYM, CDT and FAS. Results: Subjects ranged in age from 55 to 94 years, with a mean age of 71.42 ± 9.86 years. Classification rates of DemTect® were superior for both the MCI and AD groups compared with the MMSE, with high sensitivities of 90% (cut-off ≤15) and 96.8% (cut-off < 10), respectively. The DemTect® Polish language version proved to be independent of age and education level. Conclusion: The Polish language version of the DemTect® scale is easy to administer. It may be seen as a superior cognitive screening tool in day-to-day practice as it achieves more accurate differentiation between HC/MCI/AD compared with MMSE.

Met and unmet care needs of the elderly with dementia living at home: Personal and informal carers’ perspectives:

In Poland, there are few reports of the holistic approach to caring for older people with dementia. The aim of this study was to assess the needs of people with dementia living at home. This was done by evaluating the perspective of people with dementia themselves and that of their carers. The study included 47 people diagnosed with mild to moderate dementia and 41 informal carers, all living in Wroclaw in Poland, involved in the MeetingDem project. The needs were assessed using the CANE. Other scales used were: the MMSE, the GDS and the QOL-AD. The carers reported significantly more needs, both met and unmet, than the people with dementia themselves. The most frequent reported unmet needs both by the people with dementia and their carers included activities of daily living, psychological distress and the need for company. Based on this study’s findings, tailored multidisciplinary treatment, adjusted to their needs and wishes, can be offered thus creating integrated and individualised support.

Is there any difference in acromegaly and other chronic disease in quality of life and psychiatric morbidity

INTRODUCTION The study aimed to evaluate the psychological profile of patients with acromegaly in comparison to other chronic diseases such as non-functioning pituitary adenomas, Cushing disease, and plaque psoriasis, and to a healthy control group. MATERIAL AND METHODS A total sample of 153 participants in clinical groups underwent a cross-sectional assessment including the quality of life (AcroQoL, WHOQoL-BREF), psychiatric morbidity (GHQ-28), and the acceptance of illness (AIS), as well as 65 participants in the healthy control group. RESULTS The whole study sample had a predominance of urban married females (61%) with medium level of education (41%). Patients with acromegaly were diagnosed significantly later than patients from other clinical groups, after the onset of the first symptoms. Acromegaly was related to the presence of more symptoms of anxiety and insomnia, and poorer social relationships compared with the general population but not more than in other chronic diseases. A better quality of life score in all domains of WHOQoL-BREF was associated with a better score on the acceptance of illness scale and lower scores on GHQ-28. CONCLUSIONS Psychiatric morbidity, mainly anxiety and insomnia, occurs in 50% of patients with acromegaly. However, the psychological wellbeing and mood seem to be related to other factors such as the acceptance of the illness. Thus, concerning the diagnosis, treatment, and monitoring of acromegaly an interdisciplinary approach, taking into account psychological and psychiatric consultation, is needed.

Psychopathological profile and quality of life of patients with oral lichen planus

Abstract Objectives Oral lichen planus (OLP) is a chronic, multifocal, sometimes painful, inflammatory disease of the oral mucosa. OLP can predispose development of psycho-emotional disorders. Until now, the relationship between the severity of lichen planus and the psychological profile of patients (psychological well-being, perceived stress and pain coping strategies) has never been studied. Material and Methods Study was conducted on 42 OLP patients. Number of sites involved, severity and activity score of OLP were evaluated. Psychological tests were used to evaluate patients’ psycho-emotional condition. The mean duration time of symptomatic OLP was 43 months. Results We detected that the longer the duration of subjective symptoms, the poorer the quality of life and the higher the level of perceived stress (PSS). Also, the higher the PSS results, the greater the anxiety and depression on Hospital Anxiety and Depression Scale (HADS). Likewise, higher level of depression in HADS was strongly correlated with worse quality of life. (p≤0.05). Conclusions In this study, we detected a relationship between duration of the disease, level of perceived stress and quality of life. The longer the disease lasts, the higher it tends to catastrophize. This may influence development or increase of the anxiety and depression and may decrease patients’ quality of life.

Evaluation of the implementation of the Meeting Centres Support Program in Italy, Poland, and the UK; exploration of the effects on people with dementia

MEETINGDEM investigated whether the Dutch Meeting Centres Support Programme (MCSP) could be implemented in Italy, Poland, and the UK with comparable benefits. This paper reports on the impact on people living with dementia attending pilot Meeting Centres in the 3 countries.

FIMA, the questionnaire for health-related resource use in the elderly population: validity, reliability, and usage of the Polish version in clinical practice

Purpose The purpose of this study was to determine the validity and reliability of the Polish version of the Questionnaire for Health-Related Resource Use in an Elderly Population [Fragebogen zur Inanspruchnahme medizinischer und nicht-medizinischer Versorgungsleistungen im Alter (FIMA)]. Patients and methods This was a cross-sectional study conducted in a rehabilitation care unit in Poland between January and June of 2017. Sixty-one patients aged ≥65 years who had been admitted to the unit were enrolled into the study. Each participant was evaluated twice: once within 48 hours of admission (T1) and once after 2 weeks (T2). Results The translated instrument was understood by most respondents in a selected population and it maintained a reading and comprehension level that was accessible by most respondents, even of a low education level. With the aid of the prevalence-adjusted bias-adjusted kappa (PABAK) and intraclass correlation coefficient (ICC), 100% test–retest reliability for 10 out of the 12 questions that were subjected to analysis was indicated. The most frequent health-related resource uses were appointments at the general practitioner (90.2%) and orthopedist (54.1%), medication (93.4%), and the necessity to have glasses as supportive equipment (70.5%). Conclusion The Polish FIMA demonstrated very good test–retest reliability, good validity, and ease of use for elderly people. Further investigation is required. In the future, the routine use of this instrument could be encouraged to assess the use and demand for medical and nonmedical services among the elderly.