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Mulders A.J.M.J.,Radboud University Nijmegen | Mulders A.J.M.J.,Archipel Care Group | Zuidema S.U.,University of Groningen | Verhey F.R.,School for Mental Health and Neuroscience MHeNS | Koopmans R.T.C.M.,Radboud University Nijmegen
International Psychogeriatrics | Year: 2014

Background: People with Young Onset Dementia (YOD) have specific needs for care. These people eventually require institutional care, usually delivered by institutions designed for the elderly. The Dutch network of care organizations delivering specialized YOD care offers a unique opportunity to obtain more knowledge of this special population. Methods: Our cross-sectional study collected data from 230 people with YOD in eight care homes providing YOD specialized care. Data collected: demographic data, disease duration, dementia subtype, comorbidity, dementia severity (Global Deterioration Scale - GDS), neuropsychiatric symptoms (NPS; Neuropsychiatric Inventory - NPI, Cohen Mansfield Agitation Inventory - CMAI), disease awareness (Guidelines for the Rating of Awareness Deficits - GRAD), need for assistance (hierarchic Activities of Daily Living (ADL) scale - Resident Assessment Instrument - Minimum Data Set (RAI-MDS)). Results: The mean age of the residents with YOD in care homes was 60 years and 53% of them were men. There is a large variety of etiologic diagnoses underlying the dementia. Dementia severity was very mild to mild in 18%, moderate in 25%, and severe or very severe in 58% of the participants. The prevalence of NPS was high with 90% exhibiting one or more clinically relevant NPS. Comorbidity was present in more than three quarters of the participants, most frequently psychiatric disorders. Conclusions: The institutionalized YOD population is heterogeneous. NPS occur in almost all institutionalized people with YOD, and frequency and severity of NPS are higher than in late onset dementia (LOD) and community-dwelling YOD patients. Care should be delivered in settings accommodating a mixed male and female population, with appropriate, meaningful activities for all individuals. Further research is needed on NPS in YOD, to enhance quality of life and work in specialized YOD-care. © International Psychogeriatric Association 2014. Source

Henskens L.H.G.,Maastricht University | Van Boxtel M.P.J.,School for Mental Health and Neuroscience MHeNS | Kroon A.A.,Maastricht University | Van Oostenbrugge R.J.,Maastricht University | And 2 more authors.
Journal of Hypertension | Year: 2011

Objective: We aimed to investigate whether subjective sleep disturbance during overnight blood pressure (BP) monitoring results in higher night-time BP levels, and whether this affects the correlation between nocturnal BP and hypertensive target-organ damage. Methods: In 203 untreated hypertensive patients (104 men) without a history of cardiovascular disease, with a mean age of 52.1 ± 12.5 years, and with office BP levels of 170 ± 23/104 ± 12 mmHg, we performed duplicate ambulatory BP monitoring (ABPM), assessed subjective sleep quality using the Groningen Sleep Quality Scale, and obtained information on hypertension-related cardiac damage by echocardiography. Results: Overnight BP monitoring disturbed sleep significantly, but habituation to nocturnal measurements occurred on the second ABPM. Participants whose subjective sleep quality was less than usual on either ABPM did not have higher nocturnal BP levels than those who slept similar to usual (P > 0.05). When comparing the nocturnal BP levels between the first and second ABPM, we found that participants whose subjective sleep quality was less on the second ABPM had significantly higher pressure levels and a smaller BP dip than participants with a similar sleep quality for both ABPMs (P < 0.05). Accordingly, the correlations between the nocturnal BP and cardiac damage tended to be weaker based on the ABPM with the lowest sleep quality. Conclusions: Subjectively assessed sleep disturbance during overnight BP monitoring increases the nocturnal BP level and potentially attenuates the correlation with hypertension-related cardiac damage, even though habituation to overnight BP monitoring occurs. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source

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