Advanced Dementia: Brain-State Characteristics and Clinical Indicators of Early Mortality
| Autor: | Efraim Jaul, Oded Meiron |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Electroencephalography Organic disease 03 medical and health sciences 0302 clinical medicine mental disorders medicine Dementia Humans 030212 general & internal medicine Intensive care medicine Pathological medicine.diagnostic_test business.industry General Neuroscience Disease progression Brain General Medicine medicine.disease Prognosis Psychiatry and Mental health Clinical Psychology Malnutrition Brain state Advanced dementia Disease Progression Geriatrics and Gerontology business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Alzheimer's disease : JAD. 81(3) |
| ISSN: | 1875-8908 |
| Popis: | There is an urgent need in advanced dementia for evidence-based clinical prognostic predictors that could positively influence ethical decisions allowing health provider and family preparation for early mortality. Accordingly, the authors review and discuss the prognostic utility of clinical assessments and objective measures of pathological brain states in advanced dementia patients associated with accelerated mortality. Overall, due to the paucity of brain-activity and clinical-comorbidity predictors of survival in advanced dementia, authors outline the potential prognostic value of brain-state electroencephalography (EEG) measures and reliable clinical indicators for forecasting early mortality in advanced dementia patients. In conclusion, two consistent risk-factors for predicting accelerated mortality in terminal-stage patients with advanced dementia were identified: pressure ulcers and paroxysmal slow-wave EEG parameters associated with cognitive impairment severity and organic disease progression. In parallel, immobility, malnutrition, and co-morbid systemic diseases are highly associated with the risk for early mortality in advanced dementia patients. Importantly, the authors’ conclusions suggest utilizing reliable quantitative-parameters of disease progression for estimating accelerated mortality in dementia patients entering the terminal disease-stages characterized by severe intellectual deficits and functional disability. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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