The Experts below are selected from a list of 11064 Experts worldwide ranked by ideXlab platform

Laura N Gitlin - One of the best experts on this subject based on the ideXlab platform.

  • dementia family Caregivers willingness to pay for an in home program to reduce behavioral symptoms and Caregiver Stress
    PharmacoEconomics, 2019
    Co-Authors: Eric Jutkowitz, Danny Scerpella, Laura T Pizzi, Katherine Marx, Quincy M Samus, Catherine Verrier Piersol, Laura N Gitlin
    Abstract:

    Our objective was to determine whether family Caregivers of people with dementia (PwD) are willing to pay for an in-home intervention that provides strategies to manage behavioral symptoms and Caregiver Stress and to identify predictors of willingness-to-pay (WTP). During baseline interviews of a randomized trial and before treatment assignment, Caregivers were asked how much they were willing to pay per session for an eight-session program over 3 months. We stratified the sample into those who refused to provide a WTP, those willing to pay $US0, and those willing to pay > $US0. We used a two-part model, controlling for demographic characteristics, to predict adjusted mean WTP and to examine associations between WTP, clinical features (cognition, function, behavioral symptoms), and time spent assisting PwD with daily activities. First, we used logistic regression to model the probability a Caregiver was willing to pay > $US0. Second, we used a generalized linear model (log link and Gamma distribution) to estimate the amount Caregivers were willing to pay conditional on WTP > $US0. Of 250 dyads enrolled, 226 (90%) had complete data and were included in our analyses. Of 226 dyads, 26 (11%) refused to provide a WTP value, 72 (32%) were willing to pay $US0, and 128 (57%) were willing to pay > $US0. In the combined model, mean adjusted WTP was $US36.00 (95% confidence interval [CI] 26.72–45.27) per session. Clinical features were not significantly associated with WTP. One additional hour providing PwD assistance was associated with a $US1.64 (95% CI 0.23–3.04) increase in WTP per session. As Caregivers spend more time assisting with daily activities, they are willing to pay more for a supportive program. NCT01892579.

  • the role of the occupational therapist in the management of neuropsychiatric symptoms of dementia in clinical settings
    Occupational Therapy in Health Care, 2014
    Co-Authors: Joyce Fraker, Helen C Kales, Mary Blazek, Janet Kavanagh, Laura N Gitlin
    Abstract:

    ABSTRACTNeuropsychiatric symptoms (NPS) of dementia include aggression, agitation, depression, anxiety, delusions, hallucinations, apathy, and disinhibition. NPS affect dementia patients nearly universally across dementia stages and etiologies. They are associated with poor patient and Caregiver outcomes, including increased health care utilization, excess morbidity and mortality, and earlier nursing home placement, as well as Caregiver Stress, depression and reduced employment. There are no FDA-approved medications for NPS, but it is a common clinical practice to use psychotropic medications such as antipsychotics, to control symptoms; however, antipsychotics show only modest efficacy in improving NPS and have significant risks for patients, including side effects and mortality. Nonpharmacologic treatments are considered first-line by multiple medical bodies and expert consensus, as they show evidence for efficacy and have limited potential for adverse effects. Ideally, nonpharmacological management of N...

Igor Grant - One of the best experts on this subject based on the ideXlab platform.

  • alzheimer Caregiver Stress basal natural killer cell activity pituitary adrenal cortical function and sympathetic tone
    Annals of Behavioral Medicine, 1997
    Co-Authors: Michael R Irwin, Thomas L Patterson, Richard L Hauger, Shirley J Semple, Michael G Ziegler, Igor Grant
    Abstract:

    The association between Alzheimer caregiving and natural killer (NK) cell activity and basal plasma levels of adrenocorticotropic hormone (ACTH), cortisol, β-endorphin, prolactin, epinephrine, norepinephrine, and neuropeptide Y was determined in 100 spousal Alzheimer Caregivers and 33 age-and gender-comparable control volunteers upon intake into a study of the psychological and physiologic impact of caregiving. The relationship between these physiologic measures and individual characteristics such as age, gender, medical status, severity of Stress, severity of depressive symptoms, and Caregiver burden was tested. In addition, the association between NK activity and alterations of the neuroendocrine measures was investigated. As compared to controls, the Alzheimer Caregivers had similar levels of NK activity and of basal plasma neuroendocrine hormones and sympathetic measures. While older age and male gender status were associated with increased levels of ACTH, neither medical caseness, severity of life Stress, nor severity of depressive symptoms was associated with alterations in any of the multiple physiologic domains. Classification of Alzheimer Caregiver burden identified Caregivers who were mismatched in terms of the amount of care they were required to provide and the amount of respite time received. The mismatched Caregivers had significantly higher basal plasma ACTH but no change in other physiological measures, as compared to non-mismatched Caregivers. NK activity was negatively correlated with plasma levels of neuropeptide Y but not with any of the other neuroendocrine measures. Based on this cross-sectional evaluation of NK activity and neuroendocrine and sympathetic measures, we conclude that most Alzheimer Caregivers do not show evidence of altered basal physiology.

  • neuropeptide y and natural killer cell activity findings in depression and alzheimer Caregiver Stress
    The FASEB Journal, 1991
    Co-Authors: Michael R Irwin, Marvin R Brown, Thomas L Patterson, Richard L Hauger, Anne Mascovich, Igor Grant
    Abstract:

    A reduction in immune function has been found in patients with a major depressive disorder and in persons undergoing severe life Stress. This study investigated the association between increased sympathetic nervous system activity and reduced natural killer (NK) cytotoxicity in depression and Alzheimer Caregiver Stress. NK activity and plasma concentrations of epinephrine, norepinephrine, and neuropeptide Y were measured in depressed patients (n = 19) and age- and gender-matched controls (n = 19), and in Alzheimer spousal Caregivers (n = 48) and matched nonCaregiver controls (n = 17). Plasma levels of neuropeptide Y, but not circulating basal levels of catecholamines, were significantly (P less than 0.01) elevated in the depressed patients and in the Caregivers compared with respective controls. NK activity was significantly (P less than 0.001) lower in the depressed patients than in their controls, but not different between the Caregivers and the nonCaregiver controls. Circulating concentrations of neuro...

Filippo Bogetto - One of the best experts on this subject based on the ideXlab platform.

Ricardo F Allegri - One of the best experts on this subject based on the ideXlab platform.

  • living with dementia increased level of Caregiver Stress in times of covid 19
    International Psychogeriatrics, 2020
    Co-Authors: Gabriela Cohen, Maria Julieta Russo, Jorge Campos, Ricardo F Allegri
    Abstract:

    COVID-19 pandemic in Argentina has affected the care of older adults with dementia deeply. Our objective was to study how the obligatory social isolation affected Stress Caregiver and burden of care of family members of subjects living with dementia in the community after the initial 4 weeks of quarantine in our setting. We did a questionnaire survey among 80 family Caregivers of persons with Alzheimer's disease (AD) or related dementia collected on April 2020. We designed a visual analog scale to test the level of the burden of care. Characteristics of people with dementia and their Caregivers were analyzed with descriptive (mean, standard deviation, frequency and percent) and inferential statistics (chi-square test). The sample included older adults (mean age: 80.51 ± 7.65) with different stages of dementia. Family was the primary provider of care in 65%. Overall, COVID-19 confinement increased Stress Caregiver independently of the dementia stage, but those caring for severe cases had more Stress compared to milder forms of the disease. Other findings were that half of the subjects with dementia experienced increased anxiety and that most family members discontinued all sort of cognitive and physical therapies. Family members' main concerns were for severe dementia cases, fear of absence of the paid Caregiver during the epidemic, and for mild cases fear of spreading the disease while assisting patients with instrumental activities. A partnership between departments of public health, care workers and families must be planned to guarantee continuity of care during these unique COVID-19 times.

Nori Minich - One of the best experts on this subject based on the ideXlab platform.

  • a prospective study of long term Caregiver and family adaptation following brain injury in children
    Journal of Head Trauma Rehabilitation, 2002
    Co-Authors: Shari L Wade, H G Taylor, Dennis Drotar, Terry Stancin, Keith Owen Yeates, Nori Minich
    Abstract:

    OBJECTIVE: We examined long-term differences in family adaptation following traumatic brain injuries (TBI) and orthopedic injuries. DESIGN: Families of children with severe TBI (n = 53), moderate TBI (n = 56), and orthopedic injuries (n = 80) were assessed at baseline, 6 months, and 12 months post injury and at an extended follow-up an average of 4.1 years post injury. Caregiver and family outcomes were examined using mixed model analysis. RESULTS: Patterns of adaptation over time varied across groups but indicated long-standing injury-related Stress and burden in the severe TBI group. CONCLUSIONS: Severe TBI results in persistent Caregiver Stress for a substantial proportion of families.