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  • 1
    Online Resource
    Online Resource
    Impact of COVID‐19 pandemic on mortality rate in memory clinic patients
    Wiley ; 2024
    In:  Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring Vol. 16, No. 1 ( 2024-01)
    Details
    In: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, Wiley, Vol. 16, No. 1 ( 2024-01)
    Abstract: We investigated whether mortality in memory clinic patients changed due to coronavirus disease 2019 (COVID‐19) pandemic. METHODS We included patients from the Amsterdam Dementia Cohort: (1) n  = 923 pandemic patients (baseline visit: 2017–2018, follow‐up: until 2021), and (2) n  = 830 historical control patients (baseline visit: 2015–2016, follow‐up: until 2019). Groups were well‐balanced. We compared mortality during pandemic with historical control patients using Cox regression. Differences in cause of death between groups were explored using Fisher's exact test. RESULTS Pandemic patients had a higher risk of mortality than historical control patients (hazard ratio [HR] [95% confidence interval {CI}]  = 1.34 [1.05–1.70]). Stratified for syndrome diagnosis, the effect remained significant in dementia patients (HR [95% CI]  = 1.35 [1.03–1.78]). Excluding patients who died of COVID‐19‐infection, the higher mortality risk in pandemic patients attenuated (HR [95% CI]  = 1.24 [0.97–1.58]). Only the difference in cause of death between pandemic patients and historical control patients for death to COVID‐19‐infection ( p  = 0.001) was observed. CONCLUSION Memory clinic patients had increased mortality risk during COVID‐19 compared to historical control patients, attributable to dementia patients. Highlights We investigated if mortality rates in memory clinic patients changed due to COVID‐19 pandemic. We included patients along the cognitive continuum, including SCD, MCI, and dementia. We used a well‐balanced historical control group. Memory clinic patients had higher risk for mortality during COVID‐19 lockdown. Our results indicate that excess mortality is mainly caused by death to COVID‐19 infection.
    Type of Medium: Online Resource
    ISSN: 2352-8729 , 2352-8729
    URL: Issue
    URL: Article
    DOI: 10.1002/dad2.v16.1
    DOI: 10.1002/dad2.12541
    Language: English
    Publisher: Wiley
    Publication Date: 2024
    detail.hit.zdb_id: 2832898-X
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  • 2
    Online Resource
    Online Resource
    Psychosocial Effects of COVID-19 Measures on (Pre-)Dementia Patients During Second Lockdown
    IOS Press ; 2022
    In:  Journal of Alzheimer's Disease Vol. 86, No. 2 ( 2022-03-22), p. 931-939
    Details
    In: Journal of Alzheimer's Disease, IOS Press, Vol. 86, No. 2 ( 2022-03-22), p. 931-939
    Abstract: Background: The COVID-19 pandemic poses enormous social challenges, especially during lockdown. People with cognitive decline and their caregivers are particularly at risk of lockdown consequences. Objective: To investigate psychosocial effects in (pre-)dementia patients and caregivers during second lockdown and compare effects between first and second lockdown. Methods: We included n = 511 (pre-)dementia patients and n = 826 caregivers from the Amsterdam Dementia Cohort and via Alzheimer Nederland. All respondents completed a self-designed survey on psychosocial effects of COVID-19. We examined relations between experienced support and psychosocial and behavioral symptoms using logistic regression. In a subset of patients and caregivers we compared responses between first and second lockdown using generalized estimating equation (GEE). Results: The majority of patients (≥58%) and caregivers (≥60%) reported that family and friends, hobbies, and music helped them cope. Support from family and friends was strongly related to less negative feelings in patients (loneliness: OR = 0.3[0.1–0.6]) and caregivers (loneliness: OR = 0.2[0.1–0.3] ; depression: OR = 0.4[0.2–0.5]; anxiety: OR = 0.4[0.3–0.6] ; uncertainty: OR = 0.3[0.2–0.5]; fatigue: OR = 0.3[0.2–0.4] ; stress: OR = 0.3[0.2–0.5]). In second lockdown, less psychosocial and behavio ral symptoms were reported compared to first lockdown (patients; e.g., anxiety: 22% versus 13%, p = 0.007; apathy: 27% versus 8%, p  〈  0.001, caregivers; e.g., anxiety: 23% versus 16%, p = 0.033; patient’s behavioral problems: 50% versus 35%, p  〈  0.001). Patients experienced more support (e.g., family and friends: 52% versus 93%, p  〈  0.001; neighbors: 28% versus 66%, p  〈  0.001). Conclusion: During second lockdown, patients and caregivers adapted to challenges posed by lockdown, as psychosocial and behavioral effects decreased, while patients experienced more social support compared to first lockdown. Support from family and friends is a major protective factor for negative outcomes in patients and caregivers.
    Type of Medium: Online Resource
    ISSN: 1387-2877 , 1875-8908
    URL: Article
    DOI: 10.3233/JAD-215342
    Language: Unknown
    Publisher: IOS Press
    Publication Date: 2022
    detail.hit.zdb_id: 2070772-1
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  • 3
    Online Resource
    Online Resource
    Clinical applicability of quantitative atrophy measures on MRI in patients suspected of Alzheimer’s disease
    Springer Science and Business Media LLC ; 2022
    In:  European Radiology Vol. 32, No. 11 ( 2022-05-31), p. 7789-7799
    Details
    In: European Radiology, Springer Science and Business Media LLC, Vol. 32, No. 11 ( 2022-05-31), p. 7789-7799
    Abstract: Neurodegeneration in suspected Alzheimer’s disease can be determined using visual rating or quantitative volumetric assessments. We examined the feasibility of volumetric measurements of gray matter (GMV) and hippocampal volume (HCV) and compared their diagnostic performance with visual rating scales in academic and non-academic memory clinics. Materials and methods We included 231 patients attending local memory clinics (LMC) in the Netherlands and 501 of the academic Amsterdam Dementia Cohort (ADC). MRI scans were acquired using local protocols, including a T1-weighted sequence. Quantification of GMV and HCV was performed using FSL and FreeSurfer. Medial temporal atrophy and global atrophy were assessed with visual rating scales. ROC curves were derived to determine which measure discriminated best between cognitively normal (CN), mild cognitive impairment (MCI), and Alzheimer’s dementia (AD). Results Patients attending LMC (age 70.9 ± 8.9 years; 47% females; 19% CN; 34% MCI; 47% AD) were older, had more cerebrovascular pathology, and had lower GMV and HCV compared to those of the ADC (age 64.9 ± 8.2 years; 42% females; 35% CN, 43% MCI, 22% AD). While visual ratings were feasible in  〉  95% of scans in both cohorts, quantification was achieved in 94–98% of ADC, but only 68–85% of LMC scans, depending on the software. Visual ratings and volumetric outcomes performed similarly in discriminating CN vs AD in both cohorts. Conclusion In clinical settings, quantification of GM and hippocampal atrophy currently fails in up to one-third of scans, probably due to lack of standardized acquisition protocols. Diagnostic accuracy is similar for volumetric measures and visual rating scales, making the latter suited for clinical practice. Summary statement In a real-life clinical setting, volumetric assessment of MRI scans in dementia patients may require acquisition protocol optimization and does not outperform visual rating scales. Key Points • In a real-life clinical setting, the diagnostic performance of visual rating scales is similar to that of automatic volumetric quantification and may be sufficient to distinguish Alzheimer’s disease groups . • Volumetric assessment of gray matter and hippocampal volumes from MRI scans of patients attending non-academic memory clinics fails in up to 32% of cases . • Clinical MR acquisition protocols should be optimized to improve the output of quantitative software for segmentation of Alzheimer’s disease–specific outcomes .
    Type of Medium: Online Resource
    ISSN: 1432-1084
    URL: Article
    DOI: 10.1007/s00330-021-08503-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1472718-3
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