[Organ donation after euthanasia in patients with a mental disorder: extra caution required].

A relative high number of cases of organ donation after euthanasia (ODE) is performed in patients with a mental disorder. We feel there are morally relevant differences between people who receive euthanasia on grounds of somatic illness and those who receive it on grounds of a mental disorder. More research is needed before it can be assumed that patients with a mental disorder who have their requests for euthanasia granted may also be eligible for ODE without further testing.

Effects of the DICE Method to Improve Timely Recognition and Treatment of Neuropsychiatric Symptoms in Early Alzheimer's Disease at the Memory Clinic: The BEAT-IT Study.

Background: Neuropsychiatric symptoms (NPS) are highly prevalent in Alzheimer's disease (AD) and are associated with negative outcomes. However, NPS are currently underrecognized at the memory clinic and non-pharmacological interventions are scarcely implemented.

Objective: To evaluate the effectiveness of the Describe, Investigate, Create, Evaluate (DICE) method™ to improve the care for NPS in AD at the memory clinic.

Scope of treatment and clinical-decision making in the older patient with COVID-19 infection, a European perspective.

Purpose: Older patients were particularly vulnerable to severe COVID-19 disease resulting in high in-hospital mortality rates during the two first waves. The aims of this study were to better characterize the management of older people presenting with COVID-19 in European hospitals and to identify national guidelines on hospital admission and ICU admission for this population.

Methods: Online survey based on a vignette of a frail older patient with Covid-19 distributed by e-mail to all members of the European Geriatric Medicine Society.

The recognition and management of neuropsychiatric symptoms in early Alzheimer's disease: a qualitative study among Dutch memory clinic physicians.

Background: Timely recognition and treatment of neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) dementia may improve quality of life, reduce caregiver burden, and delay disease progression. However, management of NPS in early AD dementia remains challenging. To date, little is known about the specific challenges for memory clinic-based physicians.

The Multidimensional Prognostic Index Predicts Mortality in Older Outpatients with Cognitive Decline.

Since the heterogeneity of the growing group of older outpatients with cognitive decline, it is challenging to evaluate survival rates in clinical shared decision making. The primary outcome was to determine whether the Multidimensional Prognostic Index (MPI) predicts mortality, whilst assessing the MPI distribution was considered secondary. This retrospective chart review included 311 outpatients aged ≥65 years and diagnosed with dementia or mild cognitive impairment (MCI).

Neuropsychological assessment in the multicultural memory clinic: Development and feasibility of the TULIPA battery.

Neuropsychological assessment of culturally diverse populations is hindered by barriers in language, culture, education, and a lack of suitable tests. Furthermore, individuals from diverse backgrounds are often unfamiliar with being cognitively tested. The aim of this study was to develop a new neuropsychological test battery and study its feasibility in multicultural memory clinics.

Diversity in Alzheimer's disease drug trials: The importance of eligibility criteria.

Introduction: To generalize safety and efficacy findings, it is essential that diverse populations are well represented in Alzheimer's disease (AD) drug trials. In this review, we aimed to investigate participant diversity in disease-modifying AD trials over time, and the frequencies of participant eligibility criteria.

Methods: A systematic review was performed using Medline, Embase, the Cochrane Library, and Clinicaltrials.

COVID outcome prediction in the emergency department (COPE): using retrospective Dutch hospital data to develop simple and valid models for predicting mortality and need for intensive care unit admission in patients who present at the emergency department with suspected COVID-19.

Objectives: Develop simple and valid models for predicting mortality and need for intensive care unit (ICU) admission in patients who present at the emergency department (ED) with suspected COVID-19.

Design: Retrospective.

Setting: Secondary care in four large Dutch hospitals.

Advance care planning and end-of-life care in patients with an implantable cardioverter defibrillator: The perspective of relatives.

Background: Little is known about the last phase of life of patients with implantable cardioverter defibrillators and the practice of advance care planning in this population.

Aim: To describe the last phase of life and advance care planning process of patients with an implantable cardioverter defibrillator, and to assess relatives' satisfaction with treatment and care.

Design: Mixed-methods study, including a survey and focus group study.

Ethical frameworks for complex medical decision making in older patients: A narrative review.

Background: With an ageing population physicians are more and more faced with complex medical and moral situations. Medical professional guidelines are often of limited use in these cases. To assist the decision making process, several ethical frameworks have been proposed.

Requests for futile treatments: what mechanisms play a role? Results of a qualitative study among Dutch physicians.

Objectives: Overtreatment is increasingly seen as a challenge in clinical practice and can lead to unnecessary interventions, poor healthcare outcomes and increasing costs. However, little is known as to what exactly causes overtreatment. In 2015, the Royal Dutch Medical Association (RDMA) attempted to address this problem and distinguished several mechanisms that were thought to drive overtreatment.

What to do when patients and physicians disagree? Qualitative research among physicians with different working experiences.

Purpose: Impasses between patients, relatives and physicians occur frequently. With the growing attention for shared decision making, it is valuable to know how impasses arise. To understand the challenges experienced by physicians when their opinion on medical decisions differ from those of patients or relatives.

Challenges and needs of informal caregivers in elderly care: Qualitative research in four European countries, the TRACE project.

Background: Providing informal care may affects caregivers' life in different ways. Determining the needs of caregivers and supporting them can improve both the quality of life of the caregivers, as well as the elderly they take care of.

Objective: To explore the experiences and needs of the informal caregivers in four countries.

Consultation Recording: What Is the Added Value for Patients Aged 50 Years and Over? A Systematic Review.

This systematic review aimed to provide medical professionals with insight into beneficial and harmful effects of consultation recording for patients aged 50 years and over. This insight could enable medical professionals to decide on whether or not to promote consultation recording in their practice. The systematic literature search was performed in six databases; additional relevant articles were sought using the snowball method.

Implantable cardioverter defibrillator deactivation and advance care planning: a focus group study.

Objective: Implantable cardioverter defibrillators can treat life-threatening arrhythmias, but may negatively influence the last phase of life if not deactivated. Advance care planning conversations can prepare patients for future decision-making about implantable cardioverter defibrillator deactivation. This study aimed at gaining insight in the experiences of patients with advance care planning conversations about implantable cardioverter defibrillator deactivation.

Assessment of Visual Association Memory in Low-Educated, Non-Western Immigrants with the Modified Visual Association Test.

Background: Neuropsychological tests are influenced by culture, language, level of education, and literacy, but there are few cognitive tests of which the applicability in ethnic minority populations has been studied.

Objectives: The aim of this study was to assess the reliability and validity of the Visual Association Test (VAT), a test of visual association memory, in a non-Western, low-educated memory clinic population. Additionally, a modified version of the VAT using colored photographs instead of line drawings was studied (mVAT).

Trends in time in the management of the implantable cardioverter defibrillator in the last phase of life: a retrospective study of medical records.

Background: The implantable cardioverter defibrillator (ICD) might give unwanted shocks in the last month of life. Guidelines recommend deactivation of the ICD prior to death.

Aims: The aims of this study were to examine trends in time (2007-2016) in how and when decisions are made about ICD deactivation, and to examine patient- and disease-related factors which may have influenced these decisions.

Is training for informal caregivers and their older persons helpful? A systematic review.

Background: The steady increase in the number of people suffering from chronic diseases and increasing life expectancy raises new demands on health care. At the same time, the need for informal caregivers is increasing. This study aims to perform a systematic review of the methodologies used to identify effect of different types of training on informal caregivers and their older persons.

Percutaneous endoscopic gastrostomy in older patients with and without dementia: Survival and ethical considerations.

Background And Aim: Notwithstanding multiple recommendations in guidelines, percutaneous endoscopic gastrostomy (PEG)-tube placement is still performed in patients with dementia. In this study, we aim to investigate survival in patients with and without dementia after PEG-tube placement.

Methods: We conducted a retrospective multicenter study in four different hospitals in the Netherlands.

The incidence and impact of implantable cardioverter defibrillator shocks in the last phase of life: An integrated review.

Background: Although the implantable cardioverter defibrillator is successful in terminating life threatening arrhythmias, it might give unwanted shocks in the last phase of life if not deactivated in a timely manner.

Aims: This integrated review aimed to provide an overview of studies reporting on implantable cardioverter defibrillator shock incidence and impact in the last phase of life.

Methods And Results: We systematically searched five electronic databases.

[Melanomas more serious in the elderly].

Two patients, a 96-year-old woman and a 94-year-old man, were diagnosed with metastatic cutaneous melanoma. The first patient had undergone radical excision of the primary tumour 18 months before. The second patient presented with neurological symptoms caused by a metastatic melanoma; the primary tumour had recently been resected.

High systolic and pulse pressure levels are associated with better cognitive performance in patients with probable Alzheimer's disease: a cross-sectional observational study in a geriatric outpatient population.

Background: The prevalence of cardiovascular disease and Alzheimer's disease (AD) increases with age. A number of studies have demonstrated an association between AD and cardiovascular risk factors and disease. However, data are inconsistent.