Since the end of 2019, a life-threatening infectious disease (coronavirus disease 2019: COVID-19) has spread globally, and numerous victims have been reported. In particular, older persons tend to suffer more severely when infected with a novel coronavirus (SARS-CoV-2) and have higher case mortality rates; additionally, outbreaks frequently occur in hospitals and long-term care facilities where most of the residents are older persons. Unfortunately, it has been stated that the COVID-19 pandemic has caused a medical collapse in some countries, resulting in the depletion of medical resources, such as ventilators, and triage based on chronological age. Furthermore, as some COVID-19 cases show a rapid deterioration of clinical symptoms and accordingly, the medical and long-term care staff cannot always confirm the patient's values and wishes in time, we are very concerned as to whether older patients are receiving the medical and long-term care services that they wish for. It was once again recognized that it is vital to implement advance care planning as early as possible before suffering from COVID-19. To this end, in August 2020, the Japan Geriatrics Society announced ethical recommendations for medical and long-term care for older persons and emphasized the importance of conducting advance care planning at earlier stages. Geriatr Gerontol Int 2020; 20: 1112-1119.
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http://dx.doi.org/10.1111/ggi.14075 | DOI Listing |
Alzheimers Dement
December 2024
Karolinska Institute, Stockholm, Södermanland and Uppland, Sweden.
Background: Novel anti-amyloid therapies (AAT) for Alzheimer's Disease (AD) have recently been approved in the United States, Japan and China, and are under regulatory review in Europe. Questions remain regarding the long-term effectiveness and value of these drugs when used in routine clinical practice. Data from follow-up studies will be important to inform their optimal use, including criteria for treatment initiation, monitoring strategies, stopping rules, pricing and reimbursement considerations.
View Article and Find Full Text PDFBackground: Patients with Alzheimer's disease (AD) often experience burdensome neuropsychiatric symptoms, including agitation which occurs in both home and long-term care (LTC) facilities, and is associated with substantial increases in caregiver burden and LTC placements. AXS-05 (45-mg dextromethorphan/105-mg bupropion), a novel, oral NMDA receptor antagonist and sigma-1 receptor agonist, approved by the FDA for major depressive disorder, is being investigated for treatment of AD agitation (ADA). AXS-05 has been evaluated in 2 randomized, double-blind studies: Phase 2 ADVANCE-1 (NCT03226522); Phase 3 ACCORD (NCT04797715).
View Article and Find Full Text PDFBackground: Alzheimer's disease (AD) remains a formidable neurodegenerative challenge, characterized by profound cognitive decline. Despite decades of research, effective disease-modifying therapies are elusive. Recent advances in molecular neuropharmacology have unveiled potential therapeutic targets for AD, offering renewed hope.
View Article and Find Full Text PDFBackground: The new anti-Aβ antibody drugs aducanumab and lecanemab (approved in the US, not yet in Europe) must be followed up closely and regularly long-term. Previous knowledge on progression of AD in routine clinical settings longterm is crucial when introducing new dementia medications. The Swedish national quality database on dementia/cognitive disorders, SveDem, where data on different dementia disorders at the time of the dementia diagnosis since 2007 and on mild cognitive impairment (MCI) since 2021 with annual follow-ups of MMSE scores can provide this unique information.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
Background: The effectiveness of multimodal lifestyle interventions to prevent dementia is being validated. Since a relatively long period (∼2 years) is required for manifesting an impact on cognitive function, the exploration of an alternative marker that exhibits changes within a comparatively brief duration, thereby prognosticating future alterations in cognitive function, is needed. The decline in gait function is associated with cognitive impairment and is also a predictor of future cognitive decline.
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