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Special Care Must Be Provided to Patients with Dementia

A significant number of older adults with dementia live in nursing home facilities. Young-onset dementia (YOD), dementia that develops before the age of 65, is a crucial social and clinical problem that leads to critical consequences for patients and their overall wellbeing.  Neuropsychiatric symptoms (NPSs) that occur due to YOD have a serious impact on both patients and their families.  They include agitation, depression, and apathy.  A recent study published this year in the Journal of the American Medical Directors Association sought to understand the prevalence and factors that determined neuropsychiatric symptoms in elderly nursing home residents with YOD, due to its importance for treatment and planning of care services.  Researchers of the study hope that its findings will contribute to improving quality of life of nursing home patients with YOD, as well as their families and professional caregivers.

Young-onset dementia clinically differs from late-onset dementia in that the most common causes are due to frontotemporal dementia, Huntington’s disease, and alcohol-related dementia, rather than due to Alzheimer’s disease.  Research has also shown that patients with YOD express higher rates of neuropsychiatric symptoms than those with long-term dementia, possibly associated with the more unanticipated loss of autonomy and active societal roles at younger ages.

The research for the study was in Dutch long-term care facilities that provided specialized care for patients with young-onset dementia.  Participants included 230 residents of the facilities with YOD.  The results of the study showed that 90% of the nursing home patients with young-onset dementia expressed one or more neuropsychiatric symptoms.  Moreover, 88% of participants expressed significant agitation and 56% expressed relevant apathy.  There were no differences in gender.  Symptoms that were found to be most common in patients with very critical cognitive decline were both physically and non-physically aggressive behavior, and apathy.  All patients except for those with the most critical stages of dementia showed verbally agitated behavior.  Patients with alcohol-related dementia commonly showed apathetic behavior.  Patients who expressed low levels of awareness were related to more physically aggressive behavior and deviant motor behavior.

The study concluded that there was a high rate of neuropsychiatric symptoms and was related to the severity and type of dementia and disease awareness.   According to the researchers, the most significant symptoms to pay attention to in young-onset dementia are agitation and apathy.  The high rate of neuropsychiatric symptoms confirms the idea of providing care in special care units.  Further studies are needed to discover the potentially influencing environment factors associated with neuropsychiatric symptoms in young-onset dementia.

As the older adult population continues to grow in the United States, there will be an increasing number of patients residing in nursing home facilities. Many of these patients will have various forms of dementia that significantly increase their vulnerability to adverse outcomes and diminished quality of life.  It is crucial that nursing home staff continuously provide quality care and appropriate treatment to these patients to maintain their wellbeing as much as possible. If you or a loved one has endured suffering as a result of neglect or elder abuse from a nursing facility, contact us today for a free consultation.