From the article: "Individuals with dementia often experience a decline in their ability to use language. Language problems have been reported in individuals with dementia caused by Alzheimer’s disease, Parkinson’s disease or degeneration of the fronto-temporal area. Acoustic properties are relatively easy to measure with software, which promises a cost-effective way to analyze larger discourses. We study the usefulness of acoustic features to distinguish the speech of German-speaking controls and patients with dementia caused by (a) Alzheimer’s disease, (b) Parkinson’s disease or (c) PPA/FTD. Previous studies have shown that each of these types affects speech parameters such as prosody, voice quality and fluency (Schulz 2002; Ma, Whitehill, and Cheung 2010; Rusz et al. 2016; Kato et al. 2013; Peintner et al. 2008). Prior work on the characteristics of the speech of individuals with dementia is usually based on samples from clinical tests, such as the Western Aphasia Battery or the Wechsler Logical Memory task. Spontaneous day-to-day speech may be different, because participants may show less of their vocal abilities in casual speech than in specifically designed test scenarios. It is unclear to what extent the previously reported speech characteristics are still detectable in casual conversations by software. The research question in this study is: how useful for classification are acoustic properties measured in spontaneous speech."
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There are currently about 6 million – mainly older – people with dementia in the European Union. With ageing, a number of sensory changes occur. Dementia syndrome exacerbates the effects of these sensory changes and alters perception of stimuli. People with dementia have an altered sensitivity for indoor environmental conditions, which can induce problematic behaviour with burdensome symptoms to both the person with dementia and the family carer. This paper, based on literature review, provides an overview of the indoor environmental parameters, as well as the integrated design and implementation of relevant building systems. The overview is presented in relation to the intrinsic ageing of senses, the responses of older people with dementia and the impact on other relevant stakeholders through the combined use of the International Classification of Functioning, Disability and Health, and the Model of Integrated Building Design. Results are presented as indicators of the basic value, functional value and economic value, as well as a synthesis of building-related solutions. Results can help designers and building services engineers to create optimal environmental conditions inside the living environments for people with dementia, and can be used to raise awareness among health care professionals about of the influence of the indoor environment on behaviour of the person with dementia.
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The design of healthcare facilities is a complex and dynamic process, which involves many stakeholders each with their own set of needs. In the context of healthcare facilities, this complexity exists at the intersection of technology and society because the very design of these buildings forces us to consider the technology–human interface directly in terms of living-space, ethics and social priorities. In order to grasp this complexity, current healthcare design models need mechanisms to help prioritize the needs of the stakeholders. Assistance in this process can be derived by incorporating elements of technology philosophy into existing design models. In this article, we develop and examine the Inclusive and Integrated Health Facilities Design model (In2Health Design model) and its foundations. This model brings together three existing approaches: (i) the International Classification of Functioning, Disability and Health, (ii) the Model of Integrated Building Design, and (iii) the ontology by Dooyeweerd. The model can be used to analyze the needs of the various stakeholders, in relationship to the required performances of a building as delivered by various building systems. The applicability of the In2Health Design model is illustrated by two case studies concerning (i) the evaluation of the indoor environment for older people with dementia and (ii) the design process of the redevelopment of an existing hospital for psychiatric patients.
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Analysis of spontaneous speech is an important tool for clinical linguists to diagnose various types of neurodegenerative disease that affect the language processing areas. Prosody, fluency and voice quality may be affected in individuals with Parkinson's disease (PD, degradation of voice quality, unstable pitch), Alzheimer's disease (AD, monotonic pitch), and the non-fluent type of Primary Progressive Aphasia (PPA-NF, hesitant, non-fluent speech). In this study, the performance of a SVM classifier is evaluated that is trained on acoustic features only. The goal is to distinguish different types of brain damage based on recorded speech. Results show that the classifier can distinguish some dementia types (PPA-NF, AD), but not others (PD).
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Rede, uitgesproken bij de openbare aanvaarding van het ambt van bijzonder hoogleraar Professionalisering van de verpleging en verzorging in de ouderenzorg aan Tilburg University op 29 september 2023 door Prof. dr. Robbert J.J. Gobbens
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In dit rapport ziet en leest u wat er in vierenhalf jaar in vier leernetwerken van verschillende zorgorganisaties in Noord-Nederland in het project ‘LeerSaam Noord, samen werken, samen leren’ is gedaan om persoonsgerichte zorg te bevorderen en te versterken. In deze rapportage kunt u zich in hoofdstuk 1 oriënteren op het project via een algemene beschrijving en overzicht van het project. Vervolgens komen in de hoofdstukken 2 en 3 de onderzoeksbevindingen aan bod vanuit een review en de 4 verrichtte deelstudies. In hoofdstuk 4 zijn de verschillende evaluatieve onderdelen van het projectproces beschreven, in hoofdstuk 5 vindt u de beschrijving van de toolbox en tot slot geeft hoofdstuk 6 de conclusie en praktische aanbevelingen en geleerde lessen. In elk hoofdstuk vindt u onder het kopje ‘meer weten en lezen’ links naar relevante documenten, onderzoeksverslagen en publicaties aan. Daar waar publicaties onder review zijn, staat dit eveneens aangegeven. Deze worden bij daadwerkelijke publicatie alsnog toegevoegd. In de tekst staan, daar waar relevant, ook directe links naar websites of verwijzingen naar informatie in de rapportage.
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Er lijkt een duidelijke mate van evidentie te bestaan betreffende de relatie fysieke activiteit, respectievelijk fitheid en gezondheid in de algemene populatie en bij bepaalde pathologieën. Er is evenwel nog behoefte aan verder wetenschappelijk onderzoek naar mogelijke determinanten en onderliggende mechanismen, als ook naar evidentie bij bepaalde, specifieke aandoeningen. Tevens mag duidelijk zijn dat ondanks de bestaande evidentie fysieke activiteit/oefening te weinig toegepast wordt in de gezondheidszorg. Het onderzoek naar de effectiviteit van gezondheidskundige interventies is dan ook uitermate belangrijk. Dit lectoraat hoopt dan ook een bescheiden bijdrage hieraan te kunnen leveren. Hiervoor heeft zij reeds afspraken tot samenwerking met de academische en medische wereld (in Utrecht, Amsterdam, Maastricht en Leuven), met de gezondheidszorg (RIVM Bilthoven en GG&GD Utrecht) en met de beroepen- of bedrijfswereld (Politie regio Utrecht; Enraf Nonius, Delft). De beoogde doelstellingen zullen echter naar alle waarschijnlijkheid beduidend meer tijd in beslag nemen dan de periode van 4 jaar die de Stichting Kennis Ontwikkeling voorzien heeft met betrekking tot het oprichten en financieren van de lectoraten.
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BACKGROUND: Paratonia, a form of hypertonia, is associated with loss of mobility and with the development of contractures especially in the late stages of the dementia. Passive movement therapy (PMT) currently is the main physiotherapeutic intervention. General doubt about the beneficial effects of this widely used therapy necessitates a randomised clinical trial (RCT) to study the efficacy of PMT on the severity of paratonia and on the improvement of daily care.METHODS/DESIGN: A RCT with a 4-week follow-up period. Patients with dementia (according to the DSM-IV-TR Criteria) and moderate to severe paratonia are included in the study after proxy consent. By means of computerised and concealed block randomisation (block-size of 4) patients are included in one of two groups. The first group receives PMT, the second group receives usual care without PMT. PMT is given according to a protocol by physical therapist three times a week for four weeks in a row. The severity of paratonia (Modified Ashworth scale), the severity of the dementia (Global Deterioration Scale), the clinical improvement (Clinical Global Impressions), the difficulty in daily care (Patient Specific Complaints) and the experienced pain in daily care of the participant (PACSLAC-D) is assessed by assessors blind to treatment allocation at baseline, after 6 and 12 treatments. Success of the intervention is defined as a significant increase of decline on the modified Ashworth scale. The 'proportion of change' in two and four weeks time on this scale will be analysed. Also a multiple logistic regression analysis using declined/not declined criteria as dependent variable with correction for relevant confounders (e.g. stage of dementia, medication, co-morbidity) will be used.DISCUSSION: This study is the first RCT of this size to gain further insight on the effect of passive movement therapy on the severity of paratonia.TRIAL REGISTRATION: Current Controlled Trials ISRCTN43069940.
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Most people with dementia (PwD) are cared for by unpaid family carers, many of whom must balance caring with paid work. This regularly entails dealing with care-related emergencies (CRE). This study aims to explore the impact of carers’ autonomy at work regarding breaks, schedule, and place on their ability to manage CRE, and use technology to that end. We conducted interviews with 16 working carers of PwD in Scotland. Data were analysed thematically to identify key themes. Autonomy at work appeared on a spectrum from no to complete autonomy. Carers’ position on this spectrum was often dynamic and determined by the nature of their work, their workplace culture and regulations, and their line managers’ support – or clients in the case of self-employed carers. Break autonomy allowed carers to use technology to be notified of and delegate the CRE response. Schedule autonomy allowed for an in-person response to CRE. Place autonomy allowed carers to work and care simultaneously, which enabled them to manage CRE immediately but presented them with additional challenges. Distance between workplace and PwD’s residence impacted carers’ ability to manage CRE, despite having complete autonomy. Implications for healthcare professionals, service providers, employers, policymakers, and technology developers are presented.
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Our study shows a steady increase in dementia- and DHT-related publications, particularly in areas such as mobile health, virtual reality, artificial intelligence, and sensor-based technologies interventions. This increase underscores the importance of systematic approaches and interdisciplinary collaborations, while identifying knowledge gaps, especially in lower-income regions. It is crucial that researchers worldwide adhere to evidence-based medicine principles to avoid duplication of efforts. This analysis offers a valuable foundation for policy makers and academics, emphasizing the need for an international collaborative task force to address knowledge gaps and advance dementia care globally.
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