The ATENción Plena en Enfermedad de Alzheimer (ATENEA-Mindfulness in Alzheimer's Disease) Program for Caregivers: Study Protocol for a Randomized Controlled Trial.

A person affected by Alzheimer's disease (AD) gradually loses the ability to perform activities of daily living and becomes dependent on caregivers, thereby having a negative impact on the caregivers' quality of life. There is evidence that suggests that interventions aimed at caregivers, such as mindfulness, may be effective at reducing this burden and emotional issues, such as depression and anxiety, and improving their quality of life. However, there is a lack of consistency in the findings and conclusions remain tentative. In addition, as neuropsychiatric symptoms (NPSs) of AD are major determinants of the caregiver's burden, these interventions should examine the relationship between these symptoms and caregiver outcomes. Importantly, to improve the design of therapeutic interventions for caregivers and complement the treatment of AD, aspects related to occupational performance and the participation of people with AD and their caregivers should also be considered. Therefore, this study will aim to examine first, the effects of a mindfulness-based program designed for caregivers on NPSs of AD and caregivers' anxiety and depression; second, the effects of this program on patients' functional capacity, cognitive performance, executive functions, and quality of life, and on caregivers' burden, quality of life, occupational balance, executive functions, psychological wellbeing, and self-compassion. We believe that the findings of this study will have significant implications for future healthcare strategies focused on improving the quality of life and wellbeing of caregivers.

Síndrome de Cotard asociado a demencia degenerativa. Presentación de tres casos / No disponible

Introducción y objetivo: el síndrome de Cotard es un cuadro inusual cuyo rasgo central es un delirio de negación en el que el paciente cree haber fallecido, carecer de partes de su cuerpo o sufrir un mal funcionamiento de sus órganos. Puede asociarse a patología psiquiátrica o neurológica. La bibliografía al respecto es escasa, particularmente en demencia. Describimos varios casos asociados a demencia degenerativa. Material y método: pacientes con demencia degenerativa y síndrome de Cotard diagnosticados en nuestra unidad desde enero 2010 a diciembre 2011: número, características demográficas, semiología, demencia subyacente, tratamiento y evolución. Resultados: tres mujeres, de 78 a 86 años. En una el síndrome se manifestó con ideas de muerte y rechazo a la ingesta. En las otras dos, con ideas de negación acerca de partes de su cuerpo junto con rechazo a la alimentación, ideas de posesión y/o de deformación corporal. Las tres cumplían criterios de demencia con cuerpos de Lewy (DLB) y mejoraron tras la administración de neurolépticos atípicos. Conclusiones: probablemente el síndrome de Cotard es más frecuente en pacientes con demencia de lo hasta ahora publicado, especialmente en DLB. Su identificación y tratamiento adecuado son importantes, ya que pueden evitar el internamiento en un centro sanitario (AU)

Background and objective: Cotard’s syndrome is an unusual condition whose central features are nihilistic delusions. As a result, some patients believe they are dead, their organs don’t exist or don’t work. Cotard’s syndrome can appear associated with several psychiatric and neurological disorders. The available literature is scarce, particularly in dementia. We present some new cases associated with degenerative dementia. Method: some patients with degenerative dementia and Cotard’s syndrome have been diagnosed in our hospital from january 2010 to december 2011. We describe their demographic characteristics, semiology, underlying dementia disorder, treatment and course. Results: three womens, from 78 to 86 years old. One patient developed death ideas and refused to eat. The others two patients had denial ideas about several parts of their bodies together with a flat refusal to eat, delusions of possession and/or delusions of a deformity of body parts. All of them met Lewy bodies dementia (DLB) criteria and improved with atypical neuroleptics treatment. Conclusions: probably Cotard’s syndrome is more frequent in patients with dementia than the literature is reporting, especially in DLB. It is important to recognize the syndrome and to know its treatment because that can avoid patient institutionalize (AU)