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EN
It is estimated that there are 36 million people with dementia in the world and in 2050 this number will double. The number of patients with Alzheimer’s Poles is estimated at about 200‒250 thousand. 150 thousands have no primary diagnosis. With the ageing of the Polish society the number of sufferers is likely to grow. The disease usually develops after the age of 65. Incidence of the disease increases with age. Symptoms of the disease are: memory disorders, sudden mood changes, cognitive and behavior disorders.. Is it irreversible changes in the brain – for people with Alzheimer’s cerebral cortex fades, because the neurons build up amyloid. Although the situation of the people affected by this disease in Poland recently somewhat improved: faster diagnosis and access to modern drugs for which to get the patient, Poland is still not ready for adequate action which involves an increase in morbidity. Many institutions do not fulfill their tasks in terms of aid to the sick and their families. It lacks effective system solutions. Patients in general are deprived of the possibility of using, for example, living houses. In practice, in general it’s hard to talk about any kind of institutional support for people with Alzheimer’s disease. A major problem is the lack of systems and standards of care, lack of support for families and carers. With Alzheimer’s patients in Poland can do it all.
EN
The average length of human life is increasing, which means that older people make more and more numerous group of society. Nowadays there are a lot of different activity offers, addressed to older people, including broadly understood education offers. The Universities of Third Age are obvious example here. However, the lengthening life span means also that the number of seniors diagnosed with dementia is increasing. Older people with dementia can and should be included in geragogics initiatives. At pre-dementive (MCI) and early dementia stages it means above all brain training (ROT). Along with the progress of dementia more holistic intervention should be offered. One of them is the psychobiographic model according to Erwin Böhm. Böhm aims at so-called “reactivation of senior’s spirit”, meaning activating senior’s noopsyche (or cognitive sphere) as well as their thymopsyche (or emotional sphere). Therefore Böhm proposes seven steps scale of interaction (that is seven steps of connecting with senior) which allows to define senior’s needs as well as to enhance their competences. Böhm’s psychobiographic model uses in innovative way the biographical work method, adapting it to the situation of seniors with dementia. Thus the senior is not reduced to their diagnosis but is understood as a person, which means as a bio-psycho-social-spiritual entity.
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Content available remote National policies for healthy ageing: the maltese experience
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EN
Public policy in Malta is strongly geared towards improving the levels of healthy ageing of present and incoming cohorts of older persons. Ageing policy in Malta follows the European Commission’s document Guiding Principles for Active Ageing and Solidarity between Generations which underlined how societies must not be solely content with a remarkable increase in life expectancy, but must also strive to extend healthy life years, and then to provide opportunities for physical and mental activities that are adapted to the capacities of older individuals. The government of Malta employs 14 consultant geriatricians who work mainly in the public rehabilitation hospital and residential/nursing homes, concentrating on frail elders, and in specialty clinics – for example, on memory, falls, and continence. This means that there is a consultant geriatrician for every 7,948 persons aged 60-plus, which compares well to other European Union nations such as Germany (7,496), Spain (7,701), United Kingdom (8,871), and Switzerland (9,250). At the same time, the Maltese government has launched the National Strategic Policy for Active Ageing, National Dementia Strategy, and the Minimum Standards for Care Homes in Malta all of which include a range of recommendations that aim to lead older persons towards higher levels of healthy ageing.
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EN
Bilingualism is a topic that is most often discussed in the context of raising and working with children. However, the role that bilingualism plays in adulthood and late adulthood is underestimated in the literature. At this stage of life, some people may develop the first symptoms of neurodegenerative diseases, mainly associated with memory and communication disorders. The article briefly introduces the most common causes of dementia symptoms and then discusses bilingualism in several, closely related aspects. The publication contains information on the impact of bilingualism on delaying the symptoms of dementia and triggers of this phenomenon. The creativity of bilinguals and the unique impact of bilingualism on working memory and executive control are addressed.
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Content available remote Riziko dehumanizácie u ľudí žijúcich s demenciou:
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EN
The concept of dehumanization has received quite a lot of attention in recent decades. Its various forms have inconsistent conceptualization, but they also overlap to some extent. Researchers have argued that some groups are more vulnerable to dehumanization than others. One such group is people living with dementia. In this overview, a more comprehensive view of the dehumanization of this extremely vulnerable group by identifying three main attributes is presented. Dementia is a disease which does not have obvious physical signs and affects mainly people aged 65 and over. Therefore, stereotypes related to old age are likely to be activated first. Another attribute is patient status. In the health care and social care facilities, there is a relatively widespread type of communication that neglects individuality and contribute to the homogenization and objectification of all patients with the same diagnosis. The diagnosis of dementia is the last attribute. People with dementia have problems with social functioning that leads to social isolation. The authors argue that society has to play a key role in limiting the dehumanization of people living with dementia. The first step must be an appropriate approach to institutional care. One suitable approach is a patient-centered approach emphasizing a holistic approach to treatment and care based on the bio-psycho-social model of the disease.
EN
The paper reviews the methods for improving verbal communication in selected variants of Alzheimer’s disease, both in the typical and language variant. It emphasises the need to optimise the management within the framework of patientcentred care, allowing to address individual needs. As far as indirect interventions are concerned, the article presents techniques aimed at improving communication with the affected person, and more broadly – aimed at preserving the quality of life in the course of the illness. Among direct interventions, those aimed at selected system abilities and supporting language function in the context of cognitive and social function are presented. It is shown how speech and language therapy can integrate other therapeutic paradigms, developed in psychology, such as patientcentred therapy and cognitive neuropsychological rehabilitation.
EN
The Abbreviated Mental Test Score (AMTS) is a tool designed for the assessment of cognitive functions, such as episodic memory, semantic memory and working memory, to screen for potential problems in elderly age. It was originally developed in English in 1972 for hospitalised patients, and has since been modified by numerous authors for use in various populations. AMTS is a 10-item questionnaire comprising questions and simple tasks for the patient. It can be used as a bedside test, hence its usefulness in a clinical setting, as it merely requires verbal contact between the interviewer and the interviewee, takes only several minutes to perform, is simple, and no professional knowledge or equipment are needed. Also, as opposed to the commercially available scales, it is free. AMTS allows the identification of cognitive function disorders and their severity. If the patient’s result is unsatisfying, a further, more detailed diagnosis is pursued under specialist geriatric or psychiatric care. The test’s Polish modified version has been included as an element of the overall geriatric assessment taught as part of continued training for medical staff, and in geriatric care standards in Poland. Certain discrepancies, however, exist between the English and Polish language versions, potentially leading to an erroneous evaluation of the patient’s cognitive function. Moreover, the Polish-language version has not yet been validated. This study is aimed at a comparative analysis of the items in the Polish and the original, English-language, versions of the test. The problematic items have been elaborated on, with recommendations made as to how the test’s reliability may be increased.
PL
Skrócony Test Sprawności Umysłowej (Abbreviated Mental Test Score, AMTS) jest narzędziem przeznaczonym do przesiewowej oceny funkcji poznawczych – pamięci epizodycznej, semantycznej i operacyjnej – w okresie starości. Oryginalnie test został opracowany w języku angielskim w 1972 roku dla pacjentów hospitalizowanych. Od tego czasu wielu badaczy modyfikowało go na użytek badań różnych populacji. AMTS jest skalą składającą się z 10 pozycji – pytań i poleceń dla osoby badanej. Ma on cechy testu „przyłóżkowego”, szczególnie pożądane w warunkach klinicznych: wymaga jedynie kontaktu werbalnego pomiędzy badaczem i badanym, jego czas wykonania wynosi kilka minut, jest łatwy do przeprowadzenia, nie wymaga profesjonalnej wiedzy oraz oprzyrządowania. Ponadto w odróżnieniu od skal komercyjnych jest dostępny bezpłatnie. AMTS pozwala na stwierdzenie istnienia zaburzeń funkcji poznawczych oraz stopnia ich nasilenia. Wynik  niezadowalający skłania do  pogłębionej diagnostyki w ramach specjalistycznej opieki geriatrycznej bądź psychiatrycznej. Zmodyfikowany i przetłumaczony na język polski test został zaproponowany jako element całościowej oceny geriatrycznej w ramach szkolenia ustawicznego personelu medycznego oraz w standardach postępowania w opiece geriatrycznej. Pomiędzy wersją anglojęzyczną i polskojęzyczną istnieją jednak rozbieżności, które mogą być przyczyną wadliwej klasyfikacji sprawności umysłowej osób badanych. Ponadto dla testu w wersji polskojęzycznej nie przeprowadzono dotychczas badań walidacyjnych. W artykule dokonano analizy porównawczej poszczególnych zadań testowych polskojęzycznej i oryginalnej anglojęzycznej wersji testu z zaznaczeniem miejsc problematycznych oraz przedstawiono rekomendacje mające na celu zwiększenie wiarygodności testu.
EN
Caregivers of persons suffering from dementia constitute a group displaying a great need for mental health support, while at the same time being largely neglected in terms of receiving this support. In this context, the aim of this article is to propose the Stepped Care 2.0 (S.C. 2.0) model as a mental health care systemic solution for carers of persons with dementia. In this article, we focus on presenting the argumentation that proves the need and validity of introducing the proposed mental health care model for carers of persons with dementia. For this purpose, we draw on the results of our own pilot study, as well as a review of the subject literature. As the literature review indicates, caring for individuals with dementia is a source of multidimensional burden and deterioration in well-being. Results obtained in our own study indicate that there exists a burden of care among carers of persons with dementia in Poland and their well-being is significantly lower compared to non-carers. Moreover, the results suggest that the degree of negative consequences of being a caregiver varies depending of the degree of the patient’s disability. The flexibility of support and client-centric approach assumed in the S.C. 2.0 model can provide a good response to the diverse and changing needs of the carers of persons with dementia. It can also serve as a kind of hub encompassing and organising existing forms of support for carers. Moreover, the effectiveness of the selected types of support included in this model is confirmed by existing research findings. The need for mental health support for carers of individuals with dementia is undeniable. In the light of the arguments provided, the S.C. 2.0 model is a suitable solution for the systemic organisation of such support.
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Content available remote Respect Towards Elderly Demented Patients
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Diametros
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2014
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nr 39
109-124
EN
One question of applied ethics is the status and proper treatment of marginal cases, i.e., of people who are not yet or not anymore in full possession of their rational capacities, such as elderly demented people. Does one belittle them if one does not treat them like normal human adults, or would it be disrespectful and demanding too much if one did? Are elderly demented even the proper object of respect? In this paper I explore what Kant would say about these questions if he had addressed them. I look at what Kantian respect is, how he justifies the requirement to respect others, and what it demands more specifically. My claim is that Kant conceives of respect as a maxim of not exalting oneself above others. One should adopt this attitude independently of what the other is like. Differences between normal human adults and marginal cases are important for how one should treat them, but ultimately not for the question of why one should treat them with respect. Accordingly, elderly demented people should be respected, and it depends on the individual case what kind of actions this implies.
10
Content available Neuropsychologiczne uwarunkowania zespołu Downa
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EN
Authors of the article undertook an important subject of the correlation of conditions of Down syndrom (its genetic syndrome) with the latest reports from medical world literature. Fragments relating to relationships between Down syndrom and dementative syndroms deserve special attention (particularly at adults and older people) as well as the indication of exact dependences between genetic syndrome and dementia diseases.
Logopedia
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2018
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tom 47 EN
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nr 1
79-98
EN
The present study focuses on disorders of speech coherence and describes them using the concept of connotation. Connotation is the term that has become established in science with several meanings. The author makes a review of these meanings and shows how the phenomenon of connotation is associated with language disorders. Early studies on connotation in the philosophicallogical dimension go back to the 19th century and are connected with the works by J.S. Mill, while K. Bühler is regarded as the founder of the linguistic theory of connotation. Within linguistics, connotation was perceived in different ways, and knowledge about it developed with the development of this discipline. Studies by N. Chomsky show that it is formal and semantic relationships between words used in an utterance that determine its coherence. Chomsky himself did not use the concept of connotation but he presented two levels of coherence disorders in his works. The principles of connotation are presented there as rules of subcategorization and selection. The author of the paper emphasizes that the connotation properties of verbs are a factor that determines the syntactic pattern. The paper shows the proposal of including investigations on connotation in the issues of logopedics. The author draws attention to the occurrence of connotation disorders in schizophasia, aphasia, and dementia. It should be stressed that the disintegration of connotation relationships looks different in each of these disorders. Connotation disorders are related to the improper functioning of the brain, particularly to disorders in the frontotemporal region.
EN
This study investigated the use of computer games to detect the symptoms of mild cognitive impairment (MCI), an early stage of dementia, in the elderly. To this end, three serious games were used to measure the visio-perception coordination and psycho-motor abilities, spatial memory, and short-term digit span memory. Subsequently, the correlations between the results of the games and the results of the Korean Mini-Mental State Examination (K-MMSE), a dementia screening test, were analyzed. In addition, the game results of normal elderly persons were compared with those of elderly patients who exhibited MCI symptoms. The results indicated that the game play time and the frequency of errors had significant correlations with K-MMSE. Significant differences were also found in several factors between the control group and the group with MCI. Based on these findings, the advantages and disadvantages of using serious games as tools for screening mild cognitive impairment were discussed.
13
Content available remote Genetic study of familial cases of Alzheimer's disease.
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EN
A small number (1-5%) of Alzheimer's disease (AD) cases associated with the early-onset form of the disease (EOAD) appears to be transmitted as a pure genetic, autosomal dominant trait. To date, three genes responsible for familial EOAD have been identified in the human genome: amyloid precursor protein (APP), presenilin 1 (PS1), and presenilin 2 (PS2). Mutations in these genes account for a significant fraction (18 to 50%) of familial cases of early onset AD. The mutations affect APP processing causing increased production of the toxic Aβ42 peptide. According to the "amyloid cascade hypothesis", aggregation of the Aβ42 peptide in brain is a primary event in AD pathogenesis. In our study of twenty AD patients with a positive family history of dementia, 15% (3 of 20) of the cases could be explained by coding sequence mutations in the PS1 gene. Although a frequency of PS1 mutations is less than 2% in the whole population of AD patients, their detection has a significant diagnostic value for both genetic counseling and treatment in families with AD.
EN
The pandemic has had a significant impact on the social reality, the current characteristics of which include: unpredictability, permanent change, and difficulties in defining actions to deal with the consequences of the existing threats, both at the macro and micro level. This situation particularly affects groups that need social support. One of them includes home caregivers of people suffering from dementia. The aim of the article is to present the situation of home caregivers who take care of their family members suffering from dementia. The description is based on data obtained in random interviews carried out in 2021 on a sample selected in a purposeful manner. The respondents recognized that the pandemic had a significant impact on the way they function, in particular: the way they provide care (a feeling of greater burden due to limited institutional support and access to medical care), the need to function in virtual reality, an increase in the sense of exclusion, and the deterioration of mood resulting from both from personal experience and observation of the condition of the person under their care.
PL
Wybuch pandemii w znaczący sposób wpłynął na rzeczywistość społeczną, której obecna charakterystyka odnosi się przede wszystkim do nieprzewidywalności, permanentnej zmiany i trudności w określeniu działań pozwalających poradzić sobie z konsekwencjami występujących zagrożeń, zarówno na poziomie makro, jak i mikro. Sytuacja ta w sposób szczególny dotyka grup, które jeszcze przed wybuchem pandemii potrzebowały wsparcia. Jedną z nich stanowią opiekunowie domowi osób cierpiących na demencję. Celem artykułu jest przedstawienie sytuacji opiekunów domowych, związanej ze świadczeniem opieki na rzecz ich bliskich chorujących na demencję w kontekście pandemii. Opis dokonywany jest na podstawie danych pozyskanych w wywiadach swobodnych pogłębionych, zrealizowanych w 2021 roku na próbie dobranej w sposób celowy. Badani uznali, że pandemia w zdecydowany sposób wpłynęła na ich funkcjonowanie, w szczególności na sprawowanie opieki (poczucie większego obciążenia ze względu na ograniczenie wsparcia instytucjonalnego i dostępności do podmiotów medycznych), konieczność odnalezienia się w rzeczywistości wirtualnej, wzrost poczucia wykluczenia oraz pogorszenie nastroju wynikające zarówno z doświadczeń osobistych, jak i obserwacji stanu osoby pozostającej pod ich opieką.
EN
This paper refers to the problem of care, help and support in terms of persons with dementia and points the issue of compassion fatigue and long-term involvement of patient’s family. It presents some suggestions of the German educator and psychologist Janina Steurenthaler to develop a new geragogics discipline Dementagogik, that is pedagogy directed at people with dementia. In this paper the author pays a particular attention to the basic aims of pedagogy of persons with dementia as a subdiscipline of special geragogics, pointing to demographic changes and the increasing number of persons suffering dementia, both in a global scale and in Poland. This article also provides the discussion on recommendations of the World Health Organization and the European Union experts that are aimed at protection and support of elderly people with chronic issues and their caregivers. The paper ends with the basic tasks for the implementation of the pedagogy of people with dementia, as well as the final conclusion that the “dementagogics” emerged in the European Year of the Brain (2014) and presents a vision of promoting – in the time of globalization – a dementia-friendly society.
XX
Speech disorders, especially the lexical and semantic efficiencies, are the inseparable component of dementia clinical view. The test of lexical and semantic efficiency constitutes then the crucial aspect of speech therapy diagnosis in case of dementia. The reliable assessment of language efficiencies enables to obtain the information concerning the mental condition of elderly people, which conditions significantly the effective programming of speech therapy of patient suffering from the disorder of cognition in dementia. The diagnosis of lexical resource is included in the scope of interests of specialists in many branches, i.a. educationalists, psychologists and speech therapists, therefore this problem is considered from the different perspectives. The article aims at the brief characteristics of selected methods of lexical testing as well as the assessment of usefulness in speech therapy diagnosis of lexicographical tests in dementia, being widely applied in Poland and in the world. The principal part of the dissertation is dedicated to the description of authorial test structure to measure the lexical and semantic efficiency in people suffering from dementia which enables the speech therapy assessment of language behaviours in people with dementia.
EN
Dementia is a neurological condition manifested by reduced cognitive and psychological functioning, altered behaviour and decreased autonomy for social and professional performance in activities of daily living. Dementia is one of the most important causes of disability in the elderly. The number of dementia patients is increasing, as the population is growing older. Recent epidemiological evidence suggested a 2001 prevalence of 24.3 million cases of dementia worldwide. Alzheimer’s disease (AD) remains the most common cause of dementia, responsible for 60–70% of cases in Europe. There are 4.6 million new cases of dementia reported every year – that’s one new case every 7 seconds. Patients with AD gradually lose the ability to function independently and interest in life and many experience changes in personality, social withdrawal, uninhibited behaviour, and psychotic symptoms such as delusions, hallucinations and aggressive behaviour. The associated likely impact on the health and quality of life of persons with AD, their families, and societal healthcare and welfare resources, have led many authors to describe the condition as a “ticking bomb”. The depression prevalence in later life is 8 to 15%. Suicide in the elderly represents an immensely important and often overlooked medical problem. Based on its many distinct features, age-specifi c risk factors could be identifi ed. Proper diagnosis and treatment of affective disorders – contributing greatly to the pathogenesis of suicide in the elderly – could lead to a major decline in the suicide rate in this population.
19
Content available remote Solidarity in Healthcare – the Challenge of Dementia
75%
EN
Dementia will soon be ranked as the world’s largest economy. At present, it ranges from the 16th to 18th place, with countries such as Indonesia, the Netherlands, and Turkey. Dementia is not only a financial challenge, but also a philosophical one. It provokes a paradigm shift in the traditional view of healthcare and expands the classic concepts of human personhood and autonomy. A promising response to these challenges is the idea of cooperative solidarity. Cooperative solidarity, contrary to its ‘humanitarian’ version, promotes spontaneous teamwork and individual initiative. It obliges us not only to help 'the suffering, the troubled and the disadvantaged’, but above all to support those who already do so for spontaneous moral or affective reasons. In the field of dementia study, solidary initiatives are described within the framework of supportive care.
EN
Localization systems are an important component of Active and Assisted Living (AAL) platforms supporting persons with cognitive impairments. The paper presents a positioning system being a part of the platform developed within the IONIS European project. The system’s main function is providing the platform with data on user mobility and localization, which would be used to analyze his/her behavior and detect dementia wandering symptoms. An additional function of the system is localization of items, which are frequently misplaced by dementia sufferers. The paper includes a brief description of system’sarchitecture, design of anchor nodes and tags and exchange of data between devices.both localization algorithms for user and item positioning are also presented. Exemplary results illustrating the system’s capabilities are also included.
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