BackgroundDuring the past decades, mortality from stroke decreased in many western European countries; however, changes concerning long‐term stroke mortality in eastern European countries are less evident.ObjectiveTo assess age‐ and gender‐specific trends in stroke mortality in Klaipeda (Lithuania) from 1994 to 2013.DesignDescriptive epidemiological study.Setting/subjectsPermanent population of Klaipeda.MethodsData on 2509 permanent residents of Klaipeda aged 35–79 years who died from stroke between 1994 and 2013 were gathered. Directly, age‐standardized (European population) stroke mortality rates were analyzed using joinpoint regression separately for specific age groups (35–64, 65–79, and 35–79 years) and by gender. Annual percentage change (APC) and 95% CIs were presented.ResultsStroke mortality in the 35‐ to 79‐year‐old age group peaked in 1994–1997, it then decreased by −9.9% (95% CI: −18.7, −0.2) yearly up until 2001 and leveled off by −0.2% (−5.1, 4.9) between 2001 and 2013. Among men aged 35–64 years, mortality decreased substantially by 12.8% (−21.5, −3.3) per year from 1994 to 2001 and turned positive by 6.3% (0.8, 12.1) between 2000 and 2013. Among women aged 35–64 years, mortality decreased significantly by 15.5% (−28.1, −0.7) from 1994 to 2000. There was evidence of recent plateauing of trends for 35‐ to 64‐year‐old women between 2000 and 2013. In the 65‐ to 79‐year‐old age group, mortality decreased from 1994 onward yearly by −5.5% (−7.9, −3.0) in women and by −3.3% (−5.6, −0.9) in men.ConclusionsJoinpoint regression revealed steadily decreasing trend in stroke mortality between 1994 and 2001. The decline in death rates flattened out in the recent decade. Mortality rates varied among age groups and were more pronounced in adults aged 35–64 years. It is essential to monitor and manage stroke risk factors, especially among middle‐aged population.

The objective of the study was to evaluate the trends in stroke mortality in the population of Klaipėda aged 35–79 years from 1994 to 2008. Material and Methods. Mortality data on all permanent residents of Klaipėda aged 35–79 years who died from stroke in 1994–2008 were gathered for the study. All death certificates of permanent residents of Klaipėda aged 35–79 years who died during 1994–2008 were examined in this study. The International Classification of Diseases (ICD-9 codes 430–436, and ICD-10 codes I60–I64) was used. Sex-specific mortality rates were standardized according to the Segi’s world population; all the mortality rates were calculated per 100 000 population per year. Trends in stroke mortality were estimated using log-linear regression models. Sex-specific mortality rates and trends were calculated for 3 age groups (35–79, 35–64, and 65–79 years). Results. During the entire study period (1994–2008), a marked decline in stroke mortality with a clear slowdown after 2002 was observed. The average annual percent changes in mortality rates for men and women aged 35–79 years were –4.6% (P=0.041) and –6.5% (P=0.002), respectively. From 1994 to 2002, the stroke mortality rate decreased consistently among both Klaipėda men and women aged 35–64 years (20.4% per year, P=0.002, and 14.7% per year, P=0.006, respectively) and in the elderly population aged 65–79 years (13.8% per year, P=0.005; and 12% per year, P=0.019). During 2003–2008, stroke mortality increased by 16.3% per year in middle-aged men (35–64 years), whereas among women (aged 35–64 and 65–79 years) and elderly men (aged 65–79 years), the age-adjusted mortality rate remained relatively unchanged. Conclusions. Among both men and women, the mortality rates from stroke sharply declined between 1994 and 2008 with a clear slowdown in the decline after 2002. Stroke mortality increased significantly among middle-aged men from 2003, while it remained without significant changes among women of the same age and both elderly men and women.

cancelled P2002The SERAD study: galantamine improves cognitive function in nursing home patients with severe Alzheimer's disease Background and aims: Data on cholinesterase inhibitor therapy of patients with severe Alzheimer's disease (AD) are limited. The SERAD study assessed the efficacy of galantamine on cognitive function and activities of daily living (ADL) in nursing home patients with severe AD. Methods: During a 6-month, double-blind, placebo-controlled phase of a multicentre study, galantamine was titrated from 8 to 24 mg/day, with subsequent reduction to 16 mg/day if necessary. The co-primary efficacy variables were cognitive function (Severe Impairment Battery [SIB]), and ADL (Minimum Data Set -Activities of Daily Living [MDS-ADL]), with efficacy analyses based on an intent-to-treat population with observed-case analysis at week 26. Results: 407 patients were enrolled, and 168/207 (81%) receiving galantamine and 160/200 (80%) receiving placebo completed 6 months of treatment. Mean SIB score improved by 1.9 in the galantamine group, vs. deterioration of 3.0 with placebo (p=0.006). Mean MDS-ADL scores worsened by 1.2 and 1.6 points in the galantamine and placebo groups, respectively (p=0.384). The most common adverse events were urinary tract infection (galantamine, 16%; placebo, 22%), vomiting (16% vs. 15%), diarrhoea (14% vs. 18%), nausea (12% vs. 6%) and fall (12% vs. 11%). Serious adverse events occurred in 18% and 21% of patients in the galantamine and placebo groups, respectively. 8 deaths (4%) occurred in the galantamine group and 21 (11%) in the placebo group (p=0.0012). Conclusion: In patients with severe AD, galantamine is well tolerated and associated with significant improvement in cognitive function, but not ADL, compared with placebo after 26 weeks of treatment. Aims:To investigate associations between dementia severity (MMSE), levels of CSF total-tau and p-tau181 and regional cerebral glucose metabolism measured with 18F-FDG-PET in brain regions typically affected by neurofibrillary tangle pathology in Alzheimer's disease (AD) patients. Methods: In 38 patients (mean age 66.5±8.0 years) with probable AD Mini-Mental State Examination (MMSE) scores were evaluated and CSF levels of t-tau and p-tau181 were measured. All patients received an 18FDG-PET scan under resting conditions. Image analysis (smoothing, normalization and automated VOI analysis to obtain regional values of glucose metabolism) were performed using the software "VINCI" (Volume Imaging in Neurological Research, Co-Registration and ROIs included). Results: No correlations were found between levels of CSF biomarkers and MMSE scores (t-tau: rP=-0.105, p=0.529; p-tau181: rP= -0.007, p=0.967). T-tau correlated only weakly with impairment of glucose metabolism in parietal cortex, amygdala and precentral gyrus and P-tau181 did not correlate at all. Several correlations were detectable between MMSE and reduced glucose metabolism in precuneus, posterior cingulate, parietal and occipital cortex as well as in medial and inferior temporal ...

Research background. According to the statistics, every fourth resident of Lithuania complains of rheumatic malaise. Rheumatoid arthritis is the most serious disorder of rheumatic diseases. Reduced joint flexibility, joint deformities, and the surrounding muscles atrophy is one of the worst effects of RA. They affect self-care, productivity and leisure activities of the persons. For these reasons it is crucial for the persons with rheumatoid arthritis to be aware of possible harmful and dangerous aspects of their e daily life activities as well as the necessity of self-dependence. The aim of the research was to evaluate the knowledge of persons with rheumatoid arthritis about the joint protection during the exacerbations and remissions of the disease. Methods. The research involved 30 Kaunas city “Arthritis” club members with rheumatoid arthritis. Average age of respondents was 69.9 ± 0.9 years. The study was supported by a questionnaire, which included 29 questions. In order to protect their privacy, the patients were interviewed anonymously. Results. The research results showed which joint protection principles were best know and worst by the patients with RA. The study provided data about the behaviours of respondents in daily life activities protecting their joints of disease exacerbation and remission. Conclusions. It became clear that patients with rheumatoid arthritis had little knowledge about the possible ways of substitution of the injured joints, work and relaxation regimens, preservation of energy, joint mobility and stability and the use of technical rehabilitation devices. Persons with rheumatoid arthritis often avoided various activities during the exacerbation of the disease as well as they did not take care of their joints during the remission of the disease.Keywords: rheumatoid arthritis, joint protection, occupational therapy.