Caregiver awareness of cerebrovascular risk of patients with dementia due to Alzheimer's disease in São Paulo, Brazil

Abstract

Background: Proper control of cerebrovascular risk is essential to prevent cognitive change in dementia due to Alzheimer's disease (AD). Objective: To investigate whether caregiver awareness to control cerebrovascular risk impacts the lifestyles of patients with AD. Methods: Consecutive outpatients with AD were assessed for demographic features, Clinical Dementia Rating scores, cerebrovascular risk, pharmacotherapy, dietary therapy and practice of physical activities. Patients and caregivers were inquired on awareness of the importance of measures to control cerebrovascular risk. Chi-square test was employed for statistics, significance at ρ < 0.05. Results: A total of 217 patients were included; whereas 149 caregivers (68.7%) were aware of the need to control cerebrovascular risk, only 11 patients (5.1%) simultaneously practiced physical activities and received pharmacological treatment and dietary therapy. Patients with hypertension and diabetes mellitus were more likely to receive dietary therapy (ρ = 0.007). Male patients were more engaged in physical activities (ρ = 0.018). Patients in earlier AD stages exercised (ρ = 0.0003) and received pharmacological treatment more often (ρ = 0.0072). Caregiver awareness of the need to control cerebrovascular risk was higher when patients had hypertension (ρ = 0.024) and/or hypercholesterolemia (ρ = 0.006), and influenced adherence to dietary therapy (ρ = 0.002) and to pharmacological treatment (ρ = 0.001). Discussion: Caregiver awareness of the need to control cerebrovascular risk has positive impacts for patients with AD.

Elderly caregiver: knowledge, attitudes and practices about falls and its prevention

“…A little more than half of the participants minimally know that the fall of the aged is a frequent event and that it is at risk, identifying some causes and consequences of falls and referring to certain measures to prevent them. This result is compatible with those of other studies in which the knowledge about fall prevention presented by informal elderly caregivers was incomplete or considered minimal (25) and superficial (26) .…”

“…In one of the studies, the results showed that less than a half of the caregivers (42.7%) reported having knowledge about how to reduce the occurrence of falls, and 48.3% considered that the prevention of the event is possible (25) . In another study, the authors found that the knowledge that caregivers had about the prevention of falls of the elderly was superficial because they had not received adequate guidance (26) .…”

Associations of Blood Pressure with Functional and Cognitive Changes in Patients with Alzheimer's Disease

“…These findings should alert physicians to allow mildly elevated BP levels in patients with AD, while caregiver awareness of measures to control cerebrovascular risk should be strengthened regarding such patients [38]. …”

Supporting self-care of long-term conditions in people with dementia: A systematic review

“…Reasons for scoring four out of five were not providing sufficient interpretation of qualitative results (Sadak et al, 2017). For studies that were rated three out of five reasons included lack of information about blinding or adherence to the intervention (Chen et al, 2017), lack of information on data source, collection and analysis (Brauner et al, 2000), incoherence between data collection, analysis and interpretation (Sadak et al, 2018) or due to inappropriate statistical analysis (De Oliveira et al, 2014). One case study scored two out of five for appropriateness of methodology for the research question (Allen et al, 2017).…”

“…No individuals with severe impairment practiced physical activity regularly, whereas people in the earlier stages of dementia used exercise as a treatment for diabetes or hypertension (De Oliveira et al, 2014).…”