As the number of patients suffering from dementia is still growing, most of the patients display behavioral symptoms at some time during the disease and these behavioral symptoms lower the quality... Show moreAs the number of patients suffering from dementia is still growing, most of the patients display behavioral symptoms at some time during the disease and these behavioral symptoms lower the quality of life and increase the burden of caregivers, adequate management of these symptoms is warranted. However, the etiology and management of behavioral symptoms is complex, resulting in (mis)use of pharmacological interventions: a cure which is often worse than the disease. In healthy adults, caffeine is known to influence behavior. Four different studies were conducted to see if caffeine is an easy to adjust cause or a pragmatic intervention for behavioral symptoms in patients with dementia. Based on these studies, we conclude caffeine can influence behavior in persons with dementia, but most likely not in all persons, not in all situations and not all of the time; but it can have an influence. In clinical practice it is advisable to consider caffeine as a possible moderator in the clinical assessment of behavioral symptoms in persons with dementia. Show less
Objectiv(e): To investigate the relationship between Alzheimer's disease biomarkers and neuropsychiatric symptoms. Methods: Data from two large cohort studies, the Dutch Parelsnoer Institute -... Show moreObjectiv(e): To investigate the relationship between Alzheimer's disease biomarkers and neuropsychiatric symptoms. Methods: Data from two large cohort studies, the Dutch Parelsnoer Institute - Neurodegenerative Diseases and the Alzheimer's Disease Neuroimaging Initiative was used, including subjects with subjective cognitive decline (N= 650), mild cognitive impairment (N = 887), and Alzheimer's disease dementia (N = 626). Cerebrospinal fluid (CSF) levels of A beta(42), t-tau, p-tau, and hippocampal volume were associated with neuropsychiatric symptoms (measured with the Neuropsychiatric Inventory) using multiple logistic regression analyses. The effect of the Mini-Mental State Examination (as proxy for cognitive functioning) on these relationships was assessed with mediation analyses. Results: Alzheimer's disease biomarkers were not associated with depression, agitation, irritability, and sleep disturbances. Lower levels of CSF A beta(42), higher levels of t- and p-tau were associated with presence of anxiety. Lower levels of CSF A beta(42) and smaller hippocampal volumes were associated with presence of apathy. All associations were mediated by cognitive functioning. Conclusion: The association between Alzheimer's disease pathology and anxiety and apathy is partly due to impairment in cognitive functioning. Show less
The aim of this thesis was to get a better understanding of the incidence and course of neuropsychiatric symptoms in HD, particularly irritability that is a core behavioral symptoms. Also, we aimed... Show moreThe aim of this thesis was to get a better understanding of the incidence and course of neuropsychiatric symptoms in HD, particularly irritability that is a core behavioral symptoms. Also, we aimed to investigate the realtionship between activity of the immune system and presence of neuropsychiatric symptoms. In this thesis, the psychometric properties of the Irritability Scale, and cross sectional and longitudinal analyses of irritability are described. The role of the innate immune system was investigated using both plasma acute-phase proteins and cytokines. Show less
Bouwens, J.A.; Duijn, E. van; Cobbaert, C.M.; Roos, R.A.C.; Mast, R.C. van der; Giltay, E.J. 2016
This thesis addressed two different aspects of the care for SLE patients. In the first part, issues concerning health care delivery to this special group of patients were evaluated. In the second... Show moreThis thesis addressed two different aspects of the care for SLE patients. In the first part, issues concerning health care delivery to this special group of patients were evaluated. In the second part, studies were described that concern a specific manifestation of the disease: neuropsychiatric symptoms. Show less
Bouwens, J.A.; Hubers, A.A.M.; Duijn, E. van; Cobbaert, C.M.; Roos, R.A.C.; Mast, R.C. van der; Giltay, E.J. 2014
