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Biomedical subjects

E Scherder

Publications and source records attributed to E Scherder.

6 recordsLinked to original sources
PubMed2006

Cardiovascular risk factors in cognitively impaired nursing home patients: a relationship with pain?

Cardiovascular risk factors (CRF) such as hypertension and diabetes mellitus favour the development of both vascular dementia (VaD) and Alzheimer's disease (AD). The resulting deafferentation may increase the experience of pain in VaD and in AD. The goal of the present study was to examine the relationship between CRF and pain in a sample of 107 cognitively impaired nursing home patients who had also a chronic pain condition. The prevalence of pain in patients with hypertension or diabetes mellitus was higher (25/41=61% of them had pain) than those without diabetes or hypertension (of whom 24/66=36.4% had pain, p=0.017). In a multivariate logistic regression model (adjusted for gender, age and depression) the presence of diabetes or hypertension was a risk indicator for pain: odds ratio: 3.48, p=0.005, 95% CI: 1.45-8.38. This finding supports the hypothesis that as a result of CRF, disruptions of cortico-cortico and cortico-subcortical pathways occur, and consequently, enhances pain in this group of patients.

Age Distribution↗
PubMed2005

[Is the Activities-specific Balance Confidence Scale suitable for Dutch older persons living in the community?].

BACKGROUND: In ageing populations fear of falling is an important issue. International studies and collaborations require scales suitable to more cultures. Scales developed in one culture require adaptation and additional investigation of psychometric properties for use in other countries. OBJECTIVE: To investigate the psychometric properties of a Dutch version of the Activities-specific Balance Confidence scale (ABC-NL) and whether adding questions about complex/dual tasks improves the discriminatory power. METHOD: Subjects were 106 men and 140 women aged 65-92 years. Measures were the 16-item ABC-NL and seven additional more complex items, fall history, general and physical self-efficacy, a functional reach test and a balance platform test. RESULTS: The ABC-NL had a weak ceiling effect. Internal consistency (Cronbachs alpha) was high. The relationship between ABC-NL and physical self-efficacy was significantly stronger than between the ABC-NL and general self-efficacy. Relationships with performance-based measures of balance were moderate. Differences between fallers and non-fallers and between activity avoiders and non-avoiders were significant. Adding questions about complex tasks hardly improved discriminatory power, reliability and validity. CONCLUSION: Psychometric properties of the ABC-NL were satisfactory. Further research is needed for use in high-functioning older persons.

Accidental Falls↗
PubMed1999

Alzheimer patients report less pain intensity and pain affect than non-demented elderly.

Pain assessment for patients with Alzheimer's disease (AD) is generally aimed at quantifying pain, i.e., the intensity and locations of pain. Based on the extensive neuropathology in limbic brain areas with this disorder, we hypothesized that, compared to control patients, AD patients would report an additional loss of qualitative aspects of pain, i.e., pain affect. This hypothesis was tested by administering specific parts of three pain questionnaires and comparing the use of analgesics in 19 AD patients with that of 18 elderly patients without dementia who were matched for the presence of painful conditions. Results reveal that AD patients, compared to controls, experience less intense pain and less pain affect. In contrast, the number of AD patients using analgesics did not differ from the number of controls. These findings suggest that pain assessment for patients with AD should be focused on both quantitative and qualitative aspects of pain.

Affect↗
PubMed1997

[Peripheral nerve stimulation in Alzheimer's disease].

The "use it or lose it' concept implies that stimulation of neurons might stop degenerative activities and initiate regenerative processes in aging and Alzheimer's disease (AD). Based on this concept, the effects of Transcutaneous Electrical Nerve Stimulation (TENS), tactile stimulation, and a combination of the two on memory and affective behaviour of AD patients were examined. The results suggest that, compared to AD patients of the control group, patients of the experimental group improved in visual short-term memory, verbal and visual long-term memory, and verbal fluency. Moreover, stimulated AD patients participated more independently in activities of daily life and their affective behaviour improved. As in those studies the therapist was present during the peripheral stimulation of the experimental group and the sham stimulation of the control group, interpersonal communication alone could not explain the treatment effects. However, a positive effect of the combination of TENS with personal interpersonal communication could not be excluded. Consequently, it was examined whether TENS, in the absence of the therapist, could also have a beneficial influence on the cognitive and behavioural functioning of AD patients. In addition, it was investigated whether TENS had a positive effect on the rest-activity rhythm of AD-patients. The results show that improvements in visual short- and long-term memory, verbal long-term memory, and verbal fluency are solely due to the peripheral stimulus itself. Furthermore, the independent and affective functioning of both the experimental and control group appeared to relatively improve by interpersonal communication. Moreover, the rest-activity rhythm of stimulated AD-patients improved. Peripheral nerve stimulation in AD might thus become a new treatment strategy to improve patients' quality of life.

Activities of Daily Living↗
PubMedDate not supplied

Repeated pain assessment in Alzheimer's disease.

In previous studies, patients with probable Alzheimer's disease (AD) have indicated that they experienced less pain intensity and affect from their painful conditions than nondemented elderly persons. However, in those studies, pain assessment occurred only once. Therefore, it may be possible that pain which had occurred, for example, a day earlier, could have been forgotten. Therefore, in the present study, AD patients' pain was assessed daily, i.e. once a day and even three times a day, during a longer period. The results parallel those of earlier studies, i.e. compared to elderly persons without dementia, AD patients appear to perceive less pain intensity and pain affect. These findings support the hypothesis that AD is characterized by an alteration in pain experience.

Aged↗