Trial Design and Sample Size
The main outcome of this Prospective Cohort Study is incidence of dementia in subjects with Parkinson’s disease.
An estimated sample size of 235 study subjects across two centers in Hawaii and Massachusetts is foreseen. This sample size was selected based on the literature, and standard statistics charts showing an effect size, E/S = 0.30, α = 0.050, and β = 0.100, and at a power = 0.900. It is envisaged that there will be a total of 117 study subjects at the center in Hawaii and 118 study subjects at the center in Massachusetts. An effect size > 0.10 was chosen in order to detect a meaningful magnitude of the association of coffee consumption with the incidence of PDD in the population. A large enough sample
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It is expected that those who will not be exposed to dementia will be more than 50% greater than those subjects who will have dementia. To detect the presence or absence of dementia in study subjects, MMSE scores will be used. Study subjects will be evaluated for signs/no signs of dementia every six months for five years. In the interim, consideration will be given to those study subjects who either die during the study or opted out of the study for personal reasons. For events of these types happening, the statistical analyses will be adjusted accordingly to accommodate them. The final statistical analysis will be performed after a five- year continuous observation or after a significant and measurable effect in cognition is …show more content…
•By making sure that the participation is based on voluntary and fully informed consent.
•The interviewer will secure the written Informed Consent, and Boston University IRB will review it.
•The Protocol will be reviewed by Boston University IRB.
• Subjects who are dependent on others, they can be affected by coercion of undue influence.
EXPECTED PROJECT CHALLENGES:
Long time of study is a challenge.
Follow-up with all participants and ensuring minimum loss to follow- up is challenging, especially when considering age and mortality rate of Parkinson disease population.
Participants may move from one group to other( exposed vs. unexposed) during the study period.
Participants who have a long history of chronic conditions like diabetes, high cholesterol and who develop strokes during study cannot be diagnosed with dementia due to Parkinson disease with certainty. It may well be that they have underlying multi-infarct dementia, and neither can be diagnosed with certainty.
During study follow-up some participants are likely to deteriorate which will require assesment of their
If you eat unhealthy, fatty foods your whole life, you have a higher risk of developing diabetes, cardiovascular disease, or arteriosclerosis. If you have unprotected sex, you may contract a sexually transmitted disease, such as syphilis, gonorrhea, or HIV/AIDS. But, Parkinson’s doesn’t racially discriminate, nor does it care if someone is wealthy, poor, educated, non-educated, male or female. Anyone can develop Parkinson’s disease. The disease begins in the brain, our most intricate, delicate organ, whose complexity is still not entirely understood, even with today’s technology and experts. The brain intrigues me. I find myself curious about brain
The major component shared by both Parkinson’s disease and dementia is the functioning of neurons, with a then understandable association. Dementia is caused by neuron demise or diminished capacity of communication with other cells, while Parkinson’s disease, neurons in the basal ganglia experience deterioration that disrupts the normal neurotransmitter dopamine balance where neurons waste and die. With this shared neuron deterioration, the prevalence of dementia associated with Parkinson’s disease is clearly understood. One-third of all patients with Parkinson’s disease will display dementia (LeMone, Burke, & Bauldoff, 2011) with indicators identical to Alzheimer’s form of dementia.
With dementia being so complex, there are several types. Senile dementia is the most common with it exhibiting its self within twenty percent of people over the age of sixty-five. It has been defined as a “clinically important intellectual impairment” (World Book, Inc., 2015). Vascular dementia is another common form in which it lends itself to over ten percent of patients over the age of sixty-five and is a precipitate by interference with the blood flow frequenting to the brain (Hamdy, Hamdy, Hudgins, & Piotrowski, 2014). Multi-infarct dementia (MID) is the most common type of vascular dementia. The onset of multi-infarct dementia is usually sudden and is the
Many may not know Parkinson’s disease is the second most common neurodegenerative disorder in the world. This disease is most seen in the elderly starting at 62 years of age although, younger individuals can still have the disease it isn’t common. Parkinson’s make it difficult for its victims to carry out everyday activities that might have once been easy for them. As the disease progresses it makes it hard for the patient to do things like walk, stand, swallow and speak. A great deal of people don’t realize how helpful therapy can be when dealing with such disease!
Parkinson’s disease, a type of dementia also known as idiopathic or primary parkinsonism, paralysis agitans, or hypokinetic rigid syndrome/HRS, is on the rise in the U.S. Each year there are over 60,000 new cases in the U.S. alone. With the average person diagnosed with Parkinson’s disease over the age of 65 and America’s rapidly growing elderly population, awareness and concern are becoming significant points of interest for many healthcare professionals.
Alzheimer’s disease and Parkinson’s disease are two common illnesses with the older people. Both affects the elderly in different ways but share many common traits such as similarity with its signs and symptoms. It targets the elderly and affects a major percentage of aging adults. According to Whiteman (2013), “Scientists have discovered biological mechanisms that may link Parkinson's disease to Alzheimer's disease.” These two diseases affect the brain and cause degeneration and target the nerve cells in the brain.
Advancing age remains the single most important risk factor for developing dementia (Luengo-Fernandex, Leal, Gray 2010). It is estimated that there are currently over 46 million people living with dementia worldwide (World Alzheimer Report 2015), with a total of 835,000 people living with dementia in the UK alone (Alzheimer 's Society, 2014). Dementia is a major cause of disability for older people (WHO, Dementia - A Public Health Priority 2012). Dementia also remains a greatest challenge for the society and has a huge economic impact on the health care system, people with dementia and their families (Dowrick 2014).
Alzheimer’s disease primarily affects memory. In advanced stages, the disease also impairs motor functions. Parkinson’s disease primarily affects movement and coordination. In advanced stages, it may impair memory and other cognitive functions. There were significant psychiatric differences between patients with Alzheimer's disease and demented patients with Parkinson's disease (Rosen,
Disease risks are uprising and are showing differences in specific sexes. Most clinical trials have a majority of female participants. A clinical trail done in March 2007 and May 2010 of early treated Parkinson’s disease severity; scientist gathered and compared research from male and female candidates. The research contained collected data information of the age at which one was diagnosed, symptoms at diagnosis, and
Parkinson’s disease is a chronic neurodegenerative disorder characterized by degeneration and cell loss of the substantia nigra, which causes disturbances of voluntary motor control [5]. It impairs ones ability to produce movements and is commonly associated with difficulties of daily living. Parkinson’s disease (PD) affects approximately 1.5% to 2.0% of the population over the age of sixty years old [2] and “… it is estimated that 6 million individuals worldwide are currently living with PD,” [7] (pg323). Parkinson’s sufferers often experience physical distress and an altered quality of life.
The cutoff score of 80 points or below is indicative of dementia symptoms in PDD. Several disease specific instruments exist such as the Mini-Mental-Parkinson (MMP), the Scales for Outcomes of Parkinson’s Disease – Cognitions (SCOPA-Cog), the Parkinson’s Neuropsychometric Dementia Assessment (PANDA), the Parkinson’s Disease Cognitive Rating Scale (PD-SRS), and Non-Motor Symptom Assessment Scale for Parkinson’s Disease (N-MSASPD). All of these instruments are promising and useful; however, their validity is limited because they were validated on very small samples. As a result, future research on the sensitivity and specificity of such instruments for identifying PDD is required (Martinez‐Martin et al.; 2015; Ravdin & Katzen,
Parkinson’s disease has a major impact on the quality of life of the patient. As the disease progresses, the symptoms will eventually inhibit patients from performing typical daily activities such as walking, writing, and swallowing. With such an effect on daily life, it is important for those who have Parkinson’s disease to manage their symptoms effectively. The symptoms of Parkinson’s disease can be managed using medication such as Levodopa, physical therapy, or even deep brain stimulation. These treatments are very beneficial, but rely on the correct diagnosis. There currently is not a definitive cause of Parkinson’s disease, only speculation as to what causes the disease. Since there is no definitive cause, there is no truly conclusive test to lead to an irrefutable diagnosis of Parkinson’s disease. This indicates that the diagnosis of Parkinson’s disease is reliant on the knowledge of the physician
Parkinson’s disease is a progressive loss of functioning of the brain that results in stiffness, trembling and loss of fine motor control. This disease mainly affects the neurons in the particular area called the substantia nigra with a total loss of dopamine, the absence of these dopamine-producing cells causes the loss of the brain’s ability to control the body movements progressively ("Parkinson’s disease", 2016). Parkinson’s disease is very common, with about 70000 Australians as well as the average age of diagnosis is 65 years, however, upcoming generations can also be diagnosed with Parkinson’s. It is also not easy to analyze Parkinson’s as there is no laboratory test, but a neurologist can make the diagnosis of this disease ("What is Parkinson 's", 2016). John Magill has a case of Parkinson’s disease before 5 years and after having a fall at home, he was admitted to the hospital and was recognised as having a generalised tremor and decrease in mobility. This essay aims to provide the risk factors, clinical manifestation, medical managements, holistic nursing care plan and discharge plan for John Magill.
Parkinson Disease is change in the region that affects the brain which deals with the key point of movement. With the changes in Parkinson disease it gradually spread and then affect the mental functions such as memory, the ability to pay attention and make sound judgements. Dementia is an abnormal microscopic deposit composed chiefly of alpha-synuclein. Dementia is a protein that’s found widely in the brain research haven’t found their normal function yet. Lewy bodies is a deposit that are found in several other brain disorders. Expert are saying that Parkinson’s disease may be linked to the same underlying
Parkinson’s Disease (PD) is a progressive neurodegenerative movement disease affecting approximately 1% of people at age 60. It is the most second most commonly occurring neurodegenerative disease in the elderly (after Alzheimer’s Disease). In PD patients, loss of dopamine-producing neurons results in a range of motor and non-motor symptoms. The prevalence of PD increases with age, and currently there is no cure, no means of slowing the disease progression, and no means of prevention.