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      Clinical Aspects of Foot Health in Individuals with Alzheimer’s Disease

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          Abstract

          Alzheimer’s disease (AD) shows a marked presence of physiologic changes and the start or aggravation of underlying diseases such as physical frailty in diverse anatomical regions. It is believed to have a particularly harmful effect on the health of the foot. We examined the foot health status in older persons with AD, with a specific focus on the extent to which people with AD may be using inadequate footwear in old age. Seventy-three community-dwelling people with probable, mild to moderate AD aged 65–95 years were recruited from a center of excellence for AD. A single trained physician evaluated health status and foot conditions. Current shoe and foot length and width measurements were taken using a calibrated Brannock device. The results indicate that sixty-five participants (89.04%) suffered from feet problems. Also, only twenty-two subjects (30.14%) used the correct shoes in width and size related with the morphology of their feet. Fifty-one participants (69.86%) were using incorrect shoes in length or width. The present study revealed that peoples with AD had a high presence of foot health problems. Also, the use of inappropriate shoes revealed measurable differences of association between shoe size and the morphology of the foot.

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          Most cited references15

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          Prevalence of Dementia in the United States: The Aging, Demographics, and Memory Study

          Aim: To estimate the prevalence of Alzheimer’s disease (AD) and other dementias in the USA using a nationally representative sample. Methods: The Aging, Demographics, and Memory Study sample was composed of 856 individuals aged 71 years and older from the nationally representative Health and Retirement Study (HRS) who were evaluated for dementia using a comprehensive in-home assessment. An expert consensus panel used this information to assign a diagnosis of normal cognition, cognitive impairment but not demented, or dementia (and dementia subtype). Using sampling weights derived from the HRS, we estimated the national prevalence of dementia, AD and vascular dementia by age and gender. Results: The prevalence of dementia among individuals aged 71 and older was 13.9%, comprising about 3.4 million individuals in the USA in 2002. The corresponding values for AD were 9.7% and 2.4 million individuals. Dementia prevalence increased with age, from 5.0% of those aged 71–79 years to 37.4% of those aged 90 and older. Conclusions: Dementia prevalence estimates from this first nationally representative population-based study of dementia in the USA to include subjects from all regions of the country can provide essential information for effective planning for the impending healthcare needs of the large and increasing number of individuals at risk for dementia as our population ages.
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            Incidence of dementia and major subtypes in Europe: A collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group.

            The authors examined the association of incident dementia and subtypes with age, sex, and geographic area in Europe. Incidence data from eight population-based studies carried out in seven European countries were compared and pooled. The pooled data included 835 mild to severe dementia cases and 42,996 person-years of follow-up. In all studies a higher proportion of cases were diagnosed with AD (60 to 70% of all demented cases) than vascular dementia (VaD). The incidence of dementia and AD continued to increase with age up to age 85 years, after which rates increased in women but not men. There was a large variation in VaD incidence across studies. In the pooled analysis, the incidence rates increased with age without any substantial difference between men and women. Surprisingly, higher incidence rates of dementia and AD were found in the very old in northwest countries than in southern countries. This study confirms that AD is the most frequent dementing disorder in all ages, and that there is a higher incidence of dementia, specifically AD, in women than men among the very old. Finally, there may be regional differences in dementia incidence.
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              Stroke rehabilitation: analysis of repeated Barthel index measures.

              Functional abilities of stroke patients in a rehabilitation hospital are recorded every 2 weeks using the Barthel index. For purposes of this study, data were collected retrospectively and prospectively from consecutive records according to predetermined criteria on forms coded for computer analysis. Total scores of 110 patients were correlated with length of stay, placement at discharge and scores in individual functional abilities. Analysis of the data reveals that an initial score over 40 on the Barthel index defines a population with a greater proportion of discharges to home and that patients with initial scores over 60 have a shorter length of stay. Further analysis indicates a predictable progression in the development of functional skills in this population so that with a Barthel score below 40, no one was independent in the mobility skills and fewer than 50% were independent in the very basic skills, such as feeding, grooming and sphincter control. A score of 60 appears to be a pivotal score where patients move from dependency to assisted independence.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                07 February 2018
                February 2018
                : 15
                : 2
                : 286
                Affiliations
                [1 ]Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, 15403 Ferrol, Spain; daniellopez@ 123456udc.es (D.L.-L.); martagrela95@ 123456gmail.com (M.G.-F.)
                [2 ]Faculty of Health Sciences, Universidad Rey Juan, 28922 Carlos, Spain; marta.losa@ 123456urjc.es
                [3 ]Nursing and Physical Therapy Department, Institute of Biomedicine (IBIOMED), Universidad de León, 24401 Ponferrada, Spain
                [4 ]Research Group, Faculty of Health, Exercise and Sport, European University of Madrid, 28670 Villaviciosa de Odón, Spain; davidrodriguezsanz@ 123456gmail.com
                [5 ]University Center of Plasencia, Universidad de Extremadura, 06071 Badajoz, Spain; patibiom@ 123456unex.es
                [6 ]School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; ribebeva@ 123456ucm.es
                Author notes
                [* ]Correspondence: ccall@ 123456unileon.es ; Tel.: +34-98744 (ext. 2053)
                [†]

                All authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0002-9818-6290
                https://orcid.org/0000-0002-6569-1311
                https://orcid.org/0000-0003-3821-949X
                https://orcid.org/0000-0003-1568-7602
                Article
                ijerph-15-00286
                10.3390/ijerph15020286
                5858355
                29414905
                564508bd-2d0e-4eb4-a587-0d19b63976e7
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 10 January 2018
                : 04 February 2018
                Categories
                Article

                Public health
                alzheimer’s disease,foot diseases,joint flexibility,musculoskeletal system,shoes
                Public health
                alzheimer’s disease, foot diseases, joint flexibility, musculoskeletal system, shoes

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