This thesis deals with effects of some chosen 7-methoxitacrine (7 MEOTA) analogues on enzymatic activity of acetylcholinesterase (AChE). 7-MEOTA is a derivative of tacrine, which had been used for symptomatic treatment of Alzheimer's disease (AD), until drugs with better therapeutic index were developed. 7-MEOTA the same way as tacrine therapeutically acts by inhibition of acetylcholinesterase and a neurotransmitter acetylcholine rise in the organism. It shows similar strength and type of inhibition, but it's less toxic contrary to tacrine. Some of the previously examined analogues of 7-MEOTA were as strong or even stronger AChE inhibitors than 7-MEOTA and so promising future medicaments. However, all the compounds analyzed in this thesis showed weaker enzymatic reaction inhibition and AChE affinity. For each of the examined compounds IC50, Ki and Ki' were calculated and AChE inhibition type was determined. All the 7 MEOTA analogues showed a mixed type of the inhibition. The theoretical part of this thesis deals with manifestations and origins of AD, its genetic factors etc. and tries to show some of the anthropological findings a theories connected with the theme. Powered by TCPDF (www.tcpdf.org)

Ce travail de thèse avait pour objectif principal de contribuer à une meilleure compréhension de la mémoire procédurale dans le vieillissement normal et pathologique. Plus spécifiquement, nous avons tenté de déterminer de manière plus précise limpact du mode dentraînement afin didentifier les conditions qui optimisent lacquisition de nouvelles habiletés dans le vieillissement normal et pathologique. Avant dexaminer plus précisément les implications de nos résultats sur les plans théorique et clinique, il convient tout dabord den faire un bref récapitulatif. LEtude 1 comportait un double objectif : (1) développer une épreuve évaluant lacquisition de nouvelles habiletés perceptivo-motrices qui serait facilement applicable dans un contexte clinique ; (2) étudier limpact du mode dentraînement sur lacquisition de ces nouvelles habiletés chez des sujets adultes. Dans cette perspective, nous avons créé une version informatisée du paradigme de dessin en miroir. Dans cette tâche, les sujets devaient parcourir des figures géométriques, le plus rapidement possible, à laide dune souris dordinateur inversée. Afin de poursuivre nos objectifs, trois expérimentations ont été menées. Dans lexpérience 1, deux types dentraînement étaient comparés : un entraînement constant et un entraînement variable. Nous pensions que ce dernier engendrerait de plus faibles performances durant la phase dacquisition, mais de meilleures performances lors de la phase test. Cependant, aucune différence de performance nest apparue entre les deux conditions. Nous avons, dès lors, supposé que cette absence de différence puisse être liée à la nature de linstruction donnée aux participants exigeant une grande rapidité. Ainsi, les sujets de la condition constante, parce quils réalisaient la tâche à la limite de leurs possibilités, se trouvaient de facto dans une condition comparable (en termes dinvestissement) à la condition variable. Dans lexpérience 2, une limitation de vitesse a été imposée sur les mêmes tâches afin de renforcer le contraste entre les conditions constante et variable. Cependant, aucune différence nest apparue entre les groupes. A nouveau, nous avons postulé que la méthodologie employée nétait pas en mesure de mettre en évidence une différence entre les modes dentraînement. En effet, durant lexpérimentation, il est apparu que les sujets des deux groupes commettaient de nombreuses erreurs engeandrant à leur tour un ralentissement du déplacement de la cible, obligeant donc les sujets à freiner et constamment contrôler leur mouvement. Par conséquent, il est possible que ce contrôle ait pu à nouveau rendre la condition constante comparable à la condition variable en termes dinvestissement cognitif. Nous avons dés lors proposé une nouvelle consigne durant la phase dacquisition de lexpérience 3 : réaliser le parcours en commettant le moins derreurs possible et sans contrainte de temps. Cette nouvelle adaptation na pas, une fois encore, permis de mettre en évidence de différence dapprentissage entre les diverses conditions dentraînement (constante, bloc et variable). Ces résultats suggèrent que la tâche de dessin en miroir informatisée était trop complexe pour mettre en avant un effet du mode dentraînement. LEtude 2 comportait également un double objectif : (1) créer une épreuve de lecture en miroir permettant dévaluer de manière plus précise lacquisition de nouvelles habiletés perceptivo-verbales ; (2) explorer plus spécifiquement ces capacités dans le vieillissement normal et dans la maladie dAlzheimer. En effet, après avoir remis en question la pertinence du paradigme de lecture en miroir de Cohen et Squire (1980), Masson (1986) a créé un nouveau paradigme mais navait, de façon étonnante, pas observé dapprentissage procédural chez des sujets jeunes. Dans ce contexte, nous avons apporté plusieurs modifications (lettres majuscules, non-mots, sens de lecture) à ce paradigme afin de le rendre plus efficace dans lévaluation de lapprentissage procédural. Ainsi, notre première expérience montre chez des sujets jeunes un apprentissage avec une amélioration des performances entre la phase dacquisition et la phase test tant pour des non-mots composés de lettres déjà traitées que pour des non-mots composés de nouvelles lettres encore jamais vues. Ces résultats suggéraient donc que la nouvelle version de cette tâche permettait dévaluer lapprentissage procédural et non plus un effet damorçage de répétition sur les lettres. Lors dune seconde expérience, nous avons donc mis à profit cette tâche pour évaluer lapprentissage de nouvelles habiletés perceptivo-verbales de manière plus fine et adaptée dans la maladie dAlzheimer. Les résultats ont mis en évidence un effet damorçage de répétition chez les patients et les sujets âgés de contrôle mais un apprentissage procédural uniquement chez les sujets âgés de contrôle. Cette incapacité pourrait remettre en question lidée générale selon laquelle lapprentissage procédural est généralement préservé dans cette pathologie. Toutefois, la difficulté des patients à acquérir cette habileté pourrait être liée à une trop grande variabilité de la tâche utilisée. Dès lors, administrer cette même épreuve selon un mode plus constant pourrait permettre aux patients, par une diminution du recours aux processus contrôlés, dacquérir cette habileté de lecture en miroir. Toujours dans le but dexplorer les capacités de mémoire procédurale dans le vieillissement pathologique, lEtude 3 a investigué cet aspect dans la démence à corps de Lewy (DCL). Bien quun intérêt grandissant est né pour cette pathologie depuis quelques années, aucune étude na jusquici tenté dy investiguer le statut de la mémoire procédurale. Les résultats ainsi obtenus montraient que les patients DCL, tout comme les sujets âgés, amélioraient leurs performances entre la phase dacquisition et la phase test tant pour les lettres déjà rencontrées que pour les nouvelles lettres. Dans lEtude 4, nous avons voulu déterminer si un mode dentraînement caractérisé par une plus faible variabilité, permettrait aux patients Alzheimer dacquérir lhabileté de lecture en miroir. Concrètement, cette étude comportait également un double objectif : (1) investiguer limpact du mode dentraînement (bloc versus variable) dans un domaine perceptivo-verbal chez des patients Alzheimer ; (2) tester lhypothèse selon laquelle un entraînement variable est caractérisé par un recours plus important au fonctionnement exécutif quun entraînement en bloc. Vingt-quatre patients Alzheimer ont été testés et deux conditions dentraînement ont été comparées. La condition en bloc consistait à présenter des non-mots construits avec une première série de lettres (série A) et ensuite présenter des non-mots avec une autre série de lettres (série B). En revanche, dans la pratique variable, lensemble des non-mots étaient construits avec des lettres appartenant aux séries A et B simultanément. Il est apparu que les patients issus de la condition en bloc lisaient les non-mots composés de nouvelles lettres significativement plus vite que le groupe variable, qui lui, na pas amélioré sa performance. De plus, nos résultats ont confirmé limplication du fonctionnement exécutif dans la pratique variable et non dans la pratique en bloc. Ces résultats montrent que des patients déficitaires sur le plan exécutif auront plus de difficultés à apprendre de nouvelles habiletés perceptivo-verbales au travers dun entraînement variable.

Dissertation title: Dancing and movement programme for seniors with specific needs. Dissertation objectives: The aim of the Dissertation is A) within the framework of a prospective study, to assess the dancing therapy influence on mobility, self-sufficiency, cognitive state, consumption of psycho-pharmaceutical drugs, depressiveness and quality of life of seniors in institutions. If a significant positive effect is proven, then B) to create an easy-to-implement dancing and movement programme for seniors in institutions with a special regard to seniors suffering of dementia and wheelchair-bound seniors who account for 60%-70% of inhabitants of old people's homes. Besides this, also to verify its efficiency on the health condition of seniors, improvement of quality of life, reduction of healthcare consumption, as well as on improvement of communication between clients and treatment staff. Method: A) The three-year prospective randomised controlled study made use of the method of quantitative and qualitative research. It was using the technique of analysis of questionnaire surveys (both ex-ante and ex-post) of intervention, comparison of development in the intervened and control groups, making of video records and their analysis, semi-structured interviews. B) Altogether 3 descriptive methodological...

The thesis focuses on care of clients with Alzheimer's, including the burden of family members and possible options of using services of a day care and a week care centre. The theoretical part of the thesis deals with Alzheimer's disease together with nursing care, health care system in the Czech Republic and possibility to use services of day care and week care centres. In the empirical part of the thesis the method of qualitative research was used. A non standardized interview was applied as a method of questioning. The results of the qualitative research clearly show that the care for clients with Alzheimer's dementia represents a major burden for family members who care for the ill and in connection with the care provided they have to tackle following problems. They have to cope with the gradual deterioration of memory of the ill, which is associated with occasional forgetfulness, disorientation, wandering around. Another problem is to handle in an acceptable way the change of behaviour of their loved ones who often attack them both verbally and physically. Family members help patients with feeding, emptying, hygiene and grooming. They must solve the difficulties with activation of patients including memory exercises, they watch whether the patients swallow the medication. The conclusions of the thesis show that family members have to deal with many above mentioned problems when providing care for their loved ones. They themselves are tired and exhausted due to the care they provide, which is related to the incidents of their own health problems. They neglect themselves and their families, it is difficult for them to coordinate the care with their job and often come to work sleepy. For these reasons they would like to use services of day care and week care centres. It eases them of the burden of care, which they see as a benefit. The research revealed the expected services of the day care centre including expected nursing care. The research results were presented to the management of the Aftercare Hospital in Humpolec as it had planned to open a day care centre for patients with Alzheimer's dementia. Furthermore, the results served as a basis for the seminar for potential applicants, who would like to work in the centre. Based on information obtained in the course of writing of the thesis, a draft of the brochure was created which would serve as information material for family members of clients with Alzheimer's including the patients themselves.

Alzheimer's Disease is a progressive, irreversible neurodegenerative illness and the most common of the dementing disorders. Only few diseases disrupt patients and their relatives so completely or for so long a period of time as Alzheimer 's. Caring is held to be very demanding and emotionally involving. Caregiver burden has been defined as a multidimensional response to emotional, social, physical, psychological, and financial stressors associated with the caregiving experience. The objective of the 1st study was to assess the degree of burden and its possible change in family caregivers of the long-term sick family member with progressive Alzheimer's disease during eight-month monitoring. In addition to the common psychiatric examination the Mini- Mental State Examination (MMSE) was administered in patients to indicate the severity of the dementia and the Zarit Burden Interview was administered in caregivers to assessed degree of burden. The total of 60 people have been examined - 30 patients with AD and 30 their caregivers (24 females, 6 males) were recruited from the Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague. At the beginning of the study there were 18 patients with mild stage of AD (60%), 11 patients suffered...

This thesis concentrates on the issues of both negative manifestation of adaptation syndrome and individual nursing care planning in elderly patients during their first days after the admission to the rest home.The theoretical part is engaged in the problems of process of adaptation and adaptation syndrome itself. The results of the research projectare presented in the practical part of the thesis.In the realization of this research there has been used such techniques and methods and as direct observation, analysis of the residents documentetion, the review of causation initiating into the issue of adaptation of a women client suffering the severe form of dementia.

The present thesis which focuses on the needs of people with dementia and the support of their independent living in the home environment was written within the framework of the PhD study in Longevity at the Faculty of Humanities, Charles University, GAČR project co- researcher and AZV participated in during post gradual studies. Presented research focuses on the needs of home dwelling people with dementia, the needs of their informal carers, the needs and experiences with providing care of patients with dementia in acute hospital care. The text of the thesis is divided into four parts, which are based on texts reviewed and published or prepared for publication. The first three parts present own research aimed at identifying the needs of people with dementia and experiences with caring of them in their home environment and in the hospital environment during acute care. The final part presents the possibilities and services to support their independent life in their own environment.

5 ABSTRACT This thesis is focused on examining quality and range of care services for people with dementia and their family carers in the region of Ústí. Through the testimony of nine respondents provides a view of social awareness about this diagnosis. It also focuses on providing information of possibilities of prevention, medical treatment and social care that is currently available. Last but not least it deals with possibilities of development of the services within this area. Key words: Alzheimer disease, dementia, social services, healtcare services, family care.

Dissertation title: Dancing and movement programme for seniors with specific needs. Dissertation objectives: The aim of the Dissertation is A) within the framework of a prospective study, to assess the dancing therapy influence on mobility, self-sufficiency, cognitive state, consumption of psycho-pharmaceutical drugs, depressiveness and quality of life of seniors in institutions. If a significant positive effect is proven, then B) to create an easy-to-implement dancing and movement programme for seniors in institutions with a special regard to seniors suffering of dementia and wheelchair-bound seniors who account for 60%-70% of inhabitants of old people's homes. Besides this, also to verify its efficiency on the health condition of seniors, improvement of quality of life, reduction of healthcare consumption, as well as on improvement of communication between clients and treatment staff. Method: A) The three-year prospective randomised controlled study made use of the method of quantitative and qualitative research. It was using the technique of analysis of questionnaire surveys (both ex-ante and ex-post) of intervention, comparison of development in the intervened and control groups, making of video records and their analysis, semi-structured interviews. B) Altogether 3 descriptive methodological...

This diploma thesis is focused on providing speech therapy intervention for seniors in residential facilities. The aim of this special pedagogical work is to show the problems in the communication of seniors and a possible support in the home for the elderly. The thesis has two parts. The theoretical part is divided into three chapters. In this part, secondary communication disorders observed among adults, selected diseases related to old age, the definition of old age and residential services for seniors are described. In the empirical part, the research, case studies and the results are obtained. The research is qualitative. The main goal was to analyze providing speech therapy intervention in the home for the elderly. Partial goals were to find out whether there would be a progress in the senior communication based on speech therapy intervention and to find out whether the support of home workers in cooperation with an expert can help in this regard as well. Another goal was to elaborate case studies. KEYWORDS Speech therapy intervention, senior, secondary communication disorder, dementia, Alzheimer's disease, Parkinson's disease, retirement home