Rivastigmine in the Treatment of Hypersexuality in Alzheimer Disease
Inappropriate sexual behaviors (ISB) represent uncommon and often misdiagnosed clinical disorders among patients with Alzheimer disease. So far, no randomized clinical trials regarding the treatment of ISB in demented people have been conducted, but available data from case series and isolated case reports suggest the efficacy of selective serotonin reuptake inhibitors (SSRIs), antipsychotics, antiandrogens, and H2-receptor antagonists. Controversial data exist on the therapeutic influence of cholinesterase inhibitors on sexual disorders. In the present article, we describe the case of an Alzheimer disease patient presenti...
Source: Alzheimer Disease and Associated Disorders - July 1, 2013 Category: Geriatrics Tags: Case Report Source Type: research

Extrapyramidal Signs by Dementia Severity in Alzheimer Disease and Dementia With Lewy Bodies
Alzheimer disease (AD) and dementia with Lewy bodies (DLB) are common etiologies of dementia with overlapping clinical features. Our objective was to determine which extrapyramidal signs (EPSs) are most helpful in identifying DLB. We analyzed data from the National Alzheimer’s Coordinating Center, including demographics, Unified Parkinson’s Disease Rating Scale (UPDRS) scores, Mini-Mental State Examination (MMSE) scores, and clinical diagnosis. The subjects were divided into 3 groups: AD, DLB, or Lewy body variant (LBV). The UPDRS motor scores were totaled and analyzed within and across the MMSE strata using re...
Source: Alzheimer Disease and Associated Disorders - July 1, 2013 Category: Geriatrics Tags: Original Articles Source Type: research

Evaluation of Plasma Proteomic Data for Alzheimer Disease State Classification and for the Prediction of Progression From Mild Cognitive Impairment to Alzheimer Disease
In this study, we performed a multivariate analysis of 146 plasma analytes (the Human DiscoveryMAP v 1.0 from Rules-Based Medicine) in 527 subjects with AD, mild cognitive impairment (MCI), or cognitively normal elderly subjects from the Alzheimer’s Disease Neuroimaging Initiative database. We identified 4 different proteomic signatures, each using 5 to 14 analytes, that differentiate AD from control patients with sensitivity and specificity ranging from 74% to 85%. Five analytes were common to all 4 signatures: apolipoprotein A-II, apolipoprotein E, serum glutamic oxaloacetic transaminase, α-1-microglobulin, a...
Source: Alzheimer Disease and Associated Disorders - July 1, 2013 Category: Geriatrics Tags: Original Articles Source Type: research

Combining Direct and Proxy Assessments to Reduce Attrition Bias in a Longitudinal Study
Retaining severely impaired individuals poses a major challenge in longitudinal studies of determinants of dementia or memory decline. In the Health and Retirement Study (HRS), participants complete direct memory assessments biennially until they are too impaired to complete the interview. Thereafter, proxy informants, typically spouses, assess the subject’s memory and cognitive function using standardized instruments. Because there is no common scale for direct memory assessments and proxy assessments, proxy reports are often excluded from longitudinal analyses. The Aging, Demographics, and Memory Study (ADAMS) impl...
Source: Alzheimer Disease and Associated Disorders - July 1, 2013 Category: Geriatrics Tags: Original Articles Source Type: research

Rivastigmine Patch Ameliorates Depression in Mild AD: Preliminary Evidence From a 6-Month Open-label Observational Study
Here we investigated the effect of the rivastigmine patch alone on depression in 50 mild Alzheimer's Disease (AD) patients with comorbid major depressive episode (MDE). First diagnosis acetyl-cholinesterase inhibitor and psychoactive drug-free outpatients (n=50) were recruited in memory clinics and reassessed after 3 and 6 months. Global cognitive functioning, depressive symptoms and MDE frequency were evaluated with the Mini Mental State Examination, the CERAD Dysphoria scale and the modified DSM-IV criteria for MDE in AD. MDE frequency reduced significantly from the first diagnostic visit (100%) to the 6-month follow-up ...
Source: Alzheimer Disease and Associated Disorders - July 1, 2013 Category: Geriatrics Tags: Brief Report Source Type: research

Is There Evidence for Cognitive Intervention in Alzheimer Disease? A Systematic Review of Efficacy, Feasibility, and Cost-Effectiveness
Several studies have shown that cognitive intervention may be beneficial for people with Alzheimer disease (AD), but literature reviews conducted so far, have yielded mixed and inconclusive results. In this work, through an extensive bibliographic search, we aim: (1) to analyze the efficacy of cognitive intervention in patients diagnosed with AD; (2) to provide an estimate of the feasibility of cognitive intervention; and (3) to review available cost-effectiveness data of this approach. Four randomized controlled trials of cognitive intervention, for patients diagnosed with AD that incorporated cognitive intervention and m...
Source: Alzheimer Disease and Associated Disorders - July 1, 2013 Category: Geriatrics Tags: Review Article Source Type: research

Proinflammatory Cytokines and the Clinical Features of Dementia With Lewy Bodies.
Authors: Clough Z, Jeyapaul P, Zotova E, Holmes C PMID: 23792923 [PubMed - as supplied by publisher] (Source: Alzheimer Disease and Associated Disorders)
Source: Alzheimer Disease and Associated Disorders - June 25, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

A Case of Globular Glial Tauopathy Presenting Clinically as Alzheimer Disease.
Authors: Santacruz KS, Rottunda SJ, Meints JP, Bearer EL, Bigio EH, McCarten JR PMID: 23751368 [PubMed - as supplied by publisher] (Source: Alzheimer Disease and Associated Disorders)
Source: Alzheimer Disease and Associated Disorders - June 12, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

The Red Cell Distribution Width and Anemia in Association With Prevalent Dementia.
Authors: Weuve J, Mendes de Leon CF, Bennett DA, Dong X, Evans DA Abstract The red cell distribution width (RDW), a measure of anisocytosis, independently predicts cardiovascular disease outcomes and chronic disease mortality. Little is known about the RDW, or the interplay between RDW and anemia, in relation to dementia risk. We evaluated the association between the RDW and prevalent dementia, overall and by anemia status, among 2556 community-dwelling older adults participating in the Chicago Health and Aging Project. RDW measurements came from complete blood counts, and participants underwent diagnosis for demen...
Source: Alzheimer Disease and Associated Disorders - June 12, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Need for and Challenges Facing Functional Communication as Outcome Parameter in AD Clinical Trials.
Authors: Haberstroh J, Wollstadt P, Knebel M, Oswald F, Schröder J, Pantel J Abstract This paper (1) highlights the relevance of functional communication as an outcome parameter in Alzheimer disease (AD) clinical trials; (2) identifies studies that have reported functional communication outcome measures in AD clinical trials; (3) critically reviews the scales of functional communication used in recent AD clinical trials by summarizing the sources of information, characteristics, and available psychometric data for these scales; and (4) evaluates whether these measures actually or partially assess functional co...
Source: Alzheimer Disease and Associated Disorders - June 12, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Cortical and Subcortical Atrophy in Alzheimer Disease: Parallel Atrophy of Thalamus and Hippocampus.
In this study, we carried out an integrative evaluation of AD-related atrophy. Twelve patients with AD and 13 healthy controls were enrolled. We conducted a cross-sectional analysis of total brain tissue volumes with SIENAX. Localized gray matter atrophy was identified with optimized voxel-wise morphometry (FSL-VBM), and subcortical atrophy was evaluated by active shape model implemented in FMRIB's Integrated Registration Segmentation Toolkit. SIENAX analysis demonstrated total brain atrophy in AD patients; voxel-based morphometry analysis showed atrophy in the bilateral mediotemporal regions and in the posterior brain reg...
Source: Alzheimer Disease and Associated Disorders - June 12, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Physical Activity and Cognitive Trajectories in Cognitively Normal Adults: The Adult Children Study.
In this study, we examined the relationship between the physical activity and trajectories of cognitive functioning over serial assessments. Cognitively normal (Clinical Dementia Rating 0) middle-aged and older adults (N=173; mean age, 60.7±7.8 y) completed a self-report measure of physical activity and a battery of standard neuropsychological tests assessing processing speed, attention, executive functioning, and verbal memory. At baseline, individuals with higher physical activity levels performed better on tests of episodic memory and visuospatial functioning. Over subsequent follow-up visits, higher physical act...
Source: Alzheimer Disease and Associated Disorders - June 7, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Factors Affecting Dementia Screening by General Practitioners in Community-dwelling Elderly Populations: A Large Cross-Sectional Study in 2 Areas of France.
Authors: Gaboreau Y, Imbert P, Jacquet JP, Paumier F, Couturier P, Gavazzi G Abstract In patients aged 75 years and above, dementia is associated with increased expenditure and high morbimortality. Although the incidence of dementia is well known, it is often underrecognized in primary care. We conducted a cross-sectional study in 2 areas in the southeast of France to identify the factors affecting dementia-screening implementation by the French general practitioners (GPs). In May 2008, an anonymized survey was sent by e-mail and/or post to all GPs with a large clinic practice. Two months later, reminder letters we...
Source: Alzheimer Disease and Associated Disorders - June 7, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Early-onset Alzheimers and Cortical Vision Impairment in a Woman With Valosin-containing Protein Disease Associated With 2 APOE [Latin Small Letter Open E]4/APOE [Latin Small Letter Open E]4 Genotype.
In conclusion, we report a unique patient with an APOE [Latin Small Letter Open E]4/APOE [Latin Small Letter Open E]4 genotype and atypical VCP disease associated with early Alzheimer disease and severe vision impairment. Future studies will elucidate the interaction of VCP mutations and APOE [Latin Small Letter Open E]4 alleles in understanding common mechanisms in AD and VCP disease. PMID: 23715207 [PubMed - as supplied by publisher] (Source: Alzheimer Disease and Associated Disorders)
Source: Alzheimer Disease and Associated Disorders - May 31, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Ventricular Enlargement and its Clinical Correlates in the Imaging Cohort From the ADCS MCI Donepezil/Vitamin E Study.
Authors: Apostolova LG, Babakchanian S, Hwang KS, Green AE, Zlatev D, Chou YY, Decarli C, Jack CR, Petersen RC, Aisen PS, Cummings JL, Toga AW, Thompson PM Abstract We analyzed the baseline and 3-year T1-weighted magnetic resonance imaging data of 110 amnestic mild cognitive impairment (MCI) participants with minimal hippocampal atrophy at baseline from the Alzheimer's Disease Cooperative Study group MCI Donepezil/Vitamin E trial. Forty-six subjects converted to Alzheimer disease (AD) (MCIc), whereas 64 remained stable (MCInc). We used the radial distance technique to examine the differences in lateral ventricle sh...
Source: Alzheimer Disease and Associated Disorders - May 23, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Object Alternation: A Novel Probe of Medial Frontal Function in Frontotemporal Dementia.
Authors: Freedman M, Binns MA, Black SE, Levine B, Miller BL, Ramirez J, Szilagyi GM, Scott CJ, McNeely AA, Stuss DT Abstract We studied behavioral variant frontotemporal dementia (bvFTD) using object alternation (OA) as a novel probe of cognition. This task was adopted from animal models and is sensitive to ventrolateral-orbitofrontal and medial frontal function in humans. OA was administered to bvFTD patients, normal controls, and a dementia control group with Alzheimer disease (AD). Two other frontal lobe measures adopted from animal models were administered: delayed response (DR) and delayed alternation (DA). B...
Source: Alzheimer Disease and Associated Disorders - April 23, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Effect of Cognitive Reserve Markers on Alzheimer Pathologic Progression.
Authors: Lo RY, Jagust WJ, for the Alzheimer’s Disease Neuroimaging Initiative Abstract Education, occupation, premorbid intelligence, and brain size are surrogate markers for cognitive reserve. Whether these markers have biological influence on Alzheimer disease (AD) pathology is not known. We thus aimed to investigate the effect of cognitive reserve proxies on longitudinal change of AD biomarkers. A total of 819 participants with normal cognition, mild cognitive impairment, and mild AD were enrolled in the Alzheimer's Disease Neuroimaging Initiative and followed up with repeated measures of cerebrospinal fl...
Source: Alzheimer Disease and Associated Disorders - April 5, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

The Value of Hippocampal and Temporal Horn Volumes and Rates of Change in Predicting Future Conversion to AD
Hippocampal pathology occurs early in Alzheimer disease (AD), and atrophy, measured by volumes and volume changes, may predict which subjects will develop AD. Measures of the temporal horn (TH), which is situated adjacent to the hippocampus, may also indicate early changes in AD. Previous studies suggest that these metrics can predict conversion from amnestic mild cognitive impairment (MCI) to AD with conversion and volume change measured concurrently. However, the ability of these metrics to predict future conversion has not been investigated. We compared the abilities of hippocampal, TH, and global measures to predict fu...
Source: Alzheimer Disease and Associated Disorders - April 1, 2013 Category: Geriatrics Tags: Original Studies Source Type: research

The APOE ε4 Allele Is Associated With Increased Frontally Mediated Neurobehavioral Symptoms in Amnestic MCI
The apolipoprotein E ε4 allele is a risk factor for late-onset Alzheimer disease (AD), and the frontal lobes may be among the regions that manifest effects of ε4 even early in the disease. We predicted that among patients with amnestic mild cognitive impairment (aMCI) and AD, ε4 would be associated with increased neurobehavioral symptoms when assessed using a measure sensitive to frontal lobe integrity. We obtained cognitive data and caregiver ratings on the Frontal Systems Behavior Scale (FrSBe) for aMCI patients (N=29 ε4 carriers; N=29 noncarriers) and AD patients (N=47 carriers; N=42 nonc...
Source: Alzheimer Disease and Associated Disorders - April 1, 2013 Category: Geriatrics Tags: Original Studies Source Type: research

Cultural Diversity and Views on Alzheimer Disease in Older African Americans
Cultural constructs prevalent in older African Americans may influence their risk perceptions and knowledge of Alzheimer disease (AD). To examine this issue, we administered 3 sociocultural scales, the AD Knowledge Scale, and a Risk Perception questionnaire to 271 older African Americans who were recruited from a large community senior center and local churches. Higher Present Time Orientation was significantly related to perceptions of having little control over risks to health (P=0.004), God’s Will in determining AD (P=0.001), and lower AD knowledge (P (Source: Alzheimer Disease and Associated Disorders)
Source: Alzheimer Disease and Associated Disorders - April 1, 2013 Category: Geriatrics Tags: Original Studies Source Type: research

Improved Statistical Power of Alzheimer Clinical Trials by Item-Response Theory: Proof of Concept by Application to the Activities of Daily Living Scale
Discovery of effective treatment for Alzheimer disease (AD) depends upon the availability of outcome measures that exhibit good sensitivity to rates of longitudinal decline on global functional performance. The Alzheimer’s Disease Cooperative Study-Activities of Daily Living inventory (ADCS-ADL) is a frequently used functional endpoint in clinical trials for AD that assesses patient functional ability on the basis of informant ratings of patient performance on a variety of everyday tasks. Previous research has shown that the items comprising the ADCS-ADL are sensitive to characteristic longitudinal trajectories in AD...
Source: Alzheimer Disease and Associated Disorders - April 1, 2013 Category: Geriatrics Tags: Original Studies Source Type: research

Patient Adherence to Transdermal Rivastigmine After Switching From Oral Donepezil: A Retrospective Claims Database Study
Conclusions: Switching from donepezil to the rivastigmine patch seems to be associated with increased adherence, especially in patients who switched within the first year of initiating donepezil. (Source: Alzheimer Disease and Associated Disorders)
Source: Alzheimer Disease and Associated Disorders - April 1, 2013 Category: Geriatrics Tags: Original Studies Source Type: research

Neurodegenerative Disease Phenotypes in Carriers of MAPT p.A152T, A Risk Factor for Frontotemporal Dementia Spectrum Disorders and Alzheimer Disease.
We describe clinical features of 9 patients with neurodegenerative disease (4 women) harboring p.A152T, aged 51 to 79 years at symptom onset. Seven developed FTD spectrum clinical syndromes, including progressive supranuclear palsy syndrome (n=2), behavioral variant FTD (bvFTD, n=1), nonfluent variant primary progressive aphasia (nfvPPA, n=2), and corticobasal syndrome (n=2); 2 patients were diagnosed with clinical AD. Thus, MAPT p.A152T is associated with a variety of FTD spectrum clinical presentations, although patients with clinical AD are also identified. These data warrant larger studies with clinicopathologic correl...
Source: Alzheimer Disease and Associated Disorders - March 23, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Three-week nutritional supplementation effect on long-term nutritional status of patients with mild Alzheimer disease.
Authors: de Sousa OL, Amaral TF Abstract Short-term nutritional supplements enable an improvement in Alzheimer patients' nutritional status, but it remains to be seen whether they will be sufficient to improve long-term nutritional status. The aim of this study was to evaluate the long-term impact of a 3-week nutritional supplementation on the nutritional status of undernourished patients with probable mild Alzheimer disease. A 21-day prospective randomized nonblinded controlled trial was conducted. Patients were followed-up for an additional period until the 90th day after the beginning of the intervention. Interv...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Anomalous PiB enhancement in the superior sagittal and transverse venous sinuses.
Authors: Raymond SB, Cohen AD, Becker C, Price J, Klunk WE Abstract Pittsburgh compound-B (PiB), an amyloid-binding positron emission tomography (PET) tracer, is widely used for imaging amyloid-β in those with and at risk for Alzheimer disease. Here, we report on an otherwise normal 68-year-old female with abnormally high and very focal PiB retention. Coregistered T1-weighted magnetic resonance imaging and dynamic 2-fluoro-2-deoxy-D-glucose (FDG) images confirmed that the focal PiB enhancement was in the superior sagittal and transverse sinuses, outside of the adjacent cortex. Flow through the venous vasculatu...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Longitudinal trajectories of awareness in early-stage dementia.
We examined awareness in 101 individuals with early-stage dementia (PwD) and their carers; 66 were reassessed after 12 months and 51 were seen again at 20 months. Awareness was assessed in relation to memory, everyday activities, and socio-emotional functioning using discrepancies between PwD and carer ratings on parallel questionnaires. PwD completed neuropsychological tests and measures of mood and quality of life. Carers completed measures of mood and stress. At initial assessment, discrepancies were greatest for activities of daily living, moderate for memory, and least pronounced for socio-emotional functioning. Discr...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Cardiovascular risk factors cause cortical thinning in cognitively impaired patients: relationships among cardiovascular risk factors, white matter hyperintensities, and cortical atrophy.
Authors: Seo SW, Lee JM, Im K, Park JS, Kim SH, Kim ST, Ahn JH, Kim MJ, Kim GH, Kim JH, Roh JH, Cheong HK, Na DL Abstract Cardiovascular risk factors are associated with cognitive impairments. However, the effects of cardiovascular risk factors on the topography of cortical thinning have not yet been studied in patients with mild cognitive impairment (MCI) or dementia. Thus, we aimed to evaluate the topography of cortical thinning related to cardiovascular risk factors and the relationships among cardiovascular risk factors, white matter hyperintensities (WMH), and cortical atrophy. Participants included 226 patien...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Using mental imagery to improve memory in patients with Alzheimer disease: trouble generating or remembering the mind's eye?
This study was conducted to understand whether patients with mild Alzheimer disease (AD) could use general or self-referential mental imagery to improve their recognition of visually presented words. Experiment 1 showed that, unlike healthy controls, patients generally did not benefit from either type of imagery. To help determine whether the patients' inability to benefit from mental imagery at encoding was due to poor memory or due to an impairment in mental imagery, participants performed 4 imagery tasks with varying imagery and cognitive demands. Experiment 2 showed that patients successfully performed basic visual ima...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Anticipatory grief in new family caregivers of persons with mild cognitive impairment and dementia.
Authors: Garand L, Lingler JH, Deardorf KE, DeKosky ST, Schulz R, Reynolds CF, Dew MA Abstract Anticipatory grief is the process of experiencing normal phases of bereavement in advance of the loss of a significant person. To date, anticipatory grief has been examined in family caregivers to individuals who have had Alzheimer disease (AD) an average of 3 to 6 years. Whether such grief is manifested early in the disease trajectory (at diagnosis) is unknown. Using a cross-sectional design, we examined differences in the nature and extent of anticipatory grief between family caregivers of persons with a new diagnosis o...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Neuropathological profile of mild cognitive impairment from a population perspective.
Authors: Stephan BC, Matthews FE, Hunter S, Savva GM, Bond J, McKeith IG, Ince P, Brayne C, Medical Research Council Cognitive Function and Ageing Study (MRC CFAS) Abstract Whether the neuropathological profile of mild cognitive impairment (MCI) reflects an intermediate state between normal aging and dementia is not clear. Identifying which phenomena initiate disease and which occur secondary to the neuropathological process is important for targeted disease prevention. Current definitions of MCI include amnestic (aMCI), nonamnestic (nMCI), and multidomain (mMCI) subtypes. In an unbiased population-based cohort of ...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Total daily activity measured with actigraphy and motor function in community-dwelling older persons with and without dementia.
Authors: James BD, Boyle PA, Bennett DA, Buchman AS Abstract Actigraphic measures of physical activity do not rely on participants' self-report and may be of particular importance for examining the health benefits of physical activity across the full spectrum of older individuals, especially those with dementia, a group in which loss of motor function is particularly salient. We tested whether actigraphy could be used to examine the relationship between total daily physical activity and motor function in community-dwelling older persons both with (n = 70) and without (n = 624) clinical dementia. Total daily activit...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Prodromal dementia with lewy bodies manifesting as sertraline-induced parkinsonism: a case report.
CONCLUSIONS: To our knowledge, there has been no report of sertraline-induced or aggravated parkinsonian motor symptoms in DLB patients. Our patient had a short period with neither dementia nor parkinsonism during the early stage of his illness, and this period might have been regarded as the preclinical stage of DLB in the natural course of his illness. PMID: 21946016 [PubMed - indexed for MEDLINE] (Source: Alzheimer Disease and Associated Disorders)
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

NALP1/NLRP1 genetic variants are associated with Alzheimer disease.
Authors: Pontillo A, Catamo E, Arosio B, Mari D, Crovella S Abstract Alzheimer disease (AD) is a complex neurodegenerative disease. Genetic and molecular studies have confirmed that in the human brain, amyloid-β fibrils can induce, through the activation of NALP1 inflammosome, inflammatory and apoptotic responses involved in the pathogenesis of AD. Considering that AD pathogenesis is multifactorial, we hypothesized that NALP1/NLRP1 could be a susceptibility gene involved in the devolvement of the disease. The possible association between 9 selected polymorphisms in the NALP1/NLRP1 gene and AD was evaluated by ...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Molecular genetic analysis of the APP, PSEN1, and PSEN2 genes in Finnish patients with early-onset Alzheimer disease and frontotemporal lobar degeneration.
Authors: Krüger J, Moilanen V, Majamaa K, Remes AM Abstract Mutations in 3 genes, amyloid precursor protein (APP), presenilin 1 (PSEN1), and presenilin 2 (PSEN2), have been identified as causing a proportion of early-onset Alzheimer disease (eoAD) cases. A few PSEN mutations have also been previously detected in patients with frontotemporal lobar degeneration (FTLD). In order to evaluate the role of these genes in a clinical series of Finnish eoAD and FTLD patients, we sequenced exons 16 and 17 of the APP gene and the coding regions of the PSEN1 and PSEN2 genes in 140 eoAD and 66 FTLD patients. No pathogenic m...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Long-standing prion dementia manifesting as posterior cortical atrophy.
We present the clinical and neuropathological features of a family with an early and long-standing dementia manifesting with posterior cortical atrophy and related to a 120 bp insertional mutation of the prion protein gene. Two cases exhibited mixed prion and Aβ pathology. The differential diagnosis with Alzheimer disease is discussed. PMID: 21959360 [PubMed - indexed for MEDLINE] (Source: Alzheimer Disease and Associated Disorders)
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Dystypia without aphasia associated with visuospatial memory impairment in a patient with acute stroke.
Authors: Ryu DW, Kim JS, Yang DW, Kim YI, Lee KS Abstract Keyboard typing is a multifunctional task related to language, visual-spatial and motor abilities. If one of these functions is impaired, difficulty during typing could occur. Here, a 64-year-old right-handed man is reported who developed a sudden typing disturbance without aphasia or neglect. Magnetic resonance imaging of the brain showed discrete acute infarcts in the border-zone regions, bilaterally, predominantly in the left hemisphere. The neuropsychiatric testing showed an impaired visual-spatial memory domain; however, other cognitive functions were a...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Crossed aphasia in a dextral patient with logopenic/phonological variant of primary progressive aphasia.
CONCLUSIONS: This case report provides evidence that crossed PPA can present with a logopenic variant in addition to the nonfluent type demonstrated by others. Functional neuroimaging showed unexpected right-sided hypoperfusion in this case with only subtle structural brain asymmetry, implicating a reverse pattern of language dominance. PMID: 21959362 [PubMed - indexed for MEDLINE] (Source: Alzheimer Disease and Associated Disorders)
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Regional cerebral blood flow abnormalities associated with apathy and depression in Alzheimer disease.
Authors: Kang JY, Lee JS, Kang H, Lee HW, Kim YK, Jeon HJ, Chung JK, Lee MC, Cho MJ, Lee DS Abstract The aim of this study was to identify brain areas related to apathy or depression in patients with Alzheimer disease (AD). Eighty-one AD patients were enrolled in this prospective study. (99m)Tc-HMPAO single photon emission computed tomography was performed to evaluate regional cerebral blood flow (rCBF). According to the Neuropsychiatric Inventory subscores of apathy and depression, 9 patients were classified as clinically significant (cs) depressed and non-cs-apathetic (D+) groups and 9 were classified as cs-apath...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

CORDIAL: cognitive rehabilitation and cognitive-behavioral treatment for early dementia in Alzheimer disease: a multicenter, randomized, controlled trial.
In this study, we evaluated the feasibility, acceptance, efficacy, and usefulness of a CR intervention in a multicenter, randomized, controlled trial on 201 patients with mild dementia in Alzheimer disease and their carers. The intervention comprised 12 individual weekly sessions and combined 4 established strategies adopted from neurorehabilitation and psychotherapy. Activities of daily living were chosen as the primary outcome. The results show that the feasibility, treatment adherence, and carer commitment were excellent. However, no effect of the intervention was demonstrable on everyday functioning. There were improve...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

The SIST-M: predictive validity of a brief structured clinical dementia rating interview.
CONCLUSION: CDR scores based on items from this shortened interview had high predictive ability for AD-comparable to that using a lengthy clinical interview. PMID: 21986342 [PubMed - indexed for MEDLINE] (Source: Alzheimer Disease and Associated Disorders)
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Rapidly progressive dementia: experience in a tertiary care medical center.
In conclusion, nonprion neurodegenerative diseases are the most common cause of RPD in our center. Our results suggest that although CJD is often suspected as a cause of RPD, its frequency depends on the referral differences across specialized centers. PMID: 22001379 [PubMed - indexed for MEDLINE] (Source: Alzheimer Disease and Associated Disorders)
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Ghrelin-attenuated cognitive dysfunction in streptozotocin-induced diabetic rats.
This study aimed to explore the pathogenesis of diabetic encephalopathy and the mechanisms of ghrelin to ameliorate cognitive dysfunction in diabetic rats. Thirty-six streptozotocin diabetic rat models were established; 12 weeks later, all the rats were randomly divided into 3 groups [diabetic model group (D), ghrelin treatment group (T1), and ghrelin and D-lys-3-GHRP-6 treatment group (T2)] of 12 each. Twelve normoglycemic rats were classified in the normal group (N). Learning and memory behaviors were measured using a spatial version of the Morris water maze test. The brain-derived neurotrophic factor (BDNF), cAMP respon...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Sources of stress for family members of nursing home residents with advanced dementia.
Authors: Givens JL, Lopez RP, Mazor KM, Mitchell SL Abstract The sources of stress for families of nursing home (NH) residents with advanced dementia have not been well described. Semistructured interviews were conducted with 16 family members previously enrolled in the Choices, Attitudes, and Strategies for Care of Advanced Dementia at the End-of-Life study, a prospective cohort of 323 NH residents with advanced dementia and their family members. Questions were asked pertaining to the experience of having a family member in the NH, communication with health-care professionals, surrogate decision making, emotional ...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

The influence of chronic stress on dementia-related diagnostic change in older adults.
Authors: Peavy GM, Jacobson MW, Salmon DP, Gamst AC, Patterson TL, Goldman S, Mills PJ, Khandrika S, Galasko D Abstract Increased susceptibility of the aging brain to both chronic stress and incipient dementia-related neuropathology may accelerate cognitive decline. We investigated associations between chronic stress and diagnostic change in 62 individuals (mean age, 78.7 y) participating in an Alzheimer disease research center longitudinal study. The subjects, diagnosed at baseline as cognitively normal (CN) or with mild cognitive impairment (MCI), were followed for an average of 2.5 years. Senior neurologists, bl...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Agreement on diagnosis among patients, companions, and professionals after a dementia evaluation.
This study documents discrepancies that can arise in diagnostic communication, which could influence adjustment to a diagnosis of dementia and decisions regarding future planning and care. PMID: 22037598 [PubMed - indexed for MEDLINE] (Source: Alzheimer Disease and Associated Disorders)
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Alpha-synuclein in the cerebrospinal fluid differentiates synucleinopathies (Parkinson Disease, dementia with Lewy bodies, multiple system atrophy) from Alzheimer disease.
We examined the utility of quantification of α-synuclein (SNCA) in the cerebrospinal fluid (CSF) to differentiate patients with Alzheimer disease (AD), dementia with Lewy bodies (DLB), Parkinson disease (PD), and multiple system atrophy (MSA). METHODS: Thirty-seven patients were divided into 4 age-matched and sex-matched clinical groups: AD (n = 9), DLB (n = 6), PD (n = 11), and MSA (n = 11). Eleven subjects served as neurological disease controls. The total of 48 subjects included 27 men and 21 women, aged 66.5 ± 11.4 years. We performed a solid-phase sandwich enzyme-linked immunosorbent assay, which enab...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Plasma levels of complement 4a protein are increased in Alzheimer's disease.
Authors: Bennett S, Grant M, Creese AJ, Mangialasche F, Cecchetti R, Cooper HJ, Mecocci P, Aldred S Abstract Alzheimer's disease (AD) is a devastating neurodegenerative disorder that has been predicted to affect 106.2 million people worldwide by 2050. Currently, definitive diagnosis for this disease is given post mortem, and there is a need for biomarker identification to enable earlier diagnosis of this disease. Biomarkers of AD would ideally represent early disease process and will be present in peripheral tissue before cognitive decline develops in this population. Proteomic technologies offer a strategy to unde...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Predictive factors for the objective burden of informal care in people with dementia: a systematic review.
CONCLUSIONS: Many factors were found to be (potential) predictors of objective burden, reflecting its complex nature. Objective and subjective burdens are 2 different relevant aspects of informal care. Interventions aimed at countering behavioral problems and impairments regarding daily functioning could reduce objective burden. PMID: 22075941 [PubMed - indexed for MEDLINE] (Source: Alzheimer Disease and Associated Disorders)
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

Sharing transnational experiences of psychogeriatric units dedicated to the management of behavioral and psychological symptoms in demented patients.
Authors: Bellelli G, Trabucchi M PMID: 22082623 [PubMed - indexed for MEDLINE] (Source: Alzheimer Disease and Associated Disorders)
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research

The Cognitive Change in Women study (CCW): informant ratings of cognitive change but not self-ratings are associated with neuropsychological performance over 3 years.
Authors: Gavett R, Dunn JE, Stoddard A, Harty B, Weintraub S Abstract The value of self-reported memory complaints for identifying or predicting future cognitive decline or dementia is controversial, but observations from a third party, or "informant," may prove more useful. The relationship between Informant and Self-ratings of cognitive status and neuropsychological test scores was examined in a cohort of 384 nondemented, community-dwelling women, aged 60 years and older, participating in a single-site Women's Health Initiative ancillary study. Each participant and her respective informant separately co...
Source: Alzheimer Disease and Associated Disorders - March 9, 2013 Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research