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Possible AD (possible + ad)
Selected AbstractsValidation of a memory inventory for the assessment of awareness of memory deficits in Alzheimer's disease in Chinese elderlyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 10 2006Victor Wing Cheong Lui Abstract Background This paper describes the development and validation of the Memory Inventory for Chinese (MIC), for measuring the awareness of memory deficits in the Chinese population with Alzheimer's disease (AD). Methods A combination of qualitative and quantitative approaches was adopted. The MIC was developed with focus group discussion and pilot testing. It has a patient and a caregiver version. A consecutive series of 79 new out-patients with the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorder Association (NINCDS-ADRDA) criteria of probable and possible AD and 20 non-demented elderly subjects were recruited. Results A high internal consistency was found, with Cronbach alpha of 0.89 for the patient version and 0.90 for the caregiver version of MIC. The inter-rater reliability was satisfactory. For validity assessment, the caregiver score of the MIC correlated significantly with cognitive score of the subject as assessed by the Mini-Mental State Examination (rp,=,,0.37; p,<,0.01). The Memory Deficit Awareness Score, calculated by subtracting the patient score from the caregiver score, correlated significantly with clinician ratings of awareness of memory impairment (rs,=,,0.67; p,<,0.01). Conclusions The MIC appears to be a culturally appropriate and valid instrument for the measurement of awareness of memory deficits in Chinese patients with AD. Potential applications of the MIC should be further explored in other subtypes of dementia and in prospective studies. Copyright © 2006 John Wiley & Sons, Ltd. [source] 5-HT2A T102C receptor polymorphism and neuropsychiatric symptoms in Alzheimer's diseaseINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 6 2004Linda Chiu Wa Lam Abstract Objective To investigate the association between 5-HT2A receptor polymorphism and neuropsychiatric (NP) symptoms in Chinese elderly with Alzheimer's disease (AD). Methods This case-control study evaluated Chinese subjects with AD first presented to an university affiliated psychogeriatric clinic. Eighty-seven subjects with NINCDS-ADRDA diagnosis for probable and possible AD were recruited consecutively from the psychogeriatric clinics of the Prince of Wales Hospital in Hong Kong. 5-HT2A receptor polymorphisms were examined by polymerase chain reaction (PCR), enzyme digestion and gel electrophoresis. NP symptoms were assessed by the Chinese version of the Neuropsychiatric Inventory (NPI). Results The genotype frequencies were significantly different in subjects with regards to the presentation of delusions, aggression, aberrant motor behavior and apathy (Pearson Chi Squares, p,<,0.05). If only homozygote states were included, there were significantly fewer subjects of CC genotype with delusion (Pearson chi square, p,<,0.05). Conclusions Specific NP symptoms in AD were significantly associated with 5-HT2A receptor polymorphisms. Possible ethnic differences in the behavioral expression of 5-HT2A receptor polymorphisms are worthy of further exploration. Copyright © 2004 John Wiley & Sons, Ltd. [source] A randomized, placebo-controlled study of the efficacy and safety of sertraline in the treatment of the behavioral manifestations of Alzheimer's disease in outpatients treated with donepezilINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2004Sanford I. Finkel Abstract Objective To examine the safety and efficacy of sertraline augmentation therapy in the treatment of behavioral manifestations of Alzheimer's disease (AD) in outpatients treated with donepezil. Methods and materials Patients with probable or possible AD, and a Neuropsychiatric Inventory (NPI) total score >5 (with a severity score ,2 in at least one domain), were treated with donepezil (5,10,mg) for 8 weeks, then randomly assigned to 12 weeks of double-blind augmentation therapy with either sertraline (50,200,mg) or placebo. Primary efficacy measures were the 12-item Neuropsychiatric Inventory (NPI) and the Clinical Global Impression Improvement (CGI-I) and Severity (CGI-S) scales. Results 24 patients were treated with donepezil+sertraline and 120 patients with donepezil+placebo. There were no statistically significant differences at endpoint on any of the three primary efficacy measures. However, a linear mixed model analysis found modest but statistically significantly greater improvements in the CGI-I score on donepezil+sertraline. Moreover, in a sub-group of patients with moderate-to-severe behavioral and psychological symptoms of dementia, 60% of patients on sertraline vs 40% on placebo (p,=,0.006) achieved a response (defined as ,;50% reduction in a four-item NPI-behavioral subscale). One adverse event (diarrhea) was significantly (p,<,0.05) more common in the donepezil+sertraline group compared to the donepezil+placebo group. Conclusion Sertraline augmentation was well-tolerated in this sample of AD outpatients. In addition, post hoc analyses demonstrated a modest but statistically significant advantage of sertraline over placebo augmentation in mixed model analyses and a clinically and statistically significant advantage in a subgroup of patients with moderate-to-severe behavioral and psychological symptoms of dementia. Copyright © 2004 John Wiley & Sons, Ltd. [source] Behavioral profile of Alzheimer's disease in Chinese elderly , a validation study of the Chinese version of the Alzheimer's disease behavioral pathology rating scaleINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2001Linda C. W. Lam Abstract Objectives This study aims to examine the psychometric properties of the Chinese version of the Alzheimer's disease behavioral pathology rating scale (CBehave-AD) and the behavioral profile of Chinese patients with AD. Methods Seventy-one subjects with NINCDS-ADRDA diagnosis of probable and possible AD were assessed for validation of the CBehave-AD. A behavioral symptom frequency checklist, the Chinese version of the Blessed Roth dementia scale (CDS) and the Cantonese version of the Mini-Mental State Examination (CMMSE) were used for comparison. An extended sample of 120 AD patients was then evaluated with the CBehave-AD. Results High correlations between the CBehave-AD and checklist scores were found (paranoid and delusional ideation, hallucinations, activity disturbances, aggressiveness and diurnal rhythm disturbances). The scale also demonstrated satisfactory inter-rater and test-retest reliabilities. The mean (SD) CMMSE score of the 120 patients was 9.4 (7.1). Among them, 32% have delusions, 15% had hallucinations, 54% had activity disturbances, 61% had aggressive behavior, 44% had sleep disturbance, 24% had affective disturbances, 19% had anxiety and phobias. Delusional ideation was significantly associated with hallucinations, aggressiveness, and affective disturbances. Diurnal rhythm disturbances were associated with activity disturbances and aggressiveness. CBehave-AD total scores were not significantly correlated with severity of AD, but individual symptom categories showed different pattern of correlation. Delusions, hallucinations, anxiety and phobias were significantly correlated with dementia staging. Conclusion The findings suggest that the CBehave-AD is a valid assessment tool for behavioral disturbances in patients with AD. Variable associations between different symptom categories and dementia staging suggest a need for further exploration of the complex interactions between behavioral and cognitive disturbances in dementia. Copyright © 2001 John Wiley & Sons, Ltd. [source] The neuropathology of probable Alzheimer disease and mild cognitive impairment,ANNALS OF NEUROLOGY, Issue 2 2009Julie A. Schneider MD Objective Mixed pathologies are common in older persons with dementia. Little is known about mixed pathologies in probable Alzheimer disease (AD) and about the spectrum of neuropathology in mild cognitive impairment (MCI). The objective of this study was to investigate single and mixed common age-related neuropathologies in persons with probable AD and MCI. Methods The study included 483 autopsied participants from the Religious Orders Study and the Rush Memory and Aging Project with probable AD (National Institute of Neurological and Communicative Disorders and Stroke,Alzheimer's Disease and Related Disorders Association criteria), MCI (amnestic and nonamnestic), or no cognitive impairment. We excluded 41 persons with clinically possible AD and 14 with other dementias. We documented the neuropathology of AD (National Institute on Aging,Reagan criteria), macroscopic cerebral infarcts, and neocortical Lewy body (LB) disease. Results Of 179 persons (average age, 86.9 years) with probable AD, 87.7% had pathologically confirmed AD, and 45.8% had mixed pathologies, most commonly AD with macroscopic infarcts (n = 54), followed by AD with neocortical LB disease (n = 19) and both (n = 8). Of the 134 persons with MCI, 54.4% had pathologically diagnosed AD (58.7% amnestic; 49.2% nonamnestic); 19.4% had mixed pathologies (22.7% amnestic; 15.3% nonamnestic). Macroscopic infarcts without pathologically diagnosed AD accounted for 4.5% of probable AD, 13.3% of amnestic MCI, and 18.6% of nonamnestic MCI. Pure neocortical LB disease was uncommon in all persons with cognitive impairment (<6%). Microscopic infarcts (without macroscopic infarcts) were common as a mixed pathology, but rarely accounted for a clinical diagnosis of probable AD (n = 4) or MCI (n = 3). Interpretation Clinically diagnosed probable AD and MCI, even amnestic MCI, are pathologically heterogeneous disorders, with many persons exhibiting mixed pathologies. Ann Neurol 2009;66:200,208 [source] | ||||||||||