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Alzheimer's Disease (alzheimer + disease)
Kinds of Alzheimer's Disease Terms modified by Alzheimer's Disease Selected AbstractsTHE ROLE OF TUMOR NECROSIS FACTOR-ALPHA IN COGNITIVE IMPROVEMENT AFTER PEROXISOME PROLIFERATOR-ACTIVATOR RECEPTOR GAMMA AGONIST PIOGLITAZONE TREATMENT IN ALZHEIMER'S DISEASEJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2010Haruo Hanyu MD No abstract is available for this article. [source] THE APOLIPOPROTEIN 2 ALLELE IN ALZHEIMER'S DISEASE: SUGGESTIONS FOR A JUDICIOUS USE OF ANTIPLATELET AND ANTICOAGULANT MEDICATIONSJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2009Santosh B. Murthy MD No abstract is available for this article. [source] ADHERENCE TO CHOLINESTERASE INHIBITORS IN PATIENTS WITH ALZHEIMER'S DISEASEJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2009Lucie Blais PhD No abstract is available for this article. [source] COGNITIVE SYNDROME OF THE THALAMUS: A MISLEADING DIFFERENTIAL DIAGNOSIS OF ALZHEIMER'S DISEASEJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2008Emilie Beaufils MD No abstract is available for this article. [source] A RETROSPECTIVE CHART REVIEW OF THE TOLERABILITY AND EFFICACY OF INTRAVENOUS IMMUNOGLOBULIN IN THE TREATMENT OF ALZHEIMER'S DISEASEJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2008Gayatri Devi MD No abstract is available for this article. [source] DIET, CHOLESTEROL METABOLISM, AND ALZHEIMER'S DISEASE: APOLIPOPROTEIN E AS A POSSIBLE LINK?JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2006Francesco Panza MD No abstract is available for this article. [source] NATIONWIDE USE OF MEDICINES FOR ALZHEIMER'S DISEASE BY COMMUNITY-DWELLING PERSONS IN FINLANDJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2006Jarmo Ålander MD No abstract is available for this article. [source] DONEPEZIL AND ATHETOSIS IN AN ELDERLY PATIENT WITH ALZHEIMER'S DISEASEJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2003Makoto Tanaka MD No abstract is available for this article. [source] Alzheimer's Disease: A Physician's Guide to Practical ManagementEUROPEAN JOURNAL OF NEUROLOGY, Issue 4 2004K. A. Jellinger No abstract is available for this article. [source] A Couplehood Typology for Spouses of Institutionalized Persons With Alzheimer's Disease: Perceptions of "We","I",FAMILY RELATIONS, Issue 1 2001Lori Kaplan A qualitative analysis of 68 community-dwelling spouses of institutionalized patients with Alzheimer's disease was conducted. The goal was to ascertain to what degree they perceived themselves as married. Five groups representing different degrees of couplehood emerged. Ranging from strong couplehood to no couplehood, groups were given the following terms: "'Til Death Do Us Parts,""We, but ,,""Husbandless Wives/Wifeless Husbands,""Becoming an I," and "Unmarried Marrieds." Ways to interpret this typology and implications for both further research and practitioners are described. [source] Association between cognition and daily life functioning in dementia subtypesINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2009Sharon F. M. Bouwens Abstract Objective To investigate the association between cognition and daily life functioning in dementia subtypes. Methods Cross-sectional data were used from 615 patients with dementia who were referred to the Maastricht Memory Clinic of the Maastricht University Medical Centre. Pearson correlation coefficients were calculated between the Mini-Mental State Examination (MMSE; to measure cognitive status) and the Blessed Dementia Scale (BDS; to measure daily life functioning) for the following types of dementia: Alzheimer's Disease (AD, n,=,442); Vascular dementia (VaD, n,=,113); frontotemporal dementia (FTD, n,=,18); Parkinson's dementia (PD, n,=,21); and primary progressive aphasia (PPA, n,=,21). One-way ANOVA was used to test differences in age, MMSE scores and BDS scores across dementia subtypes. Results Scores on the MMSE showed strong correlation with BDS scores in cases of FTD (r,=,,0.80); moderate correlation in cases of AD, VaD, and PD (range r,=,,0.50,0.60); while no correlation was found in PPA cases. Conclusions The association between cognition and daily life functioning varied among dementia subtypes for AD, VaD, FTD and PD. Furthermore, the overall scores on both domains differ between dementia subtypes, indicating that different types of dementia are characterized by a specific pattern of cognitive status and daily life functioning. These findings underline the need for multidomain assessment in patients with dementia. Copyright © 2009 John Wiley & Sons, Ltd. [source] A 2-year follow-up of 233 very mild (CDR 0.5) Alzheimer's disease patients (REAL. FR cohort)INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2008Fati Nourhashémi Abstract Objectives Making an early diagnosis of Alzheimer's Disease (AD) is becoming increasingly important. The Clinical Dementia Rating scale (CDR), a semi-structured interview with patient and caregiver, is a global rating scale designed for use in staging dementia. The primary objective of our study was to examine the evolution of AD in individuals with very mild AD (CDR 0.5) across a 2-year follow up. Methods A cohort of AD patients (n,=,682) living in the community were followed during 2 years in 16 centres of the French AD network. Each subject underwent extensive medical examination including the MMSE and CDR every 6 months. Results Two hundred and thirty-three AD patients were rated CDR 0.5 at baseline (mean MMSE score: 23.15,±,2.57). They were younger and reported an average duration of symptoms of approximately 0.8 years less than patients with CDR,,,1. During the 2-year follow-up, none of the AD CDR 0.5 subjects improved; 65% of them showed an increase in the CDR score. The rate of cognitive decline was similar between the AD CDR 0.5 and CDR,,,1 groups. The ADL decline was more significant in patients with CDR,,,1 at inclusion. Conclusions It is certainly possible to identify AD at a very early stage focusing on intra individual change in cognitive and functional impairment. Criteria with a high sensitivity and specificity for detecting AD at an early stage will help to further develop effective pharmacological and behavioural interventions for delaying the onset and progression of the disease. Copyright © 2007 John Wiley & Sons, Ltd. [source] Genetic research into Alzheimer's Disease: a European focus group study on ethical issuesINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2008Anco van der Vorm Abstract Background Nowadays, there is an increasing interest in the heritable aspects of Alzheimer's Disease (AD). The ethical implications of this kind of research are also attracting attention. However, relatively few open-ended qualitative studies have been carried out to study these aspects. Objective To explore and analyse ethical issues raised by genetic research into AD. Methods A modified focus group technique. Results Participants stressed the importance of relatives in genetic research and suggested a family consent procedure. The consent procedure ought to be more uniform within Europe and should allow for variation in the types of research being done. The long-term results of genetic research into AD are expected to be positive while the short-term results seem likely to be negative. The perception of AD as a disease could be changed by the results from genetic research into AD, and this could have effects at the individual level (feelings of guilt and responsibility for one's own health). Conclusions (1) The role of the family in genetic AD research differs from its role in other biomedical research into AD. The development of a family consent procedure might solve some informed consent problems. (2) Negative social consequences of genetic AD research are expected in the short term, but there are hopes of positive consequences in the long term. Copyright © 2007 John Wiley & Sons, Ltd. [source] Quality of life in dementia: care recipient and caregiver perceptions of quality of life in dementia: the LASER-AD studyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 10 2007Juanita Hoe Abstract Background Quality of Life (QoL) is a key outcome in dementia. Aim To compare care recipients' (CR) and caregivers' (CG) views on CRs' QoL and identify determinants. Methods CRs and CGs completed the Quality of Life - Alzheimer's Disease (QOL-AD) scale. Results One hundred and ninety-one CR/CG dyads were interviewed. There were differences between determinants of the CRs and CGs views about QoL. Family-CGs rated CRs' QoL higher when CRs had fewer depressive symptoms, less irritability, less apathy, less daily living impairment and lived at home. Fewer depressive symptoms, living at home and taking acetylcholinesterase-inhibitors (AChEI) predicted higher CR rated QoL. Conclusion Proxy ratings in dementia do not replicate CRs' views of QoL. This is the first study to employ a validated QoL measure for people with dementia taking AChEIs. Randomised controlled trials are needed before drawing conclusions about their effect on QoL. Interpretation of correlations between QoL and symptoms should be cautious as QoL is designed to reflect the impact of psychological and physical symptoms. Copyright © 2007 John Wiley & Sons, Ltd. [source] Validation 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] Confronting Alzheimer's Disease and Other DementiasJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2010Paul Attea JD First page of article [source] High Blood Pressure and Microinfarcts: A Link Between Vascular Risk Factors, Dementia, and Clinical Alzheimer's DiseaseJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2009Julie A. Schneider MD No abstract is available for this article. [source] Ethnic Differences in Singapore's Dementia Prevalence: The Stroke, Parkinson's Disease, Epilepsy, and Dementia in Singapore StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2008Suresh Sahadevan MBBS OBJECTIVES: To study the prevalence of dementia in Singapore among Chinese, Malays, and Indians. DESIGN: A two-phase, cross-sectional study of randomly selected population from central Singapore with disproportionate race stratification. SETTING: Community-based study. Subjects screened to have cognitive impairment at phase 1 in their homes were evaluated clinically for dementia at phase 2 in nearby community centers. PARTICIPANTS: Fourteen thousand eight hundred seventeen subjects aged 50 and older (67% participation rate). MEASUREMENTS: The locally validated Abbreviated Mental Test was used to screen for cognitive impairment at phase 1. Dementia was diagnosed at phase 2 as per Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. Possible Alzheimer's disease (AD) and possible vascular dementia (VD) were diagnosed along the National Institute of Neurological and Communicative Disorders,Alzheimer's Disease and Related Disorders Association and National Institute of Neurological Disorders and Stroke,Association Internationale pour la Recherche et l'Enseignement en Neuroscienes criteria, respectively. RESULTS: The overall age- and race-standardized dementia prevalence was 1.26% (95% confidence interval (CI)=1.10,1.45). Prevalence (in 5-year age bands) was 0.08% (50,54), 0.08% (55,59), 0.44% (60,64), 1.16% (65,69), 1.84% (70,74), 3.26% (75,79), 8.35% (80,84), and 16.42% (,85). From age 50 to 69, 65% of dementia cases were VD; at older ages, 60% were AD. Logistic regression (adjusted for age, sex, education) showed that Malays had twice the risk for AD as Chinese, and Indians had more than twice the risk for AD and VD than Chinese. CONCLUSION: Singapore's dementia prevalence, primarily influenced by its Chinese majority, is lower than seen in the West. The striking interethnic differences suggest a need for a dementia incidence study and further investigation of underlying genetic and cultural differences between the three ethnic groups in relation to dementia risk. [source] Energy-Containing Nutritional Supplements Can Affect Usual Energy Intake Postsupplementation in Institutionalized Seniors with Probable Alzheimer's DiseaseJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2006Matthew D. Parrott BSc OBJECTIVES: To determine whether increases in caloric intake associated with consumption of a mid-morning nutritional supplement for 3 weeks were maintained in the week after stopping the supplement and to investigate the effects of body mass index (BMI) and cognitive and behavioral measures on this response. DESIGN: Secondary analysis of a previously published randomized, crossover, nonblinded clinical trial. SETTING: A fully accredited geriatric care facility affiliated with the University of Toronto. PARTICIPANTS: Thirty institutionalized seniors with probable Alzheimer's disease (AD) who ate independently. MEASUREMENTS: Investigator-weighed food intake, body weight, cognitive (Severe Impairment Battery; Global Deterioration Scale) and behavioral (Neuropsychiatric Inventory,Nursing Home version; London Psychogeriatric Rating Scale) assessments. RESULTS: Individuals who responded successfully to supplementation as indicated by increases in daily energy intake were likely to maintain 58.8% of that increase postsupplementation, although stopping the supplement was associated with decreased habitual energy intake in low-BMI individuals who reduced their daily intakes during supplementation in response to the extra calories. Cognitive/behavioral tests were not reliable predictors of postsupplement intake. CONCLUSION: Institutionalized seniors with probable AD are likely to alter their usual energy intakes to maintain changes resulting from 3 weeks of supplementation. This effect may allow for rotating supplementation schedules in nursing homes that could reduce staff burden, but only for those individuals who are most likely to respond favorably. These data indicate that nutritional supplements and diet plans should be carefully prescribed in low-BMI individuals to limit variability in total energy provided and thus prevent lower-than-normal intake. [source] Apolipoprotein E Genotype and Mortality: Findings from the Cache County StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2005Kathleen M. Hayden PhD Objectives: To evaluate the association between apolipoprotein E (apo E) ,4 and mortality, the population attributable risk for mortality with ,4, and relative contributions of cardiovascular disease (CVD) and Alzheimer's disease (AD). Design: Population-based cohort study. Setting: Community-based. Participants: Permanent residents of Cache County, Utah, aged 65 and older as of January 1, 1995. Measurements: Participants were genotyped at the apo E locus using buccal-swab deoxyribonucleic acid. Cardiovascular health was ascertained using self- or proxy-report interviews at participants' residences. AD was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, and National Institute of Neurological and Communicative Disorders and Stroke,Alzheimer's Disease and Related Disorders criteria. Utah Department of Vital Statistics quarterly reports were reviewed to identify participants who died. Results: Crude evaluations showed nonsignificantly greater risk of death for ,2/2 (hazard ratio (HR)=1.66, 95% confidence interval (CI)=0.92,2.76) and ,3/4 (HR=1.11, 95% CI=0.97,1.26) genotypes and significantly greater risk for ,4/4 (HR=1.48, 95% CI=1.09,1.96). After adjustment for age, age2, sex, and education, risks increased to 1.98 (95% CI=1.08,3.35), 1.28 (95% CI=1.12,1.46), and 2.02 (95% CI=1.47,2.71), respectively, compared with ,3/3 genotypes. Adjustment for presence of any CVD did not change the risk of death for ,3/4 and ,4/4. Adjustment for AD reduced the risk of death for ,3/4 (HR=1.13, 95% CI=0.99,1.30) and ,4/4 (HR=1.59, 95% CI=1.15,2.14). The population attributable risk of death for ,3/4 and ,4/4 genotypes combined is estimated at 9.6%. Conclusion: These findings suggested that the ,2/2, ,3/4, and ,4/4 genotypes have greater early mortality risks. Further analyses showed that AD partially mediates the association between ,3/4, ,4/4, and death. [source] Providing Nutrition Supplements to Institutionalized Seniors with Probable Alzheimer's Disease Is Least Beneficial to Those with Low Body Weight StatusJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2004Karen W. H. Young MSc Objectives: To examine whether providing a midmorning nutrition supplement increases habitual energy intake in seniors with probable Alzheimer's disease (AD) and to investigate the effects of body weight status and cognitive and behavioral function on the response to the intervention. Design: Randomized, crossover, nonblinded clinical trial. Setting: A fully accredited geriatric teaching facility affiliated with the University of Toronto's Medical School with a home for the aged. Participants: Thirty-four institutionalized seniors with probable AD who ate independently. Intervention: Nutrition supplements were provided between breakfast and lunch for 21 consecutive days and compared with 21 consecutive days of habitual intake. Measurements: Investigator-weighed food intake, body weight, cognitive function (Severe Impairment Battery and Global Deterioration Scale), behavioral disturbances (Neuropsychiatric Inventory,Nursing Home Version), and behavioral function (London Psychogeriatric Rating Scale). Results: Relative to habitual intake, group mean analyses showed increased 24-hour energy, protein, and carbohydrate intake during the supplement phase, but five of 31 subjects who finished all study phases completely compensated for the energy provided by the supplement by reducing lunch intake, and 24-hour energy intake was enhanced in only 21 of 31 subjects. Compensation at lunch was more likely in subjects with lower body mass indices, increased aberrant motor behavior, poorer attention, and increased mental disorganization/confusion. Conclusion: Nutrition supplements were least likely to enhance habitual energy intake in subjects who would normally be targeted for nutrition intervention,those with low body weight status. Those likely to benefit include those with higher body mass indices, less aberrant motor problems, less mental disorganization, and increased attention. [source] Current Status of Metals as Therapeutic Targets in Alzheimer's DiseaseJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2003Anne E. Finefrock MA There is accumulating evidence that interactions between ,-amyloid and copper, iron, and zinc are associated with the pathophysiology of Alzheimer's disease (AD). A significant dyshomeostasis of copper, iron, and zinc has been detected, and the mismanagement of these metals induces ,-amyloid precipitation and neurotoxicity. Chelating agents offer a potential therapeutic solution to the neurotoxicity induced by copper and iron dyshomeostasis. Currently, the copper and zinc chelating agent clioquinol represents a potential therapeutic route that may not only inhibit ,-amyloid neurotoxicity, but may also reverse the accumulation of neocortical ,-amyloid. A Phase II double-blind clinical trial of clioquinol with B12 supplementation will be published soon, and the results are promising. This article summarizes the role of transition metals in amyloidgenesis and reviews the potential promise of chelation therapy as a treatment for AD. [source] Alzheimer's Disease: Current Pharmacotherapy in the Context of Patient and Family NeedsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5s2 2003David S. Geldmacher MD The objective of this paper is to review current evidence and treatment patterns for pharmacotherapy in Alzheimer's disease (AD), with an emphasis on outcomes considered important to patients and families. The sources for the information are the peer-reviewed literature, Food and Drug Administration-approved package labeling for acetylcholinesterase inhibitors (AChEIs), expert opinions expressed at the First Annual Dementia Congress, and clinical experience. Three AChEI agents are in routine use in the United States. They are considered part of the standard of care for patients with mild-to-moderate AD. There are differences in metabolism, pharmacokinetics, side effects, and ease of use that may influence the prescriber's choice of agent and dosage. The three approved agents have similar outcomes in cognition and global clinician ratings of effectiveness in double-blind placebo controlled trials. Persistent therapy with effective doses of AChEIs is associated with reduced risk for, or delayed, nursing home placement, which is a stated priority of AD caregivers. Agents from this class of drugs have also been shown to be associated with statistically significant preservation of daily function and benefits in treatment of adverse behaviors in AD. Numerous additional choices are available to the clinician for pharmacotherapy of adverse behaviors. Community-based psychoeducational support is also of value to caregivers. [source] Optimizing Coding and Reimbursement to Improve Management of Alzheimer's Disease and Related DementiasJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2002Howard Fillit MD The objectives of this study were to review the diagnostic, International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM), diagnosis related groups (DRGs), and common procedural terminology (CPT) coding and reimbursement issues (including Medicare Part B reimbursement for physicians) encountered in caring for patients with Alzheimer's disease and related dementias (ADRD); to review the implications of these policies for the long-term clinical management of the patient with ADRD; and to provide recommendations for promoting appropriate recognition and reimbursement for clinical services provided to ADRD patients. Relevant English-language articles identified from MEDLINE about ADRD prevalence estimates; disease morbidity and mortality; diagnostic coding practices for ADRD; and Medicare, Medicaid, and managed care organization data on diagnostic coding and reimbursement were reviewed. Alzheimer's disease (AD) is grossly undercoded. Few AD cases are recognized at an early stage. Only 13% of a group of patients receiving the AD therapy donepezil had AD as the primary diagnosis, and AD is rarely included as a primary or secondary DRG diagnosis when the condition precipitating admission to the hospital is caused by AD. In addition, AD is often not mentioned on death certificates, although it may be the proximate cause of death. There is only one ICD-9-CM code for AD,331.0,and no clinical modification codes, despite numerous complications that can be directly attributed to AD. Medicare carriers consider ICD-9 codes for senile dementia (290 series) to be mental health codes and pay them at a lower rate than medical codes. DRG coding is biased against recognition of ADRD as an acute, admitting diagnosis. The CPT code system is an impediment to quality of care for ADRD patients because the complex, time-intensive services ADRD patients require are not adequately, if at all, reimbursed. Also, physicians treating significant numbers of AD patients are at greater risk of audit if they submit a high frequency of complex codes. AD is grossly undercoded in acute hospital and outpatient care settings because of failure to diagnose, limitations of the coding system, and reimbursement issues. Such undercoding leads to a lack of recognition of the effect of AD and its complications on clinical care and impedes the development of better care management. We recommend continuing physician education on the importance of early diagnosis and care management of AD and its documentation through appropriate coding, expansion of the current ICD-9-CM codes for AD, more appropriate use of DRG coding for ADRD, recognition of the need for time-intensive services by ADRD patients that result in a higher frequency of use of complex CPT codes, and reimbursement for CPT codes that cover ADRD care management services. [source] Incidence of Dementia, Alzheimer's Disease, and Vascular Dementia in Italy.JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2002The ILSA Study OBJECTIVES: To estimate the incidence of dementia, Alzheimer's disease (AD), and vascular dementia (VaD) in older Italians and evaluate the relationship of age, gender, and education to developing dementia. DESIGN: Cohort incidence study in the context of the Italian Longitudinal Study on Aging. SETTING: Population sample from eight Italian municipalities. PARTICIPANTS: A dementia-free cohort of 3,208 individuals (aged 65,84), individuated after a baseline evaluation performed in 1992 / 93, aimed at detecting prevalent cases. MEASUREMENTS: The dementia-free cohort was reexamined in 1995 to identify incident cases. The Mini-Mental State Examination (cutoff 23 / 24) was employed to screen for dementia. Trained neurologists evaluated the individuals who screened positive. Final diagnoses had to meet Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised criteria for dementia, National Institute of Neurological and Communicative Disorders and Stroke,Alzheimer's Disease and Related Disorders Association criteria for AD, and International Classification of Diseases, Tenth Revision criteria for VaD. RESULTS: Before the follow-up examination, 382 individuals had died (232 had reliable information). Of the 2,826 survivors, 2,266 completed the study. Overall, 127 new dementia cases were identified. Average incidence rates per 1,000 person-years were 12.47 (95% confidence interval (CI) = 10.23,14.72) for dementia, 6.55 (95% CI = 4.92,8.17) for AD, and 3.30 (95% CI = 2.14,4.45) for VaD. Both AD and VaD showed age-dependent patterns. Education was protective against dementia and AD. Women carried a significantly higher risk of developing AD (hazard ratio = 1.67, 95% CI = 1.02,2.75), and men of developing VaD (hazard ratio = 2.23, 95% CI = 1.06,4.71). CONCLUSIONS: Incidence of dementia in Italy paralleled that in most industrialized countries. About 150,000 new cases per year are expected. A significant gender effect was evidenced for major dementia subtypes. The burden of VaD, especially in men, offers opportunities for prevention. [source] Apathy in Alzheimer's DiseaseJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2001Allan M. Landes MA Apathy, or loss of motivation, is arguably the most common change in behavior in Alzheimer's disease (AD) but is underrecognized. Apathy represents a form of executive cognitive dysfunction. Patients with apathy suffer from decreased daily function and specific cognitive deficits and rely on families to provide more care, which results in increased stress for families. Apathy is one of the primary syndromes associated with frontal and subcortical pathology, and apathy in AD appears to have multiple neuroanatomical correlates that implicate components of frontal subcortical networks. Despite the profound effects of this common syndrome, only a few instruments have been designed to specifically assess apathy, and these instruments have not been directly compared. Assessment of apathy in AD requires clinicians to distinguish loss of motivation from loss of ability due to cognitive decline. Although apathy may be misdiagnosed as depression because of an overlap in symptoms, current research has shown apathy to be a discrete syndrome. Distinguishing apathy from depression has important treatment implications, because these disorders respond to different interventions. Further research is required to clarify the specific neuroanatomical and neuropsychological correlates of apathy and to determine how correct diagnosis and treatment of apathy may improve patient functioning and ease caregiver burden. [source] Angiotensin Receptor Blocker Use May Decrease the Incidence and Progression of Alzheimer's Disease and Dementia in Older Men but the Strength of the Evidence Is QuestionableJOURNAL OF CLINICAL HYPERTENSION, Issue 6 2010Michael J. Bloch MD First page of article [source] Broad DNA repair responses in neural injury are associated with activation of the IL-6 pathway in cholesterol-fed rabbitsJOURNAL OF NEUROCHEMISTRY, Issue 4 2009Min Wu Abstract The importance of DNA repair in the pathogenic mechanism of Alzheimer's Disease (AD) is still poorly understood. Here, we report that a broad range of responses by DNA repair proteins plays a critical role in the regulation of inflammatory response in rabbits fed with cholesterol-rich diet, a model system for AD. We found accumulation of oxodG DNA adduct in the brain of rabbits fed with cholesterol-enriched diets compared to control diets, which subsequently induced a broad range of DNA repair protein activities. Also, the hippocampus was identified as the primary site of oxidative DNA damage and elevated OGG1 activity. In addition, a physical interaction between XPB and OGG1 may account for a potential mechanism involving these DNA repair responses. DNA repair proteins also impact activation of various signaling cascades, including Src in response to cholesterol oxidation. Furthermore, OGG1 deficient mice showed no IL-6 activation as seen in wt mice but a drastic increase of TNF-,, a pro-inflammatory cytokine. Thus, OGG1 may be associated with cytokine production induced by high cholesterol levels, impacting neurodegeneration. Together, our studies suggest that critical DNA repair proteins are associated with development of AD, and may serve as potential targets for the treatment of AD. [source] The Controversy Over Levels of Sex Steroids in Cases with Alzheimer's DiseaseJOURNAL OF NEUROENDOCRINOLOGY, Issue 2 2004E. Hogervorst No abstract is available for this article. [source] Serum Testosterone Levels in Males with Alzheimer's DiseaseJOURNAL OF NEUROENDOCRINOLOGY, Issue 2 2004C. Pennanen Abstract This study aimed to investigate whether there are differences in serum testosterone levels between male patients with Alzheimer's disease (AD) and cognitively normal male controls. Testosterone and sex hormone binding globulin (SHBG) levels were measured from 14 patients with mild to moderate AD and 16 age-matched control males. The AD patients had higher levels of serum total (P = 0.02) and free testosterone (P < 0.001), and higher free androgen index (FAI) (P = 0.02) compared to controls. No differences were found for the SHBG levels. These data provide no support for hypotheses of (disproportionally) decreased levels of serum testosterone in AD. These data also show that all cognitively normal controls had an FAI below the normal range. [source] | |||||||||||||||||||||||||||||||||||||||||||