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Dementia AND older e

Robert S Wilson, Ana W Capuano, Lei Yu, Jingyun Yang, Namhee Kim, Sue E Leurgans, Melissa Lamar, Julie A Schneider, David A Bennett, Patricia A Boyle
Retest learning impacts estimates of cognitive aging, but its bases are uncertain. Here, we test the hypothesis that dementia-related neurodegeneration impairs retest learning. Older persons without cognitive impairment at enrollment (n = 567) had annual cognitive testing for a mean of 11 years, died, and had a neuropathologic examination to quantify 5 neurodegenerative pathologies. Change point models were used to divide cognitive trajectories into an early retest sensitive component and a later component less sensitive to retest...
March 17, 2018: Neurobiology of Aging
John R Best, Janice J Eng, Jennifer C Davis, Robin Hsiung, Peter A Hall, Laura E Middleton, Peter Graf, Charles H Goldsmith, Teresa Liu-Ambrose
INTRODUCTION: Cerebrovascular disease-such as stroke-is the second most common cause of dementia (ie, vascular dementia). Specifically, a stroke increases one's risk for dementia by a factor of two. Thus, stroke survivors represent a target population in need of intervention strategies to promote cognitive function and prevent dementia. The current standard of care in stroke rehabilitation does not adequately address the significant cognitive consequences of stroke, especially for those who are in the chronic phase (ie, >12 months since an index stroke)...
March 17, 2018: BMJ Open
Hugo Botha, William G Mantyh, Melissa E Murray, David S Knopman, Scott A Przybelski, Heather J Wiste, Jonathan Graff-Radford, Keith A Josephs, Christopher G Schwarz, Walter K Kremers, Bradley F Boeve, Ronald C Petersen, Mary M Machulda, Joseph E Parisi, Dennis W Dickson, Val Lowe, Clifford R Jack, David T Jones
Predicting underlying pathology based on clinical presentation has historically proven difficult, especially in older cohorts. Age-related hippocampal sclerosis may account for a significant proportion of elderly participants with amnestic dementia. Advances in molecular neuroimaging have allowed for detailed biomarker-based phenotyping, but in the absence of antemortem markers of hippocampal sclerosis, cases of mixed pathology remain problematic. We evaluated the utility of 18F-FDG-PET to differentiate flortaucipir tau PET negative from flortaucipir positive amnestic mild cognitive impairment and dementia and used an autopsy confirmed cohort to test the hypothesis that hippocampal sclerosis might account for the observed pattern...
March 12, 2018: Brain: a Journal of Neurology
Diego Z Carvalho, Erik K St Louis, David S Knopman, Bradley F Boeve, Val J Lowe, Rosebud O Roberts, Michelle M Mielke, Scott A Przybelski, Mary M Machulda, Ronald C Petersen, Clifford R Jack, Prashanthi Vemuri
Importance: Aging is associated with excessive daytime sleepiness (EDS), which has been linked to cognitive decline in the elderly. However, whether EDS is associated with the pathologic processes of Alzheimer disease remains unclear. Objective: To investigate whether EDS at baseline is associated with a longitudinal increase in regional β-amyloid (Aβ) accumulation in a cohort of elderly individuals without dementia. Design, Setting, and Participants: This prospective analysis included participants enrolled in the Mayo Clinic Study of Aging, a longitudinal population-based study in Olmsted County, Minnesota...
March 12, 2018: JAMA Neurology
Beatrice J Edwards, Xiaotao Zhang, Ming Sun, Holly M Holmes, Leena Ketonen, Nandita Guha, Peter Khalil, Juhee Song, Shelli Kesler, Jay B Shah, Debasish Tripathy, Vicente Valero, Richard E Champlin
OBJECTIVE: To assess cognitive function in older adults undergoing cancer care. MATERIALS AND METHODS: This is a cross-sectional study, in the University of Texas MD Anderson Cancer Center, in older adults undergoing cancer care. Comprehensive geriatric assessments were conducted prior to surgery, chemotherapy or allogeneic stem cell transplantation, at the Program for Healthy Aging from January 1, 2013 through March 31, 2015. Cognitive assessment was conducted through personal and family interview, and the Montreal cognitive assessment (MoCA)...
March 9, 2018: Journal of Geriatric Oncology
Yemisi Takwoingi, Terence J Quinn
Diagnostic Test Accuracy (DTA) describes a field of research that aims to assess how well a test is able to detect or exclude a condition of interest. Although geriatric medicine is not as reliant on investigations as other medical disciplines, almost all patient encounters with older adults will involve some form of diagnostic assessment. Thus, understanding the terminology and methods of DTA is essential for any clinician. In this review we use examples based around the diagnosis of dementia to highlight issues in DTA research...
March 8, 2018: Age and Ageing
Michael Dennis, Laura Shine, Ann John, Amanda Marchant, Joanna McGregor, Ronan A Lyons, Sinead Brophy
This article was originally published under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), but has now been made available under a Creative Commons Attribution 4.0 International License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made...
March 9, 2018: Neurology and Therapy
Supriya G Mohile, Allison Magnuson, Chintan Pandya, Carla Velarde, Paul Duberstein, Arti Hurria, Kah Poh Loh, Megan Wells, Sandy Plumb, Nikesha Gilmore, Marie Flannery, Marsha Wittink, Ronald Epstein, Charles E Heckler, Michelle Janelsins, Karen Mustian, Judith O Hopkins, Jane Liu, Srihari Peri, William Dale
Background: This study's objectives were to describe community oncologists' beliefs about and confidence with geriatric care and to determine whether geriatric-relevant information influences cancer treatment decisions. Methods: Community oncologists were recruited to participate in 2 multisite geriatric oncology trials. Participants shared their beliefs about and confidence in caring for older adults. They were also asked to make a first-line chemotherapy recommendation (combination vs single-agent vs no chemotherapy) for a hypothetical vignette of an older patient with advanced pancreatic cancer...
March 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Lindsay R Clark, Sara E Berman, Derek Norton, Rebecca L Koscik, Erin Jonaitis, Kaj Blennow, Barbara B Bendlin, Sanjay Asthana, Sterling C Johnson, Henrik Zetterberg, Cynthia M Carlsson
OBJECTIVE: Compare cognitive and hippocampal volume trajectories in asymptomatic middle-aged and older adults with positive CSF markers of β-amyloid (Aβ) or tau to adults without an Alzheimer disease (AD)-associated biomarker profile. METHODS: Three hundred ninety-two adults enrolled in a longitudinal cohort study (Wisconsin Registry for Alzheimer's Prevention or Wisconsin Alzheimer's Disease Research Center) completed a lumbar puncture and at least 2 biennial or annual neuropsychological evaluations...
March 9, 2018: Neurology
Nicole R Fowler, C Elizabeth Shaaban, Alexia M Torke, Kathleen A Lane, Samir Saba, Amber E Barnato
Background: The decision to implant a cardiac device in a person with Alzheimer's disease or related dementia requires considering the possible trade-offs of quality of life (QOL) and quantity of life. This study measured the decision-making experience of patients with and without cognitive impairment (CI) who received a cardiac device and their family members who were involved in the decision. Methods and Results: Semi-structured interviews and questionnaires were administered with 15 patient-family member dyads...
2018: Cardiol Cardiovasc Med
Michael E Ward, Jeffrey M Gelfand, Li-Yung Lui, Yvonne Ou, Ari J Green, Katie Stone, Kathryn L Pedula, Steven R Cummings, Kristine Yaffe
OBJECTIVE: Several cross-sectional studies have reported an association between visual contrast sensitivity (a functional measure of low contrast vision) and poor cognitive performance or dementia, but no studies have investigated this association prospectively in a population based cohort with final adjudication of mild cognitive impairment (MCI)/dementia. METHODS: In a prospective, community-based study of aging women (Study of Osteoporotic Fractures), we analyzed whether visual contrast sensitivity was associated with increased risk of MCI or dementia and/or worse performance on various cognitive tests assessed 10 years later...
March 8, 2018: Annals of Neurology
L A Rafferty, P E Cawkill, S A M Stevelink, K Greenberg, N Greenberg
BACKGROUND: Dementia is currently incurable, irreversible and a major cause of disability for the world's older population. The association between mental health difficulties, such as post-traumatic stress disorder (PTSD) and major depressive disorder (MDD), and dementia has a long history within the civilian population. Despite the increased importance of this link within the military veteran population, who suffer a greater propensity of mental health difficulties and consist largely of over 65s, attention is only recently being paid to the salience of such an association for this group...
March 8, 2018: Psychological Medicine
Lauren L Mitchell, Colleen M Peterson, Shaina R Rud, Eric Jutkowitz, Andrielle Sarkinen, Sierra Trost, Carolyn M Porta, Jessica M Finlay, Joseph E Gaugler
Technologies have emerged that aim to help older persons with Alzheimer's disease and related dementias (ADRDs) remain at home while also supporting their caregiving family members. However, the usefulness of these innovations, particularly in home-based care contexts, remains underexplored. The current study evaluated the acceptability and utility of an in-home remote activity monitoring (RAM) system for 30 family caregivers of persons with ADRD via quantitative survey data collected over a 6-month period and qualitative survey and interview data collected for up to 18 months...
March 1, 2018: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
Scott Martin Vouri, Mario Schootman, Seth A Strope, Stanley J Birge, Margaret A Olsen
BACKGROUND: Oral oxybutynin has been associated with the development of cognitive impairment. OBJECTIVE: The objective of this study was to describe the use of oral oxybutynin versus other antimuscarinics (e.g., tolterodine, darifenacin, solifenacin, trospium, fesoterodine, transdermal oxybutynin) in older adults with documented cognitive impairment. METHODS: This is a population-based retrospective analysis of antimuscarinic new users aged ≥ 66 years from January 2008 to December 2011 (n = 42,886) using a 5% random sample of Medicare claims linked with Part D data...
February 28, 2018: Drugs & Aging
Chloe Rodgers, David Rogerson, Judy Stevenson, Davina Porock
BACKGROUND: Physical activity has been cited as a potential symptomatic treatment option for people living with dementia. At present, much of the research concerning physical activity and dementia considers older adults, and there are several review articles summarising the evidence in this area. Less is known about physical activity for younger people with dementia, despite the marked differences in needs and preferences between the two groups. The aim of this scoping review is to systematically explore and critically appraise the current state of the evidence regarding physical activity for people with young-onset dementia and carers...
February 27, 2018: Systematic Reviews
Rowan H Harwood, Veronika van der Wardt, Sarah E Goldberg, Fiona Kearney, Pip Logan, Vicky Hood-Moore, Vicky Booth, Jennie E Hancox, Tahir Masud, Zoe Hoare, Andrew Brand, Rhiannon Tudor Edwards, Carys Jones, Roshan das Nair, Kristian Pollock, Maureen Godfrey, John R F Gladman, Kavita Vedhara, Helen Smith, Martin Orrell
Background: People with dementia progressively lose abilities and are prone to falling. Exercise- and activity-based interventions hold the prospect of increasing abilities, reducing falls, and slowing decline in cognition. Current falls prevention approaches are poorly suited to people with dementia, however, and are of uncertain effectiveness. We used multiple sources, and a co-production approach, to develop a new intervention, which we will evaluate in a feasibility randomised controlled trial (RCT), with embedded adherence, process and economic analyses...
2018: Pilot and Feasibility Studies
Zoe Arvanitakis, Sue E Leurgans, Debra A Fleischman, Julie A Schneider, Kumar B Rajan, Jeremy J Pruzin, Raj C Shah, Denis A Evans, Lisa L Barnes, David A Bennett
OBJECTIVE: To determine relationships of memory complaints to cognitive function and decline, incident dementia, and neurodegenerative and other neuropathologies, as well as the population-attributable risk for dementia in older black and white persons. METHODS: 4015 community-based persons (28% black; 74% women; mean baseline age 78 years), were enrolled in one of four longitudinal cohort studies, and another 2937 in a population-based cohort. Memory scores, assessed using two questions (5-point Likert scales) were categorized as complaints present or absent...
February 21, 2018: Annals of Neurology
E Freiberger
Cognitive abilities and gait with its physical parameters are important for mobility. There is clinically sound evidence that a reduction of gait speed can be seen as an early subclinical indicator of cognitive decline of even higher risk of onset of dementia. The dual-task paradigm is a method in which the older person has to simultaneously solve two different task. It is of utmost importance to identify older persons at risk of falls or onset of dementia. The dual-task paradigm seems to be an important method in this process...
February 19, 2018: Der Internist
Hanneke F M Rhodius-Meester, Hilkka Liedes, Ted Koene, Afina W Lemstra, Charlotte E Teunissen, Frederik Barkhof, Philip Scheltens, Mark van Gils, Jyrki Lötjönen, Wiesje M van der Flier
BACKGROUND: Survival after dementia diagnosis varies considerably. Previous studies were focused mainly on factors related to demographics and comorbidity rather than on Alzheimer's disease (AD)-related determinants. We set out to answer the question whether markers with proven diagnostic value also have prognostic value. We aimed to identify disease-related determinants associated with mortality in patients with AD. METHODS: We included 616 patients (50% female; age 67 ± 8 years; mean Mini Mental State Examination score 22 ± 3) with dementia due to AD from the Amsterdam Dementia Cohort...
February 20, 2018: Alzheimer's Research & Therapy
Sang Won Seo, Marie-Pierre Thibodeau, David C Perry, Alice Hua, Manu Sidhu, Isabel Sible, Jose Norberto S Vargas, Stephanie E Gaus, Gil D Rabinovici, Katherine D Rankin, Adam L Boxer, Joel H Kramer, Howard J Rosen, Maria Luisa Gorno-Tempini, Lea T Grinberg, Eric J Huang, Stephen J DeArmond, John Q Trojanowski, Bruce L Miller, William W Seeley
OBJECTIVE: To examine clinicopathologic correlations in early vs late age at onset frontotemporal dementia (FTD) and frontotemporal lobar degeneration (FTLD). METHODS: All patients were clinically evaluated and prospectively diagnosed at the UCSF Memory and Aging Center. Two consecutive series were included: (1) patients with a clinically diagnosed FTD syndrome who underwent autopsy (cohort 1) and (2) patients with a primary pathologic diagnosis of FTLD, regardless of the clinical syndrome (cohort 2)...
February 16, 2018: Neurology
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