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Sara Garcia-Ptacek, J Simon Bell, Edwin Ck Tan, Sarah N Hilmer
BACKGROUND: Alzheimer's disease is the most common form of dementia and is a major contributor to morbidity and mortality in older Australians. OBJECTIVE: The aim of this article is to provide an overview of available pharmacological therapies for the symptomatic treatment of Alzheimer's disease. DISCUSSION: Acetylcholinesterase inhibitors (AChEIs) or memantine may be trialled in people with Alzheimer's disease to delay symptoms of cognitive and functional decline...
September 2018: Australian journal of general practice
Dimity Pond
BACKGROUND: Dementia is an increasingly prevalent condition, currently affecting over 400,000 Australians, and this is expected to rise to over one million by 2056. Diagnosis of dementia is a clinical one, as there is no single well-defined blood test, imaging or cognitive function test that validly diagnoses dementia. There are also many causes of cognitive impairment other than dementia, which need to be identified or excluded. General practitioners (GPs) are on the frontline of presentation and will therefore play an increasingly important role in identification and management...
September 2018: Australian journal of general practice
María F Zappa Villar, Juliette López Hanotte, Eugenia Falomir Lockhart, Lucía S Trípodi, Gustavo R Morel, Paula C Reggiani
Sporadic Alzheimer's disease (SAD) is the most common form of dementia; therefore, there is an urgent need for a model that recapitulates the main pathologic hallmarks of this disease. The intracerebroventricular (icv) injection of streptozotocin (icv-STZ) in rats constitutes a promising model, and thus, icv-STZ rats develop insulin-resistant brain state and cognitive impairments. Even though a great piece of studies has hitherto described this system as a model for SAD, further behavioral and morphometric studies are still needed to fully characterize it...
September 22, 2018: Journal of Neural Transmission
Kevin A Matthews, Wei Xu, Anne H Gaglioti, James B Holt, Janet B Croft, Dominic Mack, Lisa C McGuire
INTRODUCTION: Alzheimer's disease and related dementias (ADRD) cause a high burden of morbidity and mortality in the United States. Age, race, and ethnicity are important risk factors for ADRD. METHODS: We estimated the future US burden of ADRD by age, sex, and race and ethnicity by applying subgroup-specific prevalence among Medicare Fee-for-Service beneficiaries aged ≥65 years in 2014 to subgroup-specific population estimates for 2014 and population projection data from the US Census Bureau for 2015 to 2060...
September 17, 2018: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
Manav V Vyas, Pranali K Raval, Jennifer A Watt, David F Tang-Wai
BACKGROUND: Despite the projected increase in dementia cases affecting various ethnic groups worldwide, representation of these ethnic groups in randomized controlled trials (RCTs) of treatments to improve cognitive function in persons with dementia or mild cognitive impairment (MCI) is unclear. We aimed to quantify the inclusion of various ethnicities in dementia treatment RCTs. METHODS: RCTs published between January 1, 2000 and August 1, 2017 (inclusive) were included...
September 12, 2018: Journal of the Neurological Sciences
C Coomans, A Sieben, M Lammens, C Ceuterick-de Groote, C Vandenbroecke, I Goethals, D Van Melkebeke, D Hemelsoet
Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia, and Nasu Hakola disease or polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy are both underrecognized progressive degenerative white matter diseases that can present with young dementia, leukoencephalopathy and brain calcifications. We report and compare three cases in terms of clinical phenotype, imaging and neuropathological findings. Both cases have led to the identification of two novel causal mutations.
September 21, 2018: Acta Neurologica Belgica
Sung-Chun Tang, Kai-Chien Yang, Chih-Hao Chen, Shieh-Yueh Yang, Ming-Jang Chiu, Chau-Chung Wu, Jiann-Shing Jeng
Increases in plasma of β-amyloids (Aβ) and tau proteins have been noted in patients with Alzheimer's dementia (AD). Our study investigated the associations of plasma Aβ and tau proteins with dementia in stroke patients. This cross-sectional study recruited 24 controls (mean age: 67.4 ± 7.5 years, 33.3% male), 27 stroke patients without dementia (mean age: 70.7 ± 6.9 years, 60.7% male), 34 stroke patients with dementia (mean age: 78.3 ± 5.3 years, 45.5% male, Clinical Dementia Ranking (CDR): 1...
September 21, 2018: Neuromolecular Medicine
Sharon Straus, Jennifer Watt
No abstract text is available yet for this article.
September 18, 2018: Annals of Internal Medicine
Kenton J Johnston, Hefei Wen, Jason M Hockenberry, Karen E Joynt Maddox
Importance: Medicare is moving toward value-based payment. The Merit-Based Incentive Payment System (MIPS) program judges outpatient clinicians' performance on a measure of annual Medicare spending. However, this measure may disadvantage outpatient clinicians who care for vulnerable populations because the algorithm omits meaningful determinants of cost. Objectives: To determine whether factors not included in Medicare risk adjustment, including patient neuropsychological and functional status, as well as local area health resources and economic conditions, are associated with Medicare total annual cost of care (TACC), and evaluate whether accounting for these factors is associated with improved TACC performance by outpatient safety-net clinicians...
September 17, 2018: JAMA Internal Medicine
Andrée-Ann Baril, Julie Carrier, Alexandre Lafrenière, Simon Warby, Judes Poirier, Ricardo S Osorio, Najib Ayas, Marie-Pierre Dubé, Dominique Petit, Nadia Gosselin
Epidemiologic and mechanistic evidence is increasingly supporting the notion that obstructive sleep apnea is a risk factor for dementia. Hence, the identification of patients at risk of cognitive decline due to obstructive sleep apnea may significantly improve preventive strategies and treatment decision-making. Cerebrospinal fluid and blood biomarkers obtained through genomic, proteomic and metabolomic approaches are improving the ability to predict incident dementia. Therefore, fluid biomarkers have the potential to predict vulnerability to neurodegeneration in individuals with obstructive sleep apnea, as well as deepen our understanding of pathophysiological processes linking obstructive sleep apnea and dementia...
August 13, 2018: Sleep Medicine Reviews
Kieran A Walsh, Carol Sinnott, Aoife Fleming, Jenny Mc Sharry, Stephen Byrne, John Browne, Suzanne Timmons
OBJECTIVES: Caution is advised when prescribing antipsychotics to people with dementia. This study explored the determinants of appropriate, evidence-based antipsychotic prescribing behaviors for nursing home residents with dementia, with a view to informing future quality improvement efforts and behavior change interventions. DESIGN: Semistructured qualitative interviews based on the Theoretical Domains Framework (TDF). SETTING AND PARTICIPANTS: A purposive sample of 27 participants from 4 nursing homes, involved in the care of nursing home residents with dementia (8 nurses, 5 general practitioners, 5 healthcare assistants, 3 family members, 2 pharmacists, 2 consultant geriatricians, and 2 consultant psychiatrists of old age) in a Southern region of Ireland...
September 18, 2018: Journal of the American Medical Directors Association
Richard Dodel, Jiri Koschel, Stefan Lorenzl, Johannes Levin, Thilo van Eimeren, Günter Höglinger
Dementia with Lewy bodies is characterized histopathologically by the deposition of α-synuclein in inclusion bodies. Clinical diagnosis is based on progressive cognitive deficits, cognitive fluctuations, early visual hallucinations, REM sleep disorders and symptoms of Parkinsonism. On the basis of the new criteria published in 2017, better differentiation from other neurodegenerative diseases with dementia should be possible. Therapy concepts include treatment of loss of motor and cognitive performance as well as psychological and behavioral symptoms...
September 2018: Fortschritte der Neurologie-Psychiatrie
Lorenzo Massimi, Inna Bukreeva, Giulia Santamaria, Michela Fratini, Alessandro Corbelli, Francesco Brun, Stefano Fumagalli, Laura Maugeri, Alexandra Pacureanu, Peter Cloetens, Nicola Pieroni, Fabio Fiordaliso, Gianluigi Forloni, Antonio Uccelli, Nicole Kerlero de Rosbo, Claudia Balducci, Alessia Cedola
Alzheimer's disease (AD), the most common form of dementia, is a progressive neurodegenerative disorder associated with aberrant production of beta-amyloid (Aβ) peptide depositing in brain as amyloid plaques. While animal models allow investigation of disease progression and therapeutic efficacy, technology to fully dissect the pathological mechanisms of this complex disease at cellular and vascular levels is lacking. X-ray phase contrast tomography (XPCT) is an advanced non-destructive 3D multi-scale direct imaging from the cell through to the whole brain, with exceptional spatial and contrast resolution...
September 18, 2018: NeuroImage
Yen-Feng Lin, Albert Vernon Smith, Thor Aspelund, Rebecca A Betensky, Jordan W Smoller, Vilmundur Gudnason, Lenore J Launer, Deborah Blacker
INTRODUCTION: We sought to examine the genetic overlap between vascular pathologies and Alzheimer's disease (AD) dementia, and the potential mediating role of vascular pathologies between AD-related genetic variants and late-life cognition. METHODS: For 2907 stroke-free older individuals, we examined the association of polygenic risk scores for AD dementia (ADPRSs) with vascular pathologies and with cognition. Mediation analyses addressed whether association between ADPRSs and cognition was mediated by a vascular pathology...
September 18, 2018: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
Paul Brewster, Lisa Barnes, Mary Haan, Julene K Johnson, Jennifer J Manly, Anna María Nápoles, Rachel A Whitmer, Luis Carvajal-Carmona, Dawnte Early, Sarah Farias, Elizabeth Rose Mayeda, Rebecca Melrose, Oanh L Meyer, Adina Zeki Al Hazzouri, Ladson Hinton, Dan Mungas
In 2016, the UC Davis Latino Aging Research Resource Center and UC Davis Alzheimer's Disease Center brought together experts from across the country to consolidate current knowledge and identify future directions in aging and diversity research. This report disseminates the research priorities that emerged from this conference, building on an earlier Gerontological Society of America preconference. We review key racial/ethnic differences in cognitive aging and dementia and identify current knowledge gaps in the field...
September 18, 2018: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
Bjørn Heine Strand, Anne-Brita Knapskog, Karin Persson, Trine Holt Edwin, Rachel Amland, Marit Mjørud, Espen Bjertness, Knut Engedal, Geir Selbæk
INTRODUCTION: Alzheimer's disease patients are reported to have higher survival rate compared to patients with vascular dementia or dementia with Lewy bodies. There is a paucity of studies investigating survival including persons with cognitive decline and dementia of various aetiologies. OBJECTIVES: We aimed to compare survival for patients with subjective cognitive decline, mild cognitive impairment, Alzheimer's disease, vascular dementia, mixed Alzheimer's/vascular dementia, dementia with Lewy bodies/Parkinson's disease, and other dementias compared to the general Norwegian population, taking into account the role of gender, cognitive function, function in everyday activities, comorbidity and education...
2018: PloS One
Keisuke Ishizawa, Takashi Mitsufuji, Kei Shioda, Atsushi Kobayashi, Takashi Komori, Yoshihiko Nakazato, Tetsuyuki Kitamoto, Nobuo Araki, Toshimasa Yamamoto, Atsushi Sasaki
INTRODUCTION: Gerstmann-Sträussler-Scheinker disease P105L (GSS105) is a rare variant of GSS caused by a point mutation of the prion protein (PrP) gene at codon 105 (proline to leucine substitution). It is clinically characterized by spastic paraparesis and dementia and histopathologically defined by PrP-plaques in the brain. This report describes a clinicopathological analysis of three autopsied kindred from a Japanese GSS105 family, plus a topological analysis of PrP, hyperphosphorylated tau (p-tau), and beta-amyloid (Aβ)...
September 21, 2018: Brain and Behavior
Jogé Boumans, Leonieke C van Boekel, Caroline A Baan, Katrien G Luijkx
Background and Objectives: For people with dementia living in residential care facilities, maintaining autonomy and receiving informal care are important. The objective of this review is to understand how caregiving approaches and physical environment, including technologies contribute to the maintenance of autonomy and informal care provision for this population. Research Design and Methods: A literature review of peer-reviewed articles published between January 1995 and July 2017 was performed...
September 15, 2018: Gerontologist
Daniel A Solomon, Alan Stepto, Wing Hei Au, Yoshitsugu Adachi, Danielle C Diaper, Rachel Hall, Anjeet Rekhi, Adel Boudi, Paraskevi Tziortzouda, Youn-Bok Lee, Bradley Smith, Jessika C Bridi, Greta Spinelli, Jonah Dearlove, Dickon M Humphrey, Jean-Marc Gallo, Claire Troakes, Manolis Fanto, Matthias Soller, Boris Rogelj, Richard B Parsons, Christopher E Shaw, Tibor Hortobágyi, Frank Hirth
Accumulation and aggregation of TDP-43 is a major pathological hallmark of amyotrophic lateral sclerosis and frontotemporal dementia. TDP-43 inclusions also characterize patients with GGGGCC (G4C2) hexanucleotide repeat expansion in C9orf72 that causes the most common genetic form of amyotrophic lateral sclerosis and frontotemporal dementia (C9ALS/FTD). Functional studies in cell and animal models have identified pathogenic mechanisms including repeat-induced RNA toxicity and accumulation of G4C2-derived dipeptide-repeat proteins...
September 19, 2018: Brain: a Journal of Neurology
Miguel Ángel Araque Caballero, Marc Suárez-Calvet, Marco Duering, Nicolai Franzmeier, Tammie Benzinger, Anne M Fagan, Randall J Bateman, Clifford R Jack, Johannes Levin, Martin Dichgans, Mathias Jucker, Celeste Karch, Colin L Masters, John C Morris, Michael Weiner, Martin Rossor, Nick C Fox, Jae-Hong Lee, Stephen Salloway, Adrian Danek, Alison Goate, Igor Yakushev, Jason Hassenstab, Peter R Schofield, Christian Haass, Michael Ewers
White matter alterations are present in the majority of patients with Alzheimer's disease type dementia. However, the spatiotemporal pattern of white matter changes preceding dementia symptoms in Alzheimer's disease remains unclear, largely due to the inherent diagnostic uncertainty in the preclinical phase and increased risk of confounding age-related vascular disease and stroke in late-onset Alzheimer's disease. In early-onset autosomal-dominantly inherited Alzheimer's disease, participants are destined to develop dementia, which provides the opportunity to assess brain changes years before the onset of symptoms, and in the absence of ageing-related vascular disease...
September 19, 2018: Brain: a Journal of Neurology
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