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advance dementia

Isabelle F van der Velpen, Stephanie Feleus, Anne Suzanne Bertens, Behnam Sabayan
INTRODUCTION: Cardiac function is a key player in maintaining energy homeostasis in the brain. Heart failure is closely related to higher risk of neurocognitive disorders. Recent evidence shows that this relationship might not be limited to patients with advanced heart failure, and even suboptimal cardiac functioning is associated with accelerated brain aging. Hence, hemodynamic and serum cardiac markers may provide valuable information about the risk of dementia. METHODS: We provide an overview on the link between cardiac markers and cognitive function by a systematic search in five databases...
October 19, 2016: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
Walter Pirker, Regina Katzenschlager
Human gait depends on a complex interplay of major parts of the nervous, musculoskeletal and cardiorespiratory systems. The individual gait pattern is influenced by age, personality, mood and sociocultural factors. The preferred walking speed in older adults is a sensitive marker of general health and survival. Safe walking requires intact cognition and executive control. Gait disorders lead to a loss of personal freedom, falls and injuries and result in a marked reduction in the quality of life. Acute onset of a gait disorder may indicate a cerebrovascular or other acute lesion in the nervous system but also systemic diseases or adverse effects of medication, in particular polypharmacy including sedatives...
October 21, 2016: Wiener Klinische Wochenschrift
Magnolia Cardona-Morrell, Gustavo Benfatti-Olivato, Jesse Jansen, Robin M Turner, Diana Fajardo-Pulido, Ken Hillman
OBJECTIVE: To describe the range of decision aids (DAs) available to enable informed choice for older patients at the end of life and assess their effectiveness or acceptability. METHODS: Search strategy covered PubMed, Scopus, Ovid MEDLINE, EMBASE, EBM Reviews, CINAHL and PsycInfo between 1995 and 2015. The quality criteria framework endorsed by the International Patient Decision Aids Standards (IPDAS) was used to assess usefulness. RESULTS: Seventeen DA interventions for patients, their surrogates or health professionals were included...
October 11, 2016: Patient Education and Counseling
Laura M Struble, Mary C Blazek, Helen C Kales
A 92-year-old patient with Parkinson disease and dementia provides an opportunity for the advanced practice registered nurse to shift thinking about behavioral disturbances in dementia, away from controlling behavior with pharmacologic approaches, such as antipsychotics, toward understanding behavior by applying the nonpharmacologic Describe, Investigate, Create, and Evaluate method.
November 19, 2016: Nurse Practitioner
Ricarda A L Menke, Federica Agosta, Julian Grosskreutz, Massimo Filippi, Martin R Turner
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative, clinically heterogeneous syndrome pathologically overlapping with frontotemporal dementia. To date, therapeutic trials in animal models have not been able to predict treatment response in humans, and the revised ALS Functional Rating Scale, which is based on coarse disability measures, remains the gold-standard measure of disease progression. Advances in neuroimaging have enabled mapping of functional, structural, and molecular aspects of ALS pathology, and these objective measures may be uniquely sensitive to the detection of propagation of pathology in vivo...
October 17, 2016: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Leroy L Cooper, Gary F Mitchell
BACKGROUND: Aortic stiffness is associated with cardiovascular and cerebrovascular events and cognitive decline. This mini-review focuses on relations of aortic stiffness with microvascular dysfunction and discusses the contribution of abnormal pulsatile hemodynamics to cerebrovascular damage and cognitive decline. We also provide a rationale for considering aortic stiffness as a putative and important contributor to memory impairment in older individuals. SUMMARY: Aging is associated with stiffening of the aorta but not the muscular arteries, which reduces wave reflection and increases the transmission of pulsatility into the periphery...
September 2016: Pulse (Basel, Switzerland)
Hiral Shah, Emiliano Albanese, Cynthia Duggan, Igor Rudan, Kenneth M Langa, Maria C Carrillo, Kit Yee Chan, Yves Joanette, Martin Prince, Martin Rossor, Shekhar Saxena, Heather M Snyder, Reisa Sperling, Mathew Varghese, Huali Wang, Marc Wortmann, Tarun Dua
At the First WHO Ministerial Conference on Global Action Against Dementia in March, 2015, 160 delegates, including representatives from 80 WHO Member States and four UN agencies, agreed on a call for action to reduce the global burden of dementia by fostering a collective effort to advance research. To drive this effort, we completed a globally representative research prioritisation exercise using an adapted version of the Child Health and Nutrition Research Initiative method. We elicited 863 research questions from 201 participants and consolidated these questions into 59 thematic research avenues, which were scored anonymously by 162 researchers and stakeholders from 39 countries according to five criteria...
November 2016: Lancet Neurology
Carola Stockburger, Davide Miano, Thea Pallas, Kristina Friedland, Walter E Müller
The mitochondrial cascade hypothesis of dementia assumes mitochondrial dysfunction leading to reduced energy supply, impaired neuroplasticity, and finally cell death as one major pathomechanism underlying the continuum from brain aging over mild cognitive impairment to initial and advanced late onset Alzheimer's disease. Accordingly, improving mitochondrial function has become an important strategy to treat the early stages of this continuum. The metabolic enhancer piracetam has been proposed as possible prototype for those compounds by increasing impaired mitochondrial function and related aspects like mechanisms of neuroplasticity...
2016: Neural Plasticity
Barnan Das, Diane J Cook, Narayanan C Krishnan, Maureen Schmitter-Edgecombe
Caring for individuals with dementia is frequently associated with extreme physical and emotional stress, which often leads to depression. Smart home technology and advances in machine learning techniques can provide innovative solutions to reduce caregiver burden. One key service that caregivers provide is prompting individuals with memory limitations to initiate and complete daily activities. We hypothesize that sensor technologies combined with machine learning techniques can automate the process of providing reminder-based interventions...
August 2016: IEEE Journal of Selected Topics in Signal Processing
Javier Suárez Dono, Evelín Cervantes Pérez, Marta Pena Seijo, Francisco Formigo Couceiro, Fernando Ferrón Vidán, Ignacio Novo Veleiro, Esther Del Corral Beamonte, Jesús Díez Manglano, Francisco Gude Sampedro, Antonio Pose Reino
OBJECTIVE: We have followed patients admitted to a Polypathology and Advanced Age Unit for two years in order to identify the variables that best define the mortality prognosis at medium-term (1-2years) for chronic and polypathological patients requiring admission at an Internal Medicine Department. METHODS: This is an observational, prospective study in clinical practice. Polypathological, chronic or multimorbidity patients were included. The classification of the Spanish Ministry for Health was used in order to classify patients as chronic or polypathological...
October 10, 2016: European Journal of Internal Medicine
Tammy Vu Bach, Jonathan Pan, Anne Kirstein, Cindy Joanne Grief, Daphna Grossman
Palliative care clinicians are increasingly involved in the care of elderly patients suffering from chronic malignant and nonmalignant illnesses, of which neuropathic pain is a prevalent problem. As a person becomes more frail, pain medications such as opioid analgesics and adjuvant pain medications can result in unwanted effects such as sedation, confusion, and increased risk of falls. Treating pain in patients with advanced dementia or neurodegenerative diseases that can affect swallowing is particularly challenging because most adjuvant pain medications used to ameliorate neuropathic pain must be taken orally...
October 11, 2016: Journal of Palliative Medicine
Sven Briken, Sina Cathérine Rosenkranz, Oliver Keminer, Stefan Patra, Gesche Ketels, Christoph Heesen, Rainer Hellweg, Ole Pless, Karl-Heinz Schulz, Stefan M Gold
BACKGROUND: Clinical studies have suggested beneficial effects of exercise on cognitive function in ageing adults and neurodegenerative diseases such as dementia. Recent work indicates the same for progressive multiple sclerosis (MS), an inflammatory and degenerative disease of the central nervous system (CNS). The biological pathways associated with these effects are however not well understood. OBJECTIVE: In this randomized controlled study, we explored serum levels of the myokine Irisin, the neurotrophin brain-derived neurotrophic factor (BDNF) and Interleukin-6 (IL-6) during acute endurance exercise and over the course of a 9-weeks endurance exercise training period in n=42 patients with progressive MS...
October 15, 2016: Journal of Neuroimmunology
Joan M Teno, Pedro Gozalo, Nita Khandelwal, J Randall Curtis, David Meltzer, Ruth Engelberg, Vincent Mor
Importance: Mechanical ventilation may be lifesaving, but in certain persons, such as those with advanced dementia, it may prolong patient suffering without a clear survival benefit. Objective: To describe the use and outcomes of mechanical ventilation and its association with the increasing numbers of intensive care unit (ICU) beds in the United States for patients with advanced dementia residing in a nursing home 120 days before that hospital admission. Design, Setting, and Participants: This retrospective cohort study evaluated Medicare beneficiaries with advanced dementia hospitalized from January 1, 2000, to December 31, 2013, using the Minimum Data Set assessments linked with Medicare part A claims...
October 10, 2016: JAMA Internal Medicine
Gary S Winzelberg, Laura C Hanson
No abstract text is available yet for this article.
October 10, 2016: JAMA Internal Medicine
Erin E Sundermann, Pauline M Maki, Leah H Rubin, Richard B Lipton, Susan Landau, Anat Biegon
OBJECTIVE: We investigated sex differences in verbal memory across different levels of neural dysfunction, measured by temporal lobe glucose metabolic rates (TLGluMR). METHODS: Three hundred ninety controls and 672 participants with amnestic mild cognitive impairment (aMCI) and 254 with Alzheimer disease (AD) dementia from the Alzheimer's Disease Neuroimaging Initiative completed the Rey Auditory Verbal Learning Test (RAVLT) and [(18)F]-fluorodeoxyglucose-PET. Cross-sectional analyses were conducted using linear regression to examine the sex by TLGluMR interaction on RAVLT performance in the overall sample and within diagnostic groups adjusting for age, education, and APOE ε4 genotype...
October 5, 2016: Neurology
Yoshihide Takeshita, Nobuto Shibata, Koji Kasanuki, Tomoyuki Nagata, Shunichiro Shinagawa, Nobuyuki Kobayashi, Tohru Ohnuma, Ayako Suzuki, Eri Kawai, Toshiki Takayama, Kenya Nishioka, Yumiko Motoi, Nobutaka Hattori, Kazuhiko Nakayama, Hisashi Yamada, Heii Arai
BACKGROUND/AIMS: Interaction of receptor for advanced glycation end products (RAGE) with amyloid-β increases amplification of oxidative stress and plays pathological roles in Alzheimer's disease (AD). Oxidative stress leads to α-synuclein aggregation and is also a major contributing factor in the pathogenesis of Lewy body dementias (LBDs). Therefore, we aimed to investigate whether RAGE gene polymorphisms were associated with AD and LBDs. METHODS: Four single nucleotide polymorphisms (SNPs)-rs1800624, rs1800625, rs184003, and rs2070600-of the gene were analyzed using a case-control study design comprising 288 AD patients, 76 LBDs patients, and 105 age-matched controls...
October 4, 2016: International Journal of Geriatric Psychiatry
Karen Manoutcharian, Roxanna Perez-Garmendia, Goar Gevorkian
Recombinant antibody fragments are promising alternatives to full-length immunoglobulins and offer important advantages compared with conventional monoclonal antibodies: extreme specificity, higher affinity, superior stability and solubility, reduced immunogenicity as well as easy and inexpensive large-scale production. Different antibody formats such as single-chain fragment variable (scFv), single-domain antibody fragments (VHHs or sdAbs), bispecific antibodies (bsAbs), intrabodies and nanobodies, are currently being studied in pre-clinical models of cancer as well as infectious and autoimmune diseases and many of them are being tested as therapeutics in clinical trials...
September 30, 2016: Current Neuropharmacology
Francesca Miraglia, Fabrizio Vecchio, Paolo Maria Rossini
Graph theory applications had spread widely in understanding how human cognitive functions are linked to dynamics of neuronal network structure, providing a conceptual frame that can reduce the analytical brain complexity. This review summarizes methodological advances in this field. Electroencephalographic functional network studies in pathophysiological aging will be presented, focusing on neurodegenerative disease -such Alzheimer's disease-aiming to discuss whether network science is changing the traditional concept of brain disease and how network topology knowledge could help in modeling resilience and vulnerability of diseases...
September 28, 2016: Behavioural Brain Research
Justina Yat Wa Liu, Doris Y P Leung
OBJECTIVES : This is a cross-sectional analysis at baseline of a cluster randomized controlled trial to identify factors associated with the use of pharmacological and nonpharmacological pain treatments by nursing home residents with dementia and impaired communication. METHODS : One hundred thirty-four residents with dementia and impaired communication were recruited. Nine of them were excluded because data on their pain treatments were missing, resulting in 125 for analysis. Hierarchical generalized estimating equations analyses controlling for the clustering effect of nursing homes were used to identify factors associated with the use of pharmacological and nonpharmacological pain treatments...
September 28, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
I Barnaure, M-L Montandon, C Rodriguez, F Herrmann, K O Lövblad, P Giannakopoulos, S Haller
BACKGROUND AND PURPOSE: The presence of cerebral microbleeds has been associated with dementia and cognitive decline, although studies report conflicting results. Our aim was to determine the potential role of the presence and location of cerebral microbleeds in early stages of cognitive decline. MATERIALS AND METHODS: Baseline 3T MR imaging examinations including SWI sequences of 328 cognitively intact community-dwelling controls and 72 subjects with mild cognitive impairment were analyzed with respect to the presence and distribution of cerebral microbleeds...
September 29, 2016: AJNR. American Journal of Neuroradiology
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