
Full text articles are available to fee paying members of Alzheimer’s Australia NSW by emailing lis@alznsw.asn.au
Review of issue
Vitamin D and Alzheimer's: Is There a Relationship?
p. 510
The Beneficial Role of Vitamin D in Alzheimer’s Disease
Patients with AD have a high prevalence of vitamin D deficiency, which is also associated with low mood and impaired cognitive performance in older people. Genetic studies have provided the opportunity to determine which proteins link vitamin D to AD pathology (ie, the major histocompatibility complex class II molecules, vitamin D receptor, renin–angiotensin system, apolipoprotein E, liver X receptor, Sp1 promoter gene, and the poly(ADP-ribose) polymerase-1gene). Vitamin D also exerts its effect on AD through nongenomic factors, that is, L-type voltage-sensitive calcium channels, nerve growth factor, the prostaglandins, cyclooxygenase 2, reactive oxygen species, and nitric oxide synthase. In conclusion, vitamin D clearly has a beneficial role in AD and improves cognitive function in some patients with AD. Calcitriol, 1αα,25-dihydroxyvitamin D3, is best used for AD because of its active form of vitamin D3 metabolite and its receptor in the central nervous system.
p. 511-520
Job Satisfaction and Career Commitment Among Alzheimer’s Care Providers: Addressing Turnover and Improving Staff Empowerment
This study investigated the relation between job satisfaction and career commitment among 262 Alzheimer’s care staff working in long-term and community-based care settings. It was anticipated that the results would suggest whether career commitment could be enhanced to positively influence job satisfaction, and conversely, if improvements in job satisfaction might contribute to a deepened sense of vocational empowerment. Participants attended dementia-specific training and completed 2 short work-related questionnaires that measured job satisfaction and career commitment. The results of stepwise regression revealed interrelations between the 2 constructs. Congruence appeared to be reciprocal with respect to the overall scale scores and the intrinsic job satisfaction measure. Unexpected relations appeared in analyses of the extrinsic job satisfaction measure and the career planning subscale. Results are indicative of the fundamental distinction between job satisfaction and career commitment. Implications for efforts to reduce turnover and improve staff empowerment are also considered.
p. 521-527
Comparison of Informant Reports and Neuropsychological Assessment in Mild Cognitive Impairment
The aim of this retrospective study was to investigate the accuracy of informant reports on cognitive status in mild cognitive impairment (MCI) by comparing the subjective evaluation made by patients’ relatives with the objective results of neuropsychological assessment. We enrolled 119 MCI outpatients and their relatives. Cognitive impairment was assessed by a battery of standardized neuropsychological tests. Informant reports on cognitive functioning were obtained by means of a structured interview. Subjective and objective evaluations of cognitive status were rated according to the same scoring system in order to enable comparison. All but one relative reported cognitive dysfunctions at the interview, but the kind of cognitive profile emerging from their reports was quite different from the one highlighted by neuropsychological assessment. A subjective evaluation of cognitive status based on informant reports could therefore be useful to identify patients with MCI but is unable to define MCI subtypes.
p. 528-534
Storytelling as a Model of Conversation for People With Dementia and Caregivers
Storytelling is an important method of communication at all stages of life. Sharing narratives about lived events and experiences provides topics of conversation and opportunities for connecting with other people. In this article, we apply a conventional model of storytelling to the verbal reminiscences of older people with a dementia diagnosis. Their stories retain the conventional structure, suggesting that storytelling, which is an enjoyable and engaging social activity, can provide a conversation model for people with dementia.
p. 535-541
Cognitive Reserve and Lifestyle in Spanish Individuals With Sporadic Alzheimer’s Disease
Background: Some authors suggest that besides the fundamental components, cognitive reserve (CR) also reflects the influence of a combination of factors that improve mental health. Method: After obtaining the sociodemographic profile of each participant and evaluating their neurologic and neuropsychologic abilities, first, homogeneity analysis was used as a technique to select variables and reduce the number of categories with similar behavior; then CR construct was identified through a latent class analysis model. It was then possible to categorize participants according to their level in this construct and compare the neuropsychological performance of the subgroups that emerged, using a t test of differences of means for independent samples. Results: Participants with Alzheimer’s disease with low CR scores exhibited significantly greater deficits in measures of memory, attention, and language than patients with high CR. Conclusions: Our results ratify the effect of higher education, higher professional performance, and ludic activities on CR.
p. 542-554
Use of the Telephone-Administered Minnesota Cognitive Acuity Screen to Detect Mild Cognitive Impairment
This study determined the sensitivity and specificity of the telephone-administered Minnesota Cognitive Acuity Screen (MCAS) to distinguish mild cognitive impairment (MCI) from healthy controls (HCs) and from Alzheimer’s disease (AD). A total of 100 individuals with MCI, 50 individuals with possible/probable AD, and 50 HCs were screened to exclude medical and psychiatric conditions affecting cognition. In-office evaluation included neuropsychological testing, neurologic examination, and neurodiagnostic work-up. Participants with AD obtained significantly lower MCAS total scores than participants with MCI, who in turn performed worse than the HC group. Sensitivity was 86% and specificity was 78% for distinguishing between MCI and HC. Sensitivity was 86% and specificity was 77% for discriminating between MCI and AD. Sensitivity was 91% and specificity was 78% for discriminating between impaired groups (MCI and AD) and HCs. Results suggest that the MCAS successfully discriminates MCI from HC and AD and has potential as an effective telephone-administered screening tool for memory disorders.
p. 555-562
Intonational Patterns of Nonverbal Vocalizations in People With Dementia
Nonverbal vocalizations in dementia are important clinically since they generally have been regarded as disruptive behavior that is disturbing. The aim of the present study is to describe the interactional pattern, including the prosodic package, of nonverbal vocalizations in a participant in a late stage of dementia. The acoustic analysis shows that the vocalizations do not differ significantly from the verbal utterances regarding mean fundamental frequency or pitch range. The mean fundamental frequency, F0, of the utterances from Anna was significantly higher than the mean F0 from the other elderly participants. The analysis demonstrates that there is a singing-like type of vocalizations that does not resemble the previously described patterns of nonverbal vocalizations. This pattern of the nonverbal vocalization does not resemble the intonation of Anna’s verbal utterances. The other participants perceive Anna’s vocalizations as potentially meaningful turns. Nonverbal vocalizations in clinical settings should be taken as communicative contributions.
p. 563-572
News Briefsp. 573-577
Single traumatic brain injury may prompt long-term neurodegeneration
Years after a single traumatic brain injury (TBI), survivors still show changes in their brains. In a new study, researchers from the Perelman School of Medicine at the University of Pennsylvania suggest that Alzheimer’s diseaselike neurodegeneration may be initiated or accelerated following
a single traumatic brain injury, even in young adults.
Inherited Alzheimer’s detectable 20 years before dementia
Inherited forms of Alzheimer’s disease may be detectable as many as 20 years before problems with memory and thinking develop, scientists will report July 20, 2011, at the Alzheimer’s Association International Conference on Alzheimer’s Disease in Paris.
Aerobic exercise may reduce the risk of dementia, Mayo Clinic researchers say
Any exercise that gets the heart pumping may reduce the risk of dementia and slow the condition’s progression once it starts, reported a Mayo Clinic study published this month in Mayo Clinic Proceedings. Researchers
examined the role of aerobic exercise in preserving cognitive abilities and concluded that it should not be overlooked as an important therapy against dementia.
Alzheimer’s vaccine triggers brain inflammation when brain amyloid burden is high
Patients with Alzheimer’s disease who are in the early stages of their illness will likely benefit most from vaccine therapies now being tested in a number of
human clinical trials, say researchers from Georgetown University Medical Center (GUMC).
Nutritional intervention helps in mild Alzheimer’s disease
A second clinical trial of the medical food Souvenaid confirmed that daily intake of the nutritional intervention improves memory in people with mild Alzheimer’s disease (AD).
Mood, cognition and sleep patterns improve in Alzheimer’s patients after cataract surgery
Researchers at Tenon Hospital, Paris, France, found that patients with mild
Alzheimer’s disease whose vision improved after cataract surgery also showed improvement in cognitive ability, mood, sleep patterns and other behaviors.
Many Alzheimer’s patients get drugs with opposing effects
You wouldn’t brake your car while stepping on the gas—or wash down a sleeping pill with espresso. Yet many people taking common Alzheimer’s disease medications— cholinesterase inhibitors—are given medications with
anticholinergic properties, which oppose their effects.























