May 28, 2014

American Journal of Alzheimer's Disease and Other Dementias February 2014

Full text articles are available to fee paying members of Alzheimer’s Australia NSW by emailing

The Impact of Volunteer Mentoring Schemes on Carers of People With Dementia and Volunteer Mentors
A Systematic Review
This systematic review aims to examine the differences and similarities between the various types of volunteer mentoring (befriending, mentoring and peer support) and to identify the benefits for carers and volunteers. Literature searching was performed using 8 electronic databases, gray literature, and reference list searching of relevant systematic reviews. Searches were carried out in January 2013. Four studies fitted the inclusion criteria, with 3 investigating peer support and 1 befriending for carers. Quantitative findings highlighted a weak but statistically significant (P =.04) reduction in depression after 6 months of befriending. Qualitative findings highlighted the value carers placed on the volunteer mentors’ experiential similarity. Matching was not essential for the development of successful volunteer mentoring relationships. In conclusion, the lack of need for matching and the importance of experiential similarity deserve further investigation. However, this review highlights a lack of demonstrated efficacy of volunteer mentoring for carers of people with dementia.
p. 8-17 

Registration of Alzheimer’s Disease in Taiwan
Patient and Informant
Background: To obtain updated data of patients with Alzheimer’s disease (AD) and their informants in Taiwan with the aim of fostering and supporting collaborative research.
Conclusion: We have reported the updated status of AD in Taiwan through a UDS that will foster future collaboration among countries using UDS. The updated information of patients with AD and their informants will direct the future care of AD in Taiwan.
p. 18-22 

Change and Predictors of Change in Social Skills of Nursing Home Residents With Dementia
Background Social skills are of primary importance for those with dementia and their care providers, yet we know little about the extent to which basic social skills can be maintained over time and the predictors of change.
Conclusions Social skills appear to present an opportunity to maintain interaction with these residents. The findings also suggest that a focus on the present orientation before and following admission and on staff-to-resident communication may be beneficial.
p. 23-31 

A Pilot of an Intervention Delivered to Chinese- and Spanish-Speaking Carers of People With Dementia in Australia
There are limited language- and culture-specific support programs for carers of people with dementia living in Australia. A group intervention for use with Chinese and Spanish speakers in the United States was adapted to the Australian context, and a pilot study was undertaken with these 2 communities. The intervention is based on a cognitive behavioral therapy approach and was delivered by bilingual health professionals. The adapted material comprised 7 sessions, spanning 2 hours in duration. All 22 participants completed the Depression Anxiety and Stress Scale—Short form (DASS-21) pre- and postintervention. A significant decrease in depression, anxiety, and stress was observed among Spanish speakers; a significant decrease in depression and anxiety was present among the Chinese speakers. The implications are considered in the context of Australia’s changing aged care service system.
p. 32-37 

Serum Folic Acid and RFC A80G Polymorphism in Alzheimer’s Disease and Vascular Dementia
Low level of vitamin B12 and folic acid has been reported to play an important role in the pathogenesis of Alzheimer’s disease (AD) and vascular dementia (VaD). Serum folic acid and vitamin B12 were assayed in 80 AD and 50 VaD cases and in 120 healthy controls. The reduced folate carrier (RFC1) gene, rs1051266, which encodes the RFC 1, protein was analyzed for polymorphism by polymerase chain reaction–restriction fragment length polymorphism. It was observed that the patients having folic acid <8.45 ng/mL had 2.4 (95% confidence interval [CI]: 1.4-4.5) times higher odds of having AD and 2.1 (95% CI: 1.1-4.2) times higher odds of having VaD than patients having folic acid 8.45 ng/mL. Serum vitamin B12 level did not show any such statistically significant effect in altering the odds. No direct association was found between variant (G) allele or genotype of rs1051266 with AD and VaD cases. On serum folate level no association was observed with gene polymorphism.
p. 38-44 

Hippocampal and Mesial Temporal Sclerosis in Early-Onset Frontotemporal Lobar Degeneration Versus Alzheimer’s Disease
Hippocampal sclerosis (HS) and mesial temporal sclerosis (MTS) may occur with frontotemporal lobar degeneration (FTLD) and Alzheimer’s disease (AD) as well as with normal aging. Prior studies suggest that HS/MTS may be more closely associated with FTLD but have not directly compared the prevalence and clinical characteristics of HS/MTS between neuropathologically confirmed early-onset (age ≤ 65) cohorts of FTLD and AD. We identified patients with early-onset FTLD (n = 136) and AD (n = 267) from National Alzheimer’s Center Consortium databases and compared neuropathological and clinical data between these 2 groups. The FTLD group had a significantly higher prevalence of HS/MTS than that of the AD group. However, HS/MTS was associated with increasing age and memory impairment in the AD group but not in the FTLD group. These findings are consistent with the hypothesis that HS/MTS in FTLD occurs as part of the primary pathological process, rather than as a secondary, nonspecific effect of aging on memory and hippocampal function.
p. 45-49 

Global Long Interspersed Nuclear Element 1 DNA Methylation in a Colombian Sample of Patients With Late-Onset Alzheimer’s Disease
Alterations in DNA methylation have implicated as an epigenetic event in the pathogenesis of late-onset Alzheimer’s disease (LOAD). The objective of this work was to evaluate global DNA methylation levels for long interspersed nuclear element 1 (LINE-1) repetitive sequences in Colombian patients with LOAD and controls. The LINE-1 DNA methylation levels in peripheral blood samples from 28 Colombian patients with LOAD and 30 healthy participants were assessed using a methylation-sensitive high-resolution melting (MS-HRM) quantitative assay. We did not find differences in LINE-1 methylation levels between patients with Alzheimer’s disease (AD; median 76.2%, interquartile range [IQR]: 69.8-81.9) and control participants (median 79.8%, IQR: 73.2-83.8; P = .3). Additional stratified analyses did not show differences in LINE-1 methylation levels for male or female patients versus controls nor for apolipoprotein E4 carriers and noncarriers. This is the first report of LINE-1 methylation levels in patients with LOAD using the cost-effective MS-HRM technique, and this is the first global DNA methylation study in Latin American patients with AD.
p. 50-53 

Cerebrospinal Fluid Apolipoprotein E Concentration and Severity of Cognitive Impairment in Patients With Newly Diagnosed Alzheimer’s Disease
Background/Objective: Apolipoprotein E (apoE) plays an important role in the pathogenesis of Alzheimer’s disease (AD). Altered cerebrospinal fluid (CSF) and plasma levels have been previously reported in patients with AD. We hypothesized that CSF apoE levels of patients with newly diagnosed AD might be associated with their cognitive performance.
Conclusion: The CSF apoE appears not to be suitable as a biochemical surrogate of cognitive function in AD under the given circumstances. By means of longitudinal analyses, potential associations with the velocity of decline will be investigated in the near future.
p. 54-60 

Importance of Hypertension and Social Isolation in Causing Sleep Disruption in Dementia
This study aimed to determine the effects of diabetes mellitus (DM), hypertension (HT), heart disease, social isolation, and sociodemographic factors on sleep in the elderly patients with dementia. Samples included 1210 noninstitutionalized, Malaysian elderly patients with dementia. The multiple logistic regression analysis was applied to estimate the risk of sleep disturbances among respondents. Approximately 41% of the patients experienced sleep problems. The results showed that age (odds ratio [OR] = 1.02), social isolation (OR = 1.33), and HT (OR = 1.53) significantly increased sleep disruption in respondents (P <.05). Furthermore, education (OR =.63) and non-Malay ethnicity (OR = 0.63) significantly decreased sleep problems (P <.05). It was found that DM, heart disease, sex differences, and marital status were not significant predictors of sleep disturbances (P >.05). It was concluded that age, social isolation, and HT increased sleep disruption but education and ethnic non-Malay reduced the risk of sleep problems. Moreover, HT was the most important variable to increase sleep disturbances in the elderly patients with dementia.
p. 61-66

Linking Family Dynamics and the Mental Health of Colombian Dementia Caregivers
This cross-sectional, quantitative, self-report study examined the relationship between family dynamics (cohesion, flexibility, pathology/ functioning, communication, family satisfaction, and empathy) and mental health (depression, burden, stress, and satisfaction with life [SWL]) in 90 dementia caregivers from Colombia. Hierarchical multiple regressions controlling for caregiver demographics found that family dynamics were significantly associated with caregiver depression, stress, and SWL and marginally associated with burden. Within these regressions, empathy was uniquely associated with stress; flexibility with depression and marginally with SWL; and family communication marginally with burden and stress. Nearly all family dynamic variables were bivariately associated with caregiver mental health variables, such that caregivers had stronger mental health when their family dynamics were healthy. Family-systems interventions in global regions with high levels of familism like that in the current study may improve family empathy, flexibility, and communication, thereby producing better caregiver mental health and better informal care for people with dementia.
p. 67-75 

Serum Trace Metal Levels in Alzheimer’s Disease and Normal Control Groups
Objective: To determine whether serum trace metals are related to abnormal cognition in Alzheimer’s disease (AD).
Conclusions: In this study, serum Pb, Cd, Hg, and As levels were not directly related to abnormal cognition in AD. Serum Pb levels were significantly negatively correlated with verbal memory scores.
p. 76-83 

The Bedford Alzheimer Nursing-Severity Scale to Assess Dementia Severity in Advanced Dementia
A Nonparametric Item Response Analysis and a Study of Its Psychometric Characteristics
The Bedford Alzheimer Nursing-Severity Scale (BANS-S) assesses disease severity in patients with advanced Alzheimer's disease. Since Alzheimer is a progressive disease, studying the hierarchy of the items in the scale can be useful to evaluate the progression of the disease. Data from 164 Alzheimer's patients and 186 patients with other dementia were analyzed using the Mokken Scaling Methodology to determine whether respondents can be ordered in the trait dementia severity, and to study whether an ordering between the items exist. The scalability of the scale was evaluated by the H coefficient. Results showed that the BANS-S is a reliable and medium scale (0.4≤H<0.5) for the Alzheimer group. All items with the exception of the item about mobility could be ordered. When later item was eliminated from the scale, the H coefficient decreased indicating that the scalability of the scale in the original form is more accurate than in the shorter version. For the other dementia group, the BANS-S did not fit any of the Mokken Scaling models because the scale was not unidimensional. In this group, a shorter version of the scale without the sleeping cycle item and the mobility item has better reliability and scalability properties than the original scale.
p. 84-89 

Related Genes and Potential Biomarkers for Early Diagnosis of Alzheimer’s Disease
A Preliminary Study Based on DNA Microarray
Aim: The aim of this study is to extend our understanding of the molecular mechanism of Alzheimer’s disease (AD).
Conclusion: The DEGs including CCKAR might be used as biomarkers for early diagnosis of AD. However, further experimental studies are needed to confirm our results.
p. 90-95


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