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October 21, 2014
American Journal of Alzheimer's Disease and Other Dementias - September 2014
York Can be Our Nation's Center for Alzheimer's Research
By 2025, it is
estimated that there will be 350,000 residents living with Alzheimer's in New
York. Congressman Steve Israel and New York Assemblyman Charles Lavine issued a
joint proposal in June, 2013 suggesting that New York become this country's
center for Alzheimer's research.
Significance in Dementia Research: A Review of the Literature
research traditionally relies on measures of statistical significance to assess
the strength of evidence while less attention is paid to the practical import
of the results. The objective of this study was to provide a critical overview
of the current approaches to measuring clinical significance in dementia
research and to provide suggestions for future research. A systematic search
was conducted of Medline and Embase for original, English-language,
peer-reviewed articles published before July 2012. A total of 18 articles met
the inclusion criteria, of which 13 used multiple approaches to measure
clinical significance. In all, 5 articles used expert opinion as anchors; 4
also used distribution-based approaches. In all, 8 articles used Goal
Attainment Scaling; 7 of these also relied on clinician-based impressions of
change. Another 3 articles used only clinical global impressions of change, 1
article used changes in symptomatology, and another used the value from
Health Condition in Patients With Alzheimer's Disease
To compare periodontal health status in individuals with and without
Alzheimer’s disease (AD). Results: All the evaluated periodontal parameters
were higher in individuals with AD than that in ND individuals, and the
periodontal status deteriorated with the progression of AD. There were significant
differences in mean Gingival Index, Plaque Index, Probing Depth, Clinical
Attachment Level, and % of bleeding sites between all the groups. Conclusion:
The periodontal health status of individuals with AD deteriorates with disease
progression and was closely related to their cognitive function.
Cognitive Stimulation for Portuguese Older Adults
With Cognitive Impairment
A Randomized Controlled Trial of Efficacy, Comparative Duration,
Feasibility, and Experiential Relevance
Although some studies
point to cognitive stimulation as a beneficial therapy for older adults with
cognitive impairments, this area of research and practice is still lacking
dissemination and is underrepresented in many countries. Moreover, the comparative
effects of different intervention durations remain to be established and,
besides cognitive effects, pragmatic parameters, such as cost-effectiveness and
experiential relevance to participants, are seldom explored.
A Case of a Reversible Phenotypic and Brain Function Equivalent of
dementia (FTD) is second only to Alzheimer’s disease in individuals younger
than 65 years of age. Behavioral variant FTD (bvFTD) presents with nonspecific
symptoms such as disinhibition, apathy, or emotional blunting. Although
neuropsychological testing and structural neuroimaging are not very helpful in
diagnosing bvFTD in its initial stages, newer quantitative structural methods
and functional neuroimaging have better sensitivity and specificity. Ms L
presented with blunted affect, disinhibition, impairments in insight, planning
ability and social comportment, changed dietary habits, and episodes of mutism.
We suggest that Ms L had a reversible phenotypic and brain function equivalent
of bvFTD. The case highlights the limitations of our diagnostic tools and the complex
relationship between clinical symptoms, neuroimaging, and etiology.
Vascular Risk Factors Aggravate the Progression of
A 3-Year Follow-Up Study of Chinese Population
Purpose: To explore the correlation of vascular risk
factors for Alzheimer’s disease (AD) in Chinese population.
Conclusions: Vascular risk factors are common
comorbidities in patients with AD in China, with younger, better educated ones
showing faster cognitive decline. Hypertension and hyperhomocysteinemia may
also aggravate the progression, and it is important to prevent and treat
patients with AD.
Gene Expression Profiles of Entorhinal Cortex in
This study aimed to
analyze the differentially expressed genes (DEGs) in entorhinal cortex with AD
and identify featured genes related to AD. Gene expression profile GSE5281 was
downloaded from Gene Expression Omnibus, including 10 AD and 13 control
samples. Differentially expressed genes were identified by Student t test including 119
upregulated and 591 downregulated DEGs. Then, we obtained 14 enrichment Kyoto
Encyclopedia of Genes and Genomes (KEGG) pathways among which 11 pathways were
significantly enriched (adjusted P
value < .05). The KEGG pathway network which was constructed by 14 KEGG
pathways showed that 6-phosphofructokinase, muscle type, phosphoglucomutase 1,
aldolase A, and adolase C had high degree. Glycometabolism pathways network
which was constructed by 4 glycometabolism pathways showed that adenosine
triphosphate (ATP) synthase, H+transporting, mitochondrial F1 complex ATP5B, ATP5C1, ATP5D, and ATP5G1 had high degree
related to ATP metabolism. These findings suggested that these genes with high
degree may be the underlying potential therapeutic targets for AD.
Clinical Correlates of Unawareness of Deficits Among
Patients With Dementia Due to Alzheimer’s Disease
Background: To investigate the associations between
unawareness of deficits and clinical correlates, including apathy and
depression, among patients with dementia due to Alzheimer’s disease (AD).
Conclusion: Unawareness of deficits among patients
with AD was common. The 2 domains of unawareness showed different
characteristics and may possibly present different etiologies.
Quantitative Evaluation of Changes in the
Clock-Watching Behavior of a Patient With Semantic Dementia
Background: Clock-watching activity in patients with
dementia has not been documented in detail.
Methods: A male patient having semantic dementia
was monitored at a dementia care unit in a general hospital in Japan. We used
an integrated circuit monitoring system to record the distance and location of
ambulation and the total number of movements that occurred outside the
Results: The patient was reported to clock watch a
couple of years prior to monitoring. In 2011, when monitoring started, he
regularly came out of his room saying, “8 o’clock” about 40 minutes into every
hour. It seemed as if he could only recognize the minute hand. The median
number of sensor detections increased by 4-fold at this clock-watching phase.
Behavior consistent with his clock-watching patterns was also detected during
the night. In 2012, clock-watching activity disappeared.
Conclusions: This study documented the progression of
clock-watching and subsequent disappearance with worsening cognitive function.
Evaluation of a Group Cognitive–Behavioral
Dementia Caregiver Intervention in Latin America
has identified unique cultural factors contributing to dementia caregiving in
Latin America but very few caregiver interventions have been systematically
piloted and evaluated in this region. The purpose of this study was to examine
the effectiveness of a group cognitive–behavioral intervention in improving the
mental health of dementia caregivers from Cali, Colombia. Sixty-nine caregivers
of individuals with dementia were randomly assigned to the cognitive–behavioral
intervention or an educational control condition, both spanning 8 weeks.
Compared to controls, the treatment group showed higher satisfaction with life and
lower depression and burden over the posttest and 3-month follow-ups although
there was no effect of the condition on participants’ stress levels.