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October 14, 2015
another - AMERICAN JOURNAL OF ALZHEIMER’S DISEASE & OTHER DEMENTIAS
AMERICAN JOURNAL OF
ALZHEIMER’S DISEASE & OTHER DEMENTIAS
of Genetic Association Between TREM2 and Alzheimer’s Disease in East Asian
A Systematic Review and
Large-scale genome-wide association studies have identified TREM2
variants to be significantly associated with Alzheimer’s disease (AD) in
caucasian population. The goal of this systematic study and meta-analysis was
to assess the association between Triggering receptor expressed on myeloid
cells 2 (TREM2) variants and AD in East Asian population.
Methods: In this
study, literatures were searched in PubMed, MEDLINE, EMBASE, and the Cochrane
library to screen citations from January 1990 to June 2014. Data analysis was
done by using the Stata 12 software.
studies were considered for analysis. A total of 13 535 patients with AD and 22
976 healthy controls were studied. The results showed that rs75932628 variant
was significantly associated with AD in caucasian population (P <
.001, odds ratio = 3.17, 95% confidence interval 2.45-4.09). However, the
association was not found in East Asian population.
Screening in Persons With Chronic Diseases in Primary Care: Challenges and Recommendations for Practice
integrative literature review was performed to identify the challenges in
current cognitive screening. The aim of the review was to serve as an
evaluative resource to guide clinicians in the selection of the best available
cognitive screening measures for early assessment of mild cognitive impairment
(MCI) in people with chronic diseases. The review classified the available
cognitive screening measures according to purpose, time to administer, and
cognitive domains assessed as: 1) simple/ brief cognitive screening measures,
2) disease specific screening measures, 3) domain specific screening measures,
4) self-administered screening measures, and 5) technology-based screening
measures. There is no single optimal cognitive measure for all patient
populations and settings. Although disease specific cognitive screening
measures are optimal, there is a lack of validated screening measures for many
chronic diseases. Technology-based screening measure is a promising avenue for
increasing the accessibility of cognitive screening. Future work should focus
on translating available screening measures to mobile technology format to
enhance the utility in busy primary care settings. Early cognitive screening in
persons with chronic disease should enhance appropriate referrals for detailed
neurocognitive examination and cognitive interventions to preserve and or
minimize cognitive decline.
Activity for Persons With Dementia: Family Caregiver Perspectives
threatens the capacity to engage in activity, suggesting meaningful activity
may be helpful for persons with dementia (PWDs). This study explores the
concept of meaningful activity, as defined by caregivers of PWDs. Family
caregivers of PWDs, who provide 3 hours of care over 3 days/week, were
interviewed after 6 months of cholinesterase inhibitors (ChEIs) therapy.
Caregiver responses (N = 906) to the open-ended question What do you believe
getting involved in activities outside the home means for someone with dementia
are assessed. The themes are analyzed in terms of content, frequency,
co-occurrence, and dementia severity. Caregivers emphasize the benefits of
social connectedness, physical health, and mental stimulation. Activity is also
viewed as respite, difficult, and has no meaning for care recipient. The
implications of activity for self- and social-identity in PWD and caregiver are
discussed. The benefits of activity varied by stage of disease. This knowledge
indicates areas for improved activity provision and health care support.
Hypotension-Like Syndrome After a Spinal Tap Test Performed for Idiopathic
Normal Pressure Hydrocephalus
somewhat unexpected to have headaches in patients with idiopathic normal
pressure hydrocephalus (INPH) for which the treatment is drainage of
cerebrospinal fluid (CSF) using shunt. Moreover, intracranial hypotension
syndrome (IHS) can be a challenging diagnosis, as CSF leak may be difficult to
confirm as imaging findings can be normal. This report describes a woman with
INPH who developed symptoms of IHS after a spinal tap test. There might be
cases with IHS, like our case, who do not completely fulfill the current
diagnostic criteria in terms of not having any objective evidence of
intracranial hypotension but who also could not be explained by other
conditions and recovered totally after classical IHS treatment. Current diagnostic
criteria for IHS might be revised for those having normal neuroimaging and not
accepting lumbar puncture. Nevertheless, when the history, signs, and symptoms
strongly suggest IHS even with normal imaging, treatment should be started
Family Series Workshop: A
Community-Based Psychoeducational Intervention
study describes an evaluation of a community-based psychoeducational
intervention, called The Family Series Workshop, for caregivers of
community-dwelling persons with Alzheimer’s disease or related dementias
(ADRD). In a one-group pretest–posttest design, participants (n = 35) attended
six weekly sessions. Caregiver stress, coping, and caregiving competence were
evaluated along with demographic characteristics of participants. There was a
significant improvement found for caregiving competence, and a marginally
significant increase in coping with humor. Using regression analysis we also
found that coping with humor, along with stress, were significant predictors of
caregiving competence. These findings indicate that it is possible to increase
caregiving competence utilizing a “grassroots” approach and that it is feasible
to hold educational, group discussions on a plethora of challenging caregiving
and Mental Health of Hispanic Dementia Caregivers in New York City
Dementia prevalence and related caregiving burden are increasing, particularly
among Hispanics. We studied the characteristics and mental health of Hispanic
caregivers in New York City.
recruited 139 Hispanic family caregivers. We collected data on sociodemographic
characteristics and predictors of caregiver burden, measured with the Zarit
Caregiver Burden Scale, and depressive symptoms, measured with the Geriatric
mean age was 59.3 ± 10.4 years. The majority of caregivers were daughters and
earned less than US$30 000 a year. In multivariate analyses with linear
regression, lower satisfaction with social networks was associated with higher
caregiver burden and a greater number of depressive symptoms. Higher dementia
severity was associated with higher caregiver burden, while higher caregiver
comorbidities were associated with higher depressive symptoms.
About Getting Alzheimer’s: Who’s Concerned?
prevalence of Alzheimer’s disease (AD) is projected to grow dramatically, but
efforts to treat its progression have been unsuccessful. Fear of AD among older
persons is greater than fear of cancer, and lingering worries about developing
AD can be detrimental to well-being. Yet, much remains to be known about such
worries and their precursors. This study, based on data from the Health and
Retirement Survey, examines correlates of worry. Results of multivariate
analyses show the following to be independent and significant correlates:
present memory ratings, perceived changes in memory, personal familiarity with
AD, belief that being a first-degree relative of someone with AD heightens the
chance of developing AD, and age. Interaction analyses show that memory ratings
and perceived changes in memory functioning are associated with worry
regardless of personal familiarity. These findings will enable practitioners to
identify patients and clients at risk of being worried about getting AD.
Between 11C-PIB-PET and Clinical Diagnosis in a Memory Clinic
ligands that bind to fibrillar β-amyloid are detectable by Positron Emission
Tomography (PET) allowing for in vivo visualization for Abeta burden. However,
amyloid plaques detection per se does not establish Alzheimer’s Disease
diagnosis. In this sense, the utility of amyloid imaging to improve clinical
diagnosis was settled only for specific clinical scenarios and few studies have
assessed amyloid molecular neuroimaging in a broader clinical setting. The aim
of this study is to determine the frequency of PiB amyloid findings in
different diagnostic syndromes grouped into high and low probability pre- test
categories, taking into account pre-test clinical assumption of the presence of
AD related pathology.
patients were assigned into categories of high or low pretest probability
according to clinical suspicion of AD pathology. The high probability group
included: amnestic Mild Cognitive Impairment (MCI), amnestic and other domains
MCI, Dementia of Alzheimer’s Type (DAT), Posterior Cortical Atrophy (PCA),
logopenic Primary Progressive Aphasia (PPA), Cerebral Amyloid Angiopathy and
mixed dementia. The low assumption group included: normal controls, non-amnestic
MCI, non-logopenic PPA and Frontotemporal Dementia (FTD).
normal controls and DAT patients (typical and atypical presentation) were the
most consistent across clinical and molecular diagnostics. MCI, non-logopenic
PPA and FTD were the syndromic diagnoses that most discrepancies were found.
of Asafoetida on Prevention and Treatment of Memory Impairment Induced by d-Galactose and NaNO2 in
Iranian traditional medicine, asafoetida is introduced as a valuable remedy for
nervous disorders. Dementia was induced by injection of d-galactose and NaNO2 for 60 consecutive days.
Animals were divided into normal control (NC), dementia control (DC), dementia
prophylactic (DP), and dementia treated (DT). The learning and memory functions
were examined by 1-way active and passive avoidance tests, using a shuttle box
device. Avoidance response in training tests and 1 and 3 weeks later was
significantly increased in NC, DP, and DT groups compared to the DC group. Step
through latency in all groups was significantly greater than the DC group.
Total time spent in light room, which shows the memory retention ability, in
DP, NC, and DT was significantly greater than the DC group. Our findings
indicate that asafoetida could prevent and treat amnesia. These beneficial
effects may be related to some constituent’s effectiveness such as ferulic acid
the Influence of Family Dynamics on Quality of Care by Informal Caregivers of Patients
With Alzheimer’s Dementia in Argentina
study examined the pattern of family dynamics of Argentinian individuals with
dementia that most heavily influences the quality of care provided by family
hundred and two CGs of individuals with Alzheimer’s disease in Argentina
participated in this study. The majority (75%) were female, with an average age
of 57.8 years (standard deviation = 13.5) and had spent a median of 48 months
(interquartile range [IQR]: 36.00-60.00) providing care to their family member
with dementia, devoting a median of 60 hours (IQR: 50.00-80.00) per week to
these duties. Caregivers completed Spanish versions of instruments assessing
their family dynamics and quality-of-care provision.
Hierarchical regression analyses suggested that higher quality of informal care
(Provide and Respect) was related to greater levels of empathy and reduced
levels of overall dysfunction in CGs’ families. Higher quality of care—Provide
was also related to shorter duration of time (in months) spent providing care.
Memory and Brain Aging: An
Exploratory Analysis of the Role of Error Responses in the Framingham Study
Analysis sought to determine whether Wechsler Memory Scale-Logical Memory
(LM)-correct responses and errors were related to magnetic resonance imaging
(MRI) brain volume measurements.
Methods: The LM
immediate (LM-I) and LM delay (LM-D) free recall correct responses and related
and unrelated errors were scored. Principal components analysis yielded a
3-factor solution: LM-I and LM-D correct responses, LM-I and LM-D-unrelated
errors, and LM-I/-D-related errors. The MRI total cerebral brain volume,
frontal brain volume, temporal horn volume (THV), and white matter
hyperintensities volume (WMHIV) were obtained.
Increasing THV (suggesting greater regional atrophy) was associated with lower
scores on the LM-correct responses factor. Extensive WMHIV was associated with
higher scores on the LM-related errors factor.
Risk of Dementia Among Patients With Pulmonary Tuberculosis: A Retrospective Population-Based Cohort Study
investigated and compared the risk of dementia development in a cohort of
patients with tuberculosis (TB).
study involved 6473 patient with newly diagnosed TB, and each patient was
randomly frequency matched with 4 people without TB based on age, sex, and
index year. The risk of dementia development was analyzed using Cox
proportional hazards regression.
the patients with TB, the overall risk of developing dementia was 1.21-fold
significantly higher than the non-TB cohort. In the stratified analysis of
dementia risks, only the patients with TB who were male or 50 to 64 years of
age exhibited a significantly higher risk of dementia development compared with
those without TB. An analysis of the follow-up duration revealed that patients
with TB had a 1.78-fold increased risk within 1 year of follow-up.
Italian Validation of the Anosognosia Questionnaire for Dementia in Alzheimer’s
the Anosognosia Questionnaire-Dementia (AQ-D) is one of the main instruments
for assessing awareness in Alzheimer’s disease (AD), the normative data were
until now limited to people from Argentina and Japan. This study aims to
validate this instrument in an European context, in particular in an Italian
sample. In a multicenter project (Verona, Padova, and Trapani), 130 patients
with AD and their caregivers participated in the study. Psychometric
characteristics of AQ-D are confirmed indicating that the scale permits the
early identification of anosognosia and the correct care management of
patients. Indeed, anosognosia results to be present also in patients with very
mild AD (moderate: 44.44%; mild: 47.17%; and very mild: 23.73%). Moreover, the
results indicate that deficits in awareness may vary in severity and that
different types of anosognosia may be identified.