April 19, 2017

new journal - Alzheimer's & Dementia - The Journal of the Alzheimer's Association



January 2017
Volume 13, Issue 1, p1-102

Featured Articles
 
The worldwide costs of dementia 2015 and comparisons with 2010
p1–7
 
The DIAN-TU Next Generation Alzheimer's prevention trial: Adaptive design and disease progression model

Highlights

•We describe innovative trial design features of interest for Alzheimer's disease (AD) adaptive or prevention trials.

•Dominantly Inherited Alzheimer Network (DIAN) observational study data were used to model autosomal dominant AD (ADAD) cognitive decline.

•The DIAN Trials Unit (DIAN-TU) cognitive composite is sensitive to early cognitive changes in ADAD.

•The disease progression model significantly improves power over traditional analytical methods.

•The DIAN-TU Next Generation prevention trial will test therapeutics to prevent or slow cognitive decline in the ADAD population. p8–19
 

The Predictors study: Development and baseline characteristics of the Predictors 3 cohort

p2 Abstrac
Introduction
The Predictors study was designed to predict the length of time to major disease outcomes in Alzheimer's disease (AD) patients. Here, we describe the development of a new, Predictors 3, cohort.

Methods
Patients with prevalent or incident AD and individuals at-risk for developing AD were selected from the North Manhattan community and followed annually with instruments comparable to those used in the original two Predictors cohorts.

Results
The original Predictors cohorts were clinic based and racially/ethnically homogenous (94% white, 6% black; 3% Hispanic). In contrast, the 274 elders in this cohort are community-based and ethnically diverse (39% white, 40% black, 21% other; 78% Hispanic). Confirming previous observations, psychotic features were associated with poorer function and mental status and extrapyramidal signs with poorer function.

Discussion
This new cohort will allow us to test observations made in our original clinic-based cohorts in patients that may be more representative of the general community. 0–27
 
Prevalence of dementia subtypes in United States Medicare fee-for-service beneficiaries, 2011–2013

p28–37
 
The current and future burden of late-onset dementia in the United Kingdom: Estimates and interventions
p38–44
Perspective
 
Blood-based biomarkers in Alzheimer disease: Current state of the science and a novel collaborative paradigm for advancing from discovery to clinic
p45–58
Review Articles
 
A common challenge in older adults: Classification, overlap, and therapy of depression and dementia

p5 Abstract
Late-life depression is frequently associated with cognitive impairment. Depressive symptoms are often associated with or even precede a dementia syndrome. Moreover, depressive disorders increase the risk of persistence for mild cognitive impairment and dementia. Here, we present both the current state of evidence and future perspectives regarding the integration and value of clinical assessments, neuropsychological, neurochemical, and neuroimaging biomarkers for the etiological classification of the dementia versus the depression syndrome and for the prognosis of depression relating to dementia risk. Finally, we summarize the existing evidence for both pharmacotherapy and psychotherapy of depression in demented patients. There is an urgent need for large-scale collaborative research to elucidate the role and interplay of clinical and biological features in elderly individuals with depressive disorders who are at elevated risk for developing dementia. To overcome barriers for successful drug development, we propose the introduction of the precision medicine paradigm to this research field. 9–71
 
Systematic review of dementia prevalence and incidence in United States race/ethnic populations
p72–83
 
Apathy associated with neurocognitive disorders: Recent progress and future directions

pAbstract
Introduction
Apathy is common in neurocognitive disorders (NCDs) such as Alzheimer's disease and mild cognitive impairment. Although the definition of apathy is inconsistent in the literature, apathy is primarily defined as a loss of motivation and decreased interest in daily activities.

Methods
The Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment (ISTAART) Neuropsychiatric Syndromes Professional Interest Area (NPS-PIA) Apathy workgroup reviewed the latest research regarding apathy in NCDs.

Results
Progress has recently been made in three areas relevant to apathy: (1) phenomenology, including the use of diagnostic criteria and novel instruments for measurement, (2) neurobiology, including neuroimaging, neuropathological and biomarker correlates, and (3) interventions, including pharmacologic, nonpharmacologic, and noninvasive neuromodulatory approaches.

Discussion
Recent progress confirms that apathy has a significant impact on those with major NCD and those with mild NCDs. As such, it is an important target for research and intervention.
84–100

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