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March 19, 2018
American Journal of Alzheimer's Disease & Other Dementias®
A New Memory Test for Alzheimer’s Disease in Illiterate and Less Educated
Montreal Cognitive Assessment in Differentiating Dementia With Lewy Bodies From
Alzheimer’s disease (AD) and
dementia with Lewy bodies (DLB) are the 2 most common neurodegenerative
dementias. Identification of patients with DLB is necessary to guide
appropriate clinical management and medication trials. Patients with DLB are
reported to perform poorly on tasks of visuospatial and executive function,
compared to patients with AD who perform poorly on memory tasks. Using the
Montreal Cognitive Assessment, we found that patients with DLB (n = 73) had
statistically significant lower performance in clock drawing (visuospatial and
executive function) and higher performance in delayed recall (memory) subscores
compared to patients with AD (n = 57). This score pattern should raise
suspicion for a DLB diagnosis at initial evaluation of patients with dementia.
Utility of the Shortened Version of the Wisconsin Card Sorting Test in Patients
With Sporadic Late Onset Alzheimer Disease
The classic version of the Wisconsin Card Sorting Test (WCST) consists
of correctly sorting 128 cards according to changing sorting criteria. Its
application is costly in terms of the time employed, with all the negative
consequences this entails (decrease in motivation, frustration, and fatigue).
of a Latin Dance Program for Older Latinos With Mild Cognitive Impairment
. The focus group data revealed 4
themes: enthusiasm for dance, positive aspects of BAILAMOS, unfavorable aspects
of BAILAMOS, and physical well-being after BAILAMOS. In conclusion, older
Latinos with MCI find Latin dance as an enjoyable and safe mode of physical
Ballroom Dancing Against Neurodegeneration: A Randomized Controlled Trial in
Greek Community-Dwelling Elders With Mild Cognitive impairment
Dance may be an important nonpharmacological approach that can benefit
of Aerobic Capacity via Cycle Ergometer Exercise Testing in Alzheimer’s Disease
Older adults with AD are able to safely complete a peak cycle ergometer
exercise testing protocol. We provide an individualized cycle ergometer test
for determining aerobic capacity in older adults with AD who may be unable to
perform treadmill testing due to balance or gait issues.
Assessment of the Burden on Polish Caregivers of Patients With Dementia: A
A lot of factors influence the caregivers’ burden. It appears necessary
to take into consideration the cultural, religious, and economic
distinctiveness of the country in question.
and Testing of a Measure of Caregiver Confidence in Medical Sign/Symptom
Evaluation of efforts to support
family caregivers of people with dementia in their daily medical management
responsibilities requires a measure of caregiver self-efficacy (confidence).
This article describes the development and psychometric properties of the
Caregiver Confidence in Sign/Symptom Management (CCSM) scale, the only
available instrument in this area. Measurement development included literature
and expert panel review, cognitive testing, and field testing. The CCSM is a
25-item measure (α = .92) composed of confidence in relation to 4 subscales: knowledge
of signs/symptoms (α = .83), management of cognitive signs/symptoms
(α = .85), management of medical signs/symptoms (α = .87), and general
medication management/responsiveness (α = .85), all of which relate to
caregiver role strain. The CCSM is a reliable and valid instrument to assess
caregiver confidence in sign/symptom management and is useful to determine
caregiver needs and outcomes of related interventions. Additionally, it
furthers understanding of the role of self-efficacy in caregiver quality of
Test for Language Impairments in Adults and the Aged—A New Screening Test for
Language Impairment Associated With Neurodegenerative Diseases: Validation and
To date, there is no quick
screening test that could be used during routine office visits to accurately
assess language disorders in neurodegenerative diseases. To fill this important
gap, we developed the Detection Test for Language impairments in Adults and the
Aged (DTLA), a quick, sensitive, standardized screening test designed to assess
language disorders in adults and the elderly individuals. In Study 1, we
describe the development of the DTLA. In Study 2, we report data on the DTLA’s
validity and reliability. Finally, in Study 3, we establish normative data for
the test. The DTLA has good convergent and discriminant validity as well as
good internal consistency and test–retest reliability. Norms for the DTLA
obtained from a sample of 545 healthy, community-dwelling, French-speaking
adults from 4 French-speaking countries (Belgium, Canada (Quebec), France, and
Switzerland) are provided. The development, validation, and standardization of
the DTLA constitute a significant effort to meet the need for a language
screening test adapted to neurodegenerative diseases.
Fluctuations and Cognitive Test Performance Among Institutionalized Persons
A simple linear regression model was conducted with DCFS as the
predictor variable and SIB total score as the dependent variable. The overall
model was significant, suggesting that score on the DCFS significantly
predicted SIB total score. Additionally, greater severity of CFs predicted
poorer performance in the areas of orientation, language, and praxis.
Results suggest that CFs exert a clinically significant influence over
patients’ cognitive abilities and should be considered as a source of excess
for Memory Impairment in Amnestic Mild Cognitive Impairment: A Longitudinal
To assess memory impairment insight as a predictor of dementia and
Alzheimer’s disease (AD) in amnestic mild cognitive impairment (MCI).
During a follow-up of 27.7 (20.8) months, 205 (63.3%) of 324 patients
with amnestic MCI progressed to dementia, including 141 to AD. No association
was found in the unadjusted, partially adjusted (for sociodemographic
variables), and fully adjusted multivariate Cox analysis between the awareness
of memory impairment and the progression to dementia and AD.
Awareness or anosognosia of memory deficits, identified by GDS, is not
useful to predict progression to dementia of patients with amnestic MCI.
Burden of Complex Multimorbidity Across Gradients of Cognitive Impairment
The prevalence of most conditions constituting complex MM increased
markedly across the spectrum of CI. Further, the percentage of individuals
presenting with 10 or more conditions was 19.9%, 39.3%, and 71.3% among those
with no CI, mild CI, and moderate/severe CI, respectively.
Greater CI is strongly associated with increased burden of complex MM.
Detailed characterization of MM across CI gradients will help identify
opportunities for health care improvement.
Extracts’ Active Properties Effective on Scopolamine-Induced Memory Loss
Alzheimer’s disease leads to
progressive cognitive function loss, which may impair both intellectual
capacities and psychosocial aspects. Although the current knowledge points to a
multifactorial character of Alzheimer’s disease, the most issued pathological hypothesis
remains the cholinergic theory. The main animal model used in cholinergic
theory research is the scopolamine-induced memory loss model. Although, in some
cases, a temporary symptomatic relief can be obtained through targeting the
cholinergic or glutamatergic neurotransmitter systems, no current treatment is
able to stop or slow cognitive impairment. Many potentially successful
therapies are often blocked by the blood–brain barrier since it exhibits
permeability only for several classes of active molecules. However, the plant
extracts’ active molecules are extremely diverse and heterogeneous regarding
the biochemical structure. In this way, many active compounds constituting the
recently tested plant extracts may exhibit the same general effect on acetylcholine
pathway, but on different molecular ground, which can be successfully used in
Alzheimer’s disease adjuvant therapy.
Sources for Alzheimer’s: A Review on Reports From Traditional Persian Medicine
Herbal medicines for the treatment
of Alzheimer’s disease (AD) have attracted considerable attention nowadays.
Alzheimer’s disease is described in traditional Persian medicine (TPM) by the
term Nesyān. In this study, 5 main medicinal medieval Persian manuscripts
were reviewed to filter plants reported for the treatment of Nesyān.
Databases were searched for related possible mechanisms of action of these
medicinal plants. Each herb was searched for along with these keywords: “acetyl
and butyryl cholinesterase inhibition,” “antioxidant,” “anti-inflammatory,” and
“anti-amyloidogenic.” In Total, 44 herbs were used for the treatment of Nesyān;
40 of those were authenticated. Also, 30 plants had at least one of the
mechanisms of action that were searched for or related pharmacological
functions known for the treatment of AD. In this work, we introduce promising
candidates in TPM that could undergo further investigation for identification
of their active compounds and clinical validation in the treatment of AD.
Syndrome in Frontotemporal Dementia
Diogenes syndrome refers to the
combination of extreme self-neglect and excessive collecting with clutter and
squalor, which is often present in patients with dementia. Diogenes syndrome
may be particularly common in behavioral variant frontotemporal dementia
(bvFTD), and the investigation of these patients may help clarify the nature of
this syndrome. We describe 5 patients with bvFTD who exhibited a decline in
self-care accompanied by hoarding behaviors. These patients, and a review of
the literature, suggest a combination of frontal lobe disturbances: loss of
insight or self-awareness with a failure to clean up or discard, a general
compulsive drive, and an innate impulse to take environmental items. This
impulse may be part of the environmental dependency syndrome in frontal
disease, with specific involvement of a right frontolimbic–striatal system.
Further investigation of the similarities and mechanisms of these symptoms in
bvFTD could help in understanding Diogenes syndrome and lead to potential
Inhibitors Can Be a Drug of Choice for Type 3 Diabetes: A Mini Review
As well known to the scientific
community, Alzheimer’s disease (AD) is an irreversible neurodegenerative
disease that ends up with impairment of memory and cognition due to neuronal
and synapse loss. Patient’s quality of life can be enhanced by targeting neurogenesis
as a therapeutic paradigm. Moreover, several research evidences support the
concept that AD is a type of metabolic disorder mediated by impairment in brain
insulin responsiveness and energy metabolism. Growing evidence suggests that
endogenous peptides such as glucagon-like peptide-1 (GLP-1) and stromal-derived
factor-1α (SDF-1α) provide neuroprotection across a range of experimental
models of AD. So, preserving functional activity of SDF-1α and GLP-1 by
dipeptidyl peptidase-4 inhibition will enhance the homing/recruitment of brain
resident and nonresident circulating stem cells/progenitor cells, a noninvasive
approach for promoting neurogenesis. So, herewith we provide this in support of
dipeptidyl peptidase-4 inhibitors as a new target of attention for treating AD.
Age-Dependent Hippocampal Volume Loss in Parkinson Disease With Mild Cognitive
Irrespective of the study participants’ cognitive status, older age was
associated with reduced cortical thickness in various neocortical regions.
Having mild cognitive impairment was not associated with an increased rate of
cortical thinning or volume loss in these regions, except in the hippocampus
Patients with Parkinson disease having mild cognitive impairment show an
accelerated age-dependent hippocampal volume loss when compared with
cognitively healthy patients with Parkinson disease. This may indicate
pathological processes in a key region for memory functioning in patients with
Parkinson disease at risk of developing dementia. Structural MRI of the
hippocampal region could potentially contribute to identifying patients who
should receive early treatment aimed at delaying the clinical onset of
; pp. 313–319
Positivity Using [18F]Flutemetamol-PET and Cognitive Deficits in Nondemented
Community-Dwelling Older Adults
purpose of the current study was to compare cognitive performances among
individuals having either increased amyloid deposition (Flute+) or minimal
amyloid deposition… Analysis of variance was used to identify the differences
among the cognitive and behavioral measures between Flute+/Flute− groups.
Flute+ participants performed significantly worse than Flute− participants on
RBANS indexes of immediate memory, language, delayed memory, and total scale
score, but no significant group differences in the endorsed level of depression
or subjective report of cognitive difficulties were observed. Although these
results are preliminary, [18F]flutemetamol accurately tracks cognition in a
nondemented elderly sample, which may allow for better prediction of cognitive
decline in late life.
; pp. 320–328
of Nutritional Supplementation and a Psychomotor Program on Patients With
study aims to evaluate the impact of oral nutritional supplementation (ONS) and
a psychomotor rehabilitation program on nutritional and functional status of
community-dwelling patients with Alzheimer’s disease (AD). A 21-day prospective
randomized controlled trial was conducted and third intervention group
performed a psychomotor rehabilitation program. Patients were followed up for
180 days. Mean (standard deviation) score of Mini Nutritional Assessment (MNA)
increased both in the nutritional supplementation group (NSG; n = 25), 0.4
(0.8), and in the nutritional supplementation psychomotor rehabilitation
program group (NSPRG; n = 11), 1.5 (1.0), versus −0.1 (1.1) in the control
group (CG; n = 43), P < .05. Further improvements at 90-day follow-up
for MNA in NSG: 1.3 (1.2) and NSPRG: 1.6 (1.0) versus 0.3 (1.7) in CG (P
< .05) were observed. General linear model analysis showed that the NSG and
score improved after intervention, at 21 days and 90 days, was independent of
the MNA and Mini-Mental State Examination scores at baseline (Ps >
.05). The ONS and a psychomotor rehabilitation program have a positive impact
on long-term nutritional and functional status of patients with AD.
; pp. 329–341
Plasminogen Activator Inhibitor 1 4G/5G Polymorphism and the Risk of
The results show a significantly increased risk of AD in carriers of the
4G/4G and 4G/5G genotypes versus the wild-type 5G/5G genotype (4G/4G: 28.33% in
patients vs 10.0% in controls; P < 10−3; OR = 8.78; 4G/5G:
55.0% in patients vs 38.33% in controls; OR = 4.45; P < 10−3).
The 4G allele was also more frequently found in patients compared with
controls; P < 10−3; OR = 3.07. For all participants and by
gender, homozygotic carriers (4G/4G) were at an increased risk of AD over
heterozygotes and women were at an increased risk over their male genotype
counterparts. The odds ratio for AD among 4G/4G carriers for any group was
approximately twice that of heterozygotes in the same group. Women homozygotes
ranked highest for AD risk (OR = 20.8) and, in fact, women heterozygotes (OR =
9.03) ranked higher for risk than male homozygotes (OR = 6.12).
These preliminary exploratory results should be confirmed in a larger
This study is the first to show an association between ACE-I use and
increased plasma Aβ42 level and Aβ42/Aβ40 ratio in cognitively impaired
individuals. Future investigations should assess whether a possible
ACE-I-induced increase in plasma Aβ42 indicates improved Aβ42 clearance from
brain that contributes to protection from cognitive decline.
; pp. 347–352
Stress Markers and Metal Ions are Correlated With Cognitive Function in
investigated oxidative stress markers and metal ions in patients with
Alzheimer’s disease (AD). The serum levels of ceruloplasmin (CER), C-reactive
protein (CRP), uric acid (UA), homocysteine (Hcy), copper, iron, and zinc were
determined in 125 patients with AD (mild, n = 2 8; moderate, n = 42; and
severe, n = 55) and 40 healthy control (HC) participants. Compared to HC, CER
and UA levels were significantly lower in moderate and severe AD groups,
whereas CRP and Hcy levels were significantly higher in the severe AD group.
Copper level was significantly higher in moderate and severe AD groups than the
other groups. Compared to HC, iron level was significantly higher in patients
with AD, whereas zinc level was significantly lower in patients with AD. In
patients with AD, the severity of cognitive impairment was positively
correlated with CER, UA, and zinc levels, whereas it was negatively correlated
with copper level. Taken together, our findings provide a novel approach to
assess AD progression.
; pp. 353–359
Study of Rivastigmine 6 mg Capsules (Single Dose) in Healthy Volunteers
the bioequivalence of generic formulation of rivastigmine (test) and Exelon