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Palmer SC, Ruospo M, Barulli MR, Iurillo A, Saglimbene V, Natale P, Gargano L, Murgo AM, Loy C, van Zwieten A, Wong G, Tortelli R, Craig JC, Johnson DW, Tonelli M, Hegbrant J, Wollheim C, Logroscino G, Strippoli GFM. COGNITIVE-HD study: protocol of an observational study of neurocognitive functioning and association with clinical outcomes in adults with end-stage kidney disease treated with haemodialysis. BMJ Open 2015; 5:e009328. [PMID: 26656022 PMCID: PMC4679889 DOI: 10.1136/bmjopen-2015-009328] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/06/2015] [Accepted: 11/02/2015] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The prevalence of cognitive impairment may be increased in adults with end-stage kidney disease compared with the general population. However, the specific patterns of cognitive impairment and association of cognitive dysfunction with activities of daily living and clinical outcomes (including withdrawal from treatment) among haemodialysis patients remain incompletely understood. The COGNITIVE impairment in adults with end-stage kidney disease treated with HemoDialysis (COGNITIVE-HD) study aims to characterise the age-adjusted and education-adjusted patterns of cognitive impairment (using comprehensive testing for executive function, perceptual-motor function, language, learning and memory, and complex attention) in patients on haemodialysis and association with clinical outcomes. METHODS AND ANALYSIS A prospective, longitudinal, cohort study of 750 adults with end-stage kidney disease treated with long-term haemodialysis has been recruited within haemodialysis centres in Italy (July 2013 to April 2014). Testing for neurocognitive function was carried out by a trained psychologist at baseline to assess cognitive functioning. The primary study factor is cognitive impairment and secondary study factors will be specific domains of cognitive function. The primary outcome will be total mortality. Secondary outcomes will be cause-specific mortality, major cardiovascular events, fatal and non-fatal myocardial infarction and stroke, institutionalisation, and withdrawal from treatment at 12 months. ETHICS AND DISSEMINATION This protocol was approved before study conduct by the following responsible ethics committees: Catania (approval reference 186/BE; 26/09/2013), Agrigento (protocol numbers 61-62; 28/6/2013), USL Roma C (CE 39217; 24/6/2013), USL Roma F (protocol number 0041708; 23/7/2013), USL Latina (protocol number 20090/A001/2011; 12/7/2013), Trapani (protocol number 3413; 16/7/2013) and Brindisi (protocol number 40259; 6/6/2013). All participants have provided written and informed consent and can withdraw from the study at any time. The findings of the study will be disseminated through peer-reviewed journals and national and international conference presentations and to the participants through communication within the dialysis network in which this study is conducted.
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Affiliation(s)
- Suetonia C Palmer
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Marinella Ruospo
- Diaverum Medical Scientific Office, Lund, Sweden Division of Nephrology and Transplantation, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | - Maria Rosaria Barulli
- Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology, University of Bari "A. Moro", Tricase, Lecce, Italy
| | - Annalisa Iurillo
- Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology, University of Bari "A. Moro", Tricase, Lecce, Italy
| | | | | | | | | | - Clement Loy
- Huntington Disease Service, Westmead Hospital, Westmead, NSW, Australia
| | - Anita van Zwieten
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Germaine Wong
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Rosanna Tortelli
- Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology, University of Bari "A. Moro", Tricase, Lecce, Italy
| | - Jonathan C Craig
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Australia
| | - Marcello Tonelli
- Cumming School of Medicine, Health Services, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Giancarlo Logroscino
- Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology, University of Bari "A. Moro", Tricase, Lecce, Italy Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari "A. Moro", Bari, Italy
| | - G F M Strippoli
- Diaverum Medical Scientific Office, Lund, Sweden Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, Bari, Italy Diaverum Academy, Bari, Italy
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Abstract
This report discusses the public health impact of Alzheimer’s disease (AD), including incidence and prevalence, mortality rates, costs of care and the overall effect on caregivers and society. It also examines the challenges encountered by health care providers when disclosing an AD diagnosis to patients and caregivers. An estimated 5.3 million Americans have AD; 5.1 million are age 65 years, and approximately 200,000 are age <65 years and have younger onset AD. By mid-century, the number of people living with AD in the United States is projected to grow by nearly 10 million, fueled in large part by the aging baby boom generation. Today, someone in the country develops AD every 67 seconds. By 2050, one new case of AD is expected to develop every 33 seconds, resulting in nearly 1 million new cases per year, and the estimated prevalence is expected to range from 11 million to 16 million. In 2013, official death certificates recorded 84,767 deaths from AD, making AD the sixth leading cause of death in the United States and the fifth leading cause of death in Americans age 65 years. Between 2000 and 2013, deaths resulting from heart disease, stroke and prostate cancer decreased 14%, 23% and 11%, respectively, whereas deaths from AD increased 71%. The actual number of deaths to which AD contributes (or deaths with AD) is likely much larger than the number of deaths from AD recorded on death certificates. In 2015, an estimated 700,000 Americans age 65 years will die with AD, and many of them will die from complications caused by AD. In 2014, more than 15 million family members and other unpaid caregivers provided an estimated 17.9 billion hours of care to people with AD and other dementias, a contribution valued at more than $217 billion. Average per-person Medicare payments for services to beneficiaries age 65 years with AD and other dementias are more than two and a half times as great as payments for all beneficiaries without these conditions, and Medicaid payments are 19 times as great. Total payments in 2015 for health care, long-term care and hospice services for people age 65 years with dementia are expected to be $226 billion. Among people with a diagnosis of AD or another dementia, fewer than half report having been told of the diagnosis by their health care provider. Though the benefits of a prompt, clear and accurate disclosure of an AD diagnosis are recognized by the medical profession, improvements to the disclosure process are needed. These improvements may require stronger support systems for health care providers and their patients.
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Kahle-Wrobleski K, Fillit H, Kurlander J, Reed C, Belger M. Methodological challenges in assessing the impact of comorbidities on costs in Alzheimer's disease clinical trials. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2015; 16:995-1004. [PMID: 25410743 PMCID: PMC4646926 DOI: 10.1007/s10198-014-0648-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 10/23/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is associated with considerable costs and has a significant impact on health and social care systems. OBJECTIVE This study assessed whether baseline comorbidities present in 2,594 patients with AD participating in two semagacestat randomized placebo-controlled trials (RCTs) would significantly impact overall costs. METHODS Resource utilization was captured using the Resource Utilization in Dementia Scale-Lite. Comorbidities and concomitant medications were tabulated via patient and caregiver reports. Only baseline data were analyzed. Direct and indirect costs per month were calculated per patient. The relationship between cost and explanatory variables was explored in a regression model. RESULTS The baseline monthly cost of care in this RCT population was £1,147 ± 2,483, with informal care costs accounting for 75% of costs. Gender, age, and functional status were significant predictors of costs (p ≤ 0.0001). The cost ratio was not impacted when the number of comorbidities was added to the model (cost ratio = 0.95; 95% CI 0.91-0.99) or when combined with the number of concomitant medications (cost ratio = 0.97; 95% CI 0.95-1.00). Inconsistent findings related to the impact of individual comorbidities on costs were noted in sensitivity analyses. CONCLUSIONS The number of comorbidities, alone or when combined with concomitant medications, did not impact baseline costs of care, perhaps because RCTs often enroll less severely ill and more medically stable patients. However, higher costs were consistently associated with greater functional impairment similar to non-RCT databases. Supplemental sources (e.g., claims databases) are likely needed to better estimate the effects of disease and treatment on costs of illness captured in RCTs for AD.
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Affiliation(s)
| | - Howard Fillit
- Alzheimer's Drug Discovery Foundation and Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Mark Belger
- Eli Lilly and Company Limited, Windlesham, UK
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Abstract
BACKGROUND The number of dementia patients will increase over the next decades. However, we lack information on the geographic distribution of these patients. We aimed to describe the variation of dementia prevalence and to then compare the observed to expected prevalence. METHODS This study is based on a 20% sample of Medicare beneficiaries in 2008. The crude dementia prevalence was calculated and age/sex standardized to the US population for states. We used the World Alzheimer Report 2009 prevalence to compare estimates. RESULTS 4.8 million persons were included. The adjusted prevalence is 8.24%, varying from 5.96 to 9.55% across states. The diagnosed prevalence is lower than the expected in most states. Overall, we estimate over 100 000 undiagnosed dementia patients in Medicare. CONCLUSIONS The high state variation suggests that the number of diagnosed dementia cases does not fall evenly across all states and hence may require different levels of state-level planning.
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Affiliation(s)
- D. Koller
- Department of Health Services Research, Munich School of Management, LMU Munich, 80539 Munich, Germany
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, NH 03766, USA
| | - Julie P.W. Bynum
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, NH 03766, USA
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355
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Abstract
Late-onset Alzheimer's disease (AD), a highly prevalent neurodegenerative disorder characterized by progressive deterioration in cognition, function and behavior terminating in incapacity and death, is a clinically and pathologically heterogeneous disease with a substantial heritable component. During the past 5 years, the technological developments in next-generation high-throughput genome technologies have led to the identification of more than 20 novel susceptibility loci for AD, and have implicated specific pathways in the disease, in particular intracellular trafficking/endocytosis, inflammation and immune response and lipid metabolism. These observations have significantly advanced our understanding of underlying pathogenic mechanisms and potential therapeutic targets. This review article summarizes these recent advances in AD genomics and discusses the value of identified susceptibility loci for diagnosis and prognosis of AD.
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Mechanisms of Long Non-coding RNAs in Mammalian Nervous System Development, Plasticity, Disease, and Evolution. Neuron 2015; 88:861-877. [DOI: 10.1016/j.neuron.2015.09.045] [Citation(s) in RCA: 318] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Bilgel M, An Y, Zhou Y, Wong DF, Prince JL, Ferrucci L, Resnick SM. Individual estimates of age at detectable amyloid onset for risk factor assessment. Alzheimers Dement 2015; 12:373-9. [PMID: 26588863 DOI: 10.1016/j.jalz.2015.08.166] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 08/13/2015] [Accepted: 08/27/2015] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Individualized estimates of age at detectable amyloid-beta (Aβ) accumulation, distinct from amyloid positivity, allow for analysis of onset age of Aβ accumulation as an outcome measure to understand risk factors. METHODS Using longitudinal Pittsburgh compound B (PiB) positron emission tomography data from Baltimore Longitudinal Study of Aging, we estimated the age at which each PiB+ individual began accumulating Aβ. We used survival analysis methods to quantify risk of accumulating Aβ and differences in onset age of Aβ accumulation in relation to APOE ε4 status and sex among 36 APOE ε4 carriers and 83 noncarriers. RESULTS Age at onset of Aβ accumulation for the APOE ε4- and ε4+ groups was 73.1 and 60.7, respectively. APOE ε4 positivity conferred a threefold risk of accumulating Aβ after adjusting for sex and education. DISCUSSION Estimation of onset age of amyloid accumulation may help gauge treatment efficacy in interventions to delay symptom onset in Alzheimer's disease.
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Affiliation(s)
- Murat Bilgel
- Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, Baltimore, MD, USA; Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA.
| | - Yang An
- Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Yun Zhou
- Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Dean F Wong
- Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Jerry L Prince
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA; Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Luigi Ferrucci
- Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
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Sun YH, Nfor ON, Huang JY, Liaw YP. Association between dental amalgam fillings and Alzheimer's disease: a population-based cross-sectional study in Taiwan. Alzheimers Res Ther 2015; 7:65. [PMID: 26560125 PMCID: PMC4642684 DOI: 10.1186/s13195-015-0150-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 09/28/2015] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The potential effects of amalgam fillings on the development of Alzheimer's disease (AD) are not well understood. The aim of the study was to evaluate the association between dental amalgam fillings and Alzheimer's disease in Taiwanese population aged 65 and older. METHODS Data were retrieved from the Longitudinal Health Insurance Database (LHID 2005 and 2010). The study enrolled 1,943,702 beneficiaries from the LHID database. After excluding death cases and individuals aged 65 and under, 207,587 enrollees were finally involved in the study. Dental amalgam fillings are coded as 89001C, 89002C, 89003C, 89101C, 89102C, or 89103C in the national health insurance research database (NHIRD). Alzheimer's disease was diagnosed using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 331.0. RESULTS Individuals exposed to amalgam fillings had higher risk of Alzheimer's disease (odds ratio, OR = 1.105, 95 % confidence interval, CI = 1.025-1.190) than their non-exposed counterparts. Further analysis showed that the odds ratio of Ahlzheimer's disease was 1.07 (95 % CI = 0.962-1.196) in men and 1.132 (95 % CI = 1.022-1.254) in women. CONCLUSIONS Women who were exposed to amalgam fillings were 1.132 times more likely to have Alzheimer's disease than were their non-exposed counterparts.
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Affiliation(s)
- Yi-Hua Sun
- School of Dentistry, Chung Shan Medical University, Taichung City, 40201, Taiwan.
| | - Oswald Ndi Nfor
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110 Sec. 1 Jianguo N. Road, Taichung City, 40201, Taiwan.
| | - Jing-Yang Huang
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110 Sec. 1 Jianguo N. Road, Taichung City, 40201, Taiwan.
| | - Yung-Po Liaw
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110 Sec. 1 Jianguo N. Road, Taichung City, 40201, Taiwan.
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
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Durán Agüero S, Sánchez Reyes H, Díaz Narváez V, Araya Pérez M. [Dietary factors associated with daytime somnolence in healthy elderly of Chile]. Rev Esp Geriatr Gerontol 2015; 50:270-273. [PMID: 25895703 DOI: 10.1016/j.regg.2015.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 02/17/2015] [Accepted: 02/18/2015] [Indexed: 06/04/2023]
Abstract
AIM To determine the prevalence of mild and excessive somnolence and the associated factors with the presence of daytime sleepiness in the elderly. METHODS A total of 1780 independent individuals 60 years and older of both sexes (70.9±7.9 years old; females 62%), were included, of which 1704 of them completed all the information. All of them were assessed using an Epworth sleepiness scale (ESE), an Pittsburgh sleep quality index, plus information of cigarettes smoking, dinner time, and an anthropometric evaluation. An ESE score>10 was considered drowsiness and scores>15 excessive or severe drowsiness. RESULTS Among the population under 80 years, 5.3% showed ESE score>15 and 26.2% an ESE score>10. For over 80 years, the prevalence of sleepiness was 6.3% for an ESE score>15 and 32.5% for an ESE score>10. In the adjusted model, the factors associated with increased risk of sleepiness (ESE>10) were age older than 80 years (OR=1.58; 95% CI=1.14 to 2.19) and dinner after 21 hours (OR=1.3; 95% CI=1.01 to 1.68). By contrast, only age older than 80 years was independently associated with severe sleepiness (OR=1.81; 95% CI=1.01 to 3.29). CONCLUSIONS Meals after 21 hours and age above 80 years are associated with increased likelihood of daytime sleepiness. Instead, only older than 80 years is associated with severe daytime sleepiness.
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Affiliation(s)
- Samuel Durán Agüero
- Nutrición y Dietética, Facultad de Ciencia de la Salud, Universidad San Sebastián, Concepción, Chile.
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Abstract
Alzheimer's disease is the most common type of dementia, and it is characterized by a decline in memory or other thinking skills. The greatest risk factor for Alzheimer's disease is advanced age. A recent genome-wide study identified a locus on chromosome 17 associated with the age at onset, and a specific variant in CCL11 is probably responsible for the association. The association of a protective haplotype with a 10-year delay in the onset of Alzheimer's disease and the identification of a CCL11 variant with possible functional roles in this association might allow the future development of immunomodulators with the potential to halve disease incidence.
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Affiliation(s)
- Rita Guerreiro
- Department of Molecular Neuroscience, Institute of Neurology, University College London, 1 Wakefield Street, London, WC1N 1PJ, UK.
| | - Jose Bras
- Department of Molecular Neuroscience, Institute of Neurology, University College London, 1 Wakefield Street, London, WC1N 1PJ, UK
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Herold CJ, Lewin JS, Wibmer AG, Thrall JH, Krestin GP, Dixon AK, Schoenberg SO, Geckle RJ, Muellner A, Hricak H. Imaging in the Age of Precision Medicine: Summary of the Proceedings of the 10th Biannual Symposium of the International Society for Strategic Studies in Radiology. Radiology 2015; 279:226-38. [PMID: 26465058 DOI: 10.1148/radiol.2015150709] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
During the past decade, with its breakthroughs in systems biology, precision medicine (PM) has emerged as a novel health-care paradigm. Challenging reductionism and broad-based approaches in medicine, PM is an approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle. It involves integrating information from multiple sources in a holistic manner to achieve a definitive diagnosis, focused treatment, and adequate response assessment. Biomedical imaging and imaging-guided interventions, which provide multiparametric morphologic and functional information and enable focused, minimally invasive treatments, are key elements in the infrastructure needed for PM. The emerging discipline of radiogenomics, which links genotypic information to phenotypic disease manifestations at imaging, should also greatly contribute to patient-tailored care. Because of the growing volume and complexity of imaging data, decision-support algorithms will be required to help physicians apply the most essential patient data for optimal management. These innovations will challenge traditional concepts of health care and business models. Reimbursement policies and quality assurance measures will have to be reconsidered and adapted. In their 10th biannual symposium, which was held in August 2013, the members of the International Society for Strategic Studies in Radiology discussed the opportunities and challenges arising for the imaging community with the transition to PM. This article summarizes the discussions and central messages of the symposium.
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Affiliation(s)
- Christian J Herold
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Jonathan S Lewin
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Andreas G Wibmer
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - James H Thrall
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Gabriel P Krestin
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Adrian K Dixon
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Stefan O Schoenberg
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Rena J Geckle
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Ada Muellner
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Hedvig Hricak
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
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Hescham S, Jahanshahi A, Meriaux C, Lim LW, Blokland A, Temel Y. Behavioral effects of deep brain stimulation of different areas of the Papez circuit on memory- and anxiety-related functions. Behav Brain Res 2015; 292:353-60. [DOI: 10.1016/j.bbr.2015.06.032] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 06/17/2015] [Accepted: 06/21/2015] [Indexed: 11/17/2022]
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363
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Reiman EM, Langbaum JB, Tariot PN, Lopera F, Bateman RJ, Morris JC, Sperling RA, Aisen PS, Roses AD, Welsh-Bohmer KA, Carrillo MC, Weninger S. CAP--advancing the evaluation of preclinical Alzheimer disease treatments. Nat Rev Neurol 2015; 12:56-61. [PMID: 26416539 DOI: 10.1038/nrneurol.2015.177] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
If we are to find treatments to postpone, reduce the risk of, or completely prevent the clinical onset of Alzheimer disease (AD), we need faster methods to evaluate promising preclinical AD treatments, new ways to work together in support of common goals, and a determination to expedite the initiation and performance of preclinical AD trials. In this article, we note some of the current challenges, opportunities and emerging strategies in preclinical AD treatment. We describe the Collaboration for Alzheimer's Prevention (CAP)-a convening, harmonizing and consensus-building initiative to help stakeholders advance AD prevention research with rigour, care and maximal impact-and we demonstrate the impact of CAP on the goals and design of new preclinical AD trials.
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Affiliation(s)
- Eric M Reiman
- Banner Alzheimer's Institute, 901 E. Willetta Street, Phoenix, AZ 85006, USA
| | - Jessica B Langbaum
- Banner Alzheimer's Institute, 901 E. Willetta Street, Phoenix, AZ 85006, USA
| | - Pierre N Tariot
- Banner Alzheimer's Institute, 901 E. Willetta Street, Phoenix, AZ 85006, USA
| | - Francisco Lopera
- Grupo de Neurosciencias, Universidad de Antioquia, Calle 62 #52-59, Medellin, Colombia
| | - Randall J Bateman
- Department of Neurology, Washington University, 660 South Euclid Avenue, St Louis, MO 63110, USA
| | - John C Morris
- Department of Neurology, Washington University, 660 South Euclid Avenue, St Louis, MO 63110, USA
| | - Reisa A Sperling
- Department of Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Paul S Aisen
- University of Southern California Alzheimer's Therapeutic Research Institute, 10182 Telesis Court, San Diego, CA 92121, USA
| | - Allen D Roses
- Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Department of Neurology, Duke University Medical Center, 2200 West Main Street, Durham, NC 27705, USA
| | - Kathleen A Welsh-Bohmer
- Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Department of Neurology, Duke University Medical Center, 2200 West Main Street, Durham, NC 27705, USA
| | - Maria C Carrillo
- Alzheimer's Association, Medical &Scientific Relations Division, 225 North Michigan Avenue, Chicago, IL 60601, USA
| | - Stacie Weninger
- Fidelity Biosciences Research Initiative, One Main Street, Cambridge, MA 02142, USA
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364
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Guo H, Cao M, Zou S, Ye B, Dong Y. Cranberry Extract Standardized for Proanthocyanidins Alleviates β-Amyloid Peptide Toxicity by Improving Proteostasis Through HSF-1 in Caenorhabditis elegans Model of Alzheimer's Disease. J Gerontol A Biol Sci Med Sci 2015; 71:1564-1573. [PMID: 26405062 DOI: 10.1093/gerona/glv165] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 08/31/2015] [Indexed: 12/31/2022] Open
Abstract
A growing body of evidence suggests that nutraceuticals with prolongevity properties may delay the onset of Alzheimer's disease (AD). We recently demonstrated that a proanthocyanidins-standardized cranberry extract has properties that prolong life span and promote innate immunity in Caenorhabditis elegans In this article, we report that supplementation of this cranberry extract delayed Aβ toxicity-triggered body paralysis in the C elegans AD model. Genetic analyses indicated that the cranberry-mediated Aβ toxicity alleviation required heat shock transcription factor (HSF)-1 rather than DAF-16 and SKN-1. Moreover, cranberry supplementation increased the transactivity of HSF-1 in an IIS-dependent manner. Further studies found that the cranberry extract relies on HSF-1 to significantly enhance the solubility of proteins in aged worms, implying an improved proteostasis in AD worms. Considering that HSF-1 plays a pivotal role in maintaining proteostasis, our results suggest that cranberry maintains the function of proteostasis through HSF-1, thereby protecting C elegans against Aβ toxicity. Together, our findings elucidated the mechanism whereby cranberry attenuated Aβ toxicity in C elegans and stressed the significance of proteostasis in the prevention of age-related diseases from a practical point of view.
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Affiliation(s)
- Hong Guo
- Department of Biological Sciences, Clemson University, South Carolina.,School of Life Science and Technology, China Pharmaceutical University, Nanjing, China
| | - Min Cao
- Department of Biological Sciences, Clemson University, South Carolina.,Institute for Engaged Aging, Clemson University, Clemson, South Carolina
| | - Sige Zou
- Functional Genomics Unit, Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland
| | - Boping Ye
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, China
| | - Yuqing Dong
- Department of Biological Sciences, Clemson University, South Carolina. .,Institute for Engaged Aging, Clemson University, Clemson, South Carolina
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365
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Tang X, Holland D, Dale AM, Younes L, Miller MI. Baseline shape diffeomorphometry patterns of subcortical and ventricular structures in predicting conversion of mild cognitive impairment to Alzheimer's disease. J Alzheimers Dis 2015; 44:599-611. [PMID: 25318546 DOI: 10.3233/jad-141605] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
In this paper, we propose a novel predictor for the conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD). This predictor is based on the shape diffeomorphometry patterns of subcortical and ventricular structures (left and right amygdala, hippocampus, thalamus, caudate, putamen, globus pallidus, and lateral ventricle) of 607 baseline scans from the Alzheimer's Disease Neuroimaging Initiative database, including a total of 210 healthy control subjects, 222 MCI subjects, and 175 AD subjects. The optimal predictor is obtained via a feature selection procedure applied to all of the 14 sets of shape features via linear discriminant analysis, resulting in a combination of the shape diffeomorphometry patterns of the left hippocampus, the left lateral ventricle, the right thalamus, the right caudate, and the bilateral putamen. Via 10-fold cross-validation, we substantiate our method by successfully differentiating 77.04% (104/135) of the MCI subjects who converted to AD within 36 months and 71.26% (62/87) of the non-converters. To be specific, for the MCI-converters, we are capable of correctly predicting 82.35% (14/17) of subjects converting in 6 months, 77.5% (31/40) of subjects converting in 12 months, 74.07% (20/27) of subjects converting in 18 months, 78.13% (25/32) of subjects converting in 24 months, and 73.68% (14/19) of subject converting in 36 months. Statistically significant correlation maps were observed between the shape diffeomorphometry features of each of the 14 structures, especially the bilateral amygdala, hippocampus, lateral ventricle, and two neuropsychological test scores--the Alzheimer's Disease Assessment Scale-Cognitive Behavior Section and the Mini-Mental State Examination.
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Affiliation(s)
- Xiaoying Tang
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA
| | - Dominic Holland
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Anders M Dale
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Laurent Younes
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, USA
| | - Michael I Miller
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
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366
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Liu S, Zeng F, Wang C, Chen Z, Zhao B, Li K. The nitric oxide synthase 3 G894T polymorphism associated with Alzheimer's disease risk: a meta-analysis. Sci Rep 2015; 5:13598. [PMID: 26337484 PMCID: PMC4559797 DOI: 10.1038/srep13598] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 07/27/2015] [Indexed: 12/23/2022] Open
Abstract
The association between the G894T polymorphism (Glu298Asp) of nitric oxide synthase 3 (NOS3) and risk of Alzheimer’s disease (AD) was explored by performing a meta-analysis of case-control studies. Bibliographical searches were conducted in the MEDLINE, EMBASE, and China National Knowledge Infrastructure (CNKI) databases without any language limitations. Two investigators independently assessed abstracts for relevant studies, and reviewed all eligible studies. We adopted regrouping in accordance with the most probably appropriate genetic model. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of this association. We performed a meta-analysis including 21 published articles with 23 case-control studies (5,670 cases and 5,046 controls). In the analyses, we found significant association between G894T polymorphism and AD risk under a complete overdominant model (GG + TT vs. GT) (OR = 1.18; 95%CI, 1.04–1.35; P = 0.010). When stratified by time of AD onset, we found the association between this polymorphism and AD susceptibility to be more substantial among late onset patients than among early onset patients (OR for late vs. early onset: 1.33 vs. 1.02, P interaction = 0.049). The meta-analysis showed that the polymorphism G894T of NOS3 was associated with risk of AD.
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Affiliation(s)
- Shengyuan Liu
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical College, Zhanjiang 524001, China.,Department of Chronic Disease, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China
| | - Fangfang Zeng
- Epidemiology research unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Changyi Wang
- Department of Chronic Disease, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China
| | - Zhongwei Chen
- Department of Chronic Disease, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China
| | - Bin Zhao
- Institute of Neurology, Guangdong Medical College, Zhanjiang 524001, China
| | - Keshen Li
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical College, Zhanjiang 524001, China
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367
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Rawlins J, Mcgrowder DA, Kampradi L, Ali A, Austin T, Beckles A, Dass R, Diaram M, Jahorie P, Mohammed M, Dialsingh I. Attitude Towards Alzheimer's Disease Among Undergraduate Students of University of the West Indies, Trinidad and Tobago. J Clin Diagn Res 2015; 9:LC19-25. [PMID: 26500928 DOI: 10.7860/jcdr/2015/10170.6571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 05/20/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Alzheimer's disease is most common among the dementias and is characterized by gradual declines in functional and cognitive abilities. Caregivers including family members play a key role in providing critically needed care for these patients. OBJECTIVE This study compared the knowledge and attitudes of pre-healthcare and non-medical undergraduate students towards patients with Alzheimer's disease. MATERIALS AND METHODS A cross-sectional study was conducted involving quota sampling of 691 undergraduate students (369 pre-healthcare and 322 non-medical). A 28-item questionnaire was utilised comprising of closed-ended questions and some based on a scale rating. The students' knowledge of Alzheimer's disease was arranged into categories such as: 0 for no knowledge about Alzheimer's disease, 1 for very little knowledge about Alzheimer's disease, 2 for fair knowledge about Alzheimer's disease and 3 for great knowledge about Alzheimer's disease. STATISTICAL ANALYSIS The data was analysed using the computer software SPSS and the Chi squared test of independence was also used to determine which knowledge variables were independent of student's status. RESULTS Overall, 40.01% of the students have great or fair knowledge of Alzheimer's disease, with that of pre-healthcare students being satisfactory (54.47%). Pre-healthcare students have a more positive attitude towards Alzheimer's disease and 82.2% of students wished to take advantage of predictive test for Alzheimer's disease. Age and genetics were identified as risk factors of the disease. CONCLUSION Pre-healthcare students had greater understanding of Alzheimer's disease and depicted a more empathetic and caring attitude towards patients. This can be attributed mainly to their knowledge and exposure toward the disease.
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Affiliation(s)
- Joan Rawlins
- Faculty of Medical Sciences, Department of Paraclinical Science, School of Medicine, The University of the West Indies , St Augustine Campus, Trinidad and Tobago
| | - Donovan A Mcgrowder
- Faculty of Medical Sciences, Department of Pathology, The University of the West Indies , Mona Campus, Jamaica
| | - Lirmala Kampradi
- Faculty of Medical Sciences, Department of Paraclinical Science, School of Medicine, The University of the West Indies , St Augustine Campus, Trinidad and Tobago
| | - Allan Ali
- Faculty of Medical Sciences, Department of Paraclinical Science, School of Medicine, The University of the West Indies , St Augustine Campus, Trinidad and Tobago
| | - Travis Austin
- Faculty of Medical Sciences, Department of Paraclinical Science, School of Medicine, The University of the West Indies , St Augustine Campus, Trinidad and Tobago
| | - Annalisa Beckles
- Faculty of Medical Sciences, Department of Paraclinical Science, School of Medicine, The University of the West Indies , St Augustine Campus, Trinidad and Tobago
| | - Renesha Dass
- Faculty of Medical Sciences, Department of Paraclinical Science, School of Medicine, The University of the West Indies , St Augustine Campus, Trinidad and Tobago
| | - Mahesh Diaram
- Faculty of Medical Sciences, Department of Paraclinical Science, School of Medicine, The University of the West Indies , St Augustine Campus, Trinidad and Tobago
| | - Preenita Jahorie
- Faculty of Medical Sciences, Department of Paraclinical Science, School of Medicine, The University of the West Indies , St Augustine Campus, Trinidad and Tobago
| | - Marika Mohammed
- Faculty of Medical Sciences, Department of Paraclinical Science, School of Medicine, The University of the West Indies , St Augustine Campus, Trinidad and Tobago
| | - Isaac Dialsingh
- Faculty, Department of Mathematics and Statistics, The University of the West Indies , St Augustine Campus, Trinidad and Tobago
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368
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Son SJ, Kim J, Seo J, Lee JM, Park H. Connectivity analysis of normal and mild cognitive impairment patients based on FDG and PiB-PET images. Neurosci Res 2015; 98:50-8. [DOI: 10.1016/j.neures.2015.04.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 04/02/2015] [Accepted: 04/08/2015] [Indexed: 01/18/2023]
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369
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Abstract
Alzheimer's disease (AD) has increased from a few cases in a country at the beginning of the 20th century to an incidence of recording a case every 7 seconds in the world. From a rare disease it has reached the top 8 of major health problems in the world. One of the epidemiological problems of AD is the fact that authors from different countries use different reporting units. Some report numbers to 100,000 inhabitants, others to 1,000 inhabitants and others report the total number of cases in a country. Standardization of these reports is strictly necessary. The rise in incidence and prevalence with age is known, but interesting to see is that the incidence and prevalence do not rise in a parallel manner with age as simple logic would assume. Between the ages of 60 and 90, the incidence in men increases two times and in women 41 times, prevalence increase in men is 55.25-fold and in women 77-fold. Regarding the women/men ratio, the incidence is 20.5-fold increased, and prevalence is merely 1.3936-fold increased. These numbers raise concerns about the evolution of the disease. Regarding mild cognitive impairment (MCI)/AD ratio, only about 1 in 2 people get AD (raising?) issues about the pathogenic disease relatedness.
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Affiliation(s)
- Gavril Cornutiu
- Clinic of Psychiatry, Faculty of Medicine and Pharmacy, University of Oradea, 26 Louis Pasteur Street, 410154 Oradea, Bihor, Romania.
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370
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High Resolution Discovery Proteomics Reveals Candidate Disease Progression Markers of Alzheimer's Disease in Human Cerebrospinal Fluid. PLoS One 2015; 10:e0135365. [PMID: 26270474 PMCID: PMC4535975 DOI: 10.1371/journal.pone.0135365] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 07/21/2015] [Indexed: 11/21/2022] Open
Abstract
Disease modifying treatments for Alzheimer’s disease (AD) constitute a major goal in medicine. Current trends suggest that biomarkers reflective of AD neuropathology and modifiable by treatment would provide supportive evidence for disease modification. Nevertheless, a lack of quantitative tools to assess disease modifying treatment effects remains a major hurdle. Cerebrospinal fluid (CSF) biochemical markers such as total tau, p-tau and Ab42 are well established markers of AD; however, global quantitative biochemical changes in CSF in AD disease progression remain largely uncharacterized. Here we applied a high resolution open discovery platform, dMS, to profile a cross-sectional cohort of lumbar CSF from post-mortem diagnosed AD patients versus those from non-AD/non-demented (control) patients. Multiple markers were identified to be statistically significant in the cohort tested. We selected two markers SME-1 (p<0.0001) and SME-2 (p = 0.0004) for evaluation in a second independent longitudinal cohort of human CSF from post-mortem diagnosed AD patients and age-matched and case-matched control patients. In cohort-2, SME-1, identified as neuronal secretory protein VGF, and SME-2, identified as neuronal pentraxin receptor-1 (NPTXR), in AD were 21% (p = 0.039) and 17% (p = 0.026) lower, at baseline, respectively, than in controls. Linear mixed model analysis in the longitudinal cohort estimate a decrease in the levels of VGF and NPTXR at the rate of 10.9% and 6.9% per year in the AD patients, whereas both markers increased in controls. Because these markers are detected by mass spectrometry without the need for antibody reagents, targeted MS based assays provide a clear translation path for evaluating selected AD disease-progression markers with high analytical precision in the clinic.
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371
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Gorji HT, Haddadnia J. A novel method for early diagnosis of Alzheimer's disease based on pseudo Zernike moment from structural MRI. Neuroscience 2015; 305:361-71. [PMID: 26265552 DOI: 10.1016/j.neuroscience.2015.08.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 08/04/2015] [Accepted: 08/05/2015] [Indexed: 12/31/2022]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disorder and the most common type of dementia among older people. The number of patients with AD will grow rapidly each year and AD is the fifth leading cause of death for those aged 65 and older. In recent years, one of the main challenges for medical investigators has been the early diagnosis of patients with AD because an early diagnosis can provide greater opportunities for patients to be eligible for more clinical trials and they will have enough time to plan for future, medical and financial decisions. An established risk factor for AD is mild cognitive impairment (MCI) which is described as a transitional state between normal aging and AD patients. Hence an accurate and reliable diagnosis of MCI can be very effective and helpful for early diagnosis of AD. Therefore in this paper we present a novel and efficient method based on pseudo Zernike moments (PZMs) for the diagnosis of MCI individuals from AD and healthy control (HC) groups using structural MRI. The proposed method uses PZMs to extract discriminative information from the MR images of the AD, MCI, and HC groups. Two types of artificial neural networks, which are based on pattern recognition and learning vector quantization (LVQ) networks, were used to classify the information extracted from the MRIs. We worked with 500 MRIs from the database of the Alzheimer's Disease Neuroimaging Initiative (ADNI 1 1.5T). The 1 slice of 500 MRIs used in this study included 180 AD patients, 172 MCI patients, and 148 HC individuals. We selected 50 percent of the MRIs randomly for use in training the classifiers, 25 percent for validation and we used 25 percent for the testing phase. The technique proposed here yielded the best overall classification results between AD and MCI (accuracy 94.88%, sensitivity 94.18%, and specificity 95.55%), and for pairs of the MCI and HC (accuracy 95.59%, sensitivity 95.89% and specificity 95.34%). These results were achieved using maximum order 30 of PZM and the pattern recognition network with the scaled conjugate gradient (SCG) back-propagation training algorithm as a classifier.
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Affiliation(s)
- H T Gorji
- Biomedical Engineering Department, Electrical and Computer Faculty, Hakim Sabzevari University, Sabzevar, Iran.
| | - J Haddadnia
- Biomedical Engineering Department, Electrical and Computer Faculty, Hakim Sabzevari University, Sabzevar, Iran
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372
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Leibson CL, Long KH, Ransom JE, Roberts RO, Hass SL, Duhig AM, Smith CY, Emerson JA, Pankratz VS, Petersen RC. Direct medical costs and source of cost differences across the spectrum of cognitive decline: a population-based study. Alzheimers Dement 2015; 11:917-32. [PMID: 25858682 PMCID: PMC4543557 DOI: 10.1016/j.jalz.2015.01.007] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 11/18/2014] [Accepted: 01/23/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Objective cost estimates and source of cost differences are needed across the spectrum of cognition, including cognitively normal (CN), mild cognitive impairment (MCI), newly discovered dementia, and prevalent dementia. METHODS Subjects were a subset of the Mayo Clinic Study of Aging stratified-random sampling of Olmsted County, MN, residents aged 70 to 89 years. A neurologist reviewed provider-linked medical records to identify prevalent dementia (review date = index). Remaining subjects were invited to participate in prospective clinical/neuropsychological assessments; participants were categorized as CN, MCI, or newly discovered dementia (assessment date = index). Costs for medical services/procedures 1-year pre-index (excluding indirect and long-term care costs) were estimated using line-item provider-linked administrative data. We estimated contributions of care-delivery site and comorbid conditions (including and excluding neuropsychiatric diagnoses) to between-category cost differences. RESULTS Annual mean medical costs for CN, MCI, newly discovered dementia, and prevalent dementia were $6042, $6784, $9431, $11,678, respectively. Hospital inpatient costs contributed 70% of total costs for prevalent dementia and accounted for differences between CN and both prevalent and newly discovered dementia. Ambulatory costs accounted for differences between CN and MCI. Age-, sex-, education-adjusted differences reached significance for CN versus newly discovered and prevalent dementia and for MCI versus prevalent dementia. After considering all comorbid diagnoses, between-category differences were reduced (e.g., prevalent dementia minus MCI (from $4842 to $3575); newly discovered dementia minus CN (from $3578 to $711)). Following the exclusion of neuropsychiatric diagnoses from comorbidity adjustment, between-category differences tended to revert to greater differences. CONCLUSIONS Cost estimates did not differ significantly between CN and MCI. Substantial differences between MCI and prevalent dementia reflected high inpatient costs for dementia and appear partly related to co-occurring mental disorders. Such comparisons can help inform models aimed at identifying where, when, and for which individuals proposed interventions might be cost-effective.
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Affiliation(s)
- Cynthia L Leibson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | | | - Jeanine E Ransom
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Rosebud O Roberts
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Steven L Hass
- Department of Health Economics and Outcomes Research, AbbVie, North Chicago, IL, USA
| | - Amy M Duhig
- Department of Health Economics and Outcomes Research, AbbVie, North Chicago, IL, USA
| | - Carin Y Smith
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Jane A Emerson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - V Shane Pankratz
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Ronald C Petersen
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Mayo Clinic, Rochester, MN, USA
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373
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Shi L, Zhao L, Wong A, Wang D, Mok V. Mapping the Relationship of Contributing Factors for Preclinical Alzheimer's Disease. Sci Rep 2015; 5:11259. [PMID: 26190794 PMCID: PMC4507140 DOI: 10.1038/srep11259] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 05/20/2015] [Indexed: 11/15/2022] Open
Abstract
While detecting and validating correlations among the contributing factors to the preclinical phase of Alzheimer’s disease (pAD) has been a focus, a potent meta-analysis method to integrate current findings is essential. The entity-relationship diagram with nodes as entities and edges as relationships is a graphical representation that summarizes the relationships among multiple factors in an intuitive manner. Based on this concept, a new meta-analysis approach with this type of diagram is proposed to summarize research about contributing factors of pAD and their interactions. To utilize the information for enriched visualization, width and color of the edges are encoded with reporting times, number of pAD subjects, correlation coefficient, and study design (cross-sectional or longitudinal). The proposed Probabilistic Entity-Relationship Diagram (PERD) demonstrated its effectiveness in this research for studying pAD. Another kind of diagram with occurrence order for some factors was also proposed to provide sequential information of the factors. In addition, PERD could potentially develop into an online application named PERD-online, which would help researchers to pool findings on the same relationships and guide further tests to validate uncertain relationships in PERD. PERD as a generic graphical meta-analysis tool can also be applied in studying other multifactorial diseases.
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Affiliation(s)
- Lin Shi
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR.,Chow Yuk Ho Center of Innovative Technology for Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Lei Zhao
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Adrian Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Defeng Wang
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR.,Research Center for Medical Image Computing, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Vincent Mok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
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374
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Abstract
Objective: The aim of this study was to explore gender and race-specific mortality and comorbidities associated with dementia hospitalizations among the oldest-old. Method: Using the 1999-2008 Nationwide Inpatient Sample, we identified the association between dementia mortality and hospital characteristics in the oldest-old population. Results: The oldest-old population was mostly comprised of Whites (81.1%) and women (76.0%), had shorter length of hospital stay (6.12 days), and lower hospital charges (US$18,770.32) than the young-old, despite the higher in-hospital mortality. Crude in-hospital mortality was higher for White males in the young-old population, followed by Hispanics and African Americans. However, Hispanic males had the highest mortality, followed by Whites then African Americans in the oldest-old group. After adjusting for different variables, these relationships did not change. Discussion: There should be a greater focus on potential pre-existing biases regarding hospital care in the elderly, especially the oldest-old and elderly minority groups.
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375
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Liu SY, Zhao HD, Wang JL, Huang T, Tian HW, Yao LF, Tao H, Chen ZW, Wang CY, Sheng ST, Li H, Zhao B, Li KS. Association between Polymorphisms of the AKT1 Gene Promoter and Risk of the Alzheimer's Disease in a Chinese Han Population with Type 2 Diabetes. CNS Neurosci Ther 2015; 21:619-25. [PMID: 26178916 DOI: 10.1111/cns.12430] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 05/25/2015] [Accepted: 06/08/2015] [Indexed: 12/17/2022] Open
Abstract
AIMS Alzheimer's disease (AD) is a multifactor disease that has been reported to have a close association with type 2 diabetes (T2D) where the v-akt murine thymoma viral oncogene homolog 1 (AKT1) plays an important role in the protein synthesis pathways and cell apoptosis processes. Evidence has been shown that AKT1 protein may be related to AD risk among patients with T2D. The aim of this study was to analyze the potential association between single nucleotide polymorphisms of AKT1 promoter and the risk of AD among patients with T2D. METHODS The association between AKT1 polymorphisms and AD risk in patients with T2D was assessed among 574 consecutive unrelated subjects including 112 AD patients with T2D, 231 patients with AD, and 231 healthy controls in a case-control study. The cognitive function of all subjects was assessed using MMSE. Six single nucleotide polymorphisms with minor allele frequency >0.2 (rs2498786, rs74090038, rs2494750, rs2494751, rs5811155, and rs2494752) in AKT1 promoter were analyzed by polymerase chain reaction (PCR), and the concentration of AKT1 protein in serum was tested using enzyme-linked immunosorbent assay (ELISA). RESULTS Overall, there was statistically significant difference in AKT1 rs2498786 polymorphism. The CC frequency of AKT1 rs2498786 polymorphism in AD with T2D group and AD control group was significantly higher than that in healthy control group (PAD+T2D vs. health < 0.0001, PAD vs. health < 0.0001). However, the difference was not found between AD with T2D group and AD control group. Compared with healthy control group, the plasma levels of AKT1 protein in AD with T2D group (PAD+T2D vs. health < 0.0001) and AD control group (PAD vs. health = 0.0003) decreased significantly. Among genotypes of AKT1 rs2498786 polymorphism, the AKT1 protein level in GG genotype was significantly higher than that in GC genotype (PGG vs. GC < 0.0001) and CC genotype (PGG vs. CC < 0.0001). CONCLUSION The study suggests that AKT1 rs2498786 polymorphism in insulin signaling pathway may be associated with AD risk and different genotypes may affects levels of protein expression. However, the polymorphism is not shown to be exclusive in AD patients with T2D.
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Affiliation(s)
- Sheng-Yuan Liu
- Key Laboratory of Aging-related cardio-cerebral Diseases of Guangdong Province, Affiliated Hospital of Guangdong Medical College, Zhanjiang, China.,Department of Chronic Noncommunicable Disease Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - He-Dan Zhao
- Department of Clinical Psychology, The Kangci Hospital, Jiaxing, China
| | - Jin-Long Wang
- Department of Clinical Psychology, The Kangci Hospital, Jiaxing, China
| | - Tong Huang
- Community Health Service Center of Nanyou, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Hua-Wei Tian
- Department of Prevention and Health, The Futian People's Hospital, Shenzhen, China
| | - Li-Fen Yao
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hua Tao
- Key Laboratory of Aging-related cardio-cerebral Diseases of Guangdong Province, Affiliated Hospital of Guangdong Medical College, Zhanjiang, China
| | - Zhong-Wei Chen
- Department of Chronic Noncommunicable Disease Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Chang-Yi Wang
- Department of Chronic Noncommunicable Disease Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Si-Tong Sheng
- College of Life Sciences, Shenzhen University, Shenzhen, China
| | - Hua Li
- HYK High-throughput Biotechnology Institute, Shenzhen, China
| | - Bin Zhao
- Institute of Neurology, Guangdong Medical College, Zhanjiang, China
| | - Ke-Shen Li
- Key Laboratory of Aging-related cardio-cerebral Diseases of Guangdong Province, Affiliated Hospital of Guangdong Medical College, Zhanjiang, China
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Lee KS, Lee Y, Back JH, Son SJ, Choi SH, Chung YK, Lim KY, Noh JS, Koh SH, Oh BH, Hong CH. Effects of a multidomain lifestyle modification on cognitive function in older adults: an eighteen-month community-based cluster randomized controlled trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2015; 83:270-8. [PMID: 25116574 DOI: 10.1159/000360820] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 02/23/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND A healthy lifestyle may protect against cognitive decline. We examined outcomes in elderly individuals after 18 months of a five-group intervention program consisting of various modalities to prevent cognitive decline. METHODS We conducted a cluster randomized controlled trial assessing 460 community-dwelling individuals aged 60 years and older in a geriatric community mental health center in Suwon, Republic of Korea, between 2008 and 2010. We developed an intervention program based on the principles of contingency management, which could be delivered by ordinary primary health workers. Group A (n = 81) received standard care services. Group B (n = 80) received bimonthly (once every 2 months) telephonic care management. Group C (n = 111) received monthly telephonic care management and educational materials similar to those in group B. Group D (n = 93) received bimonthly health worker-initiated visits and counseling. Group E (n = 94) received bimonthly health worker-initiated visits, counseling, and rewards for adherence to the program. RESULTS The primary outcome was the change in Mini-Mental State Examination (MMSE) scores from baseline to the final follow-up visit at 18 months. Group E showed superior cognitive function to group A (adjusted coefficient β = 0.99, p = 0.044), with participation in cognitive activities being the most important determining factor among several health behaviors (adjusted coefficient β = 1.04, p < 0.01). CONCLUSIONS Engaging in cognitive activities, in combination with positive health behaviors, may be most beneficial in preserving cognitive abilities in community-dwelling older adults.
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Affiliation(s)
- Kang Soo Lee
- Department of Psychiatry, CHA University College of Medicine, Gangnam Medical Center and CHAUM Life Center, Seoul, Republic of Korea
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Stephan BCM, Tzourio C, Auriacombe S, Amieva H, Dufouil C, Alpérovitch A, Kurth T. Usefulness of data from magnetic resonance imaging to improve prediction of dementia: population based cohort study. BMJ 2015; 350:h2863. [PMID: 26099688 PMCID: PMC4476487 DOI: 10.1136/bmj.h2863] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine whether the addition of data derived from magnetic resonance imaging (MRI) of the brain to a model incorporating conventional risk variables improves prediction of dementia over 10 years of follow-up. DESIGN Population based cohort study of individuals aged ≥ 65. SETTING The Dijon magnetic resonance imaging study cohort from the Three-City Study, France. PARTICIPANTS 1721 people without dementia who underwent an MRI scan at baseline and with known dementia status over 10 years' follow-up. MAIN OUTCOME MEASURE Incident dementia (all cause and Alzheimer's disease). RESULTS During 10 years of follow-up, there were 119 confirmed cases of dementia, 84 of which were Alzheimer's disease. The conventional risk model incorporated age, sex, education, cognition, physical function, lifestyle (smoking, alcohol use), health (cardiovascular disease, diabetes, systolic blood pressure), and the apolipoprotein genotype (C statistic for discrimination performance was 0.77, 95% confidence interval 0.71 to 0.82). No significant differences were observed in the discrimination performance of the conventional risk model compared with models incorporating data from MRI including white matter lesion volume (C statistic 0.77, 95% confidence interval 0.72 to 0.82; P=0.48 for difference of C statistics), brain volume (0.77, 0.72 to 0.82; P=0.60), hippocampal volume (0.79, 0.74 to 0.84; P=0.07), or all three variables combined (0.79, 0.75 to 0.84; P=0.05). Inclusion of hippocampal volume or all three MRI variables combined in the conventional model did, however, lead to significant improvement in reclassification measured by using the integrated discrimination improvement index (P=0.03 and P=0.04) and showed increased net benefit in decision curve analysis. Similar results were observed when the outcome was restricted to Alzheimer's disease. CONCLUSIONS Data from MRI do not significantly improve discrimination performance in prediction of all cause dementia beyond a model incorporating demographic, cognitive, health, lifestyle, physical function, and genetic data. There were, however, statistical improvements in reclassification, prognostic separation, and some evidence of clinical utility.
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Affiliation(s)
| | - Christophe Tzourio
- Inserm Research Centre for Epidemiology and Biostatistics (U897), Team Neuroepidemiology, F-33000 Bordeaux, France University of Bordeaux, College of Health Sciences, F-33000 Bordeaux, France
| | - Sophie Auriacombe
- University Hospital, Department of Neurology, Memory Consultation, CMRR, F-33000 Bordeaux, France
| | - Hélène Amieva
- Inserm Research Centre for Epidemiology and Biostatistics (U897), Team Epidemiology and Neuropsychology of Brain Aging, F-33000 Bordeaux, France
| | - Carole Dufouil
- Inserm Research Centre for Epidemiology and Biostatistics (U897), Team Neuroepidemiology, F-33000 Bordeaux, France University of Bordeaux, College of Health Sciences, F-33000 Bordeaux, France
| | - Annick Alpérovitch
- Inserm Research Centre for Epidemiology and Biostatistics (U897), Team Neuroepidemiology, F-33000 Bordeaux, France
| | - Tobias Kurth
- Inserm Research Centre for Epidemiology and Biostatistics (U897), Team Neuroepidemiology, F-33000 Bordeaux, France University of Bordeaux, College of Health Sciences, F-33000 Bordeaux, France
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Ngandu T, Lehtisalo J, Solomon A, Levälahti E, Ahtiluoto S, Antikainen R, Bäckman L, Hänninen T, Jula A, Laatikainen T, Lindström J, Mangialasche F, Paajanen T, Pajala S, Peltonen M, Rauramaa R, Stigsdotter-Neely A, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet 2015; 385:2255-63. [PMID: 25771249 DOI: 10.1016/s0140-6736(15)60461-5] [Citation(s) in RCA: 2132] [Impact Index Per Article: 213.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Modifiable vascular and lifestyle-related risk factors have been associated with dementia risk in observational studies. In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), a proof-of-concept randomised controlled trial, we aimed to assess a multidomain approach to prevent cognitive decline in at-risk elderly people from the general population. METHODS In a double-blind randomised controlled trial we enrolled individuals aged 60-77 years recruited from previous national surveys. Inclusion criteria were CAIDE (Cardiovascular Risk Factors, Aging and Dementia) Dementia Risk Score of at least 6 points and cognition at mean level or slightly lower than expected for age. We randomly assigned participants in a 1:1 ratio to a 2 year multidomain intervention (diet, exercise, cognitive training, vascular risk monitoring), or a control group (general health advice). Computer-generated allocation was done in blocks of four (two individuals randomly allocated to each group) at each site. Group allocation was not actively disclosed to participants and outcome assessors were masked to group allocation. The primary outcome was change in cognition as measured through comprehensive neuropsychological test battery (NTB) Z score. Analysis was by modified intention to treat (all participants with at least one post-baseline observation). This trial is registered at ClinicalTrials.gov, number NCT01041989. FINDINGS Between Sept 7, 2009, and Nov 24, 2011, we screened 2654 individuals and randomly assigned 1260 to the intervention group (n=631) or control group (n=629). 591 (94%) participants in the intervention group and 599 (95%) in the control group had at least one post-baseline assessment and were included in the modified intention-to-treat analysis. Estimated mean change in NTB total Z score at 2 years was 0·20 (SE 0·02, SD 0·51) in the intervention group and 0·16 (0·01, 0·51) in the control group. Between-group difference in the change of NTB total score per year was 0·022 (95% CI 0·002-0·042, p=0·030). 153 (12%) individuals dropped out overall. Adverse events occurred in 46 (7%) participants in the intervention group compared with six (1%) participants in the control group; the most common adverse event was musculoskeletal pain (32 [5%] individuals for intervention vs no individuals for control). INTERPRETATION Findings from this large, long-term, randomised controlled trial suggest that a multidomain intervention could improve or maintain cognitive functioning in at-risk elderly people from the general population. FUNDING Academy of Finland, La Carita Foundation, Alzheimer Association, Alzheimer's Research and Prevention Foundation, Juho Vainio Foundation, Novo Nordisk Foundation, Finnish Social Insurance Institution, Ministry of Education and Culture, Salama bint Hamdan Al Nahyan Foundation, Axa Research Fund, EVO funding for University Hospitals of Kuopio, Oulu, and Turku and for Seinäjoki Central Hospital and Oulu City Hospital, Swedish Research Council, Swedish Research Council for Health, Working Life and Welfare, and af Jochnick Foundation.
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Affiliation(s)
- Tiia Ngandu
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden
| | - Jenni Lehtisalo
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Alina Solomon
- Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden; Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland; Aging Research Center, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Esko Levälahti
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Satu Ahtiluoto
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Riitta Antikainen
- Institute of Health Sciences/Geriatrics, University of Oulu and Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland; Oulu City Hospital, Oulu, Finland
| | - Lars Bäckman
- Aging Research Center, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Tuomo Hänninen
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Antti Jula
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Tiina Laatikainen
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jaana Lindström
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | | | - Teemu Paajanen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Satu Pajala
- Welfare and Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Markku Peltonen
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Rainer Rauramaa
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland; Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | | | - Timo Strandberg
- Institute of Health Sciences/Geriatrics, University of Oulu and Oulu University Hospital, Oulu, Finland; Department of Medicine, Geriatric Clinic, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Jaakko Tuomilehto
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of Public Health, HJELT Institute, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland; South Ostrobothnia Central Hospital, Seinäjoki, Finland; Center for Vascular Prevention, Danube-University Krems, Krems, Austria; Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hilkka Soininen
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland; Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Miia Kivipelto
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden; Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland; Aging Research Center, Karolinska Institutet-Stockholm University, Stockholm, Sweden.
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379
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Zammit AR, Katz MJ, Zimmerman ME, Bitzer M, Lipton RB. Low eGFR is associated with dysexecutive and amnestic mild cognitive impairment. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2015; 1:152-159. [PMID: 26005710 PMCID: PMC4438786 DOI: 10.1016/j.dadm.2014.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Few studies have explored the association between renal function and major subtypes of mild cognitive impairment (MCI). METHODS The sample was from the Einstein Aging Study. The estimated glomerular filtration rate (eGFR, calculated in mL/min/1.73m2 units) was classified into low (<45), moderate (45-59) and high (≥60). Separate binary logistic regression models were run to determine if eGFR is associated withamnestic MCI (aMCI) and dysexecutive MCI (dMCI). RESULTS Out of 622 eligible participants 65 (10.5%) had low eGFR, 43 (7.1%) had aMCI, and 46 (7.6) had dMCI. Low eGFR was independently associated with dMCI and aMCI in fully adjusted models. CONCLUSION At cross-section low eGFR is associated with a higher risk of both dMCI and aMCI. eGFR may contribute to the development of these cognitive states directly. Alternatively, low eGFR may be a marker for risk factors that influence both the kidney and the brain, such as coronary microvascular disease.
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Affiliation(s)
- Andrea R. Zammit
- Saul B. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Neurology, Einstein Aging Study, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mindy J. Katz
- Saul B. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Neurology, Einstein Aging Study, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Molly E. Zimmerman
- Saul B. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Neurology, Einstein Aging Study, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Markus Bitzer
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Richard B. Lipton
- Saul B. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Neurology, Einstein Aging Study, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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380
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van Dijk G, van Heijningen S, Reijne AC, Nyakas C, van der Zee EA, Eisel ULM. Integrative neurobiology of metabolic diseases, neuroinflammation, and neurodegeneration. Front Neurosci 2015; 9:173. [PMID: 26041981 PMCID: PMC4434977 DOI: 10.3389/fnins.2015.00173] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 04/28/2015] [Indexed: 12/11/2022] Open
Abstract
Alzheimer's disease (AD) is a complex, multifactorial disease with a number of leading mechanisms, including neuroinflammation, processing of amyloid precursor protein (APP) to amyloid β peptide, tau protein hyperphosphorylation, relocalization, and deposition. These mechanisms are propagated by obesity, the metabolic syndrome and type-2 diabetes mellitus. Stress, sedentariness, dietary overconsumption of saturated fat and refined sugars, and circadian derangements/disturbed sleep contribute to obesity and related metabolic diseases, but also accelerate age-related damage and senescence that all feed the risk of developing AD too. The complex and interacting mechanisms are not yet completely understood and will require further analysis. Instead of investigating AD as a mono- or oligocausal disease we should address the disease by understanding the multiple underlying mechanisms and how these interact. Future research therefore might concentrate on integrating these by “systems biology” approaches, but also to regard them from an evolutionary medicine point of view. The current review addresses several of these interacting mechanisms in animal models and compares them with clinical data giving an overview about our current knowledge and puts them into an integrated framework.
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Affiliation(s)
- Gertjan van Dijk
- Department Behavioural Neuroscience, Groningen Institute for Evolutionary Life Sciences, University of Groningen Groningen, Netherlands
| | - Steffen van Heijningen
- Department Behavioural Neuroscience, Groningen Institute for Evolutionary Life Sciences, University of Groningen Groningen, Netherlands
| | - Aaffien C Reijne
- Department Behavioural Neuroscience, Groningen Institute for Evolutionary Life Sciences, University of Groningen Groningen, Netherlands ; Systems Biology Centre for Energy Metabolism and Ageing, University Medical Center, University of Groningen Groningen, Netherlands
| | - Csaba Nyakas
- Department Molecular Neurobiology, Groningen Institute for Evolutionary Life Sciences, University of Groningen Groningen, Netherlands
| | - Eddy A van der Zee
- Department Molecular Neurobiology, Groningen Institute for Evolutionary Life Sciences, University of Groningen Groningen, Netherlands
| | - Ulrich L M Eisel
- Department Molecular Neurobiology, Groningen Institute for Evolutionary Life Sciences, University of Groningen Groningen, Netherlands ; University Centre of Psychiatry, University Medical Center Groningen, University of Groningen Groningen, Netherlands
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381
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In silico study of peptide inhibitors against BACE 1. SYSTEMS AND SYNTHETIC BIOLOGY 2015; 9:67-72. [PMID: 25972990 DOI: 10.1007/s11693-015-9169-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 03/12/2015] [Indexed: 10/23/2022]
Abstract
Peptides are increasingly used as inhibitors of various disease specific targets. Several naturally occurring and synthetically developed peptides are undergoing clinical trials. Our work explores the possibility of reusing the non-expressing DNA sequences to predict potential drug-target specific peptides. Recently, we experimentally demonstrated the artificial synthesis of novel proteins from non-coding regions of Escherichia coli genome. In this study, a library of synthetic peptides (Synpeps) was constructed from 2500 intergenic E. coli sequences and screened against Beta-secretase 1 protein, a known drug target for Alzheimer's disease (AD). Secondary and tertiary protein structure predictions followed by protein-protein docking studies were performed to identify the most promising enzyme inhibitors. Interacting residues and favorable binding poses of lead peptide inhibitors were studied. Though initial results are encouraging, experimental validation is required in future to develop efficient target specific inhibitors against AD.
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382
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Stabilization of Alpha-Synuclein Oligomers In Vitro by the Neurotransmitters, Dopamine and Norepinephrine: The Effect of Oxidized Catecholamines. Neurochem Res 2015; 40:1341-9. [DOI: 10.1007/s11064-015-1597-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/20/2015] [Accepted: 04/30/2015] [Indexed: 10/23/2022]
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383
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Baccarelli AA, Byun HM. Platelet mitochondrial DNA methylation: a potential new marker of cardiovascular disease. Clin Epigenetics 2015; 7:44. [PMID: 25901189 PMCID: PMC4404685 DOI: 10.1186/s13148-015-0078-0] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 04/01/2015] [Indexed: 01/29/2023] Open
Abstract
Background Platelets are critical in the etiology of cardiovascular disease (CVD), and the mitochondria in these cells serve as an energy source for platelet function. Epigenetic factors, especially DNA methylation, have been employed as markers of CVD. Unlike nuclear DNA methylation, mitochondrial DNA (mtDNA) methylation has not been widely studied, in part, due to debate about its existence and role. In this study, we examined platelet mtDNA methylation in relation to CVD. Results We measured mtDNA methylation in platelets by bisulfite-PCR pyrosequencing and examined associations of CVD with methylation in mitochondrial genes; cytochrome c oxidase (MT-CO1, MT-CO2, and MT-CO3); tRNA leucine 1 (MT-TL1); ATP synthase (MT-ATP6 and MT-ATP8); and NADH dehydrogenase (MT-MD5). We report that CVD patients have significantly higher mtDNA methylation than healthy controls in MT-CO1 (18.53%, P < 0.0001), MT-CO2 (3.33%, P = 0.0001), MT-CO3 (0.92%, P < 0.0001), and MT-TL1 (1.67%, P = 0.0001), which are involved in ATP synthesis. Platelet mtDNA methylation was not related with age, BMI, and race in this study. Conclusions Our results suggest that platelet mtDNA methylation, which could serve as non-invasive and easy-to-obtain markers, may be implicated in the etiology of CVD. Electronic supplementary material The online version of this article (doi:10.1186/s13148-015-0078-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrea A Baccarelli
- Laboratory of Environmental Epigenetics, Exposure Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave., Boston, MA 02115 USA
| | - Hyang-Min Byun
- Laboratory of Environmental Epigenetics, Exposure Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave., Boston, MA 02115 USA ; Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL UK
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384
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Biswas J, Goswami P, Gupta S, Joshi N, Nath C, Singh S. Streptozotocin Induced Neurotoxicity Involves Alzheimer's Related Pathological Markers: a Study on N2A Cells. Mol Neurobiol 2015; 53:2794-2806. [PMID: 25823512 DOI: 10.1007/s12035-015-9144-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 03/18/2015] [Indexed: 01/21/2023]
Abstract
Intracerebroventricular (icv) injection of streptozotocin (STZ) in rat brain causes prolonged impairment of brain energy metabolism and oxidative damage and leads to cognitive dysfunction; however, its mechanistic specific effects on neurons are not known. The present study was conducted to investigate the STZ-induced cellular and molecular alterations in mouse neuronal N2A cells. The N2A cells were treated with STZ (10, 50, 100, 1000 μM) for 48 h, and different assays were performed. STZ treatment caused significant decrease in cell viability, choline levels, increased acetylcholinesterase (AChE) activity, tau phosphorylation and amyloid aggregation. STZ treatment also led to low levels of glucose uptake, elevated mitochondrial stress, translocation of cytochrome c in cytosol, phosphatidylserine externalization, increased expression of caspase-3 and DNA damage. Co-treatment of clinically used drug donepezil (1 μM) offered significant protection against STZ induced neurotoxicity. Donepezil treatment significantly inhibited the STZ induced neurotoxicity, altered choline level, AChE activity, lowered glucose uptake and mitochondrial stress. However, the caspase-3 expression remains unaltered with co-treatment of donepezil. In conclusion, findings showed that STZ treated N2A cells exhibited the Alzheimer's disease (AD) related pathological markers which are attenuated with co-treatment of donepezil. Findings of the study suggested the potent use of STZ treated N2A cells as in vitro experimental test model to study the disease mechanism at cellular level.
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Affiliation(s)
- Joyshree Biswas
- Toxicology Division, Central Drug Research Institute (CSIR-CDRI), Lucknow, UP, 226031, India
| | - Poonam Goswami
- Toxicology Division, Central Drug Research Institute (CSIR-CDRI), Lucknow, UP, 226031, India
| | - Sonam Gupta
- Toxicology Division, Central Drug Research Institute (CSIR-CDRI), Lucknow, UP, 226031, India
| | - Neeraj Joshi
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - Chandishwar Nath
- Toxicology Division, Central Drug Research Institute (CSIR-CDRI), Lucknow, UP, 226031, India
| | - Sarika Singh
- Toxicology Division, Central Drug Research Institute (CSIR-CDRI), Lucknow, UP, 226031, India.
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Ji LL, Zhang YY, Zhang L, He B, Lu GH. Mismatch negativity latency as a biomarker of amnestic mild cognitive impairment in chinese rural elders. Front Aging Neurosci 2015; 7:22. [PMID: 25814949 PMCID: PMC4357324 DOI: 10.3389/fnagi.2015.00022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 02/20/2015] [Indexed: 02/02/2023] Open
Abstract
The aim was to evaluate the mismatch negativity (MMN) component, a correlate of the automatic detection of changes in the acoustic environment, in healthy adults, and adults with amnestic mild cognitive impairment (aMCI). Forty-three aMCI subjects and 43 healthy Chinese older adults were arranged into experimental group and control group, respectively. Their MMN amplitude and latency were measured at the FZ, FCZ, and CZ electrode sites under a passive auditory oddball task. The results showed that the latencies obtained from the FZ, FCZ, and CZ electrode sites were significantly longer in the aMCI adults than in the control adults (P < 0.01) while there were no significant differences in MMN amplitude between two groups (P > 0.05). The MMN latency was found to be a sensitive and specific biomarker of aMCI.
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Affiliation(s)
- Li-Li Ji
- Department of Medical Nursing, Weifang Medical University , Wei Fang , China
| | - Yuan-Yuan Zhang
- Department of Medical Nursing, Weifang Medical University , Wei Fang , China
| | - Lane Zhang
- Department of Medical Nursing, Weifang Medical University , Wei Fang , China
| | - Bing He
- Department of Medical Nursing, Weifang Medical University , Wei Fang , China
| | - Guo-Hua Lu
- Department of Medical Nursing, Weifang Medical University , Wei Fang , China
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386
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Kim YH, Choi HY, Lim HS, Lee SH, Jeon HS, Hong D, Kim SS, Choi YK, Bae KS. Single dose pharmacokinetics of the novel transdermal donepezil patch in healthy volunteers. Drug Des Devel Ther 2015; 9:1419-26. [PMID: 25792802 PMCID: PMC4362658 DOI: 10.2147/dddt.s78555] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Donepezil is an acetylcholinesterase inhibitor indicated for Alzheimer’s disease. The aim of this randomized, single-blind, placebo-controlled, single-dose, dose-escalation study was to investigate the safety, tolerability, and pharmacokinetics of the donepezil patch in healthy male subjects. Methods Each healthy male subject received a single transdermal donepezil patch (72 hours patch-on periods) of 43.75 mg/12.5 cm2, 87.5 mg/25 cm2, or 175 mg/50 cm2. Serial blood samples were collected up to 312 hours after patch application. The plasma concentrations of donepezil were determined by using a validated liquid chromatography–tandem mass spectrometry method. Pharmacokinetic parameters were obtained by noncompartmental analysis. Tolerability of the patches and performance of the patches (adhesion, skin irritation, residual donepezil content in the patch) were assessed throughout the study. Results The study was completed by 36 healthy subjects. After patch application, the maximal plasma donepezil concentration (Cmax) and the area under the curve (AUC) increased in a dose-proportional manner. Median time to Cmax was ~74–76 hours (~2–4 hours after patch removal), and mean t1/2β was ~63.77–93.07 hours. The average donepezil residue in the patch after 72 hours was ~73.9%–86.7% of the loading dose. There were neither serious adverse events nor adverse events that lead to discontinuation. Skin adhesion of the patch was good in 97.2% of the subjects. All skin irritations after patch removal were mild and were resolved during the study period. Conclusion The donepezil patch appeared to be generally well tolerated and adhesive. Pharmacokinetic analysis of the donepezil patch demonstrated linear kinetics.
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Affiliation(s)
- Yo Han Kim
- Department of Clinical Pharmacology and Therapeutics, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - Hee Youn Choi
- Department of Clinical Pharmacology and Therapeutics, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - Hyeong-Seok Lim
- Department of Clinical Pharmacology and Therapeutics, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - Shi Hyang Lee
- Department of Clinical Pharmacology and Therapeutics, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - Hae Sun Jeon
- Department of Clinical Pharmacology and Therapeutics, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - Donghyun Hong
- iCure Pharmaceutical lncorporated, Anseong, Gyeonggi-do, Republic of Korea
| | - Seong Su Kim
- iCure Pharmaceutical lncorporated, Anseong, Gyeonggi-do, Republic of Korea
| | - Young Kweon Choi
- iCure Pharmaceutical lncorporated, Anseong, Gyeonggi-do, Republic of Korea
| | - Kyun-Seop Bae
- Department of Clinical Pharmacology and Therapeutics, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
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387
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Nierzwicki Ł, Czub J. Specific Binding of Cholesterol to the Amyloid Precursor Protein: Structure of the Complex and Driving Forces Characterized in Molecular Detail. J Phys Chem Lett 2015; 6:784-790. [PMID: 26262653 DOI: 10.1021/acs.jpclett.5b00197] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
C99 is the C-terminal membrane-bound fragment of the amyloid precursor protein that is cleaved by γ-secretase to release Aβ peptides, the hallmark of Alzheimer's disease (AD). Specific interactions of C99 with cholesterol have been proposed to underlie the recognized role of cholesterol in promoting amyloidogenesis. By using molecular dynamics simulations, we studied cholesterol binding to C99 in a lipid bilayer. We determined the free-energy profile of binding and analyzed the structure of C99/cholesterol complexes in two low-energy binding modes. We also examined the complexation driving forces and found, unexpectedly, that the interactions between the GxxxG dimerization motif and the cholesterol ring system are not sufficient for binding and that further stabilization mediated by the C99 N-terminal domain is essential. Taken together, our results strongly support the view that C99 specifically binds cholesterol in the cell membrane; the detailed information on the structure and energetics of the complex may assist in the design of new anti-AD drugs.
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Affiliation(s)
- Łukasz Nierzwicki
- Department of Physical Chemistry, Gdansk University of Technology, Narutowicza St. 11/12, 80-233 Gdansk, Poland
| | - Jacek Czub
- Department of Physical Chemistry, Gdansk University of Technology, Narutowicza St. 11/12, 80-233 Gdansk, Poland
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388
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Blackwell T, Yaffe K, Laffan A, Redline S, Ancoli-Israel S, Ensrud KE, Song Y, Stone KL. Associations between sleep-disordered breathing, nocturnal hypoxemia, and subsequent cognitive decline in older community-dwelling men: the Osteoporotic Fractures in Men Sleep Study. J Am Geriatr Soc 2015; 63:453-61. [PMID: 25803785 DOI: 10.1111/jgs.13321] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To determine whether sleep-disordered breathing (SDB), a group of disorders common in older adults characterized by breathing pauses during sleep often accompanied by hypoxemia, is associated with cognitive decline. DESIGN Population-based longitudinal study. SETTING Six centers in the United States. PARTICIPANTS Community-dwelling older men (N=2,636; aged 76.0±5.3) without probable mild cognitive impairment or dementia followed for 3.4±0.5 years. MEASUREMENTS SDB was measured using in-home polysomnography: nocturnal hypoxemia (≥1% of sleep time with oxygen saturation (SaO2)<90%, oxygen desaturation index (ODI: number of oxygen desaturations of ≥3% per hour of sleep)) and apnea-hypopnea index (AHI, number of apneas and hypopneas at ≥3% desaturation per hour of sleep). Cognitive decline was measured using the Modified Mini-Mental State Examination (3MS) and the Trail-Making Test Part B (Trails B) at baseline and two follow-up points. Associations between predictors and cognitive decline were examined using linear mixed models adjusted for multiple confounders. Models were further adjusted for potential mediators (sleep duration, sleep fragmentation, resting SaO2). RESULTS Nocturnal hypoxemia was related to greater decline on the 3MS. Men with 1% or more of sleep time with SaO2 less than 90% had an adjusted annualized decline of 0.43 points, compared with 0.25 for men in the reference group (P=.003). For each 5-point increase in ODI, there was an average annualized decline of 0.36 points (P=.01). Results were robust to further adjustment for potential mediators. The association between AHI and cognitive decline did not reach significance. No associations were seen with SDB and decline on the Trails B. CONCLUSION In older community-dwelling men, there was a modest association between nocturnal hypoxemia and global cognitive decline, suggesting the importance of overnight oxygenation for cognitive function.
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Affiliation(s)
- Terri Blackwell
- Research Institute, California Pacific Medical Center, San Francisco, California
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389
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Abstract
BACKGROUND The highest increase in the prevalence of dementia in the elderly population is expected in South Korea than in any other country in the world. However, there is no assessment of the community-based general populations' understanding of dementia in South Korea, in spite of the increasing burden of dementia. Thus, this study assessed the public knowledge about dementia. METHODS This is a population-based, cross-sectional study of 2,189 participants, aged 10 years or older, and living in Seoul, South Korea. A 12-item questionnaire with true/false responses was used to assess the knowledge about dementia from June to November 2011. The data obtained were analyzed using quantitative methods. RESULTS The mean score for the knowledge about dementia was 9.0 ± 2.1 points out of 12 points. More than half of the respondents (52.7%) reported that dementia is not treatable, and one-third of the participants did not know that Alzheimer's disease is the most common cause of dementia. The level of dementia knowledge was negatively associated with increasing age, and positively associated with higher education level. CONCLUSIONS Our results suggest that although laypersons had a fair knowledge about dementia, further educational programs and campaigns are needed to improve knowledge about dementia, more focusing on elderly adults as the target audience and emphasizing the causes and treatments of dementia as educational contents.
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Affiliation(s)
- Hyun-Ju Seo
- Department of Nursing,College of Medicine,Chosun University,Gwangju,South Korea
| | - Dong Young Lee
- Department of Psychiatry,Seoul National University Hospital,and Seoul Metropolitan Center for Dementia (SMCD),Seoul,South Korea
| | - Mi Ra Sung
- Department of Nursing,Yong-in Songdam College,Yongin,South Korea
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390
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Russ TC, Gatz M, Pedersen NL, Hannah J, Wyper G, Batty GD, Deary IJ, Starr JM. Geographical variation in dementia: examining the role of environmental factors in Sweden and Scotland. Epidemiology 2015; 26:263-70. [PMID: 25575031 PMCID: PMC4467562 DOI: 10.1097/ede.0000000000000230] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aimed to estimate the magnitude of geographical variation in dementia rates and suggest explanations for this variation. Small-area studies are scarce, and none has adequately investigated the relative contribution of genetic and environmental factors to the distribution of dementia. METHODS We present 2 complementary small-area hierarchical Bayesian disease-mapping studies using the comprehensive Swedish Twin Registry (n = 27,680) and the 1932 Scottish Mental Survey cohort (n = 37,597). The twin study allowed us to examine the effect of unshared environmental factors. The Scottish Mental Survey study allowed us to examine various epochs in the life course-approximately age 11 years and adulthood. RESULTS We found a 2- to 3-fold geographical variation in dementia odds in Sweden, after twin random effects-likely to capture genetic and shared environmental variance-were removed. In Scotland, we found no variation in dementia odds in childhood but substantial variation, following a broadly similar pattern to Sweden, by adulthood. CONCLUSIONS There is geographical variation in dementia rates. Most of this variation is likely to result from unshared environmental factors that have their effect in adolescence or later. Further work is required to confirm these findings and identify any potentially modifiable socioenvironmental risk factors for dementia responsible for this geographical variation in risk. However, if these factors do exist and could be optimized in the whole population, our results suggest that dementia rates could be halved.
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Affiliation(s)
- Tom C Russ
- From the aAlzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, United Kingdom; bScottish Dementia Clinical Research Network, NHS Scotland, Edinburgh, United Kingdom; cCentre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom; dDivision of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom; eDepartment of Psychology, University of Southern California, Los Angeles, CA; fDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; gGreater Glasgow & Clyde Nursing Homes Medical Practice, NHS Greater Glasgow & Clyde, Glasgow, United Kingdom; hPublic Health and Intelligence, NHS National Services Scotland, Edinburgh, United Kingdom; and iDepartment of Epidemiology and Public Health, UCL, London, United Kingdom
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391
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Lin YT, Wu PH, Kuo MC, Chen CS, Chiu YW, Yang YH, Lin MY, Hwang SJ, Chen HC. Comparison of dementia risk between end stage renal disease patients with hemodialysis and peritoneal dialysis--a population based study. Sci Rep 2015; 5:8224. [PMID: 25703589 PMCID: PMC4340159 DOI: 10.1038/srep08224] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 01/07/2015] [Indexed: 02/06/2023] Open
Abstract
A higher risk of dementia was reported in patients undergoing maintenance hemodialysis (HD) compared to those undergoing peritoneal dialysis (PD). Selection bias and competing risk of death were not considered in previous studies. The aim of this study was to investigate dementia risk in patients undergoing HD and PD by using the Taiwan Longitudinal Health Insurance Database. We enrolled 52,332 incident HD patients and 3292 incident PD patients who were older than 40 years between January 1, 1998 and December 31, 2007. During the study period, 3775 patients were diagnosed with dementia in the HD group (177.5 per 10,000 person-years incidence rate) and 181 patients in the PD group (145.9 per 10,000 person-years incidence rate). The results revealed that the higher hazard ratio of HD compared with PD for dementia disappeared after controlling for demographic characteristics, propensity score, and competing death risk (subdistribution hazard ratio was 1.086; 95% confidence interval, 0.940–1.255). In conclusion, HD did not increase the risk of dementia in dialysis-dependent patients compared to PD.
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Affiliation(s)
- Yi-Ting Lin
- 1] Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan [2] Department of Public Health, College of Life Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ping-Hsun Wu
- 1] Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan [2] Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Mei-Chuan Kuo
- 1] Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan [2] Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Cheng-Sheng Chen
- 1] Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan [2] Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Wen Chiu
- 1] Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan [2] Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Hsin Yang
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Yen Lin
- 1] Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan [2] Technology Research Center, National Applied Research Laboratories, Taiwan
| | - Shang-Jyh Hwang
- 1] Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan [2] Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Chun Chen
- 1] Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan [2] Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
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392
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Berry B, Apesoa-Varano EC, Gomez Y. How family members manage risk around functional decline: the autonomy management process in households facing dementia. Soc Sci Med 2015; 130:107-14. [PMID: 25697634 DOI: 10.1016/j.socscimed.2015.02.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Most dementia research investigates the social context of declining ability through studies of decision-making around medical treatment and end-of-life care. This study seeks to fill an important gap in research about how family members manage the risks of functional decline at home. Drawing on three waves of in-depth interviewing in 2012-2014, it investigates how family members in US households manage decline in an affected individual's natural range of daily activities over time. The findings show that early on in the study period affected individuals were perceived to have awareness of their decline and routinely drew on family members for support. Support transformed when family members detected that the individual's deficit awareness had diminished, creating a corresponding increase in risk of self-harm around everyday activities. With a loss of confidence in the individual's ability to regulate his or her own activities to avoid these risks, family members employed unilateral practices to manage the individual's autonomy around his or her activity involvements. These practices typically involved various deceits and ruses to discourage elders from engaging in activities perceived as potentially dangerous. The study concludes by discussing the implications that the social context of interpretive work around awareness and risk plays an important role in how families perceive an elder's functional ability and manage his or her activity involvements.
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393
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Pink A, Stokin GB, Bartley MM, Roberts RO, Sochor O, Machulda MM, Krell-Roesch J, Knopman DS, Acosta JI, Christianson TJ, Pankratz VS, Mielke MM, Petersen RC, Geda YE. Neuropsychiatric symptoms, APOE ε4, and the risk of incident dementia: a population-based study. Neurology 2015; 84:935-43. [PMID: 25653291 DOI: 10.1212/wnl.0000000000001307] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the population-based interaction between a biological variable (APOE ε4), neuropsychiatric symptoms, and the risk of incident dementia among subjects with prevalent mild cognitive impairment (MCI). METHODS We prospectively followed 332 participants with prevalent MCI (aged 70 years and older) enrolled in the Mayo Clinic Study of Aging for a median of 3 years. The diagnoses of MCI and dementia were made by an expert consensus panel based on published criteria, after reviewing neurologic, cognitive, and other pertinent data. Neuropsychiatric symptoms were determined at baseline using the Neuropsychiatric Inventory Questionnaire. We used Cox proportional hazards models, with age as a time scale, to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Models were adjusted for sex, education, and medical comorbidity. RESULTS Baseline agitation, nighttime behaviors, depression, and apathy significantly increased the risk of incident dementia. We observed additive interactions between APOE ε4 and depression (joint effect HR = 2.21; 95% CI = 1.24-3.91; test for additive interaction, p < 0.001); and between APOE ε4 and apathy (joint effect HR = 1.93; 95% CI = 0.93-3.98; test for additive interaction, p = 0.031). Anxiety, irritability, and appetite/eating were not associated with increased risk of incident dementia. CONCLUSIONS Among prevalent MCI cases, baseline agitation, nighttime behaviors, depression, and apathy elevated the risk of incident dementia. There was a synergistic interaction between depression or apathy and APOE ε4 in further elevating the risk of incident dementia.
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Affiliation(s)
- Anna Pink
- From Mayo Clinic Translational Neuroscience and Aging Program (A.P., J.K.-R., J.I.A., Y.E.G.), and Departments of Psychiatry & Psychology (Y.E.G.) and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ; Departments of Neurology (M.M.B., D.S.K., R.C.P.) and Psychiatry & Psychology (M.M. Machulda), Divisions of Epidemiology (R.O.R., M.M. Mielke, R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (T.J.C., V.S.P.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; International Clinical Research Center (A.P., G.B.S., O.S., J.K.-R., Y.E.G.), Brno, Czech Republic; and Paracelsus Medical University (A.P.), Salzburg, Austria
| | - Gorazd B Stokin
- From Mayo Clinic Translational Neuroscience and Aging Program (A.P., J.K.-R., J.I.A., Y.E.G.), and Departments of Psychiatry & Psychology (Y.E.G.) and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ; Departments of Neurology (M.M.B., D.S.K., R.C.P.) and Psychiatry & Psychology (M.M. Machulda), Divisions of Epidemiology (R.O.R., M.M. Mielke, R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (T.J.C., V.S.P.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; International Clinical Research Center (A.P., G.B.S., O.S., J.K.-R., Y.E.G.), Brno, Czech Republic; and Paracelsus Medical University (A.P.), Salzburg, Austria
| | - Mairead M Bartley
- From Mayo Clinic Translational Neuroscience and Aging Program (A.P., J.K.-R., J.I.A., Y.E.G.), and Departments of Psychiatry & Psychology (Y.E.G.) and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ; Departments of Neurology (M.M.B., D.S.K., R.C.P.) and Psychiatry & Psychology (M.M. Machulda), Divisions of Epidemiology (R.O.R., M.M. Mielke, R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (T.J.C., V.S.P.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; International Clinical Research Center (A.P., G.B.S., O.S., J.K.-R., Y.E.G.), Brno, Czech Republic; and Paracelsus Medical University (A.P.), Salzburg, Austria
| | - Rosebud O Roberts
- From Mayo Clinic Translational Neuroscience and Aging Program (A.P., J.K.-R., J.I.A., Y.E.G.), and Departments of Psychiatry & Psychology (Y.E.G.) and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ; Departments of Neurology (M.M.B., D.S.K., R.C.P.) and Psychiatry & Psychology (M.M. Machulda), Divisions of Epidemiology (R.O.R., M.M. Mielke, R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (T.J.C., V.S.P.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; International Clinical Research Center (A.P., G.B.S., O.S., J.K.-R., Y.E.G.), Brno, Czech Republic; and Paracelsus Medical University (A.P.), Salzburg, Austria
| | - Ondrej Sochor
- From Mayo Clinic Translational Neuroscience and Aging Program (A.P., J.K.-R., J.I.A., Y.E.G.), and Departments of Psychiatry & Psychology (Y.E.G.) and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ; Departments of Neurology (M.M.B., D.S.K., R.C.P.) and Psychiatry & Psychology (M.M. Machulda), Divisions of Epidemiology (R.O.R., M.M. Mielke, R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (T.J.C., V.S.P.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; International Clinical Research Center (A.P., G.B.S., O.S., J.K.-R., Y.E.G.), Brno, Czech Republic; and Paracelsus Medical University (A.P.), Salzburg, Austria
| | - Mary M Machulda
- From Mayo Clinic Translational Neuroscience and Aging Program (A.P., J.K.-R., J.I.A., Y.E.G.), and Departments of Psychiatry & Psychology (Y.E.G.) and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ; Departments of Neurology (M.M.B., D.S.K., R.C.P.) and Psychiatry & Psychology (M.M. Machulda), Divisions of Epidemiology (R.O.R., M.M. Mielke, R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (T.J.C., V.S.P.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; International Clinical Research Center (A.P., G.B.S., O.S., J.K.-R., Y.E.G.), Brno, Czech Republic; and Paracelsus Medical University (A.P.), Salzburg, Austria
| | - Janina Krell-Roesch
- From Mayo Clinic Translational Neuroscience and Aging Program (A.P., J.K.-R., J.I.A., Y.E.G.), and Departments of Psychiatry & Psychology (Y.E.G.) and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ; Departments of Neurology (M.M.B., D.S.K., R.C.P.) and Psychiatry & Psychology (M.M. Machulda), Divisions of Epidemiology (R.O.R., M.M. Mielke, R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (T.J.C., V.S.P.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; International Clinical Research Center (A.P., G.B.S., O.S., J.K.-R., Y.E.G.), Brno, Czech Republic; and Paracelsus Medical University (A.P.), Salzburg, Austria
| | - David S Knopman
- From Mayo Clinic Translational Neuroscience and Aging Program (A.P., J.K.-R., J.I.A., Y.E.G.), and Departments of Psychiatry & Psychology (Y.E.G.) and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ; Departments of Neurology (M.M.B., D.S.K., R.C.P.) and Psychiatry & Psychology (M.M. Machulda), Divisions of Epidemiology (R.O.R., M.M. Mielke, R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (T.J.C., V.S.P.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; International Clinical Research Center (A.P., G.B.S., O.S., J.K.-R., Y.E.G.), Brno, Czech Republic; and Paracelsus Medical University (A.P.), Salzburg, Austria
| | - Jazmin I Acosta
- From Mayo Clinic Translational Neuroscience and Aging Program (A.P., J.K.-R., J.I.A., Y.E.G.), and Departments of Psychiatry & Psychology (Y.E.G.) and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ; Departments of Neurology (M.M.B., D.S.K., R.C.P.) and Psychiatry & Psychology (M.M. Machulda), Divisions of Epidemiology (R.O.R., M.M. Mielke, R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (T.J.C., V.S.P.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; International Clinical Research Center (A.P., G.B.S., O.S., J.K.-R., Y.E.G.), Brno, Czech Republic; and Paracelsus Medical University (A.P.), Salzburg, Austria
| | - Teresa J Christianson
- From Mayo Clinic Translational Neuroscience and Aging Program (A.P., J.K.-R., J.I.A., Y.E.G.), and Departments of Psychiatry & Psychology (Y.E.G.) and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ; Departments of Neurology (M.M.B., D.S.K., R.C.P.) and Psychiatry & Psychology (M.M. Machulda), Divisions of Epidemiology (R.O.R., M.M. Mielke, R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (T.J.C., V.S.P.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; International Clinical Research Center (A.P., G.B.S., O.S., J.K.-R., Y.E.G.), Brno, Czech Republic; and Paracelsus Medical University (A.P.), Salzburg, Austria
| | - V Shane Pankratz
- From Mayo Clinic Translational Neuroscience and Aging Program (A.P., J.K.-R., J.I.A., Y.E.G.), and Departments of Psychiatry & Psychology (Y.E.G.) and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ; Departments of Neurology (M.M.B., D.S.K., R.C.P.) and Psychiatry & Psychology (M.M. Machulda), Divisions of Epidemiology (R.O.R., M.M. Mielke, R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (T.J.C., V.S.P.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; International Clinical Research Center (A.P., G.B.S., O.S., J.K.-R., Y.E.G.), Brno, Czech Republic; and Paracelsus Medical University (A.P.), Salzburg, Austria
| | - Michelle M Mielke
- From Mayo Clinic Translational Neuroscience and Aging Program (A.P., J.K.-R., J.I.A., Y.E.G.), and Departments of Psychiatry & Psychology (Y.E.G.) and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ; Departments of Neurology (M.M.B., D.S.K., R.C.P.) and Psychiatry & Psychology (M.M. Machulda), Divisions of Epidemiology (R.O.R., M.M. Mielke, R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (T.J.C., V.S.P.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; International Clinical Research Center (A.P., G.B.S., O.S., J.K.-R., Y.E.G.), Brno, Czech Republic; and Paracelsus Medical University (A.P.), Salzburg, Austria
| | - Ronald C Petersen
- From Mayo Clinic Translational Neuroscience and Aging Program (A.P., J.K.-R., J.I.A., Y.E.G.), and Departments of Psychiatry & Psychology (Y.E.G.) and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ; Departments of Neurology (M.M.B., D.S.K., R.C.P.) and Psychiatry & Psychology (M.M. Machulda), Divisions of Epidemiology (R.O.R., M.M. Mielke, R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (T.J.C., V.S.P.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; International Clinical Research Center (A.P., G.B.S., O.S., J.K.-R., Y.E.G.), Brno, Czech Republic; and Paracelsus Medical University (A.P.), Salzburg, Austria
| | - Yonas E Geda
- From Mayo Clinic Translational Neuroscience and Aging Program (A.P., J.K.-R., J.I.A., Y.E.G.), and Departments of Psychiatry & Psychology (Y.E.G.) and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ; Departments of Neurology (M.M.B., D.S.K., R.C.P.) and Psychiatry & Psychology (M.M. Machulda), Divisions of Epidemiology (R.O.R., M.M. Mielke, R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (T.J.C., V.S.P.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; International Clinical Research Center (A.P., G.B.S., O.S., J.K.-R., Y.E.G.), Brno, Czech Republic; and Paracelsus Medical University (A.P.), Salzburg, Austria.
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394
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Determining binding sites of polycyclic aromatic small molecule-based amyloid-beta peptide aggregation modulators using sequence-specific antibodies. Anal Biochem 2015; 470:61-70. [DOI: 10.1016/j.ab.2014.10.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 10/21/2014] [Accepted: 10/27/2014] [Indexed: 12/22/2022]
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395
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Innovative Research Design Exploring the Effects of Physical Activity and Genetics on Cognitive Performance in Community-Based Older Adults. J Aging Phys Act 2015; 23:559-68. [PMID: 25594264 DOI: 10.1123/japa.2014-0221] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Physical activity is predictive of better cognitive performance and lower risk of Alzheimer's disease (AD). The apolipoprotein E gene (APOE) is a susceptibility gene for AD with the e4 allele being associated with a greater risk of AD. Cross-sectional and prospective research shows that physical activity is predictive of better cognitive performance for those at greater genetic risk for AD. However, the moderating role of APOE on the effects of a physical activity intervention on cognitive performance has not been examined. The purpose of this manuscript is to justify the need for such research and to describe the design, methods, and recruitment tactics used in the conductance of a study designed to provide insight as to the extent to which cognitive benefits resulting from an 8-month physical activity program are differentiated by APOE e4 status. The effectiveness of the recruitment strategies and the feasibility of recruiting APOE e4 carriers are discussed.
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396
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Mar J, Soto-Gordoa M, Arrospide A, Moreno-Izco F, Martínez-Lage P. Fitting the epidemiology and neuropathology of the early stages of Alzheimer's disease to prevent dementia. ALZHEIMERS RESEARCH & THERAPY 2015; 7:2. [PMID: 25713598 PMCID: PMC4338563 DOI: 10.1186/s13195-014-0079-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 10/23/2014] [Indexed: 11/17/2022]
Abstract
Introduction Recent research on biomarkers has made possible the diagnosis of pre-dementia and even preclinical Alzheimer’s disease (AD), thus providing the ideal context for prevention. The aim of this study was to investigate the epidemiology of the early stages of AD by fitting neuropathologic and epidemiological data to assess the feasibility of prevention programs. Methods The study addressed primarily the construction of a discrete event simulation model of the stages of dementia. Age was included in the mathematical functions to combine the two competitive risks that determine the epidemiology of AD, that is, time to onset of dementia and time until death by other causes. Subsequently, this model was calibrated to reproduce the prevalence of pathological findings associated with AD. The beginning of the preclinical stage was taken to coincide with Thal phase 1 deposition of amyloid-beta. The duration of the prodromal stage, marked by mild cognitive impairment, was based on a 10% annual conversion rate from this level of impairment to dementia. The validation of prevalence figures also permitted estimation of the incidence and duration of preclinical and prodromal stages. Results In Spain, half of the nearly 10 million people aged more than 60 years are in the early stages of AD; 35.9% are in a preclinical stage, and up to 14.2% are in a prodromal stage. However, dementia will develop in only 38% of this population. The weighted mean time to dementia was 22.0 years from the start of Thal phase 1 and 9.0 years from the start of phase 2. Results of simulation models showed a lack of correlation between clinical and pathological classifications. Conclusions These findings raise questions about the feasibility of drug-based prevention strategies. Currently, screening programs with biomarkers in the early stages of AD cannot be applied to the half of the general population older than 60 years. Hence, intensive research is needed regarding risk factors, so that more affordable strategies may be planned. More efficient criteria are also needed to select those subjects with mild cognitive impairment who have an increased probability of positive screening for biomarkers (prodromal stage). Electronic supplementary material The online version of this article (doi:10.1186/s13195-014-0079-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Javier Mar
- Clinical Management Unit, Alto Deba Hospital, Avenida Navarra 16, Mondragon, 20500 Spain ; Health Services Research on Chronic Patients Network (REDISSEC), Avenida Navarra 16, Mondragon, 20500 Spain
| | - Myriam Soto-Gordoa
- Health Services Research on Chronic Patients Network (REDISSEC), Avenida Navarra 16, Mondragon, 20500 Spain ; AP-OSI Research Unit, Alto Deba Hospital, Avenida Navarra 16, Mondragon, 20500 Spain
| | - Arantzazu Arrospide
- Health Services Research on Chronic Patients Network (REDISSEC), Avenida Navarra 16, Mondragon, 20500 Spain ; AP-OSI Research Unit, Alto Deba Hospital, Avenida Navarra 16, Mondragon, 20500 Spain
| | - Fermín Moreno-Izco
- Department of Neurology, Donostia Hospital, C/ Dr Beguiristain s/n, Donostia-San Sebastián, 20014 Spain
| | - Pablo Martínez-Lage
- Fundación CITA-Alzheimer Fundazioa, Pº Mikeletegi 71, Donostia-San Sebastián, 20009 Spain
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397
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Fakhoury M. Role of Immunity and Inflammation in the Pathophysiology of Neurodegenerative Diseases. NEURODEGENER DIS 2015; 15:63-9. [PMID: 25591815 DOI: 10.1159/000369933] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 11/17/2014] [Indexed: 11/19/2022] Open
Abstract
Neurodegenerative diseases are the result of progressive loss of neurons and axons in the central nervous system (CNS), which can lead to cognition and motor dysfunction. It is well known that CNS inflammation and immune activation play a major role in the pathophysiology of neurodegenerative diseases. Although the blood-brain barrier (BBB) is able to protect the CNS from immune activation, it becomes more permeable during inflammation, which renders the brain vulnerable to infections. A better understanding of the interaction between inflammatory mediators, such as cytokines, and the activated immune response, including astrocytes and microglia, is critical for the development of new therapeutic strategies for neurodegenerative diseases. This review first describes the role of innate immune activation in neurodegenerative diseases and illustrates the factors that contribute to the communication between the CNS and the immune system. A closer look is given at the role of the BBB in inflammation and immunity, as well as at the animal models used to study inflammation in neurodegenerative diseases. Finally, this review outlines the key pathways and biological mechanisms involved in CNS diseases, with a particular focus on multiple sclerosis (MS), Parkinson's disease (PD), and Alzheimer's disease (AD).
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Affiliation(s)
- Marc Fakhoury
- Department of Neuroscience, Faculty of Medicine, University of Montreal, Montreal, Que., Canada
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398
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Heger NE. Predictive testing and Alzheimer disease. Clin Chem 2015; 60:1585-6. [PMID: 25580504 DOI: 10.1373/clinchem.2014.231159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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399
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Jordan F, McGuinness B, Murphy K, Passmore P, Kelly JP, Devane D. Aspirin and anti-inflammatory drugs for the prevention of dementia. Hippokratia 2015. [DOI: 10.1002/14651858.cd011459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Fionnuala Jordan
- National University of Ireland Galway; School of Nursing and Midwifery; Arus Moyola Newcastle Road Galway Ireland
| | - Bernadette McGuinness
- Belfast Health and Social Care Trust; Department of Geriatric Medicine; Lisburn Road Belfast Co Antrim UK
| | - Kathy Murphy
- National University of Ireland Galway; School of Nursing and Midwifery; Arus Moyola Newcastle Road Galway Ireland
| | - Peter Passmore
- Queen's University Belfast; Centre for Public Health; Block B, ICSB, Grosvenor Road Belfast Northern Ireland UK BT12
| | - John P Kelly
- NUI Galway; Pharmacology and Therapeutics; University Road Galway Ireland
| | - Declan Devane
- National University of Ireland Galway; School of Nursing and Midwifery; Arus Moyola Newcastle Road Galway Ireland
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Kukharsky MS, Ovchinnikov RK, Bachurin SO. Molecular aspects of the pathogenesis and current approaches to pharmacological correction of Alzheimer’s disease. Zh Nevrol Psikhiatr Im S S Korsakova 2015; 115:103-114. [DOI: 10.17116/jnevro20151156103-114] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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