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Kayama M, Nagai T, Futagami T, Terasawa K. A polymetric approach for measuring brain activity and behavior: Considerations for gait, gaze and fNIRS measurements in a 10-m walking of elderly and young adults. Technol Health Care 2024; 32:551-563. [PMID: 37545262 DOI: 10.3233/thc-220447] [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] [Indexed: 08/08/2023]
Abstract
BACKGROUND The actual changes in biological and physiological parameters during walking are little understood in multiple aspects. OBJECTIVE The objective of this paper was to examine and link the disparate measures of motor, vision, and brain activity for elderly and young adults. METHOD The participants were 15 elderly adults and 10 young adults. Accelerometry, eye tracking, and prefrontal cortex (PFC) activity in the functional near-infrared spectroscopy (fNIRS) were used to evaluate the participants in a 10-m walking test. RESULT The results for the elderly adults were 1) low variabilities of velocity and acceleration along the front-back and up-down axes, 2) a wider gaze range on the right-left axis than the young adults, 3) a high mean PFC activity, and 4) a larger number of high-relation pairs than the young adults for the correlation coefficients of both gait vs. gaze and gait vs. PFC activity. The variabilities of velocity and acceleration, gaze and PFC activity changes for the young adults were selective. CONCLUSION Measuring 10-m walking in a polymetric approach may capture some indicators related to physical and cognitive difficulties such as frailty and dementia.
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Affiliation(s)
- Mizue Kayama
- Graduate School of Medicine, Science and Technology, Shinshu University, Nagano, Japan
| | - Takashi Nagai
- Faculty of Technologists, Institute of Technologists, Saitama, Japan
| | - Takao Futagami
- Graduate School of Medicine, Science and Technology, Shinshu University, Nagano, Japan
- Toyo Corp., Tokyo, Japan
| | - Koji Terasawa
- Graduate School of Medicine, Science and Technology, Shinshu University, Nagano, Japan
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Readman MR, Polden M, Gibbs MC, Wareing L, Crawford TJ. The Potential of Naturalistic Eye Movement Tasks in the Diagnosis of Alzheimer's Disease: A Review. Brain Sci 2021; 11:brainsci11111503. [PMID: 34827502 PMCID: PMC8615459 DOI: 10.3390/brainsci11111503] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/29/2021] [Accepted: 11/07/2021] [Indexed: 01/31/2023] Open
Abstract
Extensive research has demonstrated that eye-tracking tasks can effectively indicate cognitive impairment. For example, lab-based eye-tracking tasks, such as the antisaccade task, have robustly distinguished between people with Alzheimer’s disease (AD) and healthy older adults. Due to the neurodegeneration associated with AD, people with AD often display extended saccade latencies and increased error rates on eye-tracking tasks. Although the effectiveness of using eye tracking to identify cognitive impairment appears promising, research considering the utility of eye tracking during naturalistic tasks, such as reading, in identifying cognitive impairment is limited. The current review identified 39 articles assessing eye-tracking distinctions between people with AD, mild cognitive impairment (MCI), and healthy controls when completing naturalistic task (reading, real-life simulations, static image search) or a goal-directed task involving naturalistic stimuli. The results revealed that naturalistic tasks show promising biomarkers and distinctions between healthy older adults and AD participants, and therefore show potential to be used for diagnostic and monitoring purposes. However, only twelve articles included MCI participants and assessed the sensitivity of measures to detect cognitive impairment in preclinical stages. In addition, the review revealed inconsistencies within the literature, particularly when assessing reading tasks. We urge researchers to expand on the current literature in this area and strive to assess the robustness and sensitivity of eye-tracking measures in both AD and MCI populations on naturalistic tasks.
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Wang Z, Zhang Z, Xie C, Shu H, Liu D, Zhang Z. Identification of the Neural Circuit Underlying Episodic Memory Deficit in Amnestic Mild Cognitive Impairment via Machine Learning on Gray Matter Volume. J Alzheimers Dis 2021; 84:959-964. [PMID: 34602473 DOI: 10.3233/jad-210579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Based on whole-brain gray matter volume (GMV), we used relevance vector regression to predict the Rey's Auditory Verbal Learning Test Delayed Recall (AVLT-DR) scores of individual amnestic mild cognitive impairment (aMCI) patient. The whole-brain GMV pattern could significantly predict the AVLT-DR scores (r = 0.54, p < 0.001). The most important GMV features mainly involved default-mode (e.g., posterior cingulate gyrus, angular gyrus, and middle temporal gyrus) and limbic systems (e.g., hippocampus and parahippocampal gyrus). Therefore, our results provide evidence supporting the idea that the episodic memory deficit in aMCI patients is associated with disruption of the default-mode and limbic systems.
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Affiliation(s)
- Zan Wang
- School of Medicine, Southeast University, Nanjing, China.,Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing, China
| | - Zhengsheng Zhang
- School of Medicine, Southeast University, Nanjing, China.,Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing, China
| | - Chunming Xie
- School of Medicine, Southeast University, Nanjing, China.,Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing, China
| | - Hao Shu
- School of Medicine, Southeast University, Nanjing, China.,Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing, China
| | - Duan Liu
- School of Medicine, Southeast University, Nanjing, China
| | - Zhijun Zhang
- School of Medicine, Southeast University, Nanjing, China.,Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing, China
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Mantovani E, Zucchella C, Schena F, Romanelli MG, Venturelli M, Tamburin S. Towards a Redefinition of Cognitive Frailty. J Alzheimers Dis 2021; 76:831-843. [PMID: 32568197 PMCID: PMC7504985 DOI: 10.3233/jad-200137] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: The progressive aging of the population will dramatically increase the burden of dementia related to Alzheimer’s disease (AD) and other neurodegenerative disorders in the future. Because of the absence of drugs that can modify the neuropathological substrate of AD, research is focusing on the application of preemptive and disease-modifying strategies in the pre-symptomatic period of the disease. In this perspective, the identification of people with cognitive frailty (CF), i.e., those individuals with higher risk of developing dementia, on solid pathophysiological bases and with clear operational clinical criteria is of paramount importance. Objective/Methods: This hypothesis paper reviews the current definitions of CF, presents and discusses some of their limitations, and proposes a framework for updating and improving the conceptual and operational definition of the CF construct. Results: The potential for reversibility of CF should be supported by the assessment of amyloid, tau, and neuronal damage biomarkers, especially in younger patients. Physical and cognitive components of frailty should be considered as separate entities, instead of part of a single macro-phenotype. CF should not be limited to the geriatric population, because trajectories of amyloid accumulation are supposed to start earlier than 65 years in AD. Operational criteria are needed to standardize assessment of CF. Conclusion: Based on the limitations of current CF definitions, we propose a revised one according to a multidimensional subtyping. This new definition might help stratifying CF patients for future trials to explore new lifestyle interventions or disease-modifying pharmacological strategies for AD and dementia.
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Affiliation(s)
- Elisa Mantovani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Zucchella
- Section of Neurology, Department of Neurosciences, Verona University Hospital, Verona, Italy
| | - Federico Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Maria Grazia Romanelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Massimo Venturelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Section of Neurology, Department of Neurosciences, Verona University Hospital, Verona, Italy
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5
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Poor Cognitive Function Is Associated with Obstructive Lung Diseases in Taiwanese Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052344. [PMID: 33673619 PMCID: PMC7957805 DOI: 10.3390/ijerph18052344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 12/14/2022]
Abstract
Previous studies have reported an association between the impairment of cognitive performance and lung diseases. However, whether obstructive or restrictive lung diseases have an impact on cognitive function is still inconclusive. We aimed to investigate the association between cognitive function and obstructive or restrictive lung diseases in Taiwanese adults using the Mini-Mental State Examination (MMSE). In this study, we used data from the Taiwan Biobank. Cognitive function was evaluated using the MMSE. Spirometry measurements of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were obtained to assess lung function. Participants were classified into three groups according to lung function, namely, normal, restrictive, and obstructive lung function. In total, 683 patients enrolled, of whom 357 participants had normal lung function (52.3%), 95 had restrictive lung function (13.9%), and 231 had obstructive lung function (33.8%). Compared to the normal lung function group, the obstructive lung function group was associated with a higher percentage of cognitive impairment (MMSE < 24). In multivariable analysis, a low MMSE score was significantly associated with low FVC, low FEV1, and low FEV1/FVC. Furthermore, a low MMSE score was significantly associated with low FEV1 in the participants with FEV1/FVC < 70%, whereas MMSE was not significantly associated with FVC in the participants with FEV1/FVC ≥ 70%. Our results showed that a low MMSE score was associated with low FEV1, low FVC and low FEV1/FVC. Furthermore, a low MMSE score was associated with obstructive lung diseases but not with restrictive lung diseases.
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Benussi A, Grassi M, Palluzzi F, Cantoni V, Cotelli MS, Premi E, Di Lorenzo F, Pellicciari MC, Ranieri F, Musumeci G, Marra C, Manganotti P, Nardone R, Di Lazzaro V, Koch G, Borroni B. Classification accuracy of TMS for the diagnosis of mild cognitive impairment. Brain Stimul 2021; 14:241-249. [PMID: 33453454 DOI: 10.1016/j.brs.2021.01.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/17/2020] [Accepted: 01/08/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To evaluate the performance of a Random Forest (RF) classifier on Transcranial Magnetic Stimulation (TMS) measures in patients with Mild Cognitive Impairment (MCI). METHODS We applied a RF classifier on TMS measures obtained from a multicenter cohort of patients with MCI, including MCI-Alzheimer's Disease (MCI-AD), MCI-frontotemporal dementia (MCI-FTD), MCI-dementia with Lewy bodies (MCI-DLB), and healthy controls (HC). All patients underwent TMS assessment at recruitment (index test), with application of reference clinical criteria, to predict different neurodegenerative disorders. The primary outcome measures were the classification accuracy, precision, recall and F1-score of TMS in differentiating each disorder. RESULTS 160 participants were included, namely 64 patients diagnosed as MCI-AD, 28 as MCI-FTD, 14 as MCI-DLB, and 47 as healthy controls (HC). A series of 3 binary classifiers was employed, and the prediction model exhibited high classification accuracy (ranging from 0.72 to 0.86), high precision (0.72-0.90), high recall (0.75-0.98), and high F1-scores (0.78-0.92), in differentiating each neurodegenerative disorder. By computing a new classifier, trained and validated on the current cohort of MCI patients, classification indices showed even higher accuracy (ranging from 0.83 to 0.93), precision (0.87-0.89), recall (0.83-1.00), and F1-scores (0.85-0.94). CONCLUSIONS TMS may be considered a useful additional screening tool to be used in clinical practice in the prodromal stages of neurodegenerative dementias.
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Affiliation(s)
- Alberto Benussi
- Neurology Unit, Department of Clinial and Experimental Sciences, University of Brescia, Italy
| | - Mario Grassi
- Department of Brain and Behavioural Sciences, Medical and Genomic Statistics Unit, University of Pavia, Pavia, Italy
| | - Fernando Palluzzi
- Department of Brain and Behavioural Sciences, Medical and Genomic Statistics Unit, University of Pavia, Pavia, Italy
| | - Valentina Cantoni
- Neurology Unit, Department of Clinial and Experimental Sciences, University of Brescia, Italy
| | | | - Enrico Premi
- Neurology Unit, Department of Clinial and Experimental Sciences, University of Brescia, Italy
| | | | | | - Federico Ranieri
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Gabriella Musumeci
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University, Rome, Italy
| | - Camillo Marra
- Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy
| | | | - Raffaele Nardone
- Department of Neurology, Hospital of Merano (SABES-ASDAA), Merano-Meran, Italy; Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University, Rome, Italy
| | - Giacomo Koch
- Non Invasive Brain Stimulation Unit, IRCCS Santa Lucia Foundation, Rome, Italy; Stroke Unit, Policlinico Tor Vergata, Rome, Italy
| | - Barbara Borroni
- Neurology Unit, Department of Clinial and Experimental Sciences, University of Brescia, Italy.
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7
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Shen Y, Wang H, Sun Q, Yao H, Keegan AP, Mullan M, Wilson J, Lista S, Leyhe T, Laske C, Rujescu D, Levey A, Wallin A, Blennow K, Li R, Hampel H. Increased Plasma Beta-Secretase 1 May Predict Conversion to Alzheimer's Disease Dementia in Individuals With Mild Cognitive Impairment. Biol Psychiatry 2018; 83:447-455. [PMID: 28359566 PMCID: PMC5656540 DOI: 10.1016/j.biopsych.2017.02.007] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 02/04/2017] [Accepted: 02/06/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Increased beta-secretase 1 (BACE1) activity has consistently been detected in brain tissue and cerebrospinal fluid of subjects with mild cognitive impairment (MCI) and probable Alzheimer's disease (AD) compared with control subjects. The collection of cerebrospinal fluid by lumbar puncture is invasive. We sought to identify the presence of plasma BACE1 activity and determine potential alterations in subjects with MCI with clinical follow-up examinations for 3 years using patients with diagnosed probable AD dementia compared with healthy control subjects. METHODS Seventy-five patients with probable AD, 96 individuals with MCI, and 53 age-matched and sex-matched healthy control subjects were recruited from three independent international academic memory clinics and AD research expert centers. Plasma BACE1 activity was measured by a synthetic fluorescence substrate enzyme-linked immunosorbent assay. BACE1 protein expression was assessed by Western blotting using three different antibodies that recognize the epitopes of the N-terminus, C-terminus, and full-length BACE1. RESULTS Compared with healthy control subjects, plasma BACE1 activity (Vmax) significantly increased by 53.2% in subjects with MCI and by 68.9% in patients with probable AD. Subjects with MCI who converted to probable AD dementia at follow-up examinations exhibited significantly higher BACE1 activity compared with cognitively stable MCI nonconverters and showed higher levels of BACE1 activity than patients with AD. CONCLUSIONS Plasma BACE1 activity is significantly increased in MCI converters and patients with probable AD. The sensitivities and specificities of BACE1 activity for the patients were 84% and 88%, respectively. Our results indicate that plasma BACE1 activity may be a biomarker for AD risk and could predict progression from prodromal to probable AD dementia.
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Affiliation(s)
- Yong Shen
- Neurodegenerative Disorder Research Center and Brain Bank, School of Life Sciences, University of Science and Technology of China, Material Science at Microscale National Laboratory, Hefei, China 230027,Roskamp Institute, Sarasota, FL34203 USA
| | - Haibo Wang
- Roskamp Institute, Sarasota, FL34203 USA
| | - Qiying Sun
- Roskamp Institute, Sarasota, FL34203 USA
| | - Hailan Yao
- Roskamp Institute, Sarasota, FL34203 USA
| | | | | | - Jeffrey Wilson
- Department of Economics, Arizona State University, Tempe, AZ, USA
| | - Simone Lista
- IHU-A-ICM – Paris Institute of Translational Neurosciences, Pitié-Salpêtrière University Hospital, Paris, France,AXA Research Fund & UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM)
| | - Thomas Leyhe
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany,Center of Old Age Psychiatry, Psychiatric University Hospital, Wilhelm Klein-Strasse 27, CH-4012Basel, Switzerland
| | - Christoph Laske
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany
| | - Dan Rujescu
- Department of Psychiatry and Psychotherapy, Alzheimer Memorial Center, Ludwig-Maximilian University, Munich, Germany
| | - Allan Levey
- Department of Neurology and Alzheimer’s Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Anders Wallin
- Department of Neuroscience and Physiology, University of Gothenburg, Sahlgren’s University Hospital, Mölndal, Sweden
| | - Kaj Blennow
- Department of Neuroscience and Physiology, University of Gothenburg, Sahlgren’s University Hospital, Mölndal, Sweden
| | - Rena Li
- Beijing Anding Hospital, Capital Medical University & Beijing Key Laboratory of Mental Disorders, Beijing; Beijing Institute for Brain Disorders, Beijing, China; Center for Hormone Advanced Science and Education, Sarasota.
| | - Harald Hampel
- IHU-A-ICM – Paris Institute of Translational Neurosciences, Pitié-Salpêtrière University Hospital, Paris, France,AXA Research Fund & UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM),Département de Neurologie, Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Boulevard de l’hôpital, F-75013, Paris, France
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8
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Kahana Levy N, Lavidor M, Vakil E. Prosaccade and Antisaccade Paradigms in Persons with Alzheimer’s Disease: A Meta-Analytic Review. Neuropsychol Rev 2017; 28:16-31. [DOI: 10.1007/s11065-017-9362-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 10/06/2017] [Indexed: 01/04/2023]
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9
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Borroni B, Cosseddu M, Pilotto A, Premi E, Archetti S, Gasparotti R, Cappa S, Padovani A. Early stage of behavioral variant frontotemporal dementia: clinical and neuroimaging correlates. Neurobiol Aging 2015; 36:3108-3115. [PMID: 26329689 DOI: 10.1016/j.neurobiolaging.2015.07.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 07/11/2015] [Accepted: 07/12/2015] [Indexed: 10/23/2022]
Abstract
The early stages of behavioral variant frontotemporal dementia (bvFTD) are still not completely characterized. In a consecutive series of patients with probable bvFTD diagnosis confirmed by follow-up, we retrospectively evaluated the features at onset. Patients were reclassified according to presenting features and current diagnostic criteria into probable and possible bvFTD. The term "pre-bvFTD" was adopted for patients with cognitive and/or behavioral impairment not fulfilling bvFTD criteria and no deficits in activities of daily living. One hundred ninety-four subjects were included; at first visit, 70% (n = 136) patients were already classified as probable bvFTD. Of the remaining 30% (n = 58), 60% fulfilled criteria for possible bvFTD, while 40% did not, and were classified as pre-FTD. The neuropsychological pattern in possible bvFTD and pre-bvFTD was similar, although possible bvFTD showed more behavioral abnormalities. Pre-bvFTD subjects had frontotemporal gray matter atrophy, although less extensive than possible bvFTD. Conclusively, most bvFTD patients fulfill current diagnostic criteria at first admission, whereas a relatively small group is characterized by mild behavioral and/or cognitive abnormalities in spite of frontotemporal gray matter atrophy. Our preliminary findings will require a validation in prospective studies involving larger samples of patients.
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Affiliation(s)
- Barbara Borroni
- Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy.
| | - Maura Cosseddu
- Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy
| | - Andrea Pilotto
- Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy
| | - Enrico Premi
- Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy
| | | | | | - Stefano Cappa
- Institute for Advanced Study IUSS Pavia, Pavia, Italy
| | - Alessandro Padovani
- Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy
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Elshafey R, Hassanien O, Khalil M, Allah MR, Saad S, Baghdadi M, El Zayady M. Hippocampus, caudate nucleus and entorhinal cortex volumetric MRI measurements in discrimination between Alzheimer’s disease, mild cognitive impairment, and normal aging. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2013.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Peltsch A, Hemraj A, Garcia A, Munoz DP. Saccade deficits in amnestic mild cognitive impairment resemble mild Alzheimer's disease. Eur J Neurosci 2014; 39:2000-13. [DOI: 10.1111/ejn.12617] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 03/25/2014] [Accepted: 04/11/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Alicia Peltsch
- Centre for Neuroscience Studies; Queen's University; Kingston ON K7L 3N6 Canada
| | - Alisha Hemraj
- Centre for Neuroscience Studies; Queen's University; Kingston ON K7L 3N6 Canada
| | - Angeles Garcia
- Centre for Neuroscience Studies; Queen's University; Kingston ON K7L 3N6 Canada
- Department of Medicine; Queen's University; Kingston ON Canada
| | - Douglas P. Munoz
- Centre for Neuroscience Studies; Queen's University; Kingston ON K7L 3N6 Canada
- Department of Medicine; Queen's University; Kingston ON Canada
- Department of Biomedical and Molecular Sciences; Queen's University; Kingston ON Canada
- Department of Psychology; Queen's University; Kingston ON Canada
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12
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Zheng H, Fridkin M, Youdim M. From single target to multitarget/network therapeutics in Alzheimer's therapy. Pharmaceuticals (Basel) 2014; 7:113-35. [PMID: 24463342 PMCID: PMC3942689 DOI: 10.3390/ph7020113] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 01/13/2014] [Accepted: 01/17/2014] [Indexed: 02/06/2023] Open
Abstract
Brain network dysfunction in Alzheimer’s disease (AD) involves many proteins (enzymes), processes and pathways, which overlap and influence one another in AD pathogenesis. This complexity challenges the dominant paradigm in drug discovery or a single-target drug for a single mechanism. Although this paradigm has achieved considerable success in some particular diseases, it has failed to provide effective approaches to AD therapy. Network medicines may offer alternative hope for effective treatment of AD and other complex diseases. In contrast to the single-target drug approach, network medicines employ a holistic approach to restore network dysfunction by simultaneously targeting key components in disease networks. In this paper, we explore several drugs either in the clinic or under development for AD therapy in term of their design strategies, diverse mechanisms of action and disease-modifying potential. These drugs act as multi-target ligands and may serve as leads for further development as network medicines.
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Affiliation(s)
- Hailin Zheng
- Department of Medicinal Chemistry, Intra-cellular Therapies Inc. 3960 Broadway, New York, NY 10032, USA.
| | - Mati Fridkin
- Department of Organic Chemistry, Weizmann Institute of Science, Rehovot 76100, Israel.
| | - Moussa Youdim
- Abital Pharma Pipeline Ltd., Tel Aviv 6789141, Israel.
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13
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Klekociuk SZ, Summers MJ. The learning profile of persistent mild cognitive impairment (MCI): a potential diagnostic marker of persistent amnestic MCI. Eur J Neurol 2013; 21:470-7, e23-4. [DOI: 10.1111/ene.12333] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 11/18/2013] [Indexed: 11/26/2022]
Affiliation(s)
- S. Z. Klekociuk
- School of Psychology; University of Tasmania; Launceston TAS Australia
| | - M. J. Summers
- School of Psychology; University of Tasmania; Launceston TAS Australia
- Wicking Dementia Research and Education Centre; School of Medicine; University of Tasmania; Hobart TAS Australia
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Faraco CC, Puente AN, Brown C, Terry DP, Stephen Miller L. Lateral temporal hyper-activation as a novel biomarker of mild cognitive impairment. Neuropsychologia 2013; 51:2281-93. [PMID: 23933482 DOI: 10.1016/j.neuropsychologia.2013.07.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 07/29/2013] [Accepted: 07/30/2013] [Indexed: 11/25/2022]
Abstract
Memory dysfunction in mild cognitive impairment (MCI) due to Alzheimer's pathology is primarily associated with episodic memory deficits linked to deterioration of the medial temporal lobes (MTLs). Currently, there is a call to discover novel biomarkers of MCI in order to improve research criteria. Functional activation differences in MCI during episodic memory-task performance are often evidenced in the MTLs, and frontal and parietal lobes, but it has been suggested that examination of working memory (WM) differences may be more useful in detecting MCI. In the current study, MCI and control participants performed a complex WM span (CWMS) task while functional magnetic resonance imaging (fMRI) data were acquired. Results indicated hyper-activation of the lateral temporal lobes, MTLs, and frontal and parietal regions during encoding and maintenance, and hyper-activation of the lateral temporal, frontal, and parietal lobes during CWMS recall for the MCI participants. Medial and lateral temporal differences during encoding and maintenance are consistent with previous findings, but lateral temporal differences are often not elaborated upon. Hyper-activation of the lateral temporal lobes during WM encoding and maintenance, and also during recall, suggests that this region may provide valuable information regarding WM impairment in MCI and Alzheimer's. Given that whole-brain functional imaging of the MTLs is often limited due to artifact and partial voluming of sub-fields, examination of lateral temporal differences may provide a novel biomarker related to WM impairment in MCI.
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Affiliation(s)
- Carlos C Faraco
- Biomedical Health Sciences Institute, Division of Neuroscience, University of Georgia, Psychology Building, Athens, GA 30602, United States.
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15
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Gonzalez-Palau F, Franco M, Jimenez F, Parra E, Bernate M, Solis A. Clinical Utility of the Hopkins Verbal Test-Revised for Detecting Alzheimer's Disease and Mild Cognitive Impairment in Spanish Population. Arch Clin Neuropsychol 2013; 28:245-53. [DOI: 10.1093/arclin/act004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Neuroimaging enrichment strategy for secondary prevention trials in Alzheimer disease. Alzheimer Dis Assoc Disord 2011; 24:269-77. [PMID: 20683184 DOI: 10.1097/wad.0b013e3181d1b814] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We examined the improvement in statistical power that could be obtained in therapeutic trials for early (predementia) Alzheimer disease by constraining enrollment to individuals with amnestic mild cognitive impairment (MCI) and an atrophy pattern on a screening magnetic resonance imaging (MRI) scan previously found to be predictive of clinical decline, or to individuals with MCI and the apolipoprotein E epsilon 4 genetic risk factor for Alzheimer disease. Treatable effects were defined as absolute change versus change relative to healthy controls (HCs). Data from 168 HC and 299 MCI participants were analyzed to determine sample sizes required to detect 25% slowing in mean rate of decline using global function, cognitive function, and structural measures as outcome variables. Reductions in estimated sample sizes of 10% to 43% were observed using the genetic enrichment strategy; reductions of 43% to 60% were observed with the neuroimaging enrichment strategy. Sample sizes needed to detect slowing in rate of atrophy in MCI relative to HC were dramatically larger than those needed to detect absolute change in atrophy rates. Constraining enrollment to MCI subjects with predictive atrophy on a screening MRI scan could improve the efficiency of clinical trials. Failure to take into account normal age-related changes risks under-powering trials designed to test disease-modifying properties of potential treatments.
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CSF biomarkers in prediction of cerebral and clinical change in mild cognitive impairment and Alzheimer's disease. J Neurosci 2010; 30:2088-101. [PMID: 20147537 DOI: 10.1523/jneurosci.3785-09.2010] [Citation(s) in RCA: 163] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Brain atrophy and altered CSF levels of amyloid beta (Abeta(42)) and the microtubule-associated protein tau are potent biomarkers of Alzheimer's disease (AD)-related pathology. However, the relationship between CSF biomarkers and brain morphometry is poorly understood. Thus, we addressed the following questions. (1) Can CSF biomarker levels explain the morphometric differences between normal controls (NC) and patients with mild cognitive impairment (MCI) or AD? (2) How are CSF biomarkers related to atrophy across the brain? (3) How closely are CSF biomarkers and morphometry related to clinical change [clinical dementia rating sum of boxes (CDR-sb)]? Three hundred seventy participants (105 NC, 175 MCI, 90 AD) from the Alzheimer's Disease Neuroimaging Initiative were studied, of whom 309 were followed for 1 year and 176 for 2 years. Analyses were performed across the entire cortical surface, as well as for 30 cortical and subcortical regions of interest. Results showed that CSF biomarker levels could not account for group differences in brain morphometry at baseline but that CSF biomarker levels showed moderate relationships to longitudinal atrophy rates in numerous brain areas, not restricted to medial temporal structures. Baseline morphometry was at least as predictive of atrophy as were CSF biomarkers. Even MCI patients with levels of Abeta(42) comparable with controls and of p-tau lower than controls showed more atrophy than the controls. Morphometry predicted change in CDR-sb better than did CSF biomarkers. These results indicate that morphometric changes in MCI and AD are not secondary to CSF biomarker changes and that the two types of biomarkers yield complementary information.
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He J, Farias S, Martinez O, Reed B, Mungas D, Decarli C. Differences in brain volume, hippocampal volume, cerebrovascular risk factors, and apolipoprotein E4 among mild cognitive impairment subtypes. ACTA ACUST UNITED AC 2009; 66:1393-9. [PMID: 19901172 DOI: 10.1001/archneurol.2009.252] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To evaluate demographics, magnetic resonance imaging (MRI) measures, and vascular risk among mild cognitive impairment (MCI) subtypes. DESIGN Cross-sectional study. SETTING Both clinics and the community. PARTICIPANTS A total of 153 subjects with MCI, 218 cognitively normal older individuals (controls), and 68 patients with Alzheimer disease. MAIN OUTCOME MEASURES Classification of subjects with MCI according to current subtype diagnostic convention based on neuropsychological performance, estimates of vascular risk based on medical history, research MRI unless there was a specific contraindication, and apolipoprotein E genotype. RESULTS Of the 153 subjects with MCI, 65 were diagnosed with amnestic single-domain, 46 with amnestic multiple-domain, 27 with nonamnestic single-domain, and 15 with nonamnestic multiple-domain MCI. Analyses of control, MCI, and Alzheimer disease cases revealed significant differences in brain and hippocampal volumes between each group. Post hoc analyses of MRI measures among the MCI subtypes found that patients with amnestic single-domain MCI had significantly less brain atrophy and that hippocampal volume differed significantly from controls for the 2 amnestic forms of MCI. Apolipoprotein E genotype prevalence was significantly greater in the amnestic and nonamnestic subtypes of MCI. Conversely, the nonamnestic subtypes were more likely to have increased vascular risk and to be African American. CONCLUSIONS Amnestic forms of MCI appear to have demographic, genetic, and MRI findings suggestive of Alzheimer disease pathology, whereas the nonamnestic forms of MCI have findings suggestive of vascular disease. Importantly, however, all subjects with MCI showed evidence of brain injury, and the biological differences among subtypes are relatively subtle beyond the memory vs nonmemory groupings.
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Affiliation(s)
- Jing He
- Department of Neurology, and the Imaging of Dementia and Aging Laboratory, Center for Neuroscience Preventive Medicine, University of California at Davis, Sacramento, CA 95817, USA
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Ashford JW, Borson S, O'Hara R, Dash P, Frank L, Robert P, Shankle WR, Tierney MC, Brodaty H, Schmitt FA, Kraemer HC, Buschke H. Should older adults be screened for dementia? Alzheimers Dement 2009; 2:76-85. [PMID: 19595860 DOI: 10.1016/j.jalz.2006.02.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2006] [Accepted: 02/10/2006] [Indexed: 11/17/2022]
Abstract
The question of whether to screen for dementia and Alzheimer's disease (AD) has been discussed in many forums throughout the world. Generally, medical advisory groups and policy-making groups have recognized the importance of early diagnosis but have uniformly avoided making recommendations to screen at-risk populations. This presentation reflects the support for reconsidering the importance of screening individuals at risk or above a certain age. In this statement, the majority of the authors support the consideration of dementia risk factors in individuals at age 50, with routine yearly screening after 75. Other authors remain concerned that the benefits of treatments of early disease do not yet support a general screening recommendation. These statements are made to encourage progress toward the development of a consensus regarding the widespread institution of screening policy. Accordingly, members of the worldwide scientific community are invited to add their perspective by contributing short commentaries (1500 words) on this subject.
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Affiliation(s)
- J Wesson Ashford
- Stanford/VA Alzheimer Center, Department of Psychiatry, Palo Alto VA Health Care System, Palo Alto, CA, USA.
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Fennema-Notestine C, McEvoy LK, Hagler DJ, Jacobson MW, Dale AM. Structural neuroimaging in the detection and prognosis of pre-clinical and early AD. Behav Neurol 2009; 21:3-12. [PMID: 19847040 PMCID: PMC2873895 DOI: 10.3233/ben-2009-0230] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Current research supports the strong potential of structural MRI profiles, even within cross-sectional designs, as a promising method for the discrimination of Alzheimer's Disease (AD) from normal controls and for the prediction of Mild Cognitive Impairment (MCI) progression and conversion to AD. Findings suggest that measures of structural change in mesial and lateral temporal, cingulate, parietal and midfrontal areas may facilitate the assessment of a treatment's ability to halt the progressive structural loss that accompanies clinical decline in MCI. The performance of prediction is likely to continue to improve with the incorporation of measures from other neuroimaging modalities, clinical assessments, and neuromedical biomarkers, as the regional profile of individuals at risk for progression is refined.
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Bai F, Watson DR, Zhang Z. Hippocampal dysfunction in amnestic-type mild cognitive impairment: implications for predicting Alzheimer’s risk. FUTURE NEUROLOGY 2009. [DOI: 10.2217/fnl.09.36] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Functional MRI is an attractive method for studying cognitive task-related and resting-state patterns of brain activation and connectivity. Since hippocampal dysfunction has been widely reported in patients with amnestic-type mild cognitive impairment (MCI) with Alzheimer’s risk, a number of studies have focused on this region of the brain; these studies are reviewed here. Three principle findings are highlighted: first, impaired hippocampal function relates to disturbances in episodic memory encoding and retrieval in MCI, but possibly in different ways; second, there is evidence of a nonlinear relationship between memory function and hippocampal activity as one progresses through the stages of MCI to Alzheimer’s disease; and third, hippocampal function is intimately related to default mode network mechanisms. Future work should be directed toward extending our understanding of the relationships between hippocampal function in MCI and pathological and cognitive disturbance. This may be a valuable neuroimaging marker in the objective of early detection of the disease processes that presage the development of Alzheimer’s disease.
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Affiliation(s)
- Feng Bai
- School of Clinical Medicine, Southeast University; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Ding Jia Qiao road No. 87, 210009, Nanjing, China
| | - David R Watson
- School of Medicine & Dentistry, Queen’s University Belfast, BT9 7BL, Belfast, UK
| | - Zhijun Zhang
- School of Clinical Medicine, Southeast University; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Ding Jia Qiao road No. 87, 210009, Nanjing, China
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McEvoy LK, Fennema-Notestine C, Roddey JC, Hagler DJ, Holland D, Karow DS, Pung CJ, Brewer JB, Dale AM. Alzheimer disease: quantitative structural neuroimaging for detection and prediction of clinical and structural changes in mild cognitive impairment. Radiology 2009; 251:195-205. [PMID: 19201945 DOI: 10.1148/radiol.2511080924] [Citation(s) in RCA: 224] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To use structural magnetic resonance (MR) images to identify a pattern of regional atrophy characteristic of mild Alzheimer disease (AD) and to investigate whether presence of this pattern prospectively can aid prediction of 1-year clinical decline and increased structural loss in mild cognitive impairment (MCI). MATERIALS AND METHODS The study was conducted with institutional review board approval and compliance with HIPAA regulations. Written informed consent was obtained from each participant. High-throughput volumetric segmentation and cortical surface reconstruction methods were applied to MR images from 84 subjects with mild AD, 175 with MCI, and 139 healthy control (HC) subjects. Stepwise linear discriminant analysis was used to identify regions that best can aid discrimination of HC subjects from subjects with AD. A classifier trained on data from HC subjects and those with AD was applied to data from subjects with MCI to determine whether presence of phenotypic AD atrophy at baseline was predictive of clinical decline and structural loss. RESULTS Atrophy in mesial and lateral temporal, isthmus cingulate, and orbitofrontal areas aided discrimination of HC subjects from subjects with AD, with fully cross-validated sensitivity of 83% and specificity of 93%. Subjects with MCI who had phenotypic AD atrophy showed significantly greater 1-year clinical decline and structural loss than those who did not and were more likely to have progression to probable AD (annual progression rate of 29% for subjects with MCI who had AD atrophy vs 8% for those who did not). CONCLUSION Semiautomated, individually specific quantitative MR imaging methods can be used to identify a pattern of regional atrophy in MCI that is predictive of clinical decline. Such information may aid in prediction of patient prognosis and increase the efficiency of clinical trials.
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Affiliation(s)
- Linda K McEvoy
- Department of Radiology, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093-0841, USA.
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Panza F, Capurso C, D'Introno A, Colacicco AM, Gadaleta A, Frisardi V, Santamato A, Capurso A, Solfrizzi V. Mild cognitive impairment: dementia risk factor or high-risk state for progression to dementia? J Am Geriatr Soc 2008; 56:1367-9. [PMID: 18774976 DOI: 10.1111/j.1532-5415.2008.01731.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Dementia and its most common cause, Alzheimer’s disease, affect memory and occur predominantly in the elderly. Dementia has become increasingly prevalent in the world as health has improved and life expectancy has increased. However, the fields of clinical care have not responded adequately to develop diagnostic tools and treatments for this rapidly increasing group of conditions. While scientists search for cures for the numerous causes of dementia, improvement of diagnostic measures are needed now and should begin with screening elderly populations for memory difficulties and other cognitive problems. This review examines the history of cognitive screening tests, the numerous excellent tests that are currently available and ready for use, and directions and methods that will lead to progressively better evaluations.
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Affiliation(s)
- J Wesson Ashford
- Stanford/VA Aging Clinical Research Center, VA Palo Alto Health Care System, 151-Y, 3801 Miranda Ave, Palo Alto, CA 94304, USA
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Plassman BL, Langa KM, Fisher GG, Heeringa SG, Weir DR, Ofstedal MB, Burke JR, Hurd MD, Potter GG, Rodgers WL, Steffens DC, McArdle JJ, Willis RJ, Wallace RB. Prevalence of cognitive impairment without dementia in the United States. Ann Intern Med 2008; 148:427-34. [PMID: 18347351 PMCID: PMC2670458 DOI: 10.7326/0003-4819-148-6-200803180-00005] [Citation(s) in RCA: 604] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cognitive impairment without dementia is associated with increased risk for disability, increased health care costs, and progression to dementia. There are no population-based prevalence estimates of this condition in the United States. OBJECTIVE To estimate the prevalence of cognitive impairment without dementia in the United States and determine longitudinal cognitive and mortality outcomes. DESIGN Longitudinal study from July 2001 to March 2005. SETTING In-home assessment for cognitive impairment. PARTICIPANTS Participants in ADAMS (Aging, Demographics, and Memory Study) who were age 71 years or older drawn from the nationally representative HRS (Health and Retirement Study). Of 1770 selected individuals, 856 completed initial assessment, and of 241 selected individuals, 180 completed 16- to 18-month follow-up assessment. MEASUREMENTS Assessments, including neuropsychological testing, neurologic examination, and clinical and medical history, were used to assign a diagnosis of normal cognition, cognitive impairment without dementia, or dementia. National prevalence rates were estimated by using a population-weighted sample. RESULTS In 2002, an estimated 5.4 million people (22.2%) in the United States age 71 years or older had cognitive impairment without dementia. Prominent subtypes included prodromal Alzheimer disease (8.2%) and cerebrovascular disease (5.7%). Among participants who completed follow-up assessments, 11.7% with cognitive impairment without dementia progressed to dementia annually, whereas those with subtypes of prodromal Alzheimer disease and stroke progressed at annual rates of 17% to 20%. The annual death rate was 8% among those with cognitive impairment without dementia and almost 15% among those with cognitive impairment due to medical conditions. LIMITATIONS Only 56% of the nondeceased target sample completed the initial assessment. Population sampling weights were derived to adjust for at least some of the potential bias due to nonresponse and attrition. CONCLUSION Cognitive impairment without dementia is more prevalent in the United States than dementia, and its subtypes vary in prevalence and outcomes.
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Mitchell T, Woodward M, Hirose Y. A survey of attitudes of clinicians towards the diagnosis and treatment of mild cognitive impairment in Australia and New Zealand. Int Psychogeriatr 2008; 20:77-85. [PMID: 17565765 DOI: 10.1017/s1041610207005583] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The aim of the study was to assess the attitudes of clinicians to the diagnostic construct of mild cognitive impairment (MCI), their approach to relaying the diagnosis to patients and families, and recommended treatment and follow-up. METHOD An anonymous questionnaire was sent out to 503 members of the Australian Society for Geriatric Medicine (ASGM) and New Zealand Geriatrics Society (NZGS), of whom 163 replied. RESULTS Most responders (83%) had diagnosed MCI. About 70% rated the importance of separating MCI from dementia, or MCI from normal cognition, as 4 or 5 on a scale from 1 (not very important) to 5 (very important). Most responders reported that they would inform their patients and families of a diagnosis of MCI, and used that term. A minority used the term "early Alzheimer's disease," but 44% of NZGS members used other terms to relay the diagnosis compared to 13% of ASGM members. Follow-up was most often recommended at 6-12 months. Non-pharmacological treatment (such as mental stimulation strategies) was recommended most often, followed by no treatment. CONCLUSIONS The diagnostic entity of MCI appears to have a general acceptance among those who responded to the survey, and the term has gained use in clinical practice. Most clinicians are recommending follow-up, recognizing the high risk for progression. Treatment recommendations do not favor pharmaceuticals, reflecting the current evidence for lack of effect.
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Affiliation(s)
- Terry Mitchell
- Older People's Health, Auckland City Hospital, New Zealand.
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Ribeiro F, Guerreiro M, De Mendonça A. Verbal learning and memory deficits in Mild Cognitive Impairment. J Clin Exp Neuropsychol 2007; 29:187-97. [PMID: 17365254 DOI: 10.1080/13803390600629775] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Criteria for amnestic MCI rely on the use of delayed recall tasks to establish the presence of memory impairment. This study applied the California Verbal Learning Test to detail memory performance in MCI patients (n=70), as compared to control subjects (n=92) and AD patients (n=21). Learning across the 5 trials was different among the 3 groups. Learning strategy was also different, the MCI group showing less semantic clustering than the control group. However, both MCI patients and controls could benefit from semantic cueing. This study showed that beyond consolidation deficits, MCI patients have marked difficulties in acquisition and recall strategies.
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Affiliation(s)
- F Ribeiro
- Dementia Clinics, Laboratory of Language, Neurology Department, Institute of Molecular Medicine and Faculty of Medicine of Lisbon, Portugal.
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Abstract
In preparation for the development of the Diagnostic and Statistical Manual of Mental Disorders (5th ed), the American Psychiatric Association convened workshops reviewing scientific evidence relevant to diagnosis of dementia. One of the domains covered was genetics, which is reviewed here. The following areas are reviewed: genetic data on Alzheimer's disease and other dementias; the impact of nosology on genetic research in terms of its potential to improve diagnostic sensitivity and specificity and to decrease heterogeneity; the impact of genetic research findings on nosology, specific diagnostic criteria, and subtypes; and recommendations and future directions. The focus is on Alzheimer's disease, where more genetic data are available, and other dementias are reviewed more briefly. In addition, a separate section reviews the relationship of genetic findings and mild cognitive impairment, a boundary zone between normal aging and dementia, particularly Alzheimer's disease.
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Affiliation(s)
- Deborah Blacker
- Department of Psychiatry, Mass General Hospital/Harvard Medical School, Boston, MA, USA.
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