American Journal of Alzheimers Disease and Other Dementias最新文献

{"title":"Risk Factors for Cardiovascular Events in Patients on Antidementia Medications.","authors":"Meiqi He, James M Stevenson, Yuting Zhang, Inmaculada Hernandez","doi":"10.1177/1533317520922380","DOIUrl":"10.1177/1533317520922380","url":null,"abstract":"<p><strong>Objective: </strong>To identify characteristics associated with an increased risk of cardiovascular events in patients diagnosed with Alzheimer disease (AD) and treated with antidementia medications.</p><p><strong>Methods: </strong>Demographics, diagnoses, and medication usage of 30 433 Medicare patients were analyzed using 2006 to 2013 claims data and a combined model of screening, ranking and stepwise logistic regressions to evaluate factors associated with composite outcomes of 6 cardiovascular events.</p><p><strong>Results: </strong>Incidence rate of at least 1 cardiovascular event was 25.1%. Fifty-five factors were identified from the 10 381 candidate variables by the combined model with a c-statistic of 67% and an accuracy of 75%. Factors associated with increased risk of cardiovascular events include history of heart rhythm disorders, alteration of consciousness (odds ratio [OR]: 1.25; 95% confidence interval [CI]: 1.14-1.36), and usage of β-blockers (OR: 1.19; 95% CI: 1.13-1.27).</p><p><strong>Conclusions: </strong>Clinicians should consider the increased risk of cardiovascular events in patients with AD with heart rhythm disorders and on β-blockers.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315406/pdf/nihms-1600948.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37913430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PSP-FTD Complex: A Possible Variant of PSP.","authors":"Sunil Pradhan, Ruchika Tandon","doi":"10.1177/1533317520922383","DOIUrl":"10.1177/1533317520922383","url":null,"abstract":"<p><strong>Introduction: </strong>This study tried to find out type of lobar features found in patients with progressive supranuclear palsy (PSP) and whether they differ from those of frontotemporal dementia (FTD) as both of these are tauopathies.</p><p><strong>Methods: </strong>We studied lobar functions of 45 patients with PSP.</p><p><strong>Results: </strong>Five (11.1%) patients had no lobar feature; 11 (24.4%) had PSP-like features like apathy, frontal release signs, impaired motor Luria written sequences, and fist-edge-palm test; and 29 (64.4%) patients had FTD-like lobar features like disinhibition, poor naming, and word finding difficulty. Among features resembling FTD, behavioural variant type occurred in 31.1%, primary progressive aphasia type occurred in 58.6%, 3.4% patients had semantic dementia type features, and 6.9% were unclassified.</p><p><strong>Conclusions: </strong>Hence, patients with PSP with lobar features may fall in the middle of PSP-FTD spectrum with frontal lobe features typical of PSP (PSP-frontal like) and those with frontal lobe features resembling FTD (PSP-FTD complex) in between.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38138351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antidiabetic Drugs for the Risk of Alzheimer Disease in Patients With Type 2 DM Using FAERS.","authors":"Hayato Akimoto, Akio Negishi, Shinji Oshima, Haruna Wakiyama, Mitsuyoshi Okita, Norimitsu Horii, Naoko Inoue, Shigeru Ohshima, Daisuke Kobayashi","doi":"10.1177/1533317519899546","DOIUrl":"10.1177/1533317519899546","url":null,"abstract":"<p><p>Alzheimer disease (AD) may develop after the onset of type 2 diabetes mellitus (T2DM), and the risk of AD may depend on the antidiabetic drug administered. We compared the risk of AD among 66 085 patients (≥ 65 years) with T2DM (1250 having concomitant AD) who had been administered antidiabetic drug monotherapy for T2DM who had voluntarily reported themselves in the Food and Drug Administration Adverse Event Reporting System. The risk of AD from the use of different antidiabetic drug monotherapies compared to that of metformin monotherapy was assessed by logistic regression. Rosiglitazone (adjusted reporting odds ratio [aROR] = 0.11; 95% confidence interval [CI]: 0.07-0.17; <i>P</i> < .001), exenatide (aROR = 0.22; 95% CI: 0.11-0.37; <i>P</i> < .001), liraglutide (aROR = 0.36; 95% CI: 0.19-0.62; <i>P</i> < .001), dulaglutide (aROR = 0.39; 95% CI: 0.17-0.77; <i>P</i> = .014), and sitagliptin (aROR = 0.75; 95% CI: 0.60-0.93; <i>P</i> = .011) were found to have a significantly lower associated risk of AD than that of metformin. Therefore, the administration of glucagon-like peptide 1 receptor agonists and rosiglitazone may reduce the risk of AD in patients with T2DM.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11005324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37729382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine-Learning Algorithms Based on Screening Tests for Mild Cognitive Impairment.","authors":"Jin-Hyuck Park","doi":"10.1177/1533317520927163","DOIUrl":"10.1177/1533317520927163","url":null,"abstract":"<p><strong>Background: </strong>The mobile screening test system for mild cognitive impairment (mSTS-MCI) was developed and validated to address the low sensitivity and specificity of the Montreal Cognitive Assessment (MoCA) widely used clinically.</p><p><strong>Objective: </strong>This study was to evaluate the efficacy machine learning algorithms based on the mSTS-MCI and Korean version of MoCA.</p><p><strong>Method: </strong>In total, 103 healthy individuals and 74 patients with MCI were randomly divided into training and test data sets, respectively. The algorithm using TensorFlow was trained based on the training data set, and then its accuracy was calculated based on the test data set. The cost was calculated via logistic regression in this case.</p><p><strong>Result: </strong>Predictive power of the algorithms was higher than those of the original tests. In particular, the algorithm based on the mSTS-MCI showed the highest positive-predictive value.</p><p><strong>Conclusion: </strong>The machine learning algorithms predicting MCI showed the comparable findings with the conventional screening tools.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38104881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of COVID-19 Home Confinement in Dementia Care: Physical and Cognitive Decline, Severe Neuropsychiatric Symptoms and Increased Caregiving Burden.","authors":"Flávia Borges-Machado, Duarte Barros, Óscar Ribeiro, Joana Carvalho","doi":"10.1177/1533317520976720","DOIUrl":"10.1177/1533317520976720","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to analyze home confinement impact on individuals with neurocognitive disorders (NCD) through informal caregiver's perspective and examine how it has affected caregiving burden.</p><p><strong>Methods: </strong>Thirty-six caregivers (64.94 ± 13.54 years, 41.7% female) of individuals with NCD (74.28 ± 6.76 years, 66.7% female) selected from the <i>Body & Brain</i> exercise program were interviewed over the phone. The following instruments were used: Barthel Index (BI) to assess care recipients' ability to function independently on activities of daily living (ADL), the Neuropsychiatric Inventory (NPI) to evaluate neuropsychiatric symptoms, and the CarerQol-7D/ CarerQol-VAS to determine caregiver subjective burden/well-being.</p><p><strong>Results: </strong>Pre and post-confinement comparisons showed that care recipients significantly declined their independence in ADL (p = 0.003) and increased NPI total score (MD = 5.72; 95% CI: 1.19 to 10.25, p = 0.015). As for caregivers, results also showed an increased caregiving burden (MD = -0.17; 95% CI: -0.27 to -0.08; p = 0.001) and a decline in their well-being (p = 0.015).</p><p><strong>Discussion: </strong>COVID-19 crisis sheds light on how imperative it is to find solutions and design contingency plans for future crisis, in order to ensure properly sustained support to dementia caregiving dyads and mitigate caregivers' burden.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38353614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pupil Diameter as a Possible Indicator of Neurodegenerative Diseases and Response to Acetylcholinesterase Inhibitors Therapy: In-Depth Measurements Following Topical Administration of Tropicamide and Pilocarpine.","authors":"Raffaele Nuzzi, Alessandro Bojino, Maria Sole Polito, Chiara Luppi, Federico Tridico, Massimiliano Massaia","doi":"10.1177/1533317520951693","DOIUrl":"10.1177/1533317520951693","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to assess whether pupillary modifications following ocular anticholinergic and cholinergic drugs can identify subjects with neurodegenerative diseases from early stages.</p><p><strong>Methods: </strong>51 subjects were divided into 3 groups, according to different neurodegenerative diseases, and compared with a control group of 10 patients. Pupil diameter has been measured at different times after topical administration of tropicamide 0.01% in the right eye. Then, topical administration of pilocarpine 0.06% has been performed, followed by pupillary constriction measurement. Pupillary response rates were stratified according to acetylcholinesterase inhibitors intake.</p><p><strong>Results: </strong>Observed mydriasis and pupillary constriction was similar in all study groups at all evaluation times. Patients without acetylcholinesterase inhibitors intake presented greater mydriasis.</p><p><strong>Conclusions: </strong>Although it was not possible to observe significant differences among groups in terms of pupillary response, the analysis of pupillary features may become an useful tool to detect efficacy of acetylcholinesterase inhibitors.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38432603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study on PHF-Tau Network Effected by Apolipoprotein E4.","authors":"Yuan Li, Zhijun Yao, Yongqing Yang, Feng Zhao, Yu Fu, Ying Zou, Bin Hu","doi":"10.1177/1533317520971414","DOIUrl":"10.1177/1533317520971414","url":null,"abstract":"<p><p>Apolipoprotein E 4 Allele (APOE 4) is an important factors in Mild cognitive impairment (MCI) and Alzheimer's disease(AD). It plays a primary role in abnormal modification of aggregated Tau protein-paired helical filaments Tau (PHF-Tau). In this study, 143 subjects with PHF-Tau PET were divided into 2 groups (APOE 4 carriers and noncarriers). The measurements of the PHF-Tau network properties and resilient were calculated for 2 group networks respectively. APOE 4 carriers group showed significant differences in all the network properties in the results. We also found significant differences of betweenness centrality in some brain regions for APOE 4 carriers. Moreover, the APOE 4 carriers showed less resilient to targeted or random node failure. Our results indicated that the effects of APOE 4 may lead to abnormalities of PHF-Tau protein network. These findings may be particularly helpful in uncovering the pathophysiology underlying the cognitive dysfunction in MCI patients.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38670186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Reliable Tool for Assessing MCI and Dementia: Validation Study of DemTect for Turkish Population.","authors":"Gozde Sengul Aycicek, Hatice Çalıskan, Cemile Ozsurekci, Pelin Unsal, Josef Kessler, E Kalbe, Mert Esme, Rana Tuna Dogrul, Cafer Balcı, Umran Seven, Erdem Karabulut, Meltem Halil, Mustafa Cankurtaran, Burcu Balam Yavuz","doi":"10.1177/1533317520949805","DOIUrl":"10.1177/1533317520949805","url":null,"abstract":"<p><strong>Background and aim: </strong>Mild cognitive impairment (MCI) and dementia prevalence are expected to increase with aging. The DemTect is a very quick and easy tool to administer and recognize the early stages of dementia and MCI. In this study we aimed to evaluate the reliability and validity of a Turkish version of the DemTect and define cut off values for different age and educational levels. One of our aims is also to compare the sensitivity and specifity of the DemTect to other common screening tools.</p><p><strong>Patients and methods: </strong>Fifty-four patients with MCI, 55 patients with dementia and 91 patients with subjective memory complaints (SMC) were enrolled in the study. The DemTect was translated into Turkish by forward-backward translation and compared with the Mini Mental State Examination (MMSE), the Quick Mild Cognitive Impairment Turkish version (QMCI-TR) and the Montreal Cognitive Assessment (MoCA). In order to test interrater reliability, the DemTect was administered to 11 patients, on the same day, by 2 trained raters. To establish test-retest reliability, the same rater scored the tool a second time on 11 patients within 2 weeks.</p><p><strong>Results: </strong>The median age of the patients was 73 (min-max: 65-90) years, 54.5% were female. We found a strong correlation between DemTect scores and the MMSE, the QMCI, and the MoCA (r = 0.725, r = 0.816, r = 0.821, respectively; p < 0.001). In ROC analysis, the cut-off point of the DemTect to differentiate MCI from SMC was 11.5 with 92.6% sensitivity, 91.2% specificity, AUC 0.973 and the cut-off point of the DemTect to differentiate dementia from SMC was 9.5 with 96.4% sensitivity, 100% specificity, AUC 0.916. Cronbach α was 0.823. Intraclass correlation coefficient was 0.873 (95% CI: 0.598-0.964) for interrater reliability and 0.966 (95% 0.777-0.982) for test-retest reliability (Cronbach α = 0.932, 0.966 respectively).</p><p><strong>Conclusion: </strong>The DemTect is a very reliable tool to assess Turkish patients with MCI and dementia.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38409207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disclosure of Amyloid Status for Risk of Alzheimer Disease to Cognitively Normal Research Participants With Subjective Cognitive Decline: A Longitudinal Study.","authors":"Taisei Wake, Hajime Tabuchi, Kei Funaki, Daisuke Ito, Bun Yamagata, Takahito Yoshizaki, Tadaki Nakahara, Masahiro Jinzaki, Haruo Yoshimasu, Iori Tanahashi, Hiroumi Shimazaki, Masaru Mimura","doi":"10.1177/1533317520904551","DOIUrl":"10.1177/1533317520904551","url":null,"abstract":"<p><p>This study aimed to investigate the long-term impacts of disclosing amyloid status for a risk of Alzheimer disease (AD) to cognitively normal research participants with subjective cognitive decline (SCD), which represents an initial manifestation of AD. Forty-two participants were classified as the amyloid-positive (<i>n</i> = 10) or amyloid-negative (<i>n</i> = 32) groups. We assessed symptoms of anxiety, depression, and test-related distress at 6, 24, and 52 weeks after results disclosure. No difference was found over time in anxiety, depression, and test-related distress in either group. Although no significant differences were observed between groups in anxiety or depression, the amyloid-negative group had a significantly higher level of test-related distress than the amyloid-positive group at 52 weeks. Disclosing amyloid status to cognitively healthy research participants with SCD did not cause significant long-term psychological risks. However, a theoretical spectrum of subjective concern may exist about cognitive decline in amyloid-negative individuals.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37639578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermittent Hypoxia Training for Treating Mild Cognitive Impairment: A Pilot Study.","authors":"Hong Wang, Xiangrong Shi, Hannah Schenck, James R Hall, Sarah E Ross, Geoffrey P Kline, Shande Chen, Robert T Mallet, Peijie Chen","doi":"10.1177/1533317519896725","DOIUrl":"10.1177/1533317519896725","url":null,"abstract":"<p><p>Although intermittent hypoxia training (IHT) has proven effective against various clinical disorders, its impact on mild cognitive impairment (MCI) is unknown. This pilot study examined IHT's safety and therapeutic efficacy in elderly patients with amnestic MCI (aMCI). Seven patients with aMCI (age 69 ± 3 years) alternately breathed 10% O₂ and room-air, each 5 minutes, for 8 cycles/session, 3 sessions/wk for 8 weeks. The patients' resting arterial pressures fell by 5 to 7 mm Hg (<i>P</i> < .05) and cerebral tissue oxygenation increased (<i>P</i> < .05) following IHT. Intermittent hypoxia training enhanced hypoxemia-induced cerebral vasodilation (<i>P</i> < .05) and improved mini-mental state examination and digit span scores from 25.7 ± 0.4 to 27.7 ± 0.6 (<i>P</i> = .038) and from 24.7 ± 1.2 to 26.1 ± 1.3 (<i>P</i> = .047), respectively. California verbal learning test score tended to increase (<i>P</i> = .102), but trail making test-B and controlled oral word association test scores were unchanged. Adaptation to moderate IHT may enhance cerebral oxygenation and hypoxia-induced cerebrovasodilation while improving short-term memory and attention in elderly patients with aMCI.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37513626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}