Guerry Peavy, Ann M Mayo, Cynthia Avalos, Amanda Rodriguez, Benjamin Shifflett, Steven D Edland
{"title":"Perceived Stress in Older Dementia Caregivers: Mediation by Loneliness and Depression.","authors":"Guerry Peavy, Ann M Mayo, Cynthia Avalos, Amanda Rodriguez, Benjamin Shifflett, Steven D Edland","doi":"10.1177/15333175211064756","DOIUrl":"10.1177/15333175211064756","url":null,"abstract":"<p><p>Coupled with aging, chronic stress experienced by dementia caregivers often leads to deteriorating health. Comparing caregivers and non-caregivers, we tested whether depression and loneliness mediate the relationship between caregiver status and a measure of chronic stress, the Perceived Stress Scale. Seventy-six cognitively normal older adults (mean age 72.7) were identified as caregivers or non-caregivers based on the functional independence of a paired family member. Caregivers reported more perceived stress, depression, and loneliness than non-caregivers. Using multiple mediation analyses, we found that loneliness and depression mediated the relationship of caregiver status with perceived stress. The loneliness effect on perceived stress was both direct and via its relationship with depressive symptoms. The findings suggest loneliness as a likely point of intervention to reduce caregiver stress. Initiatives to enable caregivers to maintain or develop social relationships apart from caregiver responsibilities may mitigate stress and its negative impact on mental and physical health.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39648181","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":"Associations Between Regional Cerebral Blood Flow and Psychiatric Symptoms in Dementia With Lewy Bodies Without Parkinsonism.","authors":"Tomonori Murayama, Seiju Kobayashi, Tomotaka Ishida, Kumiko Utsumi, Chiaki Kawanishi","doi":"10.1177/15333175221075109","DOIUrl":"10.1177/15333175221075109","url":null,"abstract":"<p><p>Because dementia with Lewy bodies (DLB) has various psychiatric symptoms, early diagnosis in patients without parkinsonism is difficult. To reveal associations between regional brain perfusion and psychiatric symptoms in DLB patients without parkinsonism, we quantified brain perfusion using an automated brain perfusion single-photon emission computed tomography analysis program, FineSRT. We statistically analyzed the differences in brain perfusion between groups, divided by the presence or absence of psychiatric symptoms. In DLB patients with depression, there were significant brain perfusion increases in the left angular gyrus and right upper precuneus. In DLB patients with visual hallucinations, there were significant decreases in the left inferior parietal lobule, left superior temporal gyrus, and right primary visual cortex. In DLB patients with auditory hallucinations, there were significant increases in the right middle occipital and right inferior occipital gyri. Our findings provide clues about the pathomechanisms of psychiatric symptoms and may enable early diagnosis of DLB in the future.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10581150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39928976","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}
Nazia Rashid, James B Wetmore, Muna Irfan, Victor Abler
{"title":"Adverse Outcomes Associated With Off-Label Agents Used to Treat Dementia Patients With Psychosis: A Case-Control Medicare Database Study.","authors":"Nazia Rashid, James B Wetmore, Muna Irfan, Victor Abler","doi":"10.1177/15333175221081374","DOIUrl":"10.1177/15333175221081374","url":null,"abstract":"<p><strong>Introduction: </strong>Currently, there are no Food and Drug Administration-approved therapies to treat dementia-related psychosis (DRP). This study investigated the association between using antipsychotics and the anticonvulsant divalproex (sodium valproate) to manage DRP and adverse outcomes.</p><p><strong>Methods: </strong>A retrospective case/control matching study evaluated the risk of mortality, extrapyramidal symptoms (EPS), ischemic stroke, and cardiac arrest/ventricular arrhythmia (CA/VA) with ever-use of antipsychotics/divalproex in patients with DRP vs never-use.</p><p><strong>Results: </strong>49 509 patients were included; 76.8% used an antipsychotic/divalproex. Treatment ever-use was associated with an increased risk of all-cause mortality (odds ratio, 1.14; 95% CI, 1.10-1.18) and a smaller increase in the risk of EPS (1.10; 1.00-1.19) relative to never-use (adjusted for matching demographic variables, comorbid conditions, and disability)<b><i>.</i></b></p><p><strong>Conclusions: </strong>Current agents used for DRP were associated with increased risk of death and adverse outcomes. An increased risk of death was evident within 3 months of antipsychotic/divalproex initiation and persisted with long-term use.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40325607","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":"Reassessing Diabetes and APOE Genotype as Potential Interacting Risk Factors for Alzheimer's Disease.","authors":"Kaushik Ravipati, Yunxiao Chen, Joseph R Manns","doi":"10.1177/15333175211070912","DOIUrl":"10.1177/15333175211070912","url":null,"abstract":"<p><p><b>Objective:</b> To assess whether diabetes alone or in association with Apolipoprotein E (APOE) ε4 genotype increases the risk of Alzheimer's Disease (AD) diagnosis. <b>Methods:</b> A retrospective cohort study of 33,456 participants from the National Alzheimer's Coordinating Center database. <b>Results:</b> Participants with one or two APOE ε4 alleles had 2.71 (CI:2.55-2.88) and 9.37 (CI:8.14-10.78) times higher odds of AD diagnosis, respectively, relative to those with zero ε4 alleles. In contrast, diabetic participants showed 1.07 (CI:0.96-1.18) times higher odds of AD relative to nondiabetics. Diabetes did not exacerbate the odds of AD in APOE ε4 carriers. APOE ε4 carriage was correlated with declines in long-term memory and verbal fluency, which were strongly correlated with conversion to AD. However, diabetes was correlated with working memory decline, which had a relatively weak correlation with AD. <b>Conclusions:</b> Unlike APOE ε4, there was little evidence that diabetes was a risk factor for AD.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39691387","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}
Sadaf Arefi Milani, Phillip A Cantu, Abbey B Berenson, Yong-Fang Kuo, Kyriakos S Markides, Mukaila A Raji
{"title":"Gender Differences in Neuropsychiatric Symptoms Among Community-Dwelling Mexican Americans Aged 80 and Older.","authors":"Sadaf Arefi Milani, Phillip A Cantu, Abbey B Berenson, Yong-Fang Kuo, Kyriakos S Markides, Mukaila A Raji","doi":"10.1177/15333175211042958","DOIUrl":"https://doi.org/10.1177/15333175211042958","url":null,"abstract":"<p><p>Background and ObjectivesTo assess gender differences in prevalence of neuropsychiatric symptoms (NPS) among community-dwelling Mexican Americans ≥80 years. <b>Research Design and Methods:</b> Using data from Wave 7 (2010-2011) of the Hispanic Established Population for the Epidemiological Study of the Elderly, we analyzed the NPS of 914 participants as determined by the Neuropsychiatric Inventory (NPI) with assessments conducted by their caregivers. Multivariate logistic regression models were used to test the association of individual NPS with gender, adjusting for relevant characteristics. <b>Results:</b> The average age of our sample was 86.1 years, and 65.3% were women. Over 60% of participants had at least one informant/caregiver reported NPS. After adjustment, women had lower odds than men of agitation/aggression but higher odds of dysphoria/depression and anxiety. <b>Discussion:</b> Recognizing gender differences in NPS phenotype could help guide development of culturally appropriate NPS screening and treatment programs.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8641300/pdf/nihms-1754394.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39449935","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":"Analysis of Serum miRNAs in Alzheimer's Disease.","authors":"Liu Lu, Wen-Zhuo Dai, Xi-Chen Zhu, Tao Ma","doi":"10.1177/15333175211021712","DOIUrl":"10.1177/15333175211021712","url":null,"abstract":"<p><p>This paper was aimed to analyze the microRNA (miRNA) signatures in Alzheimer disease (AD) and find the significant expressions of miRNAs, their target genes, the functional enrichment analysis of the confirmed genes, and potential drug treatment. The miRNA expression information of the gene expression profile data was downloaded from the Gene Expression Omnibus database. The total data sample size is 1309, including 1021 AD samples and 288 normal samples. A total of 21 differentially expressed miRNAs were obtained, of which 16 (hsa-miR-6761-3p, hsa-miR-6747-3p, hsa-miR-6875-3p, hsa-miR-6754-3p, hsa-miR-6736-3p, hsa-miR-6762-3p, hsa-miR-6787-3p, hsa-miR-208a-5p, hsa-miR-6740-3p, hsa-miR-6778-3p, hsa-miR-595, hsa-miR-6753-3p, hsa-miR-4747-3p, hsa-miR-3646, hsa-miR-6716-3p and hsa-miR-4435) were up-regulated and 5 (hsa-miR-125a-3p, hsa-miR-22-3p, hsa-miR-24-3p, hsa-miR-6131 and hsa-miR-125b-1-3p) were down-regulated in AD. A total of 6 miRNAs (hsa-miR-595, hsa-miR-3646, hsa-miR-4435 hsa-miR-125a-3p, hsa-miR-22-3p and hsa-miR-24-3p) and 78 miRNA-disease-related gene sub-networks were predicted, and 116 ceRNA regulatory relationship pairs, and the ceRNA regulatory network were obtained. The results of enrichment analysis suggested that the main target pathways of several miRNAs differentially expressed in AD were mitogen-activated protein kinase signal pathway. According to the prediction results of Drug-Gene Interaction database 2.0, we obtained 53 pairs of drug-gene interaction, including 7 genes (PTGS2, EGFR, CALM1, PDE4D, FGFR2, HMGCR, cdk6) and 53 drugs. We hope our results are helpful to find a viable way to prevent, delay the onset, diagnose, and treat AD.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10581118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39056059","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}
Somayeh Meysami, Cyrus A Raji, David A Merrill, Verna R Porter, Mario F Mendez
{"title":"Quantitative MRI Differences Between Early versus Late Onset Alzheimer's Disease.","authors":"Somayeh Meysami, Cyrus A Raji, David A Merrill, Verna R Porter, Mario F Mendez","doi":"10.1177/15333175211055325","DOIUrl":"10.1177/15333175211055325","url":null,"abstract":"<p><p>Investigators report greater parietal tau deposition and alternate frontoparietal network involvement in early onset Alzheimer's Disease (EOAD) with onset <65 years as compared with typical late onset AD (LOAD). To determine whether clinical brain MRI volumes reflect these differences in EOAD compared with LOAD. This study investigated the clinical MRI scans of 45 persons with Clinically Probable AD with onset <65 years, and compared them to 32 with Clinically Probable AD with onset ≥65 years. Brain volumes on their T1 MRI scans were quantified with a volumetric program. Receiver operating curve analyses were performed. Persons with EOAD had significantly smaller parietal lobes (volumetric percentiles) than LOAD. Late onset Alzheimer's Disease had a smaller left putamen and hippocampus. Area Under the Curve was 96<i>.</i>5% with brain region delineation of EOAD compared to LOAD. This study indicates parietal atrophy less than 30% of normal on clinical MRI scans is suggestive of EOAD compared to LOAD.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905498","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":"Incidence of Mild Cognitive Impairment, Conversion to Probable Dementia, and Mortality.","authors":"Yun Zhang, Ginny Natale, Sean Clouston","doi":"10.1177/15333175211012235","DOIUrl":"10.1177/15333175211012235","url":null,"abstract":"<p><strong>Background: </strong>Few studies have jointly estimated incidence of MCI, conversion to probable dementia, and mortality in a nationally representatie sample.</p><p><strong>Methods: </strong>We used data from six waves of the National Health and Aging Trends Study (2011-2016). Multivariable-adjusted multi-state survival models (MSMs) were used to model incidence upon accounting for misclassification.</p><p><strong>Results: </strong>A total of 6,078 eligible NHATS participants were included (average age: 77.49 ± 7.79 years; 58.42% females; 68.99% non-Hispanic white). The incidence of MCI was estimated to be 41.0 [35.5, 47.3]/1,000 person-years (PY). Participants converted to probable dementia at a high rate of 241.3 [189.6, 307.0]/1,000 PY, though a small number also reverted from MCI to cognitively normal. Education was associated with lower incidence of MCI and conversion to probable dementia, but increased mortality in those with MCI. There were also substantial racial and ethnic disparities in the incidence of MCI and dementia.</p><p><strong>Conclusions: </strong>Our results underscore the relatively common incidence of and conversions between MCI and dementia in community-dwelling older Americans and uncover the beneficial impact of education to withstand cognitive impairment before death.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8715729/pdf/nihms-1765991.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39015874","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}
Hana Na, Hua Tian, Zhengrong Zhang, Qiang Li, Jack B Yang, Liam Mcparland, Qini Gan, Wei Qiao Qiu
{"title":"Oral Amylin Treatment Reduces the Pathological Cascade of Alzheimer's Disease in a Mouse Model.","authors":"Hana Na, Hua Tian, Zhengrong Zhang, Qiang Li, Jack B Yang, Liam Mcparland, Qini Gan, Wei Qiao Qiu","doi":"10.1177/15333175211012867","DOIUrl":"10.1177/15333175211012867","url":null,"abstract":"<p><p>Intraperitoneal injection of amylin or its analog reduces Alzheimer's disease (AD) pathology in the brains. However, self-injecting amylin analogs is difficult for patients due to cognitive deficits. This work aims to study the effects of amylin on the brain could be achieved by oral delivery as some study reported that amylin receptor may be present in the gastrointestinal tract. A 6-week course of oral amylin treatment reduced components of AD pathology, including the levels of amyloid-β, phosphorylated tau, and ionized calcium binding adaptor molecule 1. The treatment reduced active forms of cyclin-dependent kinase 5. Oral amylin treatment led to improvements in social deficit in AD mouse. Using immunofluorescence, we observed the amylin receptor complexed with the calcitonin receptor and receptor activity-modifying proteins in the enteric neurons. The study suggests the potential of the oral delivery of amylin analogs for the treatment of AD and other neurodegenerative diseases through enteric neurons.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39239492","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}
Hyo Geun Choi, Bum Jung Park, Jae Sung Lim, Song Yong Sim, Yoon Jung Jung, Suk Woo Lee
{"title":"Herpes Zoster Does Not Increase the Risk of Neurodegenerative Dementia: A Case-Control Study.","authors":"Hyo Geun Choi, Bum Jung Park, Jae Sung Lim, Song Yong Sim, Yoon Jung Jung, Suk Woo Lee","doi":"10.1177/15333175211006504","DOIUrl":"10.1177/15333175211006504","url":null,"abstract":"<p><strong>Objective: </strong>This study was conducted to evaluate the association between neurodegenerative dementia and herpes zoster infection (HZI) using a national sample cohort.</p><p><strong>Methods: </strong>From the national cohort study conducted by the Korean National Health Insurance Service, we extracted data for patients with neurodegenerative dementia and for 1:4 matched control participants and searched the patient histories for HZI.</p><p><strong>Results: </strong>The adjusted odds ratio (OR) for HZI was 0.90 (95% CI = 0.84-0.97) in the dementia group. According to the subgroup analysis, the adjusted OR for HZI was 0.91 (95% confidence interval [CI] = 0.83 -1.00) in the < 80 years old group, 0.88 (95% CI = 0.78 -1.00) in the ≥ 80 years old group, 0.77 (95% CI = 0.66-0.89) in men and 0.96 (95% CI = 0.88 -1.05) in women.</p><p><strong>Conclusions: </strong>We concluded that HZI does not increase the risk of neurodegenerative dementia in individuals of any age or of either sex.</p>","PeriodicalId":50816,"journal":{"name":"American Journal of Alzheimers Disease and Other Dementias","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11005322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38829226","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}