101
|
|
102
|
|
103
|
|
104
|
|
105
|
|
106
|
|
107
|
2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 waitfor delay '0:0:5'] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
108
|
2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 and 2364=4691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
109
|
|
110
|
2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 and 8336=8336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
111
|
2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 and 8336=8336-- yvja] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
112
|
|
113
|
2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 and 9592=(select 9592 from pg_sleep(5))-- pgrd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
114
|
2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 and 9592=(select 9592 from pg_sleep(5))] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
115
|
2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 and (select 8682 from (select(sleep(5)))aqxj)-- zwlx] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
116
|
2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 and 5109=2486-- lenk] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
117
|
|
118
|
Grangeon L, Paquet C, Bombois S, Quillard-Muraine M, Martinaud O, Bourre B, Lefaucheur R, Nicolas G, Dumurgier J, Gerardin E, Jan M, Laplanche JL, Peoc’h K, Hugon J, Pasquier F, Maltête D, Hannequin D, Wallon D. Differential Diagnosis of Dementia with High Levels of Cerebrospinal Fluid Tau Protein. J Alzheimers Dis 2016; 51:905-13. [DOI: 10.3233/jad-151111] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Lou Grangeon
- Department of Neurology, Rouen University Hospital, Rouen, France
| | - Claire Paquet
- CMRR Paris Nord AP-HP, Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, INSERM, U942, Université Paris Diderot, Sorbonne Paris Cité, UMRS 942, Paris, France
| | - Stephanie Bombois
- Univ. Lille, Inserm U1171, Memory centre and CNR-MAJ, CHU, Lille, France
| | | | | | - Bertrand Bourre
- Department of Neurology, Rouen University Hospital, Rouen, France
| | | | - Gaël Nicolas
- INSERM U1079, Normandy Centre for Genomic Medicine and Personalized Medicine, IRIB, Normandy University, CNR-MAJ, Rouen University Hospital, Rouen, France
- Department of Genetics, Rouen University Hospital, Rouen, France
| | - Julien Dumurgier
- CMRR Paris Nord AP-HP, Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, INSERM, U942, Université Paris Diderot, Sorbonne Paris Cité, UMRS 942, Paris, France
| | | | - Mary Jan
- Department of Neurophysiology, Rouen University Hospital, Rouen, France
| | - Jean-Louis Laplanche
- Service de Biochimie et Biologie Moléculaire, Hôpital Lariboisière, APHP, Inserm UMR-S 1144, Université Paris Descartes, Paris, France
| | - Katell Peoc’h
- Service de Biochimie et Biologie Moléculaire, Hôpital Lariboisière, APHP, Inserm UMR-S 1144, Université Paris Descartes, Paris, France
- APHP, HUPNVS, Hopital Beaujon, Service de Biochimie, Clichy, France
| | - Jacques Hugon
- CMRR Paris Nord AP-HP, Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, INSERM, U942, Université Paris Diderot, Sorbonne Paris Cité, UMRS 942, Paris, France
| | - Florence Pasquier
- Univ. Lille, Inserm U1171, Memory centre and CNR-MAJ, CHU, Lille, France
| | - David Maltête
- Department of Neurology, Rouen University Hospital, Rouen, France
| | - Didier Hannequin
- Department of Neurology, Rouen University Hospital, Rouen, France
- INSERM U1079, Normandy Centre for Genomic Medicine and Personalized Medicine, IRIB, Normandy University, CNR-MAJ, Rouen University Hospital, Rouen, France
| | - David Wallon
- Department of Neurology, Rouen University Hospital, Rouen, France
- INSERM U1079, Normandy Centre for Genomic Medicine and Personalized Medicine, IRIB, Normandy University, CNR-MAJ, Rouen University Hospital, Rouen, France
| | | |
Collapse
|
119
|
CSF biomarkers in neurodegenerative and vascular dementias. Prog Neurobiol 2016; 138-140:36-53. [DOI: 10.1016/j.pneurobio.2016.03.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/12/2016] [Accepted: 03/14/2016] [Indexed: 12/14/2022]
|
120
|
Flores G, Flores-Gómez GD, de Jesús Gomez-Villalobos M. Neuronal changes after chronic high blood pressure in animal models and its implication for vascular dementia. Synapse 2016; 70:198-205. [DOI: 10.1002/syn.21887] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 01/08/2016] [Accepted: 01/15/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Gonzalo Flores
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla. 14 Sur 6301; Puebla 72570 México
| | - Gabriel D. Flores-Gómez
- Departamento de Ciencias de la Salud; Licenciatura en Medicina. Universidad de las Américas Puebla; Puebla Cholula México
| | | |
Collapse
|
121
|
Simonsen AH, Kuiperij B, El-Agnaf OMA, Engelborghs S, Herukka SK, Parnetti L, Rektorova I, Vanmechelen E, Kapaki E, Verbeek M, Mollenhauer B. The utility of α-synuclein as biofluid marker in neurodegenerative diseases: a systematic review of the literature. Biomark Med 2016; 10:19-34. [DOI: 10.2217/bmm.14.105] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The discovery of α-synuclein (α-syn) as a major component of Lewy bodies, neuropathological hallmark of Parkinson's disease (PD), dementia with Lewy bodies and of glial inclusions in multiple system atrophy initiated the investigation of α-syn as a biomarker in cerebrospinal fluid (CSF). Due to the involvement of the periphery in PD the quantification of α-syn in peripheral fluids such as serum, plasma and saliva has been investigated as well. We review how the development of multiple assays for the quantification of α-syn has yielded novel insights into the variety of α-syn species present in the different fluids; the optimal preanalytical conditions required for robust quantification and the potential clinical value of α-syn as biomarker. We also suggest future approaches to use of CSF α-syn in neurodegenerative diseases.
Collapse
Affiliation(s)
- Anja Hviid Simonsen
- Memory Disorders Research Group, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Bea Kuiperij
- Department of Neurology, Department of Laboratory Medicine, Donders Institute for Brain, Cognition & Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Omar Mukhtar Ali El-Agnaf
- College of Science and Engineering, Hamid Bin Khalifa University, Qatar Foundation, Education City, PO Box 5825 Doha, Qatar
| | - Sebastian Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp & Department of Neurology & Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium
| | - Sanna-Kaisa Herukka
- Institute of Clinical Medicine – Neurology University of Eastern Finland School of Medicine, Kuopio, Finland
| | - Lucilla Parnetti
- Centro Disturbi della Memoria- Unità Valutativa Alzheimer, Clinica Neurologica, Università di Perugia, Italy
| | - Irena Rektorova
- Applied Neuroscience Research Group, CEITEC MU, Masaryk University, Brno, Czech Republic
| | - Eugeen Vanmechelen
- ADx NeuroSciences, VIB-Bioincubator, Technologiepark Zwijnaarde 4, 9052 Ghent, Belgium
| | - Elisabeth Kapaki
- National & Kapodistrian University of Athens, School of Medicine, 1st Department of Neurology, Eginition Hospital, Athens, Greece
| | - Marcel Verbeek
- Department of Neurology, Department of Laboratory Medicine, Donders Institute for Brain, Cognition & Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel & University Medical Center (Departments of Neuropathology & Neurosurgery), Georg-August University Goettingen, Germany
| |
Collapse
|
122
|
Abstract
This report discusses the public health impact of Alzheimer’s disease (AD), including incidence and prevalence, mortality rates, costs of care and the overall effect on caregivers and society. It also examines the challenges encountered by health care providers when disclosing an AD diagnosis to patients and caregivers. An estimated 5.3 million Americans have AD; 5.1 million are age 65 years, and approximately 200,000 are age <65 years and have younger onset AD. By mid-century, the number of people living with AD in the United States is projected to grow by nearly 10 million, fueled in large part by the aging baby boom generation. Today, someone in the country develops AD every 67 seconds. By 2050, one new case of AD is expected to develop every 33 seconds, resulting in nearly 1 million new cases per year, and the estimated prevalence is expected to range from 11 million to 16 million. In 2013, official death certificates recorded 84,767 deaths from AD, making AD the sixth leading cause of death in the United States and the fifth leading cause of death in Americans age 65 years. Between 2000 and 2013, deaths resulting from heart disease, stroke and prostate cancer decreased 14%, 23% and 11%, respectively, whereas deaths from AD increased 71%. The actual number of deaths to which AD contributes (or deaths with AD) is likely much larger than the number of deaths from AD recorded on death certificates. In 2015, an estimated 700,000 Americans age 65 years will die with AD, and many of them will die from complications caused by AD. In 2014, more than 15 million family members and other unpaid caregivers provided an estimated 17.9 billion hours of care to people with AD and other dementias, a contribution valued at more than $217 billion. Average per-person Medicare payments for services to beneficiaries age 65 years with AD and other dementias are more than two and a half times as great as payments for all beneficiaries without these conditions, and Medicaid payments are 19 times as great. Total payments in 2015 for health care, long-term care and hospice services for people age 65 years with dementia are expected to be $226 billion. Among people with a diagnosis of AD or another dementia, fewer than half report having been told of the diagnosis by their health care provider. Though the benefits of a prompt, clear and accurate disclosure of an AD diagnosis are recognized by the medical profession, improvements to the disclosure process are needed. These improvements may require stronger support systems for health care providers and their patients.
Collapse
|
123
|
Sahathevan R, Linden T, Villemagne VL, Churilov L, Ly JV, Rowe C, Donnan G, Brodtmann A. Positron Emission Tomographic Imaging in Stroke: Cross-Sectional and Follow-Up Assessment of Amyloid in Ischemic Stroke. Stroke 2015; 47:113-9. [PMID: 26578658 PMCID: PMC4689176 DOI: 10.1161/strokeaha.115.010528] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/13/2015] [Indexed: 11/16/2022]
Abstract
Cardiovascular risk factors significantly increase the risk of developing Alzheimer disease. A possible mechanism may be via ischemic infarction–driving amyloid deposition. We conducted a study to determine the presence of β-amyloid in infarct, peri-infarct, and hemispheric areas after stroke. We hypothesized that an infarct would trigger β-amyloid deposition, with deposition over time.
Collapse
Affiliation(s)
- Ramesh Sahathevan
- From the Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia (R.S., T.L., L.C., J.V.L., G.D., A.D.); University of Melbourne, Victoria, Australia (R.S., V.L.V., L.C., J.V.L., C.R., G.D., A.D.); Universiti Kebangsaan Malaysia Medical Centre, Bangi, Malaysia (R.S.); Gothenburg University, Gothenburg, Sweden (T.L.); and Austin Hospital PET Centre, Melbourne, Victoria, Australia (V.L.V., C.R.)
| | - Thomas Linden
- From the Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia (R.S., T.L., L.C., J.V.L., G.D., A.D.); University of Melbourne, Victoria, Australia (R.S., V.L.V., L.C., J.V.L., C.R., G.D., A.D.); Universiti Kebangsaan Malaysia Medical Centre, Bangi, Malaysia (R.S.); Gothenburg University, Gothenburg, Sweden (T.L.); and Austin Hospital PET Centre, Melbourne, Victoria, Australia (V.L.V., C.R.)
| | - Victor L Villemagne
- From the Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia (R.S., T.L., L.C., J.V.L., G.D., A.D.); University of Melbourne, Victoria, Australia (R.S., V.L.V., L.C., J.V.L., C.R., G.D., A.D.); Universiti Kebangsaan Malaysia Medical Centre, Bangi, Malaysia (R.S.); Gothenburg University, Gothenburg, Sweden (T.L.); and Austin Hospital PET Centre, Melbourne, Victoria, Australia (V.L.V., C.R.)
| | - Leonid Churilov
- From the Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia (R.S., T.L., L.C., J.V.L., G.D., A.D.); University of Melbourne, Victoria, Australia (R.S., V.L.V., L.C., J.V.L., C.R., G.D., A.D.); Universiti Kebangsaan Malaysia Medical Centre, Bangi, Malaysia (R.S.); Gothenburg University, Gothenburg, Sweden (T.L.); and Austin Hospital PET Centre, Melbourne, Victoria, Australia (V.L.V., C.R.)
| | - John V Ly
- From the Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia (R.S., T.L., L.C., J.V.L., G.D., A.D.); University of Melbourne, Victoria, Australia (R.S., V.L.V., L.C., J.V.L., C.R., G.D., A.D.); Universiti Kebangsaan Malaysia Medical Centre, Bangi, Malaysia (R.S.); Gothenburg University, Gothenburg, Sweden (T.L.); and Austin Hospital PET Centre, Melbourne, Victoria, Australia (V.L.V., C.R.)
| | - Christopher Rowe
- From the Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia (R.S., T.L., L.C., J.V.L., G.D., A.D.); University of Melbourne, Victoria, Australia (R.S., V.L.V., L.C., J.V.L., C.R., G.D., A.D.); Universiti Kebangsaan Malaysia Medical Centre, Bangi, Malaysia (R.S.); Gothenburg University, Gothenburg, Sweden (T.L.); and Austin Hospital PET Centre, Melbourne, Victoria, Australia (V.L.V., C.R.)
| | - Geoffrey Donnan
- From the Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia (R.S., T.L., L.C., J.V.L., G.D., A.D.); University of Melbourne, Victoria, Australia (R.S., V.L.V., L.C., J.V.L., C.R., G.D., A.D.); Universiti Kebangsaan Malaysia Medical Centre, Bangi, Malaysia (R.S.); Gothenburg University, Gothenburg, Sweden (T.L.); and Austin Hospital PET Centre, Melbourne, Victoria, Australia (V.L.V., C.R.)
| | - Amy Brodtmann
- From the Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia (R.S., T.L., L.C., J.V.L., G.D., A.D.); University of Melbourne, Victoria, Australia (R.S., V.L.V., L.C., J.V.L., C.R., G.D., A.D.); Universiti Kebangsaan Malaysia Medical Centre, Bangi, Malaysia (R.S.); Gothenburg University, Gothenburg, Sweden (T.L.); and Austin Hospital PET Centre, Melbourne, Victoria, Australia (V.L.V., C.R.).
| |
Collapse
|
124
|
Abstract
Cognitive impairment is currently one of the most urgent problems. A number of newly registered cases of dementia in the world approaches to 7,7 millions that means that a new case of dementia arises every four seconds. According to WHO data, Western Europe is in the first place (appr. 7,0 millions of patients). In 2010, Russia was among 9 countries with the highest number of patients with dementia. Mixed dementia is characterized by the presence of one or several pathogenetic mechanisms of cognitive impairment. Its prevalence is about 45%. Neurodegenerative and vascular processes underlying dementia are mutually potentiated. An analysis of the majority of characteristics demonstrates that mixed dementia has characteristics of both Alzheimer's disease and vascular dementia. Disturbances of neurotransmitter systems are caused by cholinergic deficit. Galantamine (reminil) is the drug that has demonstrated its efficacy in the treatment of dementia of Alzheimer's type including dementia with chronic disturbances of cerebral blood circulation.
Collapse
|
125
|
Dao E, Hsiung GYR, Sossi V, Jacova C, Tam R, Dinelle K, Best JR, Liu-Ambrose T. Exploring the effects of coexisting amyloid in subcortical vascular cognitive impairment. BMC Neurol 2015; 15:197. [PMID: 26459220 PMCID: PMC4604093 DOI: 10.1186/s12883-015-0459-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 10/04/2015] [Indexed: 01/18/2023] Open
Abstract
Background Mixed pathology, particularly Alzheimer’s disease with cerebrovascular lesions, is reported as the second most common cause of dementia. Research on mixed dementia typically includes people with a primary AD diagnosis and hence, little is known about the effects of co-existing amyloid pathology in people with vascular cognitive impairment (VCI). The purpose of this study was to understand whether individual differences in amyloid pathology might explain variations in cognitive impairment among individuals with clinical subcortical VCI (SVCI). Methods Twenty-two participants with SVCI completed an 11C Pittsburgh compound B (PIB) position emission tomography (PET) scan to quantify global amyloid deposition. Cognitive function was measured using: 1) MOCA; 2) ADAS-Cog; 3) EXIT-25; and 4) specific executive processes including a) Digits Forward and Backwards Test, b) Stroop-Colour Word Test, and c) Trail Making Test. To assess the effect of amyloid deposition on cognitive function we conducted Pearson bivariate correlations to determine which cognitive measures to include in our regression models. Cognitive variables that were significantly correlated with PIB retention values were entered in a hierarchical multiple linear regression analysis to determine the unique effect of amyloid on cognitive function. We controlled for age, education, and ApoE ε4 status. Results Bivariate correlation results showed that PIB binding was significantly correlated with ADAS-Cog (p < 0.01) and MOCA (p < 0.01); increased PIB binding was associated with worse cognitive function on both cognitive measures. PIB binding was not significantly correlated with the EXIT-25 or with specific executive processes (p > 0.05). Regression analyses controlling for age, education, and ApoE ε4 status indicated an independent association between PIB retention and the ADAS-Cog (adjusted R-square change of 15.0 %, Sig F Change = 0.03). PIB retention was also independently associated with MOCA scores (adjusted R-Square Change of 27.0 %, Sig F Change = 0.02). Conclusion We found that increased global amyloid deposition was significantly associated with greater memory and executive dysfunctions as measured by the ADAS-Cog and MOCA. Our findings point to the important role of co-existing amyloid deposition for cognitive function in those with a primary SVCI diagnosis. As such, therapeutic approaches targeting SVCI must consider the potential role of amyloid for the optimal care of those with mixed dementia. Trial registration NCT01027858
Collapse
Affiliation(s)
- Elizabeth Dao
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6S 0A9, Canada.
| | - Ging-Yuek Robin Hsiung
- Department of Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.
| | - Vesna Sossi
- Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC, V6T 1Z1, Canada. .,UBC PET, Brain Research Centre, 2211 Westboork Mall, Vancouver, BC, V6T 2B5, Canada.
| | - Claudia Jacova
- School of Professional Psychology, Pacific University, 190 SE 8th Avenue, Hillsboro, OR, 97123, USA.
| | - Roger Tam
- Department of Radiology, University of British Columbia, 3350-950 W 10th Avenue, Vancouver, BC, V5Z 1 M9, Canada. .,MS/MRI Research Group, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6S 0A9, Canada.
| | - Katie Dinelle
- UBC PET, Brain Research Centre, 2211 Westboork Mall, Vancouver, BC, V6T 2B5, Canada.
| | - John R Best
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6S 0A9, Canada. .,Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6S 0A9, Canada. .,Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
| |
Collapse
|
126
|
Crane DE, Black SE, Ganda A, Mikulis DJ, Nestor SM, Donahue MJ, MacIntosh BJ. Gray matter blood flow and volume are reduced in association with white matter hyperintensity lesion burden: a cross-sectional MRI study. Front Aging Neurosci 2015. [PMID: 26217223 PMCID: PMC4495336 DOI: 10.3389/fnagi.2015.00131] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cerebral White Matter Hyperintensities (WMH) are associated with vascular risk factors and age-related cognitive decline. WMH have primarily been associated with global white matter and gray matter (GM) changes and less is known about regional effects in GM. The purpose of this study was to test for an association between WMH and two GM imaging measures: cerebral blood flow (CBF) and voxel-based morphometry (VBM). Twenty-six elderly adults with mild to severe WMH participated in this cross-sectional 3 Tesla magnetic resonance imaging (MRI) study. MRI measures of GM CBF and VBM were derived from arterial spin labeling (ASL) and T1-weighted images, respectively. Fluid-attenuated inversion recovery (FLAIR) images were used to quantify the WMH lesion burden (mL). GM CBF and VBM data were used as dependent variables. WMH lesion burden, age and sex were used in a regression model. Visual rating of WMH with the Fazekas method was used to compare the WMH lesion volume regression approach. WMH volume was normally distributed for this group (mean volume of 22.7 mL, range: 2.2–70.6 mL). CBF analysis revealed negative associations between WMH volume and CBF in the left anterior putamen, subcallosal, accumbens, anterior caudate, orbital frontal, anterior insula, and frontal pole (corrected p < 0.05). VBM analysis revealed negative associations between WMH and GM volume in lingual gyrus, intracalcarine, and bilateral hippocampus (corrected p < 0.05). The visual rating scale corroborated the regression findings (corrected p < 0.05). WMH lesion volume was associated with intra-group GM CBF and structural differences in this cohort of WMH adults with mild to severe lesion burden.
Collapse
Affiliation(s)
- David E Crane
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute Toronto, ON, Canada
| | - Sandra E Black
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute Toronto, ON, Canada ; Division of Neurology, Department of Medicine, University of Toronto Toronto, ON, Canada ; Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto Toronto, ON, Canada
| | - Anoop Ganda
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute Toronto, ON, Canada
| | - David J Mikulis
- Department of Medical Imaging, The Toronto Western Hospital and the University of Toronto Toronto, ON, Canada
| | - Sean M Nestor
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute Toronto, ON, Canada ; Institute of Medical Sciences, University of Toronto Toronto, ON, Canada ; MD/PhD Program, Faculty of Medicine, University of Toronto Toronto, ON, Canada
| | - Manus J Donahue
- Departments of Radiology and Radiological Sciences, Psychiatry, and Physics and Astronomy, Vanderbilt University Nashville, TN, USA
| | - Bradley J MacIntosh
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute Toronto, ON, Canada ; Department of Medical Biophysics, University of Toronto Toronto, ON, Canada
| |
Collapse
|
127
|
Howlett DR, Whitfield D, Johnson M, Attems J, O'Brien JT, Aarsland D, Lai MK, Lee JH, Chen C, Ballard C, Hortobágyi T, Francis PT. Regional Multiple Pathology Scores Are Associated with Cognitive Decline in Lewy Body Dementias. Brain Pathol 2015; 25:401-8. [PMID: 25103200 PMCID: PMC8029273 DOI: 10.1111/bpa.12182] [Citation(s) in RCA: 133] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 07/25/2014] [Indexed: 12/15/2022] Open
Abstract
Dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD) are characterized by the presence of α-synuclein-containing Lewy bodies and Lewy neurites. However, both dementias also show variable degrees of Alzheimer's disease (AD) pathology (senile plaques and neurofibrillary tangles), particularly in areas of the cortex associated with higher cognitive functions. This study investigates the contribution of the individual and combined pathologies in determining the rate of cognitive decline. Cortical α-synuclein, phosphorylated tau (phosphotau) and Aβ plaque pathology in 34 PDD and 55 DLB patients was assessed semi-quantitatively in four regions of the neocortex. The decline in cognition, assessed by Mini Mental State Examination, correlated positively with the cortical α-synuclein load. Patients also had varying degrees of senile Aβ plaque and phosphotau pathology. Regression analyses pointed to a combined pathology (Aβ plaque plus phosphotau plus α-synuclein-positive features), particularly in the prefrontal cortex (BA9) and temporal lobe neocortex with the superior and middle temporal gyrus (BA21, 22), being a major determining factor in the development of dementia. Thus, cognitive decline in Lewy body dementias is not a consequence of α-synuclein-induced neurodegeneration alone but senile plaque and phosphorylated tau pathology also contribute to the overall deficits.
Collapse
Affiliation(s)
- David R. Howlett
- Wolfson Centre for Age‐Related DiseasesKing's College LondonLondonUK
| | - David Whitfield
- Wolfson Centre for Age‐Related DiseasesKing's College LondonLondonUK
| | - Mary Johnson
- Institute for Ageing and HealthNewcastle UniversityNewcastle upon TyneUK
| | - Johannes Attems
- Institute for Ageing and HealthNewcastle UniversityNewcastle upon TyneUK
| | | | - Dag Aarsland
- Department of Neurobiology, Ward Sciences and SocietyKarolinska InstituteStockholmSweden
- Centre for Age‐Related MedicineStavanger University HospitalStavangerNorway
| | - Mitchell K.P. Lai
- Department of PharmacologyYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Jasinda H. Lee
- Department of PharmacologyYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Christopher Chen
- Department of PharmacologyYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Clive Ballard
- Wolfson Centre for Age‐Related DiseasesKing's College LondonLondonUK
| | - Tibor Hortobágyi
- Wolfson Centre for Age‐Related DiseasesKing's College LondonLondonUK
- Department of NeuropathologyInstitute of PathologyUniversity of DebrecenDebrecenHungary
| | - Paul T. Francis
- Wolfson Centre for Age‐Related DiseasesKing's College LondonLondonUK
| |
Collapse
|
128
|
Cheng XJ, Gao Y, Zhao YW, Cheng XD. Sodium Chloride Increases Aβ Levels by Suppressing Aβ Clearance in Cultured Cells. PLoS One 2015; 10:e0130432. [PMID: 26075716 PMCID: PMC4468134 DOI: 10.1371/journal.pone.0130432] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/20/2015] [Indexed: 12/27/2022] Open
Abstract
Recent studies suggest that high-salt diet is associated with cognitive decline in human and mouse. The fact that genetic factors account for less than 50% cases of sporadic Alzheimer’s disease (AD) highlights the important contribution of environmental factors, such as high-salt diet, in AD pathogenesis. However, whether and how high-salt diet fits the “amyloid cascade” hypothesis remains unexplored. Here, we show sodium chloride (NaCl) could increase Aβ levels in the medium of HEK293 cells overexpressing amyloid precursor protein (APP) or C99 fragment. NaCl treatment dose not affect APP level, gamma secretase level or activity. Instead, NaCl treatment suppresses the capacity of cells to clear Aβ and reduces Apolipoprotein E (ApoE) level. Finally, NaCl treated THP-1 or BV2 cells are inefficient in clearing Aβ when co-cultured with rat primary neurons. Our study suggests that high-salt diet may increase AD risk by directly modulating Aβ levels.
Collapse
Affiliation(s)
- Xiao-Juan Cheng
- Department of Neurology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Yuan Gao
- Department of Neurology & Institute of Neurology, Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Neurology, First People’s Hospital of Yunnan Province affiliated to Kunming University of Science and Technology, Kunming, China
| | - Yu-Wu Zhao
- Department of Neurology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- * E-mail: (YWZ); (XDC)
| | - Xiao-Dong Cheng
- School of Life Sciences and Technology, Tongji University. East Hospital Affiliated To Tongji University, Shanghai, China
- * E-mail: (YWZ); (XDC)
| |
Collapse
|
129
|
Neuropathologically mixed Alzheimer's and Lewy body disease: burden of pathological protein aggregates differs between clinical phenotypes. Acta Neuropathol 2015; 129:729-48. [PMID: 25758940 DOI: 10.1007/s00401-015-1406-3] [Citation(s) in RCA: 149] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 03/03/2015] [Accepted: 03/03/2015] [Indexed: 12/31/2022]
Abstract
Multiple different pathological protein aggregates are frequently seen in human postmortem brains and hence mixed pathology is common. Mixed dementia on the other hand is less frequent and neuropathologically should only be diagnosed if criteria for more than one full blown disease are met. We quantitatively measured the amount of hyperphosphorylated microtubule associated tau (HP-τ), amyloid-β protein (Aβ) and α-synuclein (α-syn) in cases that were neuropathologically diagnosed as mixed Alzheimer's disease (AD) and neocortical Lewy body disease (LBD) but clinically presented either as dementia due to AD or LBD, the latter including dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD). Our study group consisted of 28 cases (mean age, 76.11 SE: ±1.29 years; m:f, 17:11) of which 19 were neuropathologically diagnosed as mixed AD/DLB. Clinically, 8 mixed AD/DLB cases were diagnosed as AD (cAD), 8 as DLB (cDLB) and 3 as PDD (cPDD). In addition, we investigated cases that were both clinically and neuropathologically diagnosed as either AD (pure AD; n = 5) or DLB/neocortical LBD (pure DLB; n = 4). Sections from neocortical, limbic and subcortical areas were stained with antibodies against HP-τ, Aβ and α-syn. The area covered by immunopositivity was measured using image analysis. cAD cases had higher HP-τ loads than both cDLB and cPDD and the distribution of HP-τ in cAD was similar to the one observed in pure AD whilst cDLB showed comparatively less hippocampal HP-τ load. cPDD cases showed lower HP-τ and Aβ loads and higher α-syn loads. Here, we show that in neuropathologically mixed AD/DLB cases both the amount and the topographical distribution of pathological protein aggregates differed between distinct clinical phenotypes. Large-scale clinicopathological correlative studies using a quantitative methodology are warranted to further elucidate the neuropathological correlate of clinical symptoms in cases with mixed pathology.
Collapse
|
130
|
Hippocampal volume and shape in pure subcortical vascular dementia. Neurobiol Aging 2015; 36:485-91. [DOI: 10.1016/j.neurobiolaging.2014.08.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 08/01/2014] [Accepted: 08/07/2014] [Indexed: 01/18/2023]
|
131
|
Castro-Chavira SA, Fernandez T, Nicolini H, Diaz-Cintra S, Prado-Alcala RA. Genetic markers in biological fluids for aging-related major neurocognitive disorder. Curr Alzheimer Res 2015; 12:200-9. [PMID: 25731625 PMCID: PMC4443795 DOI: 10.2174/1567205012666150302155138] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 01/18/2015] [Accepted: 01/20/2015] [Indexed: 12/11/2022]
Abstract
Aging-related major neurocognitive disorder (NCD), formerly named dementia, comprises of the different acquired diseases whose primary deficit is impairment in cognitive functions such as complex attention, executive function, learning and memory, language, perceptual/motor skills, and social cognition, and that are related to specific brain regions and/or networks. According to its etiology, the most common subtypes of major NCDs are due to Alzheimer' s disease (AD), vascular disease (VaD), Lewy body disease (LBD), and frontotemporal lobar degeneration (FTLD). These pathologies are frequently present in mixed forms, i.e., AD plus VaD or AD plus LBD, thus diagnosed as due to multiple etiologies. In this paper, the definitions, criteria, pathologies, subtypes and genetic markers for the most common age-related major NCD subtypes are summarized. The current diagnostic criteria consider cognitive decline leading to major NCD or dementia as a progressive degenerative process with an underlying neuropathology that begins before the manifestation of symptoms. Biomarkers associated with this asymptomatic phase are being developed as accurate risk factor and biomarker assessments are fundamental to provide timely treatment since no treatments to prevent or cure NCD yet exist. Biological fluid assessment represents a safer, cheaper and less invasive method compared to contrast imaging studies to predict NCD appearance. Genetic factors particularly have a key role not only in predicting development of the disease but also the age of onset as well as the presentation of comorbidities that may contribute to the disease pathology and trigger synergistic mechanisms which may, in turn, accelerate the neurodegenerative process and its resultant behavioral and functional disorders.
Collapse
Affiliation(s)
| | | | | | | | - R A Prado-Alcala
- Departamento de Neurobiologia Conductual y Cognitiva, Instituto de Neurobiologia, Campus UNAM Juriquilla, Universidad Nacional Autonoma de Mexico, Boulevard Universitario # 3001, Juriquilla, Queretaro. C. P. 76230, Queretaro, Mexico.
| |
Collapse
|
132
|
Attems J, Neltner JH, Nelson PT. Quantitative neuropathological assessment to investigate cerebral multi-morbidity. ALZHEIMERS RESEARCH & THERAPY 2014; 6:85. [PMID: 25435922 PMCID: PMC4247208 DOI: 10.1186/s13195-014-0085-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aging brain is characterized by the simultaneous presence of multiple pathologies, and the prevalence of cerebral multi-morbidity increases with age. To understand the impact of each subtype of pathology and the combined effects of cerebral multi-morbidity on clinical signs and symptoms, large clinico-pathological correlative studies have been performed. However, such studies are often based on semi-quantitative assessment of neuropathological hallmark lesions. Here, we discuss some of the new methods for high-throughput quantitative neuropathological assessment. These methods combine increased quantitative rigor with the added technical capacity of computers and networked analyses. There are abundant new opportunities - with specific techniques that include slide scanners, automated microscopes, and tissue microarrays - and also potential pitfalls. We conclude that quantitative and digital neuropathologic approaches will be key resources to further elucidate cerebral multi-morbidity in the aged brain and also hold the potential for changing routine neuropathologic diagnoses.
Collapse
Affiliation(s)
- Johannes Attems
- Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL UK
| | - Janna H Neltner
- Department of Pathology, Division of Neuropathology, University of Kentucky, 800 Limestone Street, Lexington, KY 40536-0230 USA
| | - Peter T Nelson
- Department of Pathology, Division of Neuropathology, University of Kentucky, 800 Limestone Street, Lexington, KY 40536-0230 USA
| |
Collapse
|
133
|
Abstract
This report discusses the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality rates, costs of care, and overall effect on caregivers and society. It also examines the impact of AD on women compared with men. An estimated 5.2 million Americans have AD. Approximately 200,000 people younger than 65 years with AD comprise the younger onset AD population; 5 million are age 65 years or older. By mid-century, fueled in large part by the baby boom generation, the number of people living with AD in the United States is projected to grow by about 9 million. Today, someone in the country develops AD every 67 seconds. By 2050, one new case of AD is expected to develop every 33 seconds, or nearly a million new cases per year, and the total estimated prevalence is expected to be 13.8 million. In 2010, official death certificates recorded 83,494 deaths from AD, making AD the sixth leading cause of death in the United States and the fifth leading cause of death in Americans aged 65 years or older. Between 2000 and 2010, the proportion of deaths resulting from heart disease, stroke, and prostate cancer decreased 16%, 23%, and 8%, respectively, whereas the proportion resulting from AD increased 68%. The actual number of deaths to which AD contributes (or deaths with AD) is likely much larger than the number of deaths from AD recorded on death certificates. In 2014, an estimated 700,000 older Americans will die with AD, and many of them will die from complications caused by AD. In 2013, more than 15 million family members and other unpaid caregivers provided an estimated 17.7 billion hours of care to people with AD and other dementias, a contribution valued at more than $220 billion. Average per-person Medicare payments for services to beneficiaries aged 65 years and older with AD and other dementias are more than two and a half times as great as payments for all beneficiaries without these conditions, and Medicaid payments are 19 times as great. Total payments in 2014 for health care, long-term care, and hospice services for people aged 65 years and older with dementia are expected to be $214 billion. AD takes a stronger toll on women than men. More women than men develop the disease, and women are more likely than men to be informal caregivers for someone with AD or another dementia. As caregiving responsibilities become more time consuming and burdensome or extend for prolonged durations, women assume an even greater share of the caregiving burden. For every man who spends 21 to more than 60 hours per week as a caregiver, there are 2.1 women. For every man who lives with the care recipient and provides around-the-clock care, there are 2.5 women. In addition, for every man who has provided caregiving assistance for more than 5 years, there are 2.3 women.
Collapse
|
134
|
Attems J, Jellinger KA. The overlap between vascular disease and Alzheimer's disease--lessons from pathology. BMC Med 2014; 12:206. [PMID: 25385447 PMCID: PMC4226890 DOI: 10.1186/s12916-014-0206-2] [Citation(s) in RCA: 462] [Impact Index Per Article: 46.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 10/07/2014] [Indexed: 12/15/2022] Open
Abstract
Recent epidemiological and clinico-pathological data indicate considerable overlap between cerebrovascular disease (CVD) and Alzheimer's disease (AD) and suggest additive or synergistic effects of both pathologies on cognitive decline. The most frequent vascular pathologies in the aging brain and in AD are cerebral amyloid angiopathy and small vessel disease. Up to 84% of aged subjects show morphological substrates of CVD in addition to AD pathology. AD brains with minor CVD, similar to pure vascular dementia, show subcortical vascular lesions in about two-thirds, while in mixed type dementia (AD plus vascular dementia), multiple larger infarcts are more frequent. Small infarcts in patients with full-blown AD have no impact on cognitive decline but are overwhelmed by the severity of Alzheimer pathology, while in early stages of AD, cerebrovascular lesions may influence and promote cognitive impairment, lowering the threshold for clinically overt dementia. Further studies are warranted to elucidate the many hitherto unanswered questions regarding the overlap between CVD and AD as well as the impact of both CVD and AD pathologies on the development and progression of dementia.
Collapse
Affiliation(s)
- Johannes Attems
- Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK.
| | | |
Collapse
|
135
|
Abstract
Alzheimer's disease/senile dementia of the Alzheimer type (AD/SDAT) is the most common neuropathologic substrate of dementia. It is characterized by synapse loss (predominantly within neocortex) as well as deposition of certain distinctive lesions (the result of protein misfolding) throughout the brain. The latter include senile plaques, composed mainly of an amyloid (Aβ) core and a neuritic component; neurofibrillary tangles, composed predominantly of hyperphosphorylated tau; and cerebral amyloid angiopathy, a microangiopathy affecting both cerebral cortical capillaries and arterioles and resulting from Aβ deposition within their walls or (in the case of capillaries) immediately adjacent brain parenchyma. In this article, I discuss the hypothesized role these lesions play in causing cerebral dysfunction, as well as CSF and neuroimaging biomarkers (for dementia) that are especially relevant as immunotherapeutic approaches are being developed to remove Aβ from the brain parenchyma. In addition, I address the role of neuropathology in characterizing the sequelae of new AD/SDAT therapies and helping to validate CSF and neuroimaging biomarkers of disease. Comorbidity of AD/SDAT and various types of cerebrovascular disease is a major theme in dementia research, especially as cognitive impairment develops in the oldest old, who are especially vulnerable to ischemic and hemorrhagic brain lesions.
Collapse
Affiliation(s)
- Harry V Vinters
- Department of Pathology and Laboratory Medicine (Neuropathology), UCLA Medical Center, Los Angeles, California 90095-1732;
| |
Collapse
|
136
|
Rao AK, Chou A, Bursley B, Smulofsky J, Jezequel J. Systematic review of the effects of exercise on activities of daily living in people with Alzheimer's disease. Am J Occup Ther 2014; 68:50-6. [PMID: 24367955 DOI: 10.5014/ajot.2014.009035] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE. Alzheimer's disease (AD) results in a loss of independence in activities of daily living (ADLs), which in turn affects the quality of life of affected people and places a burden on caretakers. Limited research has examined the influence of physical training (aerobic, balance, and strength training) on ADL performance of people with AD. METHOD. Six randomized controlled trials (total of 446 participants) fit the inclusion criteria. For each study, we calculated effect sizes for primary and secondary outcomes. RESULTS. Average effect size (95% confidence interval) for exercise on the primary outcome (ADL performance) was 0.80 (p < .001). Exercise had a moderate impact on the secondary outcome of physical function (effect size = 0.53, p = .004). CONCLUSION. Occupational therapy intervention that includes aerobic and strengthening exercises may help improve independence in ADLs and improve physical performance in people with AD. Additional research is needed to identify specific components of intervention and optimal dosage to develop clinical guidelines.
Collapse
Affiliation(s)
- Ashwini K Rao
- Ashwini K. Rao, EdD, OTR, FAOTA, is Associate Professor, Department of Rehabilitation and Regenerative Medicine (Program in Physical Therapy) and G. H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, 710 West 168th Street, 8th Floor, New York, NY 10032;
| | - Aileen Chou
- Aileen Chou, Brett Bursley, Jaclyn Smulofsky, and Joel Jezequel are Students, Department of Rehabilitation and Regenerative Medicine (Program in Physical Therapy), College of Physicians and Surgeons, Columbia University, New York
| | - Brett Bursley
- Aileen Chou, Brett Bursley, Jaclyn Smulofsky, and Joel Jezequel are Students, Department of Rehabilitation and Regenerative Medicine (Program in Physical Therapy), College of Physicians and Surgeons, Columbia University, New York
| | - Jaclyn Smulofsky
- Aileen Chou, Brett Bursley, Jaclyn Smulofsky, and Joel Jezequel are Students, Department of Rehabilitation and Regenerative Medicine (Program in Physical Therapy), College of Physicians and Surgeons, Columbia University, New York
| | - Joel Jezequel
- Aileen Chou, Brett Bursley, Jaclyn Smulofsky, and Joel Jezequel are Students, Department of Rehabilitation and Regenerative Medicine (Program in Physical Therapy), College of Physicians and Surgeons, Columbia University, New York
| |
Collapse
|
137
|
Magaki S, Yong WH, Khanlou N, Tung S, Vinters HV. Comorbidity in dementia: update of an ongoing autopsy study. J Am Geriatr Soc 2014; 62:1722-8. [PMID: 25039832 DOI: 10.1111/jgs.12977] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To examine systemic and central nervous system (CNS) comorbidities of individuals with dementia evaluated during general autopsy. DESIGN Retrospective cohort study. SETTING A large tertiary academic medical center in Los Angeles, California. PARTICIPANTS Individuals with clinically and neuropathologically diagnosed dementia who received complete autopsies (n = 86) and individuals with dementia who received partial (brain only) autopsies (n = 132). MEASUREMENTS Information on cause of death and systemic and CNS comorbidities was obtained from autopsy reports and clinical information as available from the medical records. Findings were tabulated with respect to type of dementia, semiquantitative assessment of the severity of cerebral amyloid angiopathy, semiquantitative assessment of the severity of cerebrovascular disease, and evidence of ischemic damage in the brain. RESULTS Of 218 subjects with dementia, 175 (80.3%) had Alzheimer's disease alone or in combination with other lesions that might contribute to cognitive impairment, such as cerebrovascular disease and diffuse Lewy body disease (DLBD), 14 (6.4%) had frontotemporal dementia, and seven (3.2%) had isolated DLBD. The most common cause of death in participants with dementia was pneumonia (n = 57, 66.3%), followed by cardiovascular disease (n = 14, 16.3%). Eighteen subjects (20.9%) had lung disease, and 16 (18.6%) had evidence of an old or recent myocardial infarction. Clinically undiagnosed neoplasms included colonic adenocarcinoma, metastatic pulmonary neuroendocrine carcinoma, meningioma, and Schwannoma. CONCLUSION Significant comorbidities were discovered at autopsy in individuals with dementia. Understanding the causes of death and associated comorbidities in individuals with various subtypes of dementia is important in the assessment of end-of-life care in these individuals.
Collapse
Affiliation(s)
- Shino Magaki
- Section of Neuropathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | | | | | | | | |
Collapse
|
138
|
Jessen F. Therapie von Demenzerkrankungen. Internist (Berl) 2014; 55:769-74. [DOI: 10.1007/s00108-014-3465-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
139
|
McAleese KE, Firbank M, Hunter D, Sun L, Hall R, Neal JW, Mann DMA, Esiri M, Jellinger KA, O'Brien JT, Attems J. Magnetic resonance imaging of fixed post mortem brains reliably reflects subcortical vascular pathology of frontal, parietal and occipital white matter. Neuropathol Appl Neurobiol 2014; 39:485-97. [PMID: 23075072 DOI: 10.1111/j.1365-2990.2012.01310.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 10/12/2012] [Indexed: 11/28/2022]
Abstract
AIMS Subcortical vascular pathology of the white and deep grey matter (WM and DGM) is associated with cognitive impairment. Routine neuropathological assessment of subcortical vascular pathology is based on semiquantitative scoring of characteristic lesions in a limited number of histological slides from selected WM and DGM areas. Clinically, WM and DGM lesions are visualized as hyper-intensities on magnetic resonance imaging (MRI). The aim of this study was to evaluate the feasibility of MRI on fixed post mortem brain hemispheres to complement routine neuropathological assessment of subcortical vascular pathology. METHODS We assessed subcortical vascular pathology in 40 post mortem brain hemispheres from demented (n = 26) and nondemented (n = 14) individuals (mean age 83.2 ± 14.8 years; 62.5% female) using (i) routine histological assessment; (ii) extensive histological assessment of the entire hemisphere at 7-mm intervals; and (iii) full T2-weighted MRI performed on fixed post mortem brain hemispheres. RESULTS In both WM and DGM routine histological scores for subcortical vascular pathology were significantly lower (P < 0.01) than the corresponding scores obtained by extensive histological assessment. In contrast, no significant differences were seen between scores obtained by MRI and extensive histological assessment in frontal, parietal and occipital lobes while MRI scores were significantly lower in the temporal WM and DGM (P < 0.01). CONCLUSIONS The results of our study indicate that routine histological assessment underrates subcortical vascular pathology and we conclude that MRI could be used in addition to complement neuropathological post mortem assessment of subcortical vascular pathology of the WM.
Collapse
Affiliation(s)
- K E McAleese
- Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
140
|
Scheff SW, Neltner JH, Nelson PT. Is synaptic loss a unique hallmark of Alzheimer's disease? Biochem Pharmacol 2014; 88:517-28. [PMID: 24412275 DOI: 10.1016/j.bcp.2013.12.028] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 12/29/2013] [Accepted: 12/30/2013] [Indexed: 12/13/2022]
Abstract
Synapses may represent a key nidus for dementia including Alzheimer's disease (AD) pathogenesis. Here we review published studies and present new ideas related to the question of the specificity of synapse loss in AD. Currently, AD is defined by the regional presence of neuritic plaques and neurofibrillary tangles in the brain. The severity of involvement by those pathological hallmarks tends to correlate both with antemortem cognitive status, and also with synapse loss in multiple brain areas. Recent studies from large autopsy series have led to a new standard of excellence with regard to clinical-pathological correlation and to improved comprehension of the numerous brain diseases of the elderly. These studies have provided evidence that it is the rule rather than the exception for brains of aged individuals to demonstrate pathologies (often multiple) other than AD plaques and tangles. For many of these comorbid pathologies, the extent of synapse loss is imperfectly understood but could be substantial. These findings indicate that synapse loss is probably not a hallmark specific to AD but rather a change common to many diseases associated with dementia.
Collapse
Affiliation(s)
- Stephen W Scheff
- Department of Anatomy and Neurobiology, University of Kentucky Medical Center, University of Kentucky, Lexington, KY 40536, United States; Sanders-Brown Center on Aging and Alzheimer's Disease Center, University of Kentucky Medical Center, University of Kentucky, Lexington, KY 40536, United States.
| | - Janna H Neltner
- Department of Pathology and Division of Neuropathology, University of Kentucky Medical Center, University of Kentucky, Lexington, KY 40536, United States
| | - Peter T Nelson
- Sanders-Brown Center on Aging and Alzheimer's Disease Center, University of Kentucky Medical Center, University of Kentucky, Lexington, KY 40536, United States; Department of Pathology and Division of Neuropathology, University of Kentucky Medical Center, University of Kentucky, Lexington, KY 40536, United States.
| |
Collapse
|
141
|
Pimenta FAP, Bicalho MAC, Romano-Silva MA, Moraes END, Rezende NAD. Chronic diseases, cognition, functional decline, and the Charlson index in elderly people with dementia. Rev Assoc Med Bras (1992) 2013; 59:326-34. [PMID: 23850027 DOI: 10.1016/j.ramb.2013.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 11/13/2012] [Accepted: 02/11/2013] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To assess the association between chronic degenerative diseases and functional decline, cognition, and mortality prediction. METHODS A cross-sectional study was conducted in a geriatrics service in Belo Horizonte, Brazil, involving 424 patients subdivided into two groups: control and dementia. The study analyzed socio-demographic and environmental data, chronic degenerative diseases, the Charlson index, and data on functional and cognitive dementia. RESULTS After a univariate analysis, there was a greater frequency of cerebrovascular accident (CVA), urinary incontinence, constipation, and sleep disorder in the dementia group, while the multivariate analysis showed a greater number of environmental factors and sleep disorder. Regarding the Mini Mental State Examination (MMSE), patients with chronic obstructive pulmonary disease (COPD), CVA, and heart failure presented lower scores. There was a greater score in the dementia group with regarding the Charlson index. CONCLUSION These comorbidities were associated with the functional decline in elderly people with dementia.
Collapse
|
142
|
|
143
|
Hanyu H, Kume K, Sato T, Hirao K, Kanetaka H, Sakurai H, Iwamoto T. Regional differences in cortical benzodiazepine receptors of Alzheimer, vascular, and mixed dementia patients. J Neurol Sci 2012; 323:71-6. [DOI: 10.1016/j.jns.2012.08.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 08/03/2012] [Accepted: 08/17/2012] [Indexed: 10/27/2022]
|
144
|
Negash S, Xie S, Davatzikos C, Clark CM, Trojanowski JQ, Shaw LM, Wolk DA, Arnold SE. Cognitive and functional resilience despite molecular evidence of Alzheimer's disease pathology. Alzheimers Dement 2012; 9:e89-95. [PMID: 23127468 DOI: 10.1016/j.jalz.2012.01.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 12/29/2011] [Accepted: 01/10/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND The correlation between neuropathological lesions and cognition is modest. Some individuals remain cognitively intact despite the presence of significant Alzheimer's disease (AD) pathology, whereas others manifest cognitive symptoms and dementia in the same context. The aim of the present study was to examine cognitive and cerebral reserve factors associated with resilient functioning in the setting of AD pathology. METHODS University of Pennsylvania Alzheimer's Disease Center research participants with biochemical biomarker evidence of AD pathology (cerebrospinal fluid amyloid-β1-42 <192 pg/mL) and comparable medial temporal lobe atrophy were categorized by Clinical Dementia Rating Scale-Sum of Boxes (CDR-SOB) score as AD dementia (CDR-SOB >1) or AD resilient (CDR-SOB ≤0.5). Groups were compared for a variety of demographic, clinical, and neuroimaging variables to identify factors that are associated with resilience to AD pathology. RESULTS A univariate model identified education and intracranial volume (ICV) as significant covariates. In a multivariate model with backward selection procedure, ICV was retained as a factor most significantly associated with resilience. The interaction term between ICV and education was not significant, suggesting that larger cranial vault size is associated with resilience even in the absence of more education. CONCLUSIONS Premorbid brain volume, as measured through ICV, provided protection against clinical manifestations of dementia despite evidence of significant accumulations of AD pathology. This finding provides support for the brain reserve hypothesis of resilience to AD.
Collapse
Affiliation(s)
- Selam Negash
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | | | | | | |
Collapse
|
145
|
Trends in the prevalence of dementia in Japan. Int J Alzheimers Dis 2012; 2012:956354. [PMID: 23091769 PMCID: PMC3469105 DOI: 10.1155/2012/956354] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 05/23/2012] [Indexed: 11/18/2022] Open
Abstract
There is a paucity of data regarding trends in dementia and its subtype prevalence in Japan. Our aims in the current paper are to: (1) summarize epidemiological studies of dementia in Japan including relevant details of study protocol and diagnostic criteria, (2) compare the age-specific prevalence of all-cause dementia among studies, and (3) assess the trends in Alzheimer's disease (AD) versus vascular dementia (VaD) over time. We reviewed diagnostic criteria, all-cause dementia prevalence, and the AD/VaD ratio from 8 large population studies of dementia in Japan. Compared with the Okinawa 1992 study, studies conducted in 1994, 1998, 2005, and 2008 had a higher prevalence of all-cause dementia using Poisson regression models, after controlling for age and sex. In contrast to the US and some European countries, all-cause dementia prevalence is increasing in Japan. The prevalence of AD as opposed to VaD seems to be increasing over time, but large variability in diagnostic criteria, possible regional variability, and differences in prevalence of subtypes of dementia between men and women make it difficult to draw a conclusion about this trend at the national level. Further studies, for example, comparing the population attributable risk of vascular diseases to the prevalence and incidence of dementia could help to clarify the regional variations in etiological subtypes.
Collapse
|
146
|
Abstract
This report provides information to increase understanding of the public health impact of Alzheimer's disease (AD). Topics addressed include incidence, prevalence, mortality rates, health expenditures and costs of care, and effect on caregivers and society. The report also explores issues that arise when people with AD and other dementias live alone. The characteristics, risks, and unmet needs of this population are described. An estimated 5.4 million Americans have AD, including approximately 200,000 age <65 years who comprise the younger-onset AD population. Over the coming decades, the aging of the baby boom generation is projected to result in an additional 10 million people with AD. Today, someone in America develops AD every 68 seconds. By 2050, there is expected to be one new case of AD every 33 seconds, or nearly a million new cases per year, and AD prevalence is projected to be 11 million to 16 million. Dramatic increases in the number of "oldest-old" (those age ≥85 years) across all racial and ethnic groups are expected to contribute to the increased prevalence of AD. AD is the sixth leading cause of death in the United States and the fifth leading cause of death in Americans age ≥65 years. Although the proportions of deaths due to other major causes of death have decreased in the last several years, the proportion due to AD has risen significantly. Between 2000 and 2008, the proportion of deaths due to heart disease, stroke, and prostate cancer decreased by 13%, 20%, and 8%, respectively, whereas the proportion due to AD increased by 66%. In 2011, more than 15 million family members and other unpaid caregivers provided an estimated 17.4 billion hours of care to people with AD and other dementias, a contribution valued at more than $210 billion. Medicare payments for services to beneficiaries age ≥65 years with AD and other dementias are three times as great as payments for beneficiaries without these conditions, and Medicaid payments are 19 times as great. In 2012, payments for health care, long-term care, and hospice services for people age ≥65 years with AD and other dementias are expected to be $200 billion (not including the contributions of unpaid caregivers). An estimated 800,000 people with AD (one in seven) live alone, and up to half of them do not have an identifiable caregiver. People with dementia who live alone are exposed to risks that exceed the risks encountered by people with dementia who live with others, including inadequate self-care, malnutrition, untreated medical conditions, falls, wandering from home unattended, and accidental deaths.
Collapse
|
147
|
Quintessential Risk Factors: Their Role in Promoting Cognitive Dysfunction and Alzheimer’s Disease. Neurochem Res 2012; 37:2627-58. [DOI: 10.1007/s11064-012-0854-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 07/21/2012] [Indexed: 12/13/2022]
|
148
|
Nelson PT, Alafuzoff I, Bigio EH, Bouras C, Braak H, Cairns NJ, Castellani RJ, Crain BJ, Davies P, Del Tredici K, Duyckaerts C, Frosch MP, Haroutunian V, Hof PR, Hulette CM, Hyman BT, Iwatsubo T, Jellinger KA, Jicha GA, Kövari E, Kukull WA, Leverenz JB, Love S, Mackenzie IR, Mann DM, Masliah E, McKee AC, Montine TJ, Morris JC, Schneider JA, Sonnen JA, Thal DR, Trojanowski JQ, Troncoso JC, Wisniewski T, Woltjer RL, Beach TG. Correlation of Alzheimer disease neuropathologic changes with cognitive status: a review of the literature. J Neuropathol Exp Neurol 2012; 71:362-81. [PMID: 22487856 PMCID: PMC3560290 DOI: 10.1097/nen.0b013e31825018f7] [Citation(s) in RCA: 1367] [Impact Index Per Article: 113.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Clinicopathologic correlation studies are critically important for the field of Alzheimer disease (AD) research. Studies on human subjects with autopsy confirmation entail numerous potential biases that affect both their general applicability and the validity of the correlations. Many sources of data variability can weaken the apparent correlation between cognitive status and AD neuropathologic changes. Indeed, most persons in advanced old age have significant non-AD brain lesions that may alter cognition independently of AD. Worldwide research efforts have evaluated thousands of human subjects to assess the causes of cognitive impairment in the elderly, and these studies have been interpreted in different ways. We review the literature focusing on the correlation of AD neuropathologic changes (i.e. β-amyloid plaques and neurofibrillary tangles) with cognitive impairment. We discuss the various patterns of brain changes that have been observed in elderly individuals to provide a perspective for understanding AD clinicopathologic correlation and conclude that evidence from many independent research centers strongly supports the existence of a specific disease, as defined by the presence of Aβ plaques and neurofibrillary tangles. Although Aβ plaques may play a key role in AD pathogenesis, the severity of cognitive impairment correlates best with the burden of neocortical neurofibrillary tangles.
Collapse
Affiliation(s)
- Peter T Nelson
- Sanders-Brown Center on Aging, Department of Pathology, University of Kentucky, Lexington 40536-0230, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
149
|
Jellinger KA. Cerebral correlates of psychotic syndromes in neurodegenerative diseases. J Cell Mol Med 2012; 16:995-1012. [PMID: 21418522 PMCID: PMC4365880 DOI: 10.1111/j.1582-4934.2011.01311.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 03/01/2011] [Indexed: 12/20/2022] Open
Abstract
Psychosis has been recognized as a common feature in neurodegenerative diseases and a core feature of dementia that worsens most clinical courses. It includes hallucinations, delusions including paranoia, aggressive behaviour, apathy and other psychotic phenomena that occur in a wide range of degenerative disorders including Alzheimer's disease, synucleinopathies (Parkinson's disease, dementia with Lewy bodies), Huntington's disease, frontotemporal degenerations, motoneuron and prion diseases. Many of these psychiatric manifestations may be early expressions of cognitive impairment, but often there is a dissociation between psychotic/behavioural symptoms and the rather linear decline in cognitive function, suggesting independent pathophysiological mechanisms. Strictly neuropathological explanations are likely to be insufficient to explain them, and a large group of heterogeneous factors (environmental, neurochemical changes, genetic factors, etc.) may influence their pathogenesis. Clinico-pathological evaluation of behavioural and psychotic symptoms (PS) in the setting of neurodegenerative and dementing disorders presents a significant challenge for modern neurosciences. Recognition and understanding of these manifestations may lead to the development of more effective preventive and therapeutic options that can serve to delay long-term progression of these devastating disorders and improve the patients' quality of life. A better understanding of the pathophysiology and distinctive pathological features underlying the development of PS in neurodegenerative diseases may provide important insights into psychotic processes in general.
Collapse
|
150
|
Hunter S, Brayne C. Relationships between the amyloid precursor protein and its various proteolytic fragments and neuronal systems. Alzheimers Res Ther 2012; 4:10. [PMID: 22498202 PMCID: PMC3583130 DOI: 10.1186/alzrt108] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disease and in its familial form is associated with mutations in the amyloid precursor protein (APP) and the presenilins (PSs). Much data regarding the interactions of APP, its proteolytic fragments and PS have been generated, expanding our understanding of the roles of these proteins in mechanisms underlying cognitive function and revealing many complex relationships with wide ranging cellular systems. In this review, we examine the multiple interactions of APP and its proteolytic fragments with other neuronal systems in terms of feedback loops and use these relationships to build a map. We highlight the complexity involved in the APP proteolytic system and discuss alternative perspectives on the roles of APP and its proteolytic fragments in dynamic processes associated with disease progression in AD. We highlight areas where data are missing and suggest potential confounding factors. We suggest that a systems biology approach enhances representations of the data and may be more useful in modelling both normal cognition and disease processes.
Collapse
Affiliation(s)
- Sally Hunter
- Institute of Public Health, University of Cambridge, Forvie site, Robinson Way, Cambridge CB2 0SR, UK
| | - Carol Brayne
- Institute of Public Health, University of Cambridge, Forvie site, Robinson Way, Cambridge CB2 0SR, UK
| |
Collapse
|