The epidemiology of primary degenerative dementia and related neurological disorders

Alzheimer's disease in its epidemiological context

The social and public health importance of dementia has been greatly increased by the unprecedented expansion in the world's elderly. By the year 2000, the number of persons in the world aged 65 and over is expected to be about 423 million, nearly 50% of whom will be in developing countries (W.H.O., (1)). Furthermore, it is among the very elderly that the greatest increase is taking place. There will therefore be a marked expansion in the number of persons afflicted by dementia. Because of the profound human and economic consequences of this, there has been a striking increase in research activity in four areas: neurobiological studies, including the molecular biology of Alzheimer's disease (AD); epidemiological research on the dementias and on risk factors for developing it; a search for pharmacological interventions; and research on services for dementia sufferers and their families.

Polimorfismo da apolipoproteína e nos familiares em primeiro grau de pacientes com doença de Alzheimer familial ou esporádica

INTRODUÇÃO: A apolipoproteína E (apo E) é reconhecida como fator de risco para doença de Alzheimer (DA). OBJETIVO: Analisar o polimorfismo da apo E nos familiares em primeiro grau de pacientes com DA familial ou esporádica do tipo tardio, comparando a famílias sem DA. MÉTODO: Foram estudados 40 pacientes com DA familial ou esporádica do tipo tardio, sendo os grupos classificados como provável, segundo critérios da NINCS-ADRDA. RESULTADO: O alelo épsilon3 foi o mais freqüente em todos os grupos. Observou-se freqüência mais elevada de épsilon4 comparando os familiares dos probandos aos do grupo controle (p<0,0001). O alelo épsilon2 mostrou diferença significante apenas entre familiares do grupo controle e DA familial (p=0,026). CONCLUSÃO: O polimorfismo da apo E não diferencia DA familial da esporádica. O estudo de famílias permite amplificar a representatividade dos alelos épsilon2 e épsilon4, revelando, seu valor como fator protetor e de risco para DA, respectivamente.

Visual evoked potentials in Alzheimer's disease: investigations in a PET-defined collective

Intravital diagnosis of Alzheimer's disease (AD) based clinical and neuropsychological findings alone does not allow sufficient differentiation from other disorders such as vascular dementia. Positron emission tomography (PET) secures intravital diagnosis with high accuracy by determination of a typical metabolic pattern. Numerous publications have proposed visual evoked potentials (VEP) for the detection of AD. In a collective of 15 patients with probable AD according to NINCDS/ADRDA criteria and the typical metabolic pattern of AD, we examined pattern reversal and flash VEPs. The results were compared to those of an age-matched collective of patients without impairment of memory. Neither pattern reversal nor flash VEP were correlated to severity of dementia as determined by the mini-mental status examination (MMSE). The positive results of other investigators are probably due to different patient selection criteria which do not include findings of cerebral glucose metabolism in the definition of AD.