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Huggins LKL, Min SH, Kaplan S, Wei J, Welsh-Bohmer K, Xu H. Meta-Analysis of Variations in Association between APOE ɛ4 and Alzheimer's Disease and Related Dementias Across Hispanic Regions of Origin. J Alzheimers Dis 2023; 93:1095-1109. [PMID: 37182874 PMCID: PMC10441171 DOI: 10.3233/jad-221167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Emerging research has shown racial and ethnic variations in the magnitude of association between the apolipoprotein ɛ4 (APOE ɛ4) allele and the risk of developing Alzheimer's disease and related dementias (ADRD). Studies researching this association among Hispanic groups within and outside of the United States have produced inconsistent results. OBJECTIVE To examine the association between the APOE ɛ4 allele and the risk of developing ADRD in global Hispanic populations from different ethnic regions of origin. METHODS PubMed, Embase, Scopus, and PsycInfo were searched for studies relating to Hispanic/Latin American origin, APOE ɛ4, and ADRD. Odds ratios (OR) of ADRD risk for individuals with APOE ɛ4 versus those without APOE ɛ4 were extracted and calculated using random effects analysis. RESULTS 20 eligible studies represented Caribbean Hispanic, Mexican, South American, Spanish, and Cuban groups. Overall, APOE ɛ4 was significantly associated with increased risk of ADRD (Odds Ratio [OR] 3.80, 95% CI: 2.38-6.07). The association was only significant in the South American (OR: 4.61, 95% CI: 2.74-7.75) subgroup. CONCLUSION There was an association between APOE ɛ4 and increased ADRD risk for the South American subgroup. The strength of this association varied across Hispanic subgroups. Data is limited with more studies especially needed for adjusted analysis on Spanish, Central American, Cuban Hispanic, and Caribbean Hispanic groups. Results suggest additional environmental or genetic risk factors are associated with ethnic variations.
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Affiliation(s)
- Lenique KL Huggins
- Department of Biology, Duke University, Durham, NC, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Se Hee Min
- Columbia University School of Nursing, New York, NY, USA
| | - Samantha Kaplan
- Duke University Medical Center Library and Archives, Durham, NC, USA
| | - Jingkai Wei
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Kathleen Welsh-Bohmer
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Department of Neurology, Duke University School of Medicine, Durham, NC, USA
| | - Hanzhang Xu
- Duke University School of Nursing, Durham, NC, USA
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA
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Espinosa A, Hernández-Olasagarre B, Moreno-Grau S, Kleineidam L, Heilmann-Heimbach S, Hernández I, Wolfsgruber S, Wagner H, Rosende-Roca M, Mauleón A, Vargas L, Lafuente A, Rodríguez-Gómez O, Abdelnour C, Gil S, Marquié M, Santos-Santos MA, Sanabria Á, Ortega G, Monté-Rubio G, Pérez A, Ibarria M, Ruiz S, Kornhuber J, Peters O, Frölich L, Hüll M, Wiltfang J, Luck T, Riedel-Heller S, Montrreal L, Cañabate P, Moreno M, Preckler S, Aguilera N, de Rojas I, Orellana A, Alegret M, Valero S, Nöthen MM, Wagner M, Jessen F, Tárraga L, Boada M, Ramírez A, Ruiz A. Exploring Genetic Associations of Alzheimer's Disease Loci With Mild Cognitive Impairment Neurocognitive Endophenotypes. Front Aging Neurosci 2018; 10:340. [PMID: 30425636 PMCID: PMC6218590 DOI: 10.3389/fnagi.2018.00340] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 10/08/2018] [Indexed: 11/30/2022] Open
Abstract
The role of genetic risk markers for Alzheimer’s disease (AD) in mediating the neurocognitive endophenotypes (NEs) of subjects with mild cognitive impairment (MCI) has rarely been studied. The aim of the present study was to investigate the relationship between well-known AD-associated single-nucleotide polymorphisms (SNPs) and individual NEs routinely evaluated during diagnosis of MCI, AD, and other dementias. The Fundació ACE (ACE) dataset, comprising information from 1245 patients with MCI, was analyzed, including the total sample, amnestic MCI (aMCI) (n = 811), and non-amnestic MCI (naMCI) (n = 434). As probable-MCI (Pr-MCI) patients with memory impairment have a higher risk of AD, which could influence the statistical power to detect genetic associations, the MCI phenotype was also stratified into four related conditions: Pr-aMCI (n = 262), Pr-naMCI (n = 76), possible (Pss)-aMCI (n = 549), and Pss-naMCI (n = 358). Validation analyses were performed using data from the German study on Aging, Cognition, and Dementia in primary care patients (AgeCoDe), and the German Dementia Competence Network (DCN). SNP associations with NEs were calculated in PLINK using multivariate linear regression analysis adjusted for age, gender, and education. In the total MCI sample, APOE-ε4 was significantly associated with the memory function NEs “delayed recall (DR)” (β = -0.76, p = 4.1 × 10-10), “learning” (β = -1.35, p = 2.91 × 10-6), and “recognition memory” (β = -0.58, p = 9.67 × 10-5); and with “DR” in the aMCI group (β = -0.36, p = 2.96 × 10-5). These results were confirmed by validation in the AgeCoDe (n = 503) and DCN (n = 583) datasets. APOE-ε4 was also significantly associated with the NE “learning” in individuals classified as having Pss-aMCI (β = -1.37, p = 5.82 × 10-5). Moreover, there was a near study-wide significant association between the HS3ST1 locus (rs6448799) and the “backward digits” working memory NE (β = 0.52, p = 7.57 × 10-5) among individuals with Pr-aMCI, while the AP2A2 locus (rs10751667) was significantly associated with the language NE “repetition” (β = -0.19, p = 5.34 × 10-6). Overall, our findings support specific associations of established AD-associated SNPs with MCI NEs.
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Affiliation(s)
- Ana Espinosa
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Begoña Hernández-Olasagarre
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Sonia Moreno-Grau
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Luca Kleineidam
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany.,Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Isabel Hernández
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Steffen Wolfsgruber
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Holger Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Maitée Rosende-Roca
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ana Mauleón
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Liliana Vargas
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Asunción Lafuente
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Octavio Rodríguez-Gómez
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Carla Abdelnour
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Silvia Gil
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Marta Marquié
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Miguel A Santos-Santos
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ángela Sanabria
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Gemma Ortega
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Gemma Monté-Rubio
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Alba Pérez
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Marta Ibarria
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Susana Ruiz
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Clinic Erlangen, Erlangen, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité University Medicine, Berlin, Germany
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Michael Hüll
- Center for Geriatric Medicine and Section of Gerontopsychiatry and Neuropsychology, Medical School, University of Freiburg, Freiburg, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - Tobias Luck
- Department of Economic and Social Sciences & Institute of Social Medicine, Rehabilitation Sciences and Healthcare Research (ISRV), University of Applied Sciences Nordhausen, Nordhausen, Germany
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Laura Montrreal
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Pilar Cañabate
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Mariola Moreno
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Silvia Preckler
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Nuria Aguilera
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Itziar de Rojas
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Adelina Orellana
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Montserrat Alegret
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Sergi Valero
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany.,Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Michael Wagner
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.,Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany.,Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Lluis Tárraga
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Mercè Boada
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Alfredo Ramírez
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Agustín Ruiz
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain
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Morin A, Mouzon B, Ferguson S, Paris D, Saltiel N, Lungmus C, Mullan M, Crawford F. Treatment With Nilvadipine Mitigates Inflammatory Pathology and Improves Spatial Memory in Aged hTau Mice After Repetitive Mild TBI. Front Aging Neurosci 2018; 10:292. [PMID: 30364309 PMCID: PMC6193195 DOI: 10.3389/fnagi.2018.00292] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 09/04/2018] [Indexed: 12/14/2022] Open
Abstract
Mild traumatic brain injury (mTBI) is the most common form of brain trauma worldwide. The effects of mTBI are not well-studied within the elderly population, yet older adults constitute a significant portion of all mTBI patients. Few preclinical studies have focused on the effects of mTBI, or mTBI treatments, in the aged brain, and none have explored repetitive mTBI (r-mTBI). In this study, we have administered our well-characterized 5-injury model (5 r-mTBI) to hTau mice aged 24 months to explore the neurobehavioral and neuropathological outcomes, and the effects of treatment with the dihydropyridine, Nilvadipine. Our previous studies have shown that Nilvadipine inhibits spleen tyrosine kinase (Syk), is effective at reducing inflammation, tau hyperphosphorylation, and amyloid production, and it has recently been investigated in a European Phase III clinical trial for Alzheimer’s disease (AD). In our 24-month-old r-mTBI mice, we observed increased neuroinflammation and a trend toward impaired cognitive performance compared to sham controls. Treatment with Nilvadipine mitigated the TBI-induced inflammatory response in aged r-mTBI animals and significantly improved spatial memory. To our knowledge, this is the only preclinical study focusing on the treatment of r-mTBI in aged, and these results suggest a therapeutic potential of Nilvadipine for consequences of mTBI.
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Affiliation(s)
- Alexander Morin
- The Roskamp Institute, Sarasota, FL, United States.,The Open University, Milton-Keynes, United Kingdom.,James A Haley Veterans Administration, Tampa, FL, United States
| | - Benoit Mouzon
- The Roskamp Institute, Sarasota, FL, United States.,The Open University, Milton-Keynes, United Kingdom.,James A Haley Veterans Administration, Tampa, FL, United States
| | - Scott Ferguson
- The Roskamp Institute, Sarasota, FL, United States.,The Open University, Milton-Keynes, United Kingdom.,James A Haley Veterans Administration, Tampa, FL, United States
| | - Daniel Paris
- The Roskamp Institute, Sarasota, FL, United States.,The Open University, Milton-Keynes, United Kingdom.,James A Haley Veterans Administration, Tampa, FL, United States
| | - Nicole Saltiel
- The Roskamp Institute, Sarasota, FL, United States.,James A Haley Veterans Administration, Tampa, FL, United States
| | | | - Mike Mullan
- The Roskamp Institute, Sarasota, FL, United States.,The Open University, Milton-Keynes, United Kingdom
| | - Fiona Crawford
- The Roskamp Institute, Sarasota, FL, United States.,The Open University, Milton-Keynes, United Kingdom.,James A Haley Veterans Administration, Tampa, FL, United States
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Bidzan M, Bidzan L, Bidzan-Bluma I. Neuropsychiatric symptoms and faster progression of cognitive impairments as predictors of risk of conversion of mild cognitive impairment to dementia. Arch Med Sci 2017; 13:1168-1177. [PMID: 28883859 PMCID: PMC5575224 DOI: 10.5114/aoms.2017.68943] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 03/24/2017] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION The aim of this research, based on 7 years of observations, was to assess the relationship between the dynamics of changes in the realm of cognitive functions in the early stages of observations and the presence of neuropsychiatric symptoms as well as further progression of cognitive function impairments in people diagnosed with mild cognitive impairment (MCI). MATERIAL AND METHODS One hundred and ninety three individuals were included in the study, all of whom referred themselves to the Mental Health Clinic and were diagnosed with MCI based on the criteria of the Working Group on MCI. It was assumed that these individuals would be subjected to systematic psychiatric and neuropsychological observation until they were diagnosed with dementia. This report concerns a completed 7-year period of these observations. Participants were assessed based on the following scales: MMSE, NPI and GDS. RESULTS The obtained results indicate statistically significant differences between groups of subjects at the time of inclusion in the study, regarding the frequency of occurrence and severity of the following categories of impairments: thought impairments (p < 0.001), arousal/aggression (p < 0.001), depression/dysphoria (p < 0.001), disinhibition (p < 0.03), irritability/lability (p < 0.001), abnormal motor behaviors (p < 0.02), as well as sleep and night-time behavior disorders (p < 0.01) Moreover, individuals who developed dementia during observation exhibited greater progression in cognitive function impairment assessed with the MMSE scale in the first year of observation (p < 0.01). CONCLUSIONS The accruing of cognitive function impairments and the presence of neuropsychiatric symptoms seem to be important risk factors for the development of dementia.
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Affiliation(s)
- Mariola Bidzan
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, University of Gdansk, Gdansk, Poland
| | - Leszek Bidzan
- Department of Developmental Psychiatry, Psychotic Disorders and Old Age Psychiatry, Medical University of Gdansk, Gdansk, Poland
| | - Ilona Bidzan-Bluma
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, University of Gdansk, Gdansk, Poland
- Neuropsychological Diagnostic and Therapy Centre, Gdansk, Poland
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Luijpen MW, Swaab DF, Sergeant JA, Scherder EJA. Effects of Transcutaneous Electrical Nerve Stimulation (TENS) on Self-Efficacy and Mood in Elderly with Mild Cognitive Impairment. Neurorehabil Neural Repair 2016; 18:166-75. [PMID: 15375277 DOI: 10.1177/0888439004268785] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In previous studies, transcutaneous electrical nerve stimulation (TENS) has been applied to patients with either Alzheimer’s disease (AD) or incipient dementia, resulting in an enhancement in memory and verbal fluency. Moreover, affective behavior was shown to improve. Based on the positive effects of TENS in AD, it was hypothesized that TENS would improve self-efficacy in nondemented elderly with mild cognitive impairment (MCI) who live in a residential home. Four outcome measures, that is, a Dutch translation of the General Self-Efficacy Scale (Algemene Competentie Schaal), the Groninger Activity Restriction Scale, the Philadelphia Geriatric Center Morale Scale, and the Geriatric Depression Scale, were administered. Overall, the results suggest that the experimental group showed a mild improvement in self-efficacy and mood. In contrast, the placebo group showed a considerable reduction in self-efficacy and an increase in depression. Limitations of the present study and suggestions for future research are discussed.
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Affiliation(s)
- Marijn W Luijpen
- Department of Clinical Neuropsychology, Vrije Universiteit, Van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands.
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Abstract
Genetic characterization of individuals at risk of Alzheimer's disease (AD), i.e. people having amyloid deposits in the brain without symptoms, people suffering from subjective cognitive decline (SCD) or mild cognitive impairment (MCI), has spurred the interests of researchers. However, their pre-dementia genetic profile remains mostly unexplored. In this study, we reviewed the loci related to phenotypes of AD, MCI and SCD from literature and performed the first meta-analyses evaluating the role of apolipoprotein E (APOE) in the risk of conversion from a healthy status to MCI and SCD. For AD dementia risk, an increased number of loci have been identified; to date, 28 genes have been associated with Late Onset AD. In MCI syndrome, APOE is confirmed as a pheno-conversion factor leading from MCI to AD, and clusterin is a promising candidate. Additionally, our meta-analyses revealed APOE as genetic risk factor to convert from a healthy status to MCI [OR = 1.849 (1.587-2.153); P = 2.80 × 10-15] and to a lesser extent from healthy status to SCD [OR = 1.151 (1.015-1.304); P = 0.028]. Thus, we believe that genetic studies in longitudinal SCD and MCI series may provide new therapeutic targets and improve the existing knowledge of AD. This type of studies must be completed on healthy subjects to better understand the natural disease resistance to brain insults and neurodegeneration.
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Suárez VM, Fernández Y, López EDCR, Clarke DH, Bobes MA, Riverón AM, López-Cánovas L. Apolipoprotein E alleles in Cuban patients with mild cognitive impairment. Am J Alzheimers Dis Other Demen 2014; 29:236-41. [PMID: 24370622 PMCID: PMC10852632 DOI: 10.1177/1533317513517037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
BACKGROUND Apolipoprotein E (ApoE) ε4 genotype is the most clearly documented risk factor for Alzheimer's disease (AD). Epidemiological studies demonstrate an accelerated rate of progression to dementia and AD in patients with mild cognitive impairment (MCI). We assessed the ApoE allele and genotypes frequencies in Cuban patients with MCI. METHODS We performed ApoE genotyping of 74 Cuban patients more than 65 years old. Cognitive assessments included the Mini-Mental State Examination (MMSE) and a cognitive battery for evaluating memory, attention, perception, and executive function. RESULTS Cognitive impairments were characterized by amnesia and executive deficits in patients with MCI. The Apo ε4 allele frequency was 0.196 in patients with MCI, 10-fold higher than that in the controls. Patients carrying the ε4 allele exhibited poorer performance in MMSE and tests assessing executive function and short-term memory than noncarriers. CONCLUSIONS The patients exhibited amnestic MCI multiple domains. Cognitive performance was worse in patients who carried the ApoE ε4 allele.
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Affiliation(s)
| | - Yuriem Fernández
- Cognitive Neurosciences Department, Cuban Neurosciences Center, La Habana, Cuba
| | | | | | | | - Ana Maria Riverón
- Molecular Biology Department, Cuban Neurosciences Center, La Habana, Cuba
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Keleshian VL, Modi HR, Rapoport SI, Rao JS. Aging is associated with altered inflammatory, arachidonic acid cascade, and synaptic markers, influenced by epigenetic modifications, in the human frontal cortex. J Neurochem 2013; 125:63-73. [PMID: 23336521 PMCID: PMC3606672 DOI: 10.1111/jnc.12153] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 12/17/2012] [Accepted: 12/18/2012] [Indexed: 01/12/2023]
Abstract
Aging is a risk factor for Alzheimer's disease (AD) and is associated with cognitive decline. However, underlying molecular mechanisms of brain aging are not clear. Recent studies suggest epigenetic influences on gene expression in AD, as DNA methylation levels influence protein and mRNA expression in postmortem AD brain. We hypothesized that some of these changes occur with normal aging. To test this hypothesis, we measured markers of the arachidonic acid (AA) cascade, neuroinflammation, pro- and anti-apoptosis factors, and gene specific epigenetic modifications in postmortem frontal cortex from nine middle-aged [41 ± 1 (SEM) years] and 10 aged subjects (70 ± 3 years). The aged compared with middle-aged brain showed elevated levels of neuroinflammatory and AA cascade markers, altered pro and anti-apoptosis factors and loss of synaptophysin. Some of these changes correlated with promoter hypermethylation of brain derived neurotrophic factor (BDNF), cyclic AMP responsive element binding protein (CREB), and synaptophysin and hypomethylation of BCL-2 associated X protein (BAX). These molecular alterations in aging are different from or more subtle than changes associated with AD pathology. The degree to which they are related to changes in cognition or behavior during normal aging remains to be evaluated.
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Affiliation(s)
- Vasken L. Keleshian
- Brain Physiology and Metabolism Section, Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Hiren R. Modi
- Brain Physiology and Metabolism Section, Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Stanley I. Rapoport
- Brain Physiology and Metabolism Section, Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Jagadeesh S. Rao
- Brain Physiology and Metabolism Section, Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
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9
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The Influence of Apolipoprotein E Epsilon4 Polymorphism on qEEG Profiles in Healthy Young Females: A Resting EEG Study. Brain Topogr 2012; 25:431-42. [DOI: 10.1007/s10548-012-0229-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 04/23/2012] [Indexed: 12/23/2022]
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10
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APOE, ACT and CHRNA7 genes in the conversion from amnestic mild cognitive impairment to Alzheimer's disease. Neurobiol Aging 2009; 30:1254-64. [DOI: 10.1016/j.neurobiolaging.2007.11.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2007] [Revised: 10/05/2007] [Accepted: 11/04/2007] [Indexed: 11/24/2022]
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Taler V, Phillips NA. Language performance in Alzheimer's disease and mild cognitive impairment: a comparative review. J Clin Exp Neuropsychol 2008; 30:501-56. [PMID: 18569251 DOI: 10.1080/13803390701550128] [Citation(s) in RCA: 225] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Mild cognitive impairment (MCI) manifests as memory impairment in the absence of dementia and progresses to Alzheimer's disease (AD) at a rate of around 15% per annum, versus 1-2% in the general population. It thus constitutes a primary target for investigation of early markers of AD. Language deficits occur early in AD, and performance on verbal tasks is an important diagnostic criterion for both AD and MCI. We review language performance in MCI, compare these findings to those seen in AD, and identify the primary issues in understanding language performance in MCI and selecting tasks with diagnostic and prognostic value.
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Affiliation(s)
- Vanessa Taler
- Department of Psychology/Centre for Research in Human Development, Concordia University, Montréal, Québec, Canada
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Chertkow H, Massoud F, Nasreddine Z, Belleville S, Joanette Y, Bocti C, Drolet V, Kirk J, Freedman M, Bergman H. Diagnosis and treatment of dementia: 3. Mild cognitive impairment and cognitive impairment without dementia. CMAJ 2008; 178:1273-85. [PMID: 18458258 DOI: 10.1503/cmaj.070797] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Mild cognitive impairment and cognitive impairment, no dementia, are emerging terms that encompass the clinical state between normal cognition and dementia in elderly people. Controversy surrounds their characterization, definition and application in clinical practice. In this article, we provide physicians with practical guidance on the definition, diagnosis and treatment of mild cognitive impairment and cognitive impairment, no dementia, based on recommendations from the Third Canadian Consensus Conference on the Diagnosis and Treatment of Dementia, held in March 2006. METHODS We developed evidence-based guidelines using systematic literature searches, with specific criteria for study selection and quality assessment, and a clear and transparent decision-making process. We selected studies published from January 1996 to December 2005 that had mild cognitive impairment or cognitive impairment, no dementia, as the outcome. Subsequent to the conference, we searched for additional articles published between January 2006 and January 2008. We graded the strength of evidence using the criteria of the Canadian Task Force on Preventive Health Care. RESULTS We identified 2483 articles, of which 314 were considered to be relevant and of good or fair quality. From a synthesis of the evidence in these studies, we made 16 recommendations. In brief, family physicians should be aware that most types of dementia are preceded by a recognizable phase of mild cognitive decline. They should be familiar with the concepts of mild cognitive impairment and of cognitive impairment, no dementia. Patients with these conditions should be closely monitored because of their increased risk for dementia. Leisure activities, cognitive stimulation and physical activity could be promoted as part of a healthy lifestyle in elderly people and those with mild cognitive impairment. Vascular risk factors should be treated optimally. No other specific therapies can yet be recommended. INTERPRETATION Physicians will increasingly see elderly patients with mild memory loss, and learning an approach to diagnosing states such as mild cognitive impairment is now warranted. Close monitoring for progression to dementia, promotion of a healthy lifestyle and treatment of vascular risk factors are recommended for the management of patients with mild cognitive impairment.
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Affiliation(s)
- Howard Chertkow
- Bloomfield Centre for Research in Aging, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Que.
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Rogers SA, Kang CH, Miller KJ. Cognitive profiles of aging and aging-related conditions. ACTA ACUST UNITED AC 2007. [DOI: 10.2217/1745509x.3.4.457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This review presents some of the current research and thinking regarding the neuropsychological features associated with aging and aging-related conditions. In the context of the current longevity revolution, many older adults are increasingly concerned about their cognitive performance and the risk for cognitive decline. This makes it critically important to understand the neuropsychological profiles of normal aging and the cognitive features of conditions associated with aging, such as age-associated memory impairment, mild cognitive impairment and dementia. There are also several factors that can modify the neuropsychological abilities and outcomes associated with aging, including gender, genetic status, lifestyle issues and education. The authors point to the importance for future research to embrace a fluid or multifactorial approach to neuropsychology, to focus on those factors contributing to healthy cognition and successful aging, and to correlate neuropsychological changes with the results of neuroimaging.
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Affiliation(s)
| | | | - Karen J Miller
- University of California, Aging and Memory Research Center, Los Angeles, CA 90024, USA
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Heun R, Kölsch H, Jessen F. Risk factors and early signs of Alzheimer's disease in a family study sample. Risk of AD. Eur Arch Psychiatry Clin Neurosci 2006; 256:28-36. [PMID: 15895300 DOI: 10.1007/s00406-005-0596-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2004] [Accepted: 03/18/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Several predictors of Alzheimer's disease (AD) have been identified. However, the relevance and independent contribution of risk factors and of possible early signs such as mild cognitive impairment and subjective memory impairment on the development of AD has not been investigated prospectively in a cohort of non-demented elderly including first-degree relatives of AD subjects. METHOD The development of AD was investigated in 757 non-demented elderly. Initial diagnoses were made from personal interviews. Information on 633 subjects after 4.7 +/- 1.2 years (mean +/- SD) was obtained either from personal or family history interviews. Using forward logistic regression analysis, predictors were identified by comparing their presence in 38 subjects who developed AD and 577 subjects who remained non-demented. RESULTS The most important predictors of later Alzheimer's disease were increased age (Odds ratio OR = 1.086/additional year, p < 0.001), initial subjective memory complaints (OR = 2.68, p = 0.019), initial mild cognitive impairment (OR = 2.51, p = 0.032) and female gender (OR = 2.84, p = 0.069). Exploratory analysis revealed that previous depression after the age of 60 years (OR = 2.37, p = 0.033) and the presence of the apolipoprotein E4 allele (OR = 2.49, p = 0.043) individually predicted new AD during follow-up. A positive family history of AD (i. e. being a first degree relative of a subject suffering from AD) did not significantly influence the development of AD (p > 0.2). CONCLUSIONS Increased age, the presence of mild cognitive impairment, subjective memory impairment and gender are the most relevant independent predictors of later Alzheimer's disease that may be used in combination for clinical prediction of AD.
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Affiliation(s)
- Reinhard Heun
- Department of Psychiatry, University of Bonn, Venusberg, 53105 Bonn, Germany.
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Babiloni C, Benussi L, Binetti G, Cassetta E, Dal Forno G, Del Percio C, Ferreri F, Ferri R, Frisoni G, Ghidoni R, Miniussi C, Rodriguez G, Romani GL, Squitti R, Ventriglia MC, Rossini PM. Apolipoprotein E and alpha brain rhythms in mild cognitive impairment: A multicentric Electroencephalogram study. Ann Neurol 2005; 59:323-34. [PMID: 16358334 DOI: 10.1002/ana.20724] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Relationships between the apolipoprotein E epsilon4 allele and electroencephalographic (EEG) rhythmicity have been demonstrated in Alzheimer's disease (AD) patients but not in the preclinical stage prodromic to it, namely, mild cognitive impairment (MCI). The present multicentric EEG study tested the hypothesis that presence of epsilon4 affects sources of resting EEG rhythms in both MCI and AD subjects. METHODS We enrolled 89 MCI subjects (34.8% with epsilon4) and 103 AD patients (50.4% with epsilon4). Resting eyes-closed EEG data were recorded for all subjects. EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha 1 (8-10.5 Hz), alpha 2 (10.5-13Hz), beta 1 (13-20 Hz), and beta 2 (20-30 Hz). EEG cortical sources were estimated by low-resolution brain electromagnetic tomography. RESULTS Results showed that amplitude of alpha 1 and 2 sources in occipital, temporal, and limbic areas was lower in subjects carrying the epsilon4 allele than in those not carrying the epsilon4 allele (p < 0.01). This was true for both MCI and AD. For the first time to our knowledge, a relationship was shown between ApoE genotype and global neurophysiological phenotype (ie, cortical alpha rhythmicity) in a preclinical AD condition, MCI, in addition to clinically manifest AD. INTERPRETATION Such a demonstration motivates future genotype-EEG phenotype studies for the early prediction of AD conversion in individual MCI subjects.
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Affiliation(s)
- Claudio Babiloni
- Dipartimento di Fisiologia Umana e Farmacologia, Universitá La Sapienza, Rome, Italy.
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Abstract
Mild cognitive impairment (MCI) is a common problem in the elderly. Genetic research may yield valuable clues to improve the diagnostic and prognostic tools for MCI. As the majority of patients progress into Alzheimer's disease (AD) and other forms of dementia, the genetics of MCI cannot be separated from the genetics of AD and dementia in general. Follow-up studies of carriers of mutations underlying AD may yield valuable clues for the development of new diagnostic tools for MCI. In particular, large-scale studies of carriers of the apolipoprotein E 4 allele may still be of interest. Our knowledge of the genes involved in MCI is still very limited. In addition, we need powerful and carefully designed candidate gene studies aiming to discover new genes involved in the risk and progression of MCI. Although the genetics of MCI will be difficult to disentangle, there is ample opportunity to improve research of the genes involved.
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Affiliation(s)
- C M van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology and Biostatistics, Erasmus MC, PO Box 1738, Rotterdam, The Netherlands.
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Solé-Padullés C, Bartrés-Faz D, Junqué C, Via M, Matarín M, González-Pérez E, Moral P, Moya A, Clemente IC. Poorer cognitive performance in humans with mild cognitive impairment carrying the T variant of the Glu/Asp NOS3 polymorphism. Neurosci Lett 2004; 358:5-8. [PMID: 15016421 DOI: 10.1016/j.neulet.2003.12.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2003] [Accepted: 12/08/2003] [Indexed: 11/16/2022]
Abstract
Mild cognitive impairment (MCI) is a transitional state between normal aging and Alzheimer's disease (AD) and is a high-risk condition for dementia. The endothelial nitric oxide synthase (NOS3) gene encodes endothelial NOS, an enzyme that regulates the production of the vasodilatory nitric oxide associated with the cerebral small vessel pathology observed in early AD. We studied the distribution of genotype and allele frequencies of the NOS3 Glu/Asp polymorphism in a sample of 62 MCI subjects and 136 controls. Though no association between NOS3 gene variation and MCI status was observed, MCI cases carrying the Asp variant (T+) performed worse in the Mini-Mental State Examination, Wechsler Memory Scale (Revised) long-term visual memory and the phonetic verbal fluency tests. These results suggest that the T allele is a genetic risk factor for cognitive impairment in the elderly.
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Affiliation(s)
- Cristina Solé-Padullés
- Department of Psychiatry and Clinical Psychobiology, Facultat de Medicina, University of Barcelona, Casanova 143, 08036 Barcelona, Spain
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Tully T, Bourtchouladze R, Scott R, Tallman J. Targeting the CREB pathway for memory enhancers. Nat Rev Drug Discov 2003; 2:267-77. [PMID: 12669026 DOI: 10.1038/nrd1061] [Citation(s) in RCA: 231] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Today, the clinical notion of 'memory disorder' is largely synonymous with 'Alzheimer's disease.' Only 50% of all dementias are of the Alzheimer's type though, and dementias represent only the more severe of all learning/memory disorders that derive from heredity, disease, injury or age. Perhaps as many as 30 million Americans suffer some type of clinically recognized memory disorder. To date, therapeutic drugs of only one class have been approved for the treatment of Alzheimer's disease. Fortunately, basic research during the past 25 years has begun to define a 'chemistry of brain plasticity,' which is suggesting new gene targets for the discovery of memory enhancers.
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Affiliation(s)
- Tim Tully
- Helicon Therapeutics, Inc., One Bioscience Park Drive, Farmingdale, New York 11743, USA
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Abstract
Mild cognitive impairment (MCI) is a recently described syndrome that is currently thought of as a transition phase between healthy cognitive ageing and dementia. Although this notion seems to be reasonable, the general nature of the term MCI--including its many definitions--makes accurate accounting of the prevalence, prognosis, and potential benefit from treatment somewhat difficult. The differences in cognitive profile and clinical progression among individuals with MCI are generally recognised. However, recent evidence also suggests that the aetiological heterogeneity among individuals with MCI could be greater than previously reported. For example, cerebrovascular disease seems to be underestimated as a potential cause of MCI. In this review, I attempt to recognise workable definitions of MCI to discuss the prevalence, pathophysiology, prognosis, and possibilities for treatment of this disorder.
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Fillit HM, Butler RN, O'Connell AW, Albert MS, Birren JE, Cotman CW, Greenough WT, Gold PE, Kramer AF, Kuller LH, Perls TT, Sahagan BG, Tully T. Achieving and maintaining cognitive vitality with aging. Mayo Clin Proc 2002; 77:681-96. [PMID: 12108606 DOI: 10.4065/77.7.681] [Citation(s) in RCA: 181] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cognitive vitality is essential to quality of life and survival in old age. With normal aging, cognitive changes such as slowed speed of processing are common, but there is substantial interindividual variability, and cognitive decline is clearly not inevitable. In this review, we focus on recent research investigating the association of various lifestyle factors and medical comorbidities with cognitive aging. Most of these factors are potentially modifiable or manageable, and some are protective. For example, animal and human studies suggest that lifelong learning, mental and physical exercise, continuing social engagement, stress reduction, and proper nutrition may be important factors in promoting cognitive vitality in aging. Manageable medical comorbidities, such as diabetes, hypertension, and hyperlipidemia, also contribute to cognitive decline in older persons. Other comorbidities such as smoking and excess alcohol intake may contribute to cognitive decline, and avoiding these activities may promote cognitive vitality in aging. Various therapeutics, including cognitive enhancers and protective agents such as antioxidants and anti-inflammatories, may eventually prove useful as adjuncts for the prevention and treatment of cognitive decline with aging. The data presented in this review should interest physicians who provide preventive care management to middle-aged and older individuals who seek to maintain cognitive vitality with aging.
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Affiliation(s)
- Howard M Fillit
- Institute for the Study of Aging, Inc., New York, NY 10153, USA.
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Meyer JS, Li Y, Xu G, Thornby J, Chowdhury M, Quach M. Feasibility of treating mild cognitive impairment with cholinesterase inhibitors. Int J Geriatr Psychiatry 2002; 17:586-8. [PMID: 12112184 DOI: 10.1002/gps.652] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- John Stirling Meyer
- Cerebrovascular Research Laboratories, Department of Neurology, Veterans Administration Medical Center, 2002 Holcombe Boulevard, Houston, TX 77030, USA.
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Current awareness in geriatric psychiatry. Int J Geriatr Psychiatry 2001; 16:1184-91. [PMID: 11748781 DOI: 10.1002/gps.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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