Epidemiology of Alzheimer's Disease and Dementia in Arab Countries: A Systematic Review

Dementia Knowledge Among Primary Healthcare Physicians in Riyadh, Saudi Arabia

INTRODUCTION

Dementia poses a significant healthcare challenge globally, and healthcare providers must have adequate knowledge about its diagnosis, management, and support services. By assessing the knowledge level of primary care physicians in Riyadh, we can identify potential gaps and areas for improvement in dementia care, ultimately enhancing patient outcomes and quality of life. This study holds promise in shedding light on the current state of dementia knowledge among primary healthcare physicians in Riyadh and offering insights into strategies to enhance dementia care in this region.

METHODS

This cross-sectional questionnaire-based study was conducted from the first of June 2023 to the end of December 2023 in Riyadh, Saudi Arabia. A validated questionnaire was used to assess physicians' knowledge, attitude, and practice toward dementia.

RESULTS

A total of 151 physicians completed the questionnaires. The majority were male (55%), below 30 years of age (88.1%), and family medicine residents (84.8%). Most (74.8%) recognized old age as the most significant risk factor; an overwhelming majority of participants (98.7%) could not identify the minimum course of treatment to judge a medication's effectiveness. The average score of correct responses (7.74 ∓ 4.11) was equivalent to 38.7%. Furthermore, the average correct responses were significantly different among the different job levels of the participants.

CONCLUSIONS

The findings of this study highlight a lack of knowledge among primary care physicians regarding dementia, emphasizing the crucial importance of physician education in this area. Additionally, the results strongly indicate the need for emphasis on dementia education within the undergraduate medical curriculum, family medicine curriculum, and physician training programs. By addressing these educational gaps, we can better equip physicians to provide optimal care and support for individuals with dementia, ultimately improving patient care and quality of life.

Uncovering the extent of dementia prevalence in Iran: a comprehensive systematic review and meta-analysis

BACKGROUND

Dementia is one of the major causes of disability and dependency among older people worldwide. The formation of an aging population in Iran can be associated with societal problems, including age-related disorders such as dementia. This study aimed to estimate the prevalence of dementia& Alzheimer disease in adults aged 60 years or older and it's its geographical distribution in Iran.

METHODS

A systematic review and meta-analysis study included articles published in both English and Persian languages and utilized various databases including: Google Scholar, PubMed, Web of Science, Magiran, and thesis database of medicine universities up to December 2022. The pooled prevalence was calculated using random effects models. The prevalence was reported separately for different geographical locations and types of area sampling, and age adjustment was performed for the selected studies. All statistical analyses were conducted using metaprop package in STATA version 17. The I2 statistic was applied to assess heterogeneity.

RESULTS

The meta-analysis considered nine relevant studies that were carried out up to 2023 in Iran. The study found that the prevalence of dementia in central and east counties was estimated to be 0.14 (95% CI; 0.04-0.31), while in western counties, the prevalence was estimated to be 0.1 (95%CI; 0.01-0.27). The estimated overall crude prevalence of dementia was estimated at 0.14 (95% CI; 0.03-0.31). Estimated prevalence-based health centers sampling and hospital-based studies were 0.02 (95% CI; 0.02-0.03), 0.05 (95% CI 0.06-0.11), respectively. One study used nursing home sampling as the sampling method, and the estimated prevalence was 0.43 (95%CI 0.38-0.49).

CONCLUSION

This is the first systematic review and meta-analysis of the prevalence of dementia's disease up to 2023 in Iran. The estimated overall prevalence of dementia is lower than the reported prevalence in European countries and similar to other Asian countries.

In vitro biological studies and computational prediction-based analyses of pyrazolo[1,5-a]pyrimidine derivatives

There is a need for new pharmaceutical discoveries from bioactive nitrogenous derivatives due to the emergence of scourges, numerous pandemics, and diverse health problems. In this context, pyrazolo[1,5-a]pyrimidine derivatives 12a and 12b were synthesized and screened to evaluate their biological potentials in vitro as antioxidants, anti-diabetics, anti-Alzheimer's, anti-arthritics, and anti-cancer agents. Additionally, the computational pharmacokinetic and toxicity properties of the two pyrazolo[1,5-a]pyrimidines 12a and 12b were calculated and analyzed. The preliminary studies and results of this work represent the initial steps toward more advanced studies and define the bioactive chemical structure of pyrazolo[1,5-a]pyrimidine derivatives with the goal of exploring new drugs to address numerous health problems.

Adaptation of the Australian National University Alzheimer's Disease Risk Index-Short Form (ANU-ADRI-SF) into Turkish

BACKGROUND

The 'Australian National University Alzheimer's Disease Risk Index' (ANU-ADRI) assesses the risk of developing Alzheimer's disease (AD) and is a potential tool for its prevention.

OBJECTIVES

The aim of this study is to adapt the ANU-ADRI-SF (the short version of ANU-ADRI) into the Turkish language and Turkish cultural context.

METHODS

The study was methodological and involved the translation and intercultural adaptation of the ANU-ADRI-SF into the Turkish language. The study included 384 community-based participants from a province in the Western Black Sea Region of Türkiye. Data was collected via an online form prepared using Google Forms.

RESULTS

The index was translated from its original language, English, into Turkish and then retranslated to English by bilingual translators. It was then reviewed and evaluated for possible issues related to translation and degrees of equivalence. When TR-ANU-ADRI-SF levels were compared according to sex, the mean risk scores were found to be 11.25 ± 7.02 for males and 11.69 ± 7.99 for females. After cross-cultural adaptation, the TR-ANU-ADRI-SF was conceptually intelligible to Turkish adults.

CONCLUSIONS

The TR-ANU-ADRI-SF is a valid and reliable AD risk assessment tool.

IMPLICATIONS FOR PRACTICE

Given the increase in AD and its impact on people's health, there is a great need for strategies to be implemented by health professionals to improve the lifestyle of the adult population. For use in conjunction with these strategies, a localised AD risk assessment tool that can be applied by clinicians or by individual patients has been adapted and introduced to the Turkish literature.

Dementia and Multimorbidity Trends in Al-Baha, Saudi Arabia: An Analytical Retrospective Study Using Records-Based Data

BACKGROUND

The prevalence of dementia is escalating significantly, posing a substantial societal burden. Currently, there exists a dearth of comprehensive health data about dementia patients in Saudi Arabia, particularly within Al-Baha City.

METHODS

A retrospective case-series study was undertaken to ascertain the prevalence of dementia within the populace of the Al-Baha region, Kingdom of Saudi Arabia. This investigation utilized hospital-based records encompassing individuals exhibiting symptoms or diagnosed with dementia and its related forms across the Al-Baha region. Furthermore, the study aimed to evaluate the burden of comorbidities among dementia patients and document the pharmacological therapeutic interventions administered to manage dementia and its associated concurrent health conditions.

RESULTS

Our investigation explored the prevalence rates of various forms of dementia and the accompanying comorbidities among affected individuals. The study spanned from August 2020 to August 2023. Our study encompassed 407 patients diagnosed with Alzheimer's disease (AD), Parkinson's disease, vascular dementia (VaD), or other forms of dementia who were either admitted to or attended tertiary hospitals in Al-Baha. Assessment of the comorbidity burden was conducted using the Charlson Comorbidity Index (CCI). Our findings revealed that among these patients, 13.3% presented with AD, 23.6% with VaD, 33.4% with Parkinson's disease, 15.75% with amnesia, and 14.0% with other types of dementia. The spectrum of comorbidities observed among dementia patients encompassed various conditions, with diabetes mellitus emerging as the predominant comorbidity (19.1%), followed by hypertension (16.4%). Additionally, manifestations of depression were noted in 14% of patients, while 9.82% suffered from paralysis. Chronic conditions such as cancer, chronic obstructive pulmonary disorder (COPD), and cervical spondylosis were also observed among individuals afflicted with dementia and its varied forms. Statistically significant correlations were established between gender, age, nationality, comorbidities, and the prevalence of dementia. Therapeutic interventions in the form of pharmacological treatments were prescribed for dementia patients with comorbidities. Commonly administered medications included Amlod (6.3%), Amlodipine (6.6%), Amlor (5.8%), Aspirin (10.5%), chemotherapeutic drugs (4.4%), Glipizide (8.5%), Lantus (11.3%), Levodopa (23.5%), Metformin (7.8%), acetylcholinesterase inhibitors (6.8%), and Pulmicort (7.86%). These medications aimed to alleviate symptoms associated with dementia and its accompanying comorbidities.

CONCLUSIONS

Our investigation underscores the substantial burden of comorbidities experienced by dementia patients. These findings offer crucial insights into the overall health status of individuals grappling with dementia, serving as a catalyst for increased awareness among clinicians and policymakers. Such awareness can drive improvements in medical care and support frameworks tailored to the specific needs of dementia patients.

Alzheimer's Disease and Related Dementias in Muslim Women: Recommendations for Culturally Sensitive Care

Alzheimer's disease and related dementias (ADRD) present significant challenges including cognitive and functional loss, behavioral disruption, emotional distress, and significant financial burden. These stressors are amplified in minority groups, who experience higher rates of ADRD but less frequent and later diagnosis. There is therefore a critical need to identify tangible approaches to culturally informed dementia assessment and care for patients from diverse communities. Muslim patients and particularly Muslim women are among the populations most understudied in the ADRD space. Muslim patients may hold unique religious, spiritual, and cultural beliefs and practices that can impact care-seeking for dementia symptoms, diagnostic accuracy, and treatment uptake. This paper outlines culturally informed approaches to assessing and treating Muslim women and families at each stage of ADRD care, though many recommendations extend to the broader Muslim community and others of diverse racial-ethnic backgrounds. We provide concrete suggestions for building rapport within and leveraging common family structures, respecting principles of modesty and privacy for all women including those who observe hijab or niqab, and communicating dementia diagnosis and care in the context of spiritual and ethical beliefs. While not intended as a comprehensive and prescriptive guide, this review provides important points of consideration and discussion with patients of Muslim backgrounds.

Cognitive decline assessment in speakers of understudied languages

Projected trends in population aging have forecasted a massive increase in the number of people with dementia, in particular in sub-Saharan Africa and the Middle East and North Africa (MENA) region. Cognitive decline is a significant marker for dementia, typically assessed with standardized neuropsychological tools that have been validated in some well-researched languages such as English. However, with the existing language diversity, current tools cannot cater to speakers of understudied languages, putting these populations at a disadvantage when it comes to access to early and accurate diagnosis of dementia. Here, we shed light on the detrimental impact of this language gap in the context of the MENA region, highlighting inadequate tools and an unacceptable lack of expertise for a MENA population of a half billion people. Our perspective calls for more research to unravel the exact impact of the language gap on the quality of cognitive decline assessment in speakers of understudied languages.

Highlights

Cognitive decline is a marker for dementia, assessed with neuropsychological tests.There is a lack of culturally valid tests for speakers of understudied languages.For example, suboptimal cognitive tests are used in the Middle East and North Africa region.Linguistic diversity should be considered in the development of cognitive tests.

Effect of Comorbidities Features in Machine Learning Models for Survival Analysis to Predict Prodromal Alzheimer's Disease

Alzheimer's Disease (AD) is the most common form of dementia, specifically a progressive degenerative disorder affecting 47 million people worldwide and is only expected to grow in the elderly population. The detection of AD in its early stages is crucial to allow early intervention aiding in the prevention or slowing down of the disease. The effect of using comorbidity features in machine learning models to predict the time until a patient develops a prodrome was observed. In this study, we used Alzheimer's Disease Neuroimaging Initiative (ADNI) high-dimensional clinical data to compare the performance of six machine learning algorithms for survival analysis, combined with six feature selection methods trained on two settings: with and without comorbidities features. Our ridge model combined with permutation feature selection achieves maximum performance of 0.90 when using comorbidity features with the concordance index as a performance indicator. This demonstrated that incorporating comorbidities into the feature set enhances the performance of survival analysis for Alzheimer's disease. There is potential to identify risk factors (coronary artery disease) from comorbidities which could guide preventative care based on medical history.

Knowledge, Awareness, and Attitude of Healthcare Stakeholders on Alzheimer's Disease and Dementia in Qatar

Dementia is characterized by progressive cognitive decline, memory impairment, and disability. Alzheimer's disease (AD) accounts for 60-70% of cases, followed by vascular and mixed dementia. Qatar and the Middle East are at increased risk owing to aging populations and high prevalence of vascular risk factors. Appropriate levels of knowledge, attitudes, and awareness amongst health care professionals (HCPs) are the need of the hour, but literature indicates that these proficiencies may be inadequate, outdated, or markedly heterogenous. In addition to a review of published quantitative surveys investigating similar questions in the Middle East, a pilot cross-sectional online needs-assessment survey was undertaken to gauge these parameters of dementia and AD among healthcare stakeholders in Qatar between 19 April and 16 May 2022. Overall, 229 responses were recorded between physicians (21%), nurses (21%), and medical students (25%), with two-thirds from Qatar. Over half the respondents reported that >10% of their patients were elderly (>60 years). Over 25% reported having contact with >50 patients with dementia or neurodegenerative disease annually. Over 70% had not undertake related education/training in the last 2 years. The knowledge of HCPs regarding dementia and AD was moderate (mean score of 5.3 ± 1.5 out of 7) and their awareness of recent advances in basic disease pathophysiology was lacking. Differences existed across professions and location of respondents. Our findings lay the groundwork for a call-to-action for healthcare institutions to improve dementia care within Qatar and the Middle East region.

Exercise Protects Against Cognitive Injury and Inflammation in Alzheimer's Disease Through Elevating miR-148a-3p

Alzheimer's disease (AD) is a chronic neurological disorder with high morbidity. Exercise is one of the effective ways to ameliorate AD. In this study, we assessed the effects of exercise on cognition and inflammation and studied the role of miR-148a-3p in AD. In 88 patients with AD, the expression of miR-148a-3p was studied using qRT-PCR. ROC curve and Pearson analysis were utilized to evaluate the roles of miR-148a-3p in AD. MWM test was conducted to investigate the effects of miR-148a-3p and exercise on cognition and memory. Moreover, inflammatory indicators were identified using an enzyme-linked immunosorbent assay. Relative luciferase levels reflected whether miR-148a-3p targeted SYNJ1. miR-148a-3p levels declined in patients with AD, indicating its potential as a biomarker. Interestingly, miR-148a-3p levels were elevated in patients with AD after exercise. MiR-148a-3p levels correlated with cognitive scores and proinflammatory levels. The cognitive situation and pro-inflammatory state were partly recovered in the mice after exercise. MiR-148a-3p silencing reversed these abovementioned tendencies. Patients with AD exhibited a low level of miR-148a-3p, which was increased after exercise. Therefore, exercise might improve the cognitive function and memory of mice with AD by upregulating miR-148a-3p.

Gao-Zi-Yao improves learning and memory function in old spontaneous hypertensive rats

Aims

Gao-Zi-Yao has long been a unique way for treating various diseases. The present study is to explore the effect of Gao-Zi-Yao on learning and memory function in old spontaneous hypertensive rats (SHR) and its possible mechanism.

Method

Male old SHR were received different doses of Gao-Zi-Yao for 4 weeks. Systolic blood pressure (SBP) and heart rate were monitored. Serum levels of nitric oxide (NO), interleukin (IL)-1β, IL-2, and tumor necrotic factor (TNF)-α were measured. Morris water maze was performed to test the learning and memory function of the rats. Number of neurons in hippocampus was counted by Nissl staining. Western blot was applied to detect the expressions of learning and memory function related proteins, N-methyl-d-aspartate receptor 2B (NMDAR 2B), glutamate receptor 1 (GluR1), phosphorylated-calmodulin-dependent protein kinase II (p-CaMK II), and phosphorylated-cAMP responsive element-binding protein (p-CREB) in rat hippocampus.

Results

Data showed that Gao-Zi-Yao reduced SBP in old SHR, elevated NO level, and suppressed levels of IL-1β, IL-2, TNF-α. The results of Morris water maze experiment showed that Gao-Zi-Yao dose-dependently improved learning and memory function. Number of neurons in the hippocampal dentate gyrus (DG) region of the old SHR was increased by Gao-Zi-Yao treatment. In addition, Gao-Zi-Yao elevated the protein expressions of NMDAR 2B, GluR1, p-CaMK II, and p-CREB in hippocampus.

Conclusion

Gao-Zi-Yao decreases SBP and improves the learning and memory function of the old SHR by regulation of oxidative stress, inflammatory factors and neuron number in hippocampal DG area and the expression of learning and memory function related proteins.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12906-022-03630-0.

The Arabic Translation and Cross-Cultural Adaptation of the Bristol Activity of Daily Living Scale

BACKGROUND

There are few Arabic language functional scales for patients with dementia. The Bristol Activity of Daily Living Scale (BADLS) was designed and validated for use in patients with dementia.

OBJECTIVE

Our study aimed to translate, cross-culturally adapt, and validate the BADLS to the Arabic language for people with neurocognitive decline and dementia.

METHODS

The original BADLS scale was translated to the Arabic language followed by face validity assessment through a pilot testing in five Arabic countries. The Arabic BADLS was assessed in a sample of 139 participants and their caregivers for concurrent and convergent validity.

RESULTS

The Arabic BADLS had excellent internal consistency, Cronbach's alpha 0.95 (95% CI 0.93-0.96). Likewise, the Arabic BADLS had strong convergent validity with the Montreal Cognitive Assessment (r = -0.82, p <  0.001).

CONCLUSION

The Arabic BADLS is a valid scale that can used to assess the functional performance of people living with dementia.

Association of Alzheimer's Disease and Insulin Resistance in King Abdulaziz Medical City, Jeddah

Background Alzheimer's disease (AD) and insulin resistance (IR) are common in the elderly. IR reduces the ability of insulin to work effectively on target tissues. This results in hyperglycemia, increased triglyceride levels, decreased high-density lipoprotein (HDL) levels, elevated blood pressure, and central obesity, a condition known as metabolic syndrome (MetS). MetS eventually affects cognition, but its relationship with AD is unclear. Therefore, we studied the association between AD and IR and the relation between AD and diabetic patients treated with insulin. Methods This was a record-based retrospective cohort study using data from King Abdulaziz Medical City, Jeddah, Ministry of National Guards-Health Affairs. for all patients with dementia and AD, from 2009 to 2018. We examined 354 patient files. The triglyceride-glucose (TyG) index was used for the assessment of IR. Results There was no significant association between patients' demographic data, glycated hemoglobin, and co-morbidities and developing AD. Statistical models showed that, after adjustment for age, patients with IR had a significantly higher likelihood of AD (adjusted OR = 1.4; 95% CI: 1.01-2.33). After multivariate adjustment, patients with IR still had a 20% higher probability of developing AD than others (adjusted OR = 1.2; 95% CI: 1.0-3.1). Conclusion These results suggest that AD is associated with IR. Moreover, the association may be confounded by many patient-related factors.

The Arab Countries' Contribution to the Research of Neurodegenerative Disorders

Background: Neurodegenerative diseases are disorders in which nerve cells start to lose function due to different causes. Like many other illnesses, they are considered to be highly prevalent in the 22 Arabic-speaking countries known to constitute the Arab world. The two most prevalent neurodegenerative disorders are Alzheimer's disease and Parkinson's disease.

Aim: The aim of this paper is to assess the amount of research dedicated to neurodegenerative diseases by the Arab countries during a 15-year period, between 2005 and 2019.

Methods: The number of publications by each Arab country as well as some non-Arab speaking countries was retrieved from PubMed. Publications in top 10 neuroscience journals were also tracked using the same method with each journal’s name included. The numbers were then normalized with respect to the average population and average gross domestic product (GDP) in each country to eliminate bias.

Results: Arab countries were shown to contribute only 1,311 (0.774%) of the 169,330 articles published worldwide on neurodegenerative disorders. These 1,311 also constitute only 0.660% of the 198,869 Arab publications during the indicated period. Saudi Arabia had the highest contribution to these numbers with more than one-quarter the number of publications on neurodegenerative disorders. Approximately one-third of all neurodegenerative disease-related articles were associated with Alzheimer's disease, whereas one-fifth were related to Parkinson's disease. For the top 10 neuroscience journals, only a minimal contribution by Arab countries was noted.

Conclusion: Although an increase in the number of articles by the Arab world was noted from 2013 onward, the contribution of the Arab countries on the subject to the number of publications still seems to be insufficient.

Setting Up a Cognitive Training Service for Egyptian Older Adults

BACKGROUND

With greying of nations, dementia becomes a public health priority. The rising dementia prevalence escalates both health care expenses and burden, placing the entire healthcare system and caregivers under huge stress. Cognition-oriented interventions have been shown to enhance the overall cognitive performance among healthy and cognitively impaired older adults.

OBJECTIVE

This article is assumed to be a steppingstone for the introduction and establishment of cognition- oriented interventions in Egypt. In addition, it aims to offer provisional guidance for health care providers in Arab speaking countries in a stepwise approach in order to establish cognition-oriented intervention services and help them to evaluate and monitor their efficacy.

METHODS

Aconsortium of Egyptian and Greek specialists developed a protocol for the operations of the Ain Shams Cognitive Training Lab and the provision of cognition-oriented interventions. This protocol is based on a previous successful protocol that has been implemented in Greece for more than 10 years and is co-designed to fit the needs of older adults in Arabic speaking countries.

RESULTS

The types of services offered, their objectives, recruitment of participants, delivery of interventions, measurement of outcomes and privacy policy are all outlined in the policy.

CONCLUSION

Establishing the appropriate framework in which cognitive training strategies can be adapted and implemented in Arabic population, constitutes an inevitable achievement in healthy ageing and can be also assumed as a dementia prevention strategy. Moreover, setting up the first cognitive laboratory in Egypt older adults, can be a model of good practice across the Arabic countries.

Public knowledge about Alzheimer disease in Mecca Region, Kingdom of Saudi Arabia: a cross-sectional study

Background

Raising the general population knowledge of Alzheimer’s disease is crucial for optimizing care and ultimately enhancing the quality of life of people diagnosed and their caregivers.

Aim

To assess knowledge among the general population in Makkah Region about symptoms, diagnosis, causes, course, life impact, care giving, and management of Alzheimer disease.

Material and methods

A descriptive cross-sectional study was conducted during July to August 2018 in three main cities of Makkah Region, i.e., Makkah, Jeddah, and Taif, Saudi Arabia. Two to three mosques and/or malls were selected randomly from a list of all mosques and malls in each city, and then every fifth subject was selected using a systematic random technique, entering the mall or getting out from the mosques. Both genders, aged 18 years or more and able to understand Arabic were included. Valid and reliable Alzheimer’s Disease Knowledge Scale (ADKS) was used to assess knowledge about the diseases, in addition to socio-demographic characteristics of the participants.

Results

The study included 862 adult participants. Their age ranged between 18 and 65 years with a mean ± standard deviation (SD) of 31.2 ± 10.3 years. History of having a relative with Alzheimer’s disease was mentioned by 20.8% of the participants. Overall, the percentage of total Alzheimer’s disease knowledge score ranged between 26.7 and 100% with a mean of 58.5%, median of 60%, mode of 56.7%, and standard deviation of ± 11.5%. There was a significant positive correlation between participant’s age and their knowledge regarding Alzheimer’s disease (Spearman’s correlation coefficient “r” = 0.099, p = 0.004). The highest known subscale of Alzheimer’s disease was assessment (mean percentage was 62.21%), followed by treatment (62.09), care giving (61.83%) and course of the disease (60.99%) whereas the lowest known subscale was symptoms (53.25%). Participants who reported a history of having a relative with Alzheimer’s disease were more knowledgeable regarding symptoms than those who did not had such history (mean ranks were 470.48 and 421.28, respectively), p = 0.014.

Conclusion

Knowledge of the general population in Makkah Region is deficient, particularly regarding symptoms, risk factors and life impacts. Therefore, health education campaigns are required for general public in this regards.

A novel variant c.3706C>T p.(Avg 1236Cys) in the ABCA7 gene in a Saudi patient with susceptibility to Alzheimer's disease 9

Alzheimer's disease (AD) is the most common cause of dementia with around 50 million people suffering from this disease worldwide. Mutations in the ATP-binding cassette sub-family A member 7 (ABCA7) have been reported to cause susceptibility to AD 9 (OMIM #608907). In this study, we report a novel variant in ABCA7 in a Saudi patient with susceptibility to AD 9 and a strong family history of neurodegenerative disorders, which may be explained by the same variant. We studied a single 57-year-old female patient with typical symptoms of AD supported by MRI findings from a Saudi family with a positive history of a similar disease in multiple individuals. The case study was conducted in King Abdulaziz Medical City in Jeddah, Saudi Arabia. Whole-exome sequencing identified the novel heterozygous variant c.3706C>T p.(Avg 1236Cys) in the ABCA7 gene, which leads to an amino acid exchange. Furthermore, bioinformatics in silico programs predict a pathogenic effect for this variant. To the best of our knowledge, the variant has not been described in the literature so far as evidenced by a thorough literature review using multiple databases such as Ovid, Medline, EMBASE, ProQuest, Science Direct, Google Scholar, and PubMed. In this article, we reported a middle-aged Saudi woman with a novel variant in ABCA7 who had clinical features of both AD and Parkinson's disease. Given the reported function of this gene, it is most likely that it is etiological and pathological because of the presenting complex neurological disease due to decreased clearance of β-amyloid and α-Synuclein. We illustrate the importance of this interesting gene that could be implicated in several neurodegenerative disorders.

20(S)-protopanaxadiol and oleanolic acid ameliorate cognitive deficits in APP/PS1 transgenic mice by enhancing hippocampal neurogenesis

Background

Alzheimer's disease (AD) is one of the most prevalent neurodegenerative disorders. Enhancing hippocampal neurogenesis by promoting proliferation and differentiation of neural stem cells (NSCs) is a promising therapeutic strategy for AD. 20(S)-protopanaxadiol (PPD) and oleanolic acid (OA) are small, bioactive compounds found in ginseng that can promote NSC proliferation and neural differentiation in vitro. However, it is currently unknown whether PPD or OA can attenuate cognitive deficits by enhancing hippocampal neurogenesis in vivo in a transgenic APP/PS1 AD mouse model. Here, we administered PPD or OA to APP/PS1 mice and monitored the effects on cognition and hippocampal neurogenesis.

Methods

We used the Morris water maze, Y maze, and open field tests to compare the cognitive capacities of treated and untreated APP/PS1 mice. We investigated hippocampal neurogenesis using Nissl staining and BrdU/NeuN double labeling. NSC proliferation was quantified by Sox2 labeling of the hippocampal dentate gyrus. We used western blotting to determine the effects of PPD and OA on Wnt/GSK3β/β-catenin pathway activation in the hippocampus.

Results

Both PPD and OA significantly ameliorated the cognitive impairments observed in untreated APP/PS1 mice. Furthermore, PPD and OA significantly promoted hippocampal neurogenesis and NSC proliferation. At the mechanistic level, PPD and OA treatments resulted in Wnt/GSK-3β/β-catenin pathway activation in the hippocampus.

Conclusion

PPD and OA ameliorate cognitive deficits in APP/PS1 mice by enhancing hippocampal neurogenesis, achieved by stimulating the Wnt/GSK-3β/β-catenin pathway. As such, PPD and OA are promising novel therapeutic agents for the treatment of AD and other neurodegenerative diseases.