scholarly journals Acetylcholinesterase inhibitors and cognitive stimulation, combined and alone, in treating individuals with mild Alzheimer’s disease

2021 ◽  
Author(s):  
Maria Devita ◽  
Fabio Masina ◽  
Daniela Mapelli ◽  
Pasquale Anselmi ◽  
Giuseppe Sergi ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Small Sample Size ◽  
Acetylcholinesterase Inhibitors ◽  
Small Sample ◽  
Cognitive Stimulation ◽  
Cognitive Domain ◽  
Delayed Recall ◽  
Immediate Memory ◽  
General Improvement

Abstract Backgrounds Acetylcholinesterase inhibitors (AChEI) and cognitive stimulation (CS) are the standard pharmacological and non-pharmacological treatments for Alzheimer’s disease (AD). Aims The aim of this study was to investigate the effects of these treatments, alone or combined, on the neuropsychological profiles of patients with AD. Methods Forty participants were assigned to three groups receiving either only AChEI (n = 14), AChEI + CS (n = 15), or only CS (n = 11). Cognition was evaluated at baseline and after three months. Linear mixed-effects models were used to investigate differences among the treatments in terms of changes in the patients’ neuropsychological profiles. Results Results, although preliminary because of the small sample size, suggest that a general improvement was found in patients who received AChEI + CS and those who received only CS compared with those who received only AChEI. Interestingly, individuals who received only CS showed a significant improvement in immediate memory recall than those who received only AChEI. Furthermore, the group receiving AChEI + CS showed an improvement in delayed recall than the other two groups. Discussion The combination of AChEI and CS seems to have the greatest benefit for patients with mild AD. More interestingly, CS alone is more effective than AChEI alone, even in improving memory, considered to be the “lost” cognitive domain in AD.

The Effectiveness and Safety of Chemical Drugs Combined with Acupuncture for Alzheimer’s Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Shenghua Yu ◽  
Hongjie Liu ◽  
Li Xu ◽  
Yan Zhang ◽  
Yan Ma ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Early Stage ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Small Sample ◽  
Risk Of Bias ◽  
Disease Assessment ◽  
High Quality ◽  
Significant Difference

Introduction: Acupuncture has been applied with chemical drugs to treat Alzheimer’s disease (AD) in the clinic. Whether such combination is effective and safe should be studied although it is recommended by some researchers.Methods: To explore the effectiveness and safety of acupuncture combined with the chemical drugs for AD, databases like PubMed, Web of Science were searched to retrieve randomized controlled trials (RCTs) on AD treated with acupuncture and chemical drugs to perform meta-analysis. The risk of bias in each study was assessed using the Cochrane Risk of Bias scale. Meta-analysis was performed using RevMan 5.3.Results: Five studies were included in which only donepezil combined with acupuncture was evaluated. Acupuncture combined with donepezil showed a significant difference in effectiveness rate [RR=1.45, 95% CI (1.19, 1.77), P=0.0002] compared with donepezil. On the comparison of mini-mental state examination (MMSE) score and Alzheimer's disease assessment scale cognitive subscale (ADAS-Cog) score there was no difference. However, after one trial with severe AD patients was removed, acupuncture combined with donepezil showed better effect than donepezil alone. Conclusion: Acupuncture combined with donepezil could work on AD at the early stage or with mild AD, implying that acupuncture could be a complementary therapy for AD at early stage or with mild condition. Besides, scalp acupuncture seems to be more effective on improving cognitive function. However, this conclusion must be considered cautiously, given the small sample size and lack of trials of high quality. Therefore, more high-quality, multicenter, prospective, RCTs with large sample sizes are needed to further clarify the effect of acupuncture combined with chemical drugs for AD.

scholarly journals Spatial working memory in Alzheimer's disease: A study using the Corsi block-tapping test

2007 ◽  
Vol 1 (4) ◽  
pp. 392-395 ◽  
Author(s):  
Carla Cristina Guariglia
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Working Memory ◽  
Spatial Memory ◽  
Spatial Working Memory ◽  
Small Sample Size ◽  
Digit Span ◽  
Small Sample ◽  
Mild Dementia ◽  
Moderate Dementia

Abstract The Corsi block-tapping test was developed as a non-verbal task to measure spatial memory. In this test, cubes are tapped by the examiner in novel sequences of increasing length after which participants are required to reproduce each sequence immediately. Objectives: To evaluate spatial working memory in Alzheimer's disease (AD) patients. Methods: 30 elderly control subjects (21 women, 9 men) and 30 patients with probable Alzheimer's disease (15 women and 15 men), with 8 or more years of schooling, were evaluated with the Mini-Mental State Examination (MMSE), digit span and Corsi block-tapping test. Proportions were compared using Chi-Square, and continuous variables with the Mann-Whitney tests. Results: AD patients were older than controls (p=0.014), but there were no differences regarding gender or educational level between these groups. The performance on the Corsi block-tapping test differed between AD and control individuals (p=0.010), and between patients with moderate dementia and controls (p=0.032), but not between control individuals and patients with mild dementia (p=0.090). Conclusions: In the present study, AD patients with moderate dementia showed impairment in spatial working memory while those with mild dementia did not. This finding may be due to the relatively small sample size, but it is also possible that spatial memory may be normal in the initial (limbic) phase of AD.

scholarly journals Combining Transcranial Magnetic Stimulation and Electroencephalography May Contribute to Assess the Severity of Alzheimer's Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Petro Julkunen ◽  
Anne M. Jauhiainen ◽  
Mervi Könönen ◽  
Ari Pääkkönen ◽  
Jari Karhu ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Transcranial Magnetic Stimulation ◽  
Cognitive Decline ◽  
Magnetic Stimulation ◽  
Rating Scales ◽  
Small Sample Size ◽  
Small Sample ◽  
Response Characteristics ◽  
Specificity And Sensitivity

Alzheimer's disease (AD) is the most common form of old age dementia, and mild cognitive impairment (MCI) often precedes AD. In our previous study (Julkunen et al. 2008), we found that the combination of transcranial magnetic stimulation (TMS) and electroencephalography (EEG) was able to find distinct differences in AD and MCI patients as compared to controls. Here, we reanalyzed the small sample data from our previous study with the aim to test the sensitivity of the TMS-EEG characteristics to discriminate control subjects (n=4) from MCI (n=5) and AD (n=5) subjects. Furthermore, we investigated how the TMS-EEG response characteristics related to the scores of the dementia rating scales used to evaluate the severity of cognitive decline in these subjects. We found that the TMS-EEG response P30 amplitude correlated with cognitive decline and showed good specificity and sensitivity in identifying healthy subjects from those with MCI or AD. Given the small sample size, further studies may be needed to confirm the results.

scholarly journals Low Vitamin D and Its Association with Cognitive Impairment and Dementia

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Sadia Sultan ◽  
Uzma Taimuri ◽  
Shatha Abdulrzzaq Basnan ◽  
Waad Khalid Ai-Orabi ◽  
Afaf Awadallah ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Vitamin D ◽  
Cognitive Impairment ◽  
Behavioral Problems ◽  
Small Sample Size ◽  
Vitamin D Supplementation ◽  
Small Sample ◽  
Vitamin D Levels ◽  
Prevention And Treatment

Vitamin D is a neurosteroid hormone that regulates neurotransmitters and neurotrophins. It has anti-inflammatory, antioxidant, and neuroprotective properties. It increases neurotrophic factors such as nerve growth factor which further promotes brain health. Moreover, it is also helpful in the prevention of amyloid accumulation and promotes amyloid clearance. Emerging evidence suggests its role in the reduction of Alzheimer’s disease hallmarks such as amyloid-beta and phosphorylated tau. Many preclinical studies have supported the hypothesis that vitamin D leads to attentional, behavioral problems and cognitive impairment. Cross-sectional studies have consistently found that vitamin D levels are significantly low in individuals with Alzheimer’s disease and cognitive impairment compared to healthy adults. Longitudinal studies and meta-analysis have also exhibited an association of low vitamin D with cognitive impairment and Alzheimer’s disease. Despite such evidence, the causal association cannot be sufficiently answered. In contrast to observational studies, findings from interventional studies have produced mixed results on the role of vitamin D supplementation in the prevention and treatment of cognitive impairment and dementia. The biggest issue of the existing RCTs is their small sample size, lack of consensus over the dose, and age of initiation of vitamin D supplements to prevent cognitive impairment. Therefore, there is a need for large double-blind randomized control trials to assess the benefits of vitamin D supplementation in the prevention and treatment of cognitive impairment.

scholarly journals Sleep problems in Alzheimer's disease: does drug treatment help or harm?

2015 ◽  
Vol 21 (4) ◽  
pp. 219-221
Author(s):  
Katharine Smith ◽  
Mary-Jane Attenburrow
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Side Effects ◽  
Sleep Problems ◽  
Small Sample Size ◽  
Cochrane Review ◽  
Small Sample ◽  
Drug Treatments ◽  
Size Limits ◽  
Careful Assessment

SummaryDrug treatments are commonly used for sleep disturbance in Alzheimer's disease, although none have a specific licence for this indication. This month's Cochrane review assessed the available evidence of benefit or harm in the use of these medications. The review identified two studies of melatonin, which did not show significant improvement in sleep over placebo. One study of trazodone suggested a beneficial effect on sleep, but its small sample size limits the generalisability of the results. Larger studies are needed, with careful assessment of the evidence for possible improvements in sleep but also of important side-effects such as falls and increased confusion.

A Study of Familial Factors in Alzheimer's Disease

1982 ◽  
Vol 140 (3) ◽  
pp. 249-256 ◽  
Author(s):  
L. J. Whalley ◽  
A. D. Carothers ◽  
S. Collyer ◽  
R. De Mey ◽  
A. Frackiewicz
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Small Sample Size ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Small Sample ◽  
Presenile Dementia ◽  
Familial Association ◽  
The Mean ◽  
Age At Birth

SummaryData on the families of 74 probands with autopsy-proven Alzheimer's disease did not support the hypothesis, advanced by Heston and co-workers, of a familial association between Alzheimer's disease, Down's syndrome and immunoproliferative disorders. However, there are difficulties of interpreting negative conclusions in this type of study, particularly those resulting from small sample size and the impossibility of tracing all relatives; only the data for immunoproliferative disorders are incompatible with the hypothesis, those for Down's syndrome being too few to be informative. The incidence of presenile dementia among the first-degree relatives of probands was raised, as in many previous studies, and was consistent with a simple polygenic model. The mean parental age at birth of the probands was significantly raised by about 2 years (P = 0.01), but so also was that of their unaffected sibs, suggesting that the mechanism differs from that occurring in trisomy 21 and certain other aneuploidies.

scholarly journals Applicability of tactile memory examination as an option to visual- and verbal-based batteries

2021 ◽  
Vol 15 (3) ◽  
pp. 373-380
Author(s):  
Omar Gurrola Arambula ◽  
Flavia Helena Pereira Padovani ◽  
Jose Eduardo Corrente ◽  
Andreas Batista Schelp ◽  
Felipe Jacques Sanches ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Small Sample Size ◽  
Human Life ◽  
Memory Performance ◽  
Small Sample ◽  
Older Individuals ◽  
Everyday Objects ◽  
Close Relationship ◽  
Tactile Memory

ABSTRACT The validity and applicability of tactile battery tests for the diagnosis and medical follow-up of patients with Alzheimer’s disease and other dementia syndromes do not have their usefulness well understood in clinical practice. While haptic abilities in older individuals receive less attention, in earlier stages of human life they are well focused on. There are even fewer studies on tactile memory, including episodic memory of demented individuals with or without sensorial limitations. The applicability of a new haptic memory battery was evaluated in patients with Alzheimer’s disease with mild or moderate commitment. Objective: The aim of this study is to apply a battery based on tactile perception, recognition, and recollection of everyday objects in patients with Alzheimer’s disease, testing tactile delayed recall memory discrimination and late recognition to compare validated visual and verbal tests. Methods: Tactile-, visual-, and verbal-based memory performance was registered in 21 patients diagnosed with Alzheimer’s disease. Results: Except for tactile identification, it showed that there was a close relationship between the three sensory modalities of memory, with an apparent better performance of tactile incidental memory and recognition compared with the test with pictures. Conclusions: The haptic evaluation of memory demonstrated applicability in the evaluation of memory dysfunction in patients with Alzheimer’s disease. Further studies are needed to establish the sensibility and specificity of the proposed test that had a small sample size and many limitations.

Spirocyclohexadienones as an Uncommon Scaffold for Acetylcholinesterase Inhibitory Activity

2019 ◽  
Vol 15 (4) ◽  
pp. 373-382 ◽  
Author(s):  
Ralph C. Gomes ◽  
Renata P. Sakata ◽  
Wanda P. Almeida ◽  
Fernando Coelho
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Population Aging ◽  
Acetylcholinesterase Inhibitors ◽  
Acetylcholinesterase Activity ◽  
Docking Study ◽  
Biological Properties ◽  
Ache Inhibitor ◽  
Molecular Docking Study

Background: The most important cause of dementia affecting elderly people is the Alzheimer’s disease (AD). Patients affected by this progressive and neurodegenerative disease have severe memory and cognitive function impairments. Some medicines used for treating this disease in the early stages are based on inhibition of acetylcholinesterase. Population aging should contribute to increase the cases of patients suffering from Alzheimer's disease, thus requiring the development of new therapeutic entities for the treatment of this disease. Methods: The objective of this work is to identify new substances that have spatial structural similarity with donepezil, an efficient commercial drug used for the treatment of Alzheimer's disease, and to evaluate the capacity of inhibition of these new substances against the enzyme acetylcholinesterase. Results: Based on a previous results of our group, we prepared a set of 11 spirocyclohexadienones with different substitutions patterns in three steps and overall yield of up to 59%. These compounds were evaluated in vitro against acetylcholinesterase. We found that eight of them are able to inhibit the acetylcholinesterase activity, with IC50 values ranging from 0.12 to 12.67 µM. Molecular docking study indicated that the spirocyclohexadienone, 9e (IC50 = 0.12 µM), a mixedtype AChE inhibitor, showed a good interaction at active site of the enzyme, including the cationic (CAS) and the peripheral site (PAS). Conclusion: We described the first study aimed at investigating the biological properties of spirocyclohexadienones as acetylcholinesterase inhibitors. Thus, we have identified an inhibitor, which provided valuable insights for further studies aimed at the discovery of more potent acetylcholinesterase inhibitors.

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