Dementia Cafés as a Community Resource for Persons With Early-Stage Cognitive Disorders: A Nationwide Survey in Japan

We describe the close relationship between stride, cadence and velocity, as fundamental motion outcomes, in particular for the elderly. Stride (Length, Time, CoV) is a meaningful mobility outcome for clinical intervention trials. Stride variability while motor-cognitive dual-tasking is a sensitive mobility outcome for fall risk and cognitive disorders (e.g. Alzheimer’s disease) at an early stage. Salsa proved to be a safe and feasible exercise programme for older adults accompanied with a high adherence rate

Download Full-text

465 Unmasking the prevalence of cardiac amyloidosis in the real world: first insights from the phase 2 of active study, an Italian nationwide survey

European Heart Journal Supplements ◽

10.1093/eurheartj/suab142.033 ◽

2021 ◽

Vol 23 (Supplement_G) ◽

Author(s):

Marco Merlo ◽

Linda Pagura ◽

Aldostefano Porcari ◽

Matteo Cameli ◽

Giuseppe Vergaro ◽

...

Keyword(s):

Cardiac Amyloidosis ◽

Early Stage ◽

Phase 1 ◽

Nationwide Survey ◽

Phase 2 ◽

Multicentric Study ◽

The Real ◽

Refusal To Participate ◽

Diagnostic Work ◽

Echocardiographic Findings

Abstract Aims Clinicians needs to identify patients with cardiac amyloidosis (CA) at an early stage, due to the availability of disease modifying therapies. Some echocardiographic findings may rise the suspicion of CA, also in patients with mild or no symptoms, addressing second level diagnostic tests. To investigate the prevalence of CA in consecutive patients ≥55 years undergoing clinically indicated, routine transthoracic echocardiogram (TTE) in Italy with echocardiographic signs suggestive of CA. Methods and results This is a prospective multicentric study conducted in Italy. It comprises two phases: 1) an observational phase consisting in a national survey on prevalence of possible echocardiographic red flags of CA in consecutive patients ≥55 years undergoing routine TTE (previously published) and 2) a CA diagnostic phase. Preliminary results of phase 2 are herein presented. Patients that in the phase 1 presented a CA-suggestive TTE (i.e. at least one red flag of CA in hypertrophic, non-dilated left ventricles) were re-evaluated for a cardiological visit. Those who consented to proceed in the study, underwent clinical evaluation, blood and urine tests and scintigraphy with bone tracer. Diagnosis of transthyretin related-CA (TTR-CA) was made in presence of Grades 2–3 Perugini uptake at scintigraphy and absence of monoclonal protein. The study was registered at ClinicalTrials.gov (#NCT04738266). Of the 5315 screened echocardiograms, 381 exams (7.2%) were classified as AC-suggestive. Two-hundred-twelve of the 381 patients with a CA-suggestive TTE underwent phase 2 study. Main reasons for the 169 non-entering patients into the phase 2 were death (n = 53) and refusal to participate (n = 85). Sixty-five of these 212 patients (31%; 17% considering also the 169 non-entering patients into the phase 2) had a diagnosis of CA. Finally, TTR-CA was diagnosed in 53 (25%) and AL-CA in 12 (5.7%) patients. Conclusions Among a cohort of consecutive unselected patients ≥55 years with echocardiographic findings suggestive of CA, the real prevalence of CA ranged from 17 up to 31%. Although TTR-CA was predominant, AL-CA was diagnosed in a significant amount of cases. TTE has a fundamental role in screening patients, raising the suspicion of CA and orienting diagnostic work-up for CA.

Download Full-text

Incidence and Predictors of Low Dose-Intensity in Adjuvant Breast Cancer Chemotherapy: A Nationwide Study of Community Practices

Journal of Clinical Oncology ◽

10.1200/jco.2003.05.002 ◽

2003 ◽

Vol 21 (24) ◽

pp. 4524-4531 ◽

Cited By ~ 309

Author(s):

Gary H. Lyman ◽

David C. Dale ◽

Jeffrey Crawford

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Early Stage ◽

Dose Intensity ◽

Nationwide Survey ◽

Breast Cancer Chemotherapy ◽

Patterns Of Use ◽

Adjuvant Breast Cancer ◽

Chemotherapy Patients ◽

Dose Modifications

Purpose: This retrospective study was undertaken to assess practice patterns in adjuvant chemotherapy for early-stage breast cancer (ESBC) and to define the incidence and predictive factors of reduced relative dose-intensity (RDI). Patients and Methods: A nationwide survey of 1,243 community oncology practices was conducted, with data extracted from records of 20,799 ESBC patients treated with adjuvant chemotherapy. Assessments included demographic and clinical characteristics, chemotherapy dose modifications, incidence of febrile neutropenia, and patterns of use of colony-stimulating factor (CSF). Dose-intensity was compared with published reference standard regimens. Results: Dose reductions ≥15% occurred in 36.5% of patients, and there were treatment delays ≥7 days in 24.9% of patients, resulting in 55.5% of patients receiving RDI less than 85%. Nearly two thirds of patients received RDI less than 85% when adjusted for differences in regimen dose-intensity. Multivariate analysis identified several independent predictors for reduced RDI, including increased age; chemotherapy with cyclophosphamide, methotrexate, and fluorouracil, or cyclophosphamide, doxorubicin, and fluorouracil; a 28-day schedule; body-surface area greater than 2 m 2 ; and no primary CSF prophylaxis. CSF was often initiated late in the chemotherapy cycle. Conclusion: Patients with ESBC are at substantial risk for reduced RDI when treated with adjuvant chemotherapy. Patients at greatest risk include older patients, overweight patients, and those receiving three-drug combinations or 28-day schedules. Predictive models based on such risk factors should enable the selective application of supportive measures in an effort to deliver full dose-intensity chemotherapy.

Download Full-text

Neuropsychological Deficits Associated with Destruction of the Right Nigrostriatal Pathway

Journal of the International Neuropsychological Society ◽

10.1017/s1355617713000416 ◽

2013 ◽

Vol 19 (6) ◽

pp. 729-734 ◽

Cited By ~ 1

Author(s):

Carmen Sáez-Zea ◽

Francisco Escamilla-Sevilla ◽

Josefina Martínez-Simón ◽

Marisa Arnedo ◽

Adolfo Mínguez-Castellanos

Keyword(s):

Executive Functioning ◽

Visual Memory ◽

Early Stage ◽

Cognitive Disorders ◽

Brain Structures ◽

Neuropsychological Deficits ◽

Nigrostriatal Pathway ◽

Neuropsychological Dysfunction ◽

Idiopathic Parkinson's Disease ◽

The Right

AbstractHemiparkinsonism secondary to a vascular mesencephalic lesion is infrequent; these patients offer an exceptional opportunity to study neuropsychological alterations attributable to unilateral dopaminergic denervation, shedding light on the pathophysiology of cognitive disorders in early-stage idiopathic Parkinson's disease (PD). From the investigation of our case, we conclude that destruction of the right nigrostriatal pathway is accompanied by deficits in executive functioning and verbal/visual memory similar to those observed in many patients with early-stage idiopathic PD. The more complex neuropsychological dysfunction developed by other PD patients must therefore be related to the additional involvement of other brain structures. (JINS, 2013, 19, 1–6)

Download Full-text

ASKING THE PEOPLE WHO MATTER THE MOST: DESIGNING A VALUE-BASED DEMENTIA SPECIALTY CLINIC

Innovation in Aging ◽

10.1093/geroni/igz038.434 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S118-S118

Author(s):

Alyssa Aguirre ◽

Christopher Ulack ◽

Joel Suarez ◽

Kathleen Carberry ◽

Justin Rousseau ◽

...

Keyword(s):

Qualitative Methodology ◽

Early Stage ◽

Care Delivery ◽

Outcome Measurement ◽

Memory Loss ◽

Cognitive Disorders ◽

The People ◽

Care Delivery Model ◽

Care Partners ◽

Value Based Care

Abstract This presentation will highlight our research which uses a qualitative methodology to incorporate the voices and experiences of people impacted by dementia into the value-based health model. This model is characterized by a team-based approach as well as the measurement of outcomes. The aim of value-based care is to provide individuals meaningful and compassionate care that helps them achieve the health outcomes that matter most to them. Foundational to creating this person-centered model is the incorporation of the perspectives of individuals with dementia and their care partners. Experience Groups offer an opportunity for those affected by dementia to share their expertise and describe their daily challenges and successes so we are able to learn from their experiences and better understand unmet and unarticulated needs. The findings of this research—consisting of 41 patients and 11 care partners—enabled the development of outcome measurement tools implemented at the clinical level, and the design of a care delivery model that addresses unmet needs. Some of the key findings from the research that have been implemented at the Cognitive Disorders Clinic and that will be highlighted in this poster are: 1. Care partners would like more emotional support from their medical team; 2. Individuals want more information about the trajectory of the disease and an actionable “roadmap-of-care”; 3. Care partners and those with early stage memory loss desire counseling and team-based care versus strictly physician-provided care.

Download Full-text

Interactions between Personality, Depression, Anxiety and Cognition to Understand Early Stage of Alzheimer’s Disease

Current Topics in Medicinal Chemistry ◽

10.2174/1568026620666200211110545 ◽

2020 ◽

Vol 20 (9) ◽

pp. 782-791 ◽

Cited By ~ 3

Author(s):

Valérie Zufferey ◽

Armin von Gunten ◽

Ferath Kherif

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Psychiatric Symptoms ◽

Phenotypic Diversity ◽

Early Stage ◽

Cognitive Disorders ◽

Disease Stage ◽

Disease Manifestation ◽

Other Information ◽

Early Disease Stage

The multifaceted nature of Alzheimer’s disease (AD) and Mild cognitive impairment (MCI) can lead to wide inter-individual differences in disease manifestation in terms of brain pathology and cognition. The lack of understanding of phenotypic diversity in AD arises from a difficulty in understanding the integration of different levels of network organization (i.e. genes, neurons, synapses, anatomical regions, functions) and in inclusion of other information such as neuropsychiatric characteristics, personal history, information regarding general health or subjective cognitive complaints in a coherent model. Non-cognitive factors, such as personality traits and behavioral and psychiatric symptoms, can be informative markers of early disease stage. It is known that personality can affect cognition and behavioral symptoms. The aim of the paper is to review the different types of interactions existing between personality, depression/anxiety, and cognition and cognitive disorders at behavioral and brain/genetic levels.

Download Full-text

Fluid Biomarkers for Synaptic Dysfunction and Loss

Biomarker Insights ◽

10.1177/1177271920950319 ◽

2020 ◽

Vol 15 ◽

pp. 117727192095031

Author(s):

Elena Camporesi ◽

Johanna Nilsson ◽

Ann Brinkmalm ◽

Bruno Becker ◽

Nicholas J Ashton ◽

...

Keyword(s):

Neurodegenerative Disorders ◽

Early Stage ◽

Cognitive Disorders ◽

Synaptic Proteins ◽

Synaptic Dysfunction ◽

Csf Biomarkers ◽

Area Of Interest ◽

Synaptic Degeneration ◽

Synaptic Pathology ◽

Specific Disorders

Synapses are the site for brain communication where information is transmitted between neurons and stored for memory formation. Synaptic degeneration is a global and early pathogenic event in neurodegenerative disorders with reduced levels of pre- and postsynaptic proteins being recognized as a core feature of Alzheimer’s disease (AD) pathophysiology. Together with AD, other neurodegenerative and neurodevelopmental disorders show altered synaptic homeostasis as an important pathogenic event, and due to that, they are commonly referred to as synaptopathies. The exact mechanisms of synapse dysfunction in the different diseases are not well understood and their study would help understanding the pathogenic role of synaptic degeneration, as well as differences and commonalities among them and highlight candidate synaptic biomarkers for specific disorders. The assessment of synaptic proteins in cerebrospinal fluid (CSF), which can reflect synaptic dysfunction in patients with cognitive disorders, is a keen area of interest. Substantial research efforts are now directed toward the investigation of CSF synaptic pathology to improve the diagnosis of neurodegenerative disorders at an early stage as well as to monitor clinical progression. In this review, we will first summarize the pathological events that lead to synapse loss and then discuss the available data on established (eg, neurogranin, SNAP-25, synaptotagmin-1, GAP-43, and α-syn) and emerging (eg, synaptic vesicle glycoprotein 2A and neuronal pentraxins) CSF biomarkers for synapse dysfunction, while highlighting possible utilities, disease specificity, and technical challenges for their detection.

Download Full-text

Retinal Levels of Amyloid Beta Correlate with Cerebral Levels of Amyloid Beta in Young APPswe/PS1dE9 Transgenic Mice before Onset of Alzheimer’s Disease

Behavioural Neurology ◽

10.1155/2020/1574816 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Xi Mei ◽

Mengxiang Yang ◽

Lina Zhu ◽

Qi Zhou ◽

Xingxing Li ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Transgenic Mice ◽

Amyloid Beta ◽

Early Stage ◽

Degenerative Change ◽

Cognitive Disorders ◽

Inhibitory Effect ◽

Early Age ◽

Wild Type

Objectives. Retina abnormalities are related to cognitive disorders in patients with Alzheimer’s disease (AD). Retinal amyloid beta (Aβ) can be labeled by curcumin. We measured Aβ content in the cerebrum and retina of APPswe/PS1dE9 (APP) transgenic mice with early age to investigate the correlation between cerebrum and retina. Methods. APP mice and age-matched wild-type mice were investigated every month from age 2 months to 6 months to assess changes in Aβ content in the retina and cerebrum. At the beginning of each month, mice were fed a curcumin diet (50 mg/kg/day) for 7 consecutive days. The Aβ levels in the retina and cerebrum were measured by ELISAs. Correlations were identified between retinal and cerebral Aβ contents using Pearson’s correlation. Results. In the absence of curcumin, there was a significant correlation between Aβ contents in the retina and cerebrum of APP mice (r=0.7291, P=0.0014). With increasing age, Aβ-mediated degenerative change in the cerebrum (P<0.001 in 5 months) and retina (P<0.01 in 5 months) increased significantly. The inhibitory effect of curcumin on the Aβ level was significant in the cerebrum (P<0.001) and retina (P<0.01) of older APP mice in the early stage of life. Conclusion. We observed a significant correlation between the Aβ content in the retina and Aβ content in the cerebrum of APP mice. Our data suggest an appropriate time to measure retinal Aβ. Although curcumin can label Aβ in the retina, it also suppresses Aβ levels and weakens the degree of correlation between Aβ in cerebrum and retina tissues.

Download Full-text

The Use and Impact of Cognitive Enhancers among University Students: A Systematic Review

Brain Sciences ◽

10.3390/brainsci11030355 ◽

2021 ◽

Vol 11 (3) ◽

pp. 355

Author(s):

Safia Sharif ◽

Amira Guirguis ◽

Suzanne Fergus ◽

Fabrizio Schifano

Keyword(s):

Systematic Review ◽

University Students ◽

Early Stage ◽

Cognitive Disorders ◽

Neurological Complications ◽

Cognitive Enhancers ◽

Salt Mixtures ◽

Meta Analyses ◽

Medical Indications ◽

The Impact

Introduction: Cognitive enhancers (CEs), also known as “smart drugs”, “study aids” or “nootropics” are a cause of concern. Recent research studies investigated the use of CEs being taken as study aids by university students. This manuscript provides an overview of popular CEs, focusing on a range of drugs/substances (e.g., prescription CEs including amphetamine salt mixtures, methylphenidate, modafinil and piracetam; and non-prescription CEs including caffeine, cobalamin (vitamin B12), guarana, pyridoxine (vitamin B6) and vinpocetine) that have emerged as being misused. The diverted non-prescription use of these molecules and the related potential for dependence and/or addiction is being reported. It has been demonstrated that healthy students (i.e., those without any diagnosed mental disorders) are increasingly using drugs such as methylphenidate, a mixture of dextroamphetamine/amphetamine, and modafinil, for the purpose of increasing their alertness, concentration or memory. Aim: To investigate the level of knowledge, perception and impact of the use of a range of CEs within Higher Education Institutions. Methodology: A systematic review was conducted in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Whilst 1400 studies were identified within this study through a variety of electronic databases (e.g., 520 through PubMed, 490 through Science Direct and 390 through Scopus), 48 papers were deemed relevant and were included in this review. Results: The most popular molecules identified here included the stimulant CEs, e.g., methylphenidate, modafinil, amphetamine salt mixtures and caffeine-related compounds; stimulant CEs’ intake was more prevalent among males than females; drugs were largely obtained from friends and family, as well as via the Internet. It is therefore suggested that CEs are increasingly being used among healthy individuals, mainly students without any diagnosed cognitive disorders, to increase their alertness, concentration, or memory, in the belief that these CEs will improve their performance during examinations or when studying. The impact of stimulant CEs may include tolerance, dependence and/or somatic (e.g., cardiovascular; neurological) complications. Discussion: The availability of CEs for non-medical indications in different countries is influenced by a range of factors including legal, social and ethical factors. Considering the risk factors and motivations that encourage university students to use CE drugs, it is essential to raise awareness about CE-related harms, counteract myths regarding “safe” CE use and address cognitive enhancement in an early stage during education as a preventative public health measure.

Download Full-text

Fundamental motion outcomes - Steps / Strides

10.7287/peerj.preprints.1070v1 ◽

2015 ◽

Author(s):

Reto W. Kressig

Keyword(s):

Early Stage ◽

Cognitive Disorders ◽

Clinical Intervention ◽

The Elderly ◽

Exercise Programme ◽

Adherence Rate ◽

Dual Tasking ◽

High Adherence ◽

Close Relationship ◽

Intervention Trials

We describe the close relationship between stride, cadence and velocity, as fundamental motion outcomes, in particular for the elderly. Stride (Length, Time, CoV) is a meaningful mobility outcome for clinical intervention trials. Stride variability while motor-cognitive dual-tasking is a sensitive mobility outcome for fall risk and cognitive disorders (e.g. Alzheimer’s disease) at an early stage. Salsa proved to be a safe and feasible exercise programme for older adults accompanied with a high adherence rate

Download Full-text