scholarly journals Screening properties of the German IQCODE with a two-year time frame in MCI and early Alzheimer's disease

2009 ◽  
Vol 22 (1) ◽  
pp. 91-100 ◽  
Author(s):  
Michael M. Ehrensperger ◽  
Manfred Berres ◽  
Kirsten I. Taylor ◽  
Andreas U. Monsch
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Patient Group ◽  
Binary Logistic Regression ◽  
The Elderly ◽  
Time Frame ◽  
Receiver Operating Characteristic Curves ◽  
The Mean ◽  
Early Alzheimer’S Disease ◽  
State Examination

ABSTRACTBackground: The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) is a widely used screening tool for dementia. We aimed to determine the ability of the German version of the 16-item IQCODE with a two-year time frame to discriminate healthy mature control participants (NC) from mild cognitive impairment (MCI) and probable early Alzheimer's disease (AD) patients (all with Mini-mental State Examination (MMSE) scores ≥ 24/30) and to optimize diagnostic discriminability by shortening the IQCODE.Methods: 453 NC (49.7% women, age = 69.5 years ± 8.2, education = 12.2 ± 2.9), 172 MCI patients (41.9% women, age = 71.5 years ± 8.8, education = 12.3 ± 3.1) and 208 AD patients (59.1% women, age = 76.0 years ± 6.4, education = 11.4 ± 2.9) participated. Stepwise binary logistic regression analyses (LR) were used to shorten the test. Receiver operating characteristic curves (ROC) determined sensitivities, specificities, and correct classification rates (CCRs) for (a) NC vs. all patients; (b) NC vs. MCI; and (c) NC vs. AD patients.Results: The mean IQCODE was 3.00 for NC, 3.35 for MCI, and 3.73 for AD. CCRs were 85.5% (NC-patient group), 79.9% (NC-MCI), and 90.7% (NC-AD), respectively. The diagnostic discriminability of the shortened 7-item IQCODE (i.e. items 1, 2, 3, 5, 7, 10, 14) was comparable with the longer version (i.e. 7-item CCRs: NC-patient group: 85.3%; NC-MCI: 80.1%, NC-AD: 90.5%).Conclusions: The German 16-item IQCODE with two-year time frame showed excellent screening properties for MCI and early AD patients. An abbreviated 7-item version demonstrated equally high diagnostic discriminability, thus allowing for more economical screening.

scholarly journals Probiotic Supplementation in Patients with Alzheimer’s Dementia - An Explorative Intervention Study

2018 ◽  
Vol 15 (12) ◽  
pp. 1106-1113 ◽  
Author(s):  
Friedrich Leblhuber ◽  
Kostja Steiner ◽  
Burkhard Schuetz ◽  
Dietmar Fuchs ◽  
Johanna M. Gostner
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Immune Activation ◽  
Mini Mental State Examination ◽  
The Elderly ◽  
Probiotic Supplementation ◽  
Gut Inflammation ◽  
Before And After ◽  
The Mean ◽  
State Examination

Background: Dysbiosis of intestinal microbiota in the elderly can cause a leaky gut, which may result in silent systemic inflammation and promote neuroinflammation - a relevant pathomechanism in the early course of Alzheimer’s disease. Objective: The rebalancing of the microbiome could benefically impact on gut inflammation and immune activation. Methods: In this study, routine laboratory tests in twenty outpatients (9 females, 11 males, aged 76.7 ± 9.6 years) with Alzheimer’s disease were investigated. The mean Mini Mental State Examination score was 18.5 ± 7.7. Biomarkers of immune activation – serum neopterin and tryptophan breakdown - as well as gut inflammation markers and microbiota composition in fecal specimens were analyzed in 18 patients before and after probiotic supplementation for 4 weeks. Results: After treatment a decline of fecal zonulin concentrations and an increase in Faecalibacterium prausnitzii compared to baseline were observed. At the same time, serum kynurenine concentrations increased (p <0.05). Delta values (before - after) of neopterin and the kynurenine to tryptophan ratios (Kyn/Trp) correlated significantly (p <0.05). Conclusion: Results show that the supplementation of Alzheimer’s disease patients with a multispecies probiotic influences gut bacteria composition as well as tryptophan metabolism in serum. The correlation between Kyn/Trp and neopterin concentrations points to the activation of macrophages and/or dendritic cells. Further studies are warranted to dissect the potential consequences of Probiotic supplementation in the course of Alzheimer’s disease.

Hasegawa Dementia Scale - Revised, for screening of early Alzheimer's disease in the elderly with type 2 diabetes

2009 ◽  
Vol 9 (2) ◽  
pp. 213-215 ◽  
Author(s):  
Runa Tsukamoto ◽  
Taichi Akisaki ◽  
Masako Kuranaga ◽  
Toshihiro Takata ◽  
Koichi Yokono ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Type 2 Diabetes ◽  
Alzheimer's Disease ◽  
The Elderly ◽  
Early Alzheimer’S Disease

Validation of a French Version of an Informant-Based Questionnaire as a Screening Test for Alzheimer's Disease

1995 ◽  
Vol 167 (4) ◽  
pp. 541-544 ◽  
Author(s):  
Samuel Law ◽  
Christina Wolfson
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Mental State ◽  
Screening Test ◽  
Reliability And Validity ◽  
The Elderly ◽  
Screening Tests ◽  
French Version ◽  
The Mean ◽  
Elderly Living

BackgroundDevelopment of informant-based screening tests for dementia is an emerging field. The reliability and validity of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), an instrument that screens for dementia in general, have been established. We conducted a study to validate a French version of the IQCODE as a screening test for Alzheimer's dementia in the elderly living in the community.MethodIn the Canadian Study of Health and Aging, subjects were screened in their own homes using the Modified Mini-Mental State Exam (3-MS). Those who screened positive, along with a sample of subjects who screened negative, were referred for a complete clinical examination. In Quebec, an informant was asked to complete the French version, IQCODE (F), at that time. Based on the final clinical diagnoses, performances of the IQCODE (F) and Mini-Mental State Examination (MMSE, converted from 3-MS) in screening for Alzheimer's disease were evaluated.ResultsOf the 237 subjects, the mean IQCODE (F) score was 3.4 (s.d. = 0.6), on a 5-point scale (1 = improvement in condition over the past 10 years, 5 = marked deterioration, 3 = no change). The mean MMSE score was 23.1 (s.d. = 4.5). The scores on the two scales were correlated (r = –0.44, P < 0.001). The IQCODE (F) scores were unrelated to education (r = –0.07, P > 0.3) in contrast to the MMSE scores (r = 0.28, P < 0.001). With respect to a diagnosis of probable Alzheimer's disease, the IQCODE (F) (cut-off point 3.6) had a sensitivity of 75% and a specificity of 95.6%. The sensitivity and specificity of the MMSE (cut-off point 23) were 70% and 82.3% respectively.ConclusionThe findings of the IQCODE (F) are consistent with those of the English version in correlation with the MMSE and apparent freedom from educational bias. The IQCODE is superior to the MMSE as a screening test for probable Alzheimer's disease in the elderly living in the community. It may be a useful addition to the screening tests already available, especially for the less well educated.

The Mini-Mental State Examination: Czech Norms and Cutoffs for Mild Dementia and Mild Cognitive Impairment due to Alzheimer's Disease

2016 ◽  
Vol 42 (1-2) ◽  
pp. 50-57 ◽  
Author(s):  
Ales Bartos ◽  
Miloslava Raisova
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Mild Dementia ◽  
Dementia Patients ◽  
Early Alzheimer’S Disease ◽  
State Examination

Background: There is a lack of normative studies of the Mini-Mental State Examination (MMSE) for comparison with early Alzheimer's disease (AD) according to new diagnostic criteria. Participants and Methods: We administered the MMSE to normal elderly Czechs and to patients with mild cognitive impairment (MCI) and mild dementia due to AD according to NIA-AA criteria. Results: We established percentile- and standard deviation-based norms for the MMSE from 650 normal seniors (age 69 ± 8 years, education 14 ± 3 years, MMSE score 28 ± 2 points) stratified by education and age. Dementia patients scored significantly lower than the MCI patients and both groups (110 early AD patients) had significantly lower MMSE scores than the normal seniors (22 ± 5 or 25 ± 3 vs. 28 ± 2 points) (p < 0.01). The optimal cutoff was ≤27 points with sensitivity of 86% and specificity of 79% for early detection of AD patients. Conclusion: We provided MMSE norms, several cutoffs, and higher cutoff scores for early AD using recent guidelines.

Drinking Behavior and Vasopressin Responses to Hyperosmolality in Alzheimer's Disease

1994 ◽  
Vol 6 (1) ◽  
pp. 79-86 ◽  
Author(s):  
Stewart G. Albert ◽  
B. R. S. Nakra ◽  
George T. Grossberg ◽  
Eduardo R. Caminal
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Water Intake ◽  
Drinking Behavior ◽  
The Elderly ◽  
Serum Osmolality ◽  
Control Group ◽  
Fluid Restriction ◽  
Global Deterioration Scale ◽  
State Examination

Individuals with Alzheimer's disease (AD) have been shown to have abnormalities in response to fluid restriction. Twelve subjects with AD and ten elderly controls underwent overnight fluid restriction followed by measurement of plasma and urine vasopressin and serum osmolality. Estimates of “thirst” were determined after one hour of ad libitum water intake. All subjects were tested with a Mini-Mental State Examination (MMSE) and Global Deterioration Scale (GDS). Individuals with AD had a greater degree of overnight dehydration than the elderly control group (serum osmolality 310 +/−1 vs. 305 +/−1 mosmol/kg, p = 0.02). There was no difference between the groups in the plasma or urinary levels of vasopressin. There was a direct correlation (r = 0.45, p = 0.03) of the amount of water intake as a measure of “thirst” with the MMSE score as a measure of cognitive functioning. Individuals with advanced cognitive impairment may be at risk of dehydration due to loss of protective “thirst” responses with secondary complications of dehydration.

scholarly journals Impact of the Severity of Alzheimer’s Disease on the Quality of Life, Activities of Daily Living, and Caregiving Costs for Institutionalized Patients on Anti-Alzheimer Medications in Japan

2021 ◽  
pp. 1-8
Author(s):  
Takumi Ashizawa ◽  
Ataru Igarashi ◽  
Yukinori Sakata ◽  
Mie Azuma ◽  
Kenichi Fujimoto ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
The Elderly ◽  
The Mean ◽  
Institutionalized Patients ◽  
The Impact

Background: Alzheimer’s disease (AD) increases societal costs and decreases the activities of daily living (ADL) and quality of life (QoL) of the affected individuals. Objective: We assess the impact of AD severity on ADL, QoL, and caregiving costs in Japanese facilities for the elderly. Methods: Patients with AD in facilities for the elderly were included (47 facilities, N = 3,461). The QoL, ADL, and disease severity of patients were assessed using Barthel Index (BI), EuroQoL-5D-5L (EQ-5D-5L), and Mini-Mental State Examination (MMSE), respectively. Annual caregiving costs were estimated using patients’ claims data. The patients were subcategorized into the following three groups according to the MMSE score: mild (21≤MMSE≤30), moderate (11≤MMSE≤20), and severe (0≤MMSE≤10). Changes among the three groups were evaluated using the Jonckheere-Terpstra test. Results: Four hundred and one participants were on anti-AD medicines, of whom 287 (age: 86.1±6.4 years, 76.7% women) in the mild (n = 53, 84.0±6.9 years, 71.7%), moderate (n = 118, 86.6±5.9 years, 76.3%), and severe (n = 116, 86.6±6.5 years, 79.3%) groups completed the study questionnaires. The mean BI and EQ-5D-5L scores for each group were 83.6, 65.1, and 32.8 and 0.801, 0.662, and 0.436, respectively. The mean annual caregiving costs were 2.111, 2.470, and 2.809 million JPY, respectively. As AD worsened, the BI and EQ-5D-5L scores decreased and annual caregiving costs increased significantly. Conclusion: AD severity has an impact on QoL, ADL, and caregiving costs.

Pharmacological Medical Treatment of Epilepsy in Patients with Dementia: A Systematic Review

2021 ◽  
Vol 18 ◽  
Author(s):  
Christian Sandøe Musaeus ◽  
Christer Nilsson ◽  
Chris Cooper ◽  
Milica G. Kramberger ◽  
Ana Verdelho ◽  
...  
Keyword(s):  
Systematic Review ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Elderly Population ◽  
Mini Mental State Examination ◽  
The Elderly ◽  
Current Systematic Review ◽  
Increased Risk ◽  
State Examination ◽  
Relevant Interaction

Background: Patients with dementia have an increased risk of developing epilepsy, es- pecially in patients with vascular dementia and Alzheimer’s disease. In selecting the optimal an- ti-epileptic drug (AED), the possible side effects such as drowsiness and worsening of cognitive function should be taken into consideration, together with co-morbidities and type of epilepsy. Objective: The current systematic review investigates the efficacy, tolerability, and changes in cog- nitive function after administration of AED in patients with dementia and epilepsy. Methods: We searched six databases, including MEDLINE and CENTRAL, checked reference lists, contacted experts, and searched Google Scholar to identify studies reporting randomized trials. Studies identified were independently screened, data extracted, and quality appraised by two researchers. A narrative synthesis was used to report findings. Results: We included one study with 95 patients with Alzheimer’s disease randomized to either lev- etiracetam, lamotrigine, or phenobarbital. No significant differences were found for efficacy, but patients receiving levetiracetam showed an improvement in mini-mental state examination scores and had fewer adverse events. Conclusion: High-quality evidence in the form of randomized controlled trials to guide clinicians in choosing an AED in patients with dementia and concomitant epilepsy remains scarce. However, levetiracetam has previously been shown to possibly improve cognition in patients with both mild cognitive impairment and Alzheimer’s disease, is better tolerated in the elderly population, and has no clinically relevant interaction with either cholinesterase inhibitors or NMDA receptor antagon- ists.

scholarly journals Analysis of Retinal Peripapillary Segmentation in Early Alzheimer’s Disease Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Elena Salobrar-Garcia ◽  
Irene Hoyas ◽  
Mercedes Leal ◽  
Rosa de Hoz ◽  
Blanca Rojas ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Mini Mental State Examination ◽  
Fiber Layer ◽  
Fiber Damage ◽  
Rnfl Thickness ◽  
Ganglion Cell Death ◽  
Early Alzheimer’S Disease ◽  
The Right ◽  
State Examination

Decreased thickness of the retinal nerve fiber layer (RNFL) may reflect retinal neuronal-ganglion cell death. A decrease in the RNFL has been demonstrated in Alzheimer’s disease (AD) in addition to aging by optical coherence tomography (OCT). Twenty-three mild-AD patients and 28 age-matched control subjects with mean Mini-Mental State Examination 23.3 and 28.2, respectively, with no ocular disease or systemic disorders affecting vision, were considered for study. OCT peripapillary and macular segmentation thickness were examined in the right eye of each patient. Compared to controls, eyes of patients with mild-AD patients showed no statistical difference in peripapillary RNFL thickness (P>0.05); however, sectors 2, 3, 4, 8, 9, and 11 of the papilla showed thinning, while in sectors 1, 5, 6, 7, and 10 there was thickening. Total macular volume and RNFL thickness of the fovea in all four inner quadrants and in the outer temporal quadrants proved to be significantly decreased (P<0.01). Despite the fact that peripapillary RNFL thickness did not statistically differ in comparison to control eyes, the increase in peripapillary thickness in our mild-AD patients could correspond to an early neurodegeneration stage and may entail the existence of an inflammatory process that could lead to progressive peripapillary fiber damage.

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