Olfactory impairment in mild cognitive impairment with Lewy bodies and Alzheimer’s disease

2021 ◽  
pp. 1-8
Author(s):  
Alan J. Thomas ◽  
Calum A. Hamilton ◽  
Sally Barker ◽  
Rory Durcan ◽  
Sarah Lawley ◽  
...  

ABSTRACT Objectives: Impaired olfaction may be a biomarker for early Lewy body disease, but its value in mild cognitive impairment with Lewy bodies (MCI-LB) is unknown. We compared olfaction in MCI-LB with MCI due to Alzheimer’s disease (MCI-AD) and healthy older adults. We hypothesized that olfactory function would be worse in probable MCI-LB than in both MCI-AD and healthy comparison subjects (HC). Design: Cross-sectional study assessing olfaction using Sniffin’ Sticks 16 (SS-16) in MCI-LB, MCI-AD, and HC with longitudinal follow-up. Differences were adjusted for age, and receiver operating characteristic (ROC) curves were used for discriminating MCI-LB from MCI-AD and HC. Setting: Participants were recruited from Memory Services in the North East of England. Participants: Thirty-eight probable MCI-LB, 33 MCI-AD, 19 possible MCI-LB, and 32HC. Measurements: Olfaction was assessed using SS-16 and a questionnaire. Results: Participants with probable MCI-LB had worse olfaction than both MCI-AD (age-adjusted mean difference (B) = 2.05, 95% CI: 0.62–3.49, p = 0.005) and HC (B = 3.96, 95% CI: 2.51–5.40, p < 0.001). The previously identified cutoff score for the SS-16 of ≤ 10 had 84% sensitivity for probable MCI-LB (95% CI: 69–94%), but 30% specificity versus MCI-AD. ROC analysis found a lower cutoff of ≤ 7 was better (63% sensitivity for MCI-LB, with 73% specificity vs MCI-AD and 97% vs HC). Asking about olfactory impairments was not useful in identifying them. Conclusions: MCI-LB had worse olfaction than MCI-AD and normal aging. A lower cutoff score of ≤ 7 is required when using SS-16 in such patients. Olfactory testing may have value in identifying early LB disease in memory services.

2009 ◽  
Vol 5 (4S_Part_13) ◽  
pp. P383-P383
Author(s):  
Simon Forstmeier ◽  
Michael Wagner ◽  
Wolfgang Maier ◽  
Hendrik Van Den Bussche ◽  
Birgitt Wiese ◽  
...  

2020 ◽  
Vol 77 (2) ◽  
pp. 843-853
Author(s):  
Antoine R. Trammell ◽  
Darius J. McDaniel ◽  
Malik Obideen ◽  
Maureen Okafor ◽  
Tiffany L. Thomas ◽  
...  

Background: African Americans (AA) have a higher Alzheimer’s disease (AD) prevalence and report more perceived stress than White Americans. The biological basis of the stress-AD link is unclear. This study investigates the connection between stress and AD biomarkers in a biracial cohort. Objective: Establish biomarker evidence for the observed association between stress and AD, especially in AA. Methods: A cross-sectional study (n = 364, 41.8% AA) administering cognitive tests and the perceived stress scale (PSS) questionnaire. A subset (n = 309) provided cerebrospinal fluid for measurement of Aβ42, Tau, Ptau, Tau/Aβ42 (TAR), and Ptau/Aβ42 (PTAR). Multivariate linear regression, including factors that confound racial differences in AD, was performed. Results: Higher PSS scores were associated with higher Ptau (β= 0.43, p = 0.01) and PTAR (β= 0.005, p = 0.03) in AA with impaired cognition (mild cognitive impairment). Conclusion: Higher PSS scores were associated with Tau-related AD biomarker indices in AA/MCI, suggesting a potential biological connection for stress with AD and its racial disparity.


2020 ◽  
Vol 131 ◽  
pp. 110816 ◽  
Author(s):  
Felipe de Oliveira Silva ◽  
José Vinícius Ferreira ◽  
Jéssica Plácido ◽  
Daniel Chagas ◽  
Jomilto Praxedes ◽  
...  

2009 ◽  
Vol 15 (1) ◽  
pp. 154-159 ◽  
Author(s):  
ALBERTO BLANCO-CAMPAL ◽  
ROBERT F. COEN ◽  
BRIAN A. LAWLOR ◽  
JOSEPH B. WALSH ◽  
TERESA E. BURKE

AbstractWe investigated the relative discriminatory efficacy of an event-based prospective memory (PM) task, in which specificity of the instructions and perceptual salience of the PM cue were manipulated, compared with two widely used retrospective memory (RM) tests (Rivermead Paragraph Recall Test and CERAD-Word List Test), when detecting mild cognitive impairment of suspected Alzheimer’s disease etiology (MCI-AD) (N = 19) from normal controls (NC) (N = 21). Statistical analyses showed high discriminatory capacity of the PM task for detecting MCI-AD. The Non-Specific-Non-Salient condition proved particularly useful in detecting MCI-AD, possibly reflecting the difficulty of the task, requiring more strategic attentional resources to monitor for the PM cue. With a cutoff score of <4/10, the Non-Specific-Non-Salient condition achieved a sensitivity = 84%, and a specificity = 95%, superior to the most discriminative RM test used (CERAD-Total Learning: sensitivity = 83%; specificity = 76%). Results suggest that PM is an early sign of memory failure in MCI-AD and may be a more pronounced deficit than retrospective failure, probably reflecting the greater self-initiated retrieval demands involved in the PM task used. Limitations include the relatively small sample size, and the use of a convenience sample (i.e. memory clinic attenders and healthy active volunteers), reducing the generalizability of the results, which should be regarded as preliminary. (JINS, 2009, 15, 154–159.)


2017 ◽  
Vol 30 (1) ◽  
pp. 103-113 ◽  
Author(s):  
N. Siafarikas ◽  
G. Selbaek ◽  
T. Fladby ◽  
J. Šaltytė Benth ◽  
E. Auning ◽  
...  

ABSTRACTBackground:Neuropsychiatric symptoms (NPS), such as depression, apathy, agitation, and psychotic symptoms are common in mild cognitive impairment (MCI) and dementia in Alzheimer's disease (AD). Subgroups of NPS have been reported. Yet the relationship of NPS and their subgroups to different stages of cognitive impairment is unclear. Most previous studies are based on small sample sizes and show conflicting results. We sought to examine the frequency of NPS and their subgroups in MCI and different stages of dementia in AD.Methods:This was a cross-sectional study using data from a Norwegian national registry of memory clinics. From a total sample of 4,571 patients, we included those with MCI or AD (MCI 817, mild AD 883, moderate–severe AD 441). To compare variables across groups ANOVA or χ2-test was applied. We used factor analysis of Neuropsychiatric Inventory Questionnaire (NPI-Q) items to identify subgroups of NPS.Results:The frequency of any NPS was 87.2% (AD 91.2%, MCI 79.5%; p < 0.001) and increased with increasing severity of cognitive decline. The most frequent NPS in MCI was depression. Apathy was the most frequent NPS in AD across different stages of severity. The factor analysis identified three subgroups in MCI and mild AD, and a fourth one in moderate–severe AD. We labelled the subgroups “depression,” “agitation,” “psychosis,” and “elation.”Conclusions:The frequency of NPS is high in MCI and AD and increases with the severity of cognitive decline. The subgroups of NPS were relatively consistent from MCI to moderate-severe AD. The subgroup elation appeared only in moderate-severe AD.


2020 ◽  
Author(s):  
Szabolcs Garbóczy ◽  
Éva Magócs ◽  
Gergő Szőllősi ◽  
Szilvia Harsányi ◽  
Égerházi Anikó ◽  
...  

Abstract BACKGROUND Alzheimer's Disease (AD) is a growing disease process with aging. If we could recognize the disease at an early stage and increase the number of years spent in a better condition through preventive and treatment measures, we could reduce the pressure both directly on families and indirectly on society. There is a need for testing methods that are easy to perform even in general practitioner’s office, inexpensive and non-invasive, which could help early recognition of mental decline. We have selected Test Your Memory (TYM), which has proven to be reliable for detecting AD and mild cognitive impairment (MCI) in several countries. Our study was designed to test the usability of the TYM-HUN comparing with the ADAS-Cog (Alzheimer's Disease Assessment Scale-Cognitive Subscale) in MCI recognition in the Hungarian population. METHODS TYM test was translated and validated into Hungarian (TYM-HUN). The TYM-HUN test was used in conjunction with and compared with the Mini-Mental State Examination (MMSE) and the ADAS-Cog. For our study, 50 subjects were selected, 25 MCI patients and 25 healthy controls. Spearman’s rank correlation was used to analyze the correlation between the scores of MMSE and ADAS-Cog with TYM-HUN. RESULTS MCI can be distinguished from AD and normal aging using ADAS-Cog and MMSE is a useful tool to detect dementia. We established a 'cut-off' point of TYM-HUN (44/45points) where optimal sensitivity and specificity values were obtained to screen MCI. The total TYM-HUN scores significantly correlated with the MMSE scores (ρ=0.626; p<0.001) and ADAS-Cog scores (ρ=-0.723; p<0.001). CONCLUSIONS Our results showed that the Hungarian version of TYM (TYM-HUN) is an easy, fast, self-administered questionnaire with the right low threshold regarding MCI and can be used for the early diagnosis of cognitive impairment.


2020 ◽  
Author(s):  
Szabolcs Garbóczy ◽  
Éva Magócs ◽  
Gergő Szőllősi ◽  
Szilvia Harsányi ◽  
Égerházi Anikó ◽  
...  

Abstract BACKGROUND: Mild cognitive impairment (MCI) often presages the development of Alzheimer's disease (AD). Accurate and early identification of cognitive impairment will substantially reduce the burden on the family and alleviate the costs for the whole society. There is a need for testing methods that are easy to perform even in a general practitioner’s office, inexpensive and non-invasive, which could help the early recognition of mental decline. We have selected Test Your Memory (TYM), which has proven to be reliable for detecting AD and MCI in several countries. Our study was designed to test the usability of the TYM-HUN comparing with the Mini-Mental State Examination (MMSE) and the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) in MCI recognition in the Hungarian population.METHODS: TYM test was translated and validated into Hungarian (TYM-HUN) in a previous study. The TYM-HUN test was used in conjunction with and compared with the MMSE and the ADAS-Cog. For our study, 50 subjects were selected: 25 MCI patients and 25 healthy controls (HC). Spearman’s rank correlation was used to analyse the correlation between the scores of MMSE and ADAS-Cog with TYM-HUN.RESULTS: MCI can be distinguished from normal aging using TYM-HUN. We established a 'cut-off' point of TYM-HUN (44/45points) where optimal sensitivity (80%) and specificity (92%) values were obtained to screen MCI. The total TYM-HUN scores significantly correlated with the MMSE scores (ρ=0.626; p<0.001) and ADAS-Cog scores (ρ=-0.723; p<0.001).CONCLUSIONS: Our results showed that the Hungarian version of TYM (TYM-HUN) is a reliable, fast, self-administered questionnaire with the right low threshold regarding MCI and can be used for the early diagnosis of cognitive impairment.


Author(s):  
Joanna Ciafone ◽  
Alan Thomas ◽  
Rory Durcan ◽  
Paul C Donaghy ◽  
Calum A Hamilton ◽  
...  

Abstract Objective: The present study aimed to clarify the neuropsychological profile of the emergent diagnostic category of Mild Cognitive Impairment with Lewy bodies (MCI-LB) and determine whether domain-specific impairments such as in memory were related to deficits in domain-general cognitive processes (executive function or processing speed). Method: Patients (n = 83) and healthy age- and sex-matched controls (n = 34) underwent clinical and imaging assessments. Probable MCI-LB (n = 44) and MCI-Alzheimer’s disease (AD) (n = 39) were diagnosed following National Institute on Aging-Alzheimer’s Association (NIA-AA) and dementia with Lewy bodies (DLB) consortium criteria. Neuropsychological measures included cognitive and psychomotor speed, executive function, working memory, and verbal and visuospatial recall. Results: MCI-LB scored significantly lower than MCI-AD on processing speed [Trail Making Test B: p = .03, g = .45; Digit Symbol Substitution Test (DSST): p = .04, g = .47; DSST Error Check: p < .001, g = .68] and executive function [Trail Making Test Ratio (A/B): p = .04, g = .52] tasks. MCI-AD performed worse than MCI-LB on memory tasks, specifically visuospatial (Modified Taylor Complex Figure: p = .01, g = .46) and verbal (Rey Auditory Verbal Learning Test: p = .04, g = .42) delayed recall measures. Stepwise discriminant analysis correctly classified the subtype in 65.1% of MCI patients (72.7% specificity, 56.4% sensitivity). Processing speed accounted for more group-associated variance in visuospatial and verbal memory in both MCI subtypes than executive function, while no significant relationships between measures were observed in controls (all ps > .05) Conclusions: MCI-LB was characterized by executive dysfunction and slowed processing speed but did not show the visuospatial dysfunction expected, while MCI-AD displayed an amnestic profile. However, there was considerable neuropsychological profile overlap and processing speed mediated performance in both MCI subtypes.


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