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

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.

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Apathy in Alzheimer's disease: Contribution to a clinical view on progression of dementia

Dementia & Neuropsychologia ◽

10.1590/s1980-57642010dn40300007 ◽

2010 ◽

Vol 4 (3) ◽

pp. 188-193 ◽

Cited By ~ 3

Author(s):

Florindo Stella ◽

Larissa Pires de Andrade ◽

Thays Martins Vital ◽

Flávia Gomes de Melo Coelho ◽

Carla Manuela Crispim Nascimento ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Mini Mental State Examination ◽

Cognitive Status ◽

Clinical Dementia Rating ◽

Global Deterioration Scale ◽

Severe Dementia ◽

Coefficient Corrélation ◽

The Relationship ◽

State Examination

Abstract In addition to cognitive impairment, apathy is increasingly recognized as an important neuropsychiatric syndrome in Alzheimer's disease (AD). Aims: To identify the relationship between dementia severity and apathy levels, and to discuss the association of this condition with other psychopathological manifestations in AD patients. Methods: This study involved 15 AD patients (mean age: 77 years; schooling: 4.9 years), with mild, moderate and severe dementia, living in Rio Claro SP, Brazil. Procedures included evaluation of cognitive status by the Mini-Mental State Examination, Clinical Dementia Rating, and Global Deterioration Scale. Apathy syndrome was assessed by the Apathy Evaluation Scale and Neuropsychiatric Inventory (NPI-apathy domain). Other psychopathological manifestations such as depression were also considered. Results: Patients with more severe dementia presented higher levels of apathy, reinforcing the hypothesis that apathy severity aggravates as the disease progresses. Using the Spearman coefficient correlation an association was identified between the MMSE and Apathy Evaluation Scale (r=0.63; p=0.01), and also between the MMSE and NPI-apathy domain (r=0.81; p=0.01). Associations were also found between the Global Deterioration Scale and Apathy Evaluation Scale (r=0.58; p=0.02), and between the Global Deterioration Scale and NPI-apathy domain (r=0.81; p=0.01). Conclusions: Apathy is a distinct syndrome among patients with AD and increases with global deterioration.

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The Clinical Analysis of Combined Effects of Huperzine A and Memantine for Alzheimer’s Disease

Early Detection and Rehabilitation Technologies for Dementia ◽

10.4018/978-1-60960-559-9.ch014 ◽

2011 ◽

pp. 112-116

Author(s):

Shouzi Zhang ◽

Qinyun Li ◽

Maolong Gao

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Treated Group ◽

Clinical Analysis ◽

Huperzine A ◽

Control Group ◽

Clinical Effects ◽

Activity Of Daily Living ◽

State Examination ◽

Target Activity

The purpose of this study was to evaluate the clinical effects of a combination of Huperzine A and memantine for the treatment of Alzheimer’s disease (AD). Sixty patients (aged 69 ± 4.5), treated in both outpatient and hospital settings, were divided into two groups, the treated group and the control group. Over 24 weeks of clinical therapy, 30 patients received treatment with Huperzine A (0.2 mg/d), and the other 30 patients received a combination of Huperzine A (0.2 mg/d) and memantine (20 mg/d). Mini-mental State Examination (MMSE) was taken as the main value target. Activity of Daily Living Scale (ADL) and Neuropsychiatric Inventory (NPI) were secondary targets. Results: After 24 weeks, the scores from the MMSE, ADL, and NPI of the treatment group were more improved than those of the control group (P=0.05). Combination treatment with Huperzine A and memantine will be more effective for treating AD than treatment with Huperzine A alone.

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Diagnosis of Preclinical Alzheimer's Disease in a Clinical Setting

International Psychogeriatrics ◽

10.1017/s1041610201007839 ◽

2001 ◽

Vol 13 (4) ◽

pp. 411-423 ◽

Cited By ~ 20

Author(s):

Pieter Jelle Visser ◽

Frans R. J. Verhey ◽

Rudolf W. H. M. Ponds ◽

Jellemer Jolles

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Clinical Setting ◽

Global Deterioration Scale ◽

Delayed Recall ◽

Clinical Criteria ◽

Preclinical Ad ◽

State Examination

Introduction. The aim of the study was to investigate whether the preclinical stage of Alzheimer's disease (AD) can be diagnosed in a clinical setting. To this end we investigated whether subjects with preclinical AD could be differentiated from subjects with nonprogressive mild cognitive impairment and from subjects with very mild AD-type dementia. Methods. Twenty-three subjects with preclinical AD, 44 subjects with nonprogressive mild cognitive impairment, and 25 subjects with very mild AD-type dementia were selected from a memory clinic population. Variables that were used to differentiate the groups were demographic variables, the Mini-Mental State Examination score, performance on cognitive tests, measures of functional impairment, and measures of noncognitive symptomatology. Results. Age and the scores for the delayed recall task could best discriminate between subjects with preclinical AD and subjects with nonprogressive mild cognitive impairment. The overall accuracy was 87% The score on the Global Deterioration Scale and a measure of intelligence could best discriminate between subjects with preclinical AD and subjects with very mild AD-type dementia. The overall accuracy was 85% Conclusions. Subjects with preclinical AD can be distinguished from subjects with nonprogressive mild cognitive impairment and from subjects with very mild AD-type dementia. This means that preclinical AD is a diagnostic entity for which clinical criteria should be developed.

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

International Psychogeriatrics ◽

10.1017/s1041610209990962 ◽

2009 ◽

Vol 22 (1) ◽

pp. 91-100 ◽

Cited By ~ 41

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.

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

Current Alzheimer Research ◽

10.2174/1567205018666211126121529 ◽

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.

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Identification of Serum Biomarkers in Patients with Alzheimer’s Disease by 2D-DIGE Proteomics

Gerontology ◽

10.1159/000520961 ◽

2022 ◽

pp. 1-13

Author(s):

Xuezhi Zhang ◽

Wenwen Yu ◽

Xuelei Cao ◽

Yongbin Wang ◽

Chao Zhu ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Western Blot ◽

Mini Mental State Examination ◽

Serum Biomarkers ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Strongly Correlated ◽

State Examination ◽

Normal Controls

Aim: The aim of this study is to identify potential serum biomarkers of Alzheimer’s disease (AD) for early diagnosis and to evaluate these markers on a large cohort. Methods: We performed two-dimensional difference gel electrophoresis to compare the serum of AD patients and normal controls. Western blot or enzyme-linked immunosorbent assay (ELISA) was used to identify the expression levels of proteins. Results: In this study, a total of 13 differentially expressed proteins were identified. Among them, 2 proteins (inter-alpha-trypsin inhibitor heavy chain H4 [ITI-H4], Apolipoprotein A-IV) were validated by Western blot and 4 proteins (Cofilin 2, Tetranectin, Zinc-alpha-2-glycoprotein [AZGP1], Alpha-1-microglobulin/bikunin precursor [AMBP]) were validated by ELISA, respectively. Western blot results showed that the full size of the ITI-H4 protein was increased, while a fragment of ITI-H4 was decreased in AD patients. In contrast, 1 fragment of Apo A-IV was mainly found in control group and rare to be detected in AD patients. On the other hand, ELISA results showed that Cofilin 2, Tetranectin, AZGP1, and AMBP were significantly increased in AD patients, and Cofilin 2 is strongly correlated with the Mini-Mental State Examination scores of the AD patients. Serum Cofilin 2 was unchanged in Parkinson disease patients as compared to the control group, indicating a specific correlation of serum Cofilin 2 with AD. Moreover, Cofilin 2 was increased in both the serum and brain tissue in the APP/PS1 transgenic mice. Conclusion: Our study identified several potential serum biomarkers of AD, including: ITI-H4, ApoA-IV, Cofilin 2, Tetranectin, AZGP1, and AMBP. Cofilin 2 was upregulated in different AD animal models and might play important roles in AD pathology.

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Reality orientation therapy combined with cholinesterase inhibitors in Alzheimer's disease: randomised controlled trial

The British Journal of Psychiatry ◽

10.1192/bjp.187.5.450 ◽

2005 ◽

Vol 187 (5) ◽

pp. 450-455 ◽

Cited By ~ 94

Author(s):

Graziano Onder ◽

Orazio Zanetti ◽

Ezio Giacobini ◽

Giovanni B. Frisoni ◽

Luisa Bartorelli ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Treatment Group ◽

Cholinesterase Inhibitors ◽

Controlled Trial ◽

Disease Assessment ◽

Control Group ◽

Randomised Controlled ◽

Reality Orientation ◽

State Examination

BackgroundReality orientation therapy combined with cholinesterase inhibitors has not been evaluated in patients with Alzheimer's disease.AimsTo perform such an evaluation.MethodWe randomly assigned 79 of 156 patients treated with donepezil to receive a reality orientation programme. Caregivers of the treatment group were trained to offer the programme at home 3 days a week, 30 min/day for 25 consecutive weeks, and were invited to stimulate and involve patients in reality-based communication.ResultsThe treatment group showed a slight improvement in Mini-Mental State Examination (MMSE) scores (mean change + 0.2, s.e. = 0.4) compared with a decline in the control group (mean change −1.1, s.e. =0.4; P=0.02). Similarly for the Alzheimer's Disease Assessment Scale – Cognition (treatment group mean change +0.4, s.e.=0.8; control group –2.5, s.e.=0.8; P = 0.01). The intervention had an equal effect on cognition in those with mild (MMSE score ⩾20) and moderate (score < 20) dementia. No significant effect was observed for behavioural and functional outcomes.ConclusionsReality orientation enhances the effects of donepezil on cognition in Alzheimer's disease.

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Quantitative electroencephalography power and coherence measurements in the diagnosis of mild and moderate Alzheimer's disease

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2011000300006 ◽

2011 ◽

Vol 69 (2b) ◽

pp. 297-303 ◽

Cited By ~ 12

Author(s):

L C Fonseca ◽

G M A S Tedrus ◽

L R Prandi ◽

A C A Andrade

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Deficit ◽

Mini Mental State Examination ◽

Control Group ◽

Quantitative Electroencephalography ◽

Absolute Power ◽

Multiple Regression Models ◽

State Examination ◽

Limited Accuracy

OBJECTIVE: To evaluate the contribution of quantitative electroencephalographic (qEEG) analyses in the diagnosis of Alzheimer's disease (AD). METHOD: Thirty-five patients from the Neurology Outpatients Clinic of PUC-Campinas, diagnosed with AD according to the NINCDS/ADRDA were evaluated, and compared with a control group consisting of 30 individuals with no cognitive deficit. The procedures consisted of clinical-neurological, cognitive and behavioral analyses and the qEEG (absolute power and coherence). RESULTS: The AD group presented greater absolute power values in the delta and theta bands, greater theta/alpha indices and less frontal alpha and beta coherence. Logistic multiple regression models were constructed and those only showing variations in the qEEG (frontal alpha coherence and left frontal absolute theta power) showed an accuracy classification (72.3%) below that obtained in the mini-mental state examination (93%). CONCLUSION: The study of coherence and power in the qEEG showed a relatively limited accuracy with respect to its application in routine clinical practice.

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Positive effect of timed blue-enriched white light on sleep and cognition in patients with mild and moderate Alzheimer’s disease

Scientific Reports ◽

10.1038/s41598-021-89521-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Seong Jae Kim ◽

Sun Hee Lee ◽

In Bum Suh ◽

Jae-Won Jang ◽

Jin Hyeong Jhoo ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Sleep Time ◽

Control Group ◽

Dim Light ◽

Sleep And Cognition ◽

And Behavior ◽

State Examination ◽

Positive Effect ◽

Dark Blue

AbstractConflicting results have been reported regarding the effectiveness of light treatment (LT) in patients with Alzheimer’s disease (AD). We investigated the effectiveness of blue-enriched white LT on sleep, cognition, mood and behavior in patients with mild and moderate AD. The treatment group (n = 14) sat about 60 cm away from a small (136 × 73 × 16 mm) LED light box for 1 h each morning for 2 weeks. The control group (n = 11) wore dark, blue-attenuating sunglasses during the 1 h exposures. The morning light started 9–10 h after each individual’s dim light melatonin onset (DLMO). Assessments were done at baseline (T0), immediate post-treatment (T1), and 4 weeks after the end of the 2 weeks of LT (T2). Sleep was measured by actigraphy. Blue-enriched LT had a significantly better effect on the Pittsburgh Sleep Quality Index at T2 compared to blue-attenuated LT, and a trend of better effectiveness on total sleep time at T2. There was a significant increase in Mini-Mental State Examination score at T2 after blue-enriched LT than that at T0. Our findings suggest that morning blue-enriched LT has a benefit in improving sleep and cognitive function in AD patients.

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Effects of Dog-Assisted Therapies on Cognitive Mnemonic Capabilities in People Affected by Alzheimer’s Disease

Animals ◽

10.3390/ani11051366 ◽

2021 ◽

Vol 11 (5) ◽

pp. 1366

Author(s):

Fausto Quintavalla ◽

Simona Cao ◽

Diana Spinelli ◽

Paolo Caffarra ◽

Fiammetta M. Rossi ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Social Relations ◽

Companion Animals ◽

Disease Assessment ◽

Control Group ◽

Assessment Tests ◽

Brief Assessment ◽

The Relationship ◽

State Examination

Alzheimer’s disease (AD) is the most common cause of dementia in humans and, currently, a valid treatment is lacking. Our goal is to demonstrate the importance and benefits of the relationship with companion animals (considered as co-therapists), intended as a means of facilitating social relations and promoting evident wellbeing in AD patients. The study involved 30 randomly chosen patients with Alzheimer’s disease (group T) and three dogs. The group participated in a total of 24 animal-assisted interventions (AAIs) sessions over a span of 12 weeks, using the Mini-Mental State Examination (MMSE), Wellness and Cognitive Ability Questionnaire (Brief Assessment Cognition or BAC), and Alzheimer’s Disease Assessment Scale (ADAS) as assessment tests. A second group (group C), consisting of 10 people with AD, was enrolled as control group and underwent the same assessment tests but did not benefit from the presence of the dogs. Tests were carried out at time T0 (before starting sessions), T1 (end of sessions), and T2 (two months after last session). People belonging to group T achieved an overall improvement in their perceived state of wellbeing, even on a cognitive and mnemonic plane. However, two months after the end of the sessions, the test results in people suffering from AD decreased towards the baseline (T0). The study shows how such progress can be achieved through activities based on the relationship with an animal, as long as the animal is a steady presence in the life of the patient receiving the intervention. Dogs involved in other dog-assisted therapies have been found suitable also for assisting patients with AD.

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