scholarly journals REACTIONS TO AMYLOID PET SCAN RESULTS AND LEVELS OF ANXIETY AND DEPRESSION AMONG CARE PARTNERS: CARE IDEAS STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S136-S136
Author(s):  
Emmanuelle Belanger ◽  
Jessica D’Silva ◽  
Courtney H Van Houtven ◽  
Megan Shepherd-Banigan ◽  
Valerie Smith ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mild Cognitive Impairment ◽  
Qualitative Content Analysis ◽  
Diagnostic Category ◽  
Pet Scan ◽  
Amyloid Pet ◽  
Loved One ◽  
Care Partners ◽  
Positive Scan

Abstract Few studies have examined caregiver reactions to their loved ones receiving the results of an Amyloid PET scan which can be indicative of Alzheimer’s disease. Therefore, we examine: 1) What are care partner’s reactions to their loved one receiving negative or positive amyloid PET scan results?, and 2) To what extent are scan results and diagnostic category (dementia vs. mild cognitive impairment) associated with care partner depressive symptoms (PHQ-2) and anxiety (STAI-6)? Using data from 1,799 care partners in the CARE IDEAS study, we applied a sequential mixed-methods design and explored the reactions of 192 care partners who answered open-ended interview questions after learning about the Amyloid PET scan results. We first conducted qualitative content analysis of transcripts from open-ended questions to explore caregivers’ emotional responses after their loved one received an Amyloid PET scan result. The qualitative data suggest that when the scan results fit care partner’s expectations, i.e. positive scan when the patient has dementia and negative scan when the patient has mild impairment, care partners report satisfaction with this information and relief, rather than shock and frustration. Adjusted logistic regression models of survey responses support this finding; having dementia and a positive scan both increased the likelihood of care partners having high levels of anxiety, and a significant interaction indicated that a positive scan was associated with high anxiety among care partners of patients with mild cognitive impairment but not dementia. Only lower education and higher impairment in everyday cognitive function were associated with high depressive symptoms.

scholarly journals Change in cognitive function according to cholinesterase inhibitor use and amyloid PET positivity in patients with mild cognitive impairment

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Jung-Min Pyun ◽  
Nayoung Ryoo ◽  
Young Ho Park ◽  
SangYun Kim
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Disease Progression ◽  
Cognitive Assessment ◽  
Mmse Score ◽  
Cognitive Change ◽  
Pet Scan ◽  
Amyloid Pet ◽  
Amyloid Burden

Abstract Background Cholinesterase inhibitors (ChEIs) are an FDA-approved symptomatic treatment for patients with Alzheimer’s disease (AD). Its efficacy in patients with mild cognitive impairment (MCI), however, is controversial. Nonetheless, ChEIs have often been used in patients with MCI. From the perspective that ChEIs were developed based on the pathomechanism of AD, the effect of ChEIs in MCI patients could be different depending on the amyloid burden. In this retrospective observational study, we aimed to investigate the influence of ChEIs and amyloid burden on cognitive change for 1 year in patients with MCI. Methods We included 111 patients with MCI with a Clinical Dementia Rating (CDR) score of 0.5, a 1-year follow-up cognitive assessment, and amyloid positron emission tomography (PET) performed within 6 months before or after the baseline cognitive assessment (73 ChEI users and 38 ChEI non-users) from the Neurocognitive Behavior Center of Seoul National University Bundang Hospital. Additionally, those who had a positive amyloid PET scan more than 6 months before the baseline cognitive assessment and those who had a negative amyloid PET scan more than 6 months after the 1-year follow-up cognitive assessment were also included. Among the total 111 patients, 25 ChEI users and 25 ChEI non-users were matched by baseline Mini-Mental State Examination (MMSE) score, age, educational level, CDR Sum of Boxes, and amyloid PET positivity using propensity score matching. Multiple linear regression analysis was performed to assess the influence of ChEI use and amyloid PET positivity on cognitive change for 1 year. Univariate and multivariate logistic regression analyses were performed to evaluate the association between ChEI use and disease progression to CDR 1 at the 1-year follow-up visit. Results ChEI use or non-use was not associated with cognitive change for 1 year. Amyloid PET positivity or negativity did not change this non-association. Furthermore, progression to CDR 1 was related to low baseline MMSE score (OR 0.606, CI 0.381–0.873), but not with ChEI use or non-use, and not with amyloid PET result. Conclusion ChEI use or non-use was not related to cognitive change at a 1-year follow-up visit in patients with or without amyloid burden. In addition, ChEI use or non-use could not predict disease progression to CDR 1 at 1-year follow-up visit.

Elucidating the risk factors for progression from amyloid-negative amnestic mild cognitive impairment to dementia

2020 ◽  
Vol 17 ◽  
Author(s):  
Hyung-Ji Kim ◽  
Jae-Hong Lee ◽  
E-nae Cheong ◽  
Sung-Eun Chung ◽  
Sungyang Jo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Amnestic Mild Cognitive Impairment ◽  
Amyloid Pet ◽  
Clinical Progression ◽  
Amnestic Mci

Background: Amyloid PET allows for the assessment of amyloid β status in the brain, distinguishing true Alzheimer’s disease from Alzheimer’s disease-mimicking conditions. Around 15–20% of patients with clinically probable Alzheimer’s disease have been found to have no significant Alzheimer’s pathology on amyloid PET. However, a limited number of studies had been conducted this subpopulation in terms of clinical progression. Objective: We investigated the risk factors that could affect the progression to dementia in patients with amyloid-negative amnestic mild cognitive impairment (MCI). Methods: This study was a single-institutional, retrospective cohort study of patients over the age of 50 with amyloidnegative amnestic MCI who visited the memory clinic of Asan Medical Center with a follow-up period of more than 36 months. All participants underwent brain magnetic resonance imaging (MRI), detailed neuropsychological testing, and fluorine-18[F18]-florbetaben amyloid PET. Results: During the follow-up period, 39 of 107 patients progressed to dementia from amnestic MCI. In comparison with the stationary group, the progressed group had a more severe impairment in verbal and visual episodic memory function and hippocampal atrophy, which showed an Alzheimer’s disease-like pattern despite the lack of evidence for significant Alzheimer’s disease pathology. Voxel-based morphometric MRI analysis revealed that the progressed group had a reduced gray matter volume in the bilateral cerebellar cortices, right temporal cortex, and bilateral insular cortices. Conclusion: Considering the lack of evidence of amyloid pathology, clinical progression of these subpopulation may be caused by other neuropathologies such as TDP-43, abnormal tau or alpha synuclein that lead to neurodegeneration independent of amyloid-driven pathway. Further prospective studies incorporating biomarkers of Alzheimer’s diseasemimicking dementia are warranted.

scholarly journals Rethinking and Co-Design of Beloved Board Games for People With Mild Cognitive Impairment and Their Care Partners

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 558-558
Author(s):  
Chantal Kerssens ◽  
Maribeth Gandy ◽  
Kara Cohen ◽  
Laura Levy ◽  
Cecile Janssens ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Social Engagement ◽  
Game Design ◽  
Social Activity ◽  
Positive Interactions ◽  
Older Americans ◽  
Board Games ◽  
Care Partners ◽  
Progression Of Disease

Abstract Mild cognitive impairment (MCI) affects millions of older Americans and progression to dementia is common. Although people with MCI may experience impairments, they are often highly verbal, able, and eager to uphold beloved routines. Moreover, many seek opportunities to stay active, physically and mentally, to support their brain health. Some forms of cognitive training and social engagement potentially delay the onset and progression of disease, including dementia. This 12-month project used mixed methods to co-design and test an accessible version of well-known board games for people with MCI and a care partner without MCI. The overall goal was to foster a meaningful, joyous, social activity for players with differing capabilities using adapted game mechanics to create a compelling experience for both players. Coping strategies of care partners were studied to learn ways to foster positive interactions. Findings inform recommendations for game design and clinical interventions. Part of a symposium sponsored by Technology and Aging Interest Group.

scholarly journals Digital Storytelling in Older Adults With Typical Aging, and With Mild Cognitive Impairment or Dementia: A Systematic Literature Review

2021 ◽  
pp. 073346482110154
Author(s):  
Adriana Maria Rios Rincon ◽  
Antonio Miguel Cruz ◽  
Christine Daum ◽  
Noelannah Neubauer ◽  
Aidan Comeau ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Digital Storytelling ◽  
Level Of Evidence ◽  
Form Of Life ◽  
Self Confidence ◽  
Care Partners

The rates of dementia are on the rise as populations age. Storytelling is commonly used in therapies for persons living with dementia and can be in the form of life review, and reminiscence therapy. A systematic literature review was conducted to examine the range and extent of the use of digital technologies for facilitating storytelling in older adults and their care partners, and to identify the processes and methods, the technologies used and their readiness levels, the evidence, and the associated outcomes. Eight electronic databases were searched: Medline, EMBASE, PsycINFO, CINAHL, Abstracts in Social Gerontology, ERIC, Web of Science, and Scopus. We included 34 studies. Mild cognitive impairment or dementia represented over half of medical conditions reported in the studies. Overall, our findings indicate that the most common use of digital storytelling was to support older adults’ memory, reminiscence, identity, and self-confidence; however, the level of evidence of its effectiveness was low.

scholarly journals Prevalence and Covariates of Elevated Depressive Symptoms in Rural Memory Clinic Patients with Mild Cognitive Impairment or Dementia

2014 ◽  
Vol 4 (2) ◽  
pp. 209-220 ◽  
Author(s):  
Julie G. Kosteniuk ◽  
Debra G. Morgan ◽  
Megan E. O'Connell ◽  
Margaret Crossley ◽  
Andrew Kirk ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mild Cognitive Impairment ◽  
Memory Clinic

scholarly journals Depressive symptoms in relation to clinical symptom onset of mild cognitive impairment

2018 ◽  
Vol 31 (04) ◽  
pp. 561-569 ◽  
Author(s):  
Carol K. Chan ◽  
Anja Soldan ◽  
Corinne Pettigrew ◽  
Mei-Cheng Wang ◽  
Jiangxia Wang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mild Cognitive Impairment ◽  
Clinical Symptom ◽  
Symptom Onset ◽  
Symptom Severity ◽  
Hamilton Depression Scale ◽  
Cognitively Normal ◽  
Increased Risk ◽  
Time To Onset

ABSTRACTObjective:There is increasing evidence of an association between depressive symptoms and mild cognitive impairment (MCI) in cross-sectional studies, but the longitudinal association between depressive symptoms and risk of MCI onset is less clear. The authors investigated whether baseline symptom severity of depression was predictive of time to onset of symptoms of MCI.Method:These analyses included 300 participants from the BIOCARD study, a cohort of individuals who were cognitively normal at baseline (mean age = 57.4 years) and followed for up to 20 years (mean follow-up = 2.5 years). Depression symptom severity was measured using the Hamilton Depression Scale (HAM-D). The authors assessed the association between dichotomous and continuous HAM-D and time to onset of MCI within 7 years versus after 7 years from baseline (reflecting the mean time from baseline to onset of clinical symptoms in the cohort) using Cox regression models adjusted for gender, age, and education.Results:At baseline, subjects had a mean HAM-D score of 2.2 (SD = 2.8). Higher baseline HAM-D scores were associated with an increased risk of progression from normal cognition to clinical symptom onset ≤ 7 years from baseline (p= 0.043), but not with progression > 7 years from baseline (p= 0.194). These findings remained significant after adjustment for baseline cognition.Conclusions:These results suggest that low levels of depressive symptoms may be predictive of clinical symptom onset within approximately 7 years among cognitively normal individuals and may be useful in identifying persons at risk for MCI due to Alzheimer’s disease.

scholarly journals Magnetic Resonance Hippocampal Subfield Volumetric Analysis for Differentiating among Healthy Older Adults and Older Adults with Mild Cognitive Impairment or Major Depressive Disorder

2021 ◽  
Vol 73 (12) ◽  
pp. 786-792
Author(s):  
Doonyaporn Wongsawaeng ◽  
Orasa Chawalparit ◽  
Siriwan Piyapittayanan ◽  
Tanyaluck Thientunyakit ◽  
Weerasak Muangpaisan ◽  
...  
Keyword(s):  
Older Adults ◽  
Major Depressive Disorder ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Depressive Disorder ◽  
Subgroup Analysis ◽  
Amyloid Pet ◽  
Major Depressive ◽  
Healthy Older Adults ◽  
Valuable Adjunct

Objective: Depression among older adults is frequently an early symptom of cognitive decline, and is believed to be a risk factor for Alzheimer’s disease (AD). Hippocampal subfield volume loss is found in both mild cognitive impairment (MCI) and major depressive disorder (MDD). We aimed to investigate the potential of MR hippocampal subfield volumetry for discriminating among healthy older adults (HOA) and older adults with MCI or MDD. Materials and Methods: Seventy age-matched subjects (29 non-depressed MCI, 12 MDD, and 29 HOA) underwent 3-Tesla MR imaging (MRI) with high-resolution 3D-T1W-TFE whole brain. Hippocampal subfield volumetric measurements were performed using FreeSurfer software to distinguish among MCI, MDD, and HOA. Subgroup analysis with amyloid PET result was also performed.Results: Significantly smaller bilateral hippocampal tail volume was observed in MCI compared to HOA (p=0.004 and p=0.04 on the left and right side, respectively). The same comparative finding was observed at left HATA (hippocampus-amygdala-transition-area) of MCI (p=0.046). Other regions showed non-significantly smaller size in MCI than in HOA [left molecular layer HP (p=0.06), left whole hippocampus (p=0.06), and left CA1 (p=0.07)]. There was a non-significant trend toward smaller size in almost all 13 subfield hippocampal regions of MCI compared to MDD, even in subgroup analysis with amyloid PET result.Conclusion: MR hippocampal subfield volumetry may have value in routine clinical practice for screening individuals with MCI, and may be a valuable adjunct to amyloid PET study for very early-stage diagnosis of AD.

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