Dementia and Cognition

Author(s):  
Christopher H. Hawkes ◽  
Kapil D. Sethi ◽  
Thomas R. Swift

This chapter emphasizes the value of preliminary observations in making a provisional diagnosis of dementia. Significant aspects of the history are detailed, such as head injury or brain hemorrhage that could lead to hydrocephalus or superficial siderosis. Handles are given that facilitate identification of Alzheimer’s disease and its mimics, such as the posterior cortical variant. The importance of temporal pattern of disease is emphasized. Further Handles are outlined for frontotemporal dementia variants. The value of physical examination is stressed as it may disclose an underlying structural lesion.

Author(s):  
Christopher H. Hawkes ◽  
Kapil D. Sethi ◽  
Thomas R. Swift

This chapter emphasizes the value of preliminary observations in making a provisional diagnosis of dementia. Significant aspects of the history are detailed, such as head injury or brain hemorrhage that could lead to hydrocephalus or superficial siderosis. Diagnostic clues are given that facilitate identification of the posterior cortical variant of Alzheimer’s disease, characterized by progressive decline in visuospatial, visuoperceptual, literacy, and praxic skills. Emphasized is the importance of temporal pattern of disease, manifesting as episodic confusion and dementia progressing over a period of months. Further clues are outlined to facilitate identification of frontotemporal dementia variants, including semantic dementia, the behavioral variant, progressive nonfluent aphasia, and logopenic aphasia. The value of physical examination is stressed as it may disclose an underlying structural lesion.


2019 ◽  
Vol 8 (3) ◽  
Author(s):  
Gabriel Pina Paiva ◽  
Fábio Henrique Ribeiro Maldonado ◽  
Amanda Oliva Spaziani

A demência é uma das mais importantes causas de morbimortalidade entre os idosos e se caracteriza pelo declínio progressivo em múltiplos domínios cognitivos. Paciente do sexo feminino, 56 anos, iniciou quadro há 3 anos, caracterizado por apatia, anedonia e isolamento social. Procurou atendimento com médico que atribuiu sintomas a depressão. Contudo, não houve melhora. Há dois anos evoluiu com delírios persecutórios, confabulações, alucinação visual. Acompanhante notou que a paciente tinha dificuldades em se expressar e na compreensão. Devido à refratariedade ao tratamento foi solicitada avaliação de neurologista.  À consulta inicial, paciente apresentava-se orientada no tempo, espaço. Mini exame do estado mental 26/30 pontos. Fluência verbal semântica. Após 6 meses, evoluiu com empobrecimento do vocabulário. À época estava dependente de familiares para realização de atividades de vida diária. Na ressonância magnética encefálica apresentou atrofia cortical difusa, com predomínio em regiões frontais e temporais à esquerda. Atualmente está em uso de risperidona e memantina. A atrofia cerebral dos lobos frontais e temporais ou demência fronto temporal (DFT) afeta predominantemente o lobo frontal do cérebro, podendo se estender para o temporal. A patologia caracteriza-se por significativa alteração da personalidade e do comportamento, com relativa preservação das funções mnésticas e visuoespaciais. A linguagem é progressivamente afetada. A memória encontra-se preservada no início da doença e as alterações comportamentais e da personalidade são bastante significativas. A variante comportamental é a mais comum. Ela apresenta uma deterioração gradual da função executiva e da personalidade, enquanto a capacidade visuoespacial é afetada apenas em estádios avançados.Descritores: Transtornos Neurocognitivos; Demência Frontotemporal; Testes de Estado Mental e Demência.ReferênciasCarrabba LHG, Menta C, Fasolin EM, Loureiro F, Gomes I. Características psicométricas das versões completa e reduzida do IQCODE-BR em idosos de baixa renda e escolaridade. Rev bras geriatr gerontol. 2015;18(4):715-23.Lopes MCBT, Lage JSS, Vancini-Campanharo CR, Okuno MFP, Batista REA. Factors associated with functional impairment of elderly patients in the emergency departments. Einstein. 2015;13(2):209-14.Trindade APNT, Barboza MA, Oliveira FB, Borges APO. Repercussão do declínio cognitivo na capacidade funcional em idosos institucionalizados e não institucionalizados. Fisioter mov. 2013;26(2):281-89.Santos JI, Rodrigues Junior C, Zogheib JB, Malachias MVB, Rezende BA.  Assessment of hemodynamic and vascular parameters in Alzheimer's disease, vascular dementia and mild cognitive abnormalities: a pilot study. Rev bras geriatr gerontol. 2017;20(5):670-78.Burlá C, Camarano AA, Kanso S, Fernandes D, Nunes R. Panorama prospectivo das demências no Brasil: um enfoque demográfico. Ciênc saúde coletiva. 2013;18(10):2949-56.Costa GD, Souza RA, Yamashita CH, Pinheiro JCF, Alvarenga MRM, Oliveira MAC. Evaluation of professional knowledge and attitudes on dementia patient care: a trans-cultural adaptation of an evaluation instrument. Rev esc enferm USP. 2015;49(2):298-308.Bosch B, Isidro R, Zayas Ll, Hernández T, Ulloa E. Algunos determinantes sociales y su impacto en las demencias. Rev Cubana Salud Pública. 2017;43(3):449-60.Josviak ND, Batistela MS, Simão-Silva DP, Bono GF, Furtado-Alle L, Souza RLR. Revisão dos principais genes e proteínas associadas à demência frontotemporal tau-positiva. Rev bras geriatr gerontol. 2015;18(1):201-11.McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CR Jr, Kawas CH, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011;7(3):263-69.Pires FRO, Santos SMA, Mello ALSF, Silva KM. Mutual Help Group for Family Members of Older Adults with Dementia: Unveiling perspectives. Texto contexto - enferm.. 2017;26(2):e00310016.Storti LB, Quintino DT, Silva NM, Kusumota L, Marques S. Neuropsychiatric symptoms of the elderly with Alzheimer's disease and the family caregivers' distress. Rev Latino-Am Enfermagem. 2016;24:e2751.Teixeira-Jr AL, Salgado JV. Demência fronto-temporal: aspectos clínicos e terapêuticos. Rev psiquiatr Rio Gd Sul. 2006;28(1):69-76.Mendes RAB. Demência Frontotemporal. Evolução do conceito e desafios diagnósticos [dissertação]. Covilhã: Faculdade de Medicina,Universidade da Beira Interior (UBI); 2015.Moreira S, Duarte S, Moreira I, Santos E. et al. Variante comportamental da demência frontotemporal: relato de caso. Rev Port Med Geral Fam. 2017;33(2):155-61.McKhann GM, Albert MS, Grossman M, Miller B, Dickson D, Trojanowski JQ et al. Clinical and pathological diagnosis of frontotemporal dementia: Report of the work group on frontotemporal dementia and pick's disease. Arch Neurol. 2001;58(11):1803-9.Rivas Nieto JC. Frontotemporal dementia: clinical, neuropsychological, and neuroimaging description. Colomb. Med (Cali). 2014;45(3):122-26.Fernádez-Matarrubia M, Matías-Guiu JA, Moreno-Ramos T,  Matías-Guiu J. Demencia frontotemporal variante conductual: aproximación clínica y terapéutica. Neurología. 2014;29(8):464-72.Lanata SC, Miller BL. The behavioural variant frontotemporal dementia (bvFTD) syndrome in psychiatry. J Neurol Neurosurg Psychiatry. 2016;87(5):501-11.


2014 ◽  
Author(s):  
Joseph P. Barsuglia ◽  
Michelle J. Mather ◽  
Hemali V. Panchal ◽  
Aditi Joshi ◽  
Elvira Jimenez ◽  
...  

2020 ◽  
Vol 78 (2) ◽  
pp. 537-541
Author(s):  
Jordi A. Matias-Guiu ◽  
Vanesa Pytel ◽  
Jorge Matías-Guiu

We aimed to evaluate the frequency and mortality of COVID-19 in patients with Alzheimer’s disease (AD) and frontotemporal dementia (FTD). We conducted an observational case series. We enrolled 204 patients, 15.2% of whom were diagnosed with COVID-19, and 41.9% of patients with the infection died. Patients with AD were older than patients with FTD (80.36±8.77 versus 72.00±8.35 years old) and had a higher prevalence of arterial hypertension (55.8% versus 26.3%). COVID-19 occurred in 7.3% of patients living at home, but 72.0% of those living at care homes. Living in care facilities and diagnosis of AD were independently associated with a higher probability of death. We found that living in care homes is the most relevant factor for an increased risk of COVID-19 infection and death, with AD patients exhibiting a higher risk than those with FTD.


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Adeline Su Lyn Ng ◽  
Juan Wang ◽  
Kwun Kei Ng ◽  
Joanna Su Xian Chong ◽  
Xing Qian ◽  
...  

Abstract Background Alzheimer’s disease (AD) and behavioral variant frontotemporal dementia (bvFTD) cause distinct atrophy and functional disruptions within two major intrinsic brain networks, namely the default network and the salience network, respectively. It remains unclear if inter-network relationships and whole-brain network topology are also altered and underpin cognitive and social–emotional functional deficits. Methods In total, 111 participants (50 AD, 14 bvFTD, and 47 age- and gender-matched healthy controls) underwent resting-state functional magnetic resonance imaging (fMRI) and neuropsychological assessments. Functional connectivity was derived among 144 brain regions of interest. Graph theoretical analysis was applied to characterize network integration, segregation, and module distinctiveness (degree centrality, nodal efficiency, within-module degree, and participation coefficient) in AD, bvFTD, and healthy participants. Group differences in graph theoretical measures and empirically derived network community structures, as well as the associations between these indices and cognitive performance and neuropsychiatric symptoms, were subject to general linear models, with age, gender, education, motion, and scanner type controlled. Results Our results suggested that AD had lower integration in the default and control networks, while bvFTD exhibited disrupted integration in the salience network. Interestingly, AD and bvFTD had the highest and lowest degree of integration in the thalamus, respectively. Such divergence in topological aberration was recapitulated in network segregation and module distinctiveness loss, with AD showing poorer modular structure between the default and control networks, and bvFTD having more fragmented modules in the salience network and subcortical regions. Importantly, aberrations in network topology were related to worse attention deficits and greater severity in neuropsychiatric symptoms across syndromes. Conclusions Our findings underscore the reciprocal relationships between the default, control, and salience networks that may account for the cognitive decline and neuropsychiatric symptoms in dementia.


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Patricia Yuste-Checa ◽  
Victoria A. Trinkaus ◽  
Irene Riera-Tur ◽  
Rahmi Imamoglu ◽  
Theresa F. Schaller ◽  
...  

AbstractSpreading of aggregate pathology across brain regions acts as a driver of disease progression in Tau-related neurodegeneration, including Alzheimer’s disease (AD) and frontotemporal dementia. Aggregate seeds released from affected cells are internalized by naïve cells and induce the prion-like templating of soluble Tau into neurotoxic aggregates. Here we show in a cellular model system and in neurons that Clusterin, an abundant extracellular chaperone, strongly enhances Tau aggregate seeding. Upon interaction with Tau aggregates, Clusterin stabilizes highly potent, soluble seed species. Tau/Clusterin complexes enter recipient cells via endocytosis and compromise the endolysosomal compartment, allowing transfer to the cytosol where they propagate aggregation of endogenous Tau. Thus, upregulation of Clusterin, as observed in AD patients, may enhance Tau seeding and possibly accelerate the spreading of Tau pathology.


2017 ◽  
Vol 33 (1) ◽  
pp. 141-150 ◽  
Author(s):  
Marta Fernández-Matarrubia ◽  
Jordi A. Matías-Guiu ◽  
María Nieves Cabrera-Martín ◽  
Teresa Moreno-Ramos ◽  
María Valles-Salgado ◽  
...  

Cortex ◽  
2007 ◽  
Vol 43 (7) ◽  
pp. 866-874 ◽  
Author(s):  
Fabienne Collette ◽  
Hélène Amieva ◽  
Stéphane Adam ◽  
Michaël Hogge ◽  
Martial Van der Linden ◽  
...  

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