1153 Association Of Nocturnal Sleep Disturbance And Prospective Cognitive Decline In Cognitive Normal Elderly: Findings From The National Alzheimer’s Coordinating Center Uniform Dataset

Abstract Introduction We determined whether nocturnal sleep disturbance (NSD) is associated with prospective cognitive decline in clinically normal older adults Methods Prospective longitudinal study utilizing data from the National Alzheimer’s Coordinating Center (NACC) Uniform Data set (UDS). NSD data, as characterized by the Neuropsychiatric Inventory Questionnaire (NPI-Q), were derived from 10,600 participants at baseline, with at least one UDS follow-up visit, from 32 National Institute of Aging Alzheimer’s Disease Research Centers (ADRC). Prospective cognitive decline was characterized as incident mild cognitive impairment (MCI) diagnosis during UDS follow-up. Logistic mixed-effects model with random intercept and slope examined associations between the NSD and longitudinal cognitive decline. All models included age at baseline, sex, years of education, APOE ε4 status and their interactions with time. Time was operationalized as years from baseline for each participant. Results Of the 10,600 cognitively normal participants at baseline, 1,017 (8.6%) had NSD. The proportion of males versus females with sleep problems was 10.1% vs. 9.3% respectively. For participants with NSD and no NSD, the mean (SD) age was 71 (7.3) and 70 (5.7) years and average follow-up time was 5.2 (2.6) and 4.9 (2.7) years, respectively. Participants with NSD were significantly more likely to develop incident MCI during UDS follow-up (OR: 1.42, p =.003). The interaction of NSD with time was significant (p< .001) suggesting an increase in the likelihood of conversion to MCI increased over time. Furthermore, there were significant differences in mean conversion rates to MCI in the NSD group when the previous time-point was compared to the next (p<01), with a time dependent dose response in the risk of conversion to MCI observed. Conclusion In elderly cognitive-normal individuals, nocturnal sleep disturbance is associated with a time-dependent progression risk to MCI. These findings are consistent with the role of disturbed sleep in the development of Alzheimer’s Disease. Support NIH/NIA/NHLBI (L30-AG064670, CIRAD P30AG059303 Pilot, T32HL129953, R01HL118624, R21AG049348, R21AG055002, R01AG056031, R01AG022374, R21AG059179, R01AG056682, R01AG056531, K07AG05268503, K23HL125939)

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Prospective longitudinal study of depression and anosognosia in Alzheimer's disease

The British Journal of Psychiatry ◽

10.1192/bjp.171.1.47 ◽

1997 ◽

Vol 171 (1) ◽

pp. 47-52 ◽

Cited By ~ 92

Author(s):

Sergio E. Starkstein ◽

Erán Chemerinski ◽

Liliana Sabe ◽

Gabriela Kuzis ◽

Gustavo Petracca ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Major Depression ◽

Cognitive Status ◽

Initial Evaluation ◽

Consecutive Series ◽

Psychiatric Interview ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal

BackgroundThe aim was to examine the longitudinal evolution of depression and anosognosia in patients with probable Alzheimer's disease (AD).MethodSixty-two of a consecutive series of 116 AD patients that were examined with a structured psychiatric interview had a follow-up evaluation between one and two years after the initial evaluation.ResultsAt the initial evaluation 19% of the 62 patients had major depression, 34% had dysthymia, and 47% were not depressed. After a mean follow-up of 16 months, 58% of patients with major depression at the initial evaluation were still depressed, whereas only 28% of patients with initial dysthymia and 21% of the non-depressed patients were depressed at follow-up. During the follow-up period, all three groups showed similar declines in cognitive status and activities of daily living. At the initial evaluation, 39% of the patients had anosognosia, and there was a significant increment of anosognosia during the follow-up period.ConclusionsWhile dysthymia in AD is a brief emotional disorder, major depression is a longer-lasting mood change. Anosognosia is another prevalent disorder among AD patients, and increases with the progression of the illness.

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Utility of an Alzheimer’s Disease Risk-Weighted Polygenic Risk Score for Predicting Rates of Cognitive Decline in Preclinical Alzheimer’s Disease: A Prospective Longitudinal Study

Journal of Alzheimer s Disease ◽

10.3233/jad-180713 ◽

2018 ◽

Vol 66 (3) ◽

pp. 1193-1211 ◽

Cited By ~ 3

Author(s):

Tenielle Porter ◽

Samantha C. Burnham ◽

Lidija Milicic ◽

Greg Savage ◽

Paul Maruff ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Longitudinal Study ◽

Cognitive Decline ◽

Disease Risk ◽

Polygenic Risk Score ◽

Preclinical Alzheimer’S Disease ◽

Prospective Longitudinal Study ◽

Polygenic Risk ◽

Prospective Longitudinal

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Relation between neuritic plaques and depressive state in Alzheimer's disease

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2009.00423.x ◽

2010 ◽

Vol 22 (1) ◽

pp. 14-20 ◽

Cited By ~ 5

Author(s):

Gerben Meynen ◽

Heleen Van Stralen ◽

Jan H. Smit ◽

Wouter Kamphorst ◽

Dick F. Swaab ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Depressive Symptoms ◽

Temporal Cortex ◽

Clinical Severity ◽

Depressive State ◽

Neuritic Plaques ◽

Prospective Longitudinal Study ◽

Severity Of Dementia ◽

Prospective Longitudinal

Meynen G, Van Stralen H, Smit JH, Kamphorst W, Swaab DF, Hoogendijk WJG. Relation between neuritic plaques and depressive state in Alzheimer's disease.Background:To investigate for the first time in a prospective study the relationship between depressive state and the neuropathological hallmarks of Alzheimer's disease, using a scale for depressive symptoms in dementia, while controlling for clinical severity of dementia.Method:Within the framework of a prospective longitudinal study of depression in Alzheimer's disease, patients with dementia underwent a clinical evaluation every six months during the last years of their lives, using the Cornell scale for depression in dementia to assess depressive symptoms and using the Functional Assessment Staging scale to control for clinical severity of dementia. The brains of 43 Alzheimer patients were obtained. The last clinical evaluations prior to death together with post-mortem neuropathology measures were analysed.Results:We found a correlation between the Cornell scores and the sum score for the density of neuritic plaques in the entire cortex (p = 0.027), and even stronger in the temporal cortex (p = 0.012). The observed correlations were independent of sex, age of death, clinical dementia severity and duration of Alzheimer's disease.Conclusions:This study shows a positive relationship between depressive state at time of death and the presence of neuritic plaques in Alzheimer's disease, which is independent of the clinical severity of dementia.

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Smell identification test as a progression marker in Alzheimer's disease

European Psychiatry ◽

10.1016/s0924-9338(11)72209-x ◽

2011 ◽

Vol 26 (S2) ◽

pp. 502-502

Author(s):

L. Velayudhan ◽

M. Pritchard ◽

S. Lovestone

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Decline ◽

Late Onset ◽

Linear Regression Analysis ◽

Rapid Progressors ◽

Progression Marker ◽

Identification Test ◽

Smell Identification

IntroductionFactors influencing or predicting progression in Alzheimer's disease (AD) is not well understood. Olfactory dysfunction, impaired smell identification in particular, is known to occur in AD. Mesial temporal lobe, important for memory function is also critical for the processing of olfactory information. In view of the common anatomical substrate, we hypothesized that olfaction dysfunction worsens faster in people with AD with rapid cognitive decline compared to those with slower cognitive decline.AimsTo test whether smell identification test can be used as a predictor for illness progression in AD patients.MethodsForty one participants with late onset mild to moderate AD were recruited from mental health services for older adults. Subjects were classified as ‘Rapid Progressors’ defined on ‘a-priori’ with a loss of 2 or more points in Mini-Mental State Examination (MMSE) within six months. Assessments included MMSE, Neuropsychiatric Inventory, Bristol Activities of Daily Living, and the University of Pennsylvania Smell Identification Test (UPSIT), at baseline and after 3 months.ResultsTwenty subjects were ‘Rapid Progressors’, and had lower UPSIT scores compared to ‘Non-Rapid Progressors’ both at the baseline (p = 0.02) and at follow up after 3 months (p = 0.05). Baseline UPSIT correlated with follow up UPSIT (r = 0.5, p < 0.01) and MMSE (r = 0.4, p = 0.04). Also it was the baseline UPSIT score that best predicted (p < 0.05) the follow up smell and cognitive function on linear regression analysis.ConclusionsSmell identification function could be useful as a clinical measure to assess and predict progression in AD.

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A prospective longitudinal study of apathy in Alzheimer's disease

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp.2005.069575 ◽

2006 ◽

Vol 77 (1) ◽

pp. 8-11 ◽

Cited By ~ 183

Author(s):

S E Starkstein

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Longitudinal Study ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal

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The Differential Diagnosis of Alzheimer's Disease: Conceptual and Methodological Issues

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100037045 ◽

1986 ◽

Vol 13 (S4) ◽

pp. 424-426 ◽

Cited By ~ 7

Author(s):

Mary C. Tierney ◽

David W. Reid ◽

Maria L. Zorzitto ◽

W. Gary Snow ◽

Rory H. Fisher ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Large Scale ◽

Methodological Issues ◽

Normal Individuals ◽

Comparison Groups ◽

Assessment Procedures ◽

Prospective Longitudinal ◽

Insufficient Knowledge

Abstract:The study of Alzheimer's disease is hampered by insufficient knowledge of its cause. It can best be described as a syndrome whose clinical and pathological features, and their associations over time, need to be more carefully examined. Issues which impede our understanding of this syndrome include the lack of: (a) a singular “gold standard” for its identification; (b) longitudinal studies with appropriate comparison groups and neuropathological follow-up; and (c) standardized multifaceted clinical assessment procedures. Our awareness of the significance of these issues has led us to undertake a large-scale prospective, longitudinal investigation of 399 dementing and normal individuals at Sunnybrook Medical Centre. As a result of problems identified, it is proposed that research efforts across various Canadian centres be coordinated to best utilize available resources and expertise.

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Prediction of probable Alzheimer's disease in memory-impaired patients: A prospective longitudinal study

Neurology ◽

10.1212/wnl.46.3.661 ◽

1996 ◽

Vol 46 (3) ◽

pp. 661-665 ◽

Cited By ~ 310

Author(s):

M. C. Tierney ◽

J. P. Szalai ◽

W. G. Snow ◽

R. H. Fisher ◽

A. Nores ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Longitudinal Study ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal

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A Follow-Up Study of Actigraphic Measures in Home-Residing Alzheimer's Disease Patients

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/089198879801100103 ◽

1998 ◽

Vol 11 (1) ◽

pp. 7-10 ◽

Cited By ~ 31

Author(s):

Jerome A. Yesavage ◽

Leah Friedman ◽

Helena C. Kraemer ◽

Art Noda ◽

Deryl Wicks ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Circadian Rhythm ◽

Behavioral Disturbance ◽

Nocturnal Sleep ◽

Significant Deterioration ◽

Cross Sectional ◽

Sleep Parameters ◽

Rest Activity

This article reports cross-sectional and follow-up data with actigraphic measures of nocturnal sleep and rest/activity in 61 Alzheimer's disease (AD) patients as well as the relation of actigraphic measures to levels of behavioral disturbance across different stages of the disease. Over the course of approximately 1.5 years' follow-up, patients showed significant deterioration of nocturnal sleep parameters, but no significant change in rest/activity circadian rhythm parameters. There were also significant correlations among nocturnal sleep, rest/activity circadian rhythm, and behavioral disturbance measures, but only in relatively early stages of AD. It is argued that study of nocturnal sleep and circadian rhythm in relation to behavioral disturbance in AD requires longitudinal data and analyses that take into account the stage of disease at which patients are assessed.

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