scholarly journals IMPACT OF THE COVID-19 OUTBREAK ON THE CLINICAL AND RESEARCH ACTIVITIES OF MEMORY CLINICS: AN ALZHEIMER’S DISEASE CENTER FACING THE COVID-19 CRISIS

Author(s):  
P.J. Ousset ◽  
B. Vellas

The 2020 Coronavirus pandemic is the greatest global health crisis we have had in recent decades, both by its own consequences and by the impact of the measures that have been taken by various countries to deal with it (1). The effect is major on Western health systems, affecting all areas of care and research, including research on Alzheimer’s disease and cognitive aging.

2002 ◽  
Vol 18 (3) ◽  
pp. 497-507 ◽  
Author(s):  
Andrew Clegg ◽  
Jackie Bryant ◽  
Tricia Nicholson ◽  
Linda McIntyre ◽  
Sofie De Broe ◽  
...  

Objectives: Systematic review of the clinical and cost-effectiveness of donepezil, rivastigmine, and galantamine for people suffering from Alzheimer's disease.Methods: Sixteen electronic databases (including MEDLINE, the Cochrane Library, and Embase) and bibliographies of related papers were searched for published/unpublished English language studies, and experts and pharmaceutical companies were consulted for additional information. Randomized controlled trials (RCTs) and economic studies were selected. Clinical effectiveness was assessed on measurement scales assessing progression of Alzheimer's disease on the person's global health, cognition, functional ability, behavior and mood, and quality of life. Cost-effectiveness was presented as incremental cost per year spent in a nonsevere state (by Mini Mental Health State Examination) or quality-adjusted life-year.Results: Twelve of 15 RCTs included were judged to be of good quality. Although donepezil had beneficial effects in Alzheimer's patients on global health and cognition, rivastigmine on global health, and galantamine on global health, cognition, and functional scales, these improvements were small and may not be clinically significant. Measures of quality of life and behavior and mood were rarely assessed. Adverse effects were usually mild and transient. Cost-effectiveness base case estimates ranged from £2,415 savings to £49,476 additional cost (1997 prices) per unit of effect for donepezil and a small savings for rivastigmine. Estimates were not considered robust or generalizable.Conclusions: Donepezil, rivastigmine, and galantamine appear to have some clinical effect for people with Alzheimer's disease, although the extent to which these translate into real differences in everyday life remains unclear. Due to the nature of current economic studies, cost-effectiveness remains uncertain and the impact on different care sectors has been inadequately investigated. Further research is needed to establish the actual benefits of acetylcholinesterase inhibitors (AChEls) for people with Alzheimer's disease and their caregivers, the relationship of these changes to clinical management, and careful prospective evaluation of resource and budgetary consequences.


10.28945/4755 ◽  
2021 ◽  
Vol 16 ◽  
pp. 291-317
Author(s):  
Basil Cahusac de Caux

Aim/Purpose: To date, few studies have investigated the impact of global health crises on the academic writing of doctoral candidates. This paper seeks to start a conversation about the impact of the ongoing COVID-19 pandemic on doctoral candidates’ academic writing output and strategies. Background: This paper employs and analyses data elicited from surveys and interviews involving doctoral candidates from around the world. Data were collected during April 2020, at a time when government-mandated lockdowns and restrictions on movement were in full force in many countries around the world. Methodology: Surveys were conducted with 118 doctoral candidates from over 40 institutions based in four continents. Follow-up interviews were carried out with four doctoral candidates enrolled in an Australian institution. A qualitative descriptive design, employing thematic analysis, is used to assess the impact of the COVID-19 pandemic on doctoral candidates’ writing output and strategies. The data analysis includes statistical descriptions of the surveys. Contribution: This paper provides insights into the myriad challenges and obstacles facing doctoral candidates during the COVID-19 pandemic. It describes the writing strategies adopted by doctoral candidates during a period of significant societal disruption, and illustrates how thematic analysis can be employed in research involving global health crises. Findings: Despite the adoption of novel approaches to academic writing, which appear in an insignificant minority of respondents, doctoral candidates’ overall commitment to academic writing has been negatively impacted by the pandemic. Similarly, delays to academic research activities caused by the pandemic have resulted in a significant decline in commitment (motivation) to academic writing and a substantial impact on doctoral candidates’ ability to write about their research. Recommendations for Practitioners: Supervisors and mentors should strive to provide doctoral candidates with timely feedback during the pandemic. Given the impact of the pandemic on doctoral candidates’ mental health and motivation to write, increased institutional and peer support is required to help doctoral candidates overcome academic issues during the pandemic and future health crises. This researcher recommends consulting regularly with and offering individually tailored solutions to doctoral candidates who are struggling to work on their theses during the pandemic. Similarly, institutions should empower supervisors in ways that allow them to provide greater levels of support to doctoral candidates. Recommendation for Researchers: Further research on the impacts of the pandemic on various academic cohorts, such as early career researchers (doctoral candidates, postdoctoral researchers, and assistant professors) and student cohorts (e.g., undergraduate and postgraduate), will clarify the extent to which the pandemic is impacting the academic writing of doctoral candidates. Impact on Society: The pressure placed on doctoral candidates to produce quality academic writing seems to have been heightened by the pandemic. This has a range of adverse effects for the higher education sector, particularly administrators responsible for managing doctoral candidate success and the academe, which recruits many of its faculty from holders of doctorate degrees. Future Research: Additional focus on academic writing of doctoral candidates during the pandemic is needed. Research should include randomised samples and represent a range of academic disciplines.


2020 ◽  
Author(s):  
Jacqueline Mogle ◽  
Nikki Hill ◽  
Jennifer Turner

UNSTRUCTURED Increasing evidence promotes the clinical utility of self-reported memory problems for detecting early impairment associated with Alzheimer’s disease (AD). However, past work investigating memory problems often conflated the types of problems (i.e., retrospective and prospective) with their features (i.e., frequency and consequences). This bias limits the specificity of traditional measures of memory problems and minimizes their ability to detect differential trajectories associated with cognitive decline. In the present study, we use a novel measure of self-reported memory problems that uses daily reports of memory lapses to disentangle types from features to analyze the impact of each dimension in two longitudinal datasets. Further, this study explores the individual difference factors of age and gender as potential moderators of the relationships between self-reported memory lapses and objective cognitive decline. This study uses multilevel, coordinated analyses across two measurement burst datasets to examine the links between features and consequences of memory lapses (retrospective and prospective) and their association with objective cognitive decline. The current sample (n = 535; ages 50-85 years; 61% women) is drawn from two ongoing, nationally funded research studies: the Effects of Stress on Cognitive Aging, Physiology, and Emotion Study and the Einstein Aging Study. Both studies assess the daily experience of memory lapses, including the type as well as the emotional and functional outcomes, and objective measures of cognition such as processing speed and episodic memory. We will use multilevel modeling to test our conceptual model that differences in frequency and types of memory lapses show differential trends in their relationships with cognitive decline and that these relationships vary by age and gender of participant. The early and accurate identification of individuals most at risk for cognitive decline is of paramount importance. Previous research exploring self-reported memory problems and AD is promising, however limitations in measurement may explain prior reports of inconsistences. The current study addresses these concerns by examining daily reports of memory lapses, how these vary by age and gender, and their relationship with objective cognitive performance. Overall this study aims to identify key features of daily memory lapses and the differential trajectories that best predict cognitive decline to help inform future AD risk screening tools.


Author(s):  
Mark Ellisman ◽  
Maryann Martone ◽  
Gabriel Soto ◽  
Eleizer Masliah ◽  
David Hessler ◽  
...  

Structurally-oriented biologists examine cells, tissues, organelles and macromolecules in order to gain insight into cellular and molecular physiology by relating structure to function. The understanding of these structures can be greatly enhanced by the use of techniques for the visualization and quantitative analysis of three-dimensional structure. Three projects from current research activities will be presented in order to illustrate both the present capabilities of computer aided techniques as well as their limitations and future possibilities.The first project concerns the three-dimensional reconstruction of the neuritic plaques found in the brains of patients with Alzheimer's disease. We have developed a software package “Synu” for investigation of 3D data sets which has been used in conjunction with laser confocal light microscopy to study the structure of the neuritic plaque. Tissue sections of autopsy samples from patients with Alzheimer's disease were double-labeled for tau, a cytoskeletal marker for abnormal neurites, and synaptophysin, a marker of presynaptic terminals.


2020 ◽  
Vol 17 (1) ◽  
pp. 93-103 ◽  
Author(s):  
Jing Ma ◽  
Yuan Gao ◽  
Wei Tang ◽  
Wei Huang ◽  
Yong Tang

Background: Studies have suggested that cognitive impairment in Alzheimer’s disease (AD) is associated with dendritic spine loss, especially in the hippocampus. Fluoxetine (FLX) has been shown to improve cognition in the early stage of AD and to be associated with diminishing synapse degeneration in the hippocampus. However, little is known about whether FLX affects the pathogenesis of AD in the middle-tolate stage and whether its effects are correlated with the amelioration of hippocampal dendritic dysfunction. Previously, it has been observed that FLX improves the spatial learning ability of middleaged APP/PS1 mice. Objective: In the present study, we further characterized the impact of FLX on dendritic spines in the hippocampus of middle-aged APP/PS1 mice. Results: It has been found that the numbers of dendritic spines in dentate gyrus (DG), CA1 and CA2/3 of hippocampus were significantly increased by FLX. Meanwhile, FLX effectively attenuated hyperphosphorylation of tau at Ser396 and elevated protein levels of postsynaptic density 95 (PSD-95) and synapsin-1 (SYN-1) in the hippocampus. Conclusion: These results indicated that the enhanced learning ability observed in FLX-treated middle-aged APP/PS1 mice might be associated with remarkable mitigation of hippocampal dendritic spine pathology by FLX and suggested that FLX might be explored as a new strategy for therapy of AD in the middle-to-late stage.


2020 ◽  
Vol 20 (26) ◽  
pp. 2380-2390 ◽  
Author(s):  
Md. Sahab Uddin ◽  
Abdullah Al Mamun ◽  
Md. Ataur Rahman ◽  
Tapan Behl ◽  
Asma Perveen ◽  
...  

Objective: Alzheimer's disease (AD) is a devastating neurodegenerative disorder, characterized by the extracellular accumulations of amyloid beta (Aβ) as senile plaques and intracellular aggregations of tau in the form of neurofibrillary tangles (NFTs) in specific brain regions. In this review, we focus on the interaction of Aβ and tau with cytosolic proteins and several cell organelles as well as associated neurotoxicity in AD. Summary: Misfolded proteins present in cells accompanied by correctly folded, intermediately folded, as well as unfolded species. Misfolded proteins can be degraded or refolded properly with the aid of chaperone proteins, which are playing a pivotal role in protein folding, trafficking as well as intermediate stabilization in healthy cells. The continuous aggregation of misfolded proteins in the absence of their proper clearance could result in amyloid disease including AD. The neuropathological changes of AD brain include the atypical cellular accumulation of misfolded proteins as well as the loss of neurons and synapses in the cerebral cortex and certain subcortical regions. The mechanism of neurodegeneration in AD that leads to severe neuronal cell death and memory dysfunctions is not completely understood until now. Conclusion: Examining the impact, as well as the consequences of protein misfolding, could help to uncover the molecular etiologies behind the complicated AD pathogenesis.


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Luke Whiley ◽  
◽  
Katie E. Chappell ◽  
Ellie D’Hondt ◽  
Matthew R. Lewis ◽  
...  

Abstract Background Both serotonergic signalling disruption and systemic inflammation have been associated with the pathogenesis of Alzheimer’s disease (AD). The common denominator linking the two is the catabolism of the essential amino acid, tryptophan. Metabolism via tryptophan hydroxylase results in serotonin synthesis, whilst metabolism via indoleamine 2,3-dioxygenase (IDO) results in kynurenine and its downstream derivatives. IDO is reported to be activated in times of host systemic inflammation and therefore is thought to influence both pathways. To investigate metabolic alterations in AD, a large-scale metabolic phenotyping study was conducted on both urine and serum samples collected from a multi-centre clinical cohort, consisting of individuals clinically diagnosed with AD, mild cognitive impairment (MCI) and age-matched controls. Methods Metabolic phenotyping was applied to both urine (n = 560) and serum (n = 354) from the European-wide AddNeuroMed/Dementia Case Register (DCR) biobank repositories. Metabolite data were subsequently interrogated for inter-group differences; influence of gender and age; comparisons between two subgroups of MCI - versus those who remained cognitively stable at follow-up visits (sMCI); and those who underwent further cognitive decline (cMCI); and the impact of selective serotonin reuptake inhibitor (SSRI) medication on metabolite concentrations. Results Results revealed significantly lower metabolite concentrations of tryptophan pathway metabolites in the AD group: serotonin (urine, serum), 5-hydroxyindoleacetic acid (urine), kynurenine (serum), kynurenic acid (urine), tryptophan (urine, serum), xanthurenic acid (urine, serum), and kynurenine/tryptophan ratio (urine). For each listed metabolite, a decreasing trend in concentrations was observed in-line with clinical diagnosis: control > MCI > AD. There were no significant differences in the two MCI subgroups whilst SSRI medication status influenced observations in serum, but not urine. Conclusions Urine and serum serotonin concentrations were found to be significantly lower in AD compared with controls, suggesting the bioavailability of the neurotransmitter may be altered in the disease. A significant increase in the kynurenine/tryptophan ratio suggests that this may be a result of a shift to the kynurenine metabolic route due to increased IDO activity, potentially as a result of systemic inflammation. Modulation of the pathways could help improve serotonin bioavailability and signalling in AD patients.


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