scholarly journals Good rate of clinical response to cholinesterase inhibitors in mild and moderate Alzheimer's disease after three months of treatment: An open-label study

2013 ◽  
Vol 7 (2) ◽  
pp. 190-196 ◽  
Author(s):  
Luis Felipe José Ravic de Miranda ◽  
Marilourdes do Amaral Barbosa ◽  
Patrícia Regina Henrique Peles ◽  
Patrícia Hilar Pôças ◽  
Pedro Augusto Lopes Tito ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cerebrovascular Disease ◽  
Clinical Response ◽  
Cholinesterase Inhibitors ◽  
Rating Scale ◽  
The Elderly ◽  
Open Label ◽  
Age Related ◽  
Moderate Dementia

ABSTRACT Life expectancy in Brazil has increased markedly over the last 30 years. Hence, age-related disorders, such as Alzheimer's disease (AD), warrant special attention due to their high prevalence in the elderly. Pharmacologic treatment of AD is based on cholinesterase inhibitors (ChEI) and memantine, leading to modest clinical benefits both in the short and long-term. However, clinical response is heterogeneous and needs further investigation. Objective: To investigate the rate of response to ChEI in AD after three months of treatment. Methods: Patients with mild or moderate dementia due to probable AD or to AD associated with cerebrovascular disease were included in the study. The subjects were assessed at baseline and again after three months of ChEI treatment. Subjects were submitted to the Mini-Mental State Examination (MMSE), Mattis Dementia Rating Scale, Katz Basic Activities of Daily Living, Pfeffer Functional Activities Questionnaire, Neuropsychiatric Inventory and Cornell Scale for Depression in Dementia. Good response was defined by a gain of ≥2 points on the MMSE after three months of treatment in relation to baseline. Results: Seventy-one patients, 66 (93%) with probable AD and five (7%) with AD associated with cerebrovascular disease, were evaluated. The good response rate at three months was 31.0%, being 37.2% and 21.4% in mild and moderate dementia, respectively. There were no significant differences on most tests, except for improvement in hallucinations, agitation and dysphoria in moderate dementia patients. Conclusion: The rate of good clinical response to ChEI was higher than usually reported. Specific behavioral features significantly improved in the subgroup of moderate dementia.

Preventing Alzheimer's Wandering

2019 ◽  
pp. 77-89
Author(s):  
Sara Paiva ◽  
Rui Peleja ◽  
Jorge Cunha ◽  
Carlos Abreu
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Quality Of Care ◽  
Cognitive Impairments ◽  
The Elderly ◽  
Strong Impact ◽  
Brain Disorder ◽  
Age Related

With increased life expectancy, the incidence of age-related cognitive impairments, faced by the elderly and older generations, is growing. Among the population with cognitive impairments, those that suffer from Alzheimer's disease are the most common. The Alzheimer's disease is a chronic degenerative brain disorder that is characterised by a failure of memory and, in some instances, by disorders in language, perception and planning. As a consequence of the progressive damages imposed by the illness, patients will increasingly seek and need assistance. This paper presents a tool to aid the development and managing of caregiving communities, comprising immediate family members, relatives, neighbours and healthcare professionals, to assist patients with Alzheimer's disease. Such communities could have a strong impact on the quality of care provided to the patients. At the same time, it is hoped that involving communities will significantly improve the quality of life of Alzheimer's patients and their families while reducing the costs related to the care provided.

scholarly journals Protein Homeostasis Networks and the Use of Yeast to Guide Interventions in Alzheimer’s Disease

2020 ◽  
Vol 21 (21) ◽  
pp. 8014
Author(s):  
Sudip Dhakal ◽  
Ian Macreadie
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Stress Responses ◽  
Cell Biology ◽  
Neurodegenerative Disorder ◽  
The Elderly ◽  
Yeast Cells ◽  
Yeast Genome ◽  
Protein Homeostasis ◽  
Age Related

Alzheimer’s Disease (AD) is a progressive multifactorial age-related neurodegenerative disorder that causes the majority of deaths due to dementia in the elderly. Although various risk factors have been found to be associated with AD progression, the cause of the disease is still unresolved. The loss of proteostasis is one of the major causes of AD: it is evident by aggregation of misfolded proteins, lipid homeostasis disruption, accumulation of autophagic vesicles, and oxidative damage during the disease progression. Different models have been developed to study AD, one of which is a yeast model. Yeasts are simple unicellular eukaryotic cells that have provided great insights into human cell biology. Various yeast models, including unmodified and genetically modified yeasts, have been established for studying AD and have provided significant amount of information on AD pathology and potential interventions. The conservation of various human biological processes, including signal transduction, energy metabolism, protein homeostasis, stress responses, oxidative phosphorylation, vesicle trafficking, apoptosis, endocytosis, and ageing, renders yeast a fascinating, powerful model for AD. In addition, the easy manipulation of the yeast genome and availability of methods to evaluate yeast cells rapidly in high throughput technological platforms strengthen the rationale of using yeast as a model. This review focuses on the description of the proteostasis network in yeast and its comparison with the human proteostasis network. It further elaborates on the AD-associated proteostasis failure and applications of the yeast proteostasis network to understand AD pathology and its potential to guide interventions against AD.

scholarly journals The neuropsychological profiles of mild Alzheimer's disease and questionable dementia as compared to age-related cognitive decline

2003 ◽  
Vol 9 (5) ◽  
pp. 720-732 ◽  
Author(s):  
ELISE CACCAPPOLO-VAN VLIET ◽  
JENNIFER MANLY ◽  
MING-XIN TANG ◽  
KAREN MARDER ◽  
KAREN BELL ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
The Elderly ◽  
Cognitive Domain ◽  
Group Status ◽  
Control Subjects ◽  
Mini Mental Status Exam ◽  
Age Related ◽  
Questionable Dementia ◽  
Elderly Control

Test scores from a comprehensive neuropsychological battery administered to 1602 subjects consisting of 1347 subjects with probable Alzheimer's disease (AD), 100 subjects with questionable dementia (QD) and 155 non-demented elderly control subjects were cross-sectionally analyzed. Subjects with probable AD were categorized as mild (n = 244), moderate (n = 480), severe (n = 376), and very severe (n = 247) according to modified mini mental status exam (mMMSE) scores. Mean scores on individual neuropsychological tests are provided for each group of subjects. Stratified random sampling was performed to select a sample of mild AD subjects who were matched in age and education to non-demented elderly controls, and analyses focused on the performance of QD subjects and mild AD subjects, whose scores were compared to those of the elderly control subjects. Selected scores were organized by cognitive domain and logistic regressions were used to determine the domains and individual tests within each that were most predictive of group status. Results suggested a profile of scores associated with QD and mild AD including impaired recall of verbal information for both groups. Areas of lower functioning in QD subjects as compared to elderly controls included category fluency and visuospatial ability. (JINS, 2003, 9, 720–732.)

scholarly journals Ocular Vascular Changes: Choroidal Thickness as an Early Biomarker for Alzheimer’s Disease?

2021 ◽  
Vol 11 (12) ◽  
pp. 1365
Author(s):  
Chiara Villa
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Choroidal Thickness ◽  
The Elderly ◽  
Vascular Changes ◽  
Age Related ◽  
Early Biomarker ◽  
Progressive Disorder

Alzheimer’s disease (AD) is an age-related neurodegenerative and progressive disorder representing the most common form of dementia among the elderly [...]

Population-based study of the prevalence and presentation of dementia in adults with Down's syndrome

1998 ◽  
Vol 172 (6) ◽  
pp. 493-498 ◽  
Author(s):  
Anthony J. Holland ◽  
Johnny Hon ◽  
Felicia A. Huppert ◽  
Fran Stevens ◽  
Peter Watson
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
The Elderly ◽  
Population Based ◽  
Prevalence Rates ◽  
Population Based Study ◽  
Age Related ◽  
Living Skills

BackgroundThe reported prevalence rates of dementia in people with Down's syndrome have varied considerably across studies. The aim of this study was to investigate the extent of clinical change with age using an established diagnostic instrument in an unbiased, population-based sample of older people with Down's syndrome.MethodChanges in memory, personality, general mental functioning and daily living skills were assessed using a modified version of the informant interview of the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX).ResultsAge-specific prevalence rates of dementia varied according to the diagnostic criteria used. Using CAMDEX criteria for Alzheimer's disease, prevalence rates increased from 3.4 to 10.3 to 40% in the 30–39, 40–49 and 50–59 age group, respectively.ConclusionsOverall, the age-related pattern of presentation and dementia diagnoses differs from that seen in the general elderly population. However, age-specific prevalence rates of Alzheimer's disease were similar but 30–40 years earlier in life.

scholarly journals Progress in Clinical Neurosciences: Treatment of Alzheimer’s Disease and Other Dementias - Review and Comparison of the Cholinesterase Inhibitors

2002 ◽  
Vol 29 (4) ◽  
pp. 306-314 ◽  
Author(s):  
David B. Hogan ◽  
Christopher Patterson
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Side Effect ◽  
Cholinesterase Inhibitors ◽  
Mechanisms Of Action ◽  
Convincing Evidence ◽  
Clinical State ◽  
Moderate Dementia ◽  
Alzheimer’S Pathology ◽  
Clinical Trails

Background:Alzheimer’s disease (AD) is the most common cause of dementia in older adults. Acceptance of the cholinergic hypothesis led to a search for medications which could enhance central cholinergic activity in this condition. There are now three cholinesterase inhibitors available for the treatment of AD in Canada.Objectives:To review the currently available cholinesterase inhibitors approved for the treatment of AD in Canada and to provide guidance on who and how to treat with these agents.Results:Donepezil, rivastigmine, and galantamine are approved for the treatment of AD in Canada. In clinical trails, patients with mild to moderate AD treated with these agents experienced modest improvements in cognition, function, behaviour, and/or global clinical state. The magnitude of benefits seen with each agent appeared to be similar. While to date, there is no convincing evidence that one is more efficacious or effective, they do differ in their pharmacokinetics, additional mechanisms of action, and side effect profiles. Therefore, the selection of agent will be based on considerations such as side effect profiles, ease of administration, personal familiarity/experience, and beliefs about the importance of the noted differences in their pharmacokinetics and additional mechanisms of action.Conclusion:We believe that these agents should be offered to all individuals with a mild to moderate dementia where Alzheimer’s pathology is felt to be a contributing factor. We view all three available cholinesterase inhibitors as first-line drugs.

scholarly journals Curcumin and Its Derivatives as Theranostic Agents in Alzheimer’s Disease: The Implication of Nanotechnology

2020 ◽  
Vol 22 (1) ◽  
pp. 196
Author(s):  
Umair Shabbir ◽  
Momna Rubab ◽  
Akanksha Tyagi ◽  
Deog-Hwan Oh
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Neurodegenerative Disorder ◽  
The Elderly ◽  
Biological Properties ◽  
Age Related ◽  
Theranostic Agents ◽  
Nutritional Compounds ◽  
Age Related Cognitive Decline ◽  
Effective Drugs

Curcumin is a polyphenolic natural compound with diverse and attractive biological properties, which may prevent or ameliorate pathological processes underlying age-related cognitive decline, Alzheimer’s disease (AD), dementia, or mode disorders. AD is a chronic neurodegenerative disorder that is known as one of the rapidly growing diseases, especially in the elderly population. Moreover, being the eminent cause of dementia, posing problems for families, societies as well a severe burden on the economy. There are no effective drugs to cure AD. Although curcumin and its derivatives have shown properties that can be considered useful in inhibiting the hallmarks of AD, however, they have low bioavailability. Furthermore, to combat diagnostic and therapeutic limitations, various nanoformulations have also been recognized as theranostic agents that can also enhance the pharmacokinetic properties of curcumin and other bioactive compounds. Nanocarriers have shown beneficial properties to deliver curcumin and other nutritional compounds against the blood-brain barrier to efficiently distribute them in the brain. This review spotlights the role and effectiveness of curcumin and its derivatives in AD. Besides, the gut metabolism of curcumin and the effects of nanoparticles and their possible activity as diagnostic and therapeutic agents in AD also discussed.

scholarly journals White Matter Changes in Patients with Alzheimer’s Disease and Associated Factors

2019 ◽  
Vol 8 (2) ◽  
pp. 167 ◽  
Author(s):  
Yi-Hui Kao ◽  
Mei-Chuan Chou ◽  
Chun-Hung Chen ◽  
Yuan-Han Yang
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
White Matter ◽  
Rating Scale ◽  
Beta Amyloid ◽  
Future Research ◽  
White Matter Changes ◽  
Age Related ◽  
And Gender ◽  
Fazekas Scale

Alzheimer’s disease (AD) is traditionally thought of as a neurodegenerative disease. Recent evidence shows that beta amyloid-independent vascular changes and beta amyloid-dependent neuronal dysfunction both equally influence the disease, leading to loss of structural and functional connectivity. White matter changes (WMCs) in the brain are commonly observed in dementia patients. The effect of vascular factors on WMCs and the relationship between WMCs and severity of AD in patients remain to be clarified. We recruited 501 clinically diagnosed probable AD patients with a series of comprehensive neuropsychological tests and brain imaging. The WMCs in cerebral CT or MRI were rated using both the modified Fazekas scale and the combined CT-MRI age related WMC (ARWMC) rating scale. Periventricular WMCs were observed in 79.4% of the patients and deep WMCs were also seen in 48.7% of the patients. WMC scores were significantly higher in the advanced dementia stage in periventricular WMCs (p = 0.001) and total ARWMCs (p < 0.001). Age and disease severity were both independently associated with WMCs score, particularly in the total, frontal and parieto-occipital areas. Vascular factors including hypertension, diabetes mellitus, and gender were not significantly associated with WMCs. In conclusion, both age and severity of dementia were significantly associated with WMCs in AD patients. These associations highlight future research targets.

scholarly journals Trazodone for the treatment of sleep disorders in dementia: an open-label, observational and review study

2011 ◽  
Vol 69 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Einstein Francisco Camargos ◽  
Marcela Basso Pandolfi ◽  
Marco Polo Dias Freitas ◽  
Juliana Lima Quintas ◽  
Juliana de Oliveira Lima ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Clinical Practice ◽  
Sleep Disorders ◽  
The Elderly ◽  
Open Label ◽  
Review Study ◽  
One Year ◽  
The One ◽  
Trazodone Hydrochloride

Sleep disorders (SD) in patients with dementia are very common in clinical practice. The use of antidepressants with hypnotic actions, such as trazodone, plays an important role in these cases. The aim of this study is to present a profile of the use of trazodone in demented patients with SD, as well as a review of trazodone hydrochloride in SD. We evaluated 178 elderly patients with Alzheimer's disease and other dementias, clinically presenting SD and treated with hypnosedative medications. In the one-year period comprising the study, 68 (38.2%) of the 178 had sleep disorders. Most patients (114; 64%) had a diagnosis of Alzheimer's disease. Approximately 85% of patients with SD used hypnosedative drugs. Trazodone was the most commonly used drug among patients (N = 35), with an effectiveness of 65.7%. Trazodone has been shown to be a good option for treatment of the elderly with dementia and associated SD.

scholarly journals Efficacy, Safety, and Tolerability of Switching from Oral Cholinesterase Inhibitors to Rivastigmine Transdermal Patch with 1-Step Titration in Patients with Mild to Moderate Alzheimer’s Disease: A 24-Week, Open-Label, Multicenter Study in Japan

2019 ◽  
Vol 9 (2) ◽  
pp. 302-318 ◽  
Author(s):  
Kengo Ueda ◽  
Sadao Katayama ◽  
Tetsuaki Arai ◽  
Nobuo Furuta ◽  
Shinichiro Ikebe ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cholinesterase Inhibitors ◽  
Poor Response ◽  
Delivery Rate ◽  
Application Site ◽  
Transdermal Patch ◽  
Maintenance Period ◽  
Open Label ◽  
Titration Period

Background: Few studies have investigated treatment options for patients with Alzheimer’s disease (AD) showing a poor response to oral cholinesterase inhibitors (ChEIs) in Japan. Objective: To investigate the efficacy and safety of switching from oral ChEIs to rivastigmine transdermal patch in patients with AD. Methods: In this multicenter, open-label, phase IV study in outpatient clinics in Japan, patients with mild-moderate AD who had a poor response to or experienced difficulty in continuing donepezil or galantamine were switched to rivastigmine transdermal patch (5 cm2; loaded dose 9 mg, delivery rate 4.6 mg/24 h) with a 1-step titration in week 4 (10 cm2; loaded dose 18 mg, delivery rate 9.5 mg/24 h), which was continued for 4 weeks in the titration period and 16 weeks in a maintenance period. The primary endpoint was the change in Mini-Mental State Examination (MMSE) total score from baseline to week 24. Results: A total of 118 patients were enrolled and switched to rivastigmine, of which 102 completed the 24-week study. The MMSE total score was essentially unchanged during the study, with a least-square mean change (SD) of −0.35 (2.64) at week 24 (p = 0.1750). Exploratory analysis with a mixed-effect model comparing changes in MMSE between the pre- and post-switch periods suggested that switching to rivastigmine prevented a worsening of MMSE. Application site skin reactions/irritations occurred in 30.5% of patients overall, in 22.0% in the 8-week titration period, and in 10.2% in the 16-week maintenance period. Conclusion: Within-class switching from an oral ChEI to rivastigmine transdermal patch might be an efficacious and tolerable option for AD patients showing a poor or limited response to a prior oral ChEI.

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