scholarly journals Cognitive and renal dysfunction in the elderly

2013 ◽  
Vol 7 (4) ◽  
pp. 397-402
Author(s):  
Francisco Souza do Carmo ◽  
Sueli Luciano Pires ◽  
Milton Luiz Gorzoni ◽  
Luiz Antonio Miorin
Keyword(s):  
Diabetes Mellitus ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Renal Function ◽  
Arterial Hypertension ◽  
The Elderly ◽  
Systemic Arterial Hypertension ◽  
Dementia Syndrome ◽  
Study Results ◽  
Significant Difference

ABSTRACT Cognitive impairment has been associated with several diseases and organic disturbances but few studies have explored the relationship between renal function and cognition. Objective: The aim of this study was to compare the renal function of elderly patients with and without Alzheimer's disease, and to identify potential associated comorbidities, as well as the presence of microalbuminuria. Methods: A group of 60 patients with dementia syndrome and probable Alzheimer's disease, and 20 patients without dementias, followed at the Geriatric outpatient unit of the Santa Casa de São Paulo Hospital, were selected for this study. Results: The results showed that the groups studied differed in terms of age, gender and Mini-Mental State Exam score, but no statistical difference was found for the presence of comorbidities (diabetes mellitus, dyslipidemia and systemic arterial hypertension). A significant difference in estimated creatinine clearance was observed between the two groups, with the Alzheimer's disease patients presenting significantly lower values than control subjects. Similarly, analysis of a portion of the two groups for the presence of microalbuminuria revealed a statistically significant difference between the two groups. Conclusion: The study conclusions were that patients with Alzheimer's disease had lower glomerular filtration and a higher incidence of microalbuminuria, yet without having more classic risk factors for Alzheimer's disease such as systemic arterial hypertension, diabetes mellitus or dyslipidemia.

scholarly journals Worries about memory loss and knowledge on Alzheimer's disease in community-dwelling elderly from Brazil

2011 ◽  
Vol 5 (2) ◽  
pp. 108-113 ◽  
Author(s):  
Maria Niures P.S. Matioli ◽  
Arnaldo Etzel ◽  
João A.G.G. Prats ◽  
Wares F. de O. Medeiros ◽  
Taiguara R. Monteiro ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Survey Design ◽  
Memory Loss ◽  
Female Gender ◽  
The Elderly ◽  
Normal Aging ◽  
Community Dwelling ◽  
Study Results ◽  
Memory Screening

Abstract Alzheimer's disease (AD) is the most common cause of dementia in the elderly. Efforts to determine risk factors for the development of AD are important for risk stratification and early diagnosis. Furthermore, there are no standardized practices for memory screening. Lack of knowledge on AD, perception of memory loss as part of normal aging, and poor socioeconomic conditions may also be implicated in the current situation of dementia. Objective: To evaluate knowledge of AD in a literate population of elders and correlate these findings with sociodemographic characteristics. Methods: A descriptive survey design study enrolled 994 volunteers from September 2007 to May 2008 in the city of Santos, São Paulo, Brazil, to answer a brief questionnaire consisting of 8 simple questions about knowledge of AD and worries about memory loss. Results: Greater knowledge about AD was associated with eight or more years of education, female gender and age between 60 and 70 years. Also, 52.8% of responders (95% CI - 49.5-56.0%) answered that memory loss is part of normal aging and 77.5% (95% CI - 74.7-80.1%) had never sought a doctor to evaluate their memories. Conclusion: Our study results reinforced that the first line of preventing late diagnosis of dementia is to act in health promotion, especially by targeting subjects older than 70 years of male gender and with lower educational level. It also provided evidence that strategies to promote physician initiative in treating memory problems are also paramount.

Performance of healthy elderly with Alzheimer's disease at an early stage in executive function and language

2011 ◽  
Vol 26 (S2) ◽  
pp. 498-498
Author(s):  
M.T. Santos ◽  
G.C. Couto ◽  
J.C. Achieri ◽  
C.A. Júnior
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Early Stage ◽  
The Elderly ◽  
Screening Tests ◽  
Healthy Elderly ◽  
Initial Stage ◽  
Significant Difference ◽  
Common Causes ◽  
The Impact

Dementia are increasingly prevalent in population. The most common causes of dementia is Alzheimer's disease (AD). Screening tests have been used for the premature diagnosis of Alzheimer Disease (AD), specifically in the executive functions and language, which are compromised at an initial stage. However, the necessity standardized means and validated for our middle, to show oneself a pressing subject.ObjectiveTo analyze the impact of the length of sentences in the abstraction of proverbs in the Screening Test for Alzheimer's disease with Proverbs (TRDAP), healthy elderly and with Alzheimer's disease at early stage.MethodSurvey document in the database, analyzing the responses of the elderly (abstract or concrete interpretation of proverbs), relating the length of sentences (sayings) of stage B of TRDAP with the diagnosis of Alzheimer's disease and the interference of age and schooling.ResultsHealthy older people showed greater capacity for abstraction than those with AD. There was Significant differences, in the sayings 1 (p = 0.033) and 2 (p = 0.001), corresponding to lower sentences, which did not occur with the proverb 3. As for age no verified significant difference among the healthy and only saying 3 in AD patients, however schooling differenced the healthy.ConclusionElderly with Alzheimer's disease at an initial stage have lower performance in the comprehension of ambiguous sentences, interpretation and abstraction of proverbs, corroborating with the data of the literature. The size of these sentences appears to be inversely proportional to the correctness of interpretation in elderly patients with and without AD.

scholarly journals Investigation of five polymorphic DNA markers associated with late onset Alzheimer disease

Genetika ◽  
2013 ◽  
Vol 45 (2) ◽  
pp. 503-514 ◽  
Author(s):  
Jalal Gharesouran ◽  
Maryam Rezazadeh ◽  
Mohaddes Mojtaba
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Dna Markers ◽  
Neurodegenerative Disorder ◽  
Late Onset ◽  
The Elderly ◽  
Healthy Controls ◽  
Genotype Frequencies ◽  
Significant Difference ◽  
And Control

Alzheimer's disease is a complex neurodegenerative disorder characterized by memory and cognitive impairment and is the leading cause of dementia in the elderly. The aim of our study was to examine the polymorphic DNA markers CCR2 (+190 G/A), CCR5?32, TNF-? (-308 G/A), TNF-? (-863 C/A) and CALHM1 (+394 C/T) to determine the relationship between these polymorphisms and the risk of late onset Alzheimer's disease in the population of Eastern Azerbaijan of Iran. A total of 160 patient samples and 163 healthy controls were genotyped by PCR-RFLP and the results confirmed using bidirectional sequencing. Statistical analysis of obtained data revealed non-significant difference between frequency of CCR5?32 in case and control groups. The same result was observed for TNF-? (-863 C/A) genotype and allele frequencies. Contrary to above results, significant differences were detected in frequency of TNF-? (-308 G/A) and CCR2-64I genotypes between the cases and healthy controls. A weak significant difference observed between allele and genotype frequencies of rs2986017 in CALHM1 (+394 C/T; P86L) in patient and control samples. It can be concluded that the T allele of P86L variant in CALHM1 & +190 G/A allele of CCR2 have a protective role against abnormal clinical features of Alzheimer's disease.

scholarly journals Evaluation of Renal Function in Alzheimer’s Disease and Geriatric Patients: Results from a Turkish Two-Center Study

2017 ◽  
Vol 36 (1) ◽  
pp. 54-61
Author(s):  
Zubeyde Erbayraktar ◽  
Ahmet Turan Evlice ◽  
Gokhan Yilmaz ◽  
Canan Yazici ◽  
Gorsev Yener ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Renal Function ◽  
Total Protein ◽  
Geriatric Patients ◽  
Age Groups ◽  
Conclusive Evidence ◽  
University Hospitals ◽  
Protein Levels ◽  
Significant Difference

SummaryBackground:Alzheimer’s disease (AD) is a severe multifactorial neurodegenerative proteopathy associated with advanced age. Discrepancies in the renal function of these patients compared to geriatric patients with dementia have rarely been reported. In this study, we aimed to disclose the importance of associated renal changes for the pathogenesis of AD.Methods:Patients with AD (n=107) and geriatric patients with dementia and without dementia (n=124) (231 patients in total) from Dokuz Eylul and Cukurova University Hospitals were enrolled in the study. We measured serum Na, K, Cl, Ca, BUN, creatinine, total protein levels and MDRD [eGFR] in all groups.Results:From Izmir Center, the first study arm consisted of patients with AD dementia (n=74), and the second arm included geriatric patients with dementia (n=79). From Adana, 78 patients were recruited to the study, of which 33 were with AD and 45 were geriatric patients without dementia. When we analyzed comparatively the AD and geriatric dementia patients study arms, a statistically significant difference was observed both in the median age (p<0.001), as well as in the biochemical parameters from Izmir Center: Na (p<0.001), K (p<0.001), Cl (p<0.05), Ca (p<0.001), BUN (p<0.05), creatinine (p<0.001), total protein (p<0.001) and MDRD [eGFR] (p<0.001). However, these were not significantly different between AD and geriatric patients without dementia in the Adana group.Conclusions:Our results indicate that renal function is prone to alterations in different age groups of patients with AD. However, there is no conclusive evidence that renal function is one of the risk factors in AD.

scholarly journals The Association between Hypertension and Dementia in the Elderly

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Michiya Igase ◽  
Katsuhiko Kohara ◽  
Tetsuro Miki
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Vascular Dementia ◽  
Risk Reduction ◽  
Antihypertensive Agents ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
The Elderly ◽  
Converting Enzyme Inhibitors ◽  
Significant Difference ◽  
Incidence Of Dementia

Hypertension (HT) and dementia are common disorders in the elderly. HT in the elderly is associated with increased occurrence rates of dementia including Alzheimer's disease (AD) and vascular dementia (VaD). In connection to this, some studies have suggested that HT in old age correlates with the pathogenesis of dementia. Since HT is potentially reversible, a number of randomized trials have examined whether antihypertensive treatment may help in preventing dementia occurrence. We review five studies, all using subjects 60 years or older, which investigated different antihypertensive pharmacological treatments. Data from two trials (Syst-Eur, PROGRESS) open the way toward the prevention of dementia (AD or VaD) by antihypertensive treatments. In the Syst-Eur study, with the dihydropyridine calcium antagonists, a reduction in both types of dementia was demonstrated (risk reduction 55%). The PROGRESS study showed that the use of angiotensin-converting enzyme inhibitors (ACEIs), with or without diuretics, resulted in decrease incidence of stroke-related dementia (risk reduction 19%), but dementia without stroke was not reduced. In contrast, the SHEP trial, treatment with a chlorthalidone-based antihypertensive regimen, did not significantly reduced the incidence of dementia. The SCOPE study (candesartan or hydrochlorothiazide versus placebo) and the HYVET-COG study (indapamide or perindopril versus placebo) found no significant difference between the active treatment and placebo group on the incidence of dementia. We found conflicting results regarding treatment benefits in dementia prevention. Recent clinical trials and studies on animal models suggest that blockades of RAS system could have reduced cognitive decline seen in Alzheimer's disease and vascular dementia. Future trials primarily designed to investigate the effects of antihypertensive agents on impaired cognition are needed.

scholarly journals Phase II (NAVIGATE-AD study) Results of LY3202626 Effects on Patients with Mild Alzheimer’s Disease Dementia

2021 ◽  
pp. 1-16
Author(s):  
Albert C. Lo ◽  
Cynthia Duggan Evans ◽  
Michele Mancini ◽  
Hong Wang ◽  
Sergey Shcherbinin ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Adverse Events ◽  
Functional Decline ◽  
Neurofibrillary Tangle ◽  
Amyloid Β ◽  
System Organ Class ◽  
Serious Adverse Events ◽  
Study Results ◽  
Significant Difference

Background: LY3202626 is a small molecule inhibitor of β-site amyloid precursor protein cleaving enzyme (BACE)1 shown to reduce amyloid-β (Aβ)1–40 and Aβ1–42 concentrations in plasma and cerebrospinal fluid developed for the treatment of Alzheimer’s disease (AD). Objective: To assess the change from baseline in flortaucipir positron emission tomography (PET) after treatment with LY3202626 compared with placebo in patients with mild. Methods: Patients received daily 3 mg or 12 mg doses of LY3202626 or placebo for 52 weeks. The primary outcome was assessment of cerebral neurofibrillary tangle load by flortaucipir PET. The study was terminated early following an interim analysis due to a low probability of identifying a statistically significant slowing of cognitive and/or functional decline. Results: A total of 316 patients were randomized and 47 completed the study. There was no statistically significant difference between placebo and either dose of LY3202626 from baseline to 52 weeks, or in annualized change for flortaucipir PET. There was no clinically meaningful difference between placebo and LY3202626 doses on efficacy measures of cognition and function. No deaths or serious adverse events considered related to LY3202626 were reported. A statistically significant increase in treatment-emergent adverse events in the psychiatric disorders system organ class was reported for both LY3202626 doses compared to placebo. Conclusion: LY3202626 tested at doses generating 70–90% BACE inhibition was generally well tolerated in this study. LY3202626 treatment did not result in a clinically significant change in cerebral tau burden as measured by flortaucipir nor in change of functional or cognitive decline compared to placebo.

scholarly journals Analysis of oral microbiome in chronic periodontitis with Alzheimer’s disease: Pilot study

2020 ◽  
Author(s):  
Hee Sam Na ◽  
Na-Yeon Jung ◽  
Suji Choi ◽  
Si yeong Kim ◽  
Hyun‐Joo Kim ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Pilot Study ◽  
Network Analysis ◽  
Chronic Periodontitis ◽  
Alpha Diversity ◽  
The Elderly ◽  
Oral Microbiome ◽  
Periodontal Tissues ◽  
Significant Difference

Abstract Background Alzheimer's disease (AD) dementia is the most common form of dementia in the elderly. Chronic periodontitis (CP) is a progressive destructive disease in the periodontal tissues, which is also common in the elderly. CP is known to be associated with an increase in cognitive decline in Alzheimer’s disease (AD). Recently, a potential role for pathogenic microbes in the development or exacerbation of AD pathology has been proposed. To reveal the association between periodontitis-related microbes and AD, we investigated the oral microbiome in AD patients with CP. Methods Fifteen AD dementia (AD) with CP and 14 cognitively unimpaired (CU) participants with CP were recruited. Buccal, supragingival and subgingival plaque samples were collected with the full-mouth periodontal examination. Alpha diversity, beta diversity, LEfSe (linear discriminant analysis effect size), metabolic pathway prediction and network analysis were applied to compare the microbiome features. Results All participants had moderate to severe chronic periodontitis. The level of alpha diversity in subgingival microbiota of the AD group was higher than the CU group. Also, principle coordinate analysis showed significant difference in subgingival samples. When significant taxa were analyzed by LEfSe, various Prevotella spp. were more prevalent in subgingival samples from AD group. Furthermore, subgingival microbiome network analysis showed distinctive network complexity in AD compared to CU group. Conclusion We found that subgingival microbiome of AD patients had increased microbial diversity. The composition of subgingival microbiome was different between the AD and the CU groups. This pilot study provides a novel view at the changes of subgingival microbiome in AD patients with CP. Our findings need further well-designed studies with adequate sample size to confirm oral microbiome characteristics in AD with CP.

scholarly journals New Findings, New Thinking, and New Expectations in Alzheimer's Disease

CNS Spectrums ◽  
2003 ◽  
Vol 8 (11) ◽  
pp. 804-804
Author(s):  
Hillel Grossman ◽  
Deborah Marin
Keyword(s):  
Diabetes Mellitus ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Paradigm Shift ◽  
Disease Process ◽  
The Elderly ◽  
Epidemiologic Studies ◽  
Specific Gene ◽  
Insulin Degrading Enzyme ◽  
New Findings

Almost 100 years ago, Alois Alzheimer described the case of Auguste D., a woman who developed delusions and memory impairment at 56 years of age. Alzheimer went on to detail the symptoms and neuropathology of the disease that came to carry his name. For most of the subsequent century, however, little more was learned: Alzheimer's disease remained an entity with a well-described syndromal presentation, clinical course, and a distinct neuropathology but little else appreciated. Only in the past 20 years have findings regarding the pathogenesis of AD and potential treatments emerged. The emergence of standardized criteria for both the clinical diagnosis of AD and its pathological definition; the mainstreaming of a pathogenetic theory; the development of animal models; the identification of specific gene risk factors; and the first round of approved treatments have recently come to light.This wealth of discovery has been fueled by the development of new techniques and technologies. Equally important has been the shift in attitude regarding cognition in the elderly. The notion of “senility” has been largely supplanted by a growing appreciation that cognitive decline is not the rule and is indicative of a distinct disease process. This realization spurs the research to determine who declines, who does not, and the risks factors for decline. This paradigm shift has allowed a renewed focus on disease processes related to memory decline in aging, and particularly AD. This issue of CNS Spectrums focuses on the shift in thinking about AD. We are on the cusp of a dramatic change in our understanding of the risks for AD, the mechanisms for its genesis, and how it might be prevented and treated.Hillel Grossman, MD, expands the paradigm shift by focusing on diabetes mellitus and its relationship to AD. Early epidemiologic studies saw a seeming protective effect from AD among patients with diabetes mellitus. More recent prospective studies note that diabetes mellitus and insulin resistance seem to heighten the risk for AD. This finding has moved to the laboratory, where observations related to insulin-degrading enzyme and its role in amyloid metabolism suggest a potential mechanism for this heightened risk.

scholarly journals PENFIGÓIDE BOLHOSO, DESAFIO TERAPÊUTICO EM PACIENTE COM MÚLTIPLAS COMORBIDADES

2019 ◽  
Vol 6 (1) ◽  
pp. 44-46
Author(s):  
Camila Torga de Lima e Silva ◽  
Milena Katrini Costa ◽  
Fellipe Magela de Araújo ◽  
Yasmin Pugliesi ◽  
Luciane Prado e Silva Tavares ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Elderly Patient ◽  
Arterial Hypertension ◽  
Inflammatory Infiltrate ◽  
The Elderly ◽  
The Body ◽  
Laboratory Examination ◽  
Systemic Arterial Hypertension ◽  
Individualized Management ◽  
Diabetes Melitus

O Pênfigóide bolhoso (PB) é uma bulose autoimune, mais comum em idosos, caracterizada por bolhas subepidérmicas, tensas e grandes. Este trabalho apresenta uma paciente idosa, portadora de Diabetes melitus e Hipertensão arterial sistêmica, com queixa de bolhas difusas pelo corpo. Ao exame laboratorial demonstrou eosinofilia de 742/mm3 e aumento de IgE equivalente a 469 kU/L; anatomopatológico com bolha subepidérmica e infiltrado inflamatório rico em eosinófilos; e imunofluorescência com imunodepósitos na junção dermo-epidérmica constituídos por IgG e C3. Mediante esses achados, paciente recebeu diagnóstico de PB. Devido as comorbidades apresentadas, a corticoterapia não foi a primeira opção, a tetraciclina apresentou falha terapêutica e a dapsona 100mg/dia, por 6 meses, foi resolutiva. Conclui-se que cada paciente deve ter seu manejo individualizado para melhores resultados. Palavras-chave: penfigóide bolhoso; bulose; doença autoimune. ABSTRACT Bullous pemphigoid (BP) is an autoimmune bulge, more common in the elderly, characterized by subepidermal, tense and large blisters. This study presents an elderly patient with diabetes mellitus and systemic arterial hypertension, with diffuse blisters on the body. Laboratory examination showed eosinophilia of 742/mm3 and an increase of IgE equivalent to 469 kU/L; anatomopathological with subepidermal bubble and inflammatory infiltrate rich in eosinophils; and immunofluorescence with immunodeposits at the dermo-epidermal junction consisting of IgG and C3. Based on these findings, the patient was diagnosed with BP. Due to the comorbidities of the patient, corticotherapy was not the first option, tetracycline presented therapeutic failure, and dapsone 100mg / day for 6 months was resolution. It is concluded that each patient should have their individualized management for best results. Keywords: Ashy pemphigoid; bulge; autoimune disease.

scholarly journals Impact of depressive symptoms on outcome of Alzheimer's disease

2010 ◽  
Vol 4 (4) ◽  
pp. 346-352 ◽  
Author(s):  
Anita de Paula Eduardo Garavello ◽  
Regina Miksian Magaldi ◽  
Sérgio Márcio Pacheco Paschoal ◽  
Wilson Jacob Filho
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Depressive Symptoms ◽  
The Elderly ◽  
Functional Evaluation ◽  
Depression Group ◽  
Significant Difference ◽  
The Impact ◽  
Group D

Abstract There is no consensus in the medical literature about the impact of depressive symptoms on the evolution of Alzheimer's disease (AD). Objective: To compare the evolution of AD patients, with and without depressive symptoms, in terms of cognition, functionality and caregiver stress. Methods: The study entailed 2 stages: an initial retrospective stage involving review of medical charts of patients with mild and moderate AD. Patients were divided according to the presence or absence of depressive symptoms, defined by medical interview and questions on depressed mood from the CAMDEX (Cambridge Examination for Mental Disorders of the Elderly) and Neuropsychiatric Inventory (NPI). Twenty-nine patients were evaluated, 37.9% with depression (Group D+) and 62.1% without depression (Group D-). The groups were compared regarding demographic and medical characteristics, cognitive and functional performance, presence of apathy as a separate symptom, and caregiver stress, using standardized tests and questionnaires. In the second transversal step, the same tools were reapplied after 2 to 4 years of follow-up, and evolution for the two groups was compared. Results: The two groups were highly homogeneous in demographic and clinic characteristics, as well as in length of follow-up, and presented no significant difference in cognitive or functional evaluation at the time of diagnoses or after follow-up. Only caregiver stress was greater in Group D+ at the two time points (p<0.001). Conclusions: No differences in the evolution of AD patients with or without depressive symptoms were evident. Nevertheless, these symptoms were associated to emotional burden of caregivers.

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