scholarly journals Constructing the Alzheimer Patient

2009 ◽  
Vol 22 (2) ◽  
pp. 55-79
Author(s):  
Marion Droz Mendelzweig
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Neuropsychological Tests ◽  
Daily Life ◽  
Neurological Status ◽  
Grey Zone ◽  
Memory Clinic ◽  
Alzheimer Patient ◽  
Diffi Cult ◽  
Diagnosis Of Dementia

Identifying a tipping point that might draw a distinction between normal and pathological ageing is a diffi cult task. This paper reviews various steps that lead to establishing a diagnosis of dementia disorders as it is done in a memory clinic. It analyses the way different data is collected in the patient’s daily life. The steps, including a patient’s neurological status, neuropsychological tests and MRI, are interwoven with regard to identifying Alzheimer’s disease. The mild cognitive impairment category that emerges from this process appears as a grey zone, useful to the practitioners and patients despite the controversies underlying the concept. By questioning the performative dynamic stemming from the encounters between patients with cognitive concerns and professionals, this paper intends to fi nd out how this activity contributes to the standardization of the disease outlines, and how this process contributes to separating ageing signs from a pathological way of becoming aged.

An assessment of the new memory clinic at Cork University Hospital

2008 ◽  
Vol 25 (2) ◽  
pp. 61-65 ◽  
Author(s):  
Abraham Popoola ◽  
Maria O'Donovan ◽  
Eleanor Mullan
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Mmse Score ◽  
Early Recognition ◽  
Management Plan ◽  
University Hospital ◽  
Memory Clinic ◽  
Body Type ◽  
Social Interventions ◽  
Diagnosis Of Dementia

AbstractObjective: Dementia is a progressive brain disease. The prevalence of dementia increases with age. Symptomatic pharmacological treatments for dementia are available. Psychological and social interventions can support the patient and their carer. Early recognition and diagnosis of dementia are necessary to access this care and reduce crisis-led intervention. A memory clinic service is ideally placed to commence the assessment and management of dementia. The objective of this paper was to describe the setting up of the memory clinic in Cork University Hospital and review the characteristics of the first 118 patients.Method: One hundred and eighteen patients were assessed at the memory clinic between July 2004 and Feb 2007. In general the service operated on a two-appointment system. The first appointment was for a comprehensive assessment with investigations. The second appointment was a feedback session with discussion of the diagnosis, prognosis and management plan for the patient and generally their carer. We examined their demographic characteristics, clinical details, psychological test results and results of investigations.Results: Of the 127 patients referred, 118 (92.9%) attended. Fifteen (12.7%) patients had diagnosis of mild cognitive impairment (MCI), 93 (78.8%) patients were diagnosed with dementia and 5 (4.2%) had diagnosis of depressive disorder with no co-morbid dementia. The dementia type in descending frequency was Alzheimer's disease (50.5%), vascular dementia (34.4%), mixed type dementia (10.8%), Frontal lobe dementia (2.2%) and Lewy body type (2.2%). Of the 93 (78.8%) patients with dementia, 47 (50.5%) had MMSE score ≥20, 29 (31.2%) had MMSE score 11-19 and 17 (18.3%) had score of 0-10. Thirty-three (35.5%) patients were on antidementia medication at the point of referral and a further 16 (17.2%) patients were commenced on these drugs following assessment.Conclusion: The memory clinic provides a service for the assessment of mild cognitive impairment (MCI) and dementia. It offers diagnosis, an opportunity to receive specific advice regarding dementia management, differentiation between dementia and depression and a resource point for carers and patients.

Identification and Temporal Characterization of Features Associated with the Conversion from Mild Cognitive Impairment to Alzheimer’s Disease

2018 ◽  
Vol 15 (8) ◽  
pp. 751-763 ◽  
Author(s):  
Antonio Martinez-Torteya ◽  
Hugo Gomez-Rueda ◽  
Victor Trevino ◽  
Joshua Farber ◽  
Jose Tamez-Pena ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Neuropsychological Tests ◽  
Quantitative Mri ◽  
Rank Test ◽  
Longitudinal Models ◽  
Log Rank Test ◽  
Medical Histories

Background: Diagnosing Alzheimer’s disease (AD) in its earliest stages is important for therapeutic and support planning. Similarly, being able to predict who will convert from mild cognitive impairment (MCI) to AD would have clinical implications. Objectives: The goals of this study were to identify features from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database associated with the conversion from MCI to AD, and to characterize the temporal evolution of that conversion. Methods: We screened the publically available ADNI longitudinal database for subjects with MCI who have developed AD (cases: n=305), and subjects with MCI who have remained stable (controls: n=250). Analyses included 1,827 features from laboratory assays (n=12), quantitative MRI scans (n=1,423), PET studies (n=136), medical histories (n=72), and neuropsychological tests (n=184). Statistical longitudinal models identified features with significant differences in longitudinal behavior between cases and matched controls. A multiple-comparison adjusted log-rank test identified the capacity of the significant predictive features to predict early conversion. Results: 411 features (22.5%) were found to be statistically different between cases and controls at the time of AD diagnosis; 385 features were statistically different at least 6 months prior to diagnosis, and 28 features distinguished early from late conversion, 20 of which were obtained from neuropsychological tests. In addition, 69 features (3.7%) had statistically significant changes prior to AD diagnosis. Conclusion: Our results characterized features associated with disease progression from MCI to AD, and, in addition, the log-rank test identified features which are associated with the risk of early conversion.

Neurocognitive Plasticity Is Associated with Cardiorespiratory Fitness Following Physical Exercise in Older Adults with Amnestic Mild Cognitive Impairment

2021 ◽  
pp. 1-22
Author(s):  
Galit Yogev-Seligmann ◽  
Tamir Eisenstein ◽  
Elissa Ash ◽  
Nir Giladi ◽  
Haggai Sharon ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Aerobic Exercise ◽  
Cardiorespiratory Fitness ◽  
Neuropsychological Tests ◽  
Aerobic Training ◽  
Amnestic Mild Cognitive Impairment ◽  
Control Group ◽  
Memory Encoding

Background: Aerobic training has been shown to promote structural and functional neurocognitive plasticity in cognitively intact older adults. However, little is known about the neuroplastic potential of aerobic exercise in individuals at risk of Alzheimer’s disease (AD) and dementia. Objective: We aimed to explore the effect of aerobic exercise intervention and cardiorespiratory fitness improvement on brain and cognitive functions in older adults with amnestic mild cognitive impairment (aMCI). Methods: 27 participants with aMCI were randomized to either aerobic training (n = 13) or balance and toning (BAT) control group (n = 14) for a 16-week intervention. Pre- and post-assessments included functional MRI experiments of brain activation during associative memory encoding and neural synchronization during complex information processing, cognitive evaluation using neuropsychological tests, and cardiorespiratory fitness assessment. Results: The aerobic group demonstrated increased frontal activity during memory encoding and increased neural synchronization in higher-order cognitive regions such as the frontal cortex and temporo-parietal junction (TPJ) following the intervention. In contrast, the BAT control group demonstrated decreased brain activity during memory encoding, primarily in occipital, temporal, and parietal areas. Increases in cardiorespiratory fitness were associated with increases in brain activation in both the left inferior frontal and precentral gyri. Furthermore, changes in cardiorespiratory fitness were also correlated with changes in performance on several neuropsychological tests. Conclusion: Aerobic exercise training may result in functional plasticity of high-order cognitive areas, especially, frontal regions, among older adults at risk of AD and dementia. Furthermore, cardiorespiratory fitness may be an important mediating factor of the observed changes in neurocognitive functions.

scholarly journals Prevalence and Covariates of Elevated Depressive Symptoms in Rural Memory Clinic Patients with Mild Cognitive Impairment or Dementia

2014 ◽  
Vol 4 (2) ◽  
pp. 209-220 ◽  
Author(s):  
Julie G. Kosteniuk ◽  
Debra G. Morgan ◽  
Megan E. O'Connell ◽  
Margaret Crossley ◽  
Andrew Kirk ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mild Cognitive Impairment ◽  
Memory Clinic

scholarly journals Heterogeneity of Amyloid Binding in Cognitively Impaired Patients Consecutively Recruited from a Memory Clinic: Evaluating the Utility of Quantitative 18F-Flutemetamol PET-CT in Discrimination of Mild Cognitive Impairment from Alzheimer’s Disease and Other Dementias

2020 ◽  
pp. 1-14
Author(s):  
Yi-Wen Bao ◽  
Anson C.M. Chau ◽  
Patrick Ka-Chun Chiu ◽  
Yat Fung Shea ◽  
Joseph S.K. Kwan ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Amyloid Β ◽  
Standardized Uptake Value ◽  
Subjective Cognitive Decline ◽  
Cognitively Impaired ◽  
Memory Clinic ◽  
Pet Ct

Background: With the more widespread use of 18F-radioligand-based amyloid-β (Aβ) PET-CT imaging, we evaluated Aβ binding and the utility of neocortical 18F-Flutemetamol standardized uptake value ratio (SUVR) as a biomarker. Objective: 18F-Flutemetamol SUVR was used to differentiate 1) mild cognitive impairment (MCI) from Alzheimer’s disease (AD), and 2) MCI from other non-AD dementias (OD). Methods: 109 patients consecutively recruited from a University memory clinic underwent clinical evaluation, neuropsychological test, MRI and 18F-Flutemetamol PET-CT. The diagnosis was made by consensus of a panel consisting of 1 neuroradiologist and 2 geriatricians. The final cohort included 13 subjective cognitive decline (SCD), 22 AD, 39 MCI, and 35 OD. Quantitative analysis of 16 region-of-interests made by Cortex ID software (GE Healthcare). Results: The global mean 18F-Flutemetamol SUVR in SCD, MCI, AD, and OD were 0.50 (SD-0.08), 0.53 (SD-0.16), 0.76 (SD-0.10), and 0.56 (SD-0.16), respectively, with SUVR in SCD and MCI and OD being significantly lower than AD. Aβ binding in SCD, MCI, and OD was heterogeneous, being 23%, 38.5%, and 42.9% respectively, as compared to 100% amyloid positivity in AD. Using global SUVR, ROC analysis showed AUC of 0.868 and 0.588 in differentiating MCI from AD and MCI from OD respectively. Conclusion: 18F-Flutemetamol SUVR differentiated MCI from AD with high efficacy (high negative predictive value), but much lower efficacy from OD. The major benefit of the test was to differentiate cognitively impaired patients (either SCD, MCI, or OD) without AD-related-amyloid-pathology from AD in the clinical setting, which was under-emphasized in the current guidelines proposed by Amyloid Imaging Task Force.

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