scholarly journals When should a psychiatrist remember to test homocysteine levels? - a literature review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Katarzyna Nowak ◽  
Sylvia Chiriboga ◽  
Izabela Halczuk ◽  
Hanna Karakuła-Juchnowicz
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Bipolar Disorder ◽  
Amino Acid ◽  
Mental Disorders ◽  
Lifestyle Changes ◽  
Sulfur Amino Acid ◽  
Review Of The Literature ◽  
Appropriate Treatment ◽  
Pubmed Database

Abstract Introduction: Homocysteine is an endogenous sulfur amino acid, formed as a result of biochemical changes in methionine. The normal concentration of homocysteine in healthy people is within the range of 5 – 15 μmol / l, and values above 15 μmol / l are referred to as hyperhomocysteinemia. Moreover, it has been shown that the level of homocysteine may be associated with the occurrence of mental disorders. The aim of this article was to search for a relationship between the level of this amino acid and the incidence and prognosis of bipolar disorder, depression, anxiety disorders, schizophrenia or Alzheimer's disease. Material and method: For the review of the literature, available articles from the PubMed database and Google Scholar were used under the following keywords: homocysteine, depression, bipolar disorder, schizophrenia, Alzheimer's disease in the period from 1992 to 2021. Results: The research conducted so far shows that there is a significant correlation between elevated levels of homocysteine and the above-mentioned mental disorders. Conclusion: In order to prevent the consequences of the increased level of homocysteine, its concentration in blood serum should be monitored periodically and appropriate treatment should be implemented in case of abnormal results. It is important to educate patients about the consequences of hyperhomocysteinemia i.a. atherosclerosis, stroke, ischemic heart disease, osteoporosis, neural tube defects, mental disorders and neurodegenerative diseases. It should be also established a strategy to lower the level of this amino acid through lifestyle changes, as well as the supply of folic acid, vitamins B12, B6, B2, N-acetylcysteine and betaine.

Lay perceptions about mental health: where is age and where is Alzheimer's disease?

2005 ◽  
Vol 17 (3) ◽  
pp. 371-382 ◽  
Author(s):  
Perla Werner
Keyword(s):  
Mental Health ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Health Literacy ◽  
Mental Disorders ◽  
Mental Health Literacy ◽  
The Elderly ◽  
Research Directions ◽  
Lay Perceptions ◽  
Geriatric Mental Health

Studies on laypersons' beliefs and knowledge about mental disorders have proliferated in recent years. However, attention has been focused mainly on depression and schizophrenia and on young adults. The aim of this paper is to summarize research in the area, and to discuss the need to expand research in the elderly population. The unique characteristics of older persons in terms of the prevalence and type of mental disorders, especially Alzheimer's disease (AD) and other dementias, as well as in terms of their being victims of “double jeopardy” require special attention and research. The present review has three main objectives. First, it summarizes the findings of studies examining different aspects of mental health literacy. Second, the importance of age in the study of mental health literacy is discussed. Third, findings of the few studies examining laypersons' beliefs in the area of AD are presented. Finally, research directions are suggested with special emphasis on the importance of geriatric mental health and mental health literacy.

scholarly journals Modeling the β secretase cleavage site and humanizing Amyloid-Beta Precursor Protein in rat and mouse to study Alzheimer Disease.

2020 ◽  
Author(s):  
Lutgarde Serneels ◽  
Dries T'Syen ◽  
Laura Perez-Benito ◽  
Tom Theys ◽  
Bart De Strooper
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Amino Acid ◽  
Alzheimer Disease ◽  
Early Onset ◽  
Computational Modelling ◽  
Original Strain ◽  
Rodent Models ◽  
App Processing

Abstract Background Three amino acid differences between rodent and human APP affect medically important features including β-secretase cleavage of APP and aggregation of the Aβ peptide(1–3). Most rodent models for Alzheimer’s disease (AD) are therefore based on the human APP sequence expressed from artificial mini-genes randomly inserted in the rodent genome. While these models mimic rather well biochemical aspects of the disease such as Aβ-aggregation, they are also prone to overexpression artifacts and to complex phenotypical alterations due to genes affected in or close to the insertion sites of the mini-genes(4,5). Knock-in strategies introducing clinical mutants in a humanized endogenous rodent APP sequence(6) represent useful improvements, but need to be compared with appropriate humanized wild type (WT) mice.Methods Computational modelling of the human β-CTF bound to BACE1 was used to study the differential processing of rodent and human APP. We humanized the three pivotal residues G676R, F681Y and R684H (labeled according to the human APP770 isoform) in the mouse as well as in the rat by a CRISPR-Cas9 approach. These new models, termed mouse and rat App hu/hu , express APP from the endogenous promotor. We also introduced the early-onset familial Alzheimer’s disease (FAD) mutation M139T into the endogenous Rat Psen 1 gene.Results We show that the three amino acid substitutions in the rodent sequence lower the affinity of APP substrate for BACE1 cleavage. The effect on β-secretase processing was confirmed as both humanized rodent models produce three times more (human) Aβ compared to their WT rodent original strain. These models represent suitable controls or starting points for studying the effect of transgenes or knock-in mutations on APP processing(6). We introduced the early-onset familial Alzheimer disease (FAD) mutation M139T into the endogenous Rat Psen 1 gene and provide an initial characterization of Aβ processing in this novel rat AD model.Conclusion The different humanized APP models (rat and mouse) expressing human Aβ and PSEN1 M139T are valuable controls to study APP processing in vivo and allow to implement the use of human Aβ Elisa which is more sensitive than their rodent counterpart. These animals will be made available to the research community.

scholarly journals Novel Blood Biomarkers for an Earlier Diagnosis of Alzheimer’s Disease: A Literature Review

2020 ◽  
Author(s):  
Shiavax Rao ◽  
Andrew J. Boileau
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Literature Review ◽  
Clinical Diagnosis ◽  
Sensitivity And Specificity ◽  
Memory Loss ◽  
High Sensitivity ◽  
Diagnostic Techniques ◽  
Pubmed Database ◽  
Diagnostic Approaches

Alzheimer’s disease is a neurodegenerative condition associated with neurofibrillary tangles and cortical deposition of amyloid plaques. Clinical presentation of the disease involves manifestations such as memory loss, cognitive decline and dementia with some of the earliest reported deficits being episodic memory impairment and olfactory dysfunction. Current diagnostic approaches rely on autopsy characterization of gross brain pathology, or brain imaging of biomarkers late in the disease course. The aim of this literature review is to identify and compare newly emerging and novel CSF, serum and mucosal biomarkers, with the potential of making an earlier clinical diagnosis of Alzheimer’s disease. Utilizing such techniques may allow for earlier therapeutic intervention, reduction of disability and enhancement of quality of life. Literature review and analysis was performed by screening the PubMed database for relevant studies within the past 5 years. All studies showed statistically significant (P < 0.05) differences in testing between AD patients and controls. Two categories of serum biomarkers (redox-reactive antiphospholipid antibodies and microRNAs) and an olfactory mucosal marker (microRNA-206) could discriminate between early AD patients and controls with high sensitivity and specificity. In conclusion, certain studies have shown promising results with high sensitivity and specificity, high discriminative potential for Alzheimer’s disease early in its progression, and statistically significant results in larger study samples. Utilization of such diagnostic techniques should increase the efficacy of making an earlier clinical diagnosis of Alzheimer’s disease.

Suicide risk within one year of cognitive impairment diagnosis in older adults: a nationwide retrospective cohort study

2019 ◽  
Author(s):  
Jae Woo Choi ◽  
Kang Soo Lee ◽  
Euna Han
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mental Disorders ◽  
Suicide Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
One Year

Abstract Background This study aims to investigate suicide risk within one year of receiving a diagnosis of cognitive impairment in older adults without mental disorders. Methods This study used National Health Insurance Service-Senior Cohort data on older adults with newly diagnosed cognitive impairment including Alzheimer’s disease, vascular dementia, other/unspecified dementia, and mild cognitive impairment from 2004 to 2012. We selected 41,195 older adults without cognitive impairment through 1:1 propensity score matching using age, gender, Charlson Comorbidity Index, and index year, with follow-up throughout 2013. We eliminated subjects with mental disorders and estimated adjusted hazard ratios (AHR) of suicide deaths within one year after diagnosis using the Cox proportional hazards models. Results We identified 49 suicide deaths during the first year after cognitive impairment diagnosis. The proportion of observed suicide deaths was the highest within one year after cognitive impairment diagnosis (48.5% of total); older adults with cognitive impairment were at a higher suicide risk than those without cognitive impairment (AHR, 1.89; 95% confidence interval [CI], 1.18–3.04). Subjects with Alzheimer’s disease and other/unspecified dementia were at greater suicide risk than those without cognitive impairment (AHR, 1.94, 1.94; 95% CI, 1.12–3.38, 1.05–3.58). Suicide risk in female and young-old adults (60–74 years) with cognitive impairment was higher than in the comparison group (AHR, 2.61, 5.13; 95% CI, 1.29–5.28, 1.48–17.82). Conclusions Older patients with cognitive impairment were at increased suicide risk within one year of diagnosis. Early intervention for suicide prevention should be provided to older adults with cognitive impairment.

scholarly journals Therapeutic benefit of aripiprazole-olanzapine combination in the treatment of senile Alzheimer’s disease complicated by mental disorders

2020 ◽  
Vol 19 (2) ◽  
pp. 441-446
Author(s):  
Na Zheng ◽  
Ning Wang ◽  
Ji-Min Jia
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Mental Disorders ◽  
Clinical Efficacy ◽  
Lower Incidence ◽  
Adverse Reactions ◽  
Study Groups ◽  
Therapeutic Benefit ◽  
Control Group ◽  
Study Group

Purpose: To determine the clinical efficacy of aripiprazole-olanzapine combination treatment in elderly Alzheimer’s disease complicated with mental disorders. Methods: Ninety-two elderly patients with Alzheimer’s disease and mental disorders who were admitted to Binzhou People's Hospital, were enrolled in the study. They were randomized into control and study groups. Control group was treated with olanzapine, while the study group was treated with aripiprazole as an adjuvant therapy in addition to olanzapine. The clinical efficacy, scores on different scales (MMSE, ADAS-cog, CDR, ADL, NPI and CMAI), and incidence of adverse reactions were determined. Results: The overall degree of response was significantly higher in the study group than in the control group (p < 0.05). There were no significant differences in MMSE, ADAS-cog, CDR, ADL, NPI and CMAI scores between the two groups before treatment (p > 0.05). The MMSE score of the study group was significantly higher than that of the control group, and the scores in the other scales in the study group were significantly lower after treatment (p < 0.05). The study group had significantly lower incidence of adverse reactions than control group (p < 0.05). Conclusion: Aripiprazole-olanzapine combination has significant therapeutic benefit in the treatment of elderly Alzheimer’s disease patients complicated with mental disorders. It promotes recovery of neurological function, as well as produces a lower incidence of adverse reactions. Keywords: Aripiprazole, Olanzapine, Alzheimer’s disease, Mental disorders

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