Longitudinal Modeling of Functional Decline Associated with Pathologic Alzheimer’s Disease in Older Persons without Cognitive Impairment

OBJECTIVE: To analyze the correlation between balance, falls and loss of functional capacity in mild and moderate Alzheimer's disease(AD). METHOD: 40 subjects without cognitive impairment (control group) and 48 AD patients (25 mild, 23 moderate) were evaluated with the Berg Balance Scale (BBS) and the Disability Assessment for Dementia (DAD). Subjects answered a questionnaire about falls occurrence in the last twelve months. RESULTS: Moderate AD patients showed poorer balance (p=0.001) and functional capacity (p <0.0001) and it was observed a correlation between falls and balance (r= -0.613; p=0.045). CONCLUSION: There is a decline of balance related to AD which is a factor associated to the occurrence of falls, albeit not the most relevant one. The loss of functional capacity is associated with the disease's progress but not to a higher occurrence of falls. The balance impairment did not correlate with functional decline in AD patients.

Download Full-text

An explorative study of the relationship between functional and cognitive decline in older persons with mild cognitive impairment and Alzheimer’s disease

British Journal of Occupational Therapy ◽

10.1177/0308022614565114 ◽

2015 ◽

Vol 78 (3) ◽

pp. 166-174 ◽

Cited By ~ 9

Author(s):

Sophie Vermeersch ◽

Ellen Gorus ◽

Elise Cornelis ◽

Patricia De Vriendt

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Older Persons ◽

Explorative Study ◽

The Relationship

Download Full-text

Exercise Intervention Associated with Cognitive Improvement in Alzheimer’s Disease

Neural Plasticity ◽

10.1155/2018/9234105 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 17

Author(s):

Meng Ying Cui ◽

Yang Lin ◽

Ji Yao Sheng ◽

Xuewen Zhang ◽

Ran Ji Cui

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Cognitive Decline ◽

Healthy Aging ◽

Exercise Intervention ◽

Early Stage ◽

Functional Decline ◽

Cost Effective ◽

Cognitive Improvement

Alzheimer’s disease (AD) is a progressive neurodegenerative disease with the syndrome of cognitive and functional decline. Pharmacotherapy has always been in a dominant position for the treatment of AD. However, in most cases, drug therapy is accompanied with clinical delays when older adults have suffered from cognitive decline in episodic memory, working memory, and executive function. On the other hand, accumulating evidence suggests that exercise intervention may ameliorate the progression of cognitive impairment in aging ones while the standard strategy is lacking based on different levels of cognitive decline especially in mild cognitive impairment (MCI) and AD. MCI is the preclinical stage of AD in which neurodegeneration may be reversed via neuroplasticity. Therefore, taking exercise intervention in the early stage of MCI and healthy aging at the risk of AD could slow down the process of cognitive impairment and provide a promising cost-effective nonpharmacological therapy to dementia.

Download Full-text

Clinical and biological effects of long-term lithium treatment in older adults with amnestic mild cognitive impairment: randomised clinical trial

The British Journal of Psychiatry ◽

10.1192/bjp.2019.76 ◽

2019 ◽

Vol 215 (5) ◽

pp. 668-674 ◽

Cited By ~ 10

Author(s):

Orestes V. Forlenza ◽

Márcia Radanovic ◽

Leda L. Talib ◽

Wagner F. Gattaz

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Lithium Treatment ◽

Functional Decline ◽

Amnestic Mild Cognitive Impairment ◽

Community Dwelling

BackgroundExperimental studies indicate that lithium may facilitate neurotrophic/protective responses in the brain. Epidemiological and imaging studies in bipolar disorder, in addition to a few trials in Alzheimer's disease support the clinical translation of these findings. Nonetheless, there is limited controlled data about potential use of lithium to treat or prevent dementia.AimsTo determine the benefits of lithium treatment in patients with amnestic mild cognitive impairment (MCI), a clinical condition associated with high risk for Alzheimer's disease.MethodA total of 61 community-dwelling, physically healthy, older adults with MCI were randomised to receive lithium or placebo (1:1) for 2 years (double-blind phase), and followed-up for an additional 24 months (single-blinded phase) (trial registration at clinicaltrials.gov: NCT01055392). Lithium carbonate was prescribed to yield subtherapeutic concentrations (0.25–0.5 mEq/L). Primary outcome variables were the cognitive (Alzheimer's Disease Assessment Scale – cognitive subscale) and functional (Clinical Dementia Rating – Sum of Boxes) parameters obtained at baseline and after 12 and 24 months. Secondary outcomes were neuropsychological test scores; cerebrospinal fluid (CSF) concentrations of Alzheimer's disease-related biomarkers determined at 0, 12 and 36 months; conversion rate from MCI to dementia (0–48 months).ResultsParticipants in the placebo group displayed cognitive and functional decline, whereas lithium-treated patients remained stable over 2 years. Lithium treatment was associated with better performance on memory and attention tests after 24 months, and with a significant increase in CSF amyloid-beta peptide (Aβ1−42) after 36 months.ConclusionsLong-term lithium attenuates cognitive and functional decline in amnestic MCI, and modifies Alzheimer's disease-related CSF biomarkers. The present data reinforces the disease-modifying properties of lithium in the MCI–Alzheimer's disease continuum.Declaration of interestNone.

Download Full-text

Dependence and Caregiver Burden in Alzheimer’s Disease and Mild Cognitive Impairment

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/1533317510394649 ◽

2011 ◽

Vol 26 (2) ◽

pp. 110-114 ◽

Cited By ~ 50

Author(s):

Damien Gallagher ◽

Aine Ni Mhaolain ◽

Lisa Crosby ◽

Deirdre Ryan ◽

Loretto Lacey ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Caregiver Burden ◽

Neuropsychiatric Symptoms ◽

Severe Disease ◽

Functional Decline ◽

Behavioral Symptoms ◽

Dependence Scale

The dependence scale has been designed to be sensitive to the overall care needs of the patient and is considered distinct from standard measures of functional ability in this regard. Little is known regarding the relationship between patient dependence and caregiver burden. We recruited 100 patients with Alzheimer’s disease or mild cognitive impairment and their caregivers through a memory clinic. Patient function, dependence, hours of care, cognition, neuropsychiatric symptoms, and caregiver burden were assessed. Dependence was significantly correlated with caregiver burden. Functional decline and dependence were most predictive of caregiver burden in patients with mild impairment while behavioral symptoms were most predictive in patients with moderate to severe disease. The dependence scale demonstrated good utility as a predictor of caregiver burden. Interventions to reduce caregiver burden should address patient dependence, functional decline, and behavioral symptoms while successful management of the latter becomes more critical with disease progression.

Download Full-text

Poor Decision Making Is a Consequence of Cognitive Decline among Older Persons without Alzheimer’s Disease or Mild Cognitive Impairment

PLoS ONE ◽

10.1371/journal.pone.0043647 ◽

2012 ◽

Vol 7 (8) ◽

pp. e43647 ◽

Cited By ~ 84

Author(s):

Patricia A. Boyle ◽

Lei Yu ◽

Robert S. Wilson ◽

Keith Gamble ◽

Aron S. Buchman ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Decision Making ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Older Persons

Download Full-text

ANALYSIS OF THE RELATIONSHIP OF COGNITIVE IMPAIRMENT AND FUNCTIONAL IMPAIRMENT IN MILD ALZHEIMER’S DISEASE IN EXPEDITION 3

Journal of Prevention of Alzheimer's Disease ◽

10.14283/jpad.2018.22 ◽

2018 ◽

pp. 1-4

Author(s):

H. Liu-Seifert ◽

E. Siemers ◽

K. Sundell ◽

M. Mynderse ◽

J. Cummings ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Functional Impairment ◽

Functional Decline ◽

Clinical Trial Data ◽

Cognitive Outcomes ◽

Functional Measures ◽

Functional Scores ◽

The Relationship

BACKGROUND: Clinical progression of Alzheimer’s disease is characterized by impairment in cognition and function. OBJECTIVE: To assess the relationship between cognitive and functional impairment in mild Alzheimer’s disease. DESIGN: Spearman’s rank correlations between cognitive and functional measures were calculated. Autoregressive cross-lagged panel analyses were used to determine the temporal relationship between cognitive and functional decline. SETTING: Post-hoc analysis of clinical trial data. PARTICIPANTS: Placebo-treated patients with mild Alzheimer’s disease from the Phase 3 solanezumab study EXPEDITION 3. INTERVENTION: Placebo MEASUREMENTS: Cognitive and functional measures were assessed at baseline and at six post-baseline time points through Week 80. RESULTS: Correlation between cognitive and functional measures was 0.41 at baseline and 0.65 at Week 80. Autoregressive cross-lagged panel analysis demonstrated that cognitive impairment preceded and predicted subsequent functional decline, but functional scores did not predict cognitive outcomes. CONCLUSIONS: This study supports the hypothesis that functional impairment predictably follows cognitive decline in mild Alzheimer’s disease dementia.

Download Full-text