Neuro-Retina Might Reflect Alzheimer’s Disease Stage

Background: Alzheimer’s disease (AD) pathological hallmarks were found in retinas of AD patients. Several studies showed a significant reduction of neuro-retina thickness measured through optical coherence tomography (OCT) in AD patients, but possible correlations between retina morphology, cognition, and cerebrospinal fluid (CSF) AD biomarkers (Aβ42, t-tau, and p-tau) have been poorly investigated so far. Objective: In the present cross-sectional study, we measured the thickness of neuro-retinal layers through OCT searching for possible correlations with patients’ cognitive performances and CSF AD biomarkers. Methods: 137 consecutive subjects [43 with AD, 37 with mild cognitive impairment (MCI), and 57 healthy controls (HC)], received an OCT scan acquisition to measure the peripapillary retinal nerve fiber layer (RNFL) thickness. In a subsample of 21 AD, 18 MCI, and 18 HC, the macular volume of ganglion cell layer (GCL), inner plexiform layer (IPL), and inner nuclear layer was computed. A comprehensive neuropsychological assessment and CSF AD biomarkers’ concentrations were available in AD and MCI patients. Results: Peripapillary RNFL, global, and in superior quadrant was significantly thinner in AD and MCI patients when compared to HC, while macular GCL volume was significantly reduced only in AD. RNFL thickness in nasal and inferior quadrants was correlated with single CSF AD biomarker concentrations, but no differences were found in retina morphology depending on the presence of a CSF profile typical for AD. Memory performances were positively associated with GCL and IPL volume. Conclusion: Our findings might propose OCT as a reliable and easy to handle tool able to detect neuro-retinal atrophy in AD in relation with cognitive performances.

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Temporal visual resolution and disease severity in MS

Neurology Neuroimmunology & Neuroinflammation ◽

10.1212/nxi.0000000000000492 ◽

2018 ◽

Vol 5 (5) ◽

pp. e492 ◽

Cited By ~ 12

Author(s):

Noah Ayadi ◽

Jan Dörr ◽

Seyedamirhosein Motamedi ◽

Kay Gawlik ◽

Judith Bellmann-Strobl ◽

...

Keyword(s):

Visual Acuity ◽

Visual System ◽

Plexiform Layer ◽

Cross Sectional Study ◽

Inner Plexiform Layer ◽

Information Processing Speed ◽

Fiber Layer ◽

Cross Sectional ◽

Low Contrast ◽

Visual Resolution

ObjectiveTo examine temporal visual resolution assessed as critical flicker frequency (CFF) in patients with MS and to investigate associations with visual system damage and general disability and cognitive function.MethodsThirty-nine patients with MS and 31 healthy controls (HCs) were enrolled in this cross-sectional study and underwent CFF testing, high- and low-contrast visual acuity, alertness and information processing speed using the paced auditory serial addition task (PASAT), and retinal optical coherence tomography (OCT). In patients with MS, visual evoked potentials (VEPs) and Expanded Disability Status Scale (EDSS) scores were assessed.ResultsCFF in patients with MS (mean ± SD: 40.9 ± 4.4 Hz) was lower than in HCs (44.8 ± 4.4 Hz, p < 0.001). There was no significant CFF difference between eyes with and without previous optic neuritis (ON). CFF was not associated with visual acuity, VEP latency, the peripapillary retinal nerve fiber layer thickness, and the combined ganglion cell and inner plexiform layer volume. Instead, reduced CFF was associated with worse EDSS scores (r2 = 0.26, p < 0.001) and alertness (r2 = 0.42, p = 0.00042) but not with PASAT (p = 0.33).ConclusionCFF reduction in MS occurs independently of ON and structural visual system damage. Its association with the EDSS score and alertness suggests that CFF reflects global disease processes and higher cortical processing rather than focal optic nerve or retinal damage.

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Macular Thickness Decrease in Asymptomatic Subjects at High Genetic Risk of Developing Alzheimer’s Disease: An OCT Study

Journal of Clinical Medicine ◽

10.3390/jcm9061728 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1728

Author(s):

Inés López-Cuenca ◽

Rosa de Hoz ◽

Elena Salobrar-García ◽

Lorena Elvira-Hurtado ◽

Pilar Rojas ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Family History ◽

Genetic Risk ◽

Clinical Symptoms ◽

Plexiform Layer ◽

Inner Plexiform Layer ◽

Fiber Layer ◽

High Genetic Risk ◽

History Of

In this case control study, we examined the retinal thickness of the different layers in the macular region and peripapillary retinal nerve fiber layer (RNFL) with optical coherence tomography (OCT) in healthy cognitive subjects (from 51 to 74 years old) at high genetic risk for developing Alzheimer’s disease (AD). Thirty-five subjects with a family history of Alzheimer disease (AD) (FH+) and ApoE ɛ4 carriers and 29 age-matched control subjects without a family history of AD (FH−) and ApoE ɛ4 non-carriers were included. Compared to FH− ApoE ɛ4 non-carriers, in FH+ ApoE ɛ4 carriers, there were statistically significant decreases (p < 0.05) in (i) the foveal area of mRNFL; (ii) the inferior and nasal sectors in the outer and inner macular ring in the inner plexiform layer (IPL); (iii) the foveal area and the inferior sector in the outer macular ring in the inner nuclear layer (INL); and (iv) the inferior sector of the outer macular ring in the outer plexiform layer (OPL). However, no statistically significant differences were found in the peripapillary thickness of RNFL between both study groups. In subjects with cognitive health and high genetic risk for the development of AD, initial changes appeared in the macular area. OCT could be a promising, cost-effective and non-invasive test useful in early AD, before the onset of clinical symptoms.

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Perceived stress and depressive symptoms not neuropsychiatric symptoms predict caregiver burden in Alzheimer’s disease: a cross-sectional study

BMC Geriatrics ◽

10.1186/s12877-021-02136-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Manee Pinyopornpanish ◽

Kanokporn Pinyopornpanish ◽

Atiwat Soontornpun ◽

Surat Tanprawate ◽

Angkana Nadsasarn ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Depressive Symptoms ◽

Caregiver Burden ◽

Perceived Stress ◽

Neuropsychiatric Symptoms ◽

Cross Sectional Study ◽

Assessment Tools ◽

Sectional Study ◽

Cross Sectional

Abstract Background Caregiver burden affects the caregiver’s health and is related to the quality of care received by patients. This study aimed to determine the extent to which caregivers feel burdened when caring for patients with Alzheimer’s Disease (AD) and to investigate the predictors for caregiving burden. Methods A cross-sectional study was conducted. One hundred two caregivers of patients with AD at Maharaj Nakorn Chiang Mai Hospital, a tertiary care hospital, were recruited. Assessment tools included the perceived stress scale (stress), PHQ-9 (depressive symptoms), Zarit Burden Interview-12 (burden), Clinical Dementia Rating (disease severity), Neuropsychiatric Inventory Questionnaires (neuropsychiatric symptoms), and Barthel Activities Daily Living Index (dependency). The mediation analysis model was used to determine any associations. Results A higher level of severity of neuropsychiatric symptoms (r = 0.37, p < 0.01), higher level of perceived stress (r = 0.57, p < 0.01), and higher level of depressive symptoms (r = 0.54, p < 0.01) were related to a higher level of caregiver burden. The direct effect of neuropsychiatric symptoms on caregiver burden was fully mediated by perceived stress and depressive symptoms (r = 0.13, p = 0.177), rendering an increase of 46% of variance in caregiver burden by this parallel mediation model. The significant indirect effect of neuropsychiatric symptoms by these two mediators was (r = 0.21, p = 0.001). Conclusion Caregiver burden is associated with patients’ neuropsychiatric symptoms indirectly through the caregiver’s depressive symptoms and perception of stress. Early detection and provision of appropriate interventions and skills to manage stress and depression could be useful in reducing and preventing caregiver burden.

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Evaluation of macrolinguistic aspects of the oral discourse in patients with Alzheimer’s disease

International Psychogeriatrics ◽

10.1017/s1041610218001758 ◽

2018 ◽

Vol 31 (9) ◽

pp. 1343-1353 ◽

Cited By ~ 1

Author(s):

Juliana Onofre de Lira ◽

Thaís Soares Cianciarullo Minett ◽

Paulo Henrique Ferreira Bertolucci ◽

Karin Zazo Ortiz

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Language Processing ◽

Cross Sectional Study ◽

Oral Discourse ◽

Cross Sectional ◽

Cohesive Devices ◽

Global Coherence ◽

Comparison Groups ◽

Study Setting

ABSTRACTIntroduction:Alzheimer’s disease (AD) is a degenerative syndrome that impairs cognitive functioning, including speech and language. Discourse can be used to analyze language processing, which is organized into microlinguistic and macrolinguistic dimensions.Objectives:To identify the occurrence of changes in the macrolinguistic dimension of oral discourse in AD patients. Design: This was developed as a cross-sectional study. Setting: Outpatient clinic of the Behavioural Neurology Division of São Paulo Federal University.Participants:121 elderly patients, with ≥ 4 years of education, divided into AD and comparison groups.Measurements:The subjects were asked to create a narrative based on seven figures that made up a story. The macrolinguistic aspects of the narratives were analyzed.Results:The performance of the AD group was inferior to that of the comparison group on content-related, no-content-related complete and incomplete propositions as well as macropropositions, main information units, appropriated local and global coherence, cohesive devices and all subtypes, cohesive errors and some of their subtypes. Global coherence, macropropositions and ellipsis subtype of cohesive devices were the variables that best differentiated the groups.Conclusions:Changes were observed in most aspects of the macrolinguistic dimension of oral discourse in patients with AD.

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Prevalência, desempenho cognitivo e funcionalidade de idosos com Doença de Alzheimer em instituições de longa permanência de Bento Gonçalves

PAJAR - Pan-American Journal of Aging Research ◽

10.15448/2357-9641.2017.1.26051 ◽

2017 ◽

Vol 5 (1) ◽

pp. 23 ◽

Cited By ~ 2

Author(s):

Daniela Fernandes Tonholi ◽

Gisele Oltramari

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Performance ◽

Junior High School ◽

Functional Independence Measure ◽

The Elderly ◽

Functional Independence ◽

Cross Sectional Study ◽

Functional Evaluation ◽

Cross Sectional

Aims: To determine the prevalence, cognitive performance and functionality of elderly people with Alzheimer's disease in long-stay institutions for the elderlyin the city of Bento Gonçalves. Methods: Cross-sectional study including 24 elderly residents in long-stay institutions for the elderly, sociodemographic datawere obtained, and the elderly were subjected to functional evaluation by the Functional Independence Measure and evaluation of cognitive performancethrough the mental state the Mini (MMSE). Results: Most of the residents were female (83%), as 54.2% schooling had completed junior high school, mostof the elderly (70.8%) was admitted by the will of the family, 100% of the elderly showed cognitive performance bad, and the smaller the more dependentcognitive performance was the individual. Conclusion: institutionalized elderly with Alzheimer's disease had negative results on cognitive performance,as well as deficits in their ability to perform activities of daily living, thus altering their functionality.Keywords: aging; functionality; cognition; Alzheimer Disease; long-stay institutions.

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Neuropsychiatric symptoms and severity of dementia

Dementia & Neuropsychologia ◽

10.1590/s1980-57642013dn70200006 ◽

2013 ◽

Vol 7 (2) ◽

pp. 171-175

Author(s):

Gustavo Henrique de Oliveira Caldas ◽

Sueli Luciano Pires ◽

Milton Luiz Gorzoni

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Motor Behavior ◽

Neuropsychiatric Symptoms ◽

Prevalence Ratio ◽

Cross Sectional Study ◽

Clinical Dementia Rating ◽

Cross Sectional ◽

Specific Stage ◽

Severity Of Dementia

ABSTRACT Neuropsychiatric symptoms (NPS) cause distress, disabilitiy and reduced quality of life for both the patient and their families Objective: To evaluate the prevalence of NPS as a specific stage of dementia status. Methods: A cross-sectional study in patients attending an outpatient clinic for dementia was performed. We applied the Neuropsychiatric Inventory and Clinical Dementia Rating (CDR) scale. Statistical analysis was carried out with SPSS 17 software. Results: The 124 subjects (mean age of 80.4±7.0 years), 88 women (70.9%) had average duration of dementia of 7.1±3.2 years, most common dementias of Alzheimer's disease (35.5%) and mixed (31.5%) and most prevalent NPS of apathy (75%) and irritability (66.9%). Correlation between apathy and a CDR 1 had a PR (prevalence ratio) = 0.289 and p<0.001 while between apathy and CDR 4-5 (PR=8.333, p<0.005). A similar result was found between aberrant motor behavior (AMB) and CDR 1 (PR=0.352, p<0.003) and between AMB and CDR4-5 (PR=2.929, p<0.006). Conclusion: Alzheimer's disease and mixed dementia were predominant, while apathy and AMB were detected in association with the progressive stages of dementia.

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Frequency and Severity of Adverse Drug Reactions to Medications Prescribed for Alzheimer’s Disease in a Brazilian City: Cross-Sectional Study

Frontiers in Pharmacology ◽

10.3389/fphar.2020.538095 ◽

2020 ◽

Vol 11 ◽

Author(s):

Tânia Regina Ferreira ◽

Luciane Cruz Lopes ◽

Cristiane de Càssia Bergamaschi

Keyword(s):

Public Health ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Health System ◽

Psychiatric Disorders ◽

Public Health System ◽

Cross Sectional Study ◽

Sectional Study ◽

Drug Reactions ◽

Cross Sectional

Background: There is lack of national studies that assess the risks associated with the drugs provided under the Brazilian public health system for treating Alzheimer’s disease. Then, this study determined the prevalence and severity of self-reported adverse drug reactions (ADRs) prescribed to patients with Alzheimer’s disease in the Brazilian public health system.Methods: A cross-sectional study was carried out based on public data from the MEDEX system (information on dispensing data, known as exceptional dispensing medications) and interviews with patients and/or caregivers who get access to Alzheimer’s drugs at a public pharmacy in a large Brazilian city, between July and September 2017, inquiring about ADRs and serious adverse events (SAEs).Results: The subjects were asked about ADRs and SAEs related to the use of donepezil, galantamine, rivastigmine and memantine. Out of 285 patients enrolled on the database, 250 participated in the study (87.7%). Among the participants, approximately 63.0% were female, 70.3% aged ≥75 years and 70.3% had comorbidities. Overall, 209 patients (83.6%) reported at least one ADR (total 1,149 ADRs) and rivastigmine was associated with the largest number of ADRs per patient (7.9 ADRs/patient). The predominant adverse effects were psychiatric disorders with common frequency (57.1%) and mild severity (89.0%). Six patients (2.4%) had SAEs that required hospitalization. The use of antipsychotics was the variable associated with ADR (OR = 4.95; 95% CI: 1.45–16.93; p = 0.011).Conclusion: There was a large number of reported ADRs and most of them were of common frequency and mild severity, being mainly related to psychiatric disorders. Considering the fragility of these patients, it is important to improve safety-related care in the use of drugs for treating this disease.

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AFFECTIVE THEORY OF MIND IN PEOPLE WITH ALZHEIMER’S DISEASE

10.5327/1980-5764.rpda052 ◽

2021 ◽

Author(s):

Aline De Lucena ◽

Paulo Fernando Santos ◽

Marcia Cristina Dourado

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Emotional State ◽

Neuropsychiatric Symptoms ◽

Cross Sectional Study ◽

Social Situations ◽

Cross Sectional ◽

Emotional Reasoning ◽

Significant Difference ◽

Emotional Aspects

Background: In recent years, interest has been growing in cognitive and affective ToM functioning in individuals suffering from neurodegenerative disorders, such as Alzheimer’s disease (AD). However, the affective ToM has been less investigated. Objective: This study aims to compare affective ToM performance in persons with mild to moderate AD and healthy older controls (HOC), and its relationship with cognition. Methods: A cross-sectional study of 97 mild to moderate AD individuals and 40 HOC. To assess affective ToM, participants were administered a task that examines ability to comprehend the emotional situation nature along with the appropriate emotional state that one would experience in that situation. Assessments of cognition, dementia severity, functionality, awareness of disease and neuropsychiatric symptoms were completed for AD group. Results: Analyses of emotional reasoning indicated a group effect on performance. There was a significant difference between the AD and HOC groups in terms of their ability to understand situations of sadness, surprise, anger, and happiness, with the moderate AD showing the worst performance for all emotional situations. Ability to appropriately name the emotional state was significantly different for surprise, anger, and happiness, but not for sadness, with both AD groups showing lower performance for surprise and anger, and with the mild AD showing better performance for happiness. In both AD groups, ability to understand the emotional situation and to name the emotion was significantly correlated with cognitive impairment and awareness of disease. Neuropsychiatric symptoms were significantly correlated in moderate AD group. Conclusions: Impairment in understanding the emotional aspects of situations can lead moderate AD people to experience conflicts in family and social situations. Mild AD people can experience same conflicts when their preserved ability in understanding the emotional situation is underestimated.

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