scholarly journals Financial Incapacity of Patients with Mild Alzheimer’s Disease: What Neurologists Need to Know about Where the Impairment Lies

2022 ◽  
Vol 14 (1) ◽  
pp. 90-98
Author(s):  
Vaitsa Giannouli ◽  
Magda Tsolaki

Research in the last decade has focused on assessing financial capacity and incapacity mainly in old age, but new research has turned to address the question of how financial incapacity can be predicted by cognitive factors. The aim of this study was to identify which cognitive domains predict financial capacity and the relevant cognitive skills of patients with mild Alzheimer’s disease (AD) in order to assist neurologists in functional assessment and further patient referral. In this study, 109 patients diagnosed with mild AD were examined with a number of neuropsychological tests: Mini-Mental State Examination (MMSE), Functional Rating Scale for Symptoms of Dementia (FRSSD), Functional Cognitive Assessment Scale (FUCAS), Trail Making Test (TMT)-Part B, Rey-Osterrieth Complex Figure Test (ROCFT)-copy condition and delayed recall condition, Rey Auditory Verbal Learning Test (RAVLT), Boston Naming Test, Rivermead Behavioural Memory Test (RBMT), digit span forward and backward, WAIS-R digit symbol substitution test, Neuropsychiatric Inventory (NPI), Geriatric Depression Scale (GDS-15), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). LCPLTAS total score and relevant subdomains were best predicted only by the score of one item coming from MMSE: subtraction of serial sevens. This is the only measure of arithmetic testing in use for the Greek geriatric population. Financial capacity is severely impaired in the group of mild AD patients. In order to prevent financial exploitation cases, neurologists, neuropsychologists, psychiatrists, and geriatrists should pay close attention to the information from the relevant arithmetic question of MMSE, as it is one of the most widely administered screening tests in clinical settings.

2021 ◽  
Author(s):  
Patrícia Peles ◽  
Larissa Salvador ◽  
Luciano Mariano ◽  
Viviane Carvalho ◽  
Clarisse Frieldlaender ◽  
...  

Background: Neuropsychological tests are important tools for the diagnosis of mild cognitive impairment or dementia due to Alzheimer’s disease (AD). Objective: To investigate the accuracy of common neuropsychological tests used in the clinical setting for AD diagnosis. Methods: Forty two patients with diagnosis of AD continuum [A+T+/-(N)+/-] and 32 non-AD [A-T+/-(N)+/-]. All participants were submitted to a thorough neuropsychological assessment with the following instruments: Mattis Dementia Rating Scale (DRS), Rey’s Auditory Verbal Learning Test (RAVLT), Boston naming-Consortium to Establish a Registry for Alzheimer’s Disease, a reduced version of the CERAD, Digit Span Forward (DSF), Digit Span Backward (DSB) and Cubes from The Wechsler Adult Intelligence Scale (WAIS), verbal fluency – animals (VF-A), and FAS. Results: Memory (MEM) and Initiation/Perseveration (I/P) subscales of the DRS, FAS, Digit Span Backward (DSB) and Boston naming displayed good discrimination between AD and non-AD patients. The MEM subscale of the DRS, RAVLT A6 and FAS presented high sensitivity (90% or more) for AD diagnosis, while DSF displayed high specificity. Non-AD patients had greater difficulty in FAS, DSB and in Boston naming. Conclusion: Performance of patients with biological diagnosis of AD on MEM and I/P of DRS, and RAVLT A7 was significantly different from that of non-AD subjects.


2012 ◽  
Vol 70 (1) ◽  
pp. 17-21 ◽  
Author(s):  
Sergilaine Pereira Martins ◽  
Benito Pereira Damasceno

OBJECTIVES: To verify the accuracy of prospective memory (ProM) tests in Alzheimer's disease (AD). METHODS: Twenty mild AD patients (CDR 1), and 20 controls underwent Digit Span (DS), Trail Making (TM) A and B, visual perception, Rey Auditory-Verbal Learning tests, and Cornell Scale for Depression. AD diagnosis was based on DSM-IV and NINCDS-ADRDA criteria. ProM was assessed with the appointment and belonging subtests of Rivermead Behavioral Memory Test (RBMT); and with two new tests (the clock and animal tests). RESULTS: AD patients had a worse performance than controls on the majority of tests, except DS forward and TM-A. There was no correlation between RBMT and the new ProM tests. As for accuracy, the only significant difference concerned the higher sensitivity of our animal test versus the RBMT belonging test. CONCLUSIONS: The clock and the animal tests showed similar specificity, but higher sensitivity than the RBMT subtests.


BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e036990 ◽  
Author(s):  
MengFei He ◽  
Li Sun ◽  
Wenhui Cao ◽  
Changhao Yin ◽  
Wenqiang Sun ◽  
...  

IntroductionNeurogranin is known to be significantly elevated in patients with Alzheimer’s disease (AD) and may be an effective clinical predictor of cognitive decline and neurodegeneration. Amnestic mild cognitive impairment (aMCI) is an intermediate disease state between normal cognitive ageing and dementia, the latter of which can easily revert to AD. There remains significant uncertainty regarding the conversion of aMCI to AD, and therefore, elucidating such progression is paramount to the field of cognitive neuroscience. In this protocol study, we therefore aim to investigate the changes in plasma neurogranin in the early stage of AD and the mechanism thereof regarding the cognitive progression towards AD.Methods and analysisIn this study, patients with aMCI and AD patients (n=70 each) will be recruited at the memory clinic of the Department of Neurology of Hongqi Hospital affiliated with the Mudanjiang Medical University of China. Healthy older controls (n=70) will also be recruited from the community. All subjects will undergo neuroimaging and neuropsychological evaluations in addition to blood collection at the first year and the third year. We hope to identify a new biomarker of cognitive decline associated with AD and characterise its behaviour throughout the progression of aMCI to AD. This work will reveal novel targets for the therapeutic prevention, diagnosis and treatment of AD. The primary outcome measures will be (1) neuropsychological evaluation, including Mini-Mental State Examination, Montreal Cognitive Assessment, Clinical Dementia Rating scale, Shape Trail Test-A&B, Auditory Verbal Learning Test-HuaShan version; (2) microstructural alterations and hippocampal features from MRI scans; and (3) neurogranin levels in the neuronal-derived exosomes from peripheral blood samples.Ethics and disseminationThe ethics committee of the Hongqi Hospital affiliated with the Mudanjiang Medical University of China has approved this study protocol. The results will be published in peer-reviewed journals and presented at national or international scientific conferences.Trial registration numberChiCTR2000029055.


2020 ◽  
Author(s):  
Chih-Sung Liang ◽  
Kuan-Pin Su ◽  
Chia-Lin Tsai ◽  
Jiunn-Tay Lee ◽  
Che-Sheng Chu ◽  
...  

Abstract Background: The neuroprotective role of Interleukin (IL)-33 is supported in numerous pre-clinical studies but remains mostly uninvestigated in clinical studies of Alzheimer’s disease (AD). We aimed to examine the association between human blood levels of IL-33 and cognitive preservation in amnestic mild cognitive impairment (aMCI) and AD.Methods: A total of 100 participants (26 controls, 35 aMCI patients, and 39 AD patients) were completed twice Mini Mental State Examination (MMSE) over a 1-year interval. At the second MMSE, the 100 participants examined the plasma levels of IL-33, IL-β, IL-1 receptor agonist (IL-1RA), beta amyloid (Aβ), and tau and apolipoprotein E (ApoE) genotyping, and Hopkins Verbal Learning Test, Trail Making Test, forward and backward digit span, and Clinical Dementia Rating were performed as well. Results: IL-33 expression showed a positive trend among controls (1/26 = 3.8%), aMCI (9/35 = 25.7%), and AD (17/39 = 43.6%) (trend analysis: P < 0.001). The patients expressing IL-33 preserved their cognitive function compared with IL-33 non-expressing patients (1-year ΔMMSE: 0.16 ± 1.6 vs -1.5 ± 2.6; P = 0.006). The cognitive preservation was not associated with the lower levels of Aβ, tau, and AopE ε4, while higher levels of AopE ε4 and phosphorylated tau were indeed associated with cognitive decline. The aMCI patients with AD conversion during study period had higher proportion of IL-33(-) than non-AD converters (0.9% vs 53.3%, P = 0.04).Conclusions: IL-33 or its associated signaling pathways may represent a new treatment paradigm for aMCI and AD.


2007 ◽  
Vol 100 (2) ◽  
pp. 420-426 ◽  
Author(s):  
Hikari Kinjo

This paper presents an alternative measure for scoring the recognition memory task in the Alzheimer's Disease Assessment Scale (ADAS), which is one of the most common screening tests. Memory studies routinely take into account not only correct responses to old items (Hits) but also incorrect responses to new items (False Alarms). Here, a bias-corrected measure of recognition memory, Hits minus False Alarms (called Pr), is computed and its significance evaluated against the original measure, Hits. 28 male and 40 female healthy elderly people ( M age = 68.5 yr., SD = 3.5) recruited from the neighborhood community participated in this study. Multiple stepwise regression analyses first with Hit Rate then False Alarm Rate showed that False Alarm Rate significantly improved R2 in the two subscale scores of the Wechsler Memory Scale-Revised and scores of the Mini-Mental State Exam. Thus, this new measure taking into account false responses may be more sensitive and useful to detect early stages of cognitive dysfunction.


2020 ◽  
Author(s):  
Chih-Sung Liang ◽  
Kuan-Pin Su ◽  
Chia-Lin Tsai ◽  
Jiunn-Tay Lee ◽  
Che-Sheng Chu ◽  
...  

Abstract Background: The neuroprotective role of interleukin (IL)-33 is supported by numerous pre-clinical studies, but it remains uninvestigated in clinical studies of Alzheimer’s disease (AD). We aimed to examine the association between human blood levels of IL-33 and cognitive preservation in amnestic mild cognitive impairment (aMCI) and AD.Methods: A total of 100 participants (26 controls, 35 aMCI patients, and 39 AD patients) completed two Mini Mental State Examination (MMSE) over a 1-year interval. In all 100 participants at the second MMSE, we examined the plasma levels of IL-33, IL-β, IL-1 receptor agonist (IL-1RA), beta amyloid (Aβ), and tau and apolipoprotein E (ApoE) genotyping; we also performed Hopkins Verbal Learning Test, Trail Making Test, forward and backward digit span, and Clinical Dementia Rating. Results: IL-33 expression showed a positive trend among controls (1/26 = 3.8%), aMCI (9/35 = 25.7%), and AD (17/39 = 43.6%) (trend analysis: P < 0.001). Patients expressing IL-33 preserved their cognitive function compared with IL-33 non-expressing patients (1-year ΔMMSE: 0.16 ± 1.6 vs -1.5 ± 2.6; P = 0.006). The cognitive preservation was not associated with the lower levels of Aβ, tau, and ApoE ε4, while higher levels of ApoE ε4 and phosphorylated tau were indeed associated with cognitive decline. The aMCI patients with AD conversion during study period had higher proportion of IL-33(-) than non-AD converters (90.9% vs 53.3%, P = 0.04).Conclusions: IL-33 or its associated signaling pathways may represent a new treatment paradigm for aMCI and AD.


2011 ◽  
Vol 11 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Masashi INOUE ◽  
Daiki JIMBO ◽  
Miyako TANIGUCHI ◽  
Katsuya URAKAMI

2020 ◽  
Author(s):  
Chih-Sung Liang ◽  
Kuan-Pin Su ◽  
Chia-Lin Tsai ◽  
Jiunn-Tay Lee ◽  
Che-Sheng Chu ◽  
...  

Abstract Background: The neuroprotective role of Interleukin (IL)-33 is supported in numerous pre-clinical studies but remains mostly uninvestigated in clinical studies of Alzheimer’s disease (AD). We aimed to examine the association between human blood levels of IL-33 and cognitive preservation in amnestic mild cognitive impairment (aMCI) and AD.Methods: A total of 100 participants (26 controls, 35 aMCI patients, and 39 AD patients) were completed twice Mini Mental State Examination (MMSE) over a 1-year interval. At the second MMSE, the 100 participants examined the plasma levels of IL-33, IL-β, IL-1 receptor agonist (IL-1RA), beta amyloid (Aβ), and tau and apolipoprotein E (ApoE) genotyping, and Hopkins Verbal Learning Test, Trail Making Test, forward and backward digit span, and Clinical Dementia Rating were performed as well. Results: IL-33 expression showed a positive trend among controls (1/26 = 3.8%), aMCI (9/35 = 25.7%), and AD (17/39 = 43.6%) (trend analysis: P < 0.001). The patients expressing IL-33 preserved their cognitive function compared with IL-33 non-expressing patients (1-year ΔMMSE: 0.16 ± 1.6 vs -1.5 ± 2.6; P = 0.006). The cognitive preservation was not associated with the lower levels of Aβ, tau, and AopE ε4, while higher levels of AopE ε4 and phosphorylated tau were indeed associated with cognitive decline. The aMCI patients with AD conversion during study period had higher proportion of IL-33(-) than non-AD converters (0.9% vs 53.3%, P = 0.04).Conclusions: IL-33 or its associated signaling pathways may represent a new treatment paradigm for aMCI and AD.


Author(s):  
Wilma G. Rosen ◽  
Richard C. Mohs ◽  
Kenneth L. Davis

Sign in / Sign up

Export Citation Format

Share Document