Suicidal behavior in patients with dementia

203 patients were examined, including 75 with dementia at Alzheimer’s disease (AD), 73 with vascular dementia (VD) and 60 patients with mixed dementia (MD). Patients were divided into main and control group by the factor of presence/absence of signs of suicidal behavior (intentions, attempts, thoughts, anti-vital mood, statements). Among patients with AD, 36 patients were the main group, 39 were the control group; at VD 39 patients were main group, 34 were control group; in mixed dementia, 30 patients were included in the main group, 30 patients were in the control group. It has been found that in 56 % of cases with dementia due to Alzheimer’s disease, in 65 % with vascular dementia and 56 % with mixed dementia of the clinical picture, suicidal behavior (SB) is observed. The complex of factors of SB risk/anti- risk and suicide-genesis mechanisms in dementia, that became the targets for development of differentiated program for medical and psychological rehabilitation and prevention (MPRP) patients with SB in dementia were distinguished. The suicide-genesis concept in dementia which determines the mechanisms of the formation of suicidal behavior under the influence of clinical and intra-personal indexes, was worked out. Accounting the formation mechanisms and SB predictors, special features of clinical and psychopathological, clinical and phenomenological SB demonstration in various types of dementia the complex and differentiated MPRP program and SB prevention, realized on the basis of complex approach including usage of psychopharmacological, psychotherapeutic, psychoeducational psychosocial actions was worked out and tested. The result of the developed system testing proved its high efficiency, which is supported by the positive dynamics of clinical and psychopathological indexes of suicide status and level of independence in the everyday life of patients with SB in dementia.

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PECULIARITIES OF HIGHER PSYCHOLOGICAL FUNCTIONS AND EMOTIONAL SPHERE IN PATIENTS WITH DEMENTIA OF VARIOUS TYPES ASSOCIATED WITH SUICIDAL RISK

Inter Collegas ◽

10.35339/ic.5.1.46-49 ◽

2018 ◽

Vol 5 (1) ◽

pp. 46-49

Author(s):

I. Mudrenko

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

High Risk ◽

Vascular Dementia ◽

Emotional Disorders ◽

Suicidal Behavior ◽

Control Group ◽

Suicidal Risk ◽

Psychological Functions ◽

Higher Psychological Functions

PECULIARITIES OF HIGHER PSYCHOLOGICAL FUNCTIONS AND EMOTIONAL SPHERE IN PATIENTS WITH DEMENTIA OF VARIOUS TYPES ASSOCIATED WITH SUICIDAL RISKI.H. Mudrenko The study involved 208 patients with dementia who were divided into three groups according to the type of dementia: 75 patients with Alzheimer's disease, 73 patients with vascular dementia and 60 patients with the mixed type of dementia. In each group, patients were divided into the main group (in which high suicidal risk (SR) was determined) and the control group (without signs of suicidal risk).The aim of the study was to assess the influence of disturbances of higher psychological functions and emotional-volitional sphere on the formation of suicidal behavior (SB) in patients with different clinical types of dementia.On the basis of clinical, pathopsychological, neuroimaging examination of patients we determined clinical and psychopathological peculiarities associated with high risk of suicide. The state of the following spheres of the psyche was determined: thinking, memory, will, emotions, attention, speech, perception, motor sphere.Thus, it was established that torpidity of thinking, pseudomania and micromania, prevalence of hypomymia and hypothyroidism, inhibition of speech, attention fatigue and emotional disorders in the form of depressive affective manifestations are typical for patients with high risk of suicide. The patients of the control group without the signs of suicidal behavior have difficulties in planning and organization of activity, differed in psychomotor agitation, severity of fixative amnesia, and difficulty concentration.The obtained data should be considered for diagnosis and prevention of suicidal behavior in this patient population.Key words: thought disorder, memory impairment, attention disorder, perceptual disturbance, speech disturbance, emotions, vascular dementia, mixed dementia, dementia in Alzheimer's disease. ОСОБЛИВОСТІ ВИЩИХ ПСИХІЧНИХ ФУНКЦІЙ ТА ЕМОЦІЙНОЇ СФЕРИ У ХВОРИХ НА ДЕМЕНЦІЇ РІЗНИХ ТИПІВ, АСОЦІЙОВАНІ З СУЇЦИДАЛЬНИМ РИЗИКОМ Мудренко І.Г.У дослідженні прийняли участь 208 хворих на деменцію, які були розділені на три групи за типом деменції: 75 пацієнтів з хворобою Альцгеймера, 73 хворих на судинну деменцію та 60 хворих зі змішаним типом деменції. В кожній групі пацієнти були розділені на основну групу (у яких визначався високий суїцидальний ризик (СР)) та контрольну групу (без ознак суїцидального ризику).Метою дослідження явилось вивчення впливу порушень вищих психічних функцій та емоційно-вольової сфери на формування суїцидальної поведінки (СП) у хворих з різними клінічними варіантами деменцій.На підставі клінічного, патопсихологічного, нейровізуалізаційного обстеження хворих нами виділені клініко-психопатологічні особливості асоційовані з високим ризиком суїциду. Визначався стан наступних сфер психіки: мислення, пам’яті, волі, емоцій, уваги, мови, сприйняття, рухової сфери.Так, встановлено, що торпідність мислення, маячні ідеї самозвинувачення та самоприниження, переважання гіпомімії та гіпотимії, загальмованість мови, виснаженість процесу уваги та порушення в емоційній сфері, у вигляді депресивних афективних проявів притаманні для пацієнтів з високим ризиком суїциду. Пацієнти контрольної групи без ознак суїцидальної поведінки відрізнялись труднощами у плануванні та організації діяльності, психомоторним збудженням, вираженістю фіксаційної амнезії та розсіяністю уваги.Отримані дані необхідно враховувати для діагностики та профілактики суїцидальної поведінки у даного контингенту хворих.Ключові слова: порушення мислення, пам’яті, уваги, сприйняття, мови, емоцій, деменція судинна, змішана, при хворобі Альцгеймера.ОСОБЕННОСТИ ВЫСШИХ ПСИХИЧЕСКИХ ФУНКЦИЙ И ЭМОЦИОНАЛЬНОЙ СФЕРЫ У БОЛЬНЫХ С ДЕМЕНЦИЯМИ РАЗЛИЧНЫХ ТИПОВ, АССОЦИИРОВАННЫЕ С СУИЦИДАЛЬНЫМ РИСКОММудренко И.Г.В исследовании приняли участие 208 больных деменцией, которые были разделены на три группы по типу деменции: 75 пациентов с болезнью Альцгеймера, 73 больных сосудистой деменцией и 60 больных со смешанным типом деменции. В каждой группе пациенты были разделены на основную группу (в которых определялся высокий суицидальный риск (СР)) и контрольную группу (без признаков суицидального риска).Целью исследования явилось изучение влияния нарушений высших психических функций и эмоционально-волевой сферы на формирование суицидального поведения (СП) у больных с различными клиническими вариантами деменции.На основании клинического, патопсихологического, нейровизуализационного обследования больных нами выделены клинико-психопатологические особенности, ассоциированные с высоким риском суицида. Определялось состояние следующих сфер психики: мышления, памяти, воли, эмоций, внимания, речи, восприятия, двигательной сферы.Так, установлено, что торпидность мышления, бредовые идеи самообвинения и самоуничижения, преобладание гипомимии и гипотимии, заторможенность речи, истощение процесса внимания и нарушения в эмоциональной сфере, в виде депрессивных аффективных проявлений характерны для пациентов с высоким риском суицида. Пациенты контрольной группы без признаков суицидального поведения отличались трудностями в планировании и организации деятельности, психомоторным возбуждением, выраженностью фиксационной амнезии и рассеянностью внимания.Полученные данные необходимо учитывать для диагностики и профилактики суицидального поведения у данного контингента больных.Ключевые слова: нарушение мышления, памяти, внимания, восприятия, речи, эмоций, деменция сосудистая, смешанная, при болезни Альцгеймера.

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GENDER CHARACTERISTICS OF DEPRESSIVE SYMPTOMS OF DEMENTIA IN PATIENTS WITH SUICIDAL BEHAVIOR

Inter Collegas ◽

10.35339/ic.5.4.182-187 ◽

2018 ◽

Vol 5 (4) ◽

pp. 182-187

Author(s):

I. Mudrenko

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Depressive Symptoms ◽

Vascular Dementia ◽

Suicidal Behavior ◽

Mixed Type ◽

Rating Scale ◽

Mixed Dementia ◽

Vascular Type ◽

Gender Characteristics

GENDER CHARACTERISTICS OF DEPRESSIVE SYMPTOMS OF DEMENTIA IN PATIENTS WITH SUICIDAL BEHAVIORMudrenko I.H.Dementia is in most cases comorbid, which greatly reduces the quality of patients’ life and increases the risk of suicidal manifestations.The aim of the study is to determine gender characteristics of depressive symptoms in patients with various clinical types of dementia with high suicide risk.The object and methods of research. Thestudy involved examination of 105 patients with dementia of different types (due to Alzheimer's disease, vascularandmixedone) with high suicide risk using the HamiltonDeppression Rating Scale (HDRS).Results of theresearch. Statistical analysisshowedthat a high degree of depression is a markerof suicidal risk in men with a vascular type of dementia, and in women with a mixed type of dementia. Verbalization (statement of suicidal intentions, thoughts) and the behavioral component of suicidal behavior (attempts) with a pronounced torpidity of mental processes are typical for men with Alzheimer's disease and vascular dementia and for women with a mixed type of dementia. In women, affective oscillations during the day increased SR in Alzheimer's disease, and frequent wakening at night in mixed dementia. Physical limitations and inability to perform work, the problems with sexual vigor can be considered a psychogenic factor of high SR in men with vascular impairment.Key words:dementia in Alzheimer’s disease, vascular dementia, mixed dementia, gender differences, depressive symptoms, predictors of suicidal behavior. РезюмеГЕНДЕРНІ ОСОБЛИВОСТІ ДЕПРЕСИВНОЇ СИМПТОМАТИКИ В СТРУКТУРІ ДЕМЕНЦІЙ У ОСІБ З СУЇЦИДАЛЬНОЮ ПОВЕДІНКОЮМудренко І.Г.Деменція у більшості випадків коморбідна з депресією, що значно знижує якість життя хворих та підвищує ризик суїцидальних проявів у даної категорії хворих.Метою нашого дослідження є визначення гендерних особливостей депресивної симптоматики у хворих з різними клінічними варіантами деменції з високим ризиком суїциду. Об’єкт та методи дослідження. Всього обстежено 105 пацієнтів з деменціями різних типів (внаслідок хвороби Альцгеймера, судинною, змішаною) з високим суїцидальним ризиком за допомогою шкали Гамільтона для оцінки депресії (HDRS).На підставі статистичного аналізу встановлено, що високий ступінь депресії є маркером суїцидального ризику у чоловіків з судинним типом деменціїі, а у жінок зі змішаним типом дементного процесу. Вербалізація (висловлювання суїцидальних намірів, думок) та поведінковий компонент суїцидальної поведінки (спроби) на фоні вираженої торпідності психічних процесів притаманні для чоловіків з хворобою Альцгеймера та судинною деменцією та для жінок зі змішаним типом дементного враження. У жінок підвищували СР при хворобі Альцгеймера афективні коливання на протязі доби, а при змішаній деменції - часті пробудження вночі. Можна припустити, що психогенним чинником високого СР у чоловіків з судинним враженням є фізичні обмеження та нездатність до виконання робіт, проблеми з потенцією. Ключові слова:деменція при хворобі Альцгеймера, судинна, змішана, гендерні відмінності, депресивна симптоматика, пре диктори суїцидальної поведінки. РезюмеГЕНДЕРНЫЕ ОСОБЕННОСТИ ДЕПРЕССИВНОЙ СИМПТОМАТИКИ В СТРУКТУРЕ ДЕМЕНЦИИ У ЛИЦ С СУИЦИДАЛЬНЫМ ПОВЕДЕНИЕММудренко И.Г.Введение. Деменция в большинстве случаев коморбидна с депрессией, что значительно снижает качество жизни больных и повышает риск суицидальных проявлений у данной категории больных.Целью нашего исследования явилось определение гендерных особенностей депрессивной симптоматики у больных с различными клиническими вариантами деменции с высоким риском суицида. Обследовано 105 пациентов с деменцией различных типов (вследствие болезни Альцгеймера, сосудистой, смешанной) с высоким суицидальным риском (СР) с помощью шкалы Гамильтона для оценки депрессии (HDRS).На основании статистического анализа установлено, что высокая степень депрессии является маркером суицидального риска у мужчин с сосудистым типом деменциии, а у женщин со смешанным типом дементного процесса. Вербализация (высказывания суицидальных намерений, мыслей) и поведенческий компонент суицидального поведения (попытки) на фоне выраженной торпидности психических процессов присущи для мужчин с болезнью Альцгеймера и сосудистой деменцией и для женщин со смешанным типом деменции. У женщин повышали СР при болезни Альцгеймера аффективные колебания в течение суток, а при смешанной деменции - частые пробуждения ночью. Можно предположить, что психогенным фактором высокого СР у мужчин с сосудистым поражением головного мозга являются физические ограничения и неспособность к выполнению работ, проблемы с потенцией.Ключевые слова: деменция при болезни Альцгеймера, сосудистая, смешанная, гендерные различия, депрессивная симптоматика, предикторы суицидального поведения.

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Alzheimer’s disease and its related Dementia types: A review on their management via nanotechnology based therapeutic strategies

Current Alzheimer Research ◽

10.2174/1567205018666210218160812 ◽

2021 ◽

Vol 18 ◽

Author(s):

Panoraia I. Siafaka ◽

Gökce Mutlu ◽

Neslihan Üstündağ Okur

Keyword(s):

Alzheimer’S Disease ◽

Drug Delivery ◽

Alzheimer's Disease ◽

Vascular Dementia ◽

Drug Delivery Systems ◽

Delivery Systems ◽

The Body ◽

Daily Routine ◽

Mixed Dementia ◽

The Brain

Background: Dementia and its related types such as Alzheimer’s disease, vascular dementia and mixed dementia belong to brain associated diseases, resulting in long-term progressive memory loss. These diseases are so severe that can affect a person's daily routine. Up to date, treatment of de- mentias is still an unmet challenge due to their complex pathophysiology and unavailable efficient pharmacological approaches. The use of nanotechnology based pharmaceutical products could possibly improve the management of dementia given that nanocarriers could more efficiently deliver drugs to the brain. Objective: The objective of this study is to provide the current nanotechnology based drug delivery systems for the treatment of various dementia types. In addition, the current diagnosis biomarkers for the mentioned dementia types along with their available pharmacological treatment are being dis- cussed. Method: An extensive review of the current nanosystems such as brain drug delivery systems against Alzheimer’s disease, vascular dementia and mixed dementia was performed. Moreover, nan- otheranostics as possible imaging markers for such dementias were also reported. Results: The field of nanotechnology is quite advantageous for targeting dementia given that nanoscale drug delivery systems easily penetrate the blood brain barrier and circulate in the body for prolonged time. These nanoformulations consist of polymeric nanoparticles, solid lipid nanoparticles, nanostruc- tured lipid carriers, microemulsions, nanoemulsions, and liquid crystals. The delivery of the nan- otherapeutics can be achieved via various administration routes such as transdermal, injectable, oral, and more importantly, through the intranasal route. Nonetheless, the nanocarriers are mostly limited to Alzheimer’s disease targeting; thus, nanocarriers for other types of dementia should be developed. Conclusion: To conclude, understanding the mechanism of neurodegeneration and reviewing the cur- rent drug delivery systems for Alzheimer’s disease and other dementia types are significant for medical and pharmaceutical society to produce efficient therapeutic choices and novel strategies based on mul- tifunctional and biocompatible nanocarriers, which can deliver the drug sufficiently into the brain.

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Preclinical Cognitive Trajectories Differ for Alzheimer's Disease and Vascular Dementia

Journal of the International Neuropsychological Society ◽

10.1017/s1355617711001718 ◽

2012 ◽

Vol 18 (2) ◽

pp. 191-199 ◽

Cited By ~ 17

Author(s):

Erika J. Laukka ◽

Stuart W.S. MacDonald ◽

Laura Fratiglioni ◽

Lars Bäckman

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Vascular Dementia ◽

Early Stage ◽

Block Design ◽

Word Recall ◽

Cognitive Tasks ◽

Control Group ◽

Age Related ◽

Preclinical Ad

AbstractWe investigated differences between Alzheimer's disease (AD) and vascular dementia (VaD) from the appearance of the first cognitive symptoms, focusing on both time of onset and rate of accelerated decline for different cognitive functions before dementia diagnosis. Data from a longitudinal population-based study were used, including 914 participants (mean age = 82.0 years, SD = 5.0) tested with a cognitive battery (word recall and recognition, Block Design, category fluency, clock reading) on up to four occasions spanning 10 years. We fit a series of linear mixed effects models with a change point to the cognitive data, contrasting each dementia group to a control group. Significant age-related decline was observed for all five cognitive tasks. Relative to time of diagnosis, the preclinical AD persons deviated from the normal aging curve earlier (up to 9 years) compared to the preclinical VaD persons (up to 6 years). However, once the preclinical VaD persons started to decline, they deteriorated at a faster rate than the preclinical AD persons. The results have important implications for identifying the two dementia disorders at an early stage and for selecting cognitive tasks to evaluate treatment effects for persons at risk of developing AD and VaD. (JINS, 2012, 18, 191–199)

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Brevican and Neurocan Peptides as Potential Cerebrospinal Fluid Biomarkers for Differentiation Between Vascular Dementia and Alzheimer’s Disease

Journal of Alzheimer s Disease ◽

10.3233/jad-201039 ◽

2020 ◽

pp. 1-13

Author(s):

Karolina Minta ◽

Gunnar Brinkmalm ◽

Erik Portelius ◽

Per Johansson ◽

Johan Svensson ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cerebrospinal Fluid ◽

Vascular Dementia ◽

Extracellular Enzymes ◽

Control Group ◽

Healthy Controls ◽

Clear Trend ◽

Cerebrospinal Fluid Biomarkers

Background: Brevican and neurocan are central nervous system-specific extracellular matrix proteoglycans. They are degraded by extracellular enzymes, such as metalloproteinases. However, their degradation profile is largely unexplored in cerebrospinal fluid (CSF). Objective: The study aim was to quantify proteolytic peptides derived from brevican and neurocan in human CSF of patients with Alzheimer’s disease (AD) and vascular dementia (VaD) compared with controls. Methods: The first cohort consisted of 75 individuals including 25 patients with AD, 7 with mild cognitive impairment (MCI) diagnosed with AD upon follow-up, 10 patients with VaD or MCI diagnosed with VaD upon follow-up, and 33 healthy controls and cognitively stable MCI patients. In the second cohort, 31 individuals were included (5 AD patients, 14 VaD patients and 12 healthy controls). Twenty proteolytic peptides derived from brevican (n = 9) and neurocan (n = 11) were quantified using high-resolution parallel reaction monitoring mass spectrometry. Results: In the first cohort, the majority of CSF concentrations of brevican and neurocan peptides were significantly decreased inVaDas compared withADpatients (AUC = 0.83.0.93, p≤0.05) and as compared with the control group (AUC = 0.79.0.87, p ≤ 0.05). In the second cohort, CSF concentrations of two brevican peptides (B87, B156) were significantly decreased in VaD compared with AD (AUC = 0.86.0.91, p ≤ 0.05) and to controls (AUC = 0.80.0.82, p ≤ 0.05), while other brevican and neurocan peptides showed a clear trend to be decreased in VaD compared with AD (AUC = 0.64.80, p > 0.05). No peptides differed between AD and controls. Conclusion: Brevican and neurocan peptides are potential diagnostic biomarkers for VaD, with ability to separate VaD from AD.

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Vascular Dementia: A Diagnostic Challenge

International Psychogeriatrics ◽

10.1017/s1041610203009050 ◽

2003 ◽

Vol 15 (S1) ◽

pp. 111-114 ◽

Cited By ~ 7

Author(s):

Gabriel Gold

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Vascular Dementia ◽

Clinical Diagnosis ◽

Clinical Studies ◽

Mixed Dementia ◽

Diagnostic Challenge ◽

Clinical Criteria ◽

Clinicopathological Correlations ◽

Broad Consensus

Although vascular dementia was described over a century ago, it remains a difficult and challenging diagnosis. Several sets of clinical criteria have been published in an effort to establish the presence or absence of vascular dementia in a standardized fashion. Clinical studies have demonstrated that they identify different groups of patients and are thus not interchangeable. Retrospective clinicopathological correlations have shown that most are insufficiently sensitive, although they are generally relatively specific. They accurately exclude pure Alzheimer's disease but may include 9% to 39% of mixed dementia cases (Alzheimer's disease and vascular dementia combined). Further studies are needed to develop better performing criteria that could lead to a broad consensus on the clinical diagnosis of vascular and mixed dementia.

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The role of impairment of higher mental functions in suicidogenesis in the dementia caused by Alzheimer's disease

Psychosomatic Medicine and General Practice ◽

10.26766/pmgp.v3i3.104 ◽

2018 ◽

Vol 3 (3) ◽

pp. e0303104

Author(s):

Iryna Mudrenko

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

High Risk ◽

Suicidal Behavior ◽

Control Group ◽

Elderly Age ◽

Mental Functions ◽

Age Related ◽

Higher Mental Functions

Background Dementia is the age-related disease. At the same time, the elderly age has one of the peaks in the number of suicides. Psychology of patients with demetia is characterized by the feeling of hopelessness, pessimism, awareness of own insolvency, dependence on others, that affects the risk of suicide. It is established that the highest risk of suicide in the early stages of dementia with the progression of cognitive deficit, the risk of suicide decreases. Aim To study the role of impairment of higher mental functions (perception, reasoning, attention, memory, emotions, will, speech) in the formation of suicidal behaviour in patients with dementia in Alzheimer's disease. Materials and methods There were examined 75 patients with dementia in Alzheimer's disease, 36 patients with a history of suicidal behavior composed the main group, and 39 patients without the signs of suicidal behavior composed control group. The study was carried out using clinical-anamnestic, psychopathological methods and mathematical statistical methods. Results The high risk of suicide in dementia caused by Alzheimer's disease is combined with the inhibition of thinking, the delusional ideas of self-blame and self-effacement (p ≤ 0.05); depressed mood, inner agitation, anxiety, feeling of despair, hopelessness, guilt, melancholia, apathy (p ≤ 0.05); effector-volitional disorders in the form of hypobulia, hypokinesia, hypomimia, decreased libido (p ≤ 0.05); speech disturbance in the form of bradylalia p ≤ 0.05; greater exhaustion and decreased attention (p ≤ 0.05). On the contrary, the following peculiarities of higher mental functions, namely thought disorder are referred to the anti-risk factors of suicide in dementia caused by Alzheimer's disease: the delusional ideas of relation and damage (p ≤ 0.05); emotions: the feeling of fear (p ≤ 0.05); effector-volitional sphere: parabulia and hyperkinesia (p ≤ 0.05). Conclusion On the basis of clinical and psychopathological study of patients with dementia in Alzheimer's disease, the specific impairment of higher mental functions and emotional-volitional spheres reasoning, memory, attention, perception, speech, emotions) are identified associated with high risk of suicide.

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Serotonin 5-HT2A Receptor Binding in Platelets From Patients With Alzheimer's Disease or Vascular Dementia

International Psychogeriatrics ◽

10.1017/s1041610200006645 ◽

2000 ◽

Vol 12 (4) ◽

pp. 537-545 ◽

Cited By ~ 8

Author(s):

Olav Spigset ◽

Christer Wilhelmsson ◽

Tom Mjörndal ◽

Sture Eriksson

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Vascular Dementia ◽

Receptor Binding ◽

Rating Scale ◽

Control Group ◽

Receptor Status ◽

Serotonin System ◽

Significant Difference ◽

Scale Scores

It is well known that abnormalities in the brain serotonin system exist in patients with dementia. The present study was performed in order to investigate whether a peripheral serotonin system marker, the platelet 5-HT2A receptor, is affected in dementia. Thirty-eight patients with Alzheimer's disease (AD), 13 patients with vascular dementia, and 40 healthy controls were included in the study. There were no significant differences in receptor density for 5-HT2A receptor binding between the groups. Affinity of the radioligand to the receptor was significantly lower in AD than in vascular dementia and in the controls (p = .006 and p = .003, respectively), whereas there was no significant difference between the vascular dementia group and the control group. In 12 patients, treatment with citalopram was started due to depression or agitation. This treatment significantly reduced the Behavioral Pathology in Alzheimer's Disease Rating Scale scores (p = .001), but did not affect the platelet 5-HT2A receptor status. There was no correlation between 5-HT2A receptor status before treatment and the therapeutic effect of citalopram. The study indicates that platelet 5-HT2A receptor status is of limited value as a peripheral marker in dementia.

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COMPARATIVE ANALYSIS OF UNSATURATED INDICATORS FATTY ACIDS IN ELDERLY PATIENTS IN INITIAL STAGES OF ALZHEIMER’S DISEASE AND VASCULAR DEMENTIA

Успехи геронтологии ◽

10.34922/ae.2020.33.2.007 ◽

2020 ◽

pp. 265-272

Author(s):

Е. Е. Дубинина ◽

Л. В. Щедрина ◽

К. В. Ющин ◽

Е. В. Светкина ◽

Н. М. Залуцкая ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Fatty Acids ◽

Arachidonic Acid ◽

Comparative Analysis ◽

Polyunsaturated Fatty Acids ◽

Vascular Dementia ◽

Cognitive Functions ◽

Control Group ◽

Omega 3

Снижение когнитивных функций вплоть до развития деменции у пожилых людей связывают с уменьшением в крови уровня полиненасыщенных жирных кислот, особенно Омега-3, которое происходит на фоне окислительного стресса. В работе представлен сравнительный анализ спектра полиненасыщенных жирных кислот и активности отдельных компонентов ферментативной антиоксидантной системы в крови у лиц пожилого возраста с нарушением показателей когнитивного функционирования до уровня «мягкое когнитивное снижение» первично-атрофической (MCI БА, продромальная болезнь Альцгеймера) или васкулярной этиологии (MCI СД, продромальная сосудистая деменция) по сравнению с пожилыми людьми без признаков нарушений когнитивных функций. Выявлено снижение концентрации Омега-3 полиненасыщенных жирных кислот в крови обеих групп обследованных больных по сравнению с контрольной группой. У пациентов с MCI БА обнаружено резкое снижение концентрации арахидоновой кислоты (Омега-6) по сравнению с больными MCI СД и контрольной группой. Выявленное нами снижение активности антиоксидантной ферментативной системы и снижение полиненасыщенных жирных кислот за счет их пероксидации свидетельствует об интенсификации процессов окислительного стресса у пациентов с нарушением когнитивных функций. Обсуждается вопрос о патогенетической роли арахидоновой кислоты у больных, предрасположенных в будущем к развитию болезни Альцгеймера. A decrease in cognitive functions up to the development of dementia in the elderly is associated with a decrease in the blood level of polyunsaturated fatty acids, especially Omega-3, which occurs against the background of oxidative stress. The paper presents a comparative analysis of the spectrum of polyunsaturated fatty acids and the activity of individual components of the enzymatic antioxidant system in the blood of elderly people with impaired cognitive performance to the level of «mild cognitive decline» (MCI AD, prodromal Alzheimer’s disease) or vascular etiology (MCI VaD, prodromal vascular dementia) compared with older people without signs of cognitive impairment. A decrease in the concentration of Omega-3 polyunsaturated fatty acids in the blood of both groups of the examined patients was revealed compared with the control group. In patients with AD MCI, a sharp decrease in the concentration of arachidonic acid (Omega-6) was detected compared with patients with MCI VaD and the control group. The decrease in the activity of the antioxidant enzymatic system and the decrease in polyunsaturated fatty acids due to their peroxidation revealed in this study indicate an intensiﬁcation of the OS processes in patients with impaired cognitive functions. The question of the pathogenetic role of arachidonic acid in patients predisposed in the future to the development of AD is discussed.

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