Blood Pressure Profiles and Cognitive Function from Adulthood to Old Age: Chasing a Golden Middle Way?

With the demographic shift toward advanced ages, it is imperative to understand the biological mechanisms behind common, disabling age-related diseases such as cognitive impairment in its mild form to overt dementia. Hypertension, a major cardiovascular risk factor, is epidemiologically linked to vascular and Alzheimer-type dementia, with possible mechanisms being atherosclerotic macro- and microvascular damage leading to neuronal cell death, as well as proinflammatory events responsible for neurodegeneration. Nevertheless, there is currently a knowledge gap as to which population to target, what the diagnostics test, and how to manage early pathogenic events in order to prevent such a dramatic and disabling condition. While clinical trials data support the benefit of active BP control with antihypertensive medications on the risk of future cognitive impairment, hypotension appears to be related to accelerated cognitive decline in both the fit and the cognitively frail elderly. Dedicated, technologically advanced studies assessing the relation of BP with dementia are needed to clarify the pathophysiological mechanisms in the association before a tailored preventive, diagnostic, and therapeutic approach to one of the most widespread modern medical challenges becomes a reality.

Fluorescence Resonance Energy Transfer-based Screening for Protein Kinase C Ligands Using 6-Methoxynaphthalene-labeled 1,2-Diacylglycerol-lactones

Protein kinase C (PKC) is associated with a central cellular signal transduction pathway and disorders such as cancer and Alzheimer-type dementia and is therefore a target for treatment of these...

A Case of a Male Patient with Frontotemporal Dementia with Behavioral and Psychological Symptoms Responding to a Low Dose of Escitalopram

Background: Frontotemporal dementia (FTD) is a common type of early-onset dementia. It is characterized by insidious onset and gradual progression, early decline in social interpersonal conduct and regulation of personal conduct, early emotional blunting and loss of insight. Behavioral disorder, speech and language are supportive features in FTD. Here, we present a case of a patient with FTD with behavioral and psychological symptoms of dementia (BPSD) responding to escitalopram treatment.Case presentation: A 60-year-old Japanese man had been treated for early-onset Alzheimer-type dementia with galantamine (24 mg/day) for 5 years. He developed behavioral, executive and semantic deficits. He had stereotypical, compulsive behavior, eating habit changes, disinhibition, excitement, irritability and anxiety. His diagnosis changed to FTD based on clinical features and MRI and SPECT. Galantamine was tapered off, and escitalopram 5 mg/day was started and increased to 10 mg/day. The symptoms of FTD, including behavioral and psychological symptoms, were decreased.Conclusion: This case is the first report demonstrating that escitalopram might be effective for BPSD that accompany FTD.