Journal of Alzheimer's Disease - Volume 36, issue 2

Authors: Whitehouse, Peter

Article Type: Editorial

Abstract: The individual and social challenges created by population aging and especially the growing number of people labeled with dementia demand new innovative and comprehensive approaches. A broader integrative biology needs to replace reductionist, overly simplistic biomedical solutions that dominate today's scientific discourse, particularly with regards to cognitive aging. Alzheimer's disease is a heterogeneous syndrome characterized more fully at a system rather than molecular level. Coordinated scientific and community responses are needed including new attention to intergenerational relationships, innovative learning organizations, and empowering health practices. The Intergenerational School is a successful public charter school which provides learning opportunities for elementary school …children and adults of various ages, including those with dementia. InterWell is a planned primary care and public health practice to be associated with the school. Both represent innovations that balance the sciences and the humanities in address growing social challenges associated with changes in population demographics and climate. Show more

Keywords: Dementia, Alzheimer's disease, intergenerational, social relationships, school-based health care

DOI: 10.3233/JAD-130116

Citation: Journal of Alzheimer's Disease, vol. 36, no. 2, pp. 225-232, 2013

Authors: Cavanagh, Chelsea | Colby-Milley, Jessica | Bouvier, David | Farso, Mark | Chabot, Jean-Guy | Quirion, Rémi | Krantic, Slavica

Article Type: Short Communication

Abstract: Tumor necrosis factor-alpha (TNFα) regulates neuronal excitability. We investigated whether alterations in the level of TNFα occur at a time point that precedes the reported seizure-associated hyperexcitability of hippocampal networks in pre-plaque models of Alzheimer's disease (AD). Western blot and ELISA experiments indicated a significant increase in hippocampal TNFα expression in 1-month-old TgCRND8 mice that correlated with levels of the β-C-terminal fragment (βCTF) of amyloid-β protein precursor. CD11b labeling indicated changes in microglial morphology toward an activated state, suggesting that these cells may be a putative source of the observed TNFα increase during this pre-symptomatic stage of AD-like pathology.

Keywords: Alzheimer's disease, β-C-terminal fragment, pre-plaque, TgCRND8 mice, tumor necrosis factor-α

DOI: 10.3233/JAD-122131

Citation: Journal of Alzheimer's Disease, vol. 36, no. 2, pp. 233-238, 2013

Authors: Mahoney, Colin J. | Downey, Laura E. | Beck, Jon | Liang, Yuying | Mead, Simon | Perry, Richard J. | Warren, Jason D.

Article Type: Short Communication

Abstract: Primary progressive aphasia (PPA) represents a diverse group of language-led dementias most often due to frontotemporal lobar degeneration. We report clinical, neuropsychological, and neuroimaging data in the case of a 47-year-old woman presenting with non-fluent PPA due to a genetically confirmed pathogenic Presenilin 1 P264L mutation. This case highlights an unusual clinical presentation of familial Alzheimer's disease and a novel presentation of the P264L mutation. The case adds to accumulating evidence that particular mutations can promote specific brain network degeneration, with wider implications for understanding the sporadic forms of Alzheimer's disease and PPA.

Keywords: Familial Alzheimer's disease, Presenilin 1, primary progressive aphasia

DOI: 10.3233/JAD-122092

Citation: Journal of Alzheimer's Disease, vol. 36, no. 2, pp. 239-243, 2013

Authors: Zhuang, Jun-Peng | Fang, Rong | Feng, Xia | Xu, Xu-Hua | Liu, Li-Hua | Bai, Qing-Ke | Tang, Hui-Dong | Zhao, Zhen-Guo | Chen, Sheng-Di

Article Type: Research Article

Abstract: Background: Given the increasing prevalence of dementia, any intervention that can effectively slow the deterioration of cognitive function is of great importance. Objective: This study investigated the efficacy of a human-computer interaction-based comprehensive cognitive training program in cognitively impaired elderly individuals living in a nursing home. Methods: All subjects, who were aged ≥70 years and had cognitive impairment, were randomly allocated to an intervention group (n = 19) or a control group (n = 14). The intervention group received human-computer interaction-based comprehensive cognitive training for 24 weeks. Neuropsychological examinations were conducted before and after this period. …The intervention group was subdivided into two groups according to the scores of global cortical atrophy (GCA) to evaluate the impact of training effectiveness on GCA. Results: After 24 weeks, neither group showed a significant change compared with baseline cognitive examinations. However, there was a tendency for greater improvement in memory, language, and visuospatial abilities for the intervention group as compared with controls. Patients with mild cognitive impairment showed improvements in language and visuospatial capacity, while patients with dementia showed improvements in attention/orientation, memory, language, and fluency. However, none of these findings were statistically significant. The results for the intervention subgroups showed that visuospatial ability improvement was significantly greater among those with a global cortical atrophy score of ≤15 (p < 0.05). Conclusion: Human-computer interaction-based comprehensive training may improve cognitive functions among cognitively impaired elderly individuals. The training effect was most prominent among those with milder cerebral atrophy. Show more

Keywords: Dementia, human-computer interaction-based cognitive training, mild cognitive impairment, nursing home

DOI: 10.3233/JAD-130158

Citation: Journal of Alzheimer's Disease, vol. 36, no. 2, pp. 245-251, 2013

Authors: Manzine, Patrícia Regina | Barham, Elisabeth Joan | Vale, Francisco de Assis Carvalho do | Selistre-de-Araújo, Heloisa Sobreiro | Iost Pavarini, Sofia Cristina | Cominetti, Márcia Regina

Article Type: Research Article

Abstract: Background: Previous studies have demonstrated a decrease in platelet ADAM10 expression among patients with Alzheimer’s disease (AD) and healthy matched subjects. The association between cognitive tests and molecular biomarkers, such as platelet ADAM10, may contribute to an accurate AD diagnosis. Objective: The aim of this research was to investigate whether cognitive deficits in AD, assessed by Mini-Mental State Exam (MMSE), correlate with ADAM10 platelet levels and if that contributes to a more effective AD diagnosis. Methods: Elderly patients with probable AD (n = 30) and a non-AD control group (n = 25), matched by age, gender, …and education level were evaluated. Platelet proteins were analyzed on SDS-PAGE (10%) and ADAM10 expression was identified by western blotting. Κ-actin was used as the endogenous control. The Spearman correlation coefficient between ADAM10 and MMSE ratio was obtained for each group. Results: The MMSE ratio of AD subjects (0.45 ± 0.32) was significantly different (p < 0.001) compared to the non-AD group (1.14 ± 0.07). The relationship between MMSE ratio and ADAM10 expression was significant (r = 0.62, p = 0.0003) for the AD group. The combination of ADAM10 and MMSE at a cutoff ⩽0.87 presented a sensitivity of 85%, and a specificity of 97% (AUC 0.99, 95% CI 0.92 −1.00), which was significantly better for AD diagnosis than the AUCs of MMSE (p = 0.05) and ADAM10 expression (p = 0.18) separately. Conclusions: The association of MMSE and ADAM10 expression was significantly better compared with MMSE and ADAM10 expression separately, thus providing and additional diagnostic tool for AD. Show more

Keywords: ADAM10 protein, alzheimer's disease, biomarkers, correlation study, elderly, human, platelet

DOI: 10.3233/JAD-130125

Citation: Journal of Alzheimer's Disease, vol. 36, no. 2, pp. 253-260, 2013

Authors: Smid, Lojze M. | Kepe, Vladimir | Vinters, Harry V. | Bresjanac, Mara | Toyokuni, Tatsushi | Satyamurthy, Nagichettiar | Wong, Koon-Pong | Huang, Sung-Cheng | Silverman, Daniel H.S. | Miller, Karen | Small, Gary W. | Barrio, Jorge R.

Article Type: Research Article

Abstract: This work is aimed at correlating pre-mortem [18 F]FDDNP positron emission tomography (PET) scan results in a patient with dementia with Lewy bodies (DLB), with cortical neuropathology distribution determined postmortem in three physical dimensions in whole brain coronal sections. Analysis of total amyloid-β (Aβ) distribution in frontal cortex and posterior cingulate gyrus confirmed its statistically significant correlation with cortical [18 F]FDDNP PET binding values (distribution volume ratios, DVR) (p < 0.001, R = 0.97, R2 = 0.94). Neurofibrillary tangle (NFT) distribution correlated significantly with cortical [18 F]FDDNP PET DVR in the temporal lobe (p < 0.001, R = 0.87, …R2 = 0.76). Linear combination of Aβ and NFT densities was highly predictive of [18 F]FDDNP PET DVR through all analyzed regions of interest (p < 0.0001, R = 0.92, R2 = 0.85), and both densities contributed significantly to the model. Lewy bodies were present at a much lower level than either Aβ or NFTs and did not significantly contribute to the in vivo signal. [18 F]FDG PET scan results in this patient were consistent with the distinctive DLB pattern of hypometabolism. This work offers a mapping brain model applicable to all imaging probes for verification of imaging results with Aβ and/or tau neuropathology brain distribution using immunohistochemistry, fluorescence microscopy, and autoradiography. Show more

Keywords: Amyloid, brain pathology mapping, dementia with Lewy bodies, [18F]FDDNP, immunocytochemistry, tau

DOI: 10.3233/JAD-122434

Citation: Journal of Alzheimer's Disease, vol. 36, no. 2, pp. 261-274, 2013

Authors: Caracciolo, Barbara | Gatz, Margaret | Xu, Weili | Marengoni, Alessandra | Pedersen, Nancy L. | Fratiglioni, Laura

Article Type: Research Article

Abstract: We investigated the relation of subjective cognitive impairment (SCI) and cognitive impairment no dementia (CIND) to common chronic diseases of the elderly and multimorbidity, and assessed the contribution of genetic background and shared familial environment to these associations. Subjects were 11,379 dementia-free twin individuals aged ≥ 65 from the Swedish Twin Registry. SCI was defined as subjective complaint of cognitive change without objective cognitive impairment and CIND was defined according to current criteria. In unmatched, fully-adjusted regression models, mental, musculoskeletal, respiratory, and urological diseases were all significantly associated with increased odds ratios (ORs) of SCI and CIND. Circulatory and gastrointestinal …diseases were related to SCI only, while endocrine diseases were associated with CIND. The adjusted ORs of multimorbidity were 2.1 [95% confidence intervals (95% CI): 1.8–2.3] for SCI and 1.5 for CIND (95% CI: 1.3–1.8). A dose-dependent relationship was observed between number of chronic diseases and ORs for SCI but not for CIND. In co-twin control analyses, the chronic diseases-SCI association was largely unchanged. On the other hand, the chronic diseases-CIND association was no longer statistically significant, except for cancer, where an increased OR was observed. In conclusion, chronic morbidity is associated with both SCI and CIND but disease profiles do not always overlap between the two cognitive syndromes. The association is stronger when diseases co-occur, especially for SCI. Genetic and early-life environmental factors may partially explain the association of CIND but not that of SCI with chronic diseases. Show more

Keywords: Chronic diseases, chronic morbidity, cognitive impairment, co-morbidity, cross-sectional, population-based, subjective cognitive complaints, twin-study

DOI: 10.3233/JAD-122050

Citation: Journal of Alzheimer's Disease, vol. 36, no. 2, pp. 275-284, 2013

Authors: Manczak, Maria | Reddy, P. Hemachandra

Article Type: Research Article

Abstract: Alzheimer's disease (AD) is a progressive neurodegenerative mental illness characterized by memory loss, multiple cognitive impairments, and changes in personality and behavior. The purpose of our study was to determine the interaction between monomeric and oligomeric amyloid-β (Aβ) and phosphorylated tau in AD neurons. Using postmortem brains from AD patients at different stages of disease progression and control subjects, and also from AβPP, AβPPxPS1, and 3xTg-AD mice, we studied the physical interaction between Aβ and phosphorylated tau. Using immunohistological and double-immunofluorescence analyses, we also studied the localization of monomeric and oligomeric Aβ with phosphorylated tau. We found monomeric and oligomeric …Aβ interacted with phosphorylated tau in neurons affected by AD. Further, these interactions progressively increased with the disease process. These findings led us to conclude that Aβ interacts with phosphorylated tau and may damage neuronal structure and function, particularly synapses, leading to cognitive decline in AD patients. Our findings suggest that binding sites between Aβ and phosphorylated tau need to be identified and molecules developed to inhibit this interaction. Show more

Keywords: Amyloid-β, amyloid-β protein precursor, cognitive decline, phosphorylated tau, synapses

DOI: 10.3233/JAD-130275

Citation: Journal of Alzheimer's Disease, vol. 36, no. 2, pp. 285-295, 2013

Authors: Olazarán, Javier | González, Belén | López-Álvarez, Jorge | Castagna, Alessandro | Osa-Ruiz, Emma | Herrero-Cano, Vanesa | Agüera-Ortiz, Luis | Rinaldi, Salvatore | Martínez-Martín, Pablo | AD Research Unit Investigators

Article Type: Research Article

Abstract: We conducted a pilot, randomized, controlled trial to mainly investigate the feasibility, safety, and short-term motor effects of brain stimulation with radio electric asymmetric conveyer (REAC) technology in patients with advanced Alzheimer's disease (AD) who also experience some gait dysfunction. Neuropostural optimization (NPO) or sham protocol was administered to 31 nursing home patients (mean [SD] age 84.7 [7.0], 77.4% female, 6.5% moderate dementia, 51.6% moderately severe dementia, and 41.9% severe dementia). Motor, cognitive, functional, and behavioral measures were conducted at baseline (T1), immediately after treatment (T2), and 1–3 weeks after treatment (T3). There was transitory dysfunction in axial movements at …T2 in the experimental group with no other differences between the experimental group and the control group in the planned analyses. However, after reanalysis of data based on outcome, improvement in capacity of walking was observed at T3 in the experimental group (p < 0.05). NPO administration was comfortable and safe. These results warrant further research with NPO and other REAC protocols to improve motor deterioration in AD. Show more

Keywords: Alzheimer's disease, brain stimulation, gait dysfunction, motor performance, neuropostural optimization, nursing homes, radio electric asymmetric conveyer

DOI: 10.3233/JAD-130077

Citation: Journal of Alzheimer's Disease, vol. 36, no. 2, pp. 297-302, 2013

Authors: Ientile, Luisa | De Pasquale, Riccardo | Monacelli, Fiammetta | Odetti, Patrizio | Traverso, Nicola | Cammarata, Sergio | Tabaton, Massimo | Dijk, Babette

Article Type: Research Article

Abstract: People affected by dementia experienced decreased life expectancy with a 2–4 times higher risk of death at a given age compared to non-demented people. Dementia represents a major cost to health care and society in the Western world and, particularly in Italy, is projected to become a high-resource demanding chronic disease. The present study aimed to estimate the average survival rate of a group of community dwelling elderly affected by dementia in Italy, and to assess the predictive variables associated with survival length. This retrospective study collected the data of patients (n = 290) who died from 2008 to 2012. …The data were extracted from a cohort of over 2,000 patients from three outpatient Dementia Clinics of Genoa (Italy). Demographic data and other clinical parameters listed in the patients' clinical records were collected. The mean survival rate after dementia diagnosis was 3.3 ± 0.1 years, lower compared to the age-matched healthy population. The survival rate of these patients showed a significant correlation with age (n = 290; r = −0.16: p < 0.006), with the cognitive status (n = 285; r = 0.16: p < 0.007), with education (n = 204; r = 0.23: p < 0.001), with comorbidity (n = 138; r = −0.41: p < 0.0001), with depressive mood (n = 74; r = 0.44: p < 0.0001), and with the functional status (ADL: n = 242, r = 0.29: p < 0.0001; IADL: n = 243; r = 0.25: p < 0.0001). Multivariate regression revealed age, gender, and functional status as the main determinants informing patient survival. The study provides interesting and reliable data on the pivotal value of early dementia diagnosis in predicting longer survival and addresses comprehensive geriatric assessment, which encompasses most of the predictive variables provided by the study, as a remarkable tool in estimating life expectancy of patients with dementia. Show more

Keywords: Comprehensive geriatric assessment, survival rate, dementia diagnosis

DOI: 10.3233/JAD-130002

Citation: Journal of Alzheimer's Disease, vol. 36, no. 2, pp. 303-309, 2013