Journal of Alzheimer's Disease - Volume 81, issue 3

Authors: Nasrun, Martina Wiwie S. | Kusumaningrum, Profitasari | Redayani, Petrin | Lahino, Hasya Layalia | Mardhiyah, Fithriani Salma | Basfiansa, Amadeo D. | Nadila, Nindya

Article Type: Research Article

Abstract: Background: Caregivers, as one of the most important roles in caring for a person with dementia, have a challenging task. Therefore, maintaining the quality of life (QoL) of caregivers is an integral part of dementia care. Objective: To explore the relationship between the QoL of people with dementia and their caregivers in Indonesia. Methods: This is a cross-sectional study using binary correlations to analyze the relationship between people with dementia and caregivers’ QoL. Conducted in Cipto Mangunkusumo Hospital in Jakarta, the subjects were 42 people diagnosed with dementia according to the PPDGJ-III (adapted from the ICD …10) and 42 primary caregivers with at least 6 hours duration of caregiving per day. The QoL of people with dementia was measured by EuroQol-5D and VAS EQ-5D, while severity of dementia was measured by MMSE. Caregivers underwent an interview using WHO Quality of Life Instrument (WHOQOL-BREF) and NPI. Results: Most caregivers were women, aged 40–70 years old. The study found caregivers’ QoL environmental domain strongly correlated with people with dementia’s QoL (r  = 0.839). Severity of dementia had a strong correlation with caregivers’ QoL physical domain (r  = 0.946). Age, duration of caregiving per day, period of care provided by caregivers, and caregiver’s distress had a strong correlation with caregiver QoL for specific domains. Conclusion: There was a strong correlation between people with dementia’s QoL and caregiver QoL, so in managing dementia, clinicians should consider caregivers’ wellbeing as an essential part significantly affecting the quality of elderly care improvement. Show more

Keywords: Caregivers, dementia, Indonesia, quality of life

DOI: 10.3233/JAD-201550

Citation: Journal of Alzheimer's Disease, vol. 81, no. 3, pp. 1311-1320, 2021

Authors: Bertrand, Elodie | van Duinkerken, Eelco | Laks, Jerson | Dourado, Marcia Cristina Nascimento | Bernardes, Gabriel | Landeira-Fernandez, Jesus | Mograbi, Daniel C.

Article Type: Research Article

Abstract: Background: Unawareness of disease is a common feature of Alzheimer’s disease (AD), but few studies explored its neural correlates. Additionally, neural correlates according to the object of awareness are unexplored. Objective: To investigate structural brain correlates in relation to different objects of awareness. Methods: 27 people with AD underwent MRI scanning on a 3T Siemens Prisma. T1-MPRAGE was used to investigate cortical thickness and white matter microstructure was defined by DTI as fractional anisotropy, mean, axial, and radial diffusivity. Preprocessing used FreeSurfer6.0, ExploreDTI, and FSL-TBSS. Awareness of disease, cognitive deficits, emotional state, relationships, and functional capacity …were assessed with the short version of the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia. Voxel-wise correlations between brain structure and awareness were determined by FSL-PALM. Analyses were corrected for multiple comparisons using Threshold Free Cluster Enhancement and FWE. Results: Lower left hemisphere cortical thickness was related to poorer disease awareness uncorrected and corrected for age, sex, and MMSE. In the uncorrected model, mainly right-sided, but also left temporal lower cortical thickness was related to decreased awareness of cognitive deficits. Correcting for age, sex, and MMSE eliminated correlations for the right hemisphere, but extensive correlations in the left hemisphere remained. For white matter integrity, higher right hemisphere MD was related to lower cognitive awareness deficits, and lower FA was related to lower functional capacity awareness. Conclusion: Findings suggest that extensive regions of the brain are linked to self-awareness, with particular frontal and temporal alterations leading to unawareness, in agreement with theoretical models indicating executive and mnemonic forms of anosognosia in AD. Show more

Keywords: Alzheimer’s disease, anosognosia, awareness, diffusion tensor imaging MRI, magnetic resonance imaging

DOI: 10.3233/JAD-201246

Citation: Journal of Alzheimer's Disease, vol. 81, no. 3, pp. 1321-1330, 2021

Authors: Wang, Ya-Yu | Ge, Yi-Jun | Tan, Chen-Chen | Cao, Xi-Peng | Tan, Lan | Xu, Wei

Article Type: Research Article

Abstract: Background: The apolipoprotein E epsilon 4 (APOE4 ) is the strongest genetic risk factor for sporadic Alzheimer’s disease (AD). Its carriage percentage in non-demented population varies across geographic regions and ethnic groups. Objective: To estimate the proportion of APOE4 (2/4, 3/4, or 4/4) carriers in non-demented community-dwellers. Methods: PubMed, EMBASE, and China National Knowledge Infrastructure were searched from inception to April 20, 2020. Community-based studies that reported APOE polymorphisms with a sample of≥500 non-demented participants were included. Random-effects models were used to pool the results. Meta-regression and subgroup analyses were performed to test the …source of heterogeneity and stratified effects. Age-standardized pooled proportion estimates (ASPPE) were calculated by direct standardization method. Results: A total of 121 studies were included, with a pooled sample of  389,000 community-dwellers from 38 countries. The global average proportion of APOE4 carriers was 23.9% (age-standardized proportion: 26.3%; 2.1% for APOE4/4 , 20.6% for APOE3/4 and 2.3% for APOE2/4 ), and varied significantly with geographical regions (from 19.3% to 30.0%) and ethnic groups (from 19.1% to 37.5%). The proportion was highest in Africa, followed by Europe, North America, Oceania, and lowest in South America and Asia (p  < 0.0001). With respect to ethnicity, it was highest in Africans, followed by Caucasians, and was lowest in Hispanics/Latinos and Chinese (p  < 0.0001). Conclusion: APOE4 carriers are common in communities, especially in Africans and Caucasians. Developing precision medicine strategies in this specific high-risk population is highly warranted in the future. Show more

Keywords: Alzheimer’s disease, APOE4 , proportion, worldwide

DOI: 10.3233/JAD-201606

Citation: Journal of Alzheimer's Disease, vol. 81, no. 3, pp. 1331-1339, 2021

Article Type: Correction

DOI: 10.3233/JAD-219004

Citation: Journal of Alzheimer's Disease, vol. 81, no. 3, pp. 1341-1341, 2021

Article Type: Correction

DOI: 10.3233/JAD-219005

Citation: Journal of Alzheimer's Disease, vol. 81, no. 3, pp. 1343-1343, 2021