Journal of Alzheimer's Disease - Volume 94, issue 3

Authors: Kang, Jae Myeong | Shin, Jeong-Hyeon | Kim, Woo-Ram | Seo, Seongho | Seo, Haeun | Lee, Sang-Yoon | Park, Kee Hyung | Na, Duk L. | Okamura, Nobuyuki | Seong, Joon-Kyoung | Noh, Young

Article Type: Research Article

Abstract: Background: Little is known regarding the differential effects of the apolipoprotein E (APOE ) ɛ 4 on the regional topography of amyloid and tau in patients with both early-onset (EOAD) and late-onset Alzheimer’s disease (LOAD). Objective: To compare the distribution and association of tau, amyloid, and cortical thickness among groups classified by the presence of APOE ɛ 4 allele and onset age. Methods: A total of 165 participants including 54 EOAD patients (29 ɛ 4-; 25 ɛ 4+), 45 LOAD patients (21 ɛ 4-; 24 ɛ 4+), and 66 age-matched controls underwent 3T MRI, 18 …F-THK5351 (THK) and 18 F-flutemetamol (FLUTE) PET scans, APOE genotyping, and neuropsychological tests. Data for voxel-wise and standardized uptake values from PET scans were analyzed in the context of APOE and age at onset. Results: EOAD ɛ 4- patients showed greater THK retention in the association cortices, whereas their EOAD ɛ 4+ counterparts had more retention in medial temporal areas. THK topography of LOAD ɛ 4+ was similar to EOAD ɛ 4 + . THK correlated positively with FLUTE and conversely with mean cortical thickness, being lowest in EOAD ɛ 4-, highest in LOAD ɛ 4-, and modest in ɛ 4+ groups. Even in the APOE ɛ 4+ groups, THK tended to correlate with FLUTE and mean cortical thickness in the inferior parietal region in EOAD and in the medial temporal region in LOAD. LOAD ɛ 4- manifested with prevalent small vessel disease markers and the lowest correlation between THK retention and cognition. Conclusion: Our observations suggest the differential effects of the APOE ɛ 4 on the relationship between tau and amyloid in EOAD and LOAD. Show more

Keywords: Alzheimer’s disease, amyloid, APOE, early-onset Alzheimer’s disease, tau

DOI: 10.3233/JAD-230339

Citation: Journal of Alzheimer's Disease, vol. 94, no. 3, pp. 1233-1246, 2023

Authors: D’Cunha, Nathan M. | Holloway, Helen | Gibson, Diane | Thompson, Jane | Bail, Kasia | Kurrle, Susan | Day, Sally | Olson, James | Smith, Nicole | Clarke, Heather | Buckley, Charise | Isbel, Stephen

Article Type: Research Article

Abstract: Background: Small-scale models of dementia care are a potential solution to deinstitutionalize residential aged care and have been associated with improved resident outcomes, including quality of life and reduced hospitalizations for people living with dementia. Objective: This study aimed to generate strategies and ideas on how homes for people living with dementia in a village setting within a suburban community, could be designed and function without external boundaries. In particular, how could residents of the village and members of the surrounding community access and engage safely and equitably so that interpersonal connections might be fostered? Methods: …Twenty-one participants provided an idea for discussion at three Nominal Group Technique workshops, including people living with dementia, carers or former carers, academics, researchers, and clinicians. Discussion and ranking of ideas were facilitated in each workshop, and qualitative data were analyzed thematically. Results: All three workshops highlighted the importance of a surrounding community invested in the village; education and dementia awareness training for staff, families, services, and the community; and the necessity for adequately and appropriately trained staff. An appropriate mission, vision, and values of the organization providing care were deemed essential to facilitate an inclusive culture that promotes dignity of risk and meaningful activities. Conclusion: These principles can be used to develop an improved model of residential aged care for people living with dementia. In particular, inclusivity, enablement, and dignity of risk are essential principles for residents to live meaningful lives free from stigma in a village without external boundaries. Show more

Keywords: Alzheimer’s disease, aged care, co-design, dementia, dementia care, dementia village, geriatrics, group homes, nursing, nursing homes

DOI: 10.3233/JAD-230368

Citation: Journal of Alzheimer's Disease, vol. 94, no. 3, pp. 1247-1263, 2023