Alzheimer's Disease - Dementia

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Alzheimer's Disease - Dementia

NIH - Medical Encyclopedia Alzheimer's Disease

"Alzheimer's disease (AD), one form of dementia, is a progressive, degenerative brain disease. It affects memory, thinking, and behavior. Memory impairment is a necessary feature for the diagnosis of this or any type of dementia. Change in one of the following areas must also be present: language, decision-making ability, judgment, attention, and other areas of mental function and personality. The rate of progression is different for each person. If AD develops rapidly, it is likely to continue to progress rapidly. If it has been slow to progress, it will likely continue on a slow course. There are two types of AD -- early onset and late onset. In early onset AD, symptoms first appear before age 60. Early onset AD is much less common, accounting for only 5-10% of cases. However, it tends to progress rapidly. The brain tissue shows "neurofibrillary tangles" (twisted fragments of protein within nerve cells that clog up the cell), "neuritic plaques" (abnormal clusters of dead and dying nerve cells, other brain cells, and protein), and "senile plaques" (areas where products of dying nerve cells have accumulated around protein). Although these changes occur to some extent in all brains with age, there are many more of them in the brains of people with AD."

Highlighted Articles

Education and Alzheimer disease without dementia: support for the cognitive reserve hypothesis. (Neurology. 2007)

"CONCLUSIONS: Regardless of the neuropathologic criteria used, education is predictive of dementia status among individuals with neuropathologic Alzheimer disease. These results support the theory that individuals with greater cognitive reserve, as reflected in years of education, are better able to cope with AD brain pathology without observable deficits in cognition."

Nutritional factors, cognitive decline, and dementia. (Brain Res Bull. 2006)

"Nutritional factors and nutritional deficiencies have been repeatedly associated with cognitive impairment. … Deficiencies of several B vitamins have been associated with cognitive dysfunction in many observational studies. More recently, deficiencies of folate (B(9)) and cobalamine (B(12)) have been studied in relation to hyperhomocysteinemia as potential determinants of cognitive impairment, dementia, and Alzheimer's disease (AD). A small number of studies assessed the association between intake of macronutrients and cognitive function or dementia. Among the others, the intake of fatty acids and cholesterol has received particular attention. Although the results are not always consistent, most studies have reported a protective role of dietary intakes of poly- and mono-unsaturated fatty acids against cognitive decline and AD."

Exercise Is Associated with Reduced Risk for Incident Dementia among Persons 65 Years of Age and Older (Annals of Internal Medicine 2006)

"Conclusion: These results suggest that regular exercise is associated with a delay in onset of dementia and Alzheimer disease, further supporting its value for elderly persons."

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Alzheimer's Disease - Dementia

Diagnosis, Imaging, and Screening

NEWS:

Alzheimer's May Be Present Decades Before It Is Diagnosed “The study findings add to others showing that individuals who will eventually develop Alzheimer's differ from those who don't many decades before. In 1996, the Nun Study found that Alzheimer's disease with onset in old age could be predicted accurately from characteristics of autobiographical essays written at an average age of 22. Other studies have shown that those who develop Alzheimer's have specific deficits on tests of memory and thinking decades before the disease is diagnosed. The fact that subtle signs of Alzheimer's appear many years before symptoms appear may be useful for predicting who is at risk of the illness and identifying individuals earlier in life who could benefit from preventive therapies.”

Alzheimer's Study Links Brain Size to Mental Decline “Ballard said it was consistent with other studies that showed "people with higher levels of education or cognitive reserve may be protected from some of the effects of dementia".”

Brain Imaging Study Supports The 'Cognitive Reserve' Hypothesis “"Education interacts with Alzheimer disease pathological burden such that a greater pathological burden is required to show an effect on cognition among persons with more education."”

Detecting Alzheimer’s Earlier with MRI “They found the new MRI procedure to be as accurate as the standard segmentation process. Alzheimer’s patients had lost an average of 32 percent of their hippocampus volume while those with mild cognitive impairment lost an average of 19 percent.”

Higher Cutoff Point on Dementia Screening Test Recommended for Educated Patients

Most Early-Onset Dementia Not Alzheimer's: Other neurodegenerative, autoimmune diseases are more often cause, study finds “The study authors acknowledge that -- age aside -- the most common forms of dementia are Alzheimer's disease, vascular dementia and the brain damage-associated condition known as Lewy body dementia. However, their current work indicates that among patients below the age of 45, the problem is much more likely to be traced back to diseases such as multiple sclerosis, Huntington's, lupus or HIV infection, among others.”

MRI Assessment of Hippocampal Volume Can Identify Alzheimer's Patients “Automated volumetry of the hippocampus based on magnetic resonance imaging can discriminate between Alzheimer's disease (AD), mild cognitive impairment (MCI) and normal aging, French researchers report in the July issue of Radiology. … Hippocampal volume was 32% smaller in AD patients and 19% smaller in MCI patients compared with controls. Hippocampal volume was 15% smaller in AD patients compared with those with amnestic MCI.”

ARTICLES:

7 Alzheimer's Warning Signs

Diagnosis and treatment of dementia: Introduction. Introducing a series based on the Third Canadian Consensus Conference on the Diagnosis and Treatment of Dementia

JOURNAL ARTICLES:

A meta-analysis of hippocampal atrophy rates in Alzheimer's disease (Neurobiology of Aging 2008) “Mean (95% CIs) annualised hippocampal atrophy rates were found to be 4.66% (95% CI 3.92, 5.40) for AD subjects and 1.41% (0.52, 2.30) for controls. The difference between AD and control subject in this rate was 3.33% (1.73, 4.94).”

Basal forebrain atrophy is a presymptomatic marker for Alzheimer's disease. (Alzheimers Dement. 2008) “CONCLUSIONS: Atrophy in the basal forebrain precedes the development of AD in subjects with cognition judged to be normal by neuropsychological testing. The time required to develop dementia appears to be shortened if hippocampal atrophy is also present. These data indicate that atrophy restricted to medial basal forebrain is a biomarker that predicts development of probable AD in asymptomatic elderly subjects.”

Degeneration of dementia with Lewy bodies measured by diffusion tensor imaging. (NMR Biomed. 2008)

Diagnosis and treatment of dementia: 2. Diagnosis (CMAJ 2008)

Diagnosis and treatment of dementia: 3. Mild cognitive impairment and cognitive impairment without dementia (CMAJ 2008)

Hippocampal shape differences in dementia with Lewy bodies. (Neuroimage. 2008)

Impact of white matter hyperintensity volume progression on rate of cognitive and motor decline (NEUROLOGY 2008) “Conclusion: Increased total and periventricular (PV) white matter hyperintensity (WMH) burden and progression of PV WMH burden are associated with decreased gait performance over time, while progression of subcortical WMH volume is associated with memory decline in cognitively intact elderly. Greater progression of WMH burden is associated with an increased risk of memory and gait dysfunction, and thus should not be considered a benign process.”

Posterior parahippocampal gyrus pathology in Alzheimer's disease. (Neuroscience. 2008)

Rate of entorhinal and hippocampal atrophy in incipient and mild AD: Relation to memory function (Neurobiology of Aging 2008) “Longitudinal analyses showed that the rate of atrophy of the entorhinal cortex and hippocampus for the stable controls differed significantly from MCI participants who converted to AD and the AD groups. Furthermore, longitudinal decreases in hippocampal and entorhinal volume were related to longitudinal decline in declarative memory performance. These findings suggest that the rate of atrophy of mesial temporal lobe structures can differentiate healthy from pathological aging.”

Regional atrophy of the corpus callosum in dementia. (J Int Neuropsychol Soc. 2008)

[Regional cerebral blood flow patterns in extremely elderly patients with Alzheimer's disease] (Nippon Ronen Igakkai Zasshi. 2008)

Strongly reduced volumes of putamen and thalamus in Alzheimer's disease: an MRI study. (Brain. 2008)

The cerebellum in mild cognitive impairment and Alzheimer's disease - A structural MRI study. (J Psychiatr Res. 2008) “Posterior cerebellar lobes were significantly smaller in AD patients when compared to healthy controls. In the AD group, atrophy of the posterior cerebellar regions was associated with poorer cognitive performance. Our findings lend further support for cerebellar involvement in AD.”

Usefulness of computed tomography linear measurements in diagnosing Alzheimer's disease. (Acta Radiol. 2008)

Whole-brain atrophy rate in Alzheimer disease (NEUROLOGY 2008) “Conclusions: Our results suggest it is possible to characterize a subgroup of patients with Alzheimer disease (AD) who are at risk of faster loss of brain volume. Patients with more generalized, rather than focal hippocampal atrophy, who often have an onset before the age of 65, and are APOE 4 negative, seem to be at risk of faster whole-brain atrophy rates than the more commonly seen patients with AD, who are older, are APOE 4 positive, and have pronounced hippocampal atrophy.”

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