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:

Accelerated hippocampal atrophy rates in stable and progressive amnestic mild cognitive impairment. (Psychiatry Res. 2009)

Biomarkers Appear to Predict Alzheimer's Disease

Brain Damage Seen On Brain Scans May Predict Memory Loss In Old Age “The study found that people with white matter hyperintensities were nearly twice as likely to have mild cognitive impairment that included memory loss. However, people who had infarcts on their brain scans were more likely to experience mild cognitive impairment in abilities other than memory loss. The results remained the same regardless of a person's age, gender, ethnic group, education, and if they had a gene thought to be a strong risk factor for dementia, called the ApoEe4 gene. "The most interesting finding in this study was that white matter hyperintensities, or ministrokes, predicted memory problems, while strokes predicted non-memory problems," said study author José Luchsinger, MD, MPH, with Columbia University Medical Center in New York. "Traditionally, ministrokes and strokes are thought to have a common origin and to more strongly predict non-memory cognitive problems. There are an increasing number of studies challenging the idea that all white matter hyperintensities are similar to strokes. The fact that white matter hyperintensities more strongly predicted memory problems could challenge traditional views that white matter hyperintensities are milder versions of stroke that are produced only by conditions such as high blood pressure," said Luchsinger.”

Cerebrospinal Fluid Shows Alzheimer's Disease Deterioration Much Earlier

Cognitive Decline In Alzheimer's Disease Predicted By Simple Balance Test

Decline In Other Cognitive Skills May Precede Memory Loss In Alzheimer's

MCI a Useful Diagnostic Term for Neurologists, but Guidelines Needed for Practice

SNM 2009: PET Can Be Used to Classify Dementia Subtype “Dr. Drzezga said it does occur in clinical practice that patients are prescribed inappropriate medications because of inappropriate disease classification. "It's good to have measures that give you an objective answer," said Dr. Drzezga. "The symptoms can be misleading, and imaging may give you a more definite proof of what patients are suffering from."“

ARTICLES:

Early Warning Signs: When to Call the Doctor about Alzheimer's

JOURNAL ARTICLES:

Brain Lesions at Autopsy in Older Japanese-American Men as Related to Cognitive Impairment and Dementia in the Final Years of Life: A Summary Report from the Honolulu-Asia Aging Study. (J Alzheimers Dis. 2009)

Differences in brain volume, hippocampal volume, cerebrovascular risk factors, and apolipoprotein E4 among mild cognitive impairment subtypes. ( Arch Neurol. 2009)

Early diagnosis of Alzheimer's disease using cortical thickness: impact of cognitive reserve. (Brain. 2009)

Hippocampal atrophy rates in Alzheimer disease: added value over whole brain volume measures. (Neurology. 2009)

Hippocampal volume and asymmetry in mild cognitive impairment and Alzheimer's disease: Meta-analyses of MRI studies. (Hippocampus. 2009)

Hippocampal volume is an independent predictor of cognitive performance in CADASIL (Neurobiology of Aging 2009) “These findings strengthen the view that hippocampal atrophy is an important pathway of cognitive impairment in vascular as well as degenerative disease.”

Increase in the Oxidized/Total Coenzyme Q–10 Ratio in the Cerebrospinal Fluid of Alzheimer's Disease Patients (Dementia and Geriatric Cognitive Disorders 2009)

Memory Performance is Related to Amyloid and Tau Pathology in the Hippocampus. (J Neurol Neurosurg Psychiatry. 2009) “Interpretation: This study implicates both amyloid deposition and tau pathology in the hippocampus as an early and late cause of decline in memory function over time in AD. Memory performance appears to be specifically related with amount of amyloid plaques, NFTs and NTs in the entorhinal cortex and hippocampus.”

MRI of hippocampal volume loss in early Alzheimer's disease in relation to ApoE genotype and biomarkers (Brain 2009)

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