ISSN:0893-0341    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0893-0341    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0893-0341    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The objective of this study was to determine whether unawareness of cognitive deficit is disease-specific. One hundred thirty-two patients were studied, grouped according to diagnosis of definite or probable Alzheimer disease, vascular dementia, geropsychiatric control, or geriatric control. Diagnosis was the independent variable, and unawareness of cognitive deficit was the dependent variable. The Mini-Mental State Examination score was used as a dementia severity covariate. Analysis of covariance was significant (F= 8.0,p< 0.0001). Follow-up mean comparisons showed the Alzheimer disease group to have significantly greater unawareness of cognitive deficit than all other groups. The vascular dementia group had significantly greater unawareness of cognitive deficit than the two control groups. These results support the premise that, independent of dementia severity, unawareness of cognitive deficit is disease specific.

ISSN:0893-0341    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

In a group of 45 patients with Alzheimer disease (AD) and 15 control subjects, we studied the relationship between parameters showing postural and gait disturbance and regional cerebral blood flow (rCBF) measured withN-isopropyl-p-[123]iodoamphetamine single photon emission computed tomography at different clinical stages. Patients with AD with mild dementia exhibited only increased postural sway associated with a reduced mean value of rCBF in the cortex. At a moderate stage, the reduced mean values of rCBF in the cortex and in the frontal lobe were associated with increased postural sway and stride length variability and with decreased stride length. At a severe stage, reduced rCBF in the basal ganglia and in the frontal lobe additionally were associated with increased postural sway, double support time, and stride length variability, and with decreased walking speed and stride length. In multiple regression analysis, there was a high contribution by rCBF in the frontal lobe to account for postural and gait disturbance in AD. We propose that impaired frontal lobe circulation is an important factor causing postural and gait disturbance as AD progresses.

ISSN:0893-0341    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Memory and attention are interrelated cognitive processes that most likely influence the functioning of each other, yet they are often difficult to distinguish in psychological experiments. Young, aged adults, and patients with Alzheimer disease (AD) were tested on a delay response task measuring spatial memory that also placed high demands on attentional resources. Aged adults performed as well as young, suggesting that neither attentional nor memory abilities were exceeded in either group. However, AD subjects were severely impaired on this task. Two further experiments with AD patients examined the relative contribution of attentional and memory deficits in the performance of this population. Both memory and attentional impairments were found; however, errors due to memory factors were more closely related to severity of disease as measured on the Folstein Mini-Mental State Examination than were errors of attentional origin. These studies demonstrate the necessity of accounting for attentional components in studies examining memory, especially in patients with AD.

ISSN:0893-0341    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The P1 component of the middle latency auditory evoked potential (MLAEP) was found to be absent in 47.5% of 101 patients with Alzheimer disease (AD). Lack of a P1 component recently has been associated with a more rapid decline in cognitive performance. The blink reflex (BR) was tested in 36 patients with probable AD and 17 elderly control subjects. All subjects also underwent P1 recording. Patients lacking a P1 potential showed a significant increase in latency of the contralateral R2 response of the BR. The P1 component and the R2 response may differentiate a subgroup of AD patients with involvement of the brainstem, especially the reticular formation.

ISSN:0893-0341    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

A meta-analysis was performed on 10 studies that directly compared an informant questionnaire with a brief cognitive test at screening for dementia. The effectiveness (effect size) of the screening tests used in each study was measured using the standardized difference between the means of the demented and control samples. The informant questionnaires were found to have a weighted mean effectiveness of 1.74 [95% confidence interval (CI): 1.39–2.09], whereas for the cognitive tests, the mean was 1.48 (95% CI: 1.23–1.73). These means translate into sensitivities and specificities of 0.86 and 0.80 for informant questionnaires, compared with 0.79 and 0.80 for brief cognitive tests. The effectiveness of the informant questionnaires was found to differ significantly from study to study, but the reason for this variation is not clear. It was concluded that informant questionnaires are as effective as brief cognitive tests at screening for dementia and deserve to be used more extensively.

ISSN:0893-0341    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

A large 10-generation family with late-onset Alzheimer disease (LOAD) inherited as an autosomal dominant trait was evaluated historically, clinically, and genetically. The family origin was traced to a founder couple of French ancestry with approximately 3,000 descendants. Although the transmission of a genetic predisposition to LOAD is demonstrated through male individuals, a predominance of affected women is observed. Currently, 14 individuals, 12 of whom are women, are classified as affected with Alzheimer disease (AD). Among the affected, the age of onset ranged from 55 to 78 years. Geno-typing of the apolipoprotein E (APOE) locus demonstrated that homozygotes for the E4 allele (APOE4) developed signs of AD in their late 60s, whereas affected heterozygotes presented with the disease in their 70s. A significantly higher APOE4 frequency was observed in affected family members than in those unaffected (0.79 vs. 0.25,X2= 9.919,p= 0.0016,df= 1). Survival for more than 15 years after diagnosed onset was observed in a number of those affected and can be attributed to an improved environment, including excellent care and management during the disabling phase of illness. Alternatively, it may be an example of the genetic heterogeneity in AD. Complete documentation of large families such as the one presented will facilitate the discovery of the multiple genetic factors involved in the pathogenesis of AD.

ISSN:0893-0341    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Relatively low use of nonsteroidal anti-inflammatory drugs (NSAIDs) and other analgesics has been noted in patients with probable Alzheimer disease (AD). Although this finding has been explained by a decline in patients' capacities to communicate about pain, self-reports on pain of cognitively impaired elderly have been shown to be just as reliable as those of cognitively unimpaired elderly. However, previously published studies were aimed primarily at quantifying pain. Considering the various limbic areas affected in AD, a change also in the more qualitative, affective component of pain might be the cause of the low use of analgesics. Because affective disorders are highest in the early and middle stages of AD and decrease in the final stage, it was hypothesized in the present study that not only would the number of AD patients using analgesics would be lower than among a control group but, moreover, analgesic use would be lower in the early and middle stages of AD than in the final stage. The hypothesis was tested by comparing drug use (NSAIDs and analgesic non-NSAIDs) among 66 AD patients with that among 70 elderly people without dementia. The percentage of AD patients using analgesics was indeed significantly lower than among controls, but drug use was not dependent on the stage of AD. Consequently, our findings only partly support the hypothesis.

ISSN:0893-0341    

出版商:OVID    

年代:1997

数据来源: OVID