摘要:

Clinical and pathological overlap between Alzheimer disease (AD) and Parkinson's disease (PD) has been well described; however, the mechanisms of overlap between these two disorders remain unknown. We retrospectively examined clinical and neuropathological features from 66 individuals participating in the Rochester Alzheimer Disease Center to determine the association of AD with substantia nigra (SN) pathology. SN pathology, identified by a loss of pigmented neurons and the presence of gliosis, pigment-laden macrophages, and Lewy bodies, was blindly scored in 48 AD cases and 18 normal elderly controls. We found moderate or severe pathology in the SN in 2 control brains (11%) and 29 AD brains (60%). The numbers of neocortical and hippocampal neurofibrillary tangles (NFTs) and senile plaques (SPs) were not associated with nigral pathology. There was also no significant association of SN pathology with NFTs or SPs in the striatum, the site to which these neurons project. There was no significant association of increasing SN pathology with aging among AD patients, nor with increasing severity and duration of AD. The signs and symptoms of an extrapyramidal movement disorder were, however, associated with increasing SN pathology. We confirm that pathological lesions in the SN are a common feature of AD and an uncommon feature in normal aging. AD is a significant risk factor for SN lesions and PD, but the pathologic severity of AD, as measured by NFTs and SPs, was not associated with SN lesions.

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

There has been some debate about abnormalities in visual evoked potentials (VEPs) in Parkinson's disease (PD). To elucidate the mechanism underlying abnormal VEPs, we investigated the relationship between pattern-reversal VEPs elicited by large checks and mental functions in PD patients (n = 32), as compared with VEPs of age-matched control subjects (n = 22). The PD patients were divided into two groups: PD without dementia (nD-PD; n = 21) and PD with dementia (D-PD; n = 11). All patients but five of the nD-PD patients were being treated with anti-parkinsonian drugs. The D-PD patients showed significantly prolonged P100 latencies compared with both the nD-PD patients and controls (p < 0.01 and p < 0.01, respectively). The PD patients treated with levodopa had significantly longer P100 latencies than the other PD patients. In PD patients, the P100 latency correlated significantly with illness duration (p < 0.05). There was also a significant negative correlation with P100 latency and Mini-Mental State Examination (MMSE) score (p < 0.05). The MMSE score did not correlate with illness duration in PD patients. These findings suggest that the VEPs abnormality elicited by large checks is related to dementia independent of progression of the illness, and that a nondopaminergic neurotransmitter system may play a role in the development of VEPs delay elicited by large checks.

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Alzheimer disease (AD) leads to alterations in several biochemical properties in cultured skin fibroblasts. Because abnormal glucose metabolism has been reported in both in vivo and in vitro studies of the brain, we examined glucose and glutamine oxidation and lactate production in cultured skin fibroblasts from nine patients with familial AD, 19 with sporadic AD, and 20 age-matched controls. The production of CO2from glucose and glutamine was significantly lower in both groups of Alzheimer fibroblasts compared to controls after 10 min or 1, 2, and 4 h of incubation. The reduction in CO2production was most evident after 1 h of incubation with either (U-4C)-glucose or (U-4C)-glutamine. Lactate concentration was comparable in all groups at any time of incubation. These findings suggest that processes that require mitochondrial function as glucose or glutamine oxidation are altered in AD and provide evidence that complex metabolic differences are expressed in cultured nonneuronal cells from Alzheimer patients.

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This study describes how the situation will change with time when a close relative cares for a demented or nondemented elderly. The changes over a period of time in cognitive and behavioral deterioration, perceived burden, and social support were examined in a population-based, longitudinal study. Spouses and adult children were interviewed at a 2.5-year interval. Although the support from social services had not increased, the relatives reported less burden and decreased behavioral problems in the demented elderly group. They also reported improved physical health. On the contrary, this long-term follow-up indicated a small increase in social limitation and deteriorated physical health in the group of relatives of mentally healthy elderly. One-third of the demented elderly were admitted to an institution during Time 1 and Time 2, and this may be one reason for the decreased burden.

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Depression is difficult to assess in Alzheimer disease (AD) and controversy surrounds the prevalence, etiology, and characteristics of mood alterations in patients with this disorder. We used a variety of standardized instruments to assess mood changes in 33 patients with AD. The frequency of depression ranged from 6 to 30%, depending on the diagnostic criteria employed. No relationship was found between patient depression and dementia severity, self-awareness of cognitive deficits (as measured by a memory self-rating scale), or mood of the caregiver. Delusional patients had higher scores on mood rating scales than nondelusional patients. The results suggest that depression in AD is not severe and is unrelated to patient self-awareness of illness. We hypothesize that the cholinergic deficit of AD may ameliorate depressive symptoms.

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The efficacy of temporal-distance processing for spatial locations was evaluated in college students, elderly controls, and subjects with mild and moderate dementia of the Alzheimer type (DAT). The elderly controls showed a slightly lower level of performance than college students, but both elderly controls and college students displayed a temporal-distance effect. The mild DAT subjects performed the task accurately only at the greatest temporal distances. The moderate DAT subjects performed at chance levels for all distances. Because similar changes in the temporal-distance function have been described for humans and animals with small hippocampal or prefrontal cortex damage, there might be important hippocampal or prefrontal cortex involvement or both in early stages of Alzheimer disease.

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Although the cognitive and psychiatric symptoms associated with Alzheimer disease have received increasing attention over the past decade, the study of insight in this illness has been relatively neglected. This paper reports on the relationship between level of insight and severity of dementia in a large sample of patients with Alzheimer disease, largely with mild to moderately severe dementia. The study is based on data from 670 patients with a research diagnosis of probable Alzheimer disease who were enrolled in the Consortium to Establish a Registry for Alzheimer's Disease (CERAD). The degree of insight was rated by the examiner on the basis of the patient's answers to questions probing awareness of his or her memory deficits or other symptoms of cognitive impairment. Severity of dementia was assessed using the Clinical Dementia Rating Scale, Short Blessed Test, Blessed Dementia Rating Scale, and Folstein Mini-Mental State Examination. Two-year longitudinal follow-up data on insight level and dementia severity were available for 148 of the 670 patients. Decreased level of insight correlated significantly with severity of dementia as measured by all rating instruments. For the patients followed for 2 years, 33.1% declined in level of insight from the entry level. This decline was statistically associated with more severe dementia as measured by the Blessed Dementia Rating Scale. This study confirms the generally accepted belief that patients with Alzheimer disease experience a progressive loss of insight as the severity of dementia increases. Due to methodologic limitations, we are unable to draw conclusions about loss of insight in patients with very mild cognitive impairment.

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Most of the present screening tests for the detection of dementia fail with mild dementia. Jorm et al. recently presented the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), a simple instrument with good diagnostic validity that uses a close relative to obtain information on the cognitive decline of a patient. We used a Spanish adaptation of this questionnaire (S-IQCODE) validated in a population-based sample, and a shortened form (SS-IQCODE) obtained after analyzing the items and reducing them to only 17. The S-IQCODE and the SS-IQCODE have greater diagnostic validity for mild dementia than the Mini-Mental State Examination (MMSE) (sensitivity: 86% for both versus 57%; specificity: 92 and 91% versus 84%, positive predictive value: 54 and 50% versus 29%; negative predictive value: 91 and 90% versus 81%) and, unlike the MMSE, are independent of the age, education, and previous intelligence of the subjects. According to the results of this study, the SS-IQCODE could be a useful screening test for the detection of mild dementia in the Spanish-speaking aged population, with greater diagnostic power and less contamination by independent variables than the MMSE.

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Levels of α1-antichymotrypsin (α1-ACT) in cerebrospinal fluid (CSF) and serum from patients with probable Alzheimer disease (AD) of both early (e-AD) and late (1-AD) onset assessed by a competitive enzyme-linked immunosorbent assay were higher than those found in controls or in patients with vascular dementia (VD). A negative correlation between CSF levels of α1-ACT and the stage of the disease was present in patients with both e-AD and 1-AD. No difference in α1-macroglobulin levels in CSF and serum from patients with e-AD, 1-AD, VD, and nondemented controls was found. Serum concentrations of α1-antitrypsin from 1-AD subjects were within the normal range. Thus, increased levels of α1-ACT in CSF and serum were specifically associated with AD, and the detection of this serpin in CSF may be useful in monitoring the progression of the disease.

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID