摘要:

The T4336C mitochondrial genetic variant was associated with Alzheimer disease in several previous studies. Recent investigations, however, failed to confirm this association. We tested this association in newly diagnosed Alzheimer disease cases and controls of similar age and gender recruited from an established HMO serving Seattle, Washington and surrounding areas. In this, the largest case-control study reported to date, the T4336C variant was not associated with Alzheimer disease overall (present in 6 of 236 cases and 7 of 328 controls; odds ratio = 1.20, 95% CI 0.33 to 4.22). There was evidence of effect modification by Apolipoprotein E (APOE) status—among subjects with an APOE ϵ4 allele, the T4336C variant was associated with disease (present in 5 of 139 cases and none of 82 controls; odds ratio = infinity, 95% CI 0.73 to infinity). APOE may be an important modifier of the T4336C effect, potentially explaining variable findings across previous studies. Alternatively, the positive findings reported to date may simply reflect the problem of “type I” error inherent in genetic association studies. Substantially larger samples than are currently available would be required to resolve this question. G5460(A/T) variants were also investigated and found not to be associated with Alzheimer disease.

ISSN:0893-0341    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The epsilon 4 (ε4) and epsilon 2 (ε2) alleles of the apolipoprotein gene (APOE) located on chromosome 19 have been associated with increased and decreased risk for Alzheimer disease (AD) in older adults, respectively. However, there is a dearth of studies examining the relation ofAPOEpolymorphism with cognitive functioning among community-dwelling ethnic minority elderly. This study examined the risk for cognitive impairment associated with theAPOEε4 and ε2 alleles in a community-based cohort of non-Hispanic white (NHW; N = 739) and white Hispanics (WH; N=321). All patients were recruited consecutively from a memory-screening program and evaluated using standardized assessment procedures. Cognitive impairment was classified according to an age and education adjusted Folstein Mini-Mental State Exam (MMSAdj) score of less than 24. The results indicated theAPOEε4 allele was associated with increased risk for cognitive dysfunction in NHW and WH after controlling for the effects of age, education, and gender. This risk was generally observed to be dose-dependent, with greater risk among ε4 homozygotes in relation to ε4 heterozygotes. The ε2 allele ofAPOEdid not confer decreased risk for cognitive impairment among NHW and WH. This study supports the relation ofAPOEpolymorphism to cognitive dysfunction among two ethnic populations residing in the community.

ISSN:0893-0341    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Although there are numerous clinical guidelines regarding the management of dementia, there have been few studies on their implementation in practice. Clinicians in six United States Department of Veterans Affairs medical centers (n = 200, 85% response rate) were surveyed regarding their use of practices recommended in the California WorkgroupGuidelines for Alzheimer's Disease Management. The majority of providers (89% to 73%) reported that they routinely conducted neurological examinations, obtained histories from caregivers, discussed the diagnosis with the patient's family, discussed durable power of attorney, and made legally-required reports of drivers with dementia. Roughly two-thirds of providers said they routinely conducted cognitive screening examinations, screened for depression, reported elder abuse, and discussed care needs and decision-making issues with patients' families. Only half of all outpatient providers implemented caregiver support practices for at least half of their patients. Clinicians' choices of medications for cognition, mood, and behavior problems were broadly consistent with current practice guidelines. These results suggest possible priorities for quality improvement efforts. Further research is needed to clarify reasons for particular gaps between guidelines and practice and to identify specific targets for intervention.

ISSN:0893-0341    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectivesTo evaluate the efficacy of nizatidine, a histamine H2-blocking drug, in delaying the progression of cognitive impairment in older adults with Alzheimer disease (AD).DesignA one-year, randomized, double-blind, placebo-controlled trial.ParticipantsFifty-one older men and women aged 67 to 96 years with AD were recruited from the Cache County Study on Memory in Aging.MethodsPatients were stratified by age and by the presence of one or more ε4 alleles at the APOE locus, then randomized to receive nizatidine 75 mg (Axid AR™, Whitehall Robins) or a matching placebo tablet twice daily. Cognitive outcomes were assessed at baseline, six, and twelve months after enrollment using tests from the CERAD battery and additional measures of visuospatial memory, verbal memory, and verbal fluency.ResultsSubjects showed significant declines in language, fluency, and praxis but most measures of memory had already “bottomed out.” Intention-to-treat and compliance-based analyses showed no effect of nizatidine on any of the cognitive outcome measures over the one-year study interval.ConclusionsThese results do not support claims for the efficacy of nizatidine in over-the-counter dosages as a means of preventing symptom progression in AD.

ISSN:0893-0341    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

PurposeTo determine whether subjects with early Alzheimer Disease (AD) or Mild Cognitive Impairment (MCI) would demonstrate significant abnormalities on tests of word reading threshold (WRT), spatial contrast sensitivity (SCS), and color discrimination (CD).MethodsProspective cohort study of 13 AD subjects, 13 subjects with Mild Cognitive Impairment (MCI), and 12 healthy elderly normal controls (ENC). CD was determined using the Farnsworth D-15 method. SCS was tested using a Vistech photographic chart. For WRT determination, pattern-masked words were presented successively at increasing target durations. The threshold was determined as the target duration at which 50% of the words were read.ResultsThe mean number of errors in Color Discrimination and Spatial Contrast Sensitivity did not differ significantly among the three groups. WRT was significantly longer in the AD group (122.6 ± 70.8 ms) in comparison with ENC group (53.8 ± 15.9 ms) (p< 0.001). A WRT threshold limit of 85 msec correctly classified 11/12 ENC subjects and 10/13 AD subjects. Four of the 13 MCI subjects also exceeded this threshold and all four progressed to AD within 2 year follow-up.ConclusionWord Reading Threshold determination discriminates mild AD subjects from ENC, and correlates with severity of cognitive impairment. It may have diagnostic and prognostic utility in early AD and MCI subjects.

ISSN:0893-0341    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The aim of this study was to investigate spectral EEG theta-power during perceptive-cognitive demands in age-homogenous groups of subjects with mild cognitive impairment (MCI), mild dementia (MDE), and a healthy control (CO) group. The present study includes 51 subjects (23 males, 28 females). We used the scales of the CDR (clinical dementia rating) to assign the subjects to the different groups. EEG data were collected during 10 minutes rest condition with eyes closed and during haptic perception test.The quality of the haptic reproductions differed significantly between CO and MCI, as well as between CO and MDE. The statistical comparison between EEG theta-power under rest condition and theta-power during haptic tasks revealed a significant decrease in theta-power during haptic tasks in all three groups over parieto-occipital regions. During haptic tasks, the theta-power was significantly different between CO and MDE over occipital regions and over parieto-temporal regions. A significant difference between CO and MCI was only revealed over right occipital regions (O2). Spectral theta-power during haptic tasks is a suitable measure to distinguish healthy subjects (CO) from patients with MCI respectively MDE. The results show that haptic tasks are sensitive to early perceptive-cognitive and functional deficits in patients with MCI.

ISSN:0893-0341    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0893-0341    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Pharmacy claims data were used to evaluate medication adherence among 59 new users of donepezil aged 65 to 94 years. The probability (±95% confidence interval) of a new user continuing donepezil at 90 days was .797±.103 and at 180 days was .627±.124. Additionally, 13.9% of those who continued therapy for at least 180 days showed gaps in treatment of six weeks or more. These results suggest that adherence with donepezil could be improved in clinical practice.

ISSN:0893-0341    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

We estimated membrane fluidity by the (ESR) spectroscopy and the expression of membrane P-selectin and glycoproteins GP Ib&agr; and GP IIb/IIIa by flow cytometry in platelets (plts) from 12 AD sufferers. In AD patients membrane fluidity was significantly increased at two different depths (p< 0.05 or less). Platelet reactivity was significantly decreased, as reflected by reduced expression of GP Ib&agr; in the resting (p< 0.0001) and activated (p< 0.005) platelets, as well as the expression of P-selectin and &bgr;3subunit of GP IIb/IIIa in activated platelets (p< 0.0001;p< 0.04).

ISSN:0893-0341    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0893-0341    

出版商:OVID    

年代:2002

数据来源: OVID