Vascular neurocognitive disorders and the vascular risk factors

Dementias are clinical neurodegenerative diseases characterized by permanent and progressive transformation of cognitive functions such as memory, learning capacity, attention, thinking, language, passing judgments, calculation or orientation. Dementias represent a relatively frequent pathology, encountered at about 10% of the population of 65-year olds and 20% of the population of 80-year olds. This review presents the main etiological forms of dementia, which include Alzheimer form of dementia, vascular dementia, dementia associated with alpha-synucleionopathies, and mixed forms. Regarding vascular dementia, the risk factors are similar to those for an ischemic or hemorrhagic cerebrovascular accident: arterial hypertension, diabetes mellitus, dyslipidemia, smoking, obesity, age, alcohol consumption, cerebral atherosclerosis/ arteriosclerosis. Several studies show that efficient management of the vascular risk factors can prevent the expression and/ or progression of dementia. Thus, lifestyle changes such as stress reduction, regular physical exercise, decreasing dietary fat, multivitamin supplementation, adequate control of blood pressure and serum cholesterol, and social integration and mental stimulation in the elderly population are important factors in preventing or limiting the symptoms of dementia, a disease with significant individual, social, and economic implications

What Can Quantitative Gait Analysis Tell Us about Dementia and Its Subtypes? A Structured Review

Distinguishing dementia subtypes can be difficult due to similarities in clinical presentation. There is increasing interest in discrete gait characteristics as markers to aid diagnostic algorithms in dementia. This structured review explores the differences in quantitative gait characteristics between dementia and healthy controls, and between four dementia subtypes under single-task conditions: Alzheimer’s disease (AD), dementia with Lewy bodies and Parkinson’s disease dementia, and vascular dementia. Twenty-six papers out of an initial 5,211 were reviewed and interpreted using a validated model of gait. Dementia was associated with gait characteristics grouped by slower pace, impaired rhythm, and increased variability compared to normal aging. Only four studies compared two or more dementia subtypes. People with AD are less impaired in pace, rhythm, and variability domains of gait compared to non-AD dementias. Results demonstrate the potential of gait as a clinical marker to discriminate between dementia subtypes. Larger studies using a more comprehensive battery of gait characteristics and better characterized dementia sub-types are required

Normal aging and Alzheimer's disease : hippocampal and episodic memory differences

Alzheimer’s Disease (AD) and normal aging (NA) are characterized by structural brain changes as well as cognitive changes that appear over the lifespan. The hippocampus is an area susceptible to early atrophy in both AD and NA; however the differential causes of atrophy are not entirely clear. Hippocampal volume loss in AD is attributed to neuronal death due to underlying pathology. AD often is diagnosed years after the onset of pathology and subsequent atrophy. NA is a continuation of cognitive decline that does not become dementia. Episodic memory (EM) is processed within the hippocampus and is one of the first systems to show deficits in conjunction with both patterns of aging. This review focuses on hippocampal volume loss and EM decline in NA and AD.Communication Sciences and Disorder

Executive functions in the elderly with Mild Cognitive Impairment: a systematic review on motor and cognitive inhibition, conflict control and cognitive flexibility

Background: Mild Cognitive Impairment (MCI) is a syndrome characterised by mild cognitive decline, on one or more domains, but which does not compromise daily functions. Several studies have investigated the relationship between MCI and deficit in executive functions (EFs) but, unlike robust evidence in the mnestic domain, the nature of executive deficits in the MCI population remains uncertain. Objectives: This systematic review aims to evaluate EFs in patients with MCI, considering inhibition (motor and cognitive), conflict control and cognitive flexibility. Method: The databases used for the search were PUBMED, PsycINFO, PsycARTICLES and MEDLINE. Eligibility criteria: use of specific paradigms for EFs assessment ("Wisconsin Card Sorting Test", "Stroop Task", "Go/No-Go Task", "Flanker Task"); age over 65, studies published in English. Exclusion criteria: presence of dementia; psychiatric disorders; stroke; cranial trauma; inclusion of participants with MCI in groups with healthy elderly or those with dementia. Results: Fifty-five studies were selected, namely: Stroop Task (N=30), WCST (N=14), Go/No-Go (N=9), Flanker Task (N=2). Results have shown in people with MCI deficits in all the EFs considered. Conclusions: The results of this review support the applicability of the four experimental tasks examined for the study of EFs in people with MCI. These paradigms are useful in research, diagnosis and therapeutic purposes, allowing obtaining an articulated EFs profile that can compromise the daily life in elderly. These EFs are not generally evaluated by standard assessment of MCI, but their evaluation can lead to a better knowledge of MCI and help in the diagnosis and treatment

Monoaminergic Neuropathology in Alzheimer's disease

Acknowledgments This work was supported by The Croatian Science Foundation grant. no. IP-2014-09-9730 (“Tau protein hyperphosphorylation, aggregation, and trans-synaptic transfer in Alzheimer’s disease: cerebrospinal fluid analysis and assessment of potential neuroprotective compounds”) and European Cooperation in Science and Technology (COST) Action CM1103 (“Stucture-based drug design for diagnosis and treatment of neurological diseases: dissecting and modulating complex function in the monoaminergic systems of the brain”). PRH is supported in part by NIH grant P50 AG005138.Peer reviewedPostprin

THE ASSOCIATION BETWEEN SLEEP DURATION AND DEMENTIA: A META-ANALYSIS

In the United States, the current cases of Alzheimer’s disease will double by 2050. Therefore, it is important to study risk factors associated with dementia such as sleep duration. This meta-analysis was conducted to understand the discrepancy in study results since some demonstrated a V shaped association between duration of sleep and dementia while others found no association. If there truly is an association then sleep duration could be targeted to decrease the burdens caused by dementia. A meta-analysis of published studies was conducted to assess the association between sleep duration and the different forms of dementia. The articles were found using PubMed, Embase, Scopus, and EBSCO with the search terms (“Sleep Duration” OR “Change in Sleep Duration”) AND (Alzheimer* OR Dementia) and reviewing bibliographies. Studies were included in the analysis if they met the following criteria 1) a longitudinal study 2) a cohort, case-control, or clinical trial 3) assessed the exposure and outcome of interest 4) diagnosed dementia using established diagnostic criteria 5) provided a risk estimate and 95% confidence interval (CI) 6) in English 7) a published paper. Analyses such as test of heterogeneity, sensitivity analysis, and tests of publication bias were done using STATA15. The analysis included 11 cohort studies with a total of 48,360 participants. No significant association was found between short or long sleep duration and any form of dementia. However, there was a significant association between increase in sleep and dementia but there were only two published papers that examined this association. This study suggests that there is likely no association between sleep duration and any form of dementia which differs from results of previous meta-analyses

The Role of Frontal Lobe White Matter Integrity and Executive Functioning in Predicting Adaptive Functioning in Alzheimer\u27s Disease

Alzheimer’s disease (AD) is the most common form of dementia and is characterized by a gradual deterioration of the patients’ ability to independently perform day to day activities. Researchers have discovered significant changes in neuroanatomy, cognition and behavior that are related to the disease process of AD and researchers continue to uncover new variables, such as the presence of vascular risk factors, which may further increase our ability to understand and characterize the disease. The purpose of this study is to identify the neuroanatomical, cognitive and behavioral variables that best predict impairment of instrumental activities of daily living in individuals with probable AD. Reduced white matter integrity in the dorsolateral prefrontal cortex as well as the presence of vascular risk factors significantly predicted impairments in activities of daily living (ADLs). Executive functioning skills, typically described as frontal lobe system behaviors, were positively associated with ADLs. Further, executive functions fully mediated the relationship between frontal lobe white matter integrity and ADLs. A better understanding of the variables responsible for diminished ADLs in AD will allow researchers and clinicians to better target prevention and intervention strategies and ultimately help individuals with AD to maintain their independence for a longer duration

Plasma and Cerebrospinal fluid (CSF) Abeta42 for the differential diagnosis of Alzheimer's disease dementia in participants diagnosed with any dementia subtype in a specialist care setting

© 2014 The Cochrane Collaboration. This is the protocol for a review and there is no abstract. The objectives are as follows: To determine the diagnostic accuracy of the plasma and CSF Abeta42 index tests for distinguishing Alzheimer's disease dementia from each of the other forms of dementia in people who meet the general criteria for a dementia syndrome. To investigate the heterogeneity of test accuracy in the included studies. We expect that heterogeneity will be likely and that it will be an important component of the review. The potential sources of heterogeneity, which will be used as a framework for the investigation of heterogeneity, include target population, index test, target disorder and study quality and are detailed in the analysis section