Discriminative use of SPECT in frontal lobe-type dementia versus (senile) dementia of the Alzheimer's type.

Dementia of the Alzheimer's type [(S)DAT]and dementia with frontal features (FLD) are nosological entities with different prognoses and presumed pathophysiology. There is a need for noninvasive differ ential diagnostic tools. To evaluate whether SPECT perfusion imag ing could discriminate between these neurodegenerative disorders, we performed a comparative study. Methods: SPECT scans using99mTc-hexamethylpropylene amine oxime (""^c-HMPAO) of 21 patients with FLD were compared with those obtained in a group of 19 age- and severity-matched patients suffering from (S)DAT. Brain SPECT perfusion deficits were scored by visual qualitative analysis with respect to location, lateralization and severity. A total severity score of cerebral hypoperfusion (maximal value = 18) was calcu lated by adding all severity scores (scored between 0 and 3; 0 = no perfusion deficit; 1 = 13%-30 % hypoperfusion; 2 = 30%-50% hypoperfusion and 3 =>50 % hypoperfusion including breaching of the cortex) for right and left frontal, parietal and temporal lobes

Cross-national comparisons of the Cambridge Cognitive Examination-revised: the CAMCOG-R: results from the European Harmonization Project for Instruments in Dementia

Background: transnational and psychometrically appropriate versions of instruments used in the diagnosis of dementia are essential for comparing information between different countries. The Cambridge Examination for Mental Disorders of the Elderly incorporates a brief neuropsychological test battery, Cambridge Cognitive Examination (recently revised version), which provides objective data on performance across a number of cognitive domains. Objective: to harmonise the Cambridge Cognitive Examination between seven European countries. Method: 40 patients with probable or possible Alzheimer's disease of each of the seven countries were administered the Cambridge Cognitive Examination. The Nurse Observation Scale for Geriatrics was used to assess concordance between cognitive and behavioural measures. Results: only small differences between the various Cambridge Cognitive Examination versions were found, and patterns of correlation between Cambridge Cognitive Examination and the Nurse Observation Scale for Geriatrics were consistent. Conclusion: these findings indicate that the harmonisation of the Cambridge Cognitive Examination was successful

Cross-national comparison and validation of the Alzheimer's Disease Assessment Scale: results from the European Harmonization Project for Instruments in Dementia (EURO-HARPID)

Background The Alzheimer\ub4s Disease Assessment Scale (ADAS) is often used in international multicenter trials. Use across countries presupposes correct translation and adaptation of the scale, and maintenance of its psychometric properties. Objectives To compare the various translations of the ADAS used in Western Europe, to design internationally harmonized translations and to validate these. Setting International cooperative study in eight European countries. Methods An inventory was made of existing versions of the ADAS-Cog used in eight European countries, and adaptations were made. The concurrent validity of the harmonized versions of the ADAS was tested in 283 patients with probable or possible Alzheimer\ub4s disease. The Nurses Observation Scale for Geriatrics (NOSGER), CAMCOG-R and MMSE was used to assess concordance between cognitive and behavioral measures. Results Differences between the versions mainly involved object naming, items for verbal memory, such as the number of trials allowed, the imagery value of the words selected as targets or distractors, and the number of parallel versions. These differences were eliminated by adapting and harmonizing the various versions of the ADAS-Cog. Thereafter, only small differences between the different countries were found, and patterns of correlation between ADAS-Cog, and the NOSGER, CAMCOG-R and MMSE were consistent. Conclusions The study underlines the need to use harmonized versions of instruments for rating dementia in multinational studies. The findings indicate that the harmonization of the ADAS-Cog was successful. Copyrigh

Focusing on positive outcomes in frailty research: development of a short well-being instrument for older adults (SWIO)

Objective: Studies of frailty have tended to focus on adverse outcomes. This study aims to develop a short instrument that identifies a positive outcome, namely, the level of well-being in older adults at risk of frailty. Method: 871 older adults (49.4% women; mean age 75.72 years; SD = 8.05) with a frailty risk profile participated in the first wave of the D-SCOPE study. The possible domains of well-being were identified using a bottom-up approach. Exploratory Structural Equation Modeling (ESEM) and multidimensional Item Response Theory (IRT) analysis of 17 items in 4 domains measuring well-being was performed on a calibration sample (n = 435) to develop the instrument. The instrument was subsequently corroborated by confirmatory factor analysis and convergent/divergent relations with relevant external measures in a validation sample (n = 436). Results: The ESEM three-factor solution, with the subdimensions of sense of mastery, meaning in life, and life satisfaction, displayed good fit to the data (RMSEA = 0.070). For each dimension, the three best discriminating items were retained for the instrument following IRT analysis. Internal consistency of these dimensions was good in the validation sample (sense of mastery alpha = 0.864, meaning in life alpha = 0.715, and life satisfaction alpha = 0.782). The confirmatory factor analysis (CFA) three-factor model also showed good fit to the data (RMSEA = 0.064). Small to large zero-order correlations with the external measures were as expected. Conclusions: Using a bottom-up approach, this study developed a short instrument to identify levels of well-being in vulnerable or frail older adults. The instrument can be applied in primary care and prevention programs

Influence of triangular club-rush Schoenoplectus triqueter on the macrobenthic community of the Hangzhou Bay, China

This study focuses on the macrobenthic community of an unvegetated mudflat and that of a Schoenoplectus triqueter (synonym: Scirpus triqueter) marsh in the Southern Bank of the Hangzhou Bay, China. Samples were collected between April 2010 and January 2011 in order to evaluate possible effects of seasonality on the species composition for each habitat. Twenty-three species were found in each habitat, with higher crustacean and insect richness in the vegetated area, compared to a higher number of polychaete and mollusc species observed in the mudflat area. The highest macrofaunal abundance was recorded in summer whilst the lowest was registered in autumn. Heteromastus filiformis and Laternula marilina were the main contributors to the high abundance in the Hangzhou Bay. The results show higher mean macrobenthic abundances in the S. triqueter marsh (1,707 ind/m2 ± 1,669 SD) compared to that of the mudflat area (1,172 ind/m2 ± 1,115 SD). However, the highest mean biomass was found in the mudflat habitat (0.73 g/m2 ± 0.84 SD as opposed to 0.64 g/m2 ± 0.59 SD from the S. triqueter marsh) indicating the occurrence of larger specimens. Multivariate analyses indicate significant differences in the species composition between both habitats, confirming the importance of habitat structure on macrofaunal assemblages