253 research outputs found
Cerebral Small Vessel Disease in Dementia and Depression: a prospective population-based MRI study
__Abstract__
Cerebral white matter lesions and asymptomatic brain infarcts are common in elderly
people. These brain lesions are thought to result from cerebral small vessel disease,
and their presence and severity increase with age and the presence of arterial
hypertension. There is widespread belief that cerebral small vessel disease plays a role in
the aetiology of dementia. Small vessel disease is commonly regarded as the primary pathology
in subcortical ischemic vascular dementia, one of the subtypes of vascular dementia.
Furthermore, vascular factors, including cerebral small vessel disease, are increasingly
recognized to be involved in the aetiology of Alzheimer’s disease.8 However, there is hardly
any evidence from prospective population-based studies to support these notions
Alcohol intake in relation to brain magnetic resonance imaging findings in older persons without dementia
Alcohol intake in relation to brain magnetic resonance imaging findings in older persons without dementia
Silent brain infarcts and the risk of dementia and cognitive decline
BACKGROUND: Silent brain infarcts are frequently seen on magnetic
resonance imaging (MRI) in healthy elderly people and may be associated
with dementia and cognitive decline. METHODS: We studied the association
between silent brain infarcts and the risk of dementia and cognitive
decline in 1015 participants of the prospective, population-based
Rotterdam Scan Study, who were 60 to 90 years of age and free of dementia
and stroke at base line. Participants underwent neuropsychological testing
and cerebral MRI at base line in 1995 to 1996 and again in 1999 to 2000
and were monitored for dementia throughout the study period. We performed
Cox proportional-hazards and multiple linear-regression analyses, adjusted
for age, sex, and level of education and for the presence or absence of
subcortical atrophy and white-matter lesions. RESULTS: During 3697
person-years of follow-up (mean per person, 3.6 years), dementia developed
in 30 of the 1015 participants. The presence of silent brain infarcts at
base line more than doubled the risk of dementia (hazard ratio, 2.26; 95
percent confidence interval, 1.09 to 4.70). The presence of silent brain
infarcts on the base-line MRI was associated with worse performance on
neuropsychological tests and a steeper decline in global cognitive
function. Silent thalamic infarcts were associated with a decline in
memory performance, and nonthalamic infarcts with a decline in psychomotor
speed. When participants with silent brain infarcts at base line were
subdivided into those with and those without additional infarcts at
follow-up, the decline in cognitive function was restricted to those with
additional silent infarcts. CONCLUSIONS: Elderly people with silent brain
infarcts have an increased risk of dementia and a steeper decline in
cognitive function than those without such lesions
Alcohol intake in relation to brain magnetic resonance imaging findings in older persons without dementia
BACKGROUND: Consumers of light-to-moderate amounts of alcohol have a lower risk of dementia and, possibly, Alzheimer disease than do abstainers. Because vascular disease may contribute to symptoms of Alzheimer disease, reduction of cerebrovascular disease in consumers of light amounts of alcohol could account for that observation. However, a low concentration of alcohol may also have direct effects on the hippocampus, a brain structure highly affected by Alzheimer disease. OBJECTIVE: We investigated alcohol intake in relation to brain magnetic resonance imaging (MRI) findings of presumed vascular
Diversity in Alzheimer\u27s Disease Drug Trials: The Importance of Eligibility Criteria
INTRODUCTION: To generalize safety and efficacy findings, it is essential that diverse populations are well represented in Alzheimer\u27s disease (AD) drug trials. In this review, we aimed to investigate participant diversity in disease-modifying AD trials over time, and the frequencies of participant eligibility criteria.
METHODS: A systematic review was performed using Medline, Embase, the Cochrane Library, and Clinicaltrials.gov, identifying 2247 records.
RESULTS: In the 101 included AD trials, participants were predominantly White (median percentage: 94.7%, interquartile range: 81.0-96.7%); and this percentage showed no significant increase or decrease over time (2001-2019). Eligibility criteria such as exclusion of persons with psychiatric illness (78.2%), cardiovascular disease (71.3%) and cerebrovascular disease (68.3%), obligated caregiver attendance (80.2%), and specific Mini-Mental State Examination scores (90.1%; no significant increase/decrease over time) may have led to a disproportionate exclusion of ethnoracially diverse individuals.
DISCUSSION: Ethnoracially diverse participants continue to be underrepresented in AD clinical trials. Several recommendations are provided to broaden eligibility criteria
Application of ultrasound to monitor in vivo residual bone movement within transtibial prosthetic sockets
Transtibial prosthetic users do often struggle to achieve an optimal prosthetic fit, leading to residual limb pain and stump-socket instability. Prosthetists face challenges in objectively assessing the impact of prosthetic adjustments on residual limb loading. Understanding the mechanical behaviour of the pseudo-joint formed by the residual bone and prosthesis may facilitate prosthetic adjustments and achieving optimal fit. This study aimed to assess the feasibility of using B-mode ultrasound to monitor in vivo residual bone movement within a transtibial prosthetic socket during different stepping tasks. Five transtibial prosthesis users participated, and ultrasound images were captured using a Samsung HM70A system during five dynamic conditions. Bone movement relative to the socket was quantified by tracking the bone contour using Adobe After-Effect. During the study a methodological adjustment was made to improve data quality, and the first two participants were excluded from analysis. The remaining three participants exhibited consistent range of motion, with a signal to noise ratio ranging from 1.12 to 2.59. Medial–lateral and anterior–posterior absolute range of motion varied between 0.03 to 0.88 cm and 0.14 to 0.87 cm, respectively. This study demonstrated that it is feasible to use B-mode ultrasound to monitor in vivo residual bone movement inside an intact prosthetic socket during stepping tasks
Subjective cognitive decline and self-reported sleep problems: The SCIENCe project
We aim to investigate the frequency and type of sleep problems in memory clinic patients with subjective cognitive decline (SCD) and their association with cognition, mental health, brain magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) biomarkers. Three hundred eight subjects (65 ± 8 years, 44% female) were selected from the Subjective Cognitive Impairment Cohort (SCIENCe) project. All subjects answered two sleep questionnaires, Berlin Questionnaire (sleep apnea) and Pittsburgh Sleep Quality Index (sleep quality) and underwent a standardized memory clinic work-up. One hundred ninety-eight (64%) subjects reported sleep problems, based on 107 (35%) positive screenings on sleep apnea and 162 (53%) on poor sleep quality. Subjects with sleep problems reported more severe depressive symptoms, more anxiety, and more severe SCD. Cognitive tests, MRI, and CSF biomarkers did not differ between groups. Our results suggest that improvement of sleep quality and behaviors are potential leads for treatment in many subjects with SCD to relieve the experienced cognitive complaints
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