About Alzheimer's Disease Research Articles

Ethnic Differences in Beliefs Regarding Alzheimer Disease Among Dementia Family Caregivers

The purpose of this study was to examine ethnic differences in female dementia family caregivers' knowledge, attitudes, and beliefs about Alzheimer disease (AD). Baseline data were collected from 215 female caregivers before their participation in various psychoeducational intervention programs. Caregivers were questioned about the epidemiology, etiology, and treatment of AD. Logistic regressions and one-way analysis of variance were conducted to assess ethnic differences. Hispanic and Chinese caregivers were more likely to believe that AD is a normal part of aging and that AD can be diagnosed by a blood test than the white group. These beliefs about AD may delay help-seeking activities for these patients and their family caregivers. Increased public education about AD is needed in these communities. Results are discussed in terms of barriers to accessing information about AD and ways to improve public informational outreach activities, so that the intended audiences are reached more effectively.

Early detection of Alzheimer's disease: new diagnostic criteria

There has been unprecedented growth of scientific knowledge about Alzheimer's disease (AD). The description of distinctive and reliable biomarkers that are now available through structural brain imaging with magnetic resonance imaging, molecular neuroimaging with positron emission tomography, and cerebrospinal fluid analyses, and a better definition of the clinical profile of amnestic disorders that occur early in the course of the disease, make it possible to identify AD with high accuracy, even in the early stages of the disease. Accordingly, new criteria for the diagnosis have been proposed that capture both the prodromal and the more advanced dementia stages of the disease in the same diagnostic framework.

Public Opinion About Alzheimer Disease Among Blacks, Hispanics, and Whites

Recent research has documented notable differences in knowledge, awareness, and cultural beliefs about Alzheimer disease (AD) among groups defined by race and ethnicity. The present study was conducted to assess racial differences in knowledge and attitudes about AD among a national sample of adults. Data from 1,176 adults aged 35 years and over (48.6% White, 25.7% Black, and 25.8% Hispanic) obtained via telephone interview were used in this study. Although some notable group differences defined by race/ethnicity were observed, more similarities in patterns of response were discovered than expected. Black and Hispanic respondents were significantly more likely to believe that AD is a normal part of aging, but were more optimistic about future advances in research than White participants. Compared with White and Black respondents, Hispanics were more likely to report feeling well-prepared for handling a diagnosis of AD in a family member. Overall, the results suggest that misconceptions about AD remain among large segments of the population, that AD remains a source of significant concern, and that continued efforts are needed to educate the public about this disease.

General practitioners facing dementia: are they fully prepared?

We assessed knowledge about Alzheimer's disease (AD) in a sample of Italian general practitioners (GPs). We first carried out a propedeutic study to verify the ability of an Italian version of the University of Alabama at Birmingham's AD Knowledge Test for Health Professionals to distinguish between 20 AD specialists and 20 non-specialists and to gain reference values. We then administered the test, together with a short questionnaire, to 139 GPs attending an educational programme in November 2000. The cut-off score for discriminating specialists from non-specialists was >/=9. Among the 95 GPs who performed the AD Knowledge Test (68.3% response rate), 21% had a total score >/=9. Our findings suggest that particular focus should be given to dementia in continuing medical education (CME) programmes for GPs.

Effect of respite care training on the knowledge, attitude, and self-esteem of volunteer providers.

This pilot study explored the effect that respite care training had on volunteers' knowledge about Alzheimer's disease (AD), their attitudes toward the cognitively impaired, and their self-esteem. Volunteer respite providers (n = 52) were recruited and participated in four different day (seven-hour) respite care training programs. The sample was predominantly female (85 percent) and white (90 percent). Knowledge about AD increased significantly after respite training (p < .001), and attitudes toward someone who wanders were also significantly improved (p = .026). Overall, the findings support the immediate effectiveness of the respite training program.

Clergy support and caregiver expectactions for support: A replication study

Clergy support is an important type of support that has often been neglected. The purpose of this study is to determine how knowledgeable clergy are about Alzheimer's disease (AD), what expectations AD families hold for support from clergy, and how clergy knowledge and caregiver expectations differ between a rural and urban area. Ries survey7 in Montana of clergy knowledge and caregiver expectations for support was replicated. The Montana study drew a clergy response rate of 41 percent compared with a 22 percent rate in this study. Responses of Kentuckiana families indicated less satisfaction with clergy support than found in Ries study. Findings suggested the need for more educational opportunities for clergy.

Concluding Comments

Burns: This meeting had a number of aims, one being to review and assimilate current knowledge about Alzheimer's disease (AD), with particular reference to primary care. The introduction of guidelines for GPs would perhaps be much better implemented at a national or even regional level.

Identification of Fast and Slow Decliners in Alzheimer Disease

As the body of knowledge about Alzheimer disease (AD) expands, more evidence is appearing to suggest the existence of different subtypes. The delineation of subtypes is important for a variety of reasons, and there are probably several ways to identify subtypes. One crude but functionally promising distinction is between patients with early onset of AD and those with late onset. In theory, such a distinction appears to be a simple one, but critical methodologic issues are involved in this dichotomy, because a key aspect is estimating the rate of progression of the disease in different subtypes. This article discusses potential problems with various measures of deterioration and illustrates how the application of a novel technique--the trilinear model--can address many of these problems and provide additional valuable information. The trilinear model is especially well suited for use in pharmacologic studies because of the additional insight that it can provide.

Recruitment of black elderly for clinical research studies of dementia: the CERAD experience.

Nine Consortium to Establish a Registry for Alzheimer's Disease (CERAD) sites were surveyed to identify barriers to recruiting black subjects. Major cited obstacles were expenses, transportation difficulties, and especially lack of rapport with clinic staff. Major factors in overcoming these barriers are a good referral network involving the black community, community education about Alzheimer's disease (AD), and professional staff who are particularly sensitive to the needs of the black population. CERAD efforts to increase community awareness of Alzheimer's disease and staff sensitivity to minority needs have nearly doubled the proportion of black subjects enrolled.

The seminal role of beta-amyloid in the pathogenesis of Alzheimer disease.

New molecular information about Alzheimer disease (AD) is appearing at an unprecedented rate. Much interest centers on the beta A4 amyloid protein, which is progressively deposited in senile plaques and blood vessels in AD brain tissue. The discovery that some kindreds with familial AD have a mutation in the gene coding for the beta A4 amyloid precursor protein (APP) suggests that this mutation alone may be sufficient to cause the full spectrum of clinical and pathological changes that characterize AD. Although APP point mutations may turn out to be relatively rare causes of AD, the idea that accelerated beta A4 deposition is an early and critical event in many patients continues to gain support from studies in humans, animals, and cultured cells. Identification of the biochemical steps leading to production of the beta A4 peptide from APP is now a critical issue. Recent reports indicate that normal lysosomal processing pathways can produce carboxyl-terminal fragments of APP that contain the entire beta A4 sequence, and are therefore potentially amyloidogenic. The mechanisms by which such intermediate forms are further processed and released, resulting in extracellular beta A4 deposits in plaques and vessels, are yet to be determined. It is likely that full elucidation of the beta A4-producing pathways will ultimately yield new therapeutic approaches to this complex and tragic disorder.

Alzheimer??s Disease and Family Caregiving

This paper is a synthesis of knowledge about Alzheimer's disease (AD) and AD family caregiving published over the last decade (approximately 1979-1990). While there has been an increase in the volume of scientific work in this area, methodological difficulties, unclear findings, and gaps, particularly with regard to inclusion of ethnic minority populations, persist. The current research priority on evaluating intervention programs represents a worthy direction, yet such a focus may be premature until basic knowledge builds on, extends, and transcends the foundation established in the past decade.