Alzheimer's Disease Awareness Research Articles

Knowledge, Awareness, and Perceived Threat Toward Alzheimer's Disease Among the Family Caregivers of Individuals with Chronic Physical Conditions in Bangladesh.

Alzheimer's disease (AD) is a growing public health concern affecting millions of individuals worldwide. This disease burden is exacerbated in countries like Bangladesh, where public awareness and knowledge about the condition remains limited. This study aimed to assess the level of AD knowledge, awareness, and perceived threat among family caregivers of individuals with chronic physical conditions of Bangladesh. A descriptive cross-sectional study was conducted among the caregivers of patients selected via convenience sampling in six public hospitals between October 2022 and March 2023. The data was collected via face-to-face interviews employing a semi-structured questionnaire that contained information about socio-demographic characteristics, personal experiences with AD, knowledge of AD, level of awareness regarding AD, and perceived threat toward AD. The findings revealed a poor knowledge of AD among the study participants. Regarding AD awareness, 52.5% considered memory loss in older individuals abnormal, 26.2% attributed AD to causes like black magic, psychological distress, or bad eyes. Regarding perceived threat, 60.2% wanted to assess their AD risk, while 68.2% disagreed with the likelihood of developing the disease. Multiple linear regression analysis revealed that age, place of residence, education, and employment status significantly contribute to AD knowledge scores. This study highlights the urgent need for public education and awareness campaigns to address the knowledge gap and reduce stigmatization associated with AD in Bangladesh. Targeted efforts, particularly among older age groups and rural communities, can enhance understanding and improve the quality of care and support for AD patients and their caregivers.

Black Americans' perceptions of Alzheimer's disease, a healthy brain, and strategies for brain health promotion

ObjectivesLack of awareness of Alzheimer's disease (AD) among Black Americans may undermine their ability to identify potential AD risk. We examined Black Americans' perceptions and knowledge of AD, and views of a healthy brain, which may contribute to the development of effective and culturally sensitive strategies to address racial disparities in AD. MethodsWe conducted a mixed-methods study, integrating a cross-sectional survey of 258 older (>55 years) Black participants and qualitative interviews with a sub-sample of N = 29. Both data sets were integrated to inform the results. ResultsParticipants endorsed having little knowledge of AD. While most participants reported practicing a healthy lifestyle to promote a healthy brain, the range of activities listed were limited. Participants made several suggestions to increase AD awareness, which includes using AD educational materials containing information that would benefit the whole family, not only older adults. Outreach approaches that address both individual behaviors and structural factors were also encouraged. ConclusionOur findings identify ongoing needs to improve AD awareness among traditionally under-represented groups. InnovationThe study utilized novel approaches to examine participants' perspectives of AD that included a diverse sample of research naïve participants, and integrated exploration of participants' views of AD and brain health.

Neurophysiological correlates of altered time awareness in Alzheimer's disease and frontotemporal dementia.

Alterations in time awareness have been reported in dementia, particularly in Alzheimer's disease (AD) and frontotemporal dementia (FTD). However, the neurophysiological correlates underlying these alterations remain largely unexplored. This study aimed to investigate the neurophysiological correlates of altered time awareness in AD and FTD patients. A total of 150 participants (50 AD patients, 50 FTD patients, and 50 healthy controls [HC]) underwent a standardized neuropsychological assessment, an altered time awareness survey, and transcranial magnetic stimulation (TMS) to assess cholinergic (short latency afferent inhibition-SAI), GABAergic (short interval intracortical inhibition-SICI), and glutamatergic (intracortical facilitation-ICF) circuits. In AD patients, the most frequent symptom was difficulty in ordering past events (52.0%), while FTD patients primarily struggled with estimating temporal intervals between events (40.0%). Significant differences were observed between HC and both patient groups, as well as between AD and FTD patients in their tendency to re-live past events. Binomial logistic regression analysis revealed that impairments in glutamatergic and cholinergic circuits significantly predicted the likelihood of participants manifesting altered time awareness symptoms. This study provides novel insights into the neurophysiological correlates of altered time awareness in AD and FTD patients, highlighting the involvement of specific neurotransmitter circuits, particularly glutamatergic and cholinergic circuits. Further research is needed to explore the potential clinical implications and therapeutic targets arising from these findings.

Assessing awareness in severe Alzheimer's disease.

There is an urgent need to understand the nature of awareness in people with severe Alzheimer's disease (AD) to ensure effective person-centered care. Objective biomarkers of awareness validated in other clinical groups (e.g., anesthesia, minimally conscious states) offer an opportunity to investigate awareness in people with severe AD. In this article we demonstrate the feasibility of using Transcranial magnetic stimulation (TMS) combined with EEG, event related potentials (ERPs) and fMRI to assess awareness in severe AD. TMS-EEG was performed in six healthy older controls and three people with severe AD. The perturbational complexity index (PCIST) was calculated as a measure of capacity for conscious awareness. People with severe AD demonstrated a PCIST around or below the threshold for consciousness, suggesting reduced capacity for consciousness. ERPs were recorded during a visual perception paradigm. In response to viewing faces, two patients with severe AD provisionally demonstrated similar visual awareness negativity to healthy controls. Using a validated fMRI movie-viewing task, independent component analysis in two healthy controls and one patient with severe AD revealed activation in auditory, visual and fronto-parietal networks. Activation patterns in fronto-parietal networks did not significantly correlate between the patient and controls, suggesting potential differences in conscious awareness and engagement with the movie. Although methodological issues remain, these results demonstrate the feasibility of using objective measures of awareness in severe AD. We raise a number of challenges and research questions that should be addressed using these biomarkers of awareness in future studies to improve understanding and care for people with severe AD.

Episodic Memory Impairment Mediates the Loss of Awareness in Mild Cognitive Impairment.

IntroductionLoss of awareness is a common symptom in Alzheimer's Disease (AD) and responsible for a significant loss of functional abilities. The mechanisms underlying loss of awareness in AD is unknown, although previous findings have implicated dysfunction of primary executive functioning (EF) or episodic memory (EM) to be the cause. Therefore, our main study objective was to explore the involvement of EF and EM dysfunction in amyloid-related loss of awareness across the clinical spectrum of AD.MethodsA total of 895 participants (362 clinically normal [CN], 422 people with mild cognitive impairment [MCI] and 111 with dementia) from the Alzheimer's Disease Neuroimaging Initiative were used for the analyses. A sub-analysis was performed in 202 participants who progressed in their clinical diagnosis from CN to MCI or MCI to dementia as well as dementia patients. Mediation models were used in each clinical group with awareness (assessed with the Everyday Cognitive function questionnaire) as a dependent variable to determine whether EF and/or EM would mediate the effect of amyloid on awareness. We also ran these analyses with subjective and informant complaints as dependent variables. Direct correlations between all variables were also performed.ResultsWe found evidence for a decline in awareness across the groups, with increased awareness observed in the CN group and decreased awareness observed in the MCI and dementia groups. Our results showed that EM, and not EF, partially mediated the relationship between amyloid and awareness such that greater amyloid and lower EM performance was associated with lower awareness. When analyzing each group separately, this finding was only observed in the MCI group and in the group containing progressors and dementia patients. When repeating the analyses for subjective and informant complaints separately, the results were replicated only for the informant's complaints.DiscussionOur results demonstrate that decline in EM and, to a lesser degree, EF, mediate the effect of amyloid on awareness. In line with previous studies demonstrating the development of anosognosia in the prodromal stage, our findings suggest that decreased awareness is the result of an inability for the participant to update his/her insight into his/her cognitive performance (i.e., demonstrating a petrified self).

The Relationship Between Decision-making Capacity and the Domains of Awareness in Alzheimer Disease.

People with Alzheimer dementia (PwAD) who are aware of their overall cognitive function and diagnosis are more likely to be judged competent in decision-making capacity. Therefore, we aimed to investigate the relationship between decision-making capacity and the different domains of awareness and the relationship between decision-making capacity and the cognitive and clinical impairment of the PwAD. Using a cross-sectional design, we included 121 PwAD and their caregivers. Awareness was assessed across domains, including cognitive functioning and health condition, functional activity impairments, emotional state, social functioning, and interpersonal relationships. The MacArthur Competence Assessment Tool for Treatment was adopted to gather information about decision-making abilities. We found that decision-making capacity is related to the cognitive and functional domains of awareness and relatively independent of the emotional functioning and the relationship domains. Our finding highlighted that PwAD who are unaware of the disease or the cognitive and functional impairments might be unlikely to appreciate the personal benefits of a proposed health treatment or to understand and judge the personal consequences of a decision accurately.

Understanding Alzheimer's disease as a disorder of consciousness.

People with Alzheimer's disease (AD) demonstrate a range of alterations in consciousness. Changes in awareness of cognitive deficit, self‐awareness, and introspection are seen early in AD, and dysfunction of awareness and arousal progresses with increasing disease severity. However, heterogeneity of deficits between individuals and a lack of empirical studies in people with severe dementia highlight the importance of identifying and applying biomarkers of awareness in AD. Impairments of awareness in AD are associated with neuropathology in regions that overlap with proposed neural correlates of consciousness. Recent developments in consciousness science provide theoretical frameworks and experimental approaches to help further understand the conscious experience of people with AD. Recognition of AD as a disorder of consciousness is overdue, and important to both understand the lived experience of people with AD and to improve care.

Multidimensional Apathy in Behavioral Variant Frontotemporal Dementia, Primary Progressive Aphasia, and Alzheimer Disease.

Apathy is prevalent in dementia, such as behavioral variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA), and Alzheimer disease (AD). As a multidimensional construct, it can be assessed and subsumed under a Dimensional Apathy Framework. A consistent apathy profile in bvFTD and PPA has yet to be established. The aim was to explore apathy profiles and awareness in bvFTD, PPA, and AD. A total of 12 patients with bvFTD, 12 patients with PPA, 28 patients with AD, and 20 matched controls, as well as their informants/carers, were recruited. All participants completed the Dimensional Apathy Scale (DAS), assessing executive, emotional, and initiation apathy subtypes, a 1-dimensional apathy measure, depression measure, and functional and cognitive screens. Apathy subtype awareness was determined through DAS informant/carer and self-rating discrepancy. Apathy profile comparison showed patients with bvFTD had significantly higher emotional apathy than patients with AD (P < .01) and significantly higher apathy over all subtypes than patients with PPA (Ps < .05). Additionally, patients with bvFTD had significantly lower awareness for emotional apathy (P < .01) when compared to patients with AD and PPA. All patient groups had significant global apathy over all subtypes compared to controls. The emergent apathy profile for bvFTD seems to be emotional apathy (indifference or emotional/affective neutrality), with lower self-awareness in this subtype. Further, lower self-awareness for executive apathy (lack of motivation for planning, organization, or attention) differentiates bvFTD from PPA. Future research should investigate the cognitive and neural correlates as well as the practical impact of apathy subtypes.

Modelling the impact of functionality, cognition, and mood state on awareness in people with Alzheimer's disease.

To investigate the nature of the relationship between cognitive function, mood state, and functionality in predicting awareness in a non-clinically depressed sample of participants with mild to moderate Alzheimer's disease (AD) in Brazil. People with AD (PwAD) aged 60 years or older were recruited from an outpatient unit at the Center of AD of the Federal University of Rio de Janeiro, Brazil. Measures of awareness of condition (Assessment Scale of the Psychosocial Impact of the Diagnosis of Dementia), cognitive function (Mini-Mental State Examination), mood state (Cornell Scale for Depression in Dementia), and functionality (Pfeffer Functional Activities Questionnaire) were applied to 264 people with mild to moderate AD and their caregivers. Hypotheses were tested statistically using SEM approach. Three competing models were compared. The first model, in which the influence of mood state and cognitive function on awareness was mediated by functionality, showed a very good fit to the data and a medium effect size. The competing models, in which the mediating variables were mood state and cognitive function, respectively, only showed poor model fit. Our model supports the notion that the relationship between different factors and awareness in AD is mediated by functionality and not by depressive mood state or cognitive level. The proposed direct and indirect effects on awareness are discussed, as well as the missing direct influence of mood state on awareness. The understanding of awareness in dementia is crucial and our model gives one possible explanation of its underlying structure in AD.

Epidemiology, associated burden, and current clinical practice for the diagnosis and management of Alzheimer's disease in Japan.

The burden of dementia in Japan is large and growing. With the world’s fastest aging population, it is estimated that one in five elderly people will be living with dementia in Japan by 2025. The most common form of dementia is Alzheimer’s disease (AD), accounting for around two-thirds of dementia cases. A systematic review was conducted to examine the epidemiology and associated burden of AD in Japan and to identify how AD is diagnosed and managed in Japan. English and Japanese language databases were searched for articles published between January 2000 and November 2015. Relevant Japanese sources, clinical practice guideline registers, and reference lists were also searched. Systematic reviews and cohort and case–control studies were eligible for inclusion, with a total of 60 studies included. The most recent national survey conducted in six regions of Japan reported the mean prevalence of dementia in people aged ≥65 years to be 15.75% (95% CI: 12.4, 22.2%), which is much higher than the previous estimated rate of 10% in 2010. AD was confirmed as the predominant type of dementia, accounting for 65.8% of all cases. Advancing age and low education were the most consistently reported risk factors for AD dementia. Japanese guidelines for the management of dementia were released in 2010 providing specific guidance for AD about clinical signs, image findings, biochemical markers, and treatment approaches. Pharmacotherapies and non-pharmacotherapies to relieve cognitive symptoms were introduced, as were recommendations to achieve better patient care. No studies reporting treatment patterns were identified. Due to population aging and growing awareness of AD in Japan, health care expenditure and associated burden are expected to soar. This review highlights the importance of early detection, diagnosis, and treatment of AD as strategies to minimize the impact of AD on society in Japan.

The Relationship Between Social Cognition and Awareness in Alzheimer Disease.

A large body of evidence highlights the social cognitive impairment in neurodegenerative diseases such Alzheimer disease (AD). This study investigated the relationship among social and emotional functioning (SEF), awareness of disease, and other clinical aspects in people with AD (PwAD). A consecutive series of 50 people with mild to moderate AD and their 50 family caregivers were assessed. There was a significant difference between self-rated SEF and informant-rated SEF. In 56% of PwAD, self-rated SEF is lower than informant-rated SEF. People with AD mostly presented with mildly impaired awareness of the disease (56%), 20% had moderately impaired awareness of the disease, and 6% were unaware of the disease. The multivariate linear regression showed that informant-rated SEF was related to the social functioning, and relationships, domains of awareness of disease, and the PwAD informant-rated quality of life. The relationship between SEF and awareness of social functioning and relationship domain shows that they are comprised of judgments related to perceptions about oneself, values, and beliefs qualitatively different from awareness of memory or functionality, which can be directly observed.

Factors Related to Different Objects of Awareness in Alzheimer Disease.

Awareness of deficits is a multidimensional phenomenon described as the ability to acknowledge difficulties and impairments. We investigated whether unawareness affects distinct domains to different degrees and identified the factors related to the awareness impairment in Alzheimer Disease (AD). Using a cross-sectional design, we assessed 89 people with AD (PwAD) and their caregivers. Awareness was evaluated by scoring discrepant responses between PwAD and their caregivers across domains including cognitive functioning and health condition, functional activity impairments, emotional state, social functioning, and interpersonal relationships. The awareness of functional activity impairments domain showed a greater discrepancy compared with the other domains. Multiple regression analysis revealed that lack of awareness of cognitive functioning and health condition was related to PwAD unawareness of functional activity impairments, age, and caregiver burden. The emotional state domain was related to PwAD unawareness of functional activity impairments and depressive symptoms. There was also a relationship between the social functioning and relationships domain and caregiver burden. The functional activity impairments domain was related to deficits in the following domains: cognitive functioning and health condition, emotional state, social and emotional functioning, and PwAD self-reported quality of life. Although we observed that 1 domain can influence another, our results suggest that the factors related to each of the different objects of awareness are varied.

Is there an association between help-seeking for early detection of Alzheimer's disease and illness representations of this disease among the lay public?

Help-seeking (HS) for early detection of Alzheimer's disease (AD) is clearly essential because therapeutic interventions are recognized as being most efficient in the early stages of the disease. Using the Self-Regulation Model as its conceptual framework, the present study examined the relationship between HS for early detection of AD and lay persons' beliefs and emotional reactions towards AD. A convenience sample of 236 community-dwelling adults, aged 50 and above, completed HS measures related to early detection of AD, HS sources, cognitive and emotional representations, perceived threat, familiarity with AD, and socio-demographic questionnaires. Participants expressed low HS levels for early detection of AD. However, participants expressed higher levels of HS willingness if checking for AD would be included in the routine medical examinations conducted by their GPs. Multiple regression analyses showed that AD consequences and perceived threat were the main predictors of HS for early detection of AD, explaining 9.2% of the variance. Our findings stress the need to increase the lay public's knowledge about available treatment options and their efficacy, even in the advances stages of the disease when the consequences of the disease are much more severe. AD awareness programs should also pay attention to the potential fear which may exist in the case of HS for early detection of AD. Copyright © 2017 John Wiley & Sons, Ltd.

Increasing Community Awareness About Alzheimer's Disease in Puerto Rico Through Coffee Shop Education and Social Media.

Alzheimer's disease (AD) is the fourth leading cause of death in Puerto Rico. Using multi-media resources and in-person education may be an effective approach to improve knowledge and awareness of AD. The Un Café por el Alzheimer program in Puerto Rico incorporates an education component at coffee shops and a social media campaign using Facebook. The current study evaluates this initiative through an analysis of pre/post education survey results and social media content and use. Surveys contained close-ended and open-ended questions to understand participants' perceptions and knowledge about AD. Post-education surveys also included questions related to program satisfaction. Social media analysis of the Facebook community page examined posts from March 1 to September 30, 2015. Descriptive statistics were used to analyze survey and Facebook data. Four education sessions were conducted with a total of 212 participants. Fifty-one of the participants completed both pre- and post-surveys. Following the education program participants reported improved knowledge of risk and protective factors. All participants reported learning new information from the program. There were a total of 250 posts on the Un Café por el Alzheimer community Facebook page; 168 posts related to AD. The Facebook page reached 294,109 people, with 9963 page likes, 610 comments, 17,780 post clicks, and 3632 shares. There was an average increase of 64.8% in number of people reached by the Facebook page following the education sessions. The approach of combining social media resources and in-person education is beneficial to increase public awareness of AD and disseminate health information.

Knowledge and perceptions of dementia and Alzheimer's disease in four ethnic groups in Copenhagen, Denmark.

Older people from ethnic minorities are underrepresented in dementia care. Some of the determinants of access to care are knowledge and perceptions of dementia, which may vary between ethnic groups in the population. The aims of this study were to compare knowledge and perceptions of dementia and Alzheimer's disease (AD) among four ethnic groups in Copenhagen, Denmark, and to assess the influence of education and acculturation. Quantitative survey data from 260 participants were analyzed: 100 native Danish, and 47 Polish, 51 Turkish, and 62 Pakistani immigrants. Knowledge and perceptions of dementia and AD were assessed with the Dementia Knowledge Questionnaire (DKQ) supplemented with two questions from the Alzheimer's Disease Awareness Test (ADAT). Knowledge and perceptions of dementia and AD in the four groups were compared, and the influence of education and acculturation was assessed. Group differences were found on the DKQ total score as well as all sub-domains. Turkish and Pakistani people were most likely to hold normalizing and stigmatizing views of AD. Level of education and acculturation had limited influence on dementia knowledge, accounting for 22% of the variance at most and had only minor influence on perceptions of AD. Lacking knowledge and certain perceptions of dementia and AD may hamper access to services in some ethnic minority groups. Ongoing efforts to raise awareness that dementia and AD are not part of normal aging, particularly among Turkish and Pakistani communities, should be a high priority for educational outreach.

Public Perceptions of Presymptomatic Testing for Alzheimer Disease

ObjectiveTo explore the self-expressed desire for, envisioned reaction to, and basic understanding of presymptomatic Alzheimer disease (AD)–related genetic and biomarker tests. Patients and MethodsThe Alzheimer’s Prevention Registry is an online community of people at least 18 years of age who are interested in AD prevention research for purely informational purposes or to be considered for possible research participation in future studies. Information about presymptomatic testing and an online multiple choice format survey were posted from November 1, 2012, through June 20, 2013, on the registry website. ResultsOf 4036 respondents, 80.8% (3195/3952) wanted genetic testing if paid by insurance and 58.7% (2261/3851) if it would cost them at least $100. A total of 80.2% (3112/3879) wanted biomarker testing. If at high risk for AD, 90.5% (3478/3841) endorsed that they would “pursue a healthier lifestyle,” but 11.6% (427/3706) endorsed “seriously consider suicide.” The implication of a positive genetic test result was incorrectly understood by 13.1% (500/3812) and 32.6% (1255/3848) failed to view a positive biomarker test result as evidence of increased risk for or the presence of AD. ConclusionDespite efforts to increase public awareness of AD, our survey results suggest that greater education of the public is needed. Interested patients should probably undergo psychological screening to identify those at high risk of adverse psychological outcomes, and disclosure of presymptomatic test results should be anchored to tangible constructive action plans, such as healthy lifestyle changes, long-term care planning, and, when available and appropriate, participation in research trials.

“Boomer-ize” Your Library Collection

Call them boomers or boomers. They are generation born just after end of World War II (1946) through 1964, year Beatles were introduced on Ed Sullivan Show. This is Woodstock Generation, age that marched against establishment with hopes of ending Vietnam War. This defined generation has been seen as group that would have everything that their parents and grandparents could provide for them. Unfortunately, many of their once-strong nest eggs have shrunk over past few years because of financial crisis precipitated by mortgage collapse of 2008. In general, they are much healthier, better educated, and more financially secure than their parents or grandparents. This also is can do anything generation. Being a baby boomer myself, I can concur with all that. At same time, nature of what it means to grow older and definition of what it means to be retired is being changed rapidly by this cohort. This is where libraries can play an essential role as they broaden their senior-based collection beyond traditional large-print books. Libraries around country are developing innovative programs to make retirement years productive, creative, and engaging. These include Transforming Life After 50 program developed by California State Library and Senior Spaces: Pennsylvania Style project developed by Commonwealth Libraries. As these programs are being developed, libraries are faced with building relevant collections that address myriad informational needs surrounding growing older as a baby boomer. RUSA Guidelines for Library and Information Services for Older Adults (2008) suggest some key areas for collection development including: health, health care, social security, financial planning, housing, independent living, elder law, care giving (including grandparenting), lifelong learning (including adult literacy and computer skills), community service, civic engagement, and volunteering. It further states that the Library's collections, programs, and informational services should reflect diverse interests and needs of older adults. (1) This issue of The Alert Collector is designed to assist you in developing and enhancing your physical and virtual library collections to better serve boomer generation. It also addresses issues of aging lifespan by including material for Silent Generation and Greatest Generation (the parents and grandparents of boomers). Marketing your collection can be made easier throughout year. For example, May is Older Americans Month, September includes National Grandparents Day and November is both Alzheimer's Disease Awareness Month and National Family Caregivers Month. These suggestions are intended for all types of libraries, especially public libraries. Titles of a more scholarly nature on aging, geriatrics, and gerontology haven been intentionally excluded from this collection list. Also not included in this article are titles that were self-published or are available in e-book (e.g., Kindle) editions only. BUILDING A BASIC COLLECTION Libraries should begin with an evaluation of which of these key books they already own. These titles are standards that have been written by well-known authors and should be included in a library's basic collection. Some are updated on a regular and frequent basis. * Butler, Robert N. 2002. Why Survive? Growing Old in America. Baltimore, MD: Johns Hopkins University Press. 978-0-8018-7425-3. * Cohen, Gene D. 2006. Mature Mind: Positive Power of Aging Brain. New York: Basic Books. 978-0465-01204-6. * Freedman, Marc. 2007. Encore Careers: Finding Work That Matters in Second Half of Life. New York: PublicAffairs. 978-1-58648-634-1. (www.encore.org) * Friedan, Betty. 2006. Fountain of Age. New York: Simon & Schuster. …

How does the Canadian general public view moderate Alzheimer's disease? determination of health utility scores

Economic evaluations are playing an important role in decision making. Guidelines for the conduct of economic evaluations recommend eliciting preferences or health utility scores from members of the general public. The objectives of this study were to (1) To elicit health utility scores for moderate Alzheimer's disease (AD) using the Canadian general public; (2) to compare utility scores for Canadians' self-assessed health status with utility scores for health status defined as moderate AD; (3) to measure awareness of AD; and (4) to determine factors that influence utility scores. Five-hundred Canadians were chosen randomly to participate in a 13-minute telephone interview. The sample was national in scope and stratified by income. The EQ-5D was administered to measure utility for respondents' current health status (i.e., no AD). After describing moderate AD, respondents were asked to answer the EQ-5D again, this time imagining they had moderate AD. AD awareness was measured with the Alzheimer's Disease Knowledge Test (ADKT). Respondents were also asked about socio-demographics and whether they knew someone with AD. OLS regressions were conducted to identify determinants of EQ-5D utility scores. The mean age of respondents was 51 years, 61% were female, and 42% knew someone with AD (e.g., family member). Mean ADKT score was 3.4 (SD: 1.1) out of 5 (higher scores indicate better knowledge of AD). Respondents' mean EQ-5D score for their current health status was 0.857 (SD: 0.15). Mean EQ-5D score for a hypothetical, moderate AD health status was 0.638 (SD: .20), a utility decrement of 0.22. For the VAS component of the EQ-5D, scores were higher for the current health status (79.16 versus 57.66). Age and income were significant explanatory variables for current health status utilities, but only age was significant in the determination of the utility score under the assumption of moderate AD. Gender, knowledge of someone with AD, or AD awareness scores had no impact. When measured by the EQ-5D, Canadians would expect to assign a lower utility to their health status when they have moderate AD.

Effectiveness and Safety of Donepezil in Hispanic Patients with Alzheimer’s Disease: A 12-Week Open-Label Study

Hispanics represent 10% of the U.S. population and are the fastest growing group. Studies show a higher prevalence and incidence of Alzheimer's disease (AD) in Hispanics than in the non-Hispanic white population, with an earlier age of onset. Among the currently estimated 200,000 Hispanics with AD, a significant number remain undiagnosed and untreated, and Hispanic participation in AD clinical trials has been historically low. This study evaluated the efficacy and safety of donepezil hydrochloride (donepezil) in Hispanics with mild-to-moderate AD. In this multicenter, open-label, 12-week study conducted in the United States, subjects were Hispanic men or women aged > or =50 years with a diagnosis of mild-to-moderate AD (DSMV-IV and NINCDS/ADRDA criteria), with Mini-Mental State Examination (MMSE) scores of 10-26 (inclusive) at screening. Subjects were treated with donepezil 5 mg/day for 6 weeks followed by 10 mg/day for 6 weeks. Clinical evaluation was performed at baseline, week 6 and week 12. Cognitive improvement was measured using the MMSE, Fuld Object Memory Evaluation (FOME) and Symbol Digit Modality Test (SDMT). Behavioral symptoms and associated caregiver distress were assessed with the Neuropsychiatric Inventory (NPI). One-hundred-six patients with mild-to-moderate AD (mean age 68.6 years) were enrolled (intent to treat, n=97); most chose to have assessments conducted in Spanish. With 12 weeks of treatment, subjects showed statistically significant improvement from baseline on MMSE (P<0.0001), FOME retrieval (P=0.0042), FOME repeated retrieval (P=0.0020) and SDMT correct scores (P<0.0001). The NPI subdomain "apathy/indifference" showed statistically significant improvement (P=0.0010).The NPI Caregiver Distress scale (NPI-D) total score was statistically significantly improved (P=0.0500), suggesting a positive impact on relieving caregivers' burden associated with patient behavior. Most patients tolerated the treatment well, with only 2 discontinuing because of adverse events. The most common (>5%) adverse events were insomnia (9.5%), dizziness (7.6%), diarrhea (5.7%) and nausea (5.7%). The cognitive improvement and safety results from this study were consistent with those reported for donepezil in the general population. Increased awareness of AD in the Hispanic population will help more Hispanics with AD to benefit from early diagnosis and effective treatment.

Asian Americans and Alzheimer's disease: Assimilation, culture, and beliefs

Because most successful interventions for Alzheimer's disease (AD) rely upon early diagnosis and implementation, it is important to understand the factors influencing dementia treatment-seeking behaviors. These include perceptions, beliefs, values, and feelings relating to AD, which may vary among and within ethnic groups according to the strength of culturally-based explanatory models and individual group members' ages and experiences. This study used ten focus groups drawn from Asian American communities representing different national origins (Chinese, Japanese, and Korean) to examine the factors shaping attitudes toward AD in general, and treatment-seeking in particular, that may constitute barriers to timely diagnosis and treatment of AD among Asian Americans of various ages and cultural backgrounds. The results suggest that, while these communities share a keen awareness of AD, beliefs regarding the disorder may be influenced at least as strongly by folk wisdom and culturally acceptable partial truths as by scientific information.