Dementia Of The Alzheimer Type Research Articles

Prevalence and incidence of dementia among 75–80-year-old community-dwelling elderly in different districts of Antwerp, Belgium: The Antwerp Cognition (ANCOG) Study

Objective To analyse the prevalence and incidence of dementia in a population of community-dwelling elderly (aged 75–80), living in socio-economically differing districts of Antwerp (Belgium), taking into account possible gender and educational differences. Methods A longitudinal cohort study ( N = 825) with a 3-year follow-up period ( N = 363). The Mini Mental State Examination (MMSE) was used as a primary screen of cognitive functioning. Scoring 21 or below led to a second phase examination by a neurologist, including the CAMDEX-R-N and a neurological examination, to provide a tentative aetiological diagnosis of dementia. These procedures were conducted annually during a 3-year follow-up period. Results In accordance with international literature, the overall prevalence rate of dementia was 8.7%. The cumulative incidence rate (IR) of dementia was 36.60 per 1000 Py with annual IRs ranging from 34.39 over 35.16 to 49.04 per 1000 Py. Dementia of the Alzheimer type (DAT) was the most occurring prevalent and incident cause. Women appeared to be at higher risk and the occurrence of cognitive deterioration was more prominent in districts with lower socio-economic status, possibly related to a lower education level. Conclusion We demonstrate dementia is a considerable health problem in an urban Belgian population of community-dwelling elderly aged between 75 and 80 years old. In order to prepare health care and social security systems for the future management of dementia, proper epidemiological insight into the current and future magnitude of the burden of dementia, taking into account socio-economic differences, to which this study contributes, are required.

Musical structural determinants of emotional judgments in dementia of the Alzheimer type.

People with dementia of the Alzheimer type (DAT) may well be emotionally soothed by listening to music. However, very few systematic studies have been conducted to support the anecdotal evidence. DAT does damage certain cerebral structures that subsume emotional processing, and some studies have demonstrated deficits affecting emotional judgments of facial expression and prosody in DAT. Accordingly, this study addressed the question of whether DAT might leave musical emotional judgment intact. Twelve early DAT participants and 12 healthy elderly participants took part in this study. Emotional judgments were examined in relation to mode and tempo, two important structural properties that contribute to the happy-sad distinction in music. Their respective contributions were assessed in four different experimental conditions. The DAT participants' responses were similar to those of healthy elderly participants, showing spared ability to employ tempo and mode as cues for emotional interpretation. The DAT participants' performance was not correlated with their global cognitive functioning. These results constitute a preliminary empirical demonstration that, in early DAT, musical emotional judgments appear to be based on normal structural analysis of musical input.

Down syndrome and dementia: A randomized, controlled trial of antioxidant supplementation

Individuals with Down syndrome over age 40 years are at risk for developing dementia of the Alzheimer type and have evidence for chronic oxidative stress. There is a paucity of treatment trials for dementia in Down syndrome in comparison to Alzheimer disease in the general (non-Down syndrome) population. This 2-year randomized, double-blind, placebo-controlled trial assessed whether daily oral antioxidant supplementation (900 IU of alpha-tocopherol, 200 mg of ascorbic acid and 600 mg of alpha-lipoic acid) was effective, safe and tolerable for 53 individuals with Down syndrome and dementia. The outcome measures comprised a battery of neuropsychological assessments administered at baseline and every 6 months. Compared to the placebo group, those individuals receiving the antioxidant supplement showed neither an improvement in cognitive functioning nor a stabilization of cognitive decline. Mean plasma levels of alpha-tocopherol increased ~2-fold in the treatment group and were consistently higher than the placebo group over the treatment period. Pill counts indicated good compliance with the regimen. No serious adverse events attributed to the treatment were noted. We conclude that antioxidant supplementation is safe, though ineffective as a treatment for dementia in individuals with Down syndrome and Alzheimer type dementia. Our findings are similar to studies of antioxidant supplementation in Alzheimer disease in the general population. The feasibility of carrying out a clinical trial for dementia in Down syndrome is demonstrated.

PF-04494700, an Oral Inhibitor of Receptor for Advanced Glycation End Products (RAGE), in Alzheimer Disease

To evaluate the safety and tolerability of PF-04494700, an oral inhibitor of receptor for advanced glycation end products, in patients with mild-to-moderate dementia of the Alzheimer type. Patients aged 50 years and older who met the National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association criteria for Alzheimer disease with an Mini-Mental State Examination (MMSE) score between 12 and 26 (inclusive) were randomized to 10 weeks of double-blind treatment with either a 10 mg "low dose" of PF-04494700 (after a 6-d loading dose of 30 mg/d), a 20 mg "high dose" of PF-04494700 (after a loading dose of 60 mg/d), or placebo. Safety measures included adverse events, laboratory tests, vital signs, and 12-lead electrocardiogram. Twenty-seven patients received PF-04494700 30/co mg (female: 63%; mean age: 74.6 y; mean MMSE: 21.1), 28 patients received PF-04494700 60/20 mg (female: 57%; mean age: 76.6 y; mean MMSE: 21.6), and 12 patients received placebo (female: 67%; mean age: 74.1 y; mean MMSE: 19.2). A higher proportion of patients completed 10 weeks of double-blind treatment on both the "low-dose" regimen of PF-04494700 (88.9%) and the "high-dose" regimen (85.7%) than patients who were on placebo (66.7%). Discontinuation owing to adverse events and incidence of severe adverse events, respectively, were lower in the "low-dose" regimen (7.4%, 11.1%) and the "high-dose" regimen (3.6%, 10.7%) compared with placebo (25.0%, 16.7%). There were no clinically meaningful differences in vital signs, laboratory test results, or mean electrocardiogram parameters in patients treated with PF-04494700. PF-04494700 had no consistent effect on plasma levels of β-amyloid, inflammatory biomarkers, or secondary cognitive outcomes. Ten weeks of treatment with PF-04494700 was safe and well tolerated in patients with mild-to-moderate Alzheimer disease, indicating the feasibility of a larger long-term efficacy trial.

Ophthalmic impairments or higher order visual deficits? Posterior cortical atrophy: a case report

Posterior Cortical Atrophy (PCA) was first described by Benson in 1988 and considered as a variant of dementia of the Alzheimer type. Characteristic for PCA is its start with selective problems in vision, or in some cases with apraxia. The diagnosis PCA may be delayed because these symptoms are often not interpreted as symptoms of PCA but as a result of ophthalmic impairments. In attention and refreshing, this case report makes clear that assessment of the higher order visual perception can be helpful in this process. GK is a 64 year old man who was referred to the memory clinic by his general practitioner. At that moment his complaints concerned disturbed vision and memory deficits. Notably, for two years an optician, ophthalmologist and a specialised institute for impaired vision tried to find an ophthalmic reason for his problems. After neuropsychological screening a possible dementia as underlying cause was hypothesized and an extended neuropsychological examination (NPE) and an MRI were performed. The NPE showed an already advanced process of dementia (MMSE 21/30) and problems in the domains memory, executive functioning and information processing speed. More importantly, GK had major problems in the visuoperception and visuoconstruction. There were, however, no signs for apraxia. On the Cortical Visual Screening Test (CORVIST) GK had no problems in acuity (36/36 correct) and shape discrimination, but size discrimination, shape detection, hue discrimination, counting scattered dots, analysing fragmented numbers, face perception and reading crowded letters and numbers were impaired. The MRI showed parieto-occipital atrophy and provided further confirmation of PCA. This case study shows that the diagnostic process in patients with PCA may be hampered by searching for an ophthalmic reason for the problems in the vision. Early assessment of higher order visual perception in these patients, may be helpful in the diagnostic process and can distinguish between an ophthalmic impairment for the visual problems or a possible PCA.

Cognitive Impairment in Mental Illness: An SSA Blind Spot?

Back to table of contents Previous article Next article LettersFull AccessCognitive Impairment in Mental Illness: An SSA Blind Spot?Mark A. Amdur, M.D.Mark A. AmdurSearch for more papers by this author, M.D.Published Online:1 Jun 2011AboutSectionsView articleSupplemental MaterialPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View articleTo the Editor: The field now recognizes that our patients, particularly those with a diagnosis of schizophrenia, have significant co-occurring cognitive impairment (1). Unfortunately, in our experience at Thresholds, the disability determination process used by the Social Security Administration (SSA) often does not recognize cognitive impairment of individuals with schizophrenia and similar conditions otherwise considered stable (the exception is for the category of patients with dementia, delirium, or amnestic disorders, for whom cognitive impairment is taken into account). SSA does not recognize the importance of cognitive impairment in most mental disorders as a vocational impairment in determining disability.The current SSA guidelines for determining disability focus heavily on the overt signs and symptoms of mental impairments but do not focus on cognitive impairment. Proposed new rules would deemphasize the signs and symptoms, but there is no evidence of concern about cognitive impairment in schizophrenia and other psychiatric disorders in the proposed rules. The actual vocational disability that results from these disorders is often unrelated to delusions, hallucinations, sadness, or anxiety. Our patients, even when their symptoms have remitted, are left with cognitive impairments that interfere with concentration, attention, visuospatial function, language, memory, and executive function. These are the enduring and disabling features of serious mental illness. There is no good way to demonstrate these impairments unless you test for them.The Montreal Cognitive Assessment (MoCA) was designed as a rapid test for “mild cognitive impairment” among elderly persons (2). Like the Folstein Mini-Mental State Exam, scores on the MoCA range from 0 to 30. The MoCA takes about 12 minutes to administer. For persons with no cognitive impairment, MoCA scores averaged 27.4±2.2. Persons with known dementia of the Alzheimer type had MoCA scores that averaged 16.2±4.8. Persons with “mild cognitive impairment” had MoCA scores that averaged 22.1±3.1.In a 2010 study at Thresholds, we administered the MoCA and the Folstein Mini-Mental State Exam to 112 stable individuals with schizophrenia (Wilkniss S, Teachout A, Robin L, et al., unpublished manuscript, 2010). The mean±SD MoCA score of persons with schizophrenia was 22.7±4.3. This score falls squarely into the “mild cognitive impairment” range observed with an elderly sample. On the Folstein Mini-Mental State Exam, the same individuals had a score of 27.1±2.5, which is in the normal range.As part of preparing a report for SSA, we also administered the MoCA to 224 individuals seen for consecutive psychiatric evaluations. The group had a wide range of diagnoses. We cannot validate the representativeness of the sample with respect to all individuals who apply to SSA for disability benefits; however, we did nothing to specially select the sample. We were surprised by the high rates of cognitive impairment across all diagnostic categories. [A table with mean MoCA scores for patients in the main diagnostic categories is available in an online supplement to this letter at ps.psychiatryonline.org.]On the basis of our experience, we propose that SSA recognize cognitive impairment as a common work-related impairment in a wide range of mental disorders not confined to dementia, delirium, or amnestic disorders. Failure to do so risks inappropriate denials of disability benefits. Physicians reporting to SSA need to perform more sophisticated cognitive testing. The SSA guidelines should accommodate the concept of co-occurring cognitive impairment in all diagnostic categories. Adjudicators and administrative law judges need to be educated about this phenomenon. At the same time, strategies to facilitate recovery and exit from the disability roll must target cognitive impairment and remediation of cognitive deficits.Dr. Amdur is senior psychiatric consultant at Thresholds, Chicago.Acknowledgments and disclosuresThe author reports no competing interests.References1 Keefe RSE , Fenton WS : How should DSM-V criteria for schizophrenia include cognitive impairment? Schizophrenia Bulletin 33:912–920, 2007 Crossref, Medline, Google Scholar2 Nasreddine ZS , Phillips NA , Bédirian V , et al.: The Montreal Cognitive Assessment (MoCA): a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society 53:695–699, 2005 Crossref, Medline, Google Scholar FiguresReferencesCited byDetailsCited ByNone Volume 62Issue 6 June 2011Pages 682-682 Metrics Acknowledgments and disclosuresThe author reports no competing interests.PDF download History Published online 1 June 2011 Published in print 1 June 2011

Prosodic Impairment in Alzheimer's Disease: Assessment and Clinical Relevance

Prosodic Impairment in Alzheimer's Disease: Assessment and Clinical Relevance

Effects of attention on dichotic listening in elderly and patients with dementia of the Alzheimer type

This article presents an overview of our studies in elderly and Alzheimer patients employing Kimura’s dichotic digits paradigm as a measure for left hemispheric predominance for processing language stimuli. In addition to structural brain mechanisms, we demonstrated that attention modulates the direction and degree of ear asymmetry in dichotic listening. Elderly showed increasingly more difficulties focusing attention on the left ear (LE) with advancing age. Alzheimer patients showed severe deficits to allocate attention to the LE, which could result in a right ear advantage. These results may be attributed to a breakdown of the cortical attentional network which is mediated by frontal (inhibitory control of attention) and parietal regions (spatial attention and ‘disengagement processes’). Both interhemispheric disconnectivity (callosal atrophy) and intrahemispheric disconnectivity (subcortical white matter lesions) appear to be important factors contributing to these findings.

Quantization and analysis of hippocampal morphometric changes due to dementia of Alzheimer type using metric distances based on large deformation diffeomorphic metric mapping

Abstract The metric distance obtained from the large deformation diffeomorphic metric mapping (LDDMM) algorithm is used to quantize changes in morphometry of brain structures due to neuropsychiatric diseases. For illustrative purposes we consider changes in hippocampal morphometry (shape and size) due to very mild dementia of the Alzheimer type (DAT). LDDMM, which was previously used to calculate dense one-to-one correspondence vector fields between hippocampal shapes, measures the morphometric differences with respect to a template hippocampus by assigning metric distances on the space of anatomical images thereby allowing for direct comparison of morphometric differences. We characterize what information the metric distances provide in terms of size and shape given the hippocampal, brain and intracranial volumes. We demonstrate that metric distance is a measure of morphometry (i.e., shape and size) but mostly a measure of shape, while volume is mostly a measure of size. Moreover, we show how metric distances can be used in cross-sectional, longitudinal analysis, as well as left–right asymmetry comparisons, and provide how the metric distances can serve as a discriminative tool using logistic regression. Thus, we show that metric distances with respect to a template computed via LDDMM can be a powerful tool in detecting differences in shape.

Spotlight on the February 8 Issue

The authors identified variables that predicted prevalent dementia of the Alzheimer type (DAT) when considered together with CSF biomarkers in a cross-sectional sample of 201 participants with normal cognition and 46 with DAT. Predictive accuracy of CSF biomarkers was improved by including age, education, and normalized whole brain volumes in analyses. See p. 501; Editorial, p. 496 The authors acquired fMRI scans during a face-name memory task from a cohort of 68 subjects. These data suggest that different functional brain connectivity endophenotypes for “early” vs “late” mild …

Improving CSF biomarker accuracy in predicting prevalent and incident Alzheimer disease

To investigate factors, including cognitive and brain reserve, which may independently predict prevalent and incident dementia of the Alzheimer type (DAT) and to determine whether inclusion of identified factors increases the predictive accuracy of the CSF biomarkers Aβ(42), tau, ptau(181), tau/Aβ(42), and ptau(181)/Aβ(42). Logistic regression identified variables that predicted prevalent DAT when considered together with each CSF biomarker in a cross-sectional sample of 201 participants with normal cognition and 46 with DAT. The area under the receiver operating characteristic curve (AUC) from the resulting model was compared with the AUC generated using the biomarker alone. In a second sample with normal cognition at baseline and longitudinal data available (n = 213), Cox proportional hazards models identified variables that predicted incident DAT together with each biomarker, and the models' concordance probability estimate (CPE), which was compared to the CPE generated using the biomarker alone. APOE genotype including an ε4 allele, male gender, and smaller normalized whole brain volumes (nWBV) were cross-sectionally associated with DAT when considered together with every biomarker. In the longitudinal sample (mean follow-up = 3.2 years), 14 participants (6.6%) developed DAT. Older age predicted a faster time to DAT in every model, and greater education predicted a slower time in 4 of 5 models. Inclusion of ancillary variables resulted in better cross-sectional prediction of DAT for all biomarkers (p < 0.0021), and better longitudinal prediction for 4 of 5 biomarkers (p < 0.0022). The predictive accuracy of CSF biomarkers is improved by including age, education, and nWBV in analyses.

Longitudinal assessment of Aβ and cognition in aging and Alzheimer disease

Assess Aβ deposition longitudinally and explore its relationship with cognition and disease progression. Clinical follow-up was obtained 20 ± 3 months after [¹¹C]Pittsburgh compound B (PiB)-positron emission tomography in 206 subjects: 35 with dementia of the Alzheimer type (DAT), 65 with mild cognitive impairment (MCI), and 106 age-matched healthy controls (HCs). A second PiB scan was obtained at follow-up in 185 subjects and a third scan after 3 years in 57. At baseline, 97% of DAT, 69% of MCI, and 31% of HC subjects showed high PiB retention. At 20-month follow-up, small but significant increases in PiB standardized uptake value ratios were observed in the DAT and MCI groups, and in HCs with high PiB retention at baseline (5.7%, 2.1%, and 1.5%, respectively). Increases were associated with the number of apolipoprotein E ε4 alleles. There was a weak correlation between PiB increases and decline in cognition when all groups were combined. Progression to DAT occurred in 67% of MCI with high PiB versus 5% of those with low PiB, but 20% of the low PiB MCI subjects progressed to other dementias. Of the high PiB HCs, 16% developed MCI or DAT by 20 months and 25% by 3 years. One low PiB HC developed MCI. Aβ deposition increases slowly from cognitive normality to moderate severity DAT. Extensive Aβ deposition precedes cognitive impairment, and is associated with ApoE genotype and a higher risk of cognitive decline in HCs and progression from MCI to DAT over 1 to 2 years. However, cognitive decline is only weakly related to change in Aβ burden, suggesting that downstream factors have a more direct effect on symptom progression.

Operationalizing diagnostic criteria for Alzheimer’s disease and other age-related cognitive impairment—Part 2

This article focuses on the effects of operational differences in case ascertainment on estimates of prevalence and incidence of cognitive impairment and/or dementia of the Alzheimer type. Experience and insights are discussed by investigators from the Framingham Heart Study, the East Boston Senior Health Project, the Chicago Health and Aging Project, the Mayo Clinic Study of Aging, the Baltimore Longitudinal Study of Aging, and the Aging, Demographics, and Memory Study. There is a general consensus that the single most important factor determining prevalence estimates of Alzheimer’s disease (AD) is the severity of cognitive impairment used as a threshold to define cases. Studies that require a level of cognitive impairment in which persons are unable to provide self-care will have much lower estimates than the studies aimed at identifying persons in the earliest stages of AD. There are limited autopsy data from the aforementioned epidemiological studies to address accuracy in the diagnosis of etiological subtype, namely the specification of AD alone or in combination with other types of pathology. However, other community-based cohort studies show that many persons with mild cognitive impairment and also some persons without dementia or mild cognitive impairment meet pathological criteria for AD, thereby suggesting that the number of persons who would benefit from an effective secondary prevention intervention is probably higher than the published prevalence estimates. Improved accuracy in the clinical diagnosis of AD is anticipated with the addition of molecular and structural biomarkers in the next generation of epidemiological studies.

Das Verhältnis von Psychiatrie und Neurologie

Neurology and psychiatry deal with diseases of the (central) nervous system. Historically neurological disorders are related to a proven organic basis, whereas psychiatric disorders are mainly defined by the phenomenology and course of the symptoms. Neuroscientific research methods such as molecular genetics, neurochemistry, neurophysiology, neuropathology, functional (SPECT, PET, fMRI) or structural (MRI) imaging have dramatically increased our knowledge of psychiatric and neurological disorders in the last 20 years. Accordingly diagnostic and therapeutic procedures and the long-term prognosis of numerous diseases in both disciplines have substantially improved (i.e. pharmacotherapy, psychotherapy, functional neurosurgery). For major brain disorders - such as dementia of the Alzheimer type - close collaboration between both disciplines is developing in diagnosis, therapy and care. Due to common neurobiological research topics, educational programs, medical training and the challenges of assuring appropriate care to patients with brain disorders, further cooperation between neurology and psychiatry is expected and necessary.

P37-10 Detection of the dementia of the Alzheimer type using easy Z-score imaging system and voxel-based specific regional analysis system

P37-10 Detection of the dementia of the Alzheimer type using easy Z-score imaging system and voxel-based specific regional analysis system

Spatial correlation between brain aerobic glycolysis and amyloid-β (Aβ) deposition

Amyloid-β (Aβ) plaque deposition can precede the clinical manifestations of dementia of the Alzheimer type (DAT) by many years and can be associated with changes in brain metabolism. Both the Aβ plaque deposition and the changes in metabolism appear to be concentrated in the brain's default-mode network. In contrast to prior studies of brain metabolism which viewed brain metabolism from a unitary perspective that equated glucose utilization with oxygen consumption, we here report on regional glucose use apart from that entering oxidative phosphorylation (so-called "aerobic glycolysis"). Using PET, we found that the spatial distribution of aerobic glycolysis in normal young adults correlates spatially with Aβ deposition in individuals with DAT and cognitively normal participants with elevated Aβ, suggesting a possible link between regional aerobic glycolysis in young adulthood and later development of Alzheimer pathology.

Prevalence of Primitive Reflexes and Parkinsonian Signs in Dementia

Primitive reflexes and parkinsonian signs are used by clinicians to differentiate among dementias. We reviewed our clinical sample to determine whether primitive reflexes were more prevalent in frontally-based dementias and whether parkinsonian signs were more common in dementia with Lewy bodies (DLB) than in other types of dementia. We retrospectively reviewed charts from 204 patients with dementia who presented for consultation at Baycrest's Ross Memory Clinic between April, 2003, to December, 2007. A greater proportion of subjects with DLB and dementia of the Alzheimer type with cardiovascular disease had primitive reflexes than subjects with frontotemporal dementia (FTD). Primitive reflexes were not positively predictive of FTD or vascular dementia (VaD). Dementia with Lewy bodies subjects were more likely to have parkinsonian signs than the other dementias, and bradykinesia and rigidity were positively predictive of FTD. The palmomental reflex was the most common primitive reflex in the sample, and cogwheeling was the most common parkinsonian sign. There was no significant difference between early- and late-stage groups in presence of primitive reflexes or parkinsonian signs. Primitive reflexes appear not to be clinically discriminative of frontally-based dementias such as FTD and VaD.

Protective Effect of Naringin, a Citrus Flavonoid, Against Colchicine-Induced Cognitive Dysfunction and Oxidative Damage in Rats

Alzheimer's disease is a neurodegenerative disorder. Central administration of colchicine is well known to cause cognitive impairment and oxidative damage, which simulates sporadic dementia of the Alzheimer type in humans. The present study has been designed to investigate the protective effects of naringin against the colchicine-induced cognitive impairment and oxidative damage in rats. Colchicine (15 microg/5 microL), administered intracerebroventricularly, resulted in poor memory retention in both the Morris water maze and elevated plus maze task paradigms and caused marked oxidative damage. It also caused a significant decrease in acetylcholinesterase activity. Naringin (40 and 80 mg/kg, p.o.) treatment was given daily for a period of 25 days beginning 4 days prior to colchicine administration. Chronic treatment with naringin caused significant improvement in the cognitive performance and attenuated oxidative damage, as evidenced by lowering of malondialdehyde level and nitrite concentration and restoration of superoxide dismutase, catalase, glutathione S-transferase, and reduced glutathione levels, and acetylcholinesterase activity compared to control. The present study highlights the therapeutic potential of naringin against colchicine-induced cognitive impairment and associated oxidative damage.

Alzheimer disease identification using amyloid imaging and reserve variables

Several factors may influence the relationship between Alzheimer disease (AD) lesions and the expression of dementia, including those related to brain and cognitive reserve. Other factors may confound the association between AD pathology and dementia. We tested whether factors thought to influence the association of AD pathology and dementia help to accurately identify dementia of the Alzheimer type (DAT) when considered together with amyloid imaging. Participants with normal cognition (n = 180) and with DAT (n = 25), aged 50 years or older, took part in clinical, neurologic, and psychometric assessments. PET with the Pittsburgh compound B (PiB) tracer was used to measure brain amyloid, yielding a mean cortical binding potential (MCBP) reflecting PiB uptake. Logistic regression was used to generate receiver operating characteristic curves, and the areas under those curves (AUC), to compare the predictive accuracy of using MCBP alone vs MCBP together with other variables selected using a stepwise selection procedure to identify participants with DAT vs normal cognition. The AUC resulting from MCBP alone was 0.84 (95% confidence interval [CI] = 0.73-0.94; cross-validated AUC = 0.80, 95% CI = 0.68-0.92). The AUC for the predictive equation generated by a stepwise model including education, normalized whole brain volume, physical health rating, gender, and use of medications that may interfere with cognition was 0.94 (95% CI = 0.90-0.98; cross-validated AUC = 0.91, 95% CI = 0.85-0.96), an improvement (p = 0.025) over that yielded using MCBP alone. Results suggest that factors reported to influence associations between AD pathology and dementia can improve the predictive accuracy of amyloid imaging for the identification of symptomatic AD.

Effects of light exposure on rest-activity rhythm in elderly institutional residents with dementia of the Alzheimer type

Effects of light exposure on rest-activity rhythm in elderly institutional residents with dementia of the Alzheimer type