Prevalence Of AD Research Articles

Les facteurs de rémission du trouble de l’adaptation : la parole aux patients. Une étude qualitative

BackgroundAdjustment disorder (AD) is a frequent clinical diagnosis defined by the patient's reaction to an external factor and reversibility. While it is known that the prevalence of AD varies depending on setting and diagnostic tools utilized, the literature is rather scarce when it comes to AD's investigation or remission factors. Unlike other psychiatric disorders, the fact that there is a factor triggering AD makes it especially suitable to learn more about triggering elements, reversibility and factors of remission. ObjectivesTo study the evolution of AD, to identify and categorize AD remission factors from the patient's perspective. MethodsWe interviewed by means of semi-structured approach patients (n=11) who consulted the emergency and crisis psychiatric unit of Lausanne University Hospital (CHUV) for an AD and who presented a positive evolution in the following four months. Interviews were transcribed and then analyzed to identify and categorize the remission factors evoked by the patients; categorization was then confirmed by a consensus within the research group. ResultsWe identified three main categories of remission factors (aggregated from 11 subcategories and 101 items) based on the interviews: (i) relational factors (5 subcategories, 46 items), (ii) personal factors (5 subcategories, 36 items) and (iii) factors related to life events (3 subcategories, 19 items). No patient explained his remission by factors of one single category. On the contrary, our study reveals that a variety of remission factors exists, with 4 to 14 different factors having been reported to play a crucial role in remission of AD. ConclusionsRelationships play an important role in remission of AD, but personal and life events also contribute in a complex way. According to the patients, mental health professionals are part of a favorable evolution of AD, especially by means of their containing presence, their neutrality and their invitation to “think with the patient”. Our observations call for a therapeutic intervention with a particular focus on the therapeutic relationship – therapeutic alliance – in which the clinician is aware that remission of AD is multifactorial and dynamic.

Diet as a Risk Factor for Cognitive Decline in African Americans and Caucasians with a Parental History of Alzheimer\u2019s Disease: A Cross-Sectional Pilot Study Dietary Patterns

BackgroundAfrican Americans (AA) are more likely to develop Alzheimer’s disease (AD) than Caucasians (CC). Dietary modification may have the potential to reduce the risk of developing AD.ObjectiveThe objective of this study is to investigate the relationship between Southern and Prudent diet patterns and cognitive performance in individuals at risk for developing AD.DesignCross-sectional observational study.ParticipantsSixty-six cognitively normal AA and CC individuals aged 46–77 years with a parental history of AD were enrolled.MeasurementsParticipants completed a Food Frequency questionnaire, cognitive function testing, which consisted of 8 neuropsychological tests, and cardiovascular risk factor assessments, including evaluation of microvascular and macrovascular function and ambulatory blood pressure monitoring.ResultsResults revealed a relationship between the Southern diet and worse cognitive performance among AAs. AAs who consumed pies, mashed potatoes, tea, and sugar drinks showed worse cognitive performance (p<0.05) compared with CCs. In addition, gravy (p=0.06) and cooking oil/fat (p=0.06) showed negative trends with cognitive performance in AAs. In both CC and AA adults, greater adherence to a Prudent dietary pattern was associated with better cognitive outcomes. Cardiovascular results show that participants are overall healthy. AAs and CCs did not differ on any vascular measure including BP, arterial stiffness and endothelial function.ConclusionResearch shows that dietary factors can associate with cognitive outcomes. This preliminary crosssectional study suggests that foods characteristic of the Southern and Prudent diets may have differential effects on cognitive function in middle-aged individuals at high risk for AD. Results suggest that diet could be a non-pharmaceutical tool to reduce cognitive decline in racially diverse populations. It is possible that the increased prevalence of AD in AA could be partially reduced via diet modification.

Hereditary Disorders in Circassians of the Karachay-Cherkess Republic

The paper aims to review the diversity of monogenic hereditary disorders (MHD) in the Circassians of the Karachay-Cherkess Republic (KCR). In total, 50817 Circassians were investigated. The populations of eight districts (Ust-Dzhegutinsky, Karachayevsky, Malokarachayevsky, Prikubansky, Khabezsky, Abazinsky, Nogaysky, and Adyge-Khablsky) and of the city of Cherkessk were studied. Two hundred fifty patients from 167 families were registered. The prevalence of MHD in Circassians happens to be 1: 214. The nosological spectrum of MHD in Circassians includes 70 disorders: 34 with autosomal dominant, 25 with autosomal recessive, and 11 with X-linked inheritance patterns. Confirmatory DNA diagnostics was performed in 56 patients. Accumulation of particular diseases in the Circassian population was revealed in comparison with the previously surveyed ethnic groups/populations of Russia. The cluster analysis was performed on the basis of the prevalence of AD and AR disorders and determined the genogeographic position of the Circassians among eight ethnic groups of Russia (13 populations in total). The total size of the surveyed populations was over 3.5 million people: six Russian regions, Tatars of the Tatarstan, Bashkirs of the Bashkortostan, Chuvashs of the Chuvash Republic, Maris of the Mari El Republic, Udmurts of the Udmurt Republic, Adygeans of the Republic of Adygea, and Circassians of the Karachay-Cherkess Republic. The general pattern for AD and AR diseases was similar: six Russian populations group within a single cluster, being remote from people of the Volga-Ural region and the North Caucasus (Adyghe: Adygeans and Circassians).

Dermatite atopique de l’adulte : présentation clinique, complications et comorbidités

Atopic dermatitis (DA) is a chronic inflammatory skin disease. Its incidence and prevalence is increasing, especially in industrialized countries. The prevalence of AD in adults is estimated at 1-3 % of the general population and can present as adult-onset AD, or as infantile/childhood AD that persists, or recurs in adulthood. There are no specific diagnostic criteria for adult AD. Diagnosis may be also complicated by the fact that the clinical manifestations sometimes differ from pediatric AD. Moreover, many recent studies have identified adult AD as a systemic disease. Due to its chronicity and comorbidities, Adult AD has a major impact on quality of life and working abilities of affected patients. With the emergence of new treatments, we should see more and more adult AD in the future, a better knowledge of its characteristics is therefore required.

Animation Deformity in Postmastectomy Implant-Based Reconstruction.

A retrospective chart review was completed for patients at least 6 months postoperative from subpectoral, implant-based breast reconstruction using acellular dermal matrix in the lower pole. Patient age, BMI, and implant size were collected. A questionnaire was distributed to the patients. Returned questionnaires were compiled and data were analyzed. Eighty-four of 108 patients (77.8%) returned the questionnaire with 62 (75.6%) reporting AD; 75.6% of patients were aware of AD, 14.6% considered it moderate, and 11% considered it severe. No statistically significant differences in age, body mass index, implant size, or athleticism were found between those who noted AD versus those who did not. Forty-one of 79 patients (51.9%) would have been interested in an initial surgical procedure without AD; interest dropped significantly if the alternative surgery involved increased risk, cost, or additional stages of reconstruction. The prevalence of AD in subpectoral implant-based breast reconstruction is significantly higher than in subpectoral augmentation. The majority of patients expressed interest in an alternative procedure to avoid AD unless it involved increased risk, cost, or additional surgeries. We found insignificant differences in age, athleticism, BMI, and implant size between patients who note AD and those who do not. Further study is necessary to better define patients at risk for AD to guide patient-centered breast reconstruction.

THE ACCURACY OF DEMENTIA DIAGNOSIS IN MEDICARE CLAIMS

Medicare claims are commonly used to identify patients with dementia. But diagnoses recorded in claims may not capture mild dementia cases. Such mis-identification may result in biased estimates of disease prevalence and costs. This study estimates the sensitivity and specificity of Medicare claims to identify dementia in a cohort of older adults with clinically diagnosed dementia. The sample was drawn from participants in the Washington Heights-Inwood Columbia Aging Project (WHICAP), a multiethnic, population-based, prospective study of cognitive aging in which dementia status was assessed using a rigorous clinical protocol. The current study included 455 subjects who were diagnosed with dementia at enrollment and 1,689 subjects who were never diagnosed with dementia any time during the study. ICD-9-CM diagnosis codes in all available Medicare claims were used to determine claims-based identification of dementia. Sensitivity and specificity of claims-identified dementia compared to clinically diagnosed dementia were computed, using clinical diagnosis as the gold standard. Logistic regression was used to estimate the relationship between patient clinical and demographic characteristics and predictive value in claims identification. Medicare claims correctly identified 1,808 cases (agreement rate with clinical diagnosis=84.7%), resulting in a kappa value of 0.43 (moderate agreement). The sensitivity and specificity of dementia identification in Medicare claims was 0.38 and 0.97, respectively. Among subjects clinically diagnosed with dementia, 281 (61.8%) were not identified in Medicare claims as demented. Individuals with a clinical diagnosis of dementia but not identified as having dementia in the claims data were younger, with lower education, eligible for Medicaid, had fewer comorbidities, and better function and cognition than those for whom there was agreement between claims data and clinical diagnosis. Among those who were clinically diagnosed as non-demented, 55 (3.2%) were identified in the claims as demented. Disagreement in this group was associated with older age, unmarried status, more comorbidities, worse function and cognition. Mis-identification of dementia in Medicare claims is quite common, although there are both false positive and negative assessments of disease. Both clinical and sociodemographic characteristics affect predictive value of claims-based diagnoses. Mis-identification may be associated with biased estimation of disease prevalence and cost of AD.

Cost-effectiveness of cerebrospinal biomarkers for the diagnosis of Alzheimer\u2019s disease

BackgroundAccurate and timely diagnosis of Alzheimer’s disease (AD) is important for prompt initiation of treatment in patients with AD and to avoid inappropriate treatment of patients with false-positive diagnoses.MethodsUsing a Markov model, we estimated the lifetime costs and quality-adjusted life-years (QALYs) of cerebrospinal fluid biomarker analysis in a cohort of patients referred to a neurologist or memory clinic with suspected AD who remained without a definitive diagnosis of AD or another condition after neuroimaging. Parametric values were estimated from previous health economic models and the medical literature. Extensive deterministic and probabilistic sensitivity analyses were performed to evaluate the robustness of the results.ResultsAt a 12.7% pretest probability of AD, biomarker analysis after normal neuroimaging findings has an incremental cost-effectiveness ratio (ICER) of $11,032 per QALY gained. Results were sensitive to the pretest prevalence of AD, and the ICER increased to over $50,000 per QALY when the prevalence of AD fell below 9%. Results were also sensitive to patient age (biomarkers are less cost-effective in older cohorts), treatment uptake and adherence, biomarker test characteristics, and the degree to which patients with suspected AD who do not have AD benefit from AD treatment when they are falsely diagnosed.ConclusionsThe cost-effectiveness of biomarker analysis depends critically on the prevalence of AD in the tested population. In general practice, where the prevalence of AD after clinical assessment and normal neuroimaging findings may be low, biomarker analysis is unlikely to be cost-effective at a willingness-to-pay threshold of $50,000 per QALY gained. However, when at least 1 in 11 patients has AD after normal neuroimaging findings, biomarker analysis is likely cost-effective. Specifically, for patients referred to memory clinics with memory impairment who do not present neuroimaging evidence of medial temporal lobe atrophy, pretest prevalence of AD may exceed 15%. Biomarker analysis is a potentially cost-saving diagnostic method and should be considered for adoption in high-prevalence centers.

Multiplanar evaluation of radiological findings associated with acetabular dysplasia and investigation of its prevalence in an Asian population: a CT-based study

BackgroundAcetabular dysplasia (AD) is a well-known cause of osteoarthritis (OA) of the hip, with its prevalence previously determined on plain radiography. The prevalence of preexisting AD was reported as 7.3% in a patient-based Asian population. Although computed tomography (CT) could evaluate AD in multiple planes, its prevalence using multiplanar CT images has not been reported. We investigated its prevalence with CT on coronal, axial, and sagittal planes and then determined if adding the axial and sagittal planes enhanced the investigation.MethodsWe retrospectively examined 52 consecutive Japanese individuals (mean age 59.4 years) who had undergone CT for conditions unrelated to hip disorders. The inclusion criteria of CT images were (1) reconstructed axial slice thickness of ≤1 mm and (2) normal pelvic rotations and tilt. Exclusion criteria were (1) age <20 years, (2) neither hip center could be clearly detected, (3) evidence of hip OA. The parameters used to define AD on the coronal plane were the center–edge angle, Sharp angle, acetabular index, acetabular depth ratio, and acetabulum head index. The anterior and posterior acetabular sector angles were used as axial parameters and the vertical-center-anterior margin angle as the sagittal parameter. AD prevalence was calculated using multiplanar images and then compared with the previously reported Asian prevalence using 95% confidence intervals (CI). In this study, we defined “prevalence” as the proportion of subjects who had AD in at least one hip.ResultsThe mean prevalence of AD on coronal, axial, and sagittal planes was 16.9, 15.4, and 7.7%, respectively. The lowest prevalence found by combining the three planes was 25.0% (95% CI 15.2–38.2%). This prevalence was significantly higher than that in the previously reported Asian population (7.3%).ConclusionsAt the lowest estimate, the prevalence of AD evaluated in three planes was more than twice as high as the previously reported prevalence in Asians when we investigated its prevalence using multiplanar images. The prevalence of AD in the axial and sagittal planes was not negligible. We therefore suggest that it is important to add axial and sagittal planes’ data when investigating the prevalence of AD.

Antenatal depressive symptoms among pregnant women: Evidence from a Southern Brazilian population-based cohort study

BackgroundAntenatal depression (AD) is a major public health issue but evidence regarding its prevalence and associated factors in low and middle-income countries (LMICs) is limited. The aim of the study was to estimate the prevalence and identify risk factors for AD among Brazilian pregnant women. MethodsAll women living in the urban area of the city of Pelotas, Southern Brazil, with confirmed pregnancy and estimated delivery date in the year 2015, were invited to take part. Eligible pregnant women were recruited from health services. Symptoms of antenatal depression were assessed using the Edinburgh Postnatal Depression Scale (EPDS) by face-to-face interviews. A cutoff-point of 13 or more was used to define probable AD. ResultsEPDS scores were available for 4130 women. The prevalence of AD was 16% (95%CI 14·9–17·1). After adjustment for potential confounders, the factors most strongly associated with higher EPDS scores were a previous history of depression (PR 2·81; 95%CI 2·44-3·25), high parity (PR 1·72; 95%CI 1·38-2·15 - ≥2 children vs. 1 child) and maternal education (PR 5·47; 95%CI 4·22-7·09 - 0–4 vs. ≥12 years of formal education). LimitationsEPDS was administered through face-to-face interviews rather than questionnaires and some women may have felt uncomfortable reporting their symptoms leading to underreporting and consequently underestimation of the prevalence found. ConclusionAD prevalence is substantially higher in Brazil than in high-income countries (HICs) but similar to other LMICs. Our study identified relevant risk factors that may be potential targets to plan interventions, particularly a history of depression.

Prevalence and Factors Influencing Atopic Dermatitis in Korean Adults in Relation to Vitamin D Levels: Data from the Korea National Health and Nutrition Examination Survey 2008-2013

Purpose: The objective of this study was to identify the factors related to atopic dermatitis and its prevalence among Korean adults, and to examine the relationship of vitamin D levels to AD prevalence. Methods: Combined data from the 2008-2013 Korea National Health and Nutrition Examination Survey were analyzed by using the chi-squared test and multivariable logistic regression. Results: AD prevalence among 27,860 Korean adults was 2.7% and varied significantly with age, body mass index, and vitamin D levels, as well as presence of asthma, depression, and stress. Vitamin D deficiency and insufficiency were found in 66.8% and 27.5%, respectively. Only 5.7% had sufficient vitamin D levels. Age and asthma were factors associated with an increased prevalence of AD in those with vitamin D deficiency (7.57 times and 2.87 times, respectively), and insufficiency (4.42 times and 2.58 times). However, there were no such risk factors in patients with sufficient vitamin D levels. Conclusion: This study showed that patients with higher vitamin D levels have decreased AD prevalence despite risk factors. Development of an intervention program including lifestyle improvement is suggested.

Progression of antepartum depression differs by level of perceived social support and food insecurity

BackgroundAntepartum depression (AD) is a risk factor for adverse pregnancy outcomes and may be worsened by food insecurity (FI) and lack of social support (SS). We studied the progression of AD from mid gestation to term and examined whether such progression differed by measures of SS and longitudinal measures of FI.Methods403 women were recruited (mean (±SD) gestational age =19.4 (±−3.8) weeks) and followed to term or dropout. At baseline, SS was assessed using a modified Duke‐UNC functional scale. Women were binned into 2 SS groups, based on scoring &lt; or ≥ than the median SS value. FI (IFIAS) and AD (CES‐D≥17) were assessed at each visit using validated scales. Other variables were assessed at baseline using structured tools. Separately by SS category, we used mixed effects logistic regression models to examine the progression of AD; and, assessed whether such AD progression differed by longitudinal measures of FI.ResultsAt baseline, 55.8% of the pregnant women belonged to the higher SS group. At this time point, the prevalence of AD among women in the low SS group (80.9%) was 2 times higher than similar levels in the higher SS group (40.4%). AD in the low SS group tended to decline with increasing gestational age but was always more prevalent than AD in the high SS group. In both SS groups, the progression of AD was positively associated with longitudinal measures of FI; and, the effect of FI on the progression of AD attained statistical significance among women in the low SS group. In the adjusted analyses, the probability of AD was three times higher among food insecure women in the low SS group than it was among food secure women in the high SS category.ConclusionsWe observed high levels of antepartum depression among women in northern Uganda that differed by social support and food insecurity suggesting the need for integrating mental health services that include food security and social support components into antenatal programs in this or similar contexts.Support or Funding InformationThis research was funded in part by Cornell University Weill Medical College Intercampus Seed Funds, K01 MH098902 from NIMH and USAID Cooperative Agreement AIDOAAL1000006

Prevalence of and risk factors for atopic dermatitis: A birth cohort study of infants in southeast Turkey

BackgroundAtopic dermatitis (AD) is most common in the first year of life. The aim of this study was to determine the prevalence of and risk factors for AD in a birth cohort of infants from southeast Turkey. MethodsAdana Paediatric Allergy Research (ADAPAR) birth cohort study was derived from 1377 infants who were born in Cukurova University, Medical Hospital, Adana, Turkey between February 2010 and February 2011. At birth, a physical examination was performed, cord blood samples were taken, and the mother completed a baseline questionnaire that provided data on gestational conditions, family history of allergic diseases and environmental exposures. Follow-up visits scheduled at 3, 6, and 12 months included an infant physical examination and an extended questionnaire. Skin prick test was performed and food-specific IgE levels were measured at 6 and 12 months. Atopic dermatitis was diagnosed based on confirmatory examination by a physician. ResultsOf the 1377 infants enrolled, 59 (4.3%) were diagnosed with AD as of 12 months. Maternal allergic disease (ORs 6.28, 95% CI 1.03–38.30; p=0.046), maternal infection during gestation (ORs 3.73, 95% CI 1.25–11.09; p=0.018), and presence of food allergy (ORs 13.7, 95% CI 3.07–61.0; p=0.001) were identified as risk factors for AD. Breastfeeding and cord blood IgE levels were not identified as risk factors. ConclusionsIn this cohort we found prevalence of AD as 4.3% during the first year of life. Positive family history of atopic diseases, prenatal infections and presence of food allergy are the risk factors for early presentation of AD.

Screening of Early and Late Onset Alzheimer's Disease Genetic Risk Factors in a Cohort of Dementia Patients from Liguria, Italy.

Cohorts from a defined geographical area enable ad hoc genotype-phenotype correlation studies providing novel and unique insight into disease. We analysed genetic risk factors associated with early and late onset Alzheimer's disease (EOAD and LOAD) in a population from Liguria (northern Italy), as part of an ongoing longitudinal study. We screened 37 AD, 8 mild cognitive impairment (MCI), 3 AD and CVD (cerebrovascular disease), 3 MCI and CVD, 8 frontotemporal dementia (FTD) and 2 progressive supranuclear palsy (PSP) patients, and 28 normal controls (NCs).We sequenced PSEN1, PSEN2 and APP (EOAD risk factors), as well as MAPT, GRN and TARDBP for all cases and NCs, and analysed the APOE, CLU, CR1 and PICALM genotypes as well as the MAPT and ACE haplotypes (LOAD risk factors) for the AD (n = 37) and AD + MCI (n = 45) cases and NCs (n = 28).We identified variants in PSEN1, PSEN2 and TARDBP across a range of phenotypes (AD, AD and CVD, FTD and PSP), suggesting that screening of all known candidate genes of Alzheimer's and non-Alzheimer's forms of dementias in all dementia cases might be warranted. The analysis of the LOAD risk factors revealed no association with AD or AD + MCI status after Bonferroni correction. Lack of association with APOE is supported by previous studies in the Italian population. Our data also evidenced: 1) a potentially protective haplotype at the PSEN2 locus; 2) a nominal association with the GWAS-risk allele A for rs3818361 in CR1 and; 3) a threefold prevalence of AD in the female population compared to men.Our results will need to be further assessed and confirmed in larger cohorts from this area.

High Temperatures And Air Pollution: Investigating Interactive Effects On Atopic Dermatitis For Children

Introduction Atopic dermatitis (AD, also known as atopic eczema) is driven by a complex relationship between genetic predisposition and environmental exposures. Although few studies have proposed that ambient temperature variability is one of the main markers, seldom studies investigated the relationship between ambient temperature and the prevalence of AD for children, especially considering the modification effects of particulate matters. Methods We applied a distributed lag non-linear model (DLNM) combined with non-linear interaction terms to assess not only the effects of ambient temperature, but also the modifying effects of particulate matters with an aerodynamic diameter of 2.5μm (PM2.5) or less on the association between mean temperature and outpatient visits for children with AD during 2012 and 2014 in Beijing, China. We calculated hot effects (1 ℃ above the threshold), given that PM2.5 equaled 0μg/m3, the 25th, 50th and 75th percentile of PM2.5, respectively. Results The associations between temperature and outpatient visits for children with AD were non-linear. Only high temperatures increased the risk of daily outpatient visits for children with AD, with a threshold approximately 21.3℃. The cumulative relative hot effect was 1.051(95% confidence interval (CI):1.023, 1.079). Statistically significant interaction effects were found between PM2.5 and high temperatures on outpatient visits for children with AD. On highly polluted days (given that PM2.5 equaled 75th percentile of PM2.5), the cumulative relative risk of high temperature over lags of 0-20 days was 1.35(95%CI: 1.14, 1.61). Conclusion High temperatures are significantly associated with outpatient visits for children with AD. Enhanced adverse high temperatures effects were found at higher levels of PM2.5, which implies that it may be important to evaluate synergistic effects and not only pure temperature or air pollution effects.

Alcohol dependence and treatment utilization in Europe - a representative cross-sectional study in primary care.

BackgroundAlcohol dependence (AD) in Europe is prevalent and causes considerable health burden. Recognition by general practitioners (GPs) and provision of or referral to treatment may contribute to reduce this burden. This paper studied AD prevalence in varying European primary care settings and examined who received treatment.MethodsIn a cross-sectional multi-centre study in six European countries, 358 general practitioners assessed 13,003 primary care patients between January 2013 and January 2014, of which 8,476 patients were interviewed, collecting information on socio-demographics, physical and mental problems, and on alcohol use, problems and treatment. AD diagnoses were determined by GPs’ clinical judgement and a standardized interview. A wide definition for AD treatment included individual and group interventions provided by different health professionals. Descriptive as well as inferential statistics were employed.ResultsAD was prevalent among patients in European primary health care settings (8.7 %, 95 % confidence interval (CI): 8.1-9.3 %). Treatment rates were low (22.3 % of all AD cases, 95 % CI: 19.4-25.2 %). For both prevalence and treatment utilization, considerable country variations were observed. AD was associated with a number of socio-economic disadvantages (e.g. higher unemployment rate) and higher physical (e.g., liver disease, hypertension) and mental comorbidities (e.g., depression, anxiety). Liver problems, mental distress and daily amount of alcohol used were higher among treated versus untreated male patients with AD.ConclusionA minority of people identified as having AD received treatment, showing heavier drinking patterns and a higher level of co-morbidity. Different types of treatment, depending on severity of AD, should be considered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-015-0308-8) contains supplementary material, which is available to authorized users.

An Investigation of the Risk Factors and Prevalence of Alzheimer’s Disease in the Eastern Region of Turkey: A Population Based Door-to-Door Survey

The relationships between the prevalence of AD, socio-demographic characteristics, and other chronic diseases were researched within the population aged 65 and over living in Erzurum city center. The study was realized between June of 2010 and July of 2011. It involved 455 people over age 65 living in Erzurum city center. The Mini-Mental State Examination and Daily Living Scale were applied to participants. A total of 455 people participated in the study. AD was detected in 29 people. Twenty-one participants were female, and eight were male. The prevalence of AD was calculated to be 6.4%. According to the results of a logistic regression analysis, the AD prevalence detection rate in the a 75-84 age group was ten times greater than in the 65-74 age group, and the rate in the 85 and over group was 36 times greater than in the 65-74 age group. AD is more common in women than in men. The rate increases 4.1-fold among those with AD diabetes mellitus disease, 3.9-fold among those with Parkinson’s disease, 2.6-fold among those with heart disease, and 4.2-fold among those with dementia in their families. AD prevalence for those age of 65 and over was shown to be 6.4% in our study. The risk of AD increases 17-fold with increasing age. The risk of developing AD also increases in cases of chronic diseases.

Analysis of regional prevalence of allergic diseases in Korean school children

Purpose: This study aimed to analyze the prevalence of allergic diseases in Korean schoolchildren according to their residential areas in 2010. Methods: A nationwide, cross-sectional study was conducted in children aged 6.7 years (n=4,003) and adolescents aged 12.13 years (n=4,112) who were randomly selected. Demographic and disease-related information was obtained through a Korean version of ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire, and skin prick tests for 18 inhalant allergens were performed. Results: There was statistically significant regional difference in the prevalence of allergic rhinitis (AR) (P<0.05). The regions with highest and lowest prevalence in 12- to 13-year-old children were as follows: Chungcheong and Honam in “Diagnosis of AR, ever” (33.7% vs. 24.5%), Jeju and Yeongnam in “Treatment of AR, last 12 months” (25.5% vs. 18.0%), Chungcheong and Yeongnam in “Rhinitis with sensitization” (31.6% vs. 23.6%). The regions with highest and lowest prevalence in 6.7 years old children were as follows: Yeongnam and Seoul in “Diagnosis of AR, ever” (42.1% vs. 31.0%), Yeongnam and Jeju in “Treatment of AR, last 12 months” (31.8% vs. 21.9%), Jeju and Seoul in “Rhinitis with sensitization” (26.0% vs. 18.4%). We also found a regional difference in inhalant allergens among the children with “rhinitis with sensitization”. Conclusion: The prevalence of AR in children differs according to residential areas in a nationwide survey in 2010 while there is no significant regional difference in the prevalence of asthma and AD.

African-American TOMM40'523-APOE haplotypes are admixture of West African and Caucasian alleles

BackgroundSeveral studies have demonstrated a lower apolipoprotein E4 (APOE ε4) allele frequency in African-Americans, but yet an increased age-related prevalence of AD. An algorithm for prevention clinical trials incorporating TOMM40'523 (Translocase of Outer Mitochondria Membrane) and APOE depends on accurate TOMM40'523-APOE haplotypes. MethodsWe have compared the APOE and TOMM40'523 phased haplotype frequencies of a 9.5 kb TOMM40/APOE genomic region in West African, Caucasian, and African-American cohorts. ResultsAfrican-American haplotype frequency scans of poly-T lengths connected in phase with either APOE ε4 or APOE ε3 differ from both West Africans and Caucasians and represent admixture of several distinct West African and Caucasian haplotypes. A new West African TOMM40'523 haplotype, with APOE ε4 connected to a short TOMM40'523 allele, is observed in African-Americans but not Caucasians. ConclusionThese data have therapeutic implications for the age of onset risk algorithm estimates and the design of a prevention trial for African-Americans or other mixed ethnic populations.

Présentation clinique de cas marocains atteints de la maladie d’Alzheimer

The diagnostic approach for Alzheimer's disease is based on the presence of cerebral atrophy combined with the score of the mini-examination of the mental state. In this context, this study was conducted to assess the correlation between imaging and neuropsychological testing for cases of early-onset and late-onset Alzheimer's disease. Analysis of the clinical and paraclinical aspects of Moroccan cases with Alzheimer's disease. Seventeen sporadic cases and 8 family cases were seen at the memory clinic of the Neurology Department of the University of Casablanca Ibn Rochd Hospital. A family history was obtained through a clinical interview of the patient and a yes or no self-reporting questionnaire from the guardian or other family member. The disease was considered familial if at least one additional first degree relative suffered from early-onset AD-type dementia. All patients underwent standard somatic neurological examination, cognitive function assessment, brain imaging and laboratory tests. Written consent was obtained from the patients and their guardians prior to the study. In our study of 25 individuals, the observed mean age of AD patients was 64.52 ± 9.30 and we observed a slight female predominance (56% versus 44%). In addition, we found a prevalence of AD of approximately 20%, increasing with age, in the population below 60 years of age. Approximately half of our patients (48%) had a score lower than 10 and were affected by severe insanity, while 28% were affected by moderate severe insanity and 24% were light to moderately insane. Twenty-five patients underwent neuroimaging, 18 of whom were assessed by MRI, while 7 were assessed by CT. All patients had hippocampal atrophy, which progressed to affect others brain regions. The blood tests showed no abnormalities in the 25 enrolled AD cases. Age is undoubtedly the main risk factor for AD; this is also the true for our cases where advanced age was responsible for the exponential increase of the disease's frequency; it reached a peak in the age group of 60-69 years. The AD diagnosis approach is based on the presence of cerebral atrophy combined with the score of the mini-examination of the mental state (MMSE). In our study, in addition to the MMSE, depending on the level of education, the clinician used other tests that do not necessarily require a level of education such as the BEC96, visual short-term or digital memory assessment, work memory assessment, language assessment test (DO80) and apraxia. Neuropsychological examination of the cases with a score of less than 10 showed severe cognitive impairment. The cases presented memory and language impairments, aphasia, visual spatial disorientation, decreased autonomy, executive dysfunction and praxis deficits, all major causes of severe dementia. Neuroimaging revealed hippocampal and cortical atrophy. Correlated with the other studies that aimed to establish links between brain alterations and neuropsychological disorders, we can conclude that a higher level of atrophy reflects a decrease in neuropsychological performance.

Type 3 diabetes is sporadic Alzheimer׳s disease: Mini-review

Alzheimer׳s disease (AD) is the most common cause of dementia in North America. Growing evidence supports the concept that AD is a metabolic disease mediated by impairments in brain insulin responsiveness, glucose utilization, and energy metabolism, which lead to increased oxidative stress, inflammation, and worsening of insulin resistance. In addition, metabolic derangements directly contribute to the structural, functional, molecular, and biochemical abnormalities that characterize AD, including neuronal loss, synaptic disconnection, tau hyperphosphorylation, and amyloid-beta accumulation. Because the fundamental abnormalities in AD represent effects of brain insulin resistance and deficiency, and the molecular and biochemical consequences overlap with Type 1 and Type 2 diabetes, we suggest the term “Type 3 diabetes” to account for the underlying abnormalities associated with AD-type neurodegeneration. In light of the rapid increases in sporadic AD prevalence rates and vastly expanded use of nitrites and nitrates in foods and agricultural products over the past 30–40 years, the potential role of nitrosamine exposures as mediators of Type 3 diabetes is discussed.