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1.
Thanh G.N. Ton Thomas DeLeire Suepattra G. May Ningqi Hou Mahlet G. Tebeka Er Chen Joshua Chodosh 《Alzheimer's & dementia》2017,13(3):217-224
Introduction
Individuals with amnestic mild cognitive impairment (aMCI) are at elevated risk of developing Alzheimer's disease (AD) dementia.Methods
With data from the Aging, Demographics, and Memory Study, we used the Clinical Dementia Rating Sum of Boxes classifications to conduct a cross-sectional analysis assessing the relationship between cognitive state and various direct and indirect costs and health care utilization patterns.Results
Patients with aMCI had less medical expenditures than patients with moderate and severe AD dementia (P < .001) and were also significantly less likely to have been hospitalized (P = .04) and admitted to nursing home (P < .001). Compared to individuals with normal cognition, patients with aMCI had significantly less household income (P = .018).Discussion
Patients with aMCI had lower medical expenditures than patients with AD dementia. Poor cognitive status was linearly associated with lower household income, higher medical expenditures, higher likelihood of nursing and home care services, and lower likelihood of outpatient visits. 相似文献2.
Hugh C. Hendrie Mengjie Zheng Wei Li Kathleen Lane Roberta Ambuehl Christianna Purnell Frederick W. Unverzagt Alexia Torke Ashok Balasubramanyam Chris M. Callahan Sujuan Gao 《Alzheimer's & dementia》2017,13(2):111-118
Introduction
High blood glucose levels may be responsible for the increased risk for dementia in diabetic patients.Methods
A secondary data analysis merging electronic medical records (EMRs) with data collected from the Indianapolis–Ibadan Dementia project (IIDP). Of the enrolled 4105 African Americans, 3778 were identified in the EMR. Study endpoints were dementia, mild cognitive impairment (MCI), or normal cognition. Repeated serum glucose measurements were used as the outcome variables.Results
Diabetic participants who developed incident dementia had a significant decrease in serum glucose levels in the years preceding the diagnosis compared to the participants with normal cognition (P = .0002). They also had significantly higher glucose levels up to 9 years before the dementia diagnosis (P = .0367).Discussion
High glucose levels followed by a decline occurring years before diagnosis in African American participants with diabetes may represent a powerful presymptomatic metabolic indicator of dementia. 相似文献3.
María M. Corrada Kathleen M. Hayden Annlia Paganini-Hill Szofia S. Bullain Jaime DeMoss Colette Aguirre Ron Brookmeyer Claudia H. Kawas 《Alzheimer's & dementia》2017,13(2):103-110
Introduction
We investigated the association between age of onset of hypertension and dementia risk in an oldest-old cohort.Methods
Participants are from The 90+ Study, a population-based longitudinal study of people aged 90+ who are survivors from the Leisure World Cohort Study. We estimated hypertension onset age using self-reported information from The 90+ Study and Leisure World Cohort Study, collected about 20 years earlier. A total of 559 participants without dementia were followed every 6 months for up to 10 years.Results
A total of 224 participants developed dementia during follow-up (mean = 2.8 years). Compared with those without hypertension, participants whose hypertension onset age was 80 to 89 years had a lower dementia risk (hazard ratio = 0.58, P = .04) and participants with an onset age of 90+ years had the lowest risk (hazard ratio = 0.37, P = .004).Discussion
Developing hypertension at older ages may protect against dementia. Understanding the mechanisms for this lower risk is important for determining ways to prevent dementia in the very elderly. 相似文献4.
Joanna M. Wardlaw Stephen J. Makin Maria C. Valdés Hernández Paul A. Armitage Anna K. Heye Francesca M. Chappell Susana Muñoz-Maniega Eleni Sakka Kirsten Shuler Martin S. Dennis Michael J. Thrippleton 《Alzheimer's & dementia》2017,13(6):634-643
Introduction
Small vessel disease (SVD) is a common contributor to dementia. Subtle blood-brain barrier (BBB) leakage may be important in SVD-induced brain damage.Methods
We assessed imaging, clinical variables, and cognition in patients with mild (i.e., nondisabling) ischemic lacunar or cortical stroke. We analyzed BBB leakage, interstitial fluid, and white matter integrity using multimodal tissue-specific spatial analysis around white matter hyperintensities (WMH). We assessed predictors of 1 year cognition, recurrent stroke, and dependency.Results
In 201 patients, median age 67 (range 34–97), BBB leakage, and interstitial fluid were higher in WMH than normal-appearing white matter; leakage in normal-appearing white matter increased with proximity to WMH (P < .0001), with WMH severity (P = .033), age (P = .03), and hypertension (P < .0001). BBB leakage in WMH predicted declining cognition at 1 year.Discussion
BBB leakage increases in normal-appearing white matter with WMH and predicts worsening cognition. Interventions to reduce BBB leakage may prevent SVD-associated dementia. 相似文献5.
Camille Amadieu Sophie Lefèvre-Arbogast Cécile Delcourt Jean-François Dartigues Catherine Helmer Catherine Féart Cécilia Samieri 《Alzheimer's & dementia》2017,13(10):1125-1132
Introduction
Several nutrients may predict dementia risk. We characterized nutrient biomarker patterns, which integrate the complexity of nutrient exposure and biodisponibility associated with long-term risk of dementia in a large cohort of older persons, the Three-City study.Methods
We included 666 nondemented participants with plasma measurements of 22 fat-soluble nutrients at baseline, who were followed up for 12 years for dementia.Results
A “deleterious” pattern combining lower blood status in vitamin D, carotenoids, and polyunsaturated fats and higher saturated fats was strongly associated with a higher risk of dementia. Compared with individuals in the first quintile of the pattern score, participants in the highest quintile of score had an approximately fourfold increased risk of dementia (hazard ratio = 4.53 [95% confidence interval 1.99, 10.32], P for trend <.001) in multivariate models.Discussion
A blood pattern reflecting lower status in several nutrients among nondemented individuals appeared strongly associated with the long-term risk of dementia in this cohort. 相似文献6.
Matthew P. Pase Jayandra J. Himali Paul F. Jacques Charles DeCarli Claudia L. Satizabal Hugo Aparicio Ramachandran S. Vasan Alexa S. Beiser Sudha Seshadri 《Alzheimer's & dementia》2017,13(9):955-964
Introduction
Excess sugar consumption has been linked with Alzheimer's disease (AD) pathology in animal models.Methods
We examined the cross-sectional association of sugary beverage consumption with neuropsychological (N = 4276) and magnetic resonance imaging (N = 3846) markers of preclinical Alzheimer's disease and vascular brain injury (VBI) in the community-based Framingham Heart Study. Intake of sugary beverages was estimated using a food frequency questionnaire.Results
Relative to consuming less than one sugary beverage per day, higher intake of sugary beverages was associated with lower total brain volume (1–2/day, β ± standard error [SE] = ?0.55 ± 0.14 mean percent difference, P = .0002; >2/day, β ± SE = ?0.68 ± 0.18, P < .0001), and poorer performance on tests of episodic memory (all P < .01). Daily fruit juice intake was associated with lower total brain volume, hippocampal volume, and poorer episodic memory (all P < .05). Sugary beverage intake was not associated with VBI in a consistent manner across outcomes.Discussion
Higher intake of sugary beverages was associated cross-sectionally with markers of preclinical AD. 相似文献7.
Stephanie Kielb Emily Rogalski Sandra Weintraub Alfred Rademaker 《Alzheimer's & dementia》2017,13(12):1337-1344
Introduction
Functional and cognitive features of subjective cognitive decline (SCD) were identified in a longitudinal database from the National Alzheimer's Coordinating Center.Methods
Cognitively normal older adults with (SCD+) and without (SCD?) self-reported memory complaints (N = 3915) were compared on (1) baseline Functional Assessment Questionnaire ratings, (2) baseline scores and longitudinal rate of change estimates from nine neuropsychological tests, and (3) final clinical diagnoses.Results
SCD+ had higher baseline ratings of functional impairment, reduced episodic memory practice effects and poorer performance on neuropsychological tests of psychomotor speed and language, and higher frequencies of mild cognitive impairment and dementia diagnoses at the end of follow-up compared with the SCD-group.Discussion
Subtle clinical features of SCD identified in this large cohort are difficult to detect at the individual level. More sensitive tests are needed to identify those with SCD who are vulnerable to cognitive decline and dementia. 相似文献8.
Willa D. Brenowitz Rebecca A. Hubbard C. Dirk Keene Stephen E. Hawes W.T. Longstreth Randy L. Woltjer Walter A. Kukull 《Alzheimer's & dementia》2017,13(6):654-662
Introduction
Whether co-occurring neuropathologies interact or independently affect clinical disease progression is uncertain. We estimated rates of clinical progression and tested whether associations between clinical progression and Alzheimer's disease neuropathology (ADNP) were modified by co-occurring Lewy body disease (LBD) or vascular brain injury (VBI).Methods
Linear mixed effects models evaluated longitudinal trends in the Clinical Dementia Rating Scale Sum of Boxes on 2046 autopsied participants seen at a U.S. Alzheimer's Disease Center.Results
Annual clinical progression was slightly faster for ADNP + LBD compared with ADNP only (P = .06) and slightly slower for ADNP + VBI (P = .003). Differences in progression were less than expected if each neuropathology independently contributed to progression; ADNP interacted with LBD (P = .002) and VBI (P = .003). In secondary models, the effect of additional pathologies on clinical progression was greater in those with intermediate compared with high levels of ADNP.Discussion
The impact of co-occurring pathologies on progression may depend on severity of ADNP. 相似文献9.
Adam S. Fleisher Abhinay D. Joshi Karen L. Sundell Yun-Fei Chen Sara Kollack-Walker Ming Lu Sherry Chen Michael D. Devous John Seibyl Kenneth Marek Eric R. Siemers Mark A. Mintun 《Alzheimer's & dementia》2017,13(10):1117-1124
Introduction
We compared subject-specific white matter (SSWM) and whole cerebellum (CBL) reference regions for power to detect longitudinal change in amyloid positron emission tomography signal.Methods
Positive florbetapir positron emission tomography scans were analyzed from participants (66 placebo treated and 63 solanezumab treated) with mild dementia caused by Alzheimer's disease from the EXPEDITION and EXPEDITION2 studies. For comparison to CBL, a second normalization was performed on longitudinal data using an SSWM correction factor (SSWM normalization ratio [SSWMnr]). Analysis of covariance assessed baseline to 18-month change between treatment with solanezumab and placebo. Sample and effect size estimations provided magnitude of observed treatment changes.Results
Longitudinal percent change between placebo and solanezumab using CBL was not significant (P = .536) but was significant for SSWMnr (P = .042). Compared with CBL, SSWMnr technique increased the power to detect a treatment difference, more than tripling the effect size and reducing the sample size requirements by 85% to 90%.Discussion
Adjusting longitudinal standardized uptake value ratios with an SSWM reference region in these antiamyloid treatment trials increased mean change detection and decreased variance resulting in the substantial improvement in statistical power to detect change. 相似文献10.
Catherine Feart Catherine Helmer Bénédicte Merle François R. Herrmann Cédric Annweiler Jean-François Dartigues Cécile Delcourt Cécilia Samieri 《Alzheimer's & dementia》2017,13(11):1207-1216
Introduction
Hypovitaminosis D has been associated with several chronic conditions; yet, its association with cognitive decline and the risk of dementia and Alzheimer's disease (AD) has been inconsistent.Methods
The study population consisted of 916 participants from the Three-City Bordeaux cohort aged 65+, nondemented at baseline, with assessment of vitamin D status and who were followed for up to 12 years.Results
In multivariate analysis, compared with individuals with 25(OH)D sufficiency (n = 151), participants with 25(OH)D deficiency (n = 218) exhibited a faster cognitive decline. A total of 177 dementia cases (124 AD) occurred: 25(OH)D deficiency was associated with a nearly three-fold increased risk of AD (hazard ratio = 2.85, 95% confidence interval 1.37–5.97).Discussion
This large prospective study of French older adults suggests that maintaining adequate vitamin D status in older age could contribute to slow down cognitive decline and to delay or prevent the onset of dementia, especially of AD etiology. 相似文献11.
Vincent Chouraki Sarah R. Preis Qiong Yang Alexa Beiser Shuo Li Martin G. Larson Galit Weinstein Thomas J. Wang Robert E. Gerszten Ramachandran S. Vasan Sudha Seshadri 《Alzheimer's & dementia》2017,13(12):1327-1336
Introduction
The identification of novel biomarkers associated with Alzheimer's disease (AD) could provide key biological insights and permit targeted preclinical prevention. We investigated circulating metabolites associated with incident dementia and AD using metabolomics.Methods
Plasma levels of 217 metabolites were assessed in 2067 dementia-free Framingham Offspring Cohort participants (mean age = 55.9 ± 9.7 years; 52.4% women). We studied their associations with future dementia and AD risk in multivariate Cox models.Results
Ninety-three participants developed incident dementia (mean follow-up = 15.6 ± 5.2 years). Higher plasma anthranilic acid levels were associated with greater risk of dementia (hazard ratio [HR] = 1.40; 95% confidence interval [CI] = [1.15–1.70]; P = 8.08 × 10?4). Glutamic acid (HR = 1.38; 95% CI = [1.11–1.72]), taurine (HR = 0.74; 95% CI = [0.60–0.92]), and hypoxanthine (HR = 0.74; 95% CI = [0.60–0.92]) levels also showed suggestive associations with dementia risk.Discussion
We identified four biologically plausible, candidate plasma biomarkers for dementia. Association of anthranilic acid implicates the kynurenine pathway, which modulates glutamate excitotoxicity. The associations with hypoxanthine and taurine strengthen evidence that uric acid and taurine may be neuroprotective. 相似文献12.
Elizabeth R. Mayeda M. Maria Glymour Charles P. Quesenberry Julene K. Johnson Eliseo J. Pérez-Stable Rachel A. Whitmer 《Alzheimer's & dementia》2017,13(7):761-769
Introduction
Information on anticipated survival time after dementia diagnosis among racially/ethnically diverse patients is needed to plan for care and evaluate disparities.Methods
Dementia-free health care members aged ≥64 years were followed (1/1/2000–12/31/2013) for dementia diagnosis and subsequent survival (n = 23,032 Asian American; n = 18,778 African American; n = 21,000 Latino; n = 4543 American Indian/Alaska Native; n = 206,490 white). Kaplan–Meier curves were estimated for survival after dementia diagnosis by race/ethnicity. We contrasted mortality patterns among people with versus without dementia using Cox proportional hazards models.Results
After dementia diagnosis (n = 59,494), whites had shortest median survival (3.1 years), followed by American Indian/Alaska Natives (3.4 years), African Americans (3.7 years), Latinos (4.1 years), and Asian Americans (4.4 years). Longer postdiagnosis survival among racial/ethnic minorities compared with whites persisted after adjustment for comorbidities. Racial/ethnic mortality inequalities among dementia patients mostly paralleled mortality inequalities among people without dementia.Discussion
Survival after dementia diagnosis differs by race/ethnicity, with shortest survival among whites and longest among Asian Americans. 相似文献13.
Daniel Jaraj Carsten Wikkelsø Katrin Rabiei Thomas Marlow Christer Jensen Svante Östling Ingmar Skoog 《Alzheimer's & dementia》2017,13(8):850-857
Introduction
We examined mortality, dementia, and progression of hydrocephalic symptoms among untreated individuals with idiopathic normal-pressure hydrocephalus (iNPH) in a population-based sample.Methods
A total of 1235 persons were examined between 1986 and 2012. Shunted individuals were excluded. We examined 53 persons with hydrocephalic ventricular enlargement (probable iNPH: n = 24, asymptomatic or possible iNPH: n = 29). Comparisons were made with individuals without hydrocephalic ventricular enlargement.Results
The 5-year mortality was 87.5% among those with probable iNPH. The hazard ratio (HR) for death was 3.8 (95% confidence interval [CI]: 2.5–6.0) for probable iNPH. Those with possible iNPH and asymptomatic hydrocephalic ventricular enlargement had increased risk of developing dementia, HR 2.8 (95% CI: 1.5–5.2). Only two individuals with hydrocephalic ventricular enlargement remained asymptomatic.Discussion
In the present sample, persons with clinical and imaging signs of iNPH had excess mortality and an increased risk of dementia. The data also suggest that radiological signs of iNPH might be more important than previously supposed. 相似文献14.
Kathleen M. Hayden Daniel P. Beavers Susan E. Steck James R. Hebert Fred K. Tabung Nitin Shivappa Ramon Casanova JoAnn E. Manson Claudia B. Padula Elena Salmoirago-Blotcher Linda G. Snetselaar Oleg Zaslavsky Stephen R. Rapp 《Alzheimer's & dementia》2017,13(11):1187-1196
Introduction
The Mediterranean and Dietary Approaches to Stop Hypertension diets have been associated with lower dementia risk. We evaluated dietary inflammatory potential in relation to mild cognitive impairment (MCI)/dementia risk.Methods
Baseline food frequency questionnaires from n = 7085 women (aged 65–79 years) were used to calculate Dietary Inflammatory Index (DII) scores that were categorized into four groups. Cognitive function was evaluated annually, and MCI and all-cause dementia cases were adjudicated centrally. Mixed effect models evaluated cognitive decline on over time; Cox models evaluated the risk of MCI or dementia across DII groups.Results
Over an average of 9.7 years, there were 1081 incident cases of cognitive impairment. Higher DII scores were associated with greater cognitive decline and earlier onset of cognitive impairment. Adjusted hazard ratios (HRs) comparing lower (anti-inflammatory; group 1 referent) DII scores to the higher scores were group 2-HR: 1.01 (0.86–1.20); group 3-HR: 0.99 (0.82–1.18); and group 4-HR: 1.27 (1.06–1.52).Conclusions
Diets with the highest pro-inflammatory potential were associated with higher risk of MCI or dementia. 相似文献15.
Alex C. Bender Andrea M. Austin Francine Grodstein Julie P.W. Bynum 《Alzheimer's & dementia》2017,13(7):792-800
Introduction
We examined the relationship between health care expenditures and cognition, focusing on differences across cognitive systems defined by global cognition, executive function, or episodic memory.Methods
We used linear regression models to compare annual health expenditures by cognitive status in 8125 Nurses' Health Study participants who completed a cognitive battery and were enrolled in Medicare parts A and B.Results
Adjusting for demographics and comorbidity, executive impairment was associated with higher total annual expenditures of $1488 per person (P < .01) compared with those without impairment. No association for episodic memory impairment was found. Expenditures exhibited a linear relationship with executive function, but not episodic memory ($584 higher for every 1 standard deviation decrement in executive function; P < .01).Discussion
Impairment in executive function is specifically and linearly associated with higher health care expenditures. Focusing on management strategies that address early losses in executive function may be effective in reducing costly services. 相似文献16.
David R. Roalf Tyler M. Moore Dawn Mechanic-Hamilton David A. Wolk Steven E. Arnold Daniel A. Weintraub Paul J. Moberg 《Alzheimer's & dementia》2017,13(8):947-952
Introduction
To provide a crosswalk between the recently proposed short Montreal Cognitive Assessment (s-MoCA) and Mini-Mental State Examination (MMSE) within a clinical cohort.Methods
A total of 791 participants, with and without neurologic conditions, received both the MMSE and the MoCA at the same visit. s-MoCA scores were calculated and equipercentile equating was used to create a crosswalk between the s-MoCA and MMSE.Results
As expected, s-MoCA scores were highly correlated (Pearson r = 0.82, P < .001) with MMSE scores. s-MoCA scores correctly classified 85% of healthy older adults and 91% of individuals with neurologic conditions that impair cognition. In addition, we provide an easy to use table that enables the conversion of s-MoCA score to MMSE score.Discussion
The s-MoCA is quick to administer, provides high sensitivity and specificity for cognitive impairment, and now can be compared directly with the MMSE. 相似文献17.
Lidia Sarro Nirubol Tosakulwong Christopher G. Schwarz Jonathan Graff-Radford Scott A. Przybelski Timothy G. Lesnick Samantha M. Zuk Robert I. Reid Mekala R. Raman Bradley F. Boeve Tanis J. Ferman David S. Knopman Giancarlo Comi Massimo Filippi Melissa E. Murray Joseph E. Parisi Dennis W. Dickson Ronald C. Petersen Kejal Kantarci 《Alzheimer's & dementia》2017,13(3):257-266
Introduction
Cerebrovascular lesions on MRI are common in Alzheimer's disease (AD) dementia, but less is known about their frequency and impact on dementia with Lewy bodies (DLB).Methods
White-matter hyperintensities (WMHs) and infarcts on MRI were assessed in consecutive DLB (n = 81) and AD dementia (n = 240) patients and compared to age-matched and sex-matched cognitively normal subjects (CN) from a population-based cohort.Results
DLB had higher WMH volume compared to CN, and WMH volume was higher in the occipital and posterior periventricular regions in DLB compared to AD. Higher WMH volume was associated with history of cardiovascular disease and diabetes but not with clinical disease severity in DLB. Frequency of infarcts in DLB was not different from CN and AD dementia.Discussion
In DLB, WMH volume is higher than AD and CN and appears to be primarily associated with history of vascular disease. 相似文献18.
Franc Llorens Niels Kruse Matthias Schmitz Nadine Gotzmann Ewa Golanska Katrin Thüne Orgeta Zejneli Eirini Kanata Tobias Knipper Maria Cramm Peter Lange Saima Zafar Beata Sikorska Pawel P. Liberski Eva Mitrova Daniela Varges Christian Schmidt Theodoros Sklaviadis Inga Zerr 《Alzheimer's & dementia》2017,13(6):710-719
Introduction
Accurate diagnosis of prion diseases and discrimination from alternative dementias gain importance in the clinical routine, but partial overlap in cerebrospinal fluid (CSF) biomarkers impedes absolute discrimination in the differential diagnostic context.Methods
We established the clinical parameters for prion disease diagnosis for the quantification of CSF α-synuclein in patients with sporadic (n = 234) and genetic (n = 56) prion diseases, in cases with cognitive impairment/dementia or neurodegenerative disease (n = 278), and in the neurologic control group (n = 111).Results
An optimal cutoff value of 680 pg/mL α-synuclein results in 94% sensitivity and 96% specificity when diagnosing sporadic Creutzfeldt-Jakob disease (CJD). Genetic CJD cases showed increased CSF α-synuclein values. No increased α-synuclein levels were detected in non-CJD cases with rapid progression course.Discussion
Detection of α-synuclein in the CSF of patients with suspected CJD is a valuable diagnostic test reaching almost full discrimination from non-prion disease cases. These data highlight the utility of CSF α-synuclein quantification in front of classical CSF biomarkers in clinical routine. 相似文献19.
Francisca S. Then Tobias Luck Kathrin Heser Annette Ernst Tina Posselt Birgitt Wiese Silke Mamone Christian Brettschneider Hans-Helmut König Siegfried Weyerer Jochen Werle Edelgard Mösch Horst Bickel Angela Fuchs Michael Pentzek Wolfgang Maier Martin Scherer Michael Wagner Martin Scherer 《Alzheimer's & dementia》2017,13(4):431-440
Introduction
Previous studies have demonstrated that an overall high level of mental work demands decreased dementia risk. In our study, we investigated whether this effect is driven by specific mental work demands and whether it is exposure dependent.Methods
Patients aged 75+ years were recruited from general practitioners and participated in up to seven assessment waves (every 1.5 years) of the longitudinal AgeCoDe study. Analyses of the impact of specific mental work demands on dementia risk were carried out via multivariate regression modeling (n = 2315).Results
We observed a significantly lower dementia risk in individuals with a higher level of “information processing” (HR, 0.888), “pattern detection” (HR, 0.878), “mathematics” (HR, 0.878), and “creativity” (HR, 0.878). Yet, exposure-dependent effects were only significant for “information processing” and “pattern detection.”Discussion
Our longitudinal observations suggest that dementia risk may be reduced by some but not all types of mental work demands. 相似文献20.
Cerebral amyloid angiopathy in Down syndrome and sporadic and autosomal-dominant Alzheimer's disease
María Carmona-Iragui Mircea Balasa Bessy Benejam Daniel Alcolea Susana Fernández Laura Videla Isabel Sala María Belén Sánchez-Saudinós Estrella Morenas-Rodriguez Roser Ribosa-Nogué Ignacio Illán-Gala Sofía Gonzalez-Ortiz Jordi Clarimón Frederick Schmitt David K. Powell Beatriz Bosch Albert Lladó Michael S. Rafii Juan Fortea 《Alzheimer's & dementia》2017,13(11):1251-1260