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1.
Introduction
Spatial navigation deficits are reported in dementia, but their temporal relationship to cognitive decline is not established.Methods
This is a prospective cohort study in 442 nondemented adults (mean age 79.9 years). Spatial navigation measured with the Floor Maze Test and reported as immediate maze time (IMT) and delayed maze time (DMT). Predementia syndromes, mild cognitive impairment syndrome (MCI) and motoric cognitive risk syndrome (MCR), were primary outcomes.Results
Over a mean follow-up of 16.5 ± 13.7 months, 41 participants developed MCI and 30 participants developed MCR. In Cox models adjusted for age, sex, education, cognitive status, comorbid illnesses, and maze errors, a 10-second increment on IMT predicted incident MCI (adjusted hazard ratio [aHR]: 1.25; 95% confidence interval [CI]: 1.06–1.48) and MCR (aHR: 1.53; 95% CI: 1.23–1.90). DMT predicted MCR but not MCI.Discussion
Spatial navigation performance predicted predementia syndromes in aging and implicates navigational impairments as an early feature in dementias. 相似文献2.
David S. Knopman Rebecca F. Gottesman A. Richey Sharrett Amanda L. Tapia Sonia DavisThomas B. Gwen Windham Laura Coker Andrea L.C. Schneider Alvaro Alonso Josef Coresh Marilyn S. Albert Thomas H. Mosley 《Alzheimer's & dementia》2018,14(11):1406-1415
Introduction
The interplay between midlife vascular risk factors and midlife cognitive function with later life mild cognitive impairment (MCI) and dementia (DEM) is not well understood.Methods
In the Atherosclerosis Risk in Communities Study, cardiovascular risk factors and cognition were assessed in midlife, ages 45–64 years. In 2011–2013, 20–25 years later, all consenting Atherosclerosis Risk in Communities participants underwent a cognitive and neurological evaluation and were given adjudicated diagnoses of cognitively normal, MCI, or DEM.Results
In 5995 participants with complete covariate data, midlife diabetes, hypertension, obesity, and hypercholesterolemia were associated with late-life MCI and DEM. Low midlife cognition function was also associated with greater likelihood of late-life MCI or DEM. Both midlife vascular risk factors and midlife cognitive function remained associated with later life MCI or DEM when both were in the model.Discussion
Later life MCI and DEM were independently associated with midlife vascular risk factors and midlife cognition. 相似文献3.
Anna E. Leeuwis Marije R. Benedictus Joost P.A. Kuijer Maja A.A. Binnewijzend Astrid M. Hooghiemstra Sander C.J. Verfaillie Teddy Koene Philip Scheltens Frederik Barkhof Niels D. Prins Wiesje M. van der Flier 《Alzheimer's & dementia》2017,13(5):531-540
Introduction
We examined the association between decreased cerebral blood flow (CBF) and cognitive impairment in Alzheimer's disease (AD), mild cognitive impairment (MCI), and subjective cognitive decline (SCD).Methods
We included 161 AD, 95 MCI, and 143 SCD patients from the Amsterdam Dementia Cohort. We used 3-T pseudo-continuous arterial spin labeling to estimate whole-brain and regional partial volume–corrected CBF. Neuropsychological tests covered global cognition and five cognitive domains. Associations were investigated using linear regression analyses.Results
In the whole sample, reduced overall and regional CBF was associated with impairment in all cognitive domains. We found significant interactions between diagnosis and CBF for language and between diagnosis and parietal CBF for global cognition and executive functioning. Stratification showed that decreased CBF was associated with worse performance in AD patients but not in MCI or SCD.Discussion
Our results suggest that CBF may have potential as a functional marker of disease severity. 相似文献4.
Mustapha Bouhrara David A. Reiter Christopher M. Bergeron Linda M. Zukley Luigi Ferrucci Susan M. Resnick Richard G. Spencer 《Alzheimer's & dementia》2018,14(8):998-1004
Introduction
We investigated brain demyelination in aging, mild cognitive impairment (MCI), and dementia using a direct magnetic resonance imaging marker of myelin.Methods
Brains of young and old controls, and old subjects with MCI, Alzheimer's disease, or vascular dementia were scanned using our recently developed myelin water fraction (MWF) mapping technique, which provides greatly improved accuracy over previous comparable methods. Maps of MWF, a direct and specific myelin measure, and relaxation times and magnetization transfer ratio, indirect and nonspecific measures, were constructed.Results
MCI subjects showed decreased MWF compared with old controls. Demyelination was greater in Alzheimer's disease or vascular dementia. As expected, decreased MWF was accompanied by decreased magnetization transfer ratio and increased relaxation times. The young subjects showed greater myelin content than the old subjects.Discussion
We believe this to be the first demonstration of myelin loss in MCI, Alzheimer's disease, and vascular dementia using a method that provides a quantitative magnetic resonance imaging–based measure of myelin. Our findings add to the emerging evidence that myelination may represent an important biomarker for the pathology of MCI and dementia. This study supports the investigation of the role of myelination in MCI and dementia through use of this quantitative magnetic resonance imaging approach in clinical studies of disease progression, and relationship of functional status to myelination status. Furthermore, mapping MWF may permit myelin to serve as a therapeutic target in clinical trials. 相似文献5.
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6.
Priya Palta Honglei Chen Jennifer A. Deal A. Richey Sharrett Alden Gross David Knopman Michael Griswold Gerardo Heiss Thomas H. Mosley 《Alzheimer's & dementia》2018,14(8):1015-1021
Introduction
We tested the hypothesis that poor sense of smell is associated with lower cognitive function and higher mild cognitive impairment (MCI) prevalence.Methods
Olfaction, measured by the Sniffin' Sticks test, was categorized as olfactory impairment (OI) (score ≤6) or no OI (score >6). MCI was adjudicated based on review of a neuropsychological examination. Linear regression estimated the mean difference in cognitive factor scores, and log-binomial regression quantified MCI prevalence among participants with versus without OI.Results
Participants with OI had lower mean factor scores (memory: ?0.27 standard deviation [SD], 95% confidence interval [CI]: ?0.35 to ?0.19; language: ?0.24 SD, 95% CI: ?0.30 to ?0.17; executive function/processing speed: ?0.09 SD, 95% CI: ?0.12 to ?0.06; and general cognitive performance: ?0.25 SD, 95% CI: ?0.30 to ?0.20). OI was also associated with MCI (n = 204; prevalence ratio = 1.56, 95% CI: 1.37, 1.78).Discussion
An impaired sense of smell may serve as a readily accessible early marker of neurodegeneration and improve upon the prevailing delayed diagnoses and underascertainment of MCI/dementia. 相似文献7.
Saira Saeed Mirza M. Arfan Ikram Daniel Bos Raluca Mihaescu Albert Hofman Henning Tiemeier 《Alzheimer's & dementia》2017,13(2):130-139
Introduction
Many people with mild cognitive impairment (MCI) suffer from concomitant depression or anxiety. Whether MCI increases the risk of future depression or anxiety is unknown.Methods
In the Rotterdam Study, cross-sectional (n = 4168) and longitudinal associations (n = 2967) of MCI with Diagnostic and Statistical Manual of Mental Disorders—depressive and anxiety disorders—were assessed (2002–2005 to 2009–2011).Results
At baseline, 413 persons had MCI; 125 (22 MCI and 103 non-MCI) had a depressive disorder and 330 had an anxiety disorder (46 MCI and 284 non-MCI). In longitudinal depression analysis, of the 212 persons with prevalent MCI, 6 (2.8%) developed depression compared with 29 (1%) in the nonexposed group. In longitudinal anxiety analysis, 11 (7.3%) of the 151 with prevalent MCI developed anxiety, compared with 75 (3.4%) in nonexposed group. Persons with MCI had more depressive and anxiety disorders and also a higher risk of developing depressive disorder, odds ratio (OR) 3.13 (95% confidence interval [CI]: 1.26, 7.77), and anxiety disorder, OR 2.59 (95% CI: 1.31, 5.12).Discussion
MCI is a risk factor for dementia and for depressive and anxiety disorders, suggesting common pathological pathways for cognitive and psychiatric outcomes. 相似文献8.
Ron L.H. Handels Stephanie J.B. Vos Milica G. Kramberger Vesna Jelic Kaj Blennow Mark van Buchem Wiesje van der Flier Yvonne Freund-Levi Harald Hampel Marcel Olde Rikkert Ania Oleksik Zvezdan Pirtosek Philip Scheltens Hilkka Soininen Charlotte Teunissen Magda Tsolaki Asa K. Wallin Bengt Winblad Pieter Jelle Visser 《Alzheimer's & dementia》2017,13(8):903-912
Introduction
We aimed to determine the added value of cerebrospinal fluid (CSF) to clinical and imaging tests to predict progression from mild cognitive impairment (MCI) to any type of dementia.Methods
The risk of progression to dementia was estimated using two logistic regression models based on 250 MCI participants: the first included standard clinical measures (demographic, clinical, and imaging test information) without CSF biomarkers, and the second included standard clinical measures with CSF biomarkers.Results
Adding CSF improved predictive accuracy with 0.11 (scale from 0–1). Of all participants, 136 (54%) had a change in risk score of 0.10 or higher (which was considered clinically relevant), of whom in 101, it was in agreement with their dementia status at follow-up.Discussion
An individual person's risk of progression from MCI to dementia can be improved by relying on CSF biomarkers in addition to recommended clinical and imaging tests for usual care. 相似文献9.
Isabelle F. van der Velpen Stephanie Feleus Anne Suzanne Bertens Behnam Sabayan 《Alzheimer's & dementia》2017,13(4):441-453
Introduction
Cardiac function is a key player in maintaining energy homeostasis in the brain. Heart failure is closely related to higher risk of neurocognitive disorders. Recent evidence shows that this relationship might not be limited to patients with advanced heart failure, and even suboptimal cardiac functioning is associated with accelerated brain aging. Hence, hemodynamic and serum cardiac markers may provide valuable information about the risk of dementia.Methods
We provide an overview on the link between cardiac markers and cognitive function by a systematic search in five databases. Furthermore, we discuss the pathophysiological aspects of this link and highlight the pertinent clinical and public health implications.Results
Increasing evidence supports the associations of hemodynamic and serum cardiac markers with accelerated cognitive decline.Discussion
Hemodynamic and serum cardiac markers are closely linked with risk of cognitive impairment. This highlights the significance of the heart–brain connection in reducing the burden of dementia. 相似文献10.
Mariella Lauriola Roberto Esposito Stefano Delli Pizzi Massimiliano de Zambotti Francesco Londrillo Joel H. Kramer Gil D. Rabinovici Armando Tartaro 《Alzheimer's & dementia》2017,13(7):783-791
Introduction
Subjective cognitive decline (SCD) is a risk factor for mild cognitive impairment (MCI) and Alzheimer's disease (AD). Although sleep has been shown to be altered in MCI and AD, little is known about sleep in SCD.Methods
Seventy cognitively normal community-dwelling participants were classified as SCD (32) or controls (38) using the Subjective Cognitive Decline Questionnaire. Sleep was assessed using actigraphy and diaries. FreeSurfer was used for performing medial temporal lobes (MTLs) and brain cortical parcellation of 3T magnetic resonance images. Multiple regression models were used to assess the presence of sleep, MTL, or regional cortical differences between groups.Results
Objective sleep was disrupted in SCD participants, which showed increased nighttime wakefulness and reduced sleep efficiency. No group differences emerged in subjective sleep or magnetic resonance imaging outcomes.Discussion
Objective sleep resulted disrupted in community-dwelling SCD, without any subjective sleep or cortical change. Sleep assessment/intervention in SCD might help prevent/delay AD onset. 相似文献11.
Peng Li Lei Yu Andrew S.P. Lim Aron S. Buchman Frank A.J.L. Scheer Steven A. Shea Julie A. Schneider David A. Bennett Kun Hu 《Alzheimer's & dementia》2018,14(9):1114-1125
Introduction
Healthy physiological systems exhibit fractal regulation (FR), generating similar fluctuation patterns in physiological outputs across different time scales. FR in motor activity is degraded in dementia, and the degradation correlates to cognitive decline. We tested whether degraded FR predicts Alzheimer's dementia.Methods
FR in motor activity was assessed in 1097 nondemented older adults at baseline. Cognition was assessed annually for up to 11 years.Results
Participants with an FR metric at the 10th percentile in this cohort had a 1.8-fold Alzheimer's disease risk (equivalent to the effect of being ～5.2 years older) and 1.3-fold risk for mild cognitive impairment (equivalent to the effect of being ～3.0 years older) than those at the 90th percentile. Consistently, degraded FR predicted faster cognitive decline. These associations were independent of physical activity, sleep fragmentation, and stability of daily activity rhythms.Discussion
FR may be a useful tool for predicting Alzheimer's dementia. 相似文献12.
Introduction
Characterizing progression in Alzheimer's disease is critically important for early detection and targeted treatment. The objective was to develop a prognostic model, based on multivariate longitudinal markers, for predicting progression-free survival in patients with mild cognitive impairment.Methods
The information contained in multiple longitudinal markers was extracted using multivariate functional principal components analysis and used as predictors in the Cox regression models. Cross-validation was used for selecting the best model based on Alzheimer's Disease Neuroimaging Initiative–1. External validation was conducted on Alzheimer's Disease Neuroimaging Initiative–2.Results
Model comparison yielded a prognostic index computed as the weighted combination of historical information of five neurocognitive longitudinal markers that are routinely collected in observational studies. The comprehensive validity analysis provided solid evidence of the usefulness of the model for predicting Alzheimer's disease progression.Discussion
The prognostic model was improved by incorporating multiple longitudinal markers. It is useful for monitoring disease and identifying patients for clinical trial recruitment. 相似文献13.
Annie M. Racine Tamara G. Fong Yun Gou Thomas G. Travison Douglas Tommet Kristen Erickson Richard N. Jones Bradford C. Dickerson Eran Metzger Edward R. Marcantonio Eva M. Schmitt Sharon K. Inouye 《Alzheimer's & dementia》2018,14(5):590-600
Introduction
Older adults, including those with mild cognitive impairment (MCI), are increasingly undergoing surgery.Methods
Relative risks (RRs) of MCI alone or with delirium on adverse outcomes were estimated in an ongoing prospective, observational cohort study of 560 nondemented adults aged ≥70 years.Results
MCI (n = 61, 11%) was associated with increased RR of delirium (RR = 1.9, P < .001) and delirium severity (RR = 4.6, P < .001). Delirium alone (n = 107), but not MCI alone (n = 34), was associated with multiple adverse outcomes including more major postoperative complication(s) (RR = 2.5, P = .002) and longer length of stay (RR = 2.2, P < .001). Patients with concurrent MCI and delirium (n = 27) were more often discharged to a postacute facility (RR = 1.4, P < .001) and had synergistically increased risk for new impairments in cognitive functioning (RR = 3.6, P < .001).Discussion
MCI is associated with increased risk of delirium incidence and severity. Patients with delirium and MCI have synergistically elevated risk of developing new difficulties in cognitively demanding tasks. 相似文献14.
F. Fregni I.C. Macedo L.N. Spezia-Adachi V.L. Scarabelot G. Laste A. Souza Paulo Roberto Stefani Sanches W. Caumo I.L.S. Torres 《Brain stimulation》2018,11(2):299-301
Background
Chronic stress (CS) is associated with a decrease in pain threshold caused by the changes in neural pain circuits. It can be associated to glucocorticoid imbalance with alterations in neural circuitry. Inhibition of stress-induced pain-related neural changes by using techniques that safely induce neuroplasticity such as transcranial direct current stimulation (tDCS) may prevent hyperalgesia triggered by CS.Objective
This study aimed to verify the effect of tDCS performed prior to CS exposure on nociceptive response.Methods
Thirty-two rats were distributed in the following groups: control; stress; sham-tDCS + stress; and tDCS + stress. Bicephalic active tDCS was performed for 8 consecutive days before the CS exposure. The pain threshold was evaluated using a hot plate and tail flick latency (TFL) tests.Results
The tDCS exposure increased the pain threshold on stressed rats.Conclusion
The data obtained indicate that the treatment with bicephalic active tDCS before chronic stress exposure prevents stress-induced hyperalgesia. 相似文献15.
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16.
Han Soo Yoo Seun Jeon Seok Jong Chung Mijin Yun Phil Hyu Lee Young Ho Sohn Alan C. Evans Byoung Seok Ye 《Alzheimer's & dementia》2018,14(10):1243-1252
Introduction
Olfactory dysfunction is common in Alzheimer's disease– and Lewy body–related disorders, but its neural correlates have not been clearly elucidated.Methods
We retrospectively recruited 237 patients with Alzheimer's disease–related cognitive impairment (ADCI) and 217 with Lewy body–related cognitive impairment (LBCI). They were identically evaluated using the Cross-Cultural Smell Identification Test, neuropsychological tests, and brain magnetic resonance imaging.Results
LBCI had more severe olfactory dysfunction than ADCI. Patients with more severe cognitive dysfunction had worse olfactory function in both groups. In ADCI, lower Cross-Cultural Smell Identification Test scores correlated with a lower cortical thickness in brain regions typically affected in Alzheimer's disease, most prominently in the right parahippocampal cortex, whereas in LBCI, the scores correlated with white matter abnormalities in regions vulnerable to Lewy body, including subcortical regions of the orbitofrontal and frontoparietal cortices.Discussion
Our results suggest that cortical atrophy in ADCI and white matter abnormalities in LBCI play important roles in olfactory dysfunction. 相似文献17.
Takeshi Iwatsubo Atsushi Iwata Kazushi Suzuki Ryoko Ihara Hiroyuki Arai Kenji Ishii Michio Senda Kengo Ito Takeshi Ikeuchi Ryozo Kuwano Hiroshi Matsuda Chung-Kai Sun Laurel A. Beckett Ronald C. Petersen Michael W. Weiner Paul S. Aisen Michael C. Donohue 《Alzheimer's & dementia》2018,14(8):1077-1087
Introduction
We conducted Japanese Alzheimer's Disease Neuroimaging Initiative (J-ADNI) and compared the basic characteristics and progression profiles with those of ADNI in North America.Methods
A total of 537 Japanese subjects with normal cognition, late amnestic mild cognitive impairment (LMCI), or mild Alzheimer's disease (AD) were enrolled using the same criteria as ADNI. Rates of changes in representative cognitive or functional measures were compared for amyloid positron emission tomography- or cerebrospinal fluid amyloid β(1–42)-positive LMCI and mild AD between J-ADNI and ADNI.Results
Amyloid positivity rates were significantly higher in normal cognition of ADNI but at similar levels in LMCI and mild AD between J-ADNI and ADNI. Profiles of decline in cognitive or functional measures in amyloid-positive LMCI in J-ADNI (n = 75) and ADNI (n = 269) were remarkably similar, whereas those in mild AD were milder in J-ADNI (n = 73) compared with ADNI (n = 230).Discussion
These results support the feasibility of bridging of clinical trials in the prodromal stage of AD between Asia and western countries. 相似文献18.
Austyn Roseborough Joel Ramirez Sandra E. Black Jodi D. Edwards 《Alzheimer's & dementia》2017,13(10):1154-1167
Introduction
This systematic review synthesizes current evidence for associations between cortical amyloid β, visualized on amyloid positron emission tomography imaging, and white matter hyperintensity (WMH) burden on magnetic resonance imaging in healthy elderly adults and individuals with cognitive impairment and dementia.Methods
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) systematic review guidelines, we systematically searched MEDLINE, Embase, Cochrane, and PsycINFO databases from January 2000 to September 2015.Results
Our search returned 492 articles, 34 of which met criteria for inclusion in the final selection. Most studies reported no significant relationships between amyloid β and WMH burden across diagnostic groups.Discussion
Findings of this systematic review suggest that amyloid accumulation and WMH are independent but additive processes. The limited number of independent cohorts, lack of longitudinal data, and exclusion of individuals with mixed dementia limit the generalizability of these findings. Further studies are required to elucidate the putative contributions of vascular processes to neurodegenerative pathology. 相似文献19.
Shoichi Sasaki 《Alzheimer's & dementia》2018,14(12):1615-1622
Introduction
The objective of this study was to examine the prevalence of the coexistence of parkinsonism in patients with mild cognitive impairment (MCI) or mild Alzheimer's disease (AD).Methods
Outpatients were evaluated with Mini–Mental State Examination, Clinical Dementia Rating Scale, NIA-AA criteria, MRI, and 123I-IMP SPECT (3D-SSP). Parkinsonism in patients diagnosed with MCI (Mini–Mental State Examination ≥24, n = 63) or mild AD (Mini–Mental State Examination 20–23, n = 43) was examined using the Unified Parkinson's Disease Rating Scale–III and 123I-FP-CIT dopamine transporter SPECT.Results
One hundred six patients (60–97 years) were enrolled. Fifty-six patients (52.8%) were diagnosed as having concomitant parkinsonism with rigidity and resting tremor and dopamine transporter reduction in the basal ganglia. The mean (SD) age (n = 56) was 80.6 (6.1) years, significantly older than patients without parkinsonism [77.6 (7.0) years, n = 50] (P < .05). The mean (SD) UPDRS–III score was 5.8 (2.4).Conclusion
The prevalence rate of the coexistence of mild parkinsonism in MCI or mild AD may be higher than previously recognized. 相似文献20.
Beth E. Snitz Tianxiu Wang Yona Keich Cloonan Erin Jacobsen Chung-Chou H. Chang Tiffany F. Hughes M. Ilyas Kamboh Mary Ganguli 《Alzheimer's & dementia》2018,14(6):734-742