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1.
  • Aguero-Torres, H, et al. (författare)
  • Rethinking the dementia diagnoses in a population-based study : What is Alzheimer's disease and what is vascular dementia? A study from the Kungsholmen Project
  • 2006
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - Basel : Karger. - 1420-8008 .- 1421-9824. ; 22:3, s. 244-249
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To explore the hypothesis that older adults often are affected by more than one disease, making the differential diagnosis between Alzheimer’s disease (AD) and vascular dementia (VaD) difficult. Methods: Incident dementia cases (n = 308) from a population-based longitudinal study of people 75+ years were investigated. The DSM-III-R criteria were used for the clinical diagnosis of dementia. Data on vascular disorders (hypertension, cerebrovascular and ischemic heart diseases, heart failure, atrial fibrillation, diabetes) as well as type of onset/course of dementia were used retrospectively to reclassify dementias. Results: Only 47% of the AD cases were reclassified as pure AD without any vascular disorder. Among subjects with AD and with a vascular component, cerebrovascular disease was the most common (41%). Only 25% of VaD were reclassified as pure VaD. Further, 26% of the pure AD subjects developed a vascular disorder in the following 3 years. Conclusions: Both vascular and degenerative mechanisms may often contribute to the expression of dementia among the elderly. Most of the AD cases have vascular involvements, and pure dementia types in very old subjects constitute only a minority of dementia cases.
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2.
  • Aho, Leena, et al. (författare)
  • Systematic appraisal using immunohistochemistry of brain pathology in aged and demented subjects.
  • 2008
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - 1420-8008 .- 1421-9824. ; 25:5, s. 423-32
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND/AIMS: Abnormal processing of hyperphosphorylated tau (HPtau), amyloid-beta (Abeta) and alpha-synuclein (alphaS) proteins is considered as causative with regard to the clinical symptoms in age-related neurodegenerative diseases.METHODS: In this retrospective, postmortem study applying immunohistochemical methodology, we assessed Alzheimer's-disease (AD)-related HPtau and Abeta pathology in 178 subjects with alphaS pathology.RESULTS: These pathologies were frequently seen concomitantly, i.e. HPtau in 83% and Abeta in 62% of the alphaS-positive cases. Furthermore, the striatum was frequently involved, particularly in subjects with cognitive impairment (65%). The predictive value of widespread HPtau pathology, i.e. stages V-VI, with respect to cognitive impairment was high, since all 18 subjects presenting with this stage were demented. In contrast, the predictive value of widespread alphaS pathology, i.e. stages 5-6 according to Braak's Parkinson disease staging, was debatable. Fifty-three percent of the subjects with widespread alphaS pathology and no or mild AD-related HPtau pathology were cognitively unimpaired. It is noteworthy that striatal Abeta pathology was more often seen in demented subjects independently of HPtau and/or alphaS status.CONCLUSION: The causative pathology in subjects with clinically diagnosed dementia with Lewy bodies needs to be clarified in future studies.
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3.
  • Allard, P, et al. (författare)
  • Caudate nucleus dopamine D-2 receptors in vascular dementia
  • 2002
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - : Karger. - 1420-8008 .- 1421-9824. ; 14:1, s. 22-25
  • Tidskriftsartikel (refereegranskat)abstract
    • Caudate nucleus dopamine (DA) D-2 receptors were studied in patients with vascular dementia (VaD) and in a control group using [H-3]raclopride as a radioligand. There was no significant difference in the number of DA D-2 receptors in the VaD group as compared with controls. The binding affinity was significantly lower in the VaD group. When the VaD group was subdivided into subjects with or without neuroleptic treatment, there were no differences in the numbers of receptors as compared with controls, and the significant differences in binding affinity remained for both VaD subgroups. The present results are. discussed with reference to the previous finding of a reduced density of caudate nucleus DA uptake sites in the same VaD group and to results from studies on DA D-2 receptors in Alzheimer's disease and Parkinson's disease. Copyright (C) 2002 S. Karger AG, Basel.
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4.
  • Allard, P, et al. (författare)
  • Caudate nucleus dopamine D2 receptors in vascular dementia
  • 2002
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - 1420-8008 .- 1421-9824. ; 14:1, s. 22-25
  • Tidskriftsartikel (refereegranskat)abstract
    • Caudate nucleus dopamine (DA) D2 receptors were studied in patients with vascular dementia (VaD) and in a control group using [3H]raclopride as a radioligand. There was no significant difference in the number of DA D2 receptors in the VaD group as compared with controls. The binding affinity was significantly lower in the VaD group. When the VaD group was subdivided into subjects with or without neuroleptic treatment, there were no differences in the numbers of receptors as compared with controls, and the significant differences in binding affinity remained for both VaD subgroups. The present results are discussed with reference to the previous finding of a reduced density of caudate nucleus DA uptake sites in the same VaD group and to results from studies on DA D2 receptors in Alzheimer's disease and Parkinson's disease. Copyright ⌐ 2002 S. Karger AG, Basel.
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5.
  • Allard, Per, et al. (författare)
  • Reduced number of caudate nucleus dopamine uptake sites in vascular dementia.
  • 1999
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - 1420-8008 .- 1421-9824. ; 10:2, s. 77-80
  • Tidskriftsartikel (refereegranskat)abstract
    • The dopamine (DA) uptake sites in the caudate nucleus were studied in patients with vascular dementia (VAD) and in a control group using the presynaptic DA uptake site marker [3H][2beta-carbomethoxy-3beta-(4-fluorophenyl) tropane] as radioligand. There was a significant decrease in the number of DA uptake sites in the VAD group, while the binding affinity was unchanged. The present results indicate that in the patients investigated, the cerebrovascular disease process involves dopaminergic neuron terminals in the caudate nucleus. Our findings are discussed in relation to the reductions in number of DA uptake sites that have previously been revealed in Alzheimer's and Parkinson's diseases.
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6.
  • Andersson, Christin, et al. (författare)
  • Differential CSF biomarker levels in APOE-epsilon 4-positive and -negative patients with memory impairment
  • 2007
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - 1420-8008 .- 1421-9824. ; 23:2, s. 87-95
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To investigate the relationships between episodic memory, APOE genotype, CSF markers (total tau, T-tau; phospho-tau, P-tau; beta-amyloid, A beta 42) and longitudinal cognitive decline. Methods: 124 memory clinic patients were retrospectively divided into 6 groups based on (i) episodic memory function (Rey Auditory Verbal Learning Test, RAVLT): severe, moderate or no impairment (SIM, MIM or NIM), and (ii) APOE genotype (epsilon 4+ or epsilon 4-). CSF marker levels and cognitive decline were compared across groups. Results: Episodic memory function, according to RAVLT scores, was significantly correlated with CSF marker levels only among epsilon 4+ subjects and not among epsilon 4- subjects. When comparing the 6 subgroups, SIM epsilon 4+ and MIM epsilon 4+ groups showed significantly lower A beta 42 levels than the other groups. T-tau and P- tau levels were significantly increased in SIM epsilon 4+ when compared to all the other groups, including the SIM epsilon 4- group. However, both SIM epsilon 4+ and SIM epsilon 4- declined cognitively during the follow-up. Conclusion: It remains to be determined whether APOE genotype affects the expression of biomarkers in CSF, or whether the different biomarker patterns reflect different types of disease processes in patients with progressive cognitive dysfunction.
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7.
  • Andersson, Christin, et al. (författare)
  • Differential CSF biomarker levels in APOE-epsilon4-positive and -negative patients with memory impairment.
  • 2007
  • Ingår i: Dementia and geriatric cognitive disorders. - Basel : Karger. - 1420-8008 .- 1421-9824. ; 23:2, s. 87-95
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To investigate the relationships between episodic memory, APOE genotype, CSF markers (total tau, T-tau; phospho-tau, P-tau; beta-amyloid, Abeta42) and longitudinal cognitive decline. METHODS: 124 memory clinic patients were retrospectively divided into 6 groups based on (i) episodic memory function (Rey Auditory Verbal Learning Test, RAVLT): severe, moderate or no impairment (SIM, MIM or NIM), and (ii) APOE genotype (epsilon4+ or epsilon4-). CSF marker levels and cognitive decline were compared across groups. RESULTS: Episodic memory function, according to RAVLT scores, was significantly correlated with CSF marker levels only among epsilon4+ subjects and not among epsilon4- subjects. When comparing the 6 subgroups, SIM epsilon4+ and MIM epsilon4+ groups showed significantly lower Abeta42 levels than the other groups. T-tau and P-tau levels were significantly increased in SIM epsilon4+ when compared to all the other groups, including the SIM epsilon4- group. However, both SIM epsilon4+ and SIM epsilon4- declined cognitively during the follow-up. CONCLUSION: It remains to be determined whether APOE genotype affects the expression of biomarkers in CSF, or whether the different biomarker patterns reflect different types of disease processes in patients with progressive cognitive dysfunction.
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8.
  • Andersson, Christin, et al. (författare)
  • Identifying patients at high and low risk of cognitive decline using Rey Auditory Verbal Learning Test among middle-aged memory clinic outpatients
  • 2006
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - 1420-8008 .- 1421-9824. ; 21:4, s. 251-259
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To investigate whether application of cutoff levels in an episodic memory test (Rey Auditory Verbal Learning Test, RAVLT) is a useful method for identifying patients at high and low risk of cognitive decline and subsequent dementia. METHODS: 224 patients with memory complaints (mean age = 60.7 years, mean MMSE = 28.2) followed-up at a memory clinic over approximately 3 years were assigned retrospectively to one of three memory groups from their baseline results in RAVLT [severe (SIM), moderate (MIM) or no impairment (NIM)]. These groups were investigated regarding cognitive decline. RESULTS: Patients assigned to SIM showed significant cognitive decline and progressed to dementia at a high rate, while a normal performance in RAVLT at baseline (NIM) predicted normal cognition after 3 years. Patients with MIM constituted a heterogeneous group; some patients deteriorated cognitively, while the majority remained stable or improved. CONCLUSIONS: The application of cutoff levels in RAVLT at baseline showed that patients with severely impaired RAVLT performance were at a high risk of cognitive decline and progression to dementia, while patients with normal RAVLT results did not show cognitive decline during 3 years. Furthermore, the initial degree of memory impairment was decisive in the cognitive prognosis 3 years later.
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9.
  • Andersson, Christin, et al. (författare)
  • Lifestyle Factors and Subjective Cognitive Impairment in Patients Seeking Help at a Memory Disorder Clinic : The Role of Negative Life Events
  • 2019
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger. - 1420-8008 .- 1421-9824. ; 48:3-4, s. 196-206
  • Tidskriftsartikel (refereegranskat)abstract
    • Background/Aims: A large proportion of patients at memory disorders clinics are classified as having subjective cognitive impairment (SCI). Previous research has investigated whether particular lifestyle factors known to affect cognition can be useful in differentiating patients who do not show objective evidence of memory decline. There may also exist subgroups of patients with respect to lifestyle factors that could help clinicians to understand the patient group that presents to memory clinics. These may differ in diagnostic outcome. Very little is known about potential subgroups; however, but such information may help guide interventions and potentially eliminate unnecessary diagnostic procedures. The current study investigated patterns of lifestyle-related variables, including stress, sleep, sensory sensitivity, depression, and negative life events in patients presenting to a memory disorders clinic. The aim was to determine whether subgroups existed and whether it was possible to distinguish those with objectively impaired cognition. Methods: One hundred and seventy-eight patients (mean age 58 years) from a University Hospital Memory Disorders Clinic. Results: Cluster analysis identified three groups of lifestyle-related variables. Strong determinants of clusters were negative life events and age. Patients with a high number of negative life events also tended to have highest self-reported memory complaint, higher levels of stress, depression, and sensory sensitivity. However, they did not perform the worst on memory testing. In contrast, individuals who performed the worst on memory tests were older, tended to have the least memory complaints, and less negative lifestyle factors; this group also included the highest proportion of patients with mild cognitive impairment and had the lowest median amyloid A-beta 42 (A beta 42). The group with the best cognitive performance were younger, included the highest proportion of patients with SCI and the highest median A beta 42. On lifestyle variables, their ratings fell in between the other groups. Conclusions: Lifestyle subgroups of patients were determined by stress, emotional problems, and age. The groups were significantly associated with A beta 42 and diagnostic outcome. This pattern may confound the differentiation between objective and subjective memory problems. Asking about lifestyle variables, in conjunction with neuropsychological testing, could potentially identify individuals who are not likely to have objective memory impairment and guide interventions.
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10.
  • Andin, Josefine, 1979-, et al. (författare)
  • Rivastigmine as a Modulator of the Neuronal Glutamate Transporter rEAAC1 mRNA Expression
  • 2005
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - 1420-8008 .- 1421-9824. ; 19:1, s. 18-23
  • Tidskriftsartikel (refereegranskat)abstract
    • Alzheimer’s disease is a neurodegenerative disorder that affects the cholinergic, glutamatergic and monoaminergic systems in the neocortex and hippocampus. Today, the major pharmacological treatment involves the use of acetylcholinesterase inhibitors (AChEIs). In this study, an in situ hybridisation technique (using digoxigenin-labelled cRNA probes) was used to elucidate changes in mRNA expression of the neuronal glutamate transporter, rat excitatory amino carrier 1 (rEAAC1), after treatment with the AChEI rivastigmine. Compared with saline-treated rats, the rats subchronically (3 days) and chronically (21 days), but not acutely, treated with rivastigmine showed a significant increase in rEAAC1 mRNA expression in the hippocampal areas cornu anterior 1 (CA1), CA2, CA3 and dentate gyrus (p < 0.01), but not in the cortical areas. These results provide the first evidence that the glutamatergic system is modulated following acetylcholinesterase inhibition by rivastigmine, a finding, which is likely to be of importance for the clinical effects.
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