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- Sweeney, M. D., et al.
(författare)
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Vascular dysfunction-The disregarded partner of Alzheimer's disease
- 2019
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Ingår i: Alzheimers & Dementia. - : Wiley. - 1552-5260 .- 1552-5279. ; 15:1, s. 158-167
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Tidskriftsartikel (refereegranskat)abstract
- Increasing evidence recognizes Alzheimer's disease (AD) as a multifactorial and heterogeneous disease with multiple contributors to its pathophysiology, including vascular dysfunction. The recently updated AD Research Framework put forth by the National Institute on Aging-Alzheimer's Association describes a biomarker-based pathologic definition of AD focused on amyloid, tau, and neuronal injury. In response to this article, here we first discussed evidence that vascular dysfunction is an important early event in AD pathophysiology. Next, we examined various imaging sequences that could be easily implemented to evaluate different types of vascular dysfunction associated with, and/or contributing to, AD pathophysiology, including changes in blood-brain barrier integrity and cerebral blood flow. Vascular imaging biomarkers of small vessel disease of the brain, which is responsible for >50% of dementia worldwide, including AD, are already established, well characterized, and easy to recognize. We suggest that these vascular biomarkers should be incorporated into the AD Research Framework to gain a better understanding of AD pathophysiology and aid in treatment efforts. (C) 2018 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.
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- Mok, V. C. T., et al.
(författare)
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Tackling challenges in care of Alzheimer's disease and other dementias amid the COVID-19 pandemic, now and in the future
- 2020
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Ingår i: Alzheimer's and Dementia. - : Wiley. - 1552-5260 .- 1552-5279. ; 16:11, s. 1571-1581
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Tidskriftsartikel (refereegranskat)abstract
- We have provided an overview on the profound impact of COVID-19 upon older people with Alzheimer's disease and other dementias and the challenges encountered in our management of dementia in different health-care settings, including hospital, out-patient, care homes, and the community during the COVID-19 pandemic. We have also proposed a conceptual framework and practical suggestions for health-care providers in tackling these challenges, which can also apply to the care of older people in general, with or without other neurological diseases, such as stroke or parkinsonism. We believe this review will provide strategic directions and set standards for health-care leaders in dementia, including governmental bodies around the world in coordinating emergency response plans for protecting and caring for older people with dementia amid the COIVD-19 outbreak, which is likely to continue at varying severity in different regions around the world in the medium term. © 2020 the Alzheimer's Association
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- Mok, VCT, et al.
(författare)
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Erratum
- 2021
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Ingår i: Alzheimer's & dementia : the journal of the Alzheimer's Association. - : Wiley. - 1552-5279. ; 17:5, s. 906-907
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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- van der Flier, W. M., et al.
(författare)
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Vascular cognitive impairment
- 2018
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Ingår i: Nature Reviews Disease Primers. - : Springer Science and Business Media LLC. - 2056-676X. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- The term vascular cognitive impairment (VCI) was introduced around the start of the new millennium and refers to the contribution of vascular pathology to any severity of cognitive impairment, ranging from subjective cognitive decline and mild cognitive impairment to dementia. Although vascular pathology is common in elderly individuals with cognitive decline, pure vascular dementia (that is, dementia caused solely by vascular pathology) is uncommon. Indeed, most patients with vascular dementia also have other types of pathology, the most common of which is Alzheimer disease (specifically, the diffuse accumulation of amyloid-beta plaques and neurofibrillary tangles composed of tau). At present, the main treatment for VCI is prevention by treating vascular diseases and other risk factors for VCI, such as hypertension and diabetes mellitus. Despite the current paucity of disease-modifying pharmacological treatments, we foresee that eventually, we might be able to target specific brain diseases to prevent cognitive decline and dementia.
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- Olesen, Pernille J, et al.
(författare)
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The predictive value of cerebral ischemic lesions for dementia
- 2008
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Ingår i: Vas-Cog, Singapore 14-16 Jan 2009.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background & Objective Changes in white matter are known to be related to dementia and cognitive decline. We examined whether CT-detected white matter lesions (WMLs) predicted dementia or cognitive decline in a population followed for five years. Methods A representative sample of persons aged 70-82 years were examined with a neuropsychiatric examination and a CT scan in 2000-2001 (N=657). A follow-up examination was performed in 2005 (N=503). People without dementia at the time of CT scanning and who participated in the examinations in 2005 were included (N=497). The Wahlund scale was used to define WMLs using a score from 0 (no lesions) to 3 (severe lesions). Cognitive status was assessed with the Mini Mental State Examination (MMSE). The difference in MMSE score from 2000 to 2005 (∆MMSE) was used as a general measure on cognitive decline. Differences in performance on other neuropsychiatric tests were included to get more sensitive measures of change in cognitive function. Regression analyses were applied to analyze whether WMLs could predict the outcome of dementia or cognitive decline five years later. Results Thirty-seven people were diagnosed with dementia in 2005 (7.4%), of these 12 (32%) had any WML of severity >1 on the CT performed five years earlier. For the non-demented group the comparable number was 77 (17%). Significant cognitive decline according to ∆MMSE was seen in the group who were diagnosed with dementia. Preliminary regression analysis shows that cognitive decline and parieto-occipital WMLs predicted onset of dementia. Conclusion The findings suggest that WMLs are weak predictors of dementia. Only WMLs in parieto-occipital areas were related to dementia five years later. Further analyses will show the relation between WMLs and decline in cognitive symptoms.
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- Olesen, Pernille J, et al.
(författare)
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White matter lesions in the elderly increases the risk of major depression five years later
- 2009
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Ingår i: IFPE, Wien 16-19 April 2009.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective To study the association between ischemic white matter lesions (WMLs) and major depressive episode (MDE) in a population-based sample followed for five years. Methods A randomized sample of non-demented elderly was investigated in 2000-2001 and in 2005-2006 with psychiatric and physical examinations. Among those who participated at baseline (n=914), 813 were alive in 2005 and 681 (84%) took part in the follow-up examination. A computerized tomography (CT) of the head was done on 462 individuals aged 70-86 years at baseline. Women (n=329) were stratified into two age-groups, 70- (n=196) and 78-86-year olds (n=133). WMLs were rated from 0 (none) to 3 (severe). Results The prevalence of MDE was lower in 2000 (3.6%; n=12/329) than in 2005 (7.3%; n=24/329). Moderate to severe WMLs were present in 11.6% (n=38/329). In 70-year old women, WMLs detected in 2000 were associated with an increased risk of having MDE in 2005 (OR=6.98; CI=2.06-23.67; p=0.002). WMLs were not associated with MDE in 2000 or with MDE in those older than 70-years at baseline. Conclusion WMLs in 70-year old women were associated with an increased risk of MDE five years later.
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| 10. |
- Simoni, M, et al.
(författare)
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Prevalence of CT-detected cerebral abnormalities in an elderly Swedish population sample.
- 2008
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 118:4, s. 260-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To measure the prevalence of computed tomography (CT)-detected cerebral lesions in a population-based sample of elderly persons living in Göteborg, Sweden. METHODS: Cerebral CT-scans were performed in the case of 466 women (mean age 74.3 +/- 5.1 years) and 191 70-year-old men. A single rater assessed white matter lesions (WML) using four different scales, lacunar lesions, large infarcts, cortical atrophy, and basal ganglia calcifications. RESULTS: White matter lesions frequency assessed by different scales ranged between 54.5% and 68.5%. Lacunar lesions were detected in 46.7% (30.1% had lacunes >5 mm) and cerebral infarcts in 3.0% of participants. Overall, 72.8% of participants evidenced cerebral vascular abnormalities. Severe cortical atrophy was more common in temporal (6.4%) and frontal (6.7%) lobes, than in parietal (1.7%) and occipital (1.1%) lobes. Basal ganglia calcifications were found in 38.7% of participants. WML, lacunar lesions, large infarcts, and degree of cortical atrophy correlated positively with age. More lacunes, basal ganglia calcifications, and occipital lobe atrophy were associated with male gender. CONCLUSIONS: Vascular and other brain lesions are very common on CT-scan in an elderly population, but large vascular lesions are rare. This study provides the first reference for the prevalence of CT-detected abnormalities in an elderly Swedish population.
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