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  • Garcia, Maria João, et al. (författare)
  • Prognostic and Predictive Factors in Early Alzheimer's Disease : A Systematic Review
  • 2024
  • Ingår i: Journal of Alzheimer's Disease Reports. - 2542-4823. ; 8:1, s. 203-240
  • Forskningsöversikt (refereegranskat)abstract
    • Background: Alzheimer's disease (AD) causes progressive decline of cognition and function. There is a lack of systematic literature reviews on prognostic and predictive factors in its early clinical stages (eAD), i.e., mild cognitive impairment due to AD and mild AD dementia. Objective: To identify prognostic factors affecting eAD progression and predictive factors for treatment efficacy and safety of approved and/or under late-stage development disease-modifying treatments. Methods: Databases were searched (August 2022) for studies reporting prognostic factors associated with eAD progression and predictive factors for treatment response. The Quality in Prognostic Factor Studies tool or the Cochrane risk of bias tool were used to assess risk of bias. Two reviewers independently screened the records. A single reviewer performed data extraction and quality assessment. A second performed a 20% check. Content experts reviewed and interpreted the data collected. Results: Sixty-one studies were included. Self-reporting, diagnosis definition, and missing data led to high risk of bias. Population size ranged from 110 to 11,451. Analyses found data indicating that older age was and depression may be associated with progression. Greater baseline cognitive impairment was associated with progression. APOE4 may be a prognostic factor, a predictive factor for treatment efficacy and predicts an adverse response (ARIA). Elevated biomarkers (CSF/plasma p-tau, CSF t-tau, and plasma neurofilament light) were associated with disease progression. Conclusions: Age was the strongest risk factor for progression. Biomarkers were associated with progression, supporting their use in trial selection and aiding diagnosis. Baseline cognitive impairment was a prognostic factor. APOE4 predicted ARIA, aligning with emerging evidence and relevant to treatment initiation/monitoring.
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  • Holmbom Larsen, Axel, et al. (författare)
  • The Paintings Reveal the Story : Case Study of a Well-Known Swedish Artist Suffering from Alzheimer's Disease
  • 2024
  • Ingår i: Journal of Alzheimer's Disease Reports. - 2542-4823. ; 8:1, s. 173-187
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Creativity is a multifaceted, complex, activity, and as such is an overarching function of the brain rather than being confined to a specific structure or region. Alzheimer's disease effects several cognitive domains involved in the creative process of producing art. Objective: We analyze the art of a well-known Swedish visual artist who suffered from Alzheimer's disease to determine if, and in what way, his art and creative process might have been influenced by the disease. Methods: We compared his artistic process and artwork along with information from his spouse, medical r ecords, and cognitive tests as well as reviews of exhibitions written by art critics. Results: We show that not only did the artist continue to produce artwork well into a major decline in cognitive function, according to commonly used tests, but he could continue to do so for even longer with some assistance from his spouse. However, the artwork changed considerably as the disease progressed. We hypothesize that there is a substantial lack of representation of creative ability and function in cognitive tests. Conclusions: Signs of the Alzheimer's disease can be seen in the early artwork if viewed by critics and those with more specialized knowledge into the artist's production. Further analysis of the complex interaction between complex neural activities, such as artistic creativity, and cognitive diseases is warranted and might provide insight in the field of neurological degenerative disease.
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  • Lopatko Lindman, Karin, et al. (författare)
  • Plasma Amyloid-β in Relation to Antibodies Against Herpes Simplex Virus, Cytomegalovirus, and Chlamydophila pneumoniae
  • 2021
  • Ingår i: Journal of Alzheimer's Disease Reports. - : IOS Press. - 2542-4823. ; 5:1, s. 229-235
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Amyloid-β (Aβ), the key constituent of Alzheimer’s disease (AD) plaques, has antimicrobial properties.Objective: To investigate the association between plasma Aβ and antibodies against the AD-related pathogens herpes simplex virus (HSV), cytomegalovirus (CMV), and C. pneumoniae.Methods: Plasma from 339 AD cases, obtained on average 9.4 years (±4.00) before diagnosis, and their matched controls were analyzed for Aβ40 and Aβ42 concentrations with Luminex xMAP technology and INNOBIA plasma Aβ-form assays. Enzyme-linked immunosorbent assays were utilized for analyses of anti-HSV immunoglobulin (Ig) G, anti-HSV1 IgG, anti-HSV2 IgG, anti-CMV IgG, and anti-C. pneumoniae IgG. Follow-up samples were available for 150 of the cases.Results: Presence and levels of anti-HSV1 IgG, anti-HSV2 IgG, anti-CMV IgG, and anti-C. pneumoniae IgG did not correlate with concentrations of Aβ42 or Aβ40 in cases or controls.Conclusion: Levels of plasma Aβ were not associated with antibodies against different AD-related pathogens.
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  • Nakanishi, Miharu, et al. (författare)
  • Time Investment for Program Implementation to Manage Neuropsychiatric Symptoms: An Observational Longitudinal Study in In-Home and Residential Care Settings
  • 2020
  • Ingår i: Journal of Alzheimer's Disease Reports. - : IOS Press. - 2542-4823. ; 4:1, s. 441-453
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: There are no studies on how the same psychosocial dementia care program is adapted to both in-home andresidential care settings.Objective: To evaluate the time investment required by professionals to implement a psychosocial dementia care programto manage neuropsychiatric symptoms.Methods: A prospective observational study design was used. The program consisted of 1) a one-day training course,2) three interdisciplinary discussion meetings in five months, and 3) a web-based tool for the continued assessment ofneuropsychiatric symptoms. Care professionals implemented the intervention in in-home (19 in-home care managementagencies and 14 multiple in-home service providers) and residential care settings (19 group homes and eight nursing homes)in Japan from October 2019 to February 2020. The level of neuropsychiatric symptoms for the participants was evaluatedusing the Neuropsychiatric Inventory (NPI: 0–144). The time investment was reported by participating professionals. A totalof 125 persons with dementia were included at baseline.Results: Neuropsychiatric symptoms were significantly decreased at the final follow-up in all types of providers (Cohen’sdrm = 0.44–0.61). The mean (SD) time required for the five-month implementation was 417.9 (219.8) minutes. There wasa mean (SD) decrease of 8.6 (14.0) points in the total NPI score among the 103 persons with completed interventions. The time investment was significantly lower in in-home care management agencies than in group homes, and lower infollow-ups than at baseline assessment.Conclusion: The program implementation may incur a substantial time investment regardless of setting. An additional benefitscheme to reward the time investment would be helpful to encourage implementation until the follow-ups.
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  • Nägga, Katarina, et al. (författare)
  • Prevalence and Ascertainment of Dementia Cases in the Malmö Diet and Cancer Study
  • 2022
  • Ingår i: Journal of Alzheimer's Disease Reports. - : IOS Press. - 2542-4823. ; 6:1, s. 529-538
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Register diagnoses, both hospital-based and from open clinic care, are often used in research studies in Sweden. The validity of such diagnoses has been debated and a validation assessment can improve the diagnostic accuracy for use in research studies.Objective: The aim of this study was to investigate the quality of register-derived dementia diagnoses in the Malmö Diet and Cancer population study (MDCS) and to validate these diagnoses using systematic criteria.Methods: MDCS is a population-based prospective study comprising 30,446 participants. Register diagnoses of dementia for the MDCS population were derived from the Swedish National Patient Register (NPR) and validated through re-evaluation of available medical records by physicians.Results: In the MDCS cohort, 2,206 participants were diagnosed with dementia according to the NPR during a mean follow-up of 18.1 years. The general dementia diagnosis was valid in 96% of the cases, but 40% of the specific dementia diagnoses were changed during the process of reevaluation. The diagnostic validity varied between 25.2% and 82.9% for the different diagnoses. The results from the validity assessment per diagnostic category revealed that the validity of the NPR diagnoses was higher for the more specific diagnoses and lower for unspecified dementia. The major diagnostic shift during the re-evaluation was from unspecified dementia to more specific diagnoses.Conclusion: Validation of dementia diagnoses using medical records results in more precise diagnoses. Dementia diagnoses derived from registers should be validated in order to study associations between influential factors and different dementia diagnoses.
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  • Zuroff, Leah, et al. (författare)
  • Self- and Partner-Reported Subjective Memory Complaints : Association with Objective Cognitive Impairment and Risk of Decline
  • 2022
  • Ingår i: Journal of Alzheimer's Disease Reports. - 2542-4823. ; 6:1, s. 411-430
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Episodic memory decline is a hallmark of Alzheimer's disease (AD). Subjective memory complaints (SMCs) may represent one of the earliest signs of impending cognitive decline. The degree to which self- or partner-reported SMCs predict cognitive change remains unclear. Objective: We aimed to evaluate the relationship between self- and partner-reported SMCs, objective cognitive performance, AD biomarkers, and risk of future decline in a well-characterized longitudinal memory center cohort. We also evaluated whether study partner characteristics influence reports of SMCs. Methods: 758 participants and 690 study partners were recruited from the Penn Alzheimer's Disease Research Center Clinical Core. Participants included those with Normal Cognition, Mild Cognitive Impairment, and AD. SMCs were measured using the Prospective and Retrospective Memory Questionnaire (PRMQ), and were evaluated for their association with cognition, genetic, plasma, and neuroimaging biomarkers of AD, cognitive and functional decline, and diagnostic progression over an average of four years. Results: We found that partner-reported SMCs were more consistent with cognitive test performance and increasing symptom severity than self-reported SMCs. Partner-reported SMCs showed stronger correlations with AD-associated brain atrophy, plasma biomarkers of neurodegeneration, and longitudinal cognitive and functional decline. A 10-point increase on baseline PRMQ increased the annual risk of diagnostic progression by approximately 70%. Study partner demographics and relationship to participants influenced reports of SMCs in AD participants only. Conclusion: Partner-reported SMCs, using the PRMQ, have a stronger relationship with the neuroanatomic and cognitive changes associated with AD than patient-reported SMCs. Further work is needed to evaluate whether SMCs could be used to screen for future decline.
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