| 1. |
- Gustafson, Lars, et al.
(author)
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A factor analytic approach to symptom patterns in dementia.
- 2010
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In: International Journal of Alzheimer's Disease. - : Hindawi Limited. - 2090-0252 .- 2090-8024.
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Journal article (peer-reviewed)abstract
- Previous publications have shown a high diagnostic sensitivity and specificity of three short clinical rating scales for Alzheimer's disease (AD), frontotemporal dementia (FTD), and vascular dementia (VaD) validated against neuropathological (NP) diagnoses. In this study, the aim was to perform an exploratory factor analysis of the items in these clinical rating scales. The study included 190 patients with postmortem diagnoses of AD (n = 74), VaD (n = 33), mixed AD/VaD (n = 31), or FTD (n = 52). The factor analysis produced three strong factors. Factor 1 contained items describing cerebrovascular disease, similar to the Hachinski Ischemic Score. Factor 2 enclosed major clinical characteristics of FTD, and factor 3 showed a striking similarity to the AD scale. A fourth symptom cluster was described by perception and expression of emotions. The factor analyses strongly support the construct validity of the diagnostic rating scales.
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| 2. |
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| 3. |
- Brun, Arne, et al.
(author)
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The Birth and Early Evolution of the Frontotemporal Dementia (FTD) Concept.
- 2011
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In: Journal of Molecular Neuroscience : MN. - : Springer Science and Business Media LLC. - 1559-1166 .- 0895-8696. ; 45, s. 324-329
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Journal article (peer-reviewed)abstract
- An historical overview of the development of the concept of frontotemporal dementia is presented, regarding the last 30 years, using as a backbone the conferences held on this theme, with a start in 1986 in Lund, Sweden. Since then, a dramatic increase in research activities and publications has rapidly expanded our knowledge in this field, a step necessary for the ultimate goal to find an effective treatment of this devastating disorder.
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| 4. |
- Nilsson, Karin, et al.
(author)
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Plasma Homocysteine and Cognition in Elderly Patients with Dementia or Other Psychogeriatric Diseases.
- 2010
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In: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 30:3, s. 198-204
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Journal article (peer-reviewed)abstract
- Background: Total plasma homocysteine (tHcy) concentration is elevated in elderly patients with mental illness, and patients with vascular disease have higher plasma tHcy concentrations than patients without vascular disease. Increasing evidence indicates that vascular risk factors play a role in the development of cognitive impairment. Method: We have investigated the relation between plasma tHcy, its determinants and cognition, measured as MMSE, in 448 consecutively enrolled patients with dementia or other psychogeriatric diseases. Results: Multiple regression analyses showed that plasma tHcy was related to cognitive function in all patients as well as in demented and non-demented patients. The apparent close relationship between plasma tHcy and cognition was mainly dependent on its determinant age, whereas the other determinants of plasma tHcy exhibited a limited influence on the relation between plasma tHcy and cognition. Plasma tHcy has its own, albeit modest, relationship to cognitive function (predictive value about 5%). Conclusion: Plasma tHcy itself seems to play a minor role in cognitive impairment in patients with dementia or other psychogeriatric diseases. When investigating the relation between plasma tHcy and cognition, it is important to consider the distribution of the main determinants of plasma tHcy and to correct plasma tHcy for these variables.
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| 5. |
- Nilsson, Karin, et al.
(author)
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Plasma homocysteine, apolipoprotein E status and vascular disease in elderly patients with mental illness.
- 2010
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In: Clinical Chemistry and Laboratory Medicine. - 1437-4331. ; 48:1, s. 129-135
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Journal article (peer-reviewed)abstract
- Abstract Background: Total plasma homocysteine (tHcy) concentration is increased in elderly patients with mental illness. Also, patients with vascular disease have significantly higher plasma tHcy concentration compared with patients without vascular disease. Apolipoprotein E (apoE) status is associated with cardiovascular disease and a major genetic risk factor is inheritance of the e4 allele. In the present study, we investigated the association between plasma tHcy and apoE status. Methods: The relation between apoE status, plasma tHcy and vascular disease was investigated in a cohort of consecutively enrolled elderly patients with mental illness (n=328). Results: Plasma tHcy concentrations were increased (p<0.01) in carriers of APOE4 (13.6 mumol/L; 9.2-21.7 mumol/L) compared to non-carriers (12.4 mumol/L; 8.3-19.9 mumol/L). The proportion of patients with vascular disease was significantly (p<0.001) increased among carriers (61%) compared to non-carriers (42%). An increased percentage (p<0.001) of APOE4 carriers was observed in patients with Alzheimer's disease (AD) with (71%) or without vascular disease (42%), and in patients with vascular dementia (VaD) (54%) compared to a reference group (34%). Conclusions: Since carriers of APOE4 showed an increased likelihood of vascular disease, these patients need more intensive control of other modifiable vascular risk factors. Furthermore, the association between plasma tHcy and the presence of APOE4 might be attributed to an increased proportion of vascular disease in APOE4 carriers. Clin Chem Lab Med 2010;48.
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| 6. |
- Nilsson, Karin, et al.
(author)
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Survival in a large elderly population of patients with dementia and other forms of psychogeriatric diseases.
- 2011
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In: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 32:5, s. 342-350
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Journal article (peer-reviewed)abstract
- Background: Dementia and other psychogeriatric diseases in elderly patients bring an increased risk of death. Better knowledge of prognosis in elderly patients affected by dementia or mental illness should be of great importance in order to improve care plans and assist in medical decisions. Methods: We have investigated the survival time in 2,112 patients with dementia and other forms of psychogeriatric diseases, enrolled during 1990 to 2005 and followed up until 2009, and the influence of diagnoses, plasma homocysteine level, presence of vascular disease and renal impairment. Results: The survival time after diagnosis in most diagnostic groups is about a third compared to an average population of similar age and sex. Age was the main predictor of survival time in all patients. Conclusions: All diagnoses, except in patients with subjective cognitive impairments, showed an increased mortality. These estimates can be used for prognosis and planning for patients, carers, service providers and policy makers.
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| 9. |
- Nilsson, Karin, et al.
(author)
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The use of N-terminal pro-brain natriuretic Peptide to evaluate vascular disease in elderly patients with mental illness.
- 2012
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In: Dementia and Geriatric Cognitive Disorders Extra. - : S. Karger AG. - 1664-5464. ; 2, s. 10-18
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Journal article (peer-reviewed)abstract
- BACKGROUND: Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) is regarded as a sensitive marker of cardiovascular disease. Vascular disease plays an important role in cognitive impairment. METHOD: In 447 elderly patients with mental illness, serum NT-proBNP level and the presence or absence of vascular disease according to the medical record were used to categorize patients in different subgroups of vascular disease. RESULTS AND CONCLUSION: Patients with vascular disease and elevated serum NT-proBNP level had a lower cognition level, shorter survival time, lower renal function and a higher percentage of pathological brain imaging than patients with vascular disease and normal NT-proBNP level. Thus, elevated serum NT-proBNP level might be helpful to detect patients who have a more severe cardiovascular disease.
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| 10. |
- Nilsson, Karin, et al.
(author)
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Elevated Plasma Homocysteine Level Is Not Primarily Related to Alzheimer's Disease.
- 2012
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In: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 34:2, s. 121-127
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Journal article (peer-reviewed)abstract
- Background: A moderate elevation of plasma total homocysteine (tHcy) is considered a potential risk factor for Alzheimer's disease (AD). Methods: We have investigated the main determinants (age, renal impairment, cobalamin/folate status and the presence of vascular disease) of plasma tHcy in 326 patients with AD, and also in 281 patients with mild cognitive impairment (MCI), since about half of these patients develop AD during the first 5 years. Results: Elevated plasma tHcy in patients with AD could mainly be attributed to cobalamin/folate deficiency or renal impairment. Younger patients (below 75 years) with AD and patients with MCI without cobalamin/folate deficiency or renal impairment showed normal levels of plasma tHcy. Conclusion: Our findings suggest that plasma tHcy is not primarily involved in the pathogenesis of AD but rather a reflection of changes of the main determinants of plasma tHcy in AD patients.
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