1. |
- Minthon, Lennart, et al.
(author)
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Tacrine treatment modifies cerebrospinal fluid neuropeptide levels in Alzheimer's disease
- 1994
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In: Dementia (Switzerland). - : S. Karger AG. - 1013-7424. ; 5:6, s. 295-301
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Journal article (peer-reviewed)abstract
- Biochemical and histochemical studies have demonstrated a widespread deficit in the activity of acetylcholinesterase (AChE) in the brains of patients with Alzheimer's disease (DAT). Multiple disturbances in several transmitter systems have been found. The most consistent neurochemical changes in DAT are reductions in the cholinergic system. The major pharmacological approach today in DAT is based on the cholinergic theory assuming that acetylcholine has a major cortical impact on cognitive processes. Tetrahydroaminoacridine (THA, tacrine) is a centrally active reversible acetylcholinesterase inhibitor. A large number of trials have been performed in patients with DAT. This article was to evaluate whether THA treatment induced neuropeptide alteration in DAT before and after 1 year on oral THA treatment.
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2. |
- Elfgren, C., et al.
(author)
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Neuropsychological tests as discriminators between dementia of Alzheimer type and frontotemporal dementia
- 1994
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In: International Journal of Geriatric Psychiatry. - : Wiley. - 1099-1166 .- 0885-6230. ; 9:8, s. 635-642
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Journal article (peer-reviewed)abstract
- The aim of this study was to examine whether cognitive test performance alone could distinguish patients with dementia of Alzheimer type (DAT) from those with frontotemporal dementia (FTD). Scores from three neuropsychological tests were used as discriminating variables in 28 cases with postmortem verified diagnoses. The selected tests measured verbal ability, visuospatial ability and verbal memory. Eighty-nine per cent of the sample was correctly classified by discriminant analysis. Evaluating the ability of the obtained discriminant function to differentiate between groups of DAT and FTD in a new, clinically diagnosed sample of 38 cases yielded an overall success rate of 84%. The results suggest that cognitive tests may be helpful for differential diagnosis in the context of a neuropsychiatric examination.
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3. |
- Elmstahl, S., et al.
(author)
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Quantitative EEG in elderly patients with Alzheimer's disease and healthy controls
- 1994
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In: Dementia (Switzerland). - : S. Karger AG. - 1013-7424. ; 5:2, s. 119-124
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Journal article (peer-reviewed)abstract
- Multichannel (19) EEG were analyzed in 23 female patients with rather advanced late-onset Alzheimer's disease (AD) and compared with 56 age- and sex-matched healthy control subjects. The quantified EEG was correlated with psychometric and clinical variables. The control subjects showed increasing theta activity with age but the EEG changes did not correlate significantly with psychometric features. The AD patients showed highly significant increases in delta and theta activity and decreases in beta activity compared with controls. The EEG changes were most marked over posterior regions of the brain. The individual EEG variables showed a high degree of intercorrelation and an almost complete discrimination between patients and controls was accomplished by taking only the posterior delta activity into account. In a subgroup of 10 patients, in which a Mini Mental test score could be obtained, the score correlated with the relative theta power.
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4. |
- Elmståhl, Sölve, et al.
(author)
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Autonomic cardiovascular responses to tilting in patients with alzheimer's disease and in healthy elderly women
- 1992
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In: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 21:4, s. 301-307
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Journal article (peer-reviewed)abstract
- The cardiovascular responses to tilting and breathing were studied in 24 patients with late-onset Alzheimer's disease (AD) and 54 healthy control women aged between 75 and 96 years in order to study the parasympathetic and sympathetic heart-rate control. The cardiovascular response to tilting and breathing showed no age-associated decrease in the healthy control women. During rest, the AD patients had lower mean systolic and diastolic blood pressure but the same heart rate as the control patients. After tilting, the AD patients had a greater increase in heart rate, and the mean systolic blood pressure fell to 126 mmHg compared with 160 mmHg in the control women (p<0.001). After the initial acceleration, the following deceleration of the heart rate, an expression of parasympathetic nervous activity, was lower in the AD patients (p <0.001). The deep-breathing test showed no significant difference between the two groups, but the changes of acceleration and brake indices could indicate a dysfunction of the autonomic nervous system since the AD patients were not recumbent.
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5. |
- Elmstahl, S., et al.
(author)
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Body composition in patients with Alzheimer's disease and healthy controls
- 1992
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In: Journal of Clinical and Experimental Gerontology. - 0192-1193. ; 14:1, s. 17-31
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Journal article (peer-reviewed)abstract
- In Alzheimer's disease (AD), decreased physical activity and nutritional problems are parts of the natural course with probable implications on body composition. Body fat and lean body mass were measured with a bioelectrical impedance method in 25 women who had AD according to the criteria of NINCDS- ADRDA and in 63 health age-matched controls. The patients with AD had 9.5 kg lower body weight (p<0.01), due to almost 4.0 kg lower body fat and 6.0 kg lower lean body mass (p<0.001). This might imply a higher risk for morbidity and mortality. Body weight and lean body mass decreased with age in AD patients but not in the healthy control women. In the control group, the unmarried women had more than 13 kg lower body weight and 9 kg lower body fat than the mean values of all other marital status groups (p<0.01). The maintenance of lean body mass in the very healthy old indicate the possibilities for physical activity.
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7. |
- Elmståhl, Sölve, et al.
(author)
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A study of regional cerebral blood flow using 99mTc-HMPAO-SPECT in elderly women with senile dementia of alzheimer’s type
- 1994
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In: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 5:6, s. 302-309
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Journal article (peer-reviewed)abstract
- Thirteen women with senile dementia of Alzheimer’s type (SDAT) according to NINCDS-ADRDA and 21 age-matched control women, aged 75-96 years, were investigated with clinical examination, dementia rating scales and single photon emission computed tomography (SPECT) using99mTc-hexamethylpropyleneamine oxime (HM-PAO) as a tracer of regional cortical blood flow. The aim was to study whether typical SPECT findings of SDAT were seen also in the very old having the disease for a longer period. Neuropsychological assessment with vocabulary and spatial tests was performed in the control women, and the results were divided in three subgroups, normal, borderline and abnormal. Regional perfusion values, expressed as a ratio between cortical and cerebellar HM-PAO uptake, were lower in frontal, temporoparietal and occipital cortices in SDAT patients than in controls. The SDAT patients had the lowest uptake in the posterior temporoparietal region (0.67 ± 0.06) and the corresponding value in the controls (0.79 ± 0.05) differed significantly, p < 0.0001. The interhemispheric ratio between right and left posterior temporoparietal regions was 0.99 ± 0.05. Nine of the control women (43%) had pathological SPECT with hemispheric asymmetries in 6 cases and bilateral temporooccipital reductions in 3 women. The neuropsychological assessment matched the findings in 7 of these women. One of the control women was judged as pathological and 10 women as borderline according to the spatial and vocabulary tests. Four of the 10 women with borderline results had normal SPECT. The sensitivity of the assessment to detect abnormalities compared to SPECT was 78% if borderline and abnormal results were expressed as true-positive cases. The specificity was 67%. The results showed a high degree of pathological findings according to SPECT and neuropsychological assessment in otherwise healthy elderly women.
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8. |
- Elmståhl, Sölve, et al.
(author)
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Body composition and dietary habits in 80-year-old smoking men without cardiovascular disease
- 1991
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In: Aging (Milan, Italy). - 0394-9532. ; 3:3, s. 77-269
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Journal article (peer-reviewed)abstract
- Eighty-year-old male residents in the community of Malmö were questioned about smoking habits and the occurrence of cardiovascular disease (CVD). Of 1,280 subjects, 122 were selected for further studies and allocated into 4 groups: 1) no CVD, non-smokers; 2) no CVD, smokers; 3) CVD, smokers; and 4) CVD, non-smokers. The smokers had consumed on the average 13 g of tobacco daily for 59 years. Lean body mass (LBM), body fat (BF), % body fat (%BF), and total body water (TBW) were estimated by means of bioelectrical impedance analysis. The mean body weight (BW), LBM, and %BF for all subjects were 74.1 +/- 10.2 kg, 58.0 +/- 6.8 kg, and 21.3 +/- 5.9 kg, respectively. There were no significant differences between all subjects with and without CVD. A lower BW among smokers than in non-smokers was explained by lower BF and %BF in the former. Smokers who had lived predominantly in rural areas had lower BW (6.9 kg) and LBM (5.2 kg) than those from an urban area. A positive correlation was noted between the degree of physical activity and LBM and TBW. Seventeen percent of the smokers exercised regularly. The CVD group had higher plasma cholesterol concentrations than the non-CVD group. Plasma triglycerides showed a positive correlation with BF, %BF and BW, whereas HDL cholesterol was negatively correlated with BF, %BF and BW. It is concluded that smoking is one of several important factors related to body composition, and the penetrance of this factor is still apparent in elderly men.
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9. |
- Elmståhl, S., et al.
(author)
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Increased sweat sodium concentration in patients with Alzheimer's disease
- 1993
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In: Dementia (Switzerland). - 1013-7424. ; 4:1, s. 50-53
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Journal article (peer-reviewed)abstract
- Sweat sodium concentration was estimated with pilocarpine iontophoresis in I 15 women with Alzheimer's disease (AD) and 29 healthy control women. The age ranged from 76 to 96 years with a mean age of 85 years in both groups. The mean sodium concentration of 91 ± 41 mmol/l (n = 11) in the Alzheimer patients was significantly higher than in the control group (62 ± 29 mmol/l, n=27, p=0.0011). 27% of AD patients and 7% of the control women did not respond to stimulation. The impaired sweating in AD patients make them more vulnerable to heat stress. Further studies are needed to reveal whether the neurophysiological mechanism involved is located in the hypothalamus, in cortical projections to the hypothalamus or in postganglionic sympathetic fibers.
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