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- Sjöbeck, Martin, et al.
(author)
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Alzheimer's disease and the cerebellum: a morphologic study on neuronal and glial changes
- 2001
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In: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 12:3, s. 211-218
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Journal article (peer-reviewed)abstract
- Structural manifestations of Alzheimer's disease (AD) including neuronal loss were investigated in 12 cases of AD and in 10 healthy age-matched controls, with focus on the cerebellum. Linear Purkinje cell (PC) density was measured in the vermis and cerebellar hemispheres. Neurons were also counted in the inferior olivary nucleus. In vermis of the AD cases, the mean PC number was significantly lower (p = 0.019) than in the controls. The neurons in the inferior olive were similarly fewer, though not significantly (p = 0.13). Molecular layer gliosis and atrophy in the vermis was clearly severer in AD than in the controls. Features typical of cerebral Alzheimer encephalopathy (plaques, tangles and microvacuolization) were inconspicious. The structural cerebellar changes in the AD cases were thus neuronal loss, atrophy and gliosis, judged to represent the disease process, and with a main involvement in the vermis. This may be reflected in some of the symptoms and signs seen in AD, signs that are generally overlooked or judged to be of noncerebellar origin.
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- McCaddon, Andrew, et al.
(author)
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Transcobalamin polymorphism and serum holo-transcobalamin in relation to Alzheimer's disease
- 2004
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In: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 17:3, s. 215-221
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Journal article (peer-reviewed)abstract
- Isoforms of the vitamin B<sub>12</sub> carrier protein transcobalamin (TC) might influence its cellular availability and contribute to the association between disrupted single-carbon metabolism and Alzheimer’s disease (AD). We therefore investigated the relationships between the TC 776C>G (Pro259Arg) genetic polymorphism, total serum cobalamin and holo-TC levels, and disease onset in 70 patients with clinically diagnosed AD and 74 healthy elderly controls. TC 776C>G polymorphism was also determined for 94 histopathologically confirmed AD patients and 107 controls. Serum holo-TC levels were significantly higher in TC 776C homozygotes (p = 0.04). Kaplan-Meier survival functions differed between homozygous genotypes (Cox’s F-Test F(42, 46) = 2.1; p = 0.008) and between 776C homozygotes and heterozygotes (Cox’s F test F(46, 108) = 1.7; p = 0.02). Proportionately fewer TC 776C homozygotes appear to develop AD at any given age, but this will require confirmation in a longitudinal study.
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- Wallin, Åsa, et al.
(author)
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Five-year outcome of cholinergic treatment of Alzheimer's disease: Early response predicts prolonged time until nursing home placement, but does not alter life expectancy
- 2004
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In: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 18:2, s. 197-206
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Journal article (peer-reviewed)abstract
- Fifty consecutive outpatients with Alzheimer’s disease (AD) received treatment with the cholinesterase inhibitor tacrine in an open longitudinal study. Assessments using Mini-Mental State Examination, Alzheimer’s Disease Assessment Scale – cognitive subscale, and a global rating were made at baseline and at 6, 12, 24, 36, 48 and 60 months. Three outcome groups were characterized: responders, unchanged and deteriorated. Additional outcome measures were time until nursing home placement, and mortality rate. At 6 months –75%, at 12 months –42%, at 24 months –20%, and after that 10% of the patients still on medication had improved or remained stable. The mortality rate did not differ between the outcome groups. Response to tacrine treatment at 6 or 12 months was found to predict a prolonged time until nursing home placement. No predictors for a positive treatment response could be identified at baseline.
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- Nilsson, K, et al.
(author)
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Lack of association between plasma homocysteine and inflammation in psychogeriatric patients
- 2002
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In: Dementia and Geriatric Cognitive Disorders. - 1420-8008. ; 14:3, s. 151-155
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Journal article (peer-reviewed)abstract
- Background/Objectives: In previous studies we observed a high incidence of elevated plasma homocysteine (tHcy) concentrations in psychogeriatric patients. Plasma tHcy is increased in folate deficiency. Folates are sensitive to oxidative stress. Oxidative stress, caused by inflammatory processes, could represent an endogenous reason for folate deficiency, even when the dietary intake of the vitamin is within the recommended range. It has been suggested that oxidative stress rather than insufficient folate intake causes hyperhomocysteinemia in different forms of psychogeriatric diseases. In the present study we investigated the association between plasma tHcy and C-reactive protein (CRP), a sensitive marker for inflammation, in psychogeriatric patients. Methods: Plasma tHcy, its main determinants, and CRP were measured in plasma and serum of 132 psychogeriatric patients (53 males and 79 females, mean age 75 12 years). Results. In the psychogeriatric patients, plasma tHcy was elevated and blood folate and serum creatinine were lower than in control subjects, whereas serum CRP concentrations did not differ significantly. We also subdivided the psychogeriatric patients into different diagnosis groups, yet there were no differences in serum CRP concentrations in these groups compared with age-matched control groups. There was a significant correlation between plasma tHcy and serum CRP (rho = 0.19, p < 0.05). A stepwise multiple regression analysis including serum CRP, age, blood folate, serum cobalamin, serum methylmalonic acid and serum creatinine showed that only blood folate (p < 0.001), age (p < 0.001), serum creatinine (p < 0.001), serum cobalamin (p < 0.001), and serum methylmalonic acid (p < 0.001) independently predicted plasma tHcy concentration. Thus CRP concentration was not an independent predictor of plasma tHcy. Conclusion: The present study did not show any association between inflammatory status and plasma tHcy concentration in psychogeriatric patients.
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- Nilsson, Karin, et al.
(author)
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Relation between plasma homocysteine and Alzheimer's disease.
- 2002
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In: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 14:1, s. 41467-41467
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Several studies have shown that plasma total homocysteine (tHcy) concentration is elevated in Alzheimer's disease (AD). However, it is not clear whether elevated plasma tHcy is a primary cause or a consequence of AD. METHOD: To elucidate this question, we have analysed plasma homocysteine and its determinants in patients with early (EOAD)- and late-onset AD (LOAD) and compared the findings with those in vascular dementia (VaD) and age- and sex-matched control subjects. RESULTS: One of the main findings in the present study is that in EOAD there is no change in the levels of either plasma tHcy or its determinants compared with an age- and sex-matched control group. The fact that plasma tHcy concentration is normal in EOAD thus indicates that elevated plasma tHcy is not the primary cause of the disease. Another main finding is that patients with mixed dementia (AD and VaD) and patients with VaD showed significantly increased plasma tHcy concentration compared with controls and that plasma tHCy concentration in patients with LOAD and a history of additional cardiovascular disease was elevated compared both with AD patients without such a history and with the controls. Thus, there is an association between elevated plasma tHcy and vascular disease. A third main finding is that patients with AD who were followed up for several years showed a clinical deterioration of dementia and an elevation of plasma tHcy concentration. This finding likewise supports the notion that elevated plasma tHcy is not the primary cause of the disease. CONCLUSIONS: The findings suggest that elevated plasma tHcy is not the primary cause of the disease. Furthermore, the findings indicate that elevated plasma tHcy might be a reflection of concomitant vascular disease in AD patients.
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- Edlund, Agneta, et al.
(author)
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Delirium before and after operation for femoral neck fracture
- 2001
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In: Journal of The American Geriatrics Society. - : Wiley. - 0002-8614 .- 1532-5415. ; 49:10, s. 1335-1340
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The aim of this study was to investigate the differences between preoperative and postoperative delirium regarding predisposing, precipitating factors and outcome in older patients admitted to hospital with femoral neck fractures.DESIGN: A prospective clinical assessment of patients treated for femoral neck fractures.SETTING: Department of orthopedic surgery at Umeå University Hospital, Sweden.PARTICIPANTS: One hundred one patients, age 65 and older admitted to the hospital for treatment of femoral neck fractures.MEASUREMENTS: The Organic Brain Syndrome (OBS) Scale.RESULTS: Thirty patients (29.7%) were delirious before surgery and another 19 (18.8%) developed delirium postoperatively. Of those who were delirious preoperatively, all but one remained delirious postoperatively. The majority of those delirious before surgery were demented, had been treated with drugs with anticholinergic properties (mainly neuroleptics), had had previous episodes of delirium, and had fallen indoors. Patients who developed postoperative delirium had perioperative falls in blood pressure and had more postoperative complications such as infections. Male patients were more often delirious both preoperatively and postoperatively. Patients with preoperative delirium were more often discharged to institutional care and had poorer walking ability both on discharge and after 6 months than did patients with postoperative delirium only.CONCLUSIONS: Because preoperative and postoperative delirium are associated with different risk factors it is necessary to devise different strategies for their prevention.
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