Executive Summary
This document proposes an array of recommendations for a National Plan of Action to accelerate the discovery and development of therapies to delay or prevent the onset of disabling symptoms of Alzheimer's disease. A number of the key scientific and public policy needs identified in this document will be incorporated by the Alzheimer Study Group (ASG) into a broader National Alzheimer's Strategic Plan (NASP), which will be presented to the 111th Congress and the Obama administration in March 2009. The NASP is expected to include additional recommendations for governance, family support, healthcare and social services delivery.
Previous studies of patients with severe chronic alcoholism have shown a high prevalence of emotional distress such as anxiety and depression, and neuropsychological impairments such as executive deficits, but few have examined the relationship between these disorders. We addressed this issue in 51 abstinent patients with histories of severe chronic alcoholism utilizing the Minnesota Multiphasic Personality Inventory (MMPI) and the Halstead-Reitan Neuropsychological Test Battery (HRNTB). Applying factor analysis to the MMPI clinical and validity scales, we derived four dimensions accounting for 78% of the available variance. We found that Factor 1, which loaded on most clinical scales of the MMPI, was significantly correlated (p <.01) with performance on the Halstead Category Test (HCT), a measure of executive functioning. Further, group analysis with MANOVA using HCT (impaired and nonimpaired) as the independent variable revealed a significant main effect for Factor 1 (p <.004), which was maintained and strengthened when age and education were controlled as covariates (p <.001). The results suggest a relationship between emotional distress and executive functioning as measured by the HCT, reflecting differing facets of frontal lobe dysfunction common to cognitive and affective domains in patients with severe chronic alcoholism.
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