Alzheimer's Disease in the NAS-NRC Registry of Aging Twin Veterans

Breitner, John C.S.; Welsh, Kathleen A.; Robinette, C. D.; Gau, B. A.; Folstein, M. F.; Brandt, Jason

doi:10.1159/000106703

Cited by 15 publications

(8 citation statements)

References 10 publications

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“…VaD diagnoses followed the NINDS-AIREN criteria (Tatemichi et al, 1994). MA diagnoses followed those outlined by Breitner et al (1994Breitner et al ( , 1999. At the time of the study, the newer MCI diagnostic criteria (Petersen, 2004) were not yet published.…”

Section: Methods Participantsmentioning

confidence: 99%

“…Prior to the acceptance of the MCI classification, various terms were used for individuals with cognitive impairment but not yet meeting diagnostic criteria for dementia (Petersen & O'Brien, 2006). One such classification was the term mildambiguous (MA; Breitner et al, 1994). Regardless of the nomenclature, there is a group of aging adults who display cognitive problems that are suggestive of an early stage dementia but symptoms are not severe enough to interfere with daily functioning.…”

Section: Introductionmentioning

confidence: 99%

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Regional atrophy of the corpus callosum in dementia

Hallam

Brown

Ross

et al. 2008

J Inter Neuropsych Soc

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The regional distribution of degeneration of the corpus callosum (CC) in dementia is not yet clear. This study compared regional CC size in participants (n 5 179) from the Cache County Memory and Aging Study. Participants represented a range of cognitive function: Alzheimer's disease (AD), vascular dementia (VaD), mild ambiguous (MA-cognitive problems, but not severe enough for diagnosis of dementia), and healthy older adults. CC outlines obtained from midsagittal magnetic resonance images were divided into 99 equally spaced widths. Factor analysis of these callosal widths identified 10 callosal regions. Multivariate analysis of variance revealed significant group differences for anterior and posterior callosal regions. Post-hoc pairwise comparisons of CC regions in patient groups as compared to the control group (controlling for age) revealed trends toward smaller anterior and posterior regions, but not all were statistically significant. As compared to controls, significantly smaller anterior and posterior CC regions were found in the AD group; significantly smaller anterior CC regions in the VaD group; but no significant CC regional differences in the MA group. Findings suggest that dementia-related CC atrophy occurs primarily in the anterior and posterior portions. (JINS, 2008, 14, 414-423.)

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Section: Methods Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Regional atrophy of the corpus callosum in dementia

Hallam

Brown

Ross

et al. 2008

J Inter Neuropsych Soc

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“…This battery of neuropsychological tests has proven useful in several other research protocols that require differential diagnosis in cohorts at risk for dementia [13][14][15] . In these other protocols, and in the ADAMS, this battery of tests has been well accepted by elderly subjects, reasonably brief (average time to complete is 90-100 min), reasonably comprehensive, and sensitive to longitudinal changes in performance [16] . In addition, the tests are sensitive to early changes of AD, other dementias, and CIND, and able to assesses the full range of cognitive performance levels, thereby minimizing 'ceiling' and 'fl oor' effects [17] .…”

Section: Adams Neuropsychological and Other Measuresmentioning

confidence: 99%

The Aging, Demographics, and Memory Study: Study Design and Methods

et al. 2005

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Objective: We describe the design and methods of the Aging, Demographics, and Memory Study (ADAMS), a new national study that will provide data on the antecedents, prevalence, outcomes, and costs of dementia and ‘cognitive impairment, not demented’ (CIND) using a unique study design based on the nationally representative Health and Retirement Study (HRS). We also illustrate potential uses of the ADAMS data and provide information to interested researchers on obtaining ADAMS and HRS data. Methods: The ADAMS is the first population-based study of dementia in the United States to include subjects from all regions of the country, while at the same time using a single standardized diagnostic protocol in a community-based sample. A sample of 856 individuals age 70 or older who were participants in the ongoing HRS received an extensive in-home clinical and neuropsychological assessment to determine a diagnosis of normal, CIND, or dementia. Within the CIND and dementia categories, subcategories (e.g. Alzheimer’s disease, vascular dementia) were assigned to denote the etiology of cognitive impairment. Conclusion: Linking the ADAMS dementia clinical assessment data to the wealth of available longitudinal HRS data on health, health care utilization, informal care, and economic resources and behavior, will provide a unique opportunity to study the onset of CIND and dementia in a nationally representative population-based sample, as well as the risk factors, prevalence, outcomes, and costs of CIND and dementia.

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“…Concordance rates in LOAD between identical twins are quite high, suggesting that AD has a very significant genetic component (85,86). Moreover, family history of AD is a very important risk factor.…”

Section: Predicting the Risk For Development Of Admentioning

confidence: 99%

Alzheimer disease therapy: Can the amyloid cascade be halted?

Golde¹

2003

J. Clin. Invest.

132

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In the not too distant future, clinical management of Alzheimer disease (AD) is likely to resemble the present management of atherosclerotic disease. Sometime before an individual reaches age 50, an internist will initiate a screening program to determine that person's risk for developing AD. This assessment will include a comprehensive genetic screen for AD-risk loci, determination of plasma amyloid β peptide (Aβ) levels, family history of AD, and, perhaps, potential environmental risks. Depending on the risk prediction, a follow-up visit with an Alzheimer specialist may be scheduled. During this visit, an amyloid-binding agent will be injected and used to evaluate the extent of amyloid deposition in the brain. Based on the amount of deposition present and the initial risk assessment, the specialist will then develop a personalized therapeutic regimen. This regimen might consist of an Aβ vaccination, an amyloid-lowering drug, an anti-inflammatory agent, a neuronal growth factor, an antioxidant, or a combination of these approaches. The efficacy of therapy will be monitored by measurement of plasma Aβ levels, imaging of amyloid in the brain, and volumetric scanning of the brain. Primary screening, along with monitoring of the presymptomatic indicators of disease, and appropriate intervention will significantly reduce one's risk for developing AD.Although proposal of such a scenario might seem highly speculative, recent and expected advances in (a) understanding the pathogenesis of AD, (b) identifying the genetic factors that confer risk for AD, (c) validating potential biomarkers for AD, and (d) developing therapeutic agents that target both Aβ and downstream pathological changes greatly increase the likelihood that AD will be managed successfully in the future. AD is the leading cause of dementia in the elderlyEstimates of prevalence vary, but 1-5% of the population over age 65, and 20-40% of the population over age 85, may be affected by AD (1). Given the increasing number of elderly individuals in industrialized societies, AD represents a burgeoning epidemic that exacts a tremendous toll on the individuals it affects, along with their families and caregivers. Moreover, AD has a tremendous negative economic impact amounting to over $100 billion a year. Treatment of AD in the US reportedly costs more per patient than management of other major age-associated diseases (2, 3).Beginning with short-term memory loss, and continuing with more widespread cognitive and emotional dysfunction, typical late-onset AD (LOAD) occurs after age 65 and follows an insidious 5-to 15-year course. Although AD usually presents without motor or sensory alterations, rare variants (such as spastic paraparesis) with atypical clinical presentations are occasionally recognized (4, 5). Even today, definitive diagnosis of AD is only possible through postmortem analysis of the brain (1). This histopathological analysis of the brain demonstrates the classic triad of AD pathology: (a) senile plaques containing Aβ, (b) neurofibrillary tangles (N...

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Alzheimer's Disease in the NAS-NRC Registry of Aging Twin Veterans

Cited by 15 publications

References 10 publications

Regional atrophy of the corpus callosum in dementia

Regional atrophy of the corpus callosum in dementia

The Aging, Demographics, and Memory Study: Study Design and Methods

Alzheimer disease therapy: Can the amyloid cascade be halted?

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