Dementia Update 2005

Morris, John C.

doi:10.1097/01.wad.0000167923.56275.d8

Cited by 61 publications

(59 citation statements)

References 211 publications

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“…Mild cognitive impairment (MCI) describes elderly individuals having a decline in episodic memory function relative to other cognitive abilities (Collie and Maruff, 2000;Morris, 2003;Petersen et al, 1999;Smith et al, 1996). MCI patients are approximately 6-fold more likely to progress to Alzheimer's disease relative to healthy older individuals Petersen et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

Auditory brain-stem, middle- and long-latency evoked potentials in mild cognitive impairment

Irimajiri

Golob

Starr

2005

Clinical Neurophysiology

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Objective: Mild cognitive impairment (MCI) is a selective episodic memory deficit in the elderly with a high risk of Alzheimer's disease. The amplitudes of a long-latency auditory evoked potential (P50) are larger in MCI compared to age-matched controls. We tested whether increased P50 amplitudes in MCI were accompanied by changes of middle-latency potentials occurring around 50 ms and/or auditory brainstem potentials. Methods: Auditory evoked potentials were recorded from age-matched controls (nZ16) and MCI (nZ17) in a passive listening paradigm at two stimulus presentation rates (2/s, 1/1.5 s). A subset of subjects also received stimuli at a rate of 1/3 s. Results: Relative to controls, MCI subjects had larger long-latency P50 amplitudes at all stimulus rates. Significant group differences in N100 amplitude were dependent on stimulus rate. Amplitudes of the middle-latency components (Pa, Nb, P1 peaking at approximately 30, 40, and 50 ms, respectively) did not differ between groups, but a slow wave between 30 and 49 ms on which the middle-latency components arose was significantly increased in MCI. ABR Wave V latency and amplitude did not differ significantly between groups. Conclusions: The increase of long-latency P50 amplitudes in MCI reflects changes of a middle-latency slow wave, but not of transient middle-latency components. There was no evidence of group difference at the brain-stem level. Significance: Increased slow wave occurring as early as 50 ms may reflect neurophysiological consequences of neuropathology in MCI.

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Section: Introductionmentioning

confidence: 99%

Auditory brain-stem, middle- and long-latency evoked potentials in mild cognitive impairment

Irimajiri

Golob

Starr

2005

Clinical Neurophysiology

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“…20,21 Regarding genetic factors, rare mutations on genes coding for amyloid precursor protein, presenilin 1, and presenilin 2 have been identified that are deterministic for early-onset AD. 22 Apolipoprotein E (APOE), in contrast, affects susceptibility to AD and has three major forms. APOE ⑀3, the most common allele, is found in over half the US population.…”

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confidence: 99%

Incorporating ethnicity into genetic risk assessment for Alzheimer disease: the REVEAL study experience

Christensen

Roberts

Royal

et al. 2008

Genetics in Medicine

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Purpose: To describe how investigators in a multisite randomized clinical trial addressed scientific and ethical issues involved in creating risk models based on genetic testing for African American participants. Methods: The following informed our decision whether to stratify risk assessment by ethnicity: evaluation of epidemiological data, appraisal of benefits and risks of incorporating ethnicity into calculations, and feasibility of creating ethnicityspecific risk curves. Once the decision was made, risk curves were created based on data from a large, diverse study of first-degree relatives of patients with Alzheimer disease. Results: Review of epidemiological data suggested notable differences in risk between African Americans and whites and that Apolipoprotein E genotype predicts risk in both groups. Discussions about the benefits and risks of stratified risk assessments reached consensus that estimates based on data from whites should not preclude enrolling African Americans, but population-specific risk curves should be created if feasible. Risk models specific to ethnicity, gender, and Apolipoprotein E genotype were subsequently developed for the randomized clinical trial that oversampled African Researchers are identifying a growing number of genetic markers that are associated with increased or decreased risk for common, complex diseases. Consequently, the development of genetic risk assessment and risk communication strategies are areas of critical importance, especially given that laypersons often have a difficult time in understanding probabilistic information. 1,2 Protocols for disclosing genetic information have been developed and refined for various forms of cancer, 3-6 but similar efforts have been made only recently for other diseases. 7,8 One area of recent focus is Alzheimer disease (AD).AD is the most common form of dementia among the elderly, affecting an estimated five million individuals in the United States. Well over 10 million Americans are expected to have the condition by 2050 as the population continues to age. 9 Many risk factors are well-characterized, including age and family history, 10 -14 whereas many others are under investigation, including education level, 15,16 head trauma, 17,18 high blood pressure, 19 caloric intake, and high cholesterol. 20,21 Regarding genetic factors, rare mutations on genes coding for amyloid precursor protein, presenilin 1, and presenilin 2 have been identified that are deterministic for early-onset AD. 22 Apolipoprotein E (APOE), in contrast, affects susceptibility to AD and has three major forms. APOE ⑀3, the most common allele, is found in over half the US population. The ⑀4 allele is associated with increased risk for AD whereas the ⑀2 allele has a protective effect. 23,24 The ⑀4 allele is neither necessary nor sufficient for AD though, and individuals with the ⑀2 allele still have risk for AD. APOE variants are also associated with other conditions such as hyperlipoproteinemia and atherosclerosis 25 and may play a role in the development of ma...

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“…The impairment must represent a decline from previous level of function, and must be severe enough to interfere with daily functions and independence 2 . The prevalence of dementia increases with age, and doubles every five years, ranging between 1% among people aged 60-64 years and 45% in individuals aged 85 or older [3][4][5][6] . Today, dementia is considered one of the major social burdens in developing countries 3,7 and accounts, worldwide, for 11.2% years lived with incapacity, in people aged 60 or older, a percentage higher than that of strokes, cardiovascular disease (CvD) and cancer 8 .…”

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confidence: 99%

Risk factors for dementia in a rural area of Northeastern Brazil

Magalhães

Peixoto

Frank

et al. 2008

Arq. Neuro-Psiquiatr.

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-Objective: To identify risk factors for dementia among the elderly in a rural area of Northeastern Brazil. Method: The subjects assessed were all 60 years old or older, and lived in a rural region of Bahia, a Northeastern State of Brazil. CAMDEX, a structured clinical evaluation protocol, was used for diagnosis, and applied at the home of the subjects. Results: The risk factors identified were divided in accordance with socio-demographic characteristics, the presence of co-morbid conditions, and the use of medications. The variables with strong association with dementia were age, history of stroke, arterial hypertension, and sight impairment. Conclusion: Advanced age, arterial hypertension, and vascular brain injury were the main risk factors associated with dementia, which suggests that public health measures adopted to prevent and control modifiable risk factors can mitigate the prevalence of high rates of dementia.KEy worDS: dementia, elderly, population aging, prevalence, risk factors. Fatores de risco para demência em uma área rural do nordeste do BrasilResumo -Objetivo: Identificar fatores de risco para demência entre idosos de uma área rural do nordeste do Brasil. Método: os indivíduos avaliados tinham 60 anos ou mais e viviam numa região rural na Bahia, Estado do nordeste brasileiro. Um protocolo de avaliação clínica estruturada -CAMDEX -foi utilizado para diagnóstico e aplicado no domicílio dos indivíduos participantes. Resultados: os fatores de risco identificados foram divididos de acordo com características sócio-demográficas, a presença de comorbidades e o uso de medicações. As variáveis com forte associação para demência foram idade, história de acidente vascular encefálico, hipertensão arterial e comprometimento visual. Conclusão: Idade avançada, hipertensão arterial e lesão vascular cerebral foram os principais fatores de risco associados com demência, o que sugere que medidas de saúde pública adotadas para prevenir e controlar fatores de risco modificáveis podem diminuir a prevalência de altas taxas de demência. PAlAvrAS-ChAvE: demência, envelhecimento, prevalência, fatores de risco. Dementia is a generic term that describes a chronic or progressive dysfunction of cortical and subcortical function that results in a complex cognitive decline. These dysfunctions are usually accompanied by personality, mood and/or behavior disorders 1 . Dementia is also a condition characterized by impairment of memory and of at least one other cognitive function (aphasia, apraxia, agnosia, executive dysfunction). The impairment must represent a decline from previous level of function, and must be severe enough to interfere with daily functions and independence 2 . The prevalence of dementia increases with age, and doubles every five years, ranging between 1% among people aged 60-64 years and 45% in individuals aged 85 or older [3][4][5][6] . Today, dementia is considered one of the major social burdens in developing countries 3,7 and accounts, worldwide, for 11.2% years lived with incapacity, in people a...

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Dementia Update 2005

Cited by 61 publications

References 211 publications

Auditory brain-stem, middle- and long-latency evoked potentials in mild cognitive impairment

Auditory brain-stem, middle- and long-latency evoked potentials in mild cognitive impairment

Incorporating ethnicity into genetic risk assessment for Alzheimer disease: the REVEAL study experience

Risk factors for dementia in a rural area of Northeastern Brazil

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