Progress in Clinical Neurosciences: Cognitive Markers of Progression in Alzheimer's Disease

Behl, Pearl; Stefurak, Taresa L.; Black, Sandra E.

doi:10.1017/s0317167100003917

Cited by 43 publications

(42 citation statements)

References 132 publications

(147 reference statements)

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“…As a result, the ADAS-Cog may underestimate the benefit of treatment seen in clinical practice since it mainly measures memory, language and praxis [44]. Unlike the MMSE, which was initially developed as a screening test, the DRS is more sensitive to change and progression in AD [45] (See Behl et al for a review [46]). Factor analysis of item scores from the Dementia Rating Scale identified four factors [35] that reflect the cognitive domains of attention and registration, verbal fluency and reasoning, graphomotor skills and praxis, and short-term memory.…”

Section: Discussionmentioning

confidence: 99%

Cholinesterase Inhibitors Slow Decline in Executive Functions, Rather than Memory, in Alzheimers Disease: A 1-Year Observational Study in the Sunnybrook Dementia Cohort

Behl

Lanctôt²,

Streiner³

et al. 2006

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To determine if there are differential treatment effects of second-generation cholinesterase inhibitors over one year, 130 patients (untreated=65, treated=65) meeting NINCDS-ADRDA criteria for mild or moderate probable AD underwent standardized cognitive testing at baseline and 12 months later at a university memory clinic. Patients were followed either prior to or after the availability of treatment and were matched on education and baseline Mini Mental State Examination (MMSE). A detailed medical history evaluation was conducted. In this well matched longitudinal observational cohort study, there were no differences in the prevalence of comorbid illnesses, concomitant medication use or vascular risk factors except for a greater number of treated patients with a previous history of smoking. Separate repeated measures MANCOVAs on the MMSE, Mattis Dementia Rating Scale (DRS), and its 5 subscores (attention, initiation/perseveration, conceptualization, construction and memory) (Bonferroni corrected), after covarying for the effects of smoking, and SSRI use, showed less decline over one year in the treated group in overall cognition and in all subscores of the DRS except for memory (effect sizes 0.5-0.7). Less decline was also seen in the treated group in function and in instrumental and basic activities of daily living as measured with the Disability Assessment for Dementia Scale (DAD) (effect sizes 0.4-0.8). Executive, language and visuospatial functions, rather than memory, appeared to be more amenable to stabilization over one year by cholinesterase inhibitors in AD.

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Section: Discussionmentioning

confidence: 99%

Cholinesterase Inhibitors Slow Decline in Executive Functions, Rather than Memory, in Alzheimers Disease: A 1-Year Observational Study in the Sunnybrook Dementia Cohort

Behl

Lanctôt²,

Streiner³

et al. 2006

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“…26,27 The DRS has been widely used to study the cognitive functioning of both demented and nondemented adults. [27][28][29][30] The DRS yields a Total Score which reflects an individual's overall level of cognitive functioning.…”

Section: Dementia Rating Scalementioning

confidence: 99%

Blood Pressure Variability and Dementia Rating Scale Performance in Older Adults With Cardiovascular Disease

Keary

Gunstad

Poppas

et al. 2007

Cognitive and Behavioral Neurology

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“…2 The Dementia Rating Scale (DRS) is a commonly used neuropsychologic measure that is sensitive to dementia and cognitive decrease in older adults. [3][4][5] In addition to the DRS total score, 5 subtests assess function in different cognitive domains, namely, attention, initiation and perseveration, construction, conceptualization, and memory. The DRS was administered and scored according to established protocols by a trained research assistant.…”

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confidence: 99%

Relation of Brain Natriuretic Peptide Levels to Cognitive Dysfunction in Adults >55 Years of Age With Cardiovascular Disease

Gunstad¹,

Poppas²,

Smeal³

et al. 2006

The American Journal of Cardiology

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Cardiovascular disease (CVD) is associated with cognitive deficits long before the onset of stroke or dementia. Recent work has extended these findings and shown that patients with congestive heart failure also exhibit reduced cognitive performance. Brain natriuretic peptide (BNP) is used to help diagnose heart failure, but no study has examined whether BNP predicts cognitive dysfunction in older patients with CVD. BNP values and performance on the Dementia Rating Scale were assessed in 56 older adults with documented CVD. Forty-eight percent of the participants were women, and their average age was 70 ± 8 years. All participants had Mini-Mental State Examination scores greater than the cutoff for dementia and no histories of neurologic or severe psychiatric disorders. The average BNP level was 122 ± 202 pg/ml. Hierarchical regression analyses showed that logtransformed BNP levels predicted Dementia Rating Scale total score after adjusting for possible demographic and medical confounders (ΔR 2 = 0.09, F[1, 44] = 6.14, p = 0.017). Partial correlation analysis adjusting for these possible confounders showed a particularly strong relation to the conceptualization subtest (r = −0.44, p = 0.002), a measure of verbal and nonverbal abstraction abilities. In conclusion, the results of the present study provide the first evidence for an independent relation between BNP and cognitive dysfunction in older adults with CVD.We hypothesized that brain natriuretic peptide (BNP) levels might predict cognitive dysfunction and assessed BNP levels and cognitive performance in a sample of older adults with documented stable cardiovascular disease (CVD).The following methods were approved by the local institutional review board, and all participants provided written informed consent.Fifty-six participants enrolled in a larger, prospective study of the neurocognitive consequences of CVD were included in the present study. For inclusion into the parent study, all participants had to have documented histories of CVD, be between the ages of 55 and 85 years, have MiniMental State Examination total scores greater than the cutoff for dementia, 1 and have no histories of neurologic or severe psychiatric disorders (e.g., stroke, bipolar disorder). The demographic and medical characteristics of the sample are presented in Table 1. BNP levels were obtained on the same day as the neuropsychologic battery was conducted and <3 weeks after cardiac evaluation. BNP levels were quantified using the Bayer Advia Centaur (Bayer HealthCare, Tarrytown, New York). Blood samples were sent to the local laboratory for analysis. To promote comparison with past studies, BNP levels were log transformed before statistical analysis to adjust for the skewed distribution. 2 The Dementia Rating Scale (DRS) is a commonly used neuropsychologic measure that is sensitive to dementia and cognitive decrease in older adults. [3][4][5] In addition to the DRS total score, 5 subtests assess function in different cognitive domains, namely, attention, initiation and pers...

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Progress in Clinical Neurosciences: Cognitive Markers of Progression in Alzheimer's Disease

Cited by 43 publications

References 132 publications

Cholinesterase Inhibitors Slow Decline in Executive Functions, Rather than Memory, in Alzheimers Disease: A 1-Year Observational Study in the Sunnybrook Dementia Cohort

Cholinesterase Inhibitors Slow Decline in Executive Functions, Rather than Memory, in Alzheimers Disease: A 1-Year Observational Study in the Sunnybrook Dementia Cohort

Blood Pressure Variability and Dementia Rating Scale Performance in Older Adults With Cardiovascular Disease

Relation of Brain Natriuretic Peptide Levels to Cognitive Dysfunction in Adults >55 Years of Age With Cardiovascular Disease

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