Relationship between comprehensive geriatric assessment and amyloid PET in older persons with MCI

Lauretani, Fulvio; Ruffini, Livia; Scarlattei, Maura; Maggio, Marcello

doi:10.1186/s12877-020-01746-x

Cited by 13 publications

(11 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, the widespread deposition of amyloid in the central nervous system of patients suffering from mild cognitive impairment and Alzheimer's disease can contribute to the decline in physical and cognitive performances (Lauretani et al, 2020).…”

Section: Frailty As a Dynamic Processmentioning

confidence: 99%

Comprehensive Model for Physical and Cognitive Frailty: Current Organization and Unmet Needs

et al. 2020

Self Cite

View full text Add to dashboard Cite

Aging is characterized by the decline and deterioration of functional cells and results in a wide variety of molecular damages and reduced physical and mental capacity. The knowledge on aging process is important because life expectancy is expected to rise until 2050. Aging cannot be considered a homogeneous process and includes different trajectories characterized by states of fitness, frailty, and disability. Frailty is a dynamic condition put between a normal functional state and disability, with reduced capacity to cope with stressors. This geriatric syndrome affects physical, neuropsychological, and social domains and is driven by emotional and spiritual components. Sarcopenia is considered one of the determinants and the biological substrates of physical frailty. Physical and cognitive frailty are separately approached during daily clinical practice. The concept of motoric cognitive syndrome has partially changed this scenario, opening interesting windows toward future approaches. Thus, the purpose of this manuscript is to provide an excursus on current clinical practice, enforced by aneddoctical cases. The analysis of the current state of the art seems to support the urgent need of comprehensive organizational model incorporating physical and cognitive spheres in the same umbrella.

show abstract

Section: Frailty As a Dynamic Processmentioning

confidence: 99%

Comprehensive Model for Physical and Cognitive Frailty: Current Organization and Unmet Needs

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…LBD patients present with a wide range of motor and nonmotor (cognitive, neuropsychiatric, sleep, autonomic nervous dysfunction) symptoms. Numerous studies have paid attention to “geriatric syndromes” of dementia older adults, which can increase the disability and dependence [ 4 ], play an important role in dementia diagnoses and management as well. Previous studies point that polypharmacy [ 5 ], falls [ 6 ], fear of falling (FoF) [ 7 ], frailty [ 8 ], orthostatic hypotension (OH) [ 9 ], urinary and fecal incontinence [ 10 ], depression [ 11 ], and sleep distribution [ 2 ] may increase cognitive impairment, neuropsychiatric symptoms, and dependence on daily living, even in early-stage dementia subtypes [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

The presence and co-incidence of geriatric syndromes in older patients with mild-moderate Lewy body dementia

et al. 2022

View full text Add to dashboard Cite

Introduction Geriatric symptoms are common in dementia cases, while few studies have focused on these symptoms in Lewy body dementia (LBD). The purpose of this study is to investigate the distributions of Apolipoprotein E (APOE) ε4 and geriatric symptoms, and explore their associaitons in Dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD). Methods A retrospective study with 185 mild-moderate probable DLB (n = 93) and PDD (n = 92) patients was assigned. Demographic and clinical characteristics, neuropsychological assessments, and APOE genotypes were recorded. Description, correlation and logistic regression models were used to analyze the presence of geriatric symptom complaints and their associations with APOE ε4. Results DLB patients displayed more frequency of fluctuating cognition, visual hallucination, rapid eye movement sleep behavior disorder, delusion, depression, anxiety, apathy, and loss of appetite, whereas the PDD cases had constipation, fear of falling, and insomnia more frequently. The APOE ε4 allele was more common in DLB than PDD (29.9% vs. 7.0%, p < 0.001), and the patients with DLB + APOE ε4 (+) were presented more delusions (p = 0.005) and apathy (p = 0.007) than patients with PDD + APOE ε4 (+). We also found that the APOE ε4 allele was significantly associated with hyperhidrosis (OR = 3.472, 95%CI: 1.082–11.144, p = 0.036) and depression (OR = 3.002, 95%CI: 1.079–8.353, p = 0.035) in DLB patients, while there were no significant associations between APOE ε4 allele and the age at visit, the age at onset, scores of MDS-UPDRS III, H&Y stage, ADL, MMSE, MOCA and NPI, as well as the presences of fluctuating cognition, VH, parkinsonism and RBD in both groups. Conclusion The presence and co-incidence of geriatric symptoms are common in patients with mild-moderate LBD. The presence of APOE ε4 allele is associated with hyperhidrosis and depression, but not global cognition, activitives of daily life, motor function and other neuropsychitric symptoms in DLB. These findings improve the awareness of geriatric symptoms, and contribute to the healthcare management of mild-moderate DLB and PDD.

show abstract

“…In the same line, and as discussed earlier on, Rashidi-Ranjbar et al's work focused on two neuroimaging techniques, namely diffusionweighted imaging measuring white matter tract disruptions and resting-state functional MRI, to provide important clues on both functional and structural abnormalities shared by patients with late-life depression and/or MCI (38). Other studies show that [18F]-fluorodeoxyglucose (FDG) and amyloid-PET techniques allow in vivo assessment of regional glucose metabolism and betaamyloid plaque deposition, respectively, and their association with cognitive, behavioral, and physical performance in MCI and AD (72,73).…”

Section: Can Neuroimaging Ease the Diagnosis Of Depression In Ad?mentioning

confidence: 99%

Depression in Alzheimer's Disease: A Delphi Consensus on Etiology, Risk Factors, and Clinical Management

et al. 2021

View full text Add to dashboard Cite

Background: Alzheimer's disease (AD) and other forms of dementia are among the most common causes of disability in the elderly. Dementia is often accompanied by depression, but specific diagnostic criteria and treatment approaches are still lacking. This study aimed to gather expert opinions on dementia and depressed patient management to reduce heterogeneity in everyday practice.Methods: Prospective, multicenter, 2-round Modified Delphi survey with 53 questions regarding risk factors (11), signs and symptoms (7), diagnosis (8), and treatment (27) of depression in dementia, with a particular focus on AD. The questionnaire was completed by a panel of 37 expert physicians in neurodegenerative diseases (19 neurologists, 17 psychiatrists, and 1 geriatrician).Results: Consensus was achieved in 40 (75.5%) of the items: agreement in 33 (62.3%) and disagreement in 7 (13.2%) of them. Among the most relevant findings, depression in the elderly was considered an early sign (prodromal) and/or a dementia risk factor, so routine cognitive check-ups in depressed patients should be adopted, aided by clinical scales and information from relatives. Careful interpretation of neuropsychological assessment must be carried out in patients with depression as it can undermine cognitive outcomes. As agreed, depression in early AD is characterized by somatic symptoms and can be differentiated from apathy by the presence of sadness, depressive thoughts and early-morning awakening. In later-phases, symptoms of depression would include sleep-wake cycle reversal, aggressive behavior, and agitation. Regardless of the stage of dementia, depression would accelerate its course, whereas antidepressants would have the opposite effect. Those that improve cognitive function and/or have a dual or multimodal mode of action were preferred: Duloxetine, venlafaxine/desvenlafaxine, vortioxetine, tianeptine, and mirtazapine. Although antidepressants may be less effective than in cognitively healthy patients, neither dosage nor treatment duration should differ. Anti-dementia cholinesterase inhibitors may have a synergistic effect with antidepressants. Exercise and psychological interventions should not be applied alone before any pharmacological treatment, yet they do play a part in improving depressive symptoms in demented patients.Conclusions: This study sheds light on several unresolved clinical challenges regarding depression in dementia patients. Further studies and specific recommendations for this comorbid patient population are still needed.

show abstract

Relationship between comprehensive geriatric assessment and amyloid PET in older persons with MCI

Cited by 13 publications

References 49 publications

Comprehensive Model for Physical and Cognitive Frailty: Current Organization and Unmet Needs

Comprehensive Model for Physical and Cognitive Frailty: Current Organization and Unmet Needs

The presence and co-incidence of geriatric syndromes in older patients with mild-moderate Lewy body dementia

Depression in Alzheimer's Disease: A Delphi Consensus on Etiology, Risk Factors, and Clinical Management

Contact Info

Product

Resources

About