The Public Health Impact of Alzheimer's Disease, 2000–2050: Potential Implication of Treatment Advances

Sloane, Philip D.; Zimmerman, Sheryl; Suchindran, Chirayath; Reed, Peter; Wang, Lily; Boustani, Malaz; Sudha, S.

doi:10.1146/annurev.publhealth.23.100901.140525

Cited by 395 publications

(290 citation statements)

References 42 publications

(37 reference statements)

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“…Dementia is a grave and costly public health issue affecting 5.3 million elderly in the U.S., with the number projected to triple by 2050 [1]. It is frequently complicated by multiple co-morbidities, thereby increasing the risk for hospitalizations and adverse outcomes [2,3].…”

Section: Introductionmentioning

confidence: 99%

Age and Race Specific Trends and Mortality for Dementia Hospitalization in the US

Sherzai¹,

Sherzai²

2016

J Neurol Neurophysiol

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Objective: To explore ethnoracial and gender specific mortality associated with dementia hospitalizations from 1997 to 2008, using a nationally representative database.Design: Cross-sectional.Participants: 354,949,163 from the Nationwide Inpatient Sample (NIS) database using appropriate ICD-9 and procedure codes. Measurements:Descriptive, univariate and multivariable analysis (Linear, Cox) adjusting for comorbidity, hospital factors and socio-demographics were used.Results: Mortality was higher for dementia hospitalizations for all age groups (35-64 years and ≥ 65 years) vs. non-dementia hospitalizations (2.7% vs. 1.5% and 5.5% vs. 4.5%). For individuals aged 35-64 years, dementia hospitalizations were more common among males vs. females (53.8% vs. 46.2%). Crude in-hospital mortality was higher among Whites and males for all age groups and overall mortality declined from 1999 to 2008. Adjusted relative risk of mortality was higher among men as compared to women of all age groups (RR 2.87, 95% CI 2.82-2.92) and also higher among Hispanics and African Americans as compared to Whites (African Americans: RR 2.35, 95% CI 2.21-2.51; Hispanics: RR 2.15, 95% CI 2.06-2.23). Conclusion:African Americans, Hispanics and men bear a disproportionate burden from dementia in the hospital setting. Interventions to improve care outcomes in these populations are important.

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Section: Introductionmentioning

confidence: 99%

Age and Race Specific Trends and Mortality for Dementia Hospitalization in the US

Sherzai¹,

Sherzai²

2016

J Neurol Neurophysiol

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“…Neurodegenerative diseases such as Alzheimer's and Parkinson's disease have a predicted increased incidence of 300% in the next 30 years due to an ever aging population, especially in developing countries (3). This has become a global concern and threatens to impact heavily both socially and economically (4)(5)(6). A minimally invasive approach to identify individuals at increased risk for AD before the disease process becomes irreversible and to enhance the possibility of success of preventative diet and life-style strategies would be highly desirable.…”

Section: Introductionmentioning

confidence: 99%

Altered cytological parameters in buccal cells from individuals with mild cognitive impairment and Alzheimer's disease

et al. 2014

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Previous studies have shown that mild cognitive impairment (MCI) may be reflective of the early stages of more pronounced neurodegenerative disorders such as Alzheimer's disease (AD). There is a need for a minimally invasive and inexpensive diagnostic to identify those who exhibit cellular pathology indicative of MCI and AD risk so that they can be prioritized for primary preventative measures. The hypothesis was that a minimally invasive approach using cytological markers in isolated buccal mucosa cells can be used to identify individuals of both MCI and AD. An automated buccal cell assay was developed using laser scanning cytometry (LSC) to measure buccal cell type ratios, nuclear DNA content and shape, and neutral lipid content of buccal cells from clinically diagnosed AD (n 5 13) and MCI (n 5 13) patients prior to treatment compared to age-and gender-matched controls (n 5 26). DNA content was significantly higher in all cell types in both MCI (P < 0.01) and AD (P < 0.05) compared with controls mainly due to an increase in >2N nuclei. Abnormal nuclear shape (circularity) was significantly increased in transitional cells in MCI (P < 0.001) and AD (P < 0.01) when compared to controls. In contrast, neutral lipid content (as measured by Oil red O "ORO" staining) of buccal cells was significantly lower in the MCI group (P < 0.05) compared with the control group. The ratio of DNA content/ORO in buccal basal cells for both MCI and AD was significantly higher compared to the control group, with ratios for MCI being approximately 2.8-fold greater (P < 0.01) and AD approximately 2.3-fold greater (P < 0.05) than the control group. Furthermore, there was a strong negative correlation between buccal cell DNA content and ORO content in the AD group (r 2 5 0.75, P < 0.0001) but not in MCI or controls. The changes in the buccal cell cytome observed in this study could prove useful as potential biomarkers in identifying individuals with an increased risk of developing MCI and eventually AD. V C 2014 International Society for Advancement of Cytometry

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“…Moreover, the number of VaD patients will double by around 2020 as the population ages [2] . The increasing public costs have become a heavy burden on society and have attracted attention worldwide.…”

Section: Introductionmentioning

confidence: 99%

Cholinergic deficiency involved in vascular dementia: possible mechanism and strategy of treatment

2009

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Vascular dementia (VaD) is a progressive neurodegenerative disease with a high prevalence. Several studies have recently reported that VaD patients present cholinergic deficits in the brain and cerebrospinal fluid (CSF) that may be closely related to the pathophysiology of cognitive impairment. Moreover, cholinergic therapies have shown promising effects on cognitive improvement in VaD patients. The precise mechanisms of these cholinergic agents are currently not fully understood; however, accumulating evidence indicates that these drugs may act through the cholinergic anti-inflammatory pathway, in which the efferent vagus nerve signals suppress pro-inflammatory cytokine release and inhibit inflammation, although regulation of oxidative stress and energy metabolism, alleviation of apoptosis may also be involved. In this paper, we provide a brief overview of the cholinergic treatment strategy for VaD and its relevant mechanisms of anti-inflammation.

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The Public Health Impact of Alzheimer's Disease, 2000–2050: Potential Implication of Treatment Advances

Cited by 395 publications

References 42 publications

Age and Race Specific Trends and Mortality for Dementia Hospitalization in the US

Age and Race Specific Trends and Mortality for Dementia Hospitalization in the US

Altered cytological parameters in buccal cells from individuals with mild cognitive impairment and Alzheimer's disease

Cholinergic deficiency involved in vascular dementia: possible mechanism and strategy of treatment

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