Parallels between Down syndrome dementia and Alzheimer's disease.
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Aging↗
Biomedical subjects
M S Albert
Publications and source records attributed to M S Albert.
Risk of death from Alzheimer's disease in a community population of older persons.
A random sample of 467 persons over age 65 years from the population of an urban US community, stratified by age, sex, and performance on a brief memory test, underwent clinical evaluation for dementing illness in 1982-1984. Of these persons, 134 had probable Alzheimer's disease, 166 had possible Alzheimer's disease, and 167 had no evidence of Alzheimer's disease. Over a median follow-up period of 4.9 years following evaluation, 165 (35%) died. Overall, persons with probable Alzheimer's disease had a relative risk of death 1.44 (95% confidence interval (Cl) 1.05-1.96) times that of the unaffected. Level of cognitive impairment and the presence of cachexia upon physical examination both strongly and independently modified risk of death. Among those with probable Alzheimer's disease, mortality for those with mild or moderate cognitive impairment and no evidence of cachexia was comparable to that of the unaffected. However, among those with probable Alzheimer's disease and either severe cognitive impairment or cachexia, the risk of death was substantially higher. Persons with probable Alzheimer's disease who had both severe cognitive impairment and clear cachexia had a risk of death 4.60 (95% Cl 1.63-13.1) times that of unaffected persons.
Aged↗
Perception of affect in patients with dementia of the Alzheimer type.
The ability to perceive affect was examined in 19 patients with Alzheimer's disease and in 19 control subjects. Nine tasks were given. All participants were asked to recognize facial emotion, to provide verbal labels of facial emotion, and to identify emotion portrayed in drawings or in verbal descriptions of emotional situations. The results indicate that there are significant differences between patients with Alzheimer's disease and control subjects on all of the tasks. However, when test scores were adjusted for the cognitive abilities of the subjects, few of the tests continue to differentiate the groups. These results suggest that the deficits of patients with Alzheimer's disease on perception of affect tasks are likely to be the result of their cognitive defects and not the result of a primary impairment in the perception of emotion.
Affect↗
Gross and microscopic changes in the viscera induced by photodynamic therapy applied to the lower abdomen of intact rats.
Photodynamic therapy (PDT) is a promising approach to the treatment of cancer. Preferential retention of the photosensitizer by malignant tissue has been considered a hallmark of this treatment modality. However, photosensitivity can be observed in normal, non-neoplastic tissues, and the present study investigated the effects of PDT treatment on the abdomen of intact rats. A circular region (1 cm diameter) on the shaved abdomen of Fischer rats, pretreated 24 h prior with Photofrin II, was irradiated for 30 min at 632 nm. Control animals received either photoradiation or Photofrin II administration. Subsequent lesions were observed in the irradiated skin, its associated abdominal wall, and the underlying gut in rats receiving Photofrin II and laser irradiation. All tissues were not equally sensitive to PDT treatment. Gut lesions were consistently more severe than were skin and abdominal wall injuries. By 24 hr after treatment, the gut manifested a transmural hemorrhagic necrosis, while the irradiated skin and abdominal wall were edematous, with an inflammatory infiltrate in the dermis and around occasional swollen myocytes. These results indicate that superficial lesions induced by PDT may not be reliable indicators of the extent of deeper PDT tissue damage. Further, it may be possible to take advantage of this discrepancy in tissue sensitivity and treat deep tissues through less sensitive superficial tissues.
Abdominal Muscles↗
Modeling age using cognitive, psychosocial and physiological variables: the Boston Normative Aging Study.
A structural equation model is computed for 36 variables from eight domains of data using 100 healthy male subjects whose age varies between 30 and 80 years. Chronological age is required to be an exogenous variable while cognitive function variables are required to be an ultimate endogenous or outcome set. The model suggests that the direct effect of age on cognition is substantially reduced when social, life style, physiological, and brain state variables are allowed to become intervening variables. The study also finds that there is an association between cognitive function and psychosocial measures relating to general psychiatric symptomatology and social support systems.
Adult↗
Dementia and the older driver.
The association between dementia and driving errors in older adults has been anecdotally noted by clinicians and caregivers. However, until recently, little empirical documentation of this association existed. This paper provides a critical review of available research on dementia and driving and discusses issues that must be considered in attempting to apply this developing body of research to practical problems, such as the relicensing process for selected drivers. This is followed by a discussion of recent research relevant to the development of potential procedures for screening patients with dementing illness--particularly Alzheimer's disease--for probable driving risk.
Activities of Daily Living↗
Neuroimaging in Alzheimer's disease.
This article reviews the recent neuroimaging studies of patients with Alzheimer's disease. The neuroimaging procedures discussed include computerized tomography, magnetic resonance imaging, positron emission tomography, and single-photon emission computerized tomography.
Alzheimer Disease↗
Electrophysiologic comparisons between two groups of patients with Alzheimer's disease.
Two groups of patients with Alzheimer's disease were compared using brain electrical activity mapping. The patients were selected on the basis of their cognitive history. The initial symptom of disease of the patients in group 1 was a significant and profound memory deficit, whereas the patients in group 2 initially presented with a gradually progressive spatial impairment. Fourteen topographic features distinguished the groups. Eleven of the 14 features pertained to electrical activity differences in parietal regions, and 9 were bilateral. These features were highly correlated with cognitive measures that are also useful in distinguishing the groups.
Aged↗
The east Boston Alzheimer's Disease Registry.
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Alzheimer Disease↗
Differences in abstraction ability with age.
Three tests of abstraction were administered to 89 optimally healthy subjects aged 30-79. Performance on all 3 tasks showed significant differences with age. This was primarily, although not entirely, the result of deficits in performance by the 70-year-old subjects. These results do not appear to be related to changes in memory ability or to a differential increase in a particular type of abstraction error.
Abstracting and Indexing↗
Oral physostigmine as treatment for dementia of the Alzheimer type: a long-term outpatient trial.
Six patients with dementia of the Alzheimer type (DAT), treated with oral physostigmine and followed from 9 to 27 months (mean +/- SD, 17.8 +/- 7.3 months), were matched for sex, age, initial degree of dementia, and length of follow-up with six control patients who did not receive oral physostigmine. The small sample size precluded drawing definite conclusions about overall efficacy; however, three in the physostigmine group did not deteriorate during the course of follow-up while all of the controls deteriorated although the difference was nonsignificant. The data generated in these patients provides evidence of the safety of long-term trials of oral physostigmine. The possible role of cholinesterase inhibition in retarding the progression of DAT is discussed.
Administration, Oral↗
Oral physostigmine treatment for patients with presenile and senile dementia of the Alzheimer's type: a double-blind placebo-controlled trial.
Twelve patients aged 53 to 89 years with presenile or senile dementia of the Alzheimer's type participated in a treatment trial of oral physostigmine. Patients first received the drug during an open dose-finding phase. In a double-blind crossover design phase, the patients' memory performance during treatment with an optimal memory-enhancing dose was compared with memory performance during placebo treatment. Response to medication was assessed by the Delayed Recognition Span Test, the Selective Reminding Test, and the Alzheimer's Disease Assessment Scale. Intergroup differences in response to physostigmine were nonsignificant. Age at onset of the disease did not differentiate partial responders from nonresponders.
Administration, Oral↗
Prevalence of Alzheimer's disease in a community population of older persons. Higher than previously reported.
Clinically diagnosed Alzheimer's disease and other dementing illnesses were assessed in a geographically defined US community. Of 3623 persons (80.8% of all community residents over 65 years of age) who had brief memory testing in their homes, a stratified sample of 467 persons underwent neurological, neuropsychological, and laboratory examination. Prevalence rates of Alzheimer's disease were calculated for the community population from the sample undergoing clinical evaluation. Of those over the age of 65 years, an estimated 10.3% (95% confidence limits, 8.1% and 12.5%) had probable Alzheimer's disease. This prevalence rate was strongly associated with age. Of those 65 to 74 years old, 3.0% (95% confidence limits, 0.8 and 5.2) had probable Alzheimer's disease, compared with 18.7% (95% confidence limits, 13.2 and 24.2) of those 75 to 84 years old and 47.2% (95% confidence limits, 37.0 and 63.2) of those over 85 years. Other dementing conditions were uncommon. Of community residents with moderate or severe cognitive impairment, 84.1% had clinically diagnosed Alzheimer's disease as the only probable diagnosis. These data suggest that clinically diagnosed Alzheimer's disease is a common condition and that its public health impact will continue to increase with increasing longevity of the population.
Age Factors↗
Memory testing to improve the differential diagnosis of Alzheimer's disease.
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Alzheimer Disease↗
Age-related differences in computed tomographic scan measurements.
Seventy-nine healthy men ranging in age from 31 to 87 years underwent a computed tomographic (CT) scan and were administered a neuropsychologic test battery. Midventricular, high ventricular, and supraventricular CT slices were analyzed for each individual. Computerized techniques calculated the percent of fluid volume and the mean CT density for each slice. The mean CT density of a standard tissue sample was also evaluated. The results suggest that fluid volume at the level of the ventricles is fairly stable until individuals are in their 60s, when a dramatic increase occurs. The percent of fluid volume above the level of the ventricles appears to increase slightly the ventricles appears to increase slightly in the 50s and then level off. Whole slice mean CT density numbers decreased in a linear fashion with increasing age, but the mean CT density of a standard tissue sample did not. A discriminant function derived from the CT measures was significantly correlated with a discriminant function derived from the neuropsychologic test battery. Findings based on subjects whose health status has been less carefully screened may differ from those in the present study.
Adult↗
Changes in naming ability with age.
We administered to 80 optimally healthy subjects, 30-80 years old, the Boston Naming Test, a test of confrontation naming. Results indicated that naming ability remains fairly stable across the adult life span until individuals are in their 70s, at which point there is a significant decline in performance (p less than or equal to .0001). Semantic errors (i.e., circumlocutions, semantically related associates, and nominalizations) and perceptual errors increase with age. Lexical errors (i.e., phonologically related real words and phonologically related nonwords) do not increase with age. Results of multiple regressions that included other neuropsychological variables indicate that estimated IQ, but not new learning ability, predicts a subject's naming score.
Adult↗
Correlates of cognitive function in an elderly community population.
In 1982 and 1983, brief, structured performance tests of selected areas of cognitive function were administered to 3,682 (82.1 per cent) of the residents aged 65 years and older of the geographically defined community of East Boston, Massachusetts, a center of the Established Populations for Epidemiologic Studies of the Elderly program. There was a strong inverse relation between age and performance on all four cognitive tests in analyses adjusted for sex only as well as in those adjusted for the effects of other variables. Similarly, fewer years of formal education, increasing level of disability on the modified Katz Activities of Daily Living Scale, and less prestigious occupations, as measured by the modified Duncan Socioeconomic Index, were each independently related to lower performance on all four tests.
Activities of Daily Living↗
Differential patterns of memory loss among patients with Alzheimer's disease, Huntington's disease, and alcoholic Korsakoff's syndrome.
Patients with Huntington's disease (HD), alcoholic Korsakoff's syndrome (KS), and Alzheimer's disease (AD) were compared with normal control subjects on a task designed to assess recognition memory for different classes of stimuli: spatial, verbal, color, pattern, and facial. In addition, recall of verbal stimuli was assessed at two delay intervals. On recognition testing, AD and KS patients were impaired on each of the five stimulus conditions. However, HD patients, though impaired on four of the recognition conditions, were unimpaired when verbal stimuli were used. On recall testing, the AD, HD, and KS groups were equally impaired at the shorter delay (15 s). However, at the longer delay (two minutes), the KS and HD patients, though still impaired relative to the normal control group, performed significantly better than the AD group.
Adult↗