BrainBlog

Relationships Between Behavioral Syndromes and Cognitive Domains in Alzheimer Disease: The Impact of Mood and Psychosis American Journal of Geriatric Psychiatry . 2011 Nov 1; Koppel J, Goldberg TE, Gordon ML, Huey E, Davies P, Keehlisen L, Huet S, Christen E, Greenwald BS Abstract OBJECTIVES:: Behavioral disturbances occur in nearly all Alzheimer disease (AD) patients together with an array of cognitive impairments. Prior investigations have failed to demonstrate specific associations between them, suggesting an independent, rather than shared, pathophysiology. The objective of this study was to reexamine this issue using an extensive cognitive battery together with a sensitive neurobehavioral and functional rating scale to correlate behavioral syndromes and cognitive domains across the spectrum of impairment in dementia. DESIGN:: Cross-sectional study of comprehensive cognitive and behavioral ratings in subjects with AD and mild cognitive impairment. SETTING:: Memory disorders researc...

Santoro A, Siviero P, Minicuci N, Bellavista E, Mishto M, Olivieri F, Marchegiani F, Chiamenti AM, Benussi L, Ghidoni R, Nacmias B, Bagnoli S, Ginestroni A, Scarpino O, Feraco E, Gianni W, Cruciani G, Paganelli R, Di Iorio A, Scognamiglio M, Grimaldi LM, Gabelli C, Sorbi S, Binetti G, Crepaldi G, & Franceschi C. Effects of donepezil, galantamine and rivastigmine in 938 italian patients with Alzheimer's disease: A prospective, observational study. CNS Drugs. 2010 Feb 1; 24(2): 163-176. doi: 10.2165/11310960-000000000-00000. Department of Experimental Pathology, University of Bologna, Via S. Giacomo 12, Bologna, Italy. Acetylcholinesterase inhibitors (AChEIs) have been used to improve cognitive status and disability in patients with mild to moderate Alzheimer's disease (AD). However, while the efficacy of AChEIs (i.e. how they act in randomized controlled trials) in this setting is widely accepted, their effectiveness (i.e. how they behave in the real world) remains controv...

Today's recommended read deals with an important neuropsychological assessment issue in the domain of aging and the potential to identify the presence of cognitive problems that might (emphasis on "might" - such findings in a screen are not definitive) be part of the onset of a dementing disease process. The issue has implications, as well, for applications in CNS clinical trials. Scharre DW, Chang SI, Murden RA, Lamb J, Beversdorf DQ, Kataki M, Nagaraja HN, & Bornstein RA. Self-administered Gerocognitive Examination (SAGE): A Brief Cognitive Assessment Instrument for Mild Cognitive Impairment (MCI) and Early Dementia. Alzheimer Disease and Associate Disorders. 2010 January/March; 24(1), 64-71. OBJECTIVES: To develop a self-administered cognitive assessment instrument to facilitate the screening of mild cognitive impairment (MCI) and early dementia and determine its association with gold standard clinical assessments including neuropsychologic evaluation. METHODS: A...

Börjesson-Hanson A, Gustafson D, & Skoog I. Five-year mortality in relation to dementia and cognitive function in 95-year-olds. Neurology. 2007 Nov 27; 69(22): 2069-2075. Neuropsychiatric Epidemiology Unit, Psychiatry Section, Institute of Neuroscience and Physiology, Sahlgrenska Academy at Göteborg University, Sweden. BACKGROUND: Dementia is a known predictor of mortality, but most studies include small numbers of participants above age 90. The influence of dementia or cognition on mortality in this age group is therefore uncertain. OBJECTIVE: To examine 5-year mortality in relation to dementia and cognitive performance at age 95. METHODS: A population sample of 338 individuals examined at age 95 was followed to age 100. Dementia was diagnosed according to DSM-III-R criteria. Cognitive function was measured using the Mini-Mental State Examination (MMSE). Information on severe physical disorders was obtained from the Swedish Hospital Discharge Register, and date of death from the...

Diamond EL, Miller S, Dickerson BC, Atri A, Depeau K, Fenstermacher E, Pihlajamäki M, Celone K, Salisbury S, Gregas M, Rentz D, & Sperling RA. Relationship of fMRI activation to clinical trial memory measures in Alzheimer disease. Neurology. 2007 Sep 25; 69(13): 1331-1341. Memory Disorders Unit, Brigham and Women’s Hospital, 221 Longwood Ave, Boston, MA 02115 BACKGROUND: Functional MRI (fMRI) has shown promise as a tool to characterize altered brain function in Alzheimer disease (AD) and for use in proof of concept clinical trials. FMRI studies of subjects with AD have demonstrated altered hippocampal and neocortical activation while encoding novel stimuli compared to older controls. However, the relationship between fMRI activation and performance on standardized clinical trial memory measures has not been fully investigated. OBJECTIVE: To determine whether patterns of activation during an associative-memory fMRI paradigm correlate with performance on memory measures used in A...