bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dementia in multiple sclerosis: report of a case with cortical grey matter involvement and frontal-type-like clinical features
Authors: Correia R. , Dias D. , Bastos-Leite A.J. , Rio E. , Curral R. 
Published: May 2011

Background/introductionAlthough multiple sclerosis (MS), a demyelinating disease of unknown aetiology, is primarily a white matter disease, it may also involve the grey matter, a feature not often demonstrated in vivo by means of magnetic resonance imaging (MRI). The involvement of cortical grey matter in MS may account for cognitive dysfunction and behavioural abnormalities.ObjectiveThe purpose of this report is to present the case of a patient with MS and clinical features mimicking dementia of the frontal type due to clear-cut cortical grey matter involvement in the left frontal lobe.Case reportA 55-year-old woman with relapsing remitting MS developed a clinical picture characterized by frontal deficits (e.g. attention, verbal fluency, and speed processing), disinhibition, loss of insight, perseveration, abnormal eating behaviour, agitation, insomnia, and depersonalization phenomena. Neuropsychological evaluation also revealed abnormal performance on the Trail Making and the Stroop tests. Besides typical demyelinating lesions and “black holes”, MRI showed a striking pattern of left frontal opercular involvement including cortical thinning, focal knife-edge appearance of the gyri, and marked gliosis in the adjacent white matter.DiscussionCognitive deficits in MS are typically subcortical, due to the expected predominance of white matter lesions. Nonetheless, the involvement of grey matter structures may contribute to a different pattern of cognitive dysfunction. For example, hippocampal involvement has been linked to memory impairment. This particular case report additionally illustrates how cortical grey matter involvement in the frontal lobe may lead (not unexpectedly) to a clinical condition mostly characterised by frontal deficits and psychiatric symptoms.
Delirium in older adults: assessment scales review
Authors: Martins S. , Simões M.R. , Fernandes L. 
Published: May 2011

IntroductionDelirium is characterized by the rapid onset of symptoms which fluctuate, with an altered level of consciousness, global disturbance of cognition, perceptual abnormalities and evidence of a physical cause (DSM-IV-R, 2002).AimTo review the characteristics and psychometric properties of thirteen Delirium scales available in research and clinical practice.MethodsMEDLINE database was used to identify the delirium scales in use (1990–2010), using the keywords: delirium, confusion, questionnaires, scales, severity and screening. Only validation studies were included. Exclusion criteria were children and alcohol/drug delirium assessment scales. This study included seven screening scales: Confusion Assessment Method, Intensive Care Delirium Screening Checklist, Delirium Symptom Interview, NEECHAM Confusion Scale, Cognitive Test for Delirium, Delirium Observation Screening, Nursing Delirium Screening Scale and seven severity scales: Delirium Rating Scale, Memorial Delirium Assessment Scale, Confusional State Evaluation, Delirium Severity Scale, Delirium Index and Delirium-O-Meter.ResultsThe majority of scales were based on the Diagnosis Statistical Manual Criteria as well as on a review of selected symptoms of Delirium informed by systematic clinical observation and formal brief assessment of mental status. In most of the studies, for psychometric analysis, the inter-rater reliability and validity with severity of Delirium assessment and cognitive screening tests were used.ConclusionBearing in mind the recent review studies included, we can conclude that CAM is the most widely used instrument for delirium assessment.
Neurotrophic approach in preventive therapy of alzheimer disease
Authors: Gavrilova S. , Kolykhalov I. , Fedorova Y. , Odinak M. , Emelin A. , Gustov A. 
Published: May 2011

IntroductionDuring the last years a great number of new facts of involving nerve growth factors (NGF) in pathogenesis of Alzheimer Disease (AD) and other neurodegenerative diseases have been received. Discovery of neurotrophic effects of Cerebrolysin similar to NGF attracted new attention to it (Rockenstein E. et al. 2000).Clinical study of long-term effects of Cerebrolysin has proved that Cerebrolysin has positive modifying action on the dementia progression (Gavrilova S.I. et al., 2003). That's why we suggest that Cerebrolysin may prevent or slow down clinical manifestation of dementia in patients with mild cognitive impairment (MCI) of amnestic type.The aim of the present study was to investigate in an open comparative prospective clinical trial ability of Cerebrolysin to slow down or prevent transition of MCI syndrome into the clinically evident AD in 2 groups of patients repeatedly treated with 1 month courses of Cerebrolysin or Cavinton during a period of 3 years.Methods110 patients who met the diagnostic criteria of MCI of amnestic typewere included. During the clinical trial patients were assessed with a set of clinical scales and a battery of neuropsychological cognitive tests. Genotyping for the APOE polymorphism was performed as well.ResultsThe superiority of Cerebrolysin over Cavinton in slowing down of the cognitive deficit progression and delaying the time or transition of MCI patients to the diagnostic category of Alzheimer disease during 3 years was demonstrated. Cerebrolysin was particularly effective in MCI patients with the ApoE4 (+) genotype.ConclusionCerebrolysin could be recommended as a preventive AD therapy.
A case of dementia or simple schizoprenia?
Authors: Lee C. 
Published: May 2011

IntroductionThis is a case report of a Chinese middle-aged female who was first seen in 2006 for suspected depression. Over the course of the illness, her diagnosis was revised to that of Simple Schizophrenia and then Frontoparietal Dementia.CaseA 53 years old Chinese lady was first brought by a male friend (who has known her for past 21 years) in 2006 to continue management for her depression. For the preceding 3–4 years, her behaviour has been very child-like. She was described premorbidly to be stubborn and independent. Mental state examination then revealed that she was oriented to time, place and person. Her mood appeared depressed and reactive (secondary to some social stressors). Patient refused any basic blood investigations and her antidepressant was continued. Over the course of few months, she started to complain of forgetfulness and she was reported to go ‘missing’ for 1 to 2 hours. A differential diagnosis of chronic negative symptoms schizophrenia was entertained. In August 2007, she was arrested for shoplifting and was treated as an inpatient. Upon discharge, she was referred to a nursing home. By October 07, she was totally disoriented to time and place. Computed Axial Tomography (CAT) scan of brain was eventually performed which reported as ‘knife-shaped appearance’ of cortical gyri suggestive of frontoparietal dementia, possible Pick’s Disease. Patient is currently on antidementia therapy.ConclusionThe case report illustrates the importance of entertaining diagnosis of dementia in a middle-aged person especially with symptoms of regression and wandering behaviour.
White matter hyperintensities predict dementia in poststroke patients with cognitive impairment no dementia (CIND)
Authors: Chen Y.K. , Lee E. , Lu J.Y. , Chu W.C.W. , Mok V.C.T. , Wong K.S. , Tang W.K. 
Published: May 2011

IntroductionLongitudinal studies of predicting dementia conversion of poststroke cognitive impairment no dementia (CIND) are limited.ObjectiveTo investigate the clinical and imaging predictors of dementia conversion in poststroke patients with CIND.AimTo understand dementia conversion of CIND.Methods143 patients with CIND (defined as impairment in at least one cognitive domain without meeting the criteria of dementia) at three months after stroke were recruited and followed up for one year. Dementia was diagnosed using the criteria of Diagnostic and Statistical Manual of Mental Disorders (4th edition, DSM-IV). MRI measurements including infarction, microbleeds, white matter hyperintensities (WMHs) and hippocampal volume were conducted. Logistic regression was performed to find the predictors of dementia at follow-up.Results16 (11.2%) out of the 143 patients developed dementia 15 months after stroke. In univariate comparisons, subjects with dementia at follow-up had older age (78.0 ± 5.3 vs.71.5 ± 8.5 years, p = 0.003) and higher NIHSS score (7.1 ± 3.5 vs.4.7 ± 3.3, p = 0.005) on admission. They also had higher frequency of old infarcts in the thalamus (31.3% vs. 11.0%, p = 0.025), larger volume of old infarcts (4.2 ± 11.2 vs. 0.7 ± 2.6 cm3, p < 0.001) and WMHs volume (33.2 ± 34.0 vs. 14.2 ± 14.1 cm3, p = 0.016). In logistic regression, age (odds ratio [OR] =1.203, 95%C.I.=1.054-1.373, p = 0.006), NIHSS score on admission (OR = 1.324, 95%C.I.=1.082-1.619, p = 0.006) and WMHs volume (OR = 1.045, 95%C.I.=1.007-1.084, p = 0.019) were significant predictors of dementia at follow-up.ConclusionsWMHs volume predicts dementia in poststroke patients with CIND, suggesting subcortical ischemic vascular disease was an important origin of poststroke delayed dementia.
The relations between psychosocial factors, care burden and depression on the dementia family caregivers
Authors: Martin J.G. , Rodriguez F.M. , Gomez N.D. , Villa P.S. , Caro M.P. 
Published: May 2011

ObjectivesTo describe the relation of psychosocial factors of care (phase illness, years of care, free time, extra help and symptoms of depression) influence the care burden of dementia family caregivers. To measure the relation of the level of depressive symptoms on an intense level of burden of the dementia family caregiversMethodsIs selected a sample of 102 primary caregivers by criteria of inclusion to which a surveys do to those that the following information gathered: sociodemographic dates of the caregivers and of the dementia patients, care burden (Zarit Interview) and depressive symptoms (Beck Depression Inventory) of the family caregivers.ResultsMost of the sample experiences an intense burden level (74%) opposite to a light level (26%). Psychosocial characteristics are as per statistics significant in increasing the care burden there were free time, extra help and presence of symptoms of depression.Presence of serious symptoms of depression on the intense burden level are differently front or those who had a minor burden, 22% and 5% respectively.ConclusionsThere are most of the daughter-father/mother and spouse-spouse caregiver couples with a high percentage of caregivers of feminine sex (as in most of the studies realized on caregiver of dependent persons at European and international level). The need for free time and psychic self-care are cost-effective strategies to prevent the depressive disorders, as well as, to improve their caregiver’ws work. The psychoeducation programs that have being realized at European level directed to family caregiver are necessary in our country.
Antipsychotics medication on discharge for in-patients with dementia: a one year study
Authors: Ochuko-Emore M. 
Published: May 2011

IntroductionConcerns regarding the use of antipsychotics in people with dementia have been widely reported. However, there is paucity of studies examining antipsychotics prescribed on discharged from psychogeriatric in-patient units.ObjectivesTo determine the extent and types of antipsychotic medication prescribed for patients with dementia discharged from an in-patient psychogeriatric unit.MethodsThis was a retrospective study. Data from all in-patients with dementia discharged from a psychogeriatric unit between July 2009 and June 2010 were analysed. Antipsychotics administered to patients in the unit and antipsychotics prescribed on discharge were recorded.ResultsDuring the study period, a total of 49 patients with dementia were discharged. Thirty-eight patients (77.6%) received antipsychotic as in-patients; four of these patients (10.5%) had two antipsychotics. Thirty-two patients (65.3%) were discharged on antipsychotic medication with two (6.3%) of the patients on two antipsychotics. Of the antipsychotics prescribed on discharge, 75% were atypical and 25% typical.ConclusionAlmost two third of patients with dementia were discharged from the in-patient psychogeriatric unit on antipsychotic medication. A drive to reduce antipsychotic medication prior to discharge is needed.
Antipsychotics and dementia
Authors: Ramalho e Silva F. , Martins Correia L. , Correia D. 
Published: May 2011

IntroductionAccording to the literature, up to 90% of patients with Alzheimer's disease present at least one behavioral or psychiatric symptom (BPSD) and their overall frequency tends to increase during the course of illness. Three main BPSD syndromes are usually described: agitation, psychosis and mood disorders. These syndromes have an important impact on patients and their caregivers, representing a distress factor leading to reduced quality of life and, ultimately, the need for institutionalization. Antipsychotic drugs have been used for this purpose, but their benefits are still uncertain and some studies brought up concerns about their safety - particularly increased risk of cerebrovascular adverse events and death.Aims and objectivesThe authors aim to present a review of the relevant literature, concerning the treatment of BPSD, focusing particularly on the antipsychotic treatment. We aim to discuss their indication, efficacy and safety. We illustrate this review with 1 clinical vignette.MethodsSystematic review of the most recent and relevant literature.Discussion and conclusionsAccording to some studies, atypical antipsychotics are equal or more effective than placebo in the treatment of psychosis and aggression. However, adverse effects seem to limit their effectiveness. Therefore, the prescription of antipsychotics for these patients should be restricted to people with severe symptoms causing risk or extreme distress that have not responded to other measures, and treatment should only be continued beyond 12 weeks in exceptional circumstances.
A new apathy scale for institutionalized dementia patients: validation of the APADEM-NH scale short-version
Authors: Ramos-García M.I. , Agüera-Ortiz L. , Gil-Ruiz N. , Cruz-Orduña I. , Valentí-Soler M. , Osorio-Suárez R. , Reneses-Prieto B. , Martinez-Martín P. ,   UIPA-CAFRS Study Group
Published: May 2011

AimsTo describe validation process of the new apathy scale for institutionalized dementia patients (APADEM-NH).Methods100 elderly, institutionalized patients with diagnosis of probable Alzheimer Disease (AD) (57%), possible AD (13%), AD with cerebral vascular disease (CVD) (17%), Lewy Bodies Dementia (11%) and Parkinson associated to dementia (PDD) (2%). All stages of the disease severity according to the Global Deterioration Scale (GDS) and Clinical Dementia Rating (CDR) were assessed. The Apathy Inventory (AI), Neuropsychiatric Inventory (NPI), Cornell scale for depression, and the tested scale were applied. Re-test and inter-rater reliability was carried out in 50 patients. The feasibility and acceptability, reliability, validity, and measurement precision were analyzed.ResultsAPADEM-NH final version consists of 26 items and 3 dimensions: Deficit of Thinking and Self-Generated behaviors (DT): 13 items, Emotional Blunting (EB): 7 items, and Cognitive Inertia (CI): 6 items. Mean application time was 9.56 minutes and 74% of applications were fully computable. All subscales showed floor and ceiling effect lower than 15%. Internal consistency was excellent for each dimension (Cronbach’s α DT = 0.88, α EB = 0.83, α CI= 0.88);Test-retest reliability for the items was kW=0,48-0,92; Inter-rater reliability reached kW values 0.84-1.00; The APADEM-NH total score showed a low/moderate correlation with apathy scales (Spearman ρ, AI =0.33; NPI-Apathy= 0,31), no correlation with depression scales (NPI-Dementia = -0.003; Cornell= 0,10), and high internal validity (ρ =0.69 0.80).ConclusionsAPADEM-NH is a brief, psychometrically acceptable, and valid scale to assess apathy in patients from mild to severe dementia and discerning between apathy and depression.
Use of antipsychotics in patients with behavioural and psychiatric symptoms of dementia - a retrospective study
Authors: Siddiqui S. , Craig S. , Ahmed U. 
Published: May 2011

Aims and objectivesTo review current practice of Antipsychotics prescribing in patients with Behavioural and Psychiatric symptoms of Dementia in secondary care hospital.MethodologyThis was a retrospective audit targeting all patients who were diagnosed with a dementing illness in a large secondary care hospital from September 2008 to December 2008 inclusive. Data was collected from patients’ health care records and central computer database. Current practice was then compared with the standards proposed by the NICE Guidelines (National Institute of Clinical Excellence, 2006).ResultsOut of 18 patients who were diagnosed with dementia, 66% (n = 12) were prescribed antipsychotics. Out of these, 66%(n = 8) were males and 34%(n = 4) were females. 75%(n = 9) had explicitly documented indications for antipsychotics use in their health care records with only 25% cases (n = 3) alternative treatment options such as psychosocial interventions were considered.Discussionswith patients and/or the carers’ were documented in 50%(n=6) cases. Periodic reviews were carried out in 66% (n = 8) cases.ConclusionAntipsychotics are commonly used in behavioural and psychiatric symptoms of dementia. Considering higher risk of morbidity and mortality with antipsychotics use in this population group, it is of paramount importance that reasons for prescribing and discussion with patients and/or their carers should be clearly documented. If antipsychotics are prescribed patients should be reviewed on regular basis.
Comparative study of the effects of intranasal insulin on memory deficits in type 2 diabetes and early Alzheimer's dementia concept and study scope
Authors: Siemann H. , Müller B. , Stein E.M. , Esselmann H. , Loos S. , Ennen J. , Lehnert H. , Hallschmid M. , Wiltfang J. 
Published: May 2011

IntroductionRecent data support the view that the neurodegeneration underlying sporadic Alzheimer's Disease (AD) is in part related to brain insulin deficiency and brain insulin resistance. There is a higher incidence of AD in patients with diabetes mellitus type II (T2D) and both diseases show a decline in memory function. In a preceding trial intranasal insulin improved memory function in healthy volunteers so that an increase of central-nervous insulin concentration may improve cognitive function in both amnestic patient groups.AimsWe want to analyse the effects of intranasal insulin on patients with early Alzheimers's disease (eAD) and patients with T2D in the state of amnestic mild cognitive impairment (aMCI).MethodsRecruitment of 30 patients with eAD, 30 patients with T2D in aMCI state and 30 age-matched healthy controls. All patients undergo a run-in period of 2 weeks with 4 × daily administration of placebo. It follows a double blinded trial with daily intranasal administration of 4 × 40 I.U. insulin vs. placebo for 8 weeks and another 8 weeks of follow-up. At 4 defined time points memory function is assessed by word lists comprising 30 items of emotional, nutritional and neutral content which have to be memorized and are recalled after one week. To assess structural changes of the brain, a quantitative analysis for hippocampal N-acetyl-aspartate, choline and creatine is performed by 3 Tesla magnetic resonance spectroscopy.Results: Since the study has not finished yet, we present experiences from the initiation and the beginning phase.
Smell identification test as a progression marker in Alzheimer's disease
Authors: Velayudhan L. , Pritchard M. , Lovestone S. 
Published: May 2011

IntroductionFactors influencing or predicting progression in Alzheimer's disease (AD) is not well understood. Olfactory dysfunction, impaired smell identification in particular, is known to occur in AD. Mesial temporal lobe, important for memory function is also critical for the processing of olfactory information. In view of the common anatomical substrate, we hypothesized that olfaction dysfunction worsens faster in people with AD with rapid cognitive decline compared to those with slower cognitive decline.AimsTo test whether smell identification test can be used as a predictor for illness progression in AD patients.MethodsForty one participants with late onset mild to moderate AD were recruited from mental health services for older adults. Subjects were classified as ‘Rapid Progressors’ defined on ‘a-priori’ with a loss of 2 or more points in Mini-Mental State Examination (MMSE) within six months. Assessments included MMSE, Neuropsychiatric Inventory, Bristol Activities of Daily Living, and the University of Pennsylvania Smell Identification Test (UPSIT), at baseline and after 3 months.ResultsTwenty subjects were ‘Rapid Progressors’, and had lower UPSIT scores compared to ‘Non-Rapid Progressors’ both at the baseline (p = 0.02) and at follow up after 3 months (p = 0.05). Baseline UPSIT correlated with follow up UPSIT (r = 0.5, p < 0.01) and MMSE (r = 0.4, p = 0.04). Also it was the baseline UPSIT score that best predicted (p < 0.05) the follow up smell and cognitive function on linear regression analysis.ConclusionsSmell identification function could be useful as a clinical measure to assess and predict progression in AD.
Change of learning and memory ability and IGF-1 level in type 3 diabetes rats and effect of analog P165 of APP 5-mer peptide
Authors: Wang R. 
Published: May 2011

ObjectiveTo investigate the effect of Analog P165 of APP5-mer peptide on change of learning and memory ability in type 3 diabetes rats.MethodHealthy adult male rats were randomly divided into 3 groups: Control group; type 3 diabetes (T3DM) group; T3DM administrated P165 group. T3DM models were induced by intracerebroventricular injection of Streptozotocin (STZ, 3 mg/kg) bilaterally. P165 groups were treated with gastric P165 (355 μg/kg) Then, learning and memory ability was detected by Morris water maze test. Body weight and serum glucose were recorded. The rat serum Insulin, Gluocagon, insulin-like growth factor-1 (IFG-1) was detected by ELISA method.ResultsIn the Morris water maze test, compared with control group, the escape latency increased significantly (p < 0.05) in model group at the 3rd day. Compared with model group, the escape latency decreased significantly (p < 0.05) in the models administrated P165 group at the 3rd day. Although there was no significant difference, the escape latency decreased in P165 group at the 4th and 5th day. From the result of rats blood serum detection, the serum IGF-1 level decreased significantly in the model group (p < 0.01) than the control group. The serum IGF-1 level increased significantly in P165 treated group(p < 0.05).The body weight and the serum glucose, insulin, gluocagon had no significant difference among the groups in the period of experiment.ConclusionThere is learning and memory impairment in the T3DM rats. P165 can raise the rats blood serum IGF-1 level, ameliorate learning and memory ability but don’t influence the serum glucose.