In the news this week, there were a number of studies looking at conversion from MCI to Alzheimer’s Disease examining the influence of biological markers. Television and film portrayal of alcohol had an immediate effect on the drinking behaviour on viewers in one study, while in another study alcohol had a more marked effect on cognition in the elderly than in a younger comparison group and the elderly group were less able to recognise their impairment.
Research in Dementia
People with Lewy Body Dementia (n=29) were significantly more likely than those with Alzheimer’s Disease (n=33) to report difficulties with swallowing (Shinagawa et al, 2009)(STT3). Performance on memory tasks was inversely correlated with the number of neurofibrillary tangles in the hippocampus on post-mortem. There was also an inverse correlation between memory performance and NFT’s in the entorhinal cortex, CA1 and subiculum (Reitz et al, 2009)(STT4).
CSF ABeta42 levels were inversely correlated with brain atrophy in Alzheimer’s Disease and the authors suggest that this may result from increased ABeta42 aggregation in the disease process (Fagan et al, 2009)(STT4). An MRI study showed more temporal grey matter loss in people with Prodromal Alzheimer’s Disease compared to amnestic mild cognitive impairment (Rami et al, 2009)(STT4). A longitudinal study which involved autopsy found an inverse correlation between carrying the APOE2 gene and cognition in those over the age of 90 but a significant correlation with Alzheimer’s Disease neuropathology (Berlau et al, 2009)(STT5). A study freely available here suggests a role for the phosphatidylinositol 3-kinase in the suggested neuroprotective role of the anticholinesterase inhibitors (STT5). In another study there was evidence suggesting that Galantamine acted via a calcium/calmodulin-dependent protein kinase II and protein kinase C activation in effecting a suggested improvement in Long Term Potentiation (Moriguchi et al, 2009)(STT4).
In a study of family caregivers of people with Alzheimer’s Disease in Turkey, there was found to be a significant association between caregiver burnout and caregiver anxiety as well as patient’s self-maintenance (Yilmaz et al, 2009)(STT3). A phase I study (n=6) showed preliminary evidence that combining an error free learning approach with Donepezil in people with Alzheimer’s Disease improved performance on a naming task (Rothi et al, 2009)(STT3). People with Mild Cognitive Impairment and Alzheimer’s Disease were found to perform worse on time estimate tasks than a younger comparison group and this effect was independent of episodic memory (Rueda and Schmitter-Edgecombe, 2009)(STT4).
An intriguing hypothesis that has been developed states that cognitive changes in Alzheimer’s Disease and normal aging may represent an ‘adaptive metabolism reduction program’ and it will be interesting to see the results of future studies testing this hypothesis (Reser, 2009)(STT5). A study freely available here showed a significant relationship between MRI measured hippocampal loss and CSF AB1-42 in mild cognitive impairment as ApoeE allele in Alzheimer’s Disease (Schuff et al, 2009)(STT4). A recent study looked at a 1 year follow-up of Donepezil in 189 people with severe Alzheimer’s Disease and the authors concluded that Donepezil was safe and effective during this period (Homma et al, 2009)(STT2).
Another study shows evidence that cardiovascular risk factors do not influence progression of Alzheimer’s Disease (as opposed to onset) and it will be interesting to see the results of future replication studies (Abellan et al, 2009)(STT4).
News In Brief
Research in Psychosis
An American study looked at antipsychotic prescribing and found that a majority of patients were receiving antipsychotic medication without a diagnosis of bipolar disorder or schizophrenia and that a number of the prescriptions were of brief duration and of a subtherapeutic dose.
Research in Anxiety and Related Disorders
PTSD was found in more than 1/3 of people who had experienced a stroke and this this influenced recovery.
Research In Mood Disorders
An association between diabetes and post-partum depression was found in this study. Depression was a significant predictor of developing heart disease in a longitudinal study of Vietnam War veteran twins.
A new study shows that the enzyme P4503A is unlikely to be involved in the clearance of methadone. There is evidence of a unidirectional relationship between alcohol and depression – with the authors concluding that alcohol abuse or dependence leads to depression rather than the reverse. Increasing age was associated with a greater impairment in planning and motor coordination and decreasing insight into these impairments after drinking alcohol. Portrayal of alcohol on TV adverts and films was found to have an immediate effect on drinking behaviour in viewers in this study. In a group of people with the inactive form of Alcohol-Dehydrogenase 2 (associated with adverse responses to alcohol), high novelty seeking and low harm avoidance traits were associated with alcohol use.
Excessive daytime sleepiness has been associated with increased cardiovascular mortality in the elderly. A study of children’s moral values in the real world and also in virtual worlds provided some complex results including an association between moral values in both environments. Hypertension in children was associated with impairment on a number of cognitive tasks consistent with findings in adults. Watching a speaker’s lips and face during speech was associated with up to a six-fold increase in comprehension. The number of years of music experience of musicians was associated with their ability to identify ’emotion sounds’ in a study which compared musicians and non-musicians. Doodling was associated with a better retention of information when listening to a telephone message. There was an association between ‘positive emotions’ and better physical health reported on here. Religious believers were less likely to show activity in the Anterior Cingulate Cortex during a stroop test than non-believers in this study. In one study, subjects were found to be optimistic in predicting their performance on tasks in an ‘ideal world’ but their predictions were more realistic if they were asked how they were likely to perform without reference to the ‘ideal world’.
Abellan Van Kan G et al. Cardiovascular Disease Risk Factors and Progression of Alzheimer’s Disease. Dement Geriatr Cogn Disord. 2009. 27(3). 240-246.
Berlau D et al. APOE epsilon2 is associated with intact cognition but increased Alzheimer pathology in the oldest old. Neurology. 2009. 72(9). 829-34.
Fagan AM et al. Decreased cerebrospinal fluid Abeta(42) correlates with brain atrophy in cognitively normal elderly. Ann Neurol. 2009. 65(2). 176-183. (Epub)
Homma A et al. Long-term safety and efficacy of Donepezil in patients with severe Alzheimer’s Disease: Results from a 52-week, open-label, multicenter, extension study in Japan. Dement Geriatri Cogn Disord. 2009. 27(3). 232-239. Epub.
Moriguchi S et al. Galantamine enhancement of long-term potentiation is mediated by calcium/calmodulin-dependent protein kinase II and protein kinase C activation. Hippocampus. 2009.
Rami L et al. Voxel based morphometry features and follow-up of amnestic patients at high risk for Alzheimer’s disease conversion. Int J Geriatr Psychiatry. 2009. (Epub).
Reitz C et al. Memory performance is related to Amyloid and Tau pathology in the Hippocampus. J Neurol, Neurosurgery and Psychiatry. 2009. (Epub).
Reser J. Alzheimer’s Disease and natural cognitive aging may represent adaptive metabolism reduction programs. Behav Brain Function. 2009. 5(1). 13. (Epub).
Rothi L J et al. Errorless practice as a possible adjuvant to Donepezil in Alzheimer’s Disease. J Int Neuropsychol Soc. 2009. 15(2). 311-22.
Rudea A and Schmitter-Edgecombe. Time estimation abilities in mild cognitive impairment and Alzheimers Disease. Neuropsychology. 2009. 23(2). 178-188.
Shinagawa et al. Characteristics of eating and swallowing problems in patients who have dementia with Lewy bodies. Int Psychogeriatr. 2009. 1-6. Epub.
Schuff N et al. MRI of hippocampal volume loss in early Alzheimer’s Disease in relation to ApoE genotype and biomarkers. Brain. 2009. Epub.
Yilmaz A et al. Predictors of burnout in the family caregivers of Alzheimer’s Disease: evidence from Turkey. Australas J Ageing. 2009. 28(1). 16-21.
Steps To Treatment (STT)
STT = Steps To Treatment. An estimate of the number of steps between the results and translation into practice i.e. treatment. This is an opinion. A policy statement would have a value of 1 as this a guide for practice whereas a speculative model would get a much higher score as there are more steps between statement of the model and treatment (which would involve testing the model, informing treatment approaches and trialling these approaches for instance).
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