The National Institute of Clinical Excellence have reappraised their guidance on the use of drugs for Alzheimer’s Disease (see here) with the result that the consultation document states that the acetylcholinesterase inhibitors that are already in use can be used at an early stage of the disease and the drug Memantine can be used at the more advanced stages of the illness rather than being restricted to the research setting. The Alzheimer’s Society have produced a more detailed explanation on their website here.
One study looked at post-mortem brains in a sample with Alzheimer’s Disease (AD) or Lewy Body Dementia. The researchers were interested to learn about Lewy Body Dementia in different age groups. The samples were divided into 70-79, 80-89 and 90+. The researchers found that the frequency of LBD was lower in the two older groups but the cognitive impairment was similar for all three groups. The severity of neuropathology and clinical manifestations correlated only in the youngest group although synaptophysin severity correlated with the clinical severity in the oldest group.
In a prospective cohort study of 417 people with intracerebral haemmorhage a small subset underwent post-mortem analysis. 23% of people with lobar intracerebral haemmorhage had pre-existing dementia with 5 post-mortem analyses revealing a combination of Alzheimer’s Disease and cerebral amyloid angiopathy. In the deep intracerebral haemmorhage group the 5 sampled subjects had small vessel disease without Alzheimer’s Disease. The Informant Questionnaire on Cognitive Decline in the Elderly was used to assess cognition in this study.
A study appearing in the International Journal of Geriatric Psychiatry looked at prescription of antipsychotics in the last 90 days in people living in the community or in care homes in England and Wales by analysing a primary care database. 3677 patients were identified in the community and 2173 in care homes. Antipsychotic prescription was 0.9% in the community and 20.9% in the care homes in the last 90 days although these figures are not contextualised (e.g. the reason for prescriptions). Banerjee’s report on antipsychotics came at the end of 2009 (see here) and it would be interesting to see the figures in 2010.
A test of olfaction was used to discriminate between performance in people with Alzheimer’s Disease and Mild Cognitive Impairment (MCI) in one study. Optimal unirhinal performance did not discriminate between AD and MCI although suboptimal performance did.
There is a review of treatment of sleep disturbances in Alzheimer’s Disease in the International Journal of Geriatric Psychiatry covering non-pharmacological treatments including Bright Light Therapy as well as pharmacological treatments. The authors conclude that more research is needed in this area.
There is a write-up of a study which used susceptibility-based MRI to investigate differences between MCI. This imaging technique is effective for investigating the cerebral vasculature and the researchers found evidence of microhaemmorhages in people with MCI compared to a control group.
There is a very good round-up of Spike Activity at Mind Hacks.
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