Background: The study aimed to compare neuropsychiatric symptoms (NPS) in people with early-onset Alzheimer’s disease (EOAD) and late-onset AD (LOAD). Methods: Fifty-six participants with LOAD and 24 participants with EOAD having mild dementia were assessed for NPS for their frequency, severity, and caregiver distress as measured by Neuropsychiatry Inventory (NPI) along with assessments of cognition and functional dependence. Results: Participants with EOAD and LOAD were not significantly different for total NPI score ( P = .057). Early-onset Alzheimer disease had greater prevalence of all the NPS except apathy. Participants with EOAD were significantly worse on anxiety ( P = .03), irritability ( P = .01), and sleep ( P < .01) subscales and their carers significantly more distressed by their irritability ( P = .002) and sleeping patterns ( P = .005). Regression analysis showed that higher NPI score was associated with longer duration of illness in EOAD and higher functional dependence in LOAD. Conclusions: The NPS severity was similar between EOAD and LOAD although EOAD had higher symptom prevalence and carer distress.

Group sessions to prevent T2DM were not estimated to be within current limits of cost-effectiveness. However, there was a large degree of uncertainty surrounding these estimates, suggesting the need for further research.

Olfactory dysfunction in general, and impaired odor identification in particular, have been reported in Alzheimer's disease (AD). Olfactory testing may be a useful diagnostic aid for AD, but the types of odor most commonly affected need to be identified. This study aimed to determine pattern and types of odor affected in AD with the goal of improving clinical applicability. 54 outpatients with mild to moderate AD and 40 age and gender-matched non-demented controls (NDC) were tested using British version of University of Pennsylvania Smell Identification Test (UPSIT; Sensonics, Inc., Haddon Heights, NJ) and data analyzed to identify an optimal subset of UPSIT to best differentiate AD patients from controls. AD subjects had significantly lower UPSIT total scores than NDC. Random Forest with backward elimination identified 12 UPSIT items which accurately differentiated AD patients compared to controls (sensitivity, 0.89 and specificity, 0.83, positive predictive value of 0.889, and negative predictive value of 0.833). The 12 smell items found to be most affected in AD subjects reflects important attributes such as safety and food, known to be affected in people with AD and that has the potential to impair activities of daily living. The 12 items of British UPSIT most affected in AD subjects provides a potential brief scale for early detection of AD in clinical settings. Independent replication is needed to validate these findings.

The recruiting and training of lay volunteers with existing type 2 diabetes as type 2 trainers to support study participants at risk of developing the same condition was a cost-effective strategy in comparison to employing salaried health care professionals and warrants further investigation on health outcomes.