Challenges in the diagnosis and management of dementia in Hong Kong

Chu, LW

doi:10.12809/hkmj175066

Cited by 21 publications

(35 citation statements)

References 12 publications

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“…84,85 Our CCS values are in good agreement with these experimental results. Recently, using REMD simulations to study the stability of the Ab 11-40 trimer with antiparallel and parallel b-sheet organizations in the DPPC lipid bilayer, Ngo et al shown that the CCS values of the F20W 3Ab vary between 1351 and 1506Å 2 , 86 with an average of 1417.7Å 2 . Our CCS values are smaller than that obtained from Ngo's paper due to the different point mutations between the two studies (F19W in our case, and F20W in Ngo's paper).…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

“…1 AD is a neurodegenerative disease, which is pathologically characterized by amyloid plaques resulting from the aggregation of extracellular amyloid-b (Ab) peptide, and by neurobrillary tangles made by the accumulation of intracellular tau protein in the hippocampus and cerebral cortex. [2][3][4][5] AD progressively affects normal brain functions such as memory, judgement, and cognition, and results in the failure of crucial cellular processes. 6 Amyloid plaques consist of the extracellular accumulation of the Ab 40 and Ab 42 peptides derived from the transmembrane amyloid precursor protein (APP), which is located in the lipid-rich microdomains (lipid ras) of endosome and the plasma membrane, 7,8 aer cleavage by band g-secretases.…”

Section: Introductionmentioning

confidence: 99%

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The F19W mutation reduces the binding affinity of the transmembrane Aβ_11–40 trimer to the membrane bilayer

et al. 2021

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Section: Comparison With Other Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The F19W mutation reduces the binding affinity of the transmembrane Aβ_11–40 trimer to the membrane bilayer

et al. 2021

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“…1 Neuropsychiatric symptoms such as agitation, apathy, delusions, and disinhibition or problem behaviors such as resistance to care, obsessive-compulsive behaviors, caregiver shadowing, and hoarding behaviors can also manifest with the disease, and has to be managed by behavioral therapy. 1 2 11…”

Section: A Brief Profile Of Alzheimer's Diseasementioning

confidence: 99%

“…The treatment is only symptomatic and does not reverse or prevent the pathology from occurring in high-risk patients. 4 11 Although it does not change the disease course, cholinesterase inhibitors such as donepezil, rivastigmine, and galantamine are recommended at any stage of AD. Memantine, a competitive N-methyl-D-aspartate antagonist and dopamine agonist have been approved for patients with a mini-mental state exam score <15.…”

Section: A Brief Profile Of Alzheimer's Diseasementioning

confidence: 99%

“…Memantine, a competitive N-methyl-D-aspartate antagonist and dopamine agonist have been approved for patients with a mini-mental state exam score <15. 4 11 Huperzine A has also been suggested as effective but is yet to receive approval from the Food and Drug Administration of United States. 1 4 Omega-3 fatty acids from fish oil, for example, have also shown to improve recall and cognition.…”

Section: A Brief Profile Of Alzheimer's Diseasementioning

confidence: 99%

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3D Models as an Adjunct for Models in Studying Alzheimer's Disease

Yaqinuddin

Ikram

Ambia

et al. 2021

Journal of Health and Allied Sciences NU

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Alzheimer’s disease (AD) is one of the most common causes of dementia. Disease progression is marked by cognitive decline and memory impairment due to neurodegenerative processes in the brain stemming from amyloid-β (Aβ) deposition and formation of neurofibrillary tangles. Pathogenesis in AD is dependent on two main neurological processes: formation of intracellular neurofibrillary tangles (NFTs) composed of hyperphosphorylated tau protein and deposition of extracellular senile Aβ peptides. Given the nature of the disease, the pathology and progression of AD in vivo in humans have been difficult to study in vivo. To this degree, models can help to study the disease pathogenesis, biochemistry, immunological functions, genetics, and potential pharmacotherapy. While animal and two-dimensional (2D) cell culture models have facilitated significant progress in studying the disease, more recent application of novel three-dimensional (3D) culture models has exhibited several advantages. Herein, we describe a brief background of AD, and how current animal, 2D, and 3D models facilitate the study of this disease and associated therapeutics.

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Comparative Effectiveness and Safety of Oral Anticoagulants by Dementia Status in Older Patients With Atrial Fibrillation

et al. 2023

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ImportanceThe development of an optimal stroke prevention strategy, including the use of oral anticoagulant (OAC) therapy, is particularly important for patients with atrial fibrillation (AF) who are living with dementia, a condition that increases the risk of adverse outcomes. However, data on the role of dementia in the safety and effectiveness of OACs are limited.ObjectiveTo assess the comparative safety and effectiveness of specific OACs by dementia status among older patients with AF.Design, Setting, and ParticipantsThis retrospective comparative effectiveness study used 1:1 propensity score matching among 1 160 462 patients 65 years or older with AF. Data were obtained from the Optum Clinformatics Data Mart (January 1, 2013, to June 30, 2021), IBM MarketScan Research Database (January 1, 2013, to December 31, 2020), and Medicare claims databases maintained by the Centers for Medicare &amp; Medicaid Services (inpatient, outpatient, and pharmacy; January 1, 2013, to December 31, 2017). Data analysis was performed from September 1, 2021, to May 24, 2022.ExposuresApixaban, dabigatran, rivaroxaban, or warfarin.Main Outcomes and MeasuresComposite end point of ischemic stroke or major bleeding events over the 6-month period after OAC initiation, pooled across databases using random-effects meta-analyses.ResultsAmong 1 160 462 patients with AF, the mean (SD) age was 77.4 (7.2) years; 50.2% were male, 80.5% were White, and 7.9% had dementia. Three comparative new-user cohorts were established: warfarin vs apixaban (501 990 patients; mean [SD] age, 78.1 [7.4] years; 50.2% female), dabigatran vs apixaban (126 718 patients; mean [SD] age, 76.5 [7.1] years; 52.0% male), and rivaroxaban vs apixaban (531 754 patients; mean [SD] age, 76.9 [7.2] years; 50.2% male). Among patients with dementia, compared with apixaban users, a higher rate of the composite end point was observed in warfarin users (95.7 events per 1000 person-years [PYs] vs 64.2 events per 1000 PYs; adjusted hazard ratio [aHR], 1.5; 95% CI, 1.3-1.7), dabigatran users (84.5 events per 1000 PYs vs 54.9 events per 1000 PYs; aHR, 1.5; 95% CI, 1.2-2.0), and rivaroxaban users (87.4 events per 1000 PYs vs 68.5 events per 1000 PYs; aHR, 1.3; 95% CI, 1.1-1.5). In all 3 comparisons, the magnitude of the benefits associated with apixaban was similar regardless of dementia diagnosis on the HR scale but differed substantially on the rate difference (RD) scale. The adjusted RD of the composite outcome per 1000 PYs for warfarin vs apixaban users was 29.8 (95% CI, 18.4-41.1) events in patients with dementia vs 16.0 (95% CI, 13.6-18.4) events in patients without dementia. The corresponding adjusted RD estimates of the composite outcome were 29.6 (95% CI, 11.6-47.6) events per 1000 PYs in patients with dementia vs 5.8 (95% CI, 1.1-10.4) events per 1000 PYs in patients without dementia for dabigatran vs apixaban users and 20.5 (95% CI, 9.9-31.1) events per 1000 PYs in patients with dementia vs 15.9 (95% CI, 11.4-20.3) events per 1000 PYs in patients without dementia for rivaroxaban vs apixaban users. The pattern was more distinct for major bleeding than for ischemic stroke.Conclusions and RelevanceIn this comparative effectiveness study, apixaban was associated with lower rates of major bleeding and ischemic stroke compared with other OACs. The increased absolute risks associated with other OACs compared with apixaban were greater among patients with dementia than those without dementia, particularly for major bleeding. These findings support the use of apixaban for anticoagulation therapy in patients living with dementia who have AF.

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Challenges in the diagnosis and management of dementia in Hong Kong

Cited by 21 publications

References 12 publications

The F19W mutation reduces the binding affinity of the transmembrane Aβ_11–40 trimer to the membrane bilayer

The F19W mutation reduces the binding affinity of the transmembrane Aβ_11–40 trimer to the membrane bilayer

3D Models as an Adjunct for Models in Studying Alzheimer's Disease

Comparative Effectiveness and Safety of Oral Anticoagulants by Dementia Status in Older Patients With Atrial Fibrillation

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Challenges in the diagnosis and management of dementia in Hong Kong

Cited by 21 publications

References 12 publications

The F19W mutation reduces the binding affinity of the transmembrane Aβ11–40 trimer to the membrane bilayer

The F19W mutation reduces the binding affinity of the transmembrane Aβ11–40 trimer to the membrane bilayer

3D Models as an Adjunct for Models in Studying Alzheimer's Disease

Comparative Effectiveness and Safety of Oral Anticoagulants by Dementia Status in Older Patients With Atrial Fibrillation

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Product

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The F19W mutation reduces the binding affinity of the transmembrane Aβ_11–40 trimer to the membrane bilayer

The F19W mutation reduces the binding affinity of the transmembrane Aβ_11–40 trimer to the membrane bilayer