Detection of Cerebral Aging,an Absolute Need: Predictive Valueof Cognitive Status

Forette, Françoise; Ml, Seux; Thijs, Lutgarde; Divenah, Aude Le; Perol, M; Rigaud, A; Latour, F.; Bouchacourt, P.; Staessen, Jan A.

doi:10.1159/000052063

Cited by 10 publications

(9 citation statements)

References 46 publications

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“…These findings suggest that men who have a history of a high cholesterol level during middle age or early old age have an elevated risk of developing AD at a later age, but that the onset of AD in these cases is associated with a rapid decrease in cholesterol levels. This is in accordance with the evolution of other common risk factors for vascular disease such as high blood pressure and AD [19,20].…”

Section: Discussionsupporting

confidence: 85%

The Relationship between Apolipoprotein E4 and Lipid Metabolism Is Impaired in Alzheimer’s Disease

et al. 2001

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Background: Human apolipoprotein (Apo) E4 (ApoE4) is an important determinant of lipid metabolism and cell-to-cell cholesterol transport. It is also a major genetic risk factor for both vascular disease and familial and sporadic late-onset Alzheimer’s disease (AD). Since vascular pathology could dramatically reduce neuronal reserve capacity, a biological chain of events between ApoE4, hypercholesterolemia and AD has been postulated. The aim of the present study is to explore the relationship between lipid metabolism and ApoE isoforms in a large series of elderly subjects in relation to the presence or absence of AD. Methods: Of 332 referrals to a neurology clinic specializing in memory disorders, 146 were given a diagnosis of AD (age, mean ± SD 76 ± 13.1 years, 64.4% women) according to DSM-IIIR criteria. One hundred and seventy-six subjects were included as controls (age 80 ± 5.6 years, 58% women). The ApoE phenotype was determined by the isoelectrofocalization method, cholesterol, triglycerides, phospholipids, ApoA and ApoB were determined by routine chemistry. Findings: A significant association was observed between the E4 allele and AD (χ² = 13, p < 0.001) only below age 80. In the control group, cholesterol levels were found to be significantly higher in men but not in women with an E4 allele (6.35 ± 1.3 mmol/l) as opposed to those without (5.8 ± 1.2 mmol/l). ApoB levels were also found to be higher in the presence of ApoE4, with no gender effect. Within the AD group no significant relationship was found between ApoE4 and cholesterol levels (mean 6.05 ± 0.9 mmol/l in E4-AD subjects versus 5.8 ± 1.21 mmol/l in non-E4-AD subjects). Similar observations were made in relation to triglycerides and phospholipids. Interpretation: Our results demonstrate the disappearance of the ApoE4-raising effect on serum cholesterol, triglyceride and phospholipid levels in AD suggesting a more complex relationship between AD and lipid metabolism than has previously been supposed. This lipid abnormality may further contribute to the progression of AD.

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Section: Discussionsupporting

confidence: 85%

The Relationship between Apolipoprotein E4 and Lipid Metabolism Is Impaired in Alzheimer’s Disease

et al. 2001

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“…The Mini-Mental State Exam (27) was used to estimate cognitive impairment. This test has been used extensively to assess mental function in various geriatric populations (28,31,43). The Geriatric Depression Scale (GDS), a 30-item yes/no questionnaire with scores ranging from 0 to 30, was used to quantify depressive symptoms (93).…”

Section: Assessmentsmentioning

confidence: 99%

Etiology and modification of gait instability in older adults: a randomized controlled trial of exercise

Hausdorff

Nelson

Kaliton³

et al. 2001

Journal of Applied Physiology

181

124

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Increased gait instability is common in older adults, even in the absence of overt disease. The goal of the present study was to quantitatively investigate the factors that contribute to gait instability and its potential reversibility in functionally impaired older adults. We studied 67 older men and women with functional impairment before and after they participated in a randomized placebo-controlled, 6-mo multimodal exercise trial. We found that 1) gait instability is multifactorial; 2) stride time variability is strongly associated with functional status and performance-based measures of function that have previously been shown to predict significant clinical outcomes such as morbidity and nursing home admission; 3) neuropsychological status and health-related quality of life play important, independent roles in gait instability; and 4) improvement in physiological capacity is associated with reduced gait instability. Although the etiology of gait instability in older persons with mild-moderate functional impairment is multifactorial, interventions designed to reduce gait instability may be effective in bringing about a more consistent and more stable walking pattern.

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“…5,6 AD seems to behave as a nosological entity. 8,11 Functional decline is at first a consequence of cognitive decline, 12 stemming from inattentiveness, amnesia, apraxia, aphasia, and agnosia, and also from "negative symptoms" such as social withdrawal, apathy, 13 or depression. 6,8 Cognition declines at a predictable rate of about 4 Mini-Mental State Examination points per year, 7,9 and there is limited variance around this slope.…”

mentioning

confidence: 99%

“…While the criteria for AD have remained stable for 16 years, multiple criteria for VaD have been proposed in this same period. 12 The dementia is presumed to be caused by tissue injury from ischemia, with diverse pathologic patterns ranging from complete cortical death to mild subcortical hypoperfusion. 26 The Diagnostic and Statistical Manual of Mental Disorders (DSM), 3rd edition, revised, 30 established Multi-Infarct Dementia on the basis of history and physical examination incorporating the above elements and adding distribution of deficits as an early discriminating sign.…”

mentioning

confidence: 99%

Vascular Dementia and Alzheimer's Disease: Is There a Difference?

Groves¹,

Brandt²,

Steinberg³

et al. 2000

JNP

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This study examined differences between vascular dementia (VaD) by the NINDS/AIRENS criteria and Alzheimer's disease (AD) on clinical grounds. A consecutive series of 517 patients with probable and possible VaD or AD were evaluated for cognitive, functional, and behavioral symptoms and separated into three subgroups by duration of dementia. These AD and VaD subgroups were then compared on a series of standardized clinical measures. The only consistent trends were for VaD patients to be more depressed, more functionally impaired, and less cognitively impaired within each disease duration subgroup. The authors conclude that there are few differences between clinically diagnosed VaD and AD. Subclassification of VaD into subgroups will improve the clinical utility of this nosologic entity.

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Detection of Cerebral Aging,an Absolute Need: Predictive Valueof Cognitive Status

Cited by 10 publications

References 46 publications

The Relationship between Apolipoprotein E4 and Lipid Metabolism Is Impaired in Alzheimer’s Disease

The Relationship between Apolipoprotein E4 and Lipid Metabolism Is Impaired in Alzheimer’s Disease

Etiology and modification of gait instability in older adults: a randomized controlled trial of exercise

Vascular Dementia and Alzheimer's Disease: Is There a Difference?

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