P1‐223: Functional Markers for Cerebral Norepinephrine Deficiency in Alzheimer’s Disease

Abstract

Background: In primary care units Frailty Ambulatory is dedicated to elderly people and is an example of health innovation. In the light of a complex rethinking of primary care, it is aimed to promote initiative medicine in the field of degenerative and chronic diseases. In short, Frailty Ambulatories have to make easier the "art" of caring elderly patients' complex needs through geriatricians and outof-hospital network services. The aim of the present study was to analyze data from 300 consecutive patients sent to our ambulatories. Methods:The starting point is caring patients and their needs. The first step is represented by over-65 year-old patients' selection according to the criteria of prefrailty and frailty (at least one Fried's criterion and the patient sent to geriatrician by general practitioner). Results:Of 300 patients, 118 (39,3%) were men, mean age 82,79 6 6,65 years old, BMI 22,176 2,15 kg/m 2 . After performing multidimensional assessment we found the following scores: MMSE 11,0562,44; ADL 0,9562,06; IADL 0,0460,188; CIRS 4,9561,72. The number of drugs used was 6,16 6 2,20. The most frequent Fried's criterion found was fatigue (97,3%, Table 1); criteria's mean/patient was 4,74 6 0,56. In 80,3% out of the patients all the five criteria were found, in 13.3% four criteria, in 6,4% three criteria (Figure 1). After bivariate relationship Fried's criteria were found to be significantly correlated to MMSE and heart failure. After multivariate analysis the relationship was kept with MMSE (beta -0,209; p¼0,0001). Conclusions: Experimental activity in Frailty Ambulatories could offer a tool able to recognize conditions of prefrailty/frailty. This can lead to a consistent and complete care response, preventing/decreasing disability conditions. Data analyses timely carried on by provincial health authority let plan the possible continuation of experimentation.Background:The locus coeruleus (LC) as the only source for norepinephrine (NE) in the human brain shows early degeneration in Alzheimer's disease (AD). The LC-NE system is involved in attentional processes and different behavioral and functional markers (e.g. evoked EEG potentials, BOLD responses, pupillary dilatation) have been identified as potential markers for LC-NEfunctionality. Here, we assessed whether these markers are characteristically altered in AD, thus providing potential surrogate markers for interventional trials targeting the LC-NE-system. Methods: We aim at including patients (planned: n¼30) with cerebrospinal fluid-biomarker evidence for AD and age-matched healthy controls (planned: n¼30). We obtain reaction times and accuracy, event-related electroencephalography (EEG) potentials (P300b), task-related pupil dilation and event-related blood oxygen level dependent (BOLD) responses in a stimulus detection task (Oddball-paradigm). Additionally, structural magnetic resonance imaging (MRI) with neuromelanine-sensitive sequences is applied to determine a volumetric measure for the LC. Here, we present preliminary results for 15 subjects with ...