Prospective Studies of Cerebral Perfusion and Cognitive Testing Among Elderly Normal Volunteers and Patients with Ischemic Vascular Dementia and Alzheimer's Disease

Mortel, Karl F.; Pavol, Marykay; Wood, Stacey; Meyer, John Stirling; Terayama, Yasuo; Rexer, Jennie L.; Herod, Brian

doi:10.1177/000331979404500301

Cited by 12 publications

(7 citation statements)

References 35 publications

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“…However, this is even more likely in studies drawing longitudinal conclusions (changes of ageing) from crosssectional data (i.e. Meyer and collaborators [2,3,20] have performed large longitudinal studies on rCBF and ageing, avoiding these confounds. Meyer and collaborators [2,3,20] have performed large longitudinal studies on rCBF and ageing, avoiding these confounds.…”

Section: Discussionmentioning

confidence: 99%

Regional cerebral blood flow in normal individuals aged 40, 75 and 88 years studied by 99Tcm-d,l-HMPAO SPET

Larsson

Skoog²,

Aevarsson³

et al. 2001

Nuclear Medicine Communications

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Age-related changes in cerebral blood flow (CBF) were examined with [99Tc(m)]-d,l-hexamethylpropylene amine oxime (HMPAO), using a single photon emission tomography (SPET) gamma camera system equipped with a high resolution collimator, in 33 normal individuals in three age groups: 40 years old (n = 11), 75 years old (n = 9) and 88 years old (n = 13). A standard activity of 1000 MBq [99Tc(m)]-d,l-HMPAO was administered. Regional CBF (rCBF) (relative to cerebellar counts) was quantified in 28 grey and white matter regions. The mean rCBF of all the regions was 0.80 (95% confidence interval [CI] 0.77-0.83) in 40 year olds, 0.77 (0.74-0.80) in 75 year olds and 0.76 (0.73-0.78) in 88 year olds. rCBF in the hippocampus, angular and cingular gyri, and frontal association and motor cortices was 5-10% lower in the 75 and 88 year olds than in the middle-aged subjects (P < 0.05). The annual reduction in rCBF was 0.10% between the ages of 40 and 75 years and 0.13% between the ages of 75 and 88 years. The reduction in rCBF in the hippocampus rose from 0.14% between the ages of 40 and 75 years to 0.33% between the ages of 75 and 88 years. The mean rCBF in all 33 individuals showed no sex-related differences.

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Section: Discussionmentioning

confidence: 99%

Regional cerebral blood flow in normal individuals aged 40, 75 and 88 years studied by 99Tcm-d,l-HMPAO SPET

Larsson

Skoog²,

Aevarsson³

et al. 2001

Nuclear Medicine Communications

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“…Cessation of smoking and lowering elevated cholesterol levels had been the main types of preventive treatments. [64][65][66][67][68][69] Studies have shown that control of hypertension and other stroke risk factors improved or stabilized cognitive function. 66,67 It is also well known that treating hypertension aggressively in the elderly with medications such as diuretics and betablockers, decreases the risk of stroke by as much as 25 percent or more.…”

Section: Discussionmentioning

confidence: 99%

Donepezil (Aricept®) treatment of multi infarct dementia: The caregivers and clinical impression

Shua-Haim

Comsti³

et al. 2000

American Journal of Alzheimer's Disease

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The purpose of this study was to investigate the clinical and caregivers impression of Aricept ® treatment in patients suffering from Multi-Infarct Dementia (MID).In a prospective study 73 MID patients 1 were treated with Donepezil (Aricept ® ) for 16-to 20-weeks. Donepezil was administered as a 5mg tablet once daily at bedtime. After four weeks, patients tolerant of the 5-mg dose were increased to 10 mg daily. All patients satisfied the DSM-III-R criteria for Multi-Infarct Dementia. 2 After 16-to 20-weeks of treatment, the patient's caregiver completed a questionnaire concerning the effectiveness of the drug. Subjective cognitive improvement, MMSE, 3 ADL 4 and IADL 5 outcomes were all assessed before and after treatment (referred to as Clinical Impression). Behavioral outcomes evaluated included depression, agitation, violence, anxiety, and paranoid thoughts.Functional and overall family satisfaction were also evaluated. Side effects as well as reasons for discontinuation from the study were also reported.Seventy-three patients participated in the study. Twelve patients (16 percent) terminated participation due to side effects. Total adverse events were reported in 34 (46.5 percent) of patients. Cognitive improvement was reported in 31 (42.4 percent) patients. Verbal skills and attention were the most commonly reported cognitive improvement. Average MMSE declined by 2.6 points after 16-weeks of treatment. No behavioral improvement was reported. Behavioral deterioration was reported in 16 (21.9 percent) of patients. Functional improvement was reported in 32 (42.8 percent) patients. Overall positive family satisfaction was reported in 54 (73.9 percent) patients.Although Donepezil treatment was approved by the FDA for the treatment of Alzheimer's Disease (AD), such treatment for MID patients appears to be a reasonably safe and effective treatment from the caregiver and family's point of view.

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“…Previous work has linked cognitive decline and dementia to CVD, 1 stroke, 2 diabetes mellitus (DM) and glucose metabolism, [2][3][4][5][6][7][8][9][10][11] hypertension and high and low blood pressure, 2,[12][13][14][15][16][17] peripheral vascular disease, 18 atherosclerosis, 19 genetic factors, 20,21 and cerebral blood flow. 22,23 Apolipoprotein E ⑀4 (APOE ⑀4) genotype is associated with an increased risk of dementia and cognitive decline. 24 Apolipoprotein E ⑀4 alleles may account for 13% to 20% of dementia cases.…”

Section: T He Influence Of Cardiovas-mentioning

confidence: 99%

The Role of <EMPH TYPE="ITAL">APOE</EMPH> ∊4 in Modulating Effects of Other Risk Factors for Cognitive Decline in Elderly Persons

Haan

Shemanski²,

Jagust³

et al. 1999

JAMA

438

323

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Most healthy elderly people did not experience cognitive decline. Measures of subclinical CVD were modest predictors of cognitive decline. Those with any APOE epsilon4 allele in combination with atherosclerosis, peripheral vascular disease, or diabetes mellitus were at substantially higher risk of cognitive decline than those without the APOE epsilon4 allele or subclinical CVD. High levels of atherosclerosis increased cognitive decline independently of APOE genotype.

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Prospective Studies of Cerebral Perfusion and Cognitive Testing Among Elderly Normal Volunteers and Patients with Ischemic Vascular Dementia and Alzheimer's Disease

Cited by 12 publications

References 35 publications

Regional cerebral blood flow in normal individuals aged 40, 75 and 88 years studied by 99Tcm-d,l-HMPAO SPET

Regional cerebral blood flow in normal individuals aged 40, 75 and 88 years studied by 99Tcm-d,l-HMPAO SPET

Donepezil (Aricept®) treatment of multi infarct dementia: The caregivers and clinical impression

The Role of <EMPH TYPE="ITAL">APOE</EMPH> ∊4 in Modulating Effects of Other Risk Factors for Cognitive Decline in Elderly Persons

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