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Arquivos de Neuro-psiquiatria May 2022The field of neurodegenerative dementia genetics has advanced significantly over the past two decades, but there are still more to be discovered (such as the gene... (Review)
Review
BACKGROUND
The field of neurodegenerative dementia genetics has advanced significantly over the past two decades, but there are still more to be discovered (such as the gene mutation in some familial forms of dementia).
OBJECTIVE
to provide a brief review of the most recent discoveries regarding monogenic dementia, and covering the most frequent genetic diseases that can cause dementia (neurodegenerative or not).
METHODS
a review of the literature will be carried out.
RESULTS
neurodegenerative dementias, vascular dementias and leukoencephalopathies caused by single pathogenic variants are presented.
CONCLUSION
The spectrum of clinical presentations for most of the genes discussed is wide, and hence genetic testing in clinic should try to cover as many genes as possible.
Topics: Dementia; Humans; Mutation
PubMed: 35976293
DOI: 10.1590/0004-282X-ANP-2022-S103 -
Environmental Research Nov 2023The ageing population has been steadily increasing worldwide, leading to a higher risk of cognitive decline and dementia. Environmental toxicants, particularly metals,... (Review)
Review
The ageing population has been steadily increasing worldwide, leading to a higher risk of cognitive decline and dementia. Environmental toxicants, particularly metals, have been identified as modifiable risk factors for cognitive impairment. Continuous exposure to metals occurs mainly through dietary sources, with older adults being particularly vulnerable. However, imbalances in the gut microbiota, known as dysbiosis, have also been associated with dementia. A literature review was conducted to explore the potential role of metals in the development of cognitive decline and the most prevalent primary neurodegenerative dementias, as well as their interaction with the gut microbiota. High levels of iron (Fe) and copper (Cu) are associated with mild cognitive impairment (MCI) and Alzheimer's disease (AD), while low selenium (Se) levels are linked to poor cognitive status. Parkinson's disease dementia (PDD) is associated with elevated levels of iron (Fe), manganese (Mn), and zinc (Zn), but the role of copper (Cu) remains unclear. The relationship between metals and Lewy body dementia (LBD) requires further investigation. High aluminium (Al) exposure is associated with frontotemporal dementia (FTD), and elevated selenium (Se) levels may be linked to its onset. Challenges in comparing studies arise from the heterogeneity of metal analysis matrices and analytical techniques, as well as the limitations of small study cohorts. More research is needed to understand the influence of metals on cognition through the gut microbiota (GMB) and its potential relevance in the development of these diseases.
Topics: Humans; Aged; Dementia; Copper; Selenium; Parkinson Disease; Metals; Alzheimer Disease; Cognitive Dysfunction; Iron
PubMed: 37487923
DOI: 10.1016/j.envres.2023.116722 -
Continuum (Minneapolis, Minn.) Jun 2022Causes of health disparities in Alzheimer disease and related dementias (ADRD) in the United States are multifactorial. This article contextualizes health disparities as... (Review)
Review
PURPOSE OF REVIEW
Causes of health disparities in Alzheimer disease and related dementias (ADRD) in the United States are multifactorial. This article contextualizes health disparities as they relate to the neurodegenerative processes of ADRD.
RECENT FINDINGS
Older adults' life expectancy has increased such that a 65-year-old is expected to live 19 or more years and an 85-year-old can expect to live, on average, 6 to 7 years longer. Individuals of certain ethnoracial groups (Black, Hispanic/Latino, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander) may be at a higher risk of incident ADRD compared to non-Hispanic/Latino White people. These differences in a higher risk of ADRD across ethnoracial groups persist despite no statistically significant differences in the rate of cognitive decline over time. The intersectionality of social determinants of health, experiences with discrimination and oppression, and access to care are related to the issue of justice and the risk for and expression of ADRD. The theoretical frameworks of various health disparities provide organized approaches to tracking the progression of health disparities for diverse patients.
SUMMARY
ADRD health disparities are complex. Neurologists and their care teams must consider the main reasons for clinical ADRD evaluations of members of ethnoracial groups and the factors that may impact patient adherence and compliance with diagnostic and management recommendations.
Topics: Aged; Alzheimer Disease; Humans; United States
PubMed: 35678407
DOI: 10.1212/CON.0000000000001088 -
Journal of Alzheimer's Disease : JAD 2023Lewy body dementia is the third most common and costliest type of dementia. It is an umbrella term for dementia with Lewy bodies and Parkinson's disease dementia, both... (Review)
Review
Lewy body dementia is the third most common and costliest type of dementia. It is an umbrella term for dementia with Lewy bodies and Parkinson's disease dementia, both of which place a substantial burden on the person and society. Recent findings outline ethnoracial differences in dementia risk. Delayed and misdiagnosis across ethnoracial groups contribute to higher levels of burden. In this context, we aimed to summarize current knowledge, gaps, and unmet needs relating to race and ethnicity in Lewy body dementia. In this narrative review, we provide an overview of studies on Lewy body dementia focusing on differences across ethnoracial groups and outline several recommendations for future studies. The majority of the findings comparing different ethnoracial groups were from North American sites. There were no differences in clinical prevalence and progression across ethnoracial groups. Compared to people identifying as non-Hispanic White, co-pathologies were more common and clinical diagnostic accuracy was lower for people identifying as Black. Co-morbidities (e.g., diabetes, hypertension) were more common and medication use rates (e.g., antidepressants, antiparkinsonian agents) were lower for people identifying as Black or Hispanic compared to people identifying as White. More than 90% of clinical trial participants identified as non-Hispanic White. Despite increasing efforts to overcome disparities in Alzheimer's disease and related dementias, inclusion of individuals from minoritized communities in Lewy body dementia studies continues to be limited and the findings are inconclusive. Representation of diverse populations is crucial to improve the diagnostic and therapeutic efforts in Lewy body dementia.
Topics: Humans; Lewy Body Disease; Dementia; Ethnicity; Parkinson Disease; Alzheimer Disease
PubMed: 37355902
DOI: 10.3233/JAD-230207 -
Revista de Investigacion Clinica;... 2016The most common dementias such as Alzheimer's disease, vascular dementia, Lewy body dementia, and frontotemporal dementia are associated with a decline in cognitive and... (Review)
Review
The most common dementias such as Alzheimer's disease, vascular dementia, Lewy body dementia, and frontotemporal dementia are associated with a decline in cognitive and social abilities. Although the molecular mechanisms of tissue damage in these dementias are not completely understood, these neurodegenerative illnesses share certain alterations such as neuroinflammation and gliosis. Increasing evidence suggests that microgliosis and astrogliosis play a key role in neuroinflammation observed in these dementias. Here we provide an overview of the participation of microglia and astrocytes in the neuroinflammatory response in common dementias.
Topics: Aged; Astrocytes; Cognition Disorders; Dementia; Humans; Inflammation; Microglia; Neurodegenerative Diseases
PubMed: 27028176
DOI: No ID Found -
Current Neuropharmacology 2021Dementia is a collection of symptoms affecting a person's cognition. Dementia is debilitating, and therefore, finding an effective treatment is of utmost importance.... (Review)
Review
Dementia is a collection of symptoms affecting a person's cognition. Dementia is debilitating, and therefore, finding an effective treatment is of utmost importance. Resveratrol, which exhibits neuroprotective effects, has low bioavailability. However, its glucoside polydatin is more bioavailable. Here, the evidence that supports the protective role of polydatin against dementia- related diseases such as Alzheimer's disease, vascular dementia, alcohol-related dementia, and Lewy body dementias is presented. The beneficial effects of polydatin from a mechanistic perspective are specifically emphasized in this review. Future directions in this area of research are also discussed.
Topics: Alzheimer Disease; Dementia; Glucosides; Humans; Lewy Body Disease; Stilbenes
PubMed: 32525774
DOI: 10.2174/1570159X18666200611144825 -
Revista de Neurologia May 2018Virtual reality technology was first used in the treatment of psychological disorders in 1994. Since then, its application has aroused the interest of clinicians and... (Review)
Review
INTRODUCTION
Virtual reality technology was first used in the treatment of psychological disorders in 1994. Since then, its application has aroused the interest of clinicians and researchers, and it has become a potential tool for use in psychological evaluation and neurorehabilitation.
AIM
To review the different studies that have been published on the treatment of dementias in which virtual reality has been used, with the aim of evaluating its efficacy.
DEVELOPMENT
A search was conducted over the last 10 years (2007-2017) in different databases (PubMed, PsycINFO and Dialnet), as well as in Google Scholar. Few studies were found and, judging by the results that were obtained, they cannot be said to be conclusive, although they do offer certain evidence suggesting that virtual reality is a promising field for intervention in persons with dementia.
CONCLUSIONS
Virtual reality is a growing and very promising area for psychological intervention in general, and more particularly for the treatment of dementia. It seems to enjoy a very favourable acceptance among persons suffering from dementia. Nevertheless, it is important to understand the new technologies as a tool rather than as a substitute for the therapist. Likewise, there is a need for more rigorous and systematic research that determines the efficacy of this kind of intervention.
Topics: Aged; Aged, 80 and over; Cognitive Dysfunction; Dementia; Humans; Memory Disorders; Neuronal Plasticity; Psychomotor Performance; Therapy, Computer-Assisted; Treatment Outcome; Virtual Reality
PubMed: 29749595
DOI: No ID Found -
Neurobiology of Disease Aug 2020Frontotemporal dementia (FTD), dementia with Lewy bodies (DLB) and vascular dementia (VaD) are the most common forms of dementia after Alzheimer's disease (AD). The... (Review)
Review
Frontotemporal dementia (FTD), dementia with Lewy bodies (DLB) and vascular dementia (VaD) are the most common forms of dementia after Alzheimer's disease (AD). The heterogeneity of these disorders and/or the clinical overlap with other diseases hinder the study of their genetic components. Even though Mendelian dementias are rare, the study of these forms of disease can have a significant impact in the lives of patients and families and have successfully brought to the fore many of the genes currently known to be involved in FTD and VaD, starting to give us a glimpse of the molecular mechanisms underlying these phenotypes. More recently, genome-wide association studies have also pointed to disease risk-associated loci. This has been particularly important for DLB where familial forms of disease are very rarely described. In this review we systematically describe the Mendelian and risk genes involved in these non-AD dementias in an effort to contribute to a better understanding of their genetic architecture, find differences and commonalities between different dementia phenotypes, and uncover areas that would benefit from more intense research endeavors.
Topics: Frontotemporal Dementia; Genetic Predisposition to Disease; Genome-Wide Association Study; Humans; Lewy Body Disease
PubMed: 32439597
DOI: 10.1016/j.nbd.2020.104946 -
Journal of General Internal Medicine Aug 2022The emotional stress of caring for someone with Alzheimer's disease and related dementias is high and results in adverse effects on caregivers and the persons living...
BACKGROUND
The emotional stress of caring for someone with Alzheimer's disease and related dementias is high and results in adverse effects on caregivers and the persons living with disease. In preliminary work, caregiver reports of regularly feeling "completely overwhelmed" were associated with lack of measurable clinical benefit from a comprehensive dementia care program.
OBJECTIVE
To examine the sociodemographic and clinical characteristics of all caregivers who felt overwhelmed at entry into a comprehensive dementia care program, the trajectory of this symptom over 1 year, and its predictive value for 1-year caregiver outcomes.
DESIGN
Longitudinal cohort study SETTING: Academic health center PARTICIPANTS: Caregivers of patients enrolled in a comprehensive dementia care program EXPOSURES: Caregiver report of feeling "completely overwhelmed" at baseline MAIN MEASURES: Caregiver report of feeling "completely overwhelmed" at baseline and 1 year, and validated scales of caregiver strain, distress, depressive symptoms, burden, mortality, and long-term nursing home placement KEY RESULTS: Compared to caregivers who were not overwhelmed, overwhelmed caregivers had more distress from behavioral symptoms of the person living with dementia, worse depression scores, and higher composite dementia burden scores at baseline. They also had worse depressive symptoms, strain, and composite burden scores at 1 year, after adjustment for baseline scores. Having an overwhelmed caregiver did not predict long-term nursing home placement or mortality among persons with dementia.
CONCLUSIONS
A single question about whether a caregiver is overwhelmed might indicate caregivers who have considerable current and future symptom burden and who may benefit from increased support and resources.
Topics: Alzheimer Disease; Caregivers; Dementia; Humans; Nursing Homes; Vital Signs
PubMed: 34389938
DOI: 10.1007/s11606-021-07054-3 -
Journal of Integrative Neuroscience Apr 2022Worldwide, more than 50 million people live with dementia, and due to the rapidly aging population, dementia cases are expected to increase at least five times in 2050.... (Review)
Review
Worldwide, more than 50 million people live with dementia, and due to the rapidly aging population, dementia cases are expected to increase at least five times in 2050. 30%-40% of dementia cases are diagnosed as non-Alzheimer's dementia. Common subtypes of non-Alzheimer's dementia are known as vascular, Lewy body, and frontotemporal dementia. Despite advances in modern medicine, the mechanism of dementia is still not fully understood. The term "omics" is a general term and is used to comprehensively characterize molecules by functional and biological similarities, focusing on the basic biological processes of a living organism and these techniques have enabled us to examine the unknown areas of biology, such as the genome, transcriptome, proteome, microbiome, and metabolome. This review highlights the progress that has been made in omics research while noting the gaps in our knowledge.
Topics: Aged; Aging; Alzheimer Disease; Dementia; Humans; Learning
PubMed: 35633157
DOI: 10.31083/j.jin2103076