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Genetics in Medicine : Official Journal... Apr 2008Alzheimer disease is the most common cause of dementia and represents a major public health problem. The neuropathologic findings of amyloid-beta plaques and tau... (Review)
Review
Alzheimer disease is the most common cause of dementia and represents a major public health problem. The neuropathologic findings of amyloid-beta plaques and tau containing neurofibrillary tangles represent important molecular clues to the underlying pathogenesis. Genetic factors are well recognized, but complicated. Three rare forms of autosomal-dominant early-onset familial Alzheimer disease have been identified and are associated with mutations in amyloid precursor protein, presenilin 1, and presenilin 2 genes. The more common late-onset form of Alzheimer disease is assumed to be polygenic/multifactorial. However, thus far the only clearly identified genetic risk factor for Alzheimer disease is Apo lipoprotein E. The epsilon4 allele of Apo lipoprotein E influences age at onset of Alzheimer disease, but is neither necessary nor sufficient for the disease. The search continues for the discovery of additional genetic influences.
Topics: Alzheimer Disease; Diagnosis, Differential; Genetic Counseling; Genetic Testing; Humans
PubMed: 18414205
DOI: 10.1097/GIM.0b013e31816b64dc -
BioMed Research International 2016Alzheimer's disease (AD) is the most common cause of dementia associated with a progressive neurodegenerative disorder, with a prevalence of 44 million people throughout... (Review)
Review
Alzheimer's disease (AD) is the most common cause of dementia associated with a progressive neurodegenerative disorder, with a prevalence of 44 million people throughout the world in 2015, and this figure is estimated to double by 2050. This disease is characterized by blood-brain barrier disruption, oxidative stress, mitochondrial impairment, neuroinflammation, and hypometabolism; it is related to amyloid-β peptide accumulation and tau hyperphosphorylation as well as a decrease in acetylcholine levels and a reduction of cerebral blood flow. Obesity is a major risk factor for AD, because it induces adipokine dysregulation, which consists of the release of the proinflammatory adipokines and decreased anti-inflammatory adipokines, among other processes. The pharmacological treatments for AD can be divided into two categories: symptomatic treatments such as acetylcholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists and etiology-based treatments such as secretase inhibitors, amyloid binders, and tau therapies. Strategies for prevention of AD through nonpharmacological treatments are associated with lifestyle interventions such as exercise, mental challenges, and socialization as well as caloric restriction and a healthy diet. AD is an important health issue on which all people should be informed so that prevention strategies that minimize the risk of its development may be implemented.
Topics: Alzheimer Disease; Humans; Obesity; Risk Factors
PubMed: 27547756
DOI: 10.1155/2016/2589276 -
Journal of Gerontological Nursing Mar 2018As part of the National Plan to Address Alzheimer's Disease, reducing potentially avoidable emergency department (ED) use by individuals with dementia has been... (Review)
Review
As part of the National Plan to Address Alzheimer's Disease, reducing potentially avoidable emergency department (ED) use by individuals with dementia has been identified as a component of enhancing the quality and efficiency of care for this population. To help inform the development of interventions to achieve this goal, an integrative review was conducted to: (a) compare rates and reasons for ED visits by community-dwelling individuals with and without dementia, considering also the effect of dementia subtype and severity; and (b) identify other risk factors for increased ED use among community-dwelling individuals with dementia. Nineteen articles met inclusion criteria. Individuals with dementia had higher rates of ED visits compared to those without dementia, although differences were attenuated in the last year of life. Increased symptoms and disability were associated with increased rates of ED visits, whereas resources that enabled effective management of increased need decreased rates. Gerontological nurses across settings are on the frontlines of preventing potentially avoidable ED visits by community-dwelling individuals with dementia through patient and family education and leadership in the development of new models of care. [Journal of Gerontological Nursing, 44(3), 23-30.].
Topics: Alzheimer Disease; Case-Control Studies; Emergency Service, Hospital; Geriatric Nursing; Humans; Independent Living; Models, Psychological; Nurse's Role; Risk Factors; Severity of Illness Index; United States
PubMed: 29355877
DOI: 10.3928/00989134-20171206-01 -
International Journal of Molecular... May 2024The majority of clinical trials, whose primary aims were to moderate Alzheimer's dementia (AD), have been based upon the prevailing paradigm, i [...].
The majority of clinical trials, whose primary aims were to moderate Alzheimer's dementia (AD), have been based upon the prevailing paradigm, i [...].
Topics: Alzheimer Disease; Humans
PubMed: 38892203
DOI: 10.3390/ijms25116015 -
Neurology May 2019The field of Alzheimer disease (AD) has a nosologic problem: The diagnostic label "Alzheimer disease" has several distinctive meanings. The term probable AD was... (Review)
Review
The field of Alzheimer disease (AD) has a nosologic problem: The diagnostic label "Alzheimer disease" has several distinctive meanings. The term probable AD was introduced in 1984 to designate a clinically diagnosed acquired and progressive amnestic dementia for which there was no evidence for another etiology. Probable AD represented a clinicopathologic entity that assumed a specific and sensitive linkage between amnestic dementia and the neuropathology of β-amyloid-containing neuritic plaques and tau-containing neurofibrillary tangles. The clinicopathologic model represented by probable AD was adapted in abbreviated form for population-based studies and general clinical practice, although the uncertainty connoted by "probable" was often overlooked. Representing the growing public awareness of later life cognitive impairment, a vernacular meaning of AD arose out of the clinicopathologic model in which AD represented all dementia not due to another clinically apparent cause. In contrast, by the 1990s, neuropathologists settled on a definition of AD based entirely on a sufficient burden of neuritic plaques and neurofibrillary tangles at postmortem examination, regardless of antemortem clinical status. In the last decade, the availability of fluid and imaging biomarkers that measure β-amyloid and tau abnormalities has enabled antemortem pathobiological diagnoses, highlighting the divide between the clinicopathologic model, the vernacular usage, and the pathobiological models. Each definition has value. However, the meanings of AD as defined by each of these models are not interchangeable. The pathobiological one is the only one that is unambiguous.
Topics: Alzheimer Disease; History, 20th Century; History, 21st Century; Humans; Terminology as Topic
PubMed: 31028129
DOI: 10.1212/WNL.0000000000007583 -
Human Brain Mapping Sep 2014Because hypoperfusion of brain tissue precedes atrophy in dementia, the detection of dementia may be advanced by the use of perfusion information. Such information can...
Because hypoperfusion of brain tissue precedes atrophy in dementia, the detection of dementia may be advanced by the use of perfusion information. Such information can be obtained noninvasively with arterial spin labeling (ASL), a relatively new MR technique quantifying cerebral blood flow (CBF). Using ASL and structural MRI, we evaluated diagnostic classification in 32 prospectively included presenile early stage dementia patients and 32 healthy controls. Patients were suspected of Alzheimer's disease (AD) or frontotemporal dementia. Classification was based on CBF as perfusion marker, gray matter (GM) volume as atrophy marker, and their combination. These markers were each examined using six feature extraction methods: a voxel-wise method and a region of interest (ROI)-wise approach using five ROI-sets in the GM. These ROI-sets ranged in number from 72 brain regions to a single ROI for the entire supratentorial brain. Classification was performed with a linear support vector machine classifier. For validation of the classification method on the basis of GM features, a reference dataset from the AD Neuroimaging Initiative database was used consisting of AD patients and healthy controls. In our early stage dementia population, the voxelwise feature-extraction approach achieved more accurate results (area under the curve (AUC) range = 86 - 91%) than all other approaches (AUC = 57 - 84%). Used in isolation, CBF quantified with ASL was a good diagnostic marker for dementia. However, our findings indicated only little added diagnostic value when combining ASL with the structural MRI data (AUC = 91%), which did not significantly improve over accuracy of structural MRI atrophy marker by itself.
Topics: Aged; Alzheimer Disease; Area Under Curve; Atrophy; Brain; Cerebrovascular Circulation; Diagnosis, Differential; Female; Frontotemporal Dementia; Gray Matter; Humans; Image Interpretation, Computer-Assisted; Linear Models; Magnetic Resonance Imaging; Male; Middle Aged; Organ Size; Prospective Studies; Support Vector Machine
PubMed: 24700485
DOI: 10.1002/hbm.22522 -
BMJ (Clinical Research Ed.) Feb 1998
Review
Topics: Alzheimer Disease; Forecasting; Humans; Risk Factors
PubMed: 9492674
DOI: 10.1136/bmj.316.7129.446 -
Biochemical Pharmacology Apr 2014The future of the Alzheimer's disease (AD) field involves a more complete understanding not only the state of current scientific approaches, but also the linguistic and... (Review)
Review
The future of the Alzheimer's disease (AD) field involves a more complete understanding not only the state of current scientific approaches, but also the linguistic and cultural context of preclinical and clinical research and policy activities. The challenges surrounding dementia are large and growing but are only part of broader social and health concerns. In this latter context, the current state of research in the AD area is reviewed together with necessary priorities in moving forward. Creating a more optimistic future will depend less on genetic and reductionist approaches and more on environmental and intergenerative approaches that will aid in recalibrating the study of AD from an almost exclusive focus on biochemical, molecular and genetic aspects to better encompass "real world" ecological and psychosocial models of health.
Topics: Aging; Alzheimer Disease; Humans
PubMed: 24304687
DOI: 10.1016/j.bcp.2013.11.017 -
Stem Cells Translational Medicine Nov 2017
Topics: Alzheimer Disease; Animals; Humans
PubMed: 28949098
DOI: 10.1002/sctm.12217 -
PLoS Pathogens Jun 2020
Review
Topics: Alzheimer Disease; Herpesviridae; Herpesviridae Infections; Humans
PubMed: 32555685
DOI: 10.1371/journal.ppat.1008575