scholarly journals Are clinical diagnoses of Alzheimer's disease and other dementias affected by education and self-reported race?

2012 ◽  
Vol 24 (3) ◽  
pp. 531-544 ◽  
Author(s):  
Jeanne A. Teresi ◽  
Ellen Grober ◽  
Joseph P. Eimicke ◽  
Amy R. Ehrlich
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Clinical Diagnoses

scholarly journals Plasma P-tau 181, P-tau 217 and Other Blood-Based Alzheimer's Disease Biomarkers in a Multi-Ethnic, Community Study

2020 ◽  
Author(s):  
Adam M. Brickman ◽  
Jennifer J Manly ◽  
Lawrence Honig ◽  
Danurys Sanchez ◽  
Dolly Reyes-Dumeyer ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Ethnic Community ◽  
Community Study ◽  
Community Studies ◽  
Operating Characteristics ◽  
Neurofilament Light Chain ◽  
Neurofilament Light ◽  
Clinical Diagnoses ◽  
Washington Heights

Introduction. Blood-based Alzheimer's disease (AD) biomarkers provide opportunities for community studies and across ethnic groups. We investigated blood biomarker concentrations in the Washington Heights, Inwood, Columbia Aging Project (WHICAP), a multi-ethnic community study of aging and dementia. Methods. We measured plasma Aβ40, Aβ42,T-tau, P-tau181 and P-tau217, and neurofilament light chain (NfL) in 113 autopsied participants, (29% with high AD neuropathological changes) and in 300 clinically evaluated individuals (42% with clinical AD). Receiver operating characteristics were used to evaluate each biomarker. We also investigated biomarkers as predictors of incident clinical AD. Results. P-tau181, P-tau217 and NfL concentrations were elevated in pathologically and clinically diagnosed AD. Decreased Aβ42/Aβ40 ratio and increased P-tau217 and P-tau181 were associated with subsequent AD diagnosis. Discussion. Blood-based AD biomarker concentrations are associated with pathological and clinical diagnoses and can predict future development of clinical AD, providing evidence that they can be incorporated into multi-ethnic, community-based studies.

Predictors of Life Expectancy in Autopsy-Confirmed Alzheimer’s Disease

2022 ◽  
pp. 1-11
Author(s):  
Jeff Schaffert ◽  
Christian LoBue ◽  
Linda S. Hynan ◽  
John Hart ◽  
Heidi Rossetti ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Life Expectancy ◽  
Functional Impairment ◽  
Neuropsychiatric Symptoms ◽  
Primary Objective ◽  
Cognitive Predictors ◽  
Clinical Diagnoses ◽  
Neurological Exam ◽  
Univariate Analyses

Background: Life expectancy (LE) following Alzheimer’s disease (AD) is highly variable. The literature to date is limited by smaller sample sizes and clinical diagnoses. Objective: No study to date has evaluated predictors of AD LE in a retrospective large autopsy-confirmed sample, which was the primary objective of this study. Methods: Participants (≥50 years old) clinically and neuropathologically diagnosed with AD were evaluated using National Alzheimer’s Coordinating Center (N = 1,401) data. Analyses focused on 21 demographic, medical, neuropsychiatric, neurological, functional, and global cognitive predictors of LE at AD dementia diagnosis. These 21 predictors were evaluated in univariate analyses. Variables found to be significant were then entered into a forward multiple regression. LE was defined as months between AD diagnosis and death. Results: Fourteen predictors were significant in univariate analyses and entered into the regression. Seven predictors explained 27% of LE variance in 764 total participants. Mini-Mental State Examination (MMSE) score was the strongest predictor of LE, followed by sex, age, race/ethnicity, neuropsychiatric symptoms, abnormal neurological exam results, and functional impairment ratings. Post-hoc analyses revealed correlations of LE were strongest with MMSE ≤12. Conclusion: Global cognitive functioning was the strongest predictor of LE following diagnosis, and AD patients with severe impairment had the shortest LE. AD patients who are older, male, white, and have more motor symptoms, functional impairment, and neuropsychiatric symptoms were also more likely have shorter LE. While this model cannot provide individual prognoses, additional studies may focus on these variables to enhance predictions of LE in patients with AD.

Sensitivity, Specificity, and Positive Predictive Value of Technetium 99-HMPAO SPECT in Discriminating Alzheimer's Disease from other Dementias

1997 ◽  
Vol 10 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Donna L. Masterman ◽  
Mario F. Mendez ◽  
Lynn A. Fairbanks ◽  
Jeffrey L. Cummings
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Single Photon ◽  
Photon Emission ◽  
High Sensitivity ◽  
Hmpao Spect ◽  
Clinical Diagnoses ◽  
Sensitivity Specificity

Investigators have reported high sensitivity and specificity values for single photon emission computerized tomography (SPECT) when distinguishing Alzheimer's disease (AD) patients from normal elderly controls or from selected patient groups. The role of SPECT in identifying AD among unselected patients with memory complaints requires investigation. We examined 139 consecutive patients with 99Tc-HMPAO SPECT. NINCDS-ADRDA diagnoses were determined blind to SPECT results, and scans were read and classified by visual inspection blind to clinical diagnoses. Bilateral temporoparietal hypoperfusion (TP) occurred in 75% of probable, 65% of possible, and 45% of unlikely AD patients, yielding a sensitivity of 75% and a specificity of 52% when comparing probable AD versus unlikely AD groups. A positive predictive value of 78% was obtained based on a 69% prevalence of AD in our total clinic population. Patients with false-positive results included a variety of dementing illnesses; all patients with bilateral hypoperfusion had dementia. A pattern of TP on SPECT scans is seen in most patients with AD, but could be found in other dementias as well and cannot be regarded as specific to AD. Reduced TP perfusion discriminated between demented and nondemented individuals. Further strategies for SPECT interpretation that improve diagnostic specificity should be sought.

scholarly journals Predictors of Life Expectancy After an Alzheimer’s Disease Diagnosis in a National Multi-Center Autopsy-Confirmed Sample

2019 ◽  
Vol 34 (6) ◽  
pp. 845-845
Author(s):  
J Schaffert ◽  
C LoBue ◽  
C Presley ◽  
L Hynan ◽  
K Wilmoth ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Life Expectancy ◽  
Psychiatric Symptoms ◽  
Significant Proportion ◽  
Disease Diagnosis ◽  
Small Sample ◽  
Clinical Diagnoses ◽  
Race Ethnicity ◽  
Small Sample Sizes

Abstract Objective Life expectancy varies between 3-12 years following the diagnosis of Alzheimer’s disease (AD) and is an important clinical question for patients and families. Current literature is limited by relatively small sample sizes and a reliance on clinical diagnoses. This study sought to evaluate predictors of AD life expectancy in a large autopsy-confirmed sample. Methods Baseline data from individuals 50 years and older clinically and neuropathologically diagnosed with AD (N=764) were obtained from the National Alzheimer’s Coordinating Center. Life expectancy was calculated in months from AD diagnosis to death. Nineteen variables (demographic, medical/health, disease severity, and psychiatric) obtained at dementia diagnosis were examined. Variables that showed significant differences in life expectancy using t-tests and Pearson correlations (14 of 19) were then entered into a forward multiple regression. Results Seven predictors in the model explained 27% of the variance in life expectancy (F= 40.7, R-squared= 0.267). Lower MMSE scores (β= 0.339, p < .001), male sex (β= -0.144, p < .001), older age (β= -0.130, p < .001), non-Hispanic Caucasian race/ethnicity (β= 0.115, p < .001), greater impairment on the Functional Activities Questionnaire (β= -0.091, p=.042), abnormal neurological/physical exam (β= -0.083, p=.011), and higher Neuropsychiatric Inventory Questionnaire total scores (β= -0.079, p=.016) predicted shorter life expectancy. Conclusions Global cognitive impairment, sex, age, race/ethnicity, functional impairment, abnormal neurological exam findings, and psychiatric symptoms explain a significant proportion of life expectancy following an AD diagnosis. Future studies should explore the relationship between life expectancy, specific neurological abnormalities, and psychiatric symptoms. These 7 predictors could potentially be used to predict life expectancy in individuals diagnosed with AD.

Neuropathologically Confirmed Alzheimer's Disease: Clinical Diagnoses in 394 Cases

1991 ◽  
Vol 4 (1) ◽  
pp. 26-29 ◽  
Author(s):  
Mario F. Mendez ◽  
Angeline R. Mastri ◽  
J.H. Sung ◽  
Beth A. Zander ◽  
William H. Frey
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Clinical Diagnoses

Pathology of Olfactory Mucosa in Patients with Alzheimer's Disease

1994 ◽  
Vol 103 (6) ◽  
pp. 421-427 ◽  
Author(s):  
Masuo Yamagishi ◽  
Yoichi Ishizuka ◽  
Kohji Seki
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Neurofibrillary Tangle ◽  
Olfactory Mucosa ◽  
Olfactory Pathway ◽  
Protein Tau ◽  
Β Protein ◽  
Clinical Diagnoses ◽  
Olfactory Disturbance ◽  
The Brain

Characteristic changes that appear in the biopsied olfactory mucosa of patients with Alzheimer's disease (AD) were examined with immunohistochemical staining. Specimens were obtained from patients with clinical diagnoses of AD. Patients with vascular dementia and age-matched patients without dementia were used for controls. In most AD cases, neurofibrillary tangle-like abnormal tau protein (Tau) immunoreactivity was seen in the dendrites and perikarya of the olfactory receptor cells and in the nerve bundles. A senile plaquelike extracellular mass was found in the olfactory epithelium, and it reacted strongly to an anti-Tau antiserum and weakly to an antiamyloid-β protein antiserum. Ubiquitin (Ubq) immunoreactivity was also observed in the dendrites. Tau immunoreactivity of the perikarya and extracellular mass, and Ubq immunoreactivity were especially characteristic of the olfactory mucosa of AD patients. From these results, it is clear that the same pathologic changes in the brain are also present in the olfactory mucosa of patients with AD. Not only disruption of the central olfactory pathway, but also an olfactory disturbance of AD patients is caused by peripheral changes. Furthermore, an olfactory mucosal biopsy could be a useful method for a definitive diagnosis of AD.

scholarly journals Synthesis and biological evaluation of novel technetium-99m-labeled phenylquinoxaline derivatives as single photon emission computed tomography imaging probes targeting β-amyloid plaques in Alzheimer's disease

RSC Advances ◽  
2017 ◽  
Vol 7 (33) ◽  
pp. 20582-20590 ◽  
Author(s):  
Shimpei Iikuni ◽  
Masahiro Ono ◽  
Keiichi Tanimura ◽  
Hiroyuki Watanabe ◽  
Masashi Yoshimura ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Single Photon ◽  
Photon Emission ◽  
Biological Evaluation ◽  
Emission Computed Tomography ◽  
Technetium 99M ◽  
Imaging Probes ◽  
Clinical Diagnoses ◽  
Β Amyloid

The development of an imaging probe targeting β-amyloid (Aβ) plaques in Alzheimer's disease labeled with technetium-99m, the most commonly used radioisotope for clinical diagnoses, has been strongly anticipated.

scholarly journals Rest-Activity Pattern and Circadian Phase Alterations Across the Alzheimer’s Disease Clinical Spectrum

2021 ◽  
Vol 3 (4) ◽  
pp. 137-141
Author(s):  
Hyun Woong Roh ◽  
Sang Joon Son
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Circadian Rhythm ◽  
Activity Pattern ◽  
Comprehensive Evaluation ◽  
Disease Stage ◽  
Circadian Phase ◽  
Dementia Patients ◽  
Clinical Diagnoses ◽  
Rest Activity

Actigraphy-derived locomotor activity recordings are novel and critical tools for evaluating rest-activity pattern and circadian phase in humans. We conducted a narrative review assessing rest-activity pattern and circadian phase alterations within various stages of Alzheimer’s disease, in consideration of the reciprocal associations between neurodegeneration and circadian rhythm disruption in patients with Alzheimer’s disease. The goal of this review was to characterize possible associations between circadian rhythm disruption and neurodegeneration in Alzheimer’s disease. To the best of our knowledge, only two studies have assessed rest-activity pattern and circadian phase alterations in the preclinical Alzheimer’s disease stage and the results of the studies were inconsistent. Several studies have evaluated rest-activity pattern and circadian phase alterations in patients with Alzheimer’s dementia. The most replicated findings were delayed phase and increased activity fragmentation, represented as increased intra-daily variability. Unfortunately, many studies performed in dementia patients have not examined neuroimaging biomarkers or structured neuropsychological tests, thus limiting the specification of dementia clinical diagnoses. Future studies should consider a more comprehensive evaluation of various clinical and biomarker characteristics in patients with dementia or Alzheimer’s disease.

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