ORAL EXPRESSION SKILLS OF PEOPLE WITH DEMENTIA

Communication includes both linguistic and nonlinguistic forms and oral communication is the linguistic communication that exchanges information vocally and aurally. This process can be affected by various reasons and neurodegenerative diseases are one of them. In dementia, which is defined as a neurodegenerative disease, oral expression skills can be impaired in different ways. Linguistic problems can be observed in these patients’ speech. In this context, the oral expression skills of people with dementia of the Alzheimer type were analysed in this study. By using description tests both control group and Alzheimer group were compared within the use of verbal and nominal sentences. It was found out that these patients tend to use verbal sentences more in their oral speech. However, when compared to the control group the use of nominal sentences were higher

Cerebrospinal fluid markers for synaptic function and Alzheimer type changes in late life depression

To explore markers for synaptic function and Alzheimer disease (AD) pathology in late life depression (LLD), predementia AD and normal controls (NC). A cross-sectional study to compare cerebrospinal fluid (CSF) levels of neurogranin (Ng), Beta-site amyloid-precursor-protein cleaving enzyme1 (BACE1), Ng/BACE1 ratio and Amyloid-β 42/40 ratio, phosphorylated-tau and total-tau in LLD with (LLD AD) or without (LLD NoAD) AD pathology, predementia AD and normal controls (NC). We included 145 participants (NC = 41; predementia AD = 66 and LLD = 38). LLD comprised LLD AD (n = 16), LLD NoAD (n = 19), LLD with non-AD typical changes (n = 3, excluded). LLD AD (pADJ < 0.05) and predementia AD (pADJ < 0.0001) showed significantly higher Ng than NC. BACE1 and Ng/BACE1 ratio were altered similarly. Compared to LLD NoAD, LLD AD showed significantly higher Ng (pADJ < 0.001), BACE1 (pADJ < 0.05) and Ng/BACE1 ratio (pADJ < 0.01). All groups had significantly lower Aβ 42/40 ratio than NC (predementia AD and LLD AD, p < 0.0001; LLD NoAD, p < 0.05). Both LLD groups performed similarly on tests of memory and executive function, but significantly poorer than NC. Synaptic function in LLD depended on AD pathology. LLD showed an association to Amyloid dysmetabolism. The LLD groups performed poorer cognitively than NC. LLD AD may be conceptualized as “predementia AD with depression”.

Case Report: Coexistence of Alzheimer-Type Neuropathology in Fragile X-Associated Tremor Ataxia Syndrome

This case documents the co-occurrence of the fragile X-associated tremor ataxia syndrome (FXTAS) and Alzheimer-type neuropathology in a 71-year-old premutation carrier with 85 CGG repeats in the fragile X mental retardation 1 (FMR1) gene, in addition to an apolipoprotein E (APOE) ε4 allele. FXTAS and Alzheimer's Disease (AD) are late-onset neurodegenerative diseases that share overlapping cognitive deficits including processing speed, working memory and executive function. The prevalence of coexistent FXTAS-AD pathology remains unknown. The clinical picture in this case was marked with rapid cognitive decline between age 67 and 71 years in addition to remarkable MRI changes. Over the 16 months between the two clinical evaluations, the brain atrophied 4.12% while the lateral ventricles increased 26.4% and white matter hyperintensities (WMH) volume increased 15.6%. Other regions atrophied substantially faster than the whole brain included the thalamus (−6.28%), globus pallidus (−10.95%), hippocampus (−6.95%), and amygdala (−7.58%). A detailed postmortem assessment included an MRI with confluent WMH and evidence of cerebral microbleeds (CMB). The histopathological study demonstrated FXTAS inclusions in neurons and astrocytes, a widespread presence of phosphorylated tau protein and, amyloid β plaques in cortical areas and the hippocampus. CMBs were noticed in the precentral gyrus, middle temporal gyrus, visual cortex, and brainstem. There were high amounts of iron deposits in the globus pallidus and the putamen consistent with MRI findings. We hypothesize that coexistent FXTAS-AD neuropathology contributed to the steep decline in cognitive abilities.

Social Cognition in Patients with Amnestic Mild Cognitive Impairment and Mild Dementia of the Alzheimer Type

Background: Social cognition (SC) is a core criterion for neurocognitive disorders. However, findings in patients with amnestic mild cognitive impairment (aMCI) and dementia of the Alzheimer type (DAT) are inconsistent. Objective: We report assessments of emotion recognition (ER), affective and cognitive theory of mind (ToM) in young (YC) and older controls (OC) compared to aMCI and DAT. Methods: 28 aMCI, 30 DAT, 30 YC, and 29 OC received tests of SC and a comprehensive neuropsychological assessment. Analysis of covariance was used to determine group differences. Multiple regression models were applied to identify predictors for each SC task. Results: In controls, OC performed worse in ER and both ToM tasks compared to YC except for one subtest. No significant differences were found between OC and patients concerning ER and affective ToM. In cognitive ToM, differences between OC and patients depended on content and cognitive load with significant impairment in DAT compared to OC. A cognitive composite score predicted SC in OC, but not in patients. Associations of SC with single cognitive domains were found in all groups with language and complex attention as best predictors. Not all variance of SC performance was explained by variance in cognitive domains. Conclusion: Lower performance on SC tasks in OC versus YC was confirmed, although not all tasks were equally affected. With progressive cognitive impairment, cognitive ToM is more impaired than ER or affective ToM. SC seems to be at least partly independent of other cognitive domains, justifying its inclusion in batteries for dementia diagnostic.

IS THYROID ASSOCIATED WITH DEMENTIA? A CASE CONTROL STUDY

Objectives: The present study was undertaken with an objective to explore if thyroid is related to dementia among participants aged 45 years and above. Design: Participants aged more than 45 years of age, giving written informed consent and meeting the selection criteria were enrolled in the study. The participants were administered with a series of paper pencil tests. The data was further analyzed for any association using the Statistical Package for Social Sciences, version 22 (SPSS 22). Setting: Participants attending the Outpatient Department (OPD) at Institute of Human Behaviour and Allied sciences (IHBAS), a tertiary care neuropsychiatric hospital and normal elderly controls from local community. Participants: A sample size of at least 40 cases of Dementia of Alzheimer type and at least 40 cases of vascular/ mixed dementia and 60 normal controls were recruited. Measurements: Semi-structured Performa for demographic and clinical variables; Hindi mental status examination (HMSE) for cognitive functions was applied as screening tools for both case and control groups;Tools for patients with dementia: NINCDS-ADRDA criteria for Probable Alzheimer's disease (McKhann et al), NINDS /AIREN criteria for diagnosis of probable vascular dementia (VaD), NINDS-AIREN diagnostic criteria for “Alzheimer's disease with Cerebro-Vascular Disease” (mixed dementia), Clinical Dementia Rating Scale (Morris et al 1997), and 5 ml blood sample collection and analysis through vein puncture. Results: The results of the study indicate that subclinical hypothyroidism is associated with dementia of Alzheimer type. Conclusion: When considered in light with varied ndings of prior studies, it may be implied that subclinical thyroid dysfunction not especially hypo or hyperthyroidism is a risk for DAT.

ABCA1-Labeled Exosomes in Serum Contain Higher MicroRNA-193b Levels in Alzheimer’s Disease

Objective. We aimed to establish a method to determine whether microRNA-193b (miR-193b) levels in ABCA1-labeled serum exosomes might serve as a marker for the diagnosis of Alzheimer’s disease. Methods. We used immunocapture methods to determine the levels of ABCA1-labeled exosomal miR-193b in cultures of white blood cells (WBCs), red blood cells (RBCs), mouse hippocampal neuron HT-22 cells, and primary mouse neuronal cells. ABCA1-labeled exosomal miR-193b levels were also evaluated in the cerebrospinal fluid (CSF) and serum of APP/PS1 double-transgenic mice, as well as control subjects ( n = 60 ) and study participants with subjective cognitive decline (SCD, n = 89 ), stage and mild cognitive impairment (MCI, n = 92 ), and dementia of the Alzheimer type (DAT, n = 92 ). Results. ABCA1 levels of exosomes harvested from the medium of HT-22 cells and neurons were significantly higher than those of RBCs and WBCs ( P < 0.05 ). Exosomal ABCA1 from the CSF of APP/PS1 mice were transmitted to the serum of wild-type mice after injection, and high miR-193b levels were observed in both the serum and CSF after injection. The ABCA1-labeled exosomal miR-193b levels were higher in the CSF of MCI and DAT patients compared with the CSF of the control group ( P < 0.05 ). The ABCA1-labeled exosomal miR-193b were also slightly higher ( P > 0.05 ) in the serum of SCD patients and significantly higher in the serum of MCI and DAT patients compared with the serum of the control group ( P < 0.05 ). Conclusion. This study provides a method to capture specific exosomes. Detection of serum exosomes labeled with ABCA1 may facilitate the early diagnosis of AD.