Abstract
Amyloid-β (Aβ) and hyperphosphorylated tau are critical to the pathogenesis of Alzheimer’s disease. The sequential cleavage of the amyloid precursor protein by β-secretase and γ-secretase leads to the production of the insoluble Aβ peptide. The Aβ oligomerizes, leading to synaptic loss and dysfunction. Disease-modifying drugs targeting Aβ are a main therapeutic approach. In the current review, focus is on drugs used to decrease production or increase clearance of Aβ.
Ceccato et al (STAM Protocol in Dementia: A Multicenter, Single-Blind, Randomized and Controlled Trial) tested the Sound Training for Attention and Memory in dementia, a manualized music-based protocol, designed to be used in the rehabilitation of cognitive functions in patients with dementia. After analysis, they determined that their protocol is feasible, and it may be useful for patients with dementia.
Osmonov et al (Anticholinesterase-Induced Symptoms Improved by Pacemaker Implantation in Patients With Alzheimer’s Disease Analysis of Six Cases) describe 6 cases of patients with Alzheimer’s disease who developed syncope, dizziness, and dyspnea soon after the initiation of cholinesterase inhibitor therapy. All patients had bradyarrhythmia on electrocardiography. All the 6 patients underwent pacemaker implantation and their cholinesterase inhibitor therapy continued with alleviation of these symptoms.
In APOE Genotype in the Diagnosis of Alzheimer’s Disease in Patients With Cognitive Impairment, Sun et al investigate the utility of apolipoprotein E (APOE) genotyping in the clinical diagnosis of Alzheimer’s disease. They found that APOE ∊4 carriers had a higher percentage of Alzheimer’s disease diagnosis after follow-up than non-APOE ∊4 carriers. The APOE ∊4 designation had a high sensitivity and high positive predictive value for the diagnosis of Alzheimer’s disease but a low negative predictive value and specificity. They conclude that APOE genotyping may be helpful in diagnosing Alzheimer’s disease especially in patients presenting with atypical features or early age of onset of dementia. However, it should be noted that this test has low sensitivity and specificity for the diagnosis of Alzheimer’s disease, so it’s usefulness in clinical practice is limited.
In Reorientation Deficits Are Associated to Amnestic Mild Cognitive Impairment, De Caro et al note that spatial memory can be impaired in amnestic mild cognitive impairment. They investigate categorical spatial memory deficits using a virtual navigation–based reorientation task. The reorientation performance of amnestic mild cognitive impairment participants was worse than that of controls. They suggest that spatial assessment evaluation is appropriate in prodromal stages of Alzheimer’s disease.
In Development of an Instrument to Measure Attitudes of Physical Therapy Providers Working With People With Dementia, Staples et al developed an instrument to measure attitudes and beliefs of how physical therapist practitioners perceive working with people with differing severities of dementia. Most attitudinal questions were significant with respect of how severity impacts attitudes of physical therapy practitioners. They conclude that their brief instrument could serve as an assessment tool to determine physical therapy practitioners’ attitudes when working with patients with dementia.
Maki et al (Anosognosia: Patients’ Distress and Self-Awareness of Deficits in Alzheimer Disease) examined how patients with mild cognitive impairment and Alzheimer’s disease suffer from awareness of their deficits. The discrepancy between patient’s and caregiver’s evaluation was greater in those having more severe Alzheimer’s disease. The cause of distress differed between patients and caregivers. They conclude that understanding a patients’ disability from patients’ perspective may improve patient management.
In Validation of Non-Invasive Body Sensor Network Technology in the Detection of Agitation in Dementia, Bankole et al noted that agitation is one of the main reasons for placing patients with dementia in long-term care facilities. Here, the authors validate the ability of a custom Body Sensor Network to capture agitation against currently accepted subjective measures, the Cohen-Mansfield Agitation Inventory and the Aggressive Behavior Scale. They determined that the Body Sensor Network was a valid measure of agitation based on construct validity testing and secondary validation using nonparametric analyses of variance. Bankole et al concluded that this sensor network has promise but that further testing is needed with a larger sample.