Abstract
Heo et al (The possible role of antioxidant vitamin C in Alzheimer’s disease treatment and prevention) report that oxidative stress may play a major role in the pathogenesis of Alzheimer’s disease. Vitamin C is a key antioxidant in neural tissue. Vitamin C decreases β-amyloid generation and acetyl cholinesterase activity, and it also prevents endothelial dysfunction by regulating nitric oxide. However, clinical trials have yielded equivocal results. Their review discusses the role of vitamin C in the pathogenesis and treatment of Alzheimer’s disease.
Luong and Nuguyen build on the importance of vitamins in Alzheimer’s disease, with a focus on vitamin D (see The role of vitamin D in Alzheimer’s disease: possible genetic and cell signaling mechanisms). They believe that vitamin D has a useful effect in Alzheimer’s disease by regulating microRNA, enhancing toll-like receptors, modulating vascular endothelial factor expression, modulating angiotensin, and advanced glycation end products. Vitamin D also regulates calcium-sensing receptor expression, enhancing amyloid-β peptide clearance, interleukin-10, downregulating matrix metalloproteinases, upregulating heme oxygenase-1, and suppressing the reduced form of nicotinamide adenine dinucleotide phosphate. In their opinion, calcitriol is the best vitamin D supplement for Alzheimer’s disease.
Perry Payne (Thoughts, Issues and Controversies section) notes that the national plan to address Alzheimer’s disease calls for a novel relationship between researchers and the public which provides new information to patients and allows for patient/caregiver feedback. Better communication is needed to provide useful information exchanges between patients, caregivers, and researchers.
In Alzheimer’s disease dementia guidelines for diagnostic testing: a systematic review, Arevalo-Rodriguez et al address the need for better diagnostic tools, since the incidence of Alzheimer’s disease is growing. Clinical diagnostic criteria and biomarkers have become important. Arevalo-Rodriguez et al performed a literature search and appraisal of dementia guidelines and also analyzed diagnostic recommendations related to the use of brief cognitive tests, neuropsychological evaluation, and biomarkers. They determined that (1) the variability on assessment of quality of evidence and (2) the strength of recommendations were the main concerns with diagnostic testing.
Cruz et al (Making sense(s) in dementia: a multisensory and motor-based group activity program) base their study on the observation that lack of engagement in meaningful activities is associated with a poor quality of life in patients with dementia. Their pilot study looked at a multisensory and motor-based group activity program for those with dementia. The program involved sixteen 45-minute weekly sessions. All residents participated in the proposed activities, and they concluded that this program is a promising approach for people with advanced dementia.
Formiga et al (Predictors of cognitive decline in 85-year-old subjects without cognitive impairment at baseline: two-year follow-up of the octabaix study.) looked for predictors of cognitive decline in 85-year-old patients without cognitive impairment at baseline. Patients cognitively intact after a 2-year follow-up period were compared to those whose scores fell below 24 on a modified Mini Mental State Examination (MMSE). A higher baseline score was associated with a better end score. Not having diabetes was also predictive. They concluded that better baseline cognitive and functional status and the absence of diabetes are predictive of preserved cognition in the most elderly population.
Deng et al (Diffusion tensor imaging reveals white matter changes associated with cognitive status in Parkinson’s disease patients) investigated the relationship between magnetic resonance imaging-based white matter changes and the cognitive status of patients with Parkinson’s disease. Their data suggest that cerebral white matter deterioration may underlie a significant proportion of the progressive cognitive impairment seen in those with Parkinson’s disease.
Talarico et al note that few studies look at the restless legs syndrome in Alzheimer’s disease. The aim of their study (Restless legs syndrome in a cohort of Alzheimer's disease patients) was to assess the prevalence and characteristics of the restless legs syndrome in patients with Alzheimer’s disease. Patients with Alzheimer’s disease with restless legs syndrome were more apathetic. They found that MMSE, activities of daily living (ADL), instrumental ADL, and neuropsychiatric inventory scores were not different.
In Using cognitive-functional assessment to predict self-care performance of memory care tenants, Schaber et al studied ways to determine the level of service a patient would need based on their abilities and care needs. An incoming tenant’s functional performance capacity is obtained through family/proxy report combined with tests of global cognitive function. Their study examined the predictive validity of an assessment of cognitive-functional performance, the cognitive performance test. Linear regression results revealed a relationship between cognitive assessment and ADL performance with cognitive performance test scores accounting for over half of the variability in performance.
Zola et al (A behavioral task predicts conversion to mild cognitive impairment and Alzheimer’s disease) used a behavioral assay, the visual paired comparison task to determine whether it predicted conversion from mild cognitive impairment (MCI) to dementia or conversion from a normal status to MCI. Scores on the visual paired comparison task predicted those patients with MCI who were likely to progress to Alzheimer’s disease. They concluded that this task can be used as a biomarker to predict cognitive decline.
In Visuospatial and attentional abilities predict driving simulator performance among older HIV-infected adults, Foley et al examined the effects of aging and neuropsychological impairment on driving simulator performance within an human immunodeficiency virus (HIV)-infected cohort. They concluded that older patients with HIV may be at risk of driving-related functional compromise secondary to HIV-associated neurocognitive decline.