Abstract
Philipe Barreto (Alzheimer’s disease: learning from the past, looking to the future) notes that aspects of Alzheimer’s disease etiology remain unknown. There is a potential role for lifestyle behaviors to impact disease, and Barreto points out the potential associations between lifestyle behavior changes and a possible increase in the age of onset of Alzheimer’s disease.
In the review, The role of beta-adrenergic receptor blockers in Parkinson’s disease: potential genetic and cellular signaling mechanisms, Luong noted that genetic studies have identified the factors that link β-adrenergic blockade to Parkinson’s disease. β-Adrenergic blockade has also been implicated in Parkinson’s disease via its effects on matrix metalloproteinases, mitogen-activated protein kinase pathways, prostaglandins, cyclooxygenase 2, and nitric oxide synthase. Luong concludes that it might be beneficial to do further characterization of β-adrenergic blockade in patients with Parkinson’s disease.
Gill et al (Spontaneous and induced non transgenic animal models of AD—modelling AD using combinatorial approach) remind us that Alzheimer’s disease is pathologically characterized by extracellular amyloid deposition, intracellular neurofibrillary tangle formation, and neuronal loss. A complete animal model of Alzheimer’s disease should imitate the cognitive, behavioral, and neuropathological features of the disease. Partial models are currently in use. Gill et al’s review nicely summarizes the current literature on nontransgenic animal models of Alzheimer’s disease. They emphasize the use of these models for neuropathological, neurochemical, neurobehavioral, and neuroprotective studies.
In The neglected role of histamine in Alzheimer’s disease, Naddafi and Mirshafiey review the role of histamine receptors in Alzheimer’s disease. Histamine is a biogenic monoamine that plays a role in induction of inflammatory reactions, wound healing, and regeneration. Histamine mediates its functions via its 4 G-protein-coupled H1 to H4 receptors. The histaminergic system has a role in the treatment of brain disorders by the development of histamine receptor agonists and antagonists. Histamine H1 and H4 receptors are implicated in allergic inflammation. However, histamine antagonists regulating the H3 and H2 receptors may be more efficient in Alzheimer’s intervention.
Gauglar synthesizes the existing evidence to compare the accuracy of various Alzheimer’s disease diagnostic approaches using a meta-analysis. Cerebrospinal fluid-Tau demonstrated variable sensitivity for the diagnosis of Alzheimer’s disease. Positron emission tomography scans showed a similar range of sensitivity and specificity as diagnostic protocols.
In Safe home program: a suite of technologies to support extended home care of persons with dementia, Bowen reports the implementation/adoption of the Safe Home Program to support caregivers of persons with dementia. The majority of caregivers utilized technologies for ongoing surveillance; other technologies included an identification program and medication organizers. Bowen concluded that technology focused on the ongoing surveillance for persons with dementia in the home are needed. These technologies could be quickly adopted by caregivers to ameliorate some of the stress and burden associated with providing care for persons with dementia.
Gooblar et al examined print advertisements for Alzheimer’s disease drugs published in journals and magazines between January 2008 and February 2012, using an informational versus transformational theoretical framework to identify objective and persuasive features. Most elements contained a mixture of informational and transformational features. Not surprisingly, Gooblar found subtle and sophisticated attempts both to educate and to persuade readers. Gooblar et al concluded that it is important for consumers and prescribing physicians to read print advertisements critically so that they can make informed treatment choices. This is an important point that readers of journals need to keep in mind.
In An open-label, non-placebo-controlled study on cistanche tubulosa glycoside capsules (Memoregain) for treating moderate Alzheimer’s disease, Su et al studied the efficacy and safety of cistanche tubulosa glycoside capsules (Memoregain) for treating Alzheimer’s disease. Assessment tests included the Alzheimer’s Disease Assessment Scale-Cognitive Subscale, Mini-Mental State Examination, Activities of Daily Living, Blessed Behavioral Scale, and Clinical Global Impression scales. All adverse reactions were mild. Although the study is limited by being open label and small, their findings suggest that cistanche tubulosa glycoside may be useful as a stabilizing agent for moderately severe Alzheimer’s disease.
Webster et al note that communication difficulties associated with late-stage dementia can make it difficult for care staff in residential environments to understand individuals with dementia. This can have a negative effect on the social environment of residential facilities. They discuss the creation of portraits of people with dementia to aid care staff in understanding the individual. It is possible for families to create portraits of their relatives.
In Initiation of cholinesterase inhibitors in an inpatient setting, Wagle et al examined initiation of cholinesterase inhibitors to determine whether there was sufficient evaluation for dementia and/or delirium, and whether there are differences in outcomes (mortality, hospital readmission rates, and duration of hospitalization) between patients newly starting and those continuing cholinesterase inhibitors. One of their conclusions was that new starts were more likely to have a longer hospital stay than continuations regardless of other factors.
Suehs et al (The clinical and economic burden of newly diagnosed Alzheimer’s disease in a medicare advantage population) examined health care resource utilization, costs, and comorbidity burden immediately preceding new diagnosis of Alzheimer's disease and 2 years after diagnosis. They found that these costs were greater for members with Alzheimer’s disease during the year prior to diagnosis and during postdiagnosis years 1 and 2 compared to controls. Members withAlzheimer’s disease also displayed greater comorbidity than their non-Alzheimer’s disease counterparts during postdiagnosis years 1 and 2 as measured by 2 different comorbidity indices. This supports the growing body of data showing that there is an enormous financial burden of dementia in our society.
In Video prompting versus other instruction strategies for persons with Alzheimer’s disease, Perilli et al assessed the effectiveness of video prompting as a strategy to support daily function in persons with mild and moderate Alzheimer’s disease. They found that video prompting was effective and may be a valuable method to support daily activities in persons with Alzheimer’s disease.
Hamid et al (The effects of sleep quality, physical activity and environmental quality on the risk of falls in dementia) identify aspects of sleep quality, physical activity, environmental quality, age, ethnicity, sex differences, marital status, and educational level on the risk of falls in patients with dementia. They conclude that age, ethnic non-Malay and sleep disruption increased the risk of falls in respondents and (not surprisingly) high environmental quality reduced the risk of falls. Gender differences, marital status, educational level, and physical activity were not significant predictors of falls. This is an important topic, as falls are a serious problem in the elderly patient.