Abstract
Gosalvez et al (Mitochondrial filamentation: a therapeutic target for neurodegeneration and aging) notes that mitochondria may play an important role in neurodegeneration, neuroregeneration, and aging. Their article is a review of the potential that mitochondrial filamentation could have in the investigation of neurological diseases related to aging.
Luong et al (The role of beta-adrenergic receptor blockers in Alzheimer’s disease: potential genetic and cellular signaling mechanisms) note the relationship between Alzheimer’s disease and β-adrenergic receptor blockade as it is linked to human leukocyte antigen genes, trace amines, the renin angiotensin system, poly(adenosine diphosphate ribose) polymerase 1, nerve growth factor, vascular endothelial growth factor, and the reduced form of nicotinamide adenine dinucleotide phosphate. β-Adrenergic receptor blockade may also be implicated in Alzheimer’s disease due to its effects on matrix metalloproteinases, mitogen-activated protein kinase pathways, prostaglandins, cyclooxygenase 2, and nitric oxide synthase. They argue that the characterization of β-adrenergic receptor blockade in patients with Alzheimer’s disease is needed since there may be clinical implications.
Wattmo (Prediction models for assessing long-term outcome in Alzheimer’s disease: a review) looked at models of patients’ outcomes using PubMed and long-term extensions of clinical trials and naturalistic studies of cholinesterase inhibitors. The goal was to identify empirical statistical models such as use of data from historical cohorts or extrapolated changes from extension studies that were used to draw comparisons between cholinesterase inhibitor–treated and untreated patients. Wattmo warns us that it is essential to be aware of the limitations of comparisons made with the different approaches. Prediction models based on cholinesterase inhibitor–treated patients can be used in studies of new treatments when those treatments are added to cholinesterase inhibitors. More sophisticated models that also accommodate patient-specific characteristics could be developed for comparisons in long-term studies.
In Judging a book by its cover: uniforms and quality of life in special care units for people with dementia, Charras et al note that some feel that wearing uniforms is believed to improve the well-being of institutionalized patients with dementia by facilitating orientation and preserving hygiene. Their study investigates the impact of wearing uniforms on quality of life. They found enhanced quality-of-life scores in the experimental street clothing staff group compared with the uniform group. Caregivers also reported subjective impressions of overall beneficial outcomes for patients with dementia who were not wearing uniforms and reported feeling more at ease when interacting with them.
Yokio et al (Investigation of toilet activities in elderly patients with dementia from the viewpoint of motivation and self-awareness) evaluate the association between self-awareness and toilet activities in patients with dementia and explain the time when and the reason why a series of toilet activities as habit once acquired become unfeasible, toilet activities of the elderly patient with dementia were observed focusing on care conditions and investigated based on Hull drive-reduction theory (behavior = drive × habit × incentive) and our self-awareness model (consisting of theory of mind, self-evaluation, and self-consciousness). If theory of mind is lost, awareness of one’s desire and intention becomes vague and toilet activities begin to collapse. Furthermore, if incentive disappears, one’s intention hardly arises and toilet activities further collapse. If self-evaluation is lost, time sense fades, future goals based on the present time cannot exist and behavior loses directivity. As a result, toilet activities collapse; and with a decrease in drive, toilet activities cease.
In Comparison of 2 diagnostic criteria for the behavioral variant of frontotemporal dementia, Costa et al compare the applicability of the 1998 consensus diagnostic criteria for the behavioral variant of frontotemporal dementia with the recently proposed diagnostic criteria of the International Behavioral Variant of Frontotemporal Dementia Criteria Consortium. We reviewed each individual item in the 1998 consensus diagnostic criteria and the Frontotemporal Dementia Criteria Consortium criteria in 30 patients with behavioral variant of frontotemporal dementia followed in a memory clinic (including 2 subjects with the C9orf72 gene repeat expansion). All patients fulfilled the criteria for Frontotemporal Dementia Criteria Consortium (40% possible and 60% probable behavioral variant of frontotemporal dementia), but only 66.7% fulfilled the 1998 criteria. One of the C9orf72 expansion carriers did not fulfill the 1998 criteria. This discordance was always due to the presence of exclusionary features in the 1998 criteria, the most common being spatial disorientation and early severe amnesia. They conclude that the new Frontotemporal Dementia Criteria Consortium criteria are less restrictive and hence more sensitive for the diagnosis of behavioral variant of frontotemporal dementia.
In Frontal network syndrome testing: clinical tests and positron emission tomography brain imaging help distinguish the 3 most common dementia subtypes, Hoffman examines available tests and neuroimaging procedures that may help distinguish Alzheimer’s disease, cognitive vascular disorder, and frontotemporal lobe disorders using a hierarchical neuropsychological battery and positron-emission tomography (PET) brain scans. They found that disinhibition, word list generation, 5-word memory testing, and PET brain imaging are helpful in distinguishing these dementia subtypes.
In Incentives and barriers to research participation and brain donation among African Americans, Schneider et al use a structured face-to-face educational interview to recruit African Americans for a longitudinal aging study and to collect information about attitudes related to research. The interview was designed to build trust and respect for research and to educate participants about the need for minority participants. Of the 91 African Americans aged 65 and older who completed the interviews, 65 agreed to participate in the longitudinal study and approximately half agreed to brain donation. Those who enrolled and consented to brain donation were more likely to consider benefit to themselves or direct family unit as the main motivator for participation. The study also found a significant increase in agreement to brain donation over time. They conclude that inclusion of direct benefit and education can positively influence African American research participation.
Chaudbury et al (The role of physical environment in supporting person-centered dining in long-term care: a review of the literature) believe that the physical environment of dining rooms in long-term care facilities is an important catalyst in implementing culture-based care. Their article presents a review of the literature on environmental interventions and examines their implications for creating a more person-centered dining environment, specifically for residents with dementia. The review identifies the role of a dining environment to support (1) functional ability, (2) orientation, (3) safety and security, (4) familiarity and home likeness, (5) optimal sensory stimulation, (6) social interaction, and (7) privacy and personal control. They note the need for additional research in this area.
Foster et al (Differential lexical and semantic spreading activation in Alzheimer’s disease) note that Alzheimer’s disease is known to be associated with disruption in semantic networks. Previous studies examining changes in spreading activation in Alzheimer’s disease have used a lexical decision task paradigm. Here, Forster et al use a paradigm based on average word frequencies obtained from the words generated on the Controlled Oral Word Association Test and the Animal Naming test. They found that the Alzheimer’s disease group generated words with a higher average word frequency on the Animal Naming test but a lower word frequency on the Controlled Oral Word Association Test.
In Daily assistance for individuals with dementia via videophone, Yasuda et al use “remote tools” to assist patients with dementia. The stability of 1 patient persisted for 3 hours after remote conversations. The task completion rate by the schedule prompter system, which displays a video reminder series automatically, was 52%. They also found that 1 in 4 patients showed greater stability while conversing with a conversation partner on the video phone than while watching TV programs and that she remained stable for several hours after remote conversations. The task completion rate afforded by the revised schedule prompter system was 82%. They concluded that the 2 remote systems hold hope as tools for assisting individuals with dementia in their daily lives.
In Meta-analysis of the association between urokinase-plasminogen activator gene rs2227564 polymorphism and Alzheimer’s disease, Zhang et al performed a meta-analysis to determine the association between rs2227564 polymorphism and Alzheimer’s disease risk, using 27 studies. Their meta-analysis showed that T allele of rs2227564 polymorphism in PLAU gene could increase effects on the risk of Alzheimer’s disease. This helps clarify the association between this polymorphism and the risk of Alzheimer’s disease since individual studies have yielded conflicting results.
Janzen et al (Managing agitation using nonpharmacological interventions for seniors with dementia) investigated the perceptions of long-term care staff regarding their use of nonpharmacological interventions for reducing agitation in seniors with dementia and to identify facilitators and barriers that guide nonpharmacological intervention implementation. They confirmed that both medications and nonpharmacological interventions are used for the management of agitation. The use of nonpharmacological interventions was facilitated by consistency in staffing and the ability of all staff members to implement them. Common barriers to nonpharmacological intervention included perceived lack of time, low staff-to-resident ratios, and unpredictable and short-lasting effectiveness of nonpharmacological interventions. This study offers insight into perceived factors that influence implementation of nonpharmacological interventions. Given the side effects of pharmaceutical interventions in the elderly patients, more attention may be given to nonpharmacological interventions in the future.