International Abstracts in Alzheimer's Disease & Other Dementias

EDITORIAL COMMENT	BIOLOGICAL MARKERS FOR ALZHEIMER'S DISEASE There are a number of randomized clinical trials underway in patients with mild cognitive impairment, such as forgetfulness without dementia. we must anticipate the need to screen people with memory complaints who need treatment before the diagnosis of AD is clinically possible. The Apoe-e4 mutation is the best known marker of risk (Dik et al ), and altered ratio of amyloid precursor protein forms in platelets may also prove to be a useful biological marker (Padovavi et al ).
Memory complaints and APOE-EPSILON4 accelerate cognitive decline in cognitively normal elderly (NEUROLOGY 2001;57:2217-2222)
M.G. DIK, MSC, C. JONKER, MD, PHD, H.C. COMIJS, PHD, L.M. BOUTER, PHD, ET AL, AMSTERDAM, THE NETHERLANDS	To view this abstract in PubMed click here!
Amyloid precursor protein in platelets: a peripheral marker for the diagnosis of sporadic AD (NEUROLOGY 2001;57:2243-2248)
A. PADOVANI, MD, PHD, L. PASTORINO, PHD, B. BORRONI, MD, F. COLCIAGHI, PHD, ET AL, VARIOUS CENTRES, ITALY	To view this abstract in PubMed click here!
DIAGNOSIS OF FRONTOTEMPORAL DEMENTIA
EDITORIAL COMMENT	The report of the Work Group on FTD and Pick's disease is available (Mckhann et al ), and summarizes the clinical approach using the Lund-Manchester criteria, which can be supplemented by genetic studies looking at mutations in the TAU gene (Morris et al ). This systematic approach at diagnosing may help resolve the frequent dilemma of differentiating AD from FTD, and may facilitate multicentre randomized clinical trials which are very much needed for this condition.
Clinical and pathological diagnosis of frontotemporal dementia: report of the work group on frontotemporal dementia and Pick's disease (ARCH NEUROL 2001;58:1803-1809)
GUY M. MCKHANN, MD, MARILYN S. ALBERT, PHD, MURRAY GROSSMAN, MD, PHD, BRUCE MILLER, MD, ET AL, VARIOUS CENTRES, USA	To view this abstract in PubMed click here!
The genetic and pathological classification of familial frontotemporal dementia (ARCH NEUROL 2001;58:1813-1816)
HUW R. MORRIS, MRCP, M. NADEEM KHAN, MSC, JOHN C. JANSSEN, MRCP, JEREMY M. BROWN, MD, ET AL, VARIOUS CENTRES	To view this abstract in PubMed click here!
MANAGEMENT OF LEWY BODY DEMENTIA
EDITORIAL COMMENT	Acomprehensive review of the diagnosis and management of dementia with Lewy bodies has been written by the Newcastle upon Tyne Group, led by Ian McKeith. The four-step approach recommended is valuable for all dementias: accurate diagnosis, identification of problematic symptoms, non-pharmacologic interventions, pharmacologic treatment (Barber et al ).
Dementia with Lewy bodies: diagnosis and management (INT J GERIATR PSYCHIATRY 2001;16:S12-S18)
R.BARBER, A. PANIKKAR, I.G. MCKEITH, NEWCASTLE UPON TYNE, UK	To view this abstract in PubMed click here!
PROTECTIVE FACTORS AGAINST ALZHEIMER'S DISEASE
EDITORIAL COMMENT	One of the best established protective factors for AD is the use of NSAIDs, particularly with long-term use, defined as two years or more (Velo et al ). A newly discovered protective factor is vaccination against diphtheria, tetanus, polio or influenza (Verreault et al ), which needs confirmation in another large scale epidemiological study but offers hope that the widespread use of such vaccines may reduce the incidence of AD in the future. Another encouraging report is that leisure activities such as reading, visiting friends or relatives, going to movies or restaurants, walking for pleasure or going for an excursion reduced the incidence of dementia (scarmeas et al )
Nonsteroidal antiinflammatory drugs and the risk of alzheimer's disease (N ENGL J MED 2001;345:1515-1521)
BAS A. IN 'T. VELO MD, PHD, ANNE M. RUITENBERG, MD, PHD, ALBERT HOFMAN, MD, PHD, LENORE J. LAUNER, PHD, ET AL, THE HAGUE, ROTTERDAM, THE NETHERLANDS	To view this abstract in PubMed click here!
Past exposure to vaccines and subsequent risk of alzheimer's disease (CMAJ 2001;165[11]:1495-1498)
RENÉ VERREAULT, DANIELLE LAURIN, JOANE LINDSAY, GASTON DE SERRES, BEAUPORT, QC, OTTAWA, ON	To view this abstract in PubMed click here!
Influence of leisure activity on the incidence of alzheimer's disease (NEUROLOGY 2001;57:2236-2242)
N. SCARMEAS, MD, G. LEVY, MD, M.-X. TANG, PHD, J. MANLY, PHD, Y. STERN, PHD, NEW YORK, NY	To view this abstract in PubMed click here!
EFFECT OF METRIFONATE ON BEHAVIOUR IN AD
EDITORIAL COMMENT	Data continues to emerge about the efficacy of cholinesterase inhibitors for treating behavioural disturbances in dementia. Cummings et al pooled data from two large pivotal studies of metrifonate for mild to moderate AD. They found metrifonate not only significantly improved behaviours such as hallucinations, aggression, depression and apathy, but it also appeared to prevent the emergence of disturbed behaviours over the course of the studies. The efficacy of cholinesterase inhibitors for the treatment of behavioural disturbances must now be studied in patients with more severely disturbed behaviour.
Efficacy of metrifonate in improving the psychiatric and behavioral disturbances of patients with alzheimer's disease (J GERIATR PSYCHIATRY NEUROL 2001;14:101-108)
JEFFREY L. CUMMINGS, MD, A. NADEL, PHD, DONNA MASTERMAN, MD, PAM A. CYRUS, MD, LOS ANDGELES, CA, WEST HAVEN, CT	To view this abstract in PubMed click here!
NEUROPSYCHIATRIC DISTURBANCE IN PATIENTS WITH ALZHEIMER'S DISEASE
EDITORIAL COMMENT	In a large epidemiological study, Lyketsos et al examined 198 people with AD and found subjects could be classified into three distinct groups on the basis of their behaviours. These included a group without any disturbed behaviours or "minimally-symptomatic," a second group with predominantly affective symptoms (e.g. depression, apathy, irritability) and a third group with psychotic symptoms (e.g. hallucinations, delusions). The investigators suggest that these groupings may reflect differences in brain regions affected by the illness and may ultimately lead to a better understanding of the neurobiology of these disturbances.
Neuropsychiatric disturbance in alzheimer's disease clusters into three groups: the cache county study (INT J GERIATR PSYCHIATRY 2001;16:1043-1053)
CONSTANTINE G. LYKETSOS, JEANNIE-MARIE E. SHEPPARD, MARTIN STEINBERG, JO ANN T. TSCHANZ, ET AL, BALTIMORE, MD, CACHE COUNTY, UT	To view this abstract in PubMed click here!
THE 5-HTTPRS/L POLYMORPHISM AND AGGRESSIVE BEHAVIOUR IN ALZHEIMER'S DISEASE
EDITORIAL COMMENT	Aggression in patients with AD is one of the most serious problems faced by caregivers. Why some patients with AD exhibit this disturbing behaviour and others do not is an active area of research, the results of which may point to better therapeutic interventions. In a case-control study, Sukonick et al found significantly more AD patients with aggression carried the 5-HTTPRL/L genotype than AD patients without aggression. The investigators hypothesize that this genotype would lead to increased serotonin reuptake with less availability of serotonin in the synapse. Whether this genotype may be used to predict responsiveness to serotonergic agents, like SSRIs, remains to be determined.
The 5-HTTPRS/L polymorphism and aggressive behavior in alzheimer disease (ARCH NEUROL 2001;58:1425-1428)
DANIELLE L. SUKONICK, BA, BRUCE G. POLLOCK, MD, PHD, ROBERT A. SWEET, MD, BENOIT H. MULSANT, MD, ET AL, PITTSBURGH, PA	To view this abstract in PubMed click here!
ABSTRACTS	THE FOLLOWING PAPERS and websites were judged by the editors to also be of interest. INCIDENCE OF AD MAY DECLINE IN THE EARLY 90S FOR MEN, LATER FOR WOMEN
WEBSITES	Alzheimer Society of Canada Alzheimer's Association Alzheimer's Disease Education & Referral (ADEAR) Center

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DIAGNOSIS OF FRONTOTEMPORAL DEMENTIA

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