Nov 2000
international
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Nov 2000
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BIOLOGICAL VARIABLES TO STUDY
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alzheimer's issues: february 2003 november 2002 august 2002 may 2002 february 2002 november 2001 august 2001 may 2001 february 2001 november 2000 august 2000 june 2000 march 2000 november 1999 may 1999 february 1999 september 1998 june 1998 march 1998 december 1997 |
| EDITORIAL COMMENT |
BIOLOGICAL
VARIABLES TO STUDY RISK OF ALZHEIMER'S DISEASE |
Rates of hippocampal atrophy correlate with change
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C.R. JACK JR., MD, R.C. PETERSEN, MD, PHD, Y. XU, MD, PHD, P.C. O'BRIEN, PHD, ET AL, ROCHESTER, MN |
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SUSAN Y. BOOKHEIMER, PHD, MAGDALENA H. STROJWAS, BS, MARK S. COHEN, PHD, ANN M. SAUNDERS, PHD, ET AL, LOS ANGELES, CA, DURHAM, NC |
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(NEUROLOGY 2000;55:684-688) |
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F. JESSEN, MD, W. BLOCK, PHD, F. TRABER, PHD, E. KELLER, MD, ET AL, BONN, GERMANY, BEST, THE NETHERLANDS |
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D.P. DEVANAND, MD, KRISTIN S. MICHAELS-MARSTON, MA, XINHUA LIU, PHD, GREGORY H. PELTON, MD, ET AL, NEW YORK, NY |
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A new and promising lead is the modification of cholesterol levels by
statins, as documented by Wolozin et al. Thal et al reported
negative results from a one year trial of acetyl-L-carnitine in early-onset
AD. Sub-analysis from a previous study had suggested a therapeutic benefit
in younger patients. |
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Decreased prevalence of Alzheimer disease associated with 3-hydroxy-3-methyglutaryl coenzyme A reductase inhibitors(ARCH NEUROL 2000;57:1439-1443) |
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BENJAMIN WOLOZIN, MD, PHD, WENDY KELLMAN, PAUL ROUSSEAU, MD, GASTONE G. CELESIA, MD, ET AL, HINES, MAYWOOD, ILL, PHOENIX, AZ |
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(NEUROLOGY 2000;55:805-810) |
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L.J. THAL, MD, M. CALVANI, MD, A. AMATO, MD, A. CARTA, MD, FOR THE ACETYL-L-CARNITINE STUDY GROUP, SAN DIEGO, LA JOLLA, CA, LONDON, ENGLAND |
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For better or worse, the Mini-Mental Status Examination (MMSE) is the most commonly used screening examination in clinical practice in North America. Han et al report results from a meta-analysis that suggest the annual rate of decline of the MMSE for patients with Alzheimer's disease is 3.3, though significant variability was noted. This figure is important for clinicians who follow the MMSE for treatment outcomes and prognosis. The MMSE has also recently been studied to see if it predicts who will develop dementia. Tierney et al followed a large cohort of patients with memory complaints but no dementia for two years. Using a cut-off score of 24 or less, the specificity was 96%, suggesting the test, when positive, is a powerful predictor of the subsequent development of dementia. References: |
Tracking cognitive decline in Alzheimer's disease using the Mini-Mental State Examination: a meta-analysisINT'L PSYCHOGERIATRICS 2000;12[2]231-247) |
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LING HAN, MARTIN COLE, FRANCOIS BELLAVANCE, ET AL, MONTREAL, PQ |
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MARY C. TIERNEY, PHD, JOHN P. SZALAI, PHD, EARL DUNN, MD, DAPHNE GESLANI, ETAL, TORONTO, OTTAWA, ON |
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TARDIVE DYSKINESIA IN DEMENTIA PATIENTS |
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| EDITORIAL COMMENT |
Antipsychotics remain
the mainstay of treatment for behavioural disturbances in dementia such
as agitatation, aggression, hallucinations and delusions. Unfortunately,
elderly dementia patients are extremely sensitive to the extrapyramidal
symptoms caused by antipsychotics. The atypical antipsychotics, such as
risperidone, have been shown to be effective and have significantly fewer
extrapyramidal symptoms in patients with dementia. A recent study by Jeste
et al demonstrates the remarkably low incidence of tardive dyskinesia
in this population. The one year cumulative incidence of tardive dyskinesia
in 255 dementia patients treated with risperidone was 2.6%. This figure
would compare to approximately 30% for dementia patients treated with typical
antipsychotics, such as haloperidol.  |
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| EDITORIAL COMMENT |
Family interventions for carers of AD patients have been universally recommended,
though infrequently studied. Marriott et al demonstrated in a randomized
design that family interventions including education, stress management
and coping skills training significantly reduced carer depression and emotional
stress, and seemed to have positive, but short-lived, benefits on patient
behaviour as well. |
Effectiveness of cognitive-behavioural family intervention in reducing the burden of care in carers of patients with Alzheimer's disease(BRIT J PSYCHIATRY 2000; 176:557-562) |
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ALISON MARRIOTT, CATHERINE DONALDSON, NICHOLAS TARRIER, ALISTAIR BURNS, MANCHESTER, UK |
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THE ALPHA-2 MACROGLOBULIN GENE IN AD: A POPULATION-BASED STUDY AND META-ANALYSIS A POLYMORPHISM IN THE CYSTATIN C GENE IS A NOVEL RISK FACTOR FOR LATE-ONSET ALZHEIMER'S DISEASE SECOND INTERNATIONAL PHARMACOECONOMIC CONFERENCE ON ALZHEIMER'S DISEASE |
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