Feb 1999

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IN THIS ISSUE

MINIMAL COGNITIVE
IMPAIRMENT (MCI)

  • Dementia in the Alzheimer type with MCI can be preventable
  • AD can be predicted in memory-impaired nondemented patients

INTERHEMISPHERIC DISCONNECTION IN ALZHEIMER'S DISEASE

  • Interhemispheric tasks can be utilized as diagnostic tools for dementia
  • Corpus callosum atrophy and white matter pathology are not necessarily associated in AD

NEUROPSYCHIATRIC SYMPTOMS
AND CAREGIVER BURDEN

  • There is a correlation between patient agitation and caregiver burden
  • AD patient depression is a predictor of psychological morbidity in carers
  • Homecare support is underutilized by caregiving relatives

FRONTO-TEMPORAL DEMENTIAS
(FTD) VS ALZHEIMER'S DISEASE

  • Hereditary dysphasic disinhibition dementia is linked to chromosome 17
  • There are definite distinctions between FTD and AD
  • Lund-Manchester research criteria shows specific distinctions and similaritis between FTD and AD

ROLE OF BRAIN IMAGING IN AD

  • Memory reversibility in dementia is low

EDITORIAL
FOREWORD

MINIMAL COGNITIVE IMPAIRMENT

There is currently a major effort to delay progression from Minimal Cognitive Impairment (MCI) to dementia. The natural history of this progression has been extensively studied by various groups in the US (Grundman et al) and Canada (Tierney et al), and now offers a way to test the hypothesis that anti-oxydants such as tocopherol, cholinesterase inhibitors such as donepezil and rivastigmine, and COX-2 selective inhibitors can delay progression of AD by modification of primary or secondary disease mechanisms. More articles on MCI can be found in the FAX-back section.

Rate of dementia of the Alzheimer type (DAT)
in subjects with mild cognitive impairment

M. GRUNDMAN,
R.C. PETERSEN,
J.C. MORRIS,
S. FERRIS,
ET AL,
VARIOUS CENTRES, US


SORRY, THIS ABSTRACT IS UNAVAILABLE

Prediction of probable Alzheimer's disease in
memory-impaired patients: a prospective longitudinal study

(NEUROLOGY 1996;46:661-665)
M.C. TIERNEY, PHD,
J.P. SZALAI, PHD,
W.G. SNOW, PHD,
R.H. FISHER, MB,
ET AL,
TORONTO, ON

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INTERHEMISPHERIC DISCONNECTION
IN ALZHEIMER'S DISEASE

EDITORIAL
COMMENT
Evidence for interhemispheric disconnection through the corpus callosum has been found in AD, using a neuropsychological approach (Lakmache et al) as well as brain imaging with MRI (Teipel et al). This may offer another early differentiating tool versus normal aging, and add to the understanding of complex cognitive processing between cerebral hemispheres.

Interhemispheric disconnection syndrome in Alzheimer's disease

(PSYCHOLOGY 1998;95:9042-9046)
YAMINA LAKMACHE,
MARYSE LASSONDE,
SERGE GAUTHIER,
JEAN-YVES FRIGON,
FRANCO LEPORE,
MONTREAL, QC

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Dissociation between corpus callosum atrophy and
white matter pathology in Alzheimer's disease

(NEUROLOGY 1998;51:1381-1385)
S.J. TEIPEL, MD,
H. HAMPEL, MD,
G.E. ALEXANDER, PHD,
M.B. SCHAPIRO, MD,
ET AL,
MUNICH, GERMANY,
BETHESDA, MD

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NEUROPSYCHIATRIC SYMPTOMS
AND CAREGIVER BURDEN

EDITORIAL
COMMENT
Recent reports have documented again the impact of non-cognitive disturbances on caregivers (Victoroff et al). Suggestions have thus been made for symptom-led interventions (Donaldson et al). Homecare support was found to be underused in germany (Vetter et al) as was the case in Canada during the Study of Health and Aging of 1991 (Can J on Aging, 1994;13:470-487).

Psychiatric complications of dementia: impact on caregivers

(DEMENT GERIATR COGN DISORD 1998;9:50-55)
JEFF VICTOROFF,
WENDY J. MACK,
KRISTY A. NIELSON,
LOS ANGELES, IRVINE, DOWNEY, CA

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Determinants of carer stress in Alzheimer's disease

(INT J OF GERIAT PSYCHIATRY, 1998;13:248-256)
C. DONALDSON,
N. TARRIER,
A. BURNS,
MANCHESTER, UK

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Factors affecting the utilization of homecare
supports by caregiving relatives of Alzheimer patients

(DEMENT GERIATR COGN DISORD 1998;9:111-116)
P. VETTER,
O. STEINER,
S. KRAUS,
H. MOISES,
ET AL,
BERLIN, GERMANY

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FRONTO-TEMPORAL DEMENTIAS (FTD) VERSUS ALZHEIMER'S DISEASE

EDITORIAL
COMMENT
A number of reports have been recently published on FTD, originally known as Pick's disease (hence the expression "take your pick" in TD Bird's editorial, Neurology 1998;50:1526-1527, commenting on the observation by Lendon et al on the link between FTD and a mutation on chromosome 17). The clinical features differentiating FTD from AD have been summarized by J. Cummings at the Amsterdam meeting and the Lund-Manchester research diagnostic criteria (originally published in J Neurol Neurosurg Psychiatry 1994;57:416-418) appear to be useful in imaging studies comparing FTD and AD (Miller et al).

Hereditary dysphasic disinhibition dementia
A fronto-temporal dementia linked to 17q21-22

(NEUROLOGY 1998;50:1546-1555)
C.L. LENDON, PHD,
T. LYNCH, MD,
J. NORTON, RN,
D.W. MCKEEL, JR, MD,
ET AL,
VARIOUS CENTRES US

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Fronto-temporal dementias vs. Alzheimer's disease:
distinctions in life

(NEUROBIOLOGY AGING 1998;19(SUPPL 2))
J.L. CUMMINGS,
LOS ANGELES, CA

SORRY, THIS ABSTRACT IS UNAVAILABLE

A study of the Lund-Manchester research criteria
for frontotemporal dementia: Clinical and single-
photon emission CT correlations

(NEUROLOGY 1997;48:937-942)
B.L. MILLER, MD,
C. IKONTE, BS,
M. PONTON, PHD,
M. LEVY, MD,
ET AL,
LOS ANGELES, CA, SANTIAGO, CHILI

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ROLE OF BRAIN IMAGING IN
ALZHEIMER'S DISEASE

EDITORIAL
COMMENT
A reversible cause of dementia is very rarely found in routine computer tomography, as documented by Freter et al, hence the importance of a good history and serial follow-up.

Prevalence of potentially reversible dementias
and actual reversibility in a memory clinic cohort

(CMAJ 1998;159:657-652)
SUSAN FRETER, MD,
HOWARD BERGMAN, MD,
SUSAN GOLD, MD,
HOWARD CHERTKOW, MD,
MARK CLARFIELD, MD,
MONTREAL, QC

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