ResearchPad - diagnostic-assessment-prognosis https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Prognostic value of ATN Alzheimer biomarkers: 60‐month follow‐up results from the Argentine Alzheimer's Disease Neuroimaging Initiative]]> https://www.researchpad.co/article/elastic_article_15241 To describe results of the Amyloid, Tau, Neurodegeneration (ATN) research framework classification in the Argentine‐Alzheimer's Disease Neuroimaging Initiative (arg‐ADNI) cohort.MethodsTwenty‐three patients with mild cognitive impairment (MCI), 12 dementia of Alzheimer's type (DAT), and 14 normal controls were studied following the ADNI2 protocol. Patients were categorized according to presence or absence of the biomarkers for amyloid beta (Aβ; A: amyloid positron emission tomography [PET] scan or cerebrospinal fluid [CSF] Aβ42), tau (T: CSF phosphorylated‐tau), and neurodegeneration (N: CSF total‐tau, fluorodeoxyglucose [FDG]‐PET scan, or structural magnetic resonance imaging [MRI] scan).ResultsA+T+N+ biomarker profile was identified at baseline in 91% of mild dementia patients, 20% of early MCI patients, 46% of late MCI patients, and 14% of control subjects. Suspected non‐AD pathophysiology (SNAP, A‐T‐N+) was found in 8% of mild dementia, 20% of early MCI, 15% of late MCI, and 7% of control subjects. Conversion rates to dementia after 5‐year follow‐up were 85% in A+T+N+ MCI patients and 50% in A‐T‐N+ patients.ConclusionsWe present initial 5‐year follow‐up results of a regional ADNI based on AD biomarkers and the ATN classification. ]]> <![CDATA[Proteomic profiles of incident mild cognitive impairment and Alzheimer's disease among adults with Down syndrome]]> https://www.researchpad.co/article/elastic_article_15108 We sought to determine if proteomic profiles could predict risk for incident mild cognitive impairment (MCI) and Alzheimer's disease (AD) among adults with Down syndrome (DS).MethodsIn a cohort of 398 adults with DS, a total of n = 186 participants were determined to be non‐demented and without MCI or AD at baseline and throughout follow‐up; n = 103 had incident MCI and n = 81 had incident AD. Proteomics were conducted on banked plasma samples from a previously generated algorithm.ResultsThe proteomic profile was highly accurate in predicting incident MCI (area under the curve [AUC] = 0.92) and incident AD (AUC = 0.88). For MCI risk, the support vector machine (SVM)‐based high/low cut‐point yielded an adjusted hazard ratio (HR) = 6.46 (P < .001). For AD risk, the SVM‐based high/low cut‐point score yielded an adjusted HR = 8.4 (P < .001).DiscussionThe current results provide support for our blood‐based proteomic profile for predicting risk for MCI and AD among adults with DS. ]]> <![CDATA[The Consortium for the early identification of Alzheimer's disease–Quebec (CIMA‐Q)]]> https://www.researchpad.co/article/N62b2e4b7-3537-44f4-ab74-38a07ad2ec51

Introduction

The Consortium for the early identification of Alzheimer's disease–Quebec (CIMA-Q) created a research infrastructure to recruit, characterize, and track disease progression in individuals at risk of dementia.

Methods

CIMA-Q established standardized clinical, neuropsychological, neuroimaging, blood (plasma, serum, RNA, genomic DNA), cryopreserved peripheral blood mononuclear cells, and cerebrospinal fluid collection protocols. These data and biological materials are available to the research community.

Results

In phase 1, 115 persons with subjective cognitive decline, 88 with mild cognitive impairment, 31 with early probable Alzheimer's disease, and 56 older adults with no worries nor impairments received detailed clinical and cognitive evaluations as well as blood and peripheral blood mononuclear cells collections. Among them, 142 underwent magnetic resonance imaging, 29 a 18fluorodeoxyglucose positron emission tomography, and 60 a lumbar puncture.

Discussion

CIMA-Q provides procedures and resources to identify early biomarkers and novel therapeutic targets, and holds promise for detecting cognitive decline in Alzheimer's disease.

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<![CDATA[What outcomes are important to patients with mild cognitive impairment or Alzheimer's disease, their caregivers, and health-care professionals? A systematic review]]> https://www.researchpad.co/article/5ca25d22d5eed0c4846d4c94

Introduction

Clinical trials involving patients with Alzheimer's disease (AD) continue to try to identify disease-modifying treatments. Although trials are designed to meet regulatory and registration requirements, many do not measure outcomes of the disease most relevant to key stakeholders.

Methods

A systematic review sought research that elicited information from people with AD, their caregivers, and health-care professionals on which outcomes of the disease were important. Studies published in any language between 2008 and 2017 were included.

Results

Participants in 34 studies described 32 outcomes of AD. These included clinical (memory, mental health), practical (ability to undertake activities of daily living, access to health information), and personal (desire for patient autonomy, maintenance of identity) outcomes of the disease.

Discussion

Evidence elicited directly from the people most affected by AD reveals a range of disease outcomes that are relevant to them but are not commonly captured in clinical trials of new treatments.

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<![CDATA[Subjective cognitive decline, APOE ε4, and incident mild cognitive impairment in men and women]]> https://www.researchpad.co/article/5c9d2972d5eed0c4840ae935

Introduction

Possible joint effects of subjective cognitive decline (SCD) and apolipoprotein E (APOE) ε4 genotype on incident mild cognitive impairment (MCI) were examined for men and women separately.

Methods

Cognitively normal participants with and without SCD were included from the first follow-up examination of the population-based Heinz Nixdorf Recall study. Sex-stratified logistic regression models estimated main effects and interactions (additive, multiplicative) of SCD at the first follow-up (yes+/no−) and APOE ε4 (positive+/negative−) groups for MCI 5 years later.

Results

Odds for MCI 5 years later were higher in SCD/APOE ε4 group +/+ than the sum of groups +/− and −/+ in women, with a trend for positive interaction. Odds for incident MCI in men was highest in group +/−, with no interaction effect.

Discussion

Our findings indicate that APOE ε4 may play an important role in the association of SCD and incident MCI, especially considering sex. Further studies need to examine these associations with larger sample sizes.

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<![CDATA[Trends in health service use and potentially avoidable hospitalizations before Alzheimer's disease diagnosis: A matched, retrospective study of US Medicare beneficiaries]]> https://www.researchpad.co/article/5c801233d5eed0c484a9a52b

Introduction

This study evaluates rates of all-cause emergency department visits, all-cause hospitalizations, potentially avoidable hospitalizations, and falls in 3 years preceding Alzheimer's disease (AD) diagnosis.

Methods

Patients with AD and controls with no cognitive impairment were identified from the Medicare claims data. Patients were required to be aged ≥ 65 years and have continuous Medicare enrollment for ≥4 years before the index date (AD cohort: first AD diagnosis in 2012–2014; controls: randomly selected medical claim). Outcomes for each preindex year were compared among propensity score-matched cohorts.

Results

Each year, before index, patients with AD were more likely to have all-cause emergency department visits, all-cause hospitalizations, potentially avoidable hospitalizations, and falls (P < .05 for all comparisons) than matched controls (N = 19,679 pairs). Increasing absolute and relative risks over time were observed for all outcomes.

Discussion

The study findings highlight the growing burden of illness before AD diagnosis and emphasize the need for timely recognition and management of patients with AD.

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<![CDATA[Validation into Arabic versions of Dementia Rating Scales, Dementia Caregivers Scales, and Dementia Research Instruments]]> https://www.researchpad.co/article/5c26b641d5eed0c48476802b

Introduction

This study aimed to examine the validity and internal consistency of Arabic versions of the eight-item Alzheimer's Dementia, Alzheimer Questionnaire, and Clinical Dementia Rating scales and to assess the Arabic version of Katz Activities of Daily Living, and Neuropsychiatric Inventory.

Methods

One hundred fifty participants were recruited from different settings; they underwent clinical interviews and filled the aforementioned scales.

Results

In our sample, 56.8% of the sample suffered from dementia. The Arabic eight-item Alzheimer's Dementia had excellent psychometric properties, and the Arabic Alzheimer Questionnaire showed near-perfect properties with sensitivity and specificity reaching 100%. In addition, the Arabic Clinical Dementia Rating (A-CDR)–sum of boxes was superior to the regular A-CDR score in detecting dementia cases among the study sample. The A-CDR showed similar characteristics as the original version. The Katz scores demonstrated a strong negative correlation with eight-item Alzheimer's Dementia scores.

Conclusion

Based on this study, health professionals now have reliable and validated tools to be used in clinical and research settings among Arabic-speaking populations.

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<![CDATA[Revolutionizing Alzheimer's disease and clinical trials through biomarkers]]> https://www.researchpad.co/article/5afdc09a463d7e0beb6fdcba

The Alzheimer's Association's Research Roundtable met in May 2014 to explore recent progress in developing biomarkers to improve understanding of disease pathogenesis and expedite drug development. Although existing biomarkers have proved extremely useful for enrichment of subjects in clinical trials, there is a clear need to develop novel biomarkers that are minimally invasive and that more broadly characterize underlying pathogenic mechanisms, including neurodegeneration, neuroinflammation, and synaptic dysfunction. These may include blood-based assays and new neuropsychological testing protocols, as well as novel ligands for positron emission tomography imaging, and advanced magnetic resonance imaging methodologies. In addition, there is a need for biomarkers that can serve as theragnostic markers of response to treatment. Standardization remains a challenge, although international consortia have made substantial progress in this area and provide lessons for future standardization efforts.

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