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1.
Exp Gerontol ; 136: 110945, 2020 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-32289486

RESUMO

Inflammation plays a crucial role in Alzheimer's disease (AD). AD neurodegeneration and concurrent involvement of the peripheral immune system may promote leukocyte division and telomere shortening. We examined genotypes and plasma levels of two proinflammatory cytokines, IL-1beta and IL-18, and leukocyte telomere length (LTL) in patients with mild cognitive impairment (MCI) and AD. We wanted to determine whether changes in plasma IL-1beta and IL-18 levels, together with LTL shortening, could be diagnostic for disease progression from MCI to AD. Median plasma IL-1beta levels were in the order MCI patients (2.2 pg/ml) < AD patients (4.0 pg/ml), both of which differed significantly from the controls (0.0 pg/ml). In the AD patients, the lowest IL-1beta levels were associated with the presence of the C allele of IL-1beta rs16944 SNP. Median plasma IL-18 levels were in the order MCI patients (116.3 pg/ml) > AD patients (85.8 pg/ml), both of which were significantly higher than in the controls (17.6 pg/ml). Analysis of LTL showed a progressive reduction in the order controls > MCI > AD patients (p < 0.0001). Overall LTL reduction was correlated with increased plasma IL-1beta levels, substantiating the hypothesis that inflammatory processes secondary to neuroinflammation may trigger telomere attrition. Changes in plasma IL-1beta and Il-18 levels, and LTL seem to reflect shifts in AD stage; they may have potential use as blood biomarkers to monitor disease onset and progression from MCI to AD.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Doença de Alzheimer/genética , Biomarcadores , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/genética , Citocinas , Humanos , Interleucina-18 , Leucócitos , Telômero
2.
Exp Gerontol ; 88: 19-24, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-28039025

RESUMO

Studies investigating telomere length in association with cognitive decline, dementia, and sporadic Alzheimer's disease (AD) have frequently found shorter telomeres to be associated with the development of AD and telomerase expression with pathological processes in AD. Human telomerase is constituted by two components: the telomerase reverse transcriptase (TERT) and the telomerase RNA component (TERC). Genetic variation at the two loci has been investigated in relation to telomere length, longevity, and common diseases of advanced age, but not in relation to AD. We examined three polymorphisms of the TERT gene (VNTR MNS16A, rs2853691, rs33954691) and three polymorphisms of the TERC gene (rs12696304, rs3772190, rs16847897) in a sample of 220 AD patients and 146 controls. MNS16A LL genotype was found to be associated with an increased risk of AD only in males [interaction term adjusted OR=3.55 (95% CI 1.2-10.2)]. The three TERC single nucleotide polymorphisms are in strict linkage disequilibrium and their genotype combinations influenced the age at AD onset (AAO). The combined genotype GG-TT-CC was associated with a mean AAO six years lower (70.5±6.7) than that associated with the other genotype combinations (76.04±6.7, p=0.01). The fact that the MNS16 L allele has been reported to lower TERT expression, and that the TERC alleles G, T, C (rs12696304, rs3772190, rs16847897 in this order have been repeatedly found associated with shorter LTL, seems to corroborate the hypothesis of a role of telomere length and telomerase in AD susceptibility.


Assuntos
Doença de Alzheimer/genética , Longevidade/genética , Polimorfismo de Nucleotídeo Único , RNA/genética , Telomerase/genética , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Feminino , Predisposição Genética para Doença , Humanos , Itália , Modelos Lineares , Modelos Logísticos , Masculino , Encurtamento do Telômero
3.
Am J Alzheimers Dis Other Demen ; 30(6): 635-44, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25792664

RESUMO

Although the Anosognosia Questionnaire-Dementia (AQ-D) is one of the main instruments for assessing awareness in Alzheimer's disease (AD), the normative data were until now limited to people from Argentina and Japan. This study aims to validate this instrument in an European context, in particular in an Italian sample. In a multicenter project (Verona, Padova, and Trapani), 130 patients with AD and their caregivers participated in the study. Psychometric characteristics of AQ-D are confirmed indicating that the scale permits the early identification of anosognosia and the correct care management of patients. Indeed, anosognosia results to be present also in patients with very mild AD (moderate: 44.44%; mild: 47.17%; and very mild: 23.73%). Moreover, the results indicate that deficits in awareness may vary in severity and that different types of anosognosia may be identified.


Assuntos
Agnosia/diagnóstico , Doença de Alzheimer/diagnóstico , Escalas de Graduação Psiquiátrica/normas , Psicometria/métodos , Idoso , Idoso de 80 Anos ou mais , Agnosia/etiologia , Doença de Alzheimer/complicações , Feminino , Humanos , Itália , Masculino , Psicometria/instrumentação , Reprodutibilidade dos Testes , Índice de Gravidade de Doença
4.
Am J Alzheimers Dis Other Demen ; 30(2): 153-64, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24963080

RESUMO

Executive functions play an important role in the maintenance of autonomy in day-to-day activities. Nevertheless, there is little research into specific cognitive training for Mild Cognitive Impairment (MCI). We present the results of a program which aims to teach specific strategies and metacognitive abilities in order for patients to be able to carry out attentional and executive tasks. Two groups (A and B) were compared in a cross-over design. After the first evaluation, Group A (but not B) participated in a six month cognitive stimulation program. After a second assessment, only Group B received treatment and then a final evaluation was carried out on both groups. The results show that: i) both groups improved their performance as an effect of training; ii) improvements generalized to memory and general cognitive tasks; iii) in the interval without training, Group B's performance worsened and iv) Group A partially maintained their results over time.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Disfunção Cognitiva/reabilitação , Função Executiva/fisiologia , Transtornos da Memória/reabilitação , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/fisiopatologia , Estudos Cross-Over , Progressão da Doença , Feminino , Humanos , Masculino , Transtornos da Memória/fisiopatologia , Resultado do Tratamento
5.
Neurol Sci ; 35(3): 385-90, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23959532

RESUMO

Awareness of cognitive deficits and clinical competence were investigated in 79 mild to moderate Alzheimer's disease patients. Awareness was assessed by the anosognosia questionnaire for dementia, and clinical competence by specific neuropsychological tests such as trail making test-A, Babcock story recall test, semantic and phonemic verbal fluency. The findings show that 66 % of the patients were aware of memory deficits, while the 34 % were unaware. Deficit in awareness correlated with lower scores on the Mini Mental State Examination test that, in the score range from 24.51 to 30 and from 19.50 to 24.50, appeared to be a significant predictor of level of awareness. None of the AD patients had fully preserved clinical competence, only 7 patients (9 %) had partially preserved clinical competence and 72 patients (91 %) had completely lost clinical competence. All the patients with partially preserved clinical competence (9 %) were aware of their memory deficit. The study indicates that neuropsychological tests used for the assessment of executive functions are not suitable for investigating clinical competence. Therefore, additional and specific tools for the evaluation of clinical competence are necessary. Indeed, these might allow clinicians to identify AD patients who, despite their deficits in selected functions, retain their autonomy of choice as well as recognize those patients who should proceed to the nomination of a legal representative.


Assuntos
Doença de Alzheimer/psicologia , Conscientização/fisiologia , Transtornos Cognitivos/psicologia , Tomada de Decisões/fisiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/complicações , Transtornos Cognitivos/etiologia , Progressão da Doença , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Estatísticas não Paramétricas , Inquéritos e Questionários
6.
Neurol Sci ; 34(11): 2027-30, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24062212

RESUMO

Neurosyphilis is rather an unusual cause of dementia characterized by a rapidly progressive course and psychiatric symptoms. Diagnosis of neurosyphilis should be suspected in the presence of a global cognitive impairment consisting in disorientation, amnesia and severe impairment of speech and judgement and psychiatric symptoms such as depression, mania and psychosis, with a subacute onset. More commonly, clinical manifestations of neurosyphilis include general PARESIS (involvement of Personality, Affect, Reflexes, Eye, Sensorium, Intellect and Speech). Upon clinical suspicion, diagnosis of neurosyphilis is confirmed by a reactive cerebrospinal fluid (CSF)-Venereal Disease Research Laboratory. Here we report three Human Immunodeficiency Virus (HIV)-negative male patients presenting with psychiatric symptoms and a rapidly evolving dementia. Although magnetic resonance imaging did not address to diagnosis, CSF examination was mandatory in neurosyphilis diagnosis. Other diagnostic tools such as neuropsychology and single-photon emission computed tomography resulted supportive in the diagnosis. We showed that a prompt antibiotic treatment might stop disease progression. Therefore, neurosyphilis should be always considered even in HIV-negative patients in the presence of unexpected psychiatric symptoms accompanied by a rapidly evolving cognitive decline.


Assuntos
Demência/diagnóstico , Demência/etiologia , Neurossífilis/complicações , Neurossífilis/diagnóstico , Idoso , Encéfalo/patologia , Progressão da Doença , Humanos , Masculino , Pessoa de Meia-Idade
7.
Dement Geriatr Cogn Disord ; 35(1-2): 51-7, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23306186

RESUMO

BACKGROUND: Variation at the cyclin-dependent kinase inhibitor gene P21 in a patient sample of the Italian population was investigated in search of genetic factors potentially involved in sporadic late-onset Alzheimer's disease (AD). METHODS: Two single nucleotide polymorphisms (SNPs) were studied in this gene: a C>A transversion at codon 31 (ser>arg) in exon 2 (RS1801270) and a C>T transition occurring 20 bp downstream from the stop codon of exon 3 (RS1059234). RESULTS: The odd ratios were: RS1801270 A allele = 0.62 (95% CI = 0.33-1.18; p = 0.14); RS1059234 T allele = 0.57 (95% CI = 0.33-0.98; p = 0.04). In addition, a longer duration of disease was found with genotypes carrying the RS1059234 T allele (4.3 ± 2.5 years) than with those not carrying it (3.3 ± 2.1 years) (p = 0.001). CONCLUSION: In the present sample, one of the two SNPs seems in some way related to AD, since carriers of one allele were slightly protected against AD onset.


Assuntos
Doença de Alzheimer/genética , Doença de Alzheimer/fisiopatologia , Inibidor de Quinase Dependente de Ciclina p21/genética , Inibidor de Quinase Dependente de Ciclina p21/fisiologia , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Alelos , Doença de Alzheimer/epidemiologia , Análise de Variância , Códon , DNA/genética , Interpretação Estatística de Dados , Éxons/genética , Feminino , Frequência do Gene , Genótipo , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Polimorfismo de Nucleotídeo Único/genética
9.
Am J Alzheimers Dis Other Demen ; 27(2): 121-30, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22495340

RESUMO

Nowadays, preventing the effects of mental decline is an international priority, but there is little research into cognitive training in mild cognitive impairment (MCI). We present the results of a program aimed at teaching memory strategies and improving metacognitive abilities. This was associated with training to ameliorate caregivers' assistance. Two groups (A and B) were compared in a crossover design. After the first evaluation, group A (but not B) participated in a 6-month cognitive stimulation program. After a second assessment, only B received treatment and then a final evaluation was carried out on both the groups. The results show that (1) both the groups improved their performance as an effect of training; (2) improvements are specific to the functions trained; (3) in the interval without intervention, performance of group B worsened; and (4) group A has maintained their results over time. In conclusion, our results show that specific training may reduce memory impairment in MCI.


Assuntos
Terapia Cognitivo-Comportamental , Disfunção Cognitiva/terapia , Idoso , Idoso de 80 Anos ou mais , Atenção , Função Executiva/fisiologia , Humanos , Pessoa de Meia-Idade , Testes Neuropsicológicos , Avaliação de Programas e Projetos de Saúde , Índice de Gravidade de Doença , Análise e Desempenho de Tarefas , Resultado do Tratamento
10.
Neurol Sci ; 26(1): 55-6, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15877190
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