Neuropsychiatric and cognitive features of major depressive disorder in aging, based on the data from the US National Alzheimer's Coordinating Center (NACC).

OBJECTIVE: The diagnosis of Major Depressive Disorder (MDD) is based on the DSM-V criteria and is established by a clinician. This allows quantifying depression based on clinical criteria. As such, MDD differs from other types of depressions that are measured by subjective scales. Here, we evaluated the MDD risk factor on other neuropsychiatric symptoms (NPS) as well as MDD association with cognitive performance in Alzheimer's disease (AD), Mild Cognitive Impairment (MCI) and Healthy Controls (HC). METHODS: Data of 208 patients with AD, 291 patients with MCI and 647 HC were extracted from the National Alzheimer's Coordinating Center database. All participants included in this study were assessed by a physician for the MDD criteria, underwent an NPS evaluation using the NeuroPsychiatric Inventory, and a comprehensive cognitive assessment. Participants were classified as being with and without MDD. We performed logistic regression and MANCOVA models respectively with NPS and cognitive performance as variables of interest and MDD as fixed factors within each group. The MANCOVA was controlled for the effects of age, sex, and education. RESULTS: MDD increased the risk for psychotic, affective and behavioral NPS in MCI, as well as affective and behavioral NPS in HC and AD. Also, MCI with MDD had lower performance on selective attention and mental flexibility. CONCLUSIONS: MDD seems to increase the probability of a prevalence of NPS in all groups (HC, MCI and AD). Longitudinal data processing would help to understand the neuropsychiatric evolution of elderly subjects with MDD.

Obsessive-compulsive symptoms in dementia: Systematic review with meta-analysis.

Dementia is a highly prevalent syndrome with various causes, characterized by cognitive deficit in one or more domains, with important impairment of functioning, which frequently presents with neuropsychiatric symptoms that may include obsessive-compulsive symptoms. OBJECTIVES: The main goal of this meta-analysis was to describe and determine the prevalence of obsessive-compulsive symptoms in dementia. MATERIALS AND METHODS: To accomplish that, MEDLINE, CENTRAL and Psycnet databases were searched from inception to March 2023. The Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data was applied. The principal summary measures were the mean of prevalence of obsessive-compulsive symptoms in patients with dementia and the number of each type of obsession or compulsion. RESULTS: Of the 643 articles screened, 92 were accepted for full-text assessment. Of these, 30 with information on prevalence of obsessive-compulsive symptoms in dementia or any description of those were included, yielding a total of 37 cohorts (5 studies with two cohorts and 1 study with three cohorts). According to our results, obsessive-compulsive symptoms have considerable prevalence in dementia (35.3%, 23.1-47.6%), namely in frontotemporal dementia (48.4%, 29.8-67.0%); obsessive-compulsive symptoms were less frequent in other dementia diagnosis (17.6%, 9.1-26.2%). The more frequent obsessive contents are symmetry (28.6%) and somatic (20.0%); and the more frequent compulsions are checking (27.4%); hoarding is also a relevant symptom (27.8%). DISCUSSION: There was considerable heterogeneity in the prevalence of obsessive-compulsive symptoms in frontotemporal dementia, that is, in part related with diagnostic criteria for dementia, as well as obsessive-compulsive symptom assessment. A careful distinction between compulsions and compulsive-like symptoms is fundamental. Hypervigilance for somatic symptoms and concerns about disease and mortality, as well as deficits in cognitive domains like attention and memory may explain why somatic obsessions and checking compulsions are more prevalent. CONCLUSIONS: The present results indicate that obsessive-compulsive symptoms may be prevalent in the clinical course of many patients with dementia, especially frontotemporal dementia. Better instruments are needed to describe obsessive-compulsive phenomena in a reliable and comparable way, particularly in a population such as dementia patients, whose subjectivity is difficult to access.

[18F]2-fluoro-2-deoxy-sorbitol ([18F]FDS) PET imaging repurposed for quantitative estimation of blood-brain barrier permeability in a rat model of Alzheimer's disease.

Numerous studies suggest that blood-brain barrier (BBB) dysfunction may contribute to the progression of Alzheimer's disease (AD). Clinically available neuroimaging methods are needed for quantitative "scoring" of BBB permeability in AD patients. [18F]2-fluoro-2-deoxy-sorbitol ([18F]FDS), which can be easily obtained from simple chemical reduction of commercial [18F]2-fluoro-2-deoxy-glucose ([18F]FDG), was investigated as a small-molecule marker of BBB permeability, in a pre-clinical model of AD using in vivo PET imaging. Chemical reduction of [18F]FDG to [18F]FDS was obtained with a 100% conversion yield. Dynamic PET acquisitions were performed in the APP/PS1 rat model of AD (TgF344-AD, n=3) compared with age-matched littermates (WT, n=4). The brain uptake of [18F]FDS was determined in selected brain regions, delineated from a coregistered rat brain template. The brain uptake of [18F]FDS in the brain regions of AD rats versus WT rats was compared using a 2-way ANOVA. The uptake of [18F]FDS was significantly higher in the whole brain of AD rats, as compared with WT rats (P<0.001), suggesting increased BBB permeability. Enhanced brain uptake of [18F]FDS in AD rats was significantly different across brain regions (P<0.001). Minimum difference was observed in the amygdala (+89.0±7.6%, P<0.001) and maximum difference was observed in the midbrain (+177.8±29.2%, P<0.001). [18F]FDS, initially proposed as radio-pharmaceutical to estimate renal filtration using PET imaging, can be repurposed for non-invasive and quantitative determination of BBB permeability in vivo. Making the best with the quantitative properties of PET imaging, it was possible to estimate the extent of enhanced BBB permeability in a rat model of AD.

[Supporting psychobehavioral disorders at home and in institutions: a systemic approach]. / Accompagner les troubles psycho-comportementaux à domicile et en institution : une approche systémique.

Caring for people with Alzheimer's disease and related disorders is a complex process, that of a chronic illness. Psychological and behavioral symptoms associated to dementia can appear in all neuro-degenerative diseases to varying degrees, and depend on numerous factors that need to be understood in order to take appropriate action. We propose a systemic approach to psychological and behavioral symptoms, with a view to preventing their onset or reducing their severity.

[The nurse and psychotic disorders in neurocognitive diseases]. / L'infirmière face aux troubles psychotiques au cours de maladies neurocognitives.

Psychotic disorders, such as delusions and hallucinations, cause stress for individuals, their caregivers and healthcare professionals. Attitudes, perceived as behavioral tendencies, in the presence of these symptoms, can either alleviate or exacerbate them. How should we position ourselves in the presence of these disorders? What are the most effective attitudes for calming day-to-day situations?

[Psychopathology of Lewy body disease: the clinical benefits of early detection]. / Psychopathologie de la maladie à corps de Lewy : intérêts cliniques du repérage précoce.

Despite its high prevalence among neurodegenerative diseases, Lewy body disease (LBD), or Lewy body dementia (LBD), because of its clinical proximity to Alzheimer's and Parkinson's diseases, is often undiagnosed or misdiagnosed. Better identification of this condition, in order to provide better care for sufferers and their carers, is a health objective on which progress is desirable.

[The contribution of physical activity to motivation in patients with minor to major cognitive impairment]. / Apport de l'activité physique sur la motivation des patients atteints de troubles cognitifs mineurs à majeurs.

Alzheimer's disease (AD) brings with it the need to think about the loss of autonomy caused by cognitive impairment, and how to manage it. In this context, adapted physical activity has been shown to benefit the overall quality of life of people suffering from the disease. In our study of thirteen patients with AD or related neurodegenerative diseases, we assessed the impact of physical activity on self-esteem and motivation, with patients taking part in group exercise sessions lasting twelve weeks, one hour a week.

[The nurse, recurrent cries]. / L'infirmière face aux cris récurrents.

Recurrent screaming and vocal agitation complicate geriatric and psychogeriatric care. They are among the psychobehavioral symptoms that accompany neurocognitive diseases. Reputedly difficult to manage, they require a comprehensive pharmacological and non-pharmacological approach. How can the care team deal with these disorders in the absence of a doctor?

[Mindfulness meditation and art therapy for Alzheimer's patients and their caregivers]. / La méditation et l'art-thérapie au service des patients souffrant de la maladie d'Alzheimer.

Alzheimer's disease affects nearly three million people in France, and requires training for both healthcare professionals and caregivers. Our study underlines the value of supporting an adapted program based on mindfulness meditation, to reduce anxiety and stress for patients and their caregivers.

Interweaving of reactive oxygen species and major neurological and psychiatric disorders.

Reactive oxygen species are found to be having a wide range of biological effects ranging from regulating functions in normal physiology to alteration and damaging various processes and cell components causing a number of diseases. Mitochondria are an important organelle responsible for energy production and in many signalling mechanisms. The electron transport chain in mitochondria, where oxidative phosphorylation takes place, is also coupled with the generation of reactive oxygen species (ROS). Changes in normal homeostasis and overproduction of reactive oxygen species by various sources are found to be involved in multiple neurological and major neurodegenerative diseases. This review summarises the role of reactive oxygen species and the mechanism of neuronal loss in major neuronal disorders such as Alzheimer's disease, Parkinson's disease, Huntington's disease, depression, and schizophrenia.

[Physical activity in the elderly with a major neurocognitive disorder]. / Activité physique chez le sujet âgé atteint d'un trouble neurocognitif majeur (2/2).

A better knowledge of major neurocognitive disorders and motor learning allows us to propose motor rehabilitation (MR) adapted to subjects with Alzheimer's disease. Recent neuroscientific data on motor functions and cognition allow the construction of physical activity and MR programs, for which the dose-response relationship, content and instructions are determining factors. Further studies are needed to confirm the effectiveness of the methods used.

[Announcement of the diagnosis of Alzheimer's disease or a related disorder in a geriatric short-stay unit]. / Annonce du diagnostic de maladie d'Alzheimer ou apparentée en service de court séjour gériatrique.

The disclosure of the diagnosis of Alzheimer's disease or a related disorder, or rather the time of the diagnostic disclosure, is a crucial step in the care of people with these neurocognitive diseases. While the disclosure procedures are well defined for practitioners who work in memory consultations, there is a grey area for hospital professionals who work in acute medical units.

[Physical activity in the elderly with other major neurocognitive disorders]. / Activité physique chez le sujet âgé atteint d'un trouble neurocognitif majeur.

For decades, the literature was skeptical about the feasibility of motor rehabilitation and its impact, as well as that of physical activity (PA), in subjects with major neurocognitive disorders (MNCD), including Alzheimer's disease. Now, authors report several benefits of PA, both physical and cognitive, by promoting brain perfusion, neurogenesis and synaptic plasticity, as well as decreasing oxidative stress and inflammation. PA should be recommended in cases of TNCM.

Gut microbiome-mediated epigenetic regulation of brain disorder and application of machine learning for multi-omics data analysis.

The gut-brain axis (GBA) is a biochemical link that connects the central nervous system (CNS) and enteric nervous system (ENS). Clinical and experimental evidence suggests gut microbiota as a key regulator of the GBA. Microbes living in the gut not only interact locally with intestinal cells and the ENS but have also been found to modulate the CNS through neuroendocrine and metabolic pathways. Studies have also explored the involvement of gut microbiota dysbiosis in depression, anxiety, autism, stroke, and pathophysiology of other neurodegenerative diseases. Recent reports suggest that microbe-derived metabolites can influence host metabolism by acting as epigenetic regulators. Butyrate, an intestinal bacterial metabolite, is a known histone deacetylase inhibitor that has shown to improve learning and memory in animal models. Due to high disease variability amongst the population, a multi-omics approach that utilizes artificial intelligence and machine learning to analyze and integrate omics data is necessary to better understand the role of the GBA in pathogenesis of neurological disorders, to generate predictive models, and to develop precise and personalized therapeutics. This review examines our current understanding of epigenetic regulation of the GBA and proposes a framework to integrate multi-omics data for prediction, prevention, and development of precision health approaches to treat brain disorders.

[Use of new technologies in the diagnosis of neurodegenerative pathologies]. / Utilisation des nouvelles technologies dans le diagnostic des pathologies neurodégénératives.

These last ten years, new technologies are more and more used in therapeutic and rehabilitation programms for patients with dementia, and used for the diagnosis of theses diseases, from the signal treatment. A review of litterature shows this growing interest among the scientific communauty for these new technologies.

[Screening for Alzheimer's disease by assessing memory impairment]. / Dépister la maladie d'Alzheimer en évaluant la plainte mnésique.

The feeling of memory failure is the most frequently expressed discomfort with age. The difficulty is to distinguish between a memory complaint and a memory pathology. Alzheimer's disease is diagnosed at the stage of dementia. Early detection and the prospect of treatments likely to act lead to an interest in its pre-dementia phase, which is known to precede the appearance of the dementia syndrome by several years.

Caregiver in Alzheimer's disease, pharmacist, and pharmacy technician attitudes and knowledge about caregiver burden screening in community pharmacies.

OBJECTIVES: To explore caregiver, pharmacist and pharmacy technician attitudes toward burden screening in community pharmacies and assess caregiver burden in community pharmacies. METHODS: Descriptive cross-sectional study conducted in 10 community pharmacies in France. Pharmacists, pharmacy technicians and caregivers of patients with Alzheimer's disease were included in this study. Two self-reported questionnaires were used to explore attitudes of participants toward the burden screening in community pharmacy and to assess the caregiver burden in community pharmacy. The short version of the Zarit Burden Interview (range 0-7) was used for the burden screening. RESULTS: Fifty-two pharmacists and pharmacy technicians, and 20 caregivers (61.8±13.7years) participated in this study. Seventy percent of caregivers and 96% of pharmacists/pharmacy technicians stated that caregiver burden screening should be conducted in community pharmacies. 65% of caregivers reported their caregiver status to their community pharmacist. Eighty-two percent of pharmacist/pharmacy technicians thought they had to inform the caregiver's general practitioners (GP) about the detected burden level. Of the 20 included caregivers, 18 had a perception of burden. The mean caregiver burden score detected in this exploratory study was 4.0±1.7, corresponding to a moderate to severe burden. CONCLUSIONS: According to caregivers' opinion, community pharmacists and pharmacy technicians represent accessible health care professionals in primary care to quantify caregiver burden. The burden screening can be easily incorporated into clinical service offerings in community pharmacy practice. It provides a valuable opportunity to identify high-risk caregivers with the aim of referring them to their GP to prevent the caregiver's frailty.

[Art therapy, Alzheimer's disease and identity? Mrs Lila and the return to herself]. / Art-thérapie, maladie d'Alzheimer, identité et retour vers soi.

Alzheimer's disease and related syndromes require non-medicated support in which art therapy can play a vital role. The practice of therapy in people with these diseases must be based on targeted, flexible and capable of being assessed. Presentation of a clinical case.

[Feedback from rehabilitators in a cognitive-behavioural unit]. / Retour d'expérience des rééducateurs d'une unité cognitivo-comportementale.

Non-drug therapies are an integral part of inpatient care in cognitive-behavioural units. As such, the rehabilitators working in the Corentin-Celton Hospital unit participate in the individualized care and rehabilitation project for the patient by conducting numerous individual and group workshops in co-therapy.

[Therapeutic relationship and care with the person with severe cognitive impairment]. / Relation thérapeutique, soins centrés sur la personne et troubles cognitifs sévères.

The inevitable evolution of cognitive disorders in neurodegenerative diseases, such as Alzheimer's disease, raises questions about the modalities and objectives of care provided to people with these diseases. It justifies the acquisition of a holistic and humanistic perspective to maintain the person as a whole at the core of our priorities. Person-centered care meets this requirement by being rooted in a supportive relationship.