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1.
Int J Geriatr Psychiatry ; 22(6): 563-7, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17136705

RESUMO

BACKGROUND: Mild cognitive impairment (MCI) is a condition referring to the persons with cognitive deficits measurable in some form or another, but not meeting criteria for dementia, and who have an increased risk of becoming demented. OBJECTIVE: To establish the rate of progression to dementia in MCI, to investigate the risk of conversion for amnestic vs multiple-domains subtypes, and to identify the predictors of progression. METHODS: MCI (n = 105) individuals enrolled in a longitudinal study received annual clinical and psychometric examinations for up to a mean of 3 years. The diagnosis of MCI according to Mayo Clinic Petersen's Criteria was conducted by a panel of specialists. RESULTS: After 3 years of follow-up, 23 of 105 subjects with MCI were diagnosed with dementia. 40 showed cognitive decline not dementia, 34 were stable and showed no cognitive decline or improvement, while eight showed cognitive improvement. CONCLUSIONS: We conclude that conversion rate from MCI to DSM-IIIR dementia was 21.9% over a period of 3 years. The occurrence of depressive symptoms may constitute a predictor for those who are more likely to progress to dementia. The risk of conversion to dementia was higher among the subjects with an evidence of impairment extending beyond memory than with those who suffered only from memory deficits, and the subjects who converted to dementia in this subtype had significantly higher baseline plasma total homocysteine levels than non-converters.


Assuntos
Doença de Alzheimer/epidemiologia , Transtornos Cognitivos/epidemiologia , Transtorno Depressivo/epidemiologia , Idoso , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/psicologia , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/psicologia , Comorbidade , Estudos Transversais , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Entrevista Psiquiátrica Padronizada , Pessoa de Meia-Idade , Polônia , Fatores de Risco
2.
Int J Geriatr Psychiatry ; 19(12): 1168-72, 2004 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15526303

RESUMO

OBJECTIVE: The aim of the study was to detect the prevalence of depressive syndromes and symptoms in the sample of elderly persons with Mild Cognitive Impairment (MCI), and to analyse Montgomery-Asberg Depression Rating (MADRS) item scores. METHOD: The subjects of the study were 102 consecutive out-patients with MCI. All subjects were assessed by an experienced psychiatrist and MADRS was applied. Major and minor depressive episodes were defined according to DSM-IV criteria. Factor analysis was used to analyse baseline MADRS item scores. RESULTS: Three patient groups emerged according to the depressive symptoms distribution and severity scores basis: those with major depression constituted 19.6% (n = 20), with minor depression 26.5% (n = 27), and with very few depressive symptoms 53.9% (n = 55). Three interpretable MADRS factors were identified, using the factor analysis with Varimax rotation: the first consisting of apparent and reported sadness, inability to feel, pessimistic thoughts, the second consisting of inner tension, reduced sleep, reduced appetite, suicidal thoughts, and the third with concentration difficulties and lassitude. CONCLUSIONS: It was concluded that both major and minor depression is common in MCI. Three MADRS factors were identified and labelled as anhedonia-pessimism, anxiety-vegetative, and cognitive-inhibition.


Assuntos
Transtornos Cognitivos/psicologia , Depressão/diagnóstico , Transtorno Depressivo/diagnóstico , Idoso , Atitude Frente a Morte , Cognição , Depressão/psicologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Fatores de Risco , Estresse Psicológico
3.
Dement Geriatr Cogn Disord ; 16(2): 64-70, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12784029

RESUMO

BACKGROUND: Alzheimer's disease (AD) is the most common dementia disorder in elderly people. Currently, the only known genetic factor associated with the development of sporadic AD is the apolipoprotein E (ApoE) 4 allele. There is a need to identify other environmental and genetic risk factors that could modulate the risk of developing sporadic AD. OBJECTIVE: To analyse the correlation between the ApoE and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and plasma homocysteine levels and vitamins (B(12) and folic acid) concentrations in serum from patients with AD and mild cognitive impairment (MCI) as compared with control group. METHODS: The study was carried out in 99 AD patients, 98 subjects with MCI and 100 healthy subjects. Diagnosis of probable AD was made according to the NINCDS-ADRDA and DSM-IV criteria. The following factors were analysed: age, gender, duration of disease, concentration of plasma total homocysteine, folic acid and vitamin B(12) in the serum and the polymorphism of MTHRF and ApoE genes. The results obtained were analysed by multivariate analysis of regression. RESULTS: We found that plasma total homocysteine is increased in AD patients (p < 0.0001) and depended on the MTHFR T/T genotype in the presence of low folate levels (p < 0.05). The increased frequency of ApoE4 allele in the AD population was independent of homocysteine, folic acid and vitamin B(12) levels and MTHFR status. CONCLUSIONS: We conclude that the concentration of plasma total homocysteine is increased in AD patients. This may be associated with the T/T genotype in the MTHFR gene; however, the distribution of the MTHRF C677T polymorphism in the Polish population does not differ in AD and controls.


Assuntos
Doença de Alzheimer/sangue , Apolipoproteínas E/genética , Transtornos Cognitivos/sangue , Ácido Fólico/sangue , Homocisteína/sangue , Oxirredutases atuantes sobre Doadores de Grupo CH-NH/sangue , Oxirredutases atuantes sobre Doadores de Grupo CH-NH/genética , Vitamina B 12/sangue , Idoso , Doença de Alzheimer/enzimologia , Doença de Alzheimer/genética , Apolipoproteínas E/sangue , Transtornos Cognitivos/enzimologia , Transtornos Cognitivos/genética , Humanos , Metilenotetra-Hidrofolato Redutase (NADPH2) , Polimorfismo Genético
4.
Dement Geriatr Cogn Disord ; 14(4): 208-12, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12411763

RESUMO

The aim of this study was to define the co-occurrence of behavioural symptoms and Alzheimer's disease (AD) in relation to apolipoprotein E (APOE) genotype. Probable AD patients from the Alzheimer's Day Clinic (n = 139) were assessed with the 'Behavioural Pathology in Alzheimer's Disease' rating scale, and their APOE genotype was determined. This study demonstrated no relationship between presence of the APOE epsilon4 allele and any of the behavioural symptoms assessed, including delusions, hallucinations, depression, activity disturbances, aggressiveness and anxiety. Activity disturbances, delusions, hallucinations and aggressiveness paralleled the severity of AD, increasing in frequency with the severity of the dementia. The prevalence of delusions, hallucinations, aggressiveness and depression were found to be associated with lower levels of education.


Assuntos
Doença de Alzheimer/genética , Doença de Alzheimer/psicologia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/complicações , Apolipoproteína E2 , Apolipoproteína E4 , Apolipoproteínas E/genética , Sintomas Comportamentais/diagnóstico , Sintomas Comportamentais/etiologia , Escolaridade , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Estudos de Amostragem
5.
Neurol Neurochir Pol ; 35(3): 405-13, 2001.
Artigo em Polonês | MEDLINE | ID: mdl-11732264

RESUMO

UNLABELLED: In recent years evidence is increasing that vascular disease is associated with cognitive impairment and dementia. Moreover, presence of cerebrovascular disease may intensify the clinical symptoms of Alzheimer's disease (AD). The aim of the study was to determine the prevalence of vascular risk factors in age and sex matched patients with dementia. We studied 109 patients with AD and 37 patients vascular dementia (VD). DSM-III-R test for dementia, NINCDS-ADRDA guidelines for AD and NINDS-ARIEN for VD were applied. RESULTS: Mean age of dementia onset in AD and VD was 65.8 SD 7.8 and 67.4 SD 7.0 years (p > 0.05), the duration of dementia, MMS and GDS for patients with AD and VD was not significantly different. Arterial hypertension was associated in 51.3% VD and 30.3% AD (p < 0.05), hypotension in 11.1 and 23.6% respectively (p > 0.05), atrial fibrillation was similar in AD and VD, coronary artery disease was presents 64.8% AD and 46.8 VD (p > 0.05) and type 2 diabetes in 21.6% and 10.1% (p > 0.05) respectively. No significant differences in serum lipid profile were found in both groups, except two times higher incidence of normal HDL-cholesterol concentration in AD compare to VD. The relation between alcohol consumption, cigarette smoking and head trauma was similar in both types of dementia. CONCLUSION: Vascular disease and AD have to some extent a shared aetiology, and risk factors that they have in common increase the risk of both disorders independently and vascular disease is perhaps involved in the aetiology of AD.


Assuntos
Doença de Alzheimer/etiologia , Transtornos Cerebrovasculares/complicações , Doença da Artéria Coronariana/complicações , Demência Vascular/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/psicologia , Arritmias Cardíacas/complicações , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/epidemiologia , Fibrilação Atrial/complicações , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/epidemiologia , Transtornos Cerebrovasculares/diagnóstico , Transtornos Cerebrovasculares/epidemiologia , Colesterol/sangue , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/epidemiologia , Demência Vascular/epidemiologia , Demência Vascular/psicologia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/etiologia , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico , Hipotensão/complicações , Hipotensão/diagnóstico , Masculino , Pessoa de Meia-Idade , Fatores de Risco
6.
Psychiatr Pol ; 35(1): 93-107, 2001.
Artigo em Polonês | MEDLINE | ID: mdl-11324386

RESUMO

The aim of the study was: 1) to estimate the occurrence and intensity of some psychopathological symptoms in the course of Alzheimer's disease, and 2) to examine whether the occurrence of behavioral and psychological symptoms increases with the deepening of dementia process among persons with Alzheimer's disease living in their homes with outpatient treatment. The study was conducted among 94 persons (38 men and 56 women ageing from 52 to 86 years (x = 72.4 +/- 6.9), with education: from 2 to 17 years (x = 11.2 +/- 3.7). Three subgroups were selected for study with regard to the intensity of dementia process, estimated according to Clinical Dementia Rating (CDR): very mild (n = 16, x = 71.4 +/- 6.7), mild (n = 43, x = 72.6 +/- 7.9), moderate (n = 35, x = 72.5 +/- 6.9). Subjects in group II and III fulfill diagnostic criteria of dementia according to ICD-10, DSM IV and criteria of probable AD according to NINCDS-ADRDA. In the estimation of occurrence of behavioral and psychological disturbances: Alzheimer's Disease Assessment Scale--non-cognitive behavior (ADAS-non-cog) and subscale "Change in Personality, Interests, Drive" of Blessed Dementia Scale were used. The results have shown that with the progress of dementia process, the occurrence of the following psychopathological symptoms such as: hallucinations, intensive motor activity, purposeless hyperactivity, pacing, rigidity increases and there is a relinquishment of hobbies. In addition, regardless of the stage of dementia, such behaviors as: apathy, depression, tearfullness, impaired emotional control and disturbances of appetite were observed relatively frequently.


Assuntos
Doença de Alzheimer/epidemiologia , Transtornos Mentais/epidemiologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/classificação , Assistência Ambulatorial/estatística & dados numéricos , Comorbidade , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Distribuição por Sexo
7.
Neurol Neurochir Pol ; 35(6): 1013-20, 2001.
Artigo em Polonês | MEDLINE | ID: mdl-11987698

RESUMO

Recent studies suggest that alpha 2-macroglobulin (alpha 2 m) may play a role in the pathogenesis of Alzheimer's Disease (AD). The presence of alpha 2-macroglobulin G/G genotype is thought to increase the risk of AD. The aim of the study was to analyse alpha 2 m polymorphism in two groups: AD patients (n = 60, F = 41, M. = 19, mean age 73.3 +/- 6.3) and non-demented control group (n = 58, F = 36, M. = 22, mean age 73.1 +/- 8.3, mean MMSE score 27). Frequencies of genotypes A/A, A/G, G/G in AD group were: 0.46: 0.42: 0.12. In control group those frequencies were: 0.40: 0.48: 0.12. The lack of statistically significant difference between G/G frequencies in both groups of patients may suggest that alpha 2-macroglobulin G/G genotype is not a risk factor for AD.


Assuntos
Doença de Alzheimer/genética , Polimorfismo Genético , alfa-Macroglobulinas/genética , Idoso , Estudos de Casos e Controles , DNA/genética , Feminino , Frequência do Gene , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Fatores de Risco
8.
Psychiatr Pol ; 35(4): 647-56, 2001.
Artigo em Polonês | MEDLINE | ID: mdl-11760464

RESUMO

Mild Cognitive Impairment (MCI) is a clinical syndrome (with well-established diagnostic criteria) that carries a high risk of the patient developing dementia, which means that it requires early detection, diagnosis and treatment to alleviate suffering and to attempt to reduce the resulting the burden.


Assuntos
Doença de Alzheimer/diagnóstico , Transtornos Cognitivos/diagnóstico , Atividades Cotidianas , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Qualidade de Vida , Índice de Gravidade de Doença
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