Neuropathologic features of amnestic mild cognitive impairment.

Background: The neuropathologic substrate of amnestic mild cognitive impairment (aMCI) is not known.

Objective: To determine the neuropathologic features of patients who died while their clinical classification was aMCI.

Design: Cohort study.

Mild cognitive impairment in the oldest old.

Background: No data exist on whether the syndrome of amnestic mild cognitive impairment occurs in the oldest old, or if the relationships for functional status and neuropsychometric performance based on clinical diagnosis hold true in this age group.

Design/methods: The authors performed comprehensive neurologic evaluations, neuropsychometric testing, and functional assessments on a sample of 90- to 100-year-old residents of Rochester, MN. Subjects were diagnosed as normal or with amnestic mild cognitive impairment (MCI) or dementia according to well-accepted criteria.

Survival study of vascular dementia in Rochester, Minnesota.

Objective: To investigate the relationship between features and definitions of vascular dementia (VaD) and survival.

Design: We used the medical records linkage system of the Rochester Epidemiology Project to identify incident cases of dementia in Rochester from January 1, 1985, through December 31, 1989. Dementia and Alzheimer disease were defined using the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.

Comparative diagnostic utility of different MR modalities in mild cognitive impairment and Alzheimer's disease.

This study compares the diagnostic accuracy of magnetic resonance (MR)-based hippocampal volumetry, single voxel (1)H MR spectroscopy ((1)H MRS) and MR diffusion-weighted imaging (DWI) measurements in discriminating patients with amnestic mild cognitive impairment (MCI), Alzheimer's disease (AD) and normally aging elderly. Sixty-one normally aging elderly, 24 MCI and 22 AD patients underwent MR-based hippocampal volumetry, (1)H MRS and DWI. (1)H MRS voxels were placed over both of the posterior cingulate gyri, and N-acetyl aspartate (NAA)/creatine (Cr), myoinositol (MI)/Cr and NAA/MI ratios were obtained.

Incidence of vascular dementia in Rochester, Minn, 1985-1989.

Objective: To examine the contribution of cerebrovascular disease to dementia.

Methods: We used the records-linkage system of the Rochester Epidemiology Project to ascertain incident cases of dementia in Rochester, Minn, for 1985 through 1989. We defined dementia using the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.

Dementia and Alzheimer disease incidence rates do not vary by sex in Rochester, Minn.

Background: Incidence rates of Alzheimer disease (AD) were higher in women than in men in several recent European and Asian studies. Cohort studies in the United States, on the other hand, have consistently reported no difference in incidence across sex.

Objective: To measure age- and sex-specific incidence rates of dementia and AD for persons aged 50 years and older residing in Rochester, Minn, during 1985 to 1989.

Antemortem MRI findings correlate with hippocampal neuropathology in typical aging and dementia.

Objectives: To assess the diagnostic specificity of MRI-defined hippocampal atrophy for AD among individuals with a variety of pathologically confirmed conditions associated with dementia as well as changes attributable to typical aging, and to measure correlations among premortem MRI measurements of hippocampal atrophy, mental status examination performance, and the pathologic stage of AD.

Methods: An unselected series of 67 individuals participating in the Mayo Alzheimer's Disease Research Center/Alzheimer's Disease Patient Registry who had undergone a standardized antemortem MRI study and also postmortem examination were identified. Hippocampal volumes were measured from antemortem MRI.

Prospective analysis of risk factors for nursing home placement of dementia patients.

Objective: To examine risk factors for nursing home placement in a community-based dementia cohort.

Methods: Cognitively normal participants and cognitively impaired patients from a large AD Patient Registry were followed from diagnosis to placement, death, or last follow-up. This included over 3,600 person-years of surveillance.

Mild cognitive impairment and Alzheimer disease: regional diffusivity of water.

Purpose: To compare the regional diffusivity of water in the brains of normally aging elderly people and patients with mild cognitive impairment (MCI) or Alzheimer disease.

Materials And Methods: Magnetic resonance images were obtained in 21 patients with Alzheimer disease, 19 patients with MCI, and 55 normally aging elderly control subjects without evidence of cognitive impairment. Regions of interest were drawn to compare the apparent diffusion coefficient (ADC) and the anisotropy index (AI) in frontal, parietal, temporal, occipital, anterior, and posterior cingulate white matter (WM), and the thalami and hippocampi.

Rates of hippocampal atrophy correlate with change in clinical status in aging and AD.

Background: The cognitive continuum in the elderly population can be conceptually divided into those who are functioning normally (control subjects), those with a mild cognitive impairment (MCI), and those with probable AD.

Objectives: To test the hypothesis that the annualized rates of hippocampal atrophy differ as a function of both baseline and change in clinical group membership (control, MCI, or AD).

Methods: The authors identified 129 subjects from the Mayo Clinic AD Research Center/AD Patient Registry who met established criteria for normal control subjects, MCI, or probable AD, both at entry and at the time of a subsequent clinical follow-up evaluation 3 +/- 1 years later.

Regional metabolic patterns in mild cognitive impairment and Alzheimer's disease: A 1H MRS study.

Background: Mild cognitive impairment (MCI) is a recently described transitional clinical state between normal aging and AD. Assuming that amnestic MCI patients had pathologic changes corresponding to an early phase and probable AD patients to a later phase of the disease progression, the authors could approximate the temporal course of proton MR spectroscopic (1H MRS) alterations in AD with a cross-sectional sampling scheme.

Methods: The authors compared 1H MRS findings in the superior temporal lobe, posterior cingulate gyri, and medial occipital lobe in 21 patients with MCI, 21 patients with probable AD, and 63 elderly controls.

Risk factors for nursing home placement in a population-based dementia cohort.

Objective: To examine risk factors for nursing home placement in a population-based dementia cohort.

Methods: The Mayo Clinic Medical Records linkage system was used to identify all patients with onset of dementia between 1980 and 1984. The patient group included 314 cases who met DSM-III-R criteria for dementia, including 220 cases who were community dwelling at onset.

Usefulness of MRI measures of entorhinal cortex versus hippocampus in AD.

Objective: MRI-based measurements of hippocampal atrophy are a sensitive indicator of the early pathologic degeneration of the medial temporal lobe in AD. However, AD pathology appears first in the transentorhinal/entorhinal cortex, not the hippocampus. The authors tested the hypothesis that MRI-based measurements of the entorhinal cortex are more sensitive than measurements of hippocampal volume in discriminating among three clinical groups; controls, patients with a mild cognitive impairment (MCI), and patients with mild probable AD.

No association between TAU haplotype and Alzheimer's disease in population or clinic based series or in familial disease.

We and others have previously identified two distinct haplotypes of the TAU gene in Caucasian populations. In this study, we have assessed whether these haplotypes show an association with Alzheimer's disease in a variety of populations. They do not.

Diagnostic accuracy of four approaches to interpreting neuropsychological test data.

The diagnostic accuracy of 4 approaches to interpreting neuropsychological test results are evaluated in 672 cognitively normal and 407 cognitively impaired persons using the Mayo Cognitive Factor Scales (G. E. Smith et al.

Memory and MRI-based hippocampal volumes in aging and AD.

Objective: To demonstrate structural-functional relationships between MRI-based volumetric measurements of medial temporal lobe structures and cognitive function.

Background: Previous work has documented the ability of MRI-based measurements of the hippocampus to discriminate between age-matched control subjects and patients with very mild AD. Relatively less is known about the correlation between medial temporal lobe structures and cognitive functions.

Delirium episodes during the course of clinically diagnosed Alzheimer's disease.

A retrospective review was conducted of 122 charts of patients with clinically diagnosed Alzheimer's disease (CDAD) who had participated in a longitudinal dementia study at the Mayo Clinic from 1965 to 1970. DSM-III-R diagnoses were assigned based on the longitudinal description of symptoms detailed in the Mayo Clinic medical records of the hospitalizations; clinic, home, and nursing home visits; and state hospital admissions. Thirty patients (25%) were found to have a delirium episode during their course of CDAD that occurred during inpatient admissions; 50% (15 of 30) of the delirium episode occurred in patients ages 80 to 89.

Frequency and distribution of vascular dementia.

It remains difficult to draw conclusions about the frequency and distribution of vascular dementia (VaD). The data from current studies cannot be compared and reconciled easily. Disagreement on diagnostic criteria and their field implementation remains the major problem.

Pathologic heterogeneity in clinically diagnosed corticobasal degeneration.

Background: Early reports suggested that corticobasal degeneration (CBD) is a distinct clinicopathologic entity. Because patients have had a fairly consistent constellation of clinical and laboratory findings, many have proposed that the pathologic diagnosis can be surmised with confidence during life.

Objective: To analyze the pathologic findings in a large series of cases with clinically diagnosed CBD.

Use of physician and acute care services by persons with and without Alzheimer's disease: a population-based comparison.

Objective: To estimate differences in use of acute care services between persons with and without Alzheimer's disease (AD).

Study Design: Population-based historical cohort study.

Setting/subjects: All Rochester, Minnesota, residents with AD onset between January 1, 1980, and December 31, 1984 (n = 301), plus one age- and sex-matched nondemented control per case, were identified with a retrospective review of community-based medical records.

Prediction of AD with MRI-based hippocampal volume in mild cognitive impairment.

Objective: To test the hypothesis that MRI-based measurements of hippocampal volume are related to the risk of future conversion to Alzheimer's disease (AD) in older patients with a mild cognitive impairment (MCI).

Background: Patients who develop AD pass through a transitional state, which can be characterized as MCI. In some patients, however, MCI is a more benign condition, which may not progress to AD or may do so slowly.

A novel mutation in the apolipoprotein E gene (APOE*4 Pittsburgh) is associated with the risk of late-onset Alzheimer's disease.

Using a combination of polymerase chain reaction (PCR), single-strand conformation polymorphism (SSCP) and DNA sequencing techniques, we identified a unique missense mutation (T-->C) in exon 3 of the APOE gene which resulted in the substitution of pro-28 for leu-28. We screened 1118 White cases of late-onset (>60 years) Alzheimer's disease (AD) from three independent centers (Pittsburgh = 489, Indiana = 319, Mayo Clinic Rochester = 310) and 1123 controls (607 clinically assessed and 516 individuals randomly ascertained from the general population). Two of the 1123 control subjects had the pro-28 mutation (0.

Testing for apraxia in neurological patients: a descriptive study in two diverse cultures.

We constructed a detailed apraxia testing battery consisting of 55 items arranged in seven subparts and applied it to a convenience series of patients with a variety of neurological diseases and asymptomatic control subjects. A total of 173 subjects were evaluated in two culturally diverse settings: Rochester, MN, USA and in Istanbul, Turkey. There was little difference between performance scores in the two sites.

Mild cognitive impairment: clinical characterization and outcome.

Background: Subjects with a mild cognitive impairment (MCI) have a memory impairment beyond that expected for age and education yet are not demented. These subjects are becoming the focus of many prediction studies and early intervention trials.

Objective: To characterize clinically subjects with MCI cross-sectionally and longitudinally.

Postmenopausal estrogen replacement therapy and risk of AD: a population-based study.

Objective: To study the association between estrogen replacement therapy in postmenopausal women and AD using a case-control design.

Background: Studies of the effect of estrogen therapy on the risk of AD have been limited and have yielded conflicting results.

Methods: Case patients were all postmenopausal women who developed AD in the quinquennium 1980 through 1984 in Rochester, MN (n = 222).