Publications by authors named "Latha Velayudhan"

Background: The novel South London and Maudsley Brain Health Clinic (SLaM BHC) leverages advances in remote consultations and biomarkers to provide a timely, cost-efficient and accurate diagnosis in mild cognitive impairment (MCI).

Aims: To describe the organisation, patient cohort and acceptability of the remote diagnostic and interventional procedures.

Method: We describe the recruitment, consultation set-up, the clinical and biomarker programme, and the two online group interventions for cognitive wellbeing and lifestyle change.

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  • Cannabinoid-based medicines (CBMs) are increasingly used among older adults, but there is limited information on their adverse events (AEs).
  • This study conducted a systematic review and meta-analysis of 58 randomized clinical trials involving participants aged 50 and older, examining the incidence of AEs associated with CBMs, particularly those containing delta-9-tetrahydrocannabinol (THC).
  • Results indicate that THC-containing CBMs have a higher incidence of specific AEs like dry mouth and dizziness, with varying impacts based on the weekly doses of THC and cannabidiol (CBD), although serious AEs were not significantly higher compared to controls.
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Neural underpinnings of Parkinson's disease psychosis remain unclear to this day with relatively few studies and reviews available. Using a systematic review approach, here, we aimed to qualitatively synthesize evidence from studies investigating Parkinson's psychosis-specific alterations in brain structure, function or chemistry using different neuroimaging modalities. PubMed, Web of Science and Embase databases were searched for functional MRI (task-based and resting state), diffusion tensor imaging, PET and single-photon emission computed tomography studies comparing Parkinson's disease psychosis patients with Parkinson's patients without psychosis.

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Background: Cognitive deficits are associated with poor quality of life and increased risk of development of dementia in patients with Parkinson's disease (PD) psychosis. The trajectory of cognitive decline in PD psychosis remains however unclear.

Objective: We examined this using data from the Parkinson's Progression Markers Initiative study.

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Major depression is an established risk factor for subsequent dementia, and depression in late life may also represent a prodromal state of dementia. Considering current challenges in the clinical development of disease modifying therapies for dementia, the focus of research is shifting towards prevention and modification of risk factors to alter the neurodegenerative disease trajectory. Understanding mechanistic commonalities underlying affective symptoms and cognitive decline may reveal biomarkers to aid early identification of those at risk of progressing to dementia during the preclinical phase of disease, thus allowing for timely intervention.

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Background: Microglia are increasingly understood to play an important role in the pathogenesis of Alzheimer's disease. The rs75932628 (p.R47H) TREM2 variant is a well-established risk factor for Alzheimer's disease.

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Background: Cognitive and executive deficits lead to worsening of quality of life and are a risk factor for developing dementia in people with Parkinson's disease (PD) with psychosis (PDP). However, which key cognitive domains are differentially affected in PDP compared with those without (PDnP), remains unclear. Here, we examined this using a Bayesian meta-analytical approach.

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Objectives: A number of studies have compared Alzheimer's disease (AD), the commonest form of dementia, based on their age of onset, i.e. before the age of 65 years (early-onset AD, EO-AD) to those developing after 65 years of age (late-onset AD, LO-AD), but the differences are not clear.

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Background: Neuroanatomical alterations underlying psychosis in Parkinson's Disease (PDP) remain unclear. We carried out a meta-analysis of MRI studies investigating the neural correlates of PDP and examined its relation with dopaminergic and serotonergic receptor gene expression.

Methods: PubMed, Web of Science and Embase were searched for MRI studies (k studies = 10) of PDP compared to PD patients without psychosis (PDnP).

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  • - Parkinson's Disease (PD) can be tough to distinguish from related disorders like Progressive Supranuclear Palsy and Corticobasal Syndrome, and there's a need for better diagnostic biomarkers.
  • - A study analyzed plasma from 148 people (including those with PD, 4R-Tauopathies, and healthy controls) and found lower levels of complement proteins C1q and C3 in those with 4R-Tauopathies compared to both PD and healthy controls.
  • - While complement levels and activity didn’t show major differences between PD patients and healthy individuals, some complement proteins correlated with PD symptom severity, especially C3 with non-motor symptoms in women.
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  • * The first approach to manage these symptoms should be non-medication strategies; however, if medications are necessary, second-generation antipsychotics are more commonly prescribed than first-generation.
  • * Using antipsychotics in dementia patients can increase mortality and cause adverse effects; treatment decisions are complicated by various personal health factors, but risks can be reduced through careful monitoring and timely medication withdrawal.
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Objectives: Social distancing restrictions in the COVID-19 pandemic may have had adverse effects on older adults' mental health. Whereby the impact on mood is well-described, less is known about psychotic symptoms. The aim of this study was to compare characteristics associated with psychotic symptoms during the first UK lockdown and a pre-pandemic comparison period.

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  • Individuals with Down syndrome (DS) have a high risk of dementia, making early diagnosis challenging, but neuroimaging emerges as a promising diagnostic tool.
  • A review of studies found that neuroimaging techniques like PET scans showed distinct brain function changes in DS individuals with dementia, such as reduced glucose metabolism and specific chemical changes in the brain.
  • While neuroimaging could help in early dementia detection for those with DS, more long-term studies are needed to confirm its effectiveness.
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Background: The suspension of memory services during the COVID-19 pandemic delayed dementia diagnosis and access to early intervention. Some services responded to the challenge by developing a remote memory assessment pathway to comply with reduced social contact measures to protect vulnerable patients. The aim of the study was to establish whether remote model is considered a satisfactory experience within the context of the COVID-19 pandemic and to understand the factors associated with patient and carer satisfaction of remote pathway.

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Introduction: There is little research on factors predicting conversion to dementia in early-onset mild cognitive impairment (eoMCI), a transitional stage between healthy ageing and dementia in individuals below the age of 65. We aimed to examine whether sociodemographic and clinical factors at initial presentation predicted dementia progression in a cohort of eoMCI patients attending a memory service, at a university teaching hospital in the UK.

Methods: This is a retrospective case note study of individuals diagnosed with eoMCI between 2000 and 2013 at the Younger Person's Memory Service (YPMS) in Leicestershire, England.

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Background: Older people experience multiple barriers to enrolment in clinical trials. Caregivers play an important role in supporting patients with Parkinson's disease. Understanding the experiences of patients and caregivers who participate in trials is important to inform the design of future studies and identify problems with recruitment and retention.

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