Anatomical and functional changes in the retina in patients with Alzheimer's disease and mild cognitive impairment.

Purpose: There is evidence that mild cognitive impairment (MCI) or Alzheimer's disease (AD) is accompanied by alterations in the retina. The current study was performed to investigate structural and functional changes in patients with systemic neurodegenerative disease.

Methods: A total of 47 patients with either MCI or AD and 43 healthy age- and sex-matched control subjects were included.

Are Pre-Ascent Low-Altitude Saliva Cortisol Levels Related to the Subsequent Acute Mountain Sickness Score? Observations from a Field Study.

The associations among cortisol levels, body water status, and acute mountain sickness (AMS) remain unclear. We investigated associations between AMS prevalence and severity with resting saliva cortisol levels at low altitude (LA) and high altitude (HA) and with fluid balance during a HA stay. Twenty-two physically fit and healthy participants (12 women, 10 men) were transported to HA (Testa Grigia, 3480 m).

FUNDAMANT: an interventional 72-week phase 1 follow-up study of AADvac1, an active immunotherapy against tau protein pathology in Alzheimer's disease.

Background: Neurofibrillary pathology composed of tau protein is closely correlated with severity and phenotype of cognitive impairment in patients with Alzheimer's disease and non-Alzheimer's tauopathies. Targeting pathological tau proteins via immunotherapy is a promising strategy for disease-modifying treatment of Alzheimer's disease. Previously, we reported a 24-week phase 1 trial on the active vaccine AADvac1 against pathological tau protein; here, we present the results of a further 72 weeks of follow-up on those patients.

Secondary dementia due to Lyme neuroborreliosis.

Dementia-like syndromes are rare manifestations of Lyme neuroborreliosis. The clinical patterns are summarized using our own cases and case reports from the literature, which were diagnosed as definite Lyme neuroborreliosis according to the European guidelines. The cases disclose signs of subcortical dementia that occur more rapidly than in patients suffering from primary dementia.

Safety and immunogenicity of the tau vaccine AADvac1 in patients with Alzheimer's disease: a randomised, double-blind, placebo-controlled, phase 1 trial.

Background: Neurofibrillary pathology composed of tau protein is a main correlate of cognitive impairment in patients with Alzheimer's disease. Immunotherapy targeting pathological tau proteins is therefore a promising strategy for disease-modifying treatment of Alzheimer's disease. We have developed an active vaccine, AADvac1, against pathological tau proteins and assessed it in a phase 1 trial.

Careful neuropsychological testing reveals a novel genetic marker, GSTO1*C, linked to the pre-stage of Alzheimer's disease.

Approximately 30 million people currently suffer from late-onset Alzheimer's disease (LOAD) worldwide. Twin studies demonstrated that 60 to 80% of LOAD is genetically determined, 20% of which remaining unassigned. This case-control study included 118 cognitively healthy controls, 52 patients with mild cognitive impairment (MCI; the pre-stage of LOAD) and 71 LOAD patients.

Evolution of clinical features in possible DLB depending on FP-CIT SPECT result.

Objective: To test the hypothesis that core and suggestive features in possible dementia with Lewy bodies (DLB) would vary in their ability to predict an abnormal dopamine transporter scan and therefore a follow-up diagnosis of probable DLB. A further objective was to assess the evolution of core and suggestive features in patients with possible DLB over time depending on the (123)I-FP-CIT SPECT scan result.

Methods: A total of 187 patients with possible DLB (dementia plus one core or one suggestive feature) were randomized to have dopamine transporter imaging or to follow-up without scan.

Clinical usefulness of dopamine transporter SPECT imaging with 123I-FP-CIT in patients with possible dementia with Lewy bodies: randomised study.

Background: Dementia with Lewy bodies (DLB) is underrecognised in clinical settings.

Aims: To investigate whether performing a (123)I-ioflupane injection ((123)I-FP-CIT also called DaTSCAN™) single photon emission computed tomography (SPECT) scan in patients with possible DLB would lead to a more certain diagnosis (probable DLB or non-DLB dementia).

Method: We randomised 187 patients with possible DLB 2:1 to have a scan or not (control group).

Ginkgo biloba extract EGb 761 in the treatment of dementia: a pharmacoeconomic analysis of the Austrian setting.

Objective: We used efficacy data from three clinical trials to investigate the pharmacoeconomic implications of treating noninstitutionalized Austrian dementia patients with a drug based on EGb 761R, a standardized extract from Gingkgo biloba. In a separate analysis, we compared the pharmacoeconomic aspects of achieving treatment success with EGb 761R and cholinesterase inhibitors.

Methods: A fixed-effect model was used to conduct a metaanalysis of activities of daily living data from 1,201 patients diagnosed with dementia and treated with either EGb 761R (240 mg/day) or matched placebo for 22 or 24 weeks under double-blind conditions.

Are specific symptoms of depression predictive of Alzheimer's dementia?

Objective: To investigate whether specific symptoms of major depression are associated with later development of possible or probable Alzheimer's dementia.

Method: The analysis is part of the Vienna Transdanube Aging Study, a prospective, community-based cohort study of all 75-year-old inhabitants of 2 Viennese districts. Current depressive symptoms were captured with a DSM-IV-TR-based questionnaire.

Effect of six months of treatment with V0191 in patients with suspected prodromal Alzheimer's disease.

New criteria related to prodromal Alzheimer's disease (AD) have been proposed to overcome the issue of heterogeneity of patients with mild cognitive impairment (MCI) and to better define patients in early stage AD. Only few therapeutic trials, if any, have been reported using this newly defined population. The objective of this study was to assess the clinical efficacy and safety of a novel pro-cholinergic drug (V0191) in patients with prodromal AD.

Disorder-specific effects of polymorphisms at opposing ends of the Insulin Degrading Enzyme gene.

Background: Insulin-degrading enzyme (IDE) is the ubiquitously expressed enzyme responsible for insulin and amyloid beta (Aβ) degradation. IDE gene is located on chromosome region 10q23-q25 and exhibits a well-replicated peak of linkage with Type 2 diabetes mellitus (T2DM). Several genetic association studies examined IDE gene as a susceptibility gene for Alzheimer's disease (AD), however with controversial results.

Genetic variation in the choline O-acetyltransferase gene in depression and Alzheimer's disease: the VITA and Milano studies.

Linkage studies point to the long arm of chromosome 10 being a susceptibility region for Alzheimer's disease (AD). Additionally, the gene choline O-acetyltransferase (CHAT) located on chromosome 10 was discussed for conveying risk towards AD, but the results are ambiguous. We examined a possible association of nineteen single-nucleotide polymorphisms (SNPs) in the CHAT gene in a longitudinal cohort study, the Vienna Tansdanube Aging (VITA)-study, in which all subjects were 75 years old at baseline.

[Memory clinics in Austria - characteristics and patterns of practice].

Objective: To compile a cross-sectional overview of Austria's Memory Clinics, their staffing, diagnostic and therapeutic programs, and their acceptance and use.

Methods: In April and May 2009 27 out of the 29 Austrian Memory Clinics participated in a telephone survey based on a standardized questionnaire.

Results And Conclusions: The number of Austrian Memory Clinics has risen in an essentially linear fashion between 1987 and 2009.

Sustained effects of once-daily memantine treatment on cognition and functional communication skills in patients with moderate to severe Alzheimer's disease: results of a 16-week open-label trial.

The present study evaluated the effects of once-daily memantine (20 mg) treatment on cognition and communication in patients with moderate to severe Alzheimer's disease (AD). In a multicenter, single-arm open-label study, outpatients diagnosed with AD (MMSE < 20; n = 97) were titrated from 5 mg to 20 mg once-daily memantine over 4 weeks. Once-daily memantine treatment (20 mg) was then continued for 8 weeks, followed by a 4-week wash-out period.

Memantine in moderate to severe Alzheimer's disease: an observational post-marketing study.

Memantine is an N-methyl-D: -aspartate (NMDA) receptor antagonist, approved for the treatment of moderate to severe Alzheimer's disease (AD). We conducted a 4-month observational, post-marketing, Austrian study of memantine in 377 outpatients with moderate to severe AD. In this 'real-life' setting, memantine was well-tolerated, and produced benefits in cognition (Mini-Mental State Examination), activities of daily living (Activities of Daily Living score), and global function (Clinical Global Impression scale).

Association of a functional NOS1 promoter repeat with Alzheimer's disease in the VITA cohort.

NO synthase, type I (NOS-I) has been suggested to play a role in the etiology of Alzheimer's disease (AD). The gene encoding NOS-I harbors at least nine alternative first exons; in the promoter region of exon 1f, a polymorphic repeat (NOS1 ex1f-VNTR) has been described which influences gene expression and neuronal transcriptome. We have shown that short alleles of this repeat are associated with AD.

[Memantine for treatment of behavioural disturbances and psychotic symptoms in moderate to moderately severe Alzheimer dementia: a naturalistic study in outpatient services in Austria].

We conducted an open, 16-week study on the efficacy of memantine on behavioral disturbances and psychotic symptoms in moderate to moderately severe Alzheimer s disease in daily routine. Fifty-three patients of 20 outpatient centers in Austria were recruited. The Neuropsychiatric Inventory (NPI) was defined as main outcome measure.

Late-onset depression in elderly subjects from the Vienna Transdanube Aging (VITA) study.

Objectives: To assess whether prevalence of depression increases with age. To determine possible risk factors of late-onset depression.

Method: The Vienna Transdanube Aging (VITA) study is a community-based cohort study investigating every inhabitant of the area on the left shore of the river Danube, in Vienna, Austria, born between May 1925 and June 1926.

[Transdermal rivastigmine patch in outpatient services in Austria: a naturalistic study in 103 patients with Alzheimer dementia].

We performed a 6-month open-label study on the use of the transdermal rivastigmine patch in clinical routine in 103 patients with Alzheimer's disease from 25 outpatient services in Austria. After baseline, safety and tolerability of the 10 cm2--rivastigmine patch was assessed at week 4, 12 and 24 in all patients. A Mini Mental State Examination was done at baseline and at week 12 and 24.

[The pupillary response test as a method to differentiate various types of dementia].

Aim: Pupillometry is a non-invasive measurement technique based on the pupillary response to specific sensoric, mental and emotional variables. After topical application of a cholinergic antagonist (tropicamide) an increased pupillary dilatation response in Alzheimers s disease patients was described ("receptor test"). The aim of the present study was to evaluate the usefulness of the 0.

Risperidone long-acting injection: a review of its long term safety and efficacy.

A long-acting form of the second-generation antipsychotic drug risperidone is now broadly available for the treatment of schizophrenia and closely related psychiatric conditions. It combines the advantage of previously available depot formulations for first-generation drugs with the favorable characteristics of the modern "atypical" antipsychotics, namely higher efficacy in the treatment of the negative symptoms of schizophrenia and reduced motor disturbances. Published clinical studies show an objective clinical efficacy (as per psychiatric symptom scores and relapse data) that exceeds that of oral atypical antipsychotics when patients are switched to the long-acting injectable form, a low incidence of treatment-emergent extrapyramidal side effects, and very good acceptance by patients.

[Therapy of Alzheimer's disease: current status and future development].

Cholinesterase inhibitors and memantine can slow the course of Alzheimer's disease. In Austria the frequency of treatment is in the upper third among countries of the EU. Yet, the majority of Alzheimer patients does not receive adequate medication.

Genetic risk factors and markers for Alzheimer's disease and/or depression in the VITA study.

Objectives: In ageing population, both Alzheimer's disease (AD) and depression are common. Significant depressive symptoms are often co-morbid with cognitive impairment and dementia. In this study, we attempted to find various factors and markers for both AD and depression in a longitudinal cohort, the Vienna-Transdanube-Aging (VITA)-study.

Risk factors for Alzheimer dementia in a community-based birth cohort at the age of 75 years.

Background: Few prospective community-based cohort studies have so far concentrated specifically on the risk factors for Alzheimer dementia (AD) with onset after the age of 75 years.

Methods: We prospectively investigated a birth cohort of 585 nondemented inhabitants in the area on the East bank of the river Danube who were born between 1925 and 1926. They were investigated at the age of 75 years and followed up after 30 months.