Aims: Type 2 diabetes mellitus (T2DM) is associated with subtle cognitive changes, but also with more severe stages of cognitive dysfunction, including mild cognitive impairment (MCI) and dementia. For these severe stages, it is uncertain which domains are primarily affected and if all patients with impairment are captured by formal criteria for MCI or dementia.
Methods: Ninety-five patients with T2DM suspected of cognitive impairment, identified through screening in primary care, underwent neuropsychological examination assessing five different domains. MCI or dementia were diagnosed using formal criteria.
Results: Forty-seven participants (49%) had impairment on at least one domain, most often involving memory (30%), information processing speed (22%) and visuoperception and construction (22%). Of these 47 people, 29 (62%) had multi-domain impairment. Of the 47 participants with objective impairment, 36 (77%) met criteria for MCI, three (6%) for dementia and eight (17%) met neither diagnosis, mostly because these patients did not complain about acquired dysfunction.
Conclusions: This study shows that the clinical diagnostic evaluation of cognitive impairment in patients with T2DM should take into account that multiple domains can be affected and that not all patients with objective cognitive impairment fulfill criteria for MCI or dementia.
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http://dx.doi.org/10.1016/j.diabres.2018.05.025 | DOI Listing |
Alzheimers Dement
December 2024
Centre for Healthy Brain Ageing, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
Introduction: Neuropsychiatric symptoms (NPSs) are common in dementia with Lewy bodies (DLB) but their neurobiological mechanisms are poorly understood.
Methods: NPSs and cognition were assessed annually in participants (DLB n = 222; Alzheimer's disease [AD] n = 125) from the European DLB (E-DLB) Consortium, and plasma phosphorylated tau-181 (p-tau181) and p-tau231 concentrations were measured at baseline.
Results: Hallucinations, delusions, and depression were more common in DLB than in AD and, in a subgroup with longitudinal follow-up, persistent hallucinations and NPSs were associated with lower p-tau181 and p-tau231 in DLB.
Alzheimers Dement
December 2024
Northwestern Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Chicago, Illinois, USA.
The Alzheimer's Association convened a Diagnostic Evaluation, Testing, Counseling and Disclosure Clinical Practice Guideline workgroup to help combat the major global health challenges surrounding the timely detection, accurate diagnosis, and appropriate disclosure of mild cognitive impairment (MCI) or dementia due to Alzheimer's disease (AD) or other diseases that cause these types of cognitive-behavioral disorders. The newly published clinical practice guidelines are proposed as a structured approach to evaluation. The purpose of the present article is to provide a clinical perspective on the use of neuropsychology within the new framework and practice guidelines outlined under the Diagnostic Evaluation, Testing, Counseling and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD-ADRD) recommendations for primary care and specialty care.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Nuclear Medicine and Molecular Imaging, Imaging and Pathology, KU Leuven, Leuven, Belgium.
Introduction: The longitudinal progression of synaptic loss in Alzheimer's disease (AD) and how it is affected by tau pathology remains poorly understood.
Methods: Thirty patients with amnestic mild cognitive impairment (aMCI) and 26 healthy controls underwent cognitive evaluations and tau, synaptic vesicle protein 2A (SV2A), and amyloid positron emission tomography. Twenty-one aMCI underwent 2-year follow-up (FU) investigations.
Alzheimers Dement
December 2024
Banner Sun Health Research Institute and Banner Alzheimer's Institute, Banner Health, Sun City, Arizona, USA.
This special issue contains multiple articles related to the DETeCD-ADRD guideline.
View Article and Find Full Text PDFNeuro Endocrinol Lett
December 2024
Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China.
Background: Severe or recurring major depression is associated with increased adverse childhood experiences (ACEs), heightened atherogenicity, and immune-linked neurotoxicity (INT). Nevertheless, the interconnections among these variables in outpatient major depression (OMDD) have yet to be determined. We aim to determine the correlations among INT, atherogenicity, and ACEs in OMDD patients compared to normal controls.
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