Resting state functional connectivity abnormalities and delayed recall performance in patients with amnestic mild cognitive impairment.

Amnestic Mild Cognitive Impairment (aMCI) represents the transition between healthy aging and Alzheimer's dementia (AD) wherein gradual impairment of cognitive abilities, especially memory sets in. Impairment in episodic memory, especially delayed recall, is a hallmark of AD and therefore, patients with aMCI with more severe impairment in episodic memory are considered to be at greater risk of imminent conversion to AD. Brain structural and functional abnormalities were examined by comparing gray matter volumes, white matter micro-structural integrity and resting state functional connectivity (rsFC), between patients with aMCI (n = 46) having lower vs.

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.

Relationship of Neuropsychiatric Symptoms with Falls in Alzheimer's Disease - Does Exercise Modify the Risk?

Objectives: To explore how neuropsychiatric symptoms (NPS) are associated with number of falls and how exercise modifies the risk of falling in community-dwelling people with Alzheimer's disease (AD) and NPS.

Design: Secondary analysis of a randomized controlled trial.

Setting: Community.

Psychological morbidity after job retirement: A review.

Retirement from work is usually an inevitable and significant social life event for many elderly. The retirement age is generally around 60 years. It can have negative or positive effect in old age depending on other factors such as frailty, slowing cognitive functions, multiple physical health problems, medications and sensory impairment.

Views from an asylum: a retrospective case note analysis of a nineteenth century asylum.

Purpose: To investigate whether lifelong admission to psychiatric asylum care was usual practice before community psychiatric care was introduced.

Methods: Historical archives (1838-1938) for 50 patients at the Northampton General Lunatic Asylum in England were studied. Regression analyses were performed to investigate associations between predictor variables (age, gender, marital status, social class) and outcomes (diagnoses, length of stay and admission outcomes).

Lemierre Syndrome: Clinical Update and Protocol for a Systematic Review and Individual Patient Data Meta-analysis.

Lemierre syndrome usually affects otherwise healthy adolescents or young adults and occurs at an overall rate of 1 to 10 cases per million person-years with an estimated fatality rate of 4 to 9%. Diagnostic criteria remain debated and include acute neck/head bacterial infection (often tonsillitis caused by anaerobes at high potential for sepsis and vascular invasion, notably ) complicated by local vein thrombosis, usually involving the internal jugular vein, and systemic septic embolism. Medical treatment is based on antibiotic therapy with anaerobic coverage, anticoagulant drugs and supportive care in case of sepsis.

Risk factors for intracranial hemorrhage during vitamin K antagonist therapy in patients with nonvalvular atrial fibrillation: A case-control study.

Background: Intracranial hemorrhage (ICH) is the most fearful side effect of oral anticoagulant therapy. It is still unclear which risk factor is involved in ICH during vitamin K antagonists (VKAs) treatment and if commonly used bleeding risk scores are able to predict ICH.

Purpose: Search for individual risk factors and bleeding risk scores (HAS-BLED, ATRIA and ORBIT) associated with ICHs in patients with atrial fibrillation treated with VKAs.

Downton Fall Risk Index during hospitalisation is associated with fall-related injuries after discharge: a longitudinal observational study.

Questions: Among older people who are hospitalised, what is the predictive validity of the Downton Fall Risk Index (DFRI) in relation to fall-related injury after discharge? What is the predictive validity of the DFRI among males and females in this setting?

Design: Prospective, longitudinal, observational study.

Participants: All hospital admissions during 2012 at three geriatric clinics in the Stockholm County Council were monitored. Patients aged>65years who did not die during the admission and who lived in the Stockholm County Council region were included.

Posterior cortical atrophy variant of Alzheimer's dementia-A case report.

Alzheimer's dementia (AD) is the commonest type of dementia presenting with initial episodic memory decline followed by involvement of other cognitive domains. Posterior cortical atrophy (PCA) is one of the variants of Alzheimer's dementia (AD) characterized by the atypical presentation of relatively persevered memory in the initial stage. PCA is an uncommon early onset dementia affecting adults between 50 and 65 years.

iSupport, an online training and support program for caregivers of people with dementia: study protocol for a randomized controlled trial in India.

Background: Dementia has a huge physical, psychological, social and economic impact upon caregivers, families and societies at large. There has been a growing impetus to utilize Internet interventions given the potential scalability, and presumed cost-effectiveness and accessibility. In this paper, we describe the design of a randomized controlled trial (RCT) aiming to study the impact of online self-help programs on caregivers of people with dementia in India.

Health-related quality of life as a predictor of mortality in heterogeneous samples of older adults.

Background: Health-related quality of life (HRQoL) is associated with survival in older people with multimorbidities and disabilities. However, older people differ in their characteristics, and less is known about whether HRQoL predicts survival in heterogeneous older population samples differing in their functional, cognitive, psychological or social disabilities. The aim of this study was to explore HRQoL in heterogeneous samples of older men and women, and to explore its prognostic significance for mortality.

Clozapine use in geriatric patients- Challenges.

Clozapine is the first second generation antipsychotic with different receptor profile of action. Clozapine is the most efficacious drug for the treatment of psychotic disorder and is the drug of choice in treatment resistant schizophrenia. Clozapine is used in elderly patients infrequently owing to its adverse effects profile and tolerability.

Point of Care Testing (POCT) to assess drug concentration in patients treated with non-vitamin K antagonist oral anticoagulants (NOACs).

Background: Non-vitamin K antagonist oral anticoagulants (NOACs) do not need routine laboratory monitoring but measurement of drug concentration is important in emergency conditions. Specific laboratory tests are not readily available or not implemented in every hospital. Point-of-Care Tests (POCT) may bridge this gap and be used as a bedside solution.

Trial of Solanezumab for Mild Dementia Due to Alzheimer's Disease.

Background: Alzheimer's disease is characterized by amyloid-beta (Aβ) plaques and neurofibrillary tangles. The humanized monoclonal antibody solanezumab was designed to increase the clearance from the brain of soluble Aβ, peptides that may lead to toxic effects in the synapses and precede the deposition of fibrillary amyloid.

Methods: We conducted a double-blind, placebo-controlled, phase 3 trial involving patients with mild dementia due to Alzheimer's disease, defined as a Mini-Mental State Examination (MMSE) score of 20 to 26 (on a scale from 0 to 30, with higher scores indicating better cognition) and with amyloid deposition shown by means of florbetapir positron-emission tomography or Aβ1-42 measurements in cerebrospinal fluid.

Effect of the Apolipoprotein E Genotype on Cognitive Change During a Multidomain Lifestyle Intervention: A Subgroup Analysis of a Randomized Clinical Trial.

Importance: The role of the apolipoprotein E (APOE) ε4 allele as an effect modifier in lifestyle interventions to prevent cognitive impairment is still unclear.

Objective: To examine whether the APOE ε4 allele modifies the previously reported significant cognitive benefits of a multidomain lifestyle intervention (prespecified subgroup analysis).

Design, Setting, And Participants: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was a randomized clinical trial in 6 centers across Finland (screening and randomization performed from September 7, 2009, through November 24, 2011; intervention duration, 2 years).

Use of Anticholinergic Drugs and its Relationship With Psychological Well-Being and Mortality in Long-Term Care Facilities in Helsinki.

Objectives: To assess the burden of drugs with anticholinergic properties (DAPs) and associated factors in long-term care facilities and to explore how psychological well-being and mortality are associated with the use of DAPs.

Design: Cross-sectional study and 1-year follow-up of all-cause mortality.

Setting And Participants: All 4449 older people (>65 years of age) living in nursing homes and assisted living facilities in Helsinki in 2011 were recruited.

Subclinical Cardiac Dysfunction and Brain Health in Midlife: CARDIA (Coronary Artery Risk Development in Young Adults) Brain Magnetic Resonance Imaging Substudy.

Background: We investigated whether cardiac parameters in young adulthood are associated with indicators of brain health in midlife.

Methods And Results: This study includes 648 participants from the CARDIA (Coronary Artery Risk Development in Young Adults) study (52% women, 38% black). We studied associations of cardiac parameters assessed by echocardiography (left ventricular ejection fraction, left atrial volume, and left ventricular mass) in young adulthood (mean age: 30 years) with brain measures obtained by magnetic resonance imaging (total brain, gray and white matter volume, white matter integrity, abnormal white matter) in midlife (mean age: 50 years).

Clinical and neuropsychological profile of persons with mild cognitive impairment, a hospital based study from a lower and middle income country.

Mild Cognitive impairment (MCI) is an important pre-dementia stage to be identified towards prevention. We screened a large number of older adults seeking help at hospital and community towards a diagnosis of MCI and this study describe their clinical and neuropsychological profile. Older adults aged 60 years & above seeking help at NIMHANS outpatient & community services were screened for early cognitive deficits.

Worldwide Survey of the "Assessing Pain, Both Spontaneous Awakening and Breathing Trials, Choice of Drugs, Delirium Monitoring/Management, Early Exercise/Mobility, and Family Empowerment" (ABCDEF) Bundle.

Objectives: To assess the knowledge and use of the Assessment, prevention, and management of pain; spontaneous awakening and breathing trials; Choice of analgesia and sedation; Delirium assessment; Early mobility and exercise; and Family engagement and empowerment (ABCDEF) bundle to implement the Pain, Agitation, Delirium guidelines.

Design: Worldwide online survey.

Setting: Intensive care.

Associations of CAIDE Dementia Risk Score with MRI, PIB-PET measures, and cognition.

Background: CAIDE Dementia Risk Score is the first validated tool for estimating dementia risk based on a midlife risk profile.

Objectives: This observational study investigated longitudinal associations of CAIDE Dementia Risk Score with brain MRI, amyloid burden evaluated with PIB-PET, and detailed cognition measures.

Methods: FINGER participants were at-risk elderly without dementia.