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Alzheimer's Dementia Sleep

James E McKinley, Allen Perkins
Parkinson disease (PD) is a complex neurologic disorder that involves motor and nonmotor brain functions. PD is the second most common neurodegenerative disease after Alzheimer disease. Motor symptoms include resting tremor, cogwheel rigidity, extreme slowness of movement, shuffling gait, and impaired balance. Swallowing and speaking difficulties also are common. Nonmotor symptoms include depression, hallucinations, and sleep disturbances that seriously affect quality of life. There is no cure for PD but management of motor and nonmotor symptoms can improve quality of life...
February 2019: FP Essentials
Luca Carnicelli, Michelangelo Maestri, Elisa Di Coscio, Gloria Tognoni, Monica Fabbrini, Alessandro Schirru, Filippo S Giorgi, Gabriele Siciliano, Ubaldo Bonuccelli, Enrica Bonanni
The main condition at increased risk of dementia is considered to be mild cognitive impairment. Mild cognitive impairment has been defined as a transitional state between normal aging and dementia, of which it may represent a prodrome. The aim of our study was to evaluate whether sleep variables (both conventional and microstructural ones) in subjects with mild cognitive impairment correlate with conversion to dementia. Nineteen subjects with amnestic mild cognitive impairment (mean age 68.5 ± 7.0 years) and 11 cognitively intact healthy elderly individuals (mean age 69...
February 6, 2019: Journal of Sleep Research
Kathy C Richards, Nalaka Gooneratne, Barry Dicicco, Alexandra Hanlon, Stephen Moelter, Fannie Onen, Yanyan Wang, Amy Sawyer, Terri Weaver, Alicia Lozano, Patricia Carter, Jerry Johnson
BACKGROUND/OBJECTIVES: Obstructive sleep apnea (OSA) has been linked to an increased risk for Alzheimer's disease (AD), but little prospective evidence exists on the effects of OSA treatment in preclinical AD. The objective was to determine if continuous positive airway pressure (CPAP) treatment adherence, controlling for baseline differences, predicts cognitive and everyday function after 1 year in older adults with mild cognitive impairment (MCI) and to determine effect sizes for a larger trial...
February 6, 2019: Journal of the American Geriatrics Society
Rory Durcan, Paul Donaghy, Curtis Osborne, John-Paul Taylor, Alan J Thomas
OBJECTIVES: The aim of this review was to provide an overview of the literature on imaging in prodromal Dementia with Lewy bodies (DLB). DESIGN: Systematic PubMed search and literature review. RESULTS: Diagnostic classification of the prodromal DLB stage remains to be established but is likely to require imaging biomarkers to improve diagnostic accuracy. In subjects with mild cognitive impairment with Lewy body disease (MCI-LB) (here synonymous with prodromal DLB) and REM sleep behaviour disorder, a high risk condition for future conversion to a synucleinopathy, imaging modalities have assessed early structural brain changes, striatal dopaminergic integrity, metabolic brain and cerebral perfusion alterations...
February 3, 2019: International Journal of Geriatric Psychiatry
Gil D Rabinovici
PURPOSE OF REVIEW: Alzheimer disease (AD) is the most common cause of late-onset dementia. This article describes the epidemiology, genetic and environmental risk factors, clinical diagnosis, biomarkers, and treatment of late-onset AD, defined by age of onset of 65 years or older. RECENT FINDINGS: An estimated 5.7 million Americans are living with AD dementia, with the number of affected individuals growing rapidly because of an aging population. Vascular risk factors, sleep disorders, and traumatic brain injury are associated with an increased risk of AD, while increased cognitive and physical activity throughout the lifespan reduce the risk of disease...
February 2019: Continuum: Lifelong Learning in Neurology
Alice L La, Christine M Walsh, Thomas C Neylan, Keith A Vossel, Kristine Yaffe, Andrew D Krystal, Bruce L Miller, Elissaios Karageorgiou
BACKGROUND: Recent studies reveal an association between slow-wave sleep (SWS), amyloid-β aggregation, and cognition. OBJECTIVE: This retrospective study examines whether long-term use of trazodone, an SWS enhancer, is associated with delayed cognitive decline. METHODS: We identified 25 regular trazodone users (mean age 75.4±7.5; 9 women, 16 men) who carried a diagnosis of Alzheimer's dementia, mild cognitive impairment, or normal cognition, and 25 propensity-matched trazodone non-users (mean age 74...
January 22, 2019: Journal of Alzheimer's Disease: JAD
Yosuke Aiba, Ryuji Sakakibara, Tsuyoshi Ogata, Ayako Iimura, Keiichiro Terayama, Keiko Suzuki, Shuichi Katsuragawa, Yuuki Kato, Fuyuki Tateno, Hitoshi Terada, Tsutomu Inaoka, Tomoya Nakatsuka
Young-onset (< 65 years) dementia is a challenging clinical problem. A 61-year-old man visited our clinic because of a 2-year history of mild cognitive impairment of the executive disorder type. He was initially suspected of having young-onset Alzheimer's disease due to the lack of motor signs or hippocampal atrophy by conventional brain MRI. However, he proved to have anosmia, erectile dysfunction, hypersexuality, constipation, REM sleep behavior disorder, and emotional lability; imaging findings included positive brain perfusion SPECT, nigrosome MRI, DAT scan, and MIBG myocardial scintigraphy...
September 2018: Case Reports in Neurology
Linda A Hershey, Rhonda Coleman-Jackson
Dementia with Lewy bodies (DLB) is a complex disease that involves a variety of cognitive, behavioral and neurological symptoms, including progressive memory loss, visual hallucinations, parkinsonism, cognitive fluctuations and rapid eye movement sleep behavior disorder (RBD). These symptoms may appear in varying combinations and levels of severity in each patient who is seen in the clinic, making diagnosis and treatment a challenge. DLB is the third most common of all the neurodegenerative diseases behind both Alzheimer's disease and Parkinson's disease (PD)...
January 25, 2019: Drugs & Aging
Michael R Irwin, Michael V Vitiello
Nearly half of all adults older than 60 years of age report sleep disturbance, as characterised either by reports of insomnia complaints with daytime consequences, dissatisfaction with sleep quality or quantity, or the diagnosis of insomnia disorder. Accumulating evidence shows that sleep disturbance contributes to cognitive decline and might also increase the risk of Alzheimer's disease dementia by increasing β-amyloid burden. That sleep disturbance would be a candidate risk factor for Alzheimer's disease might seem surprising, given that disturbed sleep is usually considered a consequence of Alzheimer's disease...
January 17, 2019: Lancet Neurology
Eduardo De Pablo-Fernández, Andrew J Lees, Janice L Holton, Thomas T Warner
Importance: Clinical subtyping of Parkinson disease at diagnosis is useful in estimating disease course and survival. Severity and rate of progression of neuropathologies are important determinants of clinical Parkinson subtypes. Objective: To provide longitudinal clinical disease-course data and neuropathologic correlation for newly proposed Parkinson disease subtypes. Design, Setting, and Participants: Retrospective cohort study of consecutive patients with autopsy-confirmed Parkinson disease who were regularly seen throughout their disease course by hospital specialists in the United Kingdom and donated their brain at death to the Queen Square Brain Bank between January 2009 and December 2017...
January 14, 2019: JAMA Neurology
Oliver Cousins, Tayyabah Yousaf, Heather Wilson, Gennaro Pagano, Marios Politis
Dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia. The core clinical features of DLB include fluctuating cognition, visual hallucinations, rapid eye movement sleep behavior disorder, and parkinsonism. Molecular imaging is a powerful tool to assess the brain function in vivo. In this chapter, we reviewed the positron emission tomography, single-photon emission computed tomography, and [123 I]-metaiodobenzylguanidine scintigraphy studies evaluating the pathological processes underlying DLB, including altered brain metabolism and neurotransmitter pathways, abnormal protein aggregation, and neuroinflammation...
2019: International Review of Neurobiology
Daniel J Levendowski, Charlene Gamaldo, Erik K St Louis, Luigi Ferini-Strambi, Joanne M Hamilton, David Salat, Philip Westbrook, Chris Berka
BACKGROUND: The characterization of sleep in those with neurodegenerative disease (NDD) is essential in understanding the potential neurobiological mechanisms that underlie the connection between sleep disruption and NDD manifestations and progression. OBJECTIVE: Explore the inter-relationships between NDD and age, sex, diagnosis of obstructive sleep apnea, snoring, and duration of sleep time with the head in the supine and non-supine positions. METHODS: A case-control design was used to evaluate differences in sleep position obtained from multi-night, in-home Sleep Profiler recordings in 45 patients with diagnosed NDD (24 with mild cognitive impairment, 15 with Alzheimer's disease, and 6 with Lewy Body, Parkinson's, or other dementias) and 120 age-sex matched controls with normal cognition (NC)...
December 31, 2018: Journal of Alzheimer's Disease: JAD
Yo-El S Ju, Margaret A Zangrilli, Mary Beth Finn, Anne M Fagan, David M Holtzman
Obstructive sleep apnea (OSA) increases risk of dementia, a relationship that may be mediated by amyloid-beta (Aβ) and downstream Alzheimer's Disease pathology. We previously showed OSA may impair Aβ clearance and affect the relationship between slow wave activity (SWA) and Aβ. In this study, SWA and CSF Aβ were measured in participants with OSA before and 1-4 months after treatment. OSA treatment increased SWA, and SWA was significantly correlated with lower Aβ after treatment. Greater improvement in OSA was associated with greater decreases in Aβ...
December 31, 2018: Annals of Neurology
Bushra Elhusein, Ahmed Radwan, Abdalla Khairi, Mohamed Ahmed
We present the case of a 34-year-old Jordanian woman who was referred to mainstream mental health services because of irritability, agitation, loss of appetite, withdrawal from family activities and sleeping difficulties. She was initially diagnosed with major depressive disorder but subsequently showed very poor response to antidepressant therapy. Her presentation gradually and dramatically progressed into full blown dementia within couple of years. Brain MRI showed atrophic cortical changes and subcortical white matter alterations consistent with Alzheimer's dementia...
December 3, 2018: BMJ Case Reports
Teresa Macheda, Kelly Roberts, Danielle N Lyons, Emma Higgins, Kyle J Ritter, Ai-Ling Lin, Warren J Alilain, Adam D Bachstetter
Sleep disturbances are a common early symptom of neurodegenerative diseases, including Alzheimer's disease (AD) and other age-related dementias, and emerging evidence suggests that poor sleep may be an important contributor to development of amyloid pathology. Of the causes of sleep disturbances, it is estimated that 10-20% of adults in the United States have sleep-disordered breathing (SDB) disorder, with obstructive sleep apnea accounting for the majority of the SBD cases. The clinical and epidemiological data clearly support a link between sleep apnea and AD; yet, almost no experimental research is available exploring the mechanisms associated with this correlative link...
December 7, 2018: Neuroscience
Leonie C P Banning, Inez H G B Ramakers, Kay Deckers, Frans R J Verhey, Pauline Aalten
OBJECTIVE: APOE status has been associated to affective symptoms in cognitively impaired subjects, with conflicting results. METHODS: Databases CINAHL, Embase, PsychINFO and PubMed were searched for studies evaluating APOE genotype with affective symptoms in MCI and AD dementia. Symptoms were meta-analyzed separately and possible sources of heterogeneity were examined. RESULTS: Fifty-three abstracts fulfilled the eligibility criteria. No association was found between the individual symptoms and APOE ε4 carriership or zygosity...
January 2019: Neuroscience and Biobehavioral Reviews
Nienke Legdeur, Maryam Badissi, Stephen F Carter, Sophie de Crom, Aleid van de Kreeke, Ralph Vreeswijk, Marijke C Trappenburg, Mardien L Oudega, Huiberdina L Koek, Jos P van Campen, Carolina J P W Keijsers, Chinenye Amadi, Rainer Hinz, Mark F Gordon, Gerald Novak, Jana Podhorna, Erik Serné, Frank Verbraak, Maqsood Yaqub, Arjan Hillebrand, Alessandra Griffa, Neil Pendleton, Sophia E Kramer, Charlotte E Teunissen, Adriaan Lammertsma, Frederik Barkhof, Bart N M van Berckel, Philip Scheltens, Majon Muller, Andrea B Maier, Karl Herholz, Pieter Jelle Visser
BACKGROUND: The oldest-old (subjects aged 90 years and older) population represents the fastest growing segment of society and shows a high dementia prevalence rate of up to 40%. Only a few studies have investigated protective factors for cognitive impairment in the oldest-old. The EMIF-AD 90+ Study aims to identify factors associated with resilience to cognitive impairment in the oldest-old. In this paper we reviewed previous studies on cognitive resilience in the oldest-old and described the design of the EMIF-AD 90+ Study...
November 26, 2018: BMC Geriatrics
Gemma Lombardi, Cristina Polito, Valentina Berti, Silvia Bagnoli, Benedetta Nacmias, Alberto Pupi, Sandro Sorbi
Bilingualism is an independent component of cognitive reserve that permits to delay dementia onset up to 5 years. We describe a case of a bilingual Italian man affected by mild cognitive impairment with high cognitive reserve that, despite the presence of multiple risk factors (ApoE ɛ4/ɛ4 genotype, older age, untreated Obstructive Sleep Apnea Syndrome, AD-like biomarker alterations) did not convert to Alzheimer's disease up to 5 years follow-up. The present case confirms the role of bilingualism as a strong protective factor for dementia, even in the occurrence of multiple risk factors...
November 17, 2018: Journal of Alzheimer's Disease: JAD
Kristine Yaffe, Deborah E Barnes, Dori Rosenberg, Sascha Dublin, Allison R Kaup, Evette J Ludman, Eric Vittinghoff, Carrie B Peltz, Anne D Renz, Kristin J Adams, Eric B Larson
This article describes the protocol for the Systematic Multi-domain Alzheimer's Risk Reduction Trial (SMARRT), a single-blind randomized pilot trial to test a personalized, pragmatic, multi-domain Alzheimer's disease (AD) risk reduction intervention in a US integrated healthcare delivery system. Study participants will be 200 higher-risk older adults (age 70-89 years with subjective cognitive complaints, low normal performance on cognitive screen, and ≥ two modifiable risk factors targeted by our intervention) who will be recruited from selected primary care clinics of Kaiser Permanente Washington, oversampling people with non-white race or Hispanic ethnicity...
November 23, 2018: Journal of Alzheimer's Disease: JAD
Yoko Higami, Miyae Yamakawa, Kazue Shigenobu, Kei Kamide, Kiyoko Makimoto
AIM: Sleep disturbances in patients with Alzheimer's disease have not been systematically evaluated, because sleep monitoring has proved difficult. Our goal was to quantitatively characterize sleep disturbances in patients with Alzheimer's disease. METHODS: The present study was a cross-sectional descriptive study, carried out in dementia care units in Japan. Participants were 63 patients with Alzheimer's disease (mean age 77.6 ± 8.0 years) with severe behavioral and psychological symptoms of dementia...
November 21, 2018: Geriatrics & Gerontology International
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