Medicine and Health Sciences Commons^™

The Alzheimer’S Association Dementia Care Coordination Program: A Process Evaluation, Executive Summary, Nina Silverstein, Frank Porell, Pamela Nadash

Nina Silverstein

The Massachusetts/New Hampshire (MA/NH) Chapter of the Alzheimer's Association has long sought ways to systematically increase the number of families who utilize its services and support. According to the Alzheimer’s Association’s 2015 Alzheimer’s Disease Facts and Figures, there are 142,000 individuals living with Alzheimer’s disease in Massachusetts and New Hampshire, and the Alzheimer’s Association estimates that less than 30% of those individuals and their caregivers take advantage of its programs (Alzheimer’s Association, 2015). The MA/NH Chapter recognized that one major barrier to accessing services is a model that relies on families taking the initiative to seek out assistance.

In …

The Search For A Coherent Language: The Science And Politics Of Drug Testing And Approval, Jason Karlawish

Jason Karlawish

No abstract provided.

Older Adults’ Attitudes Toward Enrollment Of Noncompetent Subjects Participating In Alzheimer’S Research, Jason Karlawish, Jonathan Rubright, David Casarett, Mark Cary, Thomas Ten Have, Pamela Sankar

Jason Karlawish

OBJECTIVE: Research that seeks to enroll noncompetent patients with Alzheimer’s disease without presenting any potential benefit to participants is the source of substantial ethical controversy. The authors used hypothetical Alzheimer’s disease studies that included either a blood draw or a blood draw and lumbar puncture to explore older persons’ attitudes on this question. METHOD: Face-to-face interviews were conducted with 538 persons age 65 and older. Questions explored participants’ understanding of research concepts, their views on enrolling persons with Alzheimer’s disease in research, and their preferences regarding having a proxy decision maker, granting advance consent, and granting their proxy leeway to …

Receiving While Giving: The Differential Roles Of Receiving Help And Satisfaction With Help On Caregiver Rewards Among Spouses And Adult-Children., Marie Y. Savundranayagam

Marie Y. Savundranayagam

Homocysteine, Vitamin B12, And Folic Acid Levels In Alzheimer's Disease, Mild Cognitive Impairment, And Healthy Elderly: Baseline Characteristics In Subjects Of The Australian Imaging Biomarker Lifestyle Study., Noel Faux, Kathryn Ellis, Lorine Porter, Chris Fowler, Simon Laws, Ralph Martins, Kelly Pertile, Alan Rembach, Chris Rowe, Rebecca Rumble, Cassandra Szoeke, Kevin Taddei, Tania Taddei, Brett Trounson, Victor Villemagne, Vanessa Ward, David Ames, Colin Masters, Ashley Bush

Simon Laws

There is some debate regarding the differing levels of plasma homocysteine, vitamin B12 and serum folate between healthy controls (HC), mild cognitive impairment (MCI), and Alzheimer's disease (AD). As part of the Australian Imaging Biomarker Lifestyle (AIBL) study of aging cohort, consisting of 1,112 participants (768 HC, 133 MCI patients, and 211 AD patients), plasma homocysteine, vitamin B12, and serum and red cell folate were measured at baseline to investigate their levels, their inter-associations, and their relationships with cognition. The results of this cross-sectional study showed that homocysteine levels were increased in female AD patients compared to female HC subjects …

Olfactory Dysfunction Is Associated With Subjective Memory Complaints In Community-Dwelling Elderly Individuals, Hamid Sohrabi, Kristyn Bates, Mark Rodrigues, Kevin Taddei, Simon Laws, Nicola Lautenschlager, Satvinder Dhaliwal, Amy Johnston, Alan Mackay-Sim, Samuel Gandy, Jonathan Foster, Ralph Martins

Simon Laws

Olfactory dysfunction has been reported in clinical and preclinical phases of Alzheimer's disease. Subjective memory complaints have been proposed as a potential early indicator for increased risk of Alzheimer's disease, but have also been associated with depression, personality characteristics, and health problems. In this study, we aimed to determine which of these putative markers can predict memory complaints in community-dwelling elderly individuals, focusing on olfactory symptoms. A cohort of 144 elderly volunteers (42 males and 102 females), aged 50 to 86, was recruited from an ongoing longitudinal study. Participants were assessed for olfactory capacities (threshold, discrimination, and identification), subjective memory …

Plasma Amyloid-Β As A Biomarker In Alzheimer's Disease: The Aibl Study Of Aging , James Lui, Simon Laws, Qiao-Xin Li, Victor Villemagne, David Ames, Belinda Brown, Ashley Bush, Karl De Ruyck, Jasmin Dromey, Kathryn Ellis, Noel Faux, Jonathan Foster, Christopher Fowler, Veer Gupta, Peter Hudson, Katrina Laughton, Colin Masters, Kelly Pertile, Alan Rembach, Miroslava Rimajova, Mark Rodrigues, Christopher Rowe, Rebecca Rumble, Cassandra Szoecke, Kevin Taddei, Tania Taddei, Brett Trounson, Vanessa Ward

Simon Laws

Amyloid-β (Aβ) plays a central role in the pathogenesis of Alzheimer's disease (AD) and has been postulated as a potential biomarker for AD. However, there is a lack of consensus as to its suitability as an AD biomarker. The objective of this study was to determine the significance of plasma Aβ as an AD biomarker and its relationship with Aβ load and to determine the effect of different assay methods on the interpretation of Aβ levels. Plasma Aβ1-40, Aβ1-42, and N-terminal cleaved fragments were measured using both a commercial multiplex assay and a well-documented ELISA in 1032 individuals drawn from …

The Relationship Between Memory Complaints, Perceived Quality Of Life And Mental Health In Apolipoprotein Eepsilon4 Carriers And Non-Carriers, Hamid Sohrabi, Kristyn Bates, Mark Rodrigues, Kevin Taddei, Georgia Martins, Simon Laws, Nicola Lautenschlager, Satvinder Dhaliwal, Jonathan Foster, Ralph Martins

Simon Laws

Apolipoprotein E ε4 (APOE-ε4) is a major genetic risk factor for Alzheimer's disease. In this study, we addressed the question of whether possession of the APOE-ε4 allele results in adverse effects on perceived health-related quality of life (HRQL) and on symptoms of depression and anxiety in people with subjective memory complaints (SMC). 138 healthy, community-dwelling elderly volunteers, aged 52 to 85, were assessed for HRQL, depression, and anxiety. The participants were classified as i) APOE-ε4 carriers or ii) non-carriers with a) SMC or b) without memory complaints. The possible interactions of APOE genotype, gender, and SMC on HRQL, depression, and …

Site-Directed Mutations In The C-Terminal Extension Of Human Αb-Crystallin Affect Chaperone Function And Block Amyloid Fibril Formation, T. M. Treweek, Heath Ecroyd, D. M. Williams, S. Meehan, J. A. Carver, M. J. Walker

Heath Ecroyd

Alzheimer’s, Parkinson’s and Creutzfeldt-Jakob disease are associated with inappropriate protein deposition and ordered amyloid fibril assembly. Molecular chaperones, including αBcrystallin, play a role in the prevention of protein deposition. A series of site-directed mutants of the human molecular chaperone, αB-crystallin, were constructed which focused on the flexible C-terminal extension of the protein. We investigated the structural role of this region as well as its role in the chaperone function of αB-crystallin under different types of protein aggregation, i.e. disordered amorphous aggregation and ordered amyloid fibril assembly. It was found that mutation of lysine and glutamic acid residues in the C-terminal …

Community Mobility And Dementia: A Review Of The Literature, Nina M. Silverstein, Megan Vanderbur

Nina Silverstein

By the year 2030, 70 million Americans will be 65 or older. Approximately 80 percent of this population will likely be driving themselves. And without appropriate and timely interventions, many are likely to be driving with Alzheimer’s disease (AD). Current estimates suggest that 2 percent of the population 65 to 74, 19 percent of the population 75 to 84, and 47 percent of the population 85 and older are likely to suffer from Alzheimer’s disease or a related disorder. By the year 2050, the number of Americans with Alzheimer’s disease could range from 11.3 million to 16 million. This significant …

Relationships Between Appraisals Of Caregiver Communication Strategies And Burden Among Spouses And Adult-Children, Marie Savundranayagam, J. Orange

Marie Y Savundranayagam

Background: The purpose of this study was to investigate the impact of caregivers’ appraisals of the effectiveness of their own communication strategies on caregiver burden when caring for family members with Alzheimer's disease (AD).

Methods: Family caregivers (N = 84) of participants with AD completed questionnaires appraising communication strategies, problem behaviors, and levels of three types of burden.

Results: Hierarchical linear regression models revealed that effective strategies and kinship status were significantly linked with stress burden, whereas effective strategies and problem behaviors were significantly related to relationship burden. Cognitive status of participants with AD significantly predicted objective burden. Caregivers who …

Testing Self-Efficacy As A Pathway That Supports Self Care Among Family Caregivers In A Psychoeducational Intervention, Marie Savundranayagam, M. Brintnall-Peterson

Marie Y Savundranayagam

This study investigated the extent to which a psychoeducational intervention supports family-centered care by influencing health risk and self-care behaviors of caregivers of individuals with Alzheimer's disease (N = 325). Moreover, this study investigated the extent to which changes in self-efficacy explained changes in health risk and self-care behaviors. Data were analyzed using repeated measures and multivariate analysis of variance and multiple regression. Qualitative written accounts of the impact of the intervention augmented the quantitative findings. The study's findings revealed that family caregivers experienced reductions in health risk behaviors and improvements in exercise, stress management, and relaxation activities as a …

Early Identification And Treatment Of Alzheimer’S Disease: Social And Fiscal Outcomes, David Weimer, Mark Sager

David L Weimer

Alzheimer's disease (AD) is a progressive neurodegenerative disease that places substantial burdens on those who provide support for family members with declining cognitive and functional abilities. Many AD patients eventually require formal long-term care services because of the absence, exhaustion, or inability of family members to provide care. The costs of long-term care, and especially nursing home care, often deplete private financial resources, placing a substantial burden on state Medicaid programs. Current evidence suggests that pharmacological treatments and caregiver interventions can delay entry into nursing homes and potentially reduce Medicaid costs. However, these cost savings are not being realized because …

Worldwide Variation In The Doubling Time Of Alzheimer's Disease Incidence Rates, Kathryn Ziegler-Graham, Ron Brookmeyer, Elizabeth Johnson, H. Michael Arrighi

Ron Brookmeyer

Background The doubling time is the number of chronological years for the age-specific incidence rate to double in magnitude. Doubling times describe the rate of increase of the risk of Alzheimer's disease (AD) with advancing age. Estimates of doubling times of AD assist in understanding disease etiology and forecasting future disease prevalence. The objective of this study was to investigate regional and gender differences in the doubling of AD age-specific incidence rates.

Methods We identified all studies in the peer review literature that reported age-specific incidence rates for AD. We modeled the logarithm of the incidence rate as a linear …

High-Field 19.6 T 27Al Solid-State Mas Nmr Of In Vitro Aluminated Brain Tissue, Pamela L. Bryant, Walter J. Lukiw, Zhehong Gan, Randall W. Hall, Leslie G. Butler

Randall W. Hall