BioMed Research International: Geriatrics The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. PTEN Mediates the Antioxidant Effect of Resveratrol at Nutritionally Relevant Concentrations Thu, 10 Apr 2014 00:00:00 +0000 Introduction. Antioxidant properties of resveratrol have been intensively studied for the last years, both in vivo and in vitro. Its bioavailability after an oral dose is very low and therefore it is very important to make sure that plasma concentrations of free resveratrol are sufficient enough to be active as antioxidant. Aims. In the present study, using nutritionally relevant concentrations of resveratrol, we aim to confirm its antioxidant capacity on reducing peroxide levels and look for the molecular pathway involved in this antioxidant effect. Methods. We used mammary gland tumor cells (MCF-7), which were pretreated with different concentrations of resveratrol for 48 h, and/or a PTEN inhibitor (bpV: bipy). Hydrogen peroxide levels were determined by fluorimetry, PTEN levels and Akt phosphorylation by Western Blotting, and mRNA expression of antioxidant genes by real-time reverse transcriptase-polymerase chain reaction (RT-PCR). Results. Resveratrol treatment for 48 h lowered peroxide levels in MCF-7, even at low nutritional concentrations (1 nM). This effect was mediated by the activation of PTEN/Akt pathway, which resulted in an upregulation of catalase and MnSOD mRNA levels. Conclusion. Resveratrol acts as an antioxidant at nutritionally relevant concentrations by inducing the expression of antioxidant enzymes, through a mechanism involving PTEN/Akt signaling pathway. Marta Inglés, Juan Gambini, M. Graça Miguel, Vicent Bonet-Costa, Kheira M. Abdelaziz, Marya El Alami, Jose Viña, and Consuelo Borrás Copyright © 2014 Marta Inglés et al. All rights reserved. Biology of Ageing and Role of Dietary Antioxidants Thu, 03 Apr 2014 11:40:13 +0000 Interest in relationship between diet and ageing is growing. Research has shown that dietary calorie restriction and some antioxidants extend lifespan in various ageing models. On the one hand, oxygen is essential to aerobic organisms because it is a final electron acceptor in mitochondria. On the other hand, oxygen is harmful because it can continuously generate reactive oxygen species (ROS), which are believed to be the factors causing ageing of an organism. To remove these ROS in cells, aerobic organisms possess an antioxidant defense system which consists of a series of enzymes, namely, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and glutathione reductase (GR). In addition, dietary antioxidants including ascorbic acid, vitamin A, vitamin C, α-tocopherol, and plant flavonoids are also able to scavenge ROS in cells and therefore theoretically can extend the lifespan of organisms. In this connection, various antioxidants including tea catechins, theaflavins, apple polyphenols, black rice anthocyanins, and blueberry polyphenols have been shown to be capable of extending the lifespan of fruit flies. The purpose of this review is to brief the literature on modern biological theories of ageing and role of dietary antioxidants in ageing as well as underlying mechanisms by which antioxidants can prolong the lifespan with focus on fruit flies as an model. Cheng Peng, Xiaobo Wang, Jingnan Chen, Rui Jiao, Lijun Wang, Yuk Man Li, Yuanyuan Zuo, Yuwei Liu, Lin Lei, Ka Ying Ma, Yu Huang, and Zhen-Yu Chen Copyright © 2014 Cheng Peng et al. All rights reserved. Inhibitory Effects of Edaravone in β-Amyloid-Induced Neurotoxicity in Rats Wed, 02 Apr 2014 13:22:30 +0000 Amyloid protein can damage nerve cells through a variety of biological mechanisms including oxidative stress, alterations in calcium homeostasis, and proapoptosis. Edaravone, a potent free radical scavenger possessing antioxidant effects, has been proved neuroprotective effect in stroke patients. The current study aimed to investigate the effects of EDA in an Aβ-induced rat model of AD, by studying Aβ1–40-induced voltage-gated calcium channel currents in hippocampal CA1 pyramidal neurons, learning and memory behavioral tests, the number of surviving cholinergic neurons in the basal forebrain, and the acetylcholine level in the hippocampus in this rat model of AD. The results showed that the Aβ1–40-induced increase of can be inhibited by EDA in a dose-dependent manner. Treatment with EDA significantly improved Aβ1–40-induced learning and memory performance. Choline acetyltransferase positive cells in basal forebrain and acetylcholine content in the hippocampus were increased by the administration of EDA as compared with the non-EDA treated Aβ1–40 group. These results demonstrate that EDA can inhibit the neurotoxic effect of Aβ toxicity. Collectively, these findings suggest that EDA may serve as a potential complemental treatment strategy for AD. Feng He, Yan-Ping Cao, Feng-Yuan Che, Lian-Hong Yang, Song-Hua Xiao, and Jun Liu Copyright © 2014 Feng He et al. All rights reserved. Impairment in Preattentive Processing among Patients with Hypertension Revealed by Visual Mismatch Negativity Wed, 26 Mar 2014 10:12:43 +0000 Objective. Patients with hypertension show deficits in cognitive function. However, the neural mechanisms underlying the preattentive information processing in hypertensive patients are poorly understood. We seek to investigate whether hypertensive patients have impairments in preattentive information processing. Methods. We compared visual mismatch negativity (vMMN) between 15 hypertensive patients and 15 age-matched healthy controls, which was elicited by the change of visual duration randomly presented in both peripheral visual fields. In addition, the global cognitive function for all participants was assessed with Mini-Mental State Examination (MMSE). Results. The vMMN in deviant-standard comparison was observed at occipital-temporal regions. Compared with normal healthy controls, the amplitude of vMMN was significantly decreased in hypertensive patients (). Meanwhile, the vMMN peak latency was delayed in the hypertensive group (). However, the MMSE scores of patients with hypertension were not significantly different from those of controls (), and there was no significant correlation between the mean amplitude of vMMN and SBP, DBP, and MMSE in hypertensive individuals, respectively. Conclusions. These data indicate dysfunction of automatically change detection processing in patients with hypertension. Moreover, the changes of vMMN provide a more objective and reliable assessment for cognitive impairment in hypertensive patients. Cuiping Si, Changjie Ren, Peng Wang, Hetao Bian, Haiming Wang, and Zhongrui Yan Copyright © 2014 Cuiping Si et al. All rights reserved. Effect of Antioxidants Supplementation on Aging and Longevity Tue, 25 Mar 2014 13:47:38 +0000 If aging is due to or contributed by free radical reactions, as postulated by the free radical theory of aging, lifespan of organisms should be extended by administration of exogenous antioxidants. This paper reviews data on model organisms concerning the effects of exogenous antioxidants (antioxidant vitamins, lipoic acid, coenzyme Q, melatonin, resveratrol, curcumin, other polyphenols, and synthetic antioxidants including antioxidant nanoparticles) on the lifespan of model organisms. Mechanisms of effects of antioxidants, often due to indirect antioxidant action or to action not related to the antioxidant properties of the compounds administered, are discussed. The legitimacy of antioxidant supplementation in human is considered. Izabela Sadowska-Bartosz and Grzegorz Bartosz Copyright © 2014 Izabela Sadowska-Bartosz and Grzegorz Bartosz. All rights reserved. Estimating Glomerular Filtration Rate in Older People Thu, 20 Mar 2014 10:00:21 +0000 We aimed at reviewing age-related changes in kidney structure and function, methods for estimating kidney function, and impact of reduced kidney function on geriatric outcomes, as well as the reliability and applicability of equations for estimating glomerular filtration rate (eGFR) in older patients. CKD is associated with different comorbidities and adverse outcomes such as disability and premature death in older populations. Creatinine clearance and other methods for estimating kidney function are not easy to apply in older subjects. Thus, an accurate and reliable method for calculating eGFR would be highly desirable for early detection and management of CKD in this vulnerable population. Equations based on serum creatinine, age, race, and gender have been widely used. However, these equations have their own limitations, and no equation seems better than the other ones in older people. New equations specifically developed for use in older populations, especially those based on serum cystatin C, hold promises. However, further studies are needed to definitely accept them as the reference method to estimate kidney function in older patients in the clinical setting. Sabrina Garasto, Sergio Fusco, Francesco Corica, Maria Rosignuolo, Antonio Marino, Alberto Montesanto, Francesco De Rango, Marcello Maggio, Vincenzo Mari, Andrea Corsonello, and Fabrizia Lattanzio Copyright © 2014 Sabrina Garasto et al. All rights reserved. Catechol-O-methyltransferase (COMT) Genotype Affects Age-Related Changes in Plasticity in Working Memory: A Pilot Study Wed, 19 Mar 2014 07:50:48 +0000 Objectives. Recent work suggests that a genetic variation associated with increased dopamine metabolism in the prefrontal cortex (catechol-O-methyltransferase Val158Met; COMT) amplifies age-related changes in working memory performance. Research on younger adults indicates that the influence of dopamine-related genetic polymorphisms on working memory performance increases when testing the cognitive limits through training. To date, this has not been studied in older adults. Method. Here we investigate the effect of COMT genotype on plasticity in working memory in a sample of 14 younger (aged 24–30 years) and 25 older (aged 60–75 years) healthy adults. Participants underwent adaptive training in the -back working memory task over 12 sessions under increasing difficulty conditions. Results. Both younger and older adults exhibited sizeable behavioral plasticity through training (), which was larger in younger as compared to older adults (). Age-related differences were qualified by an interaction with COMT genotype (), and this interaction was due to decreased behavioral plasticity in older adults carrying the Val/Val genotype, while there was no effect of genotype in younger adults. Discussion. Our findings indicate that age-related changes in plasticity in working memory are critically affected by genetic variation in prefrontal dopamine metabolism. Stephan Heinzel, Thomas G. Riemer, Stefanie Schulte, Johanna Onken, Andreas Heinz, and Michael A. Rapp Copyright © 2014 Stephan Heinzel et al. All rights reserved. Hypoglycemia Is Independently Associated with Multidimensional Impairment in Elderly Diabetic Patients Thu, 13 Feb 2014 11:53:57 +0000 Aim. To identify the characteristics associated with multidimensional impairment, evaluated through the Multidimensional Prognostic Index (MPI), a validated predictive tool for mortality derived from a standardized Comprehensive Geriatric Assessment (CGA), in a cohort of elderly diabetic patients treated with oral hypoglycemic drugs. Methods and Results. The study population consisted of 1342 diabetic patients consecutively enrolled in 57 diabetes centers distributed throughout Italy, within the Metabolic Study. Inclusion criteria were diagnosis of type 2 diabetes mellitus (DM), 65 years old or over, and treatment with oral antidiabetic medications. Data concerning DM duration, medications for DM taken during the 3-month period before inclusion in the study, number of hypoglycemic events, and complications of DM were collected. Multidimensional impairment was assessed using the MPI evaluating functional, cognitive, and nutritional status; risk of pressure sores; comorbidity; number of drugs taken; and cohabitation status. The mean age of participants was 73.3 ± 5.5 years, and the mean MPI score was 0.22 ± 0.13. Multivariate analysis showed that advanced age, female gender, hypoglycemic events, and hospitalization for glycemic decompensation were independently associated with a worse MPI score. Conclusion. Stratification of elderly diabetic patients using the MPI might help to identify those patients at highest risk who need better-tailored treatment. A. Pilotto, M. Noale, S. Maggi, F. Addante, A. Tiengo, P. Cavallo Perin, G. Rengo, and G. Crepaldi Copyright © 2014 A. Pilotto et al. All rights reserved. Factors Determining Disease Duration in Alzheimer’s Disease: A Postmortem Study of 103 Cases Using the Kaplan-Meier Estimator and Cox Regression Wed, 22 Jan 2014 16:59:24 +0000 Factors associated with duration of dementia in a consecutive series of 103 Alzheimer’s disease (AD) cases were studied using the Kaplan-Meier estimator and Cox regression analysis (proportional hazard model). Mean disease duration was 7.1 years (range: 6 weeks–30 years, standard deviation = 5.18); 25% of cases died within four years, 50% within 6.9 years, and 75% within 10 years. Familial AD cases (FAD) had a longer duration than sporadic cases (SAD), especially cases linked to presenilin (PSEN) genes. No significant differences in duration were associated with age, sex, or apolipoprotein E (Apo E) genotype. Duration was reduced in cases with arterial hypertension. Cox regression analysis suggested longer duration was associated with an earlier disease onset and increased senile plaque (SP) and neurofibrillary tangle (NFT) pathology in the orbital gyrus (OrG), CA1 sector of the hippocampus, and nucleus basalis of Meynert (NBM). The data suggest shorter disease duration in SAD and in cases with hypertensive comorbidity. In addition, degree of neuropathology did not influence survival, but spread of SP/NFT pathology into the frontal lobe, hippocampus, and basal forebrain was associated with longer disease duration. R. A. Armstrong Copyright © 2014 R. A. Armstrong. All rights reserved. Arterial Elasticity, Strength, Fatigue, and Endurance in Older Women Wed, 08 Jan 2014 08:16:05 +0000 Arterial health may influence muscle function in older adults. Study purpose was to determine whether arterial elasticity is related to strength, central and peripheral fatigue, fatigue at rest, and treadmill endurance. Subjects were 91 healthy women aged >60. Treadmill endurance and maximal oxygen uptake (VO2 max) were measured. Peripheral and central fatigue for the knee extensors were evaluated using two isometric fatigue tests (one voluntary and one adding electrical stimulation). Arterial elasticity was determined using radial artery pulse wave analysis. Linear multiple regression was used in statistical analysis. Large artery elasticity was associated with central fatigue and treadmill endurance after adjusting for VO2 max and knee extension strength. Subjective fatigue at rest was related to large artery elasticity after adjusting for ethnic origin (<0.02). Strength was significantly related to small artery elasticity after adjusting for ethnic origin, leg lean tissue, age, and blood pressure. Arterial elasticity is independently related to strength and fatigue in older women, especially in the central nervous system where arterial elasticity is independently related to perceptions of fatigue at rest and central fatigue. These results suggest that arterial health may be involved with the ability of the central nervous system to activate muscle in older women. Gary R. Hunter, William H. Neumeier, C. Scott Bickel, John P. McCarthy, Gordon Fisher, Paula C. Chandler-Laney, and Stephen P. Glasser Copyright © 2014 Gary R. Hunter et al. All rights reserved. Differences in Trunk Kinematic between Frail and Nonfrail Elderly Persons during Turn Transition Based on a Smartphone Inertial Sensor Thu, 28 Nov 2013 15:40:27 +0000 Objective. Firstly, to, through instrumentation with the iPhone4 smartphone, measure and describe variability of tridimensional acceleration, angular velocity, and displacement of the trunk in the turn transition during the ten-meter Extended Timed-Get-up-and-Go test in two groups of frail and physically active elderly persons. Secondly, to analyse the differences and performance of the variance between the study groups during turn transition (frail and healthy). Design. This is a cross-sectional study of 30 subjects over 65 years, 14 frail subjects, and 16 healthy subjects. Results. Significant differences were found between the groups of elderly persons in the accelerometry () and angular displacement variables (), obtained in the kinematic readings of the trunk during the turning transitions. The results obtained in this study show a series of deficits in the frail elderly population group. Conclusions. The inertial sensor found in the iPhone4 is able to study and analyse the kinematics of the turning transitions in frail and physically active elderly persons. The accelerometry values for the frail elderly are lower than the physically active elderly, whilst variability in the readings for the frail elderly is also lower than the control group. Alejandro Galán-Mercant and Antonio I. Cuesta-Vargas Copyright © 2013 Alejandro Galán-Mercant and Antonio I. Cuesta-Vargas. All rights reserved. Clinical, Biological, and Imaging Features of Monogenic Alzheimer’s Disease Wed, 27 Nov 2013 14:25:44 +0000 The discovery of monogenic forms of Alzheimer’s Disease (AD) associated with mutations within PSEN1, PSEN2, and APP genes is giving a big contribution in the understanding of the underpinning mechanisms of this complex disorder. Compared with sporadic form, the phenotype associated with monogenic cases is somewhat broader including behavioural disturbances, epilepsy, myoclonus, and focal presentations. Structural and functional imaging show typical early changes also in presymptomatic monogenic carriers. Amyloid imaging and CSF tau/Aβ ratio may be useful in the differential diagnosis with other neurodegenerative dementias, especially, in early onset cases. However, to date any specific biomarkers of different monogenic cases have been identified. Thus, in clinical practice, the early identification is often difficult, but the copresence of different elements could help in recognition. This review will focus on the clinical and instrumental markers useful for the very early identification of AD monogenic cases, pivotal in the development, and evaluation of disease-modifying therapy. Andrea Pilotto, Alessandro Padovani, and Barbara Borroni Copyright © 2013 Andrea Pilotto et al. All rights reserved. Physiotherapists Have Accurate Expectations of Their Patients’ Future Health-Related Quality of Life after First Assessment in a Subacute Rehabilitation Setting Wed, 20 Nov 2013 14:44:02 +0000 Background. Expectations held by health professionals and their patients are likely to affect treatment choices in subacute inpatient rehabilitation settings for older adults. There is a scarcity of empirical evidence evaluating whether health professionals expectations of the quality of their patients’ future health states are accurate. Methods. A prospective longitudinal cohort investigation was implemented to examine agreement (kappa coefficients, exact agreement, limits-of-agreement, and intraclass-correlation coefficients) between physiotherapists’ () prediction of patients’ discharge health-related quality of life (reported on the EQ-5D-3L) and the actual health-related quality of life self-reported by patients () at their discharge assessment (using the EQ-5D-3L). The mini-mental state examination was used as an indicator of patients’ cognitive ability. Results. Overall, 232 (85%) patients had all assessment data completed and were included in analysis. Kappa coefficients (exact agreement) ranged between 0.37–0.57 (58%–83%) across EQ-5D-3L domains in the lower cognition group and 0.53–0.68 (81%–85%) in the better cognition group. Conclusions. Physiotherapists in this subacute rehabilitation setting predicted their patients’ discharge health-related quality of life with substantial accuracy. Physiotherapists are likely able to provide their patients with sound information regarding potential recovery and health-related quality of life on discharge. The prediction accuracy was higher among patients with better cognition than patients with poorer cognition. Steven M. McPhail, Emily Nalder, Anne-Marie Hill, and Terry P. Haines Copyright © 2013 Steven M. McPhail et al. All rights reserved. Functional Status in Behavioral Variant Frontotemporal Dementia: A Systematic Review Thu, 07 Nov 2013 09:51:30 +0000 The aim was to conduct a systematic review of studies that described the functional profile of patients with behavioral variant frontotemporal dementia (bvFTD), published between 2000 and 2013. The bibliographic search was conducted using the terms “frontotemporal dementia” and “frontotemporal lobar degeneration” in combination with “independence,” “functionality,” “basic activities of daily living,” “disability,” and scales that measure functional performance: “Disability Assessment for Dementia-DAD,” “Functional Activities Questionnaire (FAQ),” “Direct Assessment of Functional Status (DAFS).” To be included in the review, the study had to mention the characterization of the functional status of patients with bvFTD in the objectives of the study, using a previously validated instrument of functional assessment. Fourteen studies met this criterion. The reviewed studies suggested that individuals with bvFTD have greater functional impairment when compared to those with other subtypes of frontotemporal lobar degeneration or Alzheimer’s disease. The studies documented a significant association between cognitive impairment and measures of functionality in these patients. The cognitive profile of patients may predict faster functional decline. Thais Bento Lima-Silva, Valéria Santoro Bahia, Ricardo Nitrini, and Mônica Sanches Yassuda Copyright © 2013 Thais Bento Lima-Silva et al. All rights reserved. Do Fallers and Nonfallers Equally Benefit from Balance Specific Exercise Program? A Pilot Study Mon, 21 Oct 2013 14:09:49 +0000 The purpose of the study was to determine the sample size that would allow broad generalizability of the results. To investigate the differences in the responsiveness of fallers and nonfallers to a multicomponent functional balance specific program, 23 participating subjects (70.1 ± 6.6 years) were divided into nonfallers group (13) and fallers group (10). The components of the balance specific program were (1) changing of the center of gravity (CoG) in the vertical direction, (2) shifting of the CoG to the border of stability, (3) rotation of the head and body about the vertical axis, (4) standing and walking on soft surface, and (5) walking over obstacles or on a narrow path. At the end of eight months of the training program, there was no significant difference between the two groups regarding postural sway. The total center of pressure path length was used as the principal outcome measure for the sample size calculation. Based on these results the a priori sample size calculation yielded the estimate of 110 subjects required to be enrolled in order to get 20 subjects in fallers and 30 subjects in nonfallers group for the 80% power to detect the results as significant. Darja Rugelj, Marija Tomšič, and France Sevšek Copyright © 2013 Darja Rugelj et al. All rights reserved. Impact of Genetic Variants of Apolipoprotein E on Lipid Profile in Patients with Parkinson's Disease Tue, 24 Sep 2013 11:44:25 +0000 The pathogenesis of Parkinson's disease (PD) seems to involve genetic susceptibility to neurodegeneration. APOE gene has been considered a risk factor for PD. This study aimed to evaluate the association of APOE polymorphism with PD and its influence on lipid profile. We studied 232 PD patients (PD) and 169 individuals without the disease. The studied polymorphism was analyzed by PCR/RFLP. The Fisher's exact test, chi-square, ANOVA, and -test () were applied. The APOE3/3 genotype was prevalent in PD patients and Controls () followed by APOE3/4 (). Both groups showed recommended values for lipid profile, with increase in the values of total cholesterol and LDLc, as well as decreased values of triglycerides in PD patients compared with Controls ( for all of them). Increased levels of HDLc, in PD patients, were associated with the APOE3/3 versus APOE-/4 genotypes (). The APOE polymorphism does not distinguish PD patients from Controls, as opposed to the lipid profile alone or in association with APOE. Furthermore, a relationship between increase of HDLc levels and APOE3 in homozygous was found in PD patients only. Michele L. Gregório, Marcela A. S. Pinhel, Caroline L. Sado, Gabriela S. Longo, Fábio N. Oliveira, Gisele S. Amorim, Marcelo A. Nakazone, Greiciane M. Florim, Camila M. Mazeti, Denise P. Martins, Waldir A. Tognola, Antonio C. Brandão, Sidney Pinheiro Júnior, Moacir F. de Godoy, and Dorotéia R. S. Souza Copyright © 2013 Michele L. Gregório et al. All rights reserved. Familiar Music as an Enhancer of Self-Consciousness in Patients with Alzheimer’s Disease Wed, 11 Sep 2013 15:27:26 +0000 The main objective of this paper is to examine the impact of familiar music on self-consciousness (SC) in patients with Alzheimer’s disease (AD). For this purpose, two AD groups of 20 patients matched by age, educational level, gender, illness duration, and cognitive state were assessed using an SC questionnaire before and after music intervention. The SC questionnaire measured several aspects: personal identity, anosognosia, affective state, body representation, prospective memory, introspection and moral judgments. One AD group received familiar music stimulation and another AD group unfamiliar music stimulation over three months. The AD patients who received a familiar music intervention showed a stabilization or improvement in aspects of SC. By contrast, control AD group showed a deterioration of most of the SC aspects after unfamiliar music stimulation, except the SC aspects of body representation and affective state. Familiar music stimulation could be considered as an enhancer of SC in patients with Alzheimer’s disease. Eva M. Arroyo-Anlló, Juan Poveda Díaz, and Roger Gil Copyright © 2013 Eva M. Arroyo-Anlló et al. All rights reserved. Predictors for Increasing Eligibility Level among Home Help Service Users in the Japanese Long-Term Care Insurance System Mon, 09 Sep 2013 13:44:36 +0000 Objectives. This cross-sectional study described the prevalence of possible risk factors for increasing eligibility level of long-term care insurance in home help service users who were certified as support level 1-2 or care level 1-2 in Japan. Methods. Data were collected from October 2011 to November 2011. Variables included eligibility level, grip strength, calf circumference (CC), functional limitations, body mass index, memory impairment, depression, social support, and nutrition status. Results. A total of 417 subjects (109 males and 308 females, mean age 83 years) were examined. There were 109 subjects with memory impairment. When divided by cut-off values, care level 2 was found to have higher prevalence of low grip strength, low CC, and depression. Conclusions. Some potentially modifiable factors such as muscle strength could be the risk factors for increasing eligibility level. Kuniyasu Kamiya, Kenji Sasou, Makoto Fujita, and Sumio Yamada Copyright © 2013 Kuniyasu Kamiya et al. All rights reserved. The Impact of Cholesterol, DHA, and Sphingolipids on Alzheimer’s Disease Mon, 19 Aug 2013 11:16:08 +0000 Alzheimer’s disease (AD) is a devastating neurodegenerative disorder currently affecting over 35 million people worldwide. Pathological hallmarks of AD are massive amyloidosis, extracellular senile plaques, and intracellular neurofibrillary tangles accompanied by an excessive loss of synapses. Major constituents of senile plaques are 40–42 amino acid long peptides termed β-amyloid (Aβ). Aβ is produced by sequential proteolytic processing of the amyloid precursor protein (APP). APP processing and Aβ production have been one of the central scopes in AD research in the past. In the last years, lipids and lipid-related issues are more frequently discussed to contribute to the AD pathogenesis. This review summarizes lipid alterations found in AD postmortem brains, AD transgenic mouse models, and the current understanding of how lipids influence the molecular mechanisms leading to AD and Aβ generation, focusing especially on cholesterol, docosahexaenoic acid (DHA), and sphingolipids/glycosphingolipids. Marcus O. W. Grimm, Valerie C. Zimmer, Johannes Lehmann, Heike S. Grimm, and Tobias Hartmann Copyright © 2013 Marcus O. W. Grimm et al. All rights reserved. Serum Brain-Derived Neurotrophic Factor Levels in Different Neurological Diseases Mon, 19 Aug 2013 08:45:30 +0000 Consistent evidence indicates the involvement of the brain-derived neurotrophic factor (BDNF) in neurodegenerative disorders such as Alzheimer's disease (AD) and Parkinson’s disease (PD). In the present study, we compared serum BDNF in 624 subjects: 266 patients affected by AD, 28 by frontotemporal dementia (FTD), 40 by Lewy body dementia (LBD), 91 by vascular dementia (VAD), 30 by PD, and 169 controls. Our results evidenced lower BDNF serum levels in AD, FTD, LBD, and VAD patients () and a higher BDNF concentration in patients affected by PD (). Analyses of effects of pharmacological treatments suggested significantly higher BDNF serum levels in patients taking mood stabilizers/antiepileptics () and L-DOPA () and significant reductions in patients taking benzodiazepines (). In conclusion, our results support the role of BDNF alterations in neurodegenerative mechanisms common to different forms of neurological disorders and underline the importance of including drug treatment in the analyses to avoid confounding effects. Mariacarla Ventriglia, Roberta Zanardini, Cristina Bonomini, Orazio Zanetti, Daniele Volpe, Patrizio Pasqualetti, Massimo Gennarelli, and Luisella Bocchio-Chiavetto Copyright © 2013 Mariacarla Ventriglia et al. All rights reserved. Preserved Transcallosal Inhibition to Transcranial Magnetic Stimulation in Nondemented Elderly Patients with Leukoaraiosis Thu, 25 Jul 2013 14:09:16 +0000 Structural corpus callosum (CC) changes in patients with leukoaraiosis (LA) are significantly associated with cognitive and motor impairment. The aim of this study is to investigate the transcallosal fibers functioning by means of transcranial magnetic stimulation (TMS) in elderly patients with LA. The resting motor threshold (rMT), the motor-evoked potentials (MEPs), and the controlateral (cSP) and ipsilateral silent periods (iSP) were determined using single-pulse TMS in 15 patients and 15 age-matched controls. The neuropsychological profile and the vascular burden at brain magnetic resonance imaging (MRI) were concomitantly explored. Patients reported abnormal scores at tests evaluating executive control functions. No significant difference was found in TMS measures of intra- and intercortical excitability. No CC lesion was evident at MRI. Transcallosal inhibitory mechanisms to TMS seem to be spared in LA patients, a finding which is in line with neuroimaging features and suggests a functional integrity of the CC despite the ischemic interruption of corticosubcortical loops implicated in cognition and behavior. The observed neurophysiological finding differs from that reported in degenerative dementia, even in the preclinical or early stage. In our group of patients, the pure extent of LA is more related to impairment of frontal lobe abilities rather than functional callosal changes. Giuseppe Lanza, Rita Bella, Salvatore Giuffrida, Mariagiovanna Cantone, Giovanni Pennisi, Concetto Spampinato, Daniela Giordano, Giulia Malaguarnera, Alberto Raggi, and Manuela Pennisi Copyright © 2013 Giuseppe Lanza et al. All rights reserved. Genetics of Alzheimer’s Disease Thu, 25 Jul 2013 14:00:53 +0000 Alzheimer’s disease is the most common form of dementia and is the only top 10 cause of death in the United States that lacks disease-altering treatments. It is a complex disorder with environmental and genetic components. There are two major types of Alzheimer’s disease, early onset and the more common late onset. The genetics of early-onset Alzheimer’s disease are largely understood with variants in three different genes leading to disease. In contrast, while several common alleles associated with late-onset Alzheimer’s disease, including APOE, have been identified using association studies, the genetics of late-onset Alzheimer’s disease are not fully understood. Here we review the known genetics of early- and late-onset Alzheimer’s disease. Perry G. Ridge, Mark T. W. Ebbert, and John S. K. Kauwe Copyright © 2013 Perry G. Ridge et al. All rights reserved. Montreal Cognitive Assessment Is Superior to Standardized Mini-Mental Status Exam in Detecting Mild Cognitive Impairment in the Middle-Aged and Elderly Patients with Type 2 Diabetes Mellitus Thu, 11 Jul 2013 13:51:40 +0000 Aim. This study compares the usefulness of Montreal Cognitive Assessment (MoCA) to Standardized Mini-Mental Status Exam (SMMSE) for diagnosing mild cognitive impairment (MCI) in Type 2 diabetes mellitus (DM) population. Methods. This prospective pilot study enrolled 30 community dwelling adults with Type 2 DM aged 50 years and above. Subjects were assessed using both the SMMSE and MoCA for MCI. In all subjects, depression and dementia were ruled out using the DSM IV criteria, and a functional assessment was done. MCI was diagnosed using the standard test, the European consortium criteria. Sensitivity and specificity analysis, positive and negative predictive values, likelihood ratios and Kappa statistic were calculated. Results. In comparison to consortium criteria, the sensitivity and specificity of MoCA were 67% and 93% in identifying individuals with MCI, and SMMSE were 13% and 93%, respectively. The positive and negative predictive values for MoCA were 84% and 56%, and for SMMSE were 66% and 51%, respectively. Kappa statistics showed moderate agreement between MoCA and consortium criteria (kappa = 0.4) and a low agreement between SMMSE and consortium criteria (kappa = 0.07). Conclusion. In this pilot study, MoCA appears to be a better screening tool than SMMSE for MCI in the diabetic population. Kannayiram Alagiakrishnan, Nancy Zhao, Laurie Mereu, Peter Senior, and Ambikaipakan Senthilselvan Copyright © 2013 Kannayiram Alagiakrishnan et al. All rights reserved. Identification of Potential or Preclinical Cognitive Impairment and the Implications of Sophisticated Screening with Biomarkers and Cognitive Testing: Does It Really Matter? Mon, 08 Jul 2013 11:27:57 +0000 The last decade has seen an enormous growth in the interest in the recognition of and intervention in those diagnosed and living with the whole range of cognitive impairment and frank dementia. In the western world, the recognition of the impact on patients, families, health care systems, and societies that dementia poses has led to great efforts to help define the indicators for current and future dementia with the intention to treat those already afflicted even with the primarily symptomatic medications that exist and to recognize those at future risk with the hope of providing counselling to forestall its future development. The idea of “early diagnosis” appears at first glance to be attractive for the purposes of future planning and research studies, but it is not clear what the benefits and risks might be if screening processes define people at risk when beneficial interventions might not yet be determined. The ethical as well as financial implications must be explored and defined before implementation of such screening becomes a normal standard of practice. Michael Gordon Copyright © 2013 Michael Gordon. All rights reserved. Cardiovascular Disease and Hip Fracture among Older Inpatients in Beijing, China Mon, 01 Jul 2013 13:06:29 +0000 Objectives. To examine the associations between cardiovascular disease (CVD) and hip fracture and to determine if these associations are attributable to hypertensive disease. Methods. Data were obtained from 2006–2010 hospitalization summary reports of 31 tertiary hospitals in Beijing, China. This study included 864,408 inpatients aged ≥55 years. Occurrence rate of hip fracture was based on the first-listed ICD-10 codes (S72.0, S72.1, and S72.2) and of CVD as comorbidities were based on the second- to the eighth-listed ICD-10 codes (I00–I99). Results. The occurrence rate of hip fracture is 53% higher among older inpatients with a diagnosis of CVD than those without (, 95% CI 1.47–1.60). Those with hip fracture were more likely to have hypertensive or cerebrovascular disease, with the risk ranging from 1.34 to 1.70. Compared with those without hip fracture, the occurrence rate of overall CVDs increased by 80%, 83%, and 16% among hip fracture patients aged 55–64, 65–79, and ≥80 years. In addition, hypertensive disease did not modify the association between cerebrovascular disease and hip fracture. Conclusion. CVD was positively associated with hip fracture, and the associations observed in this sample of Chinese inpatients were similar to those reported from cohort studies conducted in the European populations. Beibei Xu, Ling Han, Hui Liu, Jing Wang, Xiao-Yuan Bao, Han-Xu Xi, Leping Zhao, and Guo-Pei Yu Copyright © 2013 Beibei Xu et al. All rights reserved. Neuropsychiatric Symptoms of Dementia: Consent, Quality of Life, and Dignity Thu, 20 Jun 2013 13:12:49 +0000 Degenerative forms of dementia are progressive, incurable, fatal, and likely to cause suffering in conjunction with personal incapacity. Timely diagnostic disclosure and counseling can facilitate important advance care planning. The risk of harm associated with neuropsychiatric symptoms (NPS) of dementia often has to be balanced against the risk of harm associated with medication management of NPS. A palliative care framework can help preserve autonomy, quality of life, comfort, and dignity for patients with NPS. Michael J. Passmore Copyright © 2013 Michael J. Passmore. All rights reserved. Nutrition and the Risk of Alzheimer's Disease Thu, 20 Jun 2013 08:34:21 +0000 Alzheimer's disease (AD) is a progressive neurodegenerative disorder that accounts for the major cause of dementia, and the increasing worldwide prevalence of AD is a major public health concern. Increasing epidemiological studies suggest that diet and nutrition might be important modifiable risk factors for AD. Dietary supplementation of antioxidants, B vitamins, polyphenols, and polyunsaturated fatty acids are beneficial to AD, and consumptions of fish, fruits, vegetables, coffee, and light-to-moderate alcohol reduce the risk of AD. However, many of the results from randomized controlled trials are contradictory to that of epidemiological studies. Dietary patterns summarizing an overall diet are gaining momentum in recent years. Adherence to a healthy diet, the Japanese diet, and the Mediterranean diet is associated with a lower risk of AD. This paper will focus on the evidence linking many nutrients, foods, and dietary patterns to AD. Nan Hu, Jin-Tai Yu, Lin Tan, Ying-Li Wang, Lei Sun, and Lan Tan Copyright © 2013 Nan Hu et al. All rights reserved. Comparison of Informal Care Time and Costs in Different Age-Related Dementias: A Review Wed, 05 Dec 2012 08:27:36 +0000 Objectives. Age-related dementia is a progressive degenerative brain syndrome whose prevalence increases with age. Dementias cause a substantial burden on society and on families who provide informal care. This study aims to review the relevant papers to compare informal care time and costs in different dementias. Methods. A bibliographic search was performed on an international medical literature database (MEDLINE). All studies which assessed the social economic burden of different dementias were selected. Informal care time and costs were analyzed in three care settings by disease stages. Results. 21 studies met our criteria. Mean informal care time was 55.73 h per week for Alzheimer disease and 15.8 h per week for Parkinson disease (), and the associated mean annual informal costs were $17,492 versus $3,284, respectively (). Conclusion. There is a lack of data about informal care time and costs among other dementias than AD or PD. Globally, AD is the most costly in terms of informal care costs than PD, $17,492 versus $3,284, respectively. Nadège Costa, Laura Ferlicoq, Hélène Derumeaux-Burel, Thomas Rapp, Valérie Garnault, Sophie Gillette-Guyonnet, Sandrine Andrieu, Bruno Vellas, Michel Lamure, Alain Grand, and Laurent Molinier Copyright © 2013 Nadège Costa et al. All rights reserved. Food Supplement 20070721-GX May Increase CD34+ Stem Cells and Telomerase Activity Sun, 22 Apr 2012 14:17:20 +0000 Few rejuvenation and antiaging markers are used to evaluate food supplements. We measured three markers in peripheral blood to evaluate the antiaging effects of a food supplement containing placental extract. Samples were evaluated for CD34+ cells, insulin-like growth factor 1 (IGF1), and telomerase activity, which are all markers related to aging. To control the quality of this food supplement, five active components were monitored. In total, we examined 44 individuals who took the food supplement from 1.2 months to 23 months; the average number of CD34+ cells was almost 6-fold higher in the experimental group compared with the control group. Food supplement intake did not change serum IGF1 levels significantly. Finally, the average telomerase activity was 30% higher in the subjects taking this food supplement. In summary, our results suggest that the placental extract in the food supplement might contribute to rejuvenation and antiaging. Po-Cheng Lin, Tzyy-Wen Chiou, Po-Yen Liu, Shee-Ping Chen, Hsin-I Wang, Pi-Chun Huang, Shinn-Zong Lin, and Horng-Jyh Harn Copyright © 2012 Po-Cheng Lin et al. All rights reserved. ELISA for Aging Biomarkers Induced by Telomere Dysfunction in Human Plasma Thu, 25 Nov 2010 09:52:31 +0000 Background. We identified cathelicidin related antimicrobial protein (CRAMP) secreted from telomere dysfunctional bone marrow cells of late generation telomerase knockout mice (G4mTerc−/−), increased in blood and various tissues. It can represented human aging and disease. The main aim of this study is to investigate the sensitive direct enzyme-linked immunosorbent assay (ELISA) method to analyze the human aging and disease in plasma and the detailed methods to quantify the direct ELISA of these aging biomarkers. Methods. Telomere lengths of 50 healthy persons are measured with real-time PCR in blood cells. Plasma samples from all subjects are analyzed using direct ELISA. Results. From 25 years old person to 78 years, the telomere length becomes shorter during aging. In blood plasma, the expression levels of CRAMP increases during human aging. There is the reverse correspondence between the telomere length and the plasma CRAMP level. We also find that the fresh plasma, the frozen plasma which thawed less than 3 times, and the plasma kept in the room temperature less than 3 hours are better for the ELISA analyze of CRAMP in the plasma. Conclusion. This CRAMP ELISA could become a powerful tool for investigating the relationship between human aging and telomere length shortening. Hong Jiang, Wenqing Chen, Lihui Qu, Ying Chen, Qiang He, Huiping Wang, Jianyong Wu, Zhangfei Shou, Zhenyu Ju, and Jianghua Chen Copyright © 2010 Hong Jiang et al. All rights reserved.