Alzheimer’s one day may be predicted during eye exam

Using technology similar to what is found in many eye doctors’ offices, researchers have detected evidence suggesting Alzheimer’s in older patients who had no symptoms of the disease | JAMA Ophthalmology | Story via ScienceDaily

eye-1173863_1920

Significant brain damage from Alzheimer’s disease can occur years before any symptoms such as memory loss and cognitive decline appear. Scientists estimate that Alzheimer’s-related plaques can build up in the brain two decades before the onset of symptoms, so researchers have been looking for ways to detect the disease sooner.

In a new study published in the journal JAMA Ophthalmology,  researchers used a noninvasive technique — called optical coherence tomography angiography — to examine the retinas in eyes of 30 study participants with an average age in the mid 70s, none of whom exhibited clinical symptoms of Alzheimer’s. One of the authors of the study says “This technique has great potential to become a screening tool that helps decide who should undergo more expensive and invasive testing for Alzheimer’s disease prior to the appearance of clinical symptoms.”

In previous studies, researchers examining the eyes of people who had died from Alzheimer’s have reported that the eyes of such patients showed signs of thinning in the center of the retina and degradation of the optic nerve.

Full story at ScienceDaily

Full reference: O’Bryhim BE et al. | Association of Preclinical Alzheimer Disease With Optical Coherence Tomographic Angiography Findings | JAMA Ophthalmology | August 23rd 2018

Clock drawing cognitive test should be done routinely in patients with high blood pressure

A clock drawing test for detecting cognitive dysfunction should be conducted routinely in patients with high blood pressure according to latest research | European Society of Cardiology | via ScienceDaily

Patients with high blood pressure who have impaired cognitive function are at increased risk of developing dementia within five years. Despite this known link, cognitive function is not routinely measured in patients with high blood pressure. Research presented at the European Society of Cardiology Congress 2018 suggests the clock drawing test should be adopted as a routine screening tool for cognitive decline in patients with high blood pressure.

clock

The Heart-Brain study evaluated the usefulness of the clock drawing test compared to the Mini-Mental State Examination (MMSE) to detect cognitive impairment.  For the clock drawing test, patients were given a piece of paper with a 10 cm diameter circle on it. They were asked to write the numbers of the clock in the correct position inside the circle and then draw hands on the clock indicating the time “twenty to four.”

The researchers found a higher prevalence of cognitive impairment with the clock drawing test (36%) compared to the MMSE (21%).

Full story at ScienceDaily

 

 

Detecting Alzheimer’s disease before symptoms emerge

Cognitive tests can detect early Alzheimer’s disease in older adults without symptoms according to a new study. | Neuropsychology Review | via ScienceDaily

A new study led by Duke Han, suggests that cognitive tests are able to detect early Alzheimer’s in people without symptoms. Han and his colleagues conducted a meta-analysis of 61 studies to explore whether neuropsychological tests can identify early Alzheimer’s disease in adults over 50 with normal cognition.

The study, which was published in Neuropsychology Review, found that people who had amyloid plaques performed worse on neuropsychological tests of global cognitive function, memory, language, visuospatial ability, processing speed and attention/working memory/executive function than people who did not have amyloid plaques.

The study also found that people with tau pathology or neurodegeneration performed worse on memory tests than people with amyloid plaques. Amyloid plaques and tau pathology were confirmed by PET scan or cerebrospinal fluid analysis.

Han believes that the study results provide a solid argument for incorporating cognitive testing into routine, annual checkups for older people.

Full story at ScienceDaily

Article reference: S. Duke Han et al. Detectable Neuropsychological Differences in Early Preclinical Alzheimer’s Disease: A Meta-Analysis. Neuropsychology Review, 2017

 

Clinicians’ experiences of anxiety in patients with dementia

Knut Engedal & Siren Eriksen Clinicians’ experiences of anxiety in patients with dementiaDementia July 14, 2016 

 

B0003584 MRI of the brain overlaid with "anxiety"
image source: Mark Lythgoe, Wellcome Images // CC BY-NC-ND 4.0

Since anxiety in patients with dementia is a complex, understudied phenomenon, this paper presents clinicians’ experiences of anxiety in this population.

Semi-structured interviews were conducted with seven clinicians experienced with dementia in elderly patients (65 years and above), and then evaluated via qualitative content analysis.

Analysis revealed three main categories: A reaction to loss and worries, symptoms of anxiety and depression interfere with each other, and anxiety in dementia—a multidisciplinary task.

Anxiety in this population is perhaps best understood as a reaction to loss and worries, and existential in nature by the participants. Care interventions can reduce or prevent anxiety symptoms in this population. However, when anxiety co-exists with depression it might be difficult to attenuate these symptoms through care measures alone. To better identify and treat the condition, valid dementia-specific anxiety-screening instruments are necessary.

Exploring attitudes and preferences for dementia screening in Britain: contributions from carers and the general public

A Patient and Public Involvement (PPI) event was organised to give members of the public from the East of England an opportunity to offer their perspectives and to comment on the findings of a systematic literature review looking at attitudes and preferences towards screening for dementia.

A total of 23 key themes emerged in relation to the carer and general population. The most frequent themes which emerged were the low levels of understanding and awareness around the dementia syndrome; the acceptability and validity of any tests; costs to the National Health Service (NHS); an individual’s existing health status existing health status; financial/profit motive for screening; the inability to change prognosis; and the importance and availability of support.

Martin S, et al. Exploring attitudes and preferences for dementia screening in Britain: contributions from carers and the general public  BMC Geriatrics 2015, 15 :110 (9 September 2015)

Screening all 75 year olds for dementia has potential

via Research scan – Health Foundation.

This study examined the likely cost-effectiveness of a one-off screening test for dementia for people aged 75 years in England and Wales. A computer model was used to estimate costs based on data from systematic reviews and research. The researchers estimated that about 3,514 people may be diagnosed as a result of screening, 2,152 of whom may not otherwise receive a diagnosis. The societal economic impact was between 3.6 million pounds in net costs and 4.7 million pounds net savings, depending on assumptions. This means that screening could be cost-effective but only if treatments and social care interventions become more effective.
Reference: Dixon J, Ferdinand M, D’Amico F, Knapp M. Exploring the cost-effectiveness of a one-off screen for dementia (for people aged 75 years in England and Wales). International Journal of Geriatric Psychiatry. 2015 Apr;30(5):446-452.

Screening all 75 year olds for dementia has potential

This study examined the likely cost-effectiveness of a one-off screening test for dementia for people aged 75 years in England and Wales. A computer model was used to estimate costs based on data from systematic reviews and research. The researchers estimated that about 3,514 people may be diagnosed as a result of screening, 2,152 of whom may not otherwise receive a diagnosis. The societal economic impact was between 3.6 million pounds in net costs and 4.7 million pounds net savings, depending on assumptions. This means that screening could be cost-effective but only if treatments and social care interventions become more effective.

Reference:

Dixon J, Ferdinand M, D’Amico F, Knapp M. Exploring the cost-effectiveness of a one-off screen for dementia (for people aged 75 years in England and Wales). International Journal of Geriatric Psychiatry. 2015 Apr;30(5):446-452