Arvanitakis Z.,Rush Alzheimer Disease Center
Neurologist | Year: 2010
Background: Frontotemporal dementia has recently been recognized as a common cause of young-onset dementia. Objective: To review the current approach to the clinical evaluation, understanding of pathophysiology, and management of frontotemporal dementia. Results: Two main clinical presentations are: (1) behavioral, with impulsive behaviors and disinhibition, change in personality such as apathy and indifference, and poor judgment, and (2) language, with a nonfluent aphasia with anomia (primary progressive aphasia), or a fluent aphasia with early loss of word meaning (semantic dementia). The differential diagnosis includes other neurodegenerative dementias, vascular and other conditions affecting the brain, and psychiatric diseases. Investigations, including neuropsychological testing, and structural and functional brain imaging, may help support the diagnosis. Recent advances in understanding the pathophysiology have suggested that most cases have underlying ubiquitin-positive inclusions, whereas some have tau-positive inclusions. Genetic mutations, particularly on chromosome 17 in the tau or progranulin genes, have been identified. Management includes a trial of symptomatic medications and a multifaceted approach, including environmental modification and long-term care planning. Conclusion: Medical researchers studying frontotemporal dementia aim to identify disease-modifying drugs and, ultimately, a cure for this devastating disease. Copyright © 2010 by Lippincott Williams & Wilkins.
Morris M.C.,Rush Alzheimer Disease Center |
Schneider J.A.,Rush University Medical Center |
Li H.,Rush Alzheimer Disease Center |
Tangney C.C.,Rush University Medical Center |
And 4 more authors.
Alzheimer's and Dementia | Year: 2015
Randomized trials of α-tocopherol supplements on cognitive decline are negative, whereas studies of dietary tocopherols have shown benefit. We investigated these inconsistencies by analyzing the relations of α- and γ-tocopherol brain concentrations to Alzheimer's disease (AD) neuropathology among 115 deceased participants of the prospective Rush Memory and Aging Project. Associations of amyloid load and neurofibrillary tangle severity with brain tocopherol concentrations were examined in separate adjusted linear regression models. γ-Tocopherol concentrations were associated with lower amyloid load (β 5-2.10, P 5.002) and lower neurofibrillary tangle severity (β 5-1.16, P 5.02). Concentrations of α-tocopherol were not associated with AD neuropathology, except as modified by γ-tocopherol: high α-tocopherol was associated with higher amyloid load when γ-tocopherol levels were low and with lower amyloid levels when γ-tocopherol levels were high (P for interaction 5 0.03). Brain concentrations of γ- and α-tocopherols may be associated with AD neuropathology in interrelated, complex ways. Randomized trials should consider the contribution of γ-tocopherol. © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.
Li H.,Section on Nutrition and Nutritional Epidemiology |
Wang Y.,Section on Nutrition and Nutritional Epidemiology |
Barnes L.,Rush Alzheimer Disease Center |
Schneider J.A.,Rush Alzheimer Disease Center |
And 4 more authors.
Neurology | Year: 2014
Objectives: We examined whether accordance to the DASH (Dietary Approach to Stop Hypertension) and Mediterranean diets is associated with slower cognitive decline in a prospective Chicago cohort study of older persons, the Memory and Aging Project. Methods: The sample comprised 826 Memory and Aging Project participants (aged 81.5 6 7.1 years) who completed a 144-item food frequency questionnaire at baseline and 2 or more cognitive assessments over 4.1 years. Dietary scores were computed for accordance to the DASH diet (0-10) and the Mediterranean diet (MedDietScore) (0-55). For both, higher scores reflect greater accordance. Both patterns share at least 3 common food components. Cognitive function was assessed annually with 19 cognitive tests from which global cognitive scores and summary measures are computed. Results: The mean global cognitive score at baseline was 0.12 (range, 23.23 to 1.60) with an overall mean annual change in score of 20.08 standardized units. Only 13 participants had possible dementia. The mean DASH score was 4.1 (range, 1.0-8.5) and the MedDietScore was 31.3 (range, 18-46). In mixed models adjusted for covariates, a 1-unit difference in DASH score was associated with a slower rate of global cognitive decline by 0.007 standardized units (standard error of estimate 5 0.003, p 5 0.03). Similarly, a 1-unit-higher MedDietScore was associated with a slower rate of global cognitive decline by 0.002 standardized units (standard error of estimate 5 0.001, p 5 0.01). Conclusions: These findings support the hypothesis that both the DASH and Mediterranean diet patterns are associated with slower rates of cognitive decline in the same cohort of older persons.