Alzheimer
Criterios de diagnóstico de la enfermedad de Alzheimer: Aplicaciones prácticas. Diagnostic criteria for Alzheimer’s disease: Practical applications
Palabras clave: Alzheimer,
diagnóstico,
Memoria Episódica en las Etapas Preclínicas de la Enfermedad de Alzheimer Genética. Episodic Memory In The Preclinical Stages Of Genetic Alzheimer’s Disease
Introduction: Episodic memory (EM) allows us to recall events or lived experiences. EM is associated to the medial temporal lobe (MTL) activity, which has circuits integrated by different cortical association areas. EM impairment is the first symptom of Alzheimer’s disease (AD), which is explained by the abnormal beta amyloid (βA) and phosphorylated tau protein (PTF) deposition in the MTL.
Development: A review about EM components and its assessment is done, especially related to preclinical stages of genetic AD. The relationship of EM components to βA and TFP deposition and the activity of MTL networks, using positron emission tomography (PET) of the brain, particularly in asymptomatic members of families at genetic risk for early AD, caused by the E280A mutation in preseniline 1 (PSN1), is revised.
Conclusions: The reviewed studies trend to validate the hypothesis, which would suggest that EM allows us to consolidate and recalling lived subjective experiences, which also allows us learning from the past. EM has been assessed with verbal declarative memory tasks. The asymptomatic members, carrying the E280A PSN1 mutation for genetic AD, have showed lower scores than asymptomatic non carriers on these memory tasks, which significantly correlates to PET-amyloid and PET-tau of MTL signals, up to 20 years before dementia onset.
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Heterogeneidad Sintomatológica. Perfiles de Pacientes Diagnosticados con Demencia Tipo Alzheimer en Antioquia (Colombia) Symptomatology Heterogeneity. Profiles Of Patients Diagnosed With Alzheimer’s Type Dementia In Antioquia (Colombia).
Objective: To describe and contrast the symptomatic variability of cases with sporadic or non-sporadic Alzheimer’s dementia (DTA + E) with the data obtained from the cases with early familial Alzheimer’s dementia caused by the E280A of the Neurobank of the Neurosciences Group of Antioquia (GNA). Materials and Method: This study was of exploratory – descriptive and correlacional type, 83 donors’ cases were taken with DTA stored in the Neurobank. These cases were divided in two groups, i) a group defined genetically like E280A; and ii) another not carrying group of the mutation (DTA+E); the scoreboards and / or characteristics neuropsychiatric, neuropsychological, neurological and neuropathological of both groups were confirmed. Results: The symptom that showed higher differences between both groups was iteration iteration (DTAF E280A with 1.2% and 18.4% for the DTA+E group). Other symptoms as depression or the time of appearance of progressive loss of memory did not show big differences among groups (DTAF E2080A=55.9%; DTA+E =53.1%) and (DTAF E2080A=55.9%; DTA+E =53.1%). The language disorders that were observed with major frequency among the donors were the loss of the language, mutism, anomia and aphasia. The sign with higher frequency in both groups was lost of sphincter control. The atrophy was with more intensity in the temporary lobes of the brains of the donors with DTA+E (83.3%). The weight of the brain and of the posterior fosse content, they have a moderate, directly proportional and highly significant relation from the statistical point of view. Conclusions: DTA +E has neuropathological differences with DTAF E280A that can be associated with the physiology hereditary from of DTAF E280A.
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Batería Neuropsicológica Set de Datos Uniformes (UDS) Para la Evaluación de Enfermedad de Alzheimer y Deterioro Cognitivo Leve: Una Revisión Sistemática. Neuropsychological Battery Uniform Data Set (Uds) For The Evaluation Of Alzheimer’s Disease And Mild Cognitive Impairment: A Systematic Review.
The neuropsychological battery UDS (of the English Uniform Data Set), is used worldwide to homogenize the investigations of Alzheimer’s disease. Objective: Quantitatively synthesize the results of the subtests of the UDS for the cognitive profile of controls, patients with mild cognitive impairment and dementia of the Alzheimer type. Method: An advanced and manual systematic search was performed in databases (PubMed / MedLine, Web of Science, Scopus, Lilacs, Science Direct, Cochrane Library, PsycINFO) evaluating the diagnostic performance of the UDS. Results: The systematic review showed a narrative synthesis where 8 articles were included that included 9260 subjects, with an age range between 60 and 90 years. The quantitative synthesis used 13 articles with a total sample of 2,884 participants, with an average age of 74 years and an average of 15 years of education. Conclusion: We described a synthesis of the medial scores, which generate cut-off points for Alzheimer’s type dementia (DTA), mild cognitive impairment (MCI) and cognitively normal controls, evidencing an adequate diagnostic precession.
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Deterioro Cognitivo en Pacientes Diabéticos De 55 a 65 Años de Edad. Reporte Final de Estudio Observacional, Transversal en la Ciudad de Guayaquil. Cognitive Impairment In Diabetic Patients Between 55 And 65 Years Old. Final Report Of A Cross-Sectional, Observational Study In Guayaquil City.
Introduction: Diabetes mellitus is a frequent and systemic illness. Deleterious effects on cognition are one of its lesser known consequences. Diabetic individuals are at an increased risk for development of dementia in the future. Objective: To compare cognitive function in middle aged diabetic population with non-diabetic control group, in order to determine high risk population for developing cognitive decline or dementia in the future. Methodology: This is a cross-sectional, observational study conducted in Guayaquil. We studied 309 individuals between the ages of 55 and 65 years, of which 142 were diabetics and 167 were non-diabetic controls. A neuropsychological evaluation was performed to assess memory, attention, executive functioning and processing speed. Results: Group comparisons revealed significant differences between diabetics and non-diabetics in systolic blood pressure (p<.001), hyperlipidemia (p<.001) and cardiovascular risk (p < .001). Cognitive performance, after considering differences in scholarship, was lower in diabetic people (memory p values between .000 and .002; attention p values between .000 and .019; executive function p values between .000 and .001). Correlation between years of disease and cognitive decline was not significant (memory -.055; attention -.040; executive function .0169). Correlation between glycated hemoglobin and cognitive performance was significant for all evaluated functions (memory -.219; attention -.186; executive function -.269). Conclusion: Middle aged diabetic population has lower cognitive performance compared with non diabetics. The identification of individuals at risk for cognitive decline will contribute to the development and implementation of intervention strategies that will allow the slowing of cognitive decline in vulnerable individuals.
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Palabras clave: Alzheimer,
Cognición,
demencia,
deterioro cognitivo,
Diabetes mellitus,
pruebas neuropsicológicas,
salud cerebral,
