Then it was that books began to happen to me, and I began to believe in nothing but books and the wonderful world in books-where if people suffered, they suffered in beautiful language, not in monosyllables, as we did in Kansas. And I was unhappy for a long time, and very lonesome living with my grandmother. Validations for pre-dementia scales such as the MBI Checklist, and incorporation into longitudinal and intervention trials, are needed to better understand impulse dyscontrol as a risk factor for mild cognitive impairment and dementia.”When I was in the second grade, my grandmother took me to Lawrence to raise me. This scoping review of agitation and impulsivity pre-dementia syndromes summarizes the current biomedical literature in terms of epidemiology, diagnosis andmeasurement, neurobiology, neuroimaging, biomarkers, course and prognosis, treatment, and ongoing clinical trials. Extending a series of reviews exploring the pre-dementia risk syndrome Mild Behavioral Impairment (MBI), we focused on late-onset agitation and impulsivity (the MBI impulse dyscontrol domain) and risk of incident cognitive decline and dementia. To identify knowledge gaps regarding new-onset agitation and impulsivity prior to onset of cognitive impairment or dementia the International Society to Advance Alzheimer’s Research and Treatment Neuropsychiatric Syndromes (NPS) Professional Interest Area conducted a scoping review. The AVLT performance in the whole study samples was predicted by age, A!-42, and the T-tau CSF biomarkers, but not by the APOE genotyping. The levels of T-tau and P-tau were significantly higher in the APOE 4 carriers than in the noncarriers, but only in the MCI patients. This pattern was also typical for the APOE 4 carriers, who had lower levels of A!-42 than the noncarriers in the AD-D and MCI groups. We found that the patients with more severe cognitive impairments had significantly lower levels of A!-42 and higher levels of T-tau and P-tau. A verbal episodic memory performance level was assessed and was based on a delayed recall trial from the 10-word list of an auditory verbal learning task (AVLT). We included 252 patients from the memory clinic with a diagnosis of SCD (n = 85), MCI (n = 87), and AD-D (n = 80). The aim of this study was to estimate the prevalence of AD CSF biomarkers in those individuals with a subjective cognitive decline (SCD), a mild cognitive impairment (MCI), and Alzheimer’s dementia (AD-D), together with the relationships between the biomarkers, an APOE 4 presence, and a verbal episodic memory performance. The concentration levels of AD cerebrospinal fluid (CSF) biomarkers, such as amyloid-!-42 (A!-42), total tau (T-tau), and phosphorylated tau (P-tau), may reflect a cerebral pathology facilitating an early diagnosis of the disease and predicting a cognitive deterioration. In the course of Alzheimer’s disease (AD), early pathological changes in the brain start decades before any clinical manifestation.
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