Gilberto Isaac Acosta-Castillo

VALIDITY AND RELIABILITY OF THE 10/66 DEMENTIA RESEARCH GROUP COGNITIVE TEST BATTERY FOR EARLY IDENTIFICATION OF COGNITIVE DECLINE IN MEXICO

to test the null hypothesis of no mean difference between delayed recall memory T-scores and language and executive function, respectively. Results: This pre-dialysis sample included 27 adults with a mean age of 66, a mean education of 13 years, and a mean estimated glomerular filtration rate (eGFR, in ml/min/1.73 m) of 13; the average length of time between the last study visit and participant report of dialysis initiation was 6 months. Delayed recall memory performance was the only measure, on average, which fell in the impaired range (T < 40) and demonstrated the lowest performance (T1⁄4 37.9) compared to both language (T 1⁄4 43.7; p 1⁄4 .03) and executive function (T 1⁄4 43.2; p 1⁄4 .05). Conclusions: Delayed recall memory performance may be preferentially reduced in advanced CKD patients prior to the initiation of HD. Future studies will investigate the pattern of pre-dialysis cognitive performance in a larger sample, further characterize the course of memory changes throughout HD, and determine whether impairment in this domain prior to HD suggests an irreversible neurodegenerative process that may not improve with HD treatment.

ROCKWOOD CLINICAL FRAILTY SCALE AS A METHOD OF PREDICTING PHYSICAL DISABILITY, COGNITIVE DETERIORATION AND MORTALITY IN THE ELDERLY

Colour trail test 1 0.01 -0.02, 0.03 0.11 -1.06, 1.28 0.02 -0.05, 0.10 1.19 0.79,1.79 -0.04 -0.07, -0.01 <99 percentile. In-transformed Choice reaction time 1.54 -4.95, 8.03 0.34 -1.08, 1.76 0.02 -0.06, 0.10 1.12 0.72,1.76 -3.42 -10.55, 3.70 <95 percentile. Sustained attention 0.30 -8.96, 9.57z* 0.25 -1.47, 197z* 0 -0.11, 0.10z* 1.29 0.83,1.98 -6.57 -13.39,0.24z <99 percentile Executive function (composite) 0.05 -0.08,0.17

ASSOCIATION BETWEEN APATHY AND CLINICAL FRONTAL-SUBCORTICAL DYSFUNCTION IN A MEXICAN SAMPLE OF ELDERLY PATIENTS WITH NEUROCOGNITIVE DISORDERS

thickness was measured using a surface-based method. We compared baseline cortical thickness, neuropsychological tests, and other risk factors between fast and slow decliners. Results:A total 22 patients with naMCI progressed clinically (fast decliners), and 99 patients remained stable over 3 years (slow decliners). Compared to slow decliners, fast decliners were older. Fast decliners had lower raw scores on memory tasks, language impairment, and frontal/executive dysfunction at baseline neuropsychological tests, and more converted to dementia compared to slow decliners. In addition, fast decliners showed cortical thinning in the left dorsolateral prefrontal cortex and bilateral medial temporal lobes, compared to slow decliners. Conclusions:Our findings suggested that fast decliners of naMCI patients may have unique clinical and brain magnetic resonance imaging features, discriminating from slow decliners. Regarding there is increasing interest in the clinical outcomes of naMCI, our finding would be helpful in clinical practice.

ASSOCIATION BETWEEN THEORY OF MIND AND EXECUTIVE FUNCTIONING IN MILD COGNITIVE IMPAIRMENT, ALZHEIMER'S DISEASE AND HEALTHY OLDER ADULTS

greater cost than their e3 counterparts. This pattern was reversed in young adulthood, with e4s tending towards a smaller cost. Across both genotypes, cost decreased with increasing WM load suggesting everybody was being forced to switch to a more focal strategy. Under WM load the e3s performed more like the e4s, which may suggest mid-age e4s were already working harder in the no load block. This differencewas supported by subjective report measures. Conclusions:Age-associated increases in prospective memory cost in e4 carriers are consistent with reduced processing in this group by mid-adulthood. Additionally, we identified age and genotype differences in the use of strategies to support PM performance. Further research is needed to understand the mechanisms of these early genotype differences in PM.

Clinical and imaging characteristics of atypical parkinsonism: Case series

Background:Weight loss might be a risk factor for mild cognitive impairment (MCI) and dementia. We assessed its impact on cognitive decline and its association with Alzheimer’s Disease (AD) biomarkers in healthy elderly (HC). Methods: Longitudinal observational study of HC (n1⁄4377) from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). We evaluated the progression to MCI or dementia, the baseline cerebrospinal fluid (CSF) core AD biomarkers profile, amyloid PET uptake (AV45) and baseline and 2-year longitudinal brain atrophy patterns according to weight trajectories (relative weight loss 5%). Results:After a mean followup of 46.8627.8 months 74 individuals (19.6%) progressed toMCI or dementia. Weight loss (HR: 1.759, CI95%: 1.057 to 2.925) predicted progression to MCI or dementia and was associated to a higher total tau/Aß42 ratio (p1⁄40.045) and increased AV45 uptake (p1⁄40.016). 132 HC had 3T MRI and CSF (tau and Aß42) available and 101 HC had 2 years MRI follow-up. Subjects with significant weight loss (WL-g) presented decreased cortical thickness at baseline in temporal regions and an accelerated 2-year cortical thinning in frontal regions in both hemispheres compared with subjects without weight loss (nWL-g) even after excluding those HC that progressed to MCI or dementia in the follow-up. Conclusions: Late-life weight loss is associated with increased AD biomarker burden, decreased CTh and accelerated atrophy rates in AD vulnerable areas. Weight loss might thus be a non-cognitive sign of preclinical AD. The mechanisms involved in this association deserve further investigation.

COMPARISON OF PERFORMANCE IN LANGUAGE TASKS AMONG HEALTHY SUBJECTS, PATIENTS WITH ALZHEIMER'S DISEASE, BEHAVIORAL VARIANT OF FRONTOTEMPORAL DEMENTIA, AND PROGRESSIVE NONFLUENT APHASIA

Background: It was shown in our previous research that individuals with PCA have challenges with internal visual imagery. (AAIC 2015 & 2016) It has also been demonstrated that mental imagery facilitates the ability to categorize objects (Wu, Duan, Tian, Wang, & Zhang, 2012). Because categorization requires mental imagery, and individuals with PCA have decreased visual imagery, we propose that individuals with PCAwill show decreased scores on a category based semantic fluency test as compared to their scores on a verbal fluency test which does not require this inner visualization. We also propose that individuals with Alzheimer’s disease will not show this discrepancy between semantic and verbal fluency scores as their internal visual imagery is not targeted by their disease allowing them to carry out semantic and verbal fluency tasks equally. Methods: Researchers will access the records of individuals who have been diagnosed with PCA and those with Alzheimer’s disease from IRB 15-000502 and compare their verbal fluency score to their semantic fluency scores. The differences in the fluency scores will then be compared to see if those with PCA show a greater decrease in their semantic fluency scores than their verbal fluency scores when compared to those with Alzheimer’s disease. Results: A pilot study was completed with 10 participants with PCA, their average semantic fluency scaled score for was 5.9, average verbal fluency scaled score 9.5. A scaled score of 9.5 places the verbal fluency scores within the average range and a scaled score of 5.9 places the semantic fluency scores in the borderline range. This discrepancy in scores shows promise in supporting our hypothesis. This data reflects only our pilot study of 10 participants, the bulk of our data is in the process of being analyzed and final semantic and verbal fluency results will be released at the conference. Conclusions:Differences in performance on semantic fluency versus verbal fluency tasks in patients with PCA may be a further indication that intrinsic visualization may be impaired. This could have some impact on a patient’s functional status and may be important in planning rehabilitation strategies in this population.

PREVALENCE OF DEMENTIA BY STATE AND LEVEL OF MARGINALIZATION IN MEXICO

8.92]) per 1,000 person years in the T2DM and non-T2DM cohorts, respectively. Individuals with cancer had a 48 % and 26 % reduction risk of LOD compared to those without cancer in the T2DM and non-T2DM cohorts, respectively. Cancer patients had a decreased risk for LOD [HR1⁄40.67, 95 % CI (0.66-0.68) p<0.01] in the T2DM and [HR1⁄40.50, 95 % CI (0.47-0.53) p< 0.01] non-T2DM cohorts. This inverse association persisted when the outcome of interest was examined with specific forms of cancers. For example, there was a decreased risk for LOD in individuals with bladder cancer in both T2DM [HR1⁄40.52, 95 % CI (0.43-0.63) p<0.01] and non-T2DM cohorts [HR1⁄40.77, 95 % CI (0.72-0.83) p<0.01]. Conclusions: Our results suggest an inverse association between several forms of cancer and LOD independent of T2DM status. In an ageing population, the understanding of biological links between comorbid conditions is imperative to improve our knowledge of biological pathways and mechanisms of common diseases. If further validated our findings may help inform more refined preventative strategies and approaches.

CARDIOVASCULAR RISK FACTORS IN MEXICAN ELDERS WITH DEMENTIA AND THEIR RELATIONSHIP TO DISEASE PROGRESSION

*Statistical significance: p value <0.05 THEIR RELATIONSHIP TO DISEASE PROGRESSION Rosa Maria Salinas-Contreras, Gilberto Isaac Acosta-Castillo, Ana Luisa Sosa-Ortiz, National Institute of Neurology and Neurosurgery, Mexico City, Mexico; National Autonomous University of Mexico, Mexico City, Mexico; National Instutute of Neurology and Neurosurgery, Mexico City, Mexico; National Instutute of Neurology and Neurosurgery, Mexico City, Mexico; Dementia Laboratory National Institute of Neurology and Neurosurgery, Mexico City, Mexico; National Institute of Neurology and Neurosurgery, Mexico City, Mexico. Contact e-mail: rox_sali@hotmail.com

WHITE MATTER FRACTIONAL ANISOTROPY ANALYSIS OF BEHAVIOURAL AND COGNITIVE DYSEXECUTIVE SYNDROMES IN AMNESTIC MILD COGNITIVE IMPAIRMENT AND ALZHEIMER'S DISEASE: A MEXICAN PILOT STUDY

* 0 .5 6 0 .4 3 Juan Francisco Flores-Vazquez, Oscar Ren e Marrufo-Melendez, Yaneth Rodriguez Agudelo, Gilberto Isaac Acosta-Castillo, Daniel Alejandro Lopez Ramos, Desir ee Guadalupe L opez-Palafox, Ana Luisa Sosa-Ortiz, Dementia Laboratory National Institute of Neurology and Neurosurgery, Mexico City, Mexico; National Institute of Neurology and Neurosurgery, Mexico City, Mexico; Universidad Nacional Aut onoma de M exico, Mexico City, Mexico; Metropolitan Autonomous University, Mexico City, Mexico; National Institute of Neurology and Neurosurgery, Mexico City, Mexico. Contact e-mail: flores.v@gmail.com

INDEX FOR THE PREDICTION OF INCIDENT DEMENTIA: THREE YEARS’ FOLLOW-UP STUDY

collected: age; sex; MMSE; neuropsychological evaluation including long term memory, executive functions, language and visuospatial abilities. Core biomarkers were collected following local practices: Scheltens’s visual assessment of medial temporal atrophy (MTA) on MR scan; visual assessment of hypometabolism/hypoperfusion on FDG-PET/SPECT brain scan; CSFAß1-42, tau and phospho-tau levels. At diagnostic workup completion, an estimate of confidence that cognitive complaints were due to AD was elicited from clinicians on a structured scale ranging from 0 to 100. Only cases with uncertain diagnoses (confidence between 15% and 85%) were retained for analysis. Generalized linear models were used to describe the relationship between the collected measures and the diagnostic confidence of AD. Results:Neuropsychological assessment was carried out in almost all cases (98% of the cases). Medial temporal atrophy ratings were done in 40% of cases, assessment of cortical hypometabolism/hypoperfusion in 34%, and CSF Aß and tau levels in 26%. The markers that better explained the variability of diagnostic confidence were CSF Aß142 level (R1⁄40.46) and hypometabolism/hypoperfusion (R1⁄40.45), followed by CSF tau level (R1⁄40.35), MTA assessment (R1⁄40.32) and. All figures were highly significant, at p<<0.001. The diagnostic confidence variability due to neuropsychological tests for different domains was lower: MMSE (R1⁄40.29); long term memory (R1⁄40.23); executive functions (R1⁄40.05); language (R1⁄40.02); visuospatial abilities (R1⁄40.04) even if significant (p<0.01). Conclusions: The use of core biomarkers in the clinical assessment of subjects with suspected AD and high diagnostic uncertainty is still limited. However, when assessed, these biomarkers show a higher impact on diagnostic confidence of AD than the most widespread clinical measures.