Hideyuki Hattori

Controlled study on the cognitive and psychological effect of coloring and drawing in mild Alzheimer's disease patients

Aim:  Art therapy has been reported to have effects on mental symptoms in patients with dementia, and its usefulness is expected. We performed a controlled trial to evaluate the usefulness of art therapy compared with calculation training in patients with mild Alzheimers disease.

Noninvasive detection of endothelial dysfunction in elderly with NIDDM by ultrasonography.

We compared endothelial function noninvasively in 15 elderly patients with noninsulin‐dependent diabetes mellitus (NIDDM) with 12 nondiabetic elderly patients. Using high resolution ultrasound, we measured flow‐mediated dilatation (FMD) of the brachial artery and sublingual nitroglycerin (NTG)‐mediated dilatation. FMD was significantly impaired in subjects with NIDDM compared with control subjects. In NIDDM subjects, FMD with complications was lower than in subjects with noncomplications. However, there was no significant difference in NTG between NIDDM subjects and the control group. Hyperemic blood flow change was lower in NIDDM subjects, but not significant. These results suggest that elderly patients with NIDDM have impaired L‐arginine/nitric oxide (NO) pathways and the possibility of capillary rarefaction.

Guidelines for Non‐Medical Care Providers to Detect Illnesses in Elderly Evacuees After the 2011 Earthquake Off the Pacific Coast of Tohoku

This study found that the gait speed and mobility were associated with global cognitive function after 3 years and were cross-sectionally associated with executive and memory functions. The results could suggest that slowing of mobility can be observed before decline in global function and coinciding with impairment in executive and memory functions in people aged 80 and older. These findings based on octogenarians and nonagenarians in Okinawa, Japan, known for their longevity, give additional generalizability to previous findings. This association has potentially important implications for early detection of cognitive impairment in older people.

Guidelines for non-medical care providers to manage the first steps of emergency triage of elderly evacuees.

On 11 March 2011, a strong earthquake occurred off of Japans Pacific coast and hit northeastern Japan. The earthquake was followed by huge tsunamis, which destroyed many coastal cities. As a result, the Study Group on Guidelines for the First Steps and Emergency Triage to Manage Elderly Evacuees quickly established guidelines enabling non‐medical care providers (e.g. volunteer, helpers, and family members taking care of elderly relatives), public health nurses, or certified social workers to rapidly detect illnesses in elderly evacuees, and 20 000 booklets were distributed to care providers in Iwate, Miyagi, and Fukushima prefectures. The aim of this publication is to reduce susceptibility to disaster‐related illnesses (i.e. infectious diseases, exacerbation of underlying illnesses, and mental stress) and deaths in elderly evacuees. Geriatr Gerontol Int 2011; 11: 383–394.

Clinical psychological tests useful for differentiating depressive state with Alzheimer's disease from major depression of the elderly

Background:  A depressive state with Alzheimers disease (AD) is difficult to differentiate from major depression (MD) in many cases. The purpose of this study was to identify differences between the two disorders using a battery of clinically available psychological tests.

Role of geriatric hospitals for dementia care in the community.

In dementia care, behavioural and psychological symptoms of dementia and physical illness in patients with dementia impose a marked care burden and require medical intervention. Therefore, it is important for patients and their families to select appropriate medical institutions and facilities with nursing units specializing in the care of behavioural and psychological symptoms of dementia, such as geriatric hospitals, which are required to deal with various aspects of dementia. Geriatric hospitals should offer two treatment approaches: a care unit for patients with behavioural and psychological symptoms of dementia or dementia with physical illness, and a multidisciplinary team approach involving physicians, nurses, psychologists, and social workers who provide coping strategies for dementia patients.

Effects of eicosapentaenoic acid on the physical properties of the common carotid artery in elderly patients with atherosclerosis

Abstract This study was conducted to assess the effects of antiatherosclerotic treatment with eicosapentaenoic acid (EPA) on the hemodynamics and physical properties of the common carotid artery in elderly patients with atherosclerosis. EPA, found in high levels in fish oil, is an omega-3 polyunsaturated fatty acid that has a variety of pharmacologic effects, including antiplatelet, arterial elasticity-maintaining, and hypolipidemic. EPA has proved to be useful in treating arteriosclerosis obliterans. A total of 18 patients (mean age, 76.2 ± 5.7 years) with atherosclerosis underwent complete Doppler ultrasonic examination of the common carotid artery before and after 16 weeks of treatment with EPA (900 mg or 1800 mg daily). The presence of atherosclerosis was determined by clinical findings, especially according to physical properties of the common carotid artery derived by ultrasound examination. The minimal diameter of the common carotid artery at minimal blood pressure decreased significantly from 7.64 ± 0.93 mm to 7.21 ± 0.97 mm ( P 5 dyne/cm 2 to 8.95 ± 2.78 × 10 5 dyne/cm 2 and from 6.44 ± 2.79 to 5.41 ± 1.79, respectively; P

Electromagnetic signatures of the preclinical and prodromal stages of Alzheimer’s disease

Biomarkers relevant to the pre-dementia stages of Alzheimer’s disease are needed. Using MEG, PET, and MRI, Nakamura et al. disentangle resting state regional spectral patterns in cognitively normal subjects and individuals with mild cognitive impairment into MEG signatures related to Aβ deposition, disease progression, or changes non-specific to Alzheimer’s disease.

Unclassified cases of behavioral variant of major frontotemporal neurocognitive disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition

In the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM‐5), the behavioral variant of major frontotemporal neurocognitive disorder (bvFT‐NCD) is subclassified into “probable bvFT‐NCD” or “possible bvFT‐NCD.” When genetic evidence is unavailable, cases without clinical neuroimaging are subclassified into “possible bvFT‐NCD,” whereas cases whose clinical images show the typical characteristics are subclassified into “probable bvFT‐NCD.” Thus, the cases that meet the diagnostic criteria of bvFT‐NCD based on their symptoms, but lack the neuroimaging characteristics, fall between the two categories of probable and possible bvFT‐NCD. These cases herein are defined as “unclassified bvFT‐NCD,” and the present study aims at considering an appropriate diagnostic approach to such cases, that is, whether unclassified bvFT‐NCD should be included in bvFT‐NCD as a third subcategory, or whether it should be classified into diseases other than bvFT‐NCD.

Decreased perfusion of the posterior cingulate gyri shown by a cingulate island score is a possible marker of vulnerability to behavioural and psychological symptoms of Alzheimer's disease: a pilot study: PCG perfusion decrease indicates BPSD

The cingulate island score (CIScore), which indicates the Z‐score ratio of the posterior cingulate gyri to the medial occipital area, has been shown to be useful for differentiating dementia with Lewy bodies from Alzheimers disease (AD). Our aim was to investigate associations between the clinical symptoms of AD and the CIScore as an index of the relative decrease in perfusion of the posterior cingulate gyri that occurs in the early stages of AD.