Paula Harris

Perfis Diferenciais de Perda de Memória entre a Demência Frontotemporal e a do Tipo Alzheimer

While in Dementia of Alzheimers Type (DAT) the initial states are characterized by the deterioration of memory, in frontotemportal dementia (FTD) the early symptoms are basically changes in behavior. However, in daily clinical practice, the establishment of a differential diagnosis is very difficult to be found. The objective of the present work is to compare the memory efficiency of patients with DTA (n= 20) and FTD (n= 20) to a control group. The patients, matched for age and educational level, were evaluated with basis on a number of exhausting neuropsychology tests. In order to examine memory, we used the learning, free recall and recognition of a list of words (episodic memory), the analysis of the performance in the Boston Naming Test (semantic memory) and the subjects memory complaints (subjective memory). The scores obtained on the most part of the tests by the two groups (DAT and FTD) were significantly worse than those of the control group. DAT patients, on the other hand, showed an important memory deficit on free recall but less encoding capacities, despite the difficulties in acknowledging their disturbance. Memory profile of FTD patients was characterized by forgetfulness while DAT profile was an amnesic one.

Cognitive reserve and Aβ1-42 in mild cognitive impairment (Argentina-Alzheimer’s Disease Neuroimaging Initiative)

Background The purpose of this study was to investigate the relationship between cognitive reserve and concentration of Aβ1-42 in the cerebrospinal fluid (CSF) of patients with mild cognitive impairment, those with Alzheimer’s disease, and in control subjects. Methods Thirty-three participants from the Argentina-Alzheimer’s Disease Neuroimaging Initiative database completed a cognitive battery, the Cognitive Reserve Questionnaire (CRQ), and an Argentinian accentuation reading test (TAP-BA) as a measure of premorbid intelligence, and underwent lumbar puncture for CSF biomarker quantification. Results The CRQ significantly correlated with TAP-BA, education, and Aβ1-42. When considering Aβ1-42 levels, significant differences were found in CRQ scores; higher levels of CSF Aβ1-42 were associated with higher CRQ scores. Conclusion Reduced Aβ1-42 in CSF is considered as evidence of amyloid deposition in the brain. Previous results suggest that individuals with higher education, higher occupational attainment, and participation in leisure activities (cognitive reserve) have a reduced risk of developing Alzheimer’s disease. Our results support the notion that enhanced neural activity has a protective role in mild cognitive impairment, as evidenced by higher CSF Aβ1-42 levels in individuals with more cognitive reserve.

Cognitive impairment and risk factor prevalence in a population over 60 in Argentina

Epidemiological data on dementia and cognitive impairment are scarce in South America. In Argentina, no dementia/cognitive impairment population-based epidemiological studies are available. The Ceibo Study is a population-based epidemiological study of dementia and cognitive impairment in individuals over 60 to be conducted. The present paper reports the results of the pilot phase (survey of cognitive impairment) conducted in Cañuelas (province of Buenos Aires). Methods In a door-to-door survey, trained high school students evaluated 1453 individuals aged 60 years and over in one day using a demographic data and risk factors questionnaire, the Mini-Mental State Examination (MMSE) and the 15-item Geriatric Depression Scale (GDS). Results Mean age of the individuals was 70.9 (±7.5) years, 61.4% were women, mean schooling was 5.5 (±3.5) years. Mean MMSE score was 24.5 (±4.7) and mean GDS 3.1 (±2.7). Risk factors of higher prevalence in the population under study were: hypertension (40.6%), smoking (35.1%), alcohol consumption (32.8%), high cholesterol (16.1%), diabetes (12.5%), cranial trauma with loss of consciousness (12.5%), 7 points or more on the GDS (11.7%). Prevalence of cognitive impairment for the whole sample was 23%, and 16.9% in subjects aged 60-69, 23.3% in 70-79 and 42.5% in subjects aged 80 or over . A significant correlation of cognitive impairment with age, functional illiteracy, cranial trauma, high blood pressure, inactivity and depression was found. Conclusion In this pilot study, the prevalence of cognitive impairment was comparable with previous international studies.

Argentina-Alzheimer's disease neuroimaging initiative (Arg-ADNI): neuropsychological evolution profile after one-year follow up

The Argentina-Alzheimers disease neuroimaging initiative (Arg-ADNI) study is a longitudinal prospective cohort of 50 participants at a single institution in Buenos Aires, Argentina. Longitudinal assessments on a neuropsychological test battery were performed on 15 controls, 24 mild cognitive impairment (MCI) patients and 12 Alzheimers disease (AD) dementia patients. In our study population, there was a high prevalence of positive AD biomarkers in the AD group, 92.3% (12/13); and a low prevalence in the normal controls, 20%; almost half (48%) of the patients diagnosed with MCI had positive amyloid detection. After a one year, the significant differences found at baseline on neuropsychological testing were similar at the follow-up assessment even though the AD group had significantly altered its functional performance (FAQ and CDR). The exception was semantic fluency, which showed greater impairment between the AD group and MCI and normal controls respectively. For these tests, the addition of AD biomarkers as a variable did not significantly alter the variations previously found for the established clinical groups model. Finally, the one-year conversion rate to dementia was 20% in the MCI cohort.

CORTICAL THICKNESS FOLLOW-UP AFTER ONE YEAR IN ADNI-ARGENTINA COHORT

P1-451 CORTICALTHICKNESS FOLLOW-UP AFTER ONE YEAR IN ADNI-ARGENTINA COHORT Ismael Luis Calandri, Ignacio Demey, Patricio Alexis Chrem Mendez, Gabriela Cohen, Maria Julieta Russo, Ezequiel Surace, Horacio Martinetto, Federico Nahas, Maria Eugenia Martin, Paula Harris, Jorge Campos, Gustavo Sevlever, Silvia Vazquez, Allegri F. Ricardo, Ra ul Carrea Institute for Neurological Research (FLENI), Buenos Aires, Argentina; Hospital Brit anico de Buenos Aires, Buenos Aires, Argentina; Ra ul Carrea Institute for Neurological Research (FLENI), Buenos Aires, Argentina. Contact e-mail: ismaelcalandri@gmail.com

Utility of the Spanish version of the Everyday Cognition scale in the diagnosis of mild cognitive impairment and mild dementia in an older cohort from the Argentina-ADNI

IntroductionThe performance of activities of daily living in elderly patients with memory disorders is directly related to living independently and to autonomy. Documenting and assessing functional capacity through detailed scales is important for both diagnostic and treatment recommendations. The Everyday Cognition (ECog) scale is a relatively new informant-rated measure of cognitive and functional abilities. In the present study, the discriminant validity of the ECog scale was evaluated in cognitively intact controls (CN) and in patients with mild cognitive impairment (MCI) and mild Alzheimer’s disease (AD) from the Argentina-ADNI cohort to establish diagnostic accuracy. In addition, we compared the sensitivity and specificity of ECog against Functional Assessment Questionnaire (FAQ) scale to discriminate among the three groups.MethodsWe evaluated 15 CN, 28 MCI, and 13 mild AD subjects. External, convergent and divergent validity and internal consistency were examined.ResultsThe average total score on the ECog was significantly different across the three diagnostic syndromes (p < .05). The ECog was more sensitive than FAQ in discriminating between CN and MCI patients and between MCI and AD subjects. The ECog showed a strong correlation with FAQ, and moderate correlations with neuropsychological tests. Cronbach’s alpha was .98.ConclusionsThe ECog scale is an efficient instrument for the differentiation of individuals with mild dementia or MCI from normal older adults, with good accuracy and good correlation with other tests measuring daily and cognitive functions. Comparing against FAQ, ECog was more useful in assessing changes in functionality in MCI patients.

EVERYDAY COGNITION SCALE PREDICTS BRAIN AMYLOID DEPOSITION: PRELIMINARY RESULTS FROM THE ARGENTINA-ADNI STUDY

P3-304 EVERYDAY COGNITION SCALE PREDICTS BRAIN AMYLOID DEPOSITION: PRELIMINARY RESULTS FROM THE ARGENTINA-ADNI STUDY Maria Julieta Russo, Gabriela Cohen, Jorge Campos, Patricio Chrem, Alejandra Amengual, Federico Nahas, Maria Eugenia Martin, Maria Florencia Clarens, Fernanda Tapajoz, Paula Harris, Gustavo Sevlever, Allegri Ricardo, Argentina Alzheimer, FLENI, Buenos Aires, Argentina. Contact e-mail: jrusso@fleni.org.ar

Cognitive training and long-term follow-up in patients with mild cognitive impairment

Background: Attention deficit hyperactivity disorder (ADHD) is a common childhood learning disorder. The frequency of ADHD in the aging population and its relationship to late-life cognitive decline or the development of dementia has not been studied previously. Methods: The Wender-Utah ADHD Rating scale was administered to cognitively normal or impaired geriatric research subjects followed longitudinally at the University of Kentucky Alzheimer’s Disease Center. The frequency of ADHD and the association of ADHD diagnosis with cognitive test profiles and diagnosis of mild cognitive impairment (MCI) or dementia were assessed using standard comparative statistical measures. Results: Wender-Utah results were obtained from 320 subjects with normal cognition (n 1⁄4 227), MCI (n 1⁄4 39), cognitive impairment not meeting criteria for dementia or MCI (n 1⁄4 9), and early dementia (n 1⁄4 17). The frequency of ADHD in this sample was 6%. ADHD diagnoses were not related to cognitive diagnoses. Cognitive test profiles demonstrate impairment in tasks requiring sustained attention including Category Fluency (p 1⁄4 0.003, Student’s t-test) and Trailmaking Test A (p 1⁄4 0.02, Student’s t-test) for subjects with ADHD. Conclusions: The frequency of ADHD appears stable across generations. The finding of deficits in attentional processing in ADHD subjects in their geriatric years suggests that such traits are stable throughout life and need to be considered when interpreting cognitive test profiles. In addition, ADHD does not appear to be a risk factor for the development of MCI or dementia.