Articles: alzheimer-disease-complications.
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Unilateral neglect--the inability to pay attention to events occurring on one side of space--usually occurs for left-side events after focal right-hemisphere damage. We report a 73-year-old woman with probable AD and no evidence of focal brain lesions who showed signs of right-side neglect and extinction. ⋯ Neuroimaging techniques demonstrated an asymmetry of cortical involvement, with cortical atrophy and hypoperfusion predominant in the left posterior regions. Unilateral neglect should be assessed systematically in AD.
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Virtually all individuals with Down syndrome (DS) have neuropathologic changes characteristic of Alzheimer's disease (AD) beginning at 40 years of age. Few studies have examined factors that influence age at onset of AD in DS. We investigated whether sex differences in age at onset and risk of AD among adults with DS are similar to those observed in the general population and whether the effect of sex on risk of AD is modified by apolipoprotein E (APOE) genotype. ⋯ Both male gender and the presence of an APOE epsilon4 allele were associated with an earlier onset of AD. Compared with women, men with DS were three times as likely to develop AD. Compared with those with the APOE 3/3 genotype, adults with DS with the 3/4 or 4/4 genotypes were four times as likely to develop AD. No individual with an APOE epsilon2 allele developed AD. No evidence of interaction of sex and APOE genotype was found in risk of AD. The higher risk of AD in men may be related to differences in hormonal function between men and women with DS that are distinct from those in the general population.
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To investigate the frequency and longitudinal course of symptoms of depression, agitation, and psychosis in a longitudinally studied sample of patients with Alzheimer's disease (AD). ⋯ Mild behavioral disturbances are common, whereas moderate to severe behavioral symptoms are less frequent in this population of AD patients. Disturbances in mood and manifestations of agitation and psychotic symptoms are not closely related to one another and show little progressive worsening over time. Rather, they tend to be episodic such that increasing severity at one time is usually followed by improvement later. Concentration problems are a manifestation of cognitive dysfunction rather than behavioral disturbance in AD. Implications of these results for treatment of noncognitive disturbances in AD are discussed.
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Dement Geriatr Cogn Disord · Nov 1997
Comparative StudyEpisodic memory functioning in population-based samples of very old adults with Alzheimer's disease and vascular dementia.
Population-based samples of normal old adults, patients with Alzheimer's disease (AD), and patients with vascular dementia (VaD) between 90 and 100 years of age were given a series of episodic memory tasks, assessing face recognition, word recall, and object recall. Results indicated (a) no group differences in those variables reflecting primary memory, and clear dementia-related deficits in secondary memory; (b) no differences between persons with AD and VaD in face recognition and object recall, and (c) an advantage of VaD patients compared with AD patients in word recall. It was suggested that the ability to transfer information from temporary to permanent storage may be particularly affected by a dementing disease. In addition, the selective AD-related deficit in word recall was interpreted in terms of a greater impairment of various language-related skills in AD compared with VaD.
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To determine the relationship of brain infarction to the clinical expression of Alzheimer disease (AD). ⋯ These findings suggest that cerebrovascular disease may play an important role in determining the presence and severity of the clinical symptoms of AD.