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  • 1
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    Vegetables, Unsaturated Fats, Moderate Alcohol Intake, and Mild Cognitive Impairment
    S. Karger AG ; 2010
    In:  Dementia and Geriatric Cognitive Disorders Vol. 29, No. 5 ( 2010), p. 413-423
    Details
    In: Dementia and Geriatric Cognitive Disorders, S. Karger AG, Vol. 29, No. 5 ( 2010), p. 413-423
    Abstract: 〈 i 〉 Background/Aims: 〈 /i 〉 To investigate associations of the Mediterranean diet (MeDi) components and the MeDi score with mild cognitive impairment (MCI). 〈 i 〉 Methods: 〈 /i 〉 Participants (aged 70–89 years) were clinically evaluated to assess MCI and dementia, and completed a 128-item food frequency questionnaire. 〈 i 〉 Results: 〈 /i 〉 163 of 1,233 nondemented persons had MCI. The odds ratio of MCI was reduced for high vegetable intake [0.66 (95% CI = 0.44–0.99), p = 0.05] and for high mono- plus polyunsaturated fatty acid to saturated fatty acid ratio [0.52 (95% CI = 0.33–0.81), p = 0.007] , adjusted for confounders. The risk of incident MCI or dementia was reduced in subjects with a high MeDi score [hazard ratio = 0.75 (95% CI = 0.46–1.21), p = 0.24]. 〈 i 〉 Conclusion: 〈 /i 〉 Vegetables, unsaturated fats, and a high MeDi score may be beneficial to cognitive function.
    Type of Medium: Online Resource
    ISSN: 1420-8008 , 1421-9824
    URL: Article
    DOI: 10.1159/000305099
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2010
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  • 2
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    The Mayo Clinic Study of Aging: Design and Sampling, Participation, Baseline Measures and Sample Characteristics
    S. Karger AG ; 2008
    In:  Neuroepidemiology Vol. 30, No. 1 ( 2008), p. 58-69
    Details
    In: Neuroepidemiology, S. Karger AG, Vol. 30, No. 1 ( 2008), p. 58-69
    Abstract: 〈 i 〉 Background: 〈 /i 〉 The objective of this study was to establish a prospective population-based cohort to investigate the prevalence, incidence and risk factors for mild cognitive impairment (MCI) and dementia. 〈 i 〉 Methods: 〈 /i 〉 The Olmsted County, Minn., population, aged 70–89 years on October 1, 2004, was enumerated using the Rochester Epidemiology Project. Eligible subjects were randomly selected and invited to participate. Participants underwent a comprehensive in-person evaluation including the Clinical Dementia Rating Scale, a neurological evaluation and neuropsychological testing. A consensus diagnosis of normal cognition, MCI or dementia was made by a panel using previously published criteria. A subsample of subjects was studied via telephone interview. 〈 i 〉 Results: 〈 /i 〉 Four hundred and two subjects with dementia were identified from a detailed review of their medical records but were not contacted. At baseline, we successfully evaluated 703 women aged 70–79 years, 769 women aged 80–89 years, 730 men aged 70–79 years and 517 men aged 80–89 years (total n = 2,719). Among the participants, 2,050 subjects were evaluated in person and 669 via telephone. 〈 i 〉 Conclusions: 〈 /i 〉 Strengths of the study are that the subjects were randomly selected from a defined population, the majority of the subjects were examined in person, and MCI was defined using published criteria. Here, we report the design and sampling, participation, baseline measures and sample characteristics.
    Type of Medium: Online Resource
    ISSN: 0251-5350 , 1423-0208
    URL: Article
    DOI: 10.1159/000115751
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2008
    detail.hit.zdb_id: 1483032-2
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  • 3
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    Sleep Disturbance in Dementia with Lewy Bodies and Alzheimer’s Disease: A Multicenter Analysis
    S. Karger AG ; 2011
    In:  Dementia and Geriatric Cognitive Disorders Vol. 31, No. 3 ( 2011), p. 239-246
    Details
    In: Dementia and Geriatric Cognitive Disorders, S. Karger AG, Vol. 31, No. 3 ( 2011), p. 239-246
    Abstract: 〈 i 〉 Background/Aims: 〈 /i 〉 Evidence suggests that patients with dementia with Lewy bodies (DLB) may have more nocturnal sleep disturbance than patients with Alzheimer’s disease (AD). We sought to confirm such observations using a large, prospectively collected, standardized, multicenter-derived database, i.e. the National Alzheimer’s Coordinating Center Uniform Data Set. 〈 i 〉 Methods: 〈 /i 〉 Nocturnal sleep disturbance (NSD) data, as characterized by the Neuropsychiatric Inventory Questionnaire (NPI-Q), were derived from 4,531 patients collected between September 2005 and November 2008 from 32 National Institute on Aging participating AD centers. Patient and informant characteristics were compared between those with and without NSD by dementia diagnosis (DLB and probable AD). Finally, a logistic regression model was created to quantify the association between NSD status and diagnosis while adjusting for these patient/informant characteristics, as well as center. 〈 i 〉 Results: 〈 /i 〉 NSD was more frequent in clinically diagnosed DLB relative to clinically diagnosed AD (odds ratio = 2.93, 95% confidence interval = 2.22–3.86). These results were independent from the gender of the patient or informant, whether the informant lived with the patient, and other patient characteristics, such as dementia severity, depressive symptoms, and NPI-Q-derived measures of hallucinations, delusions, agitation and apathy. In AD, but not DLB, patients, NSD was associated with more advanced disease. Comorbidity of NSD with hallucinations, agitation and apathy was higher in DLB than in AD. There was also evidence that the percentage of DLB cases with NSD showed wide variation across centers. 〈 i 〉 Conclusion: 〈 /i 〉 As defined by the NPI-Q, endorsement of the nocturnal behavior item by informants is more likely in patients with DLB when compared to AD, even after the adjustment of key patient/informant characteristics.
    Type of Medium: Online Resource
    ISSN: 1420-8008 , 1421-9824
    URL: Article
    DOI: 10.1159/000326238
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
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  • 4
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    MRI Correlates of Protein Deposition and Disease Severity in Postmortem Frontotemporal Lobar Degeneration
    S. Karger AG ; 2009
    In:  Neurodegenerative Diseases Vol. 6, No. 3 ( 2009), p. 106-117
    Details
    In: Neurodegenerative Diseases, S. Karger AG, Vol. 6, No. 3 ( 2009), p. 106-117
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Frontotemporal lobar degeneration (FTLD) can be classified based on the presence of the microtubule-associated protein tau and the TAR DNA binding protein-43 (TDP-43). Future treatments will likely target these proteins, therefore it is important to identify biomarkers to help predict protein biochemistry. 〈 i 〉 Objective: 〈 /i 〉 To determine whether there is an MRI signature pattern of tau or TDP-43 using a large cohort of FTLD subjects and to investigate how patterns of atrophy change according to disease severity using a large autopsy-confirmed cohort of FTLD subjects. 〈 i 〉 Methods: 〈 /i 〉 Patterns of gray matter loss were assessed using voxel-based morphometry in 37 tau-positive and 44 TDP-43-positive subjects compared to 35 age and gender-matched controls, and compared to each other. Comparisons were also repeated in behavioral variant frontotemporal dementia (bvFTD) subjects (n = 15 tau-positive and n = 30 TDP-43-positive). Patterns of atrophy were also assessed according to performance on the Clinical Dementia Rating (CDR) scale and Mini-Mental State Examination (MMSE). 〈 i 〉 Results: 〈 /i 〉 The tau-positive and TDP-43-positive groups showed patterns of frontotemporal gray matter loss compared to controls with no differences observed between the groups, for all subjects and for bvFTD subjects. Patterns of gray matter loss increased in a graded manner by CDR and MMSE with loss in the frontal lobes, insula and hippocampus in mild subjects, spreading to the temporal and parietal cortices and striatum in more advanced disease. 〈 i 〉 Conclusion: 〈 /i 〉 There is no signature pattern of atrophy for tau or TDP-43; however, patterns of atrophy in FTLD progress with measures of clinical disease severity.
    Type of Medium: Online Resource
    ISSN: 1660-2854 , 1660-2862
    URL: Article
    DOI: 10.1159/000209507
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2009
    detail.hit.zdb_id: 2126858-7
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  • 5
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    Comparative Diagnostic Utility of Different MR Modalities in Mild Cognitive Impairment and Alzheimer’s Disease
    S. Karger AG ; 2002
    In:  Dementia and Geriatric Cognitive Disorders Vol. 14, No. 4 ( 2002), p. 198-207
    Details
    In: Dementia and Geriatric Cognitive Disorders, S. Karger AG, Vol. 14, No. 4 ( 2002), p. 198-207
    Abstract: This study compares the diagnostic accuracy of magnetic resonance (MR)-based hippocampal volumetry, single voxel 〈 sup 〉 1 〈 /sup 〉 H MR spectroscopy ( 〈 sup 〉 1 〈 /sup 〉 H MRS) and MR diffusion-weighted imaging (DWI) measurements in discriminating patients with amnestic mild cognitive impairment (MCI), Alzheimer’s disease (AD) and normally aging elderly. Sixty-one normally aging elderly, 24 MCI and 22 AD patients underwent MR-based hippocampal volumetry, 〈 sup 〉 1 〈 /sup 〉 H MRS and DWI. 〈 sup 〉 1 〈 /sup 〉 H MRS voxels were placed over both of the posterior cingulate gyri, and N-acetyl aspartate (NAA)/creatine (Cr), myoinositol (MI)/Cr and NAA/MI ratios were obtained. Apparent diffusion coefficient (ADC) maps were derived from DWI, and hippocampal borders were traced to measure hippocampal ADC. At 80% specificity, the most sensitive single measurement to discriminate MCI (79%) and AD (86%) from controls was hippocampal volumes. The most sensitive single measurement to discriminate AD from MCI was posterior cingulate gyrus NAA/Cr (67%). At high specificity ( 〉 85–90%), combinations of MR measures had superior diagnostic sensitivity compared with any single MR measurement for the AD vs. control and control vs. MCI comparisons. The MR measures that best discriminate more from less affected individuals along the cognitive continuum from normal to AD vary with disease severity. Selection of imaging measures used for clinical assessment or monitoring efficiency of therapeutic intervention should be tailored to the clinical stage of the disease.
    Type of Medium: Online Resource
    ISSN: 1420-8008 , 1421-9824
    URL: Article
    DOI: 10.1159/000066021
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2002
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  • 6
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    Efficacy, Safety, and Tolerability of Armodafinil Therapy for Hypersomnia Associated with Dementia with Lewy Bodies: A Pilot Study
    S. Karger AG ; 2017
    In:  Dementia and Geriatric Cognitive Disorders Vol. 43, No. 5-6 ( 2017), p. 269-280
    Details
    In: Dementia and Geriatric Cognitive Disorders, S. Karger AG, Vol. 43, No. 5-6 ( 2017), p. 269-280
    Abstract: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 Hypersomnia is common in dementia with Lewy bodies (DLB). We assessed the efficacy, safety, and tolerability of armodafinil for hypersomnia associated with DLB. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We performed a 12-week pilot trial of armodafinil therapy (125-250 mg orally daily) in DLB outpatients with hypersomnia. The patients underwent neurologic examinations, a neuropsychological battery, laboratory testing, electrocardiography, and polysomnography. Efficacy was assessed at 2, 4, 8, and 12 weeks. Safety assessment included laboratory examinations, QTc interval, and heart rate. Tolerability was assessed by analysis of adverse events. Data were analyzed using the last-observation-carried-forward method. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of 20 participants, 17 completed the protocol. The median age was 72 years, most of the participants were men (80%), and most had spouses as caregivers. The Epworth Sleepiness Scale ( 〈 i 〉 p 〈 /i 〉 〈 0.001), Maintenance of Wakefulness Test ( 〈 i 〉 p 〈 /i 〉 = 0.003), and Clinical Global Impression of Change ( 〈 i 〉 p 〈 /i 〉 〈 0.001) scores improved at week 12. The Neuropsychiatric Inventory total score ( 〈 i 〉 p 〈 /i 〉 = 0.003), visual hallucinations ( 〈 i 〉 p 〈 /i 〉 = 0.003), and agitation ( 〈 i 〉 p 〈 /i 〉 = 0.02) improved at week 4. Caregiver overall quality of life improved at week 12 ( 〈 i 〉 p 〈 /i 〉 = 0.004). No adverse events occurred. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 These pilot data suggest improvements in hypersomnia and wakefulness and reasonable safety and tolerability of armodafinil therapy in hypersomnolent patients with DLB. Our findings inform the use of pharmacologic strategies for managing hypersomnolence in these patients.
    Type of Medium: Online Resource
    ISSN: 1420-8008 , 1421-9824
    URL: Article
    DOI: 10.1159/000471507
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
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  • 7
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    Cognitive and Noncognitive Neurological Features of Young-Onset Dementia
    S. Karger AG ; 2009
    In:  Dementia and Geriatric Cognitive Disorders Vol. 27, No. 6 ( 2009), p. 564-571
    Details
    In: Dementia and Geriatric Cognitive Disorders, S. Karger AG, Vol. 27, No. 6 ( 2009), p. 564-571
    Abstract: 〈 i 〉 Background: 〈 /i 〉 The rarity of young-onset dementia (YOD), the broad differential diagnosis and unusual clinical presentations present unique challenges to correctly recognize the condition and establish an accurate diagnosis. Limited data exist regarding clinical features associated with dementia prior to the age of 45. 〈 i 〉 Methods: 〈 /i 〉 We retrospectively assessed cognitive and noncognitive neurological characteristics of 235 patients who presented for evaluation of YOD to investigate the clinical characteristics of YOD compared to later-onset dementias and to identify clinical features associated with specific etiologies that may aid in the evaluation of YOD. 〈 i 〉 Results: 〈 /i 〉 Multiple cognitive domains were affected in most patients, and no significant differences in affected domains existed between groups. Early psychiatric and behavioral features occurred at very high frequencies. Nearly 80% of this YOD cohort had additional noncognitive symptoms or signs as a feature of their disease. Chorea was strongly associated with Huntington disease. Parkinsonism was not seen in patients having an autoimmune/inflammatory etiology. 〈 i 〉 Conclusions: 〈 /i 〉 The rarity of YOD and the high frequency of early psychiatric features led to frequent misdiagnosis early in the clinical course. The high frequency of noncognitive symptoms and signs may aid clinicians in distinguishing patients requiring a more extensive evaluation for YOD.
    Type of Medium: Online Resource
    ISSN: 1420-8008 , 1421-9824
    URL: Article
    DOI: 10.1159/000228258
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2009
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  • 8
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    Patterns of Brain Atrophy in Clinical Variants of Frontotemporal Lobar Degeneration
    S. Karger AG ; 2013
    In:  Dementia and Geriatric Cognitive Disorders Vol. 35, No. 1-2 ( 2013), p. 34-50
    Details
    In: Dementia and Geriatric Cognitive Disorders, S. Karger AG, Vol. 35, No. 1-2 ( 2013), p. 34-50
    Abstract: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 The clinical syndromes of frontotemporal lobar degeneration include behavioral variant frontotemporal dementia (bvFTD) and semantic (SV-PPA) and nonfluent variants (NF-PPA) of primary progressive aphasia. Using magnetic resonance imaging (MRI), tensor-based morphometry (TBM) was used to determine distinct patterns of atrophy between these three clinical groups. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Twenty-seven participants diagnosed with bvFTD, 16 with SV-PPA, and 19 with NF-PPA received baseline and follow-up MRI scans approximately 1 year apart. TBM was used to create three-dimensional Jacobian maps of local brain atrophy rates for individual subjects. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Regional analyses were performed on the three-dimensional maps and direct comparisons between groups (corrected for multiple comparisons using permutation tests) revealed significantly greater frontal lobe and frontal white matter atrophy in the bvFTD relative to the SV-PPA group (p 〈 0.005). The SV-PPA subjects exhibited significantly greater atrophy than the bvFTD in the fusiform gyrus (p = 0.007). The NF-PPA group showed significantly more atrophy in the parietal lobes relative to both bvFTD and SV-PPA groups (p 〈 0.05). Percent volume change in ventromedial prefrontal cortex was significantly associated with baseline behavioral symptomatology. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The bvFTD, SV-PPA, and NF-PPA groups displayed distinct patterns of progressive atrophy over a 1-year period that correspond well to the behavioral disturbances characteristic of the clinical syndromes. More specifically, the bvFTD group showed significant white matter contraction and presence of behavioral symptoms at baseline predicted significant volume loss of the ventromedial prefrontal cortex.
    Type of Medium: Online Resource
    ISSN: 1420-8008 , 1421-9824
    URL: Article
    DOI: 10.1159/000345523
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2013
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