Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 7 de 7
Filter
1.
Int Psychogeriatr ; 21(3): 548-59, 2009 Jun.
Article in English | MEDLINE | ID: mdl-19327204

ABSTRACT

BACKGROUND: To date, no single instrument has proved to be adequate for screening for Alzheimer's dementia (AD). The aim of this study was to identify a combination of instruments which were highly sensitive for screening late onset AD. METHODS: Subjects were drawn from the Vienna TransDanube Aging (VITA) study. This is an interdisciplinary, longitudinal community-based cohort study of the 21st and 22nd district of Vienna (Austria). Data refer to the cohort of 478 individuals at age 78 who took part in the first follow-up investigation of the VITA study. The psychometric instruments which were investigated were: the Ten-Point Clock Test, the Human-Figure Drawing Test, a Delayed Selective Reminding Test, Naming, the Trail Making Test-B, and Verbal Fluency. Further instruments were the Pocket Smell Test, and Subjective Memory Complaints. Data were analyzed using logistic regression analyses and cross validation. RESULTS: A combination of the Delayed Selective Reminding Test and Verbal Fluency was best for screening AD (R2 = 0.38, main model). An area under the ROC curve of 0.829 was reached. This model discriminated between subjects with incident AD and subjects who did not have incident AD with a sensitivity of 91% and a specificity of 56%. CONCLUSION: The combination of an episodic memory test and a test of verbal fluency was an effective way of screening for AD.


Subject(s)
Alzheimer Disease/diagnosis , Aged , Alzheimer Disease/psychology , Cognition Disorders/diagnosis , Cognition Disorders/psychology , Data Collection/statistics & numerical data , Female , Geriatric Assessment/statistics & numerical data , Humans , Male , Mass Screening/statistics & numerical data , Memory Disorders/diagnosis , Memory Disorders/psychology , Neuropsychological Tests/statistics & numerical data , Psychiatric Status Rating Scales/statistics & numerical data , Psychometrics , ROC Curve , Sensitivity and Specificity , Severity of Illness Index , Verbal Learning
2.
Neurology ; 68(4): 288-91, 2007 Jan 23.
Article in English | MEDLINE | ID: mdl-17242334

ABSTRACT

OBJECTIVE: To compare the rates of conversion to Alzheimer dementia (AD) between subtypes of mild cognitive impairment (MCI) in a community-based birth cohort investigated at age 75 and followed up after 30 months. METHODS: The Vienna Trans-Danube Aging Study investigated every inhabitant of the area on the left shore of the river Danube who was born between May 1925 and June 1926. With use of the official voting registry, 1505 subjects were contacted and 697 participated. Data refer to the cohort of 581 nondemented individuals who completed extensive neuropsychological examination at baseline. Follow-up after 30 months was possible in 476 probands (35 deceased). RESULTS: The 141 patients with MCI at baseline were classified into two subtypes. At follow-up, 41 of these patients with MCI were diagnosed with AD. Conversion rates to AD were 48.7% (CI: 32.4 to 65.2) for amnestic MCI and 26.8% (CI: 17.6 to 37.8) for nonamnestic MCI. Another 49 AD cases originated from cognitive health at baseline (12.6%; CI: 9.4 to 16.3). CONCLUSIONS: Patients with mild cognitive impairment (MCI) showed a high probability to be diagnosed with Alzheimer dementia (AD) after 30 months. Subtypes of MCI were not useful in defining early stages of various types of dementia: Not only amnestic MCI but also nonamnestic MCI converted frequently to AD, and conversion to vascular dementia and dementia with Lewy bodies was not restricted to nonamnestic MCI.


Subject(s)
Alzheimer Disease/epidemiology , Alzheimer Disease/etiology , Cognition Disorders/complications , Cognition Disorders/epidemiology , Aged , Aged, 80 and over , Alzheimer Disease/psychology , Cognition Disorders/classification , Cognition Disorders/psychology , Cohort Studies , Disease Progression , Female , Follow-Up Studies , Humans , Male , Residence Characteristics , Risk Factors
3.
Am J Geriatr Psychiatry ; 14(6): 531-7, 2006 Jun.
Article in English | MEDLINE | ID: mdl-16731722

ABSTRACT

OBJECTIVE: Cerebrovascular lesions that are apparent in magnetic resonance scans and regioselective atrophy of the brain have been proposed as a causative or exacerbating factor in depression with late-life onset. The objective of this study was to investigate whether deep white matter or periventricular hyperintensities, small ischemic lesions, and brain atrophy contribute to late-onset depression in the nondemented elderly. METHOD: Based on a group of 606 individuals of identical age (75.8 years, standard deviation: 0.45 years) residing in two districts of Vienna, the authors built a case-control cohort (ratio: 1:4) consisting of 51 individuals with late-onset major or minor depression matched with 204 subjects of identical gender and education status without depression, resulting in two groups that were homogenous with respect to age, place of residence, gender, and education. Scores for focal brain lesions, mediotemporal lobe atrophy, and ventricular enlargement as well as risk factors for vascular disease were compared with cognition and depression status. RESULTS: Depressed individuals had significantly lower scores than nondepressed subjects in all measures of cognitive and executive function. No significant relation was found between a diagnosis of depression and any type of discrete brain lesions, but measures of brain atrophy (Cella Media indices, mediotemporal atrophy) showed a clear statistical relation to depression. No relationship was found between depression and lipid parameters. CONCLUSION: The authors found no indication that white matter hyperintensities or minor ischemic lesions played a role in our depressed cohort, casting doubt on the vascular hypothesis of late-onset depression.


Subject(s)
Brain Ischemia/epidemiology , Brain/pathology , Depressive Disorder, Major/epidemiology , Population Surveillance/methods , Aged , Atrophy/pathology , Brain Ischemia/diagnosis , Case-Control Studies , Cohort Studies , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Male , Residence Characteristics , Risk Factors
4.
Int J Geriatr Psychiatry ; 20(5): 452-8, 2005 May.
Article in English | MEDLINE | ID: mdl-15852463

ABSTRACT

BACKGROUND: Mild cognitive impairment (MCI) is defined to diagnose prodromal dementia and prodromal Alzheimer dementia, in particular. OBJECTIVE: The main aim of this study is to identify subtypes of MCI in comparison to the frequency of Petersen's MCI-amnestic in an elderly age-cohort. PARTICIPANTS: The study is based on the cross sectional data from the Vienna-Transdanube-Aging (VITA) study. The data refer to the age cohort of 592 individuals at age 75 to 76 years who completed extensive neuropsychological examination. RESULTS: Dementia was present in 15 subjects (2.5%, CI: 1.4-4.1). 141 subjects (23.8%, CI: 20.4-27.5) of the entire age cohort 75 (n = 592) showed cognitive impairment without dementia concerning one or more cognitive functions (1.5 SD paradigm). These subjects were assigned to three subtypes of MCI: Selective Memory Impairment: n = 22 (3.7%, CI: 2.3-5.6), Memory Impairment+Non-Memory Impairment: n = 31 (5.2%, CI: 3.6-7.4) and Non-Memory Impairment: n = 88 (14.9%, CI: 12.1-18.0). CONCLUSIONS: The frequency of MCI-amnestic, the so-called prestage of AD according to Petersen, was very low (0.5%, CI: 0.1-1.5) compared to the estimated incidence rates of AD at this age. Established criteria of MCI could be modified in order to include a higher percentage of high-risk subjects for later developing Alzheimer dementia.


Subject(s)
Cognition Disorders/diagnosis , Dementia/psychology , Activities of Daily Living , Aged , Algorithms , Alzheimer Disease/diagnosis , Alzheimer Disease/psychology , Cognition Disorders/classification , Cognition Disorders/etiology , Cross-Sectional Studies , Dementia/diagnosis , Female , Humans , Male , Memory Disorders/diagnosis , Memory Disorders/etiology , Neuropsychological Tests , Psychometrics
5.
J Neural Transm (Vienna) ; 111(9): 1155-65, 2004 Sep.
Article in English | MEDLINE | ID: mdl-15338331

ABSTRACT

The Vienna Transdanube Aging (VITA) study searches for early markers of Alzheimer's disease (AD) by examining the mental status in a community-based cohort of 606, 75-years old volunteers that are then related to various clinical and genetic analyses. To determine whether mutations in mtDNA are involved in expression of AD, the mtDNA of 79 "control" participants is screened for alterations by sequencing of "hot-spot-regions". This study on mtDNA mutations has eliminated the influence of aging on the occurrence of mtDNA alterations by sequencing samples from persons at the age of exactly 75 years. Thus, our cohort reveals a snap-shot of mitochondrial sequences of elderly persons. So far, a high percentage (56%) of persons with known or unknown mutations in the fragments analyzed were found. These data will be compared in due time to a cohort of participants with proven late-onset AD.


Subject(s)
Alzheimer Disease/genetics , DNA, Mitochondrial/genetics , Genetic Predisposition to Disease/genetics , Aged , Alzheimer Disease/epidemiology , Amino Acid Substitution/genetics , Austria/epidemiology , Cohort Studies , Cross-Sectional Studies , DNA Mutational Analysis , Female , Genetic Testing , Genotype , Haplotypes/genetics , Humans , Longitudinal Studies , Male , Mutation/genetics , Polymorphism, Single Nucleotide/genetics , Predictive Value of Tests , Risk
6.
J Neural Transm Suppl ; (62): 105-16, 2002.
Article in English | MEDLINE | ID: mdl-12456056

ABSTRACT

The Vienna Transdanube Aging study "VITA" is a prospective, interdisciplinary cohort-study of all 75-years old inhabitants of the 21. and 22. district of Vienna (n = 1,745), which started in May 2000. The study design is described in this paper for the first time. The main scientific question of the study concerns the prediction of incident dementia in the elderly. The main statistical analysis will compare 8 predictors: episodic memory, verbal fluency, subjective memory complaints, depression, APOE-epsilon4, MAO-B activity in thrombocytes, MRT hippocampal atrophy, and MRT atrophy of the substantia innominata. The whole investigation comprises medical and psychosocial interviews, psychological tests, psychiatric and neurological scales, blood characteristic, genetic factors and cranial magnetic resonance imaging. Various variables will be compared with each other concerning sensitivity and specificity of prediction of cognitive decline. The dependent variable of the intended statistical analysis will be the individual's difference between Mini Mental State Examination scores at the two times of investigation. A high level of participation in geriatric epidemiological studies increases the general applicability of results but recruitment procedures must not ignore the individual's right to privacy and integrity. Using a liberal recruitment procedure as recommended by the local ethics commission the level of participation is between 36.7% and 44.3%.


Subject(s)
Aging , Alzheimer Disease/epidemiology , Cognition Disorders/epidemiology , Aged , Female , Humans , Male , Patient Dropouts/psychology , Patient Selection , Prospective Studies , Socioeconomic Factors
7.
Methods Find Exp Clin Pharmacol ; 19(9): 645-54, 1997 Nov.
Article in English | MEDLINE | ID: mdl-9500129

ABSTRACT

In a double-blind, parallel-group design study on hypnotic and anxiolytic effects of the combination drug Somnium (lorazepam 1 mg + diphenhydramine 25 mg) (SOM) as compared with 1 mg lorazepam (LOR) alone, daytime behavioral effects were studied in 44 patients with nonorganic insomnia related to a mild generalized anxiety disorder. After a placebo run-in phase of 1 week, they received active treatment for 4 weeks. Psychometric evaluations included 6 thymopsychic variables (somatic complaints, state anxiety, trait anxiety, self-rating anxiety and depression scale and adjective mood scale), 6 noopsychic variables (general, associative, numerical and total verbal memory; correct reproductions and errors-Benton visual memory test), 4 pupillary measures (pupillary diameter, latency, relative change in % and half recovery time in pupillary response) and 6 skin conductance measures (baseline, latency, ascending time, time to peak, skin conductance response and skin conductance response maximum). Multivariate statistical analysis of the thymopsyche demonstrated significant improvement after both compounds, with the combination drug significantly superior to its single component lorazepam. Also regarding noopsychic measures, Somnium was significantly superior to the single component lorazepam, as specifically verbal memory was improved after Somnium, while opposite changes occurred after lorazepam alone. Pupillary measures revealed no significant overall inter-drug differences, whereas skin conductance findings demonstrated that the combination drug Somnium was superior to the single component lorazepam also in regard to the anxiolytic effect at the autonomic nervous system level.


Subject(s)
Anxiety Disorders/drug therapy , Diphenhydramine/therapeutic use , Hypnotics and Sedatives/therapeutic use , Lorazepam/therapeutic use , Sleep Initiation and Maintenance Disorders/drug therapy , Adult , Aged , Anxiety Disorders/physiopathology , Diphenhydramine/administration & dosage , Discriminant Analysis , Double-Blind Method , Drug Combinations , Female , Humans , Hypnotics and Sedatives/administration & dosage , Lorazepam/administration & dosage , Male , Manifest Anxiety Scale , Memory/drug effects , Middle Aged , Multivariate Analysis , Psychophysiology , Reflex, Pupillary/drug effects , Single-Blind Method , Skin Physiological Phenomena/drug effects , Sleep Initiation and Maintenance Disorders/physiopathology , Test Anxiety Scale
SELECTION OF CITATIONS
SEARCH DETAIL
...