APOE3 Christchurch Heterozygosity and Autosomal Dominant Alzheimer's Disease.

BACKGROUND: Variants in APOE and PSEN1 (encoding apolipoprotein E and presenilin 1, respectively) alter the risk of Alzheimer's disease. We previously reported a delay of cognitive impairment in a person with autosomal dominant Alzheimer's disease caused by the PSEN1 E280A variant who also had two copies of the apolipoprotein E3 Christchurch variant (APOE3 Ch). Heterozygosity for the APOE3 Ch variant may influence the age at which the onset of cognitive impairment occurs. We assessed this hypothesis in a population in which the PSEN1 E280A variant is prevalent. METHODS: We analyzed data from 27 participants with one copy of the APOE3 Ch variant among 1077 carriers of the PSEN1 E280A variant in a kindred from Antioquia, Colombia, to estimate the age at the onset of cognitive impairment and dementia in this group as compared with persons without the APOE3 Ch variant. Two participants underwent brain imaging, and autopsy was performed in four participants. RESULTS: Among carriers of PSEN1 E280A who were heterozygous for the APOE3 Ch variant, the median age at the onset of cognitive impairment was 52 years (95% confidence interval [CI], 51 to 58), in contrast to a matched group of PSEN1 E280A carriers without the APOE3 Ch variant, among whom the median age at the onset was 47 years (95% CI, 47 to 49). In two participants with the APOE3 Ch and PSEN1 E280A variants who underwent brain imaging, 18F-fluorodeoxyglucose positron-emission tomographic (PET) imaging showed relatively preserved metabolic activity in areas typically involved in Alzheimer's disease. In one of these participants, who underwent 18F-flortaucipir PET imaging, tau findings were limited as compared with persons with PSEN1 E280A in whom cognitive impairment occurred at the typical age in this kindred. Four studies of autopsy material obtained from persons with the APOE3 Ch and PSEN1 E280A variants showed fewer vascular amyloid pathologic features than were seen in material obtained from persons who had the PSEN1 E280A variant but not the APOE3 Ch variant. CONCLUSIONS: Clinical data supported a delayed onset of cognitive impairment in persons who were heterozygous for the APOE3 Ch variant in a kindred with a high prevalence of autosomal dominant Alzheimer's disease. (Funded by Good Ventures and others.).

Acid emulsions stabilized by soy whey concentrates and soluble soybean polysaccharides: Role of biopolymer interaction strategies on stability against environmental stresses.

This article focuses on the evaluation of different interaction strategies between soy whey concentrates (SWC) and soluble soybean polysaccharides (SSPS) at pH 3.0 on the emulsion stability against freeze-thawing and mechanical stirring. Emulsions were prepared from aqueous dispersions of both biopolymers (3.0% w/w SSPS and SWC, 1:1 mass ratio) and sunflower oil (10% w/w) by aqueous phase complexation (APC), interfacial complexation (IC) and interfacial complexation and sonication (ICS). SWC control emulsion was a poor emulsifying ability; SSPS addition, through the APC and ICS strategies, noticeably improved the SWC emulsifying properties. ICS emulsions showed the highest stability to environmental stresses, due a combination of low initial particle size, flocculation degree and steric hindrance promoted by the presence of SSPS chains at the interface. This study provides valuable information forthe utilization of whey soy proteins in acid dispersed systems stable to environmental stresses.

Feasibility of whole genome and transcriptome profiling in pediatric and young adult cancers.

The utility of cancer whole genome and transcriptome sequencing (cWGTS) in oncology is increasingly recognized. However, implementation of cWGTS is challenged by the need to deliver results within clinically relevant timeframes, concerns about assay sensitivity, reporting and prioritization of findings. In a prospective research study we develop a workflow that reports comprehensive cWGTS results in 9 days. Comparison of cWGTS to diagnostic panel assays demonstrates the potential of cWGTS to capture all clinically reported mutations with comparable sensitivity in a single workflow. Benchmarking identifies a minimum of 80× as optimal depth for clinical WGS sequencing. Integration of germline, somatic DNA and RNA-seq data enable data-driven variant prioritization and reporting, with oncogenic findings reported in 54% more patients than standard of care. These results establish key technical considerations for the implementation of cWGTS as an integrated test in clinical oncology.

Impact of environmental stresses on the stability of acidic oil-in-water emulsions prepared with tofu whey concentrates.

The emulsifying properties of tofu-whey concentrates (TWCs) at pH 3.0, 4.0, and 5.0, and the stability of the resultant oil-in-water emulsions against freeze-thawing (24 h, -20 °C) and controlled or mechanical stress (orbital stirring at 275 rpm, 40 min) were addressed. TWCs were prepared from tofu-whey by heating at 50 °C (8.0 kPa) or 80 °C (24.0 kPa), dialysis (4 °C, 48 h), and freeze-drying, giving the samples TWC50 and TWC80, respectively. The particle size and interfacial properties at the oil/water interface were measured. Emulsions were prepared by mixing the TWC aqueous dispersions (1.0% protein w/w) and refined sunflower oil (25.0% w/w) by high-speed and ultrasound homogenization. The preparation of TWCs at higher temperatures (80 °C) promoted the formation of species of larger particle size, a slight decrease of interfacial activity, and the adsorption of more rigid biopolymer structures associated with an increase of film viscoelasticity in interfacial rheology measurements. The emulsifying properties of both concentrates were enhanced with decreasing pH (5.0-3.0), through a significant decrease of particle size (D4,3) and flocculation degree (FD), but only those prepared with TWC80 exhibited higher stability to freeze-thawing and mechanical stress at pH 3.0. This could be ascribed to a combination of low initial D4,3 and FD values, high protein load, and the presence of rigid species that impart high viscoelasticity to the oil/water interface. These results would be of great importance for the utilization of TWCs as food emulsifiers in acidic systems to impart high stability to environmental stresses.

Influence of chemical composition and structural properties on the surface behavior and foam properties of tofu-whey concentrates in acid medium.

This article focuses on the impact of chemical composition and structural properties of tofu-whey concentrates on their surface behavior at the air/water interface and foaming properties in acid medium. Liquid tofu-whey (pH 5.6 ±â€¯0.1) was concentrated at three combinations of temperature and pressure (50 °C-8.0 kPa, 65 °C-16.0 kPa and 80 °C-24.0 kPa), with further dialysis (4 °C, 48 h) and freeze-drying, giving the samples TWC50, TWC65 and TWC80, respectively. The increase of temperature during the concentration step promoted the enrichment of the concentrates in crude protein and calcium, without appreciable changes in the yield, the carbohydrate content and the polypeptide composition. For TWC80, the increase the degree of glycosylation and the intensity of the hydrophobic effect promoted the decrease of molecular flexibility and the formation of compact aggregates mediated by disulfide bridges as was evidenced by tricine-SDS-PAGE, TGA and FTIR assays. These structural differences have a pronounced impact of the pH-dependence of turbidity and solubility of protein and polysaccharides. At pH 4.0 all concentrates evidenced a ζ-potential close to zero, which enhanced their foam ability (overrun >1500%). Nevertheless, at this pH, TWC80 showed both the highest carbohydrate-to-protein mass ratio in the soluble fraction (>1.8) and foam stability (FS). Thus, the improvement of FS at pH 4.0 would be associated to the effective adsorption of compact rich-in-protein aggregates at the air/water interface and the higher content of soluble polysaccharides in the bulk phase. These findings are relevant for the application of tofu-whey concentrates in acidic dispersed systems, such as foams and aerated food emulsions.

Immune signalling responses in intestinal epithelial cells exposed to pathogenic Escherichia coli and lactic acid-producing probiotics.

Enterohaemorrhagic Escherichia coli O157:H7 and adherent-invasive Escherichia coli are two groups of enteric bacterial pathogens associated with haemorrhagic colitis and Crohn's Disease, respectively. Bacterial contact with host epithelial cells stimulates an immediate innate immune response designed to combat infection. In this study, immune responses of human epithelial cells to pathogens, either alone or in combination with probiotic bacteria were studied. Industrially prepared Lactobacillus helveticus strain R0052 was first examined by microarray analysis and then compared to broth-grown strains of R0052 and Lactobacillus rhamnosus strain GG using quantitative realt-time polymerase chain reaction. Results showed host immune activation responses increased following pathogen exposure, which were differentially ameliorated using probiotics depending on both the preparation of probiotics employed and conditions of exposure. These findings provide additional support for the concept that specific probiotic strains serve as a promising option for use in preventing the risk of enteric bacterial infections.

Importancia de la valoración del fondo de ojo en el paciente hipertenso / Importance of fundoscopic examination in hypertensive patients

La hipertensión arterial (HTA) es el principal factor de riesgo para el desarrollo de enfermedades cardiovasculares y también de lesiones vasculares en la retina. Las alteraciones oculares de la HTA incluyen tres manifestaciones distintas e independientes en la retina, nervio óptico y circulación coroidal. El estudio oftalmológico realizado de forma habitual en todo paciente hipertenso ayuda a valorar la gravedad de la hipertensión. Las últimas guías de la European Society of Hypertension-European Society of Cardiology (ESH/ESC) incluyen el examen fundoscópico dentro de los métodos para evaluar la lesión de órgano diana en el paciente hipertenso. La existencia de hemorragias y exudados, signos de hipertensión maligna, obligará a realizar un tratamiento antihipertensivo más agresivo, a la vez que se llevan a cabo exploraciones complementarias. El reciente desarrollo de técnicas de fotografía del fondo de ojo ha permitido una precisa documentación de los signos microvasculares de la retina en la HTA en estudios realizados en población general. En numerosos estudios se ha comunicado la correlación entre las lesiones retinianas microvasculares, las lesiones de órgano diana y el desarrollo de diabetes, además de constituir un predictor independiente de ictus. En esta revisión se presentan las características de las lesiones oculares en la HTA, su clasificación y su correlación con la enfermedad cardiovascular (AU)

Los inhibidores de la enzima de conversión tienen ventajas sobre los antagonistas de los receptores de angiotensina II / Converting enzyme inhibitors hold advantages over angiotensin II receptor antagonists

No disponible

Criterios de derivación de pacientes hipertensos a una Unidad de Hipertensión Arterial / Criteria for referral of hypertensive patients to a Hypertension Unit

Al inicio del siglo XXI ha quedado extensamente documentada la relevancia de la hipertensión arterial como uno de los principales componentes de múltiples síndromes relacionados con el aumento del riesgo cardiovascular. Las complicaciones de la hipertensión afectan los principales órganos diana, entre ellos corazón, cerebro, vasos y riñones. La diversidad de estas complicaciones y el gasto en salud que demanda el cuidado de estos pacientes exige mejorar la comunicación entre los diferentes componentes del sistema de salud. Sobre estas bases surge la necesidad de desarrollar criterios de derivación de pacientes hipertensos a unidades especializadas de riesgo cardiovascular para un correcto diagnóstico y estratificación de riesgo, con el fin de optimizar el tratamiento y control de esta patología. En la última guía de la SEH-LELHA se publican los principales criterios de derivación de los hipertensos a centros especializados. En esta revisión se desarrollan brevemente cada uno de estos puntos, haciendo hincapié en los signos y síntomas característicos de cada patología. Además, se agregan algunas situaciones especiales en la práctica clínica. El principal objetivo de este trabajo es proveer una orientación a los profesionales de la salud en la toma de decisión sobre la derivación de pacientes o la realización de pruebas especializadas para el diagnóstico y tratamiento. Finalmente se realizó un análisis de los pacientes enviados a la Unidad de Hipertensión del Hospital 12 de Octubre, entre octubre de 2002 y enero de 2003 que ilustran las principales pautas de proceder (AU)

Papel de Internet en la difusión de la hipertensión arterial / Role of the Internet in the diffusion of information regarding arterial hypertension

No disponible

Aneurismas renales extraparenquimatosos. Resultados quirúrgicos y su impacto sobre la hipertensión arterial / Extraparenchymal renal artery aneurysms. Surgical results and impact hypertension

Objetivo. El trabajo intenta evaluar la incidencia de la hipertensión arterial (HTA) en los pacientes con aneurismas extraparenquimatosos de arteria renal y su evolución después de la cirugía. Material y métodos. Desde enero de 1978 a diciembre de 1999 se han intervenido en nuestro servicio, de forma consecutiva, 19 pacientes con 23 aneurismas extraparenquimatosos de arteria renal. Diecisiete pacientes (89,5 por ciento) tenían HTA.i Resultados. En 12 de 16 pacientes hipertensos se demostró HTA vasculorrenal. Veinte aneurismas estaban permeables, 1 obstruido crónicamente y un paciente comenzó clínicamente con trombosis aguda de aneurisma de aorta abdominal y arteria renal bilateral. En 11 de los 20 casos permeables existía estenosis significativa en la arteriografía preoparatoria. Diecisiete aneurismas (74 por ciento) estaban localizados en el tronco principal de la arteria renal. En todos ellos se practicaron técnicas revascularizadoras. No hubo fallecimientos postoperatorios y la permeabilidad inicial de las técnicas de revascularización fue del 100 por ciento. La tasa de mejoría/curación de la HTA a largo plazo fue del 65 por ciento (el 91 por ciento de estos pacientes tenían HTA renovascular y estenosis de la arteria renal). La permeabilidad acumulada durante el seguimiento fue del 89,2 por ciento. Conclusiones. La incidencia de HTA fue del 89,5 por ciento y la presión arterial descendió significativamente después de la cirugía. Doce pacientes (63,1 por ciento) tenían HTA vasculorrenal, que es una de nuestras 3 principales indicaciones quirúrgicas. Las otras 2 indicaciones básicas que consideramos son la prevención de rotura y la conservación de función renal. La cirugía ofrece buenas tasas de permeabilidad a largo plazo (AU)

Initial stress differences between sliding and sectional mechanics with an endosseous implant as anchorage: a 3-dimensional finite element analysis.

Endosseous implants have been used as orthodontic anchorage in recent years. A 3-dimensional mathematical model was constructed that uses the finite element method, which simulated an endosseous implant and an upper canine with its periodontal ligament and cortical and cancellous bone. Levels of initial stress were measured during 2 types of canine retraction mechanics (friction and frictionless). The lower magnitude and more uniform stresses in the implant and its cortical bone were found to have a moment-force ratio (M/F) of 6.1:1, whereas the canine and its supporting structures exerted a M/F ratio of 10.3:1. On the basis of these results, when the anchor unit is an endosseous implant, it seems better to use a precalibrated retraction system without friction (T-loop) where a low load-deflection curve would be generated.

[Control of arterial pressure: experience at a hospital monographic unit arterial hypertension]. / Control de la presión arterial: experiencia de una Unidad monográfica de Hipertensión Arterial hospitalaria.

OBJECTIVE: To analyse the evolution of blood pressure control in patients referred to our centre for study, proportion of controlled hypertensive patients, changes in the characteristics of hypertensive patients and in therapeutic guidelines in the last twenty years. MATERIAL AND METHODS: A total of 4,103 patients were referred to study of hypertension. The analysed variables year by year included sex, age, weight, systolic blood pressure (SBP) and diastolic blood pressure (DBP). Cross sections at five-year intervals were performed to collect basal SBP and DBP and the evolution of BP in the following five years. RESULTS: From 1977 to 1997 the following changes were observed: basal mean age changed from 67 +/- 9 down to 56 +/- 10 years among males and from 68 +/- 8 down to 52 +/- 9 years among females; basal mean weight changed from 71 +/- 7 up to 81 +/- 8 kg among males and from 69 +/- 12 up to 73 +/- 13 years among females. Males showed a decrease in basal mean values of SBP/DBP from 176 +/- 25/112 +/- 20 mmHg down to 154 +/- 21/94 +/- 12 mmHg. In women, the corresponding values changed from 182 +/- 36/105 +/- 19 mmHg down to and 154 +/- 23/93 +/- 12 mmHg. In the early 1980's, 62% of patients received one or no antihypertensive drug. In the last few years such percentage has been 36% and 64% have been treated with two or more drugs. CONCLUSIONS: A decrease in age and an increase in weight of hypertensive patients referred to study have been observed in the last twenty years. Such patients show a less severe hypertension compared with referred patients in the early years. The use of new hypertensive drugs and their combined use are measures that contribute to improve the percentage of controlled hypertensive patients.

Presenilin-1-associated abnormalities in regional cerebral perfusion.

OBJECTIVE: To investigate the influence of the presenilin-1 gene (PS-1) mutation on regional cerebral perfusion, SPECT was evaluated in 57 individuals. The subjects were members of a large pedigree from Colombia, South America, many of whom carry a PS-1 mutation for early-onset AD. METHODS: Members of this large kindred who were cognitively normal and did not carry the PS-1 mutation (n = 23) were compared with subjects who were carriers of the mutation but were asymptomatic (n = 18) and with individuals with the mutation and a clinical diagnosis of AD (n = 16). Cerebral perfusion was measured in each subject using hexamethylpropyleneamine oxime SPECT. The data were analyzed in two ways: 1) Mean cerebral perfusion in each of 4320 voxels in the brain was compared among the groups using t-tests (t-maps); and 2) each individual received a weighted score on 20 vectors (factors), based on a large normative sample (n = 200), using a method known as singular value decomposition (SVD). RESULTS: Based on t-maps, subjects with the PS-1 mutation who were asymptomatic demonstrated reduced perfusion in comparison with the normal control subjects in the hippocampal complex, anterior and posterior cingulate, posterior parietal lobe, and anterior frontal lobe. The AD patients demonstrated decreased perfusion in the posterior parietal and superior frontal cortex in comparison with the normal control subjects. Discriminant function analysis of the vector scores derived from SVD (adjusted for age and gender) accurately discriminated 86% of the subjects in the three groups (p < 0.0005). CONCLUSION: Regional cerebral perfusion abnormalities based on SPECT are detectable before development of the clinical symptoms of AD in carriers of the PS-1 mutation.

Control de la presión arterial: experiencia de una Unidad monográfica de Hipertensión Arterial Hospitalaria / Blood pressure control: experience in a monographic Hospital Hypertension Unit

Fundamento. Analizar la evolución del control de la hipertensión arterial (HTA) en la población remitida para estudio en nuestro centro, la proporción de hipertensos controlados, los cambios de las características del hipertenso y de las pautas terapéuticas en los últimos 20 años. Pacientes y métodos. Se incluyeron 4.013 pacientes remitidos para estudio de su HTA. Las variables analizadas año por año fueron sexo, edad, peso, presión arterial sistólica (PAS) y diastólica (PAD). Se realizaron cortes transversales cada 5 años para recoger la PAS y PAD basal y la evolución de dichos valores de PA en los 5 años siguientes. Resultados. Entre 1977 y 1997 se observaron los siguientes cambios: la edad basal media pasó de 67 ñ 9 a 56 ñ 10 años en varones y de 68 ñ 8 a 52 ñ 9 años en mujeres; el peso basal medio pasó de 71 ñ 7 a 81 ñ 8 kg en los varones y de 69 ñ 12 a 73 ñ 13 kg en las mujeres. Los varones mostraron una reducción de los valores medios basales de PAS/PAD de 176 ñ 25/112 ñ 20 mmHg a 154 ñ 21/94 ñ 12 mmHg. En las mujeres dichos valores pasaron de 182 ñ 36/105 ñ 19 mmHg a 154 ñ 23/93 ñ 12 mmHg. A principios de los ochenta el 62 por ciento de los pacientes recibían uno o ningún fármaco antihipertensivo. En los últimos años dicho porcentaje es del 36 por ciento y un 64 por ciento son tratados con 2 o más fármacos. Conclusiones. Se observa una disminución de la edad e incremento del peso de los hipertensos remitidos para estudio en los últimos 20 años. Dichos pacientes muestran una HTA menos severa en comparación con los pacientes remitidos en los primeros años. La utilización de nuevos fármacos antihipertensivos y el uso combinado de los mismos son medidas que contribuyen a mejorar el porcentaje de pacientes hipertensos controlados (AU)

Deterioro de la función renal con inhibidores de la enzima convertidora de la angiotensina / Renal function impairment with angiotensin converting enzyme inhibitors

Se trata de dos pacientes ancianos con historia de hipertensión arterial de varios años de evolución. El caso n.° 1, con patología arterioesclerótica severa del sector aortoilíaco, fue tratado con un inhibidor de la enzima convertidora de la angiotensina (IECA) y presentó deterioro reversible de la función renal. Este dato hizo pensar en patología vasculorrenal y se realizaron pruebas diagnósticas que no confirmaron dicha lesión. El diagnóstico definitivo fue nefroangioesclerosis. El caso n.° 2, mujer de 78 años, con antecedentes largos de hipertensión, fundamentalmente sistólica, fue tratada con un IECA y furosemida. La suspensión de ambos fármacos normalizó la función renal. Las exploraciones complementarias demostraron la existencia de placas de ateromas en ambas arterias renales y el diagnóstico final fue hipertensión vasculorrenal bilateral.El interés práctico de ambos casos radica en que a la hora de elegir un fármaco del tipo IECA/ARA II en pacientes ancianos se debe valorar la posible existencia de patología ateroesclerótica en las arterias renales y monitorizar la creatinina sérica durante unos días (AU)

Manejo de la hipertensión vasculorrenal / Management of renovascular hypertension

Se revisan los síntomas y signos que orientan a la hipertensión vasculorrenal. Dentro de las exploraciones complementarias, la sensibilidad y especificidad de los métodos no invasivos más utilizados (gammagrafía, Doppler, angiorresonancia y el scanner helicoidal) son muy similares, aunque dependen de los medios y experiencia de cada centro. Hasta estos momentos la gammagrafía renal basal, y tras la administración de un inhibidor de la enzima de conversión de la angiotensina, es la técnica de aproximación más utilizada. Aporta información funcional sobre el grado y repercusión de la estenosis. En relación con exploraciones morfológicas, los resultados publicados sobre la utilización de la angiorresonancia y el scanner helicoidal son muy prometedores. Cuando la sospecha clínica de hipertensión vasculorrenal (HVR) sea muy elevada se puede realizar como primera exploración una arteriografía renal. En los casos de sospecha moderada o baja se realizará como aproximación una prueba no invasiva que depende de la experiencia y resultados de cada centro. Si es positiva, se hará después una arteriografía de confirmación. El objetivo fundamental del tratamiento de la HVR es preservar o mantener la función renal. En la displasia fibromuscular la técnica de elección es la angioplastia transluminal percutánea por sus excelentes resultados, baja morbilidad y nula recidiva. En la enfermedad aterosclerótica la revascularización quirúrgica es la primera indicación, pero en pacientes de alto riesgo o con lesiones severas del sector aórtico se puede realizar angioplastia/endoprótesis. En los casos de enfermedad vasculorrenal bilateral e insuficiencia renal será preciso realizar una valoración individualizada de cada paciente (AU)

Hipertensión e hipopotasemia / Hypertension and hypopotasemia

Paciente hipertenso joven con mal control de la presión arterial y evidencia de hipopotasemia en el seno de tratamiento farmacológico con tiazidas y carvedilol. Después de suspender el diurético el potasio era de 2,8 mEq/l y en orina de 124 mEq/día. El estudio del sistema renina-aldosterona mostró (basal): renina, 6,9 ng/ml; aldosterona, 148 ng/dl (cociente: 21,4); con ortostatismo de 2 horas: renina, 5,7 ng/ml, y aldosterona, 237 ng/dl (cociente: 41,5).Un escáner abdominal demostró una lesión nodular en la glándula suprarrenal izquierda. El estudio confirmó la existencia de un hiperaldosteronismo primario por adenoma suprarrenal izquierdo y se realizó adrenelectomía izquierda. Un mes más tarde la presión arterial era de 110/70 mmHg y el potasio sérico 4,5 mEq/l. Se revisan las causas de hipertensión e hipopotasemia y el protocolo de estudio escalonado de un paciente con dicha patología (AU)

Cognitive decline in patients with familial Alzheimer's disease associated with E280a presenilin-1 mutation: a longitudinal study.

Few longitudinal studies have been carried out to investigate the cognitive decline in early onset of familial Alzheimer's disease (FAD). In this study 12 patients with FAD (M age = 49.61 years, SD = 4.99), 10 patients with sporadic Alzheimer's disease (SAD) (M age = 71.40, SD =10.00), and 15 matched normal controls (M age = 45.01, SD = 7.24) were selected. A comprehensive neuropsychological battery was administered three times over a period of 18 months. Individuals designated as FAD met the criteria for dementia and were positive for the E280A presenilin 1 mutation. Participants with SAD met the criteria for dementia and were negative for the E280A presenilin 1 mutation. Normal control participants were the FAD patients' relatives, who were negative for the mutation. Two groups of neuropsychological instruments were administered: (1) The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological test battery, and (2) additional neuropsychological tests of abstraction and constructional abilities. Patients with FAD were significantly impaired on all measures at the first examination except for reading of words. While the performance of the normal controls remained unchanged over the 18 months for most neuropsychological tests, the patients with FAD displayed a decline in verbal memory, language, constructional and abstraction tests. The greatest decline was observed on the Mini-Mental State Exam scores. Patients with SAD demonstrated a similar pattern of cognitive decline, but the decline was faster in FAD than in SAD participants.