- Email: [email protected]
Detection of amyloid β-peptide — methodological considerations
S237
respectively. Results: The Integrated OptIcal Density (IOD, 261.43) and Average Optical Density (AOD, 0.89) in the Alzheimer’ disease group were obvious higher than those in the Vascular dementia group (lOD=l20.55; AOD=O.XS) and the healthy elderly group (IOD= 139.70; AOD= l.OO), P
loaded \ymptoms than Normals (p<.Ol). whde total CDS tcores did not differ across groups. Interestingly, the Normal+Dep subjects endorsed a similar number of cognitively-loaded symptoms ar the two impaired groups. The endorsement of cognitively-loaded symptoma in the absence of mood-specific symptoma differentiates MCI patients from both depressed and nondepressed cognitively healthy older adults. Consequently, an exammation of the type of depressive symptom5 endorsed by patrents could guide diagnostic and treatment decisions.
DETECTION OF AMYLOID CONSIDERATIONS
P-PEPTIDE _ METHODOLOGICAL
COMBINATION OF MINI-MENTAL-STATE-EXAM AND CLOCK DRAWING TEST LEADS TO AN ENHANCED SENSITIVITY IN SCREENING FOR DEMENTIA.
Objective: The MMSE ib a frequently wed screening instrument in the evaluation of cognitive impairment, wth deficits m the differentiation between healthy and beginnmg dementia. The Clock Drawing Te\t provides a simple and reliable measure of visuospatml ability and the question is posed if a combination of the MMSE and the Clock Drawing Test leads to an enhancement in the sensitivity and specificity in screening for dementia. Method: The outpatienta of a memory clinic in Frankfurt am Main were assessed with &nical, neuropsychological and apparative diagnostic procedures. Based on the results, a dementia was either diagnowd or excluded.lneluded in the assewnent was the Clock Drawing Test in which the patients were given a piece of paper with a preprtnted circle and instructed to draw a clock with the hands of the clock signalling the time I I: IO.The Clock Drawing Test was scored with four different methods according to the rating cc&s of Shulman et al. (1986). Sunderland et al. (1989). Wolf-Klein et al. (1989) and Watson et al. (1993). MMSE and Clock Drawing Test were analysed in regard to interrater-reliability, sensitivity and specificity in the differentiation between healthy and demented subjectr. Results: All four methods of scoring the Clock Drawing Test showed a significant correlation between disease severity and neuropsychometric test results. The Shulman rating xale demonstrated a superior sensitivity compared to the other scoring methods and compared to the MMSE.In addition, the combination of the MMSE with Clock Drawing Teat according to Shulman lead to an even higher sensitivity than each tebt alone. Cunclusion: The combination of the MMSE with the Clock Drawing Test xcorcd according to Shulman i.\ an extremely efficient and sensitive method for the Identification of mild to moderate dementia. However, the possibility of a false pwitive result must be kept in mind and controlled for by periodical retesting. Nevertheless, the combination of the two tejts prowdes an Ideal tool for the lmeasurement of severity of cognitive deficits in the setting of the prm~ary care physician as gatekeeper in the diagnosis of demented patient\.
(10831
WITHDRAWN
piiq
DEPRESSION IMPAIRMENT:
SYMPTOMS ASSOCIATED WITH IS IT REALLY DEPRESSION?
COGNITIVE
Alzheimer’s disease (AD) may br preceded by depressive symptoms by as many as three to eight years. Recently, researchers noted that cognttively-loaded depressive symptoms (e.g., initiation/motivation, concentration) are endorsed more often than mood symptoms (e.g., anhedonia, hopelessness) by individuals who later develop AD. These findings suggest that what is perceived as depression may in fact be early cognitive decline. The goal of this study was to investigate the pattern of depressive symptoms endorsed by cognitively healthy and impaired older adults evaluated in our Memory Disorders Clinic in the past two years. Impaired subjects included those with mild AD (N= 15, MMSEz22) and mild cognitive impairment (MCI; N=22, MMSEz25). Healthy older adults were either nondepressed (Normal; N=l3, MMSEz27) or depressed (Normal+Dep; N= 13, MMSEr27). Using the Geriatric Depression Scale (GDS), a commonly employed screening instrument, items with a higher cognitive load and items that were more mood-specific were identified (criterion based). Frequency of symptom endorsement across groups was compared using Chi-square analyses. Overall, the two cognitively impaired groups reported fewer mood-specific aymptoms than did Normal and Normal+Dep individuals (~4.05). As expected, Normal+Dep subjects reported more depressive symptoms than did Normals (p<.Ol). In addition, MCI patients endorsed more cognitively-
Amyloldp-peptlde (AP) is the main constituent m plaques of Alrheimer’s disease (AD). Afiis a 40-42 amino acid peptide and a degradation product of the membrane bound amyloid precursor protein. The peptlde is produced by various cell types and 1s secreted into blood and cerebrospinal fluid (CSF). The most abundant form of secreted Apcontains 40 amino acids (AP40) and 10% of APconsist of AP42. We have prewously found that the level of secreted APin CSF was increased in the early stages of AD and decline with the disease progression. APis found in aggregated and monomeric forms and we wanted to investigate in what conditions APwas detected. APwas measured by ELJSA using the 4GR antibody (recognising residues 17-20 of AD) as capture antibody, and AP40 and AD42 specific polyclonal detection antibodies. By introducing a fibrillization-breaking treatment to CSF samples and synthetic A& we are investigating the possibilities to increase the amount of Apmonofibrils. Preliminary results indicate that this procedure dissociates Appolymers leading to a higher apparent signal in ELISA.
A NEW 17 POINT MEMORY TEST EVALUATING THE TREAT(10861 MENT OF PATIENTS WITH PROBABLE ALZHEIMER’S DISEASE IN A BUSY PRIlilARY
CARE PRACTICE
The II point memory twt has hren developed a\ 3 quick, ca\y, accurate tool for Imonitoring the propre\s of patlent\ with probable Alrhelmer’\ Disease. treated with drug’ prcxntly available in a busy primary care office, and compared to the more lime conwming 30 pomt memory test.
respectively. Results: The Integrated OptIcal Density (IOD, 261.43) and Average Optical Density (AOD, 0.89) in the Alzheimer’ disease group were obvious higher than those in the Vascular dementia group (lOD=l20.55; AOD=O.XS) and the healthy elderly group (IOD= 139.70; AOD= l.OO), P
loaded \ymptoms than Normals (p<.Ol). whde total CDS tcores did not differ across groups. Interestingly, the Normal+Dep subjects endorsed a similar number of cognitively-loaded symptoms ar the two impaired groups. The endorsement of cognitively-loaded symptoma in the absence of mood-specific symptoma differentiates MCI patients from both depressed and nondepressed cognitively healthy older adults. Consequently, an exammation of the type of depressive symptom5 endorsed by patrents could guide diagnostic and treatment decisions.
DETECTION OF AMYLOID CONSIDERATIONS
P-PEPTIDE _ METHODOLOGICAL
COMBINATION OF MINI-MENTAL-STATE-EXAM AND CLOCK DRAWING TEST LEADS TO AN ENHANCED SENSITIVITY IN SCREENING FOR DEMENTIA.
Objective: The MMSE ib a frequently wed screening instrument in the evaluation of cognitive impairment, wth deficits m the differentiation between healthy and beginnmg dementia. The Clock Drawing Te\t provides a simple and reliable measure of visuospatml ability and the question is posed if a combination of the MMSE and the Clock Drawing Test leads to an enhancement in the sensitivity and specificity in screening for dementia. Method: The outpatienta of a memory clinic in Frankfurt am Main were assessed with &nical, neuropsychological and apparative diagnostic procedures. Based on the results, a dementia was either diagnowd or excluded.lneluded in the assewnent was the Clock Drawing Test in which the patients were given a piece of paper with a preprtnted circle and instructed to draw a clock with the hands of the clock signalling the time I I: IO.The Clock Drawing Test was scored with four different methods according to the rating cc&s of Shulman et al. (1986). Sunderland et al. (1989). Wolf-Klein et al. (1989) and Watson et al. (1993). MMSE and Clock Drawing Test were analysed in regard to interrater-reliability, sensitivity and specificity in the differentiation between healthy and demented subjectr. Results: All four methods of scoring the Clock Drawing Test showed a significant correlation between disease severity and neuropsychometric test results. The Shulman rating xale demonstrated a superior sensitivity compared to the other scoring methods and compared to the MMSE.In addition, the combination of the MMSE with Clock Drawing Teat according to Shulman lead to an even higher sensitivity than each tebt alone. Cunclusion: The combination of the MMSE with the Clock Drawing Test xcorcd according to Shulman i.\ an extremely efficient and sensitive method for the Identification of mild to moderate dementia. However, the possibility of a false pwitive result must be kept in mind and controlled for by periodical retesting. Nevertheless, the combination of the two tejts prowdes an Ideal tool for the lmeasurement of severity of cognitive deficits in the setting of the prm~ary care physician as gatekeeper in the diagnosis of demented patient\.
(10831
WITHDRAWN
piiq
DEPRESSION IMPAIRMENT:
SYMPTOMS ASSOCIATED WITH IS IT REALLY DEPRESSION?
COGNITIVE
Alzheimer’s disease (AD) may br preceded by depressive symptoms by as many as three to eight years. Recently, researchers noted that cognttively-loaded depressive symptoms (e.g., initiation/motivation, concentration) are endorsed more often than mood symptoms (e.g., anhedonia, hopelessness) by individuals who later develop AD. These findings suggest that what is perceived as depression may in fact be early cognitive decline. The goal of this study was to investigate the pattern of depressive symptoms endorsed by cognitively healthy and impaired older adults evaluated in our Memory Disorders Clinic in the past two years. Impaired subjects included those with mild AD (N= 15, MMSEz22) and mild cognitive impairment (MCI; N=22, MMSEz25). Healthy older adults were either nondepressed (Normal; N=l3, MMSEz27) or depressed (Normal+Dep; N= 13, MMSEr27). Using the Geriatric Depression Scale (GDS), a commonly employed screening instrument, items with a higher cognitive load and items that were more mood-specific were identified (criterion based). Frequency of symptom endorsement across groups was compared using Chi-square analyses. Overall, the two cognitively impaired groups reported fewer mood-specific aymptoms than did Normal and Normal+Dep individuals (~4.05). As expected, Normal+Dep subjects reported more depressive symptoms than did Normals (p<.Ol). In addition, MCI patients endorsed more cognitively-
Amyloldp-peptlde (AP) is the main constituent m plaques of Alrheimer’s disease (AD). Afiis a 40-42 amino acid peptide and a degradation product of the membrane bound amyloid precursor protein. The peptlde is produced by various cell types and 1s secreted into blood and cerebrospinal fluid (CSF). The most abundant form of secreted Apcontains 40 amino acids (AP40) and 10% of APconsist of AP42. We have prewously found that the level of secreted APin CSF was increased in the early stages of AD and decline with the disease progression. APis found in aggregated and monomeric forms and we wanted to investigate in what conditions APwas detected. APwas measured by ELJSA using the 4GR antibody (recognising residues 17-20 of AD) as capture antibody, and AP40 and AD42 specific polyclonal detection antibodies. By introducing a fibrillization-breaking treatment to CSF samples and synthetic A& we are investigating the possibilities to increase the amount of Apmonofibrils. Preliminary results indicate that this procedure dissociates Appolymers leading to a higher apparent signal in ELISA.
A NEW 17 POINT MEMORY TEST EVALUATING THE TREAT(10861 MENT OF PATIENTS WITH PROBABLE ALZHEIMER’S DISEASE IN A BUSY PRIlilARY
CARE PRACTICE
The II point memory twt has hren developed a\ 3 quick, ca\y, accurate tool for Imonitoring the propre\s of patlent\ with probable Alrhelmer’\ Disease. treated with drug’ prcxntly available in a busy primary care office, and compared to the more lime conwming 30 pomt memory test.