- Email: [email protected]
P1-171
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Poster Presentations P1
tical lesions, clinically symptomatic stroke, and increases in carotid wall thickness were found to be statistically significant in comparison with non diabetes. NMR abnormalities were present in 92 % in group A and 70% in group B consisting of arterial constriction or an atheromatous plaque confirmed in Doppler examination. Conclusions: Measurements of carotid wall thickness via Doppler were considered to be valuable in prediction of risk of brain damage and future stroke due to hypertension in diabetes and non diabetes patients. P1-171
P1-173
EDUCATION AND PRECLINICAL ALZHEIMER’S DISEASE WITHOUT DEMENTIA
Catherine M. Roe1, Chengjie Xiong2, J. Philip Miller2, John C. Morris2. 1Washington University School of Medicine, St. Louis, MO, USA; 2Washington University School of Medicine, St. Louis, USA. Contact e-mail: [email protected] Background: Individuals with no cognitive impairment during life but who have neuropathological Alzheimer’s disease (AD) may represent either presymptomatic or unrecognized early symptomatic AD. The Cognitive Reserve Hypothesis suggests that at a particular level of AD pathology, highly educated individuals are less likely to manifest clinical symptoms of dementia compared with less-educated individuals. This proposition is supported by recent studies which show an association between education and cognitive functioning, as reflected in neuropsychological test results proximate to death, among autopsied individuals with varying amounts of AD-related neuropathology. Objectives: To investigate whether education can help explain preclinical dementia (defined as neuropathological AD without cognitive impairment during life). Methods: Samples of participants (aged 65⫹ years at death) meeting each of three widely-used neuropathological criteria for AD were constructed using data from the National Alzheimer’s Coordinating Center Minimum (MDS) and Neuropathology (NDS) Data Sets. Generalized linear mixed models (using the logit link function) were conducted in each sample to examine whether years of education was associated with a diagnosis of dementia (versus no dementia) within one year of death, adjusting for the effects of Alzheimer Disease Center and other relevant variables. Twelve percent of individuals meeting Khachaturian (122/1,009), 19% meeting Low, Intermediate, or High Likelihood for NIA/Reagan Institute (320/ 1,704), and 14% meeting Possible, Probable, or Definite CERAD (265/ 1,835) neuropathological criteria for AD were nondemented at their final clinical assessment. Increasing education was inversely associated with the probability of a dementia diagnosis in each sample, as was increasing age at death. Dementia diagnosis at the final clinical assessment was significantly associated with greater AD histopathology, as reflected by more severe neuropathological diagnosis stages in the NIA/Reagan and CERAD samples, but was not significantly related to sex, history of stroke, and time between last assessment and death. Clinical depression was predictive of dementia in the samples defined using Khachaturian and CERAD, but not NIA/Reagan, criteria. Conclusions: Regardless of the neuropathological criteria used, greater education predicts the absence of dementia in individuals with neuropathologic AD. P1-172
was 60.4 years. We found the 39 demented peoples; mean age 67.9 years, Alzheimer’s disease was a common type of dementia (64.2 %) and second most common were Vascular Dementia and Hypothyroidism (14.3 %). The prevalence of dementia was 2.35 %. Conclusion: Prevalence of dementia in Chiang Mai was 2.35 % which not differ from the previous study. Alzheimer’s disease was a common type of dementia.
THE PREVALENCE OF DEMENTIA IN CHIANGMAI,THAILAND (AGE 45 YEARS AND ABOVE)
Suparus Wangtongkum. Chiangmai Neurological Hospital, Chiangmai, Thailand. Contact e-mail: [email protected] Objective: To determine the prevalence of dementia in Thai people with age ⱖ 45 years. Subjects and Methods: This population based cross sectional study in Chiang Mai, door to door survey during OCT 2004- SEP 2005. Participants were test with Thai Mini Mental State Examination (TMSE) and Beck Depression Inventory (BDI). If anyone had TMSE score ⬍ 24 points they were assessed again with ADL assessment, Clock Drawing Test (CDT) and physical examination by neurologist. Results: We enrolled 1,492 people; 610 males and 882 females, which mean age
COMPARISON OF DEMOGRAPHICS AND REFERRAL SOURCE OF AFRICAN AMERICAN (AA) CASES AND CONTROLS IN A LONGITUDINAL STUDY OF ALZHEIMER’S DISEASE
Alan J. Lerner, Robert Friedland, McKee McClendon, Alexander Auchus. Case Western Reserve University, Cleveland, OH, USA. Contact e-mail: [email protected] Background: Targeted efforts to recruit African Americans into clinical research have been made by many researchers. These efforts include outreach via community leaders (e.g. pastors), advertising and clinic referrals. Studies have looked at genetic and environmental differences between AA subjects and other groups, without consideration of confounding produced by referral and recruitment patterns. Objective(s): To compare the referral sources and demographic characteristics of AA Alzheimer s disease (AD) cases and controls. Methods: Longitudinal AD natural history study in an Alzheimer’s disease research center in Cleveland, OH. Population: 226 AA subjects recruited into a research registry since 1987. Statistical Method: Comparison of referral source and demographics of cases and controls. All analyses were done with SPSS. Results: There were 70 AA controls and 156 AA probable possible AD subjects. Controls were younger (66.7 9.6 vs. 77.3 8.3) and better educated than cases (13.7 3.2 vs.11.0 3.3)(all p⬍.001). Gender distributions were controls 56F:14M vs. 54M:102F AD (p⬍.05). Referral source was available for 43 controls and 123 AD patients. Comparing community outreach, clinic and media referral sources, control N s were 32,8, and 3; AD N s were 59, 58 and 6 (p⬍.01). Conclusions: Well known risk factors of increased age and reduced education were found in our AA population. Community outreach efforts succeeded in recruiting nearly all controls. However, cases derived from community outreach, and nearly one-half from clinic referrals. This differential may introduce bias into research comparing AD cases to controls. Attempts to reduce this imbalance include recruitment in other settings such as outreach to primary care or neighborhood clinics. Special emphasis on encouraging recruitment by primary care physicians may also be useful, especially in recruiting male controls. Study supported by: NIA P50 AG08120. P1-174
NEUROPSYCHIATRIC SYMPTOMS IN DEMENTED AND NON DEMENTED COMMUNITY DWELLING ELDERLY NIGERIANS
Olusegun Baiyewu. College of Medicine, University of Ibadan, Ibadan, Nigeria. Contact e-mail: [email protected] Background: Very few studies in the developing world have been carried out on dementia and mild cognitive impairment; however, the expected demographic transformation in the region makes the need for such studies urgent. Objective(s): To assess the level of neuropsychiatric symptoms in community dwelling individuals from Ibadan, Nigeria with dementia and mild cognitive impairment (MCI) and normal subjects. Methods: Subjects from the Ibadan-Indianapolis Dementia Resarch Project were diagnosed with Dementia, MCI and Normal after Screening, Neuropsychological Assessment using CERAD, Informant Interview (which included items from Blessed Dementia Scale) and Physician’s evaluation. Caregivers of these subjects were administered the Neuropsychiatric Inventory (NPI), during the 4th wave of our study in 2003. Scores on the NPI between the 3 diagnoses were compared using ANOVA. Following a significant overall p-value, Tukey’s multiple comparison tests were used to compare the
Poster Presentations P1
tical lesions, clinically symptomatic stroke, and increases in carotid wall thickness were found to be statistically significant in comparison with non diabetes. NMR abnormalities were present in 92 % in group A and 70% in group B consisting of arterial constriction or an atheromatous plaque confirmed in Doppler examination. Conclusions: Measurements of carotid wall thickness via Doppler were considered to be valuable in prediction of risk of brain damage and future stroke due to hypertension in diabetes and non diabetes patients. P1-171
P1-173
EDUCATION AND PRECLINICAL ALZHEIMER’S DISEASE WITHOUT DEMENTIA
Catherine M. Roe1, Chengjie Xiong2, J. Philip Miller2, John C. Morris2. 1Washington University School of Medicine, St. Louis, MO, USA; 2Washington University School of Medicine, St. Louis, USA. Contact e-mail: [email protected] Background: Individuals with no cognitive impairment during life but who have neuropathological Alzheimer’s disease (AD) may represent either presymptomatic or unrecognized early symptomatic AD. The Cognitive Reserve Hypothesis suggests that at a particular level of AD pathology, highly educated individuals are less likely to manifest clinical symptoms of dementia compared with less-educated individuals. This proposition is supported by recent studies which show an association between education and cognitive functioning, as reflected in neuropsychological test results proximate to death, among autopsied individuals with varying amounts of AD-related neuropathology. Objectives: To investigate whether education can help explain preclinical dementia (defined as neuropathological AD without cognitive impairment during life). Methods: Samples of participants (aged 65⫹ years at death) meeting each of three widely-used neuropathological criteria for AD were constructed using data from the National Alzheimer’s Coordinating Center Minimum (MDS) and Neuropathology (NDS) Data Sets. Generalized linear mixed models (using the logit link function) were conducted in each sample to examine whether years of education was associated with a diagnosis of dementia (versus no dementia) within one year of death, adjusting for the effects of Alzheimer Disease Center and other relevant variables. Twelve percent of individuals meeting Khachaturian (122/1,009), 19% meeting Low, Intermediate, or High Likelihood for NIA/Reagan Institute (320/ 1,704), and 14% meeting Possible, Probable, or Definite CERAD (265/ 1,835) neuropathological criteria for AD were nondemented at their final clinical assessment. Increasing education was inversely associated with the probability of a dementia diagnosis in each sample, as was increasing age at death. Dementia diagnosis at the final clinical assessment was significantly associated with greater AD histopathology, as reflected by more severe neuropathological diagnosis stages in the NIA/Reagan and CERAD samples, but was not significantly related to sex, history of stroke, and time between last assessment and death. Clinical depression was predictive of dementia in the samples defined using Khachaturian and CERAD, but not NIA/Reagan, criteria. Conclusions: Regardless of the neuropathological criteria used, greater education predicts the absence of dementia in individuals with neuropathologic AD. P1-172
was 60.4 years. We found the 39 demented peoples; mean age 67.9 years, Alzheimer’s disease was a common type of dementia (64.2 %) and second most common were Vascular Dementia and Hypothyroidism (14.3 %). The prevalence of dementia was 2.35 %. Conclusion: Prevalence of dementia in Chiang Mai was 2.35 % which not differ from the previous study. Alzheimer’s disease was a common type of dementia.
THE PREVALENCE OF DEMENTIA IN CHIANGMAI,THAILAND (AGE 45 YEARS AND ABOVE)
Suparus Wangtongkum. Chiangmai Neurological Hospital, Chiangmai, Thailand. Contact e-mail: [email protected] Objective: To determine the prevalence of dementia in Thai people with age ⱖ 45 years. Subjects and Methods: This population based cross sectional study in Chiang Mai, door to door survey during OCT 2004- SEP 2005. Participants were test with Thai Mini Mental State Examination (TMSE) and Beck Depression Inventory (BDI). If anyone had TMSE score ⬍ 24 points they were assessed again with ADL assessment, Clock Drawing Test (CDT) and physical examination by neurologist. Results: We enrolled 1,492 people; 610 males and 882 females, which mean age
COMPARISON OF DEMOGRAPHICS AND REFERRAL SOURCE OF AFRICAN AMERICAN (AA) CASES AND CONTROLS IN A LONGITUDINAL STUDY OF ALZHEIMER’S DISEASE
Alan J. Lerner, Robert Friedland, McKee McClendon, Alexander Auchus. Case Western Reserve University, Cleveland, OH, USA. Contact e-mail: [email protected] Background: Targeted efforts to recruit African Americans into clinical research have been made by many researchers. These efforts include outreach via community leaders (e.g. pastors), advertising and clinic referrals. Studies have looked at genetic and environmental differences between AA subjects and other groups, without consideration of confounding produced by referral and recruitment patterns. Objective(s): To compare the referral sources and demographic characteristics of AA Alzheimer s disease (AD) cases and controls. Methods: Longitudinal AD natural history study in an Alzheimer’s disease research center in Cleveland, OH. Population: 226 AA subjects recruited into a research registry since 1987. Statistical Method: Comparison of referral source and demographics of cases and controls. All analyses were done with SPSS. Results: There were 70 AA controls and 156 AA probable possible AD subjects. Controls were younger (66.7 9.6 vs. 77.3 8.3) and better educated than cases (13.7 3.2 vs.11.0 3.3)(all p⬍.001). Gender distributions were controls 56F:14M vs. 54M:102F AD (p⬍.05). Referral source was available for 43 controls and 123 AD patients. Comparing community outreach, clinic and media referral sources, control N s were 32,8, and 3; AD N s were 59, 58 and 6 (p⬍.01). Conclusions: Well known risk factors of increased age and reduced education were found in our AA population. Community outreach efforts succeeded in recruiting nearly all controls. However, cases derived from community outreach, and nearly one-half from clinic referrals. This differential may introduce bias into research comparing AD cases to controls. Attempts to reduce this imbalance include recruitment in other settings such as outreach to primary care or neighborhood clinics. Special emphasis on encouraging recruitment by primary care physicians may also be useful, especially in recruiting male controls. Study supported by: NIA P50 AG08120. P1-174
NEUROPSYCHIATRIC SYMPTOMS IN DEMENTED AND NON DEMENTED COMMUNITY DWELLING ELDERLY NIGERIANS
Olusegun Baiyewu. College of Medicine, University of Ibadan, Ibadan, Nigeria. Contact e-mail: [email protected] Background: Very few studies in the developing world have been carried out on dementia and mild cognitive impairment; however, the expected demographic transformation in the region makes the need for such studies urgent. Objective(s): To assess the level of neuropsychiatric symptoms in community dwelling individuals from Ibadan, Nigeria with dementia and mild cognitive impairment (MCI) and normal subjects. Methods: Subjects from the Ibadan-Indianapolis Dementia Resarch Project were diagnosed with Dementia, MCI and Normal after Screening, Neuropsychological Assessment using CERAD, Informant Interview (which included items from Blessed Dementia Scale) and Physician’s evaluation. Caregivers of these subjects were administered the Neuropsychiatric Inventory (NPI), during the 4th wave of our study in 2003. Scores on the NPI between the 3 diagnoses were compared using ANOVA. Following a significant overall p-value, Tukey’s multiple comparison tests were used to compare the