- Email: [email protected]
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Poster Presentations P1 P1-227
NEUROPSYCHIATRIC SYNDROMES IN DEMENTIA. RESULTS FROM THE EUROPEAN ALZHEIMER’S DISEASE CONSORTIUM (EADC)
Pauline Aalten, European Alzheimer’s Disease Consortium (EADC), Maastricht University, Maastricht, The Netherlands. Contact e-mail: [email protected] Background: Several factor analytic studies have been performed trying to identify the presence of neuropsychiatric syndromes in dementia. These studies led to inconclusive results due to the use of different designs, assessment tools and limited sample size. In this respect, the initiative was taken to evaluate the presence of neuropsychiatric syndromes by analyzing the largest dementia population ever studied in this regard. Objective(s): The aim of the present study was to identify neuropsychiatric syndromes of the Neuropsychiatric Inventory (NPI) in a large cohort of patients with dementia from several EADC centers. Methods: Twelve EADC centres, representing 12 European countries, combined data for the purpose of performing a factor analytic study of the 12-item NPI. This resulted in the inclusion of 3866 patients. Principal component analysis was used for the identification of syndromes of the NPI. Sub-analyses were performed for each country, dementia diagnosis, dementia severity, medication use, age and gender. Results: Results showed the presence of 4 factors, explaining 52% of the variance: (1) a factor including agitation, euphoria, disinhibition, irritability and aberrant motor behavior; (2) a factor including depression and anxiety; (3) a factor including delusions, hallucinations and sleep problems; (4) a factor including apathy and eating problems. Sub-analyses for dementia severity, age and gender broadly resulted in the same factor structures. About 84% of patients had a diagnosis of Alzheimer’s disease (AD), having the same factor structure as mentioned above. Sub-analyses per country and medication (e.g. cholinesterase inhibitors and antipsychotics) are in progress. Conclusions: The present study provides additional evidence for the existence of 4 neuropsychiatric syndromes in dementia corresponding to hyperactive (agitated) behaviours, affective behaviours, psychosis and apathy. These neuropsychiatric syndromes can give insight into possible relationships between clinical features and their underlying causal and/or risk factors. The conclusions from this large EADC dataset will lead to consensus about the presence of neuropsychiatric syndromes and allow future sub-studies related to this topic.
sex, and education were entered as covariates into a multivariable model, the association of hemoglobin concentration with dementia was no longer significant (p ⫽ 0.2576). Similar results were obtained when anemia status rather than hemoglobin concentration was considered (p ⫽ 0.3364). Conclusions: Present cross-sectional population-based study failed to demonstrate a significant association between anemia or hemoglobin concentration and dementia in the very old. P1-229
ASSOCIATION OF ANEMIA AND HEMOGLOBIN CONCENTRATION WITH DEMENTIA IN THE VERY OLD: THE MONZINO 80-PLUS STUDY
Emma Riva1, Mariateresa Garrì2, Alessandro Nobili1, Mauro Tettamanti1, Ugo Lucca1, 1Istituto Ricerche Farmacologiche "Mario Negri", Milan, Italy; 2Istituto Ricerche Farmacologiche, Milan, Italy. Contact e-mail: [email protected] Background: Mild anemia is a common finding in the elderly population and its prevalence increases with age. Anemia has been suggested to be a potential risk factor for dementia, though published studies are very few and results inconsistent. Objective: To cross-sectionally examine the association of anemia or hemoglobin concentration with dementia in the very old (80⫹). Methods: Consent to blood sampling was obtained in 435 participants in a population-based, door-to-door study on the prevalence and incidence of dementia among the very old residents in the lower Olona Valley, northern Italy (The Monzino 80-plus Study). Diagnosis of dementia was based on DSM-IV criteria. Anemia was defined according to WHO criteria as a concentration of hemoglobin ⬍ 120 g/L in women and ⬍ 130 g/L in men. Results: Participants were 87.4 ⫾ 4.0 years old, 77% women, and had 4.9 ⫾ 2.2 years of education. Ninety-three subjects (21.4 %) were anemic. The prevalence of anemia was significantly higher (p ⫽ 0.0137) in men (30.3%) than in women (18.8%) and increased with increasing age (p ⫽ 0.034). Mean Mini-Mental State Examination score was similar between anemic and non anemic elderly (22.8 ⫾ 5.8 vs 23.2 ⫾ 5.8 respectively, p ⫽ 0.5664). In univariate analyses, hemoglobin concentration was significantly associated with dementia (p ⫽ 0.0061), while anemia status was marginally significantly associated (p ⫽ 0.0591). When age,
26-YEAR CHANGE IN TOTAL CHOLESTEROL LEVELS AND INCIDENT DEMENTIA: THE HONOLULU-ASIA AGING STUDY
Robert Stewart1, Lon R. White2, Qian-Li Xue3, Lenore J. Launer4, 1 King’s College London (Institute of Psychiatry), London, United Kingdom; 2Pacific Health Research Institute, Honolulu, HI, USA; 3Johns Hopkins Center on Aging and Health, Baltimore, MD, USA; 4National Institute on Aging, Bethesda, MD, USA. Contact e-mail: [email protected] Background: The relationship between total cholesterol levels and dementia is unclear. Objective: To compare the natural history of change in total cholesterol over 26 years between men who did and did not develop dementia three years after the last measurement point. Methods: In the Honolulu-Asia Aging Study, 1027 Japanese-American men had total cholesterol levels assayed on five occasions between 1965 and 1993 and were screened for dementia on two occasions between 1991 and 1996. The slope of 26-year change in serum total cholesterol levels was estimated by a repeated measures analysis, and was compared between men with incident dementia (n⫽56) and those without dementia (n⫽971) at the end of the follow-up period. Results: Cholesterol levels in men with dementia, and in particular those with Alzheimer’s disease, had declined at least 15 years before the diagnosis and remained lower than men without dementia throughout that period. The difference in slopes was robust to adjustment for potential confounding factors, including vascular risk factors, weight change, alcohol intake and lipid lowering agents. Conclusions: A decline in serum total cholesterol levels may be associated with early stages in the development of dementia. P1-230
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S163
SERUM ANTIOXIDANTS AND FISH FATTY ACIDS IN 50-YEAR OLD MEN ARE NOT RELATED TO RISK OF ALZHEIMER’S DISEASE. A 35-YEAR FOLLOW UP OF THE UPPSALA LONGITUDINAL STUDY ON ADULT MEN (ULSAM)
Lena Kilander, Elina Ro¨nnemaa, Johan Sundelo¨f, Malin Degerman-Gunnarsson, Lars Lannfelt, Bengt Vessby, Uppsala University, Uppsala, Sweden. Contact e-mail: [email protected] Background and Objectives: It has been suggested that antioxidants and polyunsaturated fatty acids are important in maintaining brain function intact in high age. There is some evidence from epidemiological studies that a high intake of fish fatty acids may lower the risk of Alzheimer’s disease (AD) and dementia in general, but the results are far from clear-cut. We investigated the relations between serum concentrations of antioxidants and fish fatty acids measured in mid-life and the risk of AD up to 35 years later. Methods: The Uppsala Longitudinal Study on Adult Men (ULSAM) started in 1970-4 with 2322 men born in 1920-4. At baseline (age 50 years), proportions of fatty acids in serum cholesterol esters, and serum antioxidants (beta carotene, alphatocopherol, selenium and retinol) were analyzed. Blood pressure, body mass index, serum HDL and LDL cholesterol and triglycerides, glucose and insulin were measured, and educational level, physical activity and smoking habits were recorded. Thirty-five years later, the cohort has been re-examined four times and since the age of 70 years, with regard also to cognitive function. Cognitive testing and reviews of medical
NEUROPSYCHIATRIC SYNDROMES IN DEMENTIA. RESULTS FROM THE EUROPEAN ALZHEIMER’S DISEASE CONSORTIUM (EADC)
Pauline Aalten, European Alzheimer’s Disease Consortium (EADC), Maastricht University, Maastricht, The Netherlands. Contact e-mail: [email protected] Background: Several factor analytic studies have been performed trying to identify the presence of neuropsychiatric syndromes in dementia. These studies led to inconclusive results due to the use of different designs, assessment tools and limited sample size. In this respect, the initiative was taken to evaluate the presence of neuropsychiatric syndromes by analyzing the largest dementia population ever studied in this regard. Objective(s): The aim of the present study was to identify neuropsychiatric syndromes of the Neuropsychiatric Inventory (NPI) in a large cohort of patients with dementia from several EADC centers. Methods: Twelve EADC centres, representing 12 European countries, combined data for the purpose of performing a factor analytic study of the 12-item NPI. This resulted in the inclusion of 3866 patients. Principal component analysis was used for the identification of syndromes of the NPI. Sub-analyses were performed for each country, dementia diagnosis, dementia severity, medication use, age and gender. Results: Results showed the presence of 4 factors, explaining 52% of the variance: (1) a factor including agitation, euphoria, disinhibition, irritability and aberrant motor behavior; (2) a factor including depression and anxiety; (3) a factor including delusions, hallucinations and sleep problems; (4) a factor including apathy and eating problems. Sub-analyses for dementia severity, age and gender broadly resulted in the same factor structures. About 84% of patients had a diagnosis of Alzheimer’s disease (AD), having the same factor structure as mentioned above. Sub-analyses per country and medication (e.g. cholinesterase inhibitors and antipsychotics) are in progress. Conclusions: The present study provides additional evidence for the existence of 4 neuropsychiatric syndromes in dementia corresponding to hyperactive (agitated) behaviours, affective behaviours, psychosis and apathy. These neuropsychiatric syndromes can give insight into possible relationships between clinical features and their underlying causal and/or risk factors. The conclusions from this large EADC dataset will lead to consensus about the presence of neuropsychiatric syndromes and allow future sub-studies related to this topic.
sex, and education were entered as covariates into a multivariable model, the association of hemoglobin concentration with dementia was no longer significant (p ⫽ 0.2576). Similar results were obtained when anemia status rather than hemoglobin concentration was considered (p ⫽ 0.3364). Conclusions: Present cross-sectional population-based study failed to demonstrate a significant association between anemia or hemoglobin concentration and dementia in the very old. P1-229
ASSOCIATION OF ANEMIA AND HEMOGLOBIN CONCENTRATION WITH DEMENTIA IN THE VERY OLD: THE MONZINO 80-PLUS STUDY
Emma Riva1, Mariateresa Garrì2, Alessandro Nobili1, Mauro Tettamanti1, Ugo Lucca1, 1Istituto Ricerche Farmacologiche "Mario Negri", Milan, Italy; 2Istituto Ricerche Farmacologiche, Milan, Italy. Contact e-mail: [email protected] Background: Mild anemia is a common finding in the elderly population and its prevalence increases with age. Anemia has been suggested to be a potential risk factor for dementia, though published studies are very few and results inconsistent. Objective: To cross-sectionally examine the association of anemia or hemoglobin concentration with dementia in the very old (80⫹). Methods: Consent to blood sampling was obtained in 435 participants in a population-based, door-to-door study on the prevalence and incidence of dementia among the very old residents in the lower Olona Valley, northern Italy (The Monzino 80-plus Study). Diagnosis of dementia was based on DSM-IV criteria. Anemia was defined according to WHO criteria as a concentration of hemoglobin ⬍ 120 g/L in women and ⬍ 130 g/L in men. Results: Participants were 87.4 ⫾ 4.0 years old, 77% women, and had 4.9 ⫾ 2.2 years of education. Ninety-three subjects (21.4 %) were anemic. The prevalence of anemia was significantly higher (p ⫽ 0.0137) in men (30.3%) than in women (18.8%) and increased with increasing age (p ⫽ 0.034). Mean Mini-Mental State Examination score was similar between anemic and non anemic elderly (22.8 ⫾ 5.8 vs 23.2 ⫾ 5.8 respectively, p ⫽ 0.5664). In univariate analyses, hemoglobin concentration was significantly associated with dementia (p ⫽ 0.0061), while anemia status was marginally significantly associated (p ⫽ 0.0591). When age,
26-YEAR CHANGE IN TOTAL CHOLESTEROL LEVELS AND INCIDENT DEMENTIA: THE HONOLULU-ASIA AGING STUDY
Robert Stewart1, Lon R. White2, Qian-Li Xue3, Lenore J. Launer4, 1 King’s College London (Institute of Psychiatry), London, United Kingdom; 2Pacific Health Research Institute, Honolulu, HI, USA; 3Johns Hopkins Center on Aging and Health, Baltimore, MD, USA; 4National Institute on Aging, Bethesda, MD, USA. Contact e-mail: [email protected] Background: The relationship between total cholesterol levels and dementia is unclear. Objective: To compare the natural history of change in total cholesterol over 26 years between men who did and did not develop dementia three years after the last measurement point. Methods: In the Honolulu-Asia Aging Study, 1027 Japanese-American men had total cholesterol levels assayed on five occasions between 1965 and 1993 and were screened for dementia on two occasions between 1991 and 1996. The slope of 26-year change in serum total cholesterol levels was estimated by a repeated measures analysis, and was compared between men with incident dementia (n⫽56) and those without dementia (n⫽971) at the end of the follow-up period. Results: Cholesterol levels in men with dementia, and in particular those with Alzheimer’s disease, had declined at least 15 years before the diagnosis and remained lower than men without dementia throughout that period. The difference in slopes was robust to adjustment for potential confounding factors, including vascular risk factors, weight change, alcohol intake and lipid lowering agents. Conclusions: A decline in serum total cholesterol levels may be associated with early stages in the development of dementia. P1-230
P1-228
S163
SERUM ANTIOXIDANTS AND FISH FATTY ACIDS IN 50-YEAR OLD MEN ARE NOT RELATED TO RISK OF ALZHEIMER’S DISEASE. A 35-YEAR FOLLOW UP OF THE UPPSALA LONGITUDINAL STUDY ON ADULT MEN (ULSAM)
Lena Kilander, Elina Ro¨nnemaa, Johan Sundelo¨f, Malin Degerman-Gunnarsson, Lars Lannfelt, Bengt Vessby, Uppsala University, Uppsala, Sweden. Contact e-mail: [email protected] Background and Objectives: It has been suggested that antioxidants and polyunsaturated fatty acids are important in maintaining brain function intact in high age. There is some evidence from epidemiological studies that a high intake of fish fatty acids may lower the risk of Alzheimer’s disease (AD) and dementia in general, but the results are far from clear-cut. We investigated the relations between serum concentrations of antioxidants and fish fatty acids measured in mid-life and the risk of AD up to 35 years later. Methods: The Uppsala Longitudinal Study on Adult Men (ULSAM) started in 1970-4 with 2322 men born in 1920-4. At baseline (age 50 years), proportions of fatty acids in serum cholesterol esters, and serum antioxidants (beta carotene, alphatocopherol, selenium and retinol) were analyzed. Blood pressure, body mass index, serum HDL and LDL cholesterol and triglycerides, glucose and insulin were measured, and educational level, physical activity and smoking habits were recorded. Thirty-five years later, the cohort has been re-examined four times and since the age of 70 years, with regard also to cognitive function. Cognitive testing and reviews of medical