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01/2018 journal articles

Editorials

OVERSIMPLIFICATION OF DEMENTIA RISK REDUCTION MESSAGING IS A THREAT TO KNOWLEDGE TRANSLATION IN DEMENTIA PREVENTION RESEARCH

K.J. Anstey, R. Peters

J Prev Alz Dis 2018;5(1):2-4

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CITATION:
K.J. Anstey ; R. Peters (2017): Oversimplification of Dementia Risk Reduction Messaging Is a Threat to Knowledge Translation in Dementia Prevention Research. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2017.27

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PRIMARY PREVENTION OF DEMENTIA: THE FUTURE OF POPULATION-BASED MULTIDOMAIN LIFESTYLE INTERVENTIONS

Y. Lee

J Prev Alz Dis 2018;5(1):5-7

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Dementia affects 46.8 million of the world’s population, and is projected to increase to 131.5 million by 2050 (1). Increasingly, with no available disease-modifying drug or cure for the disease, preventive strategies are being pursued to curb the worldwide epidemic. Accumulating evidence supports the importance of dementia prevention, with seven risk factors (diabetes mellitus, midlife obesity, midlife hypertension, physical inactivity, depression, smoking, and low education) estimated to contribute to 9.6 million cases, equivalent to a third of Alzheimer’s disease worldwide (2). The potential public health impact of prevention is huge as a 20% reduction per decade from 2010 in the prevalence of these risk factors would translate to a 16.3% (1.5 million) reduction in dementia prevalence by 2050.

CITATION:
Y. Lee (2017): Primary Prevention of Dementia: The Future of Population-based Multidomain Lifestyle Interventions. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2017.17

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Original Research

DELAYED-START ANALYSES IN THE PHASE 3 SOLANEZUMAB EXPEDITION3 STUDY IN MILD ALZHEIMER’S DISEASE

H. Liu-Seifert, M.G. Case, S.W. Andersen, K.C. Holdridge, P.S. Aisen, S. Kollack-Walker, E. Siemers

J Prev Alz Dis 2018;5(1):8-14

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OBJECTIVE: A delayed-start design has been proposed to assess a potential disease-modifying effect in investigational drugs for Alzheimer’s disease that target the underlying disease process. We extended this methodology to recently obtained data from the EXPEDITION3. METHODS: EXPEDITION3 was a Phase 3, double-blind study with participants randomized to solanezumab (400 mg) or placebo every 4 weeks for 80 weeks, with an optional extension of active treatment. The delayed-start analysis was designed to determine if a statistically significant treatment difference established during the placebo-controlled period is maintained (at predefined level) during the delayed-start period, which would suggest the active drug has a disease-modifying effect. The delayed-start analysis was assessed across multiple efficacy measures, and includes data from baseline in the placebo-controlled period and up to 9 months in the delayed-start period. RESULTS: No significant difference was observed between the placebo and solanezumab treatment groups at the end of the placebo-controlled period for the Alzheimer’s Disease Assessment Scale-Cognitive 14-item subscale. A significant treatment difference was observed at the end of the placebo-controlled period for the Alzheimer’s Disease Cooperative Study-Activities of Daily Living instrumental items, an effect also seen at 6 months in the delayed-start period, and the noninferiority criterion was met. No other efficacy measures met these criteria. CONCLUSIONS: Delayed-start statistical methodology was used to understand the longitudinal outcomes in EXPEDITION3 and its extension. The small treatment differences observed at the end of the placebo-controlled phase prevented adequate assessment of any putative disease modifying effect.

CITATION:
H. Liu-Seifert ; M.G. Case ; S.W. Andersen ; K.C. Holdridge ; P.S. Aisen ; S. Kollack-Walker ; E. Siemers (2018): Delayed-Start Analyses in the Phase 3 Solanezumab EXPEDITION3 Study in Mild Alzheimer’s Disease. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2018.1

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DETECTING TREATMENT GROUP DIFFERENCES IN ALZHEIMER’S DISEASE CLINICAL TRIALS: A COMPARISON OF ALZHEIMER’S DISEASE ASSESSMENT SCALE - COGNITIVE SUBSCALE (ADAS-COG) AND THE CLINICAL DEMENTIA RATING - SUM OF BOXES (CDR-SB)

A.M Wessels, S.A. Dowsett, J.R. Sims

J Prev Alz Dis 2018;5(1):15-20

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The Alzheimer’s Disease Assessment Scale’s cognitive subscale (ADAS-Cog) has been widely used as an outcome measure in Alzheimer’s Disease (AD) clinical trials. In its original form (ADAS-Cog11), the scale has been used successfully in mild-to-moderate AD dementia populations, but its use is more limited in the study of earlier disease (mild cognitive impairment [MCI] or mild dementia due to AD) owing to lack of appropriate sensitivity of some items. With recent focus on earlier treatment, efforts have focused on the development of more sensitive tools, including the Clinical Dementia Rating-Sum of Boxes (CDR-SB), a global assessment tool to evaluate both cognition and function. The ability of the ADAS-Cog and CDR-SB to detect treatment group differences in the clinical trial environment has not been systematically studied. The aim of this analysis was to compare the utility of these tools in detecting treatment group differences, by reviewing study findings identified through advanced searches of clinicaltrials.gov and Ovid, and press releases and scientific presentations. Findings from placebo-controlled studies of ≥ 6m duration and enrolling >100 participants were included; reporting of both the ADAS-Cog and CDR-SB at endpoint was also a requirement. Of the >300 records identified, 34 studies fulfilled the criteria. There were significant placebo versus active drug group differences based on findings from at least one measure for 14 studies. The ADAS-Cog detected treatment differences more frequently than the CDR-SB. Based on these and previously published findings, the ADAS-Cog appears more useful than the CDR-SB in detecting treatment group differences.

CITATION:
A.M. Wessels ; S.A. Dowsett ; J.R. Sims (2018): Detecting Treatment Group Differences in Alzheimer’s Disease Clinical Trials: A Comparison of Alzheimer’s Disease Assessment Scale - Cognitive Subscale (ADAS-Cog) and the Clinical Dementia Rating - Sum of Boxes (CDR-SB). The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2018.2

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ASSOCIATIONS OF LONG-TERM TEA CONSUMPTION WITH DEPRESSIVE AND ANXIETY SYMPTOMS IN COMMUNITY-LIVING ELDERLY: FINDINGS FROM THE DIET AND HEALTHY AGING STUDY

S.-P. Chan, P.Z.Yong, Y. Sun, R. Mahendran, J.C.M. Wong, C. Qiu, T.-P. Ng, E.-H. Kua, L. Feng

J Prev Alz Dis 2018;5(1):21-25

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Objective: To examine the association between long-term tea consumption and depressive and anxiety symptoms in community-living elderly. Design: Community based cross-sectional study. Setting: The Diet and Healthy Aging Study (DaHA), a prospective cohort study in Singapore. Participants: 614 elderly aged 60 years and above, who were free of dementia and cognitive impairment. Measurements: Information on tea consumption was obtained through interviewer-administered questionnaire. Long-term tea drinking was defined as regular consumption for at least 15 years. Depressive and anxiety symptoms were measured using the 15-item Geriatric Depression Scale (GDS-15) and the 20-item Geriatric Anxiety Inventory (GAI), respectively. A generalized structural equation model (gSEM) was applied to ascertain the association between long-term tea consumption and depressive and anxiety symptoms. Results: About 59% of the subjects had consumed tea for over 15 years. Long term tea consumption was significantly associated with a reduced odds of having depressive and anxiety symptoms, after adjusting for demographics (i.e., age, gender, education and ethnicity), comorbid conditions (i.e., heart disease, diabetes, stroke, hypertension and hyperlipidaemia) and long-term coffee consumption. Conclusion: There was evidence suggesting that long-term tea consumption was associated with reduced depressive and anxiety symptoms among community-living elderly. This suggests that it is worthwhile to further investigate the role of tea’s bioactive compounds in promoting mental health in aging.

CITATION:
S.-P. Chan ; P.Z.Yong ; Y. Sun ; R. Mahendran ; J.C.M. Wong ; C. Qiu ; T.-P. Ng ; E.-H. Kua ; L. Feng (2017): Associations of Long-Term Tea Consumption with Depressive and Anxiety Symptoms in Community-Living Elderly: Findings from the Diet and Healthy Aging Study. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2017.20

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EFFECTS OF OMEGA-3 FATTY ACIDS ON RESTING CEREBRAL PERFUSION IN PATIENTS WITH MILD COGNITIVE IMPAIRMENT: A RANDOMIZED CONTROLLED TRIAL

C. Schwarz, M. Wirth, L. Gerischer, U. Grittner, A.V. Witte, T. Köbe, A. Flöel

J Prev Alz Dis 2018;5(1):26-30

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Alteration of cerebral perfusion can be considered as a possible therapeutic target in mild cognitive impairment. This randomized, placebo-controlled, double-blind proof-of-concept study assessed effects of omega-3 fatty acids on cerebral perfusion in patients with mild cognitive impairment. In thirteen patients (omega:n=5; placebo:n=8) cerebral perfusion was measured before and after 26-weeks intervention within posterior cortical regions using magnetic resonance imaging. There was a medium effect of intervention on cerebral blood flow (η2=0.122) and blood volume (η2=0.098). The omega group showed an increase in blood flow (mean difference: 0.02 [corresponds to 26.1%], 95% confidence interval:0.00-0.05) and blood volume (mean difference: 0.08 [corresponds to 18.5%], 95% confidence interval:0.01-0.15), which was not observed in the placebo group. These preliminary findings suggest that omega-3 fatty acids supplementation may improve perfusion in cerebral regions typically affected in mild cognitive impairment.Regulation of perfusion may help to maintain brain structure and function and potentially delay conversion to dementia.

CITATION:
C. Schwarz ; M. Wirth ; L. Gerischer ; U. Grittner ; A.V. Witte ; T. Köbe ; A. Flöel (2017): Effects of Omega-3 Fatty Acids on Resting Cerebral Perfusion in Patients with Mild Cognitive Impairment: A Randomized Controlled Trial. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2017.23

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TRAJECTORY OF THE MAPT-PACC-PRECLINICAL ALZHEIMER COGNITIVE COMPOSITE IN THE PLACEBO GROUP OF A RANDOMIZED CONTROL TRIAL: RESULTS FROM THE MAPT STUDY: LESSONS FOR FURTHER TRIALS

J.K. Chhetri, P. de Souto Barreto, C. Cantet, M. Cesari, N. Coley, S. Andrieu, B. Vellas

J Prev Alz Dis 2018;5(1):31-35

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Defining the primary cognitive endpoint is a major decision for Alzheimer’s disease preventive trials. As an example for further trials we present in detail the three-year cognitive decline in the placebo group of MAPT trial, a randomized controlled trial (RCT) using a cognitive composite score (MAPT-PACC). Participants were dementia-free adults 70 years or older, with subjective memory complaints. Our findings as expected showed subjects with older age (>75), higher beta amyloid brain deposition, APOE-ε4 allele carriers, with low RBC DHA+EPA levels and higher CDR level are at higher risk of cognitive decline. The data presented in this paper can be useful for future preventive trials to choose the primary cognitive end point, assess the clinical relevance of cognitive changes and perform sample size calculation for several targeted population eg. ApoE4, amyloid +, oldest old, lower n3-PUFA. We believe that the trial group with CDR 0.5, without being selected by a memory test endpoint is a good target population for AD preventive trials.

CITATION:
J.K. Chhetri ; P. de Souto Barreto ; C. Cantet ; M. Cesari ; N. Coley ; S. Andrieu ; B. Vellas (2017): Trajectory of the MAPT-PACC-Preclinical Alzheimer Cognitive Composite in the Placebo Group of a Randomized Control Trial: Results from the MAPT Study: Lessons for Further Trials. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2017.21

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CARE MANAGEMENT TO PROMOTE TREATMENT ADHERENCE IN PATIENTS WITH COGNITIVE IMPAIRMENT AND VASCULAR RISK FACTORS: A DEMONSTRATION PROJECT

L.M. Bonner, A. Hanson, G. Robinson, E. Lowy, S. Craft

J Prev Alz Dis 2018;5(1):36-41

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Dementia prevention is highly important. Improved control of vascular risk factors has the potential to decrease dementia risk, but may be difficult. Therefore, we developed and piloted a care management protocol for Veterans at risk for dementia. We enrolled 32 Veterans with diabetes and hypertension, at least one of which was poorly controlled, and cognitive impairment. Participants were randomly assigned to a 6-month care management intervention or to usual care. At enrollment, 6-months and 12-months, we assessed cognitive performance, mood, and diabetes and hypertension control. At follow-up, diastolic blood pressure was lower in intervention participants at 6 months (p=.041) and 12 months (p=.022); hemoglobin A1c, global mental status and mood did not differ between groups. Recall of a distractor list (p=.006) and logical memory long-delay recall (p=.036) were better at 6 months in the intervention group (p=.006). Care management may contribute to improved control of dementia risk factors.

CITATION:
L.M. Bonner ; A. Hanson ; G. Robinson ; E. Lowy ; S. Craft (2017): Care Management to Promote Treatment Adherence in Patients with Cognitive Impairment and Vascular Risk Factors: A Demonstration Project. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2017.28

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COGNITIVE FRAILTY AND INCIDENCE OF DEMENTIA IN OLDER PERSONS

H. Shimada, H. Makizako, K. Tsutsumimoto, T. Doi, S. Lee, T. Suzuki

J Prev Alz Dis 2018;5(1):42-48

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BACKGROUND: Cognitive frailty may be a preventive or therapeutic target for preventing dementia and functional decline with age. OBJECTIVES: To examine the relationship between physical and cognitive frailty and the incidence of dementia in community-living older persons. DESIGN: A prospective cohort study. Setting: General community in Japan. Participants: A total of 4072 persons aged ≥ 65 years. SETTING: A community in Japan. PARTICIPANTS: A total of 4072 community-dwelling older persons aged ≥ 65 years participated in the study. MEASUREMENTS: We characterized physical frailty as ≥ 3 of the following criteria: slow walking speed, muscle weakness, exhaustion, low physical activity, and weight loss. We used the National Center for Geriatrics and Gerontology-Functional Assessment Tool, which includes tests of word list memory, attention, and executive function, and processing speed to screen for cognitive frailty. The presence of ≥ 2 cognitive impairments, indicated by an age-adjusted score of at least 1.5 standard deviations below the reference threshold, was defined as cognitive frailty. The incidence of dementia was determined using data collected by the Japanese Health Insurance System over 24 months. RESULTS: The overall prevalence rates of physical frailty, cognitive impairment, and cognitive frailty (i.e., coexistence of frailty and cognitive impairment) were 5.1%, 5.5%, and 1.1%, respectively. During the follow-up period, 81 participants (2.0%) developed dementia. We found significant relationships between the incidence of dementia and cognitive impairment (hazard ratio (HR): 3.85, 95% confidence interval (95% CI): 2.09–7.10) and cognitive frailty (HR: 6.19, 95% CI: 2.7–13.99). However, the association between dementia and physical frailty did not reach significance (HR: 1.95, 95% CI: 0.97–3.91). CONCLUSIONS: Individuals with cognitive frailty had the highest risk of dementia. Future research should implement dementia prevention strategies among older persons with cognitive frailty.

CITATION:
H. Shimada ; H. Makizako ; K. Tsutsumimoto ; T. Doi ; S. Lee ; T. Suzuki (2017): Cognitive Frailty and Incidence of Dementia in Older Persons. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2017.29

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THE VALUE OF PRE-SCREENING IN THE ALZHEIMER’S PREVENTION INITIATIVE (API) AUTOSOMAL DOMINANT ALZHEIMER’S DISEASE TRIAL

S. Rios-Romenets, M. Giraldo-Chica, H. López, F. Piedrahita, C. Ramos, N. Acosta-Baena, C. Muñoz, P. Ospina, C. Tobón, W. Cho, M. Ward, J.B. Langbaum, P.N. Tariot, E.M. Reiman, F. Lopera

J Prev Alz Dis 2018;5(1):49-54

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The Alzheimer’s Prevention Initiative (API) Autosomal Dominant Alzheimer’s Disease (ADAD) trial evaluates the anti-amyloid-β antibody crenezumab in cognitively unimpaired persons who, based on genetic background and age, are at high imminent risk of clinical progression, and provides a powerful test of the amyloid hypothesis. The Neurosciences Group of Antioquia implemented a pre-screening process with the goals of decreasing screen failures and identifying participants most likely to adhere to trial requirements of the API ADAD trial in cognitively unimpaired members of Presenilin1 E280A mutation kindreds. The pre-screening failure rate was 48.2%: the primary reason was expected inability to comply with the protocol, chiefly due to work requirements. More carriers compared to non-carriers, and more males compared to females, failed pre-screening. Carriers with illiteracy or learning/comprehension difficulties failed pre-screening more than non-carriers. With the Colombian API Registry and our prescreening efforts, we randomized 169 30-60 year-old cognitively unimpaired carriers and 83 non-carriers who agreed to participate in the trial for at least 60 months. Our findings suggest multiple benefits of implementing a pre-screening process for enrolling prevention trials in ADAD.

CITATION:
S. Rios-Romenets ; M. Giraldo-Chica ; H. López ; F. Piedrahita ; C. Ramos ; N. Acosta-Baena ; C. Muñoz ; P. Ospina ; C. Tobón ; W. Cho ; M. Ward ; J.B. Langbaum ; P.N. Tariot ; E.M. Reiman ; F. Lopera (2017): The Value of Pre-screening in the Alzheimer’s Prevention Initiative (API) Autosomal Dominant Alzheimer’s Disease Trial. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2017.44

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COSTS AND RESOURCE USE ASSOCIATED WITH ALZHEIMER’S DISEASE IN ITALY: RESULTS FROM AN OBSERVATIONAL STUDY

G. Bruno, M. Mancini, G. Bruti, G. Dell’Agnello, C. Reed

J Prev Alz Dis 2018;5(1):55-64

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Background: The GERAS II study aimed to assess societal costs and resource use associated with Alzheimer’s disease (AD) for patients and their primary caregivers in Italy and Spain, stratified for different severity stages of AD at baseline. This report presents baseline results for Italy. Design: GERAS II was a prospective, multicentre, observational study of routine care in AD. Setting: Community-dwelling patients attending specialist secondary care centres (memory clinics/Alzheimer’s Evaluation Units) and their primary informal caregivers were recruited into the study. Participants: Patients were aged ≥55 years, presented within the normal course of care, had a diagnosis of probable AD and a Mini-Mental State Examination (MMSE) score of ≤26. Patients and caregivers were stratified according to patient AD dementia severity at baseline: mild, MMSE score 21–26; moderate, MMSE score 15–20; or moderately severe/severe, MMSE score <15. Measurements: Data collected for patients and caregivers included demographics/clinical characteristics; current medication; patient cognitive, functional and behavioural assessments; patient and caregiver health-related quality of life (HRQoL); and patient and caregiver resource use. The costs associated with the resources used were calculated. Costs were broken down into patient healthcare costs, patient social care costs and caregiver informal care costs. Results: Of 198 patients enrolled from Italy, 29 (15%) had mild AD dementia, 80 (40%) had moderate AD dementia, and 89 (45%) had moderately severe/severe AD dementia. Patient and caregiver characteristics showed some differences between AD dementia severity groups; for example, a numerically higher proportion of patients with mild and moderately severe/severe AD dementia were taking memantine compared with those with moderate AD dementia. Patient functioning and behavioural and psychological symptoms worsened with increasing AD dementia severity (p<0.05 between groups for all measures). No significant difference between the disease severity groups was observed in patient HRQoL, and there was no clear pattern in resource use. However, all measures of caregiver time spent helping the patient differed significantly between groups (p<0.05) and were highest in patients with moderately severe/severe AD dementia. Mean (standard deviation) total monthly societal costs per patient (2013 values) were €1850 (1901), €1552 (1322) and €2728 (2184) for patients with mild, moderate and moderately severe/severe AD dementia, respectively (p<0.001 between groups). Caregiver informal care costs were the greatest contributor to total societal costs and amounted to €1370, €1223 and €2223 per patient per month for mild, moderate and moderately severe/severe AD dementia groups, respectively (p<0.001 between groups). Conclusion: Total Italian societal costs generally increased with increasing AD dementia severity. However, costs were slightly lower for moderate than for mild AD dementia, possibly reflecting the observed unusual trend of greater caregiver time and higher memantine use in patients with mild versus moderate AD dementia.

CITATION:
G. Bruno ; M. Mancini ; G. Bruti ; G. Dell’Agnello ; C. Reed (2017): Costs and Resource Use Associated with Alzheimer’s Disease in Italy: Results from an Observational Study. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2017.31

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NEUROPROTECTIVE EFFECTS OF GUARANA (PAULLINIA CUPANA MART.) AGAINST VINCRISTINE IN VITRO EXPOSURE

F. Veloso, A.K. Machado, F.C. Cadoná, V.F. Azzolin, I.B.M. Cruz, A.F. Silveira, ONLINE EXCLUSIVE

J Prev Alz Dis 2018;5(1):65-70

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Background: Vincristine (VCR) is not a specific chemotherapeutic drug, responsible for cause several side effects. In this sense, many natural products have been studied to reduce this problem. Objetives: To examine the guarana neuroprotective effect in mice brain and cerebellum cells against vincristine (VCR) exposition. Design: An in vitro study was performed using mice brain and cerebellum mice in monolayer culture. First, cells were exposed to VCR (0.009 µM for 24 hours and 0.0007 µM for 72 hours) to measure the cytotoxicity effect. Also, the cellular effect of hydroalcoholic extract of guarana (10; 30; 100 and 300 μg/mL) was evaluated in the same cells in 24 and 72 hours. After that, cells were exposed to VCR and guarana extract to evaluate the neuroprotective effect of guarana. Measurements: Cell viability was analyzed by MTT, Free dsDNA and LHD Assays. Moreover, metabolism oxidative profile was evaluated by reactive oxygen species (ROS), lipoperoxidation (LPO) and catalase (CAT) levels through DCFH-DA, TBARS and Catalase Activity Assays, respectively. Results: Our findings revealed that VCR caused neuronal cytotoxicity by reducing cell viability and increasing ROS and LPO levels. On the other hand, guarana did not cause cell damage in none of tested concentrations. In addition, guarana exhibited a notable protective effect on brain and cerebellum cells exposed to VCR by increasing cell viability, stimulating CAT activity, reducing levels of ROS and LPO. Conclusions: In this sense, guaraná is a remarkable antioxidant fruit that could be a target in new therapies development to reduce VCR neurotoxicity.

CITATION:
C.F. Veloso ; A.K. Machado ; F.C. Cadoná ; V.F. Azzolin ; I.B.M. Cruz ; A.F. Silveira (2017): Neuroprotective Effects of Guarana (Paullinia cupana Mart.) against Vincristine in Vitro Exposure. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2017.45

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Systematic Review

COMBINING GEOSPATIAL ANALYSIS WITH DEMENTIA RISK UTILISING GENERAL PRACTICE DATA: A SYSTEMATIC REVIEW

N. Bagheri, K. Wangdi, N. Cherbuin, K.J. Anstey, ONLINE EXCLUSIVE

J Prev Alz Dis 2018;5(1):71-77

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Geographical information systems (GIS) and geospatial analysis techniques will help to identify significant dementia risk clusters (hotspots) across communities and will enable policy makers to target prevention interventions to the right place. This review synthesises the published literature on geospatial analysis techniques for quantifying and mapping dementia risk, and reviews available dementia risk assessment tools. A systematic literature review was undertaken in four medical and life sciences databases (PubMed, Cochrane Central, Embase, and Web of Sciences) from their inception to March 2017 for all articles relating to dementia. The search terms included: ‘dementia’, ‘Alzheimer’s disease’, ‘general practice database’, ‘family physician’, ‘AD risk assessment tools’, ‘Geographical Information Systems’ and ‘geospatial analysis’, ‘geographical variation’ and ‘spatial variation’. To date, most geospatial studies on dementia have been carried out retrospectively using population based data. An alternative approach is utilisation of a rich source of general practice (family physician) databases to predict dementia risk based on available dementia risk assessment tools. In conclusion, the estimated risks of dementia can thus be geo-attributed and mapped at a small scale using geographical information systems and geospatial analysis techniques to identify dementia risk clusters across the communities and refine our understanding of the interaction between socio-demographic and environmental factors, and dementia risk clusters.  

CITATION:
N. Bagheri ; K. Wangdi ; N. Cherbuin ; K.J. Anstey (2017): Combining Geospatial Analysis with Dementia Risk Utilising General Practice Data: A Systematic Review. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2017.33

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Review Articles

THE RELATIONSHIP OF OMEGA 3 POLYUNSATURATED FATTY ACIDS IN RED BLOOD CELL MEMBRANES WITH COGNITIVE FUNCTION AND BRAIN STRUCTURE: A REVIEW FOCUSSED ON ALZHEIMER’S DISEASE

C. Hooper, P. De Souto Barreto, M. Pahor, M. Weiner, B. Vellas, ONLINE EXCLUSIVE

J Prev Alz Dis 2018;5(1):78-84

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Significant research attention has focussed on the identification of nutraceutical agents for the prevention of cognitive decline as a natural means of cognitive preservation in the elderly. There is some evidence for a reduction of brain omega 3 polyunsaturated fatty acids (n-3 PUFAs) in normal aging and in Alzheimer’s disease. n-3 PUFAs exhibit anti-inflammatory and anti-amyloidogenic properties as well as being able to reduce tau phosphorylation. Many observational studies have demonstrated a link between n-3 PUFAs and cognitive aging, and some, but not all, randomized controlled trials have demonstrated a benefit of n-3 PUFA supplementation on cognition, particularly in those subjects with mild cognitive impairment. The identification of a biomarker that reflects n-3 PUFA intake over time and consequent tissue levels is required. In this narrative review we discuss the evidence associating red blood cell membrane n-3 PUFAs with cognitive function and structural brain changes associated with Alzheimer’s disease.

CITATION:
C. Hooper ; P. De Souto Barreto ; M. Pahor ; M. Weiner ; B. Vellas (2017): The Relationship of Omega 3 Polyunsaturated Fatty Acids in Red Blood Cell Membranes with Cognitive Function and Brain Structure: A Review Focussed on Alzheimer’s Disease. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2017.19

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Letter to the Editor

DEMENTIA: CREATING A KNOWLEDGE-BASED HEALTHCARE PROFESSION

C. Scerri, ONLINE EXCLUSIVE

J Prev Alz Dis 2018;5(1):85-86

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CITATION:
C. Scerri (2017): Dementia: Creating a Knowledge-Based Healthcare Profession. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2017.43

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LONG-TERM TEA CONSUMPTION AND DEPRESSIVE AND ANXIETY SYMPTOMS IN ELDERLY

B. Joob, V. Wiwanitkit, ONLINE EXCLUSIVE

J Prev Alz Dis 2018;5(1):87

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CITATION:
B. Joob ; V. Wiwanitkit ; (2018): Long-Term Tea Consumption and Depressive and Anxiety Symptoms in Elderly. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2018.3

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RESPONSES: LONG-TERM TEA CONSUMPTION AND DEPRESSIVE AND ANXIETY SYMPTOMS IN ELDERLY

L. Feng , ONLINE EXCLUSIVE

J Prev Alz Dis 2018;5(1):87

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CITATION:
L. Feng (2018): Responses: Long-Term Tea Consumption and Depressive and Anxiety Symptoms in Elderly. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2018.4

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