A new rating scale for Alzheimer's disease Am J Psychiatry 141: 1356-1364

American Journal of Psychiatry (Impact Factor: 12.3). 12/1984; 141(11):1356-64. DOI: 10.1176/ajp.141.11.1356
Source: PubMed


A new rating instrument, the Alzheimer's Disease Assessment Scale, was designed specifically to evaluate the severity of cognitive and noncognitive behavioral dysfunctions characteristic of persons with Alzheimer's disease. Item descriptions, administration procedures, and scoring are outlined. Twenty-seven subjects with Alzheimer's disease and 28 normal elderly subjects were rated on 40 items. Twenty-one items with significant intraclass correlation coefficients for interrater reliability (range, .650-.989) and significant Spearman rank-order correlation coefficients for test-retest reliability (range, .514-1) constitute the final scale. Subjects with Alzheimer's disease had significantly more cognitive and noncognitive dysfunction than the normal elderly subjects.

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Available from: Richard C Mohs, Aug 20, 2014
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    • "Figure adapted with permission from Kuhn et al. (2015) The rationale for deep brain stimulation in Alzheimer's disease OFF followed by 2 weeks ON), then an 11 months followup open label period (Kuhn et al. 2015). The primary outcome measure was change in Alzheimer's disease assessment scale–cognitive subscale (ADAS-Cog) (Rosen et al. 1984), which worsened by an average of three points over 1 year, representing a non-significant change. Four of six patients were considered responders based on a stable or improved ADAS-Cog score at 1 year. "
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    ABSTRACT: Alzheimer's disease is a major worldwide health problem with no effective therapy. Deep brain stimulation (DBS) has emerged as a useful therapy for certain movement disorders and is increasingly being investigated for treatment of other neural circuit disorders. Here we review the rationale for investigating DBS as a therapy for Alzheimer's disease. Phase I clinical trials of DBS targeting memory circuits in Alzheimer's disease patients have shown promising results in clinical assessments of cognitive function, neurophysiological tests of cortical glucose metabolism, and neuroanatomical volumetric measurements showing reduced rates of atrophy. These findings have been supported by animal studies, where electrical stimulation of multiple nodes within the memory circuit have shown neuroplasticity through stimulation-enhanced hippocampal neurogenesis and improved performance in memory tasks. The precise mechanisms by which DBS may enhance memory and cognitive functions in Alzheimer's disease patients and the degree of its clinical efficacy continue to be examined in ongoing clinical trials.
    Journal of Neural Transmission 10/2015; DOI:10.1007/s00702-015-1462-9 · 2.40 Impact Factor
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    • "All patients were in a stable condition, without acute comorbidities. A comprehensive diagnostic battery was administered, including: 1) Cognitive instruments as the Minimental-State Evaluation (MMSE) [24] Portuguese version [33] [34], the Alzheimer Disease Assessment Scale—Cognitive (ADAS—Cog) [66] [76] Portuguese version [33] [34] and a comprehensive neuropsychological battery with normative data for the Portuguese population (BLAD) [32] exploring memory (Wechsler Memory Scale sub-tests) and other cognitive domains (including language, praxis, executive functions and visuo-constructive tests); 2) Standard staging scales which provide objective information about subject performance in various domains, including the Clinical Dementia Rating (CDR) [5] for global staging; the Disability Assessment for Dementia (DAD) ([27] [51] for evaluation of functional status and the Neuropsychiatric Inventory (NPI) [17] [50] to characterize the psychopathological profile, including the presence of Depression. All the available information (base-line cognitive test, staging scales, clinical laboratory and imaging studies) was used to reach a consensus research diagnosis, independent of the CSF biomarkers results. "
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    ABSTRACT: Cerebrospinal fluid (CSF) biomarkers have been increasingly studied for dementia diagnosis, however the accuracy to distinguish between different forms of dementia is still unsatisfactory. In this study, the added value of another CSF Aβ-peptide (Aβ40), along with the core CSF markers t-Tau, p-Tau, and Aβ42, in the discrimination between two large dementia groups of Frontotemporal Lobar Degeneration (FTLD; n=107), Alzheimer's Disease (AD; n=107) and non-demented subjects (n=33) was evaluated. In FTLD, t-Tau and p-Tau were significantly increased in relation to controls, but lower than in AD, while Aβ42 was similar in FTLD and controls, but higher than in AD. Equally reduced Aβ40 levels were seen in both dementia groups, and therefore the combination of Aβ40 with core CSF biomarkers optimally discriminated FTLD and AD patients from controls. Aβ42 and t-Tau were selected as the best biomarker subset to differentiate FTLD from AD, with no added value of Aβ40 to the model. Diagnostic accuracy between FTLD and AD was still sub-optimal, with a significant percentage (23%) of FTLD patients, in particularly women, carrying an ApoE-ε4 allele, showing a CSF-AD biomarkers profile. Although CSF Aβ40 does not appear to have an additional value in the distinction between FTLD and AD, it increases the discrimination between subjects with dementia from controls. A CSF-AD biomarker profile can be seen in patients with a clinical phenotype of FTLD, reinforcing the need for autopsy confirmation.
    Journal of the neurological sciences 09/2015; DOI:10.1016/j.jns.2015.09.022 · 2.47 Impact Factor
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    • "Legal approval of pharmacological treatment of dementia by the European Medicines Agency and the US Food and Drug Administration requires demonstration of its efficacy by objective cognitive tests. Among the best known of these objective cognitive tests are the Cambridge Cognitive Examination (CAMCOG) (Roth et al., 1986) in Europe and the cognitive part of the Alzheimer Disease Assessment Scale (ADAS-cog) (Rosen et al., 1984) in the United States.The CAMCOG has been used frequently in population studies (Roth et al., 1986; Cullum et al., 2000) and the ADAS-cog in clinical trials (Raskind et al., 2000). Important limitations of these instruments are that they are time-consuming, and also burdensome to patients . "
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    08/2015; DOI:10.1002/mpr.1484
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