Alzheimer Disease: Allali G

Dubois B, De Souza L, Allali G, Kalafat M, Sarazin M. · Centre des Maladies Cognitives et Comportementales et Inserm U 610, Hôpital de la Salpêtrière, 47, boulevard de l'Hôpital, 75013 Paris. · Bull Acad Natl Med. · Pubmed #18819687 No free full text.

Abstract: Current treatments for Alzheimer's disease aim to compensate for biochemical deficits in the brain. They are purely symptomatic and restore the central cholinergic deficit. Acetylcholinesterase inhibitors have modest but significant efficacy on cognitive disorders, activities of daily living, and the global clinical impression. Glutaminergic receptor antagonists are used for more advanced forms. Future treatments may be curative, acting specifically on the amyloid cascade. Secretase inhibitors and immunotherapy are in the pipeline. Trials will begin within a few months and will open up new perspectives.

Allali G, Assal F, Kressig RW, Dubost V, Herrmann FR, Beauchet O. · Department of Neurology, Geneva University Hospitals, University of Geneva, Geneva, Switzerland. · Dement Geriatr Cogn Disord. · Pubmed #18852489 No free full text.

Abstract: BACKGROUND: Executive dysfunction contributes to gait changes, but the precise mechanisms are still poorly understood. Dual-task-related gait changes depend in part on the capacity to appropriately allocate attention between tasks performed simultaneously and are mainly related to executive deficits. This study aimed to describe the impact of dysexecutive function on gait stability in subjects with dementia using dual tasking. METHODS: Mean values and coefficients of variation of stride time while only walking and while walking and backward counting (dual tasking) were measured using the GAITRite System in 18 subjects with dementia and impaired executive function (IEF), in 16 subjects with dementia and intact executive function, and in 22 nondemented subjects as controls. RESULTS: Stride time, and particularly its variability, significantly increased while performing dual tasking (p < 0.05). IEF was related to both stride time and stride time variability during walking only and to even more gait changes, while dual tasking compared to nondemented subjects and demented subjects without IEF. CONCLUSIONS: These findings confirm the role of executive function in dual tasking, but also strongly suggest their importance for gait stability.

Beauchet O, Allali G, Berrut G, Hommet C, Dubost V, Assal F. · Department of Geriatrics, Angers University Hospital France. · Neuropsychiatr Dis Treat. · Pubmed #18728766 links to  free full text

Abstract: Gait disorders are more prevalent in dementia than in normal aging and are related to the severity of cognitive decline. Dementia-related gait changes (DRGC) mainly include decrease in walking speed provoked by a decrease in stride length and an increase in support phase. More recently, dual-task related changes in gait were found in Alzheimer's disease (AD) and non-Alzheimer dementia, even at an early stage. An increase in stride-to-stride variability while usual walking and dual-tasking has been shown to be more specific and sensitive than any change in mean value in subjects with dementia. Those data show that DRGC are not only associated to motor disorders but also to problem with central processing of information and highlight that dysfunction of temporal and frontal lobe may in part explain gait impairment among demented subjects. Gait assessment, and more particularly dual-task analysis, is therefore crucial in early diagnosis of dementia and/or related syndromes in the elderly. Moreover, dual-task disturbances could be a specific marker of falling at a pre-dementia stage.

Assal F, Allali G, Kressig RW, Herrmann FR, Beauchet O. · No affiliation provided · J Am Geriatr Soc. · Pubmed #18454755 No free full text.

This publication has no abstract.