Alzheimer Disease: Henry RG

Henry RG, Smith BJ. · Department of Dental Services (160), Veterans Affairs Medical Center, Cooper Dr. Division, Lexington, KY 40502, USA. · Dent Clin North Am. · Pubmed #19269397 No free full text.

Abstract: Neurologic diseases represent some of the most common disabling and costly conditions in older age. Alzheimer disease and cerebrovascular accidents (strokes) are two of the most common neurologic conditions, and represent the leading causes of nursing home placement. Dental professionals will be caring for older patients who have age-associated neurologic diseases, including Alzheimer disease and stroke because of the increased longevity of the United States population coupled with improved survivorship of these conditions as a result of advanced medical diagnosis and treatment. Understanding the clinical manifestations of these two common, but distinctly different, neurologic conditions will enable dental professionals to provide safe and rational dental care.

Murphy JM, Henry RG, Langmore S, Kramer JH, Miller BL, Lomen-Hoerth C. · Department of Neurology, ALS Center, University of California, San Francisco, CA 94117, USA. · Arch Neurol. · Pubmed #17420314 links to  free full text

Abstract: OBJECTIVE: To identify the nature and prevalence of cognitive and behavioral abnormalities in patients with amyotrophic lateral sclerosis (ALS). DESIGN: Survey of clinical characteristics. SETTING: Multidisciplinary clinic within a university medical center. Patients A volunteer sample of 30 new patients with ALS were recruited consecutively. Of those invited, 23 participants (20 with sporadic ALS and 3 with familial ALS) enrolled. Participants ranged in age from 27 to 80 years (mean age, 56.5 years); the education level ranged from 12 to 21 years (mean education level, 3.5 years of college); and 17 participants (74%) were male. MAIN OUTCOME MEASURES: Neuropsychological tests, neurobehavioral interviews, and structured magnetic resonance imaging. RESULTS: Patients were classified into subtypes of frontotemporal lobar degeneration (n = 5), suspected Alzheimer disease (n = 1), and subthreshold variants of cognitive impairment (n = 2), behavioral impairment (n = 4), and cognitively and behaviorally normal (n = 11). Five neuropsychological tests, 2 behavioral abnormalities, and right hemisphere gray matter reductions differentiated patients into normal and abnormal groups. CONCLUSIONS: In this sample, a sizable proportion of patients with ALS possess a range of behavioral and cognitive changes that lie on a spectrum of frontotemporal impairment. Right hemisphere atrophy may be a biomarker for cognitive impairment in patients with ALS.

Henry RG. · Department of Veterans Affairs Medical Center, Lexington, Ky. 40502, USA. · J Calif Dent Assoc. · Pubmed #10740518 No free full text.

Abstract: With the number of adults reaching older ages, the number of Americans who develop Alzheimer's disease and other neurological impairments will also increase. The dental management of these patients requires a great deal of understanding and patience coupled with background knowledge of the disease and proficiency in providing behavior modification techniques. This paper discusses five major areas that dental practitioners should consider prior to caring for patients with Alzheimer's disease or other neurological impairments.

Saxe SR, Wekstein MW, Kryscio RJ, Henry RG, Cornett CR, Snowdon DA, Grant FT, Schmitt FA, Donegan SJ, Wekstein DR, Ehmann WD, Markesbery WR. · Geriatric Oral Health Program, College of Dentistry, University of Kentucky, Lexington, USA. · J Am Dent Assoc. · Pubmed #10036842 links to  free full text

Abstract: BACKGROUND: Mercury, or Hg, is a neurotoxin that has been speculated to play a role in the pathogenesis of Alzheimer's disease, or AD. Dental amalgam releases low levels of Hg vapor and is a potential source of Hg for a large segment of the adult population. METHODS: The authors studied 68 subjects with AD and 33 control subjects without AD to determine Hg levels in multiple brain regions at autopsy and to ascertain the subjects' dental amalgam status and history. The subjects were from central Kentucky and Elm Grove, Wis. The authors conducted dental amalgam assessments during the lives of the majority of subjects and in some subjects at the time of autopsy only. The authors also determined three dental amalgam index scores--Event (placement, repair or removal of amalgam), Location and Time In Mouth--in addition to the numbers of and surface area of occlusal amalgam restorations. The authors determined Hg levels in multiple brain regions and performed full neuropathologic evaluations to confirm the normal status of the brain or the presence of AD. RESULTS: The authors found no significant association of AD with the number, surface area or history of having dental amalgam restorations. They also found no statistically significant differences in brain Hg level between subjects with AD and control subjects. CONCLUSIONS: Hg in dental amalgam restorations does not appear to be a neurotoxic factor in the pathogenesis of AD. The authors found that brain Hg levels are not associated with dental amalgam, either from existing amalgam restorations or according to subjects' dental amalgam restoration history. CLINICAL IMPLICATIONS: Dental amalgam restorations, regardless of number, occlusal surface area or time, do not relate to brain Hg levels.