Alzheimer Disease: Péquignot R

Pariel-Madjlessi S, Opéron C, Péquignot R, Konrat C, Léonardelli S, Belmin J. · Service de gériatrie et consultation mémoire, Hôpital Charles Foix et Faculté de médecine Pierre et Marie Curie (Université Paris VI), Ivry-sur-Seine (94). · Presse Med. · Pubmed #17628389 No free full text.

Abstract: Dementia is a deterioration in several cognitive functions that affects daily living and is observed in the absence of impaired vigilance. Dementia may be revealed by symptoms of memory loss but also by a loss of functional autonomy, onset of depression or by behavioral problems; it may also be recognized during a screening examination. Evaluation of cognitive functions is an essential stage of this diagnosis. Simple tests that any physician can perform provide a first approach. A more detailed cognitive evaluation by a specialist or neuropsychologist is then necessary (except in advanced cases). Once dementia is diagnosed, a causal investigation is required to assess its severity and extent, in order to organize management. Lack of recognition of dementia in the elderly and delay in its diagnosis raise the question of screening to detect it at an earlier stage.

Belmin J, Péquignot R, Konrat C, Pariel-Madjlessi S. · Service de gériatrie et consultation mémoire, Hôpital Charles Foix et Université Paris VI, Ivry-sur-Seine (94). · Presse Med. · Pubmed #17601697 No free full text.

Abstract: Management of Alzheimer disease is based on drug and nondrug treatments. Specific drug treatment includes acetylcholinesterase inhibitors and memantine. They show moderate efficacy superior to that of placebo for global condition, cognitive disorders, need for care, and behavioral problems, but do not prevent further decline. These treatments remain underused. The efficacy of psychotropic drugs (antidepressants, neuroleptics, and antipsychotic agents) in treating behavioral problems is not well documented. Nondrug activities and interventions have not been sufficiently evaluated scientifically. These involve interventions against the consequences of the disease (loss of autonomy, malnutrition) and helping patients' family caregivers. Among these activities, the best evaluated and most interesting are: educational programs for caregivers, occupational therapy at home, and interventions at home by nurses specially trained as case managers.

Traykov L, Bayle AC, Latour F, Lenoir H, Seux ML, Hanon O, Péquignot R, Bert P, Moulin F, Cantegreil I, Wenisch E, Batouche F, Mehrabian S, Rotrou J, Rigaud AS. · Hôpital Broca, Paris, France. · J Neurol Sci. · Pubmed #17337010 No free full text.

Abstract: Late-onset depression (LOD) could be a very early manifestation of Alzheimer's disease (AD), although contradictory results have been reported. Cerebrovascular disease (CVD) may favor the development of LOD, and that the particular forms of vascular depression should be individualized. The Apolipoprotein E (ApoE) epsilon4 allele was shown to be a risk factor for AD. Its role in LOD is controversial, while it is still unknown in vascular depression. Our objective was to clarify the relationship between ApoE epsilon4 allele and LOD in patients with and without CVD. We examined the ApoE phenotypes in a sample of 311 subjects: 50 with vascular LOD, 24 with LOD without CVD, 115 with AD and 122 normal controls (NC). The study of the ApoE epsilon4 allele frequency showed significant differences between: AD group and the vascular LOD and NC groups; LOD group without CVD compared with NC group (p<0.05 to 0.001). The frequency of the epsilon4 allele in the LOD group without CVD did not differ significantly from the AD group, similarly the frequency of the epsilon4 allele in the vascular LOD group was not different from that in NC. The study suggests an association between the ApoE epsilon4 allele and the LOD without CVD. These patients could be at risk of developing AD by an epsilon4-dependent pathway. In contrast, the results show no association between the presence of ApoE epsilon4 allele and vascular depression and provide further evidence in support of the concept that ApoE epsilon4 allele is not associated with clinical CVD.