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Introduction: The study aimed to compare the profile of very mild and mild dementia with Lewy bodies (DLB) patients with disease duration up to 5 years in order to find markers for faster progression in this early stage., Method: We investigated 45 DLB patients with disease duration up to 5 years and 22 normal controls. DLB patients were divided into two subgroups on the basis of the Mini-Mental State Examination (MMSE): very mild and mild., Results: Compared to normal controls, very mild DLB patients show significant deficits on tests for attention/executive functions, language, visuospatial/constructional abilities, and retrieval of the episodic memory. In addition, mild DLB (mDLB) patients show a significantly lower score on recall and recognition of the Free and Cued Selective Reminding Test (FCSRT), Trail Making Test Part B (TMT-B), Stroop test, verbal fluency, and Clock Drawing Test than did very mild DLB (vmDLB) patients. Patients with mDLB also have more visual hallucinations, but not significant motor differences compared to vmDLB., Conclusions: In the present work we found that faster progression to the mild DLB stage in the first few years of the disease is mainly related to deterioration of memory, attention/executive functions, and visuospatial abilities, as well as an increased frequency of visual hallucinations.

Abstract: Background: The causative mechanisms of type 2 diabetes (T2D) on cognitive dysfunction are still undergoing development. Aim: To explore the cognitive dysfunction profile and its relation to the potential role of arterial stiffness in later middle age T2D patients. Methods: We studied 37 patients with T2D (age range 45–65years) and 22 normal controls. All participants underwent comprehensive neuropsychological assessment. The carotid-femoral pulse wave velocity (CF-PWV) measurements were taken with the PulsePen device. Results: Our results showed significantly poorer performance on all tests assessing attention/executive functions and processing speed in patients with T2D. In addition to cognitive slowing T2D patients demonstrated significant deficits in almost all measures of verbal episodic memory after adjustment for age, education and blood pressure (BP) levels (p<0.05). Carotid-femoral pulse wave velocity (CF-PWV) appeared significantly higher in T2D subjects than in normal controls after adjustment for age and BP level (p<0.001). Significant relationship was observed between CF-PWV and cognitive status. Conclusion: We revealed that arterial stiffness was increased and associated with cognitive impairment in T2D. The cognitive profile indicates hippocampal amnestic type mild cognitive impairment associated with a pronounced dysexecutive syndrome suggesting that diabetes may affect cognition through both vascular and neurodegenerative processes. However, neurodegenerative cognitive profile caused by hippocampal atrophy in a pure vascular process could not be excluded. [Copyright &y& Elsevier]

Abstract: Background and purpose: To determine the relationship between orthostatic hypotension (OH) and cognitive function in elderly subjects with memory complaints. Methods: We studied the association between cognitive function and OH in 495 consecutive elderly outpatients attending a memory centre. Blood pressure (BP) was measured in a sitting and standing position. We examined cognitive function using a validated comprehensive battery of neuropsychological tests, the cognitive efficiency profile (CEP) assessing the main cognitive areas. Subjects were classified into 4 categories according to their cognitive status: normal cognitive function, mild cognitive impairment (MCI), Alzheimer''s disease (AD) or vascular dementia (VaD). Results: In this population, 76±8years of age (women 72%), 18% had normal cognitive function, 28% had MCI, 47% AD, and 7% VaD. Hypertension was observed in 74% of patients. OH was present in 14% of subjects (n=69). After adjustment for age, education level, systolic BP, diastolic BP, weight, and antihypertensive drugs, subjects with OH had worse cognitive function than those without OH (CEP score 50±24 vs 56±22, p<0.05). Moreover, a significant relationship was observed between OH and cognitive status (normal cognitive function, MCI, AD, or VaD). OH was present in 22% in VaD subjects, 15% in AD subjects, 12% in MCI subjects and 4% in normal control subjects (p<0.01 for overall test). Conclusion: Our results showed an association between OH and cognitive impairment and emphasize the need for longitudinal studies designed to evaluate the nature of the relationship between OH and cognitive decline. [Copyright &y& Elsevier]