Search

Background/Aim: HLA-A is a locus of the major histocompatibility complex situated on chromosome 6p21.3. Several genome-wide linkage analyses suggested that a putative locus predisposition for Alzheimer’s disease (AD) is found on chromosome 6p21. In this study, we investigated the association between HLA-A alleles and AD in a Chinese community. Methods: Fine genotyping of 160 Chinese AD and 167 age-matched nondemented subjects was performed for the first time by sequence-based typing of the HLA-A locus. Results: We found that HLA-A2 carriers (including prevalent alleles, 0201, 0203 and 0207) were more prevalent in the AD group; the frequency of HLA-A2 was increased in AD patients versus controls, but the difference was not significant after Bonferroni correction for the number of alleles tested (p = 0.075). A gene-gene interaction was observed between ApoE and HLA-A, the presence of HLA-A24 (particularly the prevalent allele 2402) might act as another independent risk factor of developing AD for subjects not carrying the ApoE ε4 allele (relative risk = 2.98, 95% CI = 1.14–8.24). Carriers of HLA-A2 had an earlier onset of AD by 2.4 years (p = 0.030) and HLA-A2 interacted with ApoE ε4 in modulating the age at onset in AD. Conclusions: This study suggested that HLA-A may be involved in the pathogenesis of AD. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background This paper describes the development and validation of the Memory Inventory for Chinese (MIC), for measuring the awareness of memory deficits in the Chinese population with Alzheimer's disease (AD). Methods A combination of qualitative and quantitative approaches was adopted. The MIC was developed with focus group discussion and pilot testing. It has a patient and a caregiver version. A consecutive series of 79 new out-patients with the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorder Association (NINCDS-ADRDA) criteria of probable and possible AD and 20 non-demented elderly subjects were recruited. Results A high internal consistency was found, with Cronbach alpha of 0.89 for the patient version and 0.90 for the caregiver version of MIC. The inter-rater reliability was satisfactory. For validity assessment, the caregiver score of the MIC correlated significantly with cognitive score of the subject as assessed by the Mini-Mental State Examination (rp = -0.37; p < 0.01). The Memory Deficit Awareness Score, calculated by subtracting the patient score from the caregiver score, correlated significantly with clinician ratings of awareness of memory impairment (rs = -0.67; p < 0.01). Conclusions The MIC appears to be a culturally appropriate and valid instrument for the measurement of awareness of memory deficits in Chinese patients with AD. Potential applications of the MIC should be further explored in other subtypes of dementia and in prospective studies. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

BackgroundThe clinical significance of subjective memory complaints in elderly subjects has been an area of active research. In this study, we evaluated subjective complaints and self-evaluation of memory test performance in subjects with Questionable dementia (QD) and mild Alzheimer's disease (AD). MethodsNinety-two subjects (35 cognitively intact normal controls NC, 33 QD, and 24 mild AD) were assessed. Subjective memory complaints were evaluated using a memory inventory for the Chinese (MIC); objective assessment of awareness was assessed by the self-evaluation of own memory test performance. Cognitive function was assessed with the Alzheimer's Disease Assessment Scale—Cognitive subscale (ADAS-Cog), Category Verbal Fluency Test (CVFT) and Executive Interview (EXIT-25). Depressive symptoms were evaluated with the Cornell Scale for Depression in Dementia (CSDD). ResultsThe total number of subjective memory complaints (MI-tol) were significantly different between different subject groups (Kruskal Wallis test, χ2 = 13.19, p = 0.001). Significant correlations between scores of the MI-tol and CSDD (r = 0.33, p < 0.001), CMMSE (r = -0.33, p < 0.001), CDR (r = 0.36, p < 0.001) were found. In self-evaluation of memory test performance, the NC group tended to under-estimate while the AD subjects tended to over-estimate their performance. Group differences in the discrepancies of self-evaluation of memory performance were significant for both the immediate (Kruskal Wallis test, χ2 = 9.86, p = 0.007) and delayed recall (Kruskal Wallis test, χ2 = 10.55, p < 0.001) trials. ConclusionsSubjects with QD and mild AD showed higher frequency of subjective memory complaints, reflecting that the subjects still retain some ability to appreciate own memory function. However, the trend for over-estimation of performance in AD subjects suggests that the precision of estimation may be suboptimal. Moreover, depressive symptoms may affect the presentation of memory complaints and this factor should be carefully considered in future prospective studies. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Subjective memory complaints in subjects with mild cognitive impairment may represent a genuine decline in episodic memory. This paper evaluates the neuropsychological correlates of the semantic fluency test in subjects with questionable dementia (QD). Methods: A total of 331 Chinese subjects (118 normal controls, NC, 150 with QD and 63 with mild Alzheimer’s disease, AD) were assessed with the Category Verbal Fluency Test (CVFT), the AD Assessment Scale – cognitive subscale (ADAS-Cog), and digit and verbal span tests. CVFT performance was evaluated in each Clinical Dementia Rating (CDR) group. The total number of exemplars, the subcategory and the category size generated were evaluated. Neuropsychological correlates of CVFT scores were computed. Results: Significant differences in CVFT performance were found between the different CDR groups. The subjects with QD had intermediate scores compared to the NC and AD subjects (1-way ANOVA, p < 0.001, post-hoc Bonferroni comparisons). In NC the CVFT scores were significantly associated with ADAS-Cog total, and immediate and delayed recall scores (partial correlations controlled for age and education, p < 0.005). In the QD group the CVFT scores were correlated with ADAS-Cog total, and immediate recall and object naming scores (partial correlation controlled for age and education, p < 0.005). Regression analysis revealed that age and delayed recall were significant predictors of CVFT performance in NCs. In the QD group, age, ADAS-Cog immediate recall and object naming scores predicted the CVFT performance. Conclusions: The CVFT was impaired in the subjects with QD. Apart from episodic memory, semantic memory deficits also occur early in AD. The different cognitive predictors of CVFT scores in the NC and QD groups suggest that the test is associated with specific psychological functions at different stages of cognitive impairment. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]