0750 Hyperhomocysteinemia is an important risk factor for vascular dementia
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Poster Abstracts Wednesday, November 9, 2005 $291 features of one form of motor neuron degeneration associated with frontotemporal neuronal loss, microvacuolation and astrocytic gliosis. Sensitivity in clilfical diagnosis of FTLD-MND is unkllOWU. Method: Historical review of the clinical features and laboratory studies of all cases of pathologically confirmed FTLD-MND was undertaken to determine diagnostic sensitivity. Results: A total of 18 cases of pathologically confirmed FTLD-MND were identified. Of these, 72% were male. The mean age at onset and disease duration was 52 and 2.3 years, respectively. All cases had clinical features in keeping with a frontotemporal dementia; however, only 13 (72%) cases had documented clinical evidence of motor neuron disease. In the five cases without clinical evidence of motor neuron disease, two had coexistent pathologies of Alzheimer's disease and multiple sclerosis. The mean age of onset and disease duration of these five cases was 50 arid 3.6 years, respectively. Two cases were examined within 6 months of death including electromyography in one case, and all five cases witlfin 1 V2 years of death. Conclusion: Clinical diagnostic sensitivity in FTLD-MND is good, but not perfect. Clinical features of motor neuron disease may be difficult to identify in cases with mixed pathologies. It may also be the case that when dementia is present, either preclinJcal motor neuron disease exists, or it is difficult to identify very subtle arid early features of motor neuron disease. O748 Community Responses to Al.zhehner's Diseases & Role of Healthcare Workers Joshi SD r, Pandit N:, S.Kumar BK:. 1Nepal Medical College and Teaching Hospital (NMCTH) Background: The patients, who attended the Nepal medical college and teaclfing hospital arid from the nationwide CollmlUllity health camps; qualitative arid quantitative survey data was collected from Jan 2001 to Dec 2004 regarding the ageing and dementia among the older nepali-p eople. Methods: Qualitative study used screening & focus group-discussions to investigate the status of older people, local beliefs and attitudes regarding dementia. Result anti Contusions: Dementia is a lfidden problem - however it was not thought of as a health condition by community people. Dementia is a stigmatized condition at all. Traditional care is under strain and lacking family support (48%). Community people have limited understanding of dementia (77%), lack of information, unresponsive- ness of local health services (21"/o), fanrily care - the role of women, economic strain, the distress caused by incontinence, fanrily conflict. There is a need to raise awareness about dementia in the community and amongst health professionals, and to improve access to appro- priate health care for the elderly with mental illness. The study suggests directions for the future development of locally appropriate support services, such as involving the comprehensive network of conmmnity health workers. Lesson-learned: The role of healthcare-workers to educate the community-people about how to care, support and manage the patient in the family is very important in the developing country. Keywords: dementia, health workers, developing country. 0749 Immune response to AJl40 and tolerance to AJ142 occur naturally without relationship to brain AJ] burden Kawarabayashi, T 1, Xu, W 1, Shoji, M 1, Matsubara, E 2, Degnchi, K 1, Murakami T 1, Takehisa y1, Nagatu, T 1, Hayashi, T 1, and Abe K 1. 1Department of Neurology, Neuroseienee, Biophysiologieal Science, Okayama University Graduate School of Medicine and Dentistry, Okayama, Yapan; 2Department of Alzheimer's Disease Research National Institute for Longevity Sciences National Center for Geriatrics and Gerontology, Obu, Japan Antibodies to A[3 occur in human plasma naturally or after A[3 vaccine therapy. To clarify the clinical role of these antibodies, we examined plasma samples from 113 patients with Alzheimer's disease (AD) and 205 normal controls using the tissue amyloid plaque inmmnoreactivity (TAPIR) assay. A lfigh positive rate of TAPIR was revealed in AD patients and age-matched controls; however, no significant difference between these groups in TAPIR-positive rates, Mini-Mental State Examination score or disease duration was observed. TAPiR-positive plasma reacted with monomer and dimer of A[340, and reacted weakly with A[~42 monomer, but did not react with A[342 dimer. TAPIR was detected even in samples from normal young subjects. Thus, immune response to A[340 and immune tolerance to A[342 occur naturally in humans without a close relationship with A[3 burden in the brain. Clarification of the mechanism of the natural immune response to A[~42 will be necessary as the next steps in the development of inmmnotherapy for AD. 0750 Hyperhomoeygteinemia is an important risk factor for vascular dementia Khedr EM, Mahmoud Eltahtawy, Abdel Kader F Farrag and Khidaa Shehata. Department of Neurology and Clinical Pathology, Assiut University Hospital, Assiut, Egypt Background anti Purpose: Hyperhomocystenemia is an important risk factor for vascular stroke and putative risk factor for dementia. Since some vascular causes can be prevented and treated the identification of stroke-related cognitive impairment is challenge. The objective of this study was to evaluate the frequency and risk factors of post stroke dementia (PSD) three months after first ever stroke in consecutive cohort of Egyptian stroke patients in Assiut. Methods: Of 370 patients admitted to stroke unit Assiut University Hospital, during 12 month period, 100 were eligible for study, out of them 15 patients refused to participate, 4 had impairment cognitive function prior to stroke as docunxellted by Short Form of Informant Questiomxaire on Cognitive Decline in the Elderly (IQCODE), and 81 were tested and followed up 3 months after stroke. A wide range of demographic., clinical, radiological and laboratories variables were examined. PSD was diagnosed if the clinical presentation fulfilled DSM-IV criteria of vascular dementia, the subject scored _<21 on modified MMSE arid <67 points on Coglfitive Abilities Screening Instruments (CASD. Results: The incidence of PSD was 21% after exclusion of patients with prestroke dementia. Univariate analysis found that PSD was associated with low level of education (P -- 0.003), female patients above 55 years (P - 0.003), family history of dementia (P < 0.0001), motor disability (0.019), disturbed consciousness (P - 0.04), carotid artery stenosis (P - 0.024), atrial fibrillation (AF) (P - 0.003), ischemic heart disease (P < 0.001), large infarction (P - 0.001), affection of dominant hemisphere (P - 0.01) and plasma hyperhomo- cysfienemia (P < 0.001). Contusion: PSD is not infrequent among Egyptian stroke patients in Assiut. Hyperhomocystienemia is art important risk factor associated with PSD besides high age of female, low level of education, severity of stroke, fanfily history of dementia, ischenfic heart disease, AF, carotid stenosis, large sized infarction, and affection of dominant hemisphere. Avoiding and treating some of treatable risk factors can reduce the incidence of PSD. 0751 Mini-Mental State Exaufination Scores Are Significantly Lower When Administered Via Telehealth (Videoconferencing) Than When Administered In Person To Patients With Early Dementia Kirk, A ~, Crossley, M 1 , Morgan, D 1 , D'Arcy, C 1 , Biem, J 1 , Forbes, D 1 , Stewart, N 1. 1 University of Saskatchewan, Saskatoon, Canada Background: Improving videoconferencing technology is increasing utility of telehealth in assessing patients with neurological disease.
Transcript of 0750 Hyperhomocysteinemia is an important risk factor for vascular dementia
Poster Abstracts Wednesday, November 9, 2005 $291
features of one form of motor neuron degeneration associated with frontotemporal neuronal loss, microvacuolation and astrocytic gliosis. Sensitivity in clilfical diagnosis of F T L D - M N D is unkllOWU. Method: Historical review of the clinical features and laboratory studies o f all cases of pathologically confirmed F T L D - M N D was undertaken to determine diagnostic sensitivity. Results: A total of 18 cases of pathologically confirmed F T L D - M N D were identified. Of these, 72% were male. The mean age at onset and disease duration was 52 and 2.3 years, respectively. All cases had clinical features in keeping with a frontotemporal dementia; however, only 13 (72%) cases had documented clinical evidence of motor neuron disease. In the five cases without clinical evidence of motor neuron disease, two had coexistent pathologies of Alzheimer's disease and multiple sclerosis. The mean age of onset and disease duration of these five cases was 50 arid 3.6 years, respectively. Two cases were examined within 6 months of death including electromyography in one case, and all five cases witlfin 1 V2 years of death. Conclusion: Clinical diagnostic sensitivity in F T L D - M N D is good, but not perfect. Clinical features o f motor neuron disease may be difficult to identify in cases with mixed pathologies. It may also be the case that when dementia is present, either preclinJcal motor neuron disease exists, or it is difficult to identify very subtle arid early features of motor neuron disease.
O748 Community Responses to Al.zhehner's Diseases & Role of Healthcare Workers
Joshi SD r, Pandit N:, S .Kumar BK:. 1Nepal Medical College and Teaching Hospital (NMCTH)
Background: The patients, who attended the Nepal medical college and teaclfing hospital arid from the nationwide CollmlUllity health camps; qualitative arid quantitative survey data was collected from Jan 2001 to Dec 2004 regarding the ageing and dementia among the older nepali-p eople. Methods: Qualitative study used screening & focus group-discussions to investigate the status of older people, local beliefs and attitudes regarding dementia. Result anti Contusions: Dementia is a lfidden problem - however it was not thought of as a health condition by communi ty people. Dementia is a stigmatized condition at all. Traditional care is under strain and lacking family support (48%). Communi ty people have limited understanding o f dementia (77%), lack of information, unresponsive- ness of local health services (21"/o), fanrily care - the role of women, economic strain, the distress caused by incontinence, fanrily conflict. There is a need to raise awareness about dementia in the communi ty and amongs t health professionals, and to improve access to appro- priate health care for the elderly with mental illness.
The s tudy suggests directions for the future development of locally appropriate support services, such as involving the comprehensive network of conmmnity health workers. Lesson-learned: The role of healthcare-workers to educate the community-people about how to care, support and manage the patient in the family is very important in the developing country. Keywords: dementia, heal th workers, developing country.
0749 Immune response to AJl40 and tolerance to AJ142 occur naturally without relationship to brain AJ] burden
Kawarabayashi, T 1, Xu, W 1, Shoji, M 1, Matsubara , E 2, Degnchi, K 1, Murakami T 1, Takehisa y1 , Nagatu, T 1, Hayashi, T 1, and Abe K 1. 1Department of Neurology, Neuroseienee, Biophysiologieal Science, Okayama University Graduate School of Medicine and Dentistry, Okayama, Yapan; 2Department of Alzheimer's Disease Research National Institute for Longevity Sciences National Center for Geriatrics and Gerontology, Obu, Japan
Antibodies to A[3 occur in h u m a n plasma naturally or after A[3 vaccine therapy. To clarify the clinical role of these antibodies, we examined plasma samples from 113 patients with Alzheimer's disease (AD) and 205 normal controls using the tissue amyloid plaque inmmnoreactivity (TAPIR) assay. A lfigh positive rate of TAPIR was revealed in AD patients and age-matched controls; however, no significant difference between these groups in TAPIR-posit ive rates, Mini-Mental State Examination score or disease duration was observed. TAPiR-posit ive plasma reacted with monomer and dimer of A[340, and reacted weakly with A[~42 monomer , but did not react with A[342 dimer. TAPIR was detected even in samples f rom normal young subjects. Thus , immune response to A[340 and immune tolerance to A[342 occur naturally in humans without a close relationship with A[3 burden in the brain. Clarification of the mechanism of the natural immune response to A[~42 will be necessary as the next steps in the development of inmmnotherapy for AD.
0750 Hyperhomoeygteinemia is an important risk factor for vascular dementia
Khedr EM, M a h m o u d Eltahtawy, Abdel Kader F Farrag and Khidaa Shehata. Department of Neurology and Clinical Pathology, Assiut University Hospital, Assiut, Egypt
Background anti Purpose: Hyperhomocystenemia is an important risk factor for vascular stroke and putative risk factor for dementia. Since some vascular causes can be prevented and treated the identification of stroke-related cognitive impairment is challenge. The objective of this study was to evaluate the frequency and risk factors of post stroke dementia (PSD) three months after first ever stroke in consecutive cohort of Egyptian stroke patients in Assiut. Methods: Of 370 patients admitted to stroke unit Assiut University Hospital, during 12 mon th period, 100 were eligible for study, out of them 15 patients refused to participate, 4 had impairment cognitive function prior to stroke as docunxellted by Short Fo rm of Informant Questiomxaire on Cognitive Decline in the Elderly (IQCODE), and 81 were tested and followed up 3 months after stroke. A wide range of demographic., clinical, radiological and laboratories variables were examined. PSD was diagnosed if the clinical presentation fulfilled DSM-IV criteria of vascular dementia, the subject scored _<21 on modified MMSE arid <67 points on Coglfitive Abilities Screening Instruments (CASD. Results: The incidence of PSD was 21% after exclusion of patients with prestroke dementia. Univariate analysis found that PSD was associated with low level of education (P -- 0.003), female patients above 55 years (P - 0.003), family history o f dementia (P < 0.0001), motor disability (0.019), disturbed consciousness (P - 0.04), carotid artery stenosis (P - 0.024), atrial fibrillation (AF) (P - 0.003), ischemic heart disease (P < 0.001), large infarction (P - 0.001), affection of dominant hemisphere (P - 0.01) and plasma hyperhomo- cysfienemia (P < 0.001). Contusion: PSD is not infrequent among Egyptian stroke patients in Assiut. Hyperhomocystienemia is art important risk factor associated with PSD besides high age of female, low level of education, severity of stroke, fanfily history of dementia, ischenfic heart disease, AF, carotid stenosis, large sized infarction, and affection of dominant hemisphere. Avoiding and treating some of treatable risk factors can reduce the incidence of PSD.
0751 Mini-Mental State Exaufination Scores Are Significantly Lower When Administered Via Telehealth (Videoconferencing) Than When Administered In Person To Patients With Early Dementia
Kirk, A ~, Crossley, M 1 , Morgan, D 1 , D'Arcy, C 1 , Biem, J 1 , Forbes, D 1 , Stewart, N 1. 1 University of Saskatchewan, Saskatoon, Canada
Background: Improving videoconferencing technology is increasing utility of telehealth in assessing patients with neurological disease.
