Your search for: 'author:("Palmer, Katie")' has returned 4 results. (0.006s) Save search

Authors: Palmer, Katie | Di Iulio, Fulvia | Varsi, Ambra Erika | Gianni, Walter | Sancesario, Giuseppe | Caltagirone, Carlo | Spalletta, Gianfranco

Article Type: Research Article

Abstract: The aim of the study is to evaluate whether depression or apathy in patients with amnestic-mild cognitive impairment (MCI) increases the risk of progressing to Alzheimer's disease (AD). We investigated 131 consecutive memory-clinic outpatients with newly-diagnosed amnestic-MCI (mean age 70.8, SD = 6.5). Psychiatric disorders were diagnosed at baseline according to the criteria for depression and apathy in AD. Neuropsychiatric symptoms were assessed with the Neuropsychiatric Inventory (NPI). Follow-up examinations were conducted after six months and annually for four years. Neurologists diagnosed AD at follow-up using NINCDS-ADRDA criteria. Cox proportional hazard models with 95% confidence intervals were used to test …the hypothesis that apathy or depression increases the risk of developing AD. At baseline, 36.6% amnestic-MCI patients had a diagnosis of depression and 10.7} had apathy. Patients with both amnestic-MCI and an apathy diagnosis had an almost sevenfold risk of AD progression compared to amnestic-MCI patients without apathy (HR = 6.9; 2.3–20.6), after adjustment for age, gender, education, baseline global cognitive and functional status, and depression. Furthermore, the risk of developing AD increased 30% per point on the NPI apathy item (HR = 1.3; 1.1–1.4). There was no increased risk of developing AD in amnestic-MCI patients with either a diagnosis or symptoms of depression. In conclusion, apathy, but not depression, predicts which patients with amnestic-MCI will progress to AD. Thus, apathy has an important impact on amnestic-MCI and should be considered a mixed cognitive/psychiatric disturbance related to ongoing AD neurodegeneration. Show more

Keywords: Cognitive deficits, dementia, early detection, MCI, neuropsychiatric symptoms

DOI: 10.3233/JAD-2010-1352

Citation: Journal of Alzheimer's Disease, vol. 20, no. 1, pp. 175-183, 2010

Authors: Atti, Anna Rita | Forlani, Claudia | De Ronchi, Diana | Palmer, Katie | Casadio, Paola | Dalmonte, Edoardo | Fratiglioni, Laura

Article Type: Research Article

Abstract: A total of 7,389 dementia-free elderly (60–102 years old) enrolled in the "Faenza Project" (Northern Italy) were clinically evaluated by nurses and physicians with the aim of detecting the independent and combined association of medical and social factors with cognitive status. Cognitive Impairment No Dementia (CIND) was defined for MMSE scores ⩽ 2 standard deviations than the age- and education-corrected mean score obtained by the non-demented persons of the Faenza cohort. Logistic Regression analysis was used to estimate Odds Ratios and 95% Confidence Intervals (OR, 95%CI) for CIND. The diagnostic procedure identified 402 (5.4%) CIND cases. Diabetes (OR, 95%CI=1.6, 1.2–2.2), …stroke (OR, 95%CI=1.9, 1.4–2.6), and depressive symptoms (OR, 95%CI=1.9, 1.4–2.7) emerged as the most relevant medical comorbidities of CIND. Low education (OR, 95%CI=1.8, 1.1–2.9), low Socio Economic Status (SES) (OR, 95%CI=1.5, 1.1–2.1), and unmarried status (OR, 95%CI=1.7, 1.2–2.5) were associated with CIND. Medical and social factors were independently related to CIND occurrence. In comparison to subjects without any of the above mentioned conditions, subjects with one medical and one social factor had an OR, 95%CI for CIND equal to 6.0, 2.9–12.4. The strength of the association increased when more of those conditions occurred in combination, suggesting a synergistic effect. Despite some methodological limitations, data from this cross-sectional population-based Italian study show that low education, low SES, unmarried status together with diabetes, stroke, and depressive symptoms are related to cognitive impairment in the general population. The interaction of medical and social factors further increases the probability of CIND. Show more

Keywords: Cognitive impairment, cognitive impairment no dementia (CIND), comorbidity, depression, diabetes, epidemiology, stroke

DOI: 10.3233/JAD-2010-091618

Citation: Journal of Alzheimer's Disease, vol. 21, no. 4, pp. 1325-1334, 2010

Authors: Mangialasche, Francesca | Kivipelto, Miia | Mecocci, Patrizia | Rizzuto, Debora | Palmer, Katie | Winblad, Bengt | Fratiglioni, Laura

Article Type: Research Article

Abstract: In this study we investigated the association between plasma levels of eight forms of vitamin E and incidence of Alzheimer's disease (AD) among oldest-old individuals in a population-based setting. A dementia-free sample of 232 subjects aged 80+ years, derived from the Kungsholmen Project, was followed-up to 6 years to detect incident AD. Plasma levels of vitamin E (α-, β-, γ, and δ-tocopherol; α-, β-, γ-, and δ-tocotrienol) were measured at baseline. Vitamin E forms-AD association was analyzed with Cox proportional hazard model after adjustment for several potential confounders. Subjects with plasma levels of total tocopherols, total tocotrienols, or total vitamin …E in the highest tertile had a reduced risk of developing AD in comparison to persons in the lowest tertile. Multi-adjusted hazard ratios (HRs) and 95% confidence interval (CI) were 0.55 (0.32–0.94) for total tocopherols, 0.46 (0.23–0.92) for total tocotrienols, and 0.55 (0.32–0.94) for total vitamin E. When considering each vitamin E form, the risk of developing AD was reduced only in association with high plasma levels of β-tocopherol (HR: 0.62, 95% CI 0.39–0.99), whereas α-tocopherol, α- tocotrienol, and β-tocotrienol showed only a marginally significant effect in the multiadjusted model [HR (95% CI): α-tocopherol: 0.72 (0.48–1.09); α-tocotrienol: 0.70 (0.44–1.11); β-tocotrienol: 0.69 (0.45–1.06)]. In conclusion, high plasma levels of vitamin E are associated with a reduced risk of AD in advanced age. The neuroprotective effect of vitamin E seems to be related to the combination of different forms, rather than to α-tocopherol alone, whose efficacy in interventions against AD is currently debated. Show more

Keywords: Alzheimer's disease, elderly, oxidative stress, tocopherol, tocotrienol, vitamin E

DOI: 10.3233/JAD-2010-091450

Citation: Journal of Alzheimer's Disease, vol. 20, no. 4, pp. 1029-1037, 2010

Authors: Palmer, Katie | Lupo, Federica | Perri, Roberta | Salamone, Giovanna | Fadda, Lucia | Caltagirone, Carlo | Musicco, Massimo | Cravello, Luca

Article Type: Research Article

Abstract: Patients with Alzheimer's disease (AD) have heterogeneous rates of disease progression. The aim of the current study is to investigate whether neuropsychiatric disturbances predict cognitive and functional disease progression in AD, according to failure theory. We longitudinally examined 177 memory-clinic AD outpatients (mean age = 73.1, SD = 8.1; 70.6% women). Neuropsychiatric disturbances at baseline were categorized into five syndromes. Patients were followed for up to two years to detect rapid disease progression defined as a loss of ≥ 1 abilities in Activities of Daily living (ADL) or a drop of ≥ 5 points on Mini-Mental State Examination (MMSE). Hazard …ratios (HR) were calculated with Gompertz regression, adjusting for sociodemographics, baseline cognitive and functional status, and somatic comorbidities. Most patients (74.6%) exhibited one or more neuropsychiatric syndromes at baseline. The most common neuropsychiatric syndrome was Apathy (63.8%), followed by Affective (37.3%), Psychomotor (8.5%), Manic (7.9%), and Psychotic (5.6%) syndromes. The variance between the observed (Kaplen Meier) and predicted (Gompertz) decline for disease progression in cognition (0.30, CI = 0.26–0.35), was higher than the variance seen for functional decline (0.22, CI = 0.18–0.26). After multiple adjustment, patients with the Affective syndrome had an increased risk of functional decline (HR = 2.0; CI = 1.1–3.6), whereas the risk of cognitive decline was associated with the Manic (HR = 3.2, CI = 1.3–7.5) syndrome. In conclusion, specific neuropsychiatric syndromes are associated with functional and cognitive decline during the progression of AD, which may help with the long-term planning of care and treatment. These results highlight the importance of incorporating a thorough psychiatric examination in the evaluation of AD patients. Show more

Keywords: Activities of daily living, anxiety, apathy, behavioral and psychological symptoms of dementia, failure theory, cognitive impairment, dementia, depression, disease progression, Gompertz

DOI: 10.3233/JAD-2010-101836

Citation: Journal of Alzheimer's Disease, vol. 24, no. 1, pp. 35-45, 2011