Your search for: 'author:("van Gool, Willem A.")' has returned 10 results. (0.041s) Save search

Authors: Richard, Edo | Schmand, Ben | Eikelenboom, Piet | Westendorp, Rudi G. | Van Gool, Willem A.

Article Type: Research Article

Abstract: The focus of most of the research on Alzheimer's disease in the last decades has been on senile plaques and neurofibrillary tangles. The vast majority of patients with Alzheimer's disease are over 75 years of age, whereas most of the research focuses on younger subjects. To consider old-age dementia as a homogenous well-defined condition ignores the complexity of this condition and limits the development of new diagnostic methods, preventive strategies, or treatment strategies that could be widely applicable in daily practice in the majority of the older patients. The current research on biomarkers focuses on correlates of plaques and tangles, …which are poor markers in older dementia subjects. Acknowledging that dementia in old age is an essentially different condition from dementia at relatively younger age is needed and should lead to new approaches in dementia research. Show more

Keywords: Age, biomarkers, cerebrospinal fluid, magnetic resonance imaging, neuroimaging, old-age dementia, prevention

DOI: 10.3233/JAD-2012-112216

Citation: Journal of Alzheimer's Disease, vol. 31, no. s3, pp. S203-S209, 2012

Authors: Schmand, Ben | Eikelenboom, Piet | van Gool, Willem A. | for the Alzheimer's Disease Neuroimaging Initiative

Article Type: Research Article

Abstract: Using the database of the Alzheimer's Disease Neuroimaging Initiative, we examined the value of neuropsychological assessment, structural magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) biomarkers, and FDG-PET scanning with respect to prediction of conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD). We tested the hypothesis that CSF biomarkers and FDG-PET would lose prognostic value when applied in patients older than 75 years, whereas MRI and neuropsychological testing would not. At baseline 175 patients had MCI, mostly amnestic. They were followed during a mean of 2.7 years, and 81 patients converted to AD after a mean of 1.6 years. …Logistic regression analyses showed that neuropsychological assessment and MRI variables predicted conversion with 63 to 67% classification success both in patients younger and older than 75 years, while CSF biomarkers attained this success rate only in patients younger than 75 years. For FDG-PET, this rate was 57% in the total sample. We conclude that the diagnostic yield of different techniques in predicting conversion from MCI to AD is moderate, and that it is affected by age of the subject under study. MRI and neuropsychological assessment remain informative in patients older than 75 years, unlike CSF biomarkers. Show more

Keywords: Alzheimer's disease, amyloid, cerebrospinal fluid, FDG-PET, mild cognitive impairment, MRI, neuropsychological tests, tau protein

DOI: 10.3233/JAD-2012-111703

Citation: Journal of Alzheimer's Disease, vol. 29, no. 3, pp. 641-648, 2012

Authors: Richard, Edo | Moll van Charante, Eric P. | van Gool, Willem A.

Article Type: Review Article

Abstract: Epidemiological studies have consistently shown that vascular risk factors including hypertension, diabetes, obesity, hypercholesterolemia, smoking, and lack of physical exercise are associated with an increased risk of cognitive decline and dementia. Neuroradiological and neuropathological studies have confirmed the importance of cerebrovascular lesions in the etiology of late onset dementia. We have reviewed the literature and conclude that up until now randomized controlled clinical trials targeting individual risk factors and assessing cognitive decline or dementia as an outcome have not convincingly shown that treatment of vascular risk factors can actually prevent or postpone cognitive decline and dementia. New studies targeting several …vascular risk factors at the same time and using cognitive decline or dementia as primary outcome might answer the question whether cognitive decline can really be postponed or even prevented. The design of such studies is not straightforward and long follow-up is required. In this review we discuss several pertinent methodological issues that need to be addressed to achieve an optimal design of new randomized controlled trials. Show more

Keywords: Cognitive decline, dementia, multi-component intervention, prevention, randomized controlled trials, vascular risk factors

DOI: 10.3233/JAD-2012-120772

Citation: Journal of Alzheimer's Disease, vol. 32, no. 3, pp. 733-740, 2012

Authors: Wouters, Hans | Appels, Bregje | Van Campen, Jos | Lindeboom, Robert | Buiter, Maarten | Zwinderman, Aeilko H. | van Gool, Willem A. | Schmand, Ben

Article Type: Research Article

DOI: 10.3233/BEN-2010-0289

Citation: Behavioural Neurology, vol. 23, no. 4, pp. 181-183, 2010

Authors: Schmand, Ben | Rienstra, Anne | Tamminga, Hyke | Richard, Edo | van Gool, Willem A. | Caan, Matthan W.A. | Majoie, Charles B.

Article Type: Research Article

Abstract: Background: Scales of global cognition and behavior, often used as endpoints for intervention trials in Alzheimer’s disease (AD) and mild cognitive impairment (MCI), are insufficiently responsive (i.e., relatively insensitive to change). Large patient samples are needed to detect beneficial drug effects. Therefore, magnetic resonance imaging (MRI) measures of cerebral atrophy have been proposed as surrogate endpoints. Objective: To examine how neuropsychological assessment compares to MRI in this respect. Methods: We measured hippocampal atrophy, cortical thickness, and performance on neuropsychological tests in memory clinic patients at baseline and after two years. Neurologists rated the patients as cognitively normal (n = 28; …Clinical Dementia Rating, CDR = 0) or as impaired (n = 34; CDR > 0). We administered five tests of memory, executive functioning, and verbal fluency. A composite neuropsychological score was calculated by taking the mean of the demographically corrected standard scores. MRI was done on a 3 Tesla scanner. Volumetric measurements of the hippocampus and surrounding cortex were made automatically using FreeSurfer software. Results: The composite neuropsychological score deteriorated 0.6 SD in the impaired group, and was virtually unchanged in the normal group. Annual hippocampal atrophy rates were 3.4% and 0.6% in the impaired and normal cognition groups, respectively. Estimates of required sample sizes to detect a 50% reduction in rate of change were larger using rate of hippocampal atrophy (n = 131) or cortical thickness (n = 488) as outcome compared to change scores on neuropsychological assessment (n = 62). Conclusion: Neuropsychological assessment is more responsive than MRI measures of brain atrophy for detecting disease progression in memory clinic patients with MCI or AD. Show more

Keywords: Alzheimer's disease, cognition, hippocampus, longitudinal design, magnetic resonance imaging, mild cognitive impairment, neuropsychological tests, responsiveness

DOI: 10.3233/JAD-131484

Citation: Journal of Alzheimer's Disease, vol. 40, no. 2, pp. 409-418, 2014

Authors: Abdulrahman, Herrer | Richard, Edo | van Gool, Willem A. | Moll van Charante, Eric P. | van Dalen, Jan Willem

Article Type: Research Article

Abstract: Background: Older people with subjective memory complaints (SMC) and Instrumental Activities of Daily Living impairments (IADL-I) have an increased risk of developing dementia. Previous reports suggest that the predictive value of SMC and IADL-I may differ between sexes, leaving possible consequences for personalized risk prediction and prognosis. However, none of these studies addressed the competing risk of death, which may substantially differ between sexes. Objective: We investigated sex-differences in the association between IADL-I, SMC, and incident dementia and mortality as competing risk. Methods: 3,409 community-dwelling older people without dementia (mean age 74.3±2.5), were followed for 6.7 years (median). Baseline SMC …were assessed using the 15-item Geriatric Depression Scale memory question, and IADL-I using the Academic Medical Center Linear Disability Score. Potential sex-differences in the predictive value of SMC and IADL-I were assessed using Cox regression models with an interaction term for sex. Results: HRs for isolated SMC and SMC + IADL-I and risk of dementia were higher in women (HR: 2.02, 95% CI = 0.91–4.46, p  = 0.08; HR:2.85, 95% CI = 1.65–4.91, p  < 0.001) than in men (HR:1.52, 95% CI = 0.86–2.69, p  = 0.18; HR:1.24, 95% CI = 0.62–2.49, p  = 0.54), but these sex-differences were not significant. Conversely, HRs for isolated IADL-I and risk of mortality were higher in men (HR:1.56, 95% CI = 1.18–2.05, p  = 0.002) than in women (HR:1.14, 95% CI = 0.80–1.62, p  = 0.48), but again, these sex-differences were not significant. Conclusion: The predictive value of SMC and IADL-I for the risk of dementia and mortality was not significantly modified by sex. However, the competing risk of death for these factors differed considerably between men and women, suggesting it is an essential factor to consider when comparing sex-differences in IADL/dementia risk. Show more

Keywords: Alzheimer’s disease, dementia, Instrumental Activities of Daily Living, sex, subjective memory complaints

DOI: 10.3233/JAD-215191

Citation: Journal of Alzheimer's Disease, vol. 85, no. 1, pp. 283-294, 2022

Authors: Richard, Edo | van Gool, Willem A. | Hoozemans, Jeroen J.M. | an Haastert, Elise S. v | Eikelenboom, Piet | Rozemuller, Annemieke J.M. | van de Berg, Wilma D.J.

Article Type: Research Article

Abstract: Alzheimer's disease (AD) pathology is accompanied by abnormalities of the microvasculature. Despite the potential importance of morphometric changes in the cortical capillary network on neuronal dysfunction and cognitive impairment, few autopsy studies have addressed this issue. In the present study, we investigated morphological microvascular changes and capillary length density (CLD) in ten well-characterized AD patients compared to ten age-matched controls using virtual isotropic hemispheres. The CLD in the temporal cortex was increased by 33% in AD patients compared to controls (p = 0.04), whereas CLD in the occipital cortex was unchanged. An increase of CLD was correlated to a decrease …of cortical diameter in the temporal cortex (Pearson's r –0.62, p = 0.003), suggesting that the increase in temporal CLD results from, or contributes to cortical atrophy. In the occipital cortex, more string vessels, probably remnants of degenerated capillaries, were observed in AD patients than in controls (p = 0.004). An exploratory analysis suggests co-localization of Aβ and string vessels. Our data indicate that morphometric changes in the cortical capillary network occur in AD in a region-specific manner and may be related to cortical atrophy in the affected regions. Show more

Keywords: Amyloid-β, capillary length density, space balls, stereology, string vessels

DOI: 10.3233/JAD-2010-100849

Citation: Journal of Alzheimer's Disease, vol. 22, no. 3, pp. 811-818, 2010

Authors: Coppus, Antonia M.W. | Evenhuis, Heleen M. | Verberne, Gert-Jan | Visser, Frank E. | Eikelenboom, Piet | van Gool, Willem A. | Janssens, A. Cecile J.W. | van Duijn, Cornelia M.

Article Type: Research Article

Abstract: In a prospective longitudinal cohort study of dementia and mortality in persons with Down syndrome aged 45 years and older, 85 postmenopausal women were followed for a mean follow-up time of 4.3 years (range 0.0 to 7.4 years). The effect of age at menopause on age at diagnosis of dementia and survival was estimated using correlation analysis and Cox Proportional Hazard Model. We found a significant correlation between age at menopause and age at diagnosis of dementia (ρ = 0.52; p < 0.001), and between age at menopause and age at death (ρ = 0.49; p = 0.01). Early age …at menopause is associated with a 1.8 fold increased risk of dementia: Hazard Ratio (HR): 1.82 (95%Confidence Interval (CI): 1.31–2.52) and with risk of death: HR: 2.05 (95%CI: 1.33–3.16). Our study suggests that age at menopause in women with Down syndrome is a determinant of age at onset of dementia and mortality. Show more

Keywords: Alzheimer's disease, APOE genotype, Down syndrome, menopause, mortality

DOI: 10.3233/JAD-2010-1247

Citation: Journal of Alzheimer's Disease, vol. 19, no. 2, pp. 545-550, 2010

Authors: Wouters, Hans | van Campen, Jos | Appels, Bregje | Lindeboom, Robert | Buiter, Maarten | de Haan, Rob J. | Zwinderman, Aeilko H. | van Gool, Willem A. | Schmand, Ben

Article Type: Research Article

Abstract: Longer cognitive tests, such as the Alzheimer's disease assessment scale (ADAS-cog) or the Cambridge cognitive examination (CAMCOG), are more precise but less efficient than briefer tests, such as the Mini Mental State Examination (MMSE). We examined if computerized adaptive testing (CAT) of cognitive impairment can combine brevity with precision by tailoring a precise test to each individual patient. We conducted a prospective study of 84 participants [normal aging, n = 41; mild cognitive impairment (MCI), n = 21; dementia, n = 22]. CAT estimated a participant's ability during testing by selecting only items of appropriate difficulty from either the CAMCOG …or the CAMCOG supplemented with ADAS-cog items and neuropsychological tests (the CAMCOG-Plus). After tailored testing with CAT, the remaining CAMCOG and CAMCOG-Plus items not selected by CAT were administered. The time needed to complete the CAT was compared to that needed for the whole CAMCOG and CAMCOG-Plus. Results showed that testing time reductions achieved with CAT were 37% or more compared to the whole CAMCOG and 55% or more compared to the whole CAMCOG-Plus. Estimated ability levels with CAT were in excellent agreement with those based on the whole CAMCOG and CAMCOG-Plus (intraclass correlations 0.99 and 0.98, respectively). Diagnostic accuracy of detecting mild dementia and MCI seemed better for the CAT administered tests than for the MMSE, but the differences were not significant. We conclude that adaptive testing combines brevity with precision, especially in grading the severity of cognitive impairment. Show more

Keywords: Algorithms, Alzheimer's disease, amnesia, cognition disorders, dementia, logistic models, neuropsychology, vascular dementia

DOI: 10.3233/JAD-2011-101743

Citation: Journal of Alzheimer's Disease, vol. 25, no. 4, pp. 595-603, 2011

Authors: van Middelaar, Tessa | van Dalen, Jan W. | van Gool, Willem A. | van den Born, Bert-Jan H. | van Vught, Lonneke A. | Moll van Charante, Eric P. | Richard, Edo

Article Type: Research Article

Abstract: Background: High visit-to-visit variability (VVV) in blood pressure (BP) is associated with cerebrovascular lesions on neuroimaging. Objective: Our primary objective was to investigate whether VVV is associated with incident all-cause dementia. As a secondary objective, we studied the association of VVV with cognitive decline and cardiovascular disease (CVD). Methods: We included community-dwelling people (age 70–78 year) from the ‘Prevention of Dementia by Intensive Vascular Care’ (preDIVA) trial with three to five 2-yearly BP measurements during 6–8 years follow-up. VVV was defined using coefficient of variation (CV; SD/mean×100). Cognitive decline was assessed using the Mini-Mental State Examination (MMSE). Incident CVD was …defined as myocardial infarction or stroke. We used a Cox proportional hazard regression and mixed-effects model adjusted for sociodemographic factors and cardiovascular risk factors. Results: In 2,305 participants (aged 74.2±2.5), mean systolic BP over all available visits was 150.1 mmHg (SD 13.6), yielding a CV of 9.0. After 6.4 years (SD 0.8) follow-up, 110 (4.8%) participants developed dementia and 140 (6.1%) CVD. Higher VVV was not associated with increased risk of dementia (hazard ratio [HR] 1.00 per point CV increase; 95% confidence interval [CI] 0.96–1.05), although the highest quartile of VVV was associated with stronger decline in MMSE (β –0.09, 95% CI –0.17 to –0.01). Higher VVV was associated with incident CVD (HR 1.07; 95% CI 1.04–1.11). Conclusion: In our study among older people, high VVV is not associated with incident all-cause dementia. It is associated with decline in MMSE and incident CVD. Show more

Keywords: Blood pressure, blood pressure variability, cognition, cardiovascular disease, dementia

DOI: 10.3233/JAD-170757

Citation: Journal of Alzheimer's Disease, vol. 62, no. 2, pp. 727-735, 2018