Prevalencia e incidencia de la enfermedad de Alzheimer en Europa: metaanálisis
TL;DR: Los resultados del metaanalisis permiten una mejor comprension of the enfermedad y su impacto en Europa.
Abstract: Resumen Introduccion La enfermedad de Alzheimer es el principal tipo de demencia y una enfermedad de etiologia desconocida. Con el aumento de la poblacion anciana mundial, el numero de pacientes con enfermedad de Alzheimer muestra una tendencia de crecimiento rapido. El objetivo de este metaanalisis es evaluar la prevalencia e incidencia de la enfermedad de Alzheimer en Europa. Metodologia La busqueda de articulos se realizo en las bases de datos Medline, Scopus y CINAHL Complete utilizando las palabras claves «Alzheimer», «Alzheimer's disease» y «AD», combinadas con «prevalence», «incidence» y «epidemiology». Se utilizo el modelo bayesiano de efectos aleatorios, mostrando intervalos de credibilidad del 95%. Para estimar la heterogeneidad se uso el estadistico I2. Resultados La prevalencia de enfermedad de Alzheimer en Europa fue 5,05% (IC del 95%, 4,73-5,39). La prevalencia por sexo en los hombres y las mujeres fue 3,31% (IC del 95%, 2,85-3,80) y 7,13% (IC del 95%, 6,56-7,72), respectivamente, y se encontro una tendencia creciente por grupos de edad. La incidencia de enfermedad de Alzheimer en Europa fue 11,08 por 1.000 personas-ano (IC del 95%, 10,30-11,89), siendo en los hombres y las mujeres de 7,02 por 1.000 personas-ano (IC del 95%, 6,06-8,05) y 13,25 por 1.000 personas-ano (IC del 95%, 12,05-14,51), respectivamente, con igual tendencia creciente con el aumento de la edad. Conclusiones Los resultados del metaanalisis permiten una mejor comprension de la enfermedad y su impacto en Europa.
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TL;DR: It is shown that the discriminative ability of GRS in LOAD prediction is maximised when selecting a small number of SNPs, and the number of causal common SNPs for LOAD may be less than 100, suggesting LOAD is more oligogenic than polygenic.
Abstract: Genetic association studies have identified 44 common genome-wide significant risk loci for late-onset Alzheimer’s disease (LOAD). However, LOAD genetic architecture and prediction are unclear. Here we estimate the optimal P-threshold (Poptimal) of a genetic risk score (GRS) for prediction of LOAD in three independent datasets comprising 676 cases and 35,675 family history proxy cases. We show that the discriminative ability of GRS in LOAD prediction is maximised when selecting a small number of SNPs. Both simulation results and direct estimation indicate that the number of causal common SNPs for LOAD may be less than 100, suggesting LOAD is more oligogenic than polygenic. The best GRS explains approximately 75% of SNP-heritability, and individuals in the top decile of GRS have ten-fold increased odds when compared to those in the bottom decile. In addition, 14 variants are identified that contribute to both LOAD risk and age at onset of LOAD.
206 citations
TL;DR: Certain herbal products, in particular dietetic polyphenols, have proved capable of restoring dysbiosis and, therefore, their prebiotic role could be effective in counteracting the onset of AD regardless of their activity of free radical scavenging or enhancement of the cell stress response.
138 citations
TL;DR: This work aims at finding links between cognitive symptoms and the underlying neurodegeneration process by fusing the information of neuropsychological test outcomes, diagnoses, and other clinical data with the imaging features extracted solely via a data-driven decomposition of MRI.
Abstract: Many classical machine learning techniques have been used to explore Alzheimer's disease (AD), evolving from image decomposition techniques such as principal component analysis toward higher complexity, non-linear decomposition algorithms. With the arrival of the deep learning paradigm, it has become possible to extract high-level abstract features directly from MRI images that internally describe the distribution of data in low-dimensional manifolds. In this work, we try a new exploratory data analysis of AD based on deep convolutional autoencoders. We aim at finding links between cognitive symptoms and the underlying neurodegeneration process by fusing the information of neuropsychological test outcomes, diagnoses, and other clinical data with the imaging features extracted solely via a data-driven decomposition of MRI. The distribution of the extracted features in different combinations is then analyzed and visualized using regression and classification analysis, and the influence of each coordinate of the autoencoder manifold over the brain is estimated. The imaging-derived markers could then predict clinical variables with correlations above 0.6 in the case of neuropsychological evaluation variables such as the MMSE or the ADAS11 scores, achieving a classification accuracy over 80% for the diagnosis of AD.
124 citations
Cites background from "Prevalencia e incidencia de la enfe..."
...A LZHEIMER’S Disease (AD) is the most common type of neurodegenerative disease in the world, affecting more than 5% of the population in Europe [1] and with an incidence...
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...I. INTRODUCTION A LZHEIMER’S Disease (AD) is the most common typeof neurodegenerative disease in the world, affecting more than 5% of the population in Europe [1] and with an incidence of 11.08 per 1000 person-years....
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TL;DR: Es posible that mediante estrategias de prevencion primaria sobre los factores de riesgo de demencia conocidos en un futuro disminuya the carga of the demencia sobre the salud publica.
Abstract: Introduccion. La demencia es un sindrome clinico causado por multiples etiologias y que cursa habitualmente con disfuncion cerebral progresiva y difusa. Los distintos subtipos se caracterizan por un cuadro clinico con sintomas comunes que difieren en su etiologia, edad, forma de presentacion, curso clinico y trastornos asociados.
Objetivo. Presentar una actualizacion de la informacion disponible de la epidemiologia descriptiva de la demencia y de sus principales subtipos.
Desarrollo. A partir de una revision de la bibliografia, se extraen los principales datos de prevalencia, incidencia y mortalidad. La enfermedad de Alzheimer es el subtipo mas frecuente y representa el 60-80% de todos los casos, seguida de la demencia vascular y de otras demencias neurodegenerativas, como la demencia por cuerpos de Lewy, el complejo demencia-Parkinson y la demencia frontotemporal. Otros subtipos de demencias presentan frecuencias inferiores al 1%, y se dispone de indicadores epidemiologicos poco robustos.
Conclusiones. La prevalencia e incidencia de demencia se incrementa a partir de los 65 anos de forma exponencial. Como consecuencia del progresivo envejecimiento poblacional y el incremento de la esperanza de vida, el numero de casos de demencia aumentara durante las proximas decadas. Estudios recientes senalan una ligera disminucion del riesgo acumulado de demencia ajustado por grupos de edad y sexo durante las ultimas decadas en algunos paises. Es posible que mediante estrategias de prevencion primaria sobre los factores de riesgo de demencia conocidos en un futuro disminuya la carga de la demencia sobre la salud publica.
81 citations
Cites background from "Prevalencia e incidencia de la enfe..."
...Con relación a los subtipos de demencia, y espe cíficamente para la EA, un metaanálisis de ocho es tudios poblacionales europeos muestra una preva lencia del 5,1%, más frecuente en mujeres (7,1% frente a 3,3%), y un incremento exponencial con la edad (0,97% para 6574 años, 7,7% para 7584 años y 22,5% para ≥ 85 años) [27]....
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TL;DR: It was found that miR-125b was up-regulated in patients with AD and may be a novel regulator of AD progress and could be as a therapeutic target for AD therapy.
74 citations
References
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11 Jun 2013
113,134 citations
TL;DR: A simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
76,181 citations
01 Jan 2002
TL;DR: The Mini-Mental State (MMS) as mentioned in this paper is a simplified version of the standard WAIS with eleven questions and requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
Abstract: EXAMINATION of the mental state is essential in evaluating psychiatric patients.1 Many investigators have added quantitative assessment of cognitive performance to the standard examination, and have documented reliability and validity of the several “clinical tests of the sensorium”.2*3 The available batteries are lengthy. For example, WITHERS and HINTON’S test includes 33 questions and requires about 30 min to administer and score. The standard WAIS requires even more time. However, elderly patients, particularly those with delirium or dementia syndromes, cooperate well only for short periods.4 Therefore, we devised a simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely. It is “mini” because it concentrates only on the cognitive aspects of mental functions, and excludes questions concerning mood, abnormal mental experiences and the form of thinking. But within the cognitive realm it is thorough. We have documented the validity and reliability of the MMS when given to 206 patients with dementia syndromes, affective disorder, affective disorder with cognitive impairment “pseudodementia”5T6), mania, schizophrenia, personality disorders, and in 63 normal subjects.
70,887 citations
TL;DR: A new quantity is developed, I 2, which the authors believe gives a better measure of the consistency between trials in a meta-analysis, which is susceptible to the number of trials included in the meta- analysis.
Abstract: Cochrane Reviews have recently started including the quantity I 2 to help readers assess the consistency of the results of studies in meta-analyses. What does this new quantity mean, and why is assessment of heterogeneity so important to clinical practice?
Systematic reviews and meta-analyses can provide convincing and reliable evidence relevant to many aspects of medicine and health care.1 Their value is especially clear when the results of the studies they include show clinically important effects of similar magnitude. However, the conclusions are less clear when the included studies have differing results. In an attempt to establish whether studies are consistent, reports of meta-analyses commonly present a statistical test of heterogeneity. The test seeks to determine whether there are genuine differences underlying the results of the studies (heterogeneity), or whether the variation in findings is compatible with chance alone (homogeneity). However, the test is susceptible to the number of trials included in the meta-analysis. We have developed a new quantity, I 2, which we believe gives a better measure of the consistency between trials in a meta-analysis.
Assessment of the consistency of effects across studies is an essential part of meta-analysis. Unless we know how consistent the results of studies are, we cannot determine the generalisability of the findings of the meta-analysis. Indeed, several hierarchical systems for grading evidence state that the results of studies must be consistent or homogeneous to obtain the highest grading.2–4
Tests for heterogeneity are commonly used to decide on methods for combining studies and for concluding consistency or inconsistency of findings.5 6 But what does the test achieve in practice, and how should the resulting P values be interpreted?
A test for heterogeneity examines the null hypothesis that all studies are evaluating the same effect. The usual test statistic …
45,105 citations
TL;DR: The criteria proposed are intended to serve as a guide for the diagnosis of probable, possible, and definite Alzheimer's disease; these criteria will be revised as more definitive information becomes available.
Abstract: Clinical criteria for the diagnosis of Alzheimer's disease include insidious onset and progressive impairment of memory and other cognitive functions. There are no motor, sensory, or coordination deficits early in the disease. The diagnosis cannot be determined by laboratory tests. These tests are important primarily in identifying other possible causes of dementia that must be excluded before the diagnosis of Alzheimer's disease may be made with confidence. Neuropsychological tests provide confirmatory evidence of the diagnosis of dementia and help to assess the course and response to therapy. The criteria proposed are intended to serve as a guide for the diagnosis of probable, possible, and definite Alzheimer's disease; these criteria will be revised as more definitive information become available.
26,847 citations