Nov 2, 2017 in Analysis

Annotated Bibliography

Kamphuis, P. J., & Scheltens, P. (2010). Can nutrients prevent or delay the onset of Alzheimer's disease? Journal of Alzheimer's disease, 20, 765-775.

This paper resents a journal review on whether nutrients can prevent or delay the beginning of AD by Patrick J.G.H. Kamphuis from the Danone Research, Centre for Specialized Nutrition, Wageningen, The Netherlands and Philip Scheltens from the same institution. Philip Scheltens also works for and with Alzheimer Centre, VU University Medical Center, Amsterdam, and the Netherlands. The paper proposes that changes related to age and status of nutrition changes can have a significant role in brain function. Deficiencies of a certain nutrient in the elderly age, including but not limited to omega-3 fat acid, antioxidants and vitamin B range, may affect brain pathological processes. As a result, the potential of nutritional methods to delay or prevent cognitive impairment and the genesis of Alzheimer’s disease as well as other impairments is a subject of increased scientific interest.

This paper was chosen for the research due to the credibility of the originating institutions. These are the leading institutions in the field of mental health and research on AD. The researchers are also leading scholars in the research field of mental health and psychiatry. Their rationale and methodology also have reasonableness and rationality attached to it. They have not limited or constrained themselves to their findings and knowledge, but have also made reference to studies by other scholars. They provide a linkage between their study and those done by others. Most of their cited work revolves around undisputed arguments and, hence, their argument also benefits from the credibility of these works. This review analyses studies in epidemiology that link specific deficiencies in nutrition to mild cognitive impairment. It also analyses completed and ongoing studies on prevention of Alzheimer's disease and mild cognitive impairment. The paper suggests that a multi-nutritional intervention that targets a wider aspect of the nervous degeneration process focused on the earliest possible step in the evolution of the disease to be taken. It is highly likely to have the greatest potential in therapy. The paper calls for a primary prevention campaign focused on nutrition. It should provides a viable link between nutrition and the brain functioning. There is growing wealth of evidence supporting a modifiable link between nutrition and Alzheimer’s disease. It also analyses mechanisms supporting the nutritional intervention role in Prevention of Alzheimer’s Disease. The paper analyses the multiple mechanisms that underlie AD pathogenesis and suggests a rationale for a multi-target approach. Epidemiological evidence suggests that specific nutrients such as PUFAs, vitamins and antioxidants may affect cognitive decline and prevent the development of AD. Changes related to age in nutritional state play a pivotal role in functioning of the brain. Susceptibility of the elderly population to deficiencies of a particular nutrient may exacerbate pathological processes in the brain.

The information contained here is of immense value to practitioners in nutrition dealing with patients at high risk of Alzheimer’s disease. They can determine which components of day to day diet can assist in keeping neurological disorders at bay. Mothers can also use this to keep their children’s nutrition within the framework of ensuring than they are preventing neurological and cognitive deterioration. The government can as well use this research to enact a policy for detection, management and prevention of cognitive disorders, such as Alzheimer’s.

Leger, G., & Massoud, F. (2011). Pharmacological treatment of Alzheimer. Canadian Journal of Psychiatry, 10, 22-32.

This paper was chosen for the research due to the credibility of the originating institutions. These are the leading institutions in the mental health and psychiatry field. The researchers are also leading scholars in the research field of mental health and psychiatry. Their rationale and methodology also have reasonableness and rationality attached to it. They have not constrained themselves to their findings and knowledge.They have also made references and linkage to the studies done by other scholars. Most of their cited works revolve around undisputed arguments and, hence, their argument also benefits from the credibility of these works. The paper reviewed was published in The Canadian Journal of Psychiatry. The work by Fadi Massoud, MD, CSPQ, FRCPC and Gabriel C Lager, MD, CSPQ, FRCPC, considered the pharmacological treatment of Alzheimer disease. The overall objective was to analyze different drug approaches to the cognitive, behavioral and functional manifestations of Alzheimer. The methods included a thorough and comprehensive search and critical analysis of the most relevant literature on treating Alzheimer disease pharmacologically. The results were that the current pharmacological approach to treatment of Alzheimer’s disease was based on symptomatic therapy and vascular prevention. The paper discusses practical matters in relation with prevailing pharmacological management and treatment. The paper also reviewed the results of clinical trials and symptomatic treatments which are currently available.The treatments  provide mild, reproducible benefits across studies.  Most clinical trials evaluating symptomatic pharmacological treatment of Alzheimer’s disease exclude patients with medical co morbidities. There are no randomized controlled trials exceeding the 1-year duration. A few clinical trials have evaluated combinations of pharmacological treatments. Pharmacological options are presently available for symptomatic treatment of AD. The amyloidal cascade hypothesis, the validity of the animal models, and even the ability to conduct clinical trials that will detect disease modification in patients with already diagnosed AD or even mild cognitive impairment (commonly referred to as MCI) are being questioned. Dr. Massoud and Dr. Lager have both received speakers honoraria, consultant fees, and research support from Pfizer, a leading pharmaceutical company. The Canadian Psychiatric association has also acknowledged their work.No drug had been proven to completely protect neurons. The main stay of treatment for AD is agents that inhibit the degradation of acetylcholine within the synapse. Cholinesterase inhibitors are approved by the Food and Drug Administration for the treatment of AD. The use of other drugs remains controversial. The study should have reviewed all Meta analysis that has been published up to October 2008. An emergent issue that has arisen is the importance of a clear comprehension of the differences between clinical and statistical significance. Researchers should have gone further to prove their clinical relevance and benefits of the research. Positive developments in other outcomes were witnessed, but further studies need to be performed for confirmation purposes. This is because many of the trials were not included from the final analysis due to questionable quality of data. Standard.  A conclusion about their clinical significance differs between clinicians. A limitation of the research studies was that the treatment period was too short. Studies investigating the long-term effects are needed. Much of the reported data is flawed. This is based on methodological limitations of the study, and the improvements cannot be given any clinical significance. A standard and comprehensive approach covering the emerging issues regarding pharmacological approach in managing the disease needs to be developed. This should have an aim of ensuring uniformity and eradicating the huge variances exhibited in studies in the field. The lessons derived from this particular study can ensure that the loopholes are sealed. The overriding objective of the research should be to ensure consistent and correct analysis and observation. The result would be correct, cogent, credible  and impeachable results that would be more useful in solving the challenges of today. The research would also be more useful to prospective and future researchers who would not have to undertake other studies on the same issue based on shortcomings that could have been avoided in the first instance

The paper can be used in the development on new pharmacological methods of managing Alzheimer’s disease. Although, there is a limitation with the current methods being used. Policy makers may then, use this as backing allow clinical trials to extremely sick patients. Being able to detect disease modifications will also be an important result of these clinical trials. Exclusion of patients with medical co morbidities may grind to a halt as a means of ensuring access to healthcare is guaranteed to all citizens. The practical matters discussed can assist medical practitioners, pharmacists and caregivers in determining what direction to go through in the event that treatment is sought.

Lupton, M., Stahl, D., & Lovestone, S., et al. (2010). International Journal of Geriatric Psychiatry, 25, 30-36.

This research article published in The International Journal of Geriatric Psychiatry Occupation is devoted to education and age of retirement which influence on the onset of Alzheimer’s disease. The authors and researchers include: Michelle K Lupton and John F Powell from Department of Neuroscience, Institute of Psychiatry, and Kings College London, UK; Daniel Stahl from the Department of Biostatistics & Computing, Institute of Psychiatry, Kings College London, UK; Nicola Archer, Catherine Foy, Michaela Poppe, Simon Lovestone  from the Department of Old Age Psychiatry, Institute of Psychiatry, Kings College London; Carol Brayne from the Department of Psychological Medicine, Cardiff University, UK; David Rubinsztein from University of Cambridge, UK; Michael Gill, Brian Lawlor and Aoibhinn Lynch from the Mercerâs Institute, St. James Hospital and Trinity College, UK. It is necessary to note that these institutions are among the most noteworthy and acclaimed institutions in the United Kingdom.

The primary reason of the research was to determine the effects of early life education as midlife on AD. The methods that were employed included a multiple regression analyses carried out. The results showed no relation between the quality and years of education, levels of qualifications garnered, or variable in employment in males and the onset of Alzheimer’s disease. An effect of a late age of retirement in delaying the age of onset of the condition was seen in men. The conclusions were that, on that particular study no effect on levels of education or employment was seen. This was attributed, perhaps, to the limited diversity in the study population. The effect of an early age of retirement in delaying the onset of the condition was seen. The research was funded by the MRC (student-ship to ML), the Alzheimer’s Research Trust, Institute of Psychiatry and Maudsley NHS Foundation Trust, hence, creating for the results. The above organizations have traditionally and for a long time been involved with Alzheimer’s research and, hence, are known to support only viable researches that increase on the general pool of research in the subject. References are also made to previous work by internationally acclaimed researchers to provide a linkage between the previous works to this study.

The work can assist policy makers especially the government when drafting policy regarding the retirement age as well as benefits for the elderly with a view of managing the disease. This can go a long way in reducing government budgets allocated to healthcare management to the elderly. Most of them suffer from cognitive impairment. Employers and employees can also borrow a leaf in ensuring adequate preparations are made for the retirement. Age can be put as one of the considerations. Future researchers can also refer to study to avoid duplicity in works.

Reiman, E. M., Langbaum, J. B., Caselli, R. J., Fleisher, A. S., Chen, K., Quiroz, Y. T., et al. (2011). Alzheimer’s prevention initiative: A plan to accelerate the evaluation of presymptomatic treatments. Journal of Alzheimer’s Disease, 26, 321-329.

This was paper review in the Journal of Alzheimer's Disease. The Paper by Alzheimer’s Prevention Initiative was titled, 'A Plan to Accelerate the Evaluation of Presymptomatic Treatments. The authors of the paper were Eric M. Reiman, Adam S. Fleisher, Francisco Lopera and Pierre N. Tariot. The researchers were from Banner Alzheimer’s Institute,   University of Arizona, Department of Neurosciences, University of CA, San Diego, CA, USA; Alzheimer’s Disease Cooperative Study (ADCS);  Neuroscience Research Institute, and the Neuroscience Group, University of Antioquia, Medellin, Colombia. The research was in response to an urgent need to find effective treatments for Presymptomatic Alzheimer’s Disease that reduced the risk of AD's symptoms or prevent them entirely. Another reason for the research to be carried out was too considerable number people dying from the disease and the amount of money spent on the timely curative programmes. The paper sought to assess the scope of presymptomatic treatment by applying clinical endpoints. During the research brain imaging as well as other measurements to track and the earliest changes connected with the predisposition to AD were evaluated. The paper also proposed to evaluate the investigational treatment modification in healthy individuals who, based on the basis of their genetic background and age, face the most imminent risk of developing AD using brain imaging cognitive endpoints and cerebrospinal fluid. The study had several trials to try and put this into perspective.

The paper analyzed the goals of the Alzheimer’s prevention initiative which included evaluating investigational modifying treatments as soon as possible, determining the extent to which the biomarker effects of treatment predict a medical benefit. There was an urgent need for information to assist in qualifying biomarker endpoints for eventual use in acutely crucial prevention programmes. Another objective was to provide an amyloid hypothesis test as opposed to clinical trials especially, when these treatments may be too late to be optimally effective. Another initiative was to establish a registry to support trials and finally to give high imminent risk individuals access to the most promising investigational treatments achieved by clinical trials. This paper was chosen for the research because of the credibility of the originating institutions. These are the leading institutions in the field of research dealing with mental health and Alzheimer’s disease. The researchers and authors of this paper are also considered to be among the leading scholars in the research field of mental health and psychiatry. Their rationale and methodology also have reasonableness and rationality attached to it. They have not limited or constrained themselves to their findings and knowledge, but have also made reference to the studies performed by other scholars. They provide a linkage between their study and those done by others. Most of their cited works revolve around undisputed arguments and, hence, their argument also benefits from the credibility of these works.

Evaluation of cognitive impairment on the onset of it is crucial. New methods have to be developed, and current ones improved for the purpose of ensuring that cases are detected treated at early stages. This will have an impact in the long run as the early depression or Alzheimer’s condition may not necessarily grow to dementia. Moreover, it is increasingly becoming more costly to seek treatment as a curative measure than preventive measures. Early detection can ensure that the risk and costs are kept at a minimum. Prevention also ensures that not a single person has to go through the entire ordeal.

Toledo, T. C., Ferreira, L. K., M., & Buscatto, G. F. (2010). Cardiac disorders as risk factors of Alzheimer’s disease. Journal of Alzheimer’s disease, 20, 749-763.

This journal article reviews the role of disorders in the cardiac system as the risk factors contributing to Alzheimer’s disease. The journal entry was done by Luiz Kobuti Ferreira, Geraldo F. Busatto and Tania Correa de Toledo from the Department of Psychiatry, University of Sao Paulo Medical School, and Sao Paulo, Brazil. Tania Correa de Toledo also works at the Psychological Medicine and Psychiatry Department, ABC region Medical School, Santo Andre, Brazil. Mauricio Wajngarten from the Division of Geriatric Cardiology; Institute of the Heart, University of Sao Paulo Medical School, Sao Paulo, Brazil also played an extremely prominent role in the study. As the study shows, vascular risk factors have a particularly significant role to play and a decisive one in detecting the beginning of non-genetic AD.

Generally, most reported cases of Alzheimer’s disease are sporadic. Many doctors have proposed that there could be an immensely complicated interaction between the risk factors related to the vascular system and the genetic predisposition. The most common risk factors for Alzheimer’s disease include: stroke, diabetes, hypertension, smoking, homocysteine, heart failure, hypercholesterolemia and atrial fibrillation. The study also analyzes in detail the roles of each of these factors and their underlying consequences. Studies have shown the possibility that these risk factors trigger Alzheimer's disease pathology well. The article states that some explanations include usual disorders among the old, where cerebrovascular and vascular disease can come as a fore runner for Alzheimer’s disease. This implies that the start of dementia can be detected by synergized risk factors. The paper also reviews the role of risk factors related to cardiovascular systems while the development of Alzheimer’s disease and discusses the related mental mechanisms which can supersede the Alzheimer’s disease.

Cardiovascular diseases may be modified in adult life. The researchers provide a perspective for dementia prevention and promise an avenue of AD research. This paper was selected because of the credibility of the originating institutions. The three institutions  include the Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil; The Psychological Medicine and Psychiatry Department, ABC region Medical School, Santo Andre, Brazil; and the Division of Geriatric Cardiology; Institute of the Heart, University of Sao Paulo Medical School, Sao Paulo, Brazil. These are the leading institutions in the field of mental health and psychiatry in the region as well as researchers and the authors of this paper. Their rationale and methodology also have reasonableness and rationality attached to it. They have not limited or constrained themselves to their findings and knowledge, but have also made reference to the studies performed by other scholars. They provide a linkage between their study and those done by others. Most of their cited works revolve around undisputed arguments and, hence, their argument also benefits from the credibility of these works. Journal of Alzheimer's disease is the property of IOS Press, an internationally acclaimed publishing house in the region. Such acclamation presupposes there can be no compromise on quality of the publication as well as information contained in it.

Cardiac disorders being a crucial element in neurological deterioration should be managed accordingly. This research can assist policy makers in ensuring that sufficient policy regulating treatment and control of cardiac disorders is enacted. Health practitioners can also manage cardiac disorders with the view of them being a causation factor for neurological disorders and, hence, provide sufficient management of the disease and prevent impairment of cognitive functions. Information provided in the paper can be used by care givers providing domiciliary services for patients suffering from cardiac disorders as well as in health facilities. Research students can also borrow a leaf to avoid duplicity as well as refer to study with a view of contributing to the information resources available on the topic of cognitive function impairment and cardiac complications.

Yokes, M. (2007). Molecular genetics disease. Journal of Cell and Molecular Biology, 6(2), 73-97.

This paper published in the Journal of Cell and Molecular Biology from Halic University in Turkey. It seeks to analyze the molecular genetics of Alzheimer's disease. The author, Mehmet Baki Yoke, works at the Department of Molecular Biology and Genetics, Halic University, Istanbul, Turkey. Alzheimer’s disease (AD) is the most common nerve disorder that causes degeneration of nerve capabilities to communicate with the brain. It is the primary cause of dementia in the elderly. Apart from environmental factors, a person's age is the most effective and common risk factor for Alzheimer's disease Development.

More than 90 percent of AD cases have been found to develop after the age of 65 years. The occurrence is known as late-onset AD (LOAD). The paper ascertains through evidence that Alzheimer’s disease has a genetic etiology. It tries to explain the molecular mechanism that leads to AD. Three genes alleged to be involved in the disease mechanism are: ß-Amyloid Precursor Protein (APP), Presenilin 2 (PSEN2) and Presenilin 1 (PSEN1). When mutated these genes cause an autosomal dominant, leading to the early-onset AD (EOAD). More than 100 genes, as risk factors have been associated with LOAD. Out of these, only the E4 allele of the Apolipo protein Egene (APOE) is accepted as the single most dominant genetic determinant of vulnerability to Alzheimer's disease. The researchers have sought to find locations of chromosomes either by the association studies or by the linkage. Full genome screens in the study revealed many different chromosomes. Only a few of these yielded positive results in the three independent studies. 

The paper also analyses the clinics and pathology of Alzheimer’s disease. It finds that most cases of Alzheimer’s disease are sporadic and late on set. A pool of evidence also proposes that genetic factors play a role in the etiology of AD. These include the most consistent and common risk factors such as positive family history to dementia. The paper also undertakes a comprehensive analysis of the genes causing Alzheimer’s disease. It also evolves on the crucial role that genetics plays as a risk factor for Alzheimer’s disease. The information can be useful in many ways and to a variety of people, from practitioners to guardians. Therefore, it might become much easier to determine prospective Alzheimer’s disease in much younger individuals. Early warnings mean early responses. Treatment can be sought or even preventive measures undertaken to mitigate the condition. The paper contributes to the pool of information on the subject; hence, more researchers will be able to acquire more vital information for reference. It also makes reference to the past work done by other researchers, hence, has  credibility attached to it. The author of the paper is a distinguished researcher from a distinguished university. This alludes a lot as to the quality of the work done and credibility of information in the paper. The paper was chosen to be used as a part of this research due to its credibility based on its origin and the comprehensive nature in which it addresses the issues of genetics on the growth of Alzheimer’s disease.

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