Taking medication at the prescribed times is very important for people with mental issues like schizophrenia, dementia Alzheimer’s and depression. But their condition itself keeps them from doing so. They are either forgetful or choose not to take the pills intentionally. This could lead to missing dosage or overdosing both of which are dangerous to the person’s health. Hence a pill box that monitors the dosage and keeps them from being able to access the pills at undesired times is needed. The aim of the thesis is to design such a pill box for the company Victrix AB in Stockholm, Sweden, by expanding on their current pill box, Dosis. In the project, the locking mechanism to keep the lids closed was rigorously designed in phases after understanding the user conditions. The end result is a locked daily pill box that is ergonomic to use for people of all ages, mental and physical conditions. The product sets itself apart from its competitors by being compact, less medical looking and very easy to use. / Att ta mediciner vid föreskrivna tidpunkter är mycket viktigt för personer med psykiska problem som schizofreni, alzheimers, demens och depressioner. Dock kan deras tillstånd hindra dem från att göra det. De är antingen glömska eller så väljer de att inte ta medicinen avsiktligt. Sådant beteende kan leda till saknad dosering eller överdosering, vilka båda är farliga för personens hälsa. Därmed behövs en pillerask som övervakar doseringen och hindrar dem från att komma åt pillerna vid oönskade tidpunkter. Syftet med examensarbetet har varit att designa en sådan pillerask för företaget Victrix AB i Stockholm, Sverige, genom att utöka sin nuvarande ask, Dosis. I projektet designades låsmekanismen noggrant i faser, genom en ökad förståelse av användarförhållandena, för att hålla locken stängda,. Slutresultatet blev en låst daglig pillerask som är ergonomisk för personer i olika åldrar med mentala och fykiska problem. Produkten skiljer sig från dess konkurrenter genom att vara kompact, inte ha ett typiskt medicinskt utseende samt mycket enkel att använda.

La maladie d’Alzheimer (MA) représente la cause la plus importante de la démence, pourtant la cause de la MA reste toujours inconnue. Des données récentes suggèrent que la protéine BMI1 joue un rôle protecteur contre la MA et un rôle essentiel dans l’intégrité de l’hétérochromatine constitutive (hét-c) – les régions génomiques inactives au niveau de la transcription. Les niveaux de BMI1 et d’hét-c sont diminués dans les cerveaux de patients atteints de la MA, et des modèles de déficience de BMI1 in vivo et in vitro reproduisent des phénotypes canoniques de la MA. Nous avançons l’hypothèse que la perturbation de l’hét-c, effectuée par l’inactivation de gènes impliqués dans son intégrité, induira trois phénotypes canoniques de la MA : l’amyloïdopathie, la tauopathie et l’apoptose. Les knock-out (KO) de ces gènes se réalisent individuellement via le système CRISPR-Cas9 dans des neurones humains in vitro. Huit des 38 conditions de KO manifestent une perturbation d’hét-c, analysée par Western Blot; six manifestent une amyloïdopathie, deux manifestent une tauopathie et quatre manifestent des niveaux élevés d’apoptose, analysés par microscopie confocale et immunofluorescence. Les conditions de KO de gènes impliqués dans les domaines associés à la lamine manifestent plusieurs ou tous ces phénotypes de la MA. Ces résultats peuvent suggérer une nouvelle théorie qui expliquerait la cause de la MA : la dérépression de ces domaines induit l’activation des long interspersed elements (LINEs) dont leur dérépression cause des dommages à l’ADN et une réponse immunitaire innée aboutissant à un état sénescent et pro-inflammatoire qui entraîne la neurodégénérescence. / Alzheimer’s Disease (AD) represents the number one cause of dementia, however the cause of AD remains unknown. Recent data suggest that the protein BMI1 plays a protective role against AD and an essential role in the integrity of constitutive heterochromatin (c-het) – transcriptionally inactive, genomic regions. The levels of BMI1 and c-het are diminished in brains of AD patients, and models of BMI1 deficiency in vivo and in vitro reproduce canonical phenotypes of AD. We hypothesize that the disruption of c-het, brought about by inactivating genes implicated in its integrity, will induce three canonical phenotypes of AD: amyloidopathy, tauopathy and apoptosis. These gene knock-outs (KO) are carried out individually via the CRISPR-Cas9 system in human neurons in vitro. Eight of the 38 KO conditions present a disruption of c-het, analysed by Western Blot; six present amyloidopathy, two present tauopathy and four present elevated levels of apoptosis, analysed by confocal microscopy and immunofluorescence. The KO conditions of genes implicated in lamina-associated domains present some or all these AD phenotypes. These results may suggest a novel theory that would explain the cause of Alzheimer’s Disease: the derepression of these domains induces the activity of long interspersed elements (LINEs) which causes DNA damage and an innate immune response, culminating in a pro-inflammatory state of cellular senescence which leads to neurodegeneration.

Alzheimer’s disease is a neurodegenerative disease that affects approximately 6% of the global population aged over 65 and is forecasted to become even more prevalent in the future. Accurately diagnosing the disease in an early stage can play a large role in improving the quality of life for the patient. One key development for performing this diagnosis is applying machine learning to perform computer-aided diagnosis. Current research in the field has been focused on removing assumptions about the used data sets, but in doing so they have often discarded objective metadata such as the patient’s age, sex or priormedical history. This study aimed to investigate the effect of including such metadata as additional input features to neural networks used for diagnosing Alzheimer’s disease through binary classification of magnetic resonance imaging scans. Two similar neural networks were developed and compared, one with these additional features and the other without them. Including the metadata led to significant improvements in the network’s classification accuracy, and should therefore be considered in future computer-aided diagnostic systems for Alzheimer’s disease. / Alzheimers sjukdom är en form av demens som påverkar ungefär 6% av den globala befolkningen som är äldre än 65 och förutspås bli ännu vanligare i framtiden. Tidig diagnos av sjukdomen är viktigt för att säkerställa högre livskvalitet för patienten. En viktig utveckling inom fältet är datorstödd diagnos av sjukdomen med hjälp av maskininlärning. Dagens forskning fokuserar på att ta bort subjektiva antaganden om datamängden som används, men har ofta även förkastat objektiv metadata såsom patientens ålder, kön eller tidigare medicinska historia. Denna studier ämnade därför undersöka om inkluderandet av denna metadata ledde till bättre prestanda hos neuronnät som används för datorstödd diagnos av Alzheimers genom binär klassificering av bilder tagna med magnetisk resonanstomografi. Två snarlika neuronnät utvecklades och jämfördes, med skillnaden att den ena även tog metadata om patienten som indata. Inkluderandet av metadatan ledde till en markant ökning i neuronnätets prestanda, och bör därför övervägas i framtida system för datorstödd diagnos av Alzheimers sjukdom.

Aggregation of microtubule-associated protein tau is involved in the pathology of several neurodegenerative diseases, including Alzheimer’s disease. The affibody TP4 has been shown to inhibit this aggregation process, and its target-binding positions were previously grafted onto a dimeric affibody scaffold, creating the sequestrin seqTP4. This project constitutes a part of the affinity maturation process of seqTP4, using two different bacterial display methods. An error-prone PCR library was first expressed on Staphylococcus carnosus cells for selection of variants with improved tau-binding properties, resulting in a library of 1.4×107 transformants. Flow cytometric tests indicated difficulties in the setup due to nonspecific interactions, and whereas several different approaches to alleviate the problems were investigated, two cell sorting attempts were ultimately unsuccessful. Subcloning of seqTP4 and the library to an Escherichia coli surface display vector resulted in functional surface expression of seqTP4 on E. coli JK321 and BL21 cells, and a BL21 library size of 1.6×109 transformants. An initial flow cytometric test of this library indicates the presence of improved tau-binding variants, paving the way for future cell sorting. / Aggregering av mikrotubuli-associerat protein tau är involverad i patologin av flera neurodegenerativa sjukdomar, däribland Alzheimers sjukdom. Affibodymolekylen TP4 har visat sig inhibera denna aggregeringsprocess, och överföring av dess målbindande positioner till ett dimeriskt affibodyprotein har tidigare gett upphov till seqTP4, en så kallad sequestrin. Detta projekt utgör ett led i processen att affinitetsmaturera seqTP4, med hjälp av två olika metoder för presentation av proteiner på ytan av bakterieceller. Ett error-prone PCR-bibliotek uttrycktes först på ytan av Staphylococcus carnosus-celler för selektion av varianter med ökad affinitet för tau, vilket resulterade i ett bibliotek av 1.4×107 transformanter. Flödescytometriska tester tydde på svårigheter i detta upplägg på grund av ospecifika interaktioner, och emedan flera olika angreppssätt för att förmildra dessa problem undersöktes, misslyckades slutligen två cellsorteringsförsök. Omkloning av seqTP4 och biblioteket till en vektor för ytpresentation på Escherichia coli resulterade i funktionellt ytuttryck av seqTP4 på E. coli JK321- och BL21-celler, och ett BL21-bibliotek bestående av 1.6×109 transformanter. Ett första flödescytometriskt test av detta bibliotek tyder på närvaron av varianter med förbättrad förmåga att binda tau, och vägen ligger nu relativt öppen för cellsortering.

The deposition of β-amyloid peptides and of α-synuclein proteins is a neuropathological hallmark in the brains of Alzheimer’s disease (AD) and Parkinson’s disease (PD) subjects, respectively. However, there is accumulative evidence that both proteins are not exclusive for their clinical entity but instead co-exist and interact with each other. Here, we investigated the presence of a newly identified, pyroglutamate79-modified α-synuclein variant (pGlu79-aSyn)—along with the enzyme matrix metalloproteinase-3 (MMP-3) and glutaminyl cyclase (QC) implicated in its formation—in AD and in the transgenic Tg2576 AD mouse model. In the human brain, pGlu79-aSyn was detected in cortical pyramidal neurons, with more distinct labeling in AD compared to control brain tissue. Using immunohistochemical double and triple labelings and confocal laser scanning microscopy, we demonstrate an association of pGlu79-aSyn, MMP-3 and QC with β-amyloid plaques. In addition, pGlu79-aSyn and QC were present in amyloid plaque-associated reactive astrocytes that were also immunoreactive for the chaperone heat shock protein 27 (HSP27). Our data are consistent for the transgenic mouse model and the human clinical condition. We conclude that pGlu79-aSyn can be generated extracellularly or within reactive astrocytes, accumulates in proximity to β-amyloid plaques and induces an astrocytic protein unfolding mechanism involving HSP27.

Background. Omega-3 (n-3) and omega-6 (n-6) polyunsaturated fatty acids (PUFAs) may have different effects on cognitive health due to their anti- or pro-inflammatory properties. Methods. We aimed to prospectively examine the relationships between n-3 and n-6 PUFA contents in serum phospholipids with incident all-cause dementia and Alzheimer’s disease dementia (AD). We included 1264 non-demented participants aged 84 ± 3 years from the German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe) multicenter-cohort study. We investigated whether fatty acid concentrations in serum phospholipids, especially eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), alpha-linolenic acid (ALA), linoleic acid (LA), dihomo-γ-linolenic acid (DGLA), and arachidonic acid (AA), were associated with risk of incident all-cause dementia and AD. Results. During the follow-up window of seven years, 233 participants developed dementia. Higher concentrations of EPA were associated with a lower incidence of AD (hazard ratio (HR) 0.76 (95% CI 0.63; 0.93)). We also observed that higher concentrations of EPA were associated with a decreased risk for all-cause dementia (HR 0.76 (95% CI 0.61; 0.94)) and AD (HR 0.66 (95% CI 0.51; 0.85)) among apolipoprotein E ε4 (APOE ε4) non-carriers but not among APOE ε4 carriers. No other fatty acids were significantly associated with AD or dementia. Conclusions. Higher concentrations of EPA were associated with a lower risk of incident AD. This further supports a beneficial role of n-3 PUFAs for cognitive health in old age.

Based on a targeted literature review, this vision paper emphasizes the importance of dementia-sensitive built space. The article specifically focuses on supporting spatial orientation and wayfinding for people living with dementia. First, we discuss types of wayfinding challenges, underlying processes, and consequences of spatial disorientation in the context of dementia of the Alzheimer’s type. Second, we focus on current efforts aimed at planning and evaluating dementia-sensitive built space, i.e., environmental design principles, interventions, evaluation tools, strategies, and planning processes. Third, we use our findings as a starting point for developing an interdisciplinary research vision aimed at encouraging further debates and research about: (1) the perspective of a person with dementia, specifically in the context of wayfinding and spatial orientation, and (2) how this perspective supplements planning and design processes of dementia-sensitive built space. We conclude that more closely considering the perspective of people with dementia supports the development of demographically sustainable future cities and care institutions.

The classic surfactant proteins (SPs) A, B, C, and D were discovered in the lungs, where they contribute to host defense and regulate the alveolar surface tension during breathing. Their additional importance for brain physiology was discovered decades later. SP-G, a novel amphiphilic SP, was then identified in the lungs and is mostly linked to inflammation. In the brain, it is also present and significantly elevated after hemorrhage in premature infants and in distinct conditions affecting the cerebrospinal fluid circulation of adults. However, current knowledge on SP-G-expression is limited to ependymal cells and some neurons in the subventricular and superficial cortex. Therefore, we primarily focused on the distribution of SP-G-immunoreactivity (ir) and its spatial relationships with components of the neurovascular unit in murine forebrains. Triple fluorescence labeling elucidated SP-G-co-expressing neurons in the habenula, infundibulum, and hypothalamus. Exploring whether SP-G might play a role in Alzheimer’s disease (AD), 3xTg-AD mice were investigated and displayed age-dependent hippocampal deposits of β-amyloid and hyperphosphorylated tau separately from clustered, SP-G-containing dots with additional Reelin-ir—which was used as established marker for disease progression in this specific context. Semi-quantification of those dots, together with immunoassay-based quantification of intra- and extracellular SP-G, revealed a significant elevation in old 3xTg mice when compared to age-matched wildtype animals. This suggests a role of SP-G for the pathophysiology of AD, but a confirmation with human samples is required.

ATP is a (co)transmitter and signaling molecule in the CNS. It acts at a multitude of ligand-gated cationic channels termed P2X to induce rapid depolarization of the cell membrane. Within this receptor-channel family, the P2X7 receptor (R) allows the transmembrane fluxes of Na+, Ca2+, and K+, but also allows the slow permeation of larger organic molecules. This is supposed to cause necrosis by excessive Ca2+ influx, as well as depletion of intracellular ions and metabolites. Cell death may also occur by apoptosis due to the activation of the caspase enzymatic cascade. Because P2X7Rs are localized in the CNS preferentially on microglia, but also at a lower density on neuroglia (astrocytes, oligodendrocytes) the stimulation of this receptor leads to the release of neurodegeneration-inducing bioactive molecules such as pro-inflammatory cytokines, chemokines, proteases, reactive oxygen and nitrogen molecules, and the excitotoxic glutamate/ATP. Various neurodegenerative reactions of the brain/spinal cord following acute harmful events (mechanical CNS damage, ischemia, status epilepticus) or chronic neurodegenerative diseases (neuropathic pain, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis) lead to a massive release of ATP via the leaky plasma membrane of neural tissue. This causes cellular damage superimposed on the original consequences of neurodegeneration. Hence, blood-brain-barrier permeable pharmacological antagonists of P2X7Rs with excellent bioavailability are possible therapeutic agents for these diseases. The aim of this review article is to summarize our present state of knowledge on the involvement of P2X7R-mediated events in neurodegenerative illnesses endangering especially the life quality and duration of the aged human population.

The accuracy of neuropsychological assessment is critical in the diagnosis of cognitive impairments in older adults. However, existing neuropsychological tests may not be suitable for minority populations. This thesis aimed to address this issue by recruiting cognitively-healthy South Asian older adults and assessing cognitive function in this group. Results showed that typically used assessments, despite being translated, were not suitable for this cohort. Furthermore, skills required for test completion such as mathematics and writing/hand dexterity (which are related to education levels) influenced test scores. Therefore, new assessments of general cognitive function and associative memory were developed to improve the accuracy of neuropsychological test scores. The new tests were not affected by education and they achieved high internal and test re-test reliability. Time of day (TOD) that testing takes place is also known to affect cognition. Interestingly, no TOD effects were observed in this cohort. It was hypothesised that engagement in the daily five Islamic prayers may have contributed to this lack of a TOD effect. However, the results did not confirm this. The thesis then looked at overall prayer engagement and cognition. Results showed that engagement in the daily five prayers and Quran recitation significantly increased scores on assessments of processing speed. This thesis demonstrates that accurately assessing cognition in South Asian older adults is challenging and that the cognitive tests used must be suitable for this cohort. Interesting findings emerged for prayer engagement which may have wider implications for the field of cognitive reserve.