: Choline is being used in all mammalian cells as a precursor for synthesis of a major phospholipide phosphatidylcholine and as a donor of acetyl residues. Cholinergic neurons in addition require choline to synthesize neuromediator acetylcholine. The ability of cells to create choline via de novo synthesis is limited and therefore they need to transport choline from extracellular space. Limited availability of choline in brain leads specifically to diminished function of cholinergic neurons and in general to impaired reparation of biological membranes. Dysfunctions of cholinergic signaling in brain is characteristic for Alzheimer's disease. Aim of this work was to investigate whether gene and protein expression of high- affinity cholinergic transporters is altered in 5-6 months old APPswe/PS1dE9 mouse model of Alzheimer's disease. Expression of specific high-affinity cholinergic transporter CHT1 (responsible for transport of choline to be used for acetylcholine synthesis) and putative high-afinity choline transporter CTL1 (generally present in all cells and related to high affinity choline transport for phospholipide synthesis) in cerebral cortex was measured. Compared to non-trangenic littermates, no changes in the expression of both genes were detected at either mRNA (quantitative PCR) or protein...

A Doença de Alzheimer (DA) tem sido relacionada com danos oxidativos. O objetivo desse trabalho foi investigar o envolvimento NADPH oxidase 2 (Nox2), uma enzima que produz espécies reativas de oxigênio, na memória, na expressão de proteínas relacionadas à DA, na inflamação e morte neuronal no hipocampo na patologia Alzheimer-símile induzida por estreptozotocina (STZ), comparando os efeitos dessa droga em camundongos nocautes para Nox2 e camundongos selvagens (WT). A expressão gênica de Nox2 foi aumentada em animais WT após a injeção de STZ, além disso, esses animais apresentaram déficit de memória, aumento na fosforilação de TAU, na expressão de beta-amilóide, neurofilamentos, caspase-3 e marcadores de astrócitos e microglia, além de aumento na liberação de citocinas inflamatórias, após o tratamento. Estes efeitos não foram observados após a deleção de Nox2. A deleção de Nox2 aumentou a produção basal de IL-10, sugerindo que este pode ser um mecanismo pelo qual os camundongos nocautes são protegidos contra a patologia Alzheimer-símile induzida por STZ. / Alzheimer\'s disease (AD) has been linked to oxidative stress. The goal of this study was to investigate the involvement of NADPH oxidase 2 (nox2), an enzyme that produces reactive oxygen species, in memory, in AD-related proteins expression, inflammation and neuronal death in the hippocampus in the streptozotocin (STZ)-induced AD-like pathology by comparing the effects of that drug on mice lacking Nox2 and wild type (Wt) mice. Nox2 gene expression was increased in Wt mice after STZ injection. Moreover, these animals presented impairment in memory, increased phosphorylation of Tau and increased amyloid-β protein, neurofilaments, caspase-3 and astrocyte and microglial markers expression, in addition to increased inflammatory cytokines release after treatment. Nox2 depletion prevented these effects. The baseline IL-10 levels were found increased following Nox2 deletion, suggesting that this is one mechanism by which mice lacking Nox2 are protected against STZ-induced AD-like pathology.

A demanda de atenção para manter o equilíbrio postural aumenta com o envelhecimento e pode causar prejuízos na realização concomitante de duas ou mais tarefas. Indivíduos com doença de Alzheimer (DA) possuem menor reserva de atenção e, portanto, apresentam maior dificuldade em realizar uma tarefa motora associada à cognitiva, com conseqüente aumento do risco de quedas e suas conseqüências. O objetivo deste estudo foi verificar o desempenho do equilíbrio durante a realização concomitante de atividades funcionais (dinâmicas e estáticas) e tarefa cognitiva no idoso com DA. Foram avaliados 60 idosos, de ambos os sexos, com idade média de 77 ± 4 anos, divididos em dois grupos: Grupo-DA - indivíduos com DA (n=28) e Grupocontrole - indivíduos sem alteração cognitiva (n=32). O equilíbrio postural foi avaliado na atividade dinâmica através do TUGT e na atividade estática, pela plataforma fixa, Balance Master, NeuroCom. O teste estático foi realizado com os olhos abertos e fechados. Os indivíduos com DA apresentaram pior desempenho no TUGT com e sem a tarefa cognitiva concomitante. No teste estático, o desempenho do Grupo DA foi pior que do Grupo-controle no teste de olhos fechados sem tarefa cognitiva. O equilíbrio do Grupo-DA foi pior que do Grupo-controle nos testes dinâmicos. A DA interfere no desempenho do equilíbrio postural na atividade dinâmica associada à tarefa cognitiva, mas não interfere na atividade estática. A plataforma fixa de avaliação utilizada neste estudo não se mostrou um instrumento sensível para medir as alterações no equilíbrio postural estático causadas pela realização de tarefa cognitiva concomitante nos idosos com DA. / The attentional demand in order to keep the postural balance increases with the aging process and may cause damages in the concomitant performance of two or more tasks. Subjects with Alzheimers disease (AD) have less attentional reserve, and therefore present greater difficulty to perform a motor task associated with a cognitive task, increasing the risk of falls and their consequences. The aim of this study was to verify the balance of elderly people with AD during the concomitant performance of functional activities (dynamic and static) and cognitive tasks. Sixty aged people, male and female, with mean age of 77 ± 4 years, were evaluated; subjects were divided into two groups: AD Group composed by individuals with AD (n=28) and Control Group composed by individuals without cognitive alterations (n=32). The postural balance was evaluated through TUGT in the dynamic activity, and through the stable platform, Balance Master, NeuroCom in the static activity. The static test was done with opened and closed eyes. Patients with AD presented worse performance in the TUGT with and without the concomitant cognitive task. In the static test, the performance of the AD Group was worse than the performance of the Control Group in the test with closed eyes without cognitive task. The balance of the AD Group was worse than the balance of the Control Group during the dynamic tests. The AD interferes in the postural balance performance in the dynamic activity associated with a cognitive task, but it does not interfere in the static activity. The evaluation stable platform used in this study was unable to measure the alterations in static postural balance caused by the concomitant performance of the cognitive task in aged people with AD.

<p>The present study assessed olfactory and cognitive abilities in two strains of Alzheimer’s disease (AD) model mice and in healthy control mice over a four month time period. To this end an operant conditioning paradigm using an automated olfactometer and a spatial learning test with non-olfactory cues were employed and data on olfactory learning and memory, discrimination, and sensitivity as well as spatial learning and memory were collected. The mice were between 6 to 7 month old at the beginning of the study and 9 to 10 months old at the end of the data collection, that is, in the age range when the animals are supposed to display marked neuroanatomical changes typical of AD. The results demonstrate that there were no systematic differences in olfactory performance and spatial learning and memory abilities of AD model mice and the control mice up to the age they were tested. Further, there was no indication of an age-related decline in performance in any of the mouse strains across the testing period. Several reasons might account for the observed lack of difference in olfactory and cognitive performance between the mouse strains tested here: the AD model mice might not develop amyloid plaques and neurofibrillary tangles at all or they might develop them later than stated by the supplier. Alternatively, the AD model mice may have developed AD-typical neuroanatomical changes but these do not, or not yet, affect their olfactory performance and/or spatial learning and memory capabilities. Ongoing data collection will help to evaluate which of these explanations holds true.</p>

The present study assessed olfactory and cognitive abilities in two strains of Alzheimer’s disease (AD) model mice and in healthy control mice over a four month time period. To this end an operant conditioning paradigm using an automated olfactometer and a spatial learning test with non-olfactory cues were employed and data on olfactory learning and memory, discrimination, and sensitivity as well as spatial learning and memory were collected. The mice were between 6 to 7 month old at the beginning of the study and 9 to 10 months old at the end of the data collection, that is, in the age range when the animals are supposed to display marked neuroanatomical changes typical of AD. The results demonstrate that there were no systematic differences in olfactory performance and spatial learning and memory abilities of AD model mice and the control mice up to the age they were tested. Further, there was no indication of an age-related decline in performance in any of the mouse strains across the testing period. Several reasons might account for the observed lack of difference in olfactory and cognitive performance between the mouse strains tested here: the AD model mice might not develop amyloid plaques and neurofibrillary tangles at all or they might develop them later than stated by the supplier. Alternatively, the AD model mice may have developed AD-typical neuroanatomical changes but these do not, or not yet, affect their olfactory performance and/or spatial learning and memory capabilities. Ongoing data collection will help to evaluate which of these explanations holds true.

Befolkningen i dagens samhälle blir allt äldre. Många individer drabbas av någon typ av demens, exempelvis Alzheimers sjukdom, då denna sjukdom är starkt knuten till hög ålder. En demenssjukdom för med sig många svårigheter, däribland drabbas minne, språk samt kommunikation. I Sverige idag finns många yrkesgrupper representerade kring den som har insjuknat i demens men sällan finns någon som har djupgående kunskaper om de språkliga och kommunikativa svårigheter som en individ, till följd av sjukdomen får. I början av Alzheimers sjukdom är de språkliga förändringarna knappt märkbara men med tiden tilltar de språkliga svårigheterna. Den yrkesgrupp som har särskild kompetens inom området språk- och kommunikationsstörningar är logopeder. Syftet med föreliggande arbete var att undersöka hur den svenska logopedens arbete kan te sig idag vad gäller arbetet med personer med demens. Syftet var också att kartlägga några av de i litteraturen beskrivna metoder gällande språklig kognitiv intervention av personer med demens. Resultatet visade att få logopeder arbetar med kommunikationsproblem vid demens i Sverige idag men det finns dock goda exempel där logopeden är involverad både i utredningsarbetet för en diagnos samt i rådgivning till den drabbade och de anhöriga. Resultatet visade också att det i litteraturen finns metoder både för direkt och indirekt intervention gällande denna patientgrupp. Några av de metoder som svenska logopeder redan idag använder, såsom exempelvis Supported Conversation for Adults with Aphasia, (SCATM ) eller Alternativ och Kompletterande Kommunikation (AKK) kanske går att använda i arbetet med individer med demens. Slutsatsen är att det är få logopeder som arbetar inom den svenska demensvården och att det finns arbetsmetoder beskrivna i litteraturen, både för direkt samt indirekt intervention, som kan användas av logopeder vid arbete med personer med demens/Alzheimers sjukdom. Metoder som Spaced Retrieval training (SR-träning), Reminiscence samt ?The Breakfast Club? är exempel på metoder som är evidensbaserade. För att fortsätta utveckla metoder och utvärdera dess effekt på individer med demens, behövs vidare studier både kring de idag befintliga arbetsmetoderna, samt ett utprövande av nya. / The population in today´s society is getting older. A lot of people suffer from some kind of dementia, including Alzheimer´s disease, as this disease is strongly associated with old age. Dementia brings many difficulties, including difficulties with memory, language and communication. Many professions are represented around the person with dementia in Sweden today, however there is rarely any professional person with a thorough knowledge of the language and communication difficulties which the sick individual gets. In early Alzheimer´s disease the linguistic changes are barely noticeable, but as the disease gets worse, major linguistic difficulties will show. The occupational group that is already in the field of language and communication disorders is the speech therapist. The purpose of this study was to identify the Swedish speech therapists work today regard working with people with dementia and to map some of the methods described in the literature concerning cognitive communicative intervention of people with dementia. The results of this study showed, that few speech therapists are working with people with communication problems of dementia in Sweden today. There are still good examples though, where the speech therapist is involved in both diagnosing and advising the person with dementia and their relatives. The results also showed that in the literature there are methods for both direct and indirect interventions regarding this patient group. Perhaps some of the methods that Swedish speech therapists use today, like Supported Conversation for Adults with Aphasia (SCATM ) or Augmentative and Alternative Communication (AAC) can be used with patients with dementia. The conclusion is that there are few speech therapists that exist in the Swedish dementia care and that there are methods for working with this group of patients described in the literature, both for direct and indirect interventions, which can be used by speech therapists when working with people with dementia/Alzheimer´s disease. Spaced Retrieval training (SR-training), Reminiscence and “The Breakfast Club” are examples of some evidence based methods. To continue to develop methods and to assess its effect on people with dementia, further studies are needed both on the currently existing methods as well as testing of new ones.

Background: Alzheimer´s disease is a so-called degenerative dementia in which brain cells gradually degenerate and die. The disease causes memory disorders and the trait of character disappears. Alzheimer´s disease also affects the related parties that may take a great responsibility. Related caregivers are entitled to support from healthcare. Aim: The aim of the study was to describe the experiences of being related when caring for a person suffering from Alzheimer´s disease. Method: The study was based on narratives, which in this case means analysis of autobiographies. Six books were analyzed in accordance with Dahlborg-Lyckhage. Results: Three themes and nine sub-themes were developed. The related experienced several emotions. The feelings are reflected in three themes; anxiety, new life and powerlessness. Fear and anxiety were feelings that were there constantly. The new life led to a role change and aroused feelings of sorrow and loneliness. There were times when the related felt powerless. Anger, irritation, guilt and shame were experiences which they could not control. Conclusion: Alzheimer´s disease affects the entire family. The burden of the related caregiver can lead to illness. It is important that nurses take their responsibility by providing information and support the related so that he or she can better deal with the situation.

Alzheimers sjukdom är vanlig sjukdom i Sverige och övriga världen där symptombilden har en negativ inverkan på personens livssituation. Syftet med studien var att belysa vilka positiva effekter fysisk aktivitet har hos patienter med Alzheimers sjukdom. Studien genomfördes som en litteraturstudie och var grundad på 15 vetenskapliga artiklar. Resultatet indelades i tre huvudkategorier, påverkan på sinnesstämning, förbättrade kognitiva funktioner och förbättrad fysisk förmåga. Genom att utöva fysisk aktivitet förbättrades sinnesstämningen hos patienterna vilket visade sig genom att de blev mindre rastlösa, agiterade och oroliga. Psykofarmakaförbrukningen reducerades och patienterna kände sig mindre nedstämda efter att ha deltagit i fysiska övningar. Den kognitiva funktionen hos patienterna förbättrades, likaså förmågan att utföra den allmänna dagliga livsföringen. Genom fysisk träning blev patienterna rörligare, flexiblare, starkare, snabbare och de fick bättre balans. Resultatet visade att utövandet av fysisk aktivitet har olika positiva effekter hos patienter med Alzheimers sjukdom. Vidare forskning skulle kunna inrikta sig på vilken betydelse regelbunden träning har för att uppnå en positiv effekt av träningen. Patienter med Alzheimers sjukdom har lika stort behov av fysisk aktivitet som övriga befolkningen, det är därför betydelsefullt att patienternas behov av aktivitet uppmärksammas av sjuksköterskan. / Alzheimer´s disease is a common disease in Sweden and in rest of the world. The symptoms have a negative impact on the person's life situation. The purpose of this study was to investigate the positive impact of physical activity in patients with Alzheimer's disease. The study was conducted as a literature review and was based on 15 scientific articles. The results were divided into three main categories, the effect on mood, improved cognitive function and improved physical ability. The patients’ moods were improved by participation in physical activities and they became less restless, agitated and anxious. The consumption of psychotropic drugs was reduced and the patients felt less depressed after taking part in physical exercises. The cognitive function of patients improved, likewise the ability to perform the activities of daily living. The patients who participated in physical exercises became more mobilized, more flexible, stronger, faster, and they improved their balance. The results showed that physical activity has different positive impacts on patients with Alzheimer´s disease. Additional research could focus on what impact adherence has for achieving a positive effect of physical activity. Patients with Alzheimer’s disease have equal needs of physical activity as other people, therefore it´s important that nurses are aware of the patients’ needs for activity.

Lead (Pb) is one of the most well known toxic heavy metals in human beings and animals, which leads to toxic neurological disorders, cognitive problems, learning and memory disabilities. Epidemiological studies revealed that chronic lead exposure is one of the environmental risk factors which may cause Alzheimer¡¦s Disease, which were speculated for the observation of cellular necrosis, apoptosis, and £]-amyloid deposition frequently occuring altogether after chronic lead exposure. Recent studies have shown that the £]-amyloid formed during autophagic turnover of APP-rich organelles supplied by both autophagy and endocytosis. Therefore, we will conduct the new perspective for studying the possible role of autophagy on amyloidogensis disorders after lead exposure. SH-SY5Y human neuroblastoma cells, used in this study, were differentiated to a neuronal phenotype by retinoic acid (RA) to the culture medium at 10 £gM for 1, 2, 3 and 4 days. Doses of lead acetate with of lead acetate were 5 £gM and applied to the neuronal culture and then cell viability measurement by MTT assay. The apoptotic effect of non-differentiation and differentiation neuroblastoma cells after lead exposure was determined by cleaved DNA fragments. Furthermore, APP, intracellular A£]1-40 and A£]1-42 expression were quantified by Real-time PCR and ELISA, respectively. The autophagy process and variation of total and phosphorylated mammalian target of rapamycin (mTOR) forms were determined after lead exposure in non-differentiation and differentiation neuroblastoma cells by western blot. The results indicate that lead exposure enhances autophagy response in both non-differentiation and differentiation SH-SY5Y cells, which might cause neuronal apoptosis associated with £]-amyloidgenesis. Otherwise, lead exposure resulted in the inhibition of mTOR signaling, which correlated with the autophagic process. Besides, in our studies, non-differentiated cells exhibited more toxic vulnerability than RA induced differentiated neuron is congruous to previous finding that lead exposure during fetal development might be a potential risk factor for AD in the adulthood.

Bakgrund: Ungefär 100 000 människor i Sverige beräknas lida av Alzheimers sjukdom. Vanliga symtom är minnesförlust och nedsatt inlärningsförmåga. Vården av de med Alzheimers sjukdom sker ofta i hemmet av en närstående. Dessa närstående får inte tillräckligt med information och deras livskvalitet blir sämre. Det är därför viktigt att vårdpersonalen kar kunskap om de upplevelser som de närstående vårdarna har för att kunna stötta dem. Syfte: Syftet med denna litteraturstudie var att belysa upplevelser av att vårda en närstående med diagnosen Alzheimers sjukdom. Metod: I denna litteraturstudie har nio empiriska studier kvalitetsgranskats och analyserats utifrån en analysmetod med grund i metasyntes. De databaser som använts är; Cinahl, PubMed och PsycInfo. Resultat: Analysen gav 5 kategorier och 14 subkategorier. De fem kategorierna var; 1) Vårdarrollen. 2) Vårdandets positiva aspekter. 3) Diagnosens negativa konsekvenser. 4) Stöd och hjälp. 5) Det oundvikliga beslutet. Konklusion: Resultatet visar på att de som vårdar en närstående med Alzheimers sjukdom kan uppleva såväl ökad närhet som en känsla av förlust vilket är något som vårdpersonal bör vara uppmärksam på för att kunna stötta. Mer information genom sjukdomsförloppet var nödvändigt. Personcentrerad omvårdnad behövdes till följd av de skilda upplevelserna hos de närstående. Nyckelord: Närstående, upplevelse, Alzheimers sjukdom, omvårdnad.