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.

Les maladies neurodégénératives d’Alzheimer et de Parkinson sont caractérisées par des agrégats des peptides des amyloïdes-beta (Aβ) et l’alpha synucléine (αSyn), respectivement. L’agrégation de ces peptides solubles donne les matériels insolubles (les amyloïdes) sous forme de fibrilles et de plaques. L’agrégation de ces amyloïdes insolubles cause de la toxicité cellulaire dans le cerveau provoquant les effets neurodégénératifs. Les D, L-α-cyclopeptides synthétiques (e. g., CP-2, c-[leu-Nle-trp-His-ser-Lys]) furent synthétisés précédemment par le groupe de Rahimipour. Ils sont capables de former des nanotubes par pont hydrogène capables d’inhiber l’activité néfaste des amyloïdes. Les azapeptides utilisent de semicarbazide comme un substituant d’amide aminé. Insérés dans le D, L-α-cyclopeptide CP-2, les aza-résidus permettent d’améliorer la basicité de Lewis et l’acidité de Bronsted du peptide pour obtenir des ponts hydrogènes plus forts. Les azapeptides [azaNle3]-CP-2, [azaHse6]-CP-2 et [azaGly6]-CP-2 offrent d’excellents résultats au niveau des tests biologiques pour inhiber l’activité des amyloïdes ainsi que pour réduire la mortalité cellulaire en présence d’amyloïdes. À partir de ces résultats prometteurs, l’insertion de deux azapeptides dans un D, L-α-cyclopeptide a été effectué. En remplaçant l’histidine par l’alanine pour éviter des problèmes d’épimérisation, quatre nouveaux diazacyclopeptides ont été synthétisés en insérant les aza-résidus : l’aza-norleucine (azaNle), l’aza-homoserine (azaHse) et l’azaglycine (azaGly). Leur synthèse ainsi que leur caractérisation biophysique préliminaire seront présentés. / Alzheimer's and Parkinson's diseases are neurodegenerative diseases characterized by the aggregation of the peptides amyloid-beta (Aβ) and alpha-synuclein (Synα), respectively. The aggregation of these soluble peptides gives insoluble peptides (amyloids) in the forms of fibrils and plaques. Aggregation of insoluble amyloids can cause cellular toxicity in the brain resulting in neurodegenerative effects. Certain synthetic cyclic D,L-alpha-peptides (e.g., CP-2, c-[leu-Nle-trp-His-ser-Lys]) were previously synthesized by the Rahimipour laboratory and shown to form intermolecular hydrogen bonds and self-assemble into nanotubes capable of inhibiting the aggregation and harmful effects of amyloids. Azapeptides employ semicarbazides as amino amide surrogates. Insertion of aza-residues into the D,L-α-cyclopeptide CP-2 was explored to alter the Lewis basicity and Bronsted acidity of the peptide and improve hydrogen bonding potential. The azapeptides [azaNle3]-CP-2, [azaHse6]-CP-2, and [azaGly6]-CP-2 inhibited effectively amyloid aggregation and reduced amyloid-induced cell death. Based on the promising results of single aza-residue substitutions, the insertion of two aza-residues into D,L-α- cyclopeptide CP-2 analogs was investigated. Histidine was replaced with alanine to minimize epimerization. Four new diazacyclopeptides were synthesized by inserting aza-norleucine (azaNle), aza-homoserine (azaHse) and aza-glycine (azaGly). The syntheses and preliminary biophysical characterizations of the diazacyclopeptides will be presented.

Introduktion/Bakgrund: Demenssjukdom är ett spektrum av neurodegenerativa tillstånd som kännetecknas avgradvis kognitiv försämring. Globalt påverkar demenssjukdom miljontals äldre individer och deras omgivning.Oral hälsa är ofta förbisedd i vårdprocesser kring demenssjukdom. Orala hälsa är viktig för livskvaliteten. Sämreoral hälsa kan leda till sämre livskvalitet, smärta och påverkan på allmänhälsan. Munhälsointerventioner är därförviktiga för att förbättra livskvaliteten och minska riskerna för orala hälsoproblem.Syfte: Att kartlägga munhälsofrämjande interventioner riktade mot äldre individer med demenssjukdom.Frågeställningar: Vilka interventioner riktas mot demenssjuka för att främja deras orala hälsa? Vilka aktöreransvarar för genomförandet av interventionerna?Metod: En litteraturstudie genomfördes för att systematiskt granska och sammanställa befintlig forskning ochkunskap om ämnet. Databaserna PubMed och CINAHL användes. Analys genomfördes med hjälp avgranskningsmallar för att bedöma kvaliteten på de inkluderade studierna.Resultat: Utbildning för vårdpersonal och samarbetsbaserade strategier med vårdpartners ledde till bättre oralhygien och livskvalitet för äldre individer med demenssjukdom. Resultaten visade att enkla, regelbundna insatsersom tandborstningstekniker och kommunikationsträning hade positiva effekter på oral hälsa och välbefinnandebland äldre individer med demenssjukdom. Samarbete mellan tandvårdspersonal, vårdpersonal och vårdpartnersförbättrade den orala hälsan hos äldre individer med demenssjukdom.Slutsats: Äldre individer med demenssjukdom har ofta haft bristande oral hälsa. För att förbättra den orala hälsanhos äldre individer med demenssjukdomar är det viktigt att vara medveten om att det är ett komplext vårdpanoramasom äldre individer vårdas inom. Interventioner på en mer övergripande nivå, såsom syftar till att etablerasamarbete i strategier, tycks vara ett utvecklingsområde.

Alzheimer's disease (AD) and Parkinson's disease (PD), including dementia with Lewy bodies (DLB), account for the majority of dementia cases worldwide. Interestingly, a significant number of patients have clinical and neuropathological features of both AD and PD, i.e., the presence of amyloid deposits and Lewy bodies in the neocortex. The identification of α-synuclein peptides in amyloid plaques in DLB brain led to the hypothesis that both peptides mutually interact with each other to facilitate neurodegeneration. In this article, we report the influence of Aβ(1-42) and pGlu-Aβ(3-42) on the aggregation of α-synuclein in vitro. The aggregation of human recombinant α-synuclein was investigated using thioflavin-T fluorescence assay. Fibrils were investigated by means of antibody conjugated immunogold followed by transmission electron microscopy (TEM). Our data demonstrate a significantly increased aggregation propensity of α-synuclein in the presence of minor concentrations of Aβ(1-42) and pGlu-Aβ(3-42) for the first time, but without effect on toxicity on mouse primary neurons. The analysis of the composition of the fibrils by TEM combined with immunogold labeling of the peptides revealed an interaction of α-synuclein and Aβ in vitro, leading to an accelerated fibril formation. The analysis of kinetic data suggests that significantly enhanced nucleus formation accounts for this effect. Additionally, co-occurrence of α-synuclein and Aβ and pGlu-Aβ, respectively, under pathological conditions was confirmed in vivo by double immunofluorescent labelings in brains of aged transgenic mice with amyloid pathology. These observations imply a cross-talk of the amyloid peptides α-synuclein and Aβ species in neurodegeneration. Such effects might be responsible for the co-occurrence of Lewy bodies and plaques in many dementia cases.

Background: Circadian rhythm disturbance is commonly observed in Alzheimer's disease (AD). In mammals, these rhythms are orchestrated by the superchiasmatic nucleus (SCN). Our previous study in the Tg2576 AD mouse model suggests that inflammatory responses, most likely manifested by low GABA production, may be one of the underlying perpetrators for the changes in circadian rhythmicity and sleep disturbance in AD. However, the mechanistic connections between SCN dysfunction, GABA modulation, and inflammation in AD is not fully understood. Objective: To reveal influences of amyloid pathology in Tg2576 mouse brain on metabolism in SCN and to identify key metabolic sensors that couple SCN dysfunction with GABA modulation and inflammation. Methods: High resolution magic angle spinning (HR-MAS) NMR in conjunction with multivariate analysis was applied for metabolic profiling in SCN of control and Tg2576 female mice. Immunohistochemical analysis was used to detect neurons, astrocytes, expression of GABA transporter 1 (GAT1) and Bmal1. Results: Metabolic profiling revealed significant metabolic deficits in SCN of Tg2576 mice. Reductions in glucose, glutamate, GABA, and glutamine provide hints toward an impaired GABAergic glucose oxidation and neurotransmitter cycling in SCN of AD mice. In addition, decreased redox co-factor NADPH and glutathione support a redox disbalance. Immunohistochemical examinations showed low expression of the core clock protein, Bmal1, especially in activated astrocytes. Moreover, decreased expression of GAT1 in astrocytes indicates low GABA recycling in this cell type. Conclusion: Our results suggest that redox disbalance and compromised GABA signaling are important denominators and connectors between neuroinflammation and clock dysfunction in AD.

Apolipoprotein E (ApoE) ist eine verbreitet vorkommende Komponente der Plasmalipoproteine und spielt eine Schlüsselrolle bei Lipidtransport und Cholesterin-Homöostase über den Low Density Lipoprotein Rezeptor. Im ZNS wird ApoE hauptsächlich von Astrozyten synthetisiert und sekretiert. ApoE-Isoformen haben unterschiedliche Wirkung auf eine Zahl von pathologischen Prozessen, die der Alzheimerschen Krankheit zugrunde liegen. Um die Rolle des ApoE für die Alzheimersche Krankheit zu erhellen, ist es wichtig Kenntnisse über seine Regulation zu erlangen. Ein Ziel dieser Arbeit war zu untersuchen, ob die „Second-Messenger“-Signalpfade „Adenylatcyclase/Proteinkinase A (PKA)“ und/oder „Phospholipase C/Proteinkinase C (PLC/PKC)“ in die Regulation der astrozytären ApoE Sekretion eingreifen. Hierfür wurden primäre hippocampale Astrozytenkulturen von Ratten mit verschiedenen Analoga, Rezeptoragonisten und Neurotransmittern, die diese Signalpfade beeinflussen, inkubiert. Dibutyryl-cAMP (cAMP-Analogon) erhöhte die ApoE Sekretion. Auch Rezeptoragonisten des Adenylatcyclase/PKA-Signalwegs beeinflussten die ApoE Sekretion. Isoproterenol (beta-Adrenorezeptoragonist) erhöhte die ApoE Sekretion, während Clonidine (alpha-2 Adrenorezeptoragonist) sie senkte. Der PKC-Aktivator Phorbol 12-Myristat 13-Acetat senkte die ApoE Sekretion und kehrte die dibutyryl-cAMP-vermittelte Erhöhung der ApoE Sekretion um. Arterenol (alpha-1 Adrenorezeptoragonist) und Serotonin (Neurotransmitter) erhöhten die ApoE Sekretion, wohingegen Carbachol (Acetylcholiner muskarinischer Rezeptoragonist) die ApoE Sekretion senkte. Es wird gezeigt, dass die verwendeten Substanzen einen von der ApoE Sekretion verschiedenen Einfluss auf die Sekretion des Nervenwachstumsfaktors (NGF) haben. Dies legt die Vermutung nahe, dass die beobachteten Ergebnisse nicht auf einen generellen Effekt der Proteinsynthese zurückzuführen sind. Es kann gefolgert werden, dass die astrozytäre ApoE Sekretion von Faktoren beeinflusst werden kann, die die intrazelluläre Konzentration von cAMP verändern oder die PKC aktivieren. Das zweite Ziel der Arbeit war zu untersuchen ob Amyloid Fragmente einen Einfluss auf die astrozytäre ApoE Sekretion haben. Senile Amyloid-Plaques in Alzheimer-Gehirnen zeigen eine ApoE-Immunreaktivität, Astrozyten die diese Plaques umgeben dagegen nicht. Es wird gezeigt, dass gealtertes fibrilläres Amyloid (1-40) die ApoE Sekretion erhöht. Das sekretierte ApoE wird durch die, die Zellen umgebenden Amyloid-Konglomerate, gebunden. Die verwendeten Amyloid Fragmente beeinflussten nicht die Menge des sekretierten basischen Fibroblastenwachstumsfaktors. Dies legt nahe, dass die beobachteten Ergebnisse nicht auf einen generellen Effekt der Proteinsynthese zurückzuführen sind. / Apolipoprotein E (apoE) is an abundant component of plasma lipoproteins that plays a key role in lipid transport and cholesterol homeostasis via the low density lipoprotein receptor. In the CNS, apoE is synthesised and secreted especially by astrocytes. ApoE isoforms have different effects on a number of pathological processes underlying Alzheimer’s disease. Therefore, understanding the regulated synthesis of apoE is important for determining its role in Alzheimer’s disease. One aim of this work was to examine whether the second-messenger-pathways „adenylyl cyclase/proteinkinase A (PKA)“ and/or „phospholipase C/proteinkinase C (PLC/PKC) are involved in the regulation of apoE secretion in astrocytes. Therefore rat primary hippocampal astrocyte cultures were incubated with various analogues, receptor agonists and neurotransmitters which influence these pathways. Dibutyryl-cAMP (cAMP analogue) increased the apoE secretion. ApoE secretion was also modulated by receptor agonists of the adenylyl cyclase/PKA pathway. Isoproterenol (beta-adrenoceptor agonist) enhanced, while Clonidine (alpha 2-adrenoceptor agonist) decreased, the secreted apoE. In contrast, the PKC activator phorbol 12-myrisate 13-acetate decreased the apoE secretion. It also reversed the effects of dibutyryl-cAMP. Arterenol (alpha 1-adrenoceptor) and serotonin (neurotransmitter) enhanced, whereas carbachol (acetylcholine muscarinic receptor agonist) deceased secreted apoE. It is shown, that the used substances have different effects on the secretion of the nerve growth factor (NGF) as compared to apoE secretion, suggesting that the results obtained were unlikely to be due to a general effect on protein synthesis. It can be concluded that actrocytic apoE production can be regulated by factors that affect cAMP intracellular concentration or activate PKC. The second aim of this work was to examine whether amyloid fragments have an effect on the apoE secretion of astrocytes. Senile amyloid plaques in Alzheimer’s disease brains show apoE immunoreactivity, astrocytes which surround them do not. It is shown, that aged, fibrillic amyloid (1-40) increases apoE secretion. The secreted apoE is bound to the surrounding amyloid conglomerates. The used amyloid fragments did not increase or decrease basic fibroblast growth factor secretion, suggesting that the results obtained were unlikely to be due to a general effect on protein synthesis.