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All classification systems developed to identify cognitive abnormality in non-demented older people require that subtle impairment be detected with a single neuropsychological assessment. However, the dependence on single assessments for classification of mild cognitive impairment (MCI) with neuropsychological tests results in a significant proportion of false positive classifications. Consequently the specificity of MCI classification systems is generally low. False positive classifications can be reduced dramatically through the repeated application of an impairment criterion over time. Using the CogState battery we show here how the repeated application of a criterion for cognitive abnormality can improve specificity of the classification of MCI within a single assessment session. Such a procedure will be ultimately be useful in enriching entry criteria in prospective studies of the natural history of MCI as well as in reducing signal to noise ratios in clinical trials of pharmacologic interventions.

This paper summarizes findings from Cohen-Mansfield & Lipson, 2002 a, b, concerning geriatricians’ assessments of medical and dental pain in cognitively impaired nursing home residents. 79 nursing home residents participated in the study, of whom 31 had mild/moderate cognitive impairment and 48 were severely cognitively impaired. Over 80% of the participants were female and the average age was 87 years. A geriatrician from outside the nursing home reviewed lab results, performed a physical examination, and completed a detailed assessment of pain. For 42 of the participants, their personal geriatrician also completed the same assessment. For 21 residents, dental evaluations were conducted by volunteer dentists. In analyzing the assessment of medical pain, results validate geriatricians’ evaluations of pain during a medical examination for moderately impaired persons, but question their ability to evaluate pain in the severely cognitively impaired. The geriatrician identified dental pain in less than half the residents who were identified by dentists as suffering from dental pain. There is a need for increased awareness of pain in this population, as well as a need for improved methodologies to identify it.

This article summarizes a previously published study [1]. Pre-morbid scores on the Benton Visual Retention Test (BVRT) and Wechsler Adult Intelligence Scale –vocabulary (WAIS-voc) were examined to determine whether long-term deficits in these tests could predict the development of AD decades later. Participants were 1425 volunteers from the Baltimore Longitudinal Study of Aging (BLSA) aged 60 or older. The relative risk of developing AD associated with BVRT and WAIS-voc scores were estimated for different time periods up to 20 years before diagnosis. More errors on the BVRT were associated with an increased risk of AD up to 15 years later, while WAIS-voc scores were not associated with the risk of AD in any time period. Poor visual memory performance may represent an early expression of AD years before diagnosis. This result suggests the need to continue to revise our views on the natural history of AD and the possibility of an increased window of opportunity for prevention.

Audiological function is impaired in people with dementia and poor hearing is known to exaggerate the effects of cognitive deficits. We assessed the effects of increasing auditory acuity by providing hearing aids to subjects with dementia who have mild hearing loss. Subjects were screened for hearing impairment and fitted with a hearing aid. Measures of cognition, psychiatric symptoms, activities of daily living, and burden on carers were made over 6 months. Hearing aid diaries were kept. Results: More than 10% of eligible subjects were excluded as removal of wax restored hearing. Subjects showed a decline in cognitive function, no change in behavioural or psychiatric symptoms over the study period. 42% subjects showed an improvement on an independently rated measure of change. The hearing aids were well accepted. Conclusions: All patients with hearing impairment require thorough examination. The presence of dementia should not preclude assessment for a hearing aid as they are well tolerated and reduce disability caused by hearing impairment. Hearing aids alone do not improve cognitive function or reduce BPSD. There is evidence that patients improved on global measures of change.

Sixty-one patients with pathologically confirmed fronto-temporal dementia (FTD) were studied over a ten-year period at one of two centres. Data were available on presenting features and on time of symptom onset, diagnosis, institutionalization and death. The clinical groupings were frontal variant (fvFTD), semantic dementia, progressive non-fluent aphasia , motor neuron disease (FTD-MND) and corticobasal degeneration. Cases were classified pathologically as tau-positive or tau-negative. The median survival times from symptom onset and from diagnosis were 6±1.1 years (95% confidence intervals) and 3±0.4 years respectively. Survival across subgroups was equivalent except for the FTD-MND group, which had significantly shorter survival. Cases with tau-positive pathology had an older age of onset and a significantly better prognosis – median survival of 9.0±0.9 years versus 5.0±1.1 years. FTD is a malignant disorder with limited life expectancy: survival is shortest FTD-MND but is longer with tau-positive pathology.

Abstract: This study evaluated the efficacy of a psycho-educative group program for informal caregivers of demented persons. A total of 158 primary caregivers were randomized to the study (n=79) and control (n=79) groups in 12 successive waves. Subjects randomized to the control group were referred to the traditional support groups. Subjects in the study group had 15 two-hour weekly sessions focusing on stress appraisal and coping. All subjects were blindly assessed before the randomization and after 16 weeks on the frequency and reactions to behavioral problems (primary outcome), burden, psychological distress, anxiety, perceived social support, and personal efficacy. Results show that study subjects presented a 14% decrease in their reactions to the behavioral problems of the care-receivers as opposed to a 5% decrease in the control group (p=0.04). The frequency of behavior problems also decreased (p=0.06), as did the cross-product frequency/reaction (p=0.02). No significant effect appears on the secondary outcome variables.

Scientific Committee :

Prof. F. Böhmer (Austria – co-Chair), Dr T. Frûhwalld (Austria), Prof. I. Füsgen (Germany), Dr F. Hansen (Denmark), Prof. D. O’Neill (Ireland),Prof. P. Pietschmann (Austria), Prof. M. Rainfray (France) Prof. A. Sinclair ( UK – co-Chair), Prof. E. Topinkova (Czech Republic)

The program of the 3nd Congress can be sent by e-mail following request sent by e-mail to :

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The Poster session will be organized in the following categories.

/_/ Neurological and behavioral Science (e.g. Alzheimer disease, Mental Health)

/_/ Research on Geriatrics Syndromes (e.g Incontinence)

/_/ Research on Organ Specific and systemic Disorders (e.g. Cardiovascular disease, Osteoarthritis, Diabetes, including Physiology, Cellular & Molecular biology)

/_/ Health Services Research (e.g Geriatric Assessment, Health Policy)

/_/ Ethics

/_/ Aging Research

/_/ Geriatric pharmacology

/_/ Nutritional Disorders including fraitly

/_/ Epidemiology (e.g. Risk Assessment, Disease Prevalence)

/_/ Rehabilitation

/_/ Case Studies from Clinical Practice

/_/ Geriatric Education

/_/ Models of Geraitrc Care

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First Announcement

Laboratory of Nutraceuticals and Functional Foods Science, Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, 4-5-7, Konan, Minato-ku, Tokyo, 108-8477

REGISTRATION FEE: 28,000 Japanese Yens, (Including 80$ of annual subscription fee to the Journal of Nutrition, Health, & Aging (JNHA) from publisher, Serdi), Visa and Master Card accepted

For more information concerning the program of the Symposium on

Nutrition and Alzheimer’s Disease, Tokyo, October 1-2, 2004

Send this request to I.A.N.A., c/o SERDI, academy@serdi-fr.com

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