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"Agronin, Marc E"
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The dementia caregiver
Becoming a caregiver for someone with Alzheimer s disease or another neurocognitive disorder can be an unexpected, undesirable, underappreciated, and yet noble role. It is heartbreaking to watch someone lose the very cognitive capacities that once helped to define them as a person. But because of the nature of these disorders, the only way to become an effective caregiver and cope with the role's many daily challenges is to become well-informed about the disease. With the right information, resources, and tips on caregiving and working with professionals, you can become your own expert at both caring for your charge and taking care of yourself. In these pages, Marc Agronin guides readers through a better understanding of the changes their loved one may be going through, and helps them tap into the various resources available to them as they embark on an uncertain caregiving journey. Insisting that a caregiver also maintain his or her own health and well being, Agronin guides caregivers in their efforts to provide care, but to also look to themselves as recipients of care from themselves and others.
eBook
Performance of 18Fflutemetamol amyloid imaging against the neuritic plaque component of CERAD and the current (2012) NIA-AA recommendations for the neuropathologic diagnosis of Alzheimer's disease
Performance of the amyloid tracer [18F]flutemetamol was evaluated against three pathology standard of truth (SoT) measures including neuritic plaques (CERAD “original” and “modified” and the amyloid component of the 2012 NIA-AA guidelines).
After [18F]flutemetamol imaging, 106 end-of-life patients who died underwent postmortem brain examination for amyloid plaque load. Blinded positron emission tomography scan interpretations by five independent electronically trained readers were compared with pathology measures.
By SoT, sensitivity and specificity of majority image interpretations were, respectively, 91.9% and 87.5% with “original CERAD,” 90.8% and 90.0% with “modified CERAD,” and 85.7% and 100% with the 2012 NIA-AA criteria.
The high accuracy of either CERAD criteria suggests that [18F]flutemetamol predominantly reflects neuritic amyloid plaque density. However, the use of CERAD criteria as the SoT can result in some false-positive results because of the presence of diffuse plaques, which are accounted for when the positron emission tomography read is compared with the 2012 NIA-AA criteria.
•Determination of the accuracy of [18F]flutemetamol image read against Aβ at autopsy.•High sensitivity and specificity to 3 neuropathologic criteria as Standards of Truth.•Images are 100% specific when the SoT reflects both neuritic and diffuse plaques.•This study has the largest autopsy validation cohort for Aβ PET tracers to date.
Journal Article
Interventions to Enhance Empathy and Person-Centered Care for Individuals With Dementia: A Systematic Review
Empathy, or the ability to imagine what someone else may be feeling or thinking, is a crucial component of meaningful care provision, including person-centered care (PCC), and has been shown to enhance care provider and patient well-being. The purpose of the current review was to examine the impact of interventions focused on improving the ability of health care providers or students to experience and/or communicate with empathy. Of 1,427 publications reviewed, 18 articles met inclusion criteria. All studies incorporated empathy or empathic communication competencies in their training or intended variables of change. PCC concepts were used in guiding the development of most interventions. Some interventions significantly improved participant empathy, attitudes toward patients with dementia, and certain verbal and nonverbal communication skills. Current study reports on improved positive interpersonal communication skills by nursing assistants are promising. Future study to improve therapeutic communication and delivery of dementia care with empathy using enhanced study design and measurement are needed. [ Research in Gerontological Nursing, 13 (3), 158–168.]
Journal Article
Personality Disorders in Late Life: Understanding and Overcoming the Gap in Research
A review of the literature on personality disorders (PD) in late life reveals fewer research papers than those found for PD in younger adults and for other major late-life psychiatric diagnoses. The authors suggest that this gap is largely due to the difficult and inconsistent diagnostic process for late-life PDs. Diagnosis is complicated by the frequent unavailability and/or unreliability of longitudinal data, lack of age-adjusted diagnostic instruments, and failure of the current Axis II nosology to account for age-related issues, including changes in social functioning, and the effects of comorbid illness and cognitive impairment. They propose that the development of a geriatric subclassification for PD, along with improved clinical documentation of personality and data from dimensional instruments for both normal and pathologic personalities, would provide a more reliable, valid, and geriatric-friendly diagnostic process.
Journal Article
Lipidomic signatures reveal biomarkers of mild cognitive impairment
Mild cognitive impairment (MCI) is an early stage in the progression toward dementia. Lipids are central to neurodegeneration, yet the biomarker potential of lipidomics from saliva, plasma, and feces remains underexplored. As part of the
Microbiome in Aging Gut and Brain
(MiaGB) consortium, saliva, plasma, and fecal samples were collected from older adults with MCI and healthy controls. Samples were analyzed by high-performance liquid chromatography coupled with high-resolution mass spectrometry (LC/MS), to profile lipidomic alterations and identify candidate biomarkers. Lipidomic profiling annotated over 200 molecular species spanning five major lipid classes. Compared with controls, MCI patients exhibited increased oxidized triacylglycerols (oxTGs) in saliva, reduced cholesteryl linoleate (CE 18:2) in plasma, and decreased fatty acid esters of hydroxy fatty acids (FAHFAs) in feces. Receiver operating characteristic (ROC) analysis identified α-linolenic acid (FA 18:3), docosapentaenoic acid (FA 22:5), and CE 18:2 as discriminatory metabolites with notable diagnostic performance. Moreover, elevated fecal triacylglycerols containing medium-chain fatty acids (TG-MCFAs) were observed in MCI, suggesting impaired lipid absorption or altered metabolism. This multi-sample lipidomics strategy highlights TG-MCFAs as fecal biomarkers for MCI detection, supporting further mechanistic and longitudinal validation.
Journal Article