The role of familism in stress and coping processes among African American and White dementia caregivers: Effects on mental and physical health.

Objective: To explore how familism, burden, and coping styles mediate the relationships between ethnicity and the mental and physical health of caregivers. Design: A probability sample of 65 White and 95 African Americans respondents caring for an older family member with dementia was used to test hypotheses from a sociocultural stress and coping model using path analysis. Main outcome measures: Measures of caregivers' health included subjective health, self-reported diseases, blood pressure, and heart rate. Mental health measures included self-reported depression and psychological symptoms. Results: Contrary to the hypothesis, familism had an adverse effect on outcomes and was related to low education levels rather than to African American ethnicity. A buffering effect of active coping between being African American and diastolic blood pressure was found even after controlling for levels of education. Conclusions: Findings supported a core stress and coping model in which more behavior problems of care recipients were associated with poorer mental health of caregivers via greater burden and more use of avoidant coping. Results also demonstrate that this core model can be extended to physical health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self‐Therapeutic Nanoparticle That Alters Tau Protein and Ameliorates Tauopathy Toward a Functional Nanomedicine to Tackle Alzheimer's

Tauopathy is a complex disorder associated at the junction of several other pathologies. Intrinsically disordered tau protein remains therapeutically challenging due to its undruggable nature and is a possible reason for monumental failure of several tau‐based therapies. Herein, nanogold remodeled tau is reported as a pseudo‐nanochaperon and shows therapeutic benefit by passive targeting in transgenic tau P301L mutant mice. Treatment with nanogold polyethylene glycol (Au‐PEG) conjugate moderately improves the learning ability of the tau P301L mice that corroborates with diminished phosphorylated tau burden. Circulating total tau level that acts in a prion fashion is significantly reduced upon Au‐PEG treatment. Similarly, a high level of tau is found in macaque monkey serum and Au‐PEG inhibits amyloidosis of Alzheimer's patients and primate's serum samples ex vivo. Addtionally, brain MRI of an old aged macaque monkey shows the decrease of grey matter, which correlates with mutual loss of grey matter upon progressive dementia as reported. Au‐PEG tunes tau and other circulating pro‐dementia factors that are present in human AD serum, by remodeling the protein and repairing aberrant proteostasis. Alteration of proteotoxic tau function by nanogold as a kinetic stablizer holds translational potential to combat socially challenging dementia.     

The longitudinal ramifications of stroke caregiving: A systematic review.

Family members assume considerable care responsibilities for relatives suffering from stroke. Although a number of quantitative and qualitative studies examine the emotional and psychological ramifications of stroke caregiving, no recent review has considered the longitudinal implications of family stroke care. The goal of this systematic review was to determine whether duration of family care is a significant predictor of stroke caregiving outcomes and if stroke caregiving outcomes change over time. PsycINFO (1950 to 2009), MEDLINE (1966 to 2009), and CINAHL (1982 to 2009) databases were searched to identify relevant research articles. Reference lists of selected articles were also hand searched. Of 1,188 studies identified, 117 were selected for review based on eligibility criteria. Synthesized results found that duration of care did not emerge as a significant predictor of stroke caregiving outcomes in most cross-sectional quantitative studies. Caregiver stress, depression, and subjective health measures did not tend to demonstrate significant change in longitudinal quantitative studies (although some studies did indicate increases and/or decreases in well-being over time). Qualitative studies describe a more dynamic stroke caregiving process. The results of this review emphasize the need to apply more rigorous research approaches, appropriate theories, and mixed-method designs to advance the state-of-the-art. Such improvements will provide practitioners with stronger evidence to guide the development, targeting, and timing of clinical interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intraindividual variability in reaction time predicts cognitive outcomes 5 years later.

Objective: Building on results suggesting that intraindividual variability in reaction time (inconsistency) is highly sensitive to even subtle changes in cognitive ability, this study addressed the capacity of inconsistency to predict change in cognitive status (i.e., cognitive impairment, no dementia [CIND] classification) and attrition 5 years later. Method: Two hundred twelve community-dwelling older adults, initially aged 64–92 years, remained in the study after 5 years. Inconsistency was calculated from baseline reaction time performance. Participants were assigned to groups on the basis of their fluctuations in CIND classification over time. Logistic and Cox regressions were used. Results: Baseline inconsistency significantly distinguished among those who remained or transitioned into CIND over the 5 years and those who were consistently intact (e.g., stable intact vs. stable CIND, Wald (1) = 7.91, p     

Emotion regulation deficits in frontotemporal lobar degeneration and Alzheimer’s disease.

We examined instructed and spontaneous emotion regulation in patients with frontotemporal lobar degeneration (FTLD, N = 32), which presents with profound emotional and personality changes; patients with Alzheimer’s disease (AD, N = 17), which presents with profound memory impairment; and neurologically normal controls (N = 25). Participants were exposed to an aversive acoustic startle stimulus (115 dB) under 3 different conditions: (a) unwarned without instructions to down-regulate, (b) warned without instructions to down-regulate, and (c) warned with instructions to down-regulate. In the last 2 conditions, the warning took the form of a 20-s countdown. In all conditions, visible aspects of the startle response were assessed by measuring overall somatic activity and coding emotional facial expressions. FTLD patients, AD patients, and control participants showed similar patterns of down-regulation in somatic activity across the 3 startle trials. However, differences between the 3 groups emerged in the amount of emotional facial behavior expressed in the startle trials. There were no group differences in response in the unwarned condition, indicating that the startle response was intact in the patients. In the warned with instructions condition, both FTLD and AD patients were moderately impaired in down-regulatory ability compared with controls. In the warned without instructions condition, AD patients and normal controls spontaneously down-regulated their emotional responses, but FTLD patients did not. These findings illuminate specific problems that these patients have in the emotional realm. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dementia: Continuum or distinct entity?

The latent structure of dementia was examined in a group of 10,775 older adults with indicators derived from a neuropsychological test battery. The author conducted taxometric analysis of these data using mean above minus below a cut, maximum covariance, and latent mode factor analysis and found results more consistent with dementia as a dimensional (lying along a continuum) than categorical (representing a distinct entity) construct. A second study conducted with a group of 2,375 adults whose ages ranged from 21 to 64 years produced similar results. These findings denote that dementia, as measured by deficits in episodic memory, attention and concentration, executive function, and language, differs quantitatively rather than qualitatively from the cognitive status of adults without dementia. The implications of these results for classification, assessment, etiology, and prevention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The utility of Stroop task switching as a marker for early-stage Alzheimer's disease.

[Correction Notice: An erratum for this article was reported in Vol 25(4) of Psychology and Aging (see record 2010-22172-001). Author Janet M. Duchek’s name was misspelled as Janet M. Ducheck. The online version has been corrected.] Past studies have suggested attentional control tasks such as the Stroop task and the task-switching paradigm may be sensitive for the early detection of dementia of the Alzheimer's type (DAT). The authors of the current study combined these tasks to create a Stroop switching task. Performance was compared across young adults, older adults, and individuals diagnosed with very mild dementia. Results indicated that this task strongly discriminated individuals with healthy aging from those with early-stage DAT. In a logistic regression analysis, incongruent error rates from the Stroop switching task discriminated healthy aging from DAT better than any of the other 18 cognitive tasks given in a psychometric battery. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Correction to Hutchison, Balota, and Duchek (2010).

Reports an error in The utility of Stroop task switching as a marker for early-stage Alzheimer's disease by Keith A. Hutchison, David A. Balota and Janet M. Ducheck (Psychology and Aging, 2010[Sep], Vol 25[3], 545-559). Author Janet M. Duchek’s name was misspelled as Janet M. Ducheck. The online version has been corrected. (The following abstract of the original article appeared in record 2010-18944-003.) Past studies have suggested attentional control tasks such as the Stroop task and the task-switching paradigm may be sensitive for the early detection of dementia of the Alzheimer's type (DAT). The authors of the current study combined these tasks to create a Stroop switching task. Performance was compared across young adults, older adults, and individuals diagnosed with very mild dementia. Results indicated that this task strongly discriminated individuals with healthy aging from those with early-stage DAT. In a logistic regression analysis, incongruent error rates from the Stroop switching task discriminated healthy aging from DAT better than any of the other 18 cognitive tasks given in a psychometric battery. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mechanisms of TDP-43 Proteinopathy Onset and Propagation

TDP-43 is an RNA-binding protein that has been robustly linked to the pathogenesis of a number of neurodegenerative disorders, including amyotrophic lateral sclerosis and frontotemporal dementia. While mutations in the TARDBP gene that codes for the protein have been identified as causing disease in a small subset of patients, TDP-43 proteinopathy is present in the majority of cases regardless of mutation status. This raises key questions regarding the mechanisms by which TDP-43 proteinopathy arises and spreads throughout the central nervous system. Numerous studies have explored the role of a variety of cellular functions on the disease process, and nucleocytoplasmic transport, protein homeostasis, RNA interactions and cellular stress have all risen to the forefront as possible contributors to the initiation of TDP-43 pathogenesis. There is also a small but growing body of evidence suggesting that aggregation-prone TDP-43 can recruit physiological TDP-43, and be transmitted intercellularly, providing a mechanism whereby small-scale proteinopathy spreads from cell to cell, reflecting the spread of clinical symptoms observed in patients. This review will discuss the potential role of the aforementioned cellular functions in TDP-43 pathogenesis, and explore how aberrant pathology may spread, and result in a feed-forward cascade effect, leading to robust TDP-43 proteinopathy and disease.