Poster Abstracts Wednesday, November 9, 2005 $299

0780 Differentiation of mild cognitive impairment and Alzheimer's disease with Bulgarian version of CERAD

Raycbeva, NI, Mehrabian, S, Traykov, L. University Hospital Alexandrovska

Background: Recent research has identified a transitional state between the cognitive changes of normal aging and Alzheimer's disease (AD), known as mild cognitive impairment (MCI). Consequently this condition has been recognized as suitable for possible therapeutic intervention. Therefore, there is a critical need for effective neuro- psychological tools that enable us to identify MCI patients and to follow them longitudinally to better evaluate their natural history or their therapy response. Objective: To investigate the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) test performances in patients suffering from MCI and mild AD. Moreover, we wanted to determine tire sensitivity to MCI and mild AD, as well as the specificity of different CERAD subtests in our study groups. Methods: We examined 50 MCI patients, 50 mild AD patients and 30 normal controls (NC) with tire Bulgarian version of CERAD battery. Results: AD patients had a sigtffficantly worse scores on all CERAD subtests (p < 0.05 to 0.01) except Constructional praxis, titan NC. Tire findings that better discriminate MCI from NC were the Word list learning test (learning scores, delayed recall and recognition) (p < 0.01) and delayed nonverbal recall (p < 0.05). Conclusion: The study shows that the Bulgarian CERAD test battery is a reliable screening method for MCI and mild AD. Despite tire comparable global cogtfftive functioning, the findings reveal that delayed verbal and nonverbal recall better discriminate MCI from NC. Further investigation to define the best predictors of cognitive decline to dementia in patients

0781 Delusions And Hallucinations In Dementia With Lewy Bodies: Worsening With Memantine

"9 ] Ridha, BH ~, Josephs, KAy, Rossor, MN . 1Dementia Research Centre, Institute of Neurology, London, UK." 2Mayo Clinic and Mayo Foundation, Rochester, MN, USA

Background: Memantine is a non-competitive N M D A receptor antagonist, of modest benefit in Alzheimer disease (AD) and Parkinson disease (PD). Dementia with Lewy bodies (DLB) shares common pathological features with PD, and common pharmacological features with AD (positive response to cholinesterase inlffbitors). Tire efficacy of memantine has not been formally assessed in DLB, but could have a role as proposed in AD and PD. Methods: We report the development of worsening psychosis in patients with probable DLB following memantine therapy. Results: Three patients with progressive cognitive decline and parkinsonism were diagnosed with probable DLB. They were all having occasional visual hallucinations when prescribed memantine at age 67, 72 and 78 years, respectively. Patient-1 immediately developed florid paranoid delusions (thinking Iris cook was trying to poison him). Patient-2 developed worsening anxiety and agitation, florid visual hallucinations (seeing a thief at home), and difficulty recognizing his wife (Capgras phenomena) within two weeks of treatment. Patient-3 developed florid visual hallucinations within two weeks of treatment. In all three patients, tire psychosis subsided immediately once memantnie was discontinued. Conclusion: A causal relationship between memantnie and worsening delusions and hallucinations is suggested by their strong temporal association. DLB patients may be more prone to develop psychosis with N M D A receptor antagonists titan AD patients due to their greater susceptibility to dopanffne/ghitamate imbalance. Caution is required when prescribing memantine to DLB patients.

0782 Prevalence of dementia in a metropolitan dry of India through random sample survey

Roy, T, Das, S, Biswas, A, Banerjee, T, Dutt, A, Bose, P, Das, S, Raut, D, Choudhuri, A. Bangur Institute Of Neurology National Neuroseienee Centre All India Institute of Hygeine and Public Health Indian Statistical Institute

Background: Our objective was to deten-nine the prevalence of denrentia in the city of Kolkata through random sanrple survey. Methods: We stratified tire metropolitan area of the city into 7 areas according to geographical locations and shim/non-slum areas. Using table of random numbers a total 166 blocks were selected. Within each block 50% of households were randomly chosen. In this two-stage survey, the field workers screened all persons above 50 years of age for denrentia, using a pre-desigtred questiomtaire. Subsequently a neuro- psychologist applied a structured cognitive battery to every screened positive case and compared their test scores with those of age and education matched healthy controls. Finally, a neurologist did careful neurological examination and reviewed their investigational results. Results: We screened 9602 persons (men 5049, women 4553) above the age of 50 years. A total 46 persons (men 21, women 25) were found to have dementia (fulfilling DSM IV criteria) with a crude prevalence rate of 479 per 100,000 (nren 415, women 549). Above the age of 65 years the crude prevalence rate was 1022 per 100,000 (men 917, women 1131). Of the dementia subtype, Alzheimer disease was 45%, vascular 26%, and others 29%. Conclusion: Compared to developed countries, tire prevalence of denrentia was much lower in our study despite a low literacy rate. In developing countries like hrdia illiterate people are engaged in tasks that demand continuous cognitive exercise to earn their livelihood. This raises the question whether a formal academic achievement is important for protection against dementia.

0783 Cerebrospinal Fluid Levels of Phosphotau in Patients with Alzheimer's Disease

Sakka, p1, Nikolaou, C 1, Lymperopoulou, 01, Efthyiiffou, A 1. 1Memory Clinic HYGEIA Hospital, Athens, Greece

Background: Alzheimer's Disease (AD) is pathologically characterized by the accumulation of amyloid plaques and tau-associated neuro- fibrillary tangles (NFTs) in the cerebral tissue.

NFTs are intraneuronal structures composed by paired helical filaments of hyperphosphorylated form of tau protein. The search for antemortem biomarkers is important for an acurate and early diagnosis of AD. Method: Using ELISAs for tau phosphorylated at Thr 181, concentra- tions of phosphotau were determined in the cerebrospinal fluid (CSF) of 41 patients with AD and 17 controls. Results: CSF phosphotau levels were increased in AD patients compared to controls (p < 0.001). There was no association of CSF phosphotau levels with severity of dementia, age of onset, duration of the disease or scores in the Mini - Mental State Examination. Contusion: CSF levels o f phosphotau analysis is a good biomarker for AD but further studies are needed to validate the diagnostic potential of tiffs procedure.

0784 Cognitive functioning in Nigerian long term heavy cannabis users

Salawu, F ~, Bazza, B ~, Waldl, A 3, Kirawa, f~, Rabebe, I ~, Pindar, S 3, Bwala, S 4, Azare, G ~. 1Federal Medical Centre, Nguru, Yobe State, Nigeria.." 2Federal Medical Centre, Yo[a.Adamawa State, Nigeria.." 3Federal Neuropsychiatric Hospital, Maiduguri, Nigeria," 4University of Maiduguri, Maiduguri, 5 Nigeria," University of Mai~uguri Teaching Hospital, Maiduguri, Nigeria