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P1‐044: Cross‐sectional validation of a new instrument for the measurement of treatment response: The Clinical Meaningfulness in Alzheimer Disease Treatment (CLIMAT) scale
Author(s) -
Jacova Claudia,
Schulzer Michael,
Money Jonathan,
Deria Sirad,
Kupferschmidt Anthony L.,
Beattie B. Lynn,
Feldman Howard H.
Publication year - 2009
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2009.04.047
Subject(s) - clinical dementia rating , quality of life (healthcare) , dementia , psychology , rating scale , cross sectional study , correlation , severity of illness , clinical psychology , medicine , disease , psychiatry , developmental psychology , geometry , mathematics , pathology , psychotherapist
was unable to follow letters of Karaoke although his visual acuity was good. He memorized songs. At 68-year-old, he was unable to climb mountains. He showed difficulty climbing stairs. When he drove his car backward, he crashed his car (he had never done such a thing). He became easy to fall. At 69-year-old, he showed mild walking difficulty and used wheelchair. At 71-year-old, he admitted to the nursing home. Because of the chance of walking was less, he became unable to walk. He gradually became less lively. At 74-year-old, he was absent-minded, slept daytime and he showed appetite loss. Neurological examaination showed dementia, supranuclear gaze palsy, pseudobulbar palsy, neck dorsiflexion, plastic rigidity and akinesia. MRI showed midbrain atrophy like hummingbird. MIBG myocardial scintigraphy showed normal findings: early H/M ratio1⁄42.90. L-DOPA did not improve his clinical symptoms. Neuropathological examination: brain weight 1,040g. Macroscopic findings: frontotemporal atrophy of cerebrum, depigmentations of substantia nigra and locus ceruleus. Microscopic findings: 1) AD pathology plaque: Braak C, tangle: Braak VI, granulovacuolar degenerations and a Hirano body. 2) Lewy body pathology: DLB limbic form, pigmented neurons in substantia nigra were relatively preserved. Lewy bodies were in substantiae nigrae. 3) Mild PSP pathology: grumose degeneration of dentate nucleus, neurofibrillary tangles at midbrain tegmentum and loci cerulei. Conclusions: We think it important that there is parkinsonism variant of AD with DLB, who may show midbrain atrophy, negative result MIBG cardiac scintigraphy and PSP like clinical features: dementia, supranuclear gaze palsy, neck dorsiflexion and l-DOPA nonresponsive parkinsonism.