Relationships between cognitive functions, gait and balance in
patients with Alzheimer
V. Alekna, R. Leisyte, M. Tamulaitiene, A. Juocevicius.
Medicine of Vilnius University, Vilnius, Lithuania
As gait and balance disturbance is common in patients
s disease (AD), the aim of study was to investigate
relationships between cognitive functions, gait and balance.
Cross-sectional study was performed including patients
with AD and control group, aged >65 years. Exclusion criteria were
other causes of mobility disorders and severe cognitive impairment.
Mini-Mental State Examination (MMSE) was used to examine the
cognitive functions. The gait was assessed by number of steps per
minute, dual step length, step length, step width and calculated
dynamic gait index. Balancewas analyzed by Static balance and Tinetti
In total, 95 subjects were involved: 42 patients with AD (mean
age 79.45 ± 6.2; 78.6% female) and 53 controls (mean age 76.96 ± 6.99;
67.9% female). It was found that the gait parameters were lower
(p < 0.001) in patients with AD compared to controls. Moderate
correlation was found between MMSE and dual step length (r = 0.45;
p = 0.003), step length (r = 0.462; p = 0.002), step width (r =
p = 0.025), dynamic gait index (r = 0.593; p < 0.001), and the Tinetti
test score (r = 0.521, p < 0.001). Dynamic gait index was strongly
associated with Tinetti test score (r = 0.785; p < 0.001). Static balance
moderately correlated with the dual step length (r = 0.419; p = 0.006),
step length (r = 0.422; p = 0.005) and dynamic gait index (r = 0.547;
p < 0.001).
In people with Alzheimer
s disease, the moderate
correlation was found between cognitive impairment and dynamic
gait index and the Tinetti test score. Dynamic gait index was strongly
associated with Tinetti test score, and static balance moderately
correlated with the dual step length.
Rapidly progressive dementia; a case of corticobasal degeneration
with atypical presentation
B. Alvira Rasal, E. Martín de Francisco, García Gomez.
Woman of 72 years old with history of hypertension and atrial
fibrillation. At baseline she needed partial help for bathing and
dressing, walked without aids and was double continent. Last year, she
began symptoms of impaired recent memory, disorientation, anomy,
praxias and impaired executive function. Blood tests were normal
and cranial CT only showed periventricular leukoencephalopathy.
We started Rivastigmine. After four months she was dependent for all
basic activities of daily living, had impoverished language and gait
disturbance with falls syndrome. Cognitive performance in neuro-
psychological tests declined dramatically. Cholinesterase inhibitor
was stopped and we prescribed Memantine. No other studies were
developed because of family decision. Two months later she was
admitted to hospital with fever, urinary tract infection and pressure
ulcers. By this time she also suffered from mutism, fluctuating level
of consciousness and axial stiffness, no involuntary movements. In
spite of broad spectrum antibiotic therapy based on cultures there was
no response, remaining fever of unknown origin and hypoactive
delirium. Cranial MRI showed multiple hyperintense lesions on both
hemispheres and pons, also corticosubcortical diffuse atrophy.
EEG had slowed brain activity in fronto-temporal regions and
lumbar puncture result without cells, with normal levels of glucose
and proteins.14-3-3 protein was negative. Echocardiogram wasn
finally realized because of death. Necropsy was performed reporting
Corticobasal degeneration. Our patient developed and atypical pre-
sentation of this entity, since CBD is a rare disease characterized by an
asymmetric progressive parkinsonism with later impared memory
(recently being discussed). The average life spectancy is 8 years since
The association of hippocampal subfield volumes with episodic
memory and general cognitive functioning in mild cognitive
impairment and early Alzheimer
, H.L. Koek
, K. Blom
, L.E.M. Wisse
, G.J. Biessels
Internal Medicine, UMC Utrecht,
Julius Centre, UMC Utrecht,
Neurology, UMC Utrecht, The
Atrophy of the hippocampus is associated with
cognitive functioning in patients with Mild Cognitive Impairment
(MCI) and Alzheimer
s disease (AD). Due to the recent development
of ultra-high field MRI, new possibilities have emerged to study
subfields of the hippocampus. We aimed to examine the cross-
sectional association of subfields of the hippocampus with episodic
memory and Mini-Mental State Examination (MMSE) score in patients
with MCI or early AD.
Via memory clinics of a university and peripheral hospital
we recruited 25 patients, with a mean age of 73 years (SD = 7.6)
diagnosed with MCI or AD. Inclusion criteria were an MMSE score >20
and Clinical Dementia Rating (CDR) scale of 0.5 or 1.0. Hippocampal
subfield volumes were manually delineated on T2-weighted images at
7 tesla MRI with a slice thickness of 0.7 mm. Volumes were converted
in z-scores. Entorhinal cortex, subiculum, cornu ammonis (CA)1,2,3,
CA4+dentate gyrus, and tail subfields were measured. Linear regres-
sion analyses adjusted for age, sex and intracranial volume were used
to estimate the associations of subfield volumes with scores on the
15-word learning test and MMSE.
Hippocampal subfield volumes were not significantly asso-
ciated with episodic memory. Larger volume of the entorhinal cortex
was significantly associated with better MMSE score (b = 1.60; 95%CI
2.65), as was the subiculum (b = 1.34; 95%CI 0.18
2.50) and CA1
(b = 1.79; 95%CI 0.66
2.90), while the other subfields were not.
In MCI and early AD, volumes of the entorhinal cortex,
subiculum, and CA1 are significantly associated with general cognitive
functioning, but not with episodic memory performance.
The effect of D-serine administration on cognition and mood in
, L. Scoriels
, C. Madeira
, C. Vargas-Lopes
, P. Marques
, A. Manhães
, H. Teixeira-Leite
, R. Panizzutti
Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil;
of Cambridge, Cambridge, United Kingdom;
UERJ Universidade do Estado
do Rio de Janeiro,
HAS Hospital Adventista Silvestre, Rio de Janeiro, Brazil
D-serine is an endogenous co-agonist of the N-Methyl D-
Aspartate Receptor (NMDAR) that plays a crucial role in cognition
including learning processes and memory. Decreased D-serine levels
have been associated with age-related decline in mechanisms
of learning and memory in animal studies. Here, we asked whether
D-serine administration in older adults improves cognition.
Fifty healthy older adults received D-serine and placebo in a
randomized, double blind, placebo-controlled, crossover design study.
We studied the effect of D-serine administration on the performance
of cognitive tests and an analogue mood scale. We also collected blood
samples tomeasureD-serine, L-serine, glutamate and glutamine levels.
D-serine administration improved performance in the Groton
Maze learning test of spatial memory and learning and problem
solving (F(3, 38) = 4.74, p = 0.03). Subjects that achieved higher
increases in plasma D-serine levels after administration improved
more in test performance (r2 =
0.19 p = 0.009). D-serine administra-
tion was not associated with any significant changes in the other
cognitive tests or in the mood of older adults (p > 0.05).
D-serine administration may be a strategy to improve
spatial memory, learning and problem solving in healthy older adults.
Future studies should evaluate the impact of long-term D-serine
administration on cognition in older adults.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29