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Hallucinations is a core characteristic symptom in Lewy Body Dementia (DLB) and Parkinson's Dementia (PDD). It may also appear at the late stages of Alzheimer's disease (AD). They are not easily managed, and they are associated with cognitive decline, earlier institutionalization, increased mortality, and increased caregivers' burden.This is a cross-over RCT. The participants were randomly assigned in 6 different groups of 10 patients each.60 dementia patients (different types and stages of dementia).The three non-pharmacological interventions used are: A) Validation therapy (VT) in a Psycho-educational program, B) Reminiscence therapy (RT) and C) Music therapy (MT). Each intervention lasted for 5 days and there was an interval of two days, as a wash-out period (all the interventions had a duration of 3 weeks).The measurements which were used at baseline were: MMSE, ACE-R, GDS, FRSDD and NPI questionnaire at baseline and after each intervention.The most effective combination for the reduction of the hallucinations is: VT/Psycho-educational program (p = 0.005), MT (p = 0.007) and RT (p = 0.022). The same combination applies for the caregivers' distress: VT/Psychoeducational program (p = 0.010) - MT (p = 0.023) - RT (p = 0.036).VT/Psycho-educational program followed by MT, followed by RT is an effective combination of non-pharmacological interventions that can reduce hallucinations in patients with dementia and caregivers' burden. Non-pharmacological interventions should be further examined as an effective alternative for the reduction of the hallucinations in dementia.

Background: Depression is accompanied by the early stages of Alzheimer’s disease (AD) and other forms of dementia. Depression can influence the daily functioning of the patients with dementia (PwD) and their cognitive abilities. Sometimes it is hard to diagnose because it may seem like apathy. The current pharmacological treatment can manage depressive symptoms, however the side effects of the drugs are severe. Methods: Sixty (60) PwD randomly assigned in six (6) different groups of 10 participants each. They received three non-pharmacological interventions: a) Reminiscence Therapy (RT), b) Body Exercise (BE) and c) Music Therapy (MT). The study is a cross-over randomized controlled trial including patients with different types of dementia and at different stages of dementia. The neuropsychological examination before the interventions included: MMSE, ACE-R, GDS, FRSSD and NPI Questionnaire (sub-questions only for depression). The interventions lasted for 5 days and there were 2 days off as a washout period. There was no drop-out rate. Results: The combination of MT (p=0.012)- BE (p=0.020)- RT (p=0.041) is the sequence of the interventions that can reduce depression. For the caregivers, we had the same combination with the best results as well: MT (p=0.002)- BE (p=0.006)- RT (p=0.012). Conclusions: There is a combination of non-pharmacological interventions that can reduce statistically significant the depression in patients with dementia (PwD) and their caregivers.

Background and Objectives: Dementia affects more than 55 million patients worldwide, with a significant societal, economic, and psychological impact. However, many patients with Alzheimer’s disease (AD) and other related dementias have limited access to effective and individualized treatment. Care provision for dementia is often unequal, fragmented, and inefficient. The COVID-19 pandemic accelerated telemedicine use, which holds promising potential for addressing this important gap. In this narrative review, we aim to analyze and discuss how telemedicine can improve the quality of healthcare for AD and related dementias in a structured manner, based on the seven dimensions of healthcare quality defined by the World Health Organization (WHO), 2018: effectiveness, safety, people-centeredness, timeliness, equitability, integrated care, and efficiency. Materials and Methods: MEDLINE and Scopus databases were searched for peer-reviewed articles investigating the role of telemedicine in the quality of care for patients with dementia. A narrative synthesis was based on the seven WHO dimensions. Results: Most studies indicate that telemedicine is a valuable tool for AD and related dementias: it can improve effectiveness (better access to specialized care, accurate diagnosis, evidence-based treatment, avoidance of preventable hospitalizations), timeliness (reduction of waiting times and unnecessary transportation), patient-centeredness (personalized care for needs and values), safety (appropriate treatment, reduction of infection risk),integrated care (interdisciplinary approach through several dementia-related services), efficiency (mainly cost-effectiveness) and equitability (overcoming geographical barriers, cultural diversities). However, digital illiteracy, legal and organizational issues, as well as limited awareness, are significant potential barriers. Conclusions: Telemedicine may significantly improve all aspects of the quality of care for patients with dementia. However, future longitudinal studies with control groups including participants of a wide educational level spectrum will aid in our deeper understanding of the real impact of telemedicine in quality care for this population.

OBJECTIVE: Primary progressive aphasia (PPA) is a neurodegenerative syndrome characterized by a selective loss of language functions. In the nonfluent/agrammatic variant (nfvPPA), speech is slow and hesitant. Utterances are shorter, less complex and contain grammatical errors. Single word production deficits in PPA have been extensively examined. However, connected speech analysis has only recently begun to be systematically studied. The aim of the present study was to investigate connected speech deficits in a Greek-speaking person with nfvPPA. MATERIAL - METHOD: Participant LJ is a 60-year-old right-handed man, with 6 years of formal education. At the time of the study, he had a FTLD-modified CDR score of 9 (MMSE=17/30). A narrative sample was collected using the “cookie theft” picture from BDAE and analyzed following the procedures described by Saffran et al. (1989) for quantitative production analysis (QPA). QPA summary measures, percentages of dysfluent variables and counts of errors were computed. LJ’s scores were compared to a healthy control group included in a study by Varkanitsa (2012). T-values were calculated using the Crawford and Howell’s method (Crawford and Garthwaite, 2012). RESULTS: Speech rate was 40.37 words per minute. Dysfluencies included silent pauses, filled pauses, false starts, sound distortions and repetitions (23%, 20%, 3%, 2% and 1% of total words produced). LJ produced less nouns (p

Alzheimer's disease (AD) is a progressive neurodegenerative disorder and the most common cause of dementia. Beta-amyloid (Aβ) deposition and neurofibrillary tangles (NFTs) of abnormal hyperphosphorylated tau protein are the pathological hallmarks of the disease, accompanied by other pathological processes such as microglia activation. Functional and molecular nuclear medicine imaging with single-photon emission computed tomography (SPECT) and positron emission tomography (PET) techniques provides valuable information about the underlying pathological processes, many years before the appearance of clinical symptoms. Nuclear neuroimaging in AD has made great progress in the past two decades and has extended beyond the traditional role of brain perfusion and glucose metabolism evaluation. Intense efforts in radiopharmaceuticals research have led to the development of various probes able to detect Aβ deposits, tau protein accumulation, microglia activation and neuroinflammation. As a result, SPECT and PET have proposed to serve as biomarkers in recently revised diagnostic clinical criteria for the early diagnosis of AD and the prediction of progression to AD in mild cognitive impairment (MCI) subjects. 32 9 583 593

OBJECTIVE: A rare variant in TREM2 (p.R47H, rs75932628) has been consistently reported to increase the risk for Alzheimer’s disease, while mixed evidence has been reported for association of the variant with other neurodegenerative diseases. Here, we investigated the frequency of the R47H variant in a diverse and well-characterized multicenter neurodegenerative disease cohort. METHODS: We examined the frequency of the R47H variant in a diverse neurodegenerative disease cohort, including a total of 3,058 patients clinically diagnosed with Alzheimer’s disease, frontotemporal dementia spectrum syndromes, mild cognitive impairment, progressive supranuclear palsy syndrome, corticobasal syndrome, or amyotrophic lateral sclerosis and 5,089 control subjects. RESULTS: We observed a significant association between the R47H variant and Alzheimer’s disease, while no association was observed with any other neurodegenerative disease included in this study. CONCLUSIONS: Our results support the consensus that the R47H variant is significantly associated with Alzheimer’s disease. However, we did not find evidence for association of the R47H variant with other neurodegenerative diseases.