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Pupillary cholinergic hypersensitivity predicts cognitive decline in community dwelling elders.

Abstract
Previous research demonstrated that it is possible to distinguish patients with probable Alzheimer's disease from age-matched controls based on an exaggerated pupil dilation response to dilute tropicamide. The research reported here employed a prospective longitudinal design to follow over time (2-4 years) a sample of 55 community dwelling elders with and without an exaggerated pupil response using the pupil assay and a comprehensive battery of neuropsychological tests sensitive to pre-clinical AD. Discrete time survival modeling was used to assess the ability of the assay to predict a pattern of cognitive decline consistent with early AD. Analysis showed that there is an increased risk (odds ratio of 3) with a hypersensitive pupil response (>/=13% increase in pupil diameter over baseline diameter) for developing significant cognitive impairment in areas of memory attention and language in a pattern, consistent with pre-clinical Alzheimer's disease. When controlling for ApoE allele type the odds ratio for pupil response as a risk factor increased to 4. The analysis also found that an exaggerated pupil response was a significant (p=.02) predictor of cognitive decline. This analysis of longitudinal data has shown that over time an exaggerated response on the pupil assay is a significant independent risk factor for developing pre-clinical Alzheimer's disease. The risk for developing pre-clinical Alzheimer's disease is increased four-fold.
AuthorsLeonard F M Scinto
JournalNeurobiology of aging (Neurobiol Aging) Vol. 29 Issue 2 Pg. 222-30 (Feb 2008) ISSN: 1558-1497 [Electronic] United States
PMID17118493 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Acetylcholine
Topics
  • Acetylcholine (pharmacology)
  • Aged
  • Aged, 80 and over
  • Aging (physiology)
  • Cognition Disorders (diagnosis)
  • Female
  • Humans
  • Hypersensitivity (physiopathology)
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Predictive Value of Tests
  • Reflex, Pupillary (drug effects, physiology)
  • Residence Characteristics

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