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5 results

  • Chapter 32 - Corticobasal Degeneration and Corticobasal Syndrome

  • from Section 2: - Hypokinetic Movement Disorders
  • Edited by Erik Ch. Wolters, Universität Zürich, Christian R. Baumann, Universität Zürich
  • Book:
    International Compendium of Movement Disorders
    Published online:
    07 January 2025
    Print publication:
    06 February 2025, pp 390-402

  • Summary

    Corticobasal degeneration (CBD) is a neurodegenerative disease characterized by abnormal aggregation of hyperphosphorylated 4R-tau in cortical and subcortical areas of the brain. It is associated with various clinical phenotypes, such as the characteristic clinical phenotype corticobasal syndrome (CBS), which manifests with asymmetric akinetic–rigid, poorly levodopa-responsive parkinsonism, and cerebral cortical dysfunction. Other associated phenotypes are progressive supranuclear palsy (PSP) syndrome, frontotemporal dementia, Alzheimer’s disease (AD)-like dementia, and non-fluent/agrammatic variant of primary progressive aphasia. Precise use of terminology is critical for a common understanding in discussions of clinical phenotype, attempted clinical diagnosis of CBD with its many presenting phenotypes, and accurate pathologic diagnosis (which can only be made neuropathologically). Diagnosis of probable or possible CBS and the other CBD-associated syndromes is based on the presence of certain clinical features. Pathologic and neuroimaging findings and currently available biological markers are discussed. Treatment for CBD and CBS is symptomatic and supportive at present.

  • The impact of frailty and cognitive impairment on quality of life: employment and social context matter

  • Judith Godin, Joshua J. Armstrong, Lindsay Wallace, Kenneth Rockwood, Melissa K. Andrew
  • Journal:
    International Psychogeriatrics / Volume 31 / Issue 6 / June 2019
    Published online by Cambridge University Press:
    13 November 2018, pp. 789-797
  • Background:

    How cognitive impairment and frailty combine to impact on older adults’ Quality of Life (QoL) is little studied, but their inter-relationships are important given how often they co-occur. We sought to examine how frailty and cognitive impairment, as well as changes in frailty and cognition, are associated with QoL and how these relationships differ based on employment status and social circumstances.

    Methods:

    Using the Survey of Health, Ageing, and Retirement in Europe data, we employed moderated regression, followed by simple slopes analysis, to examine how the relationships between levels of health (i.e., of frailty and cognition) and QoL varied as a function of sex, age, education, social vulnerability, and employment status. We used the same analysis to test whether the relationships between changes in health (over two years) and QoL varied based on these same moderators.

    Results:

    Worse frailty (b = −1.61, p < .001) and cognitive impairment (b = −0.08, p < .05) were each associated with lower QoL. Increase in frailty (b = −2.17, p < .001) and cognitive impairment (b = −0.25, p < .001) were associated with lower QoL. The strength of these relationships varied depending on interactions with age, sex, education, social vulnerability, and employment status. Higher social vulnerability was consistently associated with lower QoL in analyses examining both static health (b = −3.16, p < .001) and change in health (b = −0.66, p < .001).

    Conclusions:

    Many predictors of QoL are modifiable, providing potential targets to improve older adults’ QoL. Even so, the relationships between health, cognition, and social circumstances that shape QoL in older adults are complex, highlighting the importance for individualized interventions.