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It is interesting that more severe AD pathology is associated with enhanced kif21b expression.
The 19-item version (ADCS-ADL19), covering mainly basic ADL, is used for the assessment of patients with more severe AD, while the 23-item version (ADCS-ADL23) includes more complex ADL for the assessment of mild to moderate AD, such as reading books or magazines, pastime activities, or household chores.
Furthermore, retrospective, pooled analysis of data from three randomized, placebo-controlled, double-blind, six-month clinical trials of patients with probable AD (MMSE score of 10 to 26) provided evidence for a cognitive benefit of rivastigmine treatment in the subset of patients with more severe AD (MMSE score of 10 to 12) [ 7].
When focusing on the glutamatergic component in this quantitative systems pharmacology model, the data indeed suggest that the clinical observation of differential effects in early stage versus more severe AD can only be reproduced when the effect is limited to a very small range of NMDA receptor inhibition.
Though some with more severe AD(H D might need it for life, medication might only teach most people with milder AD(H D to substitute pills for discipline.
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Thus, one may postulate that the subtle effect of these 'secondary' molecules might be heterologous seeding of Aβ, which could represent one of the trigger for more severe Aβ pathology during AD.
26 Several investigations indicate that cerebrovascular atherosclerosis, especially atherosclerosis of the Willis circle, is more severe in AD and correlates with the severity of AD pathology, 27, 28 implicating that atherosclerosis-induced cerebrovascular hypoperfusion correlates with AD pathology and the clinical manifestations of AD.
The changes in Aβ transporter expression at the BBB between aging and AD are in the same direction, though more severe in AD.
Changes from baseline to week 24 in the nine SIB domain scores were analyzed in the intent-to-treat (ITT) population (baseline MMSE 0 to 20), in patients with more severe baseline AD (MMSE 0 to 16), and in severity strata based on baseline MMSE scores (0 to 5, 6 to 10, 11 to 15, 16 to 20).
When comparing AD with pathological aging, white matter rarefaction and cerebral amyloid angiopathy were found to be more severe in AD [ 3].
Cognitive deficits in these two forms of dementia are consistently found to be more severe in AD patients, while the specificity of deficits in vascular dementia is less clear and more difficult to be replicated in diverse studies.
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