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Brain & Heart Practical tips for AD and PD

the short-term effects of AD and PD-D. Together with this (v) not able to converse in Turkish, and (vi) having
profile, our additional clinical perspective and practical auditory problems (hearing loss that cannot be corrected
advice will be useful to doctors working in polyclinics, with a device). All participants were evaluated in the same
where the volume of patients seen in outpatient clinic under the supervision of the senior physician (A.O.).
departments is high and psychologists are not assigned. The patients regularly visited the clinic every 3 months.
This study adds to our understanding of the interplay Age, gender, formal education period, dominant hand,
between initial symptoms and neuropathological processes marital status, duration of the disease, thyroid dysfunction,
in both types of dementia, highlighting the critical need for vascular risk factors (diabetes mellitus, hypertension,
early diagnosis, timely intervention, and the development hyperlipidemia, coronary and artery disease), alcohol
of targeted treatment strategies. consumption and smoking habit, and family history of
dementia were evaluated. Neuropsychological assessments
2. Materials and methods were carried out by a neurology resident and the results
Data of individuals treated at the Dementia Outpatient were entered into a web-based database. During each visit,
Clinic of Mersin University Faculty of Medicine Neurology the physician prescribed medications and ordered the
Department between 2013 and 2023 were obtained patients for laboratory tests, if necessary. In addition, all
from the clinic’s electronic database (www.epikriz.com/ patients underwent neurological examinations. All data
dementiadataset), which contains the assessment results were recorded in the electronic database (www.epikriz.
of all dementia patients treated at the clinic, as well as com/dementiadataset) developed under the leadership of
their demographic data, initial complaints, concomitant the Turkey Alzheimer’s Study Group. The results of the
comorbidities, and all detailed neuropsychological test neuropsychological tests listed below were retrieved from
results, have been archived since 2007. To ensure patient the database and used in this study:
confidentiality, only member neurologists can access this (1) Cognition. Turkish-validated Mini-Mental State
dataset. The data of these patients were evaluated and Examination (MMSE) was used in the screening
recorded by the same neurologists involved in this study. test .
[18]
Since this study was retrospective, the neuropsychological (2) Numerical range. The forward and backward digit-
tests previously recorded in our dataset and detailed below span test was used in our dataset. We used the
were used in this study. All neuropsychological tests were following numerical sequences in our study: 28/51–
performed by means of face-to-face interviews with the 372/494–5169/6294–83529/61074– 285164/917203–
patients and their relatives and recorded. 4072916/3508172 .
[19]
(3) Calculation. In this study, we applied the following
2.1. Study population and data collection
calculation problems: 5 + 3; 15 + 7; 31 – 8; 5 × 13; and
This study was approved by the local Ethics Committee 39/3. The maximum score for correctly answering all
of Mersin University (MEU.2013-304, October 10 2013). problems was 5 .
[20]
Patients who went to the dementia outpatient clinic of (4) Abstraction. The participants were asked to interpret
Mersin University Department of Neurology between three different proverbs. Each correct answer was
2013 and 2023 were enrolled in the study. Sixty patients awarded with 1 point. The proverbs used in this test
diagnosed with AD, 60 patients diagnosed with PD-D, and were “to be worn to the bone” (Tur. lit. “getting black
120 healthy controls were included in the study. Informed water on my feet”), “he that lies down with dogs will
consent was obtained from all participants. The diagnosis rise up with fleas” (Tur. lit. “grapes grow darker by
[16]
of AD was made based on the revised NIA-AA criteria . facing each other”) and “as the twig is bent so is the
For the diagnosis of PD-D, Movement Disorder Society tree inclined” (Tur. lit. “the tree is only bent when
(MDS) clinical diagnostic criteria were used . The control ripe”). These were chosen from among the most used
[17]
group was composed of spouses and first-degree relatives Turkish proverbs .
[21]
of the patients, who were living in the same geographical (5) The Word Memory Test (WMT). This series of tests was
area and belonging to the same age range. No criteria were used to assess verbal learning and memory through three
determined for selecting healthy control subjects based on learning experiments, delayed recall, and recognition
gender and education level. subtests. In the learning experiments, the examiner
The exclusion criteria of this study are as follows: verbally presented a set of 10 neutral nouns in different
(i) Being under the age of 18, (ii) being pregnant, sequences, such as oil, building, arm, beach, letter, cat,
(iii) having a secondary medical cause that may affect stick, ticket, grass, and motor, with no adjectives to avoid
cognitive performance, such as metabolic coma and bias. Patients were then asked to recall all the words they
psychiatric disorder, (iv) having other causes of dementia, remember, and one point was awarded for each correct

Volume 2 Issue 1 (2024) 3 https://doi.org/10.36922/bh.1712