Browsing by Subject "Alzheimerin tauti"

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  • Näsi, Anni (Helsingin yliopisto, 2020)
    Alzheimer’s disease is the most common form of dementia and one of the highest causes of death worldwide. Recent discovery of lymphatic vessels from the dura mater, the outermost meningeal layer covering the central nervous system, has led to reassessment of the role of lymphatic vessels in neuropathological diseases. The meningeal lymphatic vessels drain macromolecules from the cerebrospinal fluid into the deep cervical lymph nodes and their proper function could be crucial for preventing amyloid-beta aggregation into the brain parenchyma. The function of the meningeal lymphatic vessels is still partly unknown. They have been hypothesized to function as an immune cell hub for the brain and dysfunction of the meningeal lymphatic vessels could lead to immune cell changes in the brain parenchyma. In my thesis, the role of the lymphatic vessels in Alzheimer’s disease was investigated by inducing atrophy of the meningeal lymphatic vessels with VEGF-C depletion in an APdE9 mouse model of Alzheimer’s disease. Single cell sequencing was used to identify the cell types present in the dura mater and in the deep cervical lymph nodes of an Alzheimer’s disease mouse model with and without atrophy of the meningeal lymphatic vessels. The amyloid-beta accumulation was immunohistochemically assessed from the brain and the cognitive decline was studied with behavioral tests. The results showed that atrophy of the meningeal lymphatic vessels did not increase the amount of amyloid-beta in the brain or affect the cognitive decline. The single cell sequencing from the meninges provided a more comprehensive cell atlas than has been published before. It was also found that the atrophy of the meningeal lymphatic vessels was associated with changes in the number of immune cells in the dura mater. The biggest changes were in the number of neutrophils and B-cells, which increased. Further studies are needed to evaluate the role of the meningeal lymphatic vessels in Alzheimer’s disease progression, as the results in this thesis were opposite to the results published before.
  • Mansikka, Tuomas (Helsingin yliopisto, 2018)
    The relationship between cognition and functional capability is an important research topic as it concerns the ecological validity of clinical neuropsychology. The purpose of this thesis was to explore the relationship between executive functioning and functional capability in very mild to moderate Alzheimer's disease. A further goal was to investigate the effect of dementia severity on the relationship between executive functioning and functional capability. The study sample consisted of relatively aged individuals (mean age 83.53 years), which is meritable, since very few analogous studies have been conducted with as old a sample. The sample of this study consisted of Alzheimer's disease patients who participated in an intervention study involving elderly dementia patients by Helsinki University Central Hospital during 2014–2016. Baseline measurements of the study were used. The sample (n=97) was split into very mild/mild (n=55) and moderate (n=42) Alzheimer's disease using the Clinical Dementia Rating scale (CDR). Executive functioning and functional capability were measured using the Frontal Assessment Battery (FAB) and Alzheimer's Disease Cooperative Study–Activities of Daily Living (ADCS-ADL), respectively. The relationship between executive functioning and fuctional capability was measured using regression analysis. In this study the relationship between executive functioning and functional capability could not be replicated. Furthermore, dementia severity was found to have no effect on the relationship between executive functioning and functional capability. There might have been notable dementia comorbidity, physical morbidity and old age fragility within the sample which have had an impact on the results. Moreover, functional capability was conceptualized using only the total score of the ADL measure. In the future functional capability should be measured more minutely, inspecting the individual items of the selected ADL measure.
  • Pystynen, Johanna (Helsingfors universitet, 2017)
    There has been little research on writing impairment due to memory illness compared to how common memory illnesses are. For instance, extremely few studies on writing impairment due to Alzheimer's disease have been conducted in Finnish. The effects of AD can often first be noticed in semantic and pragmantic skills. Writing impairments emerge in the early stage of AD, and writing problems can be perceived as early signs of AD. The aim of this research was to study, what kind of changes emerge in the use of verb processes of a person with AD. Previous studies have shown that persons with AD have difficulties processing semantic roles related to verbs due to impairment of semantic memory. In AD the difficulty of generating verbs is not related to syntactic structures of verbs. Research material consisted of diary texts written by a woman with AD. She was born in 1932. Familiziaring with the research material, transcribing and narrowing of the research material was a collaboration between three students writing their Master's Thesis and a University Lecturer. The final research material consisted of texts written in June of 1986, 1996, 2001, 2006, 2008, 2010 and 2012. The verbs were categorized as belonging to Halliday's (2004) five primary process types and then the process types' percentages within the inspection points were calculated. As a result it was noted that the use of verb processes changes in AD. Especially the proportions of the three main process types levelled slightly during the last years of writing: the percentage of material processes declined, the percentage of relational processes remained relatively unchanged and the percentage of mental processes increased. The writer used verbal processes seldom throughout the years, and finally they vanished altogether. Levelling of percentages can be a sign of a fading recount ability in AD when the understanding of complex language and the awareness of incidents that recently happened to self or other incidents weakens as the disease proceeds. This research provides new logopedic information when it comes to impairment of spontaneous writing. It also provides a new perspective for applying SFL in the research of linguistic skills. Research of changes in writing abilities may sometime in the future supply a diagnostic tool in healthcare.
  • Aho, Petra (Helsingfors universitet, 2017)
    Objectives. There are approximately 14,500 new cases of dementia-associated diseases each year in Finland. The most common cause of dementia is Alzheimer's disease (AD). There are many changes associated with AD that affect the person's ability to participate in interaction. Until now only very few Finnish studies have been conducted on assessing, treating and supporting language and interaction in dementia-associated diseases, and this type of treatment is not widely available in Finland. The purpose of this study is to introduce one indirect group speech therapy intervention aimed at the spouses of persons with AD, and to study its effectiveness in the interaction strategies they apply as well as their perceptions and satisfaction regarding interaction. The participants' experiences of the intervention and its usefulness are also examined. The study also touches the applicability of a recently translated method for assessing the interaction between persons with AD and their spouses. Method. Three couples participated in the study, all of whom had one partner diagnosed with AD. The studied intervention consisted of six group meetings aimed at the healthy spouses. Data was collected at three separate occasions using VNVIS-CG – a method based on analyzing video-recorded material – and a questionnaire. The participants also filled out a feedback form at the end of the intervention. Results and conclusions. The study found that the participants adopted and implemented some of the strategies that were addressed during the intervention. The changes observed in the behavior of the participants were individual. However, the intervention seems to even out the differences in the number of strategies used by the participants. All of the participants found the intervention useful, and felt that it had affected their behavior, but only one of the participants reported greater satisfaction with the couple's interaction after the intervention. The participants' perceptions of interaction varied greatly, so conclusions about possible changes in these perceptions cannot be made. Further research on the matter, with a larger group of participants and a comparison group, is definitely needed. In the future, the methods used to evaluate effectiveness, as well as the content and the execution of the intervention, should also be modified as needed.