Delirium is characterized by the rapid onset of symptoms which fluctuate, with an altered level of consciousness, global disturbance of cognition, perceptual abnormalities and evidence of a physical cause (DSM-IV-R, 2002).

To review the characteristics and psychometric properties of thirteen Delirium scales available in research and clinical practice.

MEDLINE database was used to identify the delirium scales in use (1990–2010), using the keywords: delirium, confusion, questionnaires, scales, severity and screening. Only validation studies were included. Exclusion criteria were children and alcohol/drug delirium assessment scales. This study included seven screening scales: Confusion Assessment Method, Intensive Care Delirium Screening Checklist, Delirium Symptom Interview, NEECHAM Confusion Scale, Cognitive Test for Delirium, Delirium Observation Screening, Nursing Delirium Screening Scale and seven severity scales: Delirium Rating Scale, Memorial Delirium Assessment Scale, Confusional State Evaluation, Delirium Severity Scale, Delirium Index and Delirium-O-Meter.

The majority of scales were based on the Diagnosis Statistical Manual Criteria as well as on a review of selected symptoms of Delirium informed by systematic clinical observation and formal brief assessment of mental status. In most of the studies, for psychometric analysis, the inter-rater reliability and validity with severity of Delirium assessment and cognitive screening tests were used.

Bearing in mind the recent review studies included, we can conclude that CAM is the most widely used instrument for delirium assessment.

Behavioral and personality changes are the core symptoms of frontotemporal dementia. Suicide and suicide attempts have been reported in demented patients.

We present a case of an 80 years-old-male patient, with a suicide attempt at the age of 76 as the presentation symptom of FTD.

There are few studies of suicide or selfharm in frontotemporal dementia where such behavior might be expected to be more common. We are conducting a clinical study in FTD patients about the relation between FTD and suicide. The results of such study will be presented and discussed.

To our knowledge, there are no reliable data or reports about suicide in FTD patients. Also, we didn’t find any case report of a suicide attempt as the first presentation symptom of FTD. We discuss the known data about this issue considering our clinical study and report.

During the last years a great number of new facts of involving nerve growth factors (NGF) in pathogenesis of Alzheimer Disease (AD) and other neurodegenerative diseases have been received. Discovery of neurotrophic effects of Cerebrolysin similar to NGF attracted new attention to it (Rockenstein E. et al. 2000).Clinical study of long-term effects of Cerebrolysin has proved that Cerebrolysin has positive modifying action on the dementia progression (Gavrilova S.I. et al., 2003). That's why we suggest that Cerebrolysin may prevent or slow down clinical manifestation of dementia in patients with mild cognitive impairment (MCI) of amnestic type.The aim of the present study was to investigate in an open comparative prospective clinical trial ability of Cerebrolysin to slow down or prevent transition of MCI syndrome into the clinically evident AD in 2 groups of patients repeatedly treated with 1 month courses of Cerebrolysin or Cavinton during a period of 3 years.

110 patients who met the diagnostic criteria of MCI of amnestic typewere included. During the clinical trial patients were assessed with a set of clinical scales and a battery of neuropsychological cognitive tests. Genotyping for the APOE polymorphism was performed as well.

The superiority of Cerebrolysin over Cavinton in slowing down of the cognitive deficit progression and delaying the time or transition of MCI patients to the diagnostic category of Alzheimer disease during 3 years was demonstrated. Cerebrolysin was particularly effective in MCI patients with the ApoE4 (+) genotype.

Cerebrolysin could be recommended as a preventive AD therapy.

This is a case report of a Chinese middle-aged female who was first seen in 2006 for suspected depression. Over the course of the illness, her diagnosis was revised to that of Simple Schizophrenia and then Frontoparietal Dementia.

A 53 years old Chinese lady was first brought by a male friend (who has known her for past 21 years) in 2006 to continue management for her depression. For the preceding 3–4 years, her behaviour has been very child-like. She was described premorbidly to be stubborn and independent. Mental state examination then revealed that she was oriented to time, place and person. Her mood appeared depressed and reactive (secondary to some social stressors). Patient refused any basic blood investigations and her antidepressant was continued. Over the course of few months, she started to complain of forgetfulness and she was reported to go ‘missing’ for 1 to 2 hours. A differential diagnosis of chronic negative symptoms schizophrenia was entertained. In August 2007, she was arrested for shoplifting and was treated as an inpatient. Upon discharge, she was referred to a nursing home. By October 07, she was totally disoriented to time and place. Computed Axial Tomography (CAT) scan of brain was eventually performed which reported as ‘knife-shaped appearance’ of cortical gyri suggestive of frontoparietal dementia, possible Pick’s Disease. Patient is currently on antidementia therapy.

The case report illustrates the importance of entertaining diagnosis of dementia in a middle-aged person especially with symptoms of regression and wandering behaviour.

Longitudinal studies of predicting dementia conversion of poststroke cognitive impairment no dementia (CIND) are limited.

To investigate the clinical and imaging predictors of dementia conversion in poststroke patients with CIND.

To understand dementia conversion of CIND.

143 patients with CIND (defined as impairment in at least one cognitive domain without meeting the criteria of dementia) at three months after stroke were recruited and followed up for one year. Dementia was diagnosed using the criteria of Diagnostic and Statistical Manual of Mental Disorders (4th edition, DSM-IV). MRI measurements including infarction, microbleeds, white matter hyperintensities (WMHs) and hippocampal volume were conducted. Logistic regression was performed to find the predictors of dementia at follow-up.

16 (11.2%) out of the 143 patients developed dementia 15 months after stroke. In univariate comparisons, subjects with dementia at follow-up had older age (78.0 ± 5.3 vs.71.5 ± 8.5 years, p = 0.003) and higher NIHSS score (7.1 ± 3.5 vs.4.7 ± 3.3, p = 0.005) on admission. They also had higher frequency of old infarcts in the thalamus (31.3% vs. 11.0%, p = 0.025), larger volume of old infarcts (4.2 ± 11.2 vs. 0.7 ± 2.6 cm3, p < 0.001) and WMHs volume (33.2 ± 34.0 vs. 14.2 ± 14.1 cm3, p = 0.016). In logistic regression, age (odds ratio [OR] =1.203, 95%C.I.=1.054-1.373, p = 0.006), NIHSS score on admission (OR = 1.324, 95%C.I.=1.082-1.619, p = 0.006) and WMHs volume (OR = 1.045, 95%C.I.=1.007-1.084, p = 0.019) were significant predictors of dementia at follow-up.

WMHs volume predicts dementia in poststroke patients with CIND, suggesting subcortical ischemic vascular disease was an important origin of poststroke delayed dementia.

Vascular Dementia (VD) is the second most frequent cause of dementia (20–30% of cases) with a similar percentage associated with Alzheimer’s disease (AD). Due to increased prevalence, its early diagnosis is of particular importance for prevention and correction of risk factors.

An 82-year-old Caucasian woman has been taken to the emergency department by her husband, presenting changes in behaviour defined by aggressiveness, delusional and paranoid ideation with 1M of progression. She had also suffered cognitive impairment (memory deficits, prosoprognosia, disorientation) and some functional decline. She also experienced isolation and reduced communication, anxiety, almost total insomnia, emotional lability, slurred speech, slowed gait and urinary incontinence.

This elderly patient with multiple medical comorbidities (HTA, DM, chronic AF hypocoagulated, MI, Craneoencephalic trauma with a stroke episode) was admitted to the Department of Psychiatry and investigated with auxiliary diagnostic tests and neuroimaging. We found ischemic injury and haemorrhagic sequelae in the latter and in the neuropsychological assessment cognitive deficits were found (executive function, attentional, semantic memory and visuoespacial). Due to this findings and the rapid evolution of symptoms, the diagnosis was Cortical and Subcortical VD.

The patient was treated with a minor anxiolytic, a hypnotic inducer and an antidemencial, with improvement, after one week, of her emotional lability, behavioural symptoms and remission of delusional ideation. At discharge, she maintained slow gait, urinary incontinence, as well as attentional, mnesic and executive deficits, and she was partially oriented, in spite of anosognosia.

She was transferred to geriatrics and to a day center.

To describe the relation of psychosocial factors of care (phase illness, years of care, free time, extra help and symptoms of depression) influence the care burden of dementia family caregivers. To measure the relation of the level of depressive symptoms on an intense level of burden of the dementia family caregivers

Is selected a sample of 102 primary caregivers by criteria of inclusion to which a surveys do to those that the following information gathered: sociodemographic dates of the caregivers and of the dementia patients, care burden (Zarit Interview) and depressive symptoms (Beck Depression Inventory) of the family caregivers.

Most of the sample experiences an intense burden level (74%) opposite to a light level (26%). Psychosocial characteristics are as per statistics significant in increasing the care burden there were free time, extra help and presence of symptoms of depression.

Presence of serious symptoms of depression on the intense burden level are differently front or those who had a minor burden, 22% and 5% respectively.

There are most of the daughter-father/mother and spouse-spouse caregiver couples with a high percentage of caregivers of feminine sex (as in most of the studies realized on caregiver of dependent persons at European and international level). The need for free time and psychic self-care are cost-effective strategies to prevent the depressive disorders, as well as, to improve their caregiver’ws work. The psychoeducation programs that have being realized at European level directed to family caregiver are necessary in our country.

Concerns regarding the use of antipsychotics in people with dementia have been widely reported. However, there is paucity of studies examining antipsychotics prescribed on discharged from psychogeriatric in-patient units.

To determine the extent and types of antipsychotic medication prescribed for patients with dementia discharged from an in-patient psychogeriatric unit.

This was a retrospective study. Data from all in-patients with dementia discharged from a psychogeriatric unit between July 2009 and June 2010 were analysed. Antipsychotics administered to patients in the unit and antipsychotics prescribed on discharge were recorded.

During the study period, a total of 49 patients with dementia were discharged. Thirty-eight patients (77.6%) received antipsychotic as in-patients; four of these patients (10.5%) had two antipsychotics. Thirty-two patients (65.3%) were discharged on antipsychotic medication with two (6.3%) of the patients on two antipsychotics. Of the antipsychotics prescribed on discharge, 75% were atypical and 25% typical.

Almost two third of patients with dementia were discharged from the in-patient psychogeriatric unit on antipsychotic medication. A drive to reduce antipsychotic medication prior to discharge is needed.

Trazodone is a Serotonin-2A Antagonist/Reuptake Inhibitor (SARI) that combines its ability as a 5/HT2A receptor antagonist with some serotonin reuptake blockade actions. Studies support its use in the treatment of behavioral disturbances in patients with Alzheimer's disease and frontotemporal dementia.

To evaluate the effectiveness of trazodone in behavioral symptoms and caregiver burden in elderly patients with dementia.

In 49 patients (males and females) older than 65 years with dementia (DSM-IV), trazodone was associated to the standard treatment in a single night variable dose (50–200 mg). On days 0, 14 and 42 neuropsychiatric disorders and caregiver burden (Neuropsychiatric Inventory-Nursing Home Version, NPI-NH) were assessed. On days 0 and 42 cognitive impairment was measured by the test Mini-Mental State Examination (MMSE). The Clinical Global Impression (CGI) was administered on the last visit. Statistical evaluation was done by SPSS 17®.

38 patients completed the study. Global score NPI-NH was significantly reduced (p < 0.001). Sleep quality subscale improved significantly (p < 0.001). The MMSE was not modified. The caregiver burden showed a significant decrease (p < 0.001) on each visit.

Trazodone was well tolerated (main adverse effects were: hypotension (4.1%) and somnolence (2%). Patients evolution was positive (CGI).

Results of this study suggest that trazodone is an effective treatment for behavioral symptoms of dementia. Trazodone reduces caregiver burden without modifying the patient’s cognitive function.

Alzheimer’ disease (AD) is a complex and progressive neurodegenerative disorder with unclear aetiology. Cognitive impairment and the behavioral disturbances in patients with AD might be associated with altered serotonergic system.

Platelet serotonin (5-HT) levels and platelet monoamine oxidase type B (MAO-B) activity might be the biological markers for the progress of AD.

To determine platelet 5-HT concentrations and MAO-B activity in female patients with mild, moderate or severe stage of AD and sex and age matched healthy controls.

The study included 106 female patients with the diagnosis of probable AD (DSM-IV-TR and NINCDS-ADRDA criteria), subdivided according to the Mini Mental State Examination (MMSE) score in early (MMSE 26-18), middle (MMSE 17-10) and late (MMSE 9-0) phase of AD. Control group consisted of 102 healthy elderly women (MMSE 30-27). Platelet 5-HT concentrations and MAO-B activity were determined using spectrofluorimetric methods.

Platelet 5-HT concentrations and MAO-B activity were similar between all patients with AD and healthy controls. Patients in the late phase of AD had significantly (p < 0.05) lower platelet 5-HT concentrations and MAO-B activity than patients in other phases of AD and healthy controls. The significant correlations were found between MMSE scores and platelet 5-HT concentrations, MAO-B activity and age.

The results suggest that platelet 5-HT concentration and MAO-B activity might be the peripheral biological markers for the severity and/or clinical progress of AD.

According to the literature, up to 90% of patients with Alzheimer's disease present at least one behavioral or psychiatric symptom (BPSD) and their overall frequency tends to increase during the course of illness. Three main BPSD syndromes are usually described: agitation, psychosis and mood disorders. These syndromes have an important impact on patients and their caregivers, representing a distress factor leading to reduced quality of life and, ultimately, the need for institutionalization. Antipsychotic drugs have been used for this purpose, but their benefits are still uncertain and some studies brought up concerns about their safety - particularly increased risk of cerebrovascular adverse events and death.

The authors aim to present a review of the relevant literature, concerning the treatment of BPSD, focusing particularly on the antipsychotic treatment. We aim to discuss their indication, efficacy and safety. We illustrate this review with 1 clinical vignette.

Systematic review of the most recent and relevant literature.

According to some studies, atypical antipsychotics are equal or more effective than placebo in the treatment of psychosis and aggression. However, adverse effects seem to limit their effectiveness. Therefore, the prescription of antipsychotics for these patients should be restricted to people with severe symptoms causing risk or extreme distress that have not responded to other measures, and treatment should only be continued beyond 12 weeks in exceptional circumstances.

To describe validation process of the new apathy scale for institutionalized dementia patients (APADEM-NH).

100 elderly, institutionalized patients with diagnosis of probable Alzheimer Disease (AD) (57%), possible AD (13%), AD with cerebral vascular disease (CVD) (17%), Lewy Bodies Dementia (11%) and Parkinson associated to dementia (PDD) (2%). All stages of the disease severity according to the Global Deterioration Scale (GDS) and Clinical Dementia Rating (CDR) were assessed. The Apathy Inventory (AI), Neuropsychiatric Inventory (NPI), Cornell scale for depression, and the tested scale were applied. Re-test and inter-rater reliability was carried out in 50 patients. The feasibility and acceptability, reliability, validity, and measurement precision were analyzed.

APADEM-NH final version consists of 26 items and 3 dimensions: Deficit of Thinking and Self-Generated behaviors (DT): 13 items, Emotional Blunting (EB): 7 items, and Cognitive Inertia (CI): 6 items. Mean application time was 9.56 minutes and 74% of applications were fully computable. All subscales showed floor and ceiling effect lower than 15%. Internal consistency was excellent for each dimension (Cronbach’s α DT = 0.88, α EB = 0.83, α CI= 0.88);Test-retest reliability for the items was kW=0,48-0,92; Inter-rater reliability reached kW values 0.84-1.00; The APADEM-NH total score showed a low/moderate correlation with apathy scales (Spearman ρ, AI =0.33; NPI-Apathy= 0,31), no correlation with depression scales (NPI-Dementia = -0.003; Cornell= 0,10), and high internal validity (ρ =0.69 0.80).

APADEM-NH is a brief, psychometrically acceptable, and valid scale to assess apathy in patients from mild to severe dementia and discerning between apathy and depression.

To analyze the impact of the length of sentences in the abstraction of proverbs in the Screening Test for Alzheimer's disease with Proverbs (TRDAP), healthy elderly and with Alzheimer's disease at early stage.

Survey document in the database, analyzing the responses of the elderly (abstract or concrete interpretation of proverbs), relating the length of sentences (sayings) of stage B of TRDAP with the diagnosis of Alzheimer's disease and the interference of age and schooling.

Healthy older people showed greater capacity for abstraction than those with AD. There was Significant differences, in the sayings 1 (p = 0.033) and 2 (p = 0.001), corresponding to lower sentences, which did not occur with the proverb 3. As for age no verified significant difference among the healthy and only saying 3 in AD patients, however schooling differenced the healthy.

Elderly with Alzheimer's disease at an initial stage have lower performance in the comprehension of ambiguous sentences, interpretation and abstraction of proverbs, corroborating with the data of the literature. The size of these sentences appears to be inversely proportional to the correctness of interpretation in elderly patients with and without AD.

To review current practice of Antipsychotics prescribing in patients with Behavioural and Psychiatric symptoms of Dementia in secondary care hospital.

This was a retrospective audit targeting all patients who were diagnosed with a dementing illness in a large secondary care hospital from September 2008 to December 2008 inclusive. Data was collected from patients’ health care records and central computer database. Current practice was then compared with the standards proposed by the NICE Guidelines (National Institute of Clinical Excellence, 2006).

Out of 18 patients who were diagnosed with dementia, 66% (n = 12) were prescribed antipsychotics. Out of these, 66%(n = 8) were males and 34%(n = 4) were females. 75%(n = 9) had explicitly documented indications for antipsychotics use in their health care records with only 25% cases (n = 3) alternative treatment options such as psychosocial interventions were considered.

with patients and/or the carers’ were documented in 50%(n=6) cases. Periodic reviews were carried out in 66% (n = 8) cases.

Antipsychotics are commonly used in behavioural and psychiatric symptoms of dementia. Considering higher risk of morbidity and mortality with antipsychotics use in this population group, it is of paramount importance that reasons for prescribing and discussion with patients and/or their carers should be clearly documented. If antipsychotics are prescribed patients should be reviewed on regular basis.

Recent data support the view that the neurodegeneration underlying sporadic Alzheimer's Disease (AD) is in part related to brain insulin deficiency and brain insulin resistance. There is a higher incidence of AD in patients with diabetes mellitus type II (T2D) and both diseases show a decline in memory function. In a preceding trial intranasal insulin improved memory function in healthy volunteers so that an increase of central-nervous insulin concentration may improve cognitive function in both amnestic patient groups.

We want to analyse the effects of intranasal insulin on patients with early Alzheimers's disease (eAD) and patients with T2D in the state of amnestic mild cognitive impairment (aMCI).

Recruitment of 30 patients with eAD, 30 patients with T2D in aMCI state and 30 age-matched healthy controls. All patients undergo a run-in period of 2 weeks with 4 × daily administration of placebo. It follows a double blinded trial with daily intranasal administration of 4 × 40 I.U. insulin vs. placebo for 8 weeks and another 8 weeks of follow-up. At 4 defined time points memory function is assessed by word lists comprising 30 items of emotional, nutritional and neutral content which have to be memorized and are recalled after one week. To assess structural changes of the brain, a quantitative analysis for hippocampal N-acetyl-aspartate, choline and creatine is performed by 3 Tesla magnetic resonance spectroscopy.

Results: Since the study has not finished yet, we present experiences from the initiation and the beginning phase.

Factors influencing or predicting progression in Alzheimer's disease (AD) is not well understood. Olfactory dysfunction, impaired smell identification in particular, is known to occur in AD. Mesial temporal lobe, important for memory function is also critical for the processing of olfactory information. In view of the common anatomical substrate, we hypothesized that olfaction dysfunction worsens faster in people with AD with rapid cognitive decline compared to those with slower cognitive decline.

To test whether smell identification test can be used as a predictor for illness progression in AD patients.

Forty one participants with late onset mild to moderate AD were recruited from mental health services for older adults. Subjects were classified as ‘Rapid Progressors’ defined on ‘a-priori’ with a loss of 2 or more points in Mini-Mental State Examination (MMSE) within six months. Assessments included MMSE, Neuropsychiatric Inventory, Bristol Activities of Daily Living, and the University of Pennsylvania Smell Identification Test (UPSIT), at baseline and after 3 months.

Twenty subjects were ‘Rapid Progressors’, and had lower UPSIT scores compared to ‘Non-Rapid Progressors’ both at the baseline (p = 0.02) and at follow up after 3 months (p = 0.05). Baseline UPSIT correlated with follow up UPSIT (r = 0.5, p < 0.01) and MMSE (r = 0.4, p = 0.04). Also it was the baseline UPSIT score that best predicted (p < 0.05) the follow up smell and cognitive function on linear regression analysis.

Smell identification function could be useful as a clinical measure to assess and predict progression in AD.

To investigate the effect of Analog P165 of APP5-mer peptide on change of learning and memory ability in type 3 diabetes rats.

Healthy adult male rats were randomly divided into 3 groups: Control group; type 3 diabetes (T3DM) group; T3DM administrated P165 group. T3DM models were induced by intracerebroventricular injection of Streptozotocin (STZ, 3 mg/kg) bilaterally. P165 groups were treated with gastric P165 (355 μg/kg) Then, learning and memory ability was detected by Morris water maze test. Body weight and serum glucose were recorded. The rat serum Insulin, Gluocagon, insulin-like growth factor-1 (IFG-1) was detected by ELISA method.

In the Morris water maze test, compared with control group, the escape latency increased significantly (p < 0.05) in model group at the 3rd day. Compared with model group, the escape latency decreased significantly (p < 0.05) in the models administrated P165 group at the 3rd day. Although there was no significant difference, the escape latency decreased in P165 group at the 4th and 5th day. From the result of rats blood serum detection, the serum IGF-1 level decreased significantly in the model group (p < 0.01) than the control group. The serum IGF-1 level increased significantly in P165 treated group(p < 0.05).The body weight and the serum glucose, insulin, gluocagon had no significant difference among the groups in the period of experiment.

There is learning and memory impairment in the T3DM rats. P165 can raise the rats blood serum IGF-1 level, ameliorate learning and memory ability but don’t influence the serum glucose.

Applying programs of early cognitive intervention, concentrated on psychological influences, constitutes the important component of comprehensive medical influences nonpharmacological, influencing to the improvement in psychological functioning, in cognitive areas and qualities of life.

Evaluation of the effectiveness of the multimedia program of the cognitive rehabilitation (cognitive training, psychoeducation), directed at patients with MCI and with early stage in the AD.

Outpatients, N = 75, average of the age: 68.6 (10.14 SD), above 45 years,; MMSE > 20, I group - MCI (N = 34): with the intervention (N = 18), without (N = 16), II group - AD (N = 29): with intervention, (N = 15), without (N = 14), III group - CG: patients without cognitive disorders (N = 12).

Randomized, clinical trial. Diagnosis on the base: of clinical interview, of examining a mental state, physical, TK, MRI, of laboratory tests, screening neuropsychological (MMSE, CDT, Demtect, Fluencial). Patients participated in 6 week’s program of the cognitive rehabilitation (4 × during the week) and 18 household conditions. The evaluation of the cognitive functioning, mental state, of functioning in the everyday life, of approval of illness, of satisfaction from the life, qualities of life, caregiver burden were being before and after intervention.

An improvement in cognitive functioning was get in selected aspects: of cognitive functioning (linguistic functions, memory, attention, of visual-motor coordination), of mental state, qualities of life.

Nonpharmacological influences, spreading through cognitive training and psychoeducation, at patients with dementia or MCI constitute essential element correcting their functioning in the process psychological rehabilitation.

Explore the relationship between levels of plasma Aβ1–40, Aβ1–42 and heat shock protein 70 (HSP70) in patients with Alzheimer disease (AD) and vascular dementia (VD) and in elderly non-demented controls.

23 patients with AD and 21 patients with VD who meet diagnostic criteria of the Diagnostic Statistical Manual 4th edition and 20 control subjects were enrolled, administered the Mini-Mental State Exam (MMSE) and the Activity of Daily Living (ADL) inventory and their levels of plasma Aβ1–40, Aβ1–42 and HSP70 were measured by sandwich enzyme-linked immunosorbent assay.

The levels of plasma Aβ1–40, Aβ1–42 and the Aβ1–40/Aβ1–42 ratio were not significantly different across groups, but levels of plasma HSP70 in VD patients was significantly higher than in AD patients and in normal controls (3.19 vs 1.91 vs 1.43ng/ml, respectively; F=6.464, P=0.003). In the AD group MMSE scores were inversely correlated with ADL scores (r=-0.617, P=0.002) and with levels of plasma HSP70 (r=-0.437, P=0.037); but HSP70 levels were positively correlated with age (r=0.616, P=0.002) and with plasma Aβ1–40 (r=0.497, P=0.016) in AD group. In the VD group levels of plasma HSP70 were positively correlated with plasma Aβ1–40 (r=0.436, P=0.048).

Our findings provide further evidence that high plasma HSP70 levels may play a role in the diagnosis and differential diagnosis of AD. HSP70 levels in AD patients is inversely associated with cognitive performance and positively correlated with plasma Aβ1–40. Plasma HSP70 in VD patients is significantly elevated and positively correlated with plasma Aβ1–40.