These were misdiagnosed as symptoms of Creutzfeldt-Jacob disease (CJD) in all the cases. However, the rapidly progressive late-onset AD presented predominantly with 35 non-established focal symptoms and signs including myoclonus (75%), disturbed gait (66%) and rigidity. Memory loss presented early and was experienced 12 years before the clinically defined AD dementia in the LOAD. We found that depression and cognitive impairment were the first symptoms to appear in 98.5% and 99.1% of individuals in a study with late-onset AD (LOAD) and 9% and 80%, respectively, in early-onset AD (EOAD). Data from the included articles were extracted independently by two authors and quality assessment was undertaken with the quality assessment and diagnostic accuracy tool-2 (QUADAS tool-2 quality assessment tool). Articles were reviewed in May 2016, using the following databases: MEDLINE, PsycINFO, CINAHL, British Nursing Index, PubMed central and the Cochrane library, with no language restriction. We used systematic review methodology to investigate the existing literature. We aimed to determine the sequence and timing of the appearance of established early signs and symptoms in people who are subsequently diagnosed with AD. That moment is called Painkiller.Late diagnosis of Alzheimer's disease (AD) may be due to diagnostic uncertainties. Like Choclair’s Ice Cold was a moment in Toronto hip-hop, exactly 20 years later Ottawa might just be getting the moment it’s been waiting for a moment where they can finally believe. It was the moment when many in Toronto started to believe. The Director X directed music video, featuring Choclair and Kardinal Offishall riding around in a Hummer and Choclair riding around the financial district on the back of a motorcycle, was one of the first ones that made you feel like Toronto had arrived.

That was the album that made you as a Torontonian take notice. My friends looked at me like, “Who cares?” That started to change when Choclair dropped Ice Cold, including the hit single “Let’s Ride”. Growing up in the GTA, I still remember going to high school and mentioning that a particular Toronto artist had released an album.

Today it’s normal for Toronto to listen to and get behind its own artists, but back in the 90’s that wasn’t the case. The release of Painkiller is a throwback to when Choclair released his most notable album to date, Ice Cold, exactly 20 years ago. They might have just found one in City Fidelia. Looking at Drake in Toronto and Travis Scott in Houston, Ottawa is desperately looking for a champion. Other local artists purposely held back the release of their projects to give Fidelia the room to shine (and because after hearing it they didn’t want to get outshined). Painkiller is more than just an album it reflects the aspirations of a City. He simply has something to say and he’s doing it his way. He’s not trying to wow you with bangers and A-list or B-list collaborations. He’s not trying to sound like anyone else. With this album you get the feeling Fidelia is completely comfortable in his own skin, from the few features on the project, to the sound. Artwork for City Fidelia’s latest project, “Pain Killer” On “Close Call” he especially shows off his superior storytelling abilities, reminding us that although he’s been mixing up his music style with vocals in recent years, he can still rap. In an era dominated by bangers and repetitive flows, Painkiller is a content rich project that makes you want to sit down, vibe and listen, with thoughtful songs like “Close Call”, “About You”, and “Take Care”. Fidelia isn’t shy about his Juno aspirations for this album and he wants to bring the day-ones who started with him along for the ride. It was recorded in Ottawa and features a roster of Ottawa producers, including 613Tino and Fidelia’s brother Jeff Sanon, who also has a feature on the project. Painkiller is an ode to the city that raised him. Why? He’s the one that actually came back. One of the those artists is Fidelia, who as of late especially holds a soft spot in the capital’s heart. It has grown used to seeing its top artists leave, find success and never return, but today more and more artists are coming out of the closet and saying it proudly – “I’m from Ottawa”. With rich content and very few features, what we were given was a work of art and one of the best albums to ever come out of the city. We’ve been hearing about this album for a long time so anticipation was pretty high. Last Friday, City Fidelia released his latest and most highly anticipated project to date, Painkiller. This is the album Ottawa has been waiting for.

Fidelia review