bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of clinical and sociodemographic factors involved in older adults' cognition
Authors: Pires Lívia R , Costa Mônica Vieira , de Oliveira Hansen Erika , Pires Ricardo Lage Guerra Lott , FARIA KAREN C , Dias Bruna Fugêncio , Braga Nayara Rodrigues , Ávila Rafaela , Bertola Laiss , Bicalho Maria Aparecida C
Published: February 2022

Background

Elderly population is rising significantly in Brazil. It may reach 25.5% of the population by 2060. Cognitive and functional declines may happen during pathological aging process. Low and medium‐income countries tend to present higher dementia growth rate than high‐income countries. The aim of this study was to assess whether socio‐demographic and economic indicators are associated with cognitive performance in older adults with normal cognition and with mild cognitive impairment (MCI).

Method

We conducted a transversal study enrolling 69 Brazilian older adults from the outpatient Reference Center for the Elderly of Belo Horizonte ‐ Federal University of Minas Gerais. We included participants with MCI and without cognitive and functional impairment (control group‐NC). All participants were submitted to the same protocol. Sociodemographic and clinical variables were evaluated by self report and medical records. Neuropsychological assessment consisted by the Geriatric Depressive Scale (GDS), Pfeffer Instrumental Daily Living Activities scale (FAQ), Mattis Dementia Rating Scale (DRS), Frontal Assessment Battery (FAB) and Wechsler Abbreviated Scale of Intelligence (WASI). We used linear regression to analyze relationship between sociodemographic factors and ageing cognition.

Result

69 older adults, 69.6% women, average age of 76.58 (SD ±5.43) years, 4.55 (SD ±3.39) years of formal education were included in our study. Correlation analysis demonstrated that Diabetes Mellitus correlated with memory performance (M). Intelligence quotient (IQ) were associated with executive functions (EF), attention and conceptual abilities (C); years of formal education presented significant association with general cognitive measures (GC); socioeconomical level was associated with GC, EF, attention, construction and conceptualization; parents’ education positively correlated with visuoconstruction and, Occupational level had positive association with GC, attention and conceptualization. Regression analysis indicated IQ level predicts EF and GC in adult life. Education predicted GC, EF, memory and conceptualization. Education also showed a tendency to explain the attention domain.

Conclusion

Our results suggest sociodemographic factors, such as IQ, education, sociodemographic level, parents’ education and occupational level associate with cognitive abilities. They could act as protection factors for the cognitive decline in elderly. Prospective studies, with larger samples, are needed to evaluate if these factors are able to reduce dementia risk in elderly population of low educational level.
Protective factors associated with mental health symptoms in caregivers of persons with dementia
Authors: Reilly Shannon , Manning Carol A
Published: February 2022

Background

Caregivers (CGs) of persons with dementia (PWDs) have relatively high levels of caregiver burden, depression, and anxiety. This observational, cross‐sectional study examined the extent to which preparedness for caregiving and knowledge about dementia might be associated with lower levels of these mental health symptoms.

Method

At the entry into a dementia care coordination program, CGs (N = 74) were surveyed about personal characteristics, characteristics of the PWD they care for (N = 74), mental health symptoms, and their perceptions about caregiving. Three univariate linear regressions were conducted to assess associations between protective factors (i.e., preparedness for caregiving, dementia knowledge) and CGs’ levels of depression, anxiety, and caregiver burden, controlling for CG age, CG education, and PWD level of functional independence in activities of daily living (ADLs).

Result

(Table 1). Neither preparedness for caregiving or dementia knowledge were significantly associated with CG depression or anxiety. However, younger CGs reported higher levels of depression (B = ‐.007, t = ‐3.33, p = 0.001) and anxiety (B = ‐.12, t = ‐2.91, p = 0.005). CGs with higher preparedness for caregiving reported lower CG burden (B = ‐.67, t = ‐2.51, p = 0.015), and CGs of PWDs with lower functional independence reported higher CG burden (B = ‐2.19, t = ‐2.96, p = 0.004).

Conclusion

Results of this cross‐sectional, observational study indicate that CGs’ preparedness for caregiving is associated with CG burden and that younger GGs had higher levels of depression and anxiety. These findings suggest that CG age may impact CG mental health and provide opportunities for intervention including targeting mood in younger CGs and increasing CG preparedness to potentially decrease CG burden. Additionally, emotional preparation for providing care to PWDs may be more important for reducing CGs’ burden than teaching specific knowledge about what to expect in dementia, and CGs of PWDs with lower functional abilities may benefit from targeted supports to reduce burden.
Mnemonic strategies as dyadic interventions to increase well‐being in Alzheimer’s disease
Authors: Bormans Kasper
Published: February 2022

Background

Dementia is a growing problem with 50 million patients worldwide expecting to triple by 2050. The most common form of dementia is Alzheimer’s Disease, characterized by a long process of deterioration for the patient and negative impact on the close environment (‘caregiver burden’). Dementia is not only memory‐loss, there is also communication‐loss. More than 70% of the dementia patients are still living at home, taken care for by a family member. Dementia thus affects three times as many persons involved than there are patients. The primary objective is to examine how the accumulation of (augmented) reality to mnemonic strategies can strengthen the relation between Alzheimer patients and their caregivers. The secondary objective is to elaborate a dyadic intervention to transform the ‘hidden victims of dementia’ into ‘hidden resources’.

Method

We developed a mobile application (‘MemoryHome’) based on the ancient mnemonic strategy ‘the method of loci’. The digital tool allows caregivers to construct personalized memory walks throughout the known environment of dementia patients. These memory palaces link photos of significant others to the architectural surroundings. Previous research mainly focused on the method of loci as a solitary activity for Alzheimer patients to delay their memory problems. The novelty of our study is to use the mnemonic strategy for the first time as a dyadic intervention to increase well‐being by introducing the concept of a ‘co‐walker’. The visual‐audio‐guide encourages conversation between the patient and the caregiver.

Result

We evaluated the impact of our psychosocial intervention (week 0‐4‐8) in homecare (n=19 dyads) and in the residential setting (n=22 dyads) on quality of life (QOL‐AD), feelings of depression (GDS‐15) and connectedness of subjects in the early phase of AD and their significant others (QCPR). Results suggested a modest but positive association with quality of life, connectedness between dyads and the absence of feelings of depression. Participants reported to feel more cheerful, more physically active and socially connected.

Conclusion

The mobile application MemoryHome is a convenient instrument to reinforce the dialogue between patients and their environment. Translating mnemonic strategies into dyadic interventions can turn ‘hidden victims’ in ‘hidden resources’ in future Alzheimer research.
FTD Disorders Registry (FTDDR) disease impact survey: Understanding the lived experience of persons affected by frontotemporal degeneration (FTD), including those diagnosed, their families and caregivers
Authors: Wheaton Dianna KH , Harlass Sherry , Reddy Sweatha , Vincent Lakecia , Tatton Nadine
Published: February 2022

Background

FTD is a group of rare brain diseases that cause myriad progressive changes to behavior, personality, language, and movement with onset typically before age 60. There are currently no treatments or cure. The FTDDR is a regulatory‐compliant, web‐based portal that functions as both a Contact Registry and Research Registry for persons affected by FTD to amplify the patient/family voice and facilitate research. The Disease Impact Survey was designed to characterize person‐centric perceptions of FTD disease manifestation and the impact to those diagnosed and others.

Method

The 35‐question survey was administered online via the Research Registry to 672 participants (205 male; 467 female) between March 2017 and January 2021. Multiple‐choice style questions collected details about the diagnosis, symptoms, and daily life functionality. It also queried how the lives of people around diagnosed persons are affected.

Result

Respondents were 19.5% FTD‐diagnosed persons, 40% biological family, 40% spouse/partner caregivers. Diagnosis was 54% bvFTD, 6% nfvPPA, 7% svPPA, 4% lvPPA, 9% PSP, 7% CBD/CBS, 4% FTD‐ALS, 2% other, and 6% indeterminate. The most common first symptom was personality change (27%), cognitive problem (25%), or language problem (18%). 78% of individuals waited for a second symptom before seeking a diagnosis. 52% required seeing 3 or more doctors before an FTD diagnosis was determined. 75% of FTD diagnosed persons were reported to be living at home. Assistance required with daily activities ranged from 30% for self‐reporting FTD persons versus 43% as reported by biological family/spouse/caregivers. Family and caregivers reported a range of negative impacts including altered role/relationships (84%), disrupted plans for the future (73%), and increased stress/negative health (73%).

Conclusion

FTD is a devastating disease that hinders a person in the prime of life from performing basic mental and/or physical daily tasks, and in most cases changes the person’s personality and behaviors. The Disease Impact Survey captures these elements from the lived experience and demonstrates that FTD not only affects the person diagnosed, but also family, friends, and caregivers.
Compliance‐without‐pressure techniques to enhance the implementation of psychosocial interventions in Alzheimer’s research
Authors: Bormans Kasper
Published: February 2022

Background

Over the past 30 years more than 200 interventions, targeting the caregivers of dementia patients, have been examined and found to be effective on the basis of randomized clinical trials. Only 3% of this large collection of psychosocial interventions was translated into daily practice. The primary objective of this study is to determine facilitators and barriers for implementing psychosocial interventions in Alzheimer’s research and to come up with communicational strategies to overcome possible obstacles and resistance. The secondary objective is to describe the different challenges between implementing a digital tool in the home environment versus the residential setting.

Method

We recruited professional caregivers in homecare (n=14) and the residential setting (n=24). Both groups were enrolled in a similar intervention trajectory of 36 weeks to assist people with dementia and their loved ones using a mobile health application (‘MemoryHome’). Participants were trained in employing the technology to construct personalized memory walks through the known environment of dementia patients. The participants kept a diary to report all types of resistance and possible obstacles specific to homecare or the residential setting. Simultaneously, the caregivers received a communicational training (4 monthly sessions of 120min) based on several compliance‐without‐pressure‐techniques to encourage dementia patients and their significant others to cooperate with the intervention and to continue performing the walks regularly.

Result

The implementation of psychosocial interventions in Alzheimer’s research can be enhanced through communicational training focusing on compliance‐without‐pressure‐techniques (f.i. foot‐in‐the‐door, illusion of choice, errorless learning, sensory variety, future perspective, sense‐of‐agency and positive reinforcement). The condition of homecare and residential setting had specific facilitators (f.i. more involved family members in homecare) and barriers (f.i. decreased health conditions in the residential care setting).

Conclusion

The results suggest that the challenge for the future of psychosocial interventions is not so much to come up with new inventions, but to motivate people to actually use existing instruments. Adapting the intervention to the possibilities of the living environment and stimulating the significant others to collaborate, for example by means of compliance‐without‐pressure techniques, can provide a crucial added value for upcoming Alzheimer’s treatments.
The first intervention study addressing dementia among LGBT older adults and their caregivers: Lessons learned
Authors: Fredriksen‐Goldsen Karen , Teri Linda , Kim Hyun‐Jun , McKenzie Glenise , La Fazia David M , Emlet Charles A , Petros Ryan
Published: February 2022

Background

The cognitive health needs of LGBT older adults have not been adequately addressed in mainstream clinical trials. Aging with Pride: IDEA (Innovations in Dementia Empowerment and Action), is the first intervention worldwide designed to improve physical functioning and quality of life of LGBT adults living with dementia and caregivers.

Method

As a first step, this intervention evaluated the processes and effectiveness of culturally responsive recruitment approaches for this population. A strong research‐community partnership was necessary for the development and implementation of the intervention.

Result

LGBT participants with dementia made the first contact to research team as often as caregivers did and showed a higher rate of living alone and having a friend‐based care network. The most common reason for ineligibility was not having a caregiver.

Conclusion

Initial findings demonstrate efficacy of an enhanced intervention addressing the distinct risk and protective factors among LGBT older adults living with dementia. This study illustrates innovative ways to address serving disadvantaged communities and their caregivers and how to design a clinical trial with hard‐to‐reach participants.
Disparities in subjective cognitive impairment by sexual orientation and gender in a national population‐based study of U.S. adults
Authors: Jung Hailey , Kim Hyun‐Jun , Fredriksen‐Goldsen Karen
Published: February 2022

Background

In this presentation we discuss the findings of the first national population‐based study to examine disparities in subjective cognitive impairment among sexual minority adults.

Method

Using the U.S. National Health Interview Survey (2013‐2018), we estimated weighted prevalence of subjective cognitive impairment by sexual orientation for women and men aged 45 and older, and performed logistic regressions after adjusting for age, income, education, and race/ethnicity.

Result

Approximately one‐quarter of sexual minority women and men reported subjective cognitive impairment, and their odds were higher than heterosexual counterparts. Among women, sexual minorities had higher odds for greater severity, frequency, and extent of subjective cognitive impairment. While sexual minorities were more likely to report activity limitations resulting from cognitive impairment, they were no more likely to attribute limitations to senility/dementia.

Conclusion

Cognitive impairment is increasing and of substantial societal cost. The findings signify the need to develop targeted interventions and policies to address distinct challenges sexual minorities face.
Facing the void: The experience of Australian care partners and people living with dementia following diagnosis
Authors: Gresham Meredith D , Low Lee‐Fay , Phillipson Lyn , Jeon Yun‐Hee , Swaffer Kate , Brodaty Henry
Published: February 2022

Background

The COGNISANCE (Co‐designing dementia diagnosis and post diagnostic support) project aims to co‐design and produce resources that will improve communication of dementia diagnoses and support for people living with dementia (PLWD) and care partners following diagnosis. Internationally, dementia guidelines reinforce the need for post‐diagnostic support, however PLWD and care partners are frequently dissatisfied. COGNISANCE is being conducted in five countries; Poland, UK, Netherlands, Canada and Australia. This presentation reports on current Australian experiences of support from the perspectives of PLWD, care partners and health and social care practitioners.

Methods

Interviews and focus groups were conducted using online video conferencing with 8 PLWD who had been diagnosed with dementia in the past 24 months and 17 care partners. Nineteen health or social care professionals were interviewed individually or in small groups via videoconferencing. Techniques used included word association exercises and projective interviewing ‐ projecting thoughts and feelings onto photographs of an (hypothetical) older couple receiving a diagnosis; and discussion of barriers and facilitators to post‐diagnostic support. Interviews were transcribed and thematically analysed.

Results

Key themes were that PLWD and care partners experienced lack of support and direction following diagnosis. Support information given at the time of diagnosis was usually minimal. PLWD described ‘an information vacuum’ and care partners felt lost, and at a loss of what to do next, or where to find practical or emotional support. The majority of care partners felt abandoned and wanted follow‐up after the diagnostic interview. Health care professionals were concerned but described difficulty in recommending useful supports because of lack of available/appropriate services, lack of knowledge of supports or therapeutic nihilism.

Conclusion

Post‐diagnostic support is inadequate and could be improved by follow‐up, better linking with services, provision of information and development of a support plan.
Lipidomic signatures for APOE genotypes provides new insights about mechanisms of resilience in Alzheimer’s disease
Authors: Wang Tingting , Huynh Kevin , Giles Corey , Lim Wei Ling Florence , Duong Thy , Mellett Natalie A. , Smith Alexander , Olshansky Gavriel , Drew Brian G. , Cadby Gemma , Melton Phillip E. , Hung Joseph , Beilby John , Watts Gerald F. , Chatterjee Pratishtha , Martins Ian , Laws Simon M. , Bush Ashley I. , Rowe Christopher C. , Villemagne Victor L. , Ames David , Masters Colin L. , Arnold Matthias , Kastenmüller Gabi , Nho Kwangsik , Saykin Andrew J. , Baillie Rebecca , Han Xianlin , Martins Ralph N. , Moses Eric , Kaddurah‐Daouk Rima F. , Meikle Peter J
Published: February 2022

Background

The apolipoprotein E gene (APOE) genotype is the first and strongest genetic risk factor for late‐onset Alzheimer’s disease and has emerged as a novel therapeutic target for AD. The encoded protein (Apolipoprotein E, APOE) is well‐known to be involved in lipoprotein transport and metabolism, but its effect on lipid metabolic pathways and the potential mediating effect of these on disease risk have not been fully defined.

Method

We performed lipidomic analysis on three independent cohorts (AIBL, n = 693; ADNI, n=207; BHS, n=4,384) and defined the association between APOE polymorphisms (ε4 and ε2) and plasma lipid species. To identify associations independent of lipoprotein metabolism, the analyses was performed with adjustment for clinical lipids (total cholesterol, HDL‐C and triglycerides). Causal mediation analysis was performed to estimate the proportion of risk in the outcome model explained by a direct effect of APOE genotype on prevalent AD — the average direct effect (ADE) — and the proportion that was mediated by lipid species or lipidomic risk models — the average causal mediation effect (ACME).

Result

We identified multiple associations of species from lipid classes such as ceramide, hexosylceramide, sphingomyelin, plasmalogens, alkyldiacylglycerol and cholesteryl esters with APOE polymorphisms (ε4 and ε2) that were independent of clinical lipoprotein measurements. There were 104 and 237 lipid species associated with APOE ε4 and ε2 respectively which were largely discordant. Of these 116 were also associated with Alzheimer’s disease. Individual lipid species (notably the alkyldiacylglycerol subspecies) or lipidomic risk models of APOE genotypes mediated up to 10% and 30% of APOE ε4 and ε2 treatment effect on AD risks respectively.

Conclusion

We demonstrate a strong relationship between APOE polymorphisms and peripheral lipid species. Lipids species mediate a proportion of the effects of APOE genotypes in risk of AD, particularly resilience with e2. Our results highlight the involvement of lipids in how APOE e2 mediates its resilience to AD and solidify their involvement with the disease pathway.
Brain structure in subjective cognitive decline: A replication study
Authors: Parker Ashleigh F. , Szoeke Cassandra , Gawryluk Jodie
Published: February 2022

Background

Alzheimer’s disease (AD) is an incurable neurodegenerative disorder, which disproportionately affects women (Erol et al., 2015). Given that the current treatments for AD aim to prevent symptom progression, the primary objective of emerging research is to identify pre‐clinical biological markers. Investigating such biomarkers would be appropriate in those experiencing subjective cognitive decline (SCD). Individuals with SCD are thought to be the earliest along the cognitive continuum between healthy aging and AD, as their reported change in cognition is not yet measurable using standard neuropsychological assessment measures. Previous research has found differences to exist in brain function, but not structure between healthy controls and those with SCD (Parker et al., 2020). The current study represents a preliminary analysis of structural brain images in healthy women compared to women with SCD; no structural differences between groups were hypothesized.

Method

The 3T T1 anatomical magnetic resonance images (MRI) used in this analysis was a subset of participants obtained from the Women’s Healthy Ageing Project collected in 2012 (N = 170). This subset included 30 healthy women (mean age = 71.4; SD = 3.12) and 30 women with SCD (mean age = 70.5; SD = 2.23). Voxel‐based morphometry (VBM) analyses were conducted using FMRIB’s Software Library to examine cross sectional differences between healthy women and women with SCD.

Result

Whole brain VBM analyses did not reveal any significant differences in grey matter tissue density between healthy women and women with SCD at p < 0.05 level with threshold free cluster enhancement (corrected for multiple comparisons).

Conclusion

Although the current findings did not reveal differences in grey matter between healthy women and women with SCD, this result replicates our previous findings and other reports in the literature that structural differences may not be detectable between healthy individuals and those with SCD. Follow‐up work will include investigation of differences in functional connectivity between these two groups using resting‐state functional MRI with the total sample collected in 2012 (N = 170). Identifying changes in brain function prior to structural atrophy and measurable decline on neuropsychological measures would represent a major advance in AD biomarker research.
Differences in cerebral oxygenation between healthy older and younger adults during the Multi‐Source Interference Task
Authors: Kwan Heather , Scarapicchia Vanessa , Halliday Drew , MacDonald Stuart , Gawryluk Jodie
Published: February 2022

Background

Cognitive changes that accompany normal aging include declines in processing speed and executive function. Further research is needed to characterize the neurobiological underpinnings of these cognitive changes in older adulthood. The current study used functional near infrared spectroscopy (fNIRS), a neuroimaging technique that measures oxygenated hemoglobin (HbO), to examine differences in cerebral oxygenation between healthy younger adults (YA) and older adults (OA) during a measure of cognitive interference.

Method

There were 34 participants sampled from two age group: YA (Mean age =28.1 years, SD=2.8, F=9) and OA (Mean age =70.9 years, SD=5.4, F=9). All participants were native English speakers, neurologically healthy, and had normal or corrected to normal vision. Participants completed the Multi‐Source Interference Task, a measure of cognitive interference with high and low‐demand conditions, while undergoing fNIRS recordings by a TechEn CW6 system with 34‐source‐detector channels over the PFC. The functional activation patterns, accuracy, and reaction time were compared between groups for each condition.

Result

The functional results demonstrated a significant age‐related increase in HbO for OA in both conditions (p < 0.05). In the control condition, OA demonstrated increased HbO in 10 channels covering the left and mid‐anterior PFC in comparison to YA. In the interference condition, OA demonstrated increased HbO in 6 channels covering the mid‐anterior PFC in comparison to YA. During the control condition, OA and YA had the same accuracy (YA Mean= 0.99, OA Mean= 0.99, p>0.33), but OA were significantly slower (YA Mean= 545.63, OA Mean= 768.04, p<0.0001). During the interference condition, OA had lower accuracy (YA Mean=0.97, OA Mean=0.9, p< 0.0001) and were significantly slower (YA Mean=891.31, OA Mean=1114.5, p< 0.0001) than YA.

Conclusion

The results from this study show that OA require greater activation in mid‐PFC regions, across both low and high‐demand conditions, relative to YA. These results are consistent with cognitive aging theories such as the compensation‐related utilization of neural circuits hypothesis (CRUNCH). Specifically, the findings suggest that OA recruit additional neural resources to achieve similar behavioural performance during low‐levels of cognitive interference, but that this same compensation may be insufficient to support behavioural performance at higher levels of interference.
Structural connectome and machine learning for Alzheimer’s disease detection
Authors: Francis Farah , Cabez Manuel Blesa , Smith Keith , Luz Saturnino
Published: February 2022

Background

Alzheimer's disease (AD) is hypothesised as a disconnection syndrome where degenerating white matter fibre bundles leads to deterioration in the integration and communication between brain regions. Connectomics allows the study of in vivo brain connectivity and elucidates how the disease changes the brain network. Although some studies have shown evidence of alteration of structural connectivity between AD and cognitively normal individuals (CN), a large proportion of research focused on functional connectomics in AD. Emerging connectomics studies explored the use of machine learning (ML) to distinguish brain structural connectivity differences in AD with promising results. This project aims to identify changes in the structural connectome using novel image processing techniques to generate network metrics and utilise ML to classify between AD and CN.

Method

We examined data from 143 age‐matched subjects (AD mean: 71.1 ± 2.79 and CN mean: 71.09 ± 2.72) from the Alzheimer's Disease Neuroimaging Initiative cohort 2 (ADNI2). We used magnetic resonance images (T1‐weighted and diffusion‐weighted images) combined with the latest state‐of‐the‐art imaging processing tools to generate structural connectomes. Relevant network metrics were used to measure and compare brain connectivity, while ML algorithms were used to distinguish network metrics between AD and CN.

Result

We found significant connectivity changes in clustering coefficient (p < 0.05), normalised degree variance (p < 0.0001), hierarchical complexity (p < 0.005) and rich club (p < 0.0001) in AD (table 1). We also established and compared classification performances within our ML model. Random forest yielded sensitivity of 53.06% and specificity of 82.98% (table 2) for imbalanced data (AD=49, CN=94). On balanced data (AD=CN=49), the model was 81.63% specific and 69.39% sensitive (table 3) in detecting AD.

Conclusion

The results show the feasibility of a connectome analysis of structural imaging combining the latest network metrics with ML for AD detection. While previous ML studies achieved promising results with balanced data, we reported both balanced and imbalanced models. As real‐world AD data are more likely to be imbalanced, the lower performance of the ML models on imbalanced data suggests that further improvement is needed for clinical implementation.
Emotional regulation through second language use in dementia
Authors: Ware Caitlin , Rigaud Anne‐Sophie
Published: February 2022

Background

Cognitive reserve has been linked to bilingualism, yet the mechanisms are still unknown. Older bilinguals have been shown to benefit from cognitive advantages (Bak et al., 2014), but could dual language use affect emotional processing? Second language use has been shown to facilitate implicit emotional regulation (Morawetz 2017), and thus be a therapeutic tool in treating trauma (Dewaele and Costa 2013), and diminishing levels of distress associated with memories encoded in one’s mother tongue (Dylman and Bjarta 2018). As some dementia patients are unable to control the intensity of their affects, could a second language be employed as a means of emotional continence?

Method

We had three participants with dementia take the Thematic Apperception Test (T.A.T.), a projective personality test, in French, their mother tongue, and in English, their second language. The T.A.T involves telling stories about emotionally charged images, and responses are measured in terms of rigidity, emotional flexibility, conflict avoidance, and primary processes. The participants’ stories were recorded and transcribed, and scored by calculating the percentage of neurotic, borderline, and psychotic defense mechanisms employed.

Result

As a function of the language used, the participants’ scores differed. Most strikingly, the stories told for some of the images were more complex in English than in French. In their non‐dominant tongue, two participants were able to express more disturbing themes such as rivalry, crime, and sexuality, while these topics were avoided in their mother tongue. Finally, for two participants, a more positive interpretation was given to the last card, a blank white image, when described in English as opposed to its description in French.

Conclusion

This exploratory study provides some support for the use of a second language as a means of emotional regulation in patients living with dementia. It is interesting in the light of cognitive reserve in older adults, as the use of a second language could potentially have a beneficial effect on cognition and delay the onset of dementia (Bialystok et al., 2004). Moreover, using a second language could also be advantageous from a psychological standpoint, facilitating the verbalization of negative emotions, and changing one’s perspective.
The SLU‐AMSAD, a short screening tool for diagnosing depression in dementia patients
Authors: Chakkamparambil Binu , Chibnall John , Gao Xiaoyi , Xin Jason , Khoury Rita , Grossberg George T
Published: February 2022

Background

The prevalence of depression in people with Alzheimer’s disease is estimated to be nearly 50%, accounting for a significant amount of additional caregiver burden1. With the COVID‐19 crisis, depression in dementia patients, especially those living in long term care facilities, has increased. The Cornell Scale for Depression in Dementia (CSDD) is the gold standard for assessing depression in dementia patients, but is lengthy, taking nearly 20 minutes to administer3. The SLU AMSAD is a previously validated depression tool which consists of 5‐items and takes less than 2 minutes to administer3. The objective of this study was to compare this short tool with the lengthier gold standard, the CSDD, to diagnose depression in cognitively impaired patients.

Method

44 patients, 65years and older were enrolled in the study from an out‐patient clinic setting. A St. Louis University Mental Status Exam (SLUMS) score of less than 25 was used to include the eligible patients. All enrolled subjects were administered the SLUMS, SLU AMSAD and the CSDD. The SLUMS score was used to classify the patients as having mild, moderate and severe dementia

Result

The preliminary data set analyzed data for N=44 cases of which 54.5% were female and 88.6% Caucasian with a mean age of 79.9. The average SLUMS score was 14.3 (6.5). For the total sample, area under the curve (AUC), sensitivity, and specificity values exceeded 0.82, with a maximum sensitivity of 0.92 and specificity of 0.84 (for an optimal cut‐off score of 4/5).

Conclusion

The SLU AMSAD had a very strong correlation with the CSDD as shown by the above results in this preliminary data sample of 44 patients. We intend to continue with the study and gather a total sample of 105 patients to add stronger statistical power to the study. References: 1. Chi S, et.al. The prevalence of depression in Alzheimer's disease: a systematic review and meta‐analysis. Current Alzheimer research. 2015;12(2):189‐ 98. 2. Alexopoulos, G. S., et.al (1988). Cornell scale for depression in dementia. Biological Psychiatry, 23(3), 271–284. 3. Chakkamparambil B, et.al Development of a brief validated geriatric depression screening tool: the SLU "AM SAD". Am J Geriatr Psychiatry. 2015 Aug;23(8):780‐3.
Preliminary experience in a tertiary geriatric centre of PCASL as a potential biomarker in dementia imaging
Authors: Mangalore Sandhya , Chaurasia Kavish , P.T. Sivakumar
Published: February 2022

Background

PCASL is a perfusion imaging biomarker and is a contrast free , radiation free technique .At our tertiary neuropsychiatric centre MR/PETstudies had optimised and standardised PCASL sequence with gold standard FDG PET .In this study we have used PCASL in wide variety of cases referred for structural imaging in clinical setup and we present our experience with yield of PCASL in clinical work up along with clinical – structural MRI correlation .

Method

We present our experience with 51 cases referred from geriatric clinic for imaging work up between april 2020‐april 2021.The standardised PCASL sequence was acquired along with routine clinical dementia protocol.

Result

We were referred cases with typical and atypical clinical pattern. Psychiatric symptoms included late onset psychosis , depression , delusion , bipolar disorders.Cognitive presentation included RPD , multidomain cognitive impairment Paraneoplastic work up with serology has low specificity and ASL helped guide a whole body imaging workup. Predominantly movement disorder with cognitive impairment were planned for DBS /TMS based on outcome.We could phenotype the cases based on the perfusion profile as AD(13), FTD(26), DLB(3),Parkinsonian disorders such as PDD, CBD, MSA, PSP(8), Vascular dementia(1).We could also subtype AD as PCA AD(5) , AD‐ VaD (1) and FTD as svFTD(7) , bvFTD(7), FTD‐PSP(1),PNFA(2) , FTD‐NPH(1), CBD‐AD(1).Detailed clinical – structural – functional imaging correlation was done for all these cases

Conclusion

PCASL predated structural atrophy pattern and could help in establishing diagnosis early on in a clinical setup. It increased the sensitivity of sMRI by synergistically establishing diagnosis in conditions such as NPH , VaD with LVAO and SVD ,Post traumatic/stroke, hyponatremia, alcohol withdrawal, paraneoplastic /AIE and CJD.Further management with non pharmaceutical options such as ECT/TMS and TDCS could be evaluated.As a surrogate biomarker for FDG, tracers such as FDOPA, Amyloid and Tau imaging can be imaged simulatenously with MRPET. Imaging is crucial where there is lack of clinical history in a developing country due to lack of followup , awareness , apathy to the disease .
Dementia knowledge in three countries in sub‐Saharan Africa
Authors: Willis Rosalind , Manful Adwoa Serwaa , Igbafe Lilian , Mukayagi Patricia
Published: February 2022

Background

Limited research has been carried out in sub‐Saharan Africa about knowledge of dementia, although studies report that supernatural causes predominate while the biomedical model has less adherence. The biomedical model has been called the pathway to care, but this is less useful when infrastructure and services for dementia are limited. Three African researchers sought to explore knowledge about dementia in three sub‐Saharan African countries. This article provides added value by performing a synthesis across the three countries.

Method

Qualitative research was performed in Zambia (healthcare professionals and the general public), Kenya (people providing care for parents), and Nigeria (family members providing care for relatives). Individual interviews were analysed with thematic analysis. The findings from the three countries were synthesised to identify shared messages and areas of transferability.

Result

Zambian findings showed partial adherence to the biomedical model of dementia among professionals but not among the general public. There was evidence of othering those who believed in supernatural origins. In Kenya information‐seeking strategies were used when carers realised something unusual was happening, indicating high levels of social capital are necessary. Nigerian findings demonstrated a similar process of gradual recognition of symptoms, but also labels of madness and expectations of recovery.

Conclusion

Overall, the three sets of data imply that adherence to the biomedical model of dementia is more widespread in sub‐Saharan Africa than has been previously thought, but without care and support services and accompanying policies this will not benefit people with dementia and their families.
The effects of robot‐based cognitive intervention on resting‐state EEG in patients with mild Alzheimer's disease dementia
Authors: Kim Geon Ha , Kim Bori R , Park Kee Duk , Jeong Jee Hyang
Published: February 2022

Background

Cognitive intervention (CI) has been known to improve cognition and to delay cognitive decline in patients with dementia. The purpose of this study was to investigate the effects of our newly developed, robot‐based CI for 12 weeks on brain function and cognitive performance in patients with mild Alzheimer's disease dementia (ADD).

Methods

A single‐blind randomized controlled trial was conducted in 37 patients with ADD. ADD patients met the criteria proposed by the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association (NINCDS‐ADRDA). Mild dementia was determined if global clinical dementia rating of the patients was 0.5 or 1. All participants were randomized into the two groups: the home based cognitive intervention with robot (Robot) and waitlist control without cognitive intervention (control). A total of 20 cognitive training programs were settled in the robot, which targeted training for specific cognitive domains including attention, memory, visuospatial, calculation, language and frontal executive functions. The robot‐based cognitive intervention comprised 60‐min‐session per day for 12 weeks. The primary outcome was the changes in brain function measured by resting state electroencephalogram (EEG) with a 19‐channel wireless EEG device. The secondary outcome was the changes of cognitive function measured using the Cambridge Neuropsychological Test Automated Battery.

Results

There were no baseline demographic and clinical differences between the two groups. EEG analysis after 12‐week cognitive intervention showed decreased theta wave on the frontal areas in the Robot group, while increased theta wave on the frontal areas in the control group. In addition, Robot group also demonstrated improvement in the attention domain compared to the control group.

Conclusion

Given that increased theta wave on the frontal areas is associated with cognitive decline, our results suggest that 12‐week robot based cognitive intervention could help improve brain function and attention in patients with mild ADD.
Efficacy of doll therapy intervention on behavioral and psychological symptoms of dementia: A randomized single‐blind controlled trial
Authors: Vaccaro Roberta , Molteni Valentina , Ballabio Roberta , Ceppi Laura , Ardito Rita Bianca , Adenzato Mauro , Guaita Antonio , Pezzati Rita
Published: February 2022

Background

Doll therapy (DT) is a non‐pharmacological intervention recommended for the treatment of behavioural and psychological symptoms of dementia (BPSD), producing benefits on agitation, aggression and wandering. By recognition of the doll as a real baby, challenging behaviours, viewed as requests for care and protection (i.e. attachment behaviours), are replaced with caregiving behaviors. In order to overcome methodological issues of the available studies, we have designed a single‐blind randomised controlled trial on efficacy of DT in managing BPSD and reducing professional caregivers’ perceived stress linked to BPSD (ClinicalTrials.gov, NCT03224143).

Method

The object presentation procedure (doll or cube, a non‐anthropomorphic object) is structured with the goal of recreating a situation of separation from a known figure and interaction with the environment in order to partially recreate the prototypical phases of the ‘strange situation’. Analysis of covariance (ANCOVA) compared the intervention group and the active control group on the net change (post‐treatment minus pre‐treatment) in NPI‐NH total score and NPI‐NH Distress score. Pre‐treatment NPI‐NH total score and psychotropic medications were used as covariates in these analyses.

Result

One hundred thirty‐four women living in 26 nursing homes in the Canton Ticino area (Switzerland) were randomized, 129 completed the study. The intervention group (n= 64) and the active control group (n= 65) were comparable: age [(mean (SD)=86.9 (5.9) and mean (SD)=88.4 (5.5), respectively; z=‐1.276, p=0.202)], baseline NPI‐NH total score [(mean (SD)=33.84 (13.28) and mean (SD)= 31.55 (12.1), respectively; z=‐1.05; p=0.292)], baseline NPI‐NH‐Distress total score [(mean (SD)=12.08 (5.4) and mean (SD)=10.6 (5.04), respectively; z=‐1.86, p=0.063), Global Deterioration Scale score [(mean (iqr)=6 (5‐7) and mean (iqr)=6 (5‐7), respectively; z=‐1.146, p=0.252). Based on ANCOVA results, the intervention group reported a significantly higher decrease on NPI‐NH total score [(adjusted mean (SE)=‐ 11,63 (1,0)] with respect to the active control group [adjusted mean (SE)=‐ 4.19 (1.0); F(1)=43.433, p=<0.001; Partial 2=0.638]. The intervention group reported a significantly higher decrease on NPI‐NH‐Distress score [(adjusted mean (SE)=‐ 3.71 (0.43)] with respect to the active control group [(adjusted mean (SE)=‐1.24 (0.43); F(1)=40.97, p=<0.001; Partial 2=0.625].

Conclusion

DT significantly reduces challenging behaviors and caregivers’ perceived stress linked to BPSD.
Suitability of memory aids and strategies for people with posterior cortical atrophy: Protocol for a scoping review
Authors: Burbaite Aurelija , Leeworthy Shona , Hirst Lisa , Mioshi Eneida , Clare Linda , Ahmed Samrah
Published: February 2022

Background

Posterior cortical atrophy (PCA) is a neurodegenerative syndrome characterised by a progressive visuospatial and visuoperceptual impairment. Recent research shows that memory impairment can also occur as an early symptom of the condition and, critically, can be ameliorated by providing support in the memory recall phase. There are currently no guidelines for which memory strategies may be suitable in PCA. Due to the central visual disorder that defines PCA, careful consideration is needed when choosing such strategies.

Method

A scoping review will be conducted of published studies that have assessed memory aids and strategies in people with Alzheimer’s disease and related dementias where memory is considered a core or supplementary feature, with the aim of distinguishing those that may be suitable or adaptable for PCA. The systematic search will include the electronic databases Medline, PsycINFO and CINAHL, using search terms for dementia (such as *DEMENTIA/ and alzheimer*) and memory aids and strategies (such as memory strateg*, memory aid*, assistive technolog*).

Result

Preliminary database searches identified 1567 citations, that will be screened to choose articles eligible for full text review based on title and abstract. Reference lists will be used to identify further relevant studies. Data will be extracted by two reviewers using Mendeley.

Conclusion

The scoping review will give an overview of the memory aids and strategies used in people with Alzheimer’s disease and related dementias, and identify characteristics, modality and pragmatics to evaluate their suitability and adaptability for a PCA population. Tailored memory support strategies for people living with PCA could improve memory performance, which in turn would minimise negative patient and carer outcomes.
Differential impact of sub‐threshold amyloid‐beta deposition on gray matter volume for cognitively normal older adults according to APOE genotype: Whole brain voxel‐wise analysis
Authors: Kang Dong Woo , Lim Hyun Kook , Wang Sheng‐Min , Um Yoo Hyun
Published: February 2022

Background

Previous research has demonstrated that sub‐threshold amyloid‐beta retention is related to cognitive performance, functional brain change, and further amyloid‐beta/tau accumulation. However, few previous studies have assessed an effect of APOE genotype on the association between sub‐threshold amyloid‐beta deposition and cortical atrophy in the earliest stage of Alzheimer’s disease (AD). We aimed to evaluate the impact of sub‐threshold global and regional amyloid‐beta retention on cortical atrophy in cognitively normal older adults, according to APOE ε4‐allele status.

Method

Cognitively normal older adults with and without APOE ε4 allele (carrier, n=32; non‐carrier, n=80) underwent structural magnetic resonance imaging (MRI) scans and positron emission tomography (PET) scans with [18F] flutemetamol. Whole‐brain voxel wise analysis was conducted for evaluating the sub‐threshold amyloid‐beta deposition‐by‐APOE genotype interaction for cortical atrophy, adjusting for age, sex, and education years.

Result

Sub‐threshold amyloid‐beta deposition in posterior cingulate cortex (PCC)/precuneus showed a significant interaction with APOE genotype for gray matter volume of bilateral hippocampus, bilateral cerebellum, right middle temporal gyrus, putamen, left amygdala, postcentral, and rectus gyrus (FDR‐adjusted p < 0.001). Cognitively normal older adults with APOE ε4 allele exhibited a positive relationship between sub‐threshold amyloid‐beta retention in PCC/precuneus and normalized gray matter volume, while those without APOE ε4 allele showing an opposing association.

Conclusion

Thus, even sub‐threshold amyloid‐beta deposition has a differential impact on gray matter volume according to the representative AD risk factor, APOE ε4 allele in the earliest phase of AD. These results could contribute to the deeper understanding of the initial pathogenesis of AD.