bluuebunny/crossref_metadata_2025 huggingface dataset:
Area‐level deprivation is associated with rate of memory decline in late life within a community‐based cohort
Authors: Williams Victoria J. , Herd Pamela , Sicinski Kamil , Johnson Sterling C. , Asthana Sanjay
Published: December 2021

Background

Residing in a disadvantaged neighborhood is associated with adverse health outcomes, as well as increased risk for dementia. However, it remains unclear whether area‐level deprivation impacts the rate of age‐related memory decline, especially in community‐based populations.

Method

We quantified late life neighborhood level disadvantage using the 2013 Area Deprivation Index (ADI) for 2,554 participants with complete data of interest within the Wisconsin Longitudinal Study – a same‐aged, community‐based cohort of randomly selected 1957 Wisconsin high school graduates. Delayed recall for a 10‐item word list was assessed at two timepoints in mid to late life (Time 1 (∼2004): age 64.39 + 0.74 years; and Time 2 (∼2011): age 71.28 + 0.97 years). We used multivariate linear regression models to evaluate whether ADI was associated with memory performance at each time point, and with the annualized rate of change in memory performance over time.

Result

Increasing ADI was significantly correlated with lower adolescent IQ, less educational attainment, lower net worth, higher vascular risk scores, elevated depression metrics, and increasing age (all p<0.001). Mean ADI did not differ by sex, but was significantly higher in ApoE‐4 positive carriers (t(2552) =2.257, p=0.024). Results of multivariate regression indicated that greater area‐level deprivation (higher ADI) was not associated with delayed recall performance at Time 1 (b = 0.001; 95% CI: ‐0.003 to 0.005, P=0.790), but was associated with poorer delayed recall performance at Time 2 (B = ‐0.004; 95% CI: ‐0.007 to ‐0.001, P=0.019). Higher ADI also predicted greater annualized rate of decline in delayed recall between timepoints (B = ‐0.001; 95% CI: ‐0.001 to ‐9.9^10‐5, P=0.025). These findings held after controlling for individual‐level demographic and socioeconomic variables (age, sex, adolescent IQ, years of education, net worth), genetic risk (ApoE‐4 carrier status), depression, hearing loss, and a modified CAIDE (Cardiovascular Risk Factors, Aging, and Incidence of Dementia) risk score calculated at Time 1.

Conclusion

Even after accounting for established individual‐level demographic, socioeconomic, health, and genetic risk factors for cognitive decline, greater neighborhood disadvantage is associated with an accelerated rate of annualized decline in delayed recall performance across mid to late life in a community sample.
Association of anxiety with vascular risk factors in memory clinic patients with MCI and Alzheimer’s dementia
Authors: Razavian Narges , Dodson John , Horwitz Leora , Aphinyanaphongs Yindalon , Wisniewski Thomas , Masurkar Arjun V
Published: December 2021

Background

Anxiety is increasingly recognized as an early neuropsychiatric symptom in Alzheimer’s disease (AD) that portends faster progression. The etiology of anxiety in AD and the mechanism of this faster progression are unclear. Vascular risk factors independently associate with anxiety and dementia, and thus may play an important role in AD‐related anxiety. We aimed to study the prevalence of vascular risk factors in memory clinic patients with and without anxiety at the mild cognitive impairment (MCI) and AD dementia stages.

Method

The cohort included patients aged ≥ 65 years who were evaluated at the NYU Langone Barlow Center for Memory Evaluation and Treatment between January 1, 2015 and June 24, 2019. Analysis was limited to patients who received a diagnosis of mild cognitive impairment (MCI) or Alzheimer’s dementia (AD). At each stage, the cohort was divided into those with and without a coded diagnosis related to anxiety. Outcomes and clinical variables were based on electronic health records. Definitions for AD, MCI, anxiety, and vascular risk factors are shown in Tables 1‐2.

Result

2046 and 1594 patients were included in the MCI and AD cohorts, with anxiety prevalence of 26% and 20% in each cohort respectively. Characteristics of MCI and AD patients with and without anxiety are reported in Table 3. The rates of key cardio‐ and cerebrovascular risk factors were of increased frequency in anxious vs. non‐anxious patients in both MCI and AD cohorts: hypertension, hyperlipidemia, myocardial infarction, atrial fibrillation, ischemic heart disease, heart failure, and diabetes mellitus. Moreover, these differences were amplified in the dementia stage compared to the MCI stage. Peripheral vascular disease, stroke, and sleep apnea differences were unique to the dementia stage.

Conclusion

These results suggest that vascular risk factors could play a critical role in the relationship between anxiety and AD. This relationship strengthens as AD progresses from prodromal to dementia stage, and also involves additional factors. Further characterization of these relationships and their mechanisms may uncover novel pathways to manage AD‐related neuropsychiatric symptoms and modify AD progression.
Accounting for practice effects improves stability of MCI diagnosis and uncovers new impairments
Authors: Sanderson‐Cimino Mark E. , Elman Jeremy A. , Tu Xin M , Panizzon Matthew S. , Jak Amy J. , Franz Carol E. , Kremen William S.
Published: December 2021

Background

We previously showed that failure to account for practice effects (PEs) delays detection of conversion from unimpaired to mild cognitive impairment (MCI) and reduces diagnostic accuracy based on biomarker positivity data. Even among those who decline, PE can mask steeper declines by inflating cognitive scores. Within MCI samples, PEs may increase reversion rates and impede detection of new impairments. Here, within a baseline MCI sample, we evaluated how PEs affect prevalence, reversion rates, and progression from single‐domain to multi‐domain MCI at follow‐up.

Method

We examined 347 baseline Alzheimer’s Disease Neuroimaging Initiative MCI participants (mean age=73.2; SD=7.4). We used Jak/Bondi diagnostic criteria (6 tests). We also calculated PEs on a cognitive composite (ADAS‐cog 11) and a cognitive screener (MMSE). We identified participants who were demographically matched to returning subjects at their 1‐year follow‐up. The only difference was that one group was tested once and the other had completed prior testing. We subtracted PEs—based on comparing these groups—from follow‐up scores and recalculated MCI diagnoses.

Result

PEs were absent or small for 5 tests (Cohen’s d=.00‐.06) and medium for 1 (d=.50). There was a PE on the MMSE (Cohen’s d =.16), but none was found on the ADAS‐cog 11. Accounting for PEs increased MCI prevalence at follow‐up by 6% (252 vs 268), and reduced reversion rate by 15% (95 vs 79). PEs also masked progression from single‐domain to multi‐domain MCI: 24 vs 36 (+50.0% after accounting for PEs).

Conclusion

Although PEs were small, accounting for them in baseline MCI participants after 1‐year, increased MCI prevalence and progression from single‐domain to multi‐domain, and decreased reversion rates. PEs may be masked within a composite measures, but were present on a short cognitive screener. Failure to consider PEs reduces accuracy regarding conclusions about MCI stability/change and weakens our ability to determine when impairment spreads to new domains.
Towards a brain health diplomacy toolkit: Supporting tomorrow's brain health leaders
Authors: Dawson Walter D , Eyre Harris A
Published: December 2021

Background

The complex factors that may affect brain health at an individual, community, national, and international level require large‐scale diplomatic efforts to improve outcomes across the globe. Brain health diplomacy has recently been proposed as a framework to support the aim of mitigating threats to brain health with a specific focus on advanced age. Providing emerging brain health leaders with the tools to practice diplomacy is an important component of the framework and is essential to the ambitious goal of reducing the global burden of Alzheimer's disease and related dementias (ADRD).

Method

Drawing on several existing toolkits that support diplomacy, we propose the development of a toolkit for brain health leaders to advance brain health diplomacy across disciplines, sectors, and nations.

Result

Predicates for the brain health diplomacy toolkit include science diplomacy (American Academy for the Advancement of Science and European Science Diplomacy Cluster), innovation diplomacy (Nesta and Danish Government's TechPlomat), general diplomacy (Academy of Diplomacy, and the concept of health attaches (World Health Organization and United Nations).

Conclusion

The brain health diplomacy toolkit offers a practical set of tools for brain health leaders to enhance international efforts to reduce ADRD.
Health care professionals and use of digital technologies in patients with dementia and related disorders
Authors: Andrade Alan Cronemberger , Corrado Marta , Bertolucci Paulo Henrique Ferreira
Published: December 2021

Background

Digital technologies (digiTech) enhance benefits in healthcare and are present in elderly people lives. Healthcare professionals (HCP) who deal with dementia and related disorders face enormous challenges in delivering healthcare using digital devices, and Covid‐19 pandemic showed these pitfalls should be addressed. Technology solutions in elder people are being developed, not every HCP is heard, and we lack information about what these professionals think about this.

Methods

Using structured questionnaires and asynchronous electrotonic data capture, we asked experienced (84.3% postgraduate degrees) HCP with different backgrounds (8 practice areas) about what they think of technology use among their patients and carers. The average person in our sample (N = 51) was a highly skilled (22.2 study‐years) female (70.6%) medical doctor (62.8%) aged 39.1 years old (27 to 77 years), highly exposed to digiTech (68.6% mobile devices usage ≥4 hours/day). Neurologists (37.3%), neuropsychologists (15.7%), psychiatrists (13.7%), geriatricians (11.8%) were the most represented groups. This observational cross‐sectional study is part of a Brazilian pilot study to explore technology usage in higher risk dementia adults (DigiTAU Project).

Results

Although HCP consider asking patients and carers about technology use to be theoretically important (90.2%) and useful in practice (94.2%), they often do not do it (45.1%). There is incongruity when they feel safe to offer interventions by digital means (58.8%) but commonly agree, on average, that HCP are not prepared to use digiTech (51.0%). Despite having positive views towards benefits in adopting digiTech for patients (98.1%), they think they bring more benefits to families and caregivers than to patients themselves (56.9%). HCP consider digiTech will change their practice in the short term within 1 year (58.8%) and within 5 years (88.3%). None of the 8 options suggested as the most “promising” technology in 10 years reaches more than 25% of the choices.

Conclusions

HCP have conflicting views about the usage of technologies by their patients and caregivers but expect some positive changes in their work practice. It suggests new digiTech must be submitted to scrutiny so that its applicability overcomes the challenges. Further studies and analysis are needed to understand better this data.
The Lonafarnib target, Rhes, is uniquely dysregulated in tauopathies: A human postmortem study
Authors: Ehrenberg Alexander J. , Leng Kun , Letourneau Kaitlin , Hernandez Israel , Lew Caroline , Seeley William W. , Spina Salvatore , Miller Bruce L. , Heinsen Helmut , Kampmann Martin , Kosik Kenneth S. , Grinberg Lea T.
Published: December 2021

Background

The farnesyltransferase inhibitor, Lonafarnib, is capable of reducing tau lesions and associated atrophy in tauopathy models through activity on the Ras GTPase, Rhes (Hernandez I et al., 2019). While hinting at a role of Rhes in tau proteinopathic etiology, it is unclear how Rhes activity changes in human tauopathies or other neurodegenerative diseases. As these models reflect rare, familial forms of tauopathy, we sought to detect evidence of Rhes changes in human sporadic tauopathy versus FTLD‐TDP and synucleinopathies.

Method

Allocortical and neocortical sections from postmortem cases (Table 1) representing five different tauopathies, FTLD‐TDP, Lewy body disease, and healthy controls (HC) were immunohistochemically stained for Rhes, proteinopathic lesions (i.e. PHF‐1 positive tau inclusions, phospho‐TDP‐43, or α‐synuclein), and NeuN. Single‐nucleus RNA‐sequencing (snRNA‐seq) was also performed in a separate cohort representing HC and early AD.

Result

40 cases were examined in this study (Table 1). Rhes is widespread in cortical neurons, as detected by immunohistochemical staining and snRNA‐seq (Figure 1). In tauopathies, neurons either present Rhes as diffuse or punctiform, or feature an absence of Rhes (Figure 2). Accordingly, we classified neurons as Rhes type Diffuse, Punctiform, or Absent. The proportion of neurons with PHF‐1 positive tau inclusions significantly differ between the three neuronal Rhes phenotypes (p < 0.0001) with the majority of Absent type neurons harboring PHF‐1 positive tau inclusions and Diffuse type neurons mostly devoid of PHF‐1 positive tau inclusions (Figure 3, Table 2). Punctiform and Absent type neurons were not detected in neurons with phospho‐TDP‐43 inclusions or α‐synuclein inclusions (Figure 4).

Conclusion

Given the distribution of PHF‐1 positive tau inclusions across different Rhes‐deliniated neuronal phenotypes, we propose a model by which Rhes takes on a punctiform phenotype then is ultimately cleared from neurons with tau lesions. This postmortem study in humans, together with in vivo and in vitro work done in familial tauopathy models, suggests the presence of a causal relationship between Rhes clearance and tau proteinopathic lesions, but not phospho‐TDP‐43 or α‐synuclein inclusions. As such, Rhes cellular phenotype represents a novel postmortem hallmark of tauopathy and supports to application of Lonafarnib to the treatment of tauopathies.
Effect of genetic and vascular AD risk factors on rate of cognitive decline in EOAD vs LOAD
Authors: Sanjay Apoorva Bharthur , Li Yunyi , Gao Sujuan , Apostolova Liana G.
Published: December 2021

Background

APOE ε4 and vascular factors are well‐known risk factors for developing AD. The effect of these risk factors on rate of cognitive decline in early‐ or late‐onset AD (EOAD and LOAD) is not well understood. We investigated the effect of known AD risk factors (APOE ε4, education, hypertension, diabetes, dyslipidemia, and obesity) on longitudinal cognitive decline in EOAD and LOAD.

Method

Cognitive and demographic data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) study was used. We identified 203 EOAD and 1055 LOAD subjects based on age of onset of cognitive decline < or ≥65. Language function was assessed using the Boston Naming Test. Visuospatial function was assessed using ADAS‐Cog constructional praxis. Verbal memory was assessed by summing the scores of word recall (ADAS‐WRT),Delayed Word recall and Word recognition (ADAS‐Word). Executive function was assessed by using the category fluency test. For general cognition we used Mini‐Mental Status Examination (MMSE) and clinical dementia rating sum of boxes (CDR‐SB). To evaluate whether the risk factors had differential effect on the rate of cognitive decline between EOAD and LOAD, we performed univariable analysis for three‐way interaction (risk factor*time*group) and in multivariable analyses, we included age, time, risk factor, group, two‐way interaction effect (risk factor*group, time*group), and three‐way interaction effect (risk factor*time*group) that showed significance in univariable analyses for three‐ways interaction (p<.05).

Result

Baseline characteristics and demographic of participants are described in (Table 1).
APOE ε4 carrier status was associated with significantly faster decline in language, visuospatial, verbal memory, executive function and MMSE in LOAD (p<0.05). In EOAD it was only associated with faster decline in language domain (p=0.046). LOAD carriers had slower rate of decline in CDR‐SB. Being overweight was associated with a significantly different rate of decline between EOAD and LOAD for visuospatial function (p=0.04) and MMSE(p=0.02). It was also significantly associated with faster decline in CDR‐SB(p=0.03) in EOAD. Obesity was significantly associated with faster decline in CDR‐SB in EOAD (p=0.004) but not LOAD (Table 2).

Conclusion

Known risk factors for AD can have differential effect on type of cognitive trajectories based on age of onset of disease.
IPA criteria for psychosis in major and mild neurocognitive disorders
Authors: Reich Edgardo Gabriel
Published: December 2021

Background

Psychosis is common among individuals with neurocognitive disorders, is difficult to manage, and causes considerable burden and stress to patients and caregivers. Developing effective treatments is a substantial unmet medical need but research has been slowed by the need for updated consensus diagnostic criteria. To address this need, the International Psychogeriatrics Association (IPA) initiated a process to develop criteria for clinical use, research, and treatment development efforts. This opening can be bolstered by some epidemiology – 5.8M AD, 20% with psychosis at some time in the illness.

Method

The process included clinical, regulatory, and industry stakeholders as well as input from a global network of experts in geriatric psychiatry responding to two surveys (N=336).

Details on each survey and the meeting

Results

The consensus process confirmed that clinicians wanted elaboration of aspects of the definition proposed by Jeste and Finkel in 2000 to ensure that the criteria are applied appropriately. Based on discussions, the survey, and emerging research, criteria were revised to be applied to psychosis occurring with all major and mild neurocognitive disorders. Other important changes include providing examples of hallucinations and delusions and clarifying time course, impact, and exclusionary criteria.

Conclusions

This definition of psychosis in major and mild neurocognitive disorders can be used to advance many types of research including development of much needed pharmacologic and nonpharmacologic interventions for psychosis in patients with neurocognitive disorders.
Application of the IPA definition of agitation in cognitive disorders in clinical trials
Authors: Zhong Kate
Published: December 2021

Background

In 2015, the IPA published provisional criteria for Agitation in Cognitive Disorders. The criteria have since been extensively applied in clinical research and clinical trials. We review the impact of these criteria and the implications of their common use.

Method

The IPA criteria for Agitation in Cognitive Disorders were developed through an extensive process involving multiple stakeholders with two membership surveys, an in‐person meeting of international experts, and an iterative process of criteria and manuscript development. We reviewed the application of the IPA criteria in clinical trials since 2015 through interrogation of the clinicaltrials.gov registry.

Results

There have been 21 clinical trials for agitation in Alzheimer’s diseases conducted since 2015, out of those, IPA criteria have been used as inclusion criteria in 11 trials, the other 10 trials did not identify the IPA criteria as the explicit entry criteria. There is trend for trials planned more recently to use the criteria (6 of 9 trials registered since 2018). The criteria have been used in clinical trials with agents of a variety of mechanisms of action: 7 different mechanisms are represented in the trials using the criteria.

Conclusions

The 2015 IPA provisional criteria for Agitation in Cognitive Disorder are widely used. They have been implemented as inclusion criteria in a majority of agitation trials conducted since their introduction. A variety of pharmacologic mechanisms are represented in the trials using the criteria; the criteria facilitated comparing efficacy across multiple agents. The convergent and concurrent validity demonstrated for the criteria support removal of “provisional” from the criteria.
CSF amyloid‐beta, tau, and neurodegenerative and inflammatory biomarkers in cognitively unimpaired late middle‐aged and older adult APOE ε4 homozygotes, heterozygotes, and non‐carriers from the Arizona APOE Cohort
Authors: Ghisays Valentina , Jansen Willemijn J. , Chen Yinghua , Protas Hillary D. , Malek‐Ahmadi Michael H. , Luo Ji , Lee Wendy , Chen Kewei , Su Yi , Caselli Richard J. , Zetterberg Henrik , Blennow Kaj , Reiman Eric M.
Published: December 2021

Background

APOE4 gene dose, the number of apolipoprotein E ‐ɛ4 (APOE4) ɛ4 alleles in a person’s genotype, is associated with higher Alzheimer’s disease (AD) risk and younger median age at dementia onset. We previously found relationships between PET, plasma, and CSF measurements of amyloid‐β (Aβ) pathophysiology in APOE4 gene dose. Here, we characterize the core AD CSF biomarkers (Aβ42/40, pTau181, tTau), the neurodegeneration marker neurofilament light chain (NfL) and the glial biomarkers soluble TREM2 (sTREM2), and glial fibrillary acidic protein (GFAP) measurements in age‐matched 48‐70 year‐old cognitively unimpaired (CU) APOE4 homozygotes (HMs), heterozygotes (HTs) and non‐carriers (NCs) from the Arizona cohort.

Method

CSF biomarker measurements were performed at the University of Gothenburg using Lumipulse and ELISA immunoassays. CSF biomarker measurements were characterized and compared using linear‐tend ANOVAs in 12 HMs, 17 HTs, and 20 NCs who were CU, 48‐70 years old and did not differ significantly in their age, sex, or educational level.

Result

As expected, CSF Aβ42/40 ratios were inversely associated with APOE4 gene dose (linear trend, HM<HT<NC, p<0.05), and tTau/Aβ42 and pTau181/Aβ42 ratios were directly associated with APOE4 gene dose (HM>HT>NC p<0.05). Non‐significant trends suggested that CSF sTREM2 and sTREM2/pTau181 measurements were inversely associated with APOE4 gene dose (HM<HT≤NC, (0.05<p≤0.06). We failed to detect significant differences or linear trends in CSF pTau181, tTau, GFAP, or NfL measurements among these small subject groups.

Conclusion

APOE4 gene dose is associated with measures of CSF Aβ42/40 and Aβ‐related tau pathophysiology, reflecting higher Aβ plaque burden in CU subjects close to their estimated ages at clinical onset. Additional studies are needed to clarify relationships between different Aβ, tau, neurodegenerative, inflammatory, and other CSF, or blood‐based biomarkers, and APOE4 gene dose in larger subject groups and at other ages.
Evaluation of a person‐centered electronic health record care plan for hospitalized patients with dementia
Authors: Smith Elisha J
Published: December 2021

Background

Health care for people with dementia (PWD) has been characterized as inconsistent in quality and fraught with potentially preventable encounters to hospitals (Petty et al., 2019; Phelan et al., 2012). Person‐centered care (PCC) is the preferred model of dementia care because it improves the quality of care and quality of life, yet acute hospital settings struggle to provide care that values personhood (Clissett et al., 2013).

Objective

This DNP scholarly project evaluated the effectiveness of the recently expanded, EHR‐embedded, Patient‐specific Dementia Information (PSDI) care plan and aimed to understand its interaction on nurse perception of dementia care, nurse knowledge of PSDI, and patient‐level outcomes guided by the Donabedian Model to measure its impact on enhancing dementia care delivery at a quaternary medical center.

Method

Nonexperimental, systematic program evaluation design. Pre‐ and post‐implementation survey measured the general attitudes of acute hospital nurses in providing care to persons with dementia, the extent to which they perceived their clinical practice as being person‐centered, and their general knowledge of the EHR tool. Weekly rounding assessed facilitators and barriers to individualizing patient care based on information extracted from the dementia care plan tool. EHR chart examined primary patient‐level outcome of dementia care quality in the acute care setting (length of stay, restraint use, constant observation, fall occurrence, and superimposed delirium).

Results

The findings illustrated reduction in fall occurrence, restraint use, and an increase in positive Confusion Assessment Method delirium screening. Though results from nurse survey demonstrated high level of perceived confidence in dementia care, thematic analysis revealed poor confidence in evaluating psychosocial needs. Thematic analysis and survey responses elucidated bedside coaching as in effective strategy to promote staff awareness and learning of the PSDI and PCC practices.

Implications

Incorporation of PCC by hospital nurses through an EHR‐based care plan improves outcomes for hospitalized adults with dementia and reduce clinical complications. Further advancement can be made by utilizing the PSDI tool during care transition, offering robust education on dementia care, tailored bedside coaching techniques to teach concrete PCC intervention, promoting interdisciplinary involvement in PSDI workflow and future QI initiatives to improve care quality for PWD.
A new scale for the assessment of functional status in Alzheimer’s disease and related disorders
Authors: Elobeid Adila
Published: December 2021

Background

It is estimated that 5.7 million Americans are suffering from Alzheimer’s disease kills more people than breast cancer and prostate cancer combined. Scientists have been scrambling to figure out why Alzheimer’s disease is epidemic. Several years ago, the dowry’s theorized that genetics were to blame. The flaw with this explanation was that it did not rationally plain why the rates of Alzheimer’s disease are increasing at an unprecedented rate. While genetics may play a role, they are most certainly not the sole reason why Alzheimer’s disease is becoming such a widespread issue. While genetics may play a role, they are most certainly not the primary reason why Alzheimer’s disease is becoming such a widespread issue In 2017, a researcher finally stumbled across a logical eHeavy metals and Alzheimer’s Disease. Knowing that there were much more to Alzheimer’s disease than just genetics, researcher tuned to their attention to environmental toxins ‐ heavy metal to be specific. Related disorders included cancer and brain tumor caused heavy metal exposure and Alzheimer’s disease.

Method

One study published in the Journal of Alzheimer’s Disease found that people with Alzheimer’s disease had large amounts of aluminum, mercury and cadmium in their body. The method was to watch out on toxic or protein food in your refrigerator can cause dementia.

Result

As more and more studies supported this correlation, researchers take a deeper alert to determine how heavy metals are specifically connected to Alzheimer’s disease and damage to your brain. This damage comprises the function of your beurons rah in can result in cognitive problems, movement disorders.

Conclusion

Avoiding heavy metal exposure requires an awareness of how you get exposed to heavy metals. Here are some of the most common ways heavy metals get into your body and brain. Unlike other substances that detoxify the body, zeolite has the unique ability to travel deep into your cells where heavy metals accumulate. From there it binds to heavy metals like a magnet and transports them out of the body, so they are no longer a threat to your brain. Referenced Source: https://www.drperlmutter.com/study/circulatory-levels-of-toxic-media-patients-with-Alzheimer's-disease/. https://link.springer.com/article/10.1007/s13530-018-0340- https://www.n.I.non.nih.gig/PMC/articles/PMC4798150/.
Perceptions of sexual violence in later life, barriers and solutions to prevention
Authors: Hand Michelle Danäe
Published: December 2021

Background

Elders remain largely excluded from sexual violence (SV) prevention and intervention, owing to perceptions of older adults as asexual or undesirable due to intersectional ageism and sexism, which is further complicated when dementia is present (Bow, 2018). Thus, knowledge is limited on SV in later life and its prevention. Accordingly, a systematic scoping review was conducted to provide an understanding of how SV in later life is perceived, barriers to and possible solutions for prevention.

Methods

Included in the systematic scoping review was primary scholarly and grey source research published since 2010, on perceptions of SV, potential barriers to and solutions for prevention. Excluded were sources focused on non‐sexual abuse (e.g., neglect), focus on elder abuse without exploring SV in later life; or focus solely on victims younger than 50 years. The search returned 148 potentially relevant articles identified in eight databases. 53 were excluded upon title and abstract review, 76 were excluded upon full text reading, and one article was excluded following critical appraisal, leaving 18 articles for thematic analysis, assisted by NVivo software, to uncover themes across the reviewed studies.

Results

Seven overarching themes emerged from the 18 studies surrounding SV in later life and its prevention, involving (a) urgent needs for awareness and knowledge, particularly when dementia is involved, needs for (b) further research and (c) policy development, (d) impacts of ageism and sexism on perceptions and prevention, (e) SV being taboo, particularly when dementia is present, and needs for exploring (f) sociocultural factors, to address (g) confusion surrounding SV definitions, including in cases involving dementia among victims and/or offenders.

Conclusions

Multi‐level interdisciplinary implications remain for practice, research, policy, and education. Further interdisciplinary collaboration is needed in practice and research to influence policy and education on SV, particularly among individuals with dementia and other disabilities. Greater awareness and knowledge are needed across disciplines, particularly in cases involving dementia, through multi‐level trainings, for practitioners, family, social supports and the public. Additional research is needed on how to promote discussions of SV in later life and navigate cases involving dementia. Further implications will also be discussed.
Psychological status in the participants of the API ADAD Colombia trial assisted by a comprehensive mental health program during COVID 19 pandemic
Authors: Ramos Claudia , Madrigal Claudia , Giraldo‐Chica Margarita , Acosta‐Baena Natalia , Aponte Claudia , Aguillon David , Gómez Manuela , Espinosa Alejandro , Madrigal Lucia , Uribe Claramonika , Saldarriaga Amanda , Alzate Diana , Ruiz Alejandra , Andrade‐Villegas Angela M , Lopez Hugo Elias , Langbaum Jessica B , Sink Kaycee M , Reiman Eric M , Tariot Pierre N , Rios‐Romenets Silvia , Lopera Francisco
Published: December 2021

Background

Due to the global SARS‐CoV2 pandemic it has been hard to conduct research, including research related to prevention of neurodegenerative diseases. The Alzheimer’s Prevention Initiative (API) Autosomal Dominant Alzheimer’s Disease (ADAD) Colombia trial is being conducted in participants with family history of early‐onset dementia due to the PSEN1 E280A mutation who are cognitively unimpaired at baseline. Participants are enduring three stressors: 1) fear of developing dementia; 2) logistic changes to the study caused by the public health emergency due to the pandemic; and 3) concern about getting infected by SARS‐CoV2. Objective: To describe the frequency of new or exacerbated psychological disorders among the participants of the API ADAD Colombia trial assisted by a comprehensive mental health team during the COVID‐19 pandemic.

Method

Participants in the API ADAD Colombia trial have free access to psychology and psychiatry services, either in person or through teleassistance, as well as psychoeducational offerings. These mental health services are provided by the site, outside of the study protocol, and are supported by Health and Social plans which were created to support participants’ wellbeing during the trial. Descriptive statistics (mean, standard deviation and percentages) were used to analyze characteristics and frequency of mental health issues in the participants.

Result

66 participants (53 women, 80.3%) were treated by the Mental Health Team from March 1st, 2020 through December 31st, 2020. Mean age was 44.09 (SD 6.97) y.o. Before and after the pandemic onset, the most common psychological problems were anxiety (before 36.4%, after 63.6%) and depression (before 34.8 %, after 37.9%). From people who received psychological and psychiatric services, 70% vs. 81.6% felt that those services helped them, respectively. Among participants who received psychological vs. psychiatric assistance, 71.4% vs. 86.9% of patients with depression, 70.3% vs 75% of patients with anxiety and 60% vs 76.2% of patients with other disorders, felt the services helped them with these conditions.

Conclusion

A comprehensive mental health program immersed in a trial to prevent or treat devastating diseases as dementia, could mitigate the psychological effects of the COVID‐19 pandemic in study participants.
Modifiable factors associated with recovery of mild cognitive impairment patients: Evidence from the Chinese Longitudinal Healthy Longevity Survey
Authors: Li Bingyu , Zhao Ziyi , Wei Chang , Sha Feng
Published: December 2021

Background

It is unclear which modifiable factors are associated with reversion from mild cognitive impairment (MCI) to cognitively normal (CN) status.

Method

The study included 7,422 participants above 65 years old with MCI from Chinese Longitudinal Health Longevity Survey (CLHLS). Multivariable Cox regression with elastic net penalty was adopted to investigate the associations between reversion from MCI to CN and potential modifiable dietary/lifestyle, cardiometabolic, and psychological factors.

Results

1,604 (21.6%) participants reversed from MCI to CN with a median follow‐up of 2.8 years. Several dietary/lifestyle factors, including daily consumption of fresh fruits (HR: 1.28, 95% CI: 1.15‐1.42), daily engagement in reading (HR: 1.24, 95% CI: 1.00‐1.54), housework (HR: 1.21, 95% CI: 1.08‐1.35), or mah‐jong and other card games (HR: 1.23, 95% CI: 1.08‐1.39), were associated with a higher possibility of reversion.

Conclusion

This study identified several modifiable factors associated with MCI reversion that may transfer into large‐scale preventive practice for dementia.
Cognitive rehabilitation in Covid‐19 patients with dementia of the Alzheimer’s type
Authors: Rai Pooja
Published: December 2021

Background

Dementia of Alzheimer’s type has been characterized as marked deterioration in cognitive processes. The impairment has been progressive and could not be reverse because of its irreversible nature. However, there are some therapies or intervention like Cognitive Rehabilitation which have been proved to be effective for DAT in enhancing the patients' abilities to manage for decreased cognitive functioning. Recent scenario brings an attention on differences in cognitive rehabilitation in dementia of Alzheimer’s disease patients with Covid 19 positive (experimental group) and dementia of Alzheimer’s disease patients with Covid 19 negative (control group).

Method

The present study has been an attempt to compare the effect of video games in cognitive rehabilitation in experimental and control group by incorporating a definite time, frequency and duration for video games in their activities of daily living on 2 cases each for experimental and control group who were matched on Hindi version of Montreal Cognitive Assessment (MoCA).

Result

The findings revealed that the score of MoCA has been increased by mean of 1.5 point in dementia of Alzheimer’s disease patients with Covid 19 positive and mean of 2.5 points in dementia of Alzheimer’s disease patients with Covid 19 negative.

Conclusion

The cognitive rehabilitation using video games has been effective in both experimental and control group, however, it was better in control group as compared to experimental group.
Sovateltide prevents beta‐amyloid plaque load and restores memory deficit in an APP/PS1 mouse model of Alzheimer's disease
Authors: Briyal Seema , Voshtina Ralf , Gulati Anil
Published: December 2021

Background

Endothelin B (ETB) receptor agonist, sovateltide, is being investigated as a potential therapeutic agent for AD. However, its causative effects on decreasing beta‐amyloid (Aβ) plaque load and rescuing impaired memory in APP/PS1 mice remain unclear. In the present study, we have examined the effects of SOVA on Aβ plaques formation and functional recovery in transgenic AD mice and explored its mechanism(s) of action.

Method

APP/PS1 transgenic mice and C57BL/6 control mice were divided into two groups (vehicle and sovateltide). Sovateltide (5 μg/kg) was intravenously injected three times at 2‐hour intervals on days 1, 3, and 6 every month until study endpoints (3, 6, and 12 months age). Memory deficit was assessed using the Morris water maze test. Separate sets of mice were sacrificed at the end of 3, 6, and 12 months and Aβ plaque formation was examined in the brain. Mitochondrial dysfunction, neurogenesis, and synaptogenesis were assessed using western blot and immunofluorescence techniques.

Result

APP/PS1 transgenic mice showed significant (p<0.001) impairment in spatial memory. Treatment with SOVA rescued learning deficits and relieved memory retention in APP/PS1 mice. SOVA treatment significantly reduced memory deficit in 6 months (40%) and 12 months (46%) aged transgenic mice. SOVA administration also significantly (p<0.001) decreased Aβ plaque load in the brain compared to vehicle. Moreover, SOVA attenuated neuronal loss in the hippocampus and enhanced neurogenesis in APP/PS1 mice as evident by increased expression of NeuroD1 (p<0.0001), DoubleCortin (p<0.0001), and NeuN (p<0.0001) along with an upregulation of synaptic proteins (synapsin‐1, synaptophysin, and postsynaptic density‐95) compared to vehicle at 6 and 12 months. Further study demonstrated that treatment with SOVA upregulated (p<0.0001) mitochondrial fusion proteins, Mfn1, Mfn2, Opa1, and downregulated fission proteins, Drp1 and Fis1, compared to vehicle at 6 and 12 months. There were no changes in the expression of any of these markers at three months.

Conclusion

SOVA can improve functional recovery and has a neuroprotective effect in APP/PS1 mice via triggering neurogenesis and improving mitochondrial function mediated by ETB receptor signaling pathway, which could help in improving neurological deficits. Therefore, SOVA has the potential to be developed as a novel drug for the treatment of AD.
NIH toolbox episodic memory measure differentiates older adults with exceptional memory capacity from those with average memory
Authors: Karpouzian‐Rogers Tatiana , Makowski‐Woidan Beth , Kuang Alan , Zhang Hui , Fought Angela , Engelmeyer Janessa , Mesulam M.‐Marsel , Weintraub Sandra , Rogalski Emily J
Published: December 2021

Background

“SuperAgers” are older adults over the age of 80 with exceptional memory abilities, at least as good as cognitively average individuals in their 50s and 60s. The purpose of this study was to compare SuperAgers with their cognitively normal‐for‐age peers on subtests of the NIH Toolbox Cognition Battery (NIHTB‐CB), including a test of nonverbal picture sequence memory.

Method

Participants categorized as SuperAgers (n=46) or as cognitively average‐for‐age (n=31) completed standard neuropsychological tests of attention, executive functions, language, and episodic memory. SuperAgers are classified by a delayed recall score on the Rey Auditory Verbal Learning Test that falls at or above the average score of 50 to 65‐year‐old norms, while scores in non‐memory domains must be at least in the average range for age. Multivariable linear regression models were used to examine differences across subtests between the groups.

Result

After controlling for IQ, gender, age, and education, Picture Sequence Memory Scores were higher in Super Agers than in the cognitively normal‐for‐age group (p = 0.007). However, the groups did not differ in their scores on all other Cognition measures.

Conclusion

Findings from this study demonstrated that SuperAgers scored higher on a test of nonverbal memory in the NIHTB‐CB compared to cognitively average‐for‐age peers, while groups scored similarly on non‐memory domains. These findings demonstrate that memory abilities in SuperAgers are strong not only on tests of verbal memory, but on nonverbal measures, as well. These findings extend the potential to identify SuperAgers with more efficient assessment methods.
Objective sleep hypoxia measures are associated with subjective quality of life ratings in amnestic MCI subjects
Authors: Sanderlin Ashley H. , Hayden Kathleen M. , Leng Xiaoyan Iris , Baker Laura D. , Craft Suzanne
Published: December 2021

Background

Sleep disturbances are common in individuals with Mild Cognitive Impairment (MCI); and sleep disturbances increase the risk of Alzheimer’s disease (AD). Lower ratings of quality of life (QoL) are also found in MCI. We examined the association between sleep disturbances and QoL ratings among participants with MCI.

Methods

Baseline in‐home sleep assessments using the WatchPAT (Itamar Medical) and the QoL in AD questionnaire were collected from amnestic MCI (aMCI) participants from the diet intervention trial, Brain Energy for Amyloid Transformation in Alzheimer’s Disease (BEAT‐AD) at the Wake Forest ADRC. The WatchPAT assessed sleep time, efficiency, and sleep‐related hypoxemia measures including the apnea‐hypopnea index (AHI), oxygen desaturation index (ODI) and respiratory disturbance index (RDI), where higher values indicate greater disturbances in sleep. The QoL in AD scale ranged from 13–52 with lower scores indicating poorer QoL ratings. We assessed the association between total sleep time and sleep efficiency with QoL. Pearson correlations and regression models measured the association of sleep metrics with QoL scores.

Results

Forty‐two aMCI participants (mean age =69.0 ± 7.4 years; N=23 female; mean BMI =27.6) were studied. Disturbed sleep indicated by the average number of apneas and hypopneas (AHI, mean = 18.6 ± 14.6) and respiratory events or related arousals (RDI, mean = 20.7 ± 14.2) was negatively associated with lower subjective measures of QoL. Higher AHI and RDI scores, indicating greater intermittent hypoxia and respiratory burden, were associated with lower QoL (AHI: r= ‐0.359, p=0.027; RDI: r= ‐0.340, p=0.037). There was a trend toward a negative association of ODI and QoL scores (r= ‐0.309, p=0.059). Regression models including age, sex, and BMI did not significantly predict QoL scores with AHI (F(4,35)=1.95, p>.1) or RDI (F(4,34)=1.76, p>.15), however, AHI and RDI individually added significantly to the prediction of QoL scores (AHI: B=‐.136, t=‐2.4,P<.05; RDI: B=‐.162, t=‐2.4, p<.05).

Conclusions

Greater sleep disturbances related to hypoxic and respiratory events were associated with lower self‐ratings of QoL in MCI participants. Further research will increase the sample, investigate the impact of hypoxic and respiratory events on brain function, and whether longitudinal changes in diet influence the relationship of sleep‐related hypoxemia and QoL.
Disease progression and costs at 3‐year follow‐up of GERAS‐US: A 3‐year study of mild cognitive impairment and mild dementia due to Alzheimer’s disease in the United States
Authors: Chandler Julie , Rentz Dorene M , Zagar Anthony , Kim Yongin , Zimmer Jennifer A. , Schwartz Ronald L. , Fillit Howard
Published: December 2021

Background

GERAS‐US is a prospective study characterizing the clinical and economic outcomes of early Alzheimer’s Disease (AD). We describe changes in total societal costs at 3 years post‐baseline in amyloid positive[+] patients with mild cognitive impairment (MCI) and mild dementia (MILD) due to AD.

Method

GERAS‐US enrolled patients aged 55 to 85 (N=617) from October 30, 2016, through October 9, 2017. Cognition and function were assessed using Mini Mental State Exam (MMSE) and Cognitive Function Index (CFI), respectively. Mean 30‐day total societal costs (direct and indirect costs using opportunity formulae [Figure 1]) were calculated. Costs are presented as least square (LS) mean (95% confidence interval [CI]) at baseline, 6 months and 36 months for the overall population and stratified by baseline severity (MCI[+] vs MILD[+]) using Mixed Model Repeated Measurement (MMRM). Least square mean (95% CI) changes from 6 months to 36 months, using MMRM, are presented.

Result

At baseline, mean age was 70.3 years (MCI) and 71.7 years (MILD); 52.7% were females. Analyses at 36 months post‐baseline included 308 patients. Mean change from baseline in CFI and MMSE scores demonstrated worsening over 36 months (Table 1). The LS mean estimated total societal costs for MCI and MILD, respectively, were higher at baseline ($2430 and $4063) but remained steady from 6 months ($1977 and $3032) to 36 months ($2007 and $3392) (Figure 2). Direct medical costs did not change over the follow‐up period (6 months to 36 months) for either MILD or MCI patients or for their caregivers. Direct nonmedical costs were significantly higher for MILD but not MCI patients. Indirect nonmedical caregiver costs trended higher for both MCI and MILD cohorts but were not significant (Table 2).

Conclusion

Both function and cognition declined significantly over 36 months in this cohort of amyloid[+] patients. Direct medical costs remained steady over the follow‐up period after an initial decline from baseline, possibly due to diagnostic certainty achieved at baseline. The rise in direct nonmedical costs for MILD and the trend toward rising indirect caregiver costs in MCI and MILD patients over 36 months shows the additional economic impact associated with clinical progression in early AD.