bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrating Coalitions, Strategic Planning, and Road Map Implementation in Alzheimer’s Disease and Related Dementias Care: A Case Study from Mississippi
Authors: White Kina L. , Kurmana Sai
Published: January 2025

Background

With Alzheimer’s Disease and Related Dementias (ADRD) posing significant public health challenges globally, effective strategies that encompass policy, practice, and community engagement are essential. The Mississippi State Department of Health (MSDH) has implemented an integrated approach to ADRD, focusing on three critical themes: Coalitions and Collaborations, ADRD Strategic Plans, and Healthy Brain Initiative (HBI) Road Map Implementation. This case study provides valuable insights into a comprehensive public health approach towards ADRD.

Method

Recognizing the power of collective action, MSDH facilitated the expansion of the Alzheimer’s State Coalition. This coalition brought together diverse stakeholders, including healthcare providers, policy experts, caregivers, and community organizations. Our analysis highlights the coalition’s role in mobilizing resources, fostering community engagement, and influencing policy decisions. By evaluating the coalition’s structure, engagement strategies, and impact on ADRD initiatives, we provide insights into the effectiveness of collaborative approaches in addressing complex public health challenges. We discuss the expansion and implementation of Mississippi’s 2020‐2025 Strategic Plan for ADRD, which integrated essential components of dementia risk reduction, early diagnosis, management of comorbidities and caregiver support. Our evaluation focuses on the plan’s alignment with national priorities, its adaptability to emerging challenges, and its role in guiding statewide ADRD efforts.

Result

The implementation of the CDC’s HBI Road Map within the MS ADRDP offers a model for integrating national guidelines into state‐level ADRD programs. We analyze how the MS ADRDP incorporated HBI Road Map actions into its strategic planning and operational activities. This assessment includes a review of successes and challenges in implementation, particularly in areas that address Alzheimer’s Disease and Related Dementias, reflecting the broader goals of the CDC BOLD program.

Conclusion

The Mississippi case study underscores the effectiveness of an integrated approach in addressing ADRD. Our findings highlight the significance of collaborative efforts in coalition building, strategic planning, and national guideline implementation. These elements collectively enhance the state’s capacity to manage ADRD challenges effectively. This study offers a scalable model for other regions and countries seeking to develop comprehensive, collaborative, and strategic approaches in ADRD public health policy and practice.
Recombinant zoster vaccine and reduced risk of dementia: matched‐cohort study using large‐scale electronic health records and machine learning methodology
Authors: Schwab Patrick , Widenmaier Robyn , Tahrat Halima , Littmann Maria , Anspach Bruno , Buser‐Doepner Carolyn , Georgiou Andreas , Horn Max , Kumar Sanjay , Polisky Vitaly , Triastcyn Aleksei , Van Duijn Cornelia M , Geldsetzer Pascal
Published: January 2025

Background

With the world population aging, the number of individuals living with dementia is expected to increase significantly. Vaccination against herpes zoster (HZ) with the live‐attenuated zoster vaccine (ZVL) was associated with a lower risk of being diagnosed with dementia in previous studies. We aimed to determine whether the recombinant zoster vaccine (RZV) immunization is also associated with a reduced risk of dementia diagnosis.

Methods

This retrospective, observational, matched‐cohort study of adults aged ≥50 years used data from the United States Optum® de‐identified Electronic Health Record data set, covering the period 01‐Oct‐2007–30‐Sep‐2023. A comparison cohort comprising adults vaccinated with the pneumococcal polysaccharide vaccine (PPSV23) was created to mitigate selection bias. Matched cohorts were then formed to compare those vaccinated with ZVL vs PPSV23, RZV vs PPSV23, and RZV vs ZVL, with neither comparison arm having been exposed to the comparator vaccine. Matching (1:1) used a propensity score generated with non‐linear estimators based on 394 variables indicating past diagnoses, medication use, preventive health service uptake, and healthcare service utilization. Using the Nelson‐Aalen estimator, the relative risk (RR) for dementia diagnosis (using ICD‐9/‐10 codes) was compared between the three matched cohorts, at 3 and 5 years post‐vaccination.

Results

Post‐matching characteristics were balanced between cohorts (Table). Compared to PPSV23, ZVL significantly reduced 3‐year (RR: 0.86, 95% confidence interval [CI]: 0.86‐0.90; p<0.0001) and 5‐year (RR: 0. 92, 95%CI: 0.89‐0.95; p<0.0001) dementia risk. RZV significantly reduced 3‐year (RR: 0.76, 95%CI: 0.69‐0.84; p<0.0001) and 5‐year (RR: 0.80, 95%CI: 0.71‐0.90; p<0.0005) dementia risk, when compared to PPSV23. Compared to ZVL, RZV was also associated with a significant reduction of 3‐year (RR: 0.73, 95%CI: 0. 60‐0.89; p<0.005) and 5‐year (RR: 0.77, 95%CI: 0.64‐0.92; p<0.005) dementia risk.

Conclusion

HZ immunization was associated with a reduced risk of dementia at 3 and 5 years post‐vaccination compared to PPSV23 immunization. RZV was associated with a reduced risk of dementia compared to ZVL at 3 and 5 years post‐vaccination.
Main occupation complexity and later‐life cognitive function among older adults in Brazil and Mexico
Authors: Gonçalves Natalia G , de Medeiros Gabriela Mininel , Avila Jaqueline Contrera , Bertola Laiss , Ferri Cleusa P , Wong Rebeca , Suemoto Claudia Kimie
Published: January 2025

Background

Occupation complexity during adulthood may contribute to cognitive reserve in later life. Research on occupational complexity and cognitive function has focused on high‐income countries, where there is a large proportion of individuals with complex occupations. Thus, it is important to investigate this association in the context of low‐ and middle‐income countries where there is greater variance in occupation complexity and where there is a higher proportion of lower‐complexity occupations due to educational and other socioeconomic limitations. We use nationally representative data from the two largest countries in Latin America, Mexico and Brazil, to assess the association between main occupation complexity and cognitive function.

Method

The sample included adults 50 years or older from the 2018 waves of the Brazilian Longitudinal Study of Aging (ELSI) (n = 9,916) and the Mexican Health and Aging Study (MHAS) (n = 16,171). Participants were classified as cognitively impaired or not impaired using cognitive performance scores and a regression‐based approach compared to a normative sample. Main occupation was categorized as unskilled (agricultural workers, cooks, artisans, and maintenance workers), semiskilled (clerks, customer service workers, and trades workers), and skilled (doctors, engineers, managers, and teachers). We used logistic regression models to estimate the association between occupational complexity and cognitive function adjusted for sociodemographic variables, chronic diseases, and health behaviors.

Result

Participants of the ELSI had a mean age of 64.0±9.6 years, median years of education of 4 years, 50% were women, 48% had unskilled occupations, and 6% were categorized as cognitively impaired (Table 1). Participants of the MHAS had a mean age of 62.8±10.3 years, median years of education of 6 years, 56% were women, 65% had unskilled occupations, and 7% were categorized as cognitively impaired (Table 1). Participants with semiskilled occupations had lower odds of cognitive impairment than those with unskilled occupations in both cohorts (Table 2). There was no association between main lifetime skilled occupations and cognitive impairment in either cohort (Table 2).

Conclusion

Higher occupational complexity may contribute to later‐life cognitive reserve. The results of this study suggest that increasing opportunities for higher‐complexity occupations in Latin America may benefit efforts to prevent cognitive impairment in this region.
Neural underpinnings of cognitive resilience in Brazilian SuperAgers
Authors: Borelli Wyllians Vendramini , Leal‐Conceicao Eduardo , Schilling Lucas Porcello , Portuguez Mirna Wetters , Zimmer Eduardo R. , da Costa Jaderson Costa
Published: January 2025

Background

Although cognitive decline is a trait related to aging, some individuals are resilient to the aging process, defined as SuperAgers. Studying the neural underpinnings of SuperAgers may improve the understanding of AD pathology. In this study, our aim was to analyze amyloid and neurodegeneration imaging biomarkers in SuperAgers.

Method

We recruited 228 Brazilian adults and older adults to participate in this study. They underwent a neuropsychological battery, followed by PET [11C] PIB and [18F]FDG imaging. Individuals were classified as SuperAgers when at 80 years of age or above, episodic memory scores similar to 50‐65 normative data, and within 1 SD of normative values for age and education for executive functions, fluency and naming. Amyloid load and glucose metabolism standardized uptake value ratio (SUVR) was calculated using cerebellar crus and whole brain, respectively. SUVR values from predefined AD meta‐ROI for PIB (prefrontal, orbitofrontal, parietal, temporal, anterior and posterior cingulate and precuneus) and FDG (angular gyrus, posterior cingulate, and inferior temporal cortical) were extracted. No covariates were included in the models since sex and education were paired.

Result

After initial screening, a total of 10 young controls (C50), 10 age‐matched controls (C80) and 10 SuperAgers (Table) SA, mean age 82.1±2.51 years) were included. Educational levels were similar between groups (p>0.05), while episodic memory scores were similar only between SA (10.7±3.4) and C50 (11.4±2) but higher than C80 (10.5±3.4, p<0.001). Amyloid SUVR was lower in C50 than older groups, but similar between SA and C80 (SA: 1.25±0.2, C80: 1.32±0.3, C50: 1.07±0.1, p = 0.03). FDG SUVR was increased in SA (Figure) when compared with C80 (1.06±0.1 vs. 1.01±0.1, p = 0.02), but similar to C50 (1.03±0.1, p = 0.21).

Conclusion

Our findings indicate that SuperAgers are more resilient to amyloid burden and seem to cope with AD pathology by increasing brain glucose metabolism. The higher FDG metabolism seen in SuperAgers compared with age‐matched controls may reflect a compensatory biological response, which ultimately leads to cognitive resilience.
Associations Between Deficit Accumulation Frailty and Baseline Markers of Lifestyle and Health in the U.S. POINTER Trial
Authors: Espeland Mark A. , Demesie Yitbarek N , Cleveland Maryjo , Farias Sarah Tomaszewski , Baker Laura D , Crivelli Lucia , Garcia Katelyn R , Lockhart Samuel N. , Olson KayLoni , Snyder Heather M , Tangney Christy C , Wing Rena R. , Whitmer Rachel A. , York Michelle , Callahan Kathryn E. ,   U.S. POINTER Study Group
Published: January 2025

Background

Behavioral interventions designed to promote healthy lifestyles have the potential to slow biological aging and increase health span. Multidomain interventions that simultaneously target multiple lifestyle behaviors may particularly be promising by increasing the number of interrelated processes that might be benefited. Deficit accumulation frailty indices (FIs) are increasingly used as measures of aging and health status in clinical trials and cohort studies.

Method

A 49‐component FI was developed from baseline measures of age‐related 1) physical function and abilities, 2) cognitive function, 3) health related quality of life, 4) mood and affect, 5) clinical biomarkers, 6) physical measures, 5) sleep quality, 8) chronic diseases, 9) sensorineural abilities, 10) polypharmacy, and 11) behaviors. The FI was calculated for the 2,111 participants of the U.S. Study to Protect Brain Health through Lifestyle Intervention to Reduce Risk (U.S. POINTER), a two‐armed randomized controlled clinical trial comparing two multidomain lifestyle interventions on cognitive function. Associations between the FI and markers of intervention targets were assessed using correlation coefficients after covariate adjustment for age, gender, and clinical site.

Result

The 25%ile, 50%ile, and 75%ile of the FI distribution (Figure 1) were 0.112, 0.153, and 0.199 and are consistent with a cohort at risk for accelerated aging. Mean FI scores were greater by 13% among males compared with females and by 36% among those aged 75‐79 years compared with those aged 60‐64 years (Table 1; both p<0.001). Greater FI scores were associated with worse MIND diet scores, fewer minutes of moderate exercise per week, higher systolic blood pressures, higher fasting glucose concentrations, and worse domain‐specific and composite cognitive function (all p≤0.01) but were unrelated to the frequency of cognitive activities per week (Table 2).

Conclusion

The U.S. POINTER FI has expected associations with targets of its multidomain lifestyle interventions. It is designed to serve as a basis for assessing whether these interventions differentially slow aging and, if so, how this may contribute to better cognitive functioning.
Poor Colonoscopy Bowel Prep in 69‐Year‐old with Mild Neurocognitive Disorder: A Case Example
Authors: Joffe Yonah , Eversole Kara , Burt Juliana S , Kimmet Faith , Estores David , Tanner Jared J. , Arias Franchesca , Price Catherine C.
Published: January 2025

Introduction

Colonoscopies are medical procedures used to identify colon abnormalities and remove polyps to decrease the incidence of colorectal cancer. Prior to this exam, patients must undergo bowel preparation to ensure proper cleansing of the colon and maximize outcomes (e.g., full identification of pre‐cancerous polyps). Many risk factors for poor bowel preparation have been identified (e.g., age, low health literacy). However, there has been minimal consideration of preoperative mild or major neurocognitive disorders as a risk factor. A 2019 study by Arias and colleagues found that 68% of older adults undergoing colonoscopies met criteria for neurocognitive disorders. For these patients, inadequate bowel preparation was identified in 100% of those with major neurocognitive disorder and 28% with mild neurocognitive disorder. The present case study provides another example regarding the importance of cognition when considering colonoscopy preparation.

Case Presentation Demographics

CR is a 69‐year‐old non‐Hispanic White male with 13 years of education who worked in the oil field, then as an auto‐mechanic, and later owned an auto repair business. Neuropsychological Testing: Mild neurocognitive disorder, amnestic type, with rapid forgetting and impaired semantic fluency coupled with average attention, working memory, and processing speed. Lives with spouse and is largely independent in functional abilities. Medical records indicate history of postoperative delirium and cardiovascular history. Brain MRI shows white matter abnormalities. Problem: CR was scheduled to complete a routine colonoscopy screening. Review of medical records report colonoscopy was a failed procedure due to poor bowel preparation. Gastroenterology rating of preparation with the Boston Bowel Preparation Scale (BBPS) totaled to 4, indicating inadequate bowel preparation (0‐9, 0 = suboptimal; 9 = optimal). Outcome: CR was referred to undergo a second colonoscopy.

Discussion

This case highlights how preoperative cognitive impairment and the possibility of neurodegenerative disease (i.e., presence of white matter abnormalities) is an important consideration for individuals referred for routine colonoscopy procedures. The case is consistent with the work from Arias et al. (2019) and indicates the need for larger prospective examinations on cognitive risk for elective “routine” procedures involving preparation that involves patient planning. Supported by: K07AG066813.
Cardiometabolic health of persons at risk of APPV717I or PSEN1A431E autosomal dominant Alzheimer’s disease in Jalisco, México
Authors: Berumen‐Ocegueda Isaac Enrique , Zepeda‐Morales Adelaida Sara Minia , Figuera‐Villanueva Luis Eduardo , Ringman John M , Matute Esmeralda
Published: January 2025

Background

It is known that cardiometabolic diseases are related to Alzheimer´s Disease.

Method

We included 23 residents of Jalisco with at least one first‐degree relative with ADAD (ADADG). We rated the participants using the Clinical Dementia Rating (CDR) as CDR = 0 (n = 20, 87%), CDR = 0.5 (n = 2, 9%), and CDR = 2 (n = 1, 4%). Eleven participants were mutation carriers (APP
V717I = 9, PSEN1
A431E = 2). We compared the participant’s laboratory test results of the fasting plasma glucose (FPG), lipid profile, glycated hemoglobin (HbA1c), and thyroid function test (TFT) to those of 102 Jalisco residents within the same age range (CG).

Result

Three (13%) carrier participants (APP
V717I = 3) reported being previously diagnosed with cardiometabolic disease (hypertension = 1, prediabetes = 1, dyslipidemia = 2). For the ADADG, the most common abnormality in the laboratory tests was dyslipidemia (n = 20, 87%; mixed dyslipidemia = 15, 66%). Other abnormalities found on laboratory tests were FPG≥126 mg/dL (n = 3, 13%), HbA1c≥6.5% (n = 7, 30%), and TFT findings compatible with hypothyroidism (n = 1, 4%). Similarly, in the CG, dyslipidemia was also the most prevalent abnormality (n = 15/22, 68%), followed by HbA1c≥6.5% (n = 6/12, 50%), and at last FPG≥126 mg/dL (n = 6/47, 13%). When comparing the ADADG to the CG, we found that the ADADG has a higher frequency of mixed dyslipidemia (χ2 = 5.02, p = .038), lower levels of free thyroxine (1.12±0.16 VS 1.28±0.19; t(37) = 2.8, p = .008), higher levels of triglycerides (187.1±75 VS 147.8±69.8; t(61) = 0.32, p = .04), and higher levels of very low‐density apolipoprotein (37.4±15 VS 28.2±11; t(43) = ‐2.3, p = .024). We did not find any difference in any measure or prevalence when comparing the mutation carrier group, the non‐carrier group, and CG.

Conclusion

Dyslipidemia is the most common cardiometabolic abnormality in both ADADG and CG. The frequency of cardiometabolic abnormalities is not related to the presence of any of the two studied mutations. A follow‐up study could show if the cardiometabolic abnormalities are related to an earlier onset of ADAD.
Sleep and Physical Activity are Associated with Cognition and Resting‐State Functional Imaging Measures of Network Segregation in Non‐demented Older Adults
Authors: Callow Daniel
Published: January 2025

Background

Greater physical activity and better sleep are associated with reduced risk of cognitive decline and dementia among older adults, but little is known about their associations with measures of brain function and neuropathology.

Method

This study investigated potential independent and interactive cross‐sectional relationships between actigraphy‐estimated total volume of physical activity (TVPA) and sleep patterns [i.e., total sleep time (TST), sleep efficiency (SE)] with cognitive performance (n = 157). In a subset of participants, the physical activity and sleep measures were also evaluated in relationship to resting‐state functional magnetic resonance imaging (rs‐fMRI) measures of large‐scale network connectivity, and positron emission tomography (PET) measures of amyloid‐β (n = 135). Participants were part of the BIOCARD study including 136 cognitively normal individuals and 21 participants with mild cognitive impairment (mean age = 71.7 years). Using linear regression analyses, we assessed the association between TVPA, TST, and SE with cognition, connectivity within the default‐mode, salience, and fronto‐parietal control networks, and with network modularity, a measure of network segregation.

Result

Greater TVPA and SE each were positively associated with better global cognitive composite scores and executive function. Importantly, a TVPA by SE interaction suggested that adults with the poorest SE experienced the greatest benefit from physical activity in relation to cognition. In the imaging subsample, higher TVPA and SE were independently associated with greater network modularity, although the positive relationship of SE with modularity was only present in amyloid‐negative individuals. Additionally, higher TVPA was associated with greater connectivity within the default‐mode network, while greater SE was related to greater connectivity within the salience network. In contrast, longer TST was associated with lower network modularity, particularly among amyloid‐positive individuals, suggesting a relationship between longer sleep duration and greater network disorganization. Physical activity and sleep measures were not associated with amyloid positivity.

Conclusion

These data suggest that greater physical activity levels and more efficient sleep may promote better cognition and more segregated and potentially resilient functional networks, as well as greater functional connectivity within specific large‐scale networks. Additionally, the relationship between sleep and functional networks connectivity may depend on amyloid status while associations with physical activity may be independent of amyloid status.
Innovating using mHealth for people with dementia and co‐morbidity and their carers: Screening and economic assessment at the population level
Authors: Anza‐Ramirez Cecilia , Cardenas Maria Kathia , Landeiro Filipa , Montesinos Rosa , Custodio Nilton , Da Re Marco , Calvo Rafael A , Belon‐Hercilla Veronica , Cuba María Sofía , Bernabe Antonio , Butler Christopher , Miranda Jaime ,   IMPACT Dementia Study Group
Published: January 2025

Background

Dementia is a global health challenge, especially in low‐ and middle‐income countries like Peru, where diagnosis, access, and awareness are limited. Within the IMPACT Dementia project, a component focuses on developing, testing, and implementing an mHealth‐enabled system for dementia screening and diagnosis, and assessing its cost‐effectiveness.

Methods

Phase I. To develop a dementia diagnostic screening mHealth system: The features of the screening tool will be locally adapted using a co‐design approach including community members and community health workers (CHW) in four regions in Peru (Lima, Tumbes, Iquitos, and Huancayo) to enhance adaptability and efficacy. The final tool will be applied to older adults (60+) in the community by CHW.

Phase II. To assess the accuracy and acceptability, and characterization of older adults (60+) at the population level in Peru (n≈32,000): Using the mHealth system developed in Phase I, assessments including AD8, RUDAS‐PE, and PFAQ, will be conducted. Accuracy for dementia diagnosis will be determined through gold‐standard assessments involving interviews, neuropsychological testing, and the CDR in a subgroup of participants conducted by neurologists. The system will also collect data on socio‐demographic information, carers, co‐morbidities, quality of life, resource usage and costs.

Phase III. To integrate the mHealth diagnostic system into Peru’s primary healthcare (PHC) level: After validation, a 3‐month quasi‐experimental study in 2 centres per region will assess system performance, using waiting room recruitment and provider‐conducted screenings for older adults. Indicators will evaluate integration success, sensitivity, and specificity of the tool, cost‐effectiveness, and stakeholder perspectives through a process evaluation, guiding future scalability.

Result

Early phases suggest that the IMPACT Dementia project will offer insights into dementia challenges in Peru. The co‐design phase prioritises cultural relevance. Phase II anticipates a comprehensive dataset characterising older adults, informing prevalence and risk factors, and validating the mHealth diagnostic system. Phase III aims to assess the integration feasibility of the diagnostic system into PHC.

Conclusion

This component of IMPACT Dementia addresses the challenges of dementia in Peru, emphasizing diagnosis, comorbidity, and resource optimization through mHealth. The participation of CHW means a strategic change, which aims to alleviate the burden on health systems.
Interventions to Improve Mealtime Care Quality and Outcomes in Persons Living with Dementia and Their Caregivers: A Systematic Review and Meta‐Analysis
Authors: Liu Wen , Suh Heather , Lee Kyuri
Published: January 2025

Background

Mealtime is a fundamental daily activity to ensure nutrition, social interaction, and enjoyment of food for people with dementia (PWD). Interventions addressing multilevel barriers are critical to optimize mealtime care and outcomes. This review aimed to synthesize existing interventions on mealtime care and outcomes in PWD and their caregivers.

Method

PubMed, CINAHL, AgeLine, PsycINFO, and Cochrane were searched from January 2012 to May 2023 using keywords including dementia, Alzheimer, food intake, and mealtime. Relevant bibliographies were manually searched. Eligibility criteria were developed by defining the population, intervention, comparator, outcome, timing, and setting of interest. Eligible studies were classified by intervention, accessed for quality using the Quality Assessment Tool for Quantitative Studies, and graded for evidence using the Grading of Recommendations, Assessment, Development and Evaluation Working Group criteria. Meta‐analyses were performed for studies within the same intervention type that tested the impact on same outcomes.

Result

Of 1,137 records, 30 studies were identified and categorized into five intervention types: nutritional supplements (5), resident training/therapy (7), Dyadic training or mealtime interaction (7), environmental/food modification (7), and multiple‐component interventions (4). “Nutritional supplements” showed low evidence on cognition and nutritional status, and moderate evidence on ADL function and depression. “Resident training/therapy” showed moderate evidence on cognitive function. All intervention types showed very low to low evidence on food intake, weight, and BMI, eating difficulties, and hyperphagic behaviors. Meta‐analyses of limited number of heterogenous studies showed 1) “Environmental/food modification” increased food intake; 2) “Resident training/therapy” decreased eating difficulties, 3) “Resident training/therapy” did not increase food intake, 4) “Dyadic training or mealtime interaction” did not increase BMI, 5) “Nutritional supplements” did not improve cognition, and 6) “Multiple components” did not improve ADL function.

Conclusion

Findings support evidence of certain interventions on food intake and mealtime behaviors, and provide directions for clinical practice and research. Current evidence is based on a body of research with primarily moderate to weak quality. Future testing of interventions using high‐quality designs is needed.
A Study of Influence of Passengers on Driving Behavior of Drivers with Dementia or Mild Cognitive Impairment
Authors: Suzuki Mio
Published: January 2025

Background

In Japan, the increase in the number of accidents involving elderly drivers has become a very serious problem. The government has implemented a cognitive function test at the time of driver’s license renewal and has taken measures to disallow driving by elderly drivers with Alzheimer’s disease, but drivers with MCI and other types of dementia continue to drive. One of the measures recommended to contribute to the safe driving of elderly drivers is to encourage them to talk to their passengers. However, for drivers with MCI who are not good at multitasking, the presence and conversation with passengers may induce dangerous behavior. Therefore, the purpose of this study is to observe the differences in cognitive function and driving behavior of elderly drivers depending on whether they have a passenger or not, and to clarify the tendency of the passenger.

Method

I recorded the driving behavior of healthy elderly drivers and elderly drivers with mild cognitive impairment who live in a city in the Tokyo metropolitan area and who drive on a daily basis using a drive recorder for a month. Then, I analyzed the differences in safety confirmation between drivers with and without a passenger.

Result

The results statistically showed that in Japan, where traffic is conducted on the left side of the road, the presence of a passenger increases head movement when turning left and increases eye movement alone when turning right. This means that the presence of a passenger increases safety checking behavior. In particular, the results indicate that the driver’s head moves more carefully to the left side of the road, which is difficult to look over, and that the driver’s head tends to move in the direction where the passenger is present.

Conclusion

Since a passenger increases the number of safety checks during driving, it is clear that the driver may consciously try to concentrate on driving so as not to be distracted by the passenger. While driving with a passenger is expected to provide training in selecting and choosing information, it is also necessary to consider that the passenger does not interfere with the driver’s driving.
Late‐life Blood Pressure and Cerebral Amyloid Angiopathy among Community‐based Older Adults: An Analysis using the U.S. National Alzheimer’s Coordinating Center Uniform Data Set
Authors: Sin Mo‐Kyung
Published: January 2025

Background

Cerebral amyloid angiopathy (CAA) and hypertension are the two most common risk factors of intracranial hemorrhage leading to cognitive impairment, but less is known about how the two relate. A better understanding of the association between these risk factors is a key step towards developing new strategies to manage hypertension and attenuate CAA progression.

Method

This study analyzed data from 2,510 participants in the National Alzheimer’s Coordinating Center (NACC) dataset who had CAA and longitudinal blood pressure (BP) measurements before death. The presence of CAA (autopsy‐based) was determined on immunohistochemistry and categorized as none, mild, moderate, or severe. Multivariable proportional odds logistic regression was used to examine the associations between CAA stages and BP. Systolic BP (SBP) and pulse pressure (PP) were modeled as primary predictors. Covariates also included age at death, sex, antihypertensives, microinfarcts, APOE e4, CERAD, and Braak stages.

Result

CAA was present in 1,580 (62.9%) participants; 759 (30.2%) mild, 529 (21.1%) moderate, and 292 (11.6%) severe. Neither late‐life mean SBP ≥140mmHg nor (PP) ≥ 50mmHg were associated with CAA stages. Participants with APOE e4 allele (adjusted odds ratio (aOR) = 1.80, 95% CI: 1.53‐2.11) and males (aOR = 1.25, 95% CI: 1.08, 1.46) had significantly higher odds of having more advanced CAA stage than those who were APOE e4 noncarriers and females. The odds of more severe CAA increased with higher Braak and CERAD stages: Braak stage III‐IV (aOR = 1.51, 95% CI: 1.17‐1.95), Braak stage V‐VI (aOR = 2.43, 95% CI: 1.82, 3.23), CERAD mild (aOR = 2.73, 95% CI: 2.0, 3.60), CERAD moderate (aOR = 3.46, 95% CI: 2.61,4.60), and CERAD frequent (aOR = 5.25, 95% CI: 3.90, 7.09). Figure 1 shows the effect plots for all the variables included in the model.

Conclusion

High SBP (≥140 mmHg) and PP (≥50 mmHg) had no effect on CAA severity stage. Considering CAA and hypertension being major risk factors for intracranial hemorrhage, hypertension may have a synergistic effect on intracranial hemorrhage development in people with CAA positive. More empirical studies are needed to confirm the finding.
A Scoping Review of Non‐pharmacological Interventions for Adults with Cognitive Impairment and Diabetes
Authors: Zheng Yaguang , Rice Brynne Campbell , Wylie‐Rosett Judith , Wu Bei
Published: January 2025

Background

Adults with comorbidity of cognitive impairment and diabetes is common (19.9%‐45.0%) and increasing; however, the evidence is lacking on non‐pharmacological behavioral interventions to support cognitive health and diabetes management for individuals with both conditions. The objective of this scoping review was to systematically map the research done in this area, characterize the interventions and outcomes that are under investigation, and identify any existing gaps in knowledge.

Method

Literature searches were conducted electronically using MEDLINE (Ovid), CINAHL (EBSCO), Web of Science Core Collection, PsycINFO (Ovid), EMBASE (Ovid), and AgeLine (EBSCO), limiting to articles published in English, but without any restrictions on publication date. The review protocol was registered prospectively with the Open Science Framework (https://osf.io/2w3sh). Two reviewers independently screened the title, abstracts, and full text articles, respectively.

Results

Database and citation searching yielded 26,532 records. Duplicates were removed, leaving 16740 unique titles and abstracts to be screened for eligibility. Following full text retrieval, 101 potentially relevant papers were screened against the inclusion criteria, leaving 14 articles that were eligible for inclusion in the review (Figure 1. PRISMA). Among the 14 included studies, the non‐pharmacological interventions included diabetes education, Tai Chi, diet and/or exercise, cognitive training, and technology. Three studies showed improved HbA1c, 4 of them showed improved cognitive function, 2 of them showed improved adherence to dietary intake, and 2 reported improved self‐efficacy scores.

Conclusions

Our review indicated heterogeneous non‐pharmacological interventions for adults with comorbid cognitive impairment and diabetes, which demonstrated mixed effects on cognition and diabetes control. Limited interventions have involved family members and been tailored to the needs of both older adults with cognitive impairment and their care partners. The findings indicated the need for developing effective interventions to overcome dual care challenges for older adults with comorbid cognitive impairment and diabetes and their care partners.
The Associations of Sensory Impairment with 10‐Year Risk of Dementia and Alzheimer’s Disease: The Health and Retirement Study, 2010‐2020
Authors: Li Kun , Ghosal Rahul , Zhang Donglan , Li Yike , Lohman Matthew , Brown Monique J , Merchant Anwar T , Yang Chih‐Hsiang , Neils‐Strunjas Jean , Friedman Daniela B. , Wei Jingkai
Published: January 2025

Background

Although visual and hearing impairment have been identified as established risk factors for dementia, evidence was limited on the association of the coexistence of these two sensory impairments with incident dementia, especially in the U.S. The study aimed to examine the associations between sensory impairment and 10‐year risk of dementia or Alzheimer’s disease.

Method

A prospective cohort study was designed based on the Health and Retirement Study from 2010 to 2020. Individuals aged 50 years and older without self‐reported dementia and Alzheimer’s disease were included in the analysis. Information of self‐reported visual and hearing impairment was obtained at Wave 10 in 2010, and participants were categorized as normal, with visual impairment only, hearing impairment only, and dual sensory impairment. Main failure events included self‐reported incident dementia and Alzheimer’s disease over a 10‐year follow‐up period. Fine‐Gray competing risk regression models were applied for the associations of sensory impairment with incident dementia and Alzheimer’s disease, adjusted for demographic characteristics, health behaviors, and health conditions at baseline.

Result

Of 20,248 identified individuals, 14.6% had visual impairment only, 11.2% had hearing impairment only, and 9.1% had dual impairment at baseline. After adjustment for all covariates, dual sensory impairment was associated with higher risk of dementia (hazards ratio (HR) = 1.46, 95% CI: 1.23‐1.73) and Alzheimer’s disease (HR = 1.35, 95% CI: 1.03‐1.76). Visual impairment only was associated with incident dementia (HR = 1.98, 95% CI: 1.38‐2.83) and Alzheimer’s disease (HR = 2.99, 95% CI: 1.60‐5.62) among individuals <65 years. No association was observed between hearing impairment only and incident dementia or Alzheimer’s disease.

Conclusion

Older adults in the U.S. with visual and hearing impairments simultaneously had a particularly greater risk of dementia and Alzheimer’s disease, and having visual impairment alone was associated with an elevated risk of dementia; the associations were stronger among people <65 years.
Formal education, household size and cognitive outcomes among Latino individuals: Data from the Skills‐Based Educational strategies for Reduction of Vascular Events in Orange County, Ca (SERVE OC) Trial
Authors: Kurzman Alissa , Ding Xueting , Albala Bruce , Wing Jeffrey , Draughter Darnisha , Chavez Aryanna , Gutierrez Desiree , Boden‐Albala Bernadette
Published: January 2025

Background

In the United States, Latino communities are disproportionately impacted by Alzheimer’s disease and related dementias (ADRDs)1 with 11.1% and 5.3% living with mild cognitive impairment and mild dementia due to ADRDs, respectively.2 Education is known to be associated with adults’ cognitive function; greater amounts of formal education predict lower risk of dementia in late‐life.3 The Montreal Cognitive Assessment (MoCA) is dependent on the educational level of participants, recommending a 1‐point correction for ≤12 years of education when scoring the assessment. However, additional adjustments may be necessary for minority populations with average education levels ≤12 years. Less is known about household size, as a proxy of social support, and cognition. In this study we aim to evaluate education and household size with cognitive outcomes of Hispanic/Latino self‐identifying individuals residing in Southern California.

Methods

Baseline data from the Skills‐Based Educational strategies for Reduction of Vascular Events in Orange County (SERVE OC) Trial were used (Grant Number P50MD017366). Study participants (n = 254) were restricted to individuals ≥18 years who self‐identified as Hispanic/Latino and completed the MoCA 8.3 in English or Spanish at baseline. MoCA scores were adjusted for education, per instrument protocol. Multivariable linear regressions estimated associations between number of household residents, education, and MoCA score, overall and by age (<50 and ≥50 years), controlling for gender and preferred language.

Results

Participants were an average of 46.8 years (SD = 13.99) with 49.2%≥50 years; 67.2% of participants were female and 64.5% had ≤8 years of formal education. Average MoCA scores were 22.20 (SD = 3.71) and 20.67 (SD = 4.62) for individuals <50 and ≥50years respectively. For individuals ≥50 years, having ≤8 years of formal education was significantly associated with lower MoCA scores (B = ‐3.22; p<0.05) and with number of household residents trending towards intact cognition (B = 0.578, p = 0.063). For individuals <50 years, number of household residents is a significant predictor of MoCA score (B = ‐0.618, p<0.05).

Conclusion

Understanding the impact of education and household size is important when assessing memory/cognitive outcomes of Latino individuals. Research is needed to better understand if/how the MoCA should be further adjusted in underrepresented populations and the impact of household composition and dynamics on cognitive impairment.
Interrelationships among an Inflammatory Diet and Helicobacter pylori infection on Cognition in older adults
Authors: Chou Yi‐Chun , Han Ming‐Lun , Chiu Tina H.T. , Lee Meei‐Shyuan , Chiou Jeng‐Min , Chen Yen‐Ching , Chen Jen‐Hau
Published: January 2025

Background

The role of diet in modulating inflammation and its potential impact on cognition has raised attention. Additionally, recent research has addressed the disruption of the gut‐brain axis in dementia development. This study aims to explore how the interactions between inflammatory diets and Helicobacter pylori (Hp) infection affect cognitive domains in older adults.

Method

This eight‐year prospective cohort study recruited 511 non‐demented community‐dwelling older adults (age≥65 years) in the Taipei Metropolitan area from 2011 to 2019. At baseline, we assessed dietary inflammatory potential using the Empirical Dietary Inflammatory Index (EDII) through a 44‐item semi‐quantitative food frequency questionnaire. The level of Hp immunoglobulin G (IgG) was determined. Global and domain‐specific cognition were evaluated at baseline and biennial follow‐ups. A generalized linear mixed model was used to examine the association between EDII and cognition adjusting for important covariates. Stratified analyses by Hp seropositivity were conducted, and its interactions with EDII were tested.

Result

The average age of the study participants was 72.6 years with women accounting for 53%. Each additional increment in EDII (i.e., a more pro‐inflammatory diet) was associated with poor memory performance (logical memory‐immediate free recall: β = ‐0.69 and delayed free recall: β = ‐0.72). After stratification, one unit increment in EDII was associated with poor performance of global cognition (MoCA‐T: β = ‐1.68) and memory (logical memory‐immediate free recall: β = ‐1.07; delay free recall: β = ‐1.02) among participants with Hp seropositivity (Hp IgG ≥1.1 U/mL). Additionally, significant interactions were found between EDII and Hp seropositivity in the domains of executive function (pinteraction
= 0.08) and attention (pinteraction
= 0.02).

Conclusion

Our findings suggest that an inflammatory diet interacts synergistically with Hp infection, contributing to poor cognition. Preventing cognitive decline necessitates a holistic approach including healthy eating and Hp eradication.
Association between Self‐rated Health Status and Anxiety Symptoms in U.S. Adults with Dementia
Authors: Hong Ickpyo , LEE HOKYUNG
Published: January 2025

Background

Self‐rated health status goes beyond a mere indicator of one’s well‐being, encompassing biological, social, and functional aspects. It has emerged as a significant variable in predicting mortality. Against this backdrop, understanding the impact of subjective health status on anxiety symptoms is crucial for individuals with dementia. In patients with dementia, subjective health status reflects personal perception. Understanding how this relates to their anxiety symptoms can help develop effective health management and support strategies for them.

Method

This study utilizes the 2022 National Health and Aging Trends Study (NHATS). The relationship between subjective health status and anxiety symptoms among American adults diagnosed with dementia was examined using multivariate logistic regression analysis. The independent variable in this study was the self‐reported subjective health status, either positive or negative, among patients with dementia. The dependent variable was the level of anxiety symptoms, measured using the GAD‐2 questionnaire. Covariates include sex, age, race, and employment status.

Result

In this study of 1,176 subjects, a majority (90.65%) reported a positive perception of their health status. Demographically, women constituted a slightly larger proportion (58.35%), and the positive evaluation of subjective health status was predominantly observed in those aged over 80. The findings reveal a significant difference between dementia patients who perceived their health status positively and those who did not.. In particular, those with positive subjective health status experienced less anxiety, and women reported more anxiety symptoms than men (P = .0223, OR = 0.602; P < .05, OR = 1.653). Age and race differences in anxiety symptoms were generally not statistically significant, while black individuals tended to experience less anxiety than white individuals (P = .0269, OR = 0.709).

Conclusion

This study indicated a significant association between subjective health status and anxiety symptoms among adult dementia patients in the United States. The majority of participants positively assessed their health, and this positive subjective health perception was associated with a reduction in anxiety symptoms. These findings underscore the importance of personalized approaches in mental health management for dementia patients, taking into account gender and racial factors.
Improvement of Knowledge and Research Attitudes on Preclinical Alzheimer’s Disease Trials through Community‐based Education Among Underrepresented Korean, Filipino, and Hispanic Americans
Authors: Shin Hye‐Won , Tallakson Melanie B , Duran Edwin , Russ Eunji , Hoang Dan , Romero Romina A , Sultzer David L , Grill Joshua D , Salazar Christian R
Published: January 2025

Background

Racial and ethnic minorities, including Hispanic/Latino, Asian American and Pacific Islander individuals, lack adequate representation in preclinical Alzheimer’s disease (AD) trials. This study sought to examine the effectiveness of a culturally and linguistically appropriate community‐based educational intervention in enhancing knowledge and awareness of the AHEAD 3‐45 preclinical AD trial among underrepresented Filipino, Korean, and Hispanic/Latino Americans.

Method

With professional nursing and other partner organizations, we conducted 21 community‐based educational sessions for underrepresented older adults of Filipino, Korean, and Hispanic/Latino backgrounds. In addition to sociodemographic data, we collected the 7‐item Research Attitude Questionnaire (RAQ; Range 7‐35) and a 6‐item Knowledge Questionnaire about the AHEAD 3‐45 preclinical AD trial (Range 0‐6) before and after the educational intervention. Pre‐ and post‐summary scores were generated for both assessments. Paired t‐tests assessed changes in research attitudes and knowledge concerning the AHEAD 3‐45 trial.

Result

Among 654 attendees of the educational interventions, 472 (72%) completed surveys (Table 1). Most were women (77%), immigrants (83%), and had a primary language other than English (70%). The average age was 59 (16) years. Survey responses were obtained in English (41%), Spanish (29%), and Korean (30%). The primary motivations reported by attendees for attending the event were gaining information (48%) and concerns about memory loss for self and/or family members (41%).

Knowledge of the AHEAD 3‐45 preclinical AD trial was significantly increased from a mean of 2.15 (SD 2.2) at baseline to 4.32 (SD 1.9) post‐educational intervention (p < 0.0001, Table 2). Overall RAQ scores remained unchanged for the sample and among Filipino, Korean, and Hispanic/Latino American subgroups (Table 3A), the educational intervention had a positive impact on the research attitudes of attendees under 55 years old (Table 3B)

Conclusion

Our findings indicate the potential effectiveness of culturally and linguistically tailored educational interventions in fostering increased awareness and knowledge of preclinical AD research among Filipino, Korean, and Hispanic/Latino Americans. However, this single intervention did not affect research attitudes overall or in different subgroups most relevant to the AHEAD 3‐45 trial (55 years and older), underscoring the need for additional tailored strategies to enhance representation in preclinical Alzheimer’s disease research.