bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting postmortem neuropathology of Alzheimer’s disease and related dementias using widely accessible clinical data
Authors: Ren Yueqi , Shahbaba Babak , Stark Craig EL
Published: January 2025

Background

Faced with a rapidly aging population and the rising prevalence of Alzheimer’s disease (AD) and related dementias, the field needs to urgently consider screening tools that utilize widely accessible data modalities. We have previously shown that lower‐cost data, operationalized as data modalities accessible at primary care visits, can indeed accurately predict AD clinical diagnosis and that clustering these data can provide useful information. Here, we apply a similar approach to predicting histopathological status.

Method

We first applied our previously‐developed feature extraction method based on a supervised encoder (SE) to transform potentially noisy input features while maintaining or amplifying relevant information. We next performed classification and clustering to stratify subjects by their neuropathology. Here, we compared two traditional classification methods with a novel Bayesian clustering‐classification algorithm called an Infinite Mixture Classifier (IMC). We identified distinct trajectories of subjects based upon changes in cluster assignment over time. Data for this study come from the National Alzheimer’s Coordinating Center, funded by NIA/NIH Grant U24 AG072122 and contributed to by NIA‐funded ADRCs.

Result

We found that relatively high classification accuracy of neuropathologic lesions was possible using widely accessible, lower cost clinical data. In addition, the supervised clusters, derived from using the SE’s latent features and from the IMC, held meaningful clinical diagnostic information that differentiates subjects along the clinical and pathologic continuum. When clusters were derived using longitudinal clinical data, we further observed distinct trajectories of subjects across time as their cluster assignments changed. These trajectory subgroups have significantly different risk of showcasing each type of neuropathologic lesion obtained from postmortem neuropathology.

Conclusion

Our framework benefits from the combined strengths of clustering and classification methods while avoiding drawbacks of unsupervised methods. By using lower cost features, which could be obtained at Medicare annual wellness visits, this work is broadly generalizable and has direct implications for screening of neuropathologic lesions of AD and related dementias for the public. As blood biomarkers become more accessible, our framework can be easily extended to include additional data to improve screening for neuropathology using widely accessible data.
Assessing Race Differences on Performance‐Based Assessment in Older Adults
Authors: Kaplan Marina , Mckniff Moira , Simone Stephanie M. , Callahan Anna , Giovannetti Tania
Published: January 2025

Background

Race differences on cognitive tests have been widely reported and attributed to psychosocial factors. Cognitive assessment via performance‐based tests of everyday functioning may be less influenced by psychosocial factors, offering ecologically valid and less/unbiased measurement. This study examined differences between Black/African American and White older adults on traditional cognitive tests, self/informant report of everyday function, and a sensitive performance‐based test of everyday function called the Naturalistic Action Task (NAT). We predicted group differences on only traditional cognitive tests.

Method

100 community dwelling older adults (M age = 73±6.88; 66% Female; 65% White; M education = 16±2.69) from the Philadelphia area completed cognitive tests of episodic memory and executive functioning as well as the NAT, which requires making a breakfast and a lunch using objects on a table. Video recordings of NAT performance were scored for cognitive aspects of performance (accomplishment of task steps, completion time, and errors) as well motor imprecisions/clumsiness (motor errors). Participants and informants also completed questionnaires of the participants’ everyday functioning (Functional Activity Questionnaire, Measurement of Everyday Cognition, The Instrumental Activities of Daily Living – Compensation). Analyses of Covariance adjusting for education were used to evaluate group differences.

Result

The groups differed in education level but not age or sex distribution. As shown in Table 1, after controlling for education, the groups differed on tests of episodic memory and executive function. By contrast, there were no group differences on the NAT cognitive measures, though Black/African American participants made significantly more motor errors. Finally, there were no group differences on any of the self/informant questionnaires.

Conclusion

Consistent with prior literature, Black/African American older adults and White older adults differed significantly on traditional cognitive tests, even after controlling for education. Group differences were not observed on questionnaires nor on cognitive measures from the performance‐based test of everyday functioning (NAT). However, contrary to prediction Black/African American participants made more motor errors on the performance‐based test (NAT). In sum, performance‐based tests, such as the NAT, should be considered as an alternative to traditional cognitive tests in research and clinical contexts that include racially diverse older adults.
Sex‐specific differences in the association between ApoE genotypes and metabolic syndrome among middle‐aged and older rural Indians
Authors: Azhuvalappil Shilna , Sahadevan Pravin , Sundarakumar Jonas S , Prasad Raghav
Published: January 2025

Background

Metabolic Syndrome (MetS) is a significant health concern, characterized by a combination of cardio‐ vascular risk factors, influenced by genetic factors including the apolipoprotein E (ApoE). This study examines the sex‐ specific association between ApoE genotypes and MetS in a rural Southern Indian population

Method

This cross‐ sectional study included 3741 participants aged ≥ 45 years from the rural Srinivaspura Aging, Neuro Senescence and COGnition (SANSCOG) cohort in Karnataka, India. All participants were measured for blood pressure, anthropometric measurements, and fasting concentrations of glucose, triglycerides, cholesterol, high‐density lipoprotein cholesterol, and low‐density lipoprotein cholesterol. ApoE Genotypes of 1808 males and 1933 females were included in this study. Based on ApoE genotype, participants were categorized into three distinct groups: E2 (ɛ2/ɛ2 or ɛ2/ɛ3 genotype), E3 (ɛ3/ɛ3 genotype) and E4 (ɛ4/ɛ4 or ɛ3/ɛ4 genotype) carriers. Using the data from baseline clinical and biochemical assessments, we defined MetS using two established criteria: National Cholesterol Education Program – Adult Treatment Panel III (NCEP‐ ATP III) and Consensus. Multivariable logistic regression models adjusted for demographic and lifestyle factors, were used to find the sex specific association between ApoE genotypes and MetS also with its individual components.

Result

The study found a significant association between the ApoE E4 allele and MetS in females with an odds ratio (OR) of 1.31 (95% CI: 1.02, 1.69), as per the NCEP ATP III criteria. In contrast, no such association was found in males. We found females with E4 genotype also had a 1.33‐fold increase for hypertriglyceridemia (95% CI: 1.02, 1.73) and a 1.43‐fold increase in the odds of low HDL (95% CI: 1.03, 1.99). Interestingly, E4 female individuals had a 0.72‐ fold decrease in the odds of increased waist circumference (95% CI: 0.53, 0.99). In males, E4 carriers showed a 0.70‐ fold decreased odds of elevated blood pressure (95% CI: 0.54, 0.95). No significant association was found using the Consensus criteria between ApoE genotypes and MetS.

Conclusion

This study highlights a significant sex‐ specific association between ApoE E4 allele and MetS and its components, particularly in females, in rural southern India.

Keywords: ApoE genotypes, Metabolic syndrome, sex specific
Impact of humanized APOE on brain volumetrics and white matter microstructure within a mouse model for Alzheimer’s Disease
Authors: Bhattrai Avnish , Raikes Adam C. , McLean John W. , Wiegand Jean‐Paul L. , Brinton Roberta Diaz
Published: January 2025

Background

Frequently utilized Alzheimer’s disease (AD) preclinical models rely on risk factors expressed in familial AD, which accounts for <1% of the clinical AD population. Apolipoprotein (APOE) ε4 is the strongest genetic risk factor for the development of the more prevalent late‐onset Alzheimer’s disease (LOAD). MRI studies demonstrate a link between APOE‐ε4 and reduced gray matter volume as well as lower fractional anisotropy (FA) in AD patients. However, brain volumetric and white matter integrity (WMI) data in preclinical models is lacking. Herein, we report the effect of sex and genotype on local brain volume and WMI in an aged humanized APOE (hAPOE) LOAD mouse model.

Method

Aged hAPOE ε3/3, ε3/4, and ε4/4 mice (N=43, mean age=24.1 months, Female=20) underwent high‐resolution ex‐vivo structural (T2‐weighted RARE; 75 microns isotropic) and diffusion‐weighted (b = 1000 mm/s2; 200 microns isotropic) MRI imaging. Deformation‐based morphometry was used to identify volumetric differences and WMI was quantified using FA. Mice were classified as ε4 carriers (at least one allele) or non‐carriers (ε3/ε3). Two‐way ANOVAs were used to identify the main effects of ε4 genotype and sex. Results are reported as FDR corrected. p≤0.05 was considered statistically significant.

Result

hAPOE‐ε3/ε3 mice had larger olfactory bulbs and parieto‐temporal lobes compared to ε4 carriers and greater mean FA across major white matter tracts. Independent of genotype, females had larger cortical volumes of bilateral temporal and parietal lobes and thalami compared to males. Males had greater volume within the bilateral olfactory bulb, amygdala, hypothalamus, and hippocampi. No sex differences were observed in FA.

Conclusion

At 24 months of age (approximately 70 human years), hAPOE ε4 mice exhibited decreased WMI compared to ε3s. Decreased WMI in ε4 carriers is consistent with recent work linking APOE with reduced myelin in the APOE ε4 human brain. Further, sex differences select brain region volumes indicate sex‐specific patterns of aging in this model. Collectively, outcomes of these analyses indicate both sex and APOE genotype differences in both gray matter volumes and in white matter integrity.
Midlife Cardiovascular Risk Factors and Cognitive Decline in a Diverse Cohort of Adults Ages 80 and Older
Authors: George Kristen M. , Gilsanz Paola , Corrada María M. M. , Posis Alexander Ivan B. , Peterson Rachel , Barnes Lisa L. , Kawas Claudia H. , Mungas Dan M. , Decarli Charles , Whitmer Rachel A.
Published: January 2025

Background

Midlife cardiovascular risk factors (CVRF) are associated with late‐life cognitive impairment, but also mortality. We evaluated their association with cognitive decline in a diverse cohort of older adults who survived to age 80 without diagnosis of dementia.

Method

Three harmonized cohorts of long‐term Kaiser Permanente members were pooled and restricted to those aged 80+. We measured CVRF from Multiphasic Health Check‐ups (MHC; 1964‐1985), which assessed hyperlipidemia, hypertension, overweight/obesity, diabetes, and smoking status. Standardized z‐scores for executive function (EF) and verbal episodic memory (VEM) were measured over up to 8 waves (2017‐2023) using the Spanish and English Neuropsychological Assessment Scales. Linear mixed models with random intercepts and slopes associated CVRF, separately, with cognitive decline adjusting for age at MHC, age at cognitive assessment, race (Asian/Black/Latino/white/multiracial), education (≤high school/some college/≤college), assessment mode (in‐person/telephone), and practice effects. Sensitivity analyses evaluated the count of CVD risk factors stratified by smoking status.

Result

Participants (n = 935) averaged 40.6(±7.9) years of age at MHC, 88.0(±4.9) years at baseline cognitive assessment, and 61.4% were women (Table 1). At midlife, 47% had hyperlipidemia, 23% hypertension, 34% overweight/obese, 1% diabetes, and 51% ever smoked. Hyperlipidemia was associated with worse baseline EF (β(95% CI):‐0.24(‐0.36,‐0.12)), smoking was associated with better EF (β:0.13(0.01,0.25)), and hypertension was associated with worse EF (β:‐0.14(‐0.25, 0.002)), though the effect was not statistically significant (Table 2). There were no associations between CVRF and EF decline. Hyperlipidemia was the only CVRF associated with worse baseline VEM (β:‐0.18(‐0.31,‐0.05)), and no CVRF was associated with VEM decline (Table 2). Despite smokers having higher baseline EF compared to nonsmokers, having 3+ CVRF was associated with steeper decline in both groups compared to those with fewer CVRF (Figure 1). Baseline VEM was similar between smokers and non‐smokers, and for both smokers and nonsmokers, the steepest declines in VEM were among those with one CVRF.

Conclusion

In this diverse cohort, midlife hyperlipidemia was associated with worse cognition in late life. A positive association between smoking and EF may be indicative of resilience among midlife smokers who have reached age 80+. Regardless of smoking status, multiple CVD risk factors may be detrimental to cognitive function, particularly EF.
APOE4‐related brain vulnerabilities in memory circuitry of midlife women
Authors: Wugalter Katrina A , Thurston Rebecca C , Schroeder Rachel A , Wu Minjie , Aizenstein Howard J , Kamboh M. Ilyas , Derby Carol A. , Maki Pauline M
Published: January 2025

Background

The APOE4 genotype appears to confer differential risk of Alzheimer’s disease for women compared to men. As APOE4 effects in midlife women can be subtle (e.g., negligible main effects of APOE4 genotype on cognition and brain outcomes), there is a need for early markers of APOE4‐related brain vulnerabilities to identify those at early risk and guide treatment. We therefore examined whether patterns of brain activity and hippocampal functional connectivity that support verbal memory differ by APOE4 status in midlife women participating in MsBrain, a cohort study of brain health in midlife women.

Method

Participants completed functional magnetic resonance imaging (fMRI) assessments during verbal encoding and recognition tasks. Generalized psychophysiological interaction (gPPI) analyses estimated hippocampal functional connectivity using SPM12 and Conn, with AlphaSim (AFNI) to correct for multiple comparisons. Associations between CVLT indices and brain outcomes (regional activation, left [LHipp] and right hippocampal [RHipp] functional connectivity) were tested via multiple linear regression controlling for age, education, race, and MoCA score. Interactions by APOE4 status (carriers [E3E4 and E4E4] versus non‐carriers [E3E3]) were tested.

Result

In 166 women (mean age=59.31 years, 83.7% white, 32% APOE4 carriers), there was no main effect of APOE4 on verbal memory performance, activation, or hippocampal connectivity. During encoding, APOE4 status moderated the associations between semantic clustering and fMRI measures (e.g., activation of the left superior frontal gyrus and connectivity from LHipp to left middle frontal gyrus and to right parahippocampal gyrus; Figure 1). These associations during encoding were stronger in APOE4 carriers versus noncarriers. During recognition, APOE4 status moderated the associations between: a) total learning and activation of right inferior, middle, and superior frontal gyri; b) clustering and activation of the right superior frontal gyrus; c) total learning and LHipp connectivity to left middle temporal gyrus; and d) clustering and RHipp connectivity to right superior temporal gyrus (Figure 2). For recognition, APOE4 carriers typically showed decreased activation/connectivity, while noncarriers showed neutral or enhanced activation/connectivity.

Conclusion

These findings may indicate early compensatory mechanisms in female midlife APOE4 carriers that support verbal memory, serving as potential markers of risk and targets for intervention in midlife APOE4 carriers.
White matter integrity is lower in non‐amnestic than amnestic Alzheimer's disease and differs by clinical syndrome
Authors: Phillips Jeffrey S , Adluru Nagesh , Chung Moo K , Radhakrishnan Hamsi , Olm Christopher A , Cook Philip A. , Gee James C. , Arezoumandan Sanaz , Cousins Katheryn A Q , Wolk David A , McMillan Corey T , Irwin David J
Published: January 2025

Background

Amnestic mild cognitive impairment and Alzheimer’s disease (aAD) exhibit degeneration of white matter (WM) tracts preceding overt cognitive decline. However, WM changes in non‐amnestic AD (naAD) are understudied. We hypothesized patterns of WM degeneration would differ between aAD and naAD.

Methods

We compared WM degeneration, assessed by 30‐direction diffusion‐weighted imaging (DWI), in 41 individuals with aAD; 67 with naAD diagnoses including logopenic‐variant primary progressive aphasia (lvPPA), posterior cortical atrophy (PCA), behavioral variant AD (bvAD), and corticobasal syndrome (CBS); and 45 with normal cognition (Table 1). We performed deterministic tractography between 148 cortical/subcortical regions; connectivity was quantified by generalized fractional anisotropy (GFA). Tractwise GFA and regional grey matter (GM) volumes were converted to W‐scores adjusting for age and sex. We contrasted GFA between groups using regression models covarying for MMSE score. A mixed effects model was used to assess associations between tractwise GFA and volume of GM endpoints. Additionally, we computed the number of connected components in each person’s brain graph (i.e., number of subgraphs created by progressively stricter thresholds) across 100 GFA values. We contrasted this topological metric between groups and assessed its associations with MMSE and disease duration.

Results

GM volume was lower in naAD and aAD than controls (both p<0.0001) but did not differ between patient groups (p=0.81). aAD and naAD patients had shared WM degeneration in corpus callosum, cingulum, and inferior/superior longitudinal fasciculi; however, WM degeneration was more severe in naAD (Figure 1). In lvPPA, WM degeneration was left‐lateralized; in PCA, GFA was reduced in bilateral parietal, occipital, and temporal areas (Figure 2). Across groups, GM and WM degeneration were significantly associated [F(1,20442)=326.0, p<0.0001]. Topological analysis indicated naAD but not aAD patients had lower global connectivity than controls. A higher component number (indicating reduced connectivity) was associated with longer disease duration and lower MMSE.

Conclusion

Associations between GM volume and GFA suggest WM degeneration in naAD is related to AD pathologic change and not an independent process. Greater WM disease in naAD than aAD was not attributable to GM atrophy or symptom severity. Finally, topological metrics may serve as objective markers of global disease progression.
Confounding factors to Alzheimer`s disease plasma biomarkers in patients from a memory‐clinic cohort
Authors: Rodrigues Matheus Scarpatto , Oliveira Markley , Lussier Firoza Z , Ferreira Pamela C.L. , Bauer‐Negrini Guilherme , Povala Guilherme , Felix Cynthia , Abbas Sarah , Zalzale Hussein , Soares Carolina , Saha Pampa , Madeiros Marina Scop , Hong Chang Hyung , Roh Hyun Woong , Karim Helmet T. , de Oliveira Jade , Zimmer Eduardo R. , Karikari Thomas K , Bellaver Bruna , Son Sang Joon , Pascoal Tharick A.
Published: January 2025

Background

Blood‐based biomarkers for Alzheimer’s disease (AD) are increasingly prevalent and accessible beyond research environments. Consequently, it is crucial to determine whether confounding factors, particularly highly prevalent comorbidities, influence the levels of these blood biomarkers, thereby refining their clinical interpretation. In this study, we examined the impact of comorbidities on plasma AD biomarker levels within a memory‐clinic cohort.

Method

We analyzed 832 individuals (CU: 101, CI: 731) from the BICWALZS cohort with available information of comorbidities and plasma biomarkers measurements. The effect size of each comorbidity to plasma p‐tau217, neurofilament light chain (NfL) protein, glial fibrillary acidic protein (GFAP) and amyloid‐β (Aβ) 42/40 ratio was accessed by the β‐estimate and 95% CI values of linear regression models adjusted by clinical diagnosis, age, and sex. Comparison of biomarkers between comorbidities was carried out by ANOVA.

Result

Among the evaluated comorbidities, plasma creatinine levels, BMI index, sleep disorder, and the presence of kidney disease were the primary comorbidities linked to variations in plasma biomarker concentrations (Figure 1). Analyzing the levels of the biomarkers according to the presence of comorbidities, we observed that individuals with increased plasma creatinine exhibited significantly higher plasma levels of p‐tau217, NfL and GFAP in comparison to the individuals with normal levels of creatinine (p < 0.05, Figure 2A, B, C). The mean of p‐tau217 and NfL, but not of GFAP, was elevated between those with kidney disease (p < 0.05, Figure 2A, B). High plasma NfL levels were observed in individuals with diabetes and hypertension (p < 0.05, Figure 2B). On the other hand, high BMI index was associated with lower plasma p‐tau217, NfL and GFAP compared to individual with normal BMI (Figure 2A,B,C). We also observed that individuals with sleep disorder exhibited decreased plasma p‐tau217 levels (Figure 2A). Plasma Aβ42/40 ratio was not affected by the analyzed comorbidities (Figure 2D).

Conclusion

Our findings indicate that elevated creatinine levels, a higher BMI index, and the presence of kidney disease are the most significant confounding variables associated with alterations in AD plasma biomarkers. Together, our results shed light on the impact of different comorbidities to the interpretation of biomarker values in real‐world populations.
Sociodemographic and clinical heterogeneity among longitudinal studies in dementia with Lewy bodies
Authors: Kane Joseph PM , Rodriguez‐Porcel Federico , Bayram Ece , Abdelnour Carla , Desmarais Philippe , Echeverri Isabella Delgado , Ikeda Manabu , Gonzalez Maria Camila , Kanemoto Hideki , Poston Kathleen L. , Wyman‐Chick Kathryn A , Ricciardi Mario , Saeed Usman , Samancı Bedia , Satake Yuto , Yu Yueyi , Yu Jin‐Tai , Leverenz James B , Aarsland Dag ,   the ISTAART Lewy body dementias Consortia Working Group
Published: January 2025

Background

International collaboration is crucial to the future of research in dementia with Lewy bodies (DLB). Although it is hoped that a single global DLB cohort can be created through combination of data from the many longitudinal studies conducted internationally, a high likelihood of phenotypic heterogeneity may prohibit harmonisation and analysis of datasets. Our primary objective is to determine whether significant heterogeneity is observed in the sociodemographic and clinical characteristics of people with DLB globally.

Method

Longitudinal DLB studies and multi‐centre consortia were invited through existing professional networks to contribute limited descriptive clinical and sociodemographic data for their samples using a standardised proforma. One way analysis of variance (ANOVA) with summary statistics as input was used to compare mean scores. χ2 test was used to compare categorical variables.

Results

Descriptive data from 10 projects in seven countries, and one multinational consortium, were shared, comprising a pooled sample of 4157 individuals with DLB. The proportion of males (χ2 = 135, df = 7, p< .01) and the duration of formal education (F(3,6) = 19.41, p<.02) varied significantly between DLB projects. No significant difference in mean age (F(3,7) = 0.87, p = .61) or duration of DLB symptoms at baseline (F(2,6) = 1.46, p = 0.46) was noted, nor was it observed in scores of baseline Mini‐Mental State Examination (MMSE)(F(2,5) = 0.73, p = 0.66), Clinical Dementia Rating (CDR) (F(1,4) = 2.04, p = .48), or Part III of the Unified Parkinson’s Disease Rating Scale (UPDRS) (F(2,6) = 12.9, p = .73).

Conclusion

Despite a broad range of project methodologies and a diverse group of subjects, little sociodemographic or clinical heterogeneity was observed between longitudinal DLB projects. Interrogation of subject‐level data, rather than descriptive data for each project, and more detailed clinical data on participants would allow further examination of heterogeneity. This could support harmonisation of individual DLB datasets to create a single global DLB cohort.
Factors associated with the cognitive performance of healthy older adults and persons living with Alzheimer’s disease from a middle‐income country in Latin America
Authors: Palma Leticia Fernanda , Pulgatti Karen Letícia , Victoriano Pedro Henrique Moreira , Rebecchi Laís , de Sousa Danilo Barroso , Grigoli Marina Mantellatto , Popolin Cecilia Patricia , da Silva Vanessa Alexandre , de Oliveira Sabrina Dorta , Manzine Patricia Regina , Cominetti Márcia Regina , Pelegrini Lucas Nogueira de Carvalho
Published: January 2025

Background

Low‐ and middle‐income countries (LMIC) share characteristics, such as low education, that increase the risk of dementia among their population. Critically, around 70% of the cases of dementia in LMICs are underdiagnosed. Understanding factors contributing to older adults’ cognitive performance may support healthcare professionals from these countries in their decision‐making process when screening for cognitive decline in their communities. This study aims to analyze factors associated with the cognitive performance of older adults from a Latin American country.

Method

This is a cross‐sectional and analytical study whose participants (n = 92) were healthy older adults (n = 74) and persons living with Alzheimer’s disease (PLwAD) (n = 18) who lived in a middle‐income Latin American country (Brazil). For assessment, the following instruments were used: a sociodemographic questionnaire, the Addenbrooke’s Cognitive Examination‐Revised (ACE‐R), the Mini‐Mental State Examination (MMSE), Geriatric Depressive Scale (GDS‐15), and the Pfeffer Functional Activity Questionnaire (FAQ). Descriptive, linear regression and mediation analyses were performed on SPSS (version 29.0) and PROCESS for SPSS (version 4.1). The significance level was set at p<0.05.

Result

PLwAD were older (t = ‐5.27; p<0.001; 95%CI [‐13.12 to ‐5.75]), had less years of formal education (t = 4.16; p<0.001; 95%CI [2.94 to 8.60]), worse cognitive performance (ACE‐R‐ t = 8.41; p<0.001; 95%CI [31.84 to 52.78] / MMSE‐ t = 9.32; p<0.001; 95%CI [8.96 to 13.82]), and worse functionality (FAQ‐ t = ‐14.31; p<0.001; 95%CI [‐20.25 to ‐15.31]). GDS‐15 scores did not differ between groups (t = ‐0.81; p = 0.423; 95%CI [‐2.27 to 0.93]). Age (B = ‐0.575; t = ‐2.96; p = 0.004), years of education (B = ‐1.073; t = 5.44; p<0.001), and functionality (B = ‐1.593; t = ‐9.99; p<0.001), were significantly associated with cognitive performance, as per ACE‐R scores (R2 = 0.799; F = 102.27; p<0.001). Finally, mediation analysis suggested that years of education mediate the effect of FAQ on ACE‐R scores (total effect = ‐2.15; p<0.001 / direct effect = ‐1.78; p<0.001 / indirect effect = ‐0.3558; 95%BCaCI [‐0.61 to ‐0.18]).

Conclusion

These findings align with existing literature, yet they present a novel perspective within this population. Results demonstrate that age, education, and functionality are associated with cognitive performance, emphasizing their relevance in the screening/assessment. Our data also suggests that years of education mediate the relationship between functionality and cognitive performance.
Feasibility of Older Adult Remote Self‐Installation of Passive Sensor Assessment Technologies
Authors: Gothard Sarah , Rodrigues Nathaniel , Irish Stephanie , Kaye Jeffrey A , Beattie Zachary T , Lindauer Allison
Published: January 2025

Background

Conducting research remotely in aging and Alzheimer’s disease related (ADRD) populations using multiple passive sensing technologies (e.g., activity watches, electronic pillboxes, bed‐mats, wall‐mounted sensors) provides opportunities for greater inclusiveness and more ecologically valid data capture. A challenge to this approach has been the need to enter homes to deploy and/or maintain devices or technologies. To overcome this limitation, we developed and tested a novel protocol for entirely remote self‐deployment of technologies.

Method

Research participants in 14 households (age = 70.8±7.2 years; 61.5% female; education = 16.5±2 years; telephone MoCA = 21±1.6, days of follow‐up = 834.9±604.7) in an aging and dementia study were sent an online accessible Remote Installation Manual to guide independent installation of technologies in their homes. The manual included technology overviews, video installation tutorials, and written step‐by‐step instructions for each device. Eight separate sensing technologies could be deployed in each home (PIR motion sensors, contact door sensors, activity watches, wireless body composition scale, bed mats, driving sensors, and a data hub aggregating computer). Participants could request installation support, if necessary. The success of self‐deployment was compared to 22 study homes, which were installed in‐person by study field technicians.

Result

Four of 14 participants deployed the technologies entirely using only supplied instructions: 10/14 participants required assistance with at least one aspect of installation; all issues were resolved through remote contact. Data recovery and maintenance issues between the participant‐installed homes and the 22 technician‐installed homes were not different. The median percentage of days with technical issues were similar (volunteer = 2.3%; technician = 1.4%). The percentage of days of captured data for watches, bed‐mats, and electronic pillbox use were similar or better for volunteer‐installed homes (watch: volunteer = 72.9%, technician = 70.6%; bed‐mat: volunteer = 72.0%, technician = 67.2%; pillbox: volunteer = 72.0%, technician = 68.5%).

Conclusion

Older adults are readily able to deploy remote assessment technologies without study personnel needing to travel to or enter a residence. Data generation and technical issues related to the research technologies are comparable between study participant self‐deployment and technician‐deployment, demonstrating feasibility and effectiveness of remote older adult self‐deployment of study technologies. The ability to deploy digital technologies for continuous, objective and ecologically valid assessments anywhere with internet access may greatly broaden the inclusiveness of ADRD research.
What does it take to assess dementia in community‐dwelling immigrant older adults with limited English proficiency? – A case of Korean Americans
Authors: Han Hae‐Ra
Published: January 2025

Background

Currently, there is no national consensus on how to identify individuals with probable dementia in community‐based settings. With the rapid increase of aging populations—particularly ethnic minorities—there is an urgent need to create a process to effectively identify individuals with probable dementia to adequately plan for dementia care. The aim of this study was to evaluate a dementia screening approach applied to a recent immigrant community, Korean Americans.

Method

PLAN—Preparing for healthy aging through dementia Literacy education And Navigation—is an ongoing trial involving community‐dwelling Korean older adults with probable dementia and their care partners in the greater Washington and metropolitan New York areas. Data for the current analysis came from: community coordinator logs, recruitment tracking notes, and participant enrollment database.

Result

The study team developed a two‐phase screening process to ensure accurate assessment of dementia status: (1) Mini‐Mental Status Exam (MMSE) and (2) Clinical Dementia Rating (CDR). The screening protocol was written so once the first‐phase screening meets the pre‐established criterion (MMSE<24), the older adult‐caregiver dyad is invited to a CDR interview to confirm the dementia status. Given lack of bilingual/bicultural geriatric workforce in the community, bilingual community health workers (CHWs) were trained to conduct both screenings. As of January 19, 2024, trained CHWs screened 2,693 older adults using MMSE; 584 of them (21.7%) were screened positive and invited to the second‐phase screening using CDR. More than two thirds (n = 392 or 67.1%) agreed and participated in CDR assessment; 309 of them (or 78.8%) received a score of 1+, indicating probable dementia.

Conclusion

We were able to train bilingual CHWs to conduct dementia screenings in one of the most understudied and underserved Asian immigrant communities. The prevalence of dementia was more than 20% in the screened sample, compared to 6%∼13% in the general US older population. Nearly four of five among the MMSE positive sample were confirmed to have a substantial functional decline based on CDR, indicative of probable dementia. When working with resource‐poor communities, our approach of mobilizing community assets (CHWs) and combining a brief cognitive screener with a refined functional measure can help identify older adults with probable dementia.
Importance of digital skills in attitude towards the use of smartphones and usage behavior in ederly population
Authors: Benitez Estela , Sarmiento Elsa Araceli Revollo , Moreno Maria Celeste López , Vera Rocio Micaela , Vivas Leticia
Published: January 2025

Background

The use of technology in elderly population has increased in the past years due to COVID‐19. Therefore it is relevant to identify the factors that contribute and limit the effective use of technology by older people. In particular, digital skills have shown to be relevant to determine the attitude toward the use of technology and consequently to have an effect on usage behavior. The aim of the current poster is to analyze the relations between this variable and the use of smartphones.

Method

We employed a correlational design with a non‐probabilistic for convenience sample including 139 elderly (56.9% women). The age ranged from 60 to 90 years, with a mean of 71.1 (DS = 6.62). Participants were administered the Digital Competencies Questionnaire (Heredia & Garcia, 2017), the acceptance questionnaire for the STAM model smartphone (Chen & Chan, 2014) and questionnaire to assess usage behavior called SAMCOP (Ma et al., 2016)

Result

First, a correlation analysis was performed between digital competencies (DC) and the variables of the STAM and it indicated a positive correlation between DC and self‐efficacy in use (r = .456; p < .001), facilitating conditions (r = .434; p < .001), perceived usefulness in use(r = .508; p < .001), perceived ease of use (r = .425; p < .001), attitude towards use (r = .594; p < .001), and a negative correlation with anxiety towards use with the use of technology (r = ‐.323; p < .01). Furthermore, a linear regression analysis was performed to identify the influence of DC on SAMCOP. The results indicated an influence of DC on frequency of smartphone use (p < .001; R2 = .245); experience in smartphone use(p < .001; R2 = .175); and most frequently used apps (p < .01; R2 = .0801), but no influence on number of installed apps (p = .491).

Conclusion

The results demonstrate a direct relationship between digital competencies and smartphone acceptance variables. This indicates that greater digital competencies lead to higher smartphone acceptance and reduced anxiety in the elderly. These competencies also influence smartphone usage behavior in old age, highlighting the importance of promoting digital skills among the elderly.
Designing a Comprehensive Family Caregiver Assessment: Insights from a Multidisciplinary Professional Panel
Authors: Gholizadeh Shadi , Neal Matthew , Hayes Kirk , Geiss John Mark
Published: January 2025

Background

The imminent launch of the Guiding an Improved Dementia Experience (GUIDE) Model necessitates a nuanced understanding of family caregiver needs to support the implementation of family‐centered dementia care plans. Recognizing the multifaceted role of family caregivers, a preliminary working session was convened to outline the foundational elements of a family caregiver assessment, ensuring these assessments are equipped to guide effective interventions.

Method

A multidisciplinary panel consisting of a clinical psychologist, two health care executives, and a physician with geriatric expertise convened to delineate components of a caregiver assessment tool to supplement the Zarit Burden Interview. The panel, representing diverse expertise within the elder care setting, engaged in discussions focused on the challenges caregivers face, the support they require, and the pivotal information that could enhance care delivery. The session aimed to consolidate professional insights in order to develop a focus group interview guide as a precursor to engaging with the broader caregiver community.

Result

The panel identified essential domains for the caregiver assessment, including caregiver’s understanding of dementia, behavioral modification strategies, navigation of healthcare systems, and caregiver health behaviors. It was determined that each of these domains should be developed after literature review and insights from family caregivers. Five areas that were highlighted as often missed but crucial to include in an assessment were 1) the caregiver’s understanding of anosognosia as a dementia symptom, 2) a plan and goal setting for what the caregiver would do during respite times, 3) caregiver health behaviors, 4) cultural considerations around caregiver roles and identity and 5) learning preferences. Failing to consider language/cultural preferences and preferred modalities of support modalities emerged as a common barrier to caregiver engagement, affecting care plan acceptance.

Conclusion

Recognizing the preliminary nature of this professional panel’s insights, the next phase will involve conducting extensive focus groups with family caregivers to validate and expand upon these findings. This subsequent step is pivotal in ensuring the assessment tool captures the authentic voice, needs, and preferences of caregivers, thereby facilitating the delivery of comprehensive, person and family‐centered dementia care.
Using Natural Language Processing to identify text for qualitative research into the lived experience of people with dementia
Authors: Shapiro Lily N. , Bowers William I , Ehrlich Kelly , Maripuu Tiina , Peterson Jenna Mae , Gray Marlaine Figueroa , Sankaran Sundary , Crane Paul K. , Taylor Janelle S , Penfold Robert B
Published: January 2025

Background

Medical records present a rich potential source of information on the lived experiences of people with dementia. These records are extensive and the work of extracting relevant data is labor‐intensive. We sought to determine whether we could use natural language processing (NLP) approaches to sift through medical records to prioritize an enriched subset of notes illuminating the lived experiences of people with dementia.

Methods

We identified an analytic cohort of adults aged ≥ 65 years from the Adult Changes in Thought (ACT) Study, a prospective cohort study of dementia in Seattle, WA. We collected a corpus of 254,532 notes from the electronic medical records (2003‐present) of these participants. The corpus included a range of clinical encounters from five years prior to dementia onset to most recent visit. We implemented an NLP algorithm, pytakes, which extracted concepts from notes in our corpus. The concepts were codes adapted from a prior qualitative study, which we further refined for this study. We used these concepts to curate smaller sub‐corpora for manual, qualitative review.

Results

Starting with 32 unique concepts, pytakes extracted over 1.7 million concepts. 178,042 notes (69.94% of the original corpus) had at least one associated concept. Preliminary review of notes extracted showed acceptable concurrence between the text retrieved and the target concepts. Leveraging the extracted concepts, we curated, then randomly sampled 500 notes for three sub‐corpora, each aimed at a different research question. The first investigates the topics and timings of patient‐ or caregiver‐initiated communications with the healthcare system. The second relates to caregiving needs and networks of people with dementia and how these shift over time. The third revolves around housing situations and transitions of people with dementia. Our qualitative team is examining these sub‐corpora to investigate the lived experience of people with dementia.

Conclusions

NLP tools may be a productive method for identifying materials suited to qualitative inquiry into the lives of people with dementia. This innovative approach can provide access to data that would otherwise be difficult to obtain, offering insight into the lived experiences, care needs, living situations, and social networks of people living with dementia.
Electronic Health Record‐Embedded Dementia Screening Toolkit Tailored for Bilingual and Bicultural Needs
Authors: Shah Samantha , Huerta Gabriela Islas , Wang Kevin , Wadhwa Satpal S. , Diaz‐Santos Mirella , Vossel Keith , Chang Timothy S
Published: January 2025

Background

Alzheimer’s disease (AD) is a significant health concern affecting at least 10% of individuals aged 65 and older, with heightened risk in Black and Hispanic/Latino populations. Despite this prevalence, our analysis of University of California Los Angeles (UCLA) electronic health records (EHR) indicates that only 4% of patients aged 65 or older receive an AD diagnosis, with underdiagnosis more prevalent among Black and Hispanic/Latino patients compared to their white counterparts. To address this issue, we propose implementing a concise dementia screening tool (DST) in real‐world clinical settings.

Method

The DST, developed through collaborative efforts among multiple University of California AD Centers and the California Department of Public Health, is a brief (<5 minutes) screening tool. It includes a three‐question questionnaire for patients and, if available, their informants, followed by the Mini‐Cog assessment if applicable. The questions address changes in language, memory, and personality. A positive DST result is defined as any “Yes” response by the patient or informant to any question or a Mini‐Cog score below 3 out of 5 points. We have also created a Spanish version of the questionnaire tailored to the Hispanic/Latino cultural context.

Result

Integration of the DST into the EHR system facilitates a seamless implementation. Patients receive questionnaire through the EHR messaging system before appointments, with the Spanish version available for those who prefer it. Responses and Mini‐Cog results are easily accessible in the EHR. Additionally, a documentation link automatically populates DST results, final scores, and recommendations into provider notes.

The DST is currently in use at a large, diverse UCLA family medicine clinic serving Hispanic/Latino and Black patients. In the first fourteen months, 1,963 patients (Table 1) were seen, with 28% self‐identifying as Hispanic or Latino. Among them, 1,070 patients answered at least one question, and 340 completed the Mini‐Cog (Table 2). Notably, 31 patients received a new dementia diagnosis, and 81 were referred to Neurology.

Conclusion

Our implementation of the DST in a diverse clinical setting has successfully screened 1,070 participants, with future research comparing data from the DST period with a pre‐time period.
Exploring Semantic Topics in Dementia Caregiver Tweets
Authors: Feng Yanbo , Hou Bojian , Klein Ari , O'Connor Karen , Chen Jiong , Mondragón Andrés , Yang Shu , Gonzalez‐Hernandez Graciela , Shen Li
Published: January 2025

Background

Caring for family caregivers of dementia patients has grown to an important topic. Social media platforms, like Twitter, provide great resources for studying the needs of caregivers. It would be beneficial to understand the caregivers’ interested or concerned topics from their tweets. Meanwhile, topic modeling has become an efficient NLP tool for analyzing semantic themes within texts. Thus, in this study, we perform a novel topic model leveraging weighting strategies to analyze dementia‐caregiver‐related twitter data.

Method

The information about the twitter data collection is available at: https://aging.jmir.org/2022/3/e39547. In our analysis, we first performed quality control, as shown in Figure 1. Then, we deployed two word‐frequency weighting strategies, Log weighting and Balanced Distributional Concentration (BDC) weighting, on the Dirichlet Multinomial Mixture (DMM) model to obtain 4 DMM variants and used them to mine semantic topics within the tweets. We compared the performance of DMM variants, LDA variants, and BERTopic variants. Topic numbers of 5, 10, 15, 20 were picked to achieve comprehensive comparison. The coherence score C_V was applied to evaluate the model performance. We then leveraged the GPT‐4 to summarize the bag of words in each topic from the best model to generate interpretable themes.

Result

224,862 tweets passed the quality control and were analyzed in our study. As shown in Figure 2, the performance evaluation demonstrated that the Log‐BDC DMM has the best general performance among traditional and BERT‐based models, with an averaged coherence score of 0.5648. The bags of words from the Log‐BDC DMM with 10 topics were interpreted using GPT‐4 due to the highest coherence score of 0.6054. The interpretation yielded 10 semantic themes, as shown in Figure 3.

Conclusion

Our investigation of the twitter data shows that the DMM model with Log and BDC strategies has promising power for mining meaningful semantic topics from short and noisy tweets. The model outperforms LDA models and the BERTopic models while maintaining high model interpretability. This initial study on twitter data provides interesting findings that can provide better care to family caregivers and demonstrates the promise and interpretability of traditional topic modeling methods.
Attitudes and Perceptions of Caregivers of person with Frontotemporal Dementia in Peru: Preliminary results
Authors: Castro‐Suarez Sheila , Illanes‐Manrique Maryenela Z. , Meza‐Vega Maria , Cuenca José , Lanata Serggio , Cornejo‐Olivas Mario
Published: January 2025

Background

Frontotemporal dementia (FTD) is a clinical syndrome characterized by progressive changes in behavior, executive function, or language. In Latin America, persons with FTD are underrecognized or diagnosed late. There is a lack of knowledge about the experiences have on families.

Method

We used a mixed methods approach consisting of qualitative, semi‐structured interviews that were recorded, transcribed, and analyzed using thematic analysis. Local IRB approval was obtained for this study.

Result

We interviewed fourteen family caregivers of persons with FTD, ten of them (71.4%) were caregivers of persons with behavioral variant FTD (bvFTD). There was female predominance (78.5%). The average of education was 14.5±2,3 years. Half were sole caregivers, seven were children, five were spouses, and two were sisters. The key themes emerging from qualitative interviews were difficulties surrounding the diagnostic process, the impact of knowing the diagnosis, and challenges surrounding caregiving. Caregivers stressed how tedious it is to access health services and obtain specialized care and the lack of knowledge of the disease among health professionals. Caregivers commented on the perceived lack of skills of some professionals when informing about the diagnosis and prognosis of a neurodegenerative disease. Knowledge of FTD prognosis generates anguish, hopelessness, and frustration among caregivers. Caregivers who are sons or daughters often adopt leadership roles within the family, especially from financial and caregiving point of view. They also often change or postpone life/professional plans. On the other hand, if the caregiver is the wife or husband, the absence of their partner in the home stands out as a main stressor, even though they remain together.

Conclusion

Our preliminary results highlight the importance of providing accessible, plain‐language education and support to caregivers of persons with FTD, as well as the opportunity to improve training on healthcare professionals. The impact of caring for patients with FTD appears to be dependent on the parental relationship.