bluuebunny/crossref_metadata_2025 huggingface dataset:
The co‐design of a Brain Health Game for children to reduce risk of dementia
Authors: Wilson Christine Brown , Townsend Rebecca , Mitchell Gary , Craig Stephanie , Carter Gillian , Stark Patrick , Clarke Sonya , Wilkie Susie , McEvoy Claire T
Published: January 2025

Background

Dementia prevalence is projected to treble worldwide by 2040 highlighting the critical need for effective primary dementia prevention strategies. Initiatives to shape health behaviours/beliefs in childhood increase likelihood of engagement in healthy lifestyle behaviours during adulthood however some subgroups of children are more vulnerable to poor brain health during ageing. Therefore, children must have opportunities to learn about how they can engage in behaviours to improve cardiovascular and psychological health that will protect their brain as they age, contributing to dementia risk reduction (DRR) in later life. Serious digital games (SDG) are fun, interactive and engaging, having been used successfully for education and behaviour change. No SDGs to promote brain health/DRR for children currently exist.

Method

A SDG, ‘my Superbrain’ was codesigned with primary school children in Northern Ireland. The aims of this study were: to examine changes in understanding brain health/DRR via pre/post‐test evaluation of the SDG among children aged 8‐11 years old and determine the acceptability and feasibility of a novel SDG for DRR in children. Children completed the Kids Brain Health Questionnaire pre/post playing the Game with a modified System Usability Scale (SUS). All data analyses were conducted in SPSS version 29 following matching of pre/post data. Due to non‐normally distributed data, the non‐parametric Wilcoxon signed‐rank test was used to examine the change from pre‐test to post‐test scores on the Kids Brain Health Questionnaire.

Result

The SDG was evaluated with 46 participants. Most participants reported not having a family member/close friend living with dementia (71.7%). A Wilcoxon signed‐rank test showed a statistically significant median increase (Mdn = 1.00) in Kids Brain Health Questionnaire scores from pre‐test levels (Mdn = 52.00) to post‐test levels (Mdn = 53.0), z = 2.90, p = .004. A mean score of 36.15 out of a possible 50 was found for the SUS.

Conclusion

The findings demonstrate ‘evidence of promise’ for early intervention stage testing with a small but statistically significant increase in knowledge for children after using the SDG, ‘my Superbrain’. Participants also found the game acceptable, suggesting further work is warranted to test the SDG on a larger sample of children.
Comparing the diagnostic accuracy of cerebrospinal fluid biomarkers for Alzheimer’s disease: A novel meta‐analysis model
Authors: Sheppard Athena L , Quinn Terry J , Bujkiewicz Sylwia , Owen Rhiannon K
Published: January 2025

Background

The emergence of new biomarkers for Alzheimer’s disease is accompanied by the urgent need to evaluate their diagnostic performance in comparison to existing technologies. Meta‐analysis methods make best use of the available evidence by synthesizing all relevant published studies. Meta‐analytic models that estimate comparative diagnostic accuracy are key to informing healthcare decision‐making around which tests should be used in clinical practice. To produce robust and precise estimates of sensitivity and specificity, models must take into account associations between multiple tests evaluated in the same patient group.

Method

A novel Bayesian meta‐analysis model for jointly synthesizing accuracy data on two diagnostic tests was developed using a motivating example in Alzheimer’s disease dementia. A statistical technique known as a copula was used to flexibly capture the associations between the two tests. Comparative diagnostic accuracy data was sourced through electronic searching of The Cochrane Library. The model was fit to studies comparing the diagnostic accuracy of cerebrospinal fluid (CSF) amyloid‐β 42 (Aβ42) and total tau (t‐tau) to detect patients with mild cognitive impairment who would convert to Alzheimer’s disease dementia.

Result

CSF Aβ42 (80.6%; 95% credible interval [CrI] 70.8%, 88.3%) was more sensitive to detect Alzheimer’s disease dementia than CSF t‐tau (74.6%; 95% CrI 65.4%, 82.2%). However, CSF t‐tau demonstrated slightly higher specificity (75.5%; 95% CrI 64.9%, 84.4%) than CSF Aβ42 72.6% (95% CrI: 62.9%, 81.2%). In comparison to the meta‐regression approach currently recommended by evidence synthesis guidelines, which ignores associations between tests, the newly proposed model led to increased precision around summary sensitivity and specificity estimates.

Conclusion

The proposed model reduces uncertainty around summary test accuracy, aiding decision‐making around diagnostic strategies for Alzheimer’s disease dementia. This novel methodological development is applicable to a range of diagnostic tests for Alzheimer’s disease, including newly emerging blood‐based biomarkers. Continued development of early and minimally‐invasive diagnostic biomarkers will require comprehensive evaluation in the context of existing tests, using appropriate statistical models that capture associations between tests.
Co‐creating practical social media recommendations for dementia prevention researchers: A Delphi study
Authors: Hrincu Viorica , Roy Katie T. , Robillard Julie M.
Published: January 2025

Background

Social media provides dementia prevention researchers with additional opportunities to engage diverse audiences, including healthy individuals who unaware of their eligibility to take part in dementia‐related research. However, practical social media guidance that reflects the values and priorities of potential participants is needed. To address this gap, we sought to create consensus recommendations with research professionals and community experts.

Method

We conducted a three‐round, modified Delphi consisting of three online surveys and three conferences calls. Based on data from earlier project phases, a group of 16 experts with lived (n = 10) and professional (n = 6) experiences co‐created a set of recommendations to guide ethical social media use for dementia prevention research. Consensus was defined a priori as ≥70% agreement.

Result

Twenty‐six items attained panelist agreement. Two privacy‐related items reached consensus in Round 1: the ethical appropriateness of closed social media groups (88%) and accessing individuals not on social media through social media contacts (79%). Nine items reached consensus in Round 2, including addressing misinformation (79%), stigma (93%), and other pertinent items for social media communication (e.g., public criticism, explaining process of science). Fifteen of the sixteen remaining items reached consensus after revision in Round 3. These items included defining appropriate comments (100%), rules of engagement on dementia social media pages (100%, e.g., positive messaging, relevant topics), and ranking appropriate prevention language use for different audiences (e.g., young, healthy adults, individuals with a family history). One item pertaining to language use for people living with dementia did not reach consensus.

Recommendations were organized into seven social media use cases: setting up a social media page, handling online misinformation, actively challenging stigma, handling difficult online interactions, introducing new research to the public, help with study recruitment, and the language of prevention when writing posts.

Conclusion

Research professionals and community members co‐created consensus recommendations to facilitate the ethical use of social media by dementia prevention researchers. By providing practical guidance, these recommendations will uphold ethical decision‐making on social media. Next steps are to create an evaluation tool and distribute the recommendations to relevant audiences.
Gray‐White Matter Boundary Z‐Score and Its Volume as Imaging Biomarkers of Alzheimer’s Disease
Authors: Jahng Geon‐Ho , Tian Yunan , Oh Jang‐Hoon , Rhee Hak Young , Park Soonchan , Ryu Chang‐Woo
Published: January 2025

Background

Alzheimer's disease (AD) presents typically gray matter atrophy and white matter abnormalities in neuroimaging, suggesting that the gray‐white matter boundary could be altered in individuals with AD. The purpose of this study was to explore differences in gray‐white matter boundary Z‐score (gwBZ) and its tissue volume (gwBTV) between patients with AD, amnestic mild cognitive impairment (MCI), and cognitively normal (CN) elderly participants.

Method

Three‐dimensional T1‐weight images of a total of 227 participants were prospectively obtained to map gwBZ and gwBTV on images using a 3‐T MR system. Statistical analyses of gwBZ and gwBTV maps were performed using the full factorial one‐way analysis of covariance (ANCOVA) to compare among the three groups and the multiple regression analysis to assess the association between each map and MMSE score with both age and TIV as covariates.

Result

This study included 62 CN participants (71.8 ± 4.8 years, 20 males, 42 females), 72 MCI participants (72.6 ± 5.1 years, 23 males, 49 females), and 93 AD participants (73.6 ± 7.7 years, 22 males, 71 females). It was found that gwBZ and gwBTV were lower in AD than in CN or MCI and lower in MCI than in CN. The AD group had lower gwBZ and gwBTV than the CN and MCI groups. MMSE showed positive correlations with gwBZ and gwBTV whereas age showed negative correlations with gwBZ and gwBTV. The combination of gwBZ or gwBTV with MMSE had a high accuracy in classifying AD from CN in the hippocampus with an area under curve (AUC) value of 0.972 for both.

Conclusion

gwBZ and gwBTV were reduced in AD. They were correlated with cognitive function and age. Moreover, gwBZ or gwBTV combined with K‐MMSE had a high accuracy in differentiating AD from CN in the hippocampus. These findings suggest that evaluating gwBZ and gwBTV in the AD brain could be a useful tool for monitoring AD progression and diagnosis.
Performance of the Informant Questionnaire on Cognitive Decline for the Elderly (IQCODE) in Rural South Africa
Authors: Guo Muqi , Taporoski Tamara P. , Farrell Meagan T. , Mahlalehla Nomsa , Berkman Lisa F. , Bassil Darina T.
Published: January 2025

Background

Informant reports are commonly regarded as reliable and supplemental alongside respondent cognitive assessments, particularly in low‐literacy settings with absent normative data. We evaluate the performance of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) in rural South Africa.

Method

This study utilizes data from the Cognition and Dementia in a Longitudinal Health and Aging Study in South Africa (HAALSI‐HCAP). The study population includes 1,029 unique informants of 676 paired participants across two survey waves. Among them, 475 participants followed in both waves and 124 of them had the same informants. A Shangaan‐translated 16‐item IQCODE was surveyed among informants. We examined IQCODE completeness and scores, tested the single latent concept assumption of IQCODE when applied to South Africa using factory analysis, and assessed IQCODE inter‐item reliability and convergent validity. We finally examined whether using a different informant affects IQCODE score using a linear regression. Analyses were replicated after excluding items with higher proportion of reporting ‘participant never do’.

Result

On average, informants aged 43.6 years and knew the paired participants for 32 years. Most informants were female (65%), participants’ children (48%), with above secondary degrees (45%), and lived with participants (66%). Informants averagely reported 0.9 items “participant never do”. Informants seeing participants daily versus those living together reported less “never do” items and give lower IQCODE score, controlling participants’ age, gender, and education. Children informants versus spouses tend to give higher IQCODE scores. Consistent with literature, IQCODE is a single concept with the first factor explaining 60% of total variance. IQCODE had excellent inter‐item reliability (Cronbach’s alpha = 0.94) and moderately correlated with participants’ recall memory scores. Using different informants does not affect IQCODE changes for the same participants over years. After excluding items with above 12% of informants reporting ‘participant never do’ (e.g., handling everyday arithmetic problems, financial matters, following a story, or learning new gadgets), results remained similar.

Conclusion

Informant characteristics affects IQCODE scores but not completeness. Changing informants between waves does not impact IQCODE score. With excellent reliability and good validity even upon excluding several items, IQCODE is useful for assessing dementia among South African older adults.
Association between anti‐herpetic medications and dementia risk: A systematic review and meta‐analysis
Authors: Chang Syuan‐Ting , Fang Chuang Yi‐
Published: January 2025

Background

Previous research established a potential relationship between human herpesvirus (HHV) infections and increased risk of dementia. However, whether use of antiherpetic medications may lower dementia risk was not clear. Thus, this systematic review and meta‐analysis of cohort studies aimed to investigate the associations between anti‐herpetic medications and dementia risk.

Method

This study was registered in PROSPERO (CRD42022368318) and adhered to PRISM guidelines. Databases from inception to October 2023 were extensively searched to identify cohort studies investigating the association between oral antiherpetic medications (ie. acyclovir, famciclovir, ganciclovir, valacyclovir, and valganciclovir) and dementia risk in non‐demented older adults 50 years old. Pooled Hazard Ratios (HR) were analyzed using a random‐effects model in STATA 18. Subgroup analysis was performed to explore potential sources of heterogeneity.

Result

Twelve studies with 9,612,885 older adults assessing the impact of antiherpetic medications on dementia risk were included in our analysis. The meta‐analysis was divided into three comparison groups based on the study population setting: treated vs. untreated (regardless of infection diagnosis), diagnosed with and treated for infection vs. diagnosed but untreated, and diagnosed with and treated for infection vs. no diagnosed and no treatment. Our results showed that antiherpetic medications significantly reduced the risk of dementia by 12% (aHR = 0.88, 95% CI: 0.83‐0.93), 27% (aHR = 0.73, 95% CI: 0.65‐0.82), and 14% (aHR = 0.86, 95% CI: 0.77‐0.96) in each comparison group. Additionally, significant subgroup effect was found when considering severity of herpesvirus infection.

Conclusion

This is the first systematic review and meta‐analysis of cohort studies to show that antiherpetic medications had significantly protective effect on dementia, particularly in those with severe herpesvirus infections. Our findings provide valuable insights for effectiveness of medical interventions and the possible mechanism of dementia. Future research should focus on clinical trials to comprehensively understand the causal effects of this association and the underlying mechanisms.
Associations of the LIBRA risk score with cognitive resistance to susceptibility genes for dementia
Authors: Wagner Maude , Neuffer Jeanne , Grand Quentin Le , Mishra Aniket , Berr Claudine , Tzourio Christophe , Debette Stéphanie , Helmer Catherine , Proust‐Lima Cécile , Samieri Cécilia
Published: January 2025

Background

Some older adults succeed in maintaining excellent cognition despite high genetic risk for Alzheimer’s disease (AD), reflecting cognitive resistance (CR) to potential neuropathologies. Although the etiological factors for CR are still unknown, some literature suggests that environmental/lifestyle risk factors may contribute to offset, or at least reduce, the effect of AD‐related genes on cognitive decline and dementia risk. Yet, how modifiable lifestyle and health related risk factors may promote CR in genetically at‐risk individuals remains to be elucidated.

Method

We selected 6,774 dementia‐free participants from the Three‐City study cohort (≥65 years), who underwent ApoE and genome‐wide genotyping, at least 2 neuropsychological evaluations over time, and had information for the LIfestyle for BRAin health (LIBRA) score at baseline. LIBRA is a validated weighted score of 12 modifiable risk factors, including unhealthy lifestyle, poor cardiometabolic health, depression and renal dysfunction, with higher scores denoting increased lifestyle‐related dementia risk. We defined high genetic risk through ApoE‐ε4 status alone or combined with high AD‐specific genetic risk scores (GRS) beyond ApoE. We operationalized the concept of CR to genetic risk based on the individual slopes of global cognition estimated using latent process mixed models adjusted for demographics and genetic risk. CR status was assigned to genetically at‐risk participants with an adjusted cognitive slope in the slowest 25% of the overall population. Finally, focusing on genetically at‐risk individuals, we examined the associations between the LIBRA score, its individual components, and CR status using separate logistic regression models adjusted for sex, age, education, and study center.

Result

Among genetically at‐risk participants (n = 1,336 ε4‐carriers; n = 2,065 ε4‐carriers/GRS‐high), 237 (18%) ε4‐carriers and 470 (23%) ε4‐carriers/GRS‐high were cognitively resistant to susceptibility genes. Each unit increment in the LIBRA risk score at baseline was strongly associated with lower odds of CR in ε4‐carriers (odds ratio [OR] = 0.915; 95% confidence interval [CI] = 0.865‐0.967; P = .002; Figure) and ε4‐carriers/GRS‐high (OR = 0.883; 95%CI = 0.847‐0.920; P<.0001). When examining LIBRA components, cognitive activities and history of coronary heart diseases showed the strongest independent associations with CR (all P<0.01; Figure).

Conclusion

Genetically at‐risk older adults can develop cognitive resistance, which may be substantially promoted by prevention programs targeting lifestyle modifications and health management.
Comparative research on social health between older adults living alone and living with others
Authors: Han Jung Min
Published: January 2025

Background

The aim of this study is to find out differences in social health between older adults living alone and living with others.

Method

A survey was conducted on 73 older adults who live alone and 72 older adults who live with others aged 60 or older. Living alone was surveyed by general information, social health was surveyed by Korean Social Health Scale for Elderly (K‐SHSE), and lifestyle was surveyed by The Yonsei Lifestyle Profile (YLP). Lifestyle values were surveyed by The Yonsei Lifestyle Profile‐Values (YLP‐V), and self‐esteem was surveyed by Korean Self Rated Abilities for Health Practices (K‐SRAHP). Independent sample t‐test was used to compare the differences between older adults living alone and living with others.

Result

As a result of social health evaluation tool K‐SHSE showed a significant difference of 58.44±7.42 score for older adults living with others and 51.99±9.62 score for living alone (p = 0.011). Also, results of Activities Participation in YLP‐AP showed a significant difference of 46.24±8.31 score for older adults living with others and 40.51±11.04 score for living alone (p = 0.015).

Conclusion

There was a significant difference between the social health levels between older adults living alone compared to older adults living with others. Therefore, it is expected that follow‐up studies will conduct intervention research that can improve the social health of older adults living alone.
Escitalopram for Agitation in Alzheimer’s Dementia
Authors: Rajji Tarek K , Baksh Sheriza , Shade David , Ismail Zahinoor , Burhan Amer M. , Okhravi Hamid , Padala Prasad R , Rosenberg Paul B. , Schneider Lon S. S. , Porsteinsson Anton P. , Lyketsos Constantine G.
Published: January 2025

Background

Agitation is a common and disabling symptom of Alzheimer’s dementia (AD). Pharmacological treatments are recommended if agitation is not responsive to psychosocial intervention. Citalopram was effective in treating agitation in AD but was associated with cognitive and cardiac risks linked to its R‐ but not S‐enantiomer. Primary objective of the Escitalopram for Agitation in Alzheimer’s Disease (S‐CitAD) study was to examine the efficacy and safety of escitalopram, in combination with PSI, for the treatment of agitation in patients with AD who fail to respond to psychosocial intervention. A secondary objective was to define groups with agitation most likely to benefit from escitalopram.

Method

S‐CitAD is an NIH‐funded, multicenter, community‐based, phase 3, double‐masked randomized placebo‐controlled trial. Assessments were conducted at enrollment, following three weeks of psychosocial intervention (baseline), and then weeks 1‐4, 6, 7, 9, 10 and 12. Participants were adults with AD, a telephone Mini‐Mental State Examination Telephone score from 3 to 20, and clinically significant agitation/aggression as assessed by the Neuropsychiatric Inventory with either frequency being “Very frequently”, or frequency being “Frequently” and severity being “Moderate” or “Marked”. Following three weeks of psychosocial intervention alone, participants not showing response were randomized (1:1) to receive escitalopram at a target dose of 15mg/day or placebo for 12 weeks while continuing PSI. Participants who responded to three weeks of psychosocial intervention alone continued to receive the intervention and were monitored on usual care through week 12. Primary outcome was the proportion of participants with clinically significant improvement in agitation from baseline on the modified Alzheimer’s Disease Cooperative Study ‐ Clinical Global Impression of Change (mADCS‐CGIC).

Result

Two hundred and five (N = 205) participants were enrolled, and 173 were randomized to escitalopram or placebo for 12 weeks while continuing psychosocial intervention. The last participant will complete the study in late winter and mask will be broken in March 2024. Outcomes will be first presented at the AAIC meeting.

Conclusion

As escitalopram is a most commonly used treatment for disruptive behavior in dementia, the outcomes whether positive or negative will have major clinical impact.
Exploring Novel Molecular Targets for Alzheimer’s Disease in Neuropharmacology
Authors: Ghosh Shampa , Singh Krishna Kumar , Amist Aparajita Dasgupta , Sinha Jitendra Kumar
Published: January 2025

Background

Alzheimer’s disease (AD) remains a formidable neurodegenerative challenge, characterized by profound cognitive decline. Despite decades of research, effective disease‐modifying therapies are elusive. Recent advances in molecular neuropharmacology have unveiled potential therapeutic targets for AD, offering renewed hope.

Method

This comprehensive review explores emerging avenues to combat AD, emphasizing diverse targets with substantial promise. Key focus areas include beta‐secretase (BACE) and gamma‐secretase, crucial in amyloid‐beta (Aβ) peptide formation—the hallmark of AD pathology. The review also dissects tau protein abnormalities, neuroinflammation cascades, and proteins associated with synaptic dysfunction. Innovative modalities, such as immunotherapies and microRNA‐based interventions, are discussed.

Result

Novel therapeutic targets introduce groundbreaking dimensions to AD therapeutics, transcending traditional approaches. Immunotherapies and gene regulation techniques aim not only for symptomatic relief but also to arrest disease progression, enhancing overall patient and caregiver well‐being.

Conclusion

Understanding these emerging targets, coupled with delving into their underlying mechanisms, signifies a paradigm shift in AD intervention. The goal is not merely symptomatic alleviation but halting disease advancement. However, translating these promising prospects into clinical reality demands unwavering commitment to rigorous scientific scrutiny and meticulous clinical validation. Systematic trials are imperative to establish the efficacy, safety, and long‐term benefits of these potential treatments, ensuring their transformative impact on AD care.
Household Air Pollution and Dementia Risk in Low‐ and Middle‐Income Countries ‐A Systematic Review of literature
Authors: Kantipudi Suvarna Jyothi
Published: January 2025

Background

Exposure to the household air pollution (HAPIN) is a leading health risk in populations in LMIC s and accounts for an estimated 2.3 million premature deaths annually and 91.5 million disability‐adjusted life years (Bennitt et al,2021). While the deleterious effects of household air pollution on respiratory and cardiovascular health are well‐documented, the impact of HAP on cognitive outcomes, specifically dementia risk, remains an area of evolving research. Previous systematic reviews have highlighted associations between air pollution, especially particulate matter (PM) and neurodegenerative conditions in high‐income countries, and limits the generalizability of findings to LMICs, where unique patterns of air pollution exposure and sociodemographic factors may play crucial roles. In this context, the current study aims to contribute to the existing body of knowledge by systematically reviewing and synthesizing evidence on household air pollution exposures and their potential association with dementia risk in LMICs.

Method

A systematic search of databases for studies linking household air pollution (HAP) to dementia in low‐ and middle‐income countries will be conducted. Inclusion criteria are human studies published in peer‐reviewed journals in PubMed and Embase databases. Extracted data will include study characteristics, exposure assessments, and cognitive outcomes.

Result

The systematic review is currently ongoing, and initial searches identified a substantial number of relevant studies exploring the association between household air pollution (HAP) and dementia in low‐ and middle‐income countries. Data extraction revealed diverse study designs, geographical locations, and cognitive outcome measures. Subsequent narrative synthesis will provide a comprehensive overview of the existing evidence, elucidating patterns and potential sources of heterogeneity. Subgroup analyses will be done to understand regional differences and socio‐demographic factors, contributing to a nuanced understanding of HAP’s impact on dementia risk.

Conclusion

While the systematic review is ongoing, its anticipated outcomes hold promise for advancing our understanding of the complex relationship between household air pollution and dementia in low‐ and middle‐income countries.
Establishment of a Practical Risk Assessment Model for Mild Cognitive Impairment (MCI) in the Elderly
Authors: Li Jinlei , Ding Gongwu
Published: January 2025

Background

With a rapidly aging population, general practitioners (GPs) in communities are confronting the challenge of determining those who are at greatest risk for cognitive impairment and potentially need more specialized follow‐up and intervention to mitigate symptoms early in their course. Mild cognitive impairment (MCI) serves as an important stage for the early intervention and prevention of dementia. However, most MCI survey questionnaires require heavy investments of manpower and time, which limits the possibility of their application among GPs in communities. Therefore, we aimed to build and validate an MCI risk assessment model using potential predictors that are readily available to GPs, to identify high‐risk populations and further offer targeted cognitive impairment screening in communities.

Method

The study retrieved MCI risk factors for the elderly and then conducts quantitative analysis for the retrieved information via meta‐analysis, to determine generally available risk factors and their level of significance to MCI. The Rothman‐Keller risk assessment model was constructed based on risk factors, which takes into consideration not only the independent effects of the influencing factors but also their interactions. The performance of the Rothman‐Keller model was evaluated using the ROC curve using data from 2,545 seniors in communities.

Result

A total of 49 papers were retrieved for meta‐analysis and 15 risk factors were finally included in the MCI risk assessment model. The AUC of the MCI risk assessment model established in this study was 0.772 (95%CI: 0.753∼0.791), with a sensitivity of 78.04% and specificity of 63.95%. We also further formulate a tool (applet) that can be used in primary care, to identify with a high‐risk MCI population and delay the occurrence of dementia in communities based on the risk assessment model.

Conclusion

This model not only affords GPs the opportunity to conduct cognitive primary screening in the clinic setting but also helps individuals to identify their potential risk profile and trigger interventions that may delay or even prevent progression to dementia. The public health consequences are to reduce future dementia incidence rates.
Identifying Personal Values Influencing an Older Adult’s Lifestyle: Insights from Relative Importance Analysis Using Machine Learning
Authors: Lim Seungju , Park Ji‐Hyuk
Published: January 2025

Background

There is a growing global interest in the healthy lifestyle of older adults. However, despite lifestyle representing the individual, their way of life, research focusing on their personal values in the influence of lifestyle factors is lacking. This study aims to categorize the lifestyles of older adults into two types and utilize machine learning to identify the personal values that take precedence influence these lifestyles.

Method

This study is a cross‐sectional study targeting middle‐aged and older adults aged 55 and above living in local communities in South Korea. The study utilized data from 300 participants, collected through online surveys. The lifestyle types were dichotomized by YLP‐ABCD (Yonsei Lifestyle Profile ‐ Active, Balanced, Connected, Diverse) responses using latent profile analysis. The personal value information was collected by YLP‐V (Yonsei Lifestyle Profile ‐ Value) and analyzed by machine learning to identify the relative importance of the personal values on their lifestyle types.

Result

The lifestyle of older adults was categorized into a healthy lifestyle type (48.87%) and an unhealthy lifestyle type (51.13%). These two types showed the most significant difference in social relationship characteristics. The healthy type demonstrated well‐connected and active social interaction with people, while the unhealthy type exhibited the opposite. Among the machine learning models included in this study, the model that demonstrated the highest classification performance was the support vector machine, with an accuracy of 96% and an Area under the ROC Curve of 95%. Using this model, the relative importance of personal values results showed that individuals with a strong interest in maintaining a healthy diet, curiosity about health information, and engagement in hobbies and cultural activities were more likely to belong to the healthy lifestyle type.

Conclusion

The findings highlight the importance of a personal value‐centered approach in managing the healthy lifestyle of older adults, indicating that an approach emphasizing active social relationships, engagement in diverse activities, and an interest in a healthy diet is necessary.
Psoriasis and dementia: a population‐based matched cohort study of adults in England
Authors: Matthewman Julian , Cadogan Sharon L , Abuabara Katrina , Bhaskaran Krishnan , Smith Catherine , Mansfield Kathryn E , Langan Sinéad , Warren‐Gash Charlotte
Published: January 2025

Background

Substantial evidence suggests association between increased inflammatory markers and Alzheimer’s disease. However, evidence for association between the inflammatory skin disease psoriasis and dementia is limited and conflicting. Additionally, few studies investigate how psoriasis severity influences risk.

Method

We used primary care electronic health records from the UK’s Clinical Practice Research Datalink Aurum and linked hospital admissions data for a matched cohort study (1997‐2022) of individuals ≥40years. We matched (age, sex, primary care practice) individuals with psoriasis, without replacement, with up to five comparators without psoriasis in calendar date order. People with psoriasis were followed from latest of: first psoriasis diagnosis, practice registration +1year, study start, age 40, date practice met quality‐control standards. Comparators were followed from the same date as their psoriasis match. We used Cox regression, stratified by matched set, to estimate hazard ratios (HR) comparing dementia risk in those with and without psoriasis.

Result

In preliminary analyses, we identified 360,014 individuals with psoriasis matched to 1,799,617 without. After implicitly adjusting for age, sex, practice and calendar period (through underlying timescale and matching), and adjusting for lifestyle factors (smoking, harmful alcohol, obesity) and comorbidities (cardiovascular, cerebrovascular, chronic liver and chronic lung diseases, diabetes mellitus, depression, hyperlipidaemia, hypertension), we found evidence of association between psoriasis and all‐cause dementia (HR 1.04, 95%CI 1.01‐1.06), although absolute rate differences were small (approximately 4 per 10,000 person years). We found evidence of association between psoriasis and vascular dementia (HR 1.09, 95%CI 1.04‐1.15), but no evidence of association with Alzheimer’s (HR 1.02, 95%CI 0.98‐1.05). Compared to those without psoriasis, the association with all cause dementia was stronger in moderate‐to‐severe psoriasis (HR 1.17, 95%CI 1.07, 1.27) than in mild psoriasis (HR 1.02, 95%CI 1.00, 1.04).

We plan to: further adjust for additional potential confounders (including deprivation, ethnicity, chronic kidney disease) using more nuanced sequential modelling; and assess how robust our findings are in sensitivity analyses.

Conclusion

Our findings suggest that risk of all‐cause dementia, but not Alzheimer’s, is slightly higher in people with psoriasis, and risk is greater in more severe psoriasis. However, relative risk and absolute risk differences were small.
Comparative Comorbidity Profiles of Younger (65‐80 years of age) vs Older (90+ years) Individuals With or Without Alzheimer’s Disease and Related Dementias
Authors: Peroutka Stephen J.
Published: January 2025

Background

Alzheimer’s Disease and Related Dementias (ADRDs) patients have a well‐established increase in comorbid disorders compared to non‐cognitively impaired aged‐matched controls. Since ADRDs are considered age‐related disorders, it was hypothesized that younger ADRD patients should have a lower incidence of comorbid disorders than older ADRD patients.

Method

Four patient cohorts were defined in the TriNetX Analytics Network database (comprised of anonymized healthcare records from >150 million patients who have received care at 80+ health care organizations in the United States). Cohort #1 was comprised of individuals, aged 90 and above, who had a healthcare visit within the past 3 years and who had received a diagnosis of AD (ICD‐10 Code G.30) or unspecified dementia (ICD‐10 Code F.02). Cohort #2 had the same criteria except that the patients were aged 65‐80 years. Cohorts #3 and #4 matched Cohorts #1 and #2, respectively, except that they had not received an ADRD diagnosis.

Result

Diagnostic code data on the incidence of the 22 major subgroups in the ICD‐10 Coding system are provided in Table 1. As expected, the Cohort #1 90+ year old ADRD patients had a significantly higher incidence of comorbid disorders in nearly all ICD‐10 categories compared to Cohort #3 non‐ADRD 90+ year olds (shown graphically in Figure 1A). Similarly, Cohort #2 65‐80 year‐old ADRD patients had a significantly higher incidence of comorbid disorders compared to Cohort #4 non‐ADRD 65‐80 year‐olds (Figure 1B). However, despite the significant age difference between 65‐80 and 90+ year‐old cohorts, there were minimal comorbidity differences between the younger and older cohorts with ADRDs (Figure 1C) and without ADRDs (Figure 1D).

Conclusion

The major finding of the present study is that the well‐documented increased incidence of comordid organ dysfunction in ADRDs appears similar in younger and older ADRD patients. These data indicate that a diagnosis of ADRD is associated with coincident multi‐organ dysfunction in a pattern that is nearly identical across ADRD age groups. These data suggest that the cognitive impairment associated with ADRDs is a single component of a multi‐organ senescense syndrome, characterized by symptoms of widespread and concurrent organ dysfunction.
How can we facilitate adoption and scale for early detection of Alzheimer’s disease? Insights from implementing a community‐based screening program using cognitive assessments and RetiSpec screening in Ontario, Canada
Authors: Cohen Sharon , Giordano Jennifer , Kurzman Alissa , Hansen Amelia , Martinez Michelle , Sohbati Negar , Abdulla Naeem , Cameron Colette , Estreicher Shmuel , Semwel Sangeeta , Shaked Eliav , Bornbaum Catherine C
Published: January 2025

Background

A critical need to increase Alzheimer’s disease (AD) screening exists given rising incidence, new disease‐modifying treatments, and ill‐equipped primary care settings. This study assessed the feasibility of a novel, community‐based AD screening program to increase cognitive and retinal‐based assessments.

Methods

An observational study, supported by the Davos Alzheimer’s Collaborative, assessed the utility of leveraging community‐based settings to increase rates of cognitive assessment (conducted by Alzheimer Society (AS) social workers [SWs]) and RetiSpec’s AI‐based eye test in optometry settings to detect biologic signatures of AD (plus participant survey). Eligible participants were adults aged ≥55 years with self‐reported memory concerns. Primary and secondary endpoints were to increase cognitive assessment rates and have 10% of assessments originate from optometry, respectively. A utilization‐focused evaluation explored risks, benefits, facilitators, and barriers to these settings from frontline providers’ perspectives.

Results

N = 916 individuals were screened (60.2% from optometry) with N = 134 participants enrolled (age: 74.3 years±7.0; 63.7% female; 39.5% minority groups). N = 124 participants received cognitive assessments: 118 Montreal Cognitive Assessment (mean score: 24.7±3.7), 124 Boston Naming Test (13.3±2.0), 6 Mini‐Mental State Exam (18.7±5.7) and 6 Clock Drawing Test (1.2±1.2). N = 120 participants discussed their results with a clinician (37.9% with the NP). N = 25 dementia specialist referrals were made, N = 52 received an AD‐related diagnosis, along with medication prescription (N = 5), further medical investigation (N = 30) and clinical monitoring (N = 27). N = 99 underwent a RetiSpec scan (N = 65 predicted positive). Surveys (N = 71) demonstrated a positive scan experience (4.2±1.3/5) and unanimous interest in sharing results with a PCP (5.0±0.0/5). Endpoint 1 was met with 13.8 assessments/month completed versus 1.8/month in the pre‐study period. Endpoint 2 was met with 29.0% of assessments originating from optometry.

Evaluation findings indicate that screening programs should consider: promoting brain health awareness in community settings; utilizing clinicians with AD training for screening and follow‐up activities; leveraging optometry clinics and AS’s to enable broad access to screening; and adopting technology that leverages existing infrastructure (i.e., RetiSpec’s eye test) to enable scalable increases to AD screening.

Conclusions

Utilizing community‐based settings, including optometry clinics for RetiSpec screening and AS SWs for cognitive screening, led to meaningful improvements in early detection and subsequent medical care.
Mobile Early Detection Memory Screening in the Republic of Armenia
Authors: Mahakian Jane , Megerdichian Arina , Jivalagian Pateel , Novakovic – Agopian Tatjana , Moughamian Armen , Monin Joan
Published: January 2025

Background

The Republic of Armenia is a post‐Soviet, low‐ and middle‐income country (LMIC) in the south Caucasus region with a steadily increasing aging population. The goal of this study was to provide the first look into the national cognitive health in Armenia, considering the growing burden of cognitive impairment (CI) and widespread lack of public awareness about dementia. As a component of the early detection memory screening program launched by Alzheimer’s Care Armenia’s Brain Health Project and funded through Davos Alzheimer’s Collaborative (DAC), this study aimed to understand the prevalence of CI and associated factors across the adult population.

Methods

Utilizing a mobile clinic, a sample of 4,066 adults (aged 25‐94) were screened for cognitive impairment across 8 urban and rural provinces in Armenia. Participants completed a Montreal Cognitive Assessment (MoCA) screening test and Health Characteristic Questionnaire including items about health behaviors and chronic health conditions. Statistical analyses were used to investigate demographic trends of CI and test for significant associations.

Results

MoCA scores indicated the following cognitive levels in this population: 71.2% normal cognition, 23.7% mild cognitive impairment, 4.2% moderate cognitive impairment, and 0.8% severe cognitive impairment. The most prevalent chronic conditions included history of COVID, hypertension, history of depression, and history of heart disease (Table 1). The most common health behavior was poor sleep quality (Table 2). All health behaviors and chronic health conditions were significantly associated with CI. The sample consisted of mostly women (81.5%), individuals with 12 or less years of education, higher BMI levels, and those living in rural areas, which may present potential limitations.

Conclusion

Findings reveal lifestyle and environmental exposures relevant to CI and highlight the possible influence of behavioral and cultural factors on dementia development. As the first study to investigate the prevalence of CI and associated factors in Armenia, this research lays the foundations for understanding unmet needs for cognitive health, guiding future policy, and establishing sustainable health infrastructure in similar post‐Soviet, LMIC. Future research should be aimed at further investigating which risk factors are predictive of cognitive status and dementia development in the region.
Neighborhood economic segregation and cognitive decline among midlife women: Study of Women’s Health Across the Nation
Authors: Hyun Jinshil , Derby Carol A. , Appelhans Bradley M. , Barinas‐Mitchell Emma , Thurston Rebecca C , Karvonen‐Gutierrez Carrie A. , Hedderson Monique , Janssen Imke , Schiff Mary D.
Published: January 2025

Background

Neighborhood context includes conditions of the environment where people spend their time (e.g., work, play, seek health care) and it may affect residents’ cognitive health. Prior studies have documented that lower neighborhood‐level socioeconomic status (SES) is associated with cognitive impairment and with risk for Alzheimer’s disease and related dementia (ADRD). However, most prior studies assessed neighborhood SES within administrative boundaries (e.g., census tract) without considering the distribution of SES among adjacent neighborhood areas (i.e., spatial segregation). The present study aims to investigate whether spatial segregation of neighborhood SES is associated with longitudinal cognitive decline among women over midlife.

Method

In the Study of Women’s Health Across the Nation (SWAN), we examined effects of neighborhood economic segregation on levels and rates of cognitive decline in processing speed, working memory, and verbal episodic memory (N = 941; age at cognitive baseline 49‐60 years; mean follow‐up 9.1±4.3 years; 46% non‐Hispanic White, 24% Black, 12% Chinese, 18% Japanese). To assess neighborhood economic segregation, we used census tract poverty data (i.e., 150% below the federal poverty limit) based on participant’s residential address and local spatial statistics and identified hot spots (high concentrated poverty areas) and cold spots (low concentrated poverty areas). Covariates were baseline age, race/ethnicity, education, study site, and time‐varying financial strain, smoking, alcohol use, and menopause status.

Result

Women living in hot spots showed worse working memory at baseline and more rapid decline in episodic memory over time relative to those living in cold spots (Table 1). The significant effects persisted after controlling for absolute neighborhood poverty level within each census tract.

Conclusion

Midlife women residing in economically segregated areas experienced more rapid decline in episodic memory over an average of 9 years. Living in more socioeconomically segregated areas may impact individuals’ health‐related behaviors, use of medical facilities, psychosocial states, and availability of community social capital, which are all important risk/protective factors for cognitive impairment and ADRD. Future studies need to consider spatial associations among neighborhood areas to better characterize neighborhood environments influencing individuals’ cognitive health and should investigate individual and contextual mechanisms that underlie the observed associations.
Development Of Multiplexed Electroanalytical Biosensing Platforms For The Clinical Diagnosis Of Alzheimer’s Disease
Authors: Montero‐Calle Ana , Garranzo‐Asensio Maria , Valverde Alejandro , Segundo‐Acosta Pablo San , Povedano Eloy , Torrente Rebeca M. Rodríguez , Vázquez Mónica , Mas Vicente , Campuzano Susana , Barderas Rodrigo
Published: January 2025

Background

Alzheimer’s disease (AD) is the most common neurodegenerative disease worldwide and the leading cause of dementia in the elderly. New approaches to study AD are still needed to identify and validate blood‐based diagnostic biomarkers that could be useful for its early diagnosis. Circulating autoantibodies (AAbs) and their target proteins (autoantigens) are promising candidate biomarkers to aid in AD early diagnosis. Thus, our objective was to validate here the potential of electrochemical biosensors for the diagnosis of AD based on the measurement of plasma autoantibodies previously described as specific of AD.

Methods

An immunoplatform based on the use of Halo‐MBs (magnetic beads) modified with validated AD autoantigens (previously identified by phage microarrays, immunoprecipitation, or planar protein‐epitope signature tag (PrEST) arrays, or as aberrant AD proteins) was developed. AD autoantigens were cloned and expressed in mammalian cells as HaloTag fusion peptides or proteins. The oriented covalent immobilization of the HaloTag peptides or proteins to the surface of the MBs allowed for the efficient and selective capture of the corresponding AAbs from plasma samples. Then, signal was developed by amperometric transduction on disposable electrodes using the H2O2/HQ (hydroquinone) system after enzymatic labelling of the captured human IgGs with an HRP‐conjugated secondary antibody.

Results

With the developed methodology, plasma autoantibodies against two aberrant AD‐associated peptides, four peptide autoantigens identified by Phage Microarrays, and three full‐length AD autoantigens identified by multiomics analyses were used to construct the first multiplexed bioplatform described to date, based on the use of this type of receptors expressed in mammalian cells, to evaluate its potential for AD diagnosis by targeting their associated autoantibodies. After optimization of key variables in the development of the multiplexed biosensing bioplatform, its analytical operational characteristics demonstrated a highly significant clinical diagnostic potential in a single test.

Conclusions

Our results suggest the possibility of reliably and minimally invasive diagnose AD by using amperometric biosensing platforms detecting AD plasma autoantibodies against specific autoantigens with a high sensitivity and specificity. Additionally, these multiplexed bioplatforms could be used as point‐of‐care (POC) devices for the clinical diagnosis of AD by liquid biopsy and in less than 90 minutes.