bluuebunny/crossref_metadata_2025 huggingface dataset:
MoS2 Anchored on Agar‐Derived 3D Nitrogen‐Doped Porous Carbon for Electrocatalytic Hydrogen Evolution Reaction and Lithium‐Ion Batteries
Authors: Cao Chunling , Liu Shengkai , Fan Jinxin , Li Guodong , Arenal Raul , Wang Cheng , Li Wenjiang , Xie Fei
Published: December 2021

MoS2 has been explored as a potential material for hydrogen evolution reaction (HER) and lithium‐ion batteries (LIBs). However, the limited number of active sites and poor conductivity restrain its applications. Herein, a facile method is reported to construct MoS2 nanosheets (MoS2 NSs) grown on agar‐derived 3D nitrogen‐doped porous carbon (MoS2‐NPC). The as‐prepared MoS2‐NPC composite exhibits good stability and HER electrocatalytic properties with a low overpotential of 209 mV at 10 mA cm−2 and a small Tafel slope of 41 mV dec−1. Furthermore, as an anode of LIBs, it delivers an initial discharge capacity of 1289 mAh g−1 at 0.1 A g−1 and rate capability of 712 and 419 mAh g−1 at 0.5 and 2.0 A g−1, respectively. This is attributed to the synergistic effects and unique 3D network structure, which avoids the aggregation of MoS2 and results in more exposed active sites. The agar‐derived 3D nitrogen‐doped porous carbon can act as a support material for MoS2 NSs dispersed on the surface, providing a cheap and efficient strategy to prepare high quality catalysts for electrochemical energy conversion and storage applications.
Breaking the Cut‐Off Wavelength Limit of GaTe through Self‐Driven Oxygen Intercalation in Air
Authors: Zhang Renyan , Wei Yuehua , Kang Yan , Pu Mingbo , Li Xiong , Ma Xiaoliang , Xu Mingfeng , Luo Xiangang
Published: December 2021

Low symmetric two dimensional (2D) semiconductors are of great significance for their potential applications in polarization‐sensitive photodetection and quantum information devices. However, their real applications are limited by their photo‐detecting wavelength ranges, which are restricted by their fundamental optical bandgaps. Recently, intercalation has been demonstrated to be a powerful strategy to modulate the optical bandgaps of 2D semiconductors. Here, the authors report the self‐driven oxygen (O2) intercalation induced bandgap reduction from 1.75 to 1.19 eV in gallium telluride (GaTe) in air. This bandgap shrinkage provides the long‐wavelength detection threshold above ≈1100 nm for O2 intercalated GaTe (referred to as GaTeO2), well beyond the cut‐off wavelength at ≈708 nm for pristine GaTe. The GaTeO2 photodetectors have a high photoresponsivity, and highly anisotropic photodetection behavior to even sub‐waveband radiation. The dichroic ratio (Imax/Imin) of photocurrent is about 1.39 and 2.9 for 600 nm and 1100 nm, respectively. This findings demonstrates a broadband photodetector utilizing GaTe after breaking through its bandgap limitation by self‐driven O2 intercalation in air and further reveal its photoconductivity anisotropic nature. This provides design strategies of 2D materials‐based high‐performance broadband photodetectors for the exploration of polarized state information.
Low‐Operating‐Voltage Resistive Switching Memory Based on the Interlayer‐Spacing Regulation of MoSe2
Authors: Jian Jiaying , Feng Hao , Dong Pengfan , Chang Honglong , Vena Arnaud , Brice Sorli
Published: December 2021

The development of commercially available flexible and wearable devices requires low‐operating‐voltage circuit and resistive random access memory (RRAM). This paper reports the preparation and performances of low‐operating‐voltage RRAM based on the interlayer‐spacing regulation of MoSe2. Twine‐jumble‐like MoSe2 clusters were synthesized via hydrothermal method. The average interlayer spacing in the clusters is higher than the value for bulk MoSe2 by 9.969%. The layer count of the MoSe2 sample predicted according to the experimental value of in the Raman spectroscopy is 1.403 while it is 2 regarding the characteristic of A1g peak and the existence of B2g peak, which is inconsistent with the results of scanning electron microscope and transmission electron microscope. Calculation of van der Waals force reveals that the twine‐jumble‐like MoSe2 should not be considered as a bi‐layer (or few‐layer) crystal, but as a cluster consisting of a numerous monolayer crystals. Compared with the conventional nanosized MoSe2, the SET/RESET voltages of the RRAM device based on the monolayer MoSe2 clusters are decreased by 4–10 times while the switching ratio and endurance are increased by 2–40 and 2–10 times respectively, which is due to that the interstitial radius in the monolayer MoSe2 clusters is higher than that of a silver ion.
Longitudinal changes in hearing and visual impairments associated with risk of dementia in older adults: The Cardiovascular Health Study
Authors: Hwang Phillip H , Longstreth W.T. , Thielke Stephen , Francis Courtney E , Carone Marco , Kuller Lewis H , Fitzpatrick Annette L
Published: December 2021

Background

To determine whether dual sensory impairment (DSI) is associated with incident dementia in older adults. We hypothesized that DSI is associated with increased risk of dementia as compared to no sensory impairment. We also assessed whether duration of DSI is associated with risk of dementia.

Method

Prospective cohort study from the Cardiovascular Health Study. Hearing and vision impairments collected via self‐report at baseline and up to five follow‐up visits from 1992 to 1999. All‐cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD) classified by a multi‐disciplinary committee using standardized criteria. Time‐dependent Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) in order to estimate the risk of dementia associated with time‐varying number of sensory impairments (0, 1, or 2)

Result

A total of 2,927 participants with information on hearing and vision at all available study visits were included in the analysis. At baseline, participants had a mean age of 74.6 years and consisted of 1,704 (58.2%) women. Compared to no sensory impairment, DSI was associated with increased risk of all‐cause dementia (HR = 2.60; 95% CI = 1.66 to 2.06; P <.001), AD (HR = 3.67; 95% CI = 2.04 to 6.60; P <.001), and VaD (HR = 2.03; 95% CI = 1.00 to 4.09; P = .05). Each additional year with DSI was associated with a 31% increased risk for all‐cause dementia (HR = 1.31; 95% CI = 1.07 to 1.62; P = .02) and 46% increased risk for AD (HR = 1.46; 95% CI = 1.12 to 1.91; P = .01).

Conclusion

In this cohort study, DSI was strongly associated with increased risk of dementia, particularly AD. Evaluation of hearing and vision in older adults may help to identify those at high risk of developing dementia.
Distance assessment of cognitive deficits in older immigrants
Authors: Sala Sergio Della , Belin Catherine , Boccardi Marina , Brazzelli Miriam , Garrard Peter , Pomati Simone , Cappa Stefano
Published: December 2021

Background

In European memory clinics, requests for assessing people with cognitive complaints in a foreign language are becoming frequent. Currently, over one million people living in EU are older migrants presenting with possible cognitive deterioration. The assessments of cognitive functions is the gateway to diagnosis, and the main tool for monitoring progression of neurocognitive disorders. However, the limitations of older migrants in the language of the host country add hurdles to the diagnostic process. This represents an emerging problem for the EU healthcare systems. In several EU countries, the current best approach is to involve a translator, who assists the healthcare personnel with the assessment. This practice is far from perfect.

Methods

We convened a multidisciplinary and international team, including experts in neurocognitive disorders and in digital tools, to develop a user‐friendly process aimed at connecting clinicians dealing with the diagnosis of people affected by cognitive deficits in different languages or countries. The initial network included countries with great prevalence of immigrants (DE, F, I, UK) and referents from partner specialists from the main immigrant nationalities. This network is planned to expand.

Results

This preliminary network convened on a reference procedure to be supported with digital tools. The procedure includes referral of migrants with cognitive complaints to a colleague from the established network, for remote assessment in their mother‐tongue using tools appropriate for their cultural background. The outcome of the referral is sent to the clinicians in the adopted country who could take a better informed decision on the diagnosis and handling of the symptoms presented by the migrant.

Discussion

The proposed procedure overcomes several limitations of the current assessment of migrants via a translator, relative to time, languages availability, linguistic and cultural specificity of materials and norms used for the assessment. Assessment would improve thank to greater empathy allowed through the process, and the specific medical background will allow to detect issues that could emerge during the interview or the formal testing. The proposed process solves several problems identified within the current practice, with considerable benefit on detection of neurocognitive disorders in a heterogeneous population.
Physical activity, cognitive decline and biomarkers of Alzheimer’s disease in adults with Down syndrome
Authors: Fleming Victoria , Piro‐Gambetti Brianna , Patrick Austin M , Zammit Matthew D , Alexander Andrew L , Christian Bradley T , Handen Benjamin L , Cohen Ann D , Klunk William E , Laymon Charles M , Okonkwo Ozioma C. , Ances Beau M. , Plante David T , Hartley Sigan L
Published: December 2021

Background

Adults with Down Syndrome (DS) are at high risk for Alzheimer's disease (AD), which is characterized by the early accumulation of amyloid‐beta (Aβ), followed by neurofibrillary tangles of tau, and subsequent pathology. There is variability in the age of AD onset in DS, which may mean that non‐genetic factors impact AD timing. Physical activity is associated with less age‐related cognitive declines and lower risk of AD in non‐DS populations. The goal of this study was to examine the association between physical activity and cognitive performance and AD biomarkers (Aβ PET, tau PET, and white matter (WM)) in non‐demented adults with DS.

Methods

66 adults with DS from the Alzheimer Biomarker Consortium Down Syndrome participated. Participants wore an actigraph accelerometer on their non‐dominant wrist for 7‐days. Cognitive performance was assessed via measures of memory, executive functioning, visuospatial ability, and dementia symptoms. Participants underwent MRI and PET scans to assess the standard uptake value ratio of [11C]PiB (15 mCi) in the neocortex and striatum and [18F]AV‐145 across braak regions I‐VI. WM integrity was assessed using DTI mean diffusivity and fractional anisotrophy in major association tracts.

Results

Greater sedentary activity was associated with more dementia symptoms (r = ‐0.298, p<.05). Higher moderate‐to‐vigorous activity was associated with better memory (r = 0.309, p<.01), executive functioning (r = 0.270, p<.05), visuospatial ability (r = 0.311, p<.05), and fewer dementia symptoms (r = 0.356, p<.01). Models controlled for age and level of intellectual disability. Neither sedentary nor moderate‐to‐vigorous activity were significantly related to PET Aβ or tau PET. However, both were associated with WM integrity in the superior longitudinal fasciculus (r = ‐0.445, p<.05; r = 0.393, p<.05) and sedentary was associated with inferior longitudinal fasciculus tracts (r = ‐0.362, p<.05), after controlling for age and intellectual disability.

Conclusion

Physical activity might have a protective effect against age‐related cognitive declines in in DS. However, the reverse time‐order could also be true. Physical activity was not associated with PET Aβ or tau PET cross‐sectionally. In contrast, physical activity was associated with WM integrity, Longitudinal studies are needed to understand mechanisms driving associations, including the cardiovascular impairment
Policy recommendations from the perspective of health professionals who work with people with dementia in public tertiary hospitals in China
Authors: Zhao Wenhong , Moyle Wendy , Wu Min‐Lin (Winnie) , Petsky Helen
Published: December 2021

Background

China has the largest number of people with dementia in the world. However, there is currently no specific national policy or plan related to dementia care in China. Health professionals working in public tertiary hospitals are the primary sources of diagnosis and treatment of people with dementia. They are very familiar with this population and are in the best position to provide information to inform policymakers. The purpose of this study was to explore health professionals’ policy recommendations on dementia care in China.

Method

A qualitative study using thematic analysis with ATLAS.ti software was used. Semi‐structured in‐depth interviews using an interview guide were employed. Purposive maximum variation sampling was used to recruit health professionals working in settings where people with dementia are cared for in public tertiary hospitals (i.e., neurology, psychiatric, and geriatric departments) and who have more than six months’ experience of caring for people with dementia. Data was collected between July and December 2019 in Shijiazhuang, Hebei Province, China. Interviews were recorded and transcribed, and translated form Mandarin into English, and then analyzed into categories and themes. Ethical approval was obtained from the University Human Research Ethics Committee (2019/269) and hospitals as required.

Result

Twenty‐four participants were recruited from three public tertiary hospitals. Four themes emerged. Participants described that the medical treatment and care provided in China was not meeting the needs of people with dementia. Daycare centers and specialized nursing homes for people with dementia were recommended as a means to support family caregivers. Participants also identified low public awareness of dementia. To improve this, participants suggested that training in dementia care should be provided to family caregivers and health professionals. Setting up dementia curricula in universities was also recommended by participants.

Conclusion

China is not adequately equipped to deal with the challenges of dementia care. An integrated health system is urgently needed in China, where policymakers and stakeholders work collaboratively for the formulation of effective treatment and care strategies for people with dementia.
Change in care location of older adults who resided in group homes in Japan: An observational study using long‐term care insurance comprehensive database
Authors: Nakanishi Miharu
Published: December 2021

Background

Group homes have been introduced into Japanese public long‐term care insurance program to accommodate people with dementia in a homelike, small‐scale environments. The national dementia plan was launched in 2013 to promote provision of end‐of‐life care to people with dementia at group homes. However, discharge destinations from group homes have rarely been investigated. The present study examined the discharge destination of older adults between group homes and other types of homelike, small‐scale environments under the public long‐term care services.

Method

We used monthly data of January and July during 2013‐2016 from the long‐term care insurance comprehensive database. The 3,468 discharges from group home (n = 500), housing with care (n = 571), nursing home (n = 2097), or in‐home multiple service (n = 300) during 2013‐2016 were included in analysis.

Result

Of the 500 discharges from group homes, 173 (34.6%) were admitted to hospitals, 110 (22.0%) were admissions to facilities, and 178 (35.6%) were deceased. Controlling for individual characteristics and the use of specialized care, residents of group homes were more likely to be admitted to hospital rather than discharged by death, in comparison to those of housings with care (adjusted odds ratio [OR] = 0.35, 95% confidence interval [CI] = 0.25‐0.48) or nursing homes (adjusted OR = 0.25, 95%CI = 0.19‐0.32).

Conclusion

Group home residents were more likely to be hospitalised compared to residents of housings with care or nursing homes. Further dementia care strategies should be explored to reduce changes in location of care among people with dementia.
Gaps and novel approaches in nutrition epidemiology for dementia prevention
Authors: Grodstein Fran
Published: December 2021

Background

There is general appreciation that diet is important in the maintenance of health and prevention of chronic diseases. However, traditional epidemiologic and statistical approaches to understand specific dietary habits in the etiology and prevention of dementia may benefit from further consideration in the context of modern methods of mining data. Additionally, better investigation of culturally‐specific approaches to understand diet patterns and apply dietary research is critical.

Method

We will review several novel methods for population research in diet, including how to better incorporate under‐represented minorities in nutritional epidemiology.

Result

Network science methods of understanding biologic patterns which may underlie health have become increasingly common in basic and population research. These methods can also provide novel means of identifying diet patterns that may play key roles in dementia. In addition, especially since dementia develops over decades, better investigating the relation of diet to dementia risk through the adult lifecourse may offer new information on timepoints during life which may be especially important for halting or delaying disease processes. New statistical methods can estimate lifestyle trajectories over many repeated measures of diet in population cohorts. Finally, successful identification of diet patterns depends on broader research in more diverse populations, and new ways to conduct research and apply findings in underrepresented minorities are critical.

Conclusion

New methods to fully understand diet patterns across populations, and over time, may offer novel insights for effective interventions to test in randomized trials.
Precision medicine and biomarkers in nutrition science for dementia prevention
Authors: Samieri Cécilia
Published: December 2021

Background

There is substantial inter‐individual variability in the metabolic and neurobiological responses to diet. Deciphering such heterogeneity ‐ the foundation of precision medicine ‐ may help refine nutritional interventions for the prevention of dementia. The development of high‐throughput technologies applied to biological matrices has fostered characterization of the molecular architecture underpinning such heterogeneity across individuals, allowing to refine knowledge on how specific elements of the food matrix may impact pathways leading to dementia. Moreover, a critical step in precision medicine is to interrogate effect modification by some biological modulators that may define individualized vulnerability profiles.

Method

We will review recent epidemiological and clinical studies leveraging biomarkers, genomics and microbiomics for the identification of molecular pathways underlying the effect of nutrition on brain health and of factors of heterogeneity in metabolism and efficacy (eg, baseline nutritional status, host genome and the microbiome).

Result

Recent advances in omics (proteomics, metabolomics, nutrigenomics, epigenetics and transcriptomics) have started reveal both neurobiological pathways that may be corrected by appropriate diet as well as potential novel diet‐related targets for preventive interventions. Moreover, observational studies and randomized controlled trials have suggested that nutrient supplementation may specifically benefit individuals with baseline nutrient deficiencies. Emerging studies also suggest gene‐by‐environment interactions in dementia, as well as a strong influence of the microbiota as a key mediator and/or modulator on the way nutrients are absorbed and metabolized and how they exert biological effects on the brain along the so‐called gut brain axis.

Conclusion

A precision medicine approach of nutrition and brain health needs to be expanded, from observational epidemiology to clinical research through basic science. Given the heterogeneity of nutritional behaviors across cultures, this will necessitate cross‐cohort collaborative projects to identify robust nutritional exposures that determine neurobiological changes leading to dementia. The multiple dimensions of nutrition will have to be captured through repeated behavioral, environmental and biological measures, both reliable and valid in cross‐cultural populations. Measurement of genomic variation and of the individual microbiome have started to develop in epidemiological studies and should be expanded. Most promising strategies will be validated in preclinical models and in appropriately powered clinical trials.
Rhizolutin directly dissociates Aβ and tau aggregates and reduces apoptosis/inflammation related to Alzheimer’s disease
Authors: Shin Jisu , Kwon Yun , Nam Kwangho , An Joon Soo , Yang Seung‐Hoon , Hong Seong‐Heon , Bae Munhyung , Moon Kyuho , Cho Yakdol , Woo Jiwan , Park Keunwan , Kim Kyeonghwan , Shin Jongheon , Kim Byung‐Yong , Kim YoungSoo , Oh Dong‐Chan
Published: December 2021

Background

Alzheimer’s disease (AD) is characterized by the aggregation of amyloid‐β (Aβ) and tau, leading to neuronal cell death, neuroinflammation, and brain atrophy. As Aβ and tau aggregates are observed in the brain decades before the onset of cognitive symptoms, clearance of these aggregates has been widely accepted for AD treatments.

Method

Through the unbiased screening against the natural product libraries, rhizolutin was selected and its regulatory effects on Aβ and tau aggregation were validated by thioflavin T assays. Clearance of Aβ plaques was observed in APP/PS1 double transgenic AD model mice and subsequent analyses regarding apoptosis and inflammation were conducted using neuronal and glial cell lines.

Result

Rhizolutin‐treated AD model mice significantly decreased hippocampal Aβ plaques. Additionally, rhizolutin effectively inhibited the aggregation of Aβ and tau in vitro, more importantly, dissociated both aggregates, thereby reducing Aβ‐induced apoptosis and inflammation in neuronal and glial cells.

Conclusion

Our findings reveal that a unique chemical rhizolutin regulates both Aβ and tau at the same time by therapeutic and preventive approaches, representing its novel structure is attractive for AD drug discovery.
Motoric cognitive risk syndrome: Prevalence and cognitive performance
Authors: Márquez Isabel C , Garcia‐Cifuentes Elkin , Velandia Felipe Ramirez , Saavedra Ana María , Borda Miguel German , Chavarro‐Carvajal Diego Andrés , Osuna Margarita , Ailshire Jennifer , Cano‐Gutierrez Carlos Alberto
Published: December 2021

Introduction

: Cognitive decline and dementia have a significant impact on the quality of life of older adults and their caregivers. Increasing and optimizing accessibility of clinical dementia risk assessment is important to set up preventive measures and reduce health care costs. Motoric Cognitive Risk Syndrome (MCRS) is a pre‐dementia stage where slow gait speed and subjective memory complaints are present, but where cognitive performance is adequate and without functional impairment. In addition to dementia, MCRS seems to increase the risk of having other geriatric outcomes including frailty, disability, falls and overall mortality.

Methods

Data from the SABE Colombia study (Health, Well‐Being, and Aging) conducted in 2015 in community‐dwelling adults aged 60 years and older. Using the 4 aspects considered within the MCRS definition, we evaluated the presence of this syndrome and factors associated in this population with regression models. A sub‐sample of 19,004 participants was obtained.

Results

The multivariate analysis showed a prevalence of 5,45% of MCRS. After adjusting for cofounding variables MCRS was associated with MMSE (OR 0.90, CI 0.82‐0.99; p 0.028) and frailty (OR 9.1, CI 3.26‐25.47, p 0.000; OR 21.38, CI 6.30‐72.57, p 0.000).

Conclusion

This study found a prevalence of 5.45% of MCRS in Colombian older adults. We found an association between cognitive performance (MMSE), frailty and MCRS. Our results increase the awareness of a pre‐dementia stages different to Mild Cognitive Impairment (MCI), as these individuals are at greater risk than those with MCI to develop dementia.
Future use and implementation of AD blood biomarkers from a clinical and epidemiological perspective
Authors: Mielke Michelle M.
Published: December 2021

Background

Blood‐based biomarkers for the diagnosis and prognosis of Alzheimer’s disease are now becoming a reality. Indeed, the first plasma amyloid‐beta blood test and algorithm is available for clinical use in some locations. With the very promising plasma phosphorylated tau 181 and 217 results in the past two years, it is likely additional tests will be approved in the near future. However, many questions remain as to how blood‐based biomarkers should best be used in the clinic, including how they should be utilized in the general population and among primary care physicians.

Method

We will discuss some of the key considerations and steps that must be taken before implementation in the clinic, especially in primary practice. Examples will be incorporated from the existing literature and data collected in the Mayo Clinic Study of Aging.

Result

One consideration includes the peripheral factors that might affect the levels of the biomarkers in blood including demographics (age and sex), and comorbidities. For example, a high body mass index is associated with a larger blood volume and renal disease can affect the clearance rate of the biomarker. Another consideration is the utility of a blood‐based biomarker among those with subjective memory complaints and the corresponding ethical implications and guidance for use that is needed. A third consideration is the context of use of blood‐based biomarkers in healthcare settings would could include general screening purposes, targeted screening in people at high risk and actively seeking counseling in primary care, and/or diagnosis in specialized/tertiary care.

Conclusion

Blood‐based biomarkers for the diagnosis and/or prognosis of Alzheimer’s disease and related disorders are much more feasible and less costly and invasive than a lumbar puncture for the collection of cerebrospinal fluid or amyloid and tau PET imaging. However, it is critical to address several concerns prior to implementing blood‐based biomarkers into the clinic, both in specialty and primary care settings, for the interpretation of the results and upmost consideration of the patient. Specific research actions will be needed to better understand the role of peripheral factors and the use of blood biomarkers in clinical care.
Effectively training dementia care specialists and other dementia professionals on using the DICE ApproachTM with caregivers to improve the management of behavioral and psychological symptoms of dementia
Authors: Walaszek Art , Schroeder Molly , Albrecht Tammi , Endicott Sarah , Marschall Katelyn , Felten Kristen , Sayavedra Noelia , LeCaire Tamara , Russmann Sydney , Kern Vincent Joseph , Blazek Mary C , Kales Helen C , Carlsson Cynthia M , Mahoney Jane
Published: December 2021

Introduction

: Most persons living with dementia will exhibit at least one behavioral or psychological symptom of dementia (BPSD) (Kales, et al., 2015). As brain pathology progresses, challenging behaviors can increase in frequency and severity, causing an increase in caregiver stress and burden. Furthermore, BPSD can result in unplanned hospitalizations and unnecessary use of psychotropic medications. Non‐pharmacological management of BPSD should be the first line of treatment. The DICE (Describe, Investigate, Create, Evaluate) ApproachTM was developed by experts from the University of Michigan and John Hopkins University, to help caregivers learn how to identify and manage BPSD. This project describes a statewide implementation of the DICE approach with community‐based dementia care providers.

Methods

From September 2017 to April 2020, we held four DICE trainings (three in‐person trainings, one web‐based training) for Dementia Care Specialists (DCSs) and other dementia care professionals who work directly with family caregivers of people with dementia in Wisconsin. We assessed trainees’ knowledge and attitudes from the Dementia Attitudes Scale (DAS) and the Knowledge about Memory Loss and Care test (KAML‐C) at baseline of training, immediately after training, and six months after training. Consultations were provided to address challenging cases.

Results

Participants (N=136) in both in‐person and online DICE trainings experienced significant changes in knowledge, self‐efficacy and attitudes from baseline to post‐training (immediately after training) assessments (p<.01) (see Table 2 for details). Narrative feedback from trainees was generally very positive. Trainees used DICE with 165 caregivers who were primarily non‐Hispanic white (92%) females (74.4%) from an urban location (68.1%), caring for their spouse (52.7%) (Table 1).

Discussion

: By using the DICE approach with caregivers of persons with dementia, Wisconsin’s DCSs and other dementia professionals are uniquely positioned to help reduce risks associated with BPSD, including the use of psychotropic medications. Training satisfaction was high, knowledge about BPSD increased, and attitudes improved. The DICE trainings prepared trainees to implement this intervention with 165 family caregivers. A follow‐up survey will explore the real‐world application of DICE, including barriers to its use and modifications made in communities across the state.
Motoric cognitive risk syndrome: Its prognostic value for dementia and other adverse age‐related health outcomes—A systematic review
Authors: Mullin Donncha S. , Cockburn Alastair , Welstead Miles , Luciano Michelle , Russ Tom C. , Muñiz‐Terrera Graciela
Published: December 2021

Background

Motoric Cognitive Risk (MCR), a syndrome combining objective slow gait speed and subjective cognitive complaints, is being used to identify older adults at high risk of developing dementia. Yet, uncertainty exists regarding the prognostic value of MCR for this and other major causes of morbidity in ageing, such as cognitive impairment and falls.

This review is the first to synthesise all mental and physical health outcomes associated with MCR since the term was coined in 2013, and with its component parts of objective slow gait and subjective cognitive complaint prior to 2013. The aim of the review is to evaluate the prognostic value of MCR for adverse age‐related health outcomes.

Method

Results from multiple databases (MEDLINE, AMED, EMBASE, CINAHL, PsycINFO, and the Cochrane library; inception to May 2021) for original longitudinal cohort studies of adults aged ≥60 years that compared an MCR group to a non‐MCR group, for any health outcome were screened independently and risk of bias was assessed. We meta‐analysed incident health outcome results where appropriate using a restricted maximum‐likelihood estimator.

Result

Of 1057 records identified, 15 studies were eligible. Of these, 11 studies that examined 15 cohorts were combined by meta‐analysis reporting on four health outcomes: cognitive impairment (n=6,458), dementia (n=9,955), falls (n=12,640), and mortality (n=19,818). Risk of bias was deemed low‐to‐moderate in all studies except one, where falls was the outcome. Our meta‐analysis found that participants with MCR were at an increased risk of cognitive impairment (adjusted hazard ratio (aHR) 1.76, 95%CI 1.49–2.08; I2=24.9%), dementia (aHR 2.12, 1.85–2.42; 33.1%), falls (adjusted Relative Risk 1.38, 1.15–1.66; 62.1%), and mortality (aHR 1.49, 1.16–1.91; 79.2%), see figure 1.

Conclusion

Evidence suggests that participants with MCR at baseline are at an increased risk of cognitive impairment, dementia, falls, and mortality on follow‐up.
Ischemia‐triggered, immune‐mediated neurodegeneration as a component of VCID
Authors: Buckwalter Marion S
Published: December 2021

Background

Post‐stroke cognitive decline is an important component of vascular dementia. Ischemia and vascular disease is present in the brains of the majority of both Alzheimer’s Disease and VCID cases, and brain ischemia alone, in the form of a clinical stroke, doubles the risk of later cognitive impairment independently of known vascular dementia risk factors. In stroke survivors one of the most distressing complications is post‐stroke cognitive decline, which occurs in up to a third of individuals within five years and impacts significantly on quality of life.

Methods

To disentangle the effects of ischemia from other vascular mechanisms of dementia, we utilize mouse models of post‐stroke cognitive decline in adult and aged mice, mouse behavior, immunohistochemistry, and gene expression. In addition, we utilize prospective longitudinal cohort studies in human stroke survivors to examine how immune phenotyping of peripheral blood predicts cognitive decline at one year and chronically.

Results

We found that normal wildtype mice develop delayed cognitive decline after stroke that is associated with a chronic neuroimmune response characterized by B and T lymphocyte infiltration of the stroke. Both genetic and drug studies demonstrate that B lymphocytes are necessary for post‐stroke cognitive decline. In humans with stroke and dementia, we find similar B and T cell infiltration. In a prospective longitudinal cohort of stroke survivors tested with a comprehensive cognitive test battery we see a high rate of cognitive impairment in at least one cognitive domain among the participants. In keeping with an autoimmune‐like mechanism, humans with immune alterations in the acute phase after stroke are more likely to have cognitive decline after stroke.

Conclusions

Taken together we have demonstrated that normal mice exhibit ischemia‐triggered immune‐mediated neurodegeneration after stroke. Human studies demonstrate similar mechanisms, however more work remains to be done to identify immune mechanisms and biomarkers that predict cognitive decline in living humans after stroke. It will then be important to determine how much these post‐ischemia maladaptive immune responses contribute to VCID.
Small vessels in the brain and heart: How similar are they?
Authors: Hortobagyi Tibor
Published: December 2021

Background

In the brain and heart alike blood vessels are end arteries and their occlusion results in anaemic infarct with high mortality and severe morbidity in a high proportion of survivors. The role of collateral circulation and early recanalization is crucial in both contexts. Ischaemic preconditioning, reperfusion injury and haemorrhagic transformation are three key pathophysiological processes in both organs and the morphological and molecular processes at the level of microcirculation are fundamental to understand and therapeutically modulate the effects of ischaemia.

Method

The morphology of small vessels in brain and heart are compared based on published literature and pathologically assessed cases. The similarities and differences are related to the morphological and molecular consequences of hypoperfusion and vascular occlusion at the level of small vessels and microcirculation. In a case series, we retrospectively analysed the clinical data of 158 patients in a regional centre for acute stroke care. For clinico‐pathological analysis 98 cases (age 62±6.5y) were suitable.

Result

Although small vessels and the microcirculation share morphological and molecular similarities in health and in response to ischaemic challenge, the specific and unique features of the blood‐brain barrier and the neurovascular unit in the brain are major differences, with implications for drug transfer to the ischaemic parenchyma. Haemorrhagic transformation accelerates the secondary progression of stroke and indicates higher risk of adverse outcome. Neurodegenerative changes impair the microcirculation and, vice versa, microcirculatory damage and dysfunction may trigger and accelerate the neurodegenerative cascade. Vascular and neurodegenerative mechanisms in dementia usually coexist. The morphological patterns of infarct evolution and healing are rather different in the brain and the heart, which also applies to the characteristics of the inflammatory cell composition.

Conclusion

Our findings underline the importance of post‐mortem pathological examination in the era of advanced imaging and laboratory diagnostic techniques. The fundamental differences in the histomorphology and in the sequence of cellular and molecular events during ischaemia and reperfusion in brain and heart indicate that adaptations of findings in cardiology and clinical neuroscience should be made with caution.
Clinical trial of neuroEPO in mild‐to‐moderate Alzheimer’s disease
Authors: Pérez Leslie , Sosa Saily , Valenzuela Carmen , Bringas Giosmany , Urrutia Nelky , Peñalver Ana Ibis , Dalmau Evelio , Fernández Ana , Obaya Teresita Rodriguez
Published: December 2021

Background

NeuroEPO, a nasal pharmaceutical solution of recombinant human erythropoietin with low sialic acid, was in clinical development for the treatment of mild‐moderate Alzheimer’s disease.

Method

A double‐blind, randomized, placebo‐controlled, multicenter, prospective, with adaptive design, phase II/III clinical trial involving 174 patients with mild‐to‐moderate Alzheimer’s, was conducted. NeuroEPO or placebo, with different doses, was administered by nasal route 3 times a weeks for 48 weeks. The primary outcome measure was score on the 11‐item cognitive subscale of the Alzheimer’s disease Assessment Scale (ADAS‐cog11, with scores ranging from 0 to 70 and higher scores indicating greater impairment). Secondary outcome measures included Clinician’s Interview‐Based Impression of Change Plus Caregiver Input (CIBIC‐plus), Global Dementia Scale (GDS), activities of daily living (ADL), hippocampal volume change over time (measured with MRI), neuropsychological scales, electroencephalography (EEG) and adverse events.

Result

There were statistically significant differences between neuroEPO and placebo in median change from baseline in the primary outcome at week 48. The change in ADAS‐cog11 scores final‐initial (PP population) for patients in the neuroEPO 0.5 mg (n= 50, median change: ‐ 4.0), neuroEPO 1.0 mg (n=49, median change: ‐ 5.0) and placebo (n=49, median change: 4.0) groups. A difference of 8.0 points CI 95% (6.0; 10.0) neuroEPO 0.5 mg vs. placebo and 9.0 points CI 95% (6.8; 11.2) neuroEPO 1.0 mg vs. placebo at week 48, (p=0.000), was observed. Patients receiving both doses of neuroEPO also showed a significant difference in global improvement (CIBIC‐Plus, p=0.000) and electroencephalography (EEG, p=0.003) compared with placebo group. About hippocampal volume change, 105 patients were analyzed. From them, 58% remained stable and 42% decline hippocampus volume. No serious adverse events related with neuroEPO were reported.

Conclusion

NeuroEPO improved clinical outcomes in patients with Alzheimer’s disease with good security profile. Therefore, it could be useful in the treatment of these kind of patients.
The longitudinal association of vision impairment with transitions to cognitive impairment and dementia
Authors: Ehrlich Joshua R , Swenor Bonnielin K , Zhou Yunshu , Langa Kenneth M
Published: December 2021

Background

Vision impairment (VI) has been identified as a potentially modifiable risk factor for dementia. However, it is not known at what stage of cognitive decline VI exerts an effect. The purpose of this study was to determine whether VI increases the risk of transitions from normal to cognitive impairment no dementia (CIND) and/or from CIND to dementia. These findings may inform understanding of mechanistic processes, as well as the development and implementation of future dementia prevention interventions.

Method

We used longitudinal data including visual acuity and cognitive status from the population‐based Aging, Demographics and Memory Study (ADAMS), a sample drawn from the U.S. Health and Retirement Study. The covariate‐adjusted associations between VI (binocular distance visual acuity <20/40) and odds of cognitive transitions (normal to CIND, CIND to dementia) were evaluated using a series of multivariable logistic regression models.

Result

A total of 351 ADAMS participants without dementia at baseline were included (49.6% female, mean age 79.3 years, 21.7% with VI). Of these, 92 participants transitioned from normal to CIND and 76 transitioned from CIND to dementia during the course of the study. The odds of a transition from normal to CIND were 2.7 (95% CI 1.0‐7.5) times greater among those with VI, whereas the odds of a transition from CIND to dementia were not significantly associated with VI (OR= 0.8, 95% 0.4‐1.8).

Conclusion

This study indicates that poor vision is associated with transitions from normal to CIND but not from CIND to dementia, suggesting that the impact of VI is greatest early in the process of cognitive decline.
Transcriptomic score: A biomarker index of Alzheimer’s risk and resilience
Authors: Hou Jiahui , Hess Jonathan , Glatt Stephen
Published: December 2021

Background

One definition of resilience is the absence of disease despite high levels of risk. And in most cases, risk itself is best quantified by a multivariate profile rather than a single risk factor. Thus, multivariate risk profiles may be most appropriate for defining risk and resilience. RNA expression may serve as a risk biomarker, but no method has been proposed to build a whole‐transcriptome risk index of Alzheimer’s disease (AD) that could identify resilient individuals at the highest transcriptomic risk. Here, we derived a novel method for transcriptome‐wide gene expression data called “transcriptomic risk score” (TRS). We also employed the algorithm to build a “transcriptomic resilience score” (TReS) that offsets that risk.

Method

Analogous to a polygenic risk score, TRS is a weighted rank‐sum statistic that represents a subject’s relative expression level across the transcriptome, where the standardized beta coefficients are used as weights. We leveraged the TRS approach on peripheral blood gene expression profiles of 364 normal controls and 188 AD cases from ADNI and AddNeuroMed batch 1. Using TRSas a means of risk quantification, we then identified resilient normal controls as those with the highest percentiles of risk. High‐risk AD cases with matched TRSs range were retained for comparison. Expression levels of individual transcripts not included in the best‐fit TRS were contrasted between the high‐risk normal controls and high‐risk AD cases using mixed‐effect linear models. A TReS was derived using the residual transcriptomic variation that buffers against the transcriptomic risk. The association between TReS and case status was evaluated using a logistic regression model.

Result

The derived TReS differentiated resilient subjects (high‐risk normal controls) and high‐risk AD cases in independent replication samples (216 normal controls and 223 AD cases), with significant differentiation seen at all evaluated p‐value bins and a maximum of 3% variance accounted for at a p‐value threshold of 0.1.

Conclusion

This analysis indicated that TRS and TReS analysis of blood has the potential of facilitating the understanding of phenotypic variability and improving clinically useful biomarker profiles for AD.
Development and validation of the Yonsei Lifestyle Profile‐Satisfaction (YLP‐S) using the Rasch measurement model
Authors: Park Kang‐Hyun , Park Ji‐Hyuk , Hong Ickpyo
Published: December 2021

Background

Lifestyle also plays an important role in determining health and vitality among older adults. However, there is limited evidence about the lifestyle assessment. This study examined the psychometric properties of the Yonsei Lifestyle Profile‐Satisfaction (YLP‐S),

Method

Participants comprised community‐dwelling elderly from South. A confirmatory factor analysis (CFA) examined the unidimensionality assumption of the YLP‐S. Construct validity was tested by analyzing the item difficulty hierarchy, and item invariance was examined using differential item functioning (DIF) across sex and age. Participants comprised community‐dwelling elderly from South. A confirmatory factor analysis (CFA) examined the unidimensionality assumption of the YLP‐S. Construct validity was tested by analyzing the item difficulty hierarchy, and item invariance was examined using differential item functioning (DIF) across sex and age,

Result

Among 156 participants, 54 were males and 102 females. The CFA demonstrated that meaningful activity participation and nutrition subscales met the unidimensionality assumption. There was conceptual item difficulty hierarchy among the test items. The person strata values of the meaningful activity participation and nutrition were 5.37 and 1.33. Four items were showed showing DIF according to sex or age groups.

Conclusion

The findings indicate that the YLP‐S demonstrated sound internal validity and it can be used for occupational therapists to measure multi‐faceted lifestyle of older adults.
Monitoring dementia and stroke comorbidity in Canada: Prevalence and mortality time trends among individuals aged 65+, from 2003–2004 to 2016–2017
Authors: Shaver Larry C , Toews Jennette , Plebon‐Huff Sieara , Pelletier Catherine , Robitaille Cynthia , Mcrae Louise
Published: December 2021

Background

Dementia and stroke are debilitating and interrelated conditions. This study describes the time trends in prevalence and mortality of comorbid stroke and dementia in Canada, among individuals aged 65+.

Method

Using data from the Canadian Chronic Disease Surveillance System (CCDSS) for Canadians aged 65+, Joinpoint analyses were conducted to estimate change over time (2003–2004 to 2016–2017) in the age‐standardized prevalence and all‐cause mortality of comorbid dementia and stroke. Validated case definitions were applied to longitudinal CCDSS linked administrative health data to identify comorbid cases (regardless of the sequence of disease identification). Diagnosed cases for both conditions were identified since 1996–1997, but a run‐in period was applied until 2003–2004 to allow a better capture of prevalent cases. Time trends were significant (unless otherwise noted), but differences between sexes were not significant.

Result

From 2003–2004 to 2016–2017, the age‐standardized prevalence of the comorbidity increased from 1.4% (∼64,000 individuals) to 1.7% (∼110,000 individuals), representing an average annual percent change (AAPC) of 1.1% (females: 1.0%; males: 1.3%). The increase was more pronounced at the beginning of the period and among those aged 80‐84, 85‐89 and 90+. In contrast, during the same period, the age‐standardized prevalence rate among individuals with dementia/without stroke increased with an AAPC of 1.5% (females: 1.5%; males 1.7%), but only with an AAPC of 0.2% (not statistically significant) among those with stroke/without dementia.

Following the general declining mortality pattern observed in the Canadian population, the age‐standardized all‐cause mortality rate for those with the comorbidity decreased (AAPC ‐1.4%; females: ‐1.2%; males: ‐1.7%), with a steeper reduction over the first portion of the period. However, Canadians without the comorbidity benefited from a greater decline in all‐cause mortality (AAPC ‐2.2%; females: ‐2.1%; males: ‐2.5%).

Conclusion

This surveillance analysis explores the prevalence and all‐cause mortality of dementia and stroke comorbidity, by highlighting its evolution over time in older Canadians. Although further research is needed to explain the drivers of these trends, such public health surveillance data can inform health care policies and programs. Other countries could consider the CCDSS model for enhancing surveillance of dementia and its comorbidities.