bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors of participants in the Systematic Multidomain Alzheimer’s Risk Reduction Trial (SMARRT)
Authors: Peltz Carrie , Rosenberg Dori E , Fleckenstein Lynn E , Barnes Deborah E , Dublin Sascha , Balderson Benjamin H , Larson Eric B , Yaffe Kristine 
Published: December 2020

AbstractBackgroundUp to 30% of dementia may be preventable by addressing modifiable risk factors. The Systematic Multidomain Alzheimer’s Risk Reduction Trial (SMARRT) is an on‐going two‐year pilot trial in the US comparing a personalized risk reduction intervention to usual care among at‐risk older adults without dementia in an integrated health care system. Here we show the constellation of risk factors experienced by older adults in the SMARRT trial, and which factors individuals in the intervention arm have chosen to target.MethodsSMARRT recruited participants aged 70‐89, without dementia, and with at least two risk factors verified by electronic medical records or validated questionnaires. Intervention participants work with a health coach and nurse to develop a personalized action plan to address risk factors of their choosing. Chi square tests were used to compare risk factors across men and women.ResultsOf the 148 participants enrolled as of January 2020, the average age was 76±5.1 years, 66% were male, and 80% were white. The most common risk factors were physical inactivity (80%), poorly controlled hypertension (50%), and sleep difficulty (48%) followed by taking medications that may affect cognition (19%), depressive symptoms (18%), poorly controlled diabetes (14%), social isolation (12%), and smoking (9%). Taking risky medications, poor sleep, and depressive symptoms were all more common in women while physical inactivity was more common in men (all p<0.01; see Table). In the intervention group (n=73), most people with poorly controlled hypertension (94%), physical inactivity (92%), and poorly controlled diabetes (83%) chose to work with their health coach or nurse to reduce those risks. Getting better sleep (66%), decreasing risky medications (62%), quitting smoking (50%), reducing depression (43%), and increasing social engagement (27%) were also targets of intervention in people with those risk factors.ConclusionsOlder adults with dementia risk factors are willing to make health and lifestyle changes as well as suggested changes to medical care to potentially lower their dementia risk. The SMARRT intervention may provide valuable information to shape future studies of behavior change to reduce dementia risk.
Utilizing electronic medical record data to predict onset of Alzheimer’s disease and related dementias
Authors: Marra David E , Miller Amber H. , Li Qian , Yang Xi , Smith Glenn E. , Wu Yonghui , Bian Jiang , Maraganore Demetrius M 
Published: December 2020

AbstractBackgroundAs the population ages, the incidence of Alzheimer’s disease and related dementias (ADRD) are expected to rise and cause a significant burden to the world economy and healthcare systems. Pharmaceutical trials to cure ADRD have largely proven unsuccessful. Therefore, there is a critical need for early identification and intervention for individuals at risk of ADRD to prevent or delay disease onset.MethodUsing electronic medical record (EMR) data from a large, academic medical center, a historical cohort of Floridians aged 50 and older who developed ADRD were identified, along with an age and sex‐matched referent group. Discrete diagnostic codes, medication history, and biomarkers were used to develop 1, 3, and 5‐year ADRD machine learning‐based prediction models through theory‐driven and data‐driven approaches.ResultA cohort of 59,799 subjects were identified as meeting study criteria, including 5,711 diagnosed with ADRD during the study period. Approximately five controls (n = 18,765) for each patient were matched by birth year and sex. In the theory‐driven experiment, the logistic regression model achieved the area under the curve (AUC) of .664 for 1‐year ADRD prediction, .635 for 3‐year prediction, and .650 for 5‐year prediction. Further analysis exhibited that age, ethnicity, stroke, and history of traumatic brain injury had the highest odd’s ratios for ADRD development; whereas, use of NSAIDs and hormone‐replacement therapy was associated with reduced risk of ADRD (See Table 1). Compared to the theory‐driven models, the data‐driven models (gradient boosting trees) improved the AUC by ∼0.06 for 1‐ and 3‐year prediction.ConclusionUsing widely available EMR data, a large cohort of adults who developed ADRD and matched controls were used to create 1, 3, and 5‐year prediction models. These models can be adopted in decision‐support systems for detecting individuals at high‐risk of developing ADRD, allowing for interventions to be implemented in a timely manner. Our future research will replicate these models with data from the OneFlorida Clinical Research Consortium, a data repository including 15 million patients, covering more than 60% of the Florida population. These models will be externally validated via neuropsychological assessment before EMR‐tool kits are disseminated to medical practitioners across the state of Florida.
Cumulative cognitive deficits of Lewy body disease and Alzheimer’s disease neuropathology
Authors: Ryman Sephira , Yutsis Maya , Tian Lu , Henderson Victor , Montine Thomas J. , Salmon David P. , Galasko Doug R. , Poston Kathleen 
Published: December 2020

AbstractBackgroundAlzheimer’s disease neuropathologic change (ADNC) may contribute to the emergence of dementia in patients with Lewy body disease (LBD) and may act synergistically with LBD. It is unclear to what extent LBD is a domain‐specific predictor of cognitive impairment in isolation and in combination with ADNC.MethodData from the National Alzheimer’s Coordinating Center database was obtained for 2,433 participants with antemortem longitudinal neuropsychological assessment and postmortem neuropathological assessment. We employed a novel measurement of cognitive impairment that incorporates information about the individual’s initial deviation from normative performance and decline over time. We compared domain‐specific cumulative cognitive deficits in LBD, ADNC, and combined LBD/ADNC at three pathologic stages of LBD (brainstem, limbic, and cerebral cortical).ResultThis study included 111 participants with LBD only, 741 participants with combined LBD/ADNC, 1,357 participants with ADNC only, and 224 healthy controls (HC). Limbic and cerebral cortical LBD groups exhibited similar executive/visuospatial deficits as combined ADNC and LBD impacting the limbic and cerebral cortical regions. The cerebral cortical LBD group demonstrated a significantly greater executive/visuospatial deficit relative to ADNC only. In contrast, ADNC and ADNC/LBD groups demonstrated significantly greater cumulative memory deficits relative to HC and LBD only groups, across all LBD pathologic stages.ConclusionThe results of the current study demonstrate that the impact of ADNC and LBD pathology on cognition differs based on the cognitive domain examined and the state of progression of LBD pathology. Limbic and cerebral cortical Lewy body pathologies impact executive/visuospatial functioning independent from the impact of ADNC. In contrast, a greater memory impairment is driven by ADNC, with relatively weaker deficits observed in the LBD only groups. These findings have relevance for predicting progression in Lewy body diseases. Further, detailed characterization of cognitive phenotypes of LBD is crucial for the development of effective disease‐modifying therapeutic trials.
Cognitive characteristics of older adults with history of concussion
Authors: Maietta Julia E. , Caldwell Jessica Z.K. , Hawley Nanako , Cummings Jeffrey L. , Miller Justin B. 
Published: December 2020

AbstractBackgroundConcussion is a common injury, and among older adults often results from falls (Thompson, McCormick, & Kagan, 2006). There is some evidence to suggest that older adults with a history of concussion show higher mortality rates than their younger counterparts, as well as increased risk for developing neurodegenerative diseases (such as Alzheimer’s Disease [AD]; Becker, Kapogiannis, & Greig, 2018; Thompson et al., 2006). However, the literature on risk for neurocognitive decline in those with concussion history is limited, and the available evidence is conflicting (Abner et al., 2014). The current study aims to add to the literature regarding the cognitive differences between older adults with and without concussion in a well‐characterized cohort of patients with AD.MethodThis retrospective study investigated cognitive differences in individuals with and without self‐reported concussion history [CH] taking into account age and education level. Participants were enrolled in the Center for Neurodegeneration and Translational Neuroscience and included 52 cognitively normal controls (13 with CH), 68 mild cognitive impairment [MCI] (24 with CH), and 24 mild AD (8 with CH). Cognitive domains assessed included: Global cognitive (MoCA); verbal memory (WMS‐IV Logical Memory; RAVLT); non‐verbal memory (BVMT‐R); attention/working memory (WAIS‐IV Digit Span); verbal set‐shifting (DKEFS Verbal Fluency); and processing speed (SDMT).ResultOmnibus tests did not reveal a significant difference between those with and without CH in the CN, MCI, or AD, groups after taking into account age at time of evaluation and education [CN – F(14,35)=1.20, p>.05; MCI – F(14,46)=0.50, p>.05; AD – F(9,1)=0.66, p>.05, respectively]. Effect sizes (Cohen’s d) for the CN group ranged from small to medium (min=0.1, max=0.7). For MCI, effect sizes were small (min=0.0, max=0.3). For AD, effect sizes ranged from small to medium (min=0.0, max= ‐0.7).ConclusionResults suggest that there are no meaningful differences in cognitive test scores between individuals with and without history of self‐reported concussion after accounting for influences of age and education. Effect sizes were medium despite non‐significant ANCOVAs, suggesting that these results are under‐powered and that future research would find significant results with larger samples. Small sample size and uncertainties regarding self‐report of concussion are limitations of this study.
SUccessful Caregiver Communication and Everyday Situation Support in dementia care (SUCCESS): Using technology to support caregivers
Authors: Caspar Sienna , Garschall Markus , Sfetcu Raluca , Himmelsbach Julia , Fassl Flora 
Published: December 2020

AbstractBackgroundCaregivers of people with dementia (PwD) are diverse—they live in urban and rural locations, have varying educational backgrounds, different access to resources, different relationships to the care recipient, etc. However, one common feature of all caregivers is the need to have access to education and support on their caregiving journey. Technology provides a feasible way to reach such a large and diverse population. SUccessful Caregiver Communication and Everyday Situation Support in dementia care (SUCCESS) provides an innovative training and coaching application on a mobile device (an App) to support formal and informal caregivers of PwD. Through the use of an affective avatar, the SUCCESS App aims to help caregivers better understand dementia and related behaviours and learn communication methods grounded on the principle that opinions and needs of PwD should be acknowledged, respected, and addressed. The avatar also assists caregivers in focussing on the remaining abilities of the PwD; thereby, helping to support PwDs’ continued engagement in meaningful activities. Finally, the avatar acts as a wellness coach to help ensure caregivers remain as resilient as possible by encouraging caregivers to actively engage in individualized self‐care activities.MethodsThe SUCCESS App was evaluated in a pilot study in two countries using a pre‐post design. Participants included 63 carers of PwD located in Austria (n=26) and Romania (n=37). Quantitative and qualitative data was collected at baseline, 1‐month, 3‐months and 6‐ months. The primary outcome was satisfaction with care. Secondary outcomes included care‐related knowledge, experience of burden, and the presentation of behavioural and psychological symptoms of dementia by the PwD.ResultsPreliminary analysis of the qualitative data demonstrates the majority of the participants found the application to be very useful and practical; they also indicated they planned to continue to use it once the trial was over because it helped them to have a better understanding of what dementia is and assisted them in tangible ways as they provided care to PwD.ConclusionsInitial results indicate that the SUCCESS App has the potential to provide information and support to caregivers in a highly accessible way that is both useful and feasible.
Extrastriatal dopaminergic and serotonergic pathways in Alzheimer’s disease: A 123I‐FP‐CIT study
Authors: Pilotto Andrea , Caminiti Silvia , Liguori Claudio , Garibotto Valentina , Presotto Luca , Sala Arianna , Turrone Rosanna , Caratozzolo Salvatore , Scalvini Andrea , Rozzini Luca , D'Amelio Marcello , Mercuri Nicola , Paghera Barbara , Premi Enrico , RIzzetti Cristina , Stefani Alessandro , Padovani Alessandro , Perani Daniela 
Published: December 2020

AbstractBackgroundPathological reports suggest that dopaminergic and serotonergic pathways are early involved in Alzheimer’s disease (AD). 123I‐FP‐CIT SPECT imaging allows the evaluation of both dopamine transporter (DAT) and serotonin transporter (SERT) in several brain regions.MethodAlzheimer’s disease patients were included in a multicenter study and underwent a standardized neurological examination, structural imaging and CSF, amyloid and metabolism imaging in order to reach a biomarker diagnosis of AD (i.e. A+T+N+ classification). Each patient underwent 123I‐FP‐CIT SPECT imaging and the bindings of extrastriatal regions of interests were calculated from spatially normalized images. The occipital‐adjusted specific to non‐displaceable binding (SBR) in the different regions was compared between AD and controls adjusting for the effect of age, sex, disease duration and serotonergic/dopaminergic treatment.Result52 AD patients A+T+N+ and 75 controls entered in the study. AD patients showed lower 123I‐FP‐CIT SPECT SBR in cingulate (p=0.001) and temporal lobe (p=0.007) as well as in insula (p=0.01) and thalamus (p=0.025) compared to controls. When dividing AD according to severity, MCI due to AD (n=17) showed significantly lower parietal SBR compared to controls (p=0.002) and significantly higher SBR in insula (p=0.01), thalamus (p=<0.001) and temporal lobe (p=0.008) compared to AD dementia (n=35).ConclusionWe demonstrated extrastriatal dopaminergic and serotonoergic impairment in Alzheimer’s disease. In the parietal cortex the alterations was present already at MCI stage, while in the temporal regions, thalamus and insula alterations appeared later in the AD dementia stage. Longitudinal studies will be necessary in order to evaluate the clinical value of extrastriatal 123I‐FP‐CIT SPECT assessment for possible different pattern of progression and response to treatment in AD patients.
Intervention with nostalgic music and reminiscences provide positive emotions for people with dementia and reduces BPSD
Authors: Urabe Mie , Fukuda Hiroko , Noda Yasuha , Miyata Chiharu , Yoneda Sho , Sakai Katsumi , Kato Yuka , Kitajima Kengo , Sawada Chikao 
Published: December 2020

AbstractBackgroundNostalgic music arouses positive changes in mood and social behavior of persons with dementia. (Barnetta L., et al., 2006 )The reminiscence method for a person with dementia supports his/her memories and emotions by having their life history listen to. The intervention using nostalgic music and reminiscence provides stimulation to the emotions of a person with dementia, and positive emotions occur. Through the positive emotions, they may also have a positive effect on the behavioral and psychological symptoms of dementia (BPSD). This project aims to reduce BPSD by extracting positive emotions from people with Alzheimer's disease (AD) with BPSD by listening to and talking about their favorite nostalgic music videos. Since personal computers, Information and Communication Technology (ICT) are used, there is no need to prepare instruments, etc., and anyone can perform this individual intervention anytime, anywhere. This project is researching the interventions that utilize the emotions and the memory function of people with dementia, and has the hypothesis that positive emotions will be able to reinforce their self‐esteem and reduce BPSD. Participants of this project are patients with AD with BPSD in psychiatric hospital in japan. One session is conducted for 30 minutes, four times in total, for each participant for two months. In a session, a participant and a researcher watch the participant’s favorite nostalgic music video of a singer of the time, and talk about impressions and memories of this song. In these sessions, it is an important point to provide images of when the participant was listening to this song.
Polygenic analysis of late‐onset Alzheimer’s disease in a Japanese population
Authors: Kikuchi Masataka , Miyashita Akinori , Hara Norikazu , Shigemizu Daichi , Ozaki Kouichi , Niida Shumpei , Ikeuchi Takeshi , Nakaya Akihiro 
Published: December 2020

AbstractBackgroundLate‐onset Alzheimer’s disease (LOAD) is a neurodegenerative disease characterized by cognitive impairment and has a high heritability of 60%–80%. The genetic factor, with the strongest influence identified to date, that is associated with the increased risk of LOAD is the APOE ε4 allele. However, the APOE alleles only explain approximately 6% of LOAD phenotypic variance, and other genetic factors may be responsible for the remainder. The polygenic model explains complex traits, including diseases based on multiple single nucleotide polymorphisms (SNPs) with weak effects as well as several dozen SNPs identified by genome‐wide association studies (GWASs). Recent studies have reported that the polygenic risk score (PRS), which is an index that quantifies polygenic effects, increased the ability to discriminate LOAD patients and correlated with the amount of amyloid β in cerebrospinal fluid. In this study, we calculated PRSs for approximately 2,000 Japanese people using the European LOAD GWAS statistics provided by a previous study. To examine the discrimination ability for LOAD patients, we compared ones between PRSs calculated using the LOAD GWAS statistics and PRSs computed using the GWAS statistics in other diseases. Additionally, we also compared the discrimination ability by LOAD PRS with that of APOE ε4 variation only.MethodPRS was calculated for each individual as the weighted linear sum of the genotypes of SNPs and the GWAS statistics, including the p‐values or the odds ratios. In this study, we utilized the GWAS statistics from psychiatric disorders, including schizophrenia, and non‐psychiatric disorders, including type 2 diabetes. We performed bootstrapping to evaluate the discrimination ability for LOAD patients and simulation analysis to discuss the differences between populations.ResultThe predictive powers of LOAD were significantly higher than those from other diseases. With GWAS statistics of the same population, the accuracy prominently increased.ConclusionWe demonstrated the polygenic effects of LOAD in the Japanese population. Our simulation analysis suggested that PRS constructed based on LOAD GWAS statistics in the same population increased the discrimination ability for LOAD patients.
Home‐based evaluation of executive function (Home‐MET) for older adults with mild cognitive impairment
Authors: Ho‐yin Lai Frank 
Published: December 2020

AbstractBackgroundExecutive function helps older adults maintain their activities of daily living by making plans, setting goals, and carrying them out successfully. It is important for their independence in community living. Clinically, the underlying deficits in executive function (EF) also significantly contributed to their functional disabilities. EF has shown to be important, especially in the fast and complicated contemporary world, because it has been considered as central to independent daily living, solve problems, and resolve conflicts. EF was considered as a vital part of the independent living skills of older adults with dementia in community living. Some researchers commented that executive function is the core psychological deficit underlying dysfunction of mild cognitive impairment. The resulting functional disabilities were the major cause of extended hospital stays and protracted residential care.MethodWith a carefully match‐group of 80 mild cognitive impaired with 80 health control subjects. The home‐based evaluation of executive function (Home‐MET) was validated in subjects’ own living environment.ResultThis Home‐MET showed significant correlation in the assessment of attention control that was assessing by Test of Everyday Attention (TEA) (r = .86, p < .01), with working memory that was assessed with Trail Making Test (TMT) (r = .72, p < .01), with inhibitory control that was assessing with Stroop Test (r = .86, p < .01), with individuals’ functional disability was assessed by Chinese Disability Assessment of Dementia (CDAD) (r = .77, p < .01) and cognitive assessment was assessed by Hong Kong Montreal Cognitive Assessment (HK‐MoCA) (r = .88, p < .01). By benchmarking with the validated performance‐based executive function assessment, the Home‐MET shows significant correlation (r = .92, p < .05) with the executive function test in a standard environment in hospital, i.e. the Chinese Multiple Errands Test (the Chinese‐MET). The two‐stage hierarchical linear regression model with backward method showed functional disability was a marginally significant predictor (p < .059) for the Home‐MET with regression model showed with R2 = .93.ConclusionResults indicated the Home‐MET, can provide an objective measure of executive function for subjects with mild cognitive impairment in participants’ own home environment.