bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying dementia risk factors and implementing a culturally grounded risk‐reduction intervention in urban and regional Aboriginal Australian communities
Authors: Lavrencic Louise , Donovan Terrence , Moffatt Lindy , Allan Wendy , Daylight Gail , Garvey Gail , Hill Thi Yen , Draper Brian , Cumming Robert , Broe Gerald A , Delbaere Kim , Radford Kylie 
Published: December 2020

AbstractBackgroundAboriginal Australians are disproportionately affected by dementia compared to other Australians and many populations globally. Dementia incidence and risk factors have not been identified for Aboriginal Australians living in urban or regional areas (comprising ∼80% of First Nations Australians). There is also a pressing need in this population for non‐pharmacological interventions that are culturally‐grounded and target dementia risk‐reduction. Psychological wellbeing is a risk factor for dementia, and is relevant for Aboriginal communities where there are high levels of exposure to stress and trauma.MethodThe Koori Growing Old Well Study (KGOWS) is a longitudinal, population‐based study with Aboriginal Australians aged 60+ years; participants were from 5 partnering communities in New South Wales (N=336 at baseline; n=165 at follow‐up; n=68 died before follow‐up; mean follow‐up=6 years). Biomedical and psychosocial risk factors (baseline assessment) were examined for cognitive decline (incident MCI or dementia) using logistic regression. To address the impact of lifecourse stress and trauma on dementia risk, a comprehensive co‐design process was employed to develop the Ngarraanga Giinganay (‘thinking peacefully’) mindfulness‐based program, including expert working group, community focus group and pilot trial (n=7 older Aboriginal Australians), with quantitative and qualitative outcomes.ResultKGOWS demonstrated high rates of incident dementia (17.55/1000 person‐years; age‐standardised rate=34.71) and cognitive decline (42.34/1000 person‐years; age‐standardised rate=73.51), comparable to a remote Aboriginal population. In models adjusted for age (OR=2.12), factors predicting cognitive decline included male sex (OR=2.91), lower education (OR=0.51), moderate to severe hearing (OR=4.80) and vision (OR=3.78) problems, greater waist‐hip ratio (OR=1.56), polypharmacy (OR=2.61) and unskilled work history (OR=5.27). The working group and focus group feedback strongly guided Ngarraanga Giinganay program development, ensuring content and activities aligned with cultural understandings and practices for that community (Gumbaynggirr people). Results from the Ngarraanga Giinganay pilot demonstrated feasibility, acceptability and preliminary effectiveness of mindfulness‐based stress‐reduction; and highlighted aspects for refinement and further evaluation.ConclusionThese findings provide the first urban incidence rates and identify potentially modifiable risk factors for cognitive decline in Aboriginal Australians. Our work with communities provides insight into partnering with underrepresented populations for dementia research; and highlights the effectiveness of co‐design approaches when developing culturally‐specific interventions.
Combined findings of FDG‐PET and arterial spin labeling in sporadic Creutzfeldt‐Jakob disease
Authors: Yuan Junliang 
Published: December 2020

AbstractBackgroundSporadic Creutzfeldt‐Jakob disease (sCJD) is a fatal progressive neurodegenerative disease. Multimodal approaches, including electroencephalogram, diffusion‐weighted imaging (DWI) of brain MRI, and cerebrospinal fluid biomarkers, have been applied to increase the diagnostic accuracy of sCJD. Although previous studies suggested DWI could be the most useful modality for sCJD diagnosis, whether metabolism changes underlying in sCJD are still poorly understood.To the best of our knowledge, there are only one case using the technique of arterial spin labeling (ASL) to detection and follow‐up of perfusion changes in CJD.MethodHerein, we described a 71‐year‐old woman presented with progressive cognitive decline, behavioral and psychological symptoms for two months. The patient died one month later after her admission.ResultAs far as we know, this is the first report using the combination of fluorodeoxyglucose positron emission tomography and ASL to explore the metabolism changes in sCJD.ConclusionOur case exemplifies the difficulty clinicians may face in the diagnosis of sCJD.
Hearing loss and hearing care disparities among older adults with cognitive impairment
Authors: Nieman Carrie L , Deal Jennifer A , Betz Joshua , Reed Nicholas S , Goman Adele M , Knopman David S , Sharrett A Richey , Windham B Gwen , Oh Esther S , Albert Marilyn S , Lin Frank R 
Published: December 2020

AbstractBackgroundAlthough both age‐related and highly prevalent, little is known regarding the prevalence of hearing loss among persons with dementia (PwD). Current understanding is based on convenience samples primarily from specialized memory clinics. The Atherosclerosis Risk in Communities Neurocognitive Study (ARIC‐NCS) is a large, prospective study of a population‐based cohort from 4 U.S. community sites with audiometric and neurocognitive testing and bi‐racial representation. We examined the prevalence of hearing loss and hearing aid use among older adults with cognitive impairment and whether cognitive status influences hearing aid use.MethodWe analyzed audiometric and hearing care data from ARIC‐NCS Visit 6 (2016‐2018). Participants underwent a full neurocognitive battery and audiometric evaluation at Visit 6. Participants with complete audiometric data and an adjudicated diagnosis of cognitively normal, mild cognitive impairment (MCI), or dementia were included in the analytical cohort (N=3,385). Differences in participant characteristics by cognitive status were descriptively compared using Chi‐square tests or one‐way ANOVAs. We performed a series of logistic regression models to estimate the odds of hearing aid non‐use by cognitive status.ResultPrevalence of hearing loss was greater with increasing cognitive impairment (cognitively normal:64.7%; MCI:71.3%; dementia:83.3%). Prevalence of hearing aid use among those with hearing loss and cognitive impairment varied by race (African Americans 7.2%; whites 32.8%). In a multivariable‐adjusted model, cognitive impairment was independently associated with higher odds of non‐use of hearing aids (MCI odds ratio (OR):1.4 (95%CI:1.0‐1.8); dementia OR:1.8 (95%CI:1.2‐2.9) versus cognitively normal). The strongest risk factor for non‐use of hearing aids was race, where African Americans have almost a 5 times higher odds of not using hearing aids compared to whites (95% CI:2.9‐7.4).ConclusionHearing loss is highly prevalent but vastly untreated among older adults with cognitive impairment, particularly African Americans, and cognitive impairment is independently associated with hearing aid use. These estimates are some of the first population‐based estimates of audiometric hearing loss among diverse older adults with adjudicated diagnoses of MCI or dementia. With increased calls to address ethnic/racial disparities, we must include hearing loss, as one of the most common co‐morbidities, in order to optimize health and well‐being among all PwD.
Risk assessment for postoperative delirium: Cognitive impairment as major factor
Authors: Klingenhegel Ingo , Ihl Ralf 
Published: December 2020

AbstractBackgroundElderly patients show an increased risk of postoperative delirium. Cognitive impairment constitutes a risk factor for delirium, whereas delirium can also accelerate cognitive decline. To improve prevention and therapy of delirium, planning of surgical and anaesthetic measures could integrate a range of psychiatric, psychosocial and somatic risk factors. Here, the predictive value of risk factors was investigated.MethodIn a longitudinal design, 120 patients aged 65 years and older were included. Risk factors were assessed before surgical interventions with a questionnaire for risk factors, the TE4D as a screening tool for cognitive impairment and depression and Reisberg’s GDS staging of severity of cognitive impairment. Postoperative prevalence of delirium was assessed with the Confusion Assessment Method for the Intensive Care Unit (CAM‐ICU). Pearson correlation was calculated for metric variables. If significant (p<.05), metric variables were transformed into dummy variables by calculating the highest possible odds ratio for delirium. For nominal variables, odds ratio for delirium was calculated. A stepwise binary logistic regression was conducted.ResultPrevalence of postoperative delirium was 13.3%. Results of the Pearson correlation indicated neither significant association between postoperative delirium and age (r(118) = .089, p > .05) nor education (r(118) = ‐.002, p > .05). Postoperative delirium and duration of general anaesthesia were found to be correlated (r(118) = .33, p < .01). Logistic regression of 20 risk factors (Table 1) resulted in a 6‐factor‐model including preoperative cognitive impairment (OR 33.67), severe disease (OR 23.05), premedication with narcotics or benzodiazepine (OR 9), fracture (OR 5.77), duration of general anaesthesia above 160 minutes (OR 5.56) and male gender (OR 2.29). For the resulting model predictive sensitivity was 1, specificity was .93, Youden index J=.93, accuracy .94.ConclusionFor the risk of delirium in elderly surgical patients, preoperative cognitive impairment demonstrated the highest odds ratio followed by somatic predisposition. To decrease the risk of delirium, the result of calculating the risk factors will give the chance to adapt anaesthetic and surgical procedures. A screening tool, working title Computation of Risk for Delirium (COR‐D), including a short version based on the presented data will be provided and further validated.
Memory complaints are associated with impaired working memory and reduced frontal cortical thickness in mid‐life surgically menopausal women
Authors: Reuben Rebekah B. , Almey Anne , Gervais Nicole J. , Au April , Duchesne Annie , Gravelsins Laura , Brown Alana , Kannampuzha Courtney , Perovic Mateja , Bernardini Marcus , Eisen Andrea , Meschino Wendy , Foulkes William , Grady Cheryl , Einstein Gillian 
Published: December 2020

AbstractBackgroundAlzheimer’s disease (AD)‐related brain pathology is observed in participants within the normal ranges of cognitive assessments (Delacourte et al., 1999). Consequently, there is increased interest in subjective cognitive decline (SCD), a self‐experienced decline in cognition, as an early risk factor (Jessen et al., 2014). SCD is associated with earlier conversion to mild cognitive impairment (MCI) and AD (Jessen et al., 2010; Reisberg et al., 2010), poorer performance on cognitive tasks, and cortical thinning in AD‐related regions (Schultz et al., 2015; Sánchez‐Benavides et al., 2018). Women with surgical menopause prior to age 50 have an increased risk of AD (Rocca et al., 2007). Women with bilateral salpingo‐oophorectomy (BSO) without estradiol (E2) therapy in mid‐life show decreases in WM performance and volumetric declines in the frontal cortex and hippocampus compared to controls (Almey et al., 2018; Gervais et al., 2018).MethodThe current study evaluated the association of memory complaints with WM performance and frontal cortical thickness in a mid‐life cohort of at‐risk women with BSO. Participants with memory complaints (n = 42) and without (n = 30) completed demographics and neuropsychological tasks to assess WM. A subset of these participants with memory complaints (n = 11) and without (n = 14) were scanned using a 3T Siemens scanner, and cortical thickness was obtained from T1‐weighted scans using CIVET 2.1.1 (Ad‐Dab’bagh et al., 2005). Analyses were performed using R 1.1.4 (R Core Team, 2018).ResultOur analyses revealed participants with memory complaints performed significantly worse on WM tasks than those without. Furthermore, we found participants with memory complaints had significantly thinner cortices within the left ventrolateral prefrontal cortex (vlPFC), a region associated with WM (Badre & Wagner, 2007).ConclusionOur preliminary results demonstrate memory complaints are associated with impaired WM performance and frontal cortical thinning in women with BSO. The results suggest that women with surgical menopause and memory complaints show differences associated with SCD in WM function and frontal cortical structure at an early age (Wang et al., 2004). Ongoing research is evaluating effects of memory complaints on cognition and brain structure within spontaneously menopausal women in the COMPASS‐ND database (CCNA, 2020).
Regional distribution of amyloid deposition and grey matter atrophy in late‐life depression
Authors: Takamiya Akihiro , Casteele Thomas Vande , Koole Michel , De Winter François‐Laurent , Bouckaert Filip , Van den Stock Jan , Van Laere Koen , Emsell Louise , Vandenbulcke Mathieu 
Published: December 2020

AbstractBackgroundDepression is associated with a risk of developing dementia and is hypothesized to enhance (pathological) brain aging. Previously we reported that amyloid burden in late‐life depression (LLD) did not differ from healthy controls in cortical regions typically associated with Alzheimer’s disease (AD) [1]. Here we extend our analysis beyond hippocampal volume and AD‐specific volumes‐of‐interest, to the whole brain.MethodForty‐eight individuals with LLD (age 74.1±7.5 years, 33 female) and 52 healthy controls (72.4±6.4 years, 37 female) underwent static amyloid PET imaging with [18]F‐flutemetamol and 3D T1‐weighted structural MRI. Amyloid deposition was quantified using the standardized uptake value ratio (SUVR) relative to the cerebellar grey matter (GM). Whole‐brain voxel‐wise comparisons of amyloid PET SUVR and GM volume (GMV) between LLD and controls were performed using SPM12, with age as covariate. Total intracranial volume was included as an additional covariate in the GMV analysis. The significance threshold was set to a family‐wise error (FWE) corrected p <0.05 at cluster‐level with an individual voxel height threshold p = 0.001.ResultThere were no statistically significant group differences in amyloid deposition. In contrast, compared to controls, individuals with LLD showed widespread significant GMV reductions, predominantly in the left temporo‐parietal and the right occipital regions (Figure).ConclusionLate‐life depression is associated with lower GMV in regions also implicated in AD, but is not associated with increased amyloid burden. Future analysis investigating correlations with neuropsychological measures of mood and cognition, and accounting for the potential effects of regional atrophy and white matter pathology on amyloid quantification, may further extend our knowledge about differences in the underlying neurobiology of LLD and AD.
How much can the Alzheimer’s Disease Assessment Scale Cognitive Subscale (ADAS‐Cog) tell us? Insights from a latent state‐trait auto‐regressive (LST‐AR) model
Authors: Cogo‐Moreira Hugo , Krance Saffire H. , Rabin Jennifer S. , Lanctot Krista L. , Herrmann Nathan , Macintosh Bradley J. , Black Sandra E. , Eid Michael , Swardfager Walter 
Published: December 2020

AbstractBackgroundThe ADAS‐Cog assesses several cognitive domains and is the international gold standard for monitoring cognitive decline in clinical trials for Alzheimer’s disease (AD) dementia. These manifold cognitive deficits can progress differently and therefore, individual ADAS‐Cog items may contain different sources of information: some predictable based on the baseline score (i.e. trait), and some based on progression from one occasion to the next (i.e. accumulated or “autoregressive” effects), while some reflects unpredictable “occasion specific” fluctuations in symptoms (i.e state).MethodOver multiple occasions of measurement, latent state‐trait autoregressive (LST‐AR) models can be used to decompose each item into reliable consistent information (composed of trait information and accumulated effects), reliable occasion‐specific information (i.e. state effects), and unreliable information (i.e. measurement error). Thus, consistency (trait + accumulated effects) and reliability (consistency + occasion specificity) can be determined for each item, at each assessment. The LST‐AR model was fit to four waves of data assessments (baseline, 6, 12 and 24 months) among 341 mild AD patients that participated in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) study.ResultThe reliabilities of the memory (43.4%‐80.1%) and language (63.8%‐92.5%) items were generally greater than those of the praxis (average of 65.6%) and orientation (average of 60.8%) items. At the last assessment, all of the memory and language items had more consistency (ranging from 63.4% for comprehension of spoken language to 88.2% for word recognition) than occasion specificity. Disentangling the consistency into traits and accumulated effects, the items most reflective of traits were word recognition (79.4%) and commands (64.1%). Word recall, orientation and naming tasks contained roughly equal amounts of trait and accumulated information. Scores on comprehension of spoken language and spoken language ability were mainly related to accumulated effects (71.4% and 64.7%, respectively).ConclusionIn mild AD, most individual ADAS‐Cog memory and language items were reliable over time. Moreover, the scale captured additional information about the state, trait and accumulated effects of AD; the memory items tended to be more reflective of trait differences between subjects, whereas the language items tended to reflect effects that accumulated from one visit to the next, consistent with the typical progression of AD.
The relationship between cortical microstructural changes and in vivo amyloid‐β and tau in aging and preclinical Alzheimer's disease
Authors: Rodriguez‐Vieitez Elena , Montal Victor , Sepulcre Jorge , Lois Cristina , Hanseeuw Bernard , Vilaplana Eduard , Schultz Aaron P , Properzi Michael J , Scott Matthew R , Fortea Juan , Johnson Keith A , Sperling Reisa A , Vannini Patrizia 
Published: December 2020

AbstractBackgroundA novel technique for the analysis of diffusion‐weighted imaging (DWI) has allowed quantifying brain microstructural properties by means of cortical mean diffusivity (cMD) in the grey matter. Using this approach a biphasic trajectory of the cMD signal has been revealed, characterized by an early decline followed by an increase across preclinical stages of Alzheimer's disease (AD), primarily in temporo‐parietal brain regions (Montal et al.,Alz&Dem,2018). The initial cMD reduction has been hypothesized to be due to glial activation (Vilaplana et al.,Neurology,2020), while increased cMD in later stages is thought to reflect breakdown of cortical tissue microstructure and neurodegeneration. However, the pathological underpinnings of the cMD signal, specifically its relationship to in vivo amyloid‐β and tau, remain unknown.Methods84 cognitively‐normal participants from the Harvard Aging Brain Study underwent cross‐sectional DWI, T1‐weighted‐MRI, 11C‐PiB‐PET, and 18F‐Flortaucipir (FTP)‐PET imaging (Table 1). 11C‐PiB‐PET was quantified using non‐PVC‐corrected Logan DVR, and individual amyloid‐β burden was extracted from a cortical composite including frontal‐lateral‐retrosplenial (FLR) regions. 18F‐FTP‐PET was quantified using PVC‐corrected SUVR and individual tau burden was extracted from the entorhinal cortex. All PET data were normalized to cerebellar grey matter. First, a whole‐brain surface‐based approach was used to investigate the linear and quadratic (correcting for the linear term) vertex‐wise relationships of cMD to amyloid‐β and tau. Second, cMD signal was extracted from significant regions‐of‐interest to visualize its relationships with amyloid‐β and tau.ResultsCortical MD was not significantly associated to amyloid‐β using either the linear or quadratic term. The relationship between cMD and tau was best described by a quadratic model across the whole cohort, as seen vertex‐wise (Fig.1) and regionally (Fig.2). Specifically, cMD signal decreased and then increased as both amyloid‐β and tau accumulated.ConclusionsThe novel imaging technique of cMD is a promising approach to measure cortical microstructural changes. Our findings of a non‐linear trajectory of cortical mean diffusivity, particularly in the temporal regions, may indicate an initial phase of reduced cMD due to glial activation followed by increased cMD signal due to breakdown of cortical tissue microstructure as amyloid‐β and tau accumulate. Ongoing longitudinal studies will help elucidate the temporal dynamics of cortical microstructure and protein accumulation.
Neuropsychological factors related to progression of subjective cognitive decline
Authors: Ryoo Nayoung , Suh Jeewon , Son Eunji , Pyun Jung Min , Park Young Ho , Kim SangYun 
Published: December 2020

AbstractBackgroundIndividual with subjective cognitive decline (SCD) complains of cognitive decline on its own while cognitively normal. Current research suggests that SCD can indicate an at‐risk stage of Alzheimer’s disease (AD). In this study, we analyzed neuropsychological factors in SCD patients at a higher risk of progression to MCI.MethodThis retrospective cohort study included 68 patients who were confirmed with SCD after neuropsychological test. They were classified into progressive SCD group and stable SCD group according to whether they progressed to MCI within the follow‐up period. For both groups, neuropsychological tests including Seoul verbal language test, Boston naming test, Stroop color & word test, Rey complex figure test, and forward and backward digit span test were assessed.ResultWe collected neuropsychological data of 107 SCD individuals retrospectively, and 68 patients were followed up for a mean of 52.93 months (range 11–113 months). At follow‐up, 35.3% of patients showed cognitive decline to a diagnosis of mild cognitive impairment (MCI) and defined as progressive SCD group (N=24), and the other patients (N=44) were as stable SCD group. Patients with progressive SCD were about 4 years older and more likely to have ischemic heart disease. Furthermore, they showed worse performance on a delayed recall and a recognition task from the Seoul Verbal Learning Test, and Boston naming test compared to those with stable SCD.ConclusionSCD patients with progression of MCI have a tendency of older age, higher rate of ischemic heart disease, and worse decline in memory and language ability. This study suggest that it is worth to consider SCD subtypes based on memory and language ability so that it is possible to detect a high‐risk group of MCI at the early stage.