bluuebunny/crossref_metadata_2025_split huggingface dataset:
Head injury at different ages and cognitive performance in a diverse cohort: Findings from the KHANDLE Study
Authors: Nuno Miriam , Gilsanz Paola , Glymour M. Maria , Mayeda Elizabeth Rose , Eng Chloe W. , Peterson Rachel , George Kristen M. , Mungas Dan M. , DeCarli Charles , Whitmer Rachel A. 
Published: December 2020

AbstractBackgroundEvidence is limited on the impact of a head injury and the role of age at injury on different cognitive domains, particularly among in diverse cohorts.MethodsThe Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study examines cognitive aging across four racial/ethnic groups (29% White, 26% Black, 24% Asian, & 20% Latino). Head injury was determined by asking: “Have you ever had a head injury where you lost consciousness or for which you received medical care?” Age at first injury was grouped as 0‐15, 16‐29, 30‐64 and 65+ years. Education was coded as college graduate or more and less than college graduate. Z‐standardized measures of verbal episodic memory, semantic memory, and executive function were assess using the Spanish and English Neuropsychological Assessment Scales (SENAS). The association between head injury and cognitive domains were analyzed with adjustment for age, sex, race, and education using multivariable linear regression models.ResultsAmong the analytic sample of 1,666 participants, 392 (22.9%) reported history of a head injury. Exposure to head injury was not associated with deficits in executive function (β=0.04, 95% CI: −0.05, 0.14), verbal episodic memory (β=‐0.09, 95% CI: −0.02, 0.10), or semantic memory (β=0.07, 95% CI: −0.02, 0.16). Among those reporting a head injury, 77.1% experienced one injury, 15.5% 2 injuries, 4.6% 3 injuries, and 6.7% participants reported 4+ injuries. The median (interquartile range) age at first head injury was 24 (13‐60) years, and time since first head injury was 48 (14‐61) years. Age at first head injury was not associated with cognitive function when compared to individuals without a head injury (Table 1A). Among those with a history of head injury, age at first injury was not associated with executive function (65+ vs. 0‐15 years: β=‐0.25, 95% CI: −0.50, 0.01), verbal episodic memory (65+ vs. 0‐15 years: β=0.21, 95% CI: −0.05, 0.47), or semantic memory (65+ vs. 0‐15 years: β=‐0.09, 95% CI: −0.32, 0.13) (Table 1B).ConclusionParticipants who reported a head injury did not exhibit worse cognition compared to those without history of injury nor was age at first head injury associated with any cognitive domain.
Heart failure with preserved ejection fraction (HFpEF) is associated with cognitive impairment and reduced brain volume
Authors: Hugenschmidt Christina E. , Hughes Timothy M. , Jung Youngkyoo , Lockhart Samuel N. , Whitlow Christopher T. , Yang Mia , Williams Benjamin J. , Cleveland Maryjo , Bateman James R. , Baker Laura D. , Sachs Bonnie C. , Craft Suzanne , Kitzman Dalane 
Published: December 2020

AbstractBackgroundIncreasingly, vascular diseases are implicated in risk for Alzheimer’s disease and related dementias. Heart failure (HF) with preserved ejection fraction (HFpEF) is the most common form of HF in the U.S and most commonly affects older women with overweight/obesity. Given known systemic microvascular effects of HFpEF, dementia risk may be a potential unrecognized downstream effect of the disease.MethodHarmonized cognitive testing and brain MRI protocols were employed in Wake Forest’s Alzheimer’s Disease Research Center’s Clinical Core and the SECRET‐2 clinical trial of HFpEF. Cognitive tests included components of NACC’s Uniform Data Set version 3. Brain imaging protocols included structural MRI and cerebral blood flow images. Statistical comparisons of cognitive and imaging data by cognitive/group status were done using multivariable general linear models adjusting for basic covariates including age, race, and sex in basic models and additional adjustments for intracranial volume (for MRI) and education (for cognitive test scores) in fully adjusted models using SAS 9.4.ResultThe analysis includes a comparison of 89 participants recruited into the Wake Forest ADRC (adjudicated as cognitively normal, n=43; MCI, n=22; and dementia, n=5) and SECTRET‐2 intervention trail in HFpEF (n=19) patients. Compared to cognitively normal participants, patients with HFpEF were significantly more likely to be Black (47% vs 2%, p<0.01), have a higher body mass index (38.2 vs. 28.0, p<0.01), and a diagnosis of hypertension (84% vs 26%). Patients with HFpEF had poorer global cognitive performance [MoCA score, beta(SE)=‐1.76(0.77), p=0.02)], but no differences in Craft Story delayed recall in models adjusted for age, gender, race and education. HFpEF was also significantly associated with smaller gray matter volume [beta(SE)=‐20.7(11.6), p=<0.01)] at levels worse than MCI and dementia in models adjusted for age, gender, race and ICV. No initial differences were observed in resting cerebral blood flow or evoked cerebrovascular response due to hypercapnia.ConclusionHFpEF participants showed deficits in global cognitive function that were comparable to those with MCI, as well as global decreases in brain volume. Additional follow‐up of these participants with HFpEF will more deeply phenotype cognitive impairments by domain and adjudication criteria used for MCI and dementia.
Anterolateral entorhinal cortical thinning as a biomarker for Alzheimer’s disease in Down syndrome
Authors: Sathishkumar Mithra , Janecek John , Smith Anna , Phelan Michael , Tustison Nick , Keator David , Doran Eric , Hom Christy , Nguyen Dana , Petersen Melissa , Rosas H. Diana , Lai Florence , Brickman Adam M , Schupf Nicole , Silverman Wayne , Lott Ira T , O'Bryant Sid , Yassa Michael A. 
Published: December 2020

AbstractBackgroundVirtually all adults with Down syndrome (DS) develop Alzheimer’s disease (AD) associated neuropathology by the age of 40 and the majority of them develop dementia by age 60. Atrophy of the anterolateral entorhinal cortex (aLEC) has been previously associated with cognitive decline. Here, we sought to determine whether aLEC thinning is associated with clinical impairment in older adults with DS as well as whether it is associated with blood neurofilament light chain (NfL), another biomarker of neurodegeneration in AD.Method103 older adults with DS enrolled in the Alzheimer’s Disease in Down Syndrome (ADDS) study were included in this analysis. Scans were classified into 3 groups based on consensus diagnosis: 14 (6F) possible/definite dementia (DEM), 19 (5F) mild cognitive impairment (MCI‐DS) and 70 (28F) cognitively stable (CS). Images were processed through the joint label fusion (JLF) pipeline in ANTs to obtain medial temporal lobe subregional volumes and thickness. Cortical reconstruction was performed using Freesurfer 6.0 to obtain total intracranial volume (ICV). We used a multiple linear regression model to fit left aLEC thickness using diagnostic group as the independent variable, correcting for age, gender, ICV and scan site differences. For a subset of these data (N = 89), plasma NfL was quantified using a Simoa platform and we and tested whether left aLEC thickness was associated with NfL.ResultCortical thickness in left aLEC was a significant predictor of clinical status. Thickness values were highest in the CS group, followed by MCI‐DS, followed by DEM. Groupwise differences were significant in DEM vs. CS and DEM vs. MCI‐DS comparisons. We also found a significant correlation between NfL and left aLEC thickness specifically in the DEM group. Finally, random forest classification showed that both NfL and left aLEC thickness were important features in predicting clinical diagnosis DEM vs MCI‐DS. Their estimates provided a diagnosis ROC curve with sensitivity of 0.79 and specificity of 0.92.ConclusionIn older adults with DS, left aLEC cortical thickness atrophy may be a primary feature of structural neurodegeneration that is associated with MCI‐DS and a blood‐based measurement of NfL may be informative as to this structural degeneration.
Detecting amnestic MCI among persons with HIV with high rates of HIV‐associated neurocognitive disorder
Authors: Sundermann Erin E. , Bondi Mark W. , Umlauf Anya E. , Vaida Florin , Moore David J. 
Published: December 2020

AbstractBackgroundHIV‐associated neurocognitive disorders (HAND) occur in ∼45% of people with HIV (PWH). Older PWH are at‐risk for both HAND and age‐associated disorders including Alzheimer’s disease (AD) and its precursor, amnestic mild cognitive impairment (aMCI). Distinguishing aMCI from HAND among PWH is a diagnostic challenge given that both aMCI and HAND criteria include memory deficits. Differences between aMCI and HAND may include a more amnestic (recall and recognition deficits) and degenerative profile in aMCI versus milder (recall but not recognition deficits) and typically stable memory deficits in HAND. We exploited these differences to classify PWH based on aMCI+/‐ and HAND+/‐ status and compared trajectories of learning, recall and recognition performance among these classification groups.MethodAnalyses included 685 PWH (ages 18‐79, 88% men) from the UCSD HIV Neurobehavioral Research Program. At baseline, aMCI status was determined based on a neuropsychological classification approach (Jak/Bondi) requiring impairment (<1.0 SD below normative mean) on two tests of recall and/or recognition (at‐least one recognition impairment required) from the Hopkins Verbal Learning Test‐Revised (HVLT‐R) and the Brief Visuospatial Memory Test‐R (BVMT‐R). HAND was diagnosed based on standard Frascati criteria. Using additive mixed model, trajectories of learning (averaged HVLT‐R and BVMT‐R learning scores), recall (averaged HVLT‐R and BVMT‐R recall scores) and HVLT‐R and BVMT‐R recognition z‐scores adjusted for age, sex, race and education were compared among classification groups.ResultParticipants were classified into four groups: aMCI‐/HAND‐ (n=243), aMCI‐/HAND+ (n=199), aMCI+/HAND‐ (n=62) and aMCI+/HAND+ (n=181). There were significant diagnostic group X time interactions on learning and HVLT‐R and BVMT‐R recognition, but not recall (Figure 1). Learning showed significant change over time in the aMCI+/HAND+ and aMCI‐/HAND+ groups only. All groups showed significant, yet variable, patterns of change in HVLT‐R recognition. BVMT‐R recognition showed significant change over time in aMCI+/HAND‐ and aMCI+/HAND+ groups. Recall was poorest in the aMCI+/HAND+ versus other groups across time.ConclusionFindings suggest that PWH with memory impairment combined with other cognitive deficits at baseline show the worst memory profiles over time. Research is needed into methods of differentiating other MCI subtypes from HAND and into potential compounding effects of AD‐ and HAND‐related pathologies.
AgeWell.de (Germany)
Authors: Roehr Susanne , Hoffmann Wolfgang , Thyrian Jochen René , Kaduszkiewicz Hanna , Frese Thomas , Gensichen Jochen , Haefeli Walter E. , Czock David , König Hans‐Helmut , Wiese Birgitt , Riedel‐Heller Steffi G. 
Published: December 2020

AbstractBackgroundBased on the share of the population aged 65 years and older, Germany is among the world's oldest countries. Therefore, dementia prevention is a very important public health target. AgeWell.de is the first large‐scale multi‐component lifestyle intervention trial against cognitive decline in Germany. It has been designed with a specific focus on a pragmatic approach to allow easy translation into routine care.MethodAgeWell.de is an ongoing multi‐centric, cluster‐randomized controlled multi‐component lifestyle intervention trial aiming at preventing or delaying cognitive decline. Participants are older community‐dwelling general practitioner (GP) patients (60–77 years; n > 1,000) with increased dementia risk according to the CAIDE (Cardiovascular Risk Factors, Aging, and Incidence of Dementia) dementia risk score. The multi‐component intervention A includes nutritional counseling, physical activity, cognitive training, optimization of medication, management of vascular risk factors, social activity, and, if necessary, further specific interventions targeting grief and depression. Intervention B includes general health advice regarding the intervention components and GP treatment as usual. The observation period is two years. Trained study nurses conduct structured interviews including a comprehensive neuropsychological test battery at baseline and follow‐ups, complemented by motivational telephone sessions with the intervention group.ResultsRecruitment and baseline assessments have been completed. Baseline characteristics of the study sample will be presented at AAIC.ConclusionAgeWell.de covers a broad set of lifestyle interventions. We therefore hope to add additional knowledge on how to effectively shape dementia prevention programs in the future.
MIND China (China)
Authors: Wang Yongxiang , Qiu Chengxuan , Cong Lin , Tang Shi , Hou Tingting , Liu Cuicui , Du Yifeng 
Published: December 2020

AbstractBackgroundEpidemiologic studies have estimated that around one‐third of dementia patients worldwide might be attributable to seven modifiable risk factors. This implies that interventions to improve the control of modifiable risk factors may delay the onset of age‐related cognitive disorders such as dementia. We presented the study design and progress of the ongoing randomized controlled multimodal interventions to delay dementia and disability in rural China (MIND‐CHINA).MethodsMIND‐CHINA is designed as a 2‐year cluster‐randomized, controlled, multimodal intervention study, which targets people who are aged 60‐79 years and living in the rural communities of Yanlou Town, western Shandong Province, China. Following the baseline examination, 52 villages in Yanlou Town are randomly (cluster‐randomization) divided into three groups: control group (regular primary health care service), vascular intervention group, and multimodal intervention group. The multimodal intervention program consists of four modules that are sensitive to Chinese lifestyle and sociocultural tradition; medical control of vascular risk factors; lifestyle and nutritional guidelines; group physical exercise and personalized leisure activities; and cognitive training.ResultsIn March‐October 2018, we carried out baseline assessment for MIND‐CHINA that integrated our special examinations with the National Primary Health Care Services, during which 5764 persons were examined. We collected the following data through face‐to‐face interviews, clinical examination, testing, and laboratory tests: epidemiological, clinical, and biochemical data as well as physical function, cognitive function, mild cognitive impairment, and dementia. In May‐September 2019, the pilot study was completed to test the feasibility of the intervention programs and the implementation procedure in 7 villages (2 villages in control group, 3 villages in vascular intervention group, and 2 villages in multimodal intervention group). Recruitment of participants for interventions started in Oct/November 2019, and 2265 participants have been successfully recruited so far.ConclusionIt is feasible to integrate a comprehensive health examination program with local primary health care services in rural‐dwelling elderly Chinese people. MIND‐CHINA will be likely to address whether multimodal interventions sensitive to Chinese lifestyle and socioculture help maintain cognitive and physical functioning among community‐dwelling elderly people in rural areas.
APOE4 carrier identification, genetic disclosure and amyloid status: Results from the generation 2 program Alzheimer's disease prevention clinical trial at Glasgow Memory Clinic
Authors: Lynch Jennifer , Hendry Kirsty , Lee Emma , Wallace Lorna , Williamson Susan , Main Laura , Cranmer Alison , Inglis Fraser 
Published: December 2020

AbstractBackgroundResearch has demonstrated that the APOE‐ε4 genotype is a genetic risk factor for Alzheimer’s Disease (AD) and individuals with this genotype are also at increased risk of having higher levels of β‐amyloid (Aβ); a neurochemical indicator of AD. [1]The Generation 2 Study, co‐sponsored by Novartis, Amgen and the Banner Alzheimer Institute, investigated the impact of experimental medications on Aβ levels and whether this can result in later onset of AD in those identified as having higher genetic risk. Here, we show the Generation 2 Study screening activity completed at Glasgow Memory Clinic until the early cessation of this clinical trial.MethodTo identify subjects with the APOE‐ε4 variant of this gene, a high‐volume screening route was used. Buccal swabs were obtained and analysed. Those who were identified as having at least one copy of the APOE‐ε4 genotype were invited to participate in the Generation program at Glasgow Memory Clinic. The Generation 2 Study pre‐dominantly focused on the recruitment of carriers of one copy of the APOE‐ε4 allele. An elevated Aβ result was also required, as measured by a PET scan and/or lumbar puncture procedure, to be eligible for randomisation.Result3672 buccal swabs were obtained during recruitment for the Generation program. Of these, 1056 were heterozygous for APOE‐ε4. 653 were screened and disclosed as heterozygous for APOE‐ε4 with 421 of these subjects enrolled in the Generation 2 Study. 223 subjects attended for amyloid testing. It was found that 72 subjects (32%) had elevated amyloid level as determined by PET scan or lumbar puncture. 61 subjects were randomised into the Generation 2 Study at the time of early termination of this clinical trial.ConclusionThe Generation 2 Study enabled the effective identification of previously unidentified APOE‐ε4 carriers with elevated Aβ. This site’s screen fail rate was as anticipated with the majority of screen fails due to non‐elevated amyloid results.
A short assessment tool for small vessel disease with cognitive impairment: The Virtual Supermarket (VSM)
Authors: Boz Hatice Eraslan , Limoncu Hatice , Zygouris Stelios , Tsolaki Magda , Giakoumis Dimitris , Votis Konstantinos , Tzovaras Dimitris , Öztürk Vesile , Yener Görsev 
Published: December 2020

AbstractBackgroundDetailed neuropsychological assessment is essential to detect cognitive impairment in SVD. Therefore, a brief cognitive test is needed as an alternative to extensive assessment (Peng et al., 2019). The aim of this study is to examine cognitive functions between SVD with cognitive impairment (SVD‐CI), cognitively normal SVD (SVD‐CN), and healthy controls (HC) using the Virtual Supermarket (VSM) application and whether the VSM correlates the traditional pencil‐and‐paper neuropsychological tests.MethodThirty‐two SVD‐CI, 37 SVD‐CN and 30 HC were included the study. All participants were applied to virtual reality‐based VSM with tablet and comprehensive neuropsychological tests. (Zygouris et al., 2015; Eraslan‐Boz et al., 2019).ResultSVD‐CI patients were poorer performance in “Correct Types” (p<0.05), “Correct Money” (p < 0.05) and “Duration” (p < 0.001) compared to HC; and in “Bought Unlisted” (p < 0.05) and “Duration” (p < 0.001) compared to SVD‐CN. However, there was no significant difference between SVD‐CN and HC in VSM variables. In addition, all VSM variables had a discrimination ability with 81% correct classification rate (CCR), 78% sensitivity, and 83% specificity over SVD‐CI and HC. Moreover, “Duration” variables of the VSM was moderately related to composite z‐scores of general cognitive status (r = ‐0.491, p < 0.001), memory (r = ‐0.509, p < 0.001), language (r = ‐0.404, p = 0.001) and visuospatial functions (r =‐0.593, p < 0.001). “Correct Types” (rpb = ‐0.301, p = 0.012) and “Correct Money” (rpb = ‐0.335, p = 0.005) was associated with visuospatial function on SVD groups.ConclusionThis study is the first to evaluate cognitive functions by means of the VSM in SVD in a Turkish speaking population. This study provides encouraging preliminary findings about possibility of the VSM as a tool in the assessment of cognitive impairment and differentiation SVD‐CI from HC.
“Dempathy” ‐ From empathy to synchronization in understanding people with dementia
Authors: Chui Kenny Chi Man 
Published: December 2020

AbstractBackgroundIn Hong Kong, dementia is one of the significant reasons for the family caregivers to send their beloved one to the residential care homes. Nevertheless, over 50% of current residents are in cognitive impairment and different stages of dementia. The caring staff face a lot of challenges and uncertainty, even worries and anxiety in taking care of people with dementia. How to facilitate the care staff to implement person‐centred care is what we all would like to find out. The research began two reflective training sessions, each of which lasted 90 minutes with over 25 frontline care staff, by presenting some of the subjective experiences of residents with dementia with the aim of arousing empathy for their self‐perceptions. Afterwards, I asked the attendees a series of reflective questions as prompts to promote their reconsideration of how people with dementia might be cared for by following the person‐centred approach. The same semi‐structured questions were designed for both focus groups to gain insight into the staff’s thoughts about the self‐perception of people with dementia and the reflective training. The participating care staff had reflected upon their attitudes, skills and knowledge related to dementia care. Hardly any care staff reported having ever thought about the self‐perception or subjective views of people with dementia. On the contrary, they had assumed that people with dementia were incapable of giving rational responses and that it was therefore unnecessary to listen to their points of view. Themes including (1) From Stigmatization to Acceptance; (2) From Perceiving the Patient to Perceiving the Person; (3) From Ignoring to Responding; (4) From Being Tasked‐Oriented to Being Relationship‐Oriented; (5) From Denying to Recognizing People with Dementia were found. In the focus groups, however, the care staff suggested that they had become aware of ways to understand people with dementia from their perspectives and in their context. The implementation of person‐centred approach is associated with the change of caring attitude and perception of dementia at the fundamental level. The reflective training facilitated the care staff to transform from empathy to synchronization towards the context of people with dementia, which I called “Dempathy”.