bluuebunny/crossref_metadata_2025_split huggingface dataset:
Energy intake and expenditure in patients with Alzheimer’s disease and mild cognitive impairment: The NUDAD project
Authors: Doorduijn Astrid S , de van der Schueren Marian , van de Rest Ondine , de Leeuw Francisca A , Hendriksen Heleen MA , Teunissen Charlotte E , Scheltens Philip , van Der Flier Wiesje , Visser Marjolein 
Published: December 2020

AbstractBackgroundMalnutrition is common in patients with Alzheimer’s disease (AD) dementia and mild cognitive impairment (MCI) and is associated with institutionalization and increased mortality. Malnutrition is the result of a negative energy balance, which could be due to reduced dietary intake and/or higher energy expenditure. To study underlying mechanisms for malnutrition, we investigated dietary intake and resting energy expenditure (REE) of patients with AD dementia, MCI and controls. In addition, we studied associations of global cognition (Mini‐Mental State Examination (MMSE)) and AD biomarkers with dietary intake and REE.MethodWe included 219 participants from the NUDAD project, 71 patients with AD dementia (age: 68 ± 8 years, 58% female, MMSE 24 ± 3), 52 with MCI (67 ± 8 years, 42% female, MMSE 26 ± 2) and 96 controls (62 ± 7 years, 52% female, MMSE 28 ± 2). We used a 238‐item food frequency questionnaire to assess dietary intake (energy, protein, carbohydrate and fat). In a subgroup of 92 participants (30 patients with AD dementia, 22 with MCI and 40 controls) we measured REE with indirect calorimetry. Between‐group differences in dietary intake and REE were tested with ANOVAs. In the total sample, linear regression analyses were used to explore potential associations of MMSE score and AD biomarkers with dietary intake and REE. All analyses were adjusted for age, sex, education, and body mass index or fat‐free mass.ResultPatients with AD dementia and MCI did not differ from controls in total energy intake (1991±71 and 2172±80 vs 2022±61 kcal/d, p>0.05) nor in protein, carbohydrate or fat intake. Patients with AD dementia and MCI had a higher REE than controls (1704±41 and 1754±47 vs 1569±34 kcal/d, p<0.05). We did not find an association of MMSE score or AD biomarkers with dietary intake or REE.ConclusionWe found a higher resting energy expenditure, despite similar energy intake in patients with AD and MCI compared to controls. These findings suggest that elevated metabolism rather than reduced energy intake explains malnutrition in AD. These results could be useful to optimize dietary advice for patients with AD dementia and MCI.
Magnetic resonance imaging subtypes in subjective cognitive decline
Authors: Diaz‐Galvan Patricia , Poulakis Konstantinos , Grothe Michel J. , Fripp Jurgen , Maruff Paul T. , Rowe Christopher C. , Dore Vincent , Barroso Jose , Ferreira Daniel , Westman Eric 
Published: December 2020

AbstractBackgroundOlder adults who do not meet clinical criteria for mild cognitive impairment (MCI) or dementia, but who report progressive change in their cognitive abilities (i.e. subjective cognitive decline, SCD) are at increased risk for developing Alzheimer’s disease (AD). However, SCD can be associated to other conditions and its heterogeneity needs to be investigated further. In patients with AD dementia, data‐driven approaches to biological information have been useful in disentangling heterogeneity. We therefore utilized a data‐driven clustering method on regional structural magnetic resonance imaging (MRI) data to identify subtypes of SCD.MethodCognitively normal adults with SCD (n=86) and without SCD (n=68) from the AIBL cohort were studied. Clusters of SCD were determined based on 82 cortical and subcortical grey matter volumes using random forest pairwise similarity, multidimensional scaling, and distance‐based hierarchical clustering. The number of clusters was decided according to Carlinski‐Harabasz index. We also studied neuroanatomical, clinical, cognitive, and genetic characteristics at baseline, and clinical and cognitive progression over 7.5 years of follow‐up.ResultsThe data driven analyses yielded four SCD subtypes. The largest proportion (49%) showed regional volumes equivalent to those without SCD. Nonetheless, this group could be divided into two subtypes depending on the volume of the thalamus (no atrophy + low thalamic volume, 35%; and no atrophy + high thalamic volume, 15%). We also identified a Hippocampal‐sparing SCD subtype (32%), which displayed reduced cortical volumes but normal volume of the hippocampus; and a Diffuse SCD subtype (16%), which displayed reduced volume in both the hippocampus and cortical regions. Diffuse, Hippocampal‐sparing, and no atrophy + low Thalamic volume SCD subtypes were each associated with increased risk for MCI or dementia over 7.5 years, and showed faster decline in MMSE. The Diffuse SCD subtype was also characterized by an increased amyloid‐PET burden, small vessel disease (white matter hypointensities), and worse CDR scores at baseline.ConclusionsData‐driven analyses of structural MRI data revealed that SCD characterized by a Diffuse, Hippocampal‐sparing, or no atrophy with a low Thalamic volume pattern were at increased risk for MCI or dementia. Thus, these data‐driven methods show great potential for disentangling biological heterogeneity within SCD.
Dietary patterns and cognitive decline among older adults: Findings from Sydney Memory and Aging Study
Authors: Chen Xi Sophie , Oleary Fiona , Liu Zhixin , Brodaty Henry 
Published: December 2020

AbstractBackgroundEvidence suggested dietary patterns that may protect against cognitive decline among older adults, are mostly plant‐based, rich in poly‐/mono‐ unsaturated fatty acids, and low in processed foods. We aim to examine associations between diet with cognition and cognitive decline among older adults over a 6‐year period in Sydney Memory and Aging Study.MethodCommunity dwelling participants (n=1037) were non‐demented and aged 70‐90 years at baseline. Diet was assessed using the 80‐item Cancer Council of Victoria FFQ at baseline, Mediterranean diet scores and DASH diet scores were generated based on dietary intake for individuals. Using PCA we have derived a‐posterori patterns. Neuropsychological tests assessed global cognition and 6 cognitive domains for 4 times, at baseline and followed up every two years. Linear mixed model analyses were conducted to examine the relationship between dietary scores, cognitive health, and cognition change over time, with adjustment for age, gender, education, BMI, cardiovascular risk factors, history of stroke, smoking, depression and APOE ε4 genotype.ResultNo significance was found between adherence to Mediterranean diet or DASH diet, and cognitive decline over 6 years. However, a total intake of legumes and nuts, was positively associated with better overall performance in cognitive domains including language (β=0.058; 95% CI: 0.028, 0.113; P=0.040), visuospatial (β=0.048; 95% CI: 0.008, 0.089; P=0.019) and global cognition (β=0.059; 95% CI:0.005, 0.112; P=0.033). The prudent healthy diet pattern was associated with cognitive health in women over time, in domains of memory (β=0.332; 95% CI: 0069, 0.596 ; P=0.014), verbal memory (β=0.313; 95% CI:0.056 ,0.569 ; P=0.017), visuospatial (β=0.271; 95% CI: 0.005,0.440; P=0.009), executive (β=0.352; 95% CI:0.073, 0.631; P=0.014), attention processing speed (β=0.273; 95% CI: 0.039,0.507 ; P=0.022) and global cognition (β=0.426; 95% CI: 0.141,0.711 ; P=0.004).ConclusionIn this longitudinal analysis, a prudent healthy diet and high total intake of legumes and nuts, were associated with better cognitive performance over 6 years in various domains among older adults. Adherence to Mediterranean or DASH diet was not associated with cognitive change overtime.
Analysis of users' needs for developing a mobile health–based lifestyle care application for health promotion in elderly
Authors: Park Kang‐Hyun , Park Ji‐Hyuk , Won Kyung‐A , Yang Min Ah , Lim Seungju 
Published: December 2020

AbstractBackgroundRecently, Individuals who want to be provided mobile based health services for improving their health and quality of life are increasing. The demand regarding mobile health care services and wearable device are increased gradually in order to monitor their health wherever they are. Therefore, the purpose of this study is to analysis of user’s needs for developing mobile health based lifestyle care application for health promotion in elderly.MethodParticipants who lived in their community and used mobile phone were recruited. Finally, a questionnaire survey was conducted to 84 people. Data was anlaysized using descriptive statistics and t‐test with the SPSS version 25.0.ResultAs a result, the important functions for lifestyle care app which consumers are need are the number of daily steps, physical activities, blood pressure, sleep, nutrition and activity participation. Interestingly, in terms of the importance of activity participation as a function of the app, there was a significantly differences between age groups.ConclusionThis study investigated user’s needs and preference in order to develop and design mobile health based lifestyle care application for health promotion in elderly. Therefore, findings from this study could be valuable resource for developing lifestyle care app.
A polygenic risk score for Alzheimer’s disease determines the risk of incident dementia in APOE ɛ4 negative individuals over the age of 95: A population‐based cohort study
Authors: Najar Jenna , Joas Erik , Van Der Lee Sven J. , Wetterberg Hanna , Guerreiro Rita , Bras Jose , Hardy John A. , Waern Margda , Kern Silke , Zetterberg Henrik , Blennow Kaj , Skoog Ingmar , Zettergren Anna 
Published: December 2020

AbstractBackgroundThe combined effect of common genetic variants (SNPs) into polygenic risk scores (AD‐PRS) have been shown to have a strong influence on incident AD between ages 60 and 95 years, especially in carriers of the APOE ϵ4 genotype. However, few studies have investigated the effect of AD‐PRS on incident dementia in the general population and among the oldest old (≥ 95 years).MethodA population‐based sample of 2053 participants aged 70‐108 years, from the Gothenburg H70 Birth Cohort Studies, Sweden, was followed for incident dementia. An AD‐PRS (39 SNPs) were constructed using effect sizes from large genome‐wide association studies. Dementia was diagnosed according to DSM‐III‐R based on information from neuropsychiatric examinations and close informant interviews. Cox regression models adjusted for sex, birth year, age at blood sampling, and APOE ϵ4 status, were used to analyse the associations between AD‐PRS and incident dementia in the total sample and in the oldest old (n = 338). Additionally, we stratified the analysis by APOE ϵ4 carriership and tertiles of the AD‐PRS.ResultDuring mean follow‐up of 7.19 years (SD 4.68; 14,775.25 person‐years), 607 participants developed dementia (220 over the age of 95 years). In the total sample, AD‐PRS was associated with incident dementia (HR per increased point of the score 1.38; 95%CI 1.12‐1.73, p = 0.003), especially among APOE ϵ4 non‐carriers (HR 1.72; 95%CI 1.33‐2.23, p < 0.0001). Among the oldest old, AD‐PRS was associated with incident dementia in APOE ϵ4 non‐carriers only (HR 1.80; 95%CI 1.20‐2.69, p = 0.004). Further, in this age group, APOE ϵ4 carriership was associated with increased risk of dementia only among those in the low‐risk tertile of AD‐PRS (HR 1.84; 95%CI 1.08‐3.12, p = 0.004).ConclusionWe found an association between AD‐PRS and dementia in the general population up to very old ages, especially among APOE ϵ4 non‐carriers. In the oldest old, an effect of APOE ϵ4 carriership on dementia risk was observed among individuals in the low‐risk tertile of the AD‐PRS. These results could provide additional information to identify individuals at risk for dementia.
Genetic risk of Alzheimer’s disease is linked to short sleep duration
Authors: Leng Yue , Ackley Sarah F , Glymour M Maria , Yaffe Kristine , Brenowitz Willa D 
Published: December 2020

AbstractBackgroundSleep disturbances including short sleep duration are common in older adults, especially in those with Alzheimer’s disease (AD). However, it is unclear to what extent sleep duration is a manifestation of AD disease process. We examined whether genetic variants related to AD influence sleep duration in middle‐aged and older adults using a Mendelian randomization (MR) approach.MethodWe examined 406,687 UK Biobank participants without dementia at enrollment, with Caucasian genetic ancestry, and who self‐reported sleep duration at baseline (2006‐2010). Sleep duration was assessed by asking: “About how many hours sleep do you get in every 24 hours? (please include naps).” A genetic risk score for AD (AD‐GRS) was calculated as a weighted sum of 23 previously identified AD‐related single nucleotide polymorphisms in individuals of European ancestry. AD diagnosis was assessed over follow‐up (to 2018) based on ICD‐9/10 codes. We evaluated whether genetic risk for AD influenced sleep duration using two steps: first we used linear regression to examine the association between AD‐GRS and sleep duration, adjusting for age, sex and principle components for genetic ancestry. Next, we conducted a two‐stage least square regression using AD‐GRS as an instrumental variable for AD diagnosis to estimate the magnitude of the effect of AD on sleep duration. We also stratified the analysis by age at baseline (≤55y or >55y).ResultParticipants (aged 56.91±8.00y) had an average sleep duration of 7.2 (Standard deviation [SD]=1.1) hours and AD‐GRS of 0.11 (SD=0.40; range:‐1.15∼1.85). Higher AD‐GRS score predicted shorter sleep duration (b= ‐0.013, 95%CI:‐0.022,‐0.005), mainly among those aged over 55y (b= ‐0.023, 95%CI:‐0.034,‐0.012) and not in those 55y or younger (b= 0.006, 95%CI:‐0.012,0.013); p for interaction by age=0.02. Analysis using AD‐GRS as an instrumental variable for AD diagnosis suggested that participants with AD diagnosis had 1.76 hrs (b=‐1.76, 95%CI: ‐2.62, ‐0.90) shorter sleep duration in those aged >55y.ConclusionUsing a novel analytical approach, we found that higher genetic risk for AD predicted shorter sleep duration among older adults. This suggests shared genetic pathways; the biologic processes that lead to AD may also affect sleep duration.
An observational study in real world daily clinical practice to evaluate the effect of the medical food Souvenaid on instrumental activities of daily living in people with mild Alzheimer’s disease
Authors: Ziere Gijsbertus , Vanneste Vincent G. , Kalisvaart Kees , de Wilde Janneke , Boelaarts Leo , Sikkes Sietske A.M. 
Published: December 2020

AbstractBackgroundAlzheimer’s disease (AD) coincides with a progressive decline in instrumental activities of daily living (iADL), such as cooking and everyday technology. Souvenaid is a medical food designed to enhance synapse formation and function; it contains the specific nutrient combination Fortasyn Connect. Randomized controlled trials showed beneficial effects on memory in mild AD patients and on the cognitive‐functional outcome CDR‐SB and hippocampal atrophy in prodromal AD. In this observational study we evaluated the effects of Souvenaid on iADL of people with mild AD in real‐world, daily clinical practice.MethodParticipants were recruited from specialized memory clinics and received the medical food once a day. iADL were assessed at baseline, 6 months follow‐up, and optionally at 12 months follow‐up, using the Amsterdam iADL questionnaire (A‐IADL). Changes in A‐IADL scores were compared with a reference population (n=57), using a one‐sample t‐test. Exploratory sub‐group analyses will also be presented.Result116 participants were enrolled in the study. Self‐reported adherence to Souvenaid was high. The 6‐month change from baseline in A‐IADL was significantly less than the dementia reference population (‐1.56 [SD 6.71] vs. ‐3.68 respectively, p=0.009). The effect was maintained in participants completing the 12‐month period with a mean change from baseline of ‐3.12 (SD 8.04) compared with the reference value of ‐7.35 (p=0.011). People using AD medication showed a mean 6‐month change from baseline of ‐1.29 [SD 5.38]. People not using AD medication showed a mean change of ‐1.65 [SD 7.14]. Participants completing the 12‐month period showed a mean change of ‐5.62 [SD 6.19] when using AD medication and ‐2.06 [SD 8.63] when not using AD medication. In individuals with baseline MMSE > median, 6‐month change from baseline was ‐1.34 [SD 5.76] and ‐1.99 [SD 7.86] in individuals when baseline MMSE < median, whereas the 12‐month changes from baseline were ‐4.24 [SD 7.32] and – 1.91 [SD 8.89], respectively.ConclusionPeople with mild AD receiving Souvenaid showed less decline in iADL over 6 and 12 months compared with a reference population. This observational study suggests that this specific medical food might have an impact on iADL in mild AD in a real‐world clinical setting.
The prevalence, associated factors, and the burden on health state utilities for dementia in Chile
Authors: Zitko Pedro , Slachevsky Andrea , Jimenez Daniel 
Published: December 2020

AbstractBackgroundNew procedures based on attributional methods have not been used to estimate the burden of Dementia in term of loss of Health‐State Utilities (HSU) or Quality‐Adjusted Life Years (QALY) at the populational level. Chile, in recent decades, has presented an accelerated aging process and has few studies on dementia.MethodWe analysed data from the Chilean National Health Survey carried out between 2016‐2017 (n=5,004). Participants older than 59 years were screened for dementia, defined by a score higher than 5 in the Pfeffer and lower than 13/19 points in a modified MMSE‐version, previously validated in Chile. HSU were measured using the health‐related quality of life instrument EQ5D plus national values for utilities for each health state. The number and fraction of total HSU lost due to dementia were calculated using attributable fraction methods. We repeated the procedure on each one of five domains of EQ5D. Factors associated with dementia were explored using a logistic regression model. Other comorbidities (depression, chronic musculoskeletal pain, hypertension, diabetes) were included in the models.ResultWe estimated a prevalence of 4.4% [2.9‐5.9] for dementia in people older than 59 years. Dementia, compared with other comorbidities, showed the highest loss of HSU, accounting 38.3 [26.0‐50.6] additional points of loss of HSU over the score from those without dementia (where 0 means healthy, and 100 is equivalent to death). Prevalent cases of dementia were associated with a loss of 41,046 QALYs [29,727 – 52,158], which was equivalent to a 5.0% [3.0‐7.6] of total burden among elderlies, and 1.5% [0.9‐2.4] in the population older than 14 years. ‘Self‐care’ was the domain were dementia accounted higher burden followed by ‘usual activities’ (see figure). Age was associated with dementia, while male sex, lower education, widower compared with married, and some comorbidities showed high OR but without reaching statistical significance.ConclusionDementia at the population level showed a high impact in terms of QALY lost, as well as at the individual level in terms of loss of HUS, overpassing to other diseases. Key domains of quality of life affected higher for Dementia were self‐care and usual activities. FONDAP Program Grant 15150012.
Sniffin' Sticks Screening 12 Test can assist in the clinical distinction between psychiatric disorders and neurological/neurodegenerative disorders
Authors: Pachi Ioanna , Evans Andrew H , Loi Samantha M , Eratne Dhamidhu , Malpas Charles B , Walterfang Mark , Farrand Sarah , Kelso Wendy , Velakoulis Dennis 
Published: December 2020

AbstractBackgroundDistinguishing primary psychiatric disorders (PPD) from neurological/neurodegenerative disorders (NND) is a common diagnostic dilemma in clinical practice. Numerous studies have focused on whether cognitive, neuroimaging or blood/ cerebrospinal fluid (CSF) are of assistance in this clinical scenario. Olfactory impairment has not however been systematically examined as a clinical tool for this purpose. The aim of this study was to identify whether performance in olfactory identification can distinguish NND and PPD.MethodThis was a cross‐sectional retrospective study of inpatients assessed in Neuropsychiatry, Royal Melbourne Hospital (RMH) over the period 2015‐2019. Neuropsychiatry is a tertiary / quaternary service which provides diagnostic work up for patients with cognitive, psychiatric and neurological symptoms. Data extracted from the admission records included: demographics, tobacco use, medical comorbidities, cognitive function using the Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG), and odour identification assessed using the Sniffin’ Sticks Screening 12 Test (SS12). The final discharge diagnosis for all patients was informed by established diagnostic criteria.Result121 patients were identified who had valid Sniffin Stick testing over this period. 88 patients (72.7%) were diagnosed with NND (mean age‐ 60, including Alzheimer’s dementia, frontotemporal dementia, Lewy body parkinsonian‐related dementias [Parkinson’s disease, Multiple Systematic Atrophy, Dementia with Lewy bodies] and other neurological causes of dementia), 33 patients (27.3%) were diagnosed with PPD (mean age=57 years, including mood and psychotic disorders). Patients who scored ≤8 in SS12 were more likely to have NND than PPD, even after adjustment for age, gender and tobacco use [(p=0.005, unadjusted OR=3.51, 95% CI=1.463,8.410), (p=0.009, adjusted OR=3.848, 95% CI=1.395,10.617)]. Receiver Operating Curve (ROC) analyses demonstrated that a score of ≤8 differentiated NND from PSY with sensitivity of 56.8% and specificity of 72.7% (ROC area under the curve of 0.672, p=0.004).ConclusionPatients presenting with diagnostically complex neurocognitive / neuropsychiatric difficulties who score 8 or less on Sniffin’ Sticks are more likely to have a neurodegenerative illness. A cut‐off score of 8 is potentially a “red‐flag” for clinicians faced with the diagnostic question of PPD versus NND.