bluuebunny/crossref_metadata_2025_split huggingface dataset:
VADEC program: Cognitive impairment (CI) assessment in Spain
Authors: Palomo María Sagrario Manzano , Maiztegui Covadonga Fernandez , Vila Eduardo Martinez 
Published: December 2020

AbstractBackgroundAnalyze the controversies in diagnosis and neuropsychological approach of patients with CI. Achieve a consensus of Good Clinical Practice Guidelines (GCPG) that stablish which cognitive tests are suitable.MethodVADEC program is based on Delphi Methodology in order to reach to a consensus about diagnostic criteria and cognitive assessment scales more suitable in CI, and its relationship with epidemiologic and diagnostic guidelines or bibliographic sources published. The specific questionnaire was completed by neurologists specialized in dementia in Spain. It was proposed many items or questions (1‐9 scores), and decide the median value, the confidence degree and the group consensus achieved.ResultThe program was developed from 1st June to 31th July 2017. 130 neurologists were involved (21 years of clinical practice) in public system (90.8%). About 38.67 % of patients had CI, 41.15% moderate and 20.18% severe. There was a consensus of using Petersen criteria to define MCI as a syndrome. MMSE is considered the most useful tool, followed by Clock Drawing test (CDT), Friedman or MOCA test. It´s necessary to have more information, over all in DSM‐V, and the convenience of elaborating a GCPG which harmonized MCI criteria.ConclusionThere was a great consensus about using MMSE or MEC test. There was a wide consensus about the utility of MoCA, CDT and Friedman test. These results express the necessity of GCPG in CI about the use of cognitive test in Spain.
Application of transcranial direct current stimulation (tDCS) to enhance attention, visuo‐motor coordination and executive function in older adults with mild cognitive impairment
Authors: Ho‐yin Lai Frank 
Published: December 2020

AbstractBackgroundExtensive research had shown executive dysfunction in people with cognitive impairment is associated with functional abnormalities in prefrontal regions such as the right inferior frontal gyrus (Right IFG) or the left dorsal lateral pre‐frontal cortex (Left DLPFC). Relevant studies suggest that transcranial direct current stimulation (tDCS) may be a useful therapeutic tool in enhancing attention, visuo‐motor coordination and working memory performance.MethodThis study aimed at investigating the effect of tDCS stimulation over left DLPFC or right IFG on attention, inhibition and working memory in people with mild cognitive impairment (MCI) and healthy older adult controls (HC). Recruited participants, aged from 65 to 80 years, included mild cognitive impairment and healthy control older adults. They were randomly divided into experimental and control arms. In experimental arm, participants were randomized to receive either anodal or sham tDCS over the Right iFG or Left DLPFC. tDCS will be administrated in a 2 mA anodal tDCS or sham stimulation to the Left DLPFC or Right IFG for 20 min. Each participant will undergo the performance‐based measure of executive function (The Chinese Multiple Errands Test, Chinese MET) before and immediately after the stimulation. During the anodal or sham tDCS stimulation, subjects will perform three neuropsychological tests: Trail Making Task (TMT), Stroop Test (ST) and N‐back Task (NBT).Result16 MCI and 16 healthy control, aged 65‐80 years were recruited. Linear mixed model analysis using group (HC vs. MCI), stimulation (anodal vs. sham) and region (Left DLPFC vs. Right IFG) as factors were performed. There was significant improvement in TMT, NBT in the group that received the anodal stimulation to Left DLPFC with an effect size of .73 (95% CI = .59‐.82) and .76 (95% CI = .65‐.81) respectively. Moreover, significant improvement noted in ST when participants received anodal stimulation to Right IFG with effect size of .71 (95% CI = .58‐.83).ConclusiontDCS showed to be an useful tool in enhancing attention, visuo‐motor coordination and working memory performance in older adults with MCI. These pilot findings can be further confirmed by collection of a large sample size as in this on‐going study.
Human rights in the context of dementia
Authors: Flavin Theresa M 
Published: December 2020

AbstractBackgroundAt Present, when a diagnosis of dementia is suspected or delivered, the initial advice to the person involved is ‘get your affairs in order’. One is urged to sign over all decision making to a ‘power of attorney’ at the earliest opportunity. While this may be convenient for medical legal professionals and even family members, any potential for hope, utility or self determination for the individual is eliminated. Research has shown that when a person has appropriate support in the decision making process, that decisions, big, small, lifestyle, financial as well as those relating to daily activities can be continued well into the progression of the disease. Resources are available to educate legal, medical and care professionals as well as families and caregivers on how to do this well, however the stigma persists at the highest level that when dementia is even suspected, that capacity has to be demonstrated to make even the simplest choices. This is a very direct violation of the fundamental human right of self determination, yet as a society we have not taken any meaningful steps to address the gaps in the community understanding of what capacity means from day to day in the context of dementia, how we can support someone to maintain their dignity, self esteem and self determination as long as humanly possible. I intend to speak from lived experience to how it feels to have capacity questioned at all times, in the medical and legal context, how it feels to be urged to ‘get onto the sunset cruise’ and never look back. I also intend to speak to the lived experience of having support with decision making, and the potential for enormous changes in the outcomes when a person with dementia is not only given ‘permission’ to have support in making decisions but is afforded such support as a human right and an entitlement. There is much room for improvement, and i remain optimistic that we can do much much better in the future if we work with people living with dementia instead of for or instead of us!
Allele specific targeting of APOE‐E4 expression: The novel CRISRP/CAS9‐based platform for precision therapy for Alzheimer’s disease
Authors: Kantor Boris , Moncalvo Malik , Ilich Ekaterina , Rittiner Joseph , Dong Wendy , Asmus Natalie , Falek Carmel , Yu Young Jun , Gu Jeffrey , Tringali Dominic , Chiba‐Falek Ornit 
Published: December 2020

AbstractBackgroundAPOEe4 is well‐established genetic risk factor for late onset Alzheimer’s disease (LOAD). It has been demonstrated that DNA methylation plays an important role in controlling the levels of APOEe4 expression. Furthermore, the differential methylation levels were reported between disease‐ and naïve‐ individuals. It also has been shown that reduction of APOEe4 levels may alleviate LOAD pathology. Here we aimed to develop a novel approach for specific and accurate modulation of APOEe4 gene expression.MethodHere, we took advantage of a newly engineered VRER‐Cas9/gRNA system which specifically and accurately recognized a novel protospacer adjacent motif (PAM) created with SNP‐rs429358 T‐C transition in the APOEe4 gene. The system is based on an all‐in‐one lentiviral vector harboring gRNA/VRER‐dCas9‐DNMT3A. Using this vector, we were able to achieve an efficient enhancement in DNA methylation and the associated reduction in the expression of APOEe4 allele. The system has been validated on the isogeneic APOE‐human induced pluripotent stem cell (hiPSC)‐derived excitatory neurons.ResultWe were able to specifically and efficiently downregulate expression of APOEe4 using isogeneic APOE‐human induced pluripotent stem cell (hiPSC)‐derived excitatory neurons as the experimental model. The reduction in the gene expression was linked to robust and specific DNA methylation.ConclusionThe developed epigenome‐editing platform highlights the novel approach towards the development of “smart” therapeutics for LOAD.
The use of patient's electronic message history for the automatic preclinical detection of Alzheimer's disease
Authors: Seminck Olga , Hanseeuw Bernard J. , Cougnon Louise‐Amélie , Fairon Cédrick 
Published: December 2020

AbstractBackgroundDetecting Alzheimer’s disease (AD) before the onset of symptoms is crucial for the development of effective treatment (1). As biomarkers are costly and/or invasive, there is a need for cost‐efficient and non‐invasive methods that can indicate which individuals need further examination. We present a running project that aims at developing a screening tool applicable to the general population by automatically analyzing the history of electronic messages such as WhatsApp and e‐mails over a period of several years prior to the analysis.MethodIn the first phase of the project (model construction), 30 prodromal or mildly demented AD patients (with biomarkers‐confirmed diagnosis) and 30 clinically normal elderly volunteers are recruited to donate their electronic message histories. Data is gathered and processed according to the General Data Protection Regulation and only sent messages are considered, which are codified to hide personal information. Automatic linguistic analyses are conducted on this data, such as syntactic parsing and lexical analysis and used by machine learning algorithms that establish the evolution of the linguistic abilities of a participant over time. Specifically, we will test how long before AD diagnosis linguistic changes are noticeable versus clinically normal volunteers. In the second phase of the project (model testing), 200 elderly volunteers without AD diagnosis will be recruited to donate their electronic message history and genetically tested for Apolipoprotein E4 (APOE4). We hypothesize that our tool will identify changes in linguistic practices suggestive of preclinical AD more frequently in APOE4 carriers than in non‐carriers.ResultWe are currently collecting and processing data from patients and clinically normal volunteers. We started to run our first linguistic analyses on the data, but we do not have enough participants yet to train a computer model.ConclusionIf detection of preclinical AD using linguistic markers from electronic message history turns out to be effective, the tool we develop could play an important role in the non‐invasive and cost‐efficient screening of preclinical AD in the elderly population. Specifically, it could facilitate clinical trials in preclinical AD.Reference(1) McDade, E. and Bateman, R. J. (2017). Stop Alzheimer’s before it starts. Nature News, 547(7662):153.
Reduced social activities and networks, but not social support, associated with cognitive decline among Chinese elderly
Authors: Fan Zili , LV Xiaozhen 
Published: December 2020

AbstractBackgroundThe relationship between social connectedness, including social activities, networks and support, and cognitive function remains controversial. The literature about the role of specific social connectedness’ different domains in cognitive function is limited. Our study aimed to examine the associations of social connectedness and its subdomains, with cognitive decline in the Chinese elderly.MethodWe analyzed data from the Chinese Longitudinal Healthy Longevity Survey. A total of 3314 Chinese older adults aged 65 years and over, who completed two waves of cognitive function measurement, were included for analysis. Cognitive decline was defined as an outcome measure in two ways: (1) the absolute change on MMSE score over time, i.e. (baseline MMSE – follow‐up MMSE); (2) the index of “greater cognitive decline”, i.e. ((baseline MMSE – follow‐up MMSE)/baseline MMSE) >0.1.Social connectedness was divided into three subdomains: social activities, social networks and social support. Linear regression models and binary logistic regression analysis were conducted to evaluate the associations of social connectedness and its different domains with cognitive decline, after adjusting for age, sex, education, residence, exercise, drinking, smoking, activities of daily living (ADL), chronic diseases, depressive symptom, and baseline cognitive function. Whether the association between social connectedness and cognitive decline differed by age, education, sex and cognitive function at baseline were also explored.ResultAmong the 3314 participants, the mean age was 80.17 ±9.33years, 49.09% were women, 50.12% of the respondents were illiterate. After 3 years, 768(23.17%) developed greater cognitive decline. Linear regression models and binary logistic regression analysis showed similar results. After controlling for covariates, social connectedness, social activities and social networks were related to slower cognitive decline (social connectedness: OR=0.64, 95%CI: 0.50 ‐ 0.82; social activities: OR=0.81, 95%CI: 0.67 ‐ 0.99; social networks: OR=0.70, 95%CI: 0.57 ‐ 0.87). Social support did not show the significance (OR=0.94, 95%CI: 0.79 ‐ 1.12). The association between social connectedness and cognitive decline was stronger among those with normal cognitive function at baseline and the educated elderly.ConclusionOur findings revealed social connectedness, social activities and social network rather than social support were potentially protective against cognitive decline.
Validation of connected speech as a marker for cognitive change in late‐middle aged African American adults at risk for Alzheimer's disease
Authors: Mueller Kimberly D. , Evans Elizabeth M. , Coley Sheryl L. , Koscik Rebecca L. , Norris Nia , Ramsey Celena M. , Green‐Harris Gina , Gleason Carey E. , Johnson Sterling C. 
Published: December 2020

AbstractBackgroundConnected speech‐language (CSL) (linguistic, acoustic, and temporal measures from spoken language) is a promising performance‐based measure of cognition for studies researching Alzheimer’s disease (AD). CSL represents everyday communication and thus may be less influenced by sociocultural factors, but research investigating CSL in underrepresented groups is scarce. Picture description tasks are common for eliciting CSL, typically the Cookie Theft (CT). However, CT is outdated, it does not represent the US’s cultural diversity, and subsequently may not be effective for all groups. Our aims were 1) characterize CSL from late‐middle‐aged African Americans (AA) by sex and APOE; 2) compare AA CSL change vs. standardized language tests across cognitive statuses 3) determine if AA and non‐Hispanic whites (NHW) respond differently to the CT prompt.MethodCSL measures (Figure 1) were automatically extracted from picture description transcripts from WRAP’s Milwaukee site (AA n=48; NHW n=30). Aims 1 and 3 statistics included t‐tests, chi‐square tests, and ANCOVA. Aim 2 used linear mixed‐effects models in AA with >1‐timepoint (n=30), examining whether longitudinal CSL varied by cognitive status.ResultTable 1 shows speech metrics and demographics of AA participants by sex. AA and NHW did not differ on most baseline CSL measures including total words spoken (Table 2,3, Figure 2). Changes in CSL (Table 4) and BNT were associated with cognitive status in AA participants, but verbal fluency was not. Literacy was not related to CSL outcomes. CSL had higher effect sizes than BNT (b=.41 vs. .20).ConclusionIn one of the first studies to characterize prospective CSL from an AD‐risk‐enriched sample of AA adults, we found no sex/APOE carrier status differences in AA CSL, and no differences between AA and NHW on most CSL measures. AA and NHW did not differ in the amount of talking in response to CT. CSL change among cognitively‐declining AAs was similar to that seen previously in a NHW sample. This combined with predominantly weak associations between CSL measures and WRAT‐3 suggest that CSL may reflect a socioculturally unbiased cognitive activity. Future directions include developing an ethnoculturally relevant stimulus picture, analyses with increased time points, sample sizes and AD biomarkers.
Preservation of white matter integrity on DTI 3 years after early menopausal hormone therapies
Authors: Kara Firat , Chen Qin , Reid Robert I. , Schwarz Christopher G. , Tosakulwong Nirubol , Lesnick Timothy G. , Zuk Samantha M. , Lowe Val J. , Fields Julie A. , Gleason Carey E. , Shuster Lynne T. , Bailey Kent R. , Jack Clifford R. , Rocca Walter A. , Miller Virginia M. , Kantarci Kejal 
Published: December 2020

AbstractBackgroundThe critical‐period theory of menopausal hormone therapy (mHT) suggests that if menopausal hormone therapy begins shortly after menopause, it may have beneficial effects on brain structure and cognitive health. We investigated white matter integrity with diffusion tensor MRI (DTI) 3 years after the end of mHT trial in recently menopausal women who were randomized shortly after menopause.MethodParticipants of this study were enrolled in the Kronos Early Estrogen Prevention Study (aged 42–56 years; 5–36 months past menopause). Participants received the following treatments: 0.45 mg/d oral conjugated equine estrogen (oCEE, n=19); 50 μg/d transdermal 17β‐estradiol (tE2, n=22); or placebo (n=33) for 4 years. Oral progesterone (200 mg/d) was given to hormone therapy groups for 12 days each month. DTI was performed 3 years after the end of 4 years of hormone therapy (n=75), which corresponded to 7 years after randomization. Voxel‐based analysis was performed on DTI to evaluate fractional anisotropy (FA) and mean diffusivity (MD) differences between treatment groups (uncorrected p<0.001).ResultVoxel based analysis showed higher FA, a measure of white matter integrity, in the superior corona radiata, anterior limb of the internal capsule and splenium of the corpus callosum of participants treated with oCEE compared to placebo (p <0.001, Figure 1A). Furthermore, higher FA was observed in the superior corona radiata, anterior limb of internal capsule and thalamus in participants treated with tE2 compared to placebo (p <0.001, Figure 1B). There were no differences in FA findings between oCEE and tE2 groups, and no MD differences between treatments groups.ConclusionA relatively higher FA in a variety of white matter regions in the oCEE and tE2 groups compared to placebo suggest that mHT may have long‐term protective effects on white matter integrity. Previously, we had shown that women in the tE2 group preserved their dorsolateral prefrontal cortex volumes better than the placebo group over 7 years. Our findings suggest that the tracts that connect the dorsolateral prefrontal cortex and the thalamus such as the superior corona radiata and the anterior limb of internal capsule may particularly benefit from mHT.
Lateralizations and enhancers of the loss of function in dementia for olfactory, sensory, and motor domains
Authors: Schonfeld Ethan , Schonfeld Elan , Aman Casey , Gill Navroop , Kim Dami , Rabin Sydney , Shamshuddin Bushraa , Sealey Lloyd , Senno Ricardo Gabriel 
Published: December 2020

AbstractBackgroundThere exist functional deficits in motor, sensory, and cognitive abilities in dementias (Kluger et al, The Journals of Gerontology: Series B, 1997; Albers et al, Alzheimer’s and Dementia, 2015). In 2010, the National Institute on Aging combined the study of these functions, focusing on clinical manifestations of neurodegeneration of olfactory, sensory, and motor domains as potential clinical markers. Building on these results, we seek to study possible lateralizations in deficit severity to further clinical markers and improve outcomes through functional therapies.MethodThis IRB approved study performed left/right functional assays of olfactory, sensory, and motor ability. A Peppermint Oil test measured discrete left/right olfactory function; the Von Frey test measured discrete left/right sensory tactile function; a dynamometer was used to measure discrete left/right motor grip strength. The Mini Mental Status Exam was administered; social, medical, and laboratory data were collected (N=84).ResultWhile the non‐dementia, right‐handed, population has significantly greater right motor grip strength, the dementia population showed no significant correlation (p=0.127, n=57). Deficit in sensory tactile function worsened on left side (p=0.0387, n=63). Deficit in cranial nerve 1 (CN1) function worsened on left side (p=0.0515, n=37). Enhancers of motor deficit to right side: female (p=0.434, n=32), depression (p=0.455, n=29), MMSE<15 (p=0.382, n=24), and diabetes (p=0.451, n=13). Enhancers of sensory deficit to left side: use of psychotherapeutic agent (p=0.0514, n=47), age≥85 (p=0.070, n=30), MMSE<15 (p=0.0732, n=30), and male (p=0.0826, n=25). Enhancers of CN1 deficit to left side: age<85 (p=0.00262, n=24), medication number>10 (p=0.0725, n=24), and male (p=0.0742, n=15).ConclusionThe results suggest that in dementia, olfactory and sensory functional deficits lateralize to the left, and motor deficits to the right. Future research should identify enhancers and suppressors of these lateralizations to develop therapies to strengthen at‐risk areas. Furthermore, these lateralized LOF can act as early clinical markers.
Difference of cognitive impairment in ischemic stroke patients based on hemiparesis side at Atma Jaya Hospital, Indonesia, 2014‐2018
Authors: Hamid Gabriella , Wreksoatmodjo Budi Riyanto , Andre Andre 
Published: December 2020

AbstractBackgroundCognitive impairment in stroke patients can decrease their quality of life. The characteristics of cognitive impairment may be different based on the lesion’s location. Objective was to assess the difference of cognitive function in ischemic stroke patients based on hemiparesis side.MethodA cross‐sectional research on 125 ischemic stroke patients in Atma Jaya Hospital 2014‐2018. Analyzed data includes age, hemiparesis side, MMSE and MoCA‐INA scores. Data was analyzed using univariate and bivariate Mann‐Whitney test.ResultPatients with left hemiparesis had higher scores in all categories of MMSE and MoCA‐INA than patients with right hemiparesis. In patients aged less than 55 years old, MoCA‐INA results showed that left hemiparesis had a significantly higher language score (p=0,030); but naming, delayed recall, and orientation scores were higher in right hemiparesis. In patients aged more than 55 years old, scores for visuospatial in MMSE and language in MoCA‐INA were higher in right hemiparesis.ConclusionOverall scores for MMSE and MoCA‐INA in left hemiparesis were higher than right hemiparesis, although not significant. Language ability measured with MoCA‐INA was significantly higher in left hemiparesis in patients aged less than 55 years old.