bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripheral nerve function and dementia in older adults with and without diabetes
Authors: Brenowitz Willa D , Robbins Nathaniel M , Strotmeyer Elsa S , Yaffe Kristine 
Published: December 2020

AbstractBackgroundFew studies have focused on sensory peripheral nerve impairment as risk factor for or marker of dementia, although other sensory impairments are associated with cognitive decline. Peripheral nerve impairments are higher with aging, musculoskeletal injury, and conditions such as diabetes, which in turn may accelerate cognitive decline. We evaluated whether sensory nerve impairment in older adults was associated with higher risk of dementia and examined differences by diabetes status.MethodWe studied 1,923 black and white non‐demented participants from Health, Aging, and Body Composition (Health ABC) Study who were aged 70‐79 at 1998/99 enrollment (52% women; 35% black). Sensory nerve tests evaluated in Year 4 (2000/01) included monofilament (1.4‐g, 10‐g) and vibration threshold of the toe. Monofilament insensitivity was defined as unable to detect monofilament (3/4 touches) and poor vibration threshold was defined as >130μm. Incident dementia (over 11 years of follow‐up) was based on hospitalization records, dementia medications, or ≥1.5 SD decline in Modified Mini‐Mental State Exam score (race‐specific). Cox proportional hazard models with adjustment for demographics, comorbid health conditions, and health behaviors evaluated risk of dementia associated with peripheral nerve impairments. We tested for interactions with diabetes status.ResultOf older participants, 44.7% had 1.4‐g monofilament insensitivity, 8.3% had10‐g monofilament insensitivity, and 5.9% had poor vibration threshold. 1.4‐g monofilament insensitivity was not associated with dementia (HR: 1.14, 95% CI: 0.92, 1.40), either in the combined group or by diabetes status (interaction with diabetes p=0.78). 10‐g monofilament insensitivity was associated with higher risk of dementia in those with diabetes (HR: 2.52; 95% CI: 1.53, 4.14) but not those without diabetes (HR: 1.00; 95%CI: 0.63, 1.60) (p=0.02 for interaction). Poor vibration threshold was associated with higher risk of dementia in those without diabetes (HR: 1.72, 95%CI: 1.15,2.60), estimates were elevated but not significant in those with diabetes (HR: 1.31; 95%CI: 0.48,4.49), and the interaction by diabetes was not significant (p=0.50).ConclusionSensory nerve impairments were associated with increased risk of dementia although the effects differed by diabetes status. These associations may represent shared risk factors that affect peripheral and central nervous system degeneration.
Identification of genetic markers linked to accelerated brain volume changes in Aβ‐positive population
Authors: Vacher Michael , Porter Tenielle , Milicic Lidija , Peretti Madeline , Dore Vincent , Villemagne Victor LL , Laws Simon M , Doecke James D 
Published: December 2020

AbstractBackgroundThe blood‐brain barrier (BBB) is formed by a high‐density lining of endothelial cells, providing a border between circulating blood and the brain interstitial fluid. This structure plays a key role in protecting the brain microenvironment by restricting passage of certain molecules and circulating pathogens.MethodThis study aimed at identifying associations between longitudinal brain volumetric changes and a set of 324 BBB‐related single nucleotide polymorphisms (SNP), genotyped from 222 unrelated individuals (Ab+: N=95; Ab‐: N=127) enrolled in the Australian Imaging, Biomarker & Lifestyle (AIBL) study. We focused this research on four brain regions (cortical grey matter, cortical white matter, ventricular volume, and hippocampal volume) and used a linear mixed model approach to assess if specific genotypes were linked to rates of atrophy over a 12‐year time span.ResultsWe identified three genetic markers, specific to the Ab+ population, associated with accelerated volume change of the hippocampus and ventricular regions. Two markers, namely, rs17063341 (TJP2, flanking, p=1.35e‐05) and rs7975334 (SLCO1C1, non‐coding transcript variant, p=5.65e‐06) were associated with accelerated atrophy of the hippocampus. One marker, rs282984 (JAM2, intronic, p= 8.78e‐05) was linked to accelerated ventricular enlargement. These markers were independent of variation due to the APOE e4 allele and remained significant after correction for multiple comparisons. The identified associations were not seen in the Ab negative population.ConclusionsThe results suggest that specific markers in key genes involved in the regulation of BBB integrity are associated with longitudinal changes of specific brain regions. Further research is required to validate these findings and investigate how BBB functions maybe compromised by these genetic variations.
iSupport‐Portugal: Adapting an evidence‐based online intervention for dementia caregivers to a different culture
Authors: Teles Soraia , Zincke Maria do Rosário , Sosa‐Napolskij Milaydis , Ferreira Ana , Paúl Constança 
Published: December 2020

AbstractBackgroundInformal dementia caregivers often struggle with several stressors that place them in a position of greater risk to develop physical and mental health problems in comparison to the general population. iSupport is an online training programme developed by the World Health Organization to prevent or minimize mental and physical health problems and improve the quality of life of dementia caregivers. Caregivers’ well‐known needs for information and skills training are addressed in twenty‐three lessons organized in five modules. Problem‐solving and cognitive behavioural therapy techniques are evidence‐based methods used in iSupport to change thoughts, feelings, and behaviours and improve overall functioning and life satisfaction. iSupport design choices are grounded on good practices for digital engagement including customization, interactivity and immediate feedback as interface features. Provided its web‐based delivery, iSupport is an ubiquitous and convenient solution, with the potential of scalability. A scalable tool to relieve caregivers’ psychological distress is a necessity in Portugal, given the country’s high share of very old people, high dementia prevalence and rate of informal home care.MethodiSupport was culturally adapted to Portugal using an eight‐step methodological approach comprising: needs assessment from primary (web‐survey; N=180 caregivers) and secondary data collection; content translation; technical accuracy check by health professionals; cultural adaptation; expert panel appraisal; fidelity check by WHO; focus groups with caregivers and professionals; and usability testing.ResultThe needs assessment study suggested the potential utility and acceptance of online intervention programmes in Portugal. Findings from the adaptation process revealed the need for adjustments of the original iSupport programme in terms of content and interface. Contents were adapted for language semantic and conceptual equivalence, and adjustment to cultural habits. Definitions, designations, recommendations and case studies were modified to match local knowledge and practices. Findings from usability testing and focus groups resulted in recommendations to improve learnability, efficiency, memorability, and satisfaction with iSupport interface.ConclusioniSupport‐Portugal introduces adjustments needed to achieve a culturally‐meaningful version of an evidence‐based programme aimed at lessening the psychological distress of dementia caregivers. As the only online programme for dementia caregivers available in Portugal, iSupport studies are instrumental in assessing the feasibility of similar resources in this context.
Who are the patients diagnosed with dementia in Brazil? A nation‐wide descriptive study
Authors: Feter Natan , Leite Jayne S , Rombaldi Airton 
Published: December 2020

AbstractBackgroundBrazil has the second highest age‐standardized prevalence of dementia in the world. However, there are no studies that used national‐wide data to describe how this disease is distributed among Brazilian population. We aimed to describe demographic, clinical, and behavioral characteristics from people with dementia (PWD) in Brazil.MethodsWe extracted data from adults who had diagnosed dementia during the latest National Health Survey (2013), which is the most comprehensive survey with data about health status, lifestyle, and healthcare utilization among Brazilian adult population. We reported data about demographic (i.e. education, ethnicity, marital status, occupation), clinical (i.e. functional capacity, number of morbidities, hospital admission), and behavioral (i.e. physical inactivity, social interaction) aspects of PWD in Brazil.ResultsUsing data from 60,202 individuals (response rate: 74.2%), we reported higher prevalence of dementia in subjects aged 60 years or older (76.1%), female (67.2%), white people (50.8%), widowed (38.3%), unemployed (60.4%), and among those with low educational level (67.1%). PWD reported higher prevalence of hearing (19.5%) and visual (34.4%) impairment, functional disability (66%), physical inactivity (90.2%), social isolation (89.3%) and diagnostic of chronic diseases (73.2%). About 75% from sample self‐rated their health as regular or worse. Although habitual activities were severally limited by dementia in about 70% of sample, only 21% frequented any type of rehabilitation service. Besides a higher incidence on hospitalizations during the last 12 months before interview (27.3%), PWD had longer hospital admissions (p<0.001), with public health system being the major provider (65.7%). In addition to 61% of PWD did not have access to any public place near their houses to perform physical activity, 97.6% did not know any public program for physical activity promotion.ConclusionDementia is more prevalent in certain sociodemographic groups in Brazil. PWD have higher prevalence of morbidities, social isolation, physical inactivity, and general health rated regular or worse. Low frequency in rehabilitation services and access to physical activity practice may be associated to higher incidence and duration of hospitalizations among PWD. Strategies to reduce social inequality in dementia in Brazil should be encourage in order to reduce its burden of this disease on Brazilian healthcare system.
Association of limb length with cognitive decline in elderly
Authors: Kwon Oh Dae 
Published: December 2020

AbstractBackgroundThere are not many studies about the risk factors of dementia in Korea. Early life nutrition is very important for the body size of grown‐ups. This study investigated the associations of arm and leg length with cognitive decline in a community sample of elderly Korean.Method382 community residents aged 65 or over were clinically assessed for cognitive impairment. Arm length and leg length were measured. Neuropsychological tests, including Korean version of Mini‐mental state examination, Clinical Dementia Rating, and Geriatric Depression Scale were performed for all the participants.ResultBoth arm length and leg length were not associated with decreased cognitive function by correlation analysis. Correlation analysis with adjustment of age and education also did not show any significant correlation.ConclusionWe could not find any correlation between limb length and cognition in an elderly Korean community.
Heneicosapentaenoic acid is produced from 2‐hydroxy‐docosahexaenoic acid via α‐oxidation: Implications for Alzheimer’s disease therapy
Authors: Parets Sebastià , Irigoyen Ángel , Ordinas Margarita , Cabot Joan , Miralles Marc , Péter Mária , Balogh Gábor , Rosselló Catalina Ana , Fernández‐García Paula , Busquets Xavier , Lladó Victoria , Escriba Pablo V. , Torres Manuel 
Published: December 2020

AbstractBackgroundAlzheimer’s disease (AD) is a neurodegenerative disease with as yet no efficient therapies. Many drugs and therapies have been designed and developed against this neurodegenerative disease, although none has successfully terminated a phase‐III clinical trial in humans. To shift the perspective for the design of new AD therapies, membrane lipid therapy has been tested, which assumes that brain lipid alterations lie upstream in the pathophysiology of AD. A hydroxylated derivative of docosahexaenoic acid was used, 2‐hydroxy‐docosahexaenoic acid (DHA‐H), which has shown efficacy against hallmarks of AD pathology in a transgenic mouse model of AD (5xFAD).MethodLipid samples were obtained from cultured cells and blood plasma and brain from WT and 5xFAD mice. Both, cell cultures and animals were treated with DHA‐H and DHA under different conditions. Mice were subjected to the Radial Arm Maze test during the last month of treatment just before sacrifice. Fatty acid analysis was performed by GC‐FID and GC‐MS (Gas Chromatography‐Flame Ionization Detector and ‐Mass Spectrometry) and the lipidomic analysis carried out by ESI‐MS (Electrospray ionization‐Mass Spectrometry).ResultHere, for the first time, DHA‐H is shown to undergo α‐oxidation to generate the heneicosapentaenoic acid (HPA, C21:5, n‐3) metabolite, an odd‐chain omega‐3 polyunsaturated fatty acid that accumulates in cell cultures, mouse blood plasma and brain tissue upon DHA‐H treatment. Interestingly, DHA‐H does not share metabolic routes with its natural analog DHA (C22:6, n‐3) but rather, DHA‐H and DHA accumulate distinctly, both having different effects on cell fatty acid composition. This is partly explained because DHA‐H α‐hydroxyl group provokes steric hindrance on fatty acid carbon 1, which in turn leads to diminished uptake by cultured cells and accumulation as free fatty acid in cell membranes. Finally, DHA‐H administration to mice elevated the brain HPA levels which in turn were directly and positively correlated with cognitive spatial scores in AD mice. This effect appeared in the apparent absence of DHA‐H and without any significant change DHA levels in brain.ConclusionThe evidence presented in this work suggest that the metabolic conversion of DHA‐H into HPA could represent a key event in the therapeutic effects of DHA‐H against AD.
Association of cardiovascular risk burden with cognitive trajectories and structural brain differences
Authors: Song Ruixue , Xu Hui , Dintica Christina S. , Pan Kuan‐Yu , Qi Xiuying , Buchman Aron S , Bennett David A , Xu Weili 
Published: December 2020

AbstractBackgroundThe impact of cardiovascular risk burden on cognitive trajectories and brain structure changes remains unclear.MethodWithin the Rush Memory and Aging Project, 1,588 dementia‐free participants (mean age=79.5 years) were followed for up to 21 years. FGCRS was assessed at baseline and categorized into tertiles (the lowest, middle, and the highest). Episodic memory, semantic memory, working memory, visuospatial ability, and perceptual speed were assessed annually with a battery of 19 tests, from which composite scores were derived. A subsample (n=378) of the participants underwent magnetic resonance imaging (MRI). Structural total and regional brain volumes were estimated. Data were analyzed using linear mixed‐effects models and linear regression models.ResultIn all participants, FGCRS ranged from 4 to 28 (mean score=15.6±3.7). Compared with the lowest tertile of FGCRS, the highest was associated with faster decline in global cognition (β=‐0.019, 95% confidence interval [CI] ‐0.035 to ‐0.003), episodic memory (β=‐0.023, 95% CI ‐0.041 to ‐0.004), working memory (β=‐0.021, 95% CI ‐0.035 to ‐0.007), and perceptual speed (β=‐0.027, 95% CI ‐0.042 to ‐0.011) over the follow‐up. In MRI data analyses, higher FGCRS was related to smaller volumes of the hippocampus (β=‐0.021, 95% CI ‐0.042 to ‐0.000), total gray matter (β=‐1.569 95% CI ‐2.757 to ‐0.382), and total brain (β=‐1.588, 95% CI ‐2.832 to ‐0.344), and greater volume of white matter hyperintensities (β=0.035, 95% CI 0.001 to 0.069).ConclusionHigher cardiovascular risk burden may predict decline in episodic memory, working memory and perceptual speed, and is associated with neurodegeneration and vascular lesions in the brain.
Pointer‐ZZZ: Sleep ancillary to U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk of Alzheimer's disease
Authors: Molina‐Henry Doris P , Baker Laura D. , Woolard Nancy , Espeland Mark A. , Leng Xiaoyan Iris , Lim Andrew , Redline Susan , Stone Katie L , Hayden Kathleen M. ,   U.S. POINTER Study Group
Published: December 2020

AbstractBackgroundNon‐pharmacological approaches that target modifiable risks through lifestyle interventions provide the most promising evidence to delay disease. In older adults, chronic sleep disturbances marked by sleep‐disordered breathing (SDB) and sleep fragmentation are associated with impaired hippocampal functioning, increased beta‐amyloid burden, and greater Alzheimer’s risk. These and other sleep abnormalities are associated with reduced vascular health. Although some evidence suggests that diet, exercise, and cardiovascular risk reduction can improve sleep and improved sleep benefits cognition in older adults, these effects have not been confirmed in a rigorous clinical trial.MethodsThe U.S. study to PrOtect brain health through lifestyle INTErvention to Reduce risk (U.S. POINTER), funded by the Alzheimer’s Association, was launched in the Fall of 2018. It is investigating whether lifestyle interventions ‐ Self‐Guided (SG) versus a Structured (STR) lifestyle intervention ‐ influence cognitive trajectories over 2 years in 2000 older cognitively normal adults (aged 60‐79 yrs) who are at increased risk for cognitive decline, Alzheimer’s disease and other dementias. The NIH‐funded POINTER‐zzz ancillary study adds in‐home objective sleep assessments for 700 participants to examine the effects of lifestyle modification and cardiovascular risk management on sleep disturbances that are linked to cognitive decline and Alzheimer’s disease and that may improve with U.S. POINTER interventions.ResultsPOINTER‐zzz methods and study design will be presented, which will permit over 2000 objective sleep assessments to be completed over 2 years. These assessments will provide extensive oximetry and actigraphy data for analysis by lifestyle intervention group assignment. Sleep data will be examined relative to intervention effects on cognition and other parent trial and ancillary study outcomes, including MRI and amyloid/tau PET brain imaging. POINTER‐zzz leverages resources provided by the parent trial and other funded ancillary studies, and by well‐established collaborations with sleep experts.ConclusionsPOINTER‐zzz provides an unparalleled opportunity to test the effects of a multi‐domain lifestyle intervention on sleep abnormalities that are linked to cognitive decline and Alzheimer’s in a well‐characterized, diverse cohort of at‐risk older adults. The study may identify an effective strategy for improving sleep that could have important consequences for reduced risk of Alzheimer’s disease and related dementias.
Validation of the Cognitive Telephone Screening Instrument (COGTEL) for detecting mild cognitive impairment and dementia due to Alzheimer's disease (AD)
Authors: Alexopoulos Panagiotis , Skondra Maria , Charalampopoulou Marina , Aligianni Souzana , Kontogianni Evangelia , Lentzari Iliana , Vratsista Aikaterini , Kliegel Matthias , Politis Antonis 
Published: December 2020

AbstractBackgroundCognitive assessment is necessary for diagnosing cognitive impairment. In epidemiologic surveys and genetic family studies cognitive tests that can be administered over the telephone are valuable tools. The Cognitive Telephone Screening Instrument (COGTEL) is a brief instrument for capturing interindividual differences in cognitive functioning, with the advantage of covering more cognitive domains than traditional screening tools such as the Mini‐mental State Examination (MMSE), as well as differentiating between individual performance levels in healthy older adults. Here, we report first evidence of the utility of the COGTEL in detecting mild cognitive impairment (MCI) and dementia due to Alzheimer’s disease (AD).MethodThe COGTEL was translated into Greek. Thereafter a bilingual expert not familiar with the original COGTEL made a back translation into English. The new version was very similar to the original one. The study refers to 30 and 22 patients with MCI and dementia due to AD, respectively. They fulfilled the international NIA‐AA diagnostic criteria. The study included 45 cognitively normal elderly individuals, too. The COGTEL was compared to the conventional modified Mini Mental State Examination (3MS). They were validated against an expert diagnosis based on a comprehensive diagnostic workup which included the Montreal Cognitive Assessment (MoCA). Statistical analysis was performed using the receiver‐operator‐characteristics (ROC) method.ResultThe COGTEL outperformed the 3MS in the distinction between cognitively unimpaired individuals and patients with MCI (Area under the curve, AUC: 0.94 vs. 0.89), whilst both instruments were excellent in identifying patients suffering from dementia due to AD (AUC in both cases 0.99).ConclusionThe COGTEL is a short, practical and reliable telephone test for the identification of both MCI and dementia due to AD. It can serve as a useful instrument in studying normal cognition and cognitive impairment in aging in both clinical diagnostics and research projects. The lack of difference between COGTEL and 3MS in their capacity to detect dementia due to AD is probably attributable to the fact that healthy aging can in most cases be unambiguously distinguished from dementia due AD, while the distinction between MCI and healthy aging is more ambitious.
Sedative use by older adults with dementia is higher among women than men and exceeds recommendations
Authors: Trenaman Shanna Claire , Bowles Susan K , Kirkland Susan , Andrew Melissa K 
Published: December 2020

AbstractBackgroundSedative medications (benzodiazepines and Z‐drugs) are used to treat responsive behaviours in those with dementia despite association with adverse drug events and accepted status as potentially inappropriate medications. The objective of this study was to complete a sex‐based analysis of sedative use in a cohort of older adults with dementia in Nova Scotia, Canada.MethodWe examined sedative use in a cohort of adults aged 65 years and older with dementia in Nova Scotia, Canada. Prescription data was examined from April 1, 2010 to March 31, 2015. Concordance with prescribing guidelines was compared for men and women using descriptive statistics and unadjusted odds ratios.ResultOf the 30,703 older adults with dementia in the cohort 11,647 (37.9%) received at least one prescription for a sedative. Women were more likely to receive a benzodiazepine (OR 1.44; 95% CI [1.36‐1.53]) or a Z‐drug (OR 1.10; 95% CI [1.01‐1.19]). Lorazepam was the most commonly prescribed sedative (52% of sedative users). Zopiclone was the second most commonly prescribed (27% of sedative users). Sedative use (37.9% of cohort) which is potentially inappropriate was almost two times greater than cholinesterase inhibitor use (19.3% of cohort) which is potentially appropriate for older adults with dementia.ConclusionAmong older adults with dementia, sedatives are more commonly prescribed than cholinesterase inhibitors. Sedatives are more often used by women, suggesting that targeted interventions toward reducing sedative use in women is needed. This pattern of sedative use is not in accordance with prescribing guidelines for older adults with dementia.