bluuebunny/crossref_metadata_2025_split huggingface dataset:
BeYOND: Biomarkers in younger‐onset neurocognitive disorders — The first 50 participants
Authors: Loi Samantha M. , Eratne Dhamidhu , Waterfang Mark , Kelso Wendy , Farrand Sarah , Goh Anita M.Y. , Chadunow Carolyn , Ravenfar Parsa Seyed , Watson Rosie , Evans Andrew H. , Vidaurre Lesley , Velakoulis Dennis 
Published: December 2020

AbstractBackgroundThere are currently 28000 people in Australia with younger‐onset dementia (YOD). A recent review of younger‐onset dementia cohorts (Loi SM et al. submitted) suggested that there needs to be more detailed study in this heterogenous group in order to glean more clinically relevant information. For example, our group (Eratne D et al. 2020) investigated the utility of cerebrospinal fluid (CSF) neurofilament light (NfL) chain in a group of people with a range of psychiatric and neurodegenerative disorders and reported that NfL could distinguish between these two broad disorders, demonstrating the benefits in studying a large range of YODs. BeYOND (Biomarkers in younger‐onset neurocognitive disorders) was established as a longitudinal cohort of younger people presenting with neurocognitive symptoms to a clinical diagnostic service, with the aim of identifying clinical and investigational biomarkers which can inform diagnostic and psychosocial outcomes in a clinically heterogenous population.MethodPatients are prospectively recruited during their index presentation to Neuropsychiatry, Royal Melbourne Hospital, Australia. Neuropsychiatry is a tertiary specialist service which provides diagnostic work‐up for patients with cognitive, psychiatric and neurological symptoms. The diagnostic process includes baseline and 18 month assessments of clinical and diagnostic outcomes including CSF and blood biomarkers, cognition, neuroimaging and psychosocial (including caregiver).ResultsTo date, 50 participants have been recruited (17 females, mean age 55). Thirty of had a dementia diagnosis (including Alzheimer’s dementia, frontotemporal dementia and Huntington’s disease), with the remainder having a psychiatric disorder (including depression and schizophrenia) as principle diagnosis. All participants have had clinical, neuropsychology and imaging. Eleven have had a lumbar puncture. Twenty participants have had a research blood panel for genetic analysis)and 12 had quantitative susceptibility mapping imaging.ConclusionThe diagnosis of neurodegenerative disorders in younger people can be difficult and is often associated with diagnostic delays (Draper B et al. 2016). The BeYOND study aims to longitudinally assess younger patients with suspected neurodegenerative disease in order to improve diagnostic and psychosocial outcomes for this population. References: Loi SM et al. J Neuropsychiatry Clin Neuroscience. Submitted 23/1/2020. Eratne D et al. ANZJP. 54 (1): 57‐67. 2020. Draper B et al. Int J Geriatr Psychiatry. 31 (11): 1217‐1224. 2016.
Cognitive complaints and objective cognitive impairment in Sichuan community residents
Authors: Wang Ziqi , Dong LI , Yao Dezhong , Yang Jie , Han Ying 
Published: December 2020

AbstractBackgroundLittle knowledge was known about cognitive complaints (CC) and objective cognitive impairment (OCI) in the western China.MethodTo investigate the prevalence of CC and OCI in Sichuan province.ResultA total of 308 community‐based individuals (128 male and 180 female, aged 40–91 years) were enrolled in this study. We investigated the information on demographics, medical conditions, mental health questionnaires, subjective cognitive complain and objective cognitive performance tested by comprehensive neuropsychological batteries were analyzed.ConclusionFor CC, the total prevalence was 88.64%, and memory was 79.22%, language was 46.23%, executive function 39.60%, attention was 46.20% and other domains were 41.03%. For OCI, the total prevalence was 95.10%, and memory was 89.08%, language was 58.03%, and executive function 54.44%.
The imprint of sex on the heterogeneity of Alzheimer's disease sex differences in advanced Alzheimer’s disease: A clinical‐pathological study
Authors: Zea‐Sevilla María Ascensión , Uceda‐Heras Alicia , Rabano Alberto 
Published: December 2020

AbstractBackgroundAlzheimer's disease(AD) displays both clinical and pathological heterogeneity, and the effects of sex difference on various neuropathological, functional and epidemiological aspects of AD are currently under study. The existence of sex‐specific clinical‐pathological phenotypes is still unknown, but the accumulated evidence indicates specific patterns as well as clinical‐pathological differences suggesting that sex is a crucial variable in the heterogeneity of the disease. Hippocampal sclerosis (HS) is characterized by selective neuronal loss and gliosis of the CA 1 region of the hippocampus and the subiculum associated with age and multiple pathologies such as AD, and has recently been included in Limbic‐predominant aging‐related TDP‐43 encepahalopathy (LATE). The aim of this study is to know if AD patients with HS show sex‐specific difference both at a neuropathological and a clinical level.MethodA full postmortem neuropathological study was performed on 126 consecutive brains from a clinicopathologic cohort of institutionalized dementia patients (Vallecas Alzheimer’s Center Study), mean age at death(87.3 ± 6.6), sex ratio(79.4% females), with a predominant primary diagnosis of Alzheimer’s disease(77.6%).HS was defined based on morphologic criteria including pre‐HS changes defined by our group.Result69.79 % of AD patients displayed HS(women 83.58%, male 16.41%).Clinical disease onset was earlier in men 72.93 ± 9.3 vs 77.19 ± 6.57 (p < 0.05). In women, the presence of HS is associated with a later disease onset 78.67 ± 6.03 vs 75.05 ± 6.40 (p = 0.05), a later age at exitus 90.44 ± 5.33 vs 84.95 ± 6.62 (p < 0.05) and a longer survival time 11.78±3.85 vs 9.45 ± 4.69 (p < 0.05). In men, these variables also differed between HS+ and HS‐ subjects, but did not reach statistical significance. APOE4 was not associated with HS in any sex group.ConclusionIn our study, the difference in the age of disease onset, age of exitus and survival time in the presence of HS is linked to sex. Sex is an important factor in the phenotypic heterogeneity of AD, and male sex predominates in earlier onset AD with hippocampal preservation while later onset and limbic‐predominant disease is higher in women. In this axis of phenotypic variability, HS is a determinant factor. These disease phenotypes may be relevant to a "precision medicine" approach and should be considered in the development of therapeutic strategies and clinical trials for AD.
Does decline in cardiovascular risk factor levels also have an impact on the age‐specific cognitive function of older adults over time? A comparison of a repeated cross‐sectional panel study in the same population over 14 years
Authors: Johnsen Bente , Schirmer Henrik , Martinatyte Ieva , Strand Bjørn Heine 
Published: December 2020

AbstractBackgroundResearch suggests that cardiovascular risk factors have an impact on cognitive function and development of dementia. We lack evidence that cognitive function is actually improving in the population, as the risk factors decrease. We aim to see if the dementia‐free population of Tromsø has improved cognition over time and if so which changes are associated with improved cognition.MethodThe Tromsø Study is an ongoing large, prospective population based cohort study. Cognitive measures was included from 2001 and repeated in 2008 and 2015. Only participants in the ages of 60‐88 were included. A total of 5173 women and 4341 men did at least one cognitive test during these three waves. Age groups were stratified to 60‐66 years, 66‐73 years, 74‐80 years and 80‐88 years. The cognitive tests were Word test 1 (12‐word immediate recall), Word test 2 (recognition), Digit‐Symbol Coding and Tapping test.All participants also filled out an extensive questionnaire, had blood samples and anthropomorphic measures taken.Difference between screenings in all cognitive tests were analysed in Stata using sex specific linear regression. The results were then adjusted for age, education, blood pressure, smoking, hypercholesterolemia, previous heart attack, previous stroke, diabetes, depression, activity levels, alcohol consumption and BMI. The explanatory variables were tested to see how much they accounted for a change in the beta coefficient when added.ResultThe cognitive tests show a significant improvement in cognitive function in age specific groups in 2015, compared to 2001. This improvement is present in all age groups. (p < 0,001 for all age groups) The factors that contribute most to the improvement is alcohol consumption (15,2 % men, 20 % women), increased education (44,7 % men and 39,5 % women) and physical activity (10,7 % men and 12,8 % women). Other cardiovascular risk factors had little to no impact.ConclusionCognitive function improves in older adults consistently in four cognitive tests covering different aspects of neuropsychological functioning. Improvement in education, alcohol consumption and physical activity is the factors contributing most to this change. Improvement in traditional cardiovascular factors contribute little or nothing the improvement in cognitive function.
Are existing dementia risk prediction models reliable?
Authors: Goerdten Jantje , Čukić Iva , Danso Samuel O , Carriere Isabelle , Terrera Graciela Muniz 
Published: December 2020

AbstractBackgroundNumerous dementia risk prediction models have been developed in the past, however only a few are recommended for clinical use (Stephan et al., 2015; Tang et al., 2015). This might be due to methodological limitations that hamper their reliability and accuracy. Here we summarize and critically discuss the employed methodological approaches to develop dementia risk prediction models.MethodWe systematically reviewed the literature from March 2014 to September 2018 for publications presenting a dementia risk prediction model.ResultIn total 137 publications were included in the qualitative synthesis. Three analytical techniques are commonly used: machine learning, logistic regression and Cox regression. Additionally, we identified three major methodological weaknesses: (1) overreliance on one data source, (2) poor verification of statistical assumptions of Cox and logistic regression and (3) lack of validation.ConclusionInaccurate application of analytical techniques can cause false identification of high‐risk groups and biased prognoses (Abrahamowicz et al.,1997; Exalto et al., 2014). Hence, we recommend the use and collection of larger and more diverse samples. Furthermore, the assumptions should be tested thoroughly, and actions taken if derivations are detected. Improved practice in data analysis and innovative data designs may improve dementia risk scores. References: (1) Abrahamowicz, M., du Berger, R., & Grover, S. A. (1997). Flexible modeling of the effects of serum cholesterol on coronary heart disease mortality. Am J Epidemiol, 145(8), 714‐729. (2) Exalto, L. G., Quesenberry, C. P., Barnes, D., Kivipelto, M., Biessels, G. J., & Whitmer, R. A. (2014). Midlife risk score for the prediction of dementia four decades later. Alzheimers Dement, 10(5), 562‐570. doi:10.1016/j.jalz.2013.05.1772. (3) Stephan, B. C., Tzourio, C., Auriacombe, S., Amieva, H., Dufouil, C., Alperovitch, A., & Kurth, T. (2015). Usefulness of data from magnetic resonance imaging to improve prediction of dementia: population based cohort study. BMJ, 350, h2863. doi:10.1136/bmj.h2863. (4) Tang, E. Y., Harrison, S. L., Errington, L., Gordon, M. F., Visser, P. J., Novak, G., Stephan, B. C. (2015). Current Developments in Dementia Risk Prediction Modelling: An Updated Systematic Review. PLoS One, 10(9), e0136181. doi:10.1371/journal.pone.0136181.
Physical fitness and cognitive performance in non‐demented elderly subjects
Authors: Adler Georg , Marczak Agnies 
Published: December 2020

AbstractBackgroundPoor physical fitness is a well‐known risk factor for cognitive impairment. Physical fitness is closely correlated with age and physical morbidity. We studied, whether the correlation between poor physical fitness and cognitive impairment can be ascertained when these variables are controlled.MethodThe data of 135 non‐demented participants of a dementia prevention program, who were aged between 50 and 60 years, were evaluated (mean age: 55.3 years). Physical fitness was examined using the Step Test (ST) for cardiorespiratory fitness and the Chair Stand Test (CST) for motor fitness. We compared subjective memory disorders, cognitive blackouts (checklist for cognitive blackouts, CKB) and objective cognitive performance between people with low and normal physical fitness.ResultThe participants with low cardiorespiratory fitness (ST) were more concerned with their memory and they reported cognitive blackouts more frequently. They also had a lower orientation score and a lower MMSE score. The participants with low motor fitness (CST) also reported memory loss and cognitive blackouts more frequently and had lower scores in orientation, language, praxia as well as in higher cortical functions. Lower cardiorespiratory fitness was found more frequently in men and in participants with a history of high blood pressure. The participants with lower motor fitness had a higher BMI and a larger hip size.ConclusionPoor physical fitness is correlated with subjective memory disorders and cognitive blackouts as well as with minor objective cognitive impairments, even when controlling for age and physical morbidity.
New model giving insight in group of 256,000 people living with dementia in the Netherlands
Authors: van den Pol Henri 
Published: December 2020

AbstractBackgroundVektis has the complete dataset about health care claims in the Netherlands. By using the health care claims we are able to give a factual insight in how many people in the Netherlands live with dementia and what kind of health care they use. By establishing the group living with dementia in the Netherlands we can give factual numbers about prevalence, incidence and healthcare consumption. We can do this on each required level: age, gender, region, living situation and so on.MethodVektis has data about all the healthcare claims in the Netherlands. i.e.: General practitioner and all other kinds of primary healthcare, hospital care, mental healthcare to nursing homes and home care. Vektis receives data from all the health insurance companies in the Netherlands. Based on this data we can provide, a complete picture of the healthcare used while ensuring anonymity. To establish the group of people having dementia we investigate which healthcare claims are related to dementia and if they can be used to include someone in the group of people having dementia. For the criteria see table 1. The model is discussed with experts and validated with international reviews on the prevalence of dementia, see figure 1 and 2.ResultUsing the above criteria we establish a total group of 256.000 people living with dementia during the year 2017. Based upon this model Vektis has delivered several reports to support healthcare providers, healthcare insurance companies, towns, patient federations and other healthcare parties in improving the dementia care in the Netherlands.ConclusionIn this study we created an almost complete view on the group of people living with dementia in the Netherlands. This makes it possible to give insights in the integral healthcare of people living with dementia at every required level, intersection or slide. Next steps are forecasting and dashboards for regional partnerships.
Insulin resistance accounts for metabolic syndrome‐related alterations in brain structure
Authors: Lu Ran , Aziz N Ahmad , Diers Kersten , Stoecker Tony , Reuter Martin , Breteler Monique MB 
Published: December 2020

AbstractBackgroundMetabolic syndrome (MetS) is a major public health burden worldwide and associated with brain abnormalities. Although insulin resistance is considered a pivotal feature of MetS, its role in the pathogenesis of MetS‐related brain alterations in the general population is unclear. Therefore, we aimed to 1) assess the relation of metabolic syndrome (MetS) and insulin resistance with brain structure, and 2) determine to what extent the effects of MetS on brain structure are due to insulin resistance.MethodsWe used cross‐sectional data from 973 participants (43.4% male, mean age 52.5 years) of the Rhineland Study, an ongoing population‐based cohort study. MetS was defined in accordance with the revised criteria of the National Cholesterol Education Program Adult Treatment Panel III. Insulin resistance was assessed through fasting serum insulin and the homeostatic model assessment of insulin resistance. Cortical reconstruction and volumetric segmentation were obtained from high‐resolution brain images at 3 Tesla. The relation between metabolic measures and brain structural features was assessed through (generalized) linear models.ResultsMetS and insulin resistance were both associated with smaller cortical gray matter volume and mean cortical thickness, but not with white matter or subcortical gray matter volume. Vertex‐based brain morphometry showed that MetS and insulin resistance were related to brain structure in a similar spatial pattern, with the largest effect sizes observed in the precentral cortex, transverse and superior temporal cortex, and the cuneus and its neighboring regions. There was no independent effect of MetS on cortical gray matter when additionally adjusted for insulin resistance.ConclusionMetS and insulin resistance are associated with cortical gray matter thinning, especially in regions involved in motor regulation and auditory and visual processing, with insulin resistance largely accounting for MetS‐related changes in brain structure.
Living at home with dementia and incontinence: A qualitative analysis of patient, family carer and health care professionals’ perspectives
Authors: Murphy Catherine , Laine Christine , Fader Mandy 
Published: December 2020

AbstractBackgroundPeople with dementia are more likely than other people of the same age to experience bladder or bowel incontinence. This can be distressing and difficult to manage for both the person with dementia and family carers, potentially contributing to the breakdown of care at home. The aim of this work was to understand the range of problems that people face and their opinions on what could be done to better manage these problems and enable people to get on with their daily lives.MethodsUsing a semi‐structured topic guide, participants were interviewed about their experiences and views on the problems associated with living at home with both dementia and incontinence and the support that people would like to receive. People with dementia and family carers were invited via www.joindementiaresearch.nihr.ac.uk, dementia cafes and their nurses (dementia or continence specialists). Healthcare professionals (dementia care and continence care specialists) were invited via their employer. The interviews were transcribed and constant comparison techniques were used to interpret the data.Results45 people (27 family carers, 2 people with dementia and 16 healthcare professionals) took part. Many carers found coping with incontinence to be the most challenging part of their caring experience. They reported feeling unsupported, lacking information and expert advice, plus continence management product provision was often found to be inadequate. Dementia nurses reported little knowledge of continence care and continence nurses had not received any dementia specific training. When continence problems develop, carers generally rely on continence information from peers or product manufacturers. Many said they had initially viewed incontinence problems as a “red line” beyond which they would no longer be able to provide care. For some, this was the case, but others adapted to providing continence support. Many carers reported a distressing period of trial and error when learning how to manage with new onset continence issues.ConclusionFar more could be done to help support people to live well with the combination of dementia and incontinence. Currently there is little or no support or expertise available. There were two urgent priorities: Better information/advice and appropriate product provision.
Performance on the graded naming test in a population‐based sample of 72‐year‐olds: Associations with life‐course predictors and β‐amyloid pathology
Authors: Street Rebecca E. , Lu Kirsty , Huckvale Mark , Brotherhood Emilie V. , Pavisic Ivanna M. , James Sarah‐Naomi , Keuss Sarah E. , Buchanan Sarah M. , Parker Thomas D. , Lane Christopher A. , Keshavan Ashvini , Murray‐Smith Heidi , Cash David M. , Coath William , Wong Andrew , Fox Nick C. , Richards Marcus , Schott Jonathan M. , Crutch Sebastian J. 
Published: December 2020

AbstractBackgroundWord‐finding difficulties are a common early feature of Alzheimer’s disease (AD) and may be detectable during the preclinical stage. However, the relationship between changes in naming ability and accumulation of β‐amyloid pathology is not fully understood, and questions remain about the role of factors such as sex and education.MethodParticipants in Insight 46, a sub‐study of the British 1946 birth cohort, completed baseline cognitive assessments and neuroimaging (combined MRI/18F‐Florbetapir‐PET) at age 69‐71. Follow‐up assessments are currently underway (mean interval 28.9 months, SD 2.1) and include an audio‐recorded version of the 30‐item Graded Naming Test (GNT), which was not administered at baseline. Preliminary interim analyses have been conducted based on 211 cognitively‐normal individuals with complete neuroimaging data (see Table 1 for characteristics). A multivariable regression model was used to investigate predictors of picture naming accuracy, where the outcome was GNT score (max. 30) and predictors were sex, age at follow‐up assessment, β‐amyloid status at baseline (positive / negative), APOE genotype (ε4 carrier/non‐carrier), and prospectively‐collected measures of childhood cognitive ability, education and socioeconomic position (based on occupation). Due to the negatively‐skewed distribution of GNT scores, bootstrapping was used to produce bias‐corrected and accelerated 95% confidence intervals from 2,000 replications.Results will be updated to include the full sample before the conference. We also plan to include data on naming latency extracted from the audio‐recordings, which may be a more sensitive measure of early changes than naming accuracy.ResultHigher childhood cognitive ability predicted higher GNT scores over 60 years later (Table 2, Figure 1). Men scored 0.9 points higher than women on average. Amyloid‐positive participants scored 1.2 points lower than amyloid‐negative participants on average. These effects were all significant at the 5% level and were mutually independent.ConclusionSubtle changes in naming accuracy associated with β‐amyloid pathology are detectable in cognitively‐normal individuals as early as age 72. Performance is additionally influenced by sex and general cognitive ability, so these factors should be accounted for where possible in future studies and clinical trials that seek to detect and track the emergence of naming deficits.