bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incremental validity of the Test of Practical Judgment
Authors: Premnath Pranitha Y , Nester Caroline O , Krishnan Anjali , Pare Nadia , Wilhelm Anna F , Zatkalik Abigail L , Warren David E , Rabin Laura 
Published: January 2025

AbstractBackgroundJudgment is an aspect of executive functioning that is critical to many aspects of daily functioning, and often affected in older adults with cognitive decline. The Test of Practical Judgement (TOP‐J) evaluates judgment related real‐world issues that may arise in aging populations. The current study investigates the incremental validity of the TOP‐J—i.e., the degree to which the TOP‐J adds unique and meaningful information to a clinical assessment beyond other executive functioning tests which are often used as proxies for judgment.MethodsParticipants (N = 97, Mage = 74.73; 74.2%female) who were classified as cognitively unimpaired (CU), subjective cognitive decline (SCD), or mild cognitive impairment (MCI) completed comprehensive neuropsychological evaluation, which included the Wisconsin Card Sorting Test (64‐card version) and Delis‐Kaplan Executive Function System tests of Verbal Fluency and Trail Making Test, Condition 4. Incremental validity was assessed through hierarchical linear regression analysis and was measured by the addition of the TOP‐J (Forms A, B, a composite of A + B), above these widely used executive functioning tests, with clinical diagnosis (CU, SCD and MCI) as the outcome.ResultsThe addition of the TOP‐J A was statistically significant (R2 = .299, F(1,90) = 3.95, p = 0.05) and added incremental validity to predict diagnosis (∆R2 = .031, p = 0.05). The addition of the TOP‐J forms A + B composite also was significant (R2 = .307, F(1,90) = 4.99, p = 0.03, and added incremental validity(∆R2 = .038, p = 0.03), while the TOP‐J B trended toward significance (∆R2 = .024, p = 0.08).ConclusionOur results suggest that including the TOP‐J within neuropsychological evaluations of older adults can enhance diagnostic accuracy and provide clinically valuable information beyond what is derived from traditional executive functioning tests. Considering potential adverse impacts of impaired judgement abilities in the context of neurodegenerative disease, it is of utmost importance to improve the detection of diminished practical judgment skills to increase the protection of vulnerable populations and to prevent potential financial, social, and other areas of exploitation that may occur.
Influence of behavioral and psychological symptoms on caregiver burden for different types of dementia: clinical experience in Lima, Peru
Authors: Montesinos Rosa , Custodio Belen , Malaga Marco , Chambergo‐Michilot Diego , Verastegui Graciet , Agüero‐Flores Katherine , Alejos‐Zirena Juan , Andamayo‐Villalba Luis , Seminario G Wendy , Custodio Nilton 
Published: January 2025

AbstractBackgroundPeople caring of individuals with dementia are prone to suffering from burden. Behavioral and psychological symptoms of dementia (BPSD) may have an impact on caregiver burden. In Latin American countries there is lack of research on caregiver burden. We aimed to determine which BPSD have the greatest impact on caregiver burden among Peruvian patients with dementia; and to compare the effects of BPSD on caregiver burden across different types of dementia.MethodsCross‐sectional study of 231 patients living with Alzheimer’s dementia (AD), behavioral variant frontotemporal dementia (bvFTD), dementia with Lewy bodies (DLB) and vascular dementia (VD), and their caregivers attended in a Peruvian memory clinic. BPSD were assessed with the Neuropsychiatric Inventory (NPI). Caregiver burden was assessed with the Zarit Burden Inventory (ZBI). We used analysis of variance to compare the groups of AD, bvFTD, DLB and VD. Correlations between ZBI and NPI subscale scores were assessed with Spearman’s correlation.ResultsDLB caregivers had significantly higher levels of burden than the other patient groups (P < 0.05), and higher total NPI scores than caregivers for other patient groups (P < 0.05). bvFTD caregivers had significantly higher total NPI scores than AD and VD caregivers (P < 0.05). Hallucinations, aberrant motor behavior, and apathy were the symptoms most significantly correlated with caregiver burden in those caring for DLB, bvFTD, and AD patients, respectively.ConclusionsNeuropsychiatric symptoms are higher in DLB caregivers. Hallucinations, aberrant motor behavior, and apathy are the main symptoms correlated with burden.
Review of the MMSE as a Pre‐Screening Tool for Dementia in Clinical Trials
Authors: Voccia Pamela , Fundora Noel , Jones Cyntauria , Thomas Sheniba Pennyfeather , Boateng‐Poku Andrew , Otekalu Olumide 
Published: January 2025

AbstractBackgroundThe Mini Mental State Exam (MMSE) is a widely used prescreening tool in dementia research.MethodPsychometric Raters from two sites within the Alcanza Clinical Research network collected MMSE data from 85 potential subjects who presented for memory trials. Subjects were later screened for Alzheimer’s Dementia studies, and the results from subsequent administrations of the Clinical Dementia Rating scale were available for 53 of those subjects.ResultAll 85 prescreening subjects endorsed memory concerns as the primary complaint. However, 56% (n = 48) scored within the Normal Cognition range (25‐30) on the MMSE.Comparisons were made between some of the MMSE total scores and the calculated Global scores on subsequent administrations of the Clinical Dementia Rating scale (n = 53). The Clinical Dementia Rating Scale (CDR) is a semi‐structured clinical interview involving self‐report of memory, caregiver reports and clinician observations of cognition. The CDR is widely considered to be a reliable measure of the presence of symptoms related to dementia.The range of the total MMSE scores for 53 subjects later evaluated with the CDR was between 18 and 28. Of those, all 53 (100%) were revealed to have symptoms of dementia based on CDR scores (CDR 0.5‐2), even though 33% of those patients had scored within the Normal range on the MMSE (25‐30; N = 18).The average MMSE score for subjects falling within the Very Mild Dementia range (CDR = 0.5) was 23.9 with a standard deviation of 2.5 (n = 41). Of the subjects falling within this range, 41% scored within the Normal range on the MMSE (MMSE = 25‐28).The average MMSE score for subjects falling within the Mild to Moderate Dementia range (CDR 1 or 2) was 21.2, with a standard deviation of 2.9 (n = 12). Of the subjects falling within this range, 1 patient (8%) scored within the Normal Range on the MMSE (MMSE = 26).ConclusionBased on this limited analysis, it appears that using the MMSE alone as a screener for dementia may result in missing up to 33% of symptomatic patients. Within these sample groups, the initial self‐endorsement of memory concerns was a more reliable predictor of CDR outcomes than the MMSE.
Early identification of participants at risk of cognitive decline: An online tool for patient prediction of cognitive decline
Authors: Cespedes Marcela Ines , Canovas Rodrigo , Gillis Cai , Maserejian Nancy N , Maruff Paul , Fowler Christopher J , Rainey‐Smith Stephanie R , Martins Ralph N , Masters Colin L , Doecke James D. ,   The ADOPIC Consortium
Published: January 2025

AbstractBackgroundThe success of therapeutic options for treatment of Alzheimer’s disease (AD) and the growing emphasis for such treatment to commence in the pre‐clinical phase makes it necessary to have robust empirical models of clinical disease progression to understand findings from clinical trials, allow clinicians to evaluate effects of new drugs, and to select individuals for future trials. Such models have been developed from relatively small samples, with incomplete data/substantial loss to follow‐up. The ADOPIC consortium provides the largest complete AD natural history sample to date. We applied our sigmoid models of disease progression to cognitive data from ADOPIC, and developed an algorithm to predict cognitive change.MethodWe developed an online application (Prediction of Alzheimer’s Disease Progression Tool, [PADPT]) to estimate decline in cognition over the course of AD within 2,861 ADOPIC participants (1,434 Cognitively unimpaired [CU], 342 MCI [Mild Cognitive Impairment], 211 AD, and 847 progressed from CU→MCI or MCI→AD), with ≥1 PET Amyloid (Aβ) scan and ≥36 months of cognitive assessment with the pre‐clinical Alzheimer’s cognitive composite (PACC). Individual participant slopes were defined according to age and gender using linear mixed effects models. Aβ+ (≥50CL) participant rates of decline vs their mean PACC score were investigated using quantile polynomial regression. Within PADPT, single visit information on age, clinical classification and APOE ε4 allele status is entered to compute the estimated annual rate of decline. Candidate results are mapped to the sigmoid curve to determine their predicted rate of cognitive decline over the chosen time period.ResultQuantile regression bands (QRB’s) aligned with participant cognitive decline. Individuals with stable cognition clustered to the top right of the plot (Figure 1). Mean slopes for APOE ε4 allele status separated QRB’s for CU and AD, but not for MCI groups. All participants allocated to cognitive decline groups (past the first sigmoid inflection point) demonstrated decline in PACC score that remained in the QRB’s, regardless of initial clinical classification.ConclusionUsed in conjunction with baseline profile information, the PADPT application can assist with clinical decision making both pre and post‐treatment and also identify suitable clinical trial candidates who, untreated, will show subtle decline in cognition.
Sex differences in the relationship between physical activity and cognition as mediated by leukocyte telomere length: a UK Biobank study
Authors: Ortega Nancy E , Aslanyan Vahan , Pa Judy 
Published: January 2025

AbstractBackgroundEvaluating sex differences in modifiable risk factors for Alzheimer’s disease could provide valuable information regarding the mechanisms by which these factors confer risk. Physical activity is a risk factor that has been shown to positively impact both telomere length, a marker of cellular age, and cognition. The goal of this study was to evaluate whether telomere length mediates the association between physical activity and cognition differently by sex.MethodParticipants from the UK Biobank were included in the sample based on availability of demographic variables, physical activity questionnaires, leukocyte telomere length, and cognitive measurements (Fluid Intelligence (FI), Numeric Memory (NM), Reaction Time (RT)). Metabolic Equivalent Task (MET) scores were derived from self‐report questionnaires following the International Physical Activity Questionnaire (IPAQ) guidelines. Relative leukocyte telomere length was measured by quantitative PCR and adjusted for technical variation by the UK Biobank. The indirect effect of physical activity on cognition via telomere length was evaluated using causal mediation analyses in R. Models were adjusted for age, body mass index, and Townsend Deprivation Index (Figure 1). A priori sex‐stratified models were used to examine sex differences.ResultThe sample included 374,761 adults (52.2% women, mean age±SD = 56.3±8.12 years, see Table 1). Linear regression analyses identified negative associations between weekly physical activity measures (i.e., summed MET minutes of all activity p<0.05*, MET minutes of moderate activity p<0.001***) and telomere length in men. This negative relationship was similarly found in women (MET minutes of walking p<0.05*), except for MET minutes of vigorous activity where a positive relationship with telomere length was observed (p<0.05*). In men, telomere length mediated the relationship between MET minutes of moderate activity and FI scores (p<0.001***), whereas in women this was only seen for walking (p = 0.04*). The association between vigorous activity and performance on the NM task was mediated by telomere length in women only (p = 0.04*). Lastly, telomere length mediated the relationship between RT performance and summed minutes of all activity in men only (p<0.001***).ConclusionTelomere length mediates the relationship between physical activity and cognition differently in men and women based on the intensity level of the physical activity.
Usefulness of The Test of Practical Judgement for the detection of MCI in a Southeast Asian Population
Authors: Tanoto Pricilia , Leow Yi Jin , Ghildiyal Smriti , Lee Faith Phemie Hui En , Liew Shan Yao , Tan Isabelle Yu Zhen , Chong Wayne Freeman , Seah Eunice Limin , Azam Mohammed Adnan , Vipin Ashwati , Sandhu Gurveen Kaur , Zailan Fatin Zahra , Tan Farid Tan Bin Hasyim , Kandiah Nagaendran 
Published: January 2025

AbstractBackgroundThe Test of Practical Judgement (TOP‐J) in its 9‐item (TOPJ9) and 15‐item (TOPJ15) versions (Rabin et el., 2007), validated for assessing practical judgement, encompasses day‐to‐day scenarios in medical, financial, safety, and social/ethical domains. This study seeks to evaluate its utility in distinguishing cognitively unimpaired (CU) individuals from those with Mild Cognitive Impairment (MCI) within a Southeast Asian population. This investigation aims to contribute insights into the cross‐cultural applicability of TOP‐J in assessing practical judgement across varying cognitive states in the Southeast Asian context.MethodA cohort of 126 non‐demented participants from the Biomarker and Cognition Study, Singapore (BIOCIS) database underwent a comprehensive neuropsychological assessment, including TOPJ9, TOPJ15, Visual Cognitive Assessment Test (VCAT), Weschler Memory Scale (WMS‐IV) Logical Memory Story Delayed Recall, and Rey Auditory Verbal Learning Test (RAVLT) delayed test in a single session. MCI was diagnosed using the Petersen criteria (Petersen et al., 2001). Additionally, mean scores for neuropsychological tests were compared. Receiver Operating Characteristic (ROC) curve was used to assess the discriminative performance of TOP‐J between CU and MCI groups. Two‐by‐two tables facilitated the calculation of test sensitivity (Sn), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) for each test.ResultThe mean age of the 126 participants were 60.34 years ± 9.64, 38% male, mean education of 15.16 years ± 3.11, and 82% Chinese ethnicity. Significant mean differences between groups were observed for each test (p<0.05) (Table 1). ROC Analysis indicated optimal cut‐offs for MCI identification were determined for TOPJ9 (<16.5, AUC = 0.76, Sn = 0.71, Sp = 0.7, PPV = 0.57, NPV = 0.81) and TOPJ15 (<25.5, AUC = 0.79, Sn = 0.55, Sp = 0.9, PPV = 0.75, NPV = 0.78). Discriminative properties with story delayed and RAVLT delayed are detailed in Table 2.ConclusionBoth TOP‐J 9 and 15 items are useful for the detection of MCI in a Southeast Asian population. They exhibit comparable efficacy with other neuropsychological tests for MCI detection in Southeast Asian participants. Further validation through a longitudinal study is essential to solidify their diagnostic utility in this population.
Exploring PACC5 Associations with Cortical Thickness in Individuals with Subjective Cognitive Decline
Authors: Mulet‐Pons Lídia , Vaqué‐Alcázar Lídia , Solé‐Padullés Cristina , Cabello‐Toscano María , Perera‐Cruz Oriol , Abellaneda‐Pérez Kilian , Cattaneo Gabriele , Sánchez Javier Solana , Alviarez‐Schulze Vanessa , Tormos‐Muñoz Josep Mª , Pascual‐Leone Alvaro , Bartrés‐Faz David 
Published: January 2025

AbstractBackgroundIndividuals with subjective cognitive decline (SCD) express concern about self‐perceived cognitive decline, despite no objective impairment, and are at higher risk of developing Alzheimer’s disease (AD). The preclinical Alzheimer’s cognitive composite (PACC5) is a sensitive cognitive marker frequently used in preclinical AD, delineating cognitive trajectories based on amyloid status in SCD. The relationship between PACC5 and brain structure remains unexplored. We aimed to study whether PACC5 associations with brain structure in an SCD group differ from those in a control group.MethodSix hundred sixteen participants from the Barcelona Brain Health Initiative cohort (https://bbhi.cat/en) underwent magnetic resonance imaging acquisition and neuropsychological assessment. Among them, 89 healthy participants (56.18±7.72 years, 61 females) met the SCD criteria (memory concerns within the last 2 years). Meanwhile, 89 non‐SCD participants were age, sex, and educationally matched as the control group. PACC5 included z‐scores from dementia screening, episodic memory, processing speed, and category fluency tests. Cortical thickness (CTh) maps were generated with Freesurfer using T1‐ and T2‐weighted images. Whole‐brain vertex‐wise general linear models were employed and adjusted by age, sex, and educational level.ResultThe SCD group showed a trend toward lower PACC5 scores (W = 4569.5, p = 0.055; Figure 1a) and a significantly thinner cortex in the right middle and inferior temporal (CWP = 0.00898; Figure 1b). Examining PACC5‐CTh associations, group interactions emerged in four clusters (Figure 2a): the left posterior cingulate cortex (CC) and precuneus (CWP = 0.005), the left rostral anterior CC and superior frontal (CWP = 0.012), and the left and right post‐central cortex (CWP = 0.019, 0.001, respectively). Separate examinations uncovered a positive association in the right post‐central and superior parietal exclusively for the SCD group (CWP = 0.001; Figure 2b).ConclusionAdults with SCD trend toward a lower PACC5, presenting a reduced temporal CTh, an early atrophied region reported in neurodegenerative disorders, compared to the controls. Thinner left anterior and posterior CC and precuneus contributed to the lower PACC5 in SCD compared to controls. These results are relevant, as the CC role in resilience processes for cognitive impairment in AD is proposed, an aspect underexplored in SCD.
Natural language processing‐based analysis of connected speech in prodromal Alzheimer’s disease
Authors: Balabin Helena , Spruyt Laure , Eycken Ella , Kabouche Ines , Tamm Bastiaan , Schaeverbeke Jolien , Dupont Patrick , Moens Marie‐Francine , Vandenberghe Rik 
Published: January 2025

AbstractBackgroundConnected speech has been explored as a possible marker for Alzheimer’s disease (AD) by employing language models based on machine learning. However, most previous approaches are based on scene description tasks, and it is unclear how different types of connected speech and differences across subjects’ speech relate to changes in their brains.MethodWe analyzed transcripts of Flemish Dutch connected speech from interviews from 74 cognitively healthy elderly adults (mean MMSE = 28.71 [25‐30], age = 73.15 years, 40 female) and 27 prodromal AD patients (mean MMSE = 25.22 [20‐30], age = 71.64 years, 13 female) across five parts: an autobiography, descriptions of a recent day, a news event, a set of nouns and the Cookie Theft scene. In the noun description task, subjects were asked to explain 10 abstract and 10 concrete nouns in detail. Using the Dutch RobBERT language model, we derived speech‐based representations for each interview part and subject, and first differentiated the two groups by fine‐tuning RobBERT with a classification layer. Then, we linked speech‐based features from the best performing task and structural MRIs for 99 subjects. Normalized gray matter volumes were processed using the Brainnetome atlas, resulting in 246‐dimensional subject representations, separated by regions. Distance matrices across subjects for speech‐ and MRI‐based representations were correlated in a representational similarity analysis (RSA), yielding Spearman correlations for each brain region.ResultFor the classification task (see Table 1), all interview parts exceeded the majority class baseline accuracy of 0.733, except for the scene descriptions. The noun descriptions resulted in the highest accuracy (0.795) and specificity (0.947) across the interview parts. Overall, classification yielded high specificity but low sensitivity. Further, the RSA correlation between the subjects’ noun descriptions and their gray matter volumes can be mainly attributed to the hippocampus, fusiform gyrus (FuG) and superior temporal gyrus (STG) (see Figure 1).ConclusionConnected speech elicited by scene description tasks reveal low accuracy and sensitivity for automated natural language processing‐based detection of prodromal AD. Noun descriptions could emerge as a viable alternative, demonstrated by their improved classification performance and link to brain regions relevant for memory and language.
Demographic Correlates of Visuo‐Cognition in a Healthy Ageing Indian Population ‐ A Cross‐Sectional Analysis
Authors: Vishwanath Vindhya , Malo Palash K. , Partha Ajith , M Divya N , Lingegodwa Abhishek Mensegere , Stezin Albert , M Amitha C , Narayanasamy Rajitha , Menon Meenakshi , R Meghana , Velavarajan Goutham , HS Deva Kumar , Arvind Prathima , S Monisha , Hameed Shafeeq K Shahul , HS Sunitha , Agrawal Deepashri , Mondal Banashree , Singh Sadhana , Sundarakumar Jonas S. , Issac Thomas Gregor 
Published: January 2025

AbstractBackgroundVisuo‐cognitive skills represent a network of different abilities that rely on vision and cognition. While visuo‐cognitive abilities have been considered prominent indicators of dementia, there is a dearth of studies that profile these abilities with demographic correlates in an aging Indian population. Investigating the pattern of visuo‐cognitive abilities is essential to facilitate early indication, better prognosis and treatment of symptoms.MethodThe sample comprises baseline data collected from 1271 urban aging individuals (≥ 45 years) who are a part of the Tata Longitudinal Study on Ageing (TLSA), Bangalore, India. Visuo‐cognition was measured by Visuospatial span (VS), Visual Attention (VA), Modified Taylor Complex Figure (MTCF) Copy, Immediate Recall (IR), Delayed Recall (DR), and the visuospatial domain from Addenbrooke’s Cognitive Examination (ACE) III. Unadjusted effect was performed using Mann Whitney U and adjustments were made using General Linear Model to examine the association between each visuo‐cognitive test and demographic factors.ResultIn the total sample of 1271 participants, there were 620 females and 651 males. Mean age of females and males is 60.2±8.68 & 63.69 ±9.61 respectively. Mean years of education in females was 14.36 with a standard deviation of ±3.92. Mean years of education in males was 15.33 with a standard deviation of ±4.07. The correlation between age and MTCF Copy Time was positive, whereas with visuospatial span, visual attention, MTCF Copy, MTCF DR, and visuospatial domain of ACE III age was negatively correlated. Females performed better on tests of VA, MTCF IR, and the visuospatial domain on ACE III. There was a positive correlation between education and visuospatial span, visual attention, MTCF Copy, IR, DR, and visuospatial domain of ACE III. A negative correlation was found between education and MTCF Copy time and no significant association of the variables with MTCF IR Time.ConclusionAge and education influenced various visuo‐cognitive components, while gender had specific impacts on visual attention and MTCF measures. These findings provide insights for early diagnosis, tailored interventions, and further investigations into cognitive health.