bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical effectiveness of the NIDUS randomised control trial of a tailored, goal‐focused intervention for increasing goal attainment in people living with dementia and their family carers
Authors: Budgett Jessica , Barber Julie , Hunter Rachael M , Rapaport Penny , Lord Kathryn , Livingston Gill , Manthorpe Jill , Hoe Juanita , Rockwood Kenneth , Howard Robert J , Butler Laurie , Orgeta Vasiliki , Walters Kate , Cooper Claudia 
Published: December 2023

AbstractBackgroundMost people living with dementia want to remain living in their own homes and are supported to do so by family carers. We have co‐produced, with family carers of people with dementia and health and social care professionals, a psychosocial intervention (NIDUS‐family). NIDUS‐family is the first fully manualised intervention that is tailored to personal goals of people living with dementia and their families and is delivered by facilitators without clinical training. The intervention utilizes components of behavioural management, carer support, psychoeducation, communication and coping skills training, enablement, and environmental adaptations, with modules selected to address dyads’ selected goals.MethodA randomised, two‐arm, single‐blind, multi‐site clinical trial involving 302 people living with dementia‐family carer dyads. Dyads were randomised 2:1 to receive the NIDUS‐family intervention with usual care (n = 204) or usual care alone (n = 98). The intervention group received over 1 year, 6‐8 video call or telephone sessions (or face to face if COVID‐19 restrictions allowed) in the initial 6 months, followed by telephone follow‐ups every 1‐2 months to support implementation, with a trained facilitator. We will evaluate the effect of NIDUS‐family and usual care on attainment on goals set by family carers towards the care recipient living as well as possible at home, as measured by Goal Attainment Scaling (GAS), compared to usual care alone at 12‐month follow‐up. Secondary outcomes measures include functioning, neuropsychiatric symptoms of care recipients, time remaining living at home and care costs, and family carer mood, quality of life and reported abusive behaviours.ResultThe trial recruited to target, with good adherence to the intervention (85% fully adherent) and trial retention to date (87% at 6‐month follow‐up). The trial’s 12 month follow up data will be completed in early May 2023 and results will be analysed and ready to share by July 2023.ConclusionOur intervention, which we adapted to include remote delivery prior to commencement due to the COVID‐19 pandemic, aims to address barriers to living as well and as independently as possible. If effective, NIDUS‐family is potentially scalable to benefit many people living with dementia and their family carers.
Transcranial pulse stimulation (TPS) as a method for treating the central nervous system of patients with Alzheimer’s disease
Authors: Ziegenbein Marc , Rößner‐Ruff Vanessa , Clark Daniel 
Published: December 2023

AbstractBackgroundDementia ‐ one of the most common diseases in old age ‐ is often only diagnosed at a late stage. Therefore patients with dementia have often a 1.4 to 3.6 times greater risk of treatment as an inpatient. Consequently it is highly relevant within the caring system to identify and treat the onset of dementia at the earliest possible opportunity.Part of a new treatment center, a psychiatric clinic in the Hanover area (Wahrendorff) has concentrated on treating patients with a mild or moderate form of Alzheimer’s disease as early as possible on an outpatient basis. The method of transcranial pulse stimulation (TPS®) with the Neurolith® system is used. Acoustic pulses generated outside the body are introduced specifically into the brain regions requiring treatment. The aim being the release of growth factors and an improvement in cerebral blood flow, as a means of maintaining and promoting cognitive performance for as long as possible. The poster contribution shows reports from clinicians, patients and relatives, using TPS®. The development of cognitive performance in the course of treatment is also considered.MethodThe data collection for the quantitative study design will take place at the clinic in the period from 06/2021 to 10/2022 (N = 61). Cognitive performance is recorded using the Montreal Cognitive Assessment (MoCA test) and the experience reports via interview.ResultResults of repeated measurement and analysis of the variance in terms of cognitive performance (MoCA test, baseline and follow‐up measures) showed cognitive improvements.ConclusionTranscranial pulse stimulation is a new and promising approach in the treatment of Azheimer’s disease.
Cobalt exposure triggers impairments in cognitive and anxiety‐like behaviors, brain oxidative stress and inflammation, and hippocampo‐amygdala histomorphological alterations: Protective role of aqueous Prosopis africana seed extract
Authors: Oria Rademene Sunday 
Published: December 2023

AbstractBackgroundCobalt toxicity has become a health concern in recent years, due to overexposure resulting in neurological impairments like dementia. With a growing interest in the therapeutic roles of herbs, in toxicity research, it’s worth looking into the curative effects of aqueous Prosopis africana seed extract, a plant rich in flavonoids on cobalt‐induced dementia‐like and anxiogenic behaviour.MethodWe treated rats with Cobalt (CoCl2) or CoCl2 in combination with aqueous Prosopis africana seed extract (PAE) orally for 14 days. Control rats received distilled water for the same period. Following treatments, behavioral experiments for cognition and anxiety, analysis for oxidative stress, inflammation, histological and immunohistochemical analysis were performed.ResultResults revealed that CoCl2 reduced the exploration time, recognition index in the novel object recognition test, percentage spontaneous alternation in the Y‐maze tests, and reduced open arm entry and duration in elevated plus‐maze. However, treatment with PAE improved these parameters to levels comparable with those of the control group. Furthermore, PAE therapy reduced CoCl2‐induced surge in hydrogen peroxide, malondialdehyde, TNF‐α and IL‐1β levels in brain homogenate, while also increasing superoxide dismutase and reduced reduced‐glutathione activities. CoCl2 exposure resulted in obvious features of neurodegeneration like nuclear disintegration, nuclear shrinkage, and cytoplasmic vacuolations of the cells of the hippocampus and amygdala, with an increased expression of GFAP. The hippocampal and amygdala histology improved after PAE administration, while exacerbated GFAP expressions were attenuated.ConclusionThese findings imply that PAE may be anxiolytic and can help reduce cognitive impairments and hippocampal damage caused by CoCl2 neurotoxicity, via mechanisms that involve attenuation of oxidative stress and neuroinflammation.
Association of the cognitive reserve with the age of onset of mild cognitive impairment and dementia in patients with or Alzheimer’s disease. Antioquia, Colombia.
Authors: Orrego Natalia Trujillo , Medina Marisol , Sanchez Juan Pablo , Londono Natalia , Parra‐Rodriguez Mario A , Aguirre‐Acevedo Daniel C. , Lopera Francisco 
Published: December 2023

AbstractBackgroundThe cognitive reserve (CR) has been associated with the extension/compensation of the mental functioning of individuals affected by a neurodegenerative disease in the early stages of the disease. Most of the analyses evaluating CR are in high‐income countries, while there is a lack of capturing the variability related to low‐middle‐income environments such as Colombia. Objective: to analyze the relationship between CR and the age of onset of MCI and/or dementia by Alzheimer’s disease (AD) in patients from Antioquia‐Colombia.MethodA retrospective cohort study of 194 individuals. Clinical and socioeconomic characteristics were described using absolute and relative frequencies, followed by a mixed principal component analysis to represent the CR. A Varimax rotation was used for its interpretation, generating Z scores for the CR and the resulting dimensions. CR was categorized according to the median as high or low. This categorization aims to assess differences in the onset time of MCI and dementia by AD for the survival analysis and Cox regression with multiple imputation models (m = 30). We also examined all data to estimate the raw effect and adjusted for age, sex, and area.Resultsfrom 194 patients, 151 informed the age of onset of MCI, and 165 were later diagnosed with dementia by AD. There were differences between 5 and 9 years in the median age of onset of MCI and dementia by AD, with a later onset for patients with high CR. The CR hazard ratios (HR) were 1.05 and 0.97 for MCI and dementia, respectively. The ratio for the total score tended to be null after adjustment with confounding variables. However, its dimensions remained significant. Specifically, the HRs for an academic position, growing environment, and family status increased the speed of onset of the outcomes for MCI: 1.43, 1.06, and 1,72 and dementia: 1.40, 1.12, and 1.68.Conclusionthe onset times of the MCI and dementia were five years later in subjects with higher CR. Thus, a high academic position, a protective growth environment, and a family status that favors social relationships were associated with the reduction in clinical symptoms of AD since the early stages.
Central‐acting vs. Peripheral‐acting Angiotensin Converting Enzyme‐inhibitors and the risk of Alzheimer’s disease: A cohort study
Authors: Adesuyan Matthew , Brauer Ruth , Jani Yogini 
Published: December 2023

AbstractBackgroundCerebral Angiotensin converting enzyme (ACE) has been shown to cleave amyloid‐beta (Aβ) and its expression may have a protective effect on the risk of Alzheimer’s disease (AD). However, there are conflicting reports of the association between ACE‐inhibitors (ACEi) and AD. ACE‐i drugs differ in their ability to cross the blood brain barrier and inhibit cerebral ACE activity. No previous study has investigated the effect of ACE‐i on the risk of AD based on their different pharmacological properties.MethodA population based cohort study was performed using real‐world data from the IQVIA Medical Research Database (IMRD‐UK). Adults aged ≥40 years initiating ACEi therapy were followed from 2000‐2021. Based on previous studies of tissue‐specific ACE‐activity and radio‐labelled imaging after administration of ACEi, we classified ACEi as either central (CA) or non‐central (NC) acting. New users of CA‐ACEi were compared with new users of NC‐ACEi. Diagnostic read codes linked to clinical diagnoses were used to measure the primary outcome of incident AD. Potential confounders including, laboratory results, socioeconomic status, comorbidities, co‐prescriptions, smoking, alcohol and body mass index were adjusted for using multivariable Cox proportional hazard regression to estimate adjusted hazard ratios (HR) with 95% confidence intervals (CI).ResultThe cohort included 808,180 new ACEi initiators, with 7,356 newly diagnosed with AD during a median follow up of 8 (IQR 4‐12) years. The crude incidence rate (IR) for users of CA‐ACEi was 18.6 per 10,000 PYAR (95% CI 18.2‐19.1) and 21.6 per 10,000 PYAR (95% CI 19.3‐24.2) in NC‐ACEi initiators. The adjusted HR for the associated risk of AD in CA‐ACEi compared to NC‐ACEi was 0.83 (95% CI, 0.74‐0.94; p = 0.002). Primary results were robust to sensitivity analysis that required the outcome of AD to include both a clinical diagnosis and prescription for symptomatic treatment of AD; HR 0.80 (95% CI 0.69‐0.92; p = 0.002).ConclusionConversely, CA‐ACEi with penetrative blood‐brain‐barrier properties were associated with a lower risk of AD compared to NC‐ACEi. This may be due to improved cerebral blood flow and the prevention of angiotensin II‐mediated inhibition of acetylcholine. Our results question the significant contribution of ACE mediated Aβ degradation.
The Relationship between dementias and zip codes in the US: The African American community and higher rate of Alzheimer’s disease
Authors: Shah Yogesh 
Published: December 2023

AbstractBackgroundNot many people will connect the dementia rate with the person’s ZIP Code, but unfortunately, our ZIP Code significantly influences our overall health, including dementia. Many Black Americans experience a higher rate of Alzheimer’s and vascular dementia compared to whites, and the disproportionate impact is devastating, especially for black women. The risk of developing Alzheimer’s is two to three times higher for Black Americans—who are diagnosed at later stages—than for the general population.MethodThrough literature search, small group discussion with African American community members and faith‐based community leaders, education about relationship between dementia and zip codes was addressed.ResultsFaith‐based communities can play a significant role in improving chronic conditions, awareness, and early detection, especially in the African American patient population.ConclusionAs the U.S. population ages and communities of color become a higher proportion of the older population, a higher percentage of those with Alzheimer’s disease will be people of color. It is not entirely clear why Black Americans are at a higher risk. Still, current research suggests that the increase may be related to three factors: Higher rate of Chronic conditions ‐ the connection between vascular conditions and dementia; Delayed diagnosis ‐ Black participants in Alzheimer’s disease research studies were 35% less likely to be diagnosed than white participants and Social Determinants of Health (SDOH) ‐ there is a link between SDOH and dementia. Unfortunately, in the USA, our zip code is more important than our genetic code.
Tolerability and Likeability of a Cognitive Training Program in an Outpatient Memory Care Clinic
Authors: Ashish Dev , Anderson Allan A 
Published: December 2023

AbstractBackgroundPatients with mild cognitive impairment (MCI) or early stages of dementia often search for treatments to improve their cognitive and daily functioning or help with managing their deficits. Research suggests that multi‐component non‐pharmacological interventions provided to patients with caregivers have similar benefits as pharmacological treatments but without any side effects. Previously, we presented about developing a multi‐component and multi‐domain cognitive training program for patients and care partners. Here, we present the information about the tolerability, likability, and efficacy of the cognitive intervention.MethodThe cognitive training consists of approximately 20 sessions provided to dyads of patients with MCI or early stages of dementia and their care partners. The cognitive training program includes three main components:• Psychoeducation, training, and problem‐solving for healthy brain behaviors.• Psychoeducation, training, and problem‐solving for compensatory strategies.• Psychoeducation and cognitive training addressing attention, processing speed, executive functioning, and memory domains.A total of 14 patients started the treatment (male = 9; female = 5) that ranged 62 to 85 years of age. Diagnoses included MCI due to TBI (n = 1), Alzheimer’s (n = 1), Vascular (n = 1), or unclear (n = 5) etiologies; or dementia due to Alzheimer’s (n = 2), Parkinson’s (n = 1), Mixed (n = 3) etiologies. At the end of the training, patients completed a brief survey about their experiences.ResultsFive out of 14 patients completed the training. Four patients with MCI who completed the treatment demonstrated improvements in cognition, quality of life, improved mastery of daily activities, reduced complaints of cognitive dysfunction, and reduced caregiver burden. Only one patient with dementia completed the treatment and remained stable. All patients who completed the treatment found it helped in their daily functioning and patients rated the treatment 4 out of 4, where 4 stands for “very likely” they would recommend this training to someone who is experiencing cognitive difficulties.Four patients with MCI with significant psychological symptoms did not complete the program and five patients with dementia needed more support with caregiving and resources.ConclusionMulti‐component and multi‐domain cognitive training program with patients and care partners is best tolerated by patients with MCI. Further research will establish statistical and clinical significance.
Increased monocyte activity identified in Alzheimer’s disease by in depth single‐cell genomic and proteomic analysis
Authors: Xu Stacy , Schulz Michael , Schmidt Ronny , Richter Mario , Klein Marco , Hufnagel Katrin , Schroeder Christoph , Scolnick Jonathan 
Published: December 2023

AbstractBackgroundAlzheimer’s disease (AD) patients show sustained levels of inflammation in the brain and the peripheral immune system. It is not known how various peripheral blood mononuclear cells (PBMCs) differ in AD patients and whether those differences can act as biomarkers of AD. Here we performed a multi‐omic profiling of PBMCs from AD patients and compared the composition of their cell type and cell state as well as their gene and protein expression to normal controls.MethodSingle‐cell proteogenomics analysis was performed on PBMCs from 20 AD patients and 15 controls using Singleron Biotechnologies’ ESCAPE platform. Seven of the AD and four control samples were additionally analyzed for bulk protein expression using Sciomics’ scioDiscover platform.ResultBulk proteomics identified 100 proteins with a significant differential abundance between AD patients and controls. Data point to a higher platelet activation and degranulation, as well as changes in the EGFR / MAPK3 and VEGF signaling in AD. As an individual marker CD163 was identified at a higher abundance in AD PBMCs pointing to an increase in monocyte / macrophage activity.From the single‐cell analysis we found that AD patients had significantly more CD14+ monocytes. We further found that the CD14+ monocytes could be split into seven clusters based on their gene expression with only two clusters having a significantly higher number of cells in AD patients. One of the overrepresented clusters showed high expression of Alarmin genes, suggesting an increased inflammatory environment, while the other cluster showed a higher level of HLA expression suggesting a state primed for activation.ConclusionWe found significant changes in both gene and protein expression in PBCMs from AD patients that indicate an increased inflammatory state . While there was a good overlap of findings between gene and protein expression, some of the changes are only seen at the protein level, while others are only observed at the level of gene expression. The combination of the two measurement techniques provides us with additional insights into inflammatory nature of the peripheral immune system in AD patients and provide hints at the mechanisms different cells use to generate those inflammatory signals.
Novel Nutrition‐Related Genetic‐Clinical‐Radiological Nomogram to Predict Behavioral and Psychological Symptoms in Patients with Alzheimer’s Disease
Authors: Jiang Jiwei , Li Wenyi , Xu Jun 
Published: December 2023

AbstractBackgroundBehavioral and psychological symptoms of dementia (BPSD) are important and heterogeneous disturbances in Alzheimer’s disease (AD), affecting patient quality of life and increasing caregiver burden. Few effective treatments are available due to the complex reasons. This study aimed to develop a reliable genetic‐clinical‐radiological model for predicting the risk of the BPSD in patients with AD and further to explore the underlying mechanism of BPSD.MethodWe conducted a nested case‐control study, including 110 AD patients with BPSD, and 55 matched AD patients without BPSD from the Chinese Imaging, Biomarkers and Lifestyle (CIBL) Cohort. The participant data collected in this study comprised demographic data, medical history, the APOE e4 allele carrier status and the variants of SNP sites of the CLU, SORL1, ABCA7, MTHFR, COMT, and the CETP. The comprehensive assessment, including MMSE, ADL, MNA, CBI, and PSQI were compared between the two groups. The regional brain volumes of all patients were performed with structural 3DT1‐weighted imaging. Multivariate logistic regression analyses were used to identify the independent genetic, clinical and radiological influencing factors associated with BPSD. We developed a novel nomogram for predicting the risk of BPSD in the patients with AD, and the predictive ability was evaluated by receiver operating characteristic (ROC) curves and concordance index.ResultA multivariate conditional logistic regression model demonstrated that CETPrs1800775*A variants, the lower scores of MNA scales, the higher scores of CBI scales, and the obvious atrophy of brainstem were significantly independently associated with BPSD in patients with AD. A novel nomogram was established to predict the risk of BPSD in patients with AD based on the findings of multivariate conditional logistic regression (Figure 1). The internal validation of AUC‐ROC value of this predictive model was 0.925 with a high sensitivity (89.1%) and specificity (83.6%) (Figure 2).ConclusionThe novel predictive genetic‐clinical‐radiological model and nomogram based on the CETPrs1800775*A variants, MNA scores, CBI scores and brainstem volume can be useful for predicting the risk degree of BPSD in the patients with AD. This finding suggests nutrition‐related gene and brain region could risk BPSD through regulating the nutritional status for further exploring the underlying mechanism of BPSD.
Effects of mindfulness‐based intervention on neuropsychiatric symptoms and psychological well‐being in older adults with subjective cognitive decline and mild cognitive impairment: A meta‐analysis of randomised controlled trials
Authors: Rose Lin SY , Su Jingjing , Abu‐Odah Hammoda , Bayuo Jonathan 
Published: December 2023

AbstractBackgroundNeuropsychiatric symptoms (NPS) are highly prevalent and could progress cognitive decline towards dementia among the population with subjective cognitive decline (SCD) and mild cognitive impairment (MCI). Although emerging studies showed that mindfulness‐based intervention improved psychological well‐being among clinical and community population, its effectiveness for people at the pre‐dementia stages remain largely unknown. This meta‐analysis was conducted to examine the effect of mindfulness‐based intervention on NPS and psychological well‐being among this preclinical cohort.MethodEligible studies published from inception to August 2022 were retrieved from MEDLINE, EMBASE, JBI‐EPB, Web of Science, PubMed and Cochrane. Literature search and data extraction were conducted by two independent researchers. Methodological quality of the included studies was assessed by the Cochrane Risk‐of‐Bias Assessment Tool. Meta‐regression was conducted to examine the effects of intervention design and sample characteristics on study heterogeneity.ResultEighteen randomized controlled trials (n = 974) published between 2013 and 2022 were identified. Mindfulness‐based intervention had significant immediate post‐intervention effects on improving anxiety (SMD = ‐0.39, 95%CI‐0.76,‐0.03, stress (SMD = ‐0.58;95%CI‐0.91,‐0.25), and quality of life (SMD = 0.50, 95%CI0.04,0.95), no significant effect was detected for depression, apathy, mindfulness, and stress‐related biomarkers. No statistically signifciant follow‐up effects were detected for depression and anxiety. Meta‐regression suggested that the studies applied on SCD was associated with larger effect size in depression, while Kundalini Yoga and Kirtan Kriya mindfulness meditation was associated with greater improvement in anxiety.ConclusionThis review demonstrated the beneficial effects of mindfulness‐based intervention on anxiety, stress, and quality of life in the population with SCD and MCI. Future studies may incorporate informal mindfulness practice to facilitate its translation into everyday living. More rigorously designed and large‐scale randomized controlled trials evaluated by both self‐report and physiological parameters are warranted.