bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilingualism in the Clinical Diagnosis of Mild Cognitive Impairment and Dementia
Authors: Rosselli Monica , Velez‐Uribe Idaly , Coombes Stephen A. , Barker Warren W , Duara Ranjan , Smith Glenn E. , Curiel Rosie E , Loewenstein David A. , Marsiske Michael 
Published: December 2023

AbstractBackgroundNeuropsychological assessments determine the presence of cognitive impairment in Alzheimer’s Disease and Related Dementias (ADRD). These tests are susceptible to the influence of cultural and linguistic variables. Bilingualism is a potential contributor to cognitive reserve in elderly individuals. Positive effects of bilingualism have been observed in executive function tasks, while negative effects have been reported on verbal fluency tests. Maintaining two active languages may modify cognitive and brain reserve among bilinguals, but evidence is inconsistent and contradictory. We investigated the relationship between bilingualism and neuropsychological test performance in aging participants from the 1Florida ADRC using a longitudinal design.MethodsWe studied 238 Latino older adults (age 71.79 ± 8.01 years old, 65% female). 158 Latino participants were Spanish‐English bilinguals; 80 were Spanish monolinguals. Bilingualism was assessed by a proficiency questionnaire. Six cognitive composites were developed (Figure 1). We investigated cognitive test change scores between language group, visit (2 visits: M = 14.61 months; SD = 3.52), and diagnosis (normal, MCI, dementia) using 2×2×3 repeated measures ANCOVAs (age and level of education). Cognitive scores were correlated with frontal and temporal brain volumes in bilinguals and monolinguals separately.ResultsMain effects of the diagnostic group and visit were significant for all composites (ps < .001), with the dementia group showing the lowest scores. No significant main effect of Bilingualism was observed for any of the composites. An interaction between visit and bilingualism was seen for the Trail Making Test B‐ A. Three‐way interactions were found between diagnostic groups, visit, and bilingualism for the Verbal composite and the Logical Memory delay subtest (part of the Memory composite). A more significant decline in the monolingual groups was observed, more so in the dementia group. Significant correlations were found between most composites in both language groups, being more related to the temporal than frontal lobe areas, using MRI volumetric measures.ConclusionBilingualism seems to interact with cognitive decline in aging. It is essential to consider the individual’s level of bilingualism to obtain an accurate assessment of cognitive impairment. The interaction of bilingualism with other sociodemographic and cognitive variables will be discussed.
How much would England’s National Health Service have to invest to bring its capacity to deliver an Alzheimer’s treatment to G7 average capacity levels?
Authors: Mattke Soeren , Shi Zehao , Hanson Mark , Mitchell Susan , Lynch Chris , Kalonji Kirstie MacLean , Lanman Lydia 
Published: December 2023

AbstractBackgroundThe arrival of disease‐modifying treatments for Alzheimer’s disease (AD) creates a substantial challenge for health systems because of the large patient pool and a complex diagnostic pathway, and in particular, for those countries that already have comparatively low capacity to provide timely, accurate AD diagnostic services. We estimate how much NHS England would have to invest over 10 years to bring its memory assessment services infrastructure up to the average capacity of the other G7 countries and project the resulting changes in wait times for a disease‐modifying Alzheimer’s treatment.MethodDesk research and expert interviews for capacity and cost data. Markov model to estimate the effect of investment on wait times because of limited capacity for specialist visits and confirmatory biomarker testing.ResultEngland has the lowest number of MRI and PET scanners and the second lowest number of AD specialists of the G7 countries (Table 1). Closing this gap would require an estimated investment of ∼GBP 5.5 billion over 10 years, of which 9% would go toward acquisition of 126 PET and 1,196 MRI scanners including building modification, maintenance and IT equipment cost, and 91% to support operative costs (salaries, CSF assays, tracers, and facility use). On an annual basis, this number amounts to GBP 99 per capita and 3.1% of the overall NHS budget. Wait times in the diagnostic process to determine treatment eligibility would go from an average 58 months to 10 months by year 10 of the investment (Figures 1 and 2)ConclusionAs a result of a long‐standing underinvestment in health system infrastructure, wait times to receive an AD treatment would be substantial in England. Targeted investments aimed at increasing the NHS’ capacity to the average of the remaining G7 countries would decrease those wait times significantly. While the required investment is sizeable, the cost of inaction is equally so, since the disease would progress to more severe and costly stages while patients are held up on wait lists.
Lifestyle activities contribute to cognitive reserve in mid‐life, independently of education, in cognitively healthy middle‐aged individuals at risk for late‐life Alzheimer’s disease
Authors: Deng Feng , El‐Sherbiny Sandra , Heneghan Amy , Dounavi Maria‐Eleni , Ritchie Karen , Muniz‐Terrera Graciela , Malhotra Paresh A , Ritchie Craig W , Lawlor Brian , Naci Lorina 
Published: December 2023

AbstractBackgroundIt is now acknowledged that Alzheimer’s Disease (AD) processes are present decades before the onset of clinical symptoms, but it remains unknown whether lifestyle factors can protect against these early AD processes in mid‐life. Intellectually, physically, and socially stimulating lifestyle activities are associated with maintenance of late‐life cognitive abilities (Chan et al., 2018), and lower cognitive impairment in AD (Livingston et al., 2020). We asked whether such activities contribute to cognitive reserve (CR) from mid‐life, in cognitively healthy individuals who are at risk for late‐life AD.MethodMiddle‐aged individuals (aged 40‐59 years, mean = 52 years) from the PREVENT Dementia study (www.preventdementia.co.uk) were assessed at baseline (N = 210, 62/148 male/female) and two‐year follow‐up (N = 188, 55/133 male/female), with cognitive ability (multidomain battery) and brain health (total grey matter volume, functional brain network segregation) measures. Mid‐life activities were measured using the Lifetime of Experiences Questionnaire, which comprises occupational as well as intellectually, physically, and socially stimulating leisure activities. Dementia risk was assessed with the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) score.ResultMultivariable linear regression showed that intellectual, physical, and social activities undertaken in mid‐life made a unique contribution to episodic and relational memory in mid‐life, independent of occupation and CAIDE at baseline (β (se) = 0.04 (0.02), p = 0.02, Figure 1a) and follow‐up (β (se) = 0.07 (0.02), p = 0.002, Figure 1b). Furthermore, these activities moderated the relationship between cognitive ability and brain health at follow‐up (β (se) = 3.47 (1.40), p = 0.01), with verbal and visuospatial functions, and short‐term (conjunctive) memory of people with higher activity levels less dependent on their brain functional integrity (Figure 2), consistent with the concept of CR (Brayne et al., 2010). Such a moderation by these mid‐life activities was more prominent in individuals with higher CAIDE scores (β (se) = 4.28 (1.83), p = 0.02, Figure 3).ConclusionThese findings suggest that modifiable lifestyle activities contribute uniquely to CR and may offset cognitive decrements due to AD risk in mid‐life. They support the targeting of modifiable lifestyle activities for the prevention of Alzheimer’s disease.
Pathways linking educational attainment to cognitive functioning among older Brazilians
Authors: Farina Mateo 
Published: December 2023

AbstractBackgroundCognitive impairment in Brazil is a growing population health concern. Studies suggest that Brazil may have one of the highest age‐standardized prevalence of Alzheimer’s disease and related dementias (ADRD) in the world. However, improving education attainment among older adults may lead to a decline in cognitive impairment across the population in the coming years. The purpose of this study is to examine the pathways that link educational attainment to cognitive functioning in Brazil, a highly unequal, resource rich society.MethodI use the 2016 Brazilian Longitudinal Study of Aging, a nationally representative study of Brazilian older adults 50+, to predicting cognitive functioning at first interview. I use structural equation modeling to predict direct and indirect effects of education via childhood socioeconomic characteristics, adulthood socioeconomic conditions, health behaviors and health conditions on overall cognitive functioning as well as specific domains of cognition (memory vs. non‐memory).ResultFindings provide evidence of both indirect and direct pathways from education to cognitive functioning. The indirect pathways were mainly found through adulthood SES achievement (although health conditions had their own association with cognitive functioning). Additionally, indirect effects were limited among adults with 8+ years of education, suggesting that prior to 8 years of education the impact of education on cognitive functioning may be through cognitive development that is carried forward into older adulthood.ConclusionThis study shows the importance of early childhood education and the potential benefits for later life cognitive functioning, which has broad implications for cognitive health in rapidly aging countries with more recent early childhood educational expansion.
Challenges in identification of HIV‐Associated Neurocognitive Disorders, a focus on low and middle income countries
Authors: Paddick Stella‐Maria 
Published: December 2023

AbstractBackgroundHIV‐associated neurocognitive disorders (HAND) are highly prevalent amongst people living with HIV (PLWH), especially in Sub‐Saharan Africa (SSA) where the majority of PLWH live. Current HAND identification measures lack accuracy in older PLWH on treatment, with substantial heterogeneity observed in SSA prevalence meta‐analyses There is a need to better understand the current cognitive phenotype of this newly emergent population, to develop appropriate screening tools. We report two linked studies.Study 1 compared diagnostic accuracy of the International HIV dementia scale (IHDS), and Identification and Interventions for Dementia in Elderly Africans (IDEA) screen, for identification of HAND in older PLWH in TanzaniaStudy 2 aimed to identify cognitive domains significantly associated with symptomatic HAND (s‐HAND) in older PLWH in Tanzania, with potential utility in future screening measures.MethodA systematic sample of 253 PLWH aged ≥ 50 attending a Government clinic underwent comprehensive HAND evaluation by consensus American Academy of Neurology (AAN) criteria including locally‐normed low‐literacy clinical neuropsychological assessment. A diagnostic accuracy study of the IHDS and IDEA screen versus AAN criteria was completed with strict blinding. Participants were offered identical annual reassessment at Y1 Y2 and Y3 and the relationship of cognitive domains with s‐HAND in a logistic mixed effects modelResultHAND was highly prevalent (47%) at baseline, increasing to 57.9% at year 3.At baseline, both IHDS and IDEA had limited diagnostic accuracy for HAND (AUROC 0.639–0.667 IHDS, 0.647–0.713 IDEA). On secondary analysis of longitudinal data, tests of verbal learning and memory, categorical verbal fluency, visual memory and visuoconstruction had AUROC > 0.7 for s‐HAND (0.70 ‐ 0.72; p<0.001 for all). Tests of visual memory, verbal learning and memory (delayed recall and recognition memory), psychomotor speed, language comprehension and categorical verbal fluency were independently associated with s‐HAND (p<0.01 for all). Neuropsychological impairment pattern varied by education.ConclusionCurrent HAND screening tests no longer perform well in the new population of older PLWH in Africa. Tests most associated with s‐HAND include broad cortical and subcortical domains, some not included in existing HAND screening tests and vary by educational background. This should be considered in future HAND screening measure development.
Suitability of Neuropsychological Tests for Assessments of Dementia in Africa
Authors: Bellaj Tarek 
Published: December 2023

AbstractBackgroundNeuropsychological assessment is a centerpiece element for detecting, diagnosing, and following‐up the evolution of a dementia syndrome. It should be based on valid, reliable, standardized, and culturally suitable tests. However, the majority of the available tests were developed in western countries, and little is known about how these tests were translated and adapted in Africa in concordance with the international guidelines of psychological measurement. The aim of this review is to inspect closely the available neuropsychological tests used in Africa during the last three decades, examine their psychometric qualities, and analyze their cultural appropriateness to the local populations.MethodWe performed a systematic review on published articles dealing with the neuropsychological assessment of dementia in the 54 African countries during the latest 30 years on main scientific search databases (Web of Science, Academic Search Ultimate (Ebsco), ScienceDirect, Scopus, PubMed, APA PsycArticles, Embase, Cochran). The search keywords were: dement* and (neuropsych* or *cognit*) and (assessment or evaluation or test*) and country, without restrictions about the language of publication. Our approach is fourfold: i) papers' extraction, ii) tests identification, iii) concordance analysis, and iv) appropriateness evaluation.ResultWe identified a list of different tests used in each country and estimated the level of their concordance with the international guidelines of psychological measurement regarding the translation and adaptation procedures as well as the type of validity, reliability, and the availability of local standardized data. More than the two‐thirds of the identified tests did not respect the international guidelines of psychological measurement in developing, translating and adapting neuropsychological tests for the screening and assessment of dementia in Africa.ConclusionWe focused on the importance to fix measurement’s issues in the neuropsychological assessment of dementia in Africa. A suggested list of recommendations was provided to improve it especially that Africa is the second most populous continent after Asia and its elderly population is showing the most rapid increase in the world.
Closing the sex/gender gap in dementia: homing in on the vasculature (biomarkers)
Authors: Elahi Fanny M , Buckley Rachel F. 
Published: December 2023

AbstractAs we move toward precision medicine approaches, we cannot continue to pursue a one model fits all. Sex differences in brain aging and degeneration have been reported across the spectrum of research methodologies from human epidemiological studies and drug trials to model systems of degenerative brain disease. Blood proteomic biomarkers combined with clinical data can provide useful multi‐modal disease models in humans to uncover important biological associations with relevance to human disease. Small vessel disease in aging or AD is prevalent in the aging populations and represents a common and important risk factor for cognitive impairment. Dysregulated angiogenesis is emerging as a relevant pathology in SVD‐related vascular cognitive impairment with potential for therapeutic modulation. Recent work by our group and others is suggesting that the association of plasma markers of angiogenesis with clinical outcomes is sex dimorphic. Results demonstrate several age and sex‐dependent associations between groups of markers that capture both beneficial and pathological aspects of angiogenesis in aging. Much remains to be uncovered regarding underlying mechanisms, interactions with neurodegenerative pathologies, and ideal windows for sex‐informed therapeutic interventions on angiogenesis. However, the emerging body of work on sex differences regarding angiogenesis in aging, AD and other neurodegenerative disorders, represents a critical first step toward demonstrating the relevance of sex/gender to therapeutically oriented studies of vascular pathologies in dementia‐causing diseases.
Acceptability and Requirements for Digital Interactive Television Systems in Geriatric Institutions
Authors: Naudé Bérangère , Rigaud Anne‐Sophie , Dacunha Sébastien , Pino Maribel 
Published: December 2023

AbstractBackgroundInformation and communication technologies have great potential to address the psychosocial needs of Older Adults (OAs) living in geriatric institutions. With the development of Digital Interactive Television (DiTV) systems, communication, entertainment, online purchases and other functionalities and services are accessible directly on a television screen. Thus, DiTV could be a promising and accessible solution to help meet several needs of OAs, especially in geriatric settings.MethodA mixed‐methods research was conducted to identify barriers of DiTV use among geriatric residents with the aim of identifying accessible specifications for the system, and recommendations for its implementation. First, semi‐structured interviews were conducted within 3 French nursing homes already equipped with a DiTV (OAs: n = 18; professionals: n = 6). Interviews were then transcribed with the MAXQDA software and processed using a thematic deductive analysis inspired by a multidimensional health technology assessment model. Secondly, user tests compared the ability to use a DiTV (e.g., errors made and need of assistance) by OAs living in geriatric institutions (n = 20), and OAs living at home (n = 15). Four questionnaires (e.g., socio‐demographic and technological habits questionnaire, System usability Scale (SUS), and Technology Assessment Model (TAM)) helped identify the acceptability and usability of the DiTV.ResultPreliminary results showed that DiTV systems can be well accepted by OAs who recognize the advantage of this system in terms of communication and entertainment. However, its use may be hindered by organizational (e.g., workload), technological (e.g., ergonomic issues), human (e.g., health issues), ethical (e.g., privacy), and safety factors (e.g., frustration due to technical problems). The second part of the study revealed that OAs living in geriatric institutions made more initiation errors and needed more assistance (help or confirmation) in comparison to OAs living at home, even though the DiTV provides some guidance on the remote‐control buttons.ConclusionBeyond organizational, safety, and technological issues, the presentation and training on the DiTV are essential to reassure and accompany OAs in the discovery of a new device, even one as familiar as the television.
Closing the sex/gender gap in dementia: homing in on the vasculature (in vitro/iPSCs)
Authors: Blurton‐Jones Mathew 
Published: December 2023

AbstractInduced pluripotent stem cell (iPSC) models are increasingly being used to model the blood brain barrier (BBB) and to examine the contributions of genetic risk factors to neurovascular disease. While clinical and rodent studies clearly demonstrate the importance of sex in vascular‐related neurodegeneration, only a handful of published studies have thus far begun to employ iPSC modeling to examine the biology that underlies these sex‐related differences. Early reports suggested that female iPSC‐derived brain microvascular endothelial cells (BMECs) exhibit increased transendothelial electrical resistance (TEER) and thus decreased permeability than male BMEC counterparts. Conversely, male pluripotent cells were found to differentiate more readily into BMECs. However, these initial studies were often underpowered and failed to account for the considerable variability inherent between iPSC lines. More recently, consortiums have begun to generate and examine BMECs and glia from a large number of subjects with various neurodegenerative diseases. While much of this work is currently unpublished, these large‐scale datasets further support the concept that sex alters the transcriptome and function of BMECs and vascular‐associated glia. The development and use of ‘isogenic’ male and female iPSC lines derived from Klinefelter syndrome subjects is providing another powerful new approach to study sex‐dependent effects on cellular function. Both the complexity and utility of in vitro iPSC‐modeling of brain vasculature continues to improve and now includes both bioengineered vascular networks and vascularized organoids. In addition, recent progress with xenotransplantation models is providing further avenues to study the interactions between human glial, blood brain barrier function, and cerebral amyloid angiopathy. Nevertheless, there remains a pressing need to further examine and understand both the intrinsic and extrinsic effects of sex on BBB function and vascular‐related neurodegenerative disease, a topic that will be extensively discussed during this AAIC perspectives panel.
Relative Validity of the revised RUSH Food Frequency Questionnaire and MIND diet screener: Capturing the Mediterranean‐DASH Intervention for Neurodegenerative Delay (MIND) dietary pattern
Authors: Tangney Christy C , Agarwal Puja , Ventrelle Jennifer , Aggarwal Neelum T. , Dhana Klodian , Arfanakis Konstantinos , Barnes Lisa L. 
Published: December 2023

AbstractBackgroundThe original MIND diet score was derived from analyses of the RUSH food frequency questionnaires completed by Rush Memory and Aging Project participants. Once the tool was revised to include specific foods reflecting evidence about neuroprotection, the concurrent validity of the revised RushFFQ (rRushFFQ) was examined and further compared it with a MIND diet screener.MethodsUsing baseline data from 603 MIND diet trial participants (NCT 02817074), we calculated MIND scores using responses from 1) the rRushFFQ (142‐item questionnaire), and 2) a set of seven one‐day food records. We compared these scores with one another and with that of the MIND diet screener (14‐item questionnaire). A random sample of specimens were analyzed for plasma antioxidants (n = 442), and plasma free fatty acids (n = 433).In a sample of 149 participants, partial correlations of scores across the three independent dietary tools were run. To examine extent of bias among the different dietary tools, Bland Altman plots with limits of agreements were constructed for MIND scores from the rRushFFQ with those from the food records and that of the diet screener.ResultsThe average age of the larger sample (n = 603) was 70.3 ± 4.3 years with over half the sample being retired and married; 65% were women. Circulating concentrations of several carotenoids (lutein +zeaxanthin, lycopene as well as alpha and beta‐carotenes) were positively associated with MIND scores. Among the sample of 149 adults, (69.8 ± 4.3 years, 67.4% women), MIND scores for rRushFFQ, food records, and screener were 7.2 ± 1.6, 6.0 ± 1.6, 7.7 ± 1.8, respectively. Correlations were moderate in strength and highly significant — MIND scores from rRushFFQ with those for food records, r = 0.52; food records and MIND diet screener, r = 0.57, and for rRushFFQ with diet screener, r = 0.85. Significant moderate agreement (kappas) was observed for 8 of 14 MIND components.ConclusionsThe rRushFFQ was successful in capturing components of the MIND dietary pattern. Concordance of MIND scores from rRushFFQ with those from seven one‐day food records and the MIND diet screener as well as positive associations with blood nutrients and MIND food components support the use of these tools for future studies.