bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self Perceptions of Stress in Caregiving Moderate Associations of Within and Between Caregivers’ Physical Health Symptoms
Authors: Ho‐yin Lai Frank 
Published: December 2023

AbstractBackgroundThe success of dementia care requires the full support from the caregivers with the goal of delaying the disease’s progress. Studies over decades have reinforced that the knowledge, attitude, and skills of caregivers are crucial parameters of the success of in‐community care for dementia. Nevertheless, studies have identified that many caregivers, across different culture and ethicity, are not well prepared emotionally or practically to be the caregivers and this will result in stress, particularly when their stress are ignored by medical professionals during this long journey of care.MethodThis is a mixed‐method research to examine how self‐perceptions of aging (SPA) moderated within‐ and between‐caregivers Self‐perceived stress (SPS) associations with physiological health symptoms (PHS) and daily physical health symptoms (DPHS). SPA was measured by the Philadelphia Geriatric Centre Morale scale. SPS was measured by Zarit Burden Interview Scale and Revised Memory and Behaviour Problem Checklist. DPHS was measured daily through an adapted symptom checklist.ResultA pilot study of 20 caregivers reported significantly more physical health symptoms compared to individuals with lower perceived stress on average (p < .05). SPA significantly moderated associations between both within‐ and between‐persons perceived stress (SPS) and physiological health symptoms (PHS) (ps < .05).ConclusionMore positive SPA significantly dampened the impact of perceived stress, suggesting the importance of SPA as an individual characteristic within stress processes. Future work should examine how daily changes in SPA may exacerbate or mitigate the impacts of daily stress processes and health outcomes.
Cognitive Performance in Relation to MIND and MEPA III Accordance among NHANES Participants
Authors: Derdiger Samara A , Friedeborn Sophia A , Tangney Christy C 
Published: December 2023

AbstractBackgroundThere is growing evidence from cohort studies and clinical trials that MIND and Mediterranean‐like diets are associated with better cognitive performance, but most rely on food frequency questionnaires that may not specify key food items consistent with these patterns.MethodIn this cross‐sectional sample from two NHANES cycles (2011‐2014), scores for the MIND dietary pattern (maximum score = 14) and those for the Mediterranean Eating Pattern for Americans III (maximum score = 22) were calculated based on reported foods consumed on two non‐consecutive 24‐hour dietary recalls. Only those adults with two completed recalls and cognitive tests were studied (n = 2598). Cognitive assessments included the word learning and recall components from the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD), the Animal Fluency test (AFT), and the Digit Symbol Substitution test. The Complex Sample module in SPSS (version 26) was used to produce representative estimates of the older American population with the dietary weighting variable applied following the “least common denominator” rule.ResultThe average age of sample participants was 69.2 ± 0.3 years, with almost equal proportion of men and women. The average MIND score was (mean ± SD) 5.0 ± 0.0, whereas for MEPA III, this was 8.6 ± 2.1. There were positive associations between continuous MIND scores and education‐dependent standardized cognitive scores for each test as well as global cognition (β = 0.05‐0.10, all p‐values ≤ 0.002 when adjusted for covariates); these associations were not observed for MEPA III scores. Compared to those in the lowest MIND accordance tertile, those in the highest tertile were less likely to exhibit low cognitive performance on the AFT [odds ratio, 95% CI)] 0.45 (0.29–0.69)], CERAD Delayed Recall [0.52 (0.33–0.83)], and global cognition [0.50 (0.27–0.94)].ConclusionOlder Americans in this sample were generally non‐accordant to MIND and MEPA III patterns. However, those who reported greater MIND diet accordance exhibited better cognitive performance.
Disparities in neuropsychiatric symptom clusters across dementia diagnoses within Lewy body dementia syndromes and Alzheimer’s dementia
Authors: Oliveira Fabricio Ferreira , Graça Naffah‐Mazzacoratti Maria , Smith Marilia Arruda Cardoso , Bertolucci Paulo Henrique Ferreira 
Published: December 2023

AbstractBackgroundBehavioral clusters may differ in intensity and frequency across dementia syndromes and according to genetic variants.MethodsConsecutive outpatients with probable dementia with Lewy bodies (fourth consensus report of the DLB Consortium), Parkinson’s disease dementia (PDD, Movement Disorder Society Task Force), or late‐onset Alzheimer’s dementia (AD, National Institute on Aging/Alzheimer’s Association, rs7412&rs429358 genotyped with TaqMan® Real‐Time PCR technology) were recruited (2010‐2018) and assessed for demographic features and scores on a 15‐item Clock Drawing Test (CDT), Mini‐Mental State Examination (MMSE), Index of Independence in Activities of Daily Living (ADL), Lawton’s Scale for Instrumental Activities of Daily Living, Clinical Dementia Rating (CDR) and Zarit Caregiver Burden Interview. According to the Neuropsychiatric Inventory, affective (anxiety,apathy,dysphoria,euphoria), hyperactive (aberrant motor behavior,agitation,disinhibition,irritability), and psychotic (delusions,hallucinations) clusters were associated with cognitive, functional and caregiver burden scores, and compared according to dementia diagnoses, p<0.05.ResultsAll had similar education (p = 0.205): DLB (n = 38;57.9%♀), PDD (n = 14;64.3%♀), APOE‐ε4 carriers with AD (n = 117;72.6%♀), APOE‐ε4 non‐carriers with AD (n = 108;63.0%♀). Patients with AD used cholinesterase inhibitors (p = 0.004) and Memantine (p<0.0001) more often, had higher CDT (p = 0.027) and ADL (p<0.001) scores, and lower caregiver burden (p = 0.022);other score differences were non‐significant among groups. APOE‐ε4 carriers with AD had lower affective scores (p<0.0001), while APOE‐ε4 non‐carriers with AD had lower psychotic scores (p<0.0001);hyperactive scores were similar among groups (p = 0.146). Affective scores were associated with caregiver burden and inversely associated with MMSE scores only in AD, while inversely associated with functionality in DLB and AD;they were also associated with functionality and inversely associated with CDR Sum‐of‐Boxes scores in PDD. Hyperactive scores were inversely associated with functionality in all groups, while associated with cognitive scores in DLB, and inversely in PDD and AD;they were also associated with caregiver burden in DLB and AD, and inversely in PDD. Psychotic scores were associated with CDR Sum‐of‐Boxes scores in PDD and AD, while associated with caregiver burden and inversely with cognition and functionality in all groups.ConclusionsThe affective and hyperactive clusters have divergent associations with clinical features across dementia syndromes, while the psychotic cluster is most consistently associated with worsened cognition, functionality and caregiver burden. APOE‐ε4 carrier status may affect cluster intensity in AD.
Aligning the Alzheimer’s biomarker validation framework to technology readiness levels
Authors: Boccardi Marina , Savoini Adriano , Daussin Valérie , Alexandersson Jan , Teipel Stefan , Héder Miháli 
Published: December 2023

AbstractBackgroundTechnology readiness levels (TRL), used in technological R&D, also frame European Commission biomedical funding frameworks. Providing an adaptation to biomarker development would improve communication with industry, align stakeholders and professionals, reduce risk of development failure, costs and waste. Here, we aim to align TRLs with the Strategic Biomarker Roadmap (SBR) defined to validate biomarkers for Alzheimer’s disease (AD) and related disorders.MethodWe analyzed the NASA definition of TLR phases and a previously proposed adaptation to the biomedical field. We drafted an alignment of TRLs with the SBR Phases and Aims. We refined such alignment through discussion and consensus among coauthors and outlined discrepancies, gaps and SBR limitations relative to the TRL framework, to improve the development process for future biomarkers.ResultThe SBR covers all of the 9 TRLs. The demonstration of Analytical Validity entails TRLs_1‐4. Specifically, the SBR Phase_1 includes TRLs_1‐2; Phase_2 Primary Aim (PA) corresponds to TRL_3, and Phase_2 Secondary Aims (SAs) to TRL_4. Clinical Validity entails TRLs_5‐8. Specifically, the SBR Phase_3 corresponds to TRL_5, while TRLs_6‐8 correspond respectively to Phase_4 PA, SAs, and full completion. Demonstration of Clinical Utility corresponds to TRL_9. Despite such correspondence, the SBR entails only biomarker diagnostic performance and utility. Aspects like manufacturing and usability, fundamental in the TRL framework as well as in the previous biomedical adaptation, are still lacking. The definition of tools (e.g., Target Product Profile, introduced at TRL 3 in the biomedical adaptation) may help complement the SBR in this direction.ConclusionThe SBR and TRLs follow a consistent sequence despite different pacing and granularity, SBR steps corresponding to one‐to‐multiple TRLs. Targeting such inconsistencies and upgrading the SBR validation roadmap into a development roadmap, entailing manufacturing, usability, and an integrated procedure to assess cost‐effectiveness and plan implementation requires a structured dialogue with industry partners and other stakeholders, like regulators. Such attempt to evolve the SBR from a linear to a multi‐dimensional model may help boost the efficiency of translational research and our response to the global priority of dementia.
Unsupervised detection of dementia based on longitudinal data from the Survey of Health, Ageing and Retirement in Europe
Authors: Gharbi‐Meliani Amin , Josse Julie , Husson François , Vandendriessche Henri , Bayen Eleonore , Yaffe Kristine , Bachoud‐Levi Anne‐Catherine , de Langavant Laurent Cleret 
Published: December 2023

AbstractBackgroundIn the Survey of Health, Ageing and Retirement in Europe (SHARE), a population‐based survey of aging in multiple countries, dementia status is self‐reported. However, more than half of dementia cases remain underdiagnosed, which may hinder the use of SHARE data to study dementia determinants and outcomes. We use unsupervised machine learning and longitudinal data from SHARE to discover clusters of patients with probable dementia.MethodsWe selected participants aged 50 or more with consecutive follow‐ups across all SHARE prospective waves. We chose variables informative of participants’ daily function and cognitive performance. We applied a Multiple Factor Analysis followed by a Hierarchical Clustering to the whole longitudinal data set. To evaluate our algorithm, we looked at its discrimination power by comparing it to the self‐reported dementia. We also checked if increased risk of transition to probable dementia was associated with non‐modifiable (age, sex) and modifiable (education, hypertension, obesity, hearing loss, diabetes, physical inactivity, smoking, drinking alcohol, social isolation, depression, air pollution) dementia risk factors. Finally, we replicated this study in the English Longitudinal Survey of Aging (ELSA).ResultsThe baseline sample consisted of 15,278 initial participants across 12 countries. The algorithm identified a higher number of probable dementia cases compared with self‐reported cases. Its discriminative power was good discriminative power across all waves (Area Under the Curve > 0.75). Sensitivity attained its highest value at wave 4 reaching 0.71 [0.66–0.77]. Specificity remained high (> 0.9) in all waves. Both non‐modifiable and modifiable dementia risk factors were associated with increased risk of transition to probable dementia. These results were replicated in ELSA.ConclusionDetection of probable dementia with longitudinal data and unsupervised clustering could be used to study dementia in SHARE and ELSA cohorts. Further validation of this method is needed to apply it in other surveys of aging.
Impact on metamemory and cognitive measure of a multifactorial memory training program for older adults from Argentina
Authors: Feldberg Carolina , Barreyro Juan Pablo , Quian Rosario , Natalia Irrazabal , Ofman Silvia Deborah , Hermida Paula Daniela , Tartaglini María Florencia 
Published: December 2023

AbstractBackgroundSeveral studies have suggested that cognitive training is a potentially effective way to improve cognition and metacognitive beliefs and postpone cognitive decline in older adults. The aim of the present study is to assess the impact of a multifactorial program on metamemory and cognitive measures of older adults from Argentina.MethodDesign: Comparative, pre‐post, longitudinal intervention study. Community dwelling older adults over 60 years. Memory training program participants (n = 50) (M = 68,68 years old; ds = 8.13 years) and controls (n = 50) (M = 69.03 years old; ds = 8,03 years) were assed at the begging and the end of the program. Instruments: questionnaire of social demographic data (built ad hoc), brief neuropsychological assessment for memory and attention and a metamemory questionnaire. Procedure: all the participants of the Intervention group took part in the memory training program. The program has a duration of 8 sessions of 90 minutes each, where theoretical and practical tools are provided to improve cognitive performance in everyday life. Program participants and controls were assed twice, with eight weeks of difference between the first and second evaluation.ResultMultiple analyzes of variance (ANOVA) were performed. The results indicate an interaction effect between the training condition (training program participants and controls) and the longitudinal condition (pre‐test and post‐test condition) in the metamemory questionnaire (F(1,98) = 5.06, p = .03) and in the memory strategies subscale (F(1,98) = 15.58, p < .001). Post‐hoc analyzes indicate that the training group performed significantly better on both measures (p < .001), compared to the control group, which showed no differences. No differences were detected between the groups in measures of neuropsychological assessment.ConclusionThese results coincide with previous studies that point out the importance of assessing and intervening on metacognitive aspects in multidimensional cognitive training programs for older adults. The inclusion of cognitive training is an approach that can help cognitively vulnerable older adults and promote healthy cognitive aging.
Narrative Ethnography in Analysis Caring Demand of Spousal Caregivers for Older People with Dementia : A Qualitative Study
Authors: Ho‐Yin Lai Frank , Hai Eddie , Chan Catherine 
Published: December 2023

AbstractBackgroundWith deteriorated cognitive condition and age‐related disease, care for older adults becomes a global challenge. This challenge care is further aggravated with decreased fertility and increased longevity in an ageing population. Being an informal carer of a person with dementia can have a negative effect on the caregiver’s health and quality of life. Spouse caregivers (SC) have been found to be especially vulnerable as they need to simultaneously fulfil their supportive roles and manage the burden brought about by the demands of caregiving with the disease progression of their spouse. Nevertheless, relatively little is known about the needs of SC at different stages of the caring.MethodWith the framework of caregiving by Cameron and Gignac (2008), this paper explores the topic of caregiving with focus on specific needs of SC in caring for the spouse with different stages of the dementia. Narrative ethnography, the qualitative research technique, was selected as a methodology to study stories in the context of SC telling and use stories to interpret the caregiving phenomenon. Participant inclusion criteria were: (a) SC aged between 65 and 80, and (b) being able to understand verbal and written instructions. To eliminate the co‐founding care‐giving burden, participants with major physical dysfunctions, such as stroke and head injuries, were excluded.ResultForty‐five SC were recruited through poster advertisements. With adaptation of the stage of change model of Cameron and Gignac (2008), there were identified 5 major themes of experience from the spousal caregivers, namely a) seeking understanding, b) stabilization, c) preparation, d) implementation, and e) adaptation. Several sub‐themes and constructs to address different needs of SC, such as concern on their deteriorating physical health condition cannot further cope with both physical and mental demand in taking of their progressively deteriorated relatives with dementia. Mental well‐being of SC changed over the course of changing cognitive function and functional impairment of older adults with dementia.ConclusionNarrative ethnography indicated poor cognitive function and functional dependent were the most difficult mental burden for the SC. These two components are crucial part for the further grounded theory development.
Objectively‐measured physical behaviors, peripheral cytokines, and plasma neurofilament light chain in older adults: a population‐based study
Authors: Wang Yongxiang , Han Xiaolei , Dong Yi , Hou Tingting , Cong Lin , Du Yifeng , Qiu Chengxuan 
Published: December 2023

AbstractBackgroundEvidence has linked self‐reported sedentary behavior (SB) and physical activity (PA) with cognitive impairment; however, the underlying neuropathological mechanisms are poorly understood. We examined the dose‐response associations of the accelerometer‐measured daily SB and PA time with plasma neurofilament light chain (NfL) among older adults and the role of systemic low‐grade inflammation in the associations.MethodThis population‐based study included 1,029 dementia‐free older adults (age ≥60 years, 59.48% women) who undertook the ActiGraph substudy (March 2018‐December 2020) in MIND‐China. Plasma NfL and serum cytokines were measured on SIMOA and MSD platforms, respectively. Movement parameters were assessed with an accelerometer. Data were analyzed using the restricted cubic splines, general linear, and mediation models.ResultThere were J‐shaped associations of daily SB and PA time with plasma NfL concentration, such that more daily SB time or less daily light‐intensity physical activity (LPA) and moderate‐to‐vigorous‐intensity physical activity (MVPA) time were significantly associated with increased plasma NfL only when SB time ≥8.00 hours/day or LPA time <5.00 hours/day or MVPA time <2.00 hours/day. Furthermore, more daily SB time or less daily LPA and MVPA time was significantly associated with higher serum inflammation scores (P<0.05). Finally, serum biomarkers of low‐grade inflammation could account for 15% to 19% of the associations between movement behaviors and plasma NfL level.ConclusionMore daily SB and less PA time are associated with peripheral biomarker for neurodegeneration and systemic low‐grade inflammation in older adults. The association of movement behaviors with neurodegeneration is partially mediated by systemic low‐grade inflammation.
Causal association of cardiovascular risk factors with Alzheimer’s disease
Authors: Tripathi Shailendra Mohan , Murray Alison D. , Wischik Claude M , Schelter Bjoern 
Published: December 2023

AbstractBackgroundAlzheimer’s Disease (AD) frequently coexist with cerebrovascular disease (CVD) and makes it difficult for researchers to delineate the two pathologies with available diagnostic criteria. Neuroimaging techniques, especially FDG‐PET can help differentiate the two pathologies based on the characteristic temporo‐parietal metabolic deficitsin AD and regional patchy deficits in CVD. Co‐occurrence of the both patterns can be seen in mixed cases.Existing literature supports a possible role for cardiovascular risk factors in AD pathogenesis. This study aims to determine whether cardiovascular risk factors have a causative association with typical AD pathogenesis or it has an association with mixed AD.MethodBaseline brain FDG‐PET images of participants with a diagnosis of AD from two large clinical trials of hydromethylthionine were classified into “typical AD” and “mixed” patterns through visual analysis. Causal association of independent variable age and dependent variables cardiovascular risk factors, White matter hyperintensities (WMH), AD subtypes and severity of cognitive impairment depicted with ADAS Cog scores were analysed using Structural equation modelling (SEM).ResultOut of a total 794 participants, 533 (67.1%) were classified as typical AD and 261 (32.8%) were classified as mixed. Overall, the people with a mixed pattern were significantly younger than the people with a typical AD pattern. Age significantly influenced cardiovascular risk factors, WMH and typical AD subtype. The severity of cognitive impairment was significantly influenced by cardiovascular risk factors, WMH and typical AD subtype. Interestingly, cardiovascular risk factors had a statistically significant positive influence on typical AD subtype in comparison to mixed.ConclusionIt is well known fact that the cardiovascular risk factors are commonly associated with cerebrovascular disease but contrary to our expectations cardiovascular risk factors have a causal association with typical AD.
Neurocognitive study of bodily and traumatic memory in a Moroccan novel on Alzheimer’s disease
Authors: Taiebine Mohamed 
Published: December 2023

AbstractBackgroundPerson‐centered care in dementia focuses on empowering patient’s wellbeing and quality of life. In this context, Ben Jelloun’s novel About My Mother (2016) addresses multiple issues related to social justice, hegemony, ageism, and women’s health conditions by combining literary, fictional autobiography and factual biography in a critical period of Moroccan colonial and post‐colonial history. We will study Lalla Fatma as a prototype carrying a triple burden: early traumatic events of life, weight of tradition, and Alzheimer’s disease (AD).MethodText mining was used for lexical‐semantic analysis and to develop patterns of themes across the novel’s corpora. A neurocognitive approach has been used to describe gendered aesthetics, antero‐retrograde amnesia, traumatic and bodily memory.ResultTheoretical framework from Tulving descriptions of noetic and autonoetic memory disorders have been used to classify Lalla Fatma amnesia. Alzheimer’s disease is an incentive to adopt the narrative of filiation and reconstruction that brings into life distant memories. Ben Jelloun’s novel gives the subjectivity “insight of disease” more time and space in order to express all states of memory in a stream of consciousness until its abolition. Moreover, the question of the genesis of psychogenic‐organic memory disorders through early trauma in the life of Lalla Fatma could favor a triple stress at a physiological level “a declined global health,” a microstructural level “microaggressions from her caregivers,” and macrostructural level “the trauma of the colonial past and successive widowing”.ConclusionThis study characterized AD using a mixture of fictional and factual autobiography. The anguish of successive widowing may reactivate psychic traces and an intrapsychic conflict between the desire of Lalla Fatma to preserve the lost object “body and memory” and the weight of society “culture and tradition”. The person‐centered care was successfully implemented thanks to the involvement of multiple caregivers around the main character.