bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital‐diagnosed infections, autoimmune disease, and subsequent incidence of Alzheimer’s disease, vascular dementia, and other major dementias
Authors: Janbek Janet , Waldemar Gunhild 
Published: December 2023

AbstractBackgroundIt has been debated whether specific infections may be causally linked to dementia development. The hypothesis has been principally directed towards Alzheimer’s disease (AD) pathology, prompted by findings that Aβ peptide, whose deposition is a hallmark of AD, has antimicrobial properties. Previous epidemiological population‐based studies have reported that observed links between infection and dementia were more prominent for vascular dementia (VaD), whereas there was either a small or no increased AD risk. Similar findings have been reported for autoimmune disease, although links were overall close to null. Investigating the two exposures together gives insights into the involvement of the immune system in dementia risk. However, data on dementia subtypes in the previous studies predominantly relied on electronic health data with generally low or unknown validity. Therefore, it remains unknown whether links with infection are attributed to AD, VaD, or other dementias. It is also unknown whether the general lack of link with autoimmune disease could be modified by dementia subtypes. Further, evidence is lacking regarding young‐onset dementias, with at least one study suggesting higher dementia risk in cases diagnosed at <60 years. The aim of this study was to investigate the association between infections, autoimmune diseases, and subsequent incidence of major dementia disorders.MethodsWe conducted a nationwide nested case‐control study of dementia cases in the Danish Quality Database for Dementia (DanDem). This is a nationwide register of all dementia diagnoses given by memory clinics and are thus advantageous over previously used data on subtype diagnoses in our and other general health registries. Conditional logistic regression estimated incidence rate ratios for cases of AD, VaD, and other dementias, compared with controls, following exposure to infection and autoimmune disease (in the prior 35+ years).ResultsWe identified all incident dementia cases between 2016 and 2018 and matched them to up to three controls on age and sex. Majority of cases were diagnosed with AD, followed by mixed dementia and VaD.ConclusionThe results of this study will further knowledge on the role of the immune system for dementia risk and contribute with new data regarding the risk of different dementias.
Markerless motion capture technology to quantify functional performance in dementias: a systematic review
Authors: Jeyasingh‐Jacob Julian , Shah Harshvi , Crook‐Rumsey Mark , Joseph Theresita , Daniels Sarah , Sharp David J , Haar Shlomi 
Published: December 2023

AbstractBackgroundQuantifying functional performance objectively and unobtrusively could offer vital insights for clinical decision making on the level of support required by people living with dementia and other neurodegenerative conditions. Markerless motion capture (MMC) is more suitable for deployment in clinical and real‐world settings because single sensor MMC systems are less expensive and less complex compared to marker‐based systems. The aim of this study was to complete a systematic review of published literature on the use of MMC with full‐body tracking in people with dementias.MethodWe systematically searched for relevant articles using the search terms motion capture, motion analysis and movement analysis combined with dementia, mild cognitive impairment (MCI) and Parkinson’s disease (PD) which yielded a total of 1103 results. Inclusion criteria were MMC and full‐body tracking. Studies evaluating marker‐based motion capture, body‐worn sensors or Inertial Measurement Units, virtual reality, kinetics and interventions like DBS or exercises were excluded. 134 studies were included for full article screening out of which 17 eligible studies that met the selection criteria were included in the review.ResultMMC devices used in the reviewed studies included Microsoft Kinect (n = 15) and unspecified 2D motion camera (n = 2). Patient groups included in the studies were PD (n = 12), dementia (n = 4) and MCI (n = 1). Functional performance components evaluated were gait (n = 16), sit to stand (n = 2), turning (n = 1) and stepping in place (n = 1). About half the studies used advanced machine learning methods whereas the other half used descriptive statistical methods. The lack of standardisation in the measures used prevented us from comparing and synthesizing study results.ConclusionAlthough MMC has the potential to be used for quantifying functional performance in people with dementia, MCI and PD, there appears to be significant variation in the methods used in its evaluation. Although features of mobility were measured, none of the reviewed studies analysed activities of daily living tasks, a key component of functional performance. Standardising the process for extracting features and assessing accuracy would enable more effective validation of real‐world impact. Further research is required in people with neurodegenerative conditions for MMC to be routinely used in clinical and real‐world applications.
Co – Design of a Dance Exercise Intervention for People Living with Dementia and their Care Partners
Authors: Kelly Niamh , Skelly Fiona , Dowd Kieran , O'Neill Desmond , McCaffery Noel , McDermott Clare 
Published: December 2023

AbstractBackgroundLiving with dementia can negatively impact quality of life (QOL) by affecting social, physical, and mental capabilities (Thumuluri et al. 2022). Care partners are at an increased risk of decline to their physical and mental health due to their role (Teahan et al. 2021). Dance provides benefits associated with an exercise intervention, including protective measures against cognitive decline, benefits in strength, brain function and connectivity with added balance and memory enhancements found in dance interventions (Tao et al. 2021, Wu et al. 2021). The study’s aim is to explore exercise preferences of PLWD, care partners and recommendations from the literature.MethodA base of evidence was identified, by a literature review, focusing on how physical activity, exercise and dance interventions impact PLWD and care partners. A patient advisory group (PAG) was established to provide feedback on study methods. Interview guides were created for PLWD and care partners using the Behaviour Change Wheel Framework (Michie et al. 2011) (BCW). The PAG gave their insight on the suitability of the questions. Questions were based around physical activity knowledge and preferences of the participants. A range of recruitment methods were used, relevant organisations were contacted, site visits were made, recruitment information was shared on social media. Focus groups and interviews are currently being conducted with PLWD and care partners, data collection will be completed by March. The results will be analysed by thematic analysis using NVivo software.ResultThe literature review found physical activity and exercise provide physical and psychological benefits for PLWD and care partners. Dance is impactful as it combines physical, social and cognitive activities. Preliminary findings from the focus groups identified themes including, physical activity, exercise, dance, and social support. Participants were aware of the benefits of physical activity and exercise. Many participants described dance as enjoyable, but intimidating to join a class. The social aspect of the class is one of the most important components for these populations.ConclusionThe lived experience of PLWD and care partners highlights dance as a potential intervention approach to improve QOL, increase social support, and to enhance the acceptance and impact of the intervention.
Detecting sleep‐related breathing disorders using overnight pulse oximetry in patients with dementia and mild cognitive impairment
Authors: Li Haoxuan , Gabb Victoria , Morrison Hamish , Blackman Jonathan , Biswas Bijetri , Kendrick Adrian , Coulthard Elizabeth 
Published: December 2023

AbstractBackgroundSleep disturbance is commonly reported in Alzheimer’s disease (AD), Lewy body dementia (LBD) and mild cognitive impairment (MCI). Early identification of sleep changes is crucial as poor sleep could contribute to cognitive decline and worsen disease progression. Sleep‐related breathing disorders (SBD), including obstructive sleep apnoea, have been associated with dementia and its treatment using continuous positive airway pressure (CPAP) may improve cognitive trajectory (Osorio et al., 2015). The Remote Evaluation of Sleep To enhance understanding of Early Dementia (RESTED) study is an ongoing cohort study conducted at the University of Bristol, aiming to characterise sleep changes in early dementia using remote tools. Here, we outline preliminary data from a small group of RESTED participants undergoing overnight pulse oximetry to screen for SBD.MethodOlder adults with AD or MCI due to AD (AD‐MCI), LBD or MCI due to DLB/PD (LBD) and age‐matched healthy controls (HC) were recruited from memory clinics and volunteer databases at North Bristol NHS Trust. Participants completed baseline questionnaires including Epworth Sleepiness Scale (ESS) and STOP‐BANG, in addition to undergoing pulse oximetry testing on two consecutive nights at home. Parameters including oxygen desaturation index 3% (ODI3%) and pulse rise index were analysed. Those with suspected SBD were referred to tertiary sleep services. Mann‐Whitney test was conducted to investigate differences in ODI3% between ESS or STOP‐BANG classification cut‐offs.ResultsOvernight pulse oximetry was well‐tolerated across groups, with all participants completing at least one full night’s recording. Preliminary results demonstrated an abnormal ODI3% in eight of 13 participants (AD‐MCI n = 3/6, LBD n = 3/3, HC n = 2/4). Of the remaining 5, 2 (HC) were referred for further testing due to abnormal pulse rise index and 3 (AD‐MCI) did not demonstrate suspicion of SBD. No significant difference in ODI3% was found between ESS≤10 and >10 (p = 0.28) or STOP‐BANG<3 and ≥3 (p = 0.15).ConclusionOvernight pulse oximetry serves as an easy to use, objective method in screening for SBD, which could provide an additional avenue for targeting dementia risk. Routine screening may be implicated for older adults with cognitive impairment who may otherwise not be considered high risk for SBD, particularly in the absence of subjective daytime sleepiness.
Examining the microglial TSPO phenotype in Alzheimer’s disease
Authors: Garland Emma F , Kulagowska Laura , Scott Thomas , Antony Henrike , Bottlaender Michel , Nicoll James AR , Boche Delphine 
Published: December 2023

AbstractBackgroundNeuroinflammation is a key pathological feature of Alzheimer’s disease (AD), with microglia being the main inflammatory cell type in the CNS. In order to examine these cells in vivo, PET ligands targeting the microglial translocator protein (TSPO) have been developed. However, it remains unclear the specific target of these ligands, whether this is all microglia or a subset of cells. We aim to elucidate this by identifying the microglial phenotype most associated with TSPO in humans.MethodHuman post‐mortem sections of temporal lobe (TL) and cerebellum (Cb) from cases classified by Braak stage (0‐II, III‐IV, V‐VI; each n = 10) were immunostained for pan‐Aß, pTau, and microglial markers TSPO, Iba1 and HLA‐DR with protein load quantified. Double immunofluorescent staining was performed with TSPO and microglial markers HLA‐DR and CD68 with positive cells counted.ResultTL showed an increase in Aβ (P<0.0001), pTau (P<0.0001) and TSPO (P<0.0001) protein load, but not Iba1 or HLA‐DR, with progressing Braak stage. Aβ (P = 0.0008) and Iba1 (P = 0.012) load increased in the Cb, but not pTau, TSPO or HLA‐DR. Of note, TSPO load in TL was associated with pTau. In both areas, no difference was found in number of HLA+ or CD68+ cells, though TL TSPO+ cell number increased significantly (P = 0.0347). There was no difference in the number of HLA‐DR+/TSPO+ or CD68+/TSPO+ cells with progressing Braak stage. However, significantly more CD68+/TSPO+ than HLA‐DR+/TSPO+ cells were detected in both the TL (P<0.0001) and Cb (P = 0.009) regions.ConclusionThe results suggest that TSPO expression is related to late stage disease (pTau) and microglial phagocytosis (CD68), a function we have previously identified associated with the presence of dementia, cognitive decline and tau pathology. Further additional analysis with other microglial markers is currently ongoing.
Foundational changes to improve dementia care: Implementing person‐centered, dementia‐specific education for nursing assistant programs
Authors: Crance Sara J , Yu Fang , Hamilton Gillan , Ordonez Belinda 
Published: December 2023

AbstractNursing assistants are responsible for direct care of individuals living with dementia in long‐term care (LTC) settings. Due to their cognitive impairment, care activities often cause behavioral and psychological symptoms of dementia (BPSD), such as stress, fear, agitation, and anger. Most states, including Arizona, do not require nursing assistant (NA) training programs to provide dementia‐specific content, despite >50% of all LTC residents having dementia. The purpose of this project was to design and integrate dementia‐specific curriculum into NA programs through training the trainer. The curriculum was designed to be easily implemented in NA programs with the goal of changing the way the state educates NAs.Training was provided to 12 RNs that identified as NA program coordinators or instructors in Arizona. All 12 trainees were female, ranging in age from 30s ‐70s, 83% identified as Caucasian, 8% Latino, and 8% African American. A complete, portable didactic lesson and a lab lesson were provided, consisting of dementia basics, person‐centered care, dementia simulation, teaching techniques, and two complete one‐hour lessons to implement in the classroom after the training. Knowledge and confidence were tested pre/post‐training and barriers to implementation were assessed at one‐month follow‐up.Knowledge increased from 4±1.15 to 6.75±0.43 (t = ‐7.63, p<.001). Confidence increased from 6.64±1.63 to 9.27±0.79(t = ‐4.34, p = .001) on knowledge confidence, from 6.55±1.63 to 9.18±0.87 (t = ‐4.14, p = .002) on teaching techniques, from 6.36±1.21 to 9.27±0.79 (t = ‐5.67, p<.001) on teaching dementia‐specific content, from 6.09±1.22 to 9.18±0.87 (t = ‐5.65, p<.001) on integrating dementia‐specific skills into lab and clinical, and 6.27±1.19 to 9.36±0.81 (t = ‐6.25, p<.001) on integrating dementia‐specific education into course content. At one month follow‐up, all participants planned to or already had implemented the training into their curriculum.Trainees increased their knowledge and confidence to successfully implement person‐centered, dementia‐specific education into their NA programs without barriers. In addition, this project gained support to change the NA program curriculum in 2023 to require dementia‐specific education for all NA programs in the state, thus changing practices for front‐line healthcare workers in the state.
White matter microstructural changes in sporadic and genetic FTD using neurite orientation dispersion and density imaging
Authors: Bocchetta Martina , Todd Emily G. , Malone Ian B , Cash David M , Thomas David L , Warren Jason D , Zhang Hui , Rohrer Jonathan D. 
Published: December 2023

AbstractBackgroundFrontotemporal dementia (FTD) is characterized by abnormal white matter (WM) integrity measured with conventional diffusion tensor imaging techniques. No study has yet investigated the microstructural WM changes across different clinical FTD forms using the novel neurite orientation dispersion and density imaging (NODDI). Here, we focused the analyses on symptomatic individuals, investigating the difference between the sporadic and genetic origin within the same diagnostic group.MethodNeurite density index (NDI) and orientation dispersion index (ODI) were extracted from NODDI sequences, processed and then corrected for tissue‐weighted means. Images were acquired on a 3T MRI Siemens Prisma scanner from a cohort of participants seen in clinic at the National Hospital for Neurology and Neurosurgery, University College London, UK. Data were available for 27 individuals with behavioural variant FTD (bvFTD) and 27 with primary progressive aphasias (11 svPPA, 8 nfvPPA, 4 lvPPA, 4 PPA‐NOS). 18 of these individuals (16 bvFTD and 2 PPA‐NOS) carried an FTD‐linked genetic mutation (6 C9orf72, 7 MAPT, 5 GRN). W‐scores for NDI and ODI were computed from a regression model on 62 non‐carrier healthy individuals, adjusting for their age, sex, and total intracranial volumes.ResultThe most abnormal values (<2.5th percentile of controls) were found in bvFTD (NDI: anterior corona radiata and left cingulum), lvPPA (NDI and ODI: left superior corona radiata; ODI: splenium of the corpus callosum) and PPA‐NOS (NDI: left uncinate fasciculus) (Figure). Sporadic bvFTD and PPA‐NOS showed more abnormal and widespread WM abnormalities compared to symptomatic mutation carriers.ConclusionChanges in WM structure in this cohort of patients with symptomatic FTD appear to be related primarily to a reduction in axonal density. Despite similar clinical features, sporadic forms tend to show more severe and widespread WM involvement than genetic cases.
Subjective Cognitive Decline and Cognitive Change among diverse Hispanics/Latinos: Results from the Study of Latinos – Investigation of Neurocognitive Aging (SOL‐INCA)
Authors: Márquez Freddie , Tarraf Wassim , Kuwayama Sayaka , Stickel Ariana M , Paredes Alejandra Morlett , Guerrero Lourdes , Perreira Krista M , Gonzalez Sara , Salazar Christian R. , Wassertheil‐Smoller Sylvia , Daviglus Martha L , Gallo Linda C , González Hector M 
Published: December 2023

AbstractBackgroundThe potential utility of subjective cognitive decline (SCD) as an early risk marker of Alzheimer’s disease and related dementias is under consideration, yet few studies have examined SCD among Hispanics/Latinos. In this study, we examined associations between SCD and cognitive change among diverse middle‐aged and older Hispanics/Latinos in the U.S. Furthermore, we examined SCD and cognitive change among cognitively healthy participants.MethodParticipants were recruited from a longitudinal multisite prospective cohort study of diverse Hispanics/Latinos enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and its ancillary study, the Study of Latinos‐Investigation of Neurocognitive Aging (SOL‐INCA). The mean age was 56.37 ± 8.10 years at Visit 1 (2008‐2011) and Visit 2 (n = 6,225; 2016‐2018) occurred 7‐years later, on average. SCD was measured with the short‐form Everyday Cognition Scale (ECog‐12) at Visit 2. Global SCD and executive function and memory subdomain SCD were generated by averaging the component items. Cognitive performance was measured at both visits and operationalized using standardized scores of learning, memory, verbal fluency, executive function, and global cognition. Cognitive change was assessed using regression‐based change models. We used survey generalized regressions to model the cognitive outcomes as a function of SCD. Cognitively healthy participants did not meet criteria for Mild Cognitive Impairment.ResultAll ECog‐12 exposures were associated with global cognitive decline (ECog‐12 global: B = ‐0.17, SE = 0.02; ECog‐12 executive: B = ‐0.15, SE = 0.02; ECog‐12 memory: B = ‐0.14, SE = 0.02, p’s<0.001). Furthermore, higher global and memory‐related SCD was associated with memory decline among those that were cognitively healthy (ECog‐12 global: B = ‐0.06, SE = 0.02; ECog12 memory: B = ‐0.05, SE = 0.02, p’s<0.01). The associations were slightly attenuated but remained significant after adjustment for demographic and cardiovascular disease risk covariates.ConclusionThe results from this study support that SCD may be an indicator of concurrent decline in cognition among diverse middle‐aged and older community dwelling Hispanics/Latinos. Furthermore, the utility of memory‐related SCD as a preclinical indicator of cognitive decline may warrant further investigation. This study highlights the importance of evaluating cognitive concerns among middle‐aged and older Hispanics/Latinos during routine healthcare visits.
Amyloid and Tau PET Positivity in Progressive Apraxia of Speech and Agrammatic Aphasia
Authors: Utianski Rene L , Tosakulwong Nirubol , Duffy Joseph R , Clark Heather M , Tetzloff Katerina A , Machulda Mary M. , Botha Hugo , Whitwell Jennifer L , Josephs Keith A 
Published: December 2023

AbstractBackgroundThe spectrum of what is referred to as nonfluent/agrammatic primary progressive aphasia includes patients with isolated apraxia of speech (PPAOS), progressive agrammatic aphasia (PAA), or a combination thereof (AOS‐PAA). When AOS is present, there is typically an underlying 4R tauopathy (corticobasal degeneration; progressive supranuclear palsy); isolated PAA is more often associated with a 3R tauopathy (Pick’s disease). While pathological studies confirm the clinical syndrome is the sequela of these proteinopathies, beta‐amyloid (Aβ) deposition has also been observed. Given the growing number of treatment options, it is important to better understand the incidence of Alzheimer’s disease (AD) in PPAOS‐PAA spectrum disorders.Methods65 patients recruited by the Neurodegenerative Research Group at Mayo Clinic underwent Aβ‐PET imaging using Pittsburgh Compound B (PiB) and tau‐PET imaging with [18F]flortaucipir at the same visit (PPAOS = 23; PAA = 6; AOS‐PAA = 36). A global PiB SUVR (standardized uptake value ratio)≥1.48 and temporal lobe tau meta‐ROI SUVR≥1.25 were deemed Aβ and tau positive, respectively. The incidence of Aβ and tau positivity and clinical‐demographic profiles were compared among groups.ResultsThere was no difference in age, sex, APOE status, tau/Aβ positivity or PET SUVRs across clinical groups (Table 1). Patients differed on indices of aphasia and AOS severity, in concordance with group membership; there was no difference on a memory measure. Eight patients (12%) were both Aβ and tau positive (indicative of the presence of AD), with an additional 20 patients (31%) positive on only one biomarker (Table 1). Of the eight Aβ and tau positive patients, seven had AOS (six prosodic predominant AOS). Aβ more than tau SUVRs increased with age and were related to each other (Figure 1).ConclusionsAβ and tau positivity is not uncommon in AOS and/or PAA patients, particularly in older patients. Enrollment criteria for Aβ or tau targeted pharmacological trials should consider concordance of biological variables and clinical presentations, rather than simply biological biomarkers. Alternatively, if such patients are enrolled, the outcome measures should reflect the clinical impairments, as it is not yet known if or how concomitant AD influences the clinical presentation.