bluuebunny/crossref_metadata_2025_split huggingface dataset:
Awareness and knowledge of dementia amongst Brazilian Speech and Language Therapists: An investigation of its determinants through a national survey
Authors: Beber Bárbara Costa , Alves Emily Viega , Pereira Natalie , Freitas D´Ávila Maria Isabel , Silagi Marcela , Chaves Marcia L Fagundes , Lawlor Brian 
Published: December 2023

AbstractBackgroundCommunication disorders are a frequent problem among people with dementia and can negatively affect their lives. Speech and Language Therapists (SLTs) can improve the quality of life of dementia people if they are properly trained to intervene. This study aimed to investigate the level of awareness and knowledge that practicing SLTs from Brazil have about their role in the care of people with dementia, and to identify determinants of the awareness and knowledge.MethodWe developed an online survey to collect information from the practicing Brazilian SLTs regarding clinical and demographic characteristics, knowledge about dementia (true or false questions), and awareness about their role in the care of people with dementia (sentences to rate in a likert scale). Uni and bivariate associations were then explored using Student´s t‐test, ANOVA and Pearson´s correlation test. Multiple regression analyses were conducted including the variables that presented p>0,2 in the bivariate analyses or that or considered relevant.Results227 participants were included in the study. Participants presented a greater knowledge of the general concepts of dementia, while the answers were less accurate in the statements about primary progressive aphasia (Figure 1). Regarding the awareness of SLTs about their role in the care of people with dementia, most of them agreed that SLTs might help people with dementia, but few of them answered to feel confident to assess and treat people with dementia (Figure 2). A significant model was estimated for the level of knowledge (F = 16.12; df = 3 and 223; p<0.001), which explained 16.7% of the variability (adjusted R² = 0.167), while the significant estimated model for the level of awareness (F = 24.6; df = 2 and 224; p<0.001) explained 17.3% of its variability (adjusted R² = 0.173) (Table 1).ConclusionThe knowledge and awareness about dementia among SLTs could be higher in many aspects. Also, they depend on each other and on the age of the professionals and their time of practice with dementia. The results suggest that if we improve awareness, we can improve knowledge and vice versa, and this must be considered when we plan actions to improve the education of those professionals in the future.
Associations of mid‐life cardiovascular function with late‐life Alzheimer’s disease pathology burden in the Heart SCORE study
Authors: Royse Sarah K. , Saeed Anum , Reese Alexandria C. , Lopresti Brian J. , Snitz Beth E. , Villemagne Victor L , Nadkarni Neelesh K. , Reis Steven E. , Lopez Oscar L. , Cohen Ann D. 
Published: December 2023

AbstractBackgroundCardiovascular (CV) disease is associated with dementia and Alzheimer’s disease (AD), but its relationship with AD pathology remains elusive. We examined whether mid‐life arterial stiffness, endothelial function, and blood pressure are associated with late‐life beta‐amyloid (Aß) and tau burden.MethodParticipants in the Heart Strategies Concentrating on Risk (SCORE) study completed cardiovascular phenotyping between 2003‐2005 (midlife; 45‐59 years) and up to three brain PET sessions between 2018‐2022 (late‐life; >65 years). Mid‐life assessments included augmentation index (AI75; N = 134) as a measure of arterial stiffness, Framingham reactive hyperemia index (fRHI; N = 130) as a measure of endothelial function, and systolic‐blood pressure (SBP; N = 141); late‐life measures were global [11C]Pittsburgh Compound‐B (PiB) standardized uptake value ratio (SUVR) and regional (medial temporal, entorhinal, inferior temporal, amygdala) [18F]flortaucipir (FTP) SUVR as indices of Aß and tau deposition, respectively. In individual linear regression models, we tested associations of mid‐life AI75, RHI, and SBP with late‐life PiB and FTP SUVRs. We used mixed effects models to examine these relationships longitudinally. All models were adjusted for time between CV and PET measurements, baseline age, sex, racialization, apolipoprotein‐E4, BMI, and history of hypertension, high cholesterol, smoking, and diabetes.ResultIn multivariable models, higher mid‐life SBP was associated with lower late‐life FTP SUVR in the medial temporal lobe (β = ‐0.20, p = 0.04) and inferior temporal gyrus (β = ‐0.23, p = 0.01; Table 1); higher mid‐life SBP was also negatively associated with FTP SUVR trajectories in these regions (medial temporal lobe: β = ‐0.0004, p = 0.02; inferior temporal gyrus: β = ‐0.001, p = 0.01; Table 2). We did not detect significant relationships of mid‐life AI75 or RHI with late‐life FTP SUVRs (p≥0.05) or between any mid‐life cardiovascular measures and late‐life PiB SUVR (p≥0.08).ConclusionIn this dementia‐free, community‐based cohort, higher mid‐life SBP was associated with lower late‐life regional tau deposition and accumulation. Though counterintuitive, our findings are consistent with results of cross‐sectional studies, which suggest that CV risk factors may be followed by an initial brain arteriole response that is protective against tau accumulation through early years of late‐adulthood1,2. Future studies should interrogate the potential mechanisms and age‐modifying effects that may underlie the relationship between mid‐life CV risk factors and late‐life tau deposition.
A systematic review of the impact of amyloid PET scan disclosure on psychological and behavioral outcomes for persons with cognitive impairment and their caregivers
Authors: Couch Elyse , Ashford Miriam T. , Zang Wenhan , Prina Matthew 
Published: December 2023

AbstractBackgroundAmyloid‐β PET scans are a potentially useful diagnostic tool, however there is limited understanding of the impact of amyloid disclosure on persons with cognitive impairment and their caregivers. This study aimed to systematically review the impact of amyloid scan disclosure on patient and caregiver psychological and behavioral outcomes.MethodWe searched Medline, Embase and PsychInfo to identify relevant articles. Studies of any design including persons with subjective cognitive impairment, MCI and dementia and their caregivers were included. Outcomes were limited to psychological and behavioral outcomes recorded following disclosure. All articles were screened for eligibility by two reviewers.ResultWe identified 9 papers from 6 studies. Depression, anxiety and test‐related distress were the most common psychological outcomes and recall and knowledge of the scan result were the most common behavioral outcomes. The psychological impact of amyloid disclosure varied depending on the scan recipient’s level of impairment and scan result. Higher test related distress was observed in persons with MCI and elevated amyloid and higher levels of anxiety were found in their caregivers. Most persons with cognitive impairment and their caregivers were able to recall the scan result. However, one study found that gains in knowledge regarding the scan recipients diagnosis following disclosure were comparable to receiving psychoeducation.ConclusionPsychological responses to amyloid PET scan disclosure depends on the recipient’s level of impairment and the scan result itself. Persons with MCI and a positive scan result, and their caregivers were at greater risk of distress or anxiety and may benefit from additional post‐diagnostic support. Participants were able to correctly recall their scan results and reported an increase in knowledge regarding their diagnosis. However, psychoeducation may be equally effective at enhancing patient and caregiver knowledge, at a lower cost.
Lifestyle for Brain Health Score, Genetic Risk and Incidence of Dementia
Authors: Neuffer Jeanne , Moreno Elisa , Grand Quentin Le , Leffondre Karen , Foubert‐Samier Alexandra , Berr Claudine , Tzourio Christophe , Helmer Catherine , Debette Stéphanie , Samieri Cécilia 
Published: December 2023

AbstractBackgroundAssessing whether modifiable factors are associated with dementia risk regardless of genetic risk for the disease is primordial for precision prevention. So far, studies on gene‐by‐environment interactions (GxE) in dementia have been controversial. We leveraged a large cohort of older persons to investigate the association between numerous modifiable factors, reflected by the lifestyle for brain‐health (LIBRA) score (defined in figure 1), and the incidence of dementia, evaluating effect modification by genetic risk.MethodWe included participants from the Three‐City (3C) study, free of dementia at baseline and followed for up to 17 years. The LIBRA score and a genetic risk score (GRS) based on the latest Alzheimer’s disease GWAS (excluding the apolipoprotein E {APOE} locus) were constructed. Illness‐death models for interval‐censored data were used to assess the relation of LIBRA, GRS and carriership of the e4 allele of the APOE gene (and their interactions) to the incidence of dementia, accounting for potential competing risk by death.ResultThe population included 5170 3C participants aged on average 73.8 years at baseline. Both genetic factors and LIBRA were significantly associated with dementia risk. In multivariable‐adjusted models, each one‐point increase in LIBRA was associated with a 10% higher risk of dementia (95% CI 1.07‐1.13). We found no evidence of GxE interaction (p≥0.2 for two‐order [LIBRA by each genetic variable] and three‐order interaction terms [LIBRA‐by‐GRS‐by‐APOE4]); a higher LIBRA was significantly associated with increased dementia risk in both APOE4 carriers and non‐carriers (figure 1) and in low, medium or high GRS level (figure 2), with similar magnitude of associations in all strata. Although power was limited to examine APOE4 carriers by GRS strata, the trend of association of LIBRA (continuous) to dementia risk was not meaningfully different from what found in other groups (figure 3).ConclusionIn this large cohort of older persons, increasing number of health and lifestyle risk factors for dementia was associated with higher dementia risk in all levels of genetic risk. These findings suggest prevention programs with targeted lifestyle modifications and health management may be efficient even in those with highest risk for dementia based on their genetic susceptibility.
The prioritization of biomarkers in the diagnostic workup of motor tauopathy
Authors: Agosta Federica 
Published: December 2023

AbstractMotor tauopathies represent a spectrum of degenerative, poorly levodopa‐responsive parkinsonisms unified by the pathological accumulation of hyperphosphorylated tau protein fragments in the brain. The principal entities, progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD), are rare conditions (<10 per 100,000) and present with non‐amnestic cognitive impairment ‐ mostly involving frontal‐subcortical networks – in around 40% of patients at baseline. Additionally, the phenotypic PSP spectrum expresses with oculomotor dysfunction, falls and bulbar symptoms at varying degrees. On the other hand, CBD tauopathy is the most frequent aetiology underlying the corticobasal syndrome (CBS) that is a multifaceted disorder characterized by a markedly asymmetric Parkinsonism with apraxia and neocortical deficits. Paralleling the clinical symptoms, the distribution of functional and metabolic impairment specifically involves different brain regions in PSP and CBD. Hence, metabolism assessment by FDG‐positron emission tomography (PET) allows for accurate distinction of motor tauopathies from other parkinsonisms or one with another (AUC 0.80 and 0.92‐0.97, respectively). In this context, the European Intersociety Consensus Diagnostic Task Force recommends the use of FDG‐PET as the first‐level diagnostic biomarker to achieve early and accurate differential diagnosis of motor tauopathies. Afterwards, the assessment of CSF biomarkers of Alzheimer’s disease (AD) is advised to identify that minority of cases of CBS underpinned by an AD aetiology (10‐20%). With this sequence of biomarkers, the diagnostic workflow aims to an early identification of motor tauopathies and advocates in‐depth etiological investigation of CBS where access to AD‐specific drugs, when available, should be considered in a non‐negligible proportion of patients.
Investing in hope in dementia care practice: What do we need to consider?
Authors: Dasgupta Jayashree 
Published: December 2023

AbstractAlthough most countries have ratified the United Nations Convention on the Rights of Persons with Disabilities, only a quarter have a national dementia plan which outlines a strategy to support People Living with Dementia (PLWD) and their families. Majority of PLWD reside in low‐and‐middle‐income countries where the numbers are expected to increase disproportionately over the coming decades. Healthcare systems in these regions are already overburdened, and resources for dementia are often inaccessible or unaffordable for most of the population. Factors like low public awareness, misconceptions about early symptoms being a natural part of aging and societal stigma also contribute to delays in diagnosis and hesitancy in help seeking.However, a recent Alzheimer’s Disease International report highlights that challenges in dementia care are not limited to low resource settings, and up to an astounding 85% of PLWD worldwide may not receive post‐diagnostic support. Research using paradigms like patient public involvement have highlighted how PLWD and their families often feel devalued as dementia has ‘no‐cure,’ drawing attention to experiences which have made them feel unsupported during interactions with health systems. Globally, the majority of dementia care is actually provided at home and by family members until a stage where institutional care is possible in settings where these resources exist. This highlights the importance of interventions which can support at‐home care, particularly since home care has also been shown to be a more cost effective model when compared to institutional care. Along with building public awareness and making society more dementia inclusive, training of healthcare professionals is also required for more hopeful communication. Using the value of hope can extend support to PWLD and their families by encouraging meaningful engagement within the family context and encouraging PLWD to continue participating in socially enriching activities.Whilst endeavors to find a cure for dementia must continue, greater investment is required in interventions that instill realistic hope in PLWD and empower their families to provide care within the community. These interventions play a critical role in reducing the negative impact that social withdrawal and social isolation can have on the well‐being of PWLD and their families.
Alzheimer’s Disease as a potential diabetes type III: Pilot Study of comorbidities related to AD
Authors: González Andrea , Camila Calfio , Maccioni Ricardo Benjamin , Farías Gonzalo , Fuentes Patricio 
Published: December 2023

AbstractBackgroundAlzheimer’s disease (AD) is the most prevalent cause of dementia in the elderly population. It is a multifactorial disease in which metabolic dysregulation and glucose metabolism impairment plays a major role in the etiopathogenesis. In this research, we evaluate the comorbidities in a clinical trial for the novel biomarker Alz‐tau®, based on platelet tau, in cognitive healthy controls, mild‐cognitive impairment (MCI) and AD patients, in particular TII diabetes. Alterations in this biomarker appear to indicate high risk of developing AD, as demonstrated in previous clinical trials.MethodsFrom a cohort of 111 subjects, neuropsychology tests were performed to assign the respective group (control, MCI or AD). In addition, a health questionnaire to evaluate comorbidities. For the Alz‐tau® biomarker, platelets were obtained from plasma by centrifugation, lysed to obtain platelet protein extracts (containing tau) and further processed for a western blot analysis. The immuno‐ detection was performed with our novel monoclonal antibody tau51, which detects two variants of tau protein: a high molecular weight variant (HMW) and a low molecular weight variant (LMW). The results obtained were subjected to a densitometric analysis with ImageJ and the algorithm HWM/LMW was obtained.ResultFrom 111 patients, 17 presented diabetes type 2 as a comorbidity (15,3%). Out of them, 11 were cognitive healthy subjects (64.7%), 4 EA patients (23.5%) and 2 MCI (11.8%). Out of the control patients, 6 have the Alz‐tau® biomarker altered (54.5%), which was similar to what was observed in the EA patients (2 patients, 50%) and the MCI (1 patient, 50%). Of the 17 patients with diabetes, 53% presented an altered Alz‐tau® biomarker (cut‐off 1.2 algorithm), which is considered a risk factor for AD. It should be considered that the area under the curve (AUC) of this novel biomarker Alz‐tau® is 0.69, appropriate for a novel technique.ConclusionHere, we discovered that this early detection biomarker is correlated with the high‐risk factor of having AD in the future, since non‐symptomatic subjects exhibited an altered biomarker. Moreover, more than 50% of the TII diabetic positive cognitive healthy controls, exhibit an altered biomarker, sustaining our hypothesis of the correlation between glucose‐metabolism impairment, AD and oligomeric tau.
Associations between neuropsychiatric symptoms and ADRD serum biomarkers in Mexican American and non‐Hispanic white adults with mild cognitive impairment
Authors: Garbarino Valentina R. , Kautz Tiffany F , Trevino Hector , Vela Gabriel A. , Philip Vinu , LaRoche Ashley , Saklad Amy R. , Shipp Eric L. , Satizabal Claudia L. , Maestre Gladys E. , Royall Donald R. , Teixeira Antonio L , Seshadri Sudha , Gonzales Mitzi M. 
Published: December 2023

AbstractBackgroundMild cognitive impairment (MCI) is a heterogenous diagnostic category with trajectories ranging from reversion to unimpaired cognition to progression to dementia. Neuropsychiatric symptoms such as depression and irritability are common and influence quality of life of patients and caregivers. The role of neuropsychiatric symptoms on disease biology, presentation, and course remains poorly understood. The goal of this study was to evaluate the associations between neuropsychiatric symptoms and serum ADRD biomarkers in Mexican American and non‐Hispanic white participants diagnosed with MCI.MethodParticipants from the Texas Alzheimer’s Research and Care Consortium underwent a blood draw and clinical evaluation, including psychopathological and cognitive assessments. Diagnoses of MCI were adjudicated in consensus reviews. The presence and severity of neuropsychiatric symptoms were assessed by informant report using the Neuropsychiatric Inventory (NPI). Serum levels of total tau, neurofilament light (NfL), and glial fibrillary acidic protein (GFAP) were assessed using Simoa HD‐X Analyzer. Associations between NPI total score and individual items with serum biomarker levels were assessed using linear regression adjusted for age and sex.ResultA total of 425 participants (mean age: 71 ± 9 years, 62% female, 74% Mexican American) had a diagnosis of MCI and serum ADRD biomarkers (Table 1). Total NPI score was not associated with total tau (ß = 0.002, p = 0.609), NfL (ß = 0.001, p = 0.658), or GFAP (ß = 0.001, p = 0.777). However, endorsement of appetite changes was associated with higher NfL (ß = 0.077, p = 0.006) and GFAP (ß = 0.088, p = 0.002) levels. Stratified analyses indicated associations of appetite changes with serum NfL (ß = 0.108, p = 0.002) and GFAP (ß = 0.095, p = 0.003) in Mexican Americans, but not in non‐Hispanic whites (NfL: ß = 0.022, p = 0.633, GFAP: ß = 0.102, p = 0.066).There were no other significant associations between individual items on the NPI with serum biomarkers (p>0.05, Bonferroni adjustment p±0.003).ConclusionWithin Mexican American adults with MCI, changes in appetite were associated with higher serum NFL and GFAP levels. As elevations in circulating NfL and GFAP levels are associated with ADRD pathology and accelerated disease progression, appetite changes, a non‐invasive and easily discernible behavioral phenotype, may predict higher likelihood of worsening cognitive course. Future longitudinal studies will be necessary to confirm predictive utility of appetite changes for disease progression.
Cardiovascular health and the risk of Alzheimer’s dementia in a biracial population‐based study
Authors: Dhana Anisa , Decarli Charles , Dhana Klodian , Desai Pankaja , Holland Thomas Monroe , Evans Denis A , Rajan Kumar B 
Published: December 2023

AbstractBackgroundThe cardiovascular health (CVH) index, created by the American Heart Association (AHA) to assess and monitor the risk of cardiovascular disease, has been related to dementia risk. However, evidence is limited, and most studies originate from populations comprised of primarily white participants. We examined the association of the CVH index with the risk of incident Alzheimer’s dementia in a biracial population‐based study.MethodOur study consisted of 1,702 non‐Hispanic Black and white participants of the Chicago Health and Aging Project, a population‐based cohort. CVH was based on seven risk factors: diet, physical activity, body mass index, smoking, dyslipidemia, hypertension, and diabetes. Following AHA recommendations, we assigned points of 0, 1, or 2 based on adherence to each factor, with an overall score ranging from 0 to 14 – a higher score indicates better cardiovascular health. Clinical diagnosis of Alzheimer’s dementia was based on the NINCDS‐ADRDA criteria. Cox proportional hazard models were used to compute the hazard ratio and 95% confidence interval. Models were adjusted for age, sex, race, education, ApoE4 allele, cognitive activities, and cardiovascular disease.ResultThe average baseline age of the study population was 73 years and comprised 62% women and 53% black participants. During 14,226 person‐years of follow‐up, there were 351 incident Alzheimer’s dementia. In a multivariable‐adjusted model, CVH was linearly associated with a lower risk of incident Alzheimer’s dementia. For each additional CVH score, the HR was lower by 0.84 (95% CI 0.76 ‐ 0.94). Compared to individuals with inadequate CVH (score: 0‐6), the HRs (95% CIs) of incident Alzheimer’s dementia in participants with average (7‐9) and optimal CVH (10‐14) was 0.44 (95%CI 0.28 ‐ 0.69) and 0.37 (95%CI 0.21 ‐ 0.65), respectively. We found similar associations between CVH score, per one additional score, and risk of Alzheimer’s dementia in Black (HR 0.84, 95%CI 0.74 ‐ 0.95) and white (HR 0.83, 95%CI 0.7 ‐ 0.98) individuals.ConclusionIn a biracial cohort of older adults, the cardiovascular health burden was higher among Black individuals. However, promoting a better CVH in the general population may help lower dementia risk in Black and white older adults.