bluuebunny/crossref_metadata_2025_split huggingface dataset:
Racial and Ethnic Differences in the Risk of Dementia under Hypothetical Blood‐Pressure‐Lowering Interventions: The Multi‐Ethnic Study of Atherosclerosis
Authors: Rojas‐Saunero Liliana Paloma , Fitzpatrick Annette L. , Swanson Sonja , Diez‐Roux Ana , Mayeda Elizabeth Rose , Jimenez Marcia Pescador 
Published: December 2023

AbstractBackgroundBlack and Latino people have a higher risk of Alzheimer’s disease and related dementias (ADRD) as well as ADRD comorbidities, including hypertension. Since hypertension is perhaps the most important modifiable vascular risk factor for the development of ADRD, we aimed to study whether sustained hypothetical interventions to reduce systolic blood pressure (SBP) would differentially change ADRD risk across racial/ethnic groups.MethodWe used 19 years of follow‐up data from the Multi‐Ethnic Study of Atherosclerosis. The study population included 6806 individuals between 44 and 84 years old, free of clinically recognized CVD and dementia diagnosis at baseline. We defined two sustained interventions on SBP based on continually maintaining SBP below (1) 120 mmHg and (2) 140 mmHg. We considered incident dementia diagnoses as outcome. We applied the parametric g‐formula to adjust for baseline and time‐varying confounding. Baseline covariates included sex, age, education level, income, health insurance, and clinical variables (e.g. diabetes). Time‐varying covariates included SBP, total cholesterol, low‐density lipoprotein, body mass index, health behaviors (e.g. alcohol use), myocardial infarction, stroke, and coronary heart disease diagnosis.ResultMean age was 62.1 (SD = 10.2), 52.9% were female, 38.5% (2617) self‐identified as White, 27.8% (1890) as Black, 21.9% (1495) as Latino and 11.8% (804) as Chinese American. The observed 19‐year risk for dementia was 8.6%. Compared to no specified intervention, maintaining SBP below 120 mmHg was associated with an overall dementia risk reduction of about 5% in the full study population (risk ratio (RR): 0.95, 95%CI: 0.88, 1.02). The estimated RRs for this same comparison were: 0.95(95%CI: 0.87, 1.03) for White participants, 0.93 for Black participants (95%CI: 0.81,1.06), 0.92 for Latino participants (95%CI:0.81, 1.09), and 1.15 for Chinese American participants (95%CI: 0.74,1.63) (Table 1). Of note, the proportion of participants who would have had to have been intervened differed by race/ethnicity, where 92% Black participants, 82% of White and Chinese American, and 86% of Latino participants would have had to have been intervened to maintain SBP below 120 mmHg.ConclusionOur results highlight a heterogenous effect that should be considered for implementation of blood pressure control strategies.
Mobile Toolbox: Remote, unsupervised longitudinal assessment of a diverse cohort in the UCSF Brain Health Registry
Authors: Landavazo Bernard , Camacho Monica R , Kaat Aaron J. , Hosseinian Zahra , Gershon Richard C. , Weiner Michael S. W. , Nosheny Rachel L 
Published: December 2023

AbstractBackgroundA critical need in the AD field is development and validation of efficient, scalable cognitive assessments to identify older adults with cognitive impairment. The Mobile Toolbox (MTB), a novel suite of app‐based cognitive assessments, was developed to address this need. The goal of this study was to assess the feasibility, usability, compliance, longitudinal retention, and validity of MTB assessment in a large, ethnoculturally and educationally diverse cohort in a remote, unsupervised setting.MethodParticipants were recruited from the UCSF Brain Health Registry (BHR), an online study. BHR participants were invited by email, screened for eligibility (English fluency and access to a compatible smartphone), and provided online instructions for MTB app download. All participants could complete a baseline administration. A subset was invited to a longitudinal study, in which they complete MTB assessments at a short‐term timepoint (day 7, 14, or 21; study arms sequentially assigned), and then at 6‐month intervals. Enrollment goals were N = 800 with equal distribution across 10‐year age bands (ages 18‐80+); 60% with <16 years of education; 10% non‐Latinx Black, 15% Latinx, and 5% non‐White other ethnocultural identity.ResultOver a 5‐month period, 48,110 BHR participants were invited to the study. Of those, 8287 (17%) expressed interest, 3554 (7%) completed baseline assessment, and 1327 (3%) were assigned to the longitudinal study. Participants submitted 1205 help tickets asking for email support to complete MTB. The baseline and longitudinal cohorts underrepresented Black individuals and younger age bands, despite targeted recruitment efforts (Table 1). Longitudinal completion rates were 59.0% for the short‐term timeline and 55.2% for the 6‐month timepoint, and varied by ethnocultural group (Figure 1). Compared to those invited, those who enrolled in the longitudinal study were older, had higher education, and were more likely to identify as female non‐Latinx White (p<0.05).ConclusionResults demonstrate feasibility and usability of remote, unsupervised MTB assessment. Underrepresented populations were less likely to enrolled and to complete assessments at baseline and longitudinally, emphasizing the need to develop more inclusive recruitment and engagement efforts. This approach can be scaled up to efficiently assess cognition in many research, clinical trial, and healthcare settings.
Risk of Mild Behavioral Impairment: the role of gender and APOE allele carrier status
Authors: Mortby Moyra E , Ismail Zahinoor , Kiely Kim M , Fischer Corinne E. , Anstey Kaarin J. 
Published: December 2023

AbstractBackgroundGender differences in dementia and dementia‐related neuropsychiatric symptoms are well described. Similarly, the Apolipoprotein E (APOE) ε4 allele is a well‐known predictor of Alzheimer’s disease. However, their impact on the clinical manifestation of Mild Behavioral Impairment (MBI) remains unclear. Using data from the Australian population‐based PATH Through Life Study we explored the associations between gender and APOE ε4 carrier status with MBI. We hypothesized that MBI likelihood would be greater in males and ε4 carriers.Method1316 dementia‐free participants (48% female; aged 72‐79) were included. Gender was self‐reported (female/male). Participants were classified as APOE ε4+ if they carried at least one ε4 allele (APOE ε4/ε4, ε2/ε4, ε3/ε4). MBI was approximated using a previously published transformation algorithm, which utilizes items from the Neuropsychiatric Inventory assessed at a single study visit. Binomial logistic regression was used to examine the role of gender and APOE ε4 carrier status, and their interaction, on predicting MBI status, while controlling for self‐reported years of education.ResultOf the 1316 participants, 339 (25.8%) were APOE ε4+ and 445 (34%) had MBI symptoms. A higher proportion of APOE ε4+ carriers (χ2 (1) = 5.99, p = .014) and men (χ2 (1) = 4.59, p = .032) were in the MBI group compared to the non‐MBI group. Binomial logistic regression showed APOE ε4 carrier status (OR = 1.58, 95% CI: 1.063‐2.344) and male gender (OR = 1.45, 95% CI: 1.093‐1.925) were associated with a greater likelihood of MBI. Male gender was also associated with a 2‐fold greater likelihood of having symptoms of the Decreased Motivation (OR = 2.08, 95% CI: 1.13‐3.86) and Impulse Dyscontrol (OR = 2.16, 95% CI: 1.54‐3.03) domains. No interaction effects were found between gender and APOE ε4 carrier status for MBI or any of its domains.ConclusionThe current study found that in dementia‐free older adults both male gender and APOE ε4+ status increased the risk of having MBI. However, no cumulative/interaction effect between gender and APOE ε4 carrier status was found, suggesting that being both male and APOE ε4+ does not further increase the risk of MBI. These results provide novel and valuable insight into the connection between gender, APOE ε4 carrier status and MBI.
Single‐domain antibody‐based non‐invasive in vivo imaging of α‐synuclein or tau pathology
Authors: Jiang Yixiang 
Published: December 2023

AbstractBackgroundSynucleinopathies and tauopathies are characterized by progressive deposition of α‐synuclein (α‐syn) and tau proteins, respectively. These diseases have been linked to proteins mutations or excess α‐syn gene, indicating prominent roles of these proteins in their etiology and pathogenesis. Consequently, being able to non‐invasively image these aggregates would allow early and accurate diagnosis to facilitate clinical trials on drugs targeting these lesions and eventually for prophylactic therapies. Recently, several dye‐based imaging probes with selectivity for tau aggregates have been developed but suitable imaging biomarkers for synucleinopathies are still unavailable. However, these β‐sheet binders bind to different amyloids and thereby lack specificity. Compared to β‐sheet dyes, single domain antibodies (sdAbs), found in camelids and a few other species, are highly specific and their small size allows better brain entry and distribution than whole antibodies.MethodTo develop anti‐α‐syn or anti‐tau sdAbs, we immunized llamas with α‐syn and tau preparations, respectively. Phage display libraries were generated from peripheral blood mononuclear cells and screened for binding to α‐syn or tau proteins using various assays, resulting in prototype sdAbs deemed promising for in vivo imaging. Subsequently, these anti‐α‐syn or anti‐tau sdAbs were labeled with a near‐infrared tag and injected intravenously in synucleinopathy, tauopathy or control mice, followed by imaging in an In Vivo Imaging System (IVIS). Subsequently, brains were extracted for tissue analysis.ResultIntravenous injection of labeled anti‐α‐syn or anti‐tau sdAbs resulted in strong in vivo brain signal detected through the intact head in synucleinopathy and tauopathy mice, respectively, but not in control mice. Notably, anti‐α‐syn sdAbs did not give signal in tauopathy mice and vice versa. The in vivo brain signal correlated strongly with insoluble, soluble, and phospho‐antigen within the brain. Postmortem analysis revealed extensive co‐localization of the sdAb imaging probe with α‐syn or tau aggregates within neurons in the endosomal‐lysosomal system, indicating their interaction in these degradation pathways.ConclusionThese anti‐α‐syn or anti‐tau sdAb probes allow non‐invasive and specific in vivo imaging of α‐synuclein vs tau pathology in mice, with brain signals correlating strongly with lesion burden. These small antibody derivatives have great potential for in vivo diagnosis of these diseases.
The Black Experience of COVID‐19. What is next for Clinical Psychologists in Alzheimer’s Disease research post‐pandemic?
Authors: Browne Laurel Y , Cedeno Jeffrey A , White Payton Gabrielle , Cesar Oliver , Azad Dishari Zaman , Tosto Giuseppe , Osorio Ricardo S , Bubu Omonigho Michael M 
Published: December 2023

AbstractBackgroundCOVID‐19’s emergence in 2020 altered the dynamics of societal norms leading to a new reality of increased mortality, financial strain, and psychopathology. Individuals with dementia, older adults, and marginalized racial/ethnic communities were identified as vulnerable to being disproportionately impacted by the COVID‐19 pandemic. The unequal overrepresentation of non‐White communities in Covid‐19 infections and deaths demonstrated that the pandemic widened pre‐existing healthcare inequalities and did not impact all racial groups equally. In Louisiana, the Black community made up 76.9% of COVID‐19 cases and accounted for 70.6% of the total deaths, but only comprised 31% of the total population (Tirupathi et al., 2020). Research showed that the racial disparities experienced due to systemic racism resulted in more African Americans suffering from increased stress, anxiety, and depression. The existing literature led to the following research question: What are the Clinical implications of COVID‐19 on older adults in the Black community in Alzheimer’s Disease & related dementia research?MethodDatabases such as Pubmed, Google Scholar, and APA PsycNet were used. Keywords included COVID‐19, African/Black Americans, older adults, dementia, and racial health disparities. Articles were used to identify themes, identify risk factors in the Black community, and methods to improve them.ResultsThe results from the literature review revealed that COVID‐19 impacted older adults (65 +), affecting their activity level, sleep quality & well‐being. Contracting the disease was associated with experiencing cognitive deficits even into the recovery phase. Unfortunately, COVID‐19 disproportionately impacted older, ethnically diverse individuals. In particular, COVID‐19’s high infection rate and impact on Black mental health put older African Americans at risk for AD & related dementias. The findings elucidate that the risk of long‐term COVID‐19, AD, and related dementias need to be studied, particularly among older adults in the Black community.ConclusionCovid‐19 exacerbated historical health inequities in marginalized communities and their psychological well‐being. This research highlights the importance of clinical psychologists advocating for health equity in Alzheimer’s and related dementia research to mitigate the adverse effects of the COVID‐19 pandemic. Dismantling structural barriers, increasing cultural education, and representation in clinical trials are the next steps to advocating against health disparities.
Strengthening subject recruitment and retention of the older Black population in Alzheimer’s Disease and related dementias studies through community outreach
Authors: White Payton Gabrielle , Azad Dishari Zaman , Petersen Karyn , Browne Laurel Y , Cedeno Jeffrey A , Cesar Oliver , Jean‐Louis Girardin A , Osorio Ricardo S , Bubu Omonigho 
Published: December 2023

AbstractBackgroundRepresentation in dementia research is extremely important in creating effective prevention methods, interventions, and treatments across all populations (Lennon et. al 2022; Barnes 2022). One of the main goals set by the National Institute on Aging (NIA) for the years 2020‐2025, is to disseminate information to several outlets including older adult‐support organizations about research and interventions. The NYU Healthy Brain Aging and Sleep Center (HBASC) has successfully built relationships with community organizations in an effort to contribute to meeting the NIA’s goal using the PEACE method. We evaluated pre‐post subject retention rate, after instigation of PEACE.MethodIn 2019, HBASC began recruitment for a longitudinal study focusing on sleep and Alzheimer’s Disease (AD) in healthy older Blacks (ages 60‐75 years) in the New York Metropolitan Area using community outreach/education as a method of recruitment (i.e. partnering with senior recreation centers, local churches, etc.). Study team members implemented the PEACE method in their outreach efforts. Team members practiced Patience, when accommodating organizations’ needs and requests, Empathy, for the members of the communities they were working in, Appreciation, for the organizations’ aid in reaching the community, Cultural competence, when planning or participating in community events, and prioritized Educating the community, on AD and other related dementias before recruitment.ResultWithin the first year of recruitment, ∼77% vs. ∼23% of subjects were successfully recruited from the community favoring the PEACE method. When the PEACE method was successfully executed, the study team gained the trust of members of the community and retained ∼ 70% of subjects recruited from the community. Older Blacks trusted the HBASC study team because the PEACE method demonstrates dedication to the community. This in turn increases the likelihood of follow‐up response in longitudinal ADRD studies.ConclusionCollaborating directly with community organizations, is an efficient method not only of recruitment, but also retention of older Black subjects in ADRD studies. Collaborations with well‐known trusted community partners can establish a strong relationship between the Black community and research.
Supporting ADRD care partners from historically and currently underserved communities
Authors: Dawson Walter D , Gelmon Sherril B 
Published: December 2023

AbstractSupports for people living Alzheimer’s disease and related dementias (ADRD) and their care partners in the US remain limited. Historically and currently underserved populations in health care experience particularly stark disparities in accessing ADRD‐specific care and supports. To inform enhanced outreach and supports for underserved populations in ADRD care, and to better understand how state and federal policies can help support this goal, a study was conducted to gather insights from the perspectives of individuals with lived experience as care partners, with an emphasis on communities historically and currently underrepresented in ADRD research, for whom culturally appropriate services for people living with ADRD may be non‐existent or difficult to access.The study population focused on care partners of people living with ADRD who identify with historically and currently underserved communities including Black, Indigenous, Asian, and Latinx Americans in the Portland, Oregon region. Recruitment strategies for potential focus group participants were developed in collaboration with leaders of Portland‐area community‐based organizations that provide ADRD care and supports. Focus groups were convened with care partners from these four communities, along with one focus group with individuals who identified with other communities.ADRD care partners across all populations reported a need for additional supports to help them manage care‐related activities. The specific needs and supports identified varied across populations. The findings also indicate widespread unmet care partner needs across all populations, including more information on ADRD, financial and psychological supports, in‐home care, and respite services. While many care partners were generally satisfied with their clinical care and research involvement, nearly all identified potential areas for further supports, suggesting an opportunity for coproduced supports, services, and policies.Innovative approaches to service delivery and policy development should be pursued in order to better support care partners of people living with ADRD. US policymakers could coproduce policies through direct collaboration with care partners, researchers, and clinicians by co‐designing and implementing policies focusing on improving the care partner experience. In moving toward equitable service provision, offering specific and unique supports for care partners from underserved communities who may have difficulties accessing culturally appropriate services must be a priority.
The association of hyperglycemia and kidney dysfunction with cognitive impairment in community‐dwelling older adults in Taiwan
Authors: You Ying‐Shu , Chen Jen‐Hau , Chiou Jeng‐Min , Chen Ta‐Fu , Chen Yen‐Ching 
Published: December 2023

AbstractBackgroundDiabetes was considered one of the risk factors for dementia. However, one‐third of diabetic patients also suffer from kidney disease. It remains unclear the intercorrelation between blood sugar and kidney function that affects the occurrence of mild cognitive impairment for people with normal blood sugar levels. This study aimed to explore the relationship between hyperglycemia and kidney dysfunction (KD) on cognitive impairment in older adults.MethodThis is an eight‐year cohort study (2011‐2019). A total of 509 non‐demented older adults were recruited from the elderly health checkup program at baseline (2011‐2013) with three biannual follow‐ups. Global and domain‐specific (memory, attention, executive function, and language) cognition were assessed by the Taiwanese version of Montreal Cognitive Assessment (MoCA‐T) and a battery of neuropsychological tests, respectively. MCI was defined as a MoCA‐T score of 22 or 23. Hyperglycemia was defined as fasting blood glucose greater than 100 mg/dL. KD was defined as having either glomerular filtration rate < 60 ml/min/1.73 m2 or proteinuria. The generalized linear mixed model was utilized to examine the effects of hyperglycemia and KD on cognitive performance.ResultThe prevalence of MCI was 9.4% at baseline. Hyperglycemia [adjusted odds ratio (aOR) = 1.91] and KD (aOR = 1.98) were significantly associated with the risk of MCI over eight years after adjusting for covariates, respectively. In addition, hyperglycemia and KD were significantly associated with poor performance of logical memory (β:‐0.51 to ‐0.01), executive function (β:‐0.25 to ‐0.003), attention (β:‐0.07 to ‐0.03), and verbal fluency (β:‐0.08 to ‐0.005). Hyperglycemia and KD was associated with an increased risk of MCI participants aged less than 75 years (aOR = 2.19–2.21) and in APOE ε4 non‐carriers (aOR = 2.02–2.15).ConclusionOur finding indicated that poor glycemic control and kidney function were associated with an increased risk of MCI or poor performance of cognitive domains in older adults. Cognitive impairment may be reversible through optimal management of glycemia and kidney disease; interventions (e.g., self‐management education, dietary restriction, and sufficient physical activity, etc.) at the early stage will be helpful to prevent dementia.
Plasma oligomer βeta‐amyloid and white matter microstructural integrity in cognitively normal older adults according to cerebral amyloid deposition
Authors: Wang Sheng‐Min , Lim Hyun Kook 
Published: December 2023

AbstractBackgroundMultimer detection system‐oligomeric amyloid‐ß (MDS‐OAß) measures plasma OAß level, which is associated with earlier pathology of Alzheimer’s disease (AD). Previous studies showed that plasma levels of MDS‐OAβ were higher in patients with dementia due to AD than in cognitive normal older adults (CN), and they correlated well with conventional AD biomarkers including standardized uptake value ratio (SUVR) of Pittsburgh compound B (PiB) and CSF level of Aβ42, p‐Tau, and t‐Tau. However, no previous study investigated MDS‐OAβ difference in CN with or without cerebral Aβ burden. In addition, associations among MDS‐OAß, cerebral Aß deposition, aberrance of white matter integrity, and cortical thickness in CN is not elucidated.MethodWe studied 34 CN with amyloid‐PET negative and 23 CN with amyloid‐PET positive results who received MDS‐OAβ, structural MRI, and diffusion tensor imaging (DTI).ResultAmyloid‐PET positive group showed higher MDS‐OAß level than amyloid‐PET negative group, but two groups did not differ in WM integrity or cortical thickness. MDS‐OAβ level was significantly higher in amyloid‐PET positive group than in amyloid‐PET negative group. MDS‐OAβ positive group had significantly higher cerebral AB deposition, or mean global SUVR values, than MDS‐OAβ negative group. There was a positive correlation between MDS‐OAβ level and PET‐SUVR. In terms of DTI analysis, MDS‐OAβ positive group had significantly lower FA in the left forceps minor of corpus callosum and right superior longitudinal fasciculus than in lower MDS‐OAβ negative group. In addition, the FA values were negatively correlated with MDS‐OAβ level (figure 1). MDS‐OAB positive group showed a significant reduction in the cortical thickness in the left fusiform when compared with the MDS‐OAB negative groupConclusionPlasma MDS‐OAβ value might reflect cerebral amyloid status and global cerebral Aß retention in CN. We elucidated toxic role of OAβ by showing that the plasma OAβ value were associated with decrement of WM microstructural integrity in the early pathological process of AD. Cortical thickness did not differ according to cerebral Aβ burden but rather was associated with higher plasma OAβ level. Thus, MDS‐OAβ value might reflect earlier, and different, pathology than cerebral Aß retention measured using amyloid PET scan in CN with AD continuum.