bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of an eHealth intervention to support care management in caregivers of people with dementia: a pre‐post pilot study
Authors: Solorzano Claudio Singh , Orini Stefania , Zanetti Orazio , Chattat Rabih , Pievani Michela , Festari Cristina 
Published: December 2023

AbstractBackgroundMost people with dementia are cared for by family members. The workload associated with caregiving tasks is often associated with physical, mental, and social impairment. In line with the WHO’s Global Action Plan on Dementia 2017‐2025 (WHO, 2017), calling for the provision of affordable and accessible interventions for dementia caregivers, we tested an eHealth intervention to improve self‐efficacy and mental health in dementia caregivers.Method8‐week eHealth psycho‐educational intervention aiming at increasing the knowledge of neurocognitive disorders, their at‐home management, and the presence of national and local support services. The intervention was conducted by an experienced psychotherapist assisted by a professional expert (e.g., geriatrician, educator, social worker, lawyer and advocacy patient organisations), according to the topic of each meeting. A pre‐post study design was used and validated psychosocial self‐report questionnaires were administered before and after the intervention (e.g., State‐Trait Anxiety Inventory ‐STAI‐Y1‐2, Zarit Burden Interview ‐ZBI, Beck Depression Inventory‐II BDI‐II, Revised Scale of Caregiving Self‐Efficacy ‐RSCSE). Pre‐post differences were tested with paired t‐test, correlations between scales with Pearson correlation coefficientResult41 caregivers (mean age: 57; range 31‐82; female: 78%; children: 61%) completed the study. The intervention had high participation (88% attended at least seven meetings). Following the intervention, the self‐efficacy regarding the ability to respond to the patient’s disruptive behaviours effectively improved (RSCSE‐RDB subscale: t(40) = ‐2.817, p = 0.007), anxiety and burden levels decreased (STAI‐Y1: t(40) = 3.170, p = 0.003; STAI‐Y2: t(40) = 2.327, p = 0.025; ZBI: t(40) = 2.290, p = 0.027), while depression scores did not change significantly (BDI‐II: t(40) = 1.164, p = 0.251). Correlation analysis showed that the change of STAI‐Y1 was positively associated with the change of STAY‐Y2 (r = 0.440, p = 0.004), and the increase of RSCE‐RDB subscale was positively associated with the improvement of caregiver burden (r = 0.430, p = 0.005).ConclusionOur study showed that the eHealth intervention improved the caregiver’s ability to deal effectively with the disruptive behaviours of patients, and this change was associated with a reduction of caregiver burden. The results and participation rates support the implementation of online psycho‐educational interventions to meet the need for knowledge of disease management and avoid detrimental effects on caregivers’ health.
Technology in the service of caregiver well‐being: an online psycho‐educational intervention combined with virtual reality
Authors: Festari Cristina , Bonomini Cristina , Rosini Sandra , Gattuso Maria , Solorzano Claudio Singh , Zanetti Orazio , Corbo Daniele , Agnelli Giancarlo , Ferrari Clarissa , Gasparotti Roberto , Morganti Francesca , Pievani Michela 
Published: December 2023

AbstractBackgroundCare for community‐dwelling people with dementia (PwD) is frequently delegated to relatives, who find themselves in the role of informal caregivers (iCGs) with no practical knowledge to manage their loved ones. This situation puts iCGs at high risk for emotional distress. We will assess the efficacy of an online psycho‐educational program combined with an immersive virtual reality (VR) experience to reduce iCGs perceived stress by acting on the cognitive and affective components of empathy.MethodUsing covariate‐adaptive (by sex and baseline level of perceived stress) randomization, 100 iCGs of mild‐to‐moderate Alzheimer’s disease patients will be assigned to i) an online 6‐week psycho‐educational program (control arm); or ii) the same psycho‐educational program integrated with VR (experimental arm). VR consists of 360‐degree videos and allows caregivers to experience dementia symptoms from the patient’s perspective. The primary outcome will be a change in emotional distress, assessed with the Zarit Burden Inventory and the State‐Trait Anxiety Inventory. In addition, changes in brain activity while reading emotional stories (protocol modified from Ashar, 2017) will be assessed as a secondary outcome in a subsample of 50 participants who will undergo magnetic resonance imaging. Primary and secondary outcomes will be measured before and after the intervention. A 2‐month clinical follow‐up is also scheduled.ResultTo date, 20 iCGs (mean age: 58; range 30‐79; female: 75%; children: 55%) have been randomized to the 2 arms. The psycho‐educational program provides support for the home management of PwD, by offering knowledge on symptom management and enhancing strategies based on the cognitive component of empathy. During each session, iCGs are exposed to 30 minutes of empathy training with i) imagery exercises or ii) VR. The experimental intervention is expected to result in deeper disease comprehension and strengthen empathy’s cognitive component. At the network level, we expect to observe a greater activation of cognitive empathy circuits and a lower activation of affective empathy circuits in the experimental group.ConclusionTo our knowledge, this will be the first randomized controlled trial assessing the synergistic effect of combining traditional psycho‐educational intervention with VR in iCGs and measuring both clinical and imaging markers.
Fastball ‐ a new functional biomarker of cognitive impairment
Authors: Stothart George , Alderman Sophie , Coulthard Elizabeth 
Published: December 2023

AbstractBackgroundFastball provides a new, rapid, objective EEG method for assessing cognitive function. Fastball is culturally, linguistically and educationally independent. Participants do not need to understand the task, or provide any response, and tasks take just minutes to complete. Fastball has recently been shown to be sensitive to memory deficits in Alzheimer’s disease (Stothart et al., Brain, 2021), and we present the latest findings in Mild Cognitive Impairment (MCI) patients.MethodHealthy older adult controls (n = 56, ACE‐III = 96+‐3) and MCI patients (n = 46, ACE‐III = 82+‐10) completed a Fastball task designed to measure their recognition memory at baseline and at 12 month follow up. All EEG data were collected in patients' homes using low‐cost portable EEG. They also completed the ACE‐III and the Delayed Match to Sample 48, a validated neuropsychological measure of recognition memory.ResultBetween group comparisons, controlling for individual differences in EEG response magnitude, showed amnestic MCI patients had significantly reduced Fastball responses compared to non‐amnestic MCI patients (p = .002) and healthy older adult controls (p = .005). Fastball scores correlated with the ACE‐III memory subscale (r(46) = .44, p = 0.002) and no other ACE‐III subscale, demonstrating sensitivity and specificity to memory dysfunction. Fastball scores also correlated with performance on the Delayed Match to Sample 48 abstract subscale (r(46) = .37, p = .011). 12 month follow up is underway and data will be presented at AAIC 2023.ConclusionFastball is a passive, rapid measure of memory dysfunction in Alzheimer’s disease that we have now demonstrated to be sensitive to early memory dysfunction in Mild Cognitive Impairment. Fastball data can be reliably collected in patients' homes using low‐cost portable EEG, and the approach holds great potential as a future diagnostic tool.
Strategies to develop, design, implement and support digital health equity in key underserved groups: protocol for a systematic review
Authors: Wilson Sarah , Tolley Clare , Ardle Ríona Mc , Beswick Emily , Lawson Lauren , Slight Robert , Slight Sarah , Hassan Nehal 
Published: December 2023

AbstractBackgroundDigital health technologies (DHT) can be used to detect and remotely monitor digital biomarkers associated with prodromal dementia. However, there are growing concerns that DHT are not leading to demonstrable health benefits in all populations, particularly the underserved who are typically neglected in research resulting in worse health outcomes. One possible cause is digital exclusion, which refers to the unfair differences in access, use, motivation and reliability in DHT across different demographic groups. The UK regulatory bodies acknowledge the need to mitigate digital exclusion, leading to the development of inclusive digital strategies such as tailoring DHT to ensure it is appropriate to individuals in terms of affordability, culturally applicable, and accessible. This systematic review will synthesize the literature regarding strategies to improve digital inclusivity for underserved groups at risk of digital exclusion.MethodThis review will follow PRISMA guidelines and involve systematically searching four large databases (Medline, Embase, PsycINFO, Scopus). It has been registered on PROSPERO: CRD42022378199. Search terms will be used to identify relevant studies focusing on factors associated with digital exclusion, including: Culture (ethnicity, language, religion), Limiting conditions (visual and hearing impairments), Education, Age, Residence (rural or deprived areas, homelessness), and Socioeconomic status (low to middle‐income and unemployed individuals), summarised by the acronym CLEARS (Figure 1). Primary research English‐language studies using qualitative or mixed methods to explore facilitators and barriers to digital inclusion will be included. Studies will be independently screened by two additional reviewers using a computer software, Rayyan. The methodological quality of studies will be assessed using a checklist designed to assess qualitative and mixed methods. A narrative synthesis of data from included studies will be conducted.ResultThis review will integrate the evidence available on the facilitators and barriers associated with the design and implementation of digitally inclusive strategies for DHT in CLEARS groups. Key recommendations for digitally inclusive strategies to support health equity will also be produced.ConclusionThe results of this review will be used to support digital health equity in research by providing recommendations for the development, design, and implementation of strategies to promote digital health equity in key underserved groups.
Cognitive screening based on EEG markers for clinical trial stratification
Authors: Braboszcz Claire , Chugani Karan , Dagnino Paulina Clara , Soria‐Frisch Aureli 
Published: December 2023

AbstractBackgroundGlobal life expectancy is growing at an unprecedented rate, giving rise to multiple chronic diseases such as pathological cognitive impairment. The aim of Starlab is to provide a cognitive status report that can aid clinical trial professionals in detecting normal or abnormal brain condition using electroencephalography (EEG) biomarkers. The EEG markers deliver accurate screening of the older population based on the objective assessment of cognitive decline.MethodOur reporting system is based on normative EEG values of cognitive status using open‐access datasets. The data consist of resting state EEG recordings of subjects diagnosed with Alzheimer’s Disease (AD), Mild Cognitive Impairment (MCI) and age matched Healthy Controls (HC). We extract spectral EEG features related to cognition with the goal of identifying those which accurately distinguish between the groups. For the features that are statistically significant, we build probability density functions for each group and calculate the group thresholds determined by the intersection of the distributions.ResultApplying statistical testing on the different features extracted we found that ratios between slow and fast bands showed to be accurate at distinguishing HC and MCI groups versus AD groups. Moreover, alpha frequency features proved to be precise in differentiating HC from MCI and AD subjects. Thresholds are then calculated for each of these features for them to be delivered in a decision matrix for patient stratification.ConclusionOverall, this work provides a first version of a cognitive status reporting system based on EEG spectral biomarkers. The vision is that this reporting system can be used by clinical trial professionals as a decision support system for the recruitment of patients with cognitive decline.
Remote and in‐clinic digital cognitive screening tools outperform the MoCA to distinguish cerebral amyloid status among cognitively healthy older adults
Authors: Dion Catherine , Kunicki Zachary J. , Emrani Sheina , Strenger Jennifer , De Vito Alyssa N. , Britton Karysa J. , Harrington Karra D , Roque Nelson A , Sliwinski Martin J. , Salloway Stephen , Correia Stephen , Jones Richard N , Thompson Louisa I 
Published: December 2023

AbstractBackgroundExisting cognitive screening measures fall short in capturing preclinical AD, and cognitive impairment is unrecognized or misdiagnosed in 27‐81% of older adult primary care patients. Digital assessment technology has the potential to deliver more efficient and sensitive cognitive screening, but requires rigorous validation first. We aimed to determine the accuracy of remote (M2C2 mobile app) and clinic‐based (TabCAT and DCTclockTM) digital tests to distinguish between older adults with and without AD pathologic change. We used the Montreal Cognitive Assessment (MoCA) as a reference standard comparison test.MethodWe recruited 73 cognitively normal participants with Aß PET status (Aß+, n = 25; Aß‐, n = 48, determined by clinical read) from the Butler Hospital Alzheimer’s Prevention Registry (mean age = 69.2 and education = 16.5; 71% female; 89% White). Participants completed M2C2 tasks at home 3 times per day for 8 days, followed by the TabCAT tasks, DCTclockTM, and MoCA at an in‐person study visit. We calculated the area under the curve (AUC) to compare cognitive task accuracy to distinguish Aß status. Multi‐day learning curves were used to examine differences in M2C2 task performance by Aß status over time.ResultAmong the M2C2 tasks, average performance on the Prices task (episodic memory) over 8 days showed the highest accuracy (AUC = .77) to distinguish Aß status. The Aß+ group tended to perform worse than the Aß‐ group on the Prices task over time (Figure 1). On in‐person screening measures (single time‐point), accuracy to distinguish Aß was greatest for the TabCAT Favorites task (AUC = .76), relative to the DCTclockTM (AUC = .72) and the MoCA (AUC = .71).ConclusionWe showed that several brief digital screening approaches (memory‐specific tasks on the M2C2 and TabCAT) outperform the MoCA in distinguishing between cognitively healthy individuals with and without elevated cerebral Aβ. Although further validation in community and clinic‐based samples is needed, these results suggest that these digital cognitive assessments may be suitable for more widespread screening to detect early pathological changes in neurodegenerative disorders. Figure 1. M2C2 task performance over time (3 sessions daily for 8 days) by Aβ status.
NG‐001: A novel multi‐domain digital cognitive intervention for neuropsychiatric symptoms in mild cognitive impairment
Authors: Ng Kok Pin , Patterson Michael D. , Jabar Syaheed Bin , Leonardo Jacklyn , Chiew Hui Jin , Ng Adeline Su Lyn , Kandiah Nagaendran 
Published: December 2023

AbstractBackgroundNeuropsychiatric symptoms (NPS) are increasingly recognized as early non‐cognitive manifestations of patients at‐risk of dementia and are associated with accelerated cognitive decline. While cognitive stimulation may be an effective intervention in improving NPS and quality of life of patients and their caregivers, there is a need for a digital intervention that is accessible and scalable so that the benefits of improving behavioral outcomes can be attained on a larger scale. Here, we studied the effectiveness of a novel multi‐domain digital cognitive intervention on NPS among patients with mild cognitive impairment (MCI).MethodWe conducted a pilot 10‐week open‐label clinical trial of 30 MCI patients using the NG‐001, a multi‐domain digital intervention. NG‐001 is a digital program which consists of weekly 1‐hour training in several domains: cognitive games; physical exercise; mindfulness (e.g., yoga and meditation); health literacy; and reminiscence therapy. Participants completed the Depression Anxiety Stress Scale (DASS) and the Mild‐Behavioral Impairment‐Checklist (MBI‐C) at baseline and at the end of the trial. Changes in DASS and MBI‐C scores were assessed using paired Wilcoxon signed ranked tests (two‐tailed) and effect sizes were reported using Hedges’ g.ResultMCI patients showed significant improvements in depression (4.643 vs. 3.214, g = 0.228), anxiety (6.357 vs. 3.786, g = 0.440) and stress (7.786 vs. 5.429, g = 0.356) scores as measured by DASS with NG‐001 intervention (Figure 1). MCI patients also showed significant improvements in MBI‐C total scores (3.29 vs. 1.43, g = 0.47), the apathy sub‐domain scores (0.96 vs. 0.21, g = 0.54), and the affect sub‐domain scores (1.25 vs. 0.43, g = 0.47) with NG‐001 intervention (Figure 2). Importantly, there was high compliance among the participants who completed the full 10‐week intervention.ConclusionA 10‐week multi‐domain digital intervention with NG‐001 reduces the severity of NPS among MCI patients. A longer trial with a control arm is needed to further determine the efficacy of NG‐001 for NPS among MCI patients.
Dementia Associated Disorders, Driving Status and the Relationships between Communication, Anxiety and Objective Cognitive Testing
Authors: Weller Joanna , Kaczmarek Olivia , Gopie Ian , Baek Steven , Bumstead Barbara , Buhse Marijean , Zarif Myassar , Gudesblatt Mark 
Published: December 2023

AbstractBackgroundDementia associated diseases (DAD) refers to a heterogeneous group of disorders that are clinically characterized by progressive cognitive impairment (CI) that ultimately adversely influences an individual’s ability to function independently. CI may reflect abnormalities across multiple cognitive domains to varying degrees and combinations across various cognitive domains (CD). Identifying treatment needs and discussing treatment options requires ongoing communication between patient and provider over the disease continuum; communication capacity may be compromised but underappreciated. Impaired verbal and episodic memory function in people with DAD (PwDAD) can adversely impact communication abilities. Maintaining an effective long‐term treatment plan requires consistent monitoring of both performance ability and patient perspective (patient reported outcomes, PRO) across a continuum of patient needs (health, safety, and QoL).MethodRetrospective review of information obtained in the course of routine care including driving status, Neuro QOL‐Anxiety Short‐Form (A‐SF); Neuro QOL‐Communication Short‐Form (C‐SF); validated multi‐domain computerized cognitive assessment battery (CAB). CAB Domain Score of Verbal Function (CAB‐V) and Memory Function (CAB‐M). CAB and PRO were completed without provider influence.Result530 PwDAD (62% female, average age 71.9 +/‐ 14.3 years) was used to compare patient driving status with A‐SF, C‐SF, NT‐V, NT‐M scores. T‐Tests assuming both equal and unequal variances comparing multiple PRO scores to driving status determined significance at (p<0.01). Statistically significant relationships were identified between driving status and: A‐SF, C‐SF, CAB‐V, and CAB‐M.ConclusionSelf‐reported anxiety and ability to communicate, objective impairment in verbal, and memory function are related to driving status in PwDAD. Appreciation of disease impact, whether perceived or performance ability, across a continuum should be incorporated in routine care and monitoring of dementia disorders to optimize care and outcome by identifying issues of concern that have both visible and invisible impact both patients and clinicians to design an effective plan of care to accommodate patient centric impairment and needs. Standardized methods of routine PRO collection concerning various aspects of real‐world health outside of a clinic encounter are important to building an effective holistic treatment plan.
Modifiable dementia risk factors associated with distinct subjective and objective cognitive outcomes
Authors: Rosická Anna M , Teckentrup Vanessa , Pringle Andrew , Gallagher Eoghan , Hanlon Anna K , Lawlor Brian , Naci Lorina , Gillan Claire M 
Published: December 2023

AbstractBackgroundA range of potentially modifiable environmental, social, and lifestyle factors are estimated to contribute to over a third of dementia cases worldwide. Leading theories propose that these risk factors have different risk‐conferring mechanisms. For example, social isolation, hypertension, and exercise may respectively impact most on cognitive reserve, neurodegeneration, and inflammation. If true, this may support the development of more personalised preventative strategies, depending on risk profiles. Here, we aimed to address this by gathering multiple forms of cognitive assessment in a large sample, across lifespan.MethodN = 2831 users of a free smartphone app, Neureka (aged 18‐82, M(SD) = 46.84(14.7)), completed questionnaires about their background, health, and lifestyle. Additionally, they completed subjective and objective assessments of their cognitive status, via questionnaires (subjective memory problems, attitude to own ageing, and cognitive fluctuations) and cognitive tests (working memory, processing speed, cognitive flexibility, and model‐based planning), respectively. We tested the differential cognitive correlates of previously established risk factors using univariate regressions, controlling for age and gender.ResultLower education and socio‐economic status (SES) were associated with worse cognitive status across all domains (all p<.05). However, the association between SES and subjective cognition (ß = 0.38–0.51) was more than twice that of objective cognition (ß = 0.05–0.09), while this was not the case for education (ß = 0.15–0.32 for subjective and ß = 0.10–0.16 for objective cognition). Subjective measures were also more sensitive to depression, loneliness, hearing handicap, age‐related hearing loss, and tinnitus (all p<.01 for subjective and .001<p<.75 for objective cognition). In contrast, cardiovascular factors like diabetes, hypertension, stroke, and smoking were associated with comparable impacts on objective and subjective cognition. Overall, there was little evidence for risk factor correlates of different aspects of objective cognition (e.g., working memory vs. processing speed).ConclusionObjective and subjective cognition have dissociable associations with certain potentially modifiable risk factors for dementia. This may aid in our understanding of the distinct mechanisms through which they confer risk for dementia. The objective cognitive assessments gathered, model‐based planning, memory, processing speed and flexibility, yielded remarkably similar associations with risk factors, suggesting a common mechanism through which they are linked to risk factors for dementia.